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UNT SPHS 2015 - 11BB Hearing Disorders in Children and assessment F13(1)

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Hearing Disorders in Children and AssessmentCauses of Hearing Disorders in ChildrenAcquired Hearing DisordersMyringotomy -Hearing LossLocation of damageCauses of Conductive and Sensorineural Hearing Loss in ChildrenDegree of Hearing Loss in ChildrenAuditory Processing DisorderEar Anatomy Review- Name the StructureHearing AssessmentHearing ScreeningGoals of Hearing AssessmentTerminologySlide 15Audiological AssessmentCase HistoryPhysical examinationSlide 19Equipment used for hearing testingPure Tone Hearing TestTwo Pathways of SoundSlide 23AudiogramSpeech BananaAudiogram- Normal HearingDisorders of HearingConductive Hearing LossSensorineural Hearing LossSeverity of Hearing LossPure Tone AssessmentAuditory Brainstem ResponseBehavioral ObservationVisual Reinforcements AudiometryConditioned Play AudiometryAdditional assessmentsImmittance testing-TympanometryImmittance testing- Acoustic ReflexSpeech Audiometry- SRTSpeech Audiometry- Word Recognition TestingElectrophysiological01/16/19 1Causes of Hearing Disorders in ChildrenCongenitalAcquiredHearing loss present at birthCan be geneticCan be a result of other factorsHearing loss after birth, at any time of lifeCan be the result of a disease, injury, or other conditionbacterial meningitisMumpsMeaslesViral infectionsOtitus mediaNoise exposure01/16/19 2Acquired Hearing DisordersOtitis MediaMost common cause of conductive hearing loss in childrenOften causes 25 to 30 dB lossIntermittent and variableResearch supports high correlation in chronic otitis media and speech/language problemsMay require frequent medical management01/16/19 3Myringotomy -Ear infection is result of eustachian tube swelling and not allowing drainageTubes in the ear with history of multiple ear infections and speech delayVideo of myringotomy:http://on.aol.com/video/learn-about-middle-ear-infections-114822081 01/16/19 4Hearing LossMild, moderate, severe, profoundTemporary or permanentOne ear or bothTreatmentMedicationSurgeryHearing aidCochlear implant01/16/19 5Location of damageConductiveSensorineuralDamage or blockage in outer or middle earCochlea is still functioning so some sound information is carried to the brainOften a temporary loss as it can be treated medically or surgicallyDamage to cochlea or the acoustic nerveMost common type of permanent hearing lossCan be treated effectively with amplification or implantable device01/16/19 6Causes of Conductive and Sensorineural Hearing Loss in ChildrenConductiveSensorineuralWax buildupInflammation of ear canalMalformations of the outer and middle earOtitis mediaHereditaryMaternal illness during pregnancy- STORCH infectionsComplicated birth process- low birth weight, hyperbilirubinemia, intercranial hemorrhageNoise exposureOtotoxic drugs01/16/19 7Degree of Hearing Loss in ChildrenHearing loss in children is defined as an average threshold of greater than 15 dB (adults are 25 dB)dB is loudness or intensity of signalStandard is lower for children because they are in the process of learning speech and language and are not able to “fill in the gaps” of conversation01/16/19 8Auditory Processing DisorderChild has normal hearing Disorder caused by inefficient/ineffective processing of auditory signal in the central nervous systemDiagnosed by an audiologist and treated by a speech-language pathologist01/16/19 9Ear Anatomy Review- Name the StructureProtects the ear drumConnects to the opening of the inner earAllows for drainage of fluid from the middle earProtects the middle earCarries nerve impulses from the cochlea to the brainFluid in the cochleaMove sin response to movement of endolymph and “talks” with auditory nerveWork together to boost and transmit pressure to the inner ear01/16/191001/16/1911Hearing ScreeningIdentify those at risk for hearing lossConducted by an audiologist, Speech-language pathologist or school nurseNewbornsInfants/Toddlers/Preschoolers who are at riskSchool age children- Grades: K,1,2,3,7,11 Adults- every decade through age 50 and then at 3 year intervals01/16/1912Goals of Hearing AssessmentIdentify any hearing lossUnderstand nature/severity of lossMonitor an already identified loss01/16/1913TerminologyFrequency is the number of cycles per second of a sound wave Pitch Hertz (Hz)01/16/1914TerminologyIntensity or loudness is a measure of the magnitude or pressure of a sound wave. decibels or dB0 dB is the minimum level of sound needed to stimulate the human ear at a particular frequencyNormal hearing at variety of frequencies Adults 0-25 dBChildren 0-15 dB01/16/1915Audiological Assessment1. Case history2. Physical examination of the ear3. Pure tone audiometry4. Speech audiometry5. Immitance measures01/16/1916Case HistoryNature of the problem Cause of the problemMedical historyFamily history related to hearing loss01/16/1917Physical examinationExamine the outer ear (pinna) for any malformationPictures of various malformationshttp://www.ghorayeb.com/CongenitalEar.htmlOtoscopic examination of the ear canal and ear drumvideohttp://www.youtube.com/watch?v=iIbaq15t1L001/16/1918Physical examinationExamine the outer ear (pinna) for any malformationhttp://www.ghorayeb.com/CongenitalEar.htmlOtoscopic examination of the ear canal and ear drumhttp://www.youtube.com/watch?v=iIbaq15t1L001/16/1919Equipment used for hearing testingAudiometer – tests sounds at different frequencies and intensitiesSchool and SLP screeningsSoundproof booth01/16/1920Pure Tone Hearing TestSingle frequency (pure tones) are testedThreshold is obtained- lowest level individual can reliably hear soundPure tones may be introduced through air or bone conduction01/16/1921Two Pathways of SoundAir conduction – tested by introducing sounds through ear canal, usually with headphonesBone conduction – tested by introducing vibrations through bone behind the ear. Sound bypasses middle ear and goes directly to cochlea.01/16/1922Two Pathways of Sound01/16/1923AudiogramGraph used for plotting responses to a pure tone hearing testFrequency is plotted on horizontal axisDecibel level responses plotted on vertical axisAir conduction and bone conduction can be plotted01/16/1924Speech Banana01/16/1925Audiogram- Normal Hearing01/16/1926Disorders of HearingConductive


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UNT SPHS 2015 - 11BB Hearing Disorders in Children and assessment F13(1)

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