Pediatric Audiology Comp study

The sensitive period where the central auditory system is at its max plasticitiy is

3.5 years

List 3 implications of hearing loss in children

Delayed language

Low self esteem

Negatively impact social development

Negative impact on literacy

Increased difficulty learning in school

The incidence of hearing loss increases after infancy T/F

True

Hearing is all about the…

Brain

What type of hearing loss would be seen with an ear canal atresia

Prenatal conductive hearing loss

What type of hearing loss would be seen with Waardenburg?

SNHL from genetic syndrome

What type of hearing loss would be seen with an Enlarged vestibular aqueduct

SNHL due to prenatal inner ear anomaly

What type of hearing loss would be seen with Otitis Media

Postnatal conductive hearing loss

What type of hearing loss would be seen with Cytomegalovirus

Prenatal SNHL from infection

What type of hearing loss would be seen with Hyperbilirubienemia

Postnatal neural hearing loss

Magnetic Resonance Imaging (MRI) would be ordered to see the bony structures for the inner ear

False

Which is the most common cause for non-genetic sensorineural hearing loss in children?

CMV

What is ONE question you would ask during a pediatric case history that you wouldn't ask during an adult case history?

Was your child born full term or premature?

When an infant passes their newborn hearing screening in the hospital, the screener can tell the family the child’s hearing is normal?

False

If the chronological age is 2 months, what’s the appropriate audiological assessment method?

Sleep deprived ABR

If the developmental age is 7 years, what’s the appropriate audiological assessment method?

Conventional audiometry

If the developmental age was 15 months, what’s the appropriate audiological assessment method?

Visual Reinforcement Audiometry

If the developmental age is 4 years, what’s the appropriate audiological assessment method?

Conditioned play audiometry

If the chronological age was 12 months but the developmental age is 5 months, what’s the appropriate audiological assessment method?

Behavior Observation Audiometry

Only chronologic age should be considered when deciding which test approach to use for a child (T/F)

False

The cochlear microphonic is a response that follows the stimulus polarity (T/F)

True

Sound field testing provides ear specific information (T/F)

False

Which speech audiometry word lists can be used as an open set test OR a closed set test?

NU-CHIPS

WIPI

Equipment sold as screening equipment in California, must be FDA approved using automated testing that gives a pass/refer result and detects mild hearing loss (30-40dB) in newborns and infants (T/F)

True

The hierarchy of listening goes in what order?

Detection, Discrimination, Identification, Comprehension

Define listening and spoken language

Teaching the child to rely on their residual hearing as they learn to speak

Define cued speech

Helping children hear and “see” speech, using handshapes near their faces while they’re speaking, helping children tell the difference between words that can sound different?

Total communication

Combining a signed language system with a spoken language system (technically simultaneous communication but whatevs)

Define ASL

American Sign Language, a visual language structured differently than English

10 year old with congenital bilateral ear canal atresia (CHL). What amplification/management options would be appropriate

Bone Anchored Hearing Aids, implanted or non-surgical

Would you refer a 3 year old patient that’s just been diagnosed with hearing loss to early intervention?

No, EI is only for up to 36 months. A now 3 year old with a newly diagnosed HL would benefit from an IEP for preschool

Interpreters and translators are the same

False

Name one thing an audiologist can do to support effective ASL interpreted session in pediatric settings

Familiarize the child with the interpreter, and familiarize the interpreter with the audiological information and context in case the itnerpreter needs to look up any signs

21 month old patient with recently diagnosed permanent bilateral hearing loss. The referred services they need is under what part of IDEA:

Part C (Birth to 3)

3 is C

6 year old patient with newly diagnosed permanent unilateral hearing loss. The referred services they need is under what part of IDEA:

Part B - 3-21 years old

B is for Big Kid

Auditory neuropathy is ruled out by performing DPOAEs only

False

What value for the speech intelligibility index should be considered for deciding. tofit a mild hearing loss?

SII less than 80

Percutaneous implants protrude from the skin

True

The presence of the cochlear microphonic is key to determining if a patient may have ANSD

True

What are the important diagnoses to know about

Auditory Neuropathy Spectrum Disorder (ANSD), Cytomegalovirus (CMV), and Enlarged Vestib Aqueduct

What are some inner ear abnormalities?

Common cavity defect, cochlear aplasia, cochlear hypoplasia, mondini malformation, enlarged vestib aqueduct,

What can an enlarged vestibular aqueduct cause?

Increased risk for progerssive SNHL and fluctuations

What’s a mondini malformation?

Incomplete partition of the cochlea

What makes up 15% of the malformations of the inner ear?

Cochlear hypoplasia, where less than 1 full turn of the cochlea has developed

What impacts 25% of the inner ear malformations?

Common cavitiy defect, membranous and bony portions of cochlea is impacted

What are the verbal stages of speech development?

12-15months - 10 words,

15-20 - 50 words

18-24 - Combining words begin

24 - 200-300 words

3-5yrs - language explosion

5 years - 5k+ words

When does the ear develop in utero?

~3 weeks gestation

When are the semicircular canals formed?

7-8 weeks gestation

When is the cochlea formed

~25 weeks gestation

When does the middle ear develop?

through til the end of gestation

What derm layers develop into the outer ear, middle, and inner ears?

Ectoderm - Outer and inner, Mesoderm - Middle

What are the different counseling styles

Motivational Interviewing, Adjustment counseling, Informational counseling

What does patient-centerde care focus on

Being respectful of people’s needs and preferences, involves family and other communication partners, and includes shared decision-making and goal-setting

What are the TORCH infections

T- Toxoplasmosis - Parasite hearing loss

O - Other infections - HIV, Syphilis, Chickenpox

R - Rubella - MMR Vaccine protects ppl

C - CMV - Herpes virus that stays in life, needs more tests, multiple losses for child only in utero

H - Herpes - Infects during childbirth

What are some risks of CMV?

Progressive SNHL should test early on within first 3 weeks if suspected, can present with other developmental delays

What’s Trisomy 21 and the impact it has on hearing

Downs Syndrome, 3 copies of Chromosome 21

50% has bilateral conductive hearing loss, but can be SNHL or mixed.

Small pinna, narrow ear canal, and chronic OM

Potential ossciular malformations

What is Waardenburg syndrome and it’s audiological impacts?

Genetic condition causing hearing loss and pigmentation issues, heterochromia

Not progressive SNHL, or bilateral/unilateral SNHL

Autosomal dominant

What is Treacher Collins Syndrome? Impact on audio?

Underdevelopment of facial bones, hearing loss

Severity ranges from minimal to very severe

Hearing loss is typically CHL bc of microtia

Autosomal dominant (TCOF1 OR POLR1D) or recessive (POLR1C)

What’s Usher Syndrome? Impact on hearing if Type III?

Genetic condition with visual impairment progression and hearing loss.

Type III includes born with normal hearing, but vision and hearing loss progresses

Autosomal recessive

What is Pendred Syndrome? Impact on hearing?

Enlarged vestib aqueduct, mondini malformation can be present

SNHL mostly, but can also be mixed for low fqs

Progressive and fluctuate, and can be unilateral or bilateral

Autosomal recessive

What is brachio-oto-renal (BOR) syndrome? Audio?

Microtia and preauricular pits/tags by tragus, middle ear and inner ear malformations

Can be mixed, SNHL, or CHL

Autosomal dominant

What’s CHARGE syndrome? Audio?

Coloboma, Hearing defect, Choanal Atresia, Growth retardation, Ear abnormalities

C, H, AR, G, E

SNHL, CHL, OR MIXED HL,

Autosomal Dominant

How are ASL language milestones categorized?

Receptive and Expressive

What’s the difference between an ABR and ASSR

Auditory brainstem response, Auditory Steady State Response

ABR - Amplitude and latency, brief stimuli, slower rate, see waveform and allows you to learn morphology

ASSR - Amplitude and phase, repeated stimuli, high repeat rate, both ears at the samet ime, removes subjectivity, algorithm based

What age range do you use behavior observation audiometry?

0-6months

What age range do you do visual reinforcement audiometry

5-36 months

What age range do you do conditioned play audiometry?

30months-5 years

What age range do you do conventional audiometry?

5+ years

What’s the 1-3-6 rule?

Screen by 1 month, Diagnose by 3 months, Get to EI by 6 months