PEDIATRIC AND MENTALLY RETARDED

POPULATIONS

Minimum Response Levels (MRL’s)

No response at threshold Respond at supra-threshold levels Response = hearing No response = hearing still possible

Hearing and Language Development Babbling (6 months) still present in hearing

impaired Lalling (6mos - 9mos.) Echolalia (9 - 12 mos.) is NOT present with

hearing impaired child True Speech (12 - 18 mos.) - delayed in

many hearing impaired 2 ½ years is normal Dx of hearing impairment

in US

We must answer these questions…….

Can we detect hearing loss in the infant

Can we diagnose the loss Can we do any treatment about it

Apgar Test

Respiratory Muscle tone Heart rate Color Reflex irritability Values 0 - 10 at 1, 5, & 10 minutes after birth

Warble tone

Downs (1967) Startle response (3KHz at 90 dBSPL- Moro

reflex 1-3 mos) Risk factors (high risk registry for inclusion in

testing) Combine ABR’s with acoustic reflex and

OAE’s

A pure tone that is frequency modulated (modulation is expressed as a percentage, i.e. 5%)

Neonates (0 - 28 days) Infants (29 days - 3 years) Pre-school (3 - 5 yrs.)

Screening

ABR OAE’s Acoustic reflex

Infant testing

Noise makers Behaviorial Observation Audiometry (BOA)

keys, cellophane etc.) Sound field/free field Conditioned Orientation Reflex (COR) Visual Response Audiometry (VRA)

Ewing & Ewing 1944

rattles paper noise makers cup and spoon

Auditory localization - 8 months or later

they search for sound source cease activity awaken from a light sleep facial expression changes vocalize

1 - 5 years

Speech Audiometry Pure tone Audiometry Operant Conditioning Audiometry Tangible Reinforcement Operant

Conditioning Audiometry (TROCA) Electrophysiological hearing tests

Electro-dermal audiometry (EDA) cardiotachometry

1- 5 Yrs ( continued)

Play Audiometry (peg board) Child must be motivated Must have his attention Reinforcement must be strong

Central Auditory Processing Disorder (CAPD or L.D.) May have normal hearing but processing poor poor listening skills Short attention span Poor memory Reading comprehension deficient Hyperactive + trouble discriminating in presence of noise

School Age

Group ScreeningTests Sweep Check Tests Individual pure tone thresholds Tympanometry