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Pediatric Audiology

Pediatric Audiology

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Pediatric Audiology

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  1. Pediatric Audiology TANGUTURI NARENDRA (MSc.ASLP) Audiologist & Chief of Rehabilitation SRUTHI Centre for Hearing & Speech Rehabilitation Kothapet, Guntur-522001, A.P. Contact: 0863-2333105

  2. CONSEQUENCES OF TYPE OF HEARING LOSS • SEVER – PROFOUND HEARING LOSS: • Severely affects Communication skills development, academic skills, and quality of life remain as handicapped. • MILD – MODERATE HEARING LOSS: • Affects communication skills development. • SLOPING HEARING LOSS: • Delay development of communication skills, academic skills severely affects, quality of communication may gets deteriorates on age. • CONDUCTIVE HEARING LOSS: • Fluctuating in manner, delay development of communication skills, • UNILATERAL HEARING LOSS: • Slight delay of communication skills but may recover by age.

  3. INFANT HEARING SCREENING IAS is test battery approach by various technical methods. • Immittance • Evoked Potential • Otoacoustic Emissions

  4. Test Battery Approach Tympanogram Type A ABR at Normal level OAE Normal Normal peripheral and lower brainstem function (possible APD) normal hearing Tympanogram Type A ABR at abnormal level OAE Absent or Depressed Cochlear loss, outer hair cell loss, ABR normal, hearing aids beneficial Tympanogram Type A ABR at abnormal level OAE Present Auditory Neuropathy/ Auditory Dys-synchrony Tympanogram Type A ABR at abnormal level OAE Absent Severe or profound inner ear loss (occasionally otosclerosis) Tympanogram Not Type A ABR at abnormal or prolonged OAE Absent Conductive or mixed loss (possible severe/profound loss)

  5. Tympanometry • Objective measure of the function of the TM and middle ear • Ear Canal Volume • Tympanogram-Static Compliance

  6. Tympanogram Types Normal Tympanograms: Abnormal Tympanograms:

  7. Otoacoustic Emissions • Acoustic energy produced by the cochlea and recorded in the external auditory canal • Most likely energy produced by outer hair motility and possibly outer hair cell cilia • Objective test • DPOAE • TEOAE

  8. DPOAE

  9. DPOAE

  10. TEOAE

  11. ABR • ABR

  12. ABR Screening

  13. ABR Wave I Auditory Nerve II Auditory Nerve III Cochlear Nuclei IV SOC V ??? Interwave Latencies Absolute Latencies

  14. How will NHS done? • New Hearing Screening may be informal screening but well established standard protocols need to adopt. • NHS procedures may vary according to the Childs age. They are categorized as: • Hospital based/below one month • 1 month- 4th month • 4th month- 6th month

  15. SCREENING PROCEADURES • HOSPITAL BASED/BELOW 1 MONTH: • Impedance audiometry • OAE • 1st M0NTH - 4th M0NTH: • Impedance audiometry • OAE • ABR • 4th MONTH – 6th MONTH: • Impedance audiometry • OAE • ABR • BOA

  16. INCEDANCE & PREVALENCE

  17. Incidence of Congenital Conditions (Per 10,000)

  18. PERCENTAGE OF HIGH RISK CHILDREN HAVING HEARING LOSS

  19. IMPORTANCE OF EARLY DETECTION

  20. ACCURACY IDENTIFICATION OF HEARING LOSS IN CHILDREN • 2-step screening (OAE + ABR) • Sensitivity = 0.92 • Specificity = 0.98

  21. DEVELOPMENTAL MILE STONES

  22. DEAFNESS MANAGEMENT

  23. DEAFNESS THERAPEUTICS • AUDITORY VERBAL THERAPY • PRE SCHOOLING • INCLUSIVE EDUCATION • MAINSTREAME SCHOOLING

  24. www.babyhearing.org

  25. www.infanthearing.org www.infanthearing.org

  26. THANK YOU ALL