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 LevelsMinimum 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 AudiometrySPEAKER
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
• 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.