SPAA 343 Exam #4

What is the goal of Universal Newborn Hearing Screening?

To maximize linguistic competence and literacy development for children who are deaf or hard of hearing.

What are the two physiological tests used in the screening of newborns? What parts of the auditory system do each of these tests assess?

OAEs - Middle Ear

ABRs - Inner Ear and Retrocochlear

How is a screening ABR different from a threshold ABR?

Screening ABR is used to test newborns and has a fixed dB at 35 dB HL. Threshold ABR starts at 70 dB and decreases.

Do the physiological tests used in Universal Hearing Screening actually test “hearing?”

No, because it tests the auditory system function.

Test Sensitivity

The percentage of babies with hearing loss who fail the screening.

Test Specificity

The percentage of babies without hearing loss who pass the screening.

Why are protocols using both physiological tests better than protocols using only one physiological test?

Each test measures a different part of the ear, increasing the accuracy of the newborn hearing screening.

If a child passes the newborn screening do they need to be tested anytime in the future?

Yes, because a child can develop a hearing loss later on in life (acquired).

Are there any children who should be monitored for hearing loss at regular intervals?

Infants with known risk factors.

What are the test methods that can be used with infants from birth to 6 months of age?

• Child and family history.

• Acoustic immittance with a 1000 Hz probe tone.

• High frequency tympanometry.

• OAEs (DPOAE or TEOAE).

• ABR (click and tone burst, AC and BC).

How will a typically developing infant respond to loud sound during the first 4 months after birth?

Startle reflex.

Behavioral Observation Audiometry (BOA)

Observing startle reflex behavior of children during production of different sounds.

How does BOA work and what is the observer looking for while performing BOA?

Loud sound makers are played and the infant is observed for the startle reflex. Reflex response should occur within 2 seconds.

What types of responses constitute a startle response?

• Eye blink

• Whole body shudder

• Wide opening of eyes

• Movement of body, arms, or legs

Who is most likely to use BOA?

Concerned parents.

At what age can most typically developing infants make a head-turn (side to side) while sitting unsupported?

6 months or older.

Visual Reinforcement Audiometry (VRA)

Training kids to respond to a stimulus and then reinforcing that response. Used for young children.

How does VRA work?

During the actual hearing test, the sound is played and if the child turns the toy is lit as a reward.

For what ages is VRA appropriate?

6 months - 2 years old. Can do on kids up to 5-6 years old due to special needs.

Conditioned Play Audiometry

Using a game-based approach to measure hearing thresholds.

How does conditioned play audiometry work?

A child is conditioned to take a turn at a game when the sound is played. Only works when the child can understand the game and is motivated by it.

For what ages is conditioned play audiometry appropriate?

3 to 5 years old

What is unilateral hearing loss?

Hearing loss in one ear.

Should unilateral hearing loss be a cause for concern by audiologists and educators?

Yes, because it can make it hard for students to pay attention in the classroom or hear the teacher.

Are children with unilateral hearing loss at higher risk academically than children with normal hearing bilaterally?

Yes, because it can delay language and speech development and can hinder the child’s academic success.

What types of problems will a person with unilateral hearing loss face?

• Trouble localizing sound

• Hearing things

• Not being able to understand/process sounds

What does a hearing aid do?

Amplify sound.

What are the basic parts of a hearing aid?

• Microphone

• Amplifier

• Speaker

What are the different styles of hearing aids?

• Completely-in-the canal (CIC)

• In-the-canal (ITC)

• In-the-ear (ITE)

• Behind-the-ear (BTE)

What are the different technologies of hearing aid circuits?

• Analog

• Digital

What are the special features that hearing aids may have?

• Directional Microphones

• Noise Reduction Strategies

• Active Feedback Cancellation

• Speech Signal Enhancement

Do hearing aids improve signal to noise ratio?

No, because they amplify all noises.

Listening Check

A test to check the HA clarity across frequencies. Done using m, ah, oo, ee, sh s.

When should listen checks be performed?

Should be performed daily for children or cognitively impaired adults.

What does the ANSI S12.60.2002 specify?

Specifies that ambient noise level shouldn’t be above 35dBA and reverb time should be at least .6-.7 seconds depending on classroom size.

What are common sources of noise in a classroom?

• HVAC systems

• Electronic Equipment

• Noise from other rooms, hallways, or the outside

What can be done to make a classroom quieter?

• Limit room volume.

• Add sound absorbing surfaces.

• Close the outside door.

• Arrange the furniture for optimum SNR based on teacher and student positioning.

• Sound field amplification and other assistive technologies.

How to calculate signal-to-noise ratio?

Signal Level - Noise Level = Signal-to-Noise Ratio

What SNR do kids with normal hearing need to succeed in a classroom?

+10 dB

What SNR do kids with hearing loss need?

+15 dB

What technology is available to improve SNR?

Assistive Learning Devices (ALD)

What are the different types of assistive listening devices?

• Infrared transmitters

• FM transmitters

• Soundfield amplification

• Personal FM systems

• Magnetic induction

What are the basic features of an assistive listening device?

• Microphone

• Transmitter

• Receiver

What types of technology are used to transmit the signal?

• Infrared

• FM

• Magnetic Induction

Which ALD provides amplification to multiple listeners simultaneously?

FM

What populations benefit from using an ALD?

• Children with hearing loss

• Special populations

What is a cochlear implant?

An electronic device that can restore functional hearing.

How does a cochlear implant work?

They bypass the damaged inner ear and electrically stimulate the auditory nerve directly.

What are the types of professionals that are typically found on a cochlear implant team?

• Otolaryngologist (neurotolaryngologist)

• Audiologists

• Speech-language pathologists

• Educational psychologists

• Social worker

What does an implant team look for to determine candidacy for implantation?

• At least 12 months of age.

• Children with severe to profound sensorineural hearing loss in both ears.

• Adults with moderately-severe to profound sensorineural hearing loss in both ears.

• Receive little or no benefits from using hearing aids.

• No medical contra-indications.

• Appropriate expectations and motivation.

• Access to habilitation-rehabilitation services and follow-up.

Habilitation

Learning to hear when they have NEVER heard before. For pediatric populations.

Rehabilitation

Relearning how to hear. For adult populations.

675 Zinc Air Battery

Blue; Used in Super Power HA; Lasts 2 weeks

312 Zinc Air Battery

Brown; Used in Regular Power HA; Lasts 8-10 days

13 Zinc Air Battery

Orange; Used in Regular Power HA; Lasts 8-10 days

10 Zinc Air Battery

Yellow; Used in Completely-in-the-Canal (CIC) HA; Lasts 5 days

What are the types of batteries used for hearing aids?

Rechargeable and Zinc Air