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AUDE 6140 - Pediatric Audiology > Pediatric Speech Audiometry > Flashcards

Pediatric Speech Audiometry Flashcards

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1
Q

Is speech perception crucial for children?

A

Yes
It underpins language development, academic success, social interactions, cognitive skills, and emotional well-being
Allow children to learn words and grammar, excel in reading and writing, communicate effectively with peers, and express and understand emotions, which are all essential for their holistic development

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2
Q

Is speech perception testing the only part of the audiology test battery that functionally assesses auditory performance?

A

Yes

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3
Q

Is there a widely accepted method for evaluating word recognition ability with children?

A

No

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4
Q

Without speech perception testing, what is not possible to predict?

A

What the child hears
What the child does not hear
Whether there has been a change in auditory perception
Whether something can be done to improve auditory functioning

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5
Q

Why is speech perception testing essential?

A

Measures a child’s perception of phonetic segments, words, sentences, and connected discourse
Quantify the benefits of amplification and guide management decisions in audiologic evaluations
Monitors a child’s auditory progress and documenting improvements over time
Assists in planning and implementing audiologic rehabilitation, including speech reading and auditory training.
Identify abnormalities not predicted from PTA

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6
Q

What are some principles of developing a speech audiometry test?

A

Should match the cognitive, motor, and attentional capabilities of children
Must be interesting and motivating
Should not depend on vocabulary knowledge or advanced language skills
Should not necessitate phonological knowledge or speech production abilities
Should assess the ability to communicate effectively in everyday situations
Must accurately and sensitively measure children’s speech perception in realistic listening scenarios

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7
Q

What are some internal factors that could affect word recognition in children?

A

Vocabulary and language competency
Chronological age
Cognitive abilities
Alertness
Motivation
Fatigue

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8
Q

What are some external factors that could affect word recognition in children?

A

The designation of an appropriate response task
Effective utilization of reinforcement
Controlling the memory load inherent in the task that can influence test performance

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9
Q

What are some challenges of speech perception tests in children?

A

Language and vocabulary of the child
Cognitive, motoric, and attentional capabilities of the child
Articulation problems are common in children (may be more difficult to score these tests)

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10
Q

How should you select a speech test for children?

A

Degree of hearing loss should not be a factor
Tests should be selected based on the individual child’s language capabilities
Profound hearing loss makes it harder for children with hearing aids to receive information through hearing, though this may not apply with children with CI’s

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11
Q

What are the different ways to evaluate speech perception (4)?

A

Detection: ability to tell when a stimulus is present (just like tones but with speech)
Discrimination: ability to determine whether two stimuli are the same or different (cat vs hat)
Identification: Ability to recognize and label stimulus (name thing and they have to select it)
Comprehension: ability to understand what the stimulus means

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12
Q

What are the two different types of speech threshold tests in children?

A

Speech awareness thresholds
Speech reception thresholds

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13
Q

What is the speech awareness threshold test?

A

A test that uses speech stimuli to determine threshold—the lowest level at which a person can detect the presence of the stimulus 50% of the time.
Establishes a minimal response level for awareness for speech
Response can vary greatly from eye widening, head turn, or facial change
Stimuli can be the child’s name, nonsense words, or short phrases
Stimuli is presented typically via MLV and can be obtained in the SF (better ear response) or under headphone

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14
Q

When is SAT used?

A

Used in children who are too young, cognitively delayed, or those with limited vocabularies

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15
Q

Are the SAT thresholds always better than the PTA average?

A

Yes

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16
Q

What are the 6 ling sounds?

A

Ah
Oo
Eee
Shh
Ssss
Mmm

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17
Q

What ling sounds indicate the usable hearing through 1000 Hz (low frequencies)?

A

Ahh
Ooo
Eeee
Mmm

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18
Q

What ling sound indicates the usable hearing through 2000 Hz (mid-high frequencies)?

A

Shhh

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19
Q

What ling sound indicates usable hearing through 4000 Hz (high frequency)?

A

Ssss

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20
Q

Why would the ling sounds be used while testing a child?

A

To get frequency specific information
Tells us how a person can be expected to perceive speech stimuli across the frequency range needed for speech
Can be compared directly to pure tone thresholds

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21
Q

What is speech reception threshold testing?

A

Determines the lowest level at which a person can identify speech stimuli 50% of the time.
No visual cues are provided
Social reinforcement and exaggerated praise should be provided throughout the session

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22
Q

Do the materials for speech reception threshold testing on children depend on age?

A

Yes
Younger children: Direct them to point at pictures or body parts, pick toys, or follow simple verbal instructions
Older children: Ask them to repeat using standard tests; spondee words

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23
Q

When should you use body pointing or familiar object pointing for SRT?

A

Variable age
Depends on language
Use when other tests are too difficult

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24
Q

When should you use spondee picture pointing and repeating the word for SRT?

A

When the child has the language to identify objects

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25
What is the CRISP jr?
Evaluation of speech thresholds in quiet and in noise in children ages 2.5 years and above (3-5 typically, then onto the CRISP) Computerized application uses 4-alternative forced choice Select correct image, music as reinforcement (entertainment with positive) Monosyllabic words and the take is easier
26
What is the CRISP?
Children's realistic inventory of speech perception Used on children older than 5 Closed set spondee test using a picture book or computer Need to make sure that the child knows the words being tested Evaluation of speech thresholds in quiet and in noise in children ages 4 and above Computerized application uses 4-alternative forced choice During testing, children are engaged in a computerized game such as puzzles
27
What is bone conduction SRT?
Useful for diagnosing CHL in young children by comparing to AC SRT Used with a 2- to 4-year-old child who has bilateral ear canal atresia or microtia in order to determine the hearing status of the cochleae Speech signal is more meaningful for children and other hard-to test children than pure tone stimuli Has high correlation to PTA by BC at 500, 1000, and 2000 Hz
28
What are some limitations to bone conduction SRT?
Speech through bone oscillator is not usually calibrated Range is limited
29
What are speech recognition tests for children?
Designed to evaluate a child’s ability to understand speech under different listening conditions Performed at suprathreshold levels at different at different intensities and under varying conditions of competing noise AKA word recognition, word discrimination testing, or speech intelligibility testing Several variables can affect the outcomes of speech perception tests
30
What is the level of presentation for speech recognition tests for children?
30 dB SL re: SRT for normal hearing listeners 40 dB HL re: SRT for listeners with a hearing loss Steeply sloping losses may require a higher presentation level than 40 dB SL the goal being to make the stimuli audible Stimuli also can be presented at MCL
31
Is masking almost always indicated for WRS for an asymmetric loss?
Yes
32
What is the recommended scoring for speech recognition tests?
90-100% - Excellent 80-89% - Good 70-79% - Fair < 70% - Poor
33
How do you select the correct speech recognition test for a child?
Selection depends on child's vocabulary level and ability to cooperate Degree of hearing loss should not be a factor in selecting tests Using inappropriate vocabulary in speech perception tests can yield misleading results
34
What is an open set for speech testing?
Offers no clue The child may repeat without understanding More difficult Will yield lower test results Offers a more realistic picture of speech perception capabilities in real conversation Should be attempted by the age of 5
34
What is a closed set for speech tests?
Limited number of items from which the child needs to choose May be numbers, body parts, pictures or alphabet Guessing is still a possibility
35
What is phonemic scoring?
There exist some test relying on phonemic scoring Gives information on which frequencies seem to be impaired perceptually Vowel errors: indicate insufficient low frequency information Sibilants error: insufficient high frequency perception
36
What is whole-word scoring?
Most of the tests used have norms according to whole word scoring Even if 1 phoneme in a word is wrong (ex: sox vs fox) the whole point is deducted
37
When do you want to use recorded speech?
Has the advantage of being more reliable and easily comparable test-retest but can be time-consuming and challenging for a child, requiring breaks between stimuli, repetitions due to distractions, and timeouts for encouragement Standard
38
When do you want to use MLV?
Only used when recorded testing is not available (according to AAA) It can potentially overestimate a child's auditory function More interesting to listen to for young children
39
What are some characteristics of a full word list?
Reduces the chance of scoring errors Increases reliability Time consuming 25 words allow a good evaluation of the child’s auditory function
40
What are characteristics of a half word list?
Use it only when the word list is validated to be used with fewer number of words 10 words are not enough unless you are using the isophonemic word lists where you will be scoring on phonemes Considering your word is a CVC: then you have 3x10=30 points
41
Why do you use a carrier phrase?
Alerts the child to attend Places the word in a sentence context that more accurately represents its use in normal conversation
42
Carrier phrase examples?
Show me... Tell me... Point to the...
43
What is the early speech perception test?
Two formats (standard version and a low-verbal version that uses objects) Can be used in children as young as 3 years old who are profoundly Deaf
44
What does the early speech perception test include?
Pattern Perception (Subtest 1) Spondee Identification (Subset 2) Monosyllabic Word Identification (subset 3)
45
What is the mr. potato head task?
Modified open-set Requires child to manipulate toys in response to instructions presented in the auditory-only modality (put a hat on Mr. Potato Head, make Mr. Potato Head go to sleep) Ten instructions are presented and scored on the basis of the number of key words correct (out of possible 20) and sentences correct (out of possible 10)
46
What is nu chips?
A closed-set picture pointing word recognition test Scored as percentage Age range 3-5 Can be administered as an open-set by not using picture book 50 monosyllabic words Two recordings: one male and one female talker
47
What is the word intelligibility by picture identification (WIPI) test?
One of the most commonly used Consists of picture plates, each with six images Four images have rhyming words, and two serve as distractors to reduce the probability of a correct guess Appropriate for children whose language age is between 5 to 8 years Can be measured as open-set by not using picture book Can be performed auditory only or auditory and visual
48
What is the phonetically balanced kindergarten word list (PBK-50)?
Fifty-item, phonemically balanced, monosyllabic word lists selected from the spoken vocabulary of normal hearing kindergarten children Age range 5 to 8 years Open set Scored as percentage Requires a verbal response
49
What is the BKB-SIN?
The BKB-SIN can be used to estimate SNR loss in children ages 5+ years and adults for whom the QuickSIN test is too difficult Quick and easy to administer and score Indicate ability to understand in noise
50
Do children require the same SNR as adults?
No, they need a higher SNR SNR improves with age Scores on the BKB-SIN will be different than the QuickSIN
51
Why are children more affected by SNR loss than adults?
They are still developing their linguistic and world knowledge, essential for speech perception Test results for children should be interpreted individually, taking into account factors like the child's speech, language, and academic abilities, as well as the learning environment, including class size, room acoustics, and teaching methods
52
What should happen as a child's vocabulary increases and improves?
The more difficult the tests should be Allows comparison with normal-hearing peers
53
What test protocol should you use for a language age of >8 years?
CNC or NU6
54
What tests should be used for a child with a profound loss who does not have access to auditory information with technology?
Closed set Only used when the child cannot perform standard tests ANT Early Speech Perception (ESP) Test Mr. Potato Head Task Alphabet Test Minimal Auditory Capabilities (MAC) Test Test of Auditory Comprehension (TAC)
55
What is the auditory numbers test (ANT)?
A simple auditory test to determine whether a young child with hearing loss can perceive spectral aspects of speech or only gross temporal acoustic patterns Tests numbers perception Number identification relies mostly on vowels therefore it is mostly testing low frequencies Used with severe to profound hearing loss or those with low vocabulary level
56
Should speech perception be assessed both aided and unaided?
Yes
57
Do real-ear measurements reveal how well the brain interprets sounds or the child's hearing performance?
No
58
How do you test speech audiometry both aided and unaided?
To assess a child’s day-to-day performance and to determine if the child hears enough speech information with their technology, measure speech perception in soundfield at normal (50 dB HL/~ 65 dB SPL]) and soft (35 dB HL/~ 50 dB SPL) conversational levels in quiet as well as conversational levels in noise (50 dB +5 signal-to-noise ratio [SNR])
59
When should you attempt to do open set with a child?
Age 5 if there is no cognitive or developmental delay
60

AUDE 6140 - Pediatric Audiology (15 decks)

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