Behavioural Testing Flashcards
part 2 for behavioural BO Tests
what is tympanometry?
measures the compliance and mobility of the tympanic membrane.
by looking at the change of pressure.
Adults 226Hz Probe tube
infant older 6 months: 1000Hz probe tube
what does admittance, impedance, suceptance, reactance:
admittance: acoustic energy that flows through the ME system. denoted as Y (mmhos)
impedance: total opposite of the middle ear system to the flow of acoustic energy. denoted as Z (ohms)
susceptance: sucebtilew to letting air enter, so compliment of the admittance.
reactance: opposition to allowing sound to enter, compliments of impedance (ohms)
revise temp results
look at temp flashcard, what’s normal and abnormal.
adults ear compared to a neonates ear?
really small TM
small ear canal
more soft tissue under the ear
less cartilage.
middle ear cavity, canal and mastoid all grow.
neonate freq for objective testing?
1000Hz
use a rate of 600daPa/sec so a fast test can be obtained.
repeat trace so it is not an artefact.
how to tell if neonatal test is abnormal or normal?
under the peak, draw a line from +200 to -400daPa. if it is a straight-line or a line going up the classification is normal.
what is the purpose of behavioural testing?
you expect the child to respond to sound,
objective testing.
purpose
- screening for a hearing loss: pta
- diagnosing hearing loss: detect children with severe OME, or children that have SNHL that was not detected by newborn screening test.
- accessing impact of HL:
intervention
- infants with confirmed PCHI (PERMENANT CHILDHOOD HEARIGN IMPAIRMENT) to fit hearing aids, moniter hl, assess suitability for CI
techniques wihtout reinforcement:
BOA
Distraction Testing
techniques with reinforcement
VRA
Play audiometry
what are the developmental age for observational tests:
BOA = up to 6 Months
DT = up to 12 months
VRA = 6 - 24 Months
Play Audiometry = 2-5 years
PTA = over 5 years
why is distraction testing limited to 12 months?
they develop object permanence - they know the object is still their, so more distracted by that then the noise.
why does VRA start at 6/7 months?
ability to have head control and objective permanence
what does child need to developmentally need to do before play audiometry:
follow instructions and wait for an instruction.
soundfield? what are the difficulties?
all test except for PTA can be tested in sound field.
difficulties:
ensuring that the level of the signal at the two ears is what we intended.
threshold measured in SF only refers to better hearing ear.
CASE STUDY: 3 yo boy not conditioning to play aduimetry?
1) find out why? maybe not fining the game interesting? maybe upset about something else? see if we can fix the issue.
2) play audiometry is about reward. maybe have the parent involve to praise the child after doing one act.
3) the child is unable to hear. change the frequency or condition louder. speak louder
4) use BC to condition
5) take into account history.
6) move down to VAR
why could we use been concussion to condition for play audiometry?
if the child is still unable to hear, you condition on a loud level and to the vibration of the sound. so yk if they have a hearing loss or if they don’t understand the game.
Most appropiate test for a 7 month old child? what information do you need to try to obtain?
VAR: try to determine their audiogram. (AC, BC)
How can you adapt testing for a patient with complex needs?
asking if there is anything you can do to adapt (lights, any preferable games, being patient, any head ups on games to not use)
might just do some objective testing instead
what is a test battery approach?
when you do a mixture of objective testing (do not need the child to react, its automatic) and reactive tests.
What is Visual Reinforcement Audiometry: (VAR)
6 months to 24 months.
use a conditioned response to sound with a visual stimuli (toys or lights as reinforcement).
train the child toward the sound source when sound is presented.
VRA: What are advantages and limitations?
advantages: require head control and visual attention.
disadvantage - requires head control and may not work with severe delays in development.
what is distraction testing?
6-12 months
use toys or maybe even your hands (not distract them a lot) to distract them from the sound or stimulus. child attention I shift towards the sound. second tester distracts the child to ensure a sound, not visual cues.
disavnatge or advantage of distraction testing?
+ simple and quick for younger infants.
- limited freq information and less precise than VRA. Depends on the abilities of the second tester at distracting.
Play audiometry
2 to 5 years.
involves a game (placing a block in a bucket when a sound hears a child.
helps measure frequency specific hearing threshold.
