Case 4 - Hearing and Speech Development

Question 1

when do structures of the neurosensory ear develop

Answer 1

around 20 weeks gestation

Question 2

what happens at 25 weeks

Answer 2

we have a functional auditory system

Question 3

at 25 weeks to 5-6 months we have what

Answer 3

hair cells of the cochlea
axons of the auditory nerve
neurones of the temporal lobe auditory cortex are tuned to receive signals of specific frequencies and intensities

Question 4

what is the organ of hearing

Answer 4

cochlea

Question 5

what is the organ of balance

Answer 5

the vestibular system

Question 6

what can we see through a healthy tympanic membrane

Answer 6

the malleus, and the incus

Question 7

what is the cord of tympani important in

Answer 7

taste

Question 8

what is the role of the middle ear

Answer 8

conduction

protection

transducer

amplifier

Question 9

conduction in the middle ear

Answer 9

conduct sound form the outer part of the ear to the inner ear

Question 10

protection in the middle ear

Answer 10

creates a barrier to protect the muddle and inner ear structures from foreign bodies

Question 11

transduction in the middle ear

Answer 11

converts acoustic energy to mechanical energy
converts mechanical energy to hydraulic energy

Question 12

amplification in the middle ear

Answer 12

transformer action of the middle ear
only about 1/1000 of the acoustic energy in air would be transmitted to the inner ear fluid without the middle ear function

Question 13

what is another name for the inner ear

Answer 13

the labyrinth

Question 14

where is the inner ear found

Answer 14

the petrous portion of the temporal lobe

Question 15

what is the inner ear made up of

Answer 15

the cochlea and vestibular system

Question 16

how many turns foes the cochlea have

Answer 16

2 and a half

Question 17

what does the saccule do

Answer 17

helps with balance when not moving and standing still

Question 18

what do the semicircular canals do

Answer 18

help when we are in movement

Question 19

what is the function of the cochlea

Answer 19

is to propagate sound waves from the base which is situated near the middle ear

Question 20

physiology of hearing

Answer 20

sound waves will travel down the external auditory canal and hit the tympanic membrane

the tympanic membrane will move which will cause some vibrations of the ossicles

this will create some mechanical energy which will in turn move towards the stapes

this vibrates and this then creates some movement in the fluid in the cochlea

this energy is transducer into electrical energy which then goes on to the nerve of hearing

Question 21

why do different parts of the cochlea pick up different frequencies

Answer 21

because there is movement of fluid against the basilar membrane which has stiffness at different parts

Question 22

what is Wernicke’s area

Answer 22

temporal
speech comprehension

Question 23

what is Broca’s area

Answer 23

frontal
production of speech

Question 24

what is sound measured in and what Is the scale measured in

Answer 24

sound measured in decibels

the decibel scan itself is logarithmic

Question 25

what is severe hearing loss

Answer 25

70-90dB

Question 26

what is profound hearing lossn

Answer 26

90-120d

Question 27

what is normal range of hearing

Answer 27

10-20dB

Question 28

what is the hearing test used at 6-24 months

Answer 28

visual reinforcement audiometry

Question 29

what is the hearing test used after 24 moths

Answer 29

conditional play audiometry

Question 30

what is the hearing test used for after 36 months

Answer 30

conventional audiometry

Question 31

when are objective measures used

Answer 31

less than 6 months

Question 32

what is included in the visual reinforcement audiometry

Answer 32

toy is put in front of a child to keep their attention and they are focusing on that and they produce a sound to the side if the child hears the sound they will turn toward the sound and will get positive reinforcement conditioning them to turn their head if they hear another sound

Question 33

what is included in conditioned play audiometry

Answer 33

ear specific audiometry white is quite useful they are conditioned to perform a task when they hear a sound

Question 34

what is conventional audimetry

Answer 34

ear specific audtimetry we can test air conduction and also bone conduction

Question 35

what does bone conduction test

Answer 35

the nerve of hearing

Question 36

what does air conduction test

Answer 36

the conductive element of hearing

Question 37

what is speech audiometry

Answer 37

tests the ability to recognise and understand speech

Question 38

what is the HINT test

Answer 38

hearing in noise test

Question 39

what is the SPRINT test

Answer 39

speech recognition in noise test

Question 40

what is the WINT test

Answer 40

words in noise test

Question 41

what hearing test is performed on a new born

Answer 41

automated otoacoustic emission OAE

Question 42

how does an OAE work

Answer 42

the normal cochlea has a sound amplification mechanism, whereby the outer hair cells amplify basilar membrane movement in response to sound. you put a probe in a baby's ear and when the cochlea reacts it is picking up that reaction robust result considered to be about 20dB hearing or better

Question 43

what happens if baby fails initial OAE

Answer 43

they will have another OAE in the next few days or weeks and if they fail again they will go on to have an ABR which is an auditory brainstem response test

Question 44

what does the auditory brainstem responses test test

Answer 44

eighth nerve cochlear nucleus superior olivary nucleus lateral leminiscus inferior colliculus

Question 45

what is amplitude

Answer 45

the number of neurones fired

Question 46

what is latency

Answer 46

the speed of transmission

Question 47

what is inter peak latency

Answer 47

the difference in wave 5 latency between the two ears

Question 48

what is speed

Answer 48

the way we say something

Question 49

what is language

Answer 49

the form, meaning and use of the words and utternace

Question 50

what is neuroplasticity

Answer 50

the brains ability to change through experience

Question 51

under 6 months

Answer 51

pre verbal - crying, gestures - hungry, tired, hot, cold, pain

Question 52

2 months:

Answer 52

coos and gurgles

Question 53

3 months

Answer 53

fixed on sound and calms to familiar voices

Question 54

6-10 months

Answer 54

able to express pleasure and displeasure. child can distinguish sounds of any language and reproduce this. (lost by age 11) commutations by sounds and intonations

Question 55

6-12months

Answer 55

begin by detecting very small differences between speech and speech sounds (phonemes) at 6 months they can contract different vowel phonemes

Question 56

1 year

Answer 56

one word stage - mainly morphemes at end of first year, should be able to understand about 50 words and say around 5 learns words which produce effect - again and more etc

Question 57

18 months

Answer 57

- two word phrases - should have 20-50 words - naming - demanding -questioning

Question 58

2.5 years

Answer 58

- simple sentences - lack tenses - error in syntax - recognition of rhyme and intonation - 200-300 words

Question 59

2.5-5 years

Answer 59

- improvements in phonemes - development of pronunciation and articulation

Question 60

6-10 years

Answer 60

- master syllable stress to distinguish between similar words

Question 61

when do pre-lingually deaf children get implants

Answer 61

- prescribe hearing aids before 3 months - implant before 4 years, ideally at 12 months

Question 62

post-lingually deaf adults

Answer 62

have sound memory have used hearing aids to optimise hearing already know how to speak and use language

Question 63

what happens after the period of neuroplasticity

Answer 63

the cochlear implantation does not improve hearing or speech