Video Transcript Notes on Audiology

SOAP Acronym

• Subjective (S):

  • Patient's complaints, history (medical, family), and background information.

• Assessment (A):

  • What was done.

  • Results of tests.

  • Findings.

Report Structure

• Speech report:

  • History.

  • Tests (list tests performed).

  • Assessment results.

  • Recommendations.

Example Scenario: 3-Year-Old

• Scenario details:

  • Age: 3 years old.

  • Chronic ear infections.

  • Limited vocabulary: One to two-word phrases.

  • Tympanograms: Type B (flat), indicating fluid-filled ears (eardrum won't move).

  • Modified speech discrimination (pointing tasks).

Diagnosis

• Air conduction vs. bone conduction:

  • Bone conduction: Nerve is fine.

  • Air conduction: 40 dB airbone gap, indicating outer or middle ear issue.

• Bilateral moderate conductive hearing loss.

• Speech perception:

  • Excellent speech screen, meaning clear hearing when things are louder.

• Additional diagnosis details:

  • Reddened ear canals.

  • Bilateral type B tympanograms indicating abnormal middle ear function.

Referrals

• ENT (Ear, Nose, and Throat doctor).

• Speech therapy referral (if delayed).

• Medical management is crucial before further intervention.

Plan

• Follow-up testing post-medical management (e.g., after ENT).

Case Study: 8-Year-Old from Mexico

• Background:

  • 8 years old, placed in 2nd grade.

  • Minimal educational information.

  • Doesn't speak English or Spanish; no ASL.

  • Report suggesting bilateral profound sensorineural hearing loss.

• Testing challenges:

  • Couldn't perform regular speech threshold due to language barrier.

• Modified testing:

  • Used live voice, repeating "pop" sounds.

  • Focused on mid-to-low frequencies (peach, banana).

  • Speech Awareness Threshold (SAT) achieved when starting to hear voicing.

• Family history:

  • Uncle and grandparent had hearing loss.

  • Potential genetic component and syndrome-like features.

Subjective Information

• Reason for referral and limited history.

• Consideration of multicultural aspects.

Assessment

• Modified pure tone assessment (due to discomfort with headphones).

• Otoscopy:

  • Excessive cerumen (earwax) in the right ear, left ear canal clear.

  • Note: Cerumen should not impact testing.

• Admittance testing (tympanogram) unavailable.

• Mention of portable audiometer and quiet environment constraints.

Recommendations

• Consultation with a Teacher of the Deaf (TOD).

• Child Study Team evaluation.

• Follow-up assessment in a controlled environment.

• Recommendation for speech, focusing on auditory training.

• Emphasize the importance of early identification and intervention.

Case History

• Use case history to understand when to refer.

• Counseling role (even if not therapists).

• Strategies for word-finding techniques.

Case History Questions

• Reason for visit and what's going on outside the clinic.

• Conversational approach.

Pediatric Case Histories

• Prenatal history and birth process.

• Illnesses and upper respiratory issues.

• Developmental history (milestones, speech/language).

Important Resources

• Super Duper & Teacher Pay Teachers.

Red Flags for Referrals

• Retrocochlear issues (asymmetrical hearing loss).

• Congenital hearing loss.

• Family history of hearing loss.

HIPAA Compliance

• Signed consent required to share records.

Report Structure

• Identify patient and history.

• Reason for referral (why they came to you).

• Statement of findings.

• Treatment plan, recommendations, and referrals (how and why).

Referral Specialties

• ENT (medical concerns, tympanograms, asymmetry).

• Genetic counselor (based on test results/parent info).

• Speech pathologist (language delays due to hearing).

• Psychologist (elderly patients with depression or cognitive decline, parents of newly diagnosed kids).

Public Law 94-142

• Precursor to IDEA (Individuals with Disabilities Education Act).

• Guaranteed free and public education in the most appropriate educational environment.

• Introduced FAPE (Free Appropriate Public Education) and LRE (Least Restrictive Environment).

• Aim to keep children with their peers.

• Ensures best academic environment.

• Teachers should be aware of student needs and accommodations.

• Strategic seating (preferential).

• Personal amplification systems (FM systems).

Oral Rehabilitation

• Education, communication strategies, and counseling.

Patient Education

• Describe audiogram and explain hearing loss.

• Avoid jargon.

• Address specific problems and questions.

• Educate parents on hearing equipment, battery, etc. (if needed).

• Offer support groups.

Counseling

• Help patients achieve independence.

• Provide strategies.

Self-Assessment Inventories

• Examples: APHAB (Abbreviated Profile of Hearing Aid Benefit).

• Wife doesn’t want to go (WTF).

• Assess the impact on their life.

Emotional Response

• Impairment, disability, and handicap.

Auditory Training

• Auditory training (kids).

• Auditory retraining (adults).

Communication Strategies

• For any age.

• Be assertive and self-advocate.

• Use visual cues and reduce background noise.

• Strategic placement in restaurants.

Speech Reading

• Can enhance from speech.

• Computer-based home programs.

Geriatrics

• Potential for cognitive decline and depression.

• Changes in dexterity and visual acuity.

Terms and Communication

• Prelingual and postlingual hearing loss.

• Modes of communication depends on the patient environment and parent support.

Pediatric Factors

• Auditory processing disorders.

• Auditory neuropathy.

• Developmental disabilities.

• Language disorders.

• Psychological disorders.

Academic Potential

• This promotes his or her highest classroom potential.
  This will allow so and so his equals accress to the curriculum.

Communication Systems For Students.

• IIEP: They say IEP= This is the mini me for a child to get early intervention.

• IF SF ISFP = they want it to be family orientated and have the parents involved.

Educational Model To use

• Least Least Restrictive Envoirment
  * How delayed is the are the, If skilled are all scatter should stay in gent classroom setting with another teacher and teacher aids.

Communications For Death And Hard Of Hearing.

• Sign Language

Auditory verbal, it all depends from family dynamic. What's most supported in home what's best academically.

Communication Systems .

Total communicaitons what you see in Public schools, and depends on the children’s repsonse there’s also multiple Modi’ allity.
Interpreters won’t vocally when they sing. Also has benefit for children’s Reading and Writing as they’re seeing multiple communication.

School in interpreters what you see, do conceptualize signs and base of ASL signs the and the it. So Children get multia modality. They put it altogethe they also teach academics.

ASL

(american sign languge) Vs sign english that has all word every works
signed.
English and ASL are completely different

Death Community & Communication

Deaf : spelling with capital D refers to the Death community and culture and belifs, and wont beliave in getting cochlear implants , and they see it too invasion and take to much of who they are from who they are as it has a genetic component
d if they're getting a death diagnosis
Deaf / hard of heaing would be small d as this is diagnnois and description.
Death community vs diagnose descripition.

APD. adulatory Processing disrorder buzz word, over diagnsed and its defitly developemental, with executive function and language that overlap it its reading, and a neurology path way. Auditory discrimination and hearing. Temporal processing which has a phonics and reading problems a 13 year of can fully deveope to be reavelute adutory system has been interrupted . more common in boys and children.

Recumbent Microne remote to a audio what you’re listing too . and to separate the ear better. What is happening.

Cultural belifs