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Pediatric Audiology. TANGUTURI NARENDRA ( MSc.ASLP) Audiologist & Chief of Rehabilitation SRUTHI Centre for Hearing & Speech Rehabilitation Kothapet, Guntur-522001, A.P. Contact: 0863-2333105. CONSEQUENCES OF TYPE OF HEARING LOSS. SEVER – PROFOUND HEARING LOSS:
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Pediatric Audiology TANGUTURI NARENDRA (MSc.ASLP) Audiologist & Chief of Rehabilitation SRUTHI Centre for Hearing & Speech Rehabilitation Kothapet, Guntur-522001, A.P. Contact: 0863-2333105
CONSEQUENCES OF TYPE OF HEARING LOSS • SEVER – PROFOUND HEARING LOSS: • Severely affects Communication skills development, academic skills, and quality of life remain as handicapped. • MILD – MODERATE HEARING LOSS: • Affects communication skills development. • SLOPING HEARING LOSS: • Delay development of communication skills, academic skills severely affects, quality of communication may gets deteriorates on age. • CONDUCTIVE HEARING LOSS: • Fluctuating in manner, delay development of communication skills, • UNILATERAL HEARING LOSS: • Slight delay of communication skills but may recover by age.
INFANT HEARING SCREENING IAS is test battery approach by various technical methods. • Immittance • Evoked Potential • Otoacoustic Emissions
Test Battery Approach Tympanogram Type A ABR at Normal level OAE Normal Normal peripheral and lower brainstem function (possible APD) normal hearing Tympanogram Type A ABR at abnormal level OAE Absent or Depressed Cochlear loss, outer hair cell loss, ABR normal, hearing aids beneficial Tympanogram Type A ABR at abnormal level OAE Present Auditory Neuropathy/ Auditory Dys-synchrony Tympanogram Type A ABR at abnormal level OAE Absent Severe or profound inner ear loss (occasionally otosclerosis) Tympanogram Not Type A ABR at abnormal or prolonged OAE Absent Conductive or mixed loss (possible severe/profound loss)
Tympanometry • Objective measure of the function of the TM and middle ear • Ear Canal Volume • Tympanogram-Static Compliance
Tympanogram Types Normal Tympanograms: Abnormal Tympanograms:
Otoacoustic Emissions • Acoustic energy produced by the cochlea and recorded in the external auditory canal • Most likely energy produced by outer hair motility and possibly outer hair cell cilia • Objective test • DPOAE • TEOAE
ABR • ABR
ABR Wave I Auditory Nerve II Auditory Nerve III Cochlear Nuclei IV SOC V ??? Interwave Latencies Absolute Latencies
How will NHS done? • New Hearing Screening may be informal screening but well established standard protocols need to adopt. • NHS procedures may vary according to the Childs age. They are categorized as: • Hospital based/below one month • 1 month- 4th month • 4th month- 6th month
SCREENING PROCEADURES • HOSPITAL BASED/BELOW 1 MONTH: • Impedance audiometry • OAE • 1st M0NTH - 4th M0NTH: • Impedance audiometry • OAE • ABR • 4th MONTH – 6th MONTH: • Impedance audiometry • OAE • ABR • BOA
ACCURACY IDENTIFICATION OF HEARING LOSS IN CHILDREN • 2-step screening (OAE + ABR) • Sensitivity = 0.92 • Specificity = 0.98
DEAFNESS THERAPEUTICS • AUDITORY VERBAL THERAPY • PRE SCHOOLING • INCLUSIVE EDUCATION • MAINSTREAME SCHOOLING
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