Quiz 9 Audiology

What are the main advantages of physiological testing?

Objective; no behavioral response needed; works during sleep; sensitive to early problems.

What is a limitation of physiological testing?

It indirectly estimates hearing status; it does not directly measure hearing.

What is immittance audiometry?

An index of sound/energy transmission by the tympanic membrane and middle ear.

What does tympanometry measure?

Energy transmission as a function of middle ear pressure.

What do Type A and Type B tympanograms indicate?

Type A: normal middle ear. Type B: associated with otitis media.

What does the acoustic reflex assess?

The function of middle ear muscles in response to loud sounds.

What are otoacoustic emissions (OAEs)?

Acoustic byproducts of normal cochlear functioning, produced by outer hair cells.

How are OAEs recorded, and what are they used for?

A tiny microphone in the ear records them; used for child hearing screening and monitoring cochlear damage.

What is an auditory brainstem response (ABR)?

The summed electrical response of the auditory pathway up to the brainstem (inferior colliculus).

How is hearing screened in children ages 3–5?

Conditioned play audiometry: the child performs an activity when hearing a tone.

What are the five major physiological hearing tests?

Immittance, tympanometry, acoustic reflexes, OAEs, and ABR.

How can hearing be tested in an infant?

Using physiological tests such as OAEs, ABR, and tympanometry.

Which anatomical sites can physiological tests provide information about?

Outer/middle ear, cochlea, and VIII (vestibulocochlear) nerve.

Why are physiological tests considered objective?

They do not require a behavioral response from the subject.

Can physiological testing be performed while a patient sleeps?

Yes. Physiological testing is not affected by sleep.

Why can physiological tests detect hearing problems early?

They are sensitive and may identify problems before PTA or speech audiometry.

What are the two main limitations of physiological testing?

Hearing is estimated indirectly, and equipment is typically more expensive.

What does the acoustic reflex arc evaluate?

The entire auditory pathway.

What are ipsilateral and contralateral acoustic reflex tests?

Testing reflexes with the stimulus and measurement in the same or opposite ears.

How are OAEs generated and measured?

Outer hair cells create a reverse traveling wave; sound pressure is measured in the ear canal.

What is the clinical significance of OAEs?

They help screen children's hearing and monitor ototoxicity or noise-induced hearing loss.

How is an ABR recorded?

Small electrodes placed on the head record electrical responses to sound.

What is the upper level of the auditory pathway measured by ABR?

The brainstem, up to the inferior colliculus.

What are two clinical uses of ABR?

Infant hearing testing and neurodiagnostic evaluation, such as vestibular schwannomas.

What hearing tests are used for newborn screening?

Newborn ABR and OAEs.

How many children had significant hearing loss according to the 2009 statistic?

More than 1.4 million children.

How many additional children per 1,000 develop hearing loss by school age?

An additional 3 out of 1,000.

How many infants are born daily in the US with permanent hearing loss?

Approximately 33 infants per day.

How many children are born with hearing loss in the US annually?

Approximately 12,000 children per year.

What is the estimated rate of unilateral hearing loss in children?

3–13 children per 1,000.

What happens in the auditory pathway when sound is presented during ABR testing?

The auditory pathway and brain produce minute electrical activity in response to sound.

Why is the ABR response described as a summed response?

It represents combined electrical activity generated throughout the auditory pathway up to the brainstem.

What type of stimulus produces an ABR?

Sound.

Why is ABR useful for testing infants?

It objectively evaluates auditory pathway responses without requiring a behavioral response.

What is one neurodiagnostic application of ABR?

Evaluating conditions such as vestibular schwannomas.

What are the two major applications of ABR discussed in the lecture?

Infant hearing testing and neurodiagnostic applications.

How many NICU babies show significant hearing loss?

At least 1 in 50.

What percentage of children referred for school hearing screening are referred for further evaluation?

Approximately 10–15%.

How many school days are estimated to be missed annually because of otitis media?

Approximately 5 million school days.

How can even minimal hearing loss affect young children's learning?

It can hinder incidental learning, which accounts for an estimated 90% of very young children's knowledge.

What is the goal of hearing screening?

To indicate whether an individual may have hearing loss.

What are the two possible outcomes of a hearing screening?

Pass or refer.

What should happen if an individual receives a refer result?

They should be sent to a licensed audiologist or otologist for further evaluation.

Who can perform hearing screenings?

Audiologists, appropriately licensed SLPs with CCC-SLP, and support personnel under the supervision of a certified audiologist.

What are the recommended environmental conditions for hearing screening?

Minimal visual and auditory distractions and low ambient noise.

What equipment is used for hearing screening?

A calibrated portable or diagnostic audiometer.

What is conventional audiometry used for in children?

Typically ages 5–18; the child raises a hand or uses a response switch.

What is the difference between conditioned play and conventional audiometry?

Conditioned play audiometry is typically used for ages 3–5; conventional audiometry is typically used for ages 5–18.

What do the red and blue earphone indicators represent?

Red represents the right ear; blue represents the left ear.

At what intensity are school-age children typically screened?

20 dB HL air conduction.

Which ear should be tested first during school-age hearing screening?

The right or better-hearing ear.

Which frequencies are tested during school-age hearing screening?

1000, 2000, and 4000 Hz.

How many times should a tone be presented if the child does not respond?

It may be presented more than once, but no more than four times if there is no response.

What should you do if a child does not respond at a screening frequency?

Reinstruct the child, reposition the earphones, and rescreen during the same session.

What qualifies as a pass on a hearing screening?

Clinically reliable responses at 20 dB HL at every screening frequency in each ear.

What happens if a child passes during the second screening attempt?

The child passes the screening.

What qualifies as a refer result?

Unilateral or bilateral lack of reliable response at 20 dB HL at any screening frequency.

What terminology should be used instead of saying a child failed a hearing screening?

Use the term refer rather than fail.