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Introduction to

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Introduction to

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    1. Introduction to Cortical Auditory Evoked Potentials (CAEP) Manufactured by Frye Electronics

    2. From Sydney to Portland

    3. Clinical Uses of HEARLab ACA Verifying the effectiveness of hearing aid fittings on infants and adults or older children with disabilities in addition to hearing loss Estimating audiometric thresholds in adults who may not cooperate in conventional hearing test (worker’s compensation) Testing infants and children with auditory neuropathy

    4. First: How does HEARLab work?

    5. What is an Auditory Evoked Potential? The human brain generates random electrical activity continually We can record this electrical activity using electrodes on the scalp (EEG) Sound stimulates neural activity in the brain that we can extract from the total EEG The electrical activity generated from exposure to sound is called an Auditory Evoked Potential (AEP)

    6. Auditory Evoked Potentials

    8. Electrode Placement

    10. Test Stimuli ABR Broadband clicks (1 ms) Frequency-specific pips (1 ms) HEARLab CAEP Speech stimuli - /m/ /g/ /t/ (30 ms) Highly frequency-specific tone bursts (30 ms)

    11. ABR vs Audiometer Stimuli

    12. ABRs Unsuitable for Aided Testing ABR test occurs 1-5 ms after stimulus Digital hearing aids have digital processing delay (2-15 ms) Hearing aids respond poorly to ABR clicks

    13. CAEP Better Solution for Aided Testing Test occurs 50-300 ms after stimulus Stimulus uses speech stimulus (30 ms) Frequency emphasis speech sounds /m/ - Low frequency emphasis /g/ - Mid frequency emphasis /t/ - High frequency emphasis

    14. HEARLab “Speech” Stimuli

    15. Auditory Neuropathy Outer hair cells within the cochlea are functional, but sound information is not transmitted to the auditory nerve and brain properly. Diagnosis: Positive Otoacoustic Emissions (OAE) Negative ABR Some Auditory Neuropathy patients have relatively normal hearing levels. Others may have severe hearing losses CAEP can be used to assess audibility of highly-frequency specific tones.

    17. Infant CAEPs with Maturity

    18. HEARLab Example of CAEP

    19. Traditional Problems with CAEP Unlike ABR, CAEP waveforms vary from individual to individual Requires experience interpreting CAEP traces for clients of different ages to decide whether the sounds are likely audible to the patient

    20. Solution! Statistical Analysis using Multivariate Analysis of Variance (MANOVA) with Hotellings T2

    21. NAL Research shows Hotellings T2 works! Study done comparing a group of experts on CAEP to the Hotellings analysis Results shows that Hotellings is at least equal to, if not more able, than the “composite” examiner to differentiate a CAEP from random noise at sensation levels of 10 dB or more

    22. Example of HEARLab Test

    23. Clinical Use of HEARLab ACA Aided testing with speech sounds (infants, mentally disabled) Frequency-specific threshold estimation (multiply disabled, worker’s compensation, auditory neuropathy) Customer base: Hospitals Nursing homes Hearing aid clinics

    24. Early Hearing Intervention programs

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