slhs 340 : exam four

case history

• difficulties at birth

  • breathing problems during birth

• any medication during pregnancy

  • elicit drugs, smoking, etc.

case history after birth

• physical trauma

  • a child fell, shaken baby syndrome

• family history of hearing loss

  • someone you wouldn’t expect ( sibling, not grandma )

• physical problems

  • pain, drainage, dizziness

• perceptual problems

  • delayed speech development, lack of response, slurred speech

newborn hearing screening

OAEs and/or ABRs

pediatric diagnostic battery

otoscopy

• refer them out

• try for a tymp in both ears

if behavioral testing is abnormal or inconclusive

• OAEs : cochlear function

  • one min each ear

• ABRs : determine degree of hearing loss

  • sedate child

testing environment : sound field

stimuli presented through speaker in a sound-treated room

testing environment : positive reinforcement

an illumination animated toy when response

controversy occurs …

when determining a minimum response level or threshold

testing environment : parents tend …

to be in the room while the child is on their lap

behavioral testing : boa

• infant 4 - 6 months old

• unconditioned response

  • subtle

• second observer

boa problems

• no specific ear info

• questionable reliability

• no threshold info

• oaes & abrs > boa

loss of temporal resolution

auditory system gets worse at detecting changes in sound

• problems with time

aural (re)habilitation

can only happen if they want it or willing to participate

behin the ear

fills the entire concha

• ac

in the ear

fills entire concha

• also ac

in the canal / completely in the canal

ac

receiver in the canal / in the ear

most common

bone anchored hearing aids

bc

hearing aids used for mild to profound hearing loss

• bte

• ite

hearing aids used for mild to severe hearing loss

inc / cic

hearing aids used for all degrees of hearing loss

ric or rite

bte is more beneficial for

order adults

• especially since its more convenient for arthritis ( bigger )

ine allows for a

greater opportunity to use the pinna

• cant amplify as much

• not common

itc has

less power due to size

itc’s provide more gain

at higher frequencies

• due to acoustic resonance of ec

ric’s have

a discrete fitting

ric’s prevent

feedback ( ringing ) and occlusion effect ( hearing themselves )

bone anchored hearing aids are placed

on mastoid to send stimuli to cochlea

power supply

zinc-air or mercury zinc batteries

microphone

converts acoustic signal to analog/digital electrical signal

amplifies

increases level of electrical signal

reciever

converts electrical signals back to acoustic signala

earmold

air-tight fit in canal for no feedback

wireless fm system reciever

clips to shirt ( left side ) and connects to hearing aid

• has volume control ( right )

programmable hearing aids

adjusted by remote or computer

• visualizes changes

• uses data to get target satisfaction

direct audio input

plug fm device into hearing aid using a boot

which hearing aids are perfered for children?

bte since children grow = ear canal changes

assistive listening devices

non hearing aid device to improve ability to hear

• trasmiting amplified sound directly or transforming it

hardwire system

direct physical connection from sound source to listener

• used in medical settings and homes

hardwire system advantage

easier to cooperate because of larger control

hardwire system disadvantages

physically connected to another unit

infrared system

1. sound is converted to light waves and transmitted throughout listening environment

2. then the receiver changes the light wave back to amplified signal

• used in movie theaters, tv, a lot of words, etc.

infrared system advantage

more mobility

infrared system disadvantages

only used in closed room

fm system

sounds converted to fm waves and transmitted using microphone and receiver

• used in educational settings

fm system advantages

used outdoors and indoors

fm system disadvantages

picks up interference from signals passes along same fm wave

__ million people worldwide have hearing loss

466

• 34 million are children

• 1/3 of worlds population 65 and older

1.1 billion young people ( 12 - 35 ) are

at risk of avoidable hearing loss due sound exposure in recreational settings

by 2050

• 2.5 billion people will have hearing loss

• 700 million with require rehab

causes of hearing loss : prenatal period

genetic factors

causes of hearing loss : perinatal period

• lack of oxygen at birth

• low birth weight

  • gestational weight

causes of hearing loss : childhood and adolesence

• chronic middle ear infections

• meningitis

  • sensorineural hearing loss

causes of hearing loss : adulthood and older stage

• chronic diseases

• smoking

• presbycusis

unaddressed hearing loss

• limitations in communication and speech

  • social isolation, loneliness, and stigma

• affects cognition

• limits access to education and employment

recruitment

abnormal sensitivity to loudness and reduced dynamic range

• typical for adults

recruitment affects

speech perception

loss of frequency resolution

reduction in the ability of cochlea ( impaired ) to separate complex sounds into individual components ( blended sounds )

loss of frequency resolution makes

listening to background noise harder

informational masking

multiple frequencies pile on, masking the person you want to hear

loss of frequency causes you to

hear mumbling when someone is talking quiet

loss of temporal resolution

reduces the ability for auditory system to detect changes in sound over time

problem with loss of temortal resolution

• vot ( voice onset time )

• time characteristics of speech