Pediatric Assessment

Summer 2007

Auditory Responses

• In adults, response type was unimportant

• With children, it can have significant effects

• Possible responses cover a WIDE range of behaviors

• Children do not typically respond to sounds at threshold, but only to sounds more clearly audible: Minimum Response LevelsMinimum Response Levels

(see Table 8.1)

Identifying Hearing Loss in Infants under 3 Months of Age

• Infant hearing screening was historically done only with those “at risk” for hearing loss.

• In the last 15 years, UNIVERSAL newborn hearing screening has come into wide use – on a state-by-state basis.

• Objective tests used to screen:– OAEs– ABR

Testing Young Children• Reflexive reactions (e.g.,Moro within 2 mos)

• Behavioral Observation Audiometry: thru 6-8 mos

• Conditioned Orienting Reflex/Visual Reinforcement Audiometry from 4 months

• Play audiometry (18 months and up)

• Operant conditioning audiometry

• Electrophysiologic Tests– OAEs, Aud Evoked Responses

Visual Reinforcement AudiometrySPEAKER

LIGHT-UP, ANIMATED REINFORCERS

DISTRACTER TOY

Auditory Processing Disorders“How the ear talks to the brain and how the brain

understands what the ear is telling it.” -- Musiek

The Child with APD

• has normal hearing

• has normal intelligence

• has trouble using auditory input

• cannot learn well through audition alone

• will have difficulty in noisy, open classrooms

• may have difficulty attending to sound for any length of time

Management

• Classroom Modifications

• Remediation Activities

• Compensatory Strategies

• Each child is unique

-Blanket recommendations don’t work

Identifying Hearing Loss in the Schools

• 14.9% of US children aged six to nineteen have a measurable hearing loss in one or both ears (Niskar et. al., 1998)

• Screening programs mandated by states at specific grade levels.

Nonorganic Hearing Loss in Children

• Feigning a hearing problem, most commonly for attention.

• More common in 10 to 14 year olds,

• But may appear in younger children as well.