PEDIATRIC AND MENTALLY RETARDED POPULATIONS

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PEDIATRIC AND MENTALLY RETARDED POPULATIONS
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Minimum Response Levels (MRLs)

• No response at threshold
• Respond at supra-threshold levels
• Response hearing
• No response hearing still possible

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Hearing and Language Development

• Babbling (6 months) still present in hearing
  impaired
• Lalling (6mos - 9mos.)
• Echolalia (9 - 12 mos.) is NOT present with
  hearing impaired child
• True Speech (12 - 18 mos.) - delayed in many
  hearing impaired
• 2 ½ years is normal Dx of hearing impairment in US

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We must answer these questions.

• Can we detect hearing loss in the infant
• Can we diagnose the loss
• Can we do any treatment about it

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Apgar Test

• Respiratory
• Muscle tone
• Heart rate
• Color
• Reflex irritability
• Values 0 - 10 at 1, 5, 10 minutes after birth

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Warble tone
A pure tone that is frequency modulated
(modulation is expressed as a percentage, i.e.
5)

• Downs (1967)
• Startle response (3KHz at 90 dBSPL- Moro reflex
  1-3 mos)
• Risk factors (high risk registry for inclusion in
  testing)
• Combine ABRs with acoustic reflex and OAEs

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• Neonates (0 - 28 days)
• Infants (29 days - 3 years)
• Pre-school (3 - 5 yrs.)

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Screening

• ABR
• OAEs
• Acoustic reflex

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Infant testing

• Noise makers
• Behaviorial Observation Audiometry (BOA) keys,
  cellophane etc.)
• Sound field/free field
• Conditioned Orientation Reflex (COR)
• Visual Response Audiometry (VRA)

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Ewing Ewing 1944

• rattles
• paper
• noise makers
• cup and spoon

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Auditory localization - 8 months or later

• they search for sound source
• cease activity
• awaken from a light sleep
• facial expression changes
• vocalize

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1 - 5 years

• Speech Audiometry
• Pure tone Audiometry
• Operant Conditioning Audiometry
• Tangible Reinforcement Operant Conditioning
  Audiometry (TROCA)
• Electrophysiological hearing tests
• Electro-dermal audiometry (EDA)
• cardiotachometry

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1- 5 Yrs ( continued)

• Play Audiometry (peg board)
• Child must be motivated
• Must have his attention
• Reinforcement must be strong
• Central Auditory Processing Disorder (CAPD or
  L.D.)
• May have normal hearing but processing poor
• poor listening skills
• Short attention span
• Poor memory
• Reading comprehension deficient
• Hyperactive trouble discriminating in presence
  of noise

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School Age

• Group ScreeningTests
• Sweep Check Tests
• Individual pure tone thresholds
• Tympanometry