BEHAVIORAL ASSESSMENT MEASURES

1
TOPIC 4

• BEHAVIORAL ASSESSMENT MEASURES

2
The Audiometer

• Types
• Clinical
• Screening

3
The Audiometer

• Components
• Pure tone oscillator
• Attenuator
• Interrupter switch
• Output transducer
• Headphones
• Supra-aural
• Insert
• Bone conduction vibrators
• Forehead
• Mastoid
• Loudspeakers

4
Audiometer Components
5
Pure Tone Audiometry

• The aim of pure tone audiometry is to establish
  hearing threshold sensitivity across the range of
  audible frequencies important for communication

6
The Audiogram
7
Air Conduction vs Bone Conduction Testing

• Air conduction tests the entire auditory system.
  Bone conduction bypasses the conductive
  mechanism, so it tests only the inner ear.

8
Audiometric Symbols

• Unmasked air conduction
• Left ear
• Right ear
• Unmasked bone conduction
• Left side
• Right side
• Masked air conduction
• Left ear
• Right ear
• Masked bone conduction
• Left ear
• Right ear
• No response

9
What the Audiogram Says About the Impairment
Within normal limits
Mild
Moderate
Severe
Profound/deaf
10
What the Audiogram Says About the Impairment

• The configuration of the hearing loss
• Flat
• Rising
• Sloping

11
What the Audiogram Says About the Impairment

• The degree of hearing loss
• The configuration of the hearing loss
• The type of hearing loss
• Conductive
• Sensorineural
• Mixed

12
Establishing a Pure Tone Audiogram

• Establish which is the better ear and test first
• Start air conduction testing at 1000 Hz
• Begin at 30 dB HL. If there is no response,
  increase intensity in 20 dB steps until you see a
  response
• Follow the down in 10, up in 5 rule

13
ASHA Procedure

• Hypothetical threshold search for a listener
  whose threshold is 35 dB HL. A indicates the
  listener heard the presentation, and a - shows
  the listener didnt hear the tone. Notice that
  the hearing level of a trial is raised by 5 dB
  following a - and is lowered by 10 dB following a
  .

14
Establishing a Pure Tone Audiogram

• After several crossings of the same intensity,
  pick threshold as an intensity where 50 of the
  time the listener responds correctly
• Move to 2000 Hz, 3000 Hz, 4000 Hz, and 8000 Hz
  (as a minimum)
• Pick up the low frequency (500 and 250 Hz) tones
• Repeat for the other ear

15
Speech Audiometry

• Uses
• Sensitivity for speech
• Speech awareness threshold
• Speech reception threshold
• Pure tone cross check
• Speech recognition
• Differential diagnosis
• Central auditory processing
• Estimate of communicative function

16
Speech Audiometry

• Materials
• Types
• Nonsense syllables
• Monosyllabic words
• Spondaic words
• Sentence tests

17
Speech Audiometry

• Relationship of redundancy of informational
  content and sensitivity to the effects of hearing
  loss on three types of speech recognition
  materials

18
Speech Audiometry

• Intrinsic redundancy
• Extrinsic redundancy
• Frequency--low pass filtering
• Time--time compression
• Intensity--high presentation levels
• Competition--speech in noise
• Binaural--dichotic measures

19
Speech Audiometry

• Relationship of intrinsic and extrinsic
  redundancy to speech recognition ability in
  normal listeners

20
Speech AudiometryClinical Methods

• Speech thresholds
• Speech Reception threshold
• Start audible
• Present four spondees
• Calculate percent-correct response
• Follow down in 10, up in 5 rule
• Stop at an intensity that provides 50

21
Speech AudiometryClinical Methods

• Speech thresholds
• Speech Reception threshold
• Speech Awareness threshold
• Word recognition testing

22
Word Recognition Testing

• Things to consider
• Materials
• Goals?
• Amount of extrinsic redundancy you need?
• Language level?
• Other special needs or considerations?

23
Word Recognition Testing

• Things to consider
• Materials
• Presentation
• Monaural?
• Binaural?
• Headphones?
• Sound field?

24
Word Recognition Testing

• Things to consider
• Materials
• Presentation
• Presentation Level
• Maximal ability
• Normal conversational level

25
Speech Audiometry

• Interpreting speech discrimination results.
  Typical results based on disorder site

26
Other Behavioral Measures

• Uses
• To determine a functional or exaggerated hearing
  loss
• To provide additional information necessary to
  fit amplification
• To determine the presence of recruitment and
  adaptation
• To determine some measure of binaural integrity

27
(No Transcript)