Screening for HL

screening

Program designed to efficiently/reliably identify those likely to have a disorder w/in the general pop. More definitive follow-up testing is typically required to confirm/refute the findings of the screening.

Test sensitivity

The proportion of the pop/sample who have the disorder/trait for which the screening is being conducted and who failed the screening test (tested positive for the disorder or trait).

Test specificity

The proportion of the population or sample who do not have the disorder or trait for which the screening is being conducted and who passed the screening test (i.e., tested negative for the disorder or trait).

Prevalence

The estimated proportion of the population who have a particular disorder or trait.

True

True or false: For many adults, the development of hearing loss is often readily apparent to the hearing-impaired individual, and assistance will most likely be sought out.

10-15 years

Some older adults with mild or moderate amounts of sloping, high-frequency, sensorineural hearing loss wait as long as _____________from their first suspicion of hearing problems to their first appointment with an audiologist for a complete hearing evaluation.

simple, rapid

Screening is designed to separate persons who are likely to have an auditory disorder from those who are unlikely to have an auditory disorder and to do so in a_________and cost-effective manner

Early identification, subsequent intervention

Screening programs are intended to be preventive measures that focus on__________and _________.

• Acceptable - easy to administer, readily interpretable and well received

• Reliable - consistent results that do not differ among the same individual. Test- Retest should yield the same results

• Safe & cost effective - salary of individual administering, cost of equipment and supplies, reimbursement rate, time required

• Long term costs - False positives then yield many normal diagnostic test costs

What makes a good screening test?

Sensitivity & specificity

Validity of a test has 2 components

Sensitivity

The ability of a screening test to identify accurately an ear that is abnormal

Specificity

The ability of a screening tool to identify normal ears

Gold standard

Screening tests must be evaluated against an independent standard, often referred to as a_______

distinguish w/in the pop individuals who exhibit an auditory disorder from those who don’t

What is the primary goal of a hearing test

50

__________ of US states and D.C.’s mandate universal screening of newborns

1

All infants screened with ABR or OAE before_____ month of age

3

All infants who fail re-screen should have audiologic and medical f/u to confirm HL before ____months of age

6

All infants with confirmed permanent HL should receive intervention services by_____ months.

1, 3, 6

identify by ____ mo, confirm by ____ mo, and intervene by ____ mo.

Auditory brainstem response (ABR) and Otoacoustic emissions (OAE)

Two instruments used to determining hearing sensitivity in infancy. An integral part of a universal neonatal hearing screening program

OAE

_______ only tells us the function of the outer hair cells (OHC)

3

Most programs have concentrated their annual screening efforts on children of nursery school age through grade _____.

3-to-4 year intervals

After grade 3, children may be screened at __________________

False

True or false: Children with preexisting hearing loss, multiple diagnosis, frequent colds or ear infections, delayed language, or speech don’t need to be screened as frequently.

age, maturity, and cooperation

Selection of screening techniques will depend on the _______ of the child.

OAE & ABR, play audiometry, parent-questionnaire

Infant and Pre–Nursery Child (4 Months to 3 Years) screening

Health and education departments

Who Is Responsible for the Audiometric Screening Program?

Nurses, audiologists, speech-language pathologists, graduate students in speech and hearing, and even volunteers and secretaries.

The personnel designated to conduct the screening tests have been…

Pure-tone air conduction hearing

The ASHA guidelines for_________screening are the most widely used in the schools.

1,000, 2,000, and 4,000 Hz

Screening is conducted at 20 dB HL at ______ in each ear for AC

Failure

Failure to detect any one of these pure tones results in the ________ of the screening.

immittance testing

Screening for Middle Ear Disease in Children. This technique is used routinely in audiology centers, public health facilities, pediatricians’ and otologists’ offices, and schools.

Tympanometry, case hx, otoscopy, tympanometry w/ a low-freq (220-226 Hz) probe tone

The ASHA developed guidelines that involve the use of:

Tympanometry

Small portable handheld instruments are often used in screening programs. These handheld screening instruments record data recommended by the ASHA Immittance Screening Guidelines

follow-up

Screening is of little value if ______ is not provided for the appropriate management of children who fail the screen.

visual inspection of the ear canal and eardrum

A child who fails the rescreen should receive _________, at the screening site as soon as possible.

Parent counseling

_______ is an important aspect of the follow-up process.

educational services

During a follow-up for a child who failed a hearing screening will need to be referred to _________ that will be used for planning and placement.

adult populations.

There are almost no formalized hearing screening programs in the United States for…

True

True or false: Health professionals have failed to sensitize both the public and the educational and medical communities to the effects of auditory impairment on total development and quality of life.

Pure tone screening, communication scales (HHIE), OAE (handheld devices)

Adult screening tools

Otologic examination, a comprehensive audiologic evaluation, counseled for hearing aid selection and evaluation (if amplification is warranted)

Follow up for adults