Transcript Pediatric Testing

Pediatric Assessment
Summer 2007
Auditory Responses
• In adults, response type was unimportant
• With children, it can have significant effects
• Possible responses cover a WIDE range of
behaviors
• Children do not typically respond to sounds at
threshold, but only to sounds more clearly
audible: Minimum Response Levels
(see Table 8.1)
Identifying Hearing Loss in
Infants under 3 Months of Age
• Infant hearing screening was historically done
only with those “at risk” for hearing loss.
• In the last 15 years, UNIVERSAL newborn
hearing screening has come into wide use – on a
state-by-state basis.
• Objective tests used to screen:
– OAEs
– ABR
Testing Young Children
• Reflexive reactions (e.g.,Moro within 2 mos)
• Behavioral Observation Audiometry: thru 6-8 mos
• Conditioned Orienting Reflex/Visual
Reinforcement Audiometry from 4 months
• Play audiometry (18 months and up)
• Operant conditioning audiometry
• Electrophysiologic Tests
– OAEs, Aud Evoked Responses
Visual Reinforcement Audiometry
SPEAKER
LIGHT-UP,
ANIMATED
REINFORCERS
DISTRACTER
TOY
Auditory Processing Disorders
“How the ear talks to the brain and how the brain
understands what the ear is telling it.” -- Musiek
The Child with APD
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has normal hearing
has normal intelligence
has trouble using auditory input
cannot learn well through audition alone
will have difficulty in noisy, open classrooms
may have difficulty attending to sound for any
length of time
Management
• Classroom Modifications
• Remediation Activities
• Compensatory Strategies
• Each child is unique
-Blanket recommendations don’t work
Identifying Hearing Loss in the
Schools
• 14.9% of US children aged six to nineteen
have a measurable hearing loss in one or
both ears (Niskar et. al., 1998)
• Screening programs mandated by states at
specific grade levels.
Nonorganic Hearing Loss in Children
• Feigning a hearing problem, most commonly for
attention.
• More common in 10 to 14 year olds,
• But may appear in younger children as well.