Going Green This educational offering is joining others in an effort to save our environment by making the handouts avai

1. Going Green This educational offering is joining others in an effort to save our environment by making the handouts available on our website www.arkansascsh.org.

2. To show respect for our speakers and participants,PLEASE place your cell phone on silent or vibrate. Should you need to answer a call, PLEASE go outside to hold your phone conversation.

3. Respect the speakers and other participants around you by refraining fromside bar conversationsduring the session. If it is that important, please step outside!!!!

4. Respect the speakers and other participants around you by refraining fromside bar conversationsduring the session. If it is that important, please step outside!!!!

5. The planning committee & faculty attest that NO relevant financial, professional or personal conflict of interest exists, nor was sponsorship of commercial support obtained, in the preparation or presentation of this educational activity.

6. School Hearing Screening

7. It’s the Law! Arkansas Code 6-18-701 states that each school district shall employ a physician or nurse to make such physical examinations. The exam shall be only such as to detect contagious or infectious diseases or any defect of sight, hearing or condition that would prevent a pupil from the benefits of school work.

8. Purpose of Hearing Screening • To screen a large number of children in a short amount of time • To separate those children likely to have hearing problems from those not likely to. • To refer those children who do not pass the screening or who are suspect for hearing problems

9. Importance of Hearing Screening • 11-15% of school children have a hearing loss • Impaired hearing can seriously impede learning • Early identification and treatment can prevent or at least alleviate many hearing problems

10. Children to Screen • Grades Pre-K, K, 1, 2, 4, 6, 8 & transfer students • Special education students & teacher referrals

11. When to Screen • NOTthe first week of school • Children entering school for the first time • Have 90 days to screen • Need time to adjust to school environment • Don’t wait too long • Cold and Flu season • Need time for follow-up • Recommend screening in September • Start with older children and/or Sp. Ed. (need to screen before IEP)

12. Ear Anatomy

13. Outer Ear

14. EXAMINATION WITHAN OTOSCOPE • Always hold the otoscope in the hand of the same side as the ear you are about to examine. • Examine the good ear first. • Be sure light is bright. • Select correct size of ear piece. • Do not insert tip too far in canal.

15. Normal Eardrum

16. Middle Ear

17. Ossicles

18. Inner Ear

19. Sound & Sound Measurement SOUND:A pressure wave which consists of vibrations of molecules in an elastic medium • Frequency or Pitch: • Measured in Hertz (Hz) • Human Range is 20 to 20,000 Hz • Intensity or Loudness: • Measured in decibels (dB) • Normal conversation averages 60 dB

20. Normal Hearing

21. Speech Sounds

22. TYPES OF HEARING LOSS

23. Conductive Hearing Loss • Absence or malformation of the pinna and/or ear canal • Atresia • Obstruction of the ear canal • Foreign object or impacted wax • Inflammation or infection in the outer or middle ear • External otitis or otitis media • Perforation of the eardrum • Otosclerosis • Malformation of the ossicles • Trauma • Disarticulation and/or fracture of the ossicles

24. Conductive Hearing Loss

25. Sensorineural Hearing Loss • Congenital • Heredity • Infections– Maternal rubella, CMV • Ototoxic Drugs • Acquired • Infections– measles, mumps, meningitis, chicken pox • Ototoxic Drugs • Trauma– blow to the head, noise

26. Sensorineural Hearing Loss

27. Central Hearing Loss • These children will usually pass the nurse screening test • Difficulty understanding speech in noise most common symptom • Maturation a factor, usually diagnosed at age 7 or older • Normal or near-normal hearing sensitivity • ALDs and compensatory strategies often helpful

28. Mixed Hearing Loss

29. Ear Abnormalities

30. Microtia and Atresia

31. Wax Impaction

32. External Otitis

33. Retracted Eardrum Due to Negative Pressure

34. Middle Ear Fluid

35. Acute Otitis Media

36. Eardrum Perforation

37. PE tube

38. USHER SYNDROME

39. THREE TYPES OFUSHER SYNDROME

40. Second Hand Smoke

41. Secondhand Smoke • More ear infections and hearing problems • More upper respiratory infections • More bronchitis and pneumonia • Higher rate of SIDS • More cases of asthma • More severe symptoms in children who already have asthma

42. Secondhand Smoke • More likely to develop leukemia during childhood • Higher Cholesterol Levels in Adolescents • More likely to develop lung cancer and heart disease later in life.

43. Secondhand Smoke • Children living in households where more than three packs of cigarettes were smoked per day were more than four times as likely to be hospitalized for placement of ear tubes.

44. Otitis MediaMiddle Ear Infections • 24.5 million visits to doctors’ offices yearly • Most frequently cited reason for taking child to the emergency room • Most common surgery for children is a Tympanostomy, 110,000 per year • Health care costs are reported between $3 and $5 billion/year

45. Screening Procedure

46. Audiometer Controls • Power • Intensity Dial • Frequency Dial • Ear Selector Switch • Presentation Switch • Additional • Warble • Pulse • Masking

47. Headphone Placement • Hair behind ears. • Remove large earrings • May want to remove glasses • Diaphragm over ear canal • Adjust head band for snug, even fit. • Head band on top of head preferred

48. Protocol • Observation • Pure Tone Screening • Play Pure Tone Screening • Rescreening • Referral • Follow-up • Annual summary

49. Observation • Look for the following: • Structural defects of the outer ear • Obvious ear canal abnormalities • Inflammation • Drainage • Foreign body/object • Eardrum perforation • Signs of possible otitis media

50. Screening Protocol Observation Right Ear 1000 Hz 20 dB 2000 Hz 20 dB 4000 Hz 20 dB Left Ear 1000 Hz 20 dB 2000 Hz 20 dB 4000 Hz 20 dB Right Ear 1000 Hz 20 dB