The audiological test procedures indicated are recommended foruse with children in order to ensure that maximal use of residualhearing can be achieved in the Auditory-Verbal approach. Abattery of audiological tests is always suggested since no singleprocedure has sufficient reliability to stand alone. Optimally,every aural habilitation program should have on-site audiologicalservices, but, regardless of setting, close cooperation betweenaudiology and therapy service providers is essential. Parentsshould be present for and participate in the administration ofall assessment procedures to include them in this aspect of thechilds care.
The audiological test procedures indicated are recommended foruse with children in order to ensure that maximal use of residualhearing can be achieved in the Auditory-Verbal approach. Abattery of audiological tests is always suggested since no singleprocedure has sufficient reliability to stand alone. Optimally,every aural habilitation program should have on-site audiologicalservices, but, regardless of setting, close cooperation betweenaudiology and therapy service providers is essential. Parentsshould be present for and participate in the administration ofall assessment procedures to include them in this aspect of thechilds care.
The audiological test procedures indicated are recommended foruse with children in order to ensure that maximal use of residualhearing can be achieved in the Auditory-Verbal approach. Abattery of audiological tests is always suggested since no singleprocedure has sufficient reliability to stand alone. Optimally,every aural habilitation program should have on-site audiologicalservices, but, regardless of setting, close cooperation betweenaudiology and therapy service providers is essential. Parentsshould be present for and participate in the administration ofall assessment procedures to include them in this aspect of thechilds care.
| AGE OF CHILD | PROCEDURES |
|---|---|
| INCLUDED IN ALL ASSESSMENTS, REGARDLESS OF CHILDS AGE |
|
| 0-6 months | AUDITORY BRAINSTEM RESPONSE (ABR)
CAUTION: ABR SHOULD NOT STAND ALONE FOR DIAGNOSTIC PURPOSES. LACK OF RESPONSE TO ABR TESTING DOES NOT NECESSARILY INDICATE AN ABSENCE OF USABLE HEARING. AMPLIFICATION AND AUDITORY LEARNING ARE RECOMMENDED AS THE FIRST OPTION UNLESS SPECIAL IMAGING (CT SCAN OR MRI) CONFIRMS AN ABSENCE OF THE COCHLEA. BEHAVIORAL TESTING , AMPLIFICATION AND THERAPY ARE OTHERWISE INDICATED BEFORE A DECISION OF NO USABLE HEARING IS MADE. |
| 6 months -2 years | BEHAVIORAL OBSERVATION/VISUAL REINFORCEMENT AUDIOMETRY
|
| 2-5 years | CONDITIONED PLAY AUDIOMETRY
|
| 5 years + | STANDARD AUDIOMETRY
|
AMPLIFICATION ASSESSMENT
ELECTRO-ACOUSTIC ANALYSIS OF HEARING AIDS
- On day of fitting.
- At 30-90 day intervals at user volume as well as full-on volume.
- Whenever a hearing aid is repaired, in addition to a close check of internal settings.
- Whenever parental listening check or behavioral observation raises concern.
SOUND FIELD AIDED RESPONSE
- Parents and therapists can prepare the child by teaching him/her to respond consistently to voice and the Ling Five Sounds.
- Aided measures should include: Speech Awareness or Recognition, Word Identification at 55 dB in quiet and, if possible, in noise; response to warbled pure tones from 250-6000 Hz wearing binaural hearing aids, or monoaural measures to compare responses at each ear.
CAUTION: It is important that the aided results beevaluated in relation to the unaided audiogram. Recommended aidedresults for the left corner audiogram with optimumamplification should be in the 35-45 dB (ANSI) range at 250, 500,1000 Hz or better.
PROBE MICROPHONE (REAL EAR) MEASURES
- Unoccluded measurement of External Ear Effect as well as full occlusion with the hearing aid OFF to measure insertion loss.
- Insertion gain measured with hearing aid at customary settings to verify appropriate gain and output levels and to compare changes in settings.
CAUTION: Existing formula may underestimate the gainrequired by children with severe to profound hearing impairment.
FM SYSTEMS
- When FM Systems are in use, they should be evaluated at the time of the complete audiological and hearing aid assessment using the same format described for amplification.
FREQUENCY OF ASSESSMENT (AIDED AND UNAIDED)
- Every 90 days once diagnosis is confirmed and amplification fitted, until age 3..
- As early as possible, but at least by age 2, a complete unaided and aided audiogram should be obtained (preferably under headphones, but at least in the sound field.)
- New earmolds may need to be obtained at 90 day intervals or sooner until age 3-4 in view of the typically rapid growth rate during this time.
- Assessment every 6 months from age 4-6 is appropriate if progress is satisfactory.
- Above age 6, assessment at 6-12 month intervals is appropriate with earmolds at the same intervals.
- Immediate evaluation should be scheduled if parents or caretakers suspect a change in hearing or hearing aid function.
CAUTION: Modifications of this schedule are appropriate whenmiddle ear disease is chronic or recurrent and when additionaldisabilities are present.
REPORTS
- Reports should be supplied promptly upon receipt of written release to parents, therapists, physicians and educators. Reports should include:
- Test procedures and reliability assessment
- The complete audiogram with symbol key, calibration standard, stimuli used
- Hearing aid identification – make, model, output and tone settings, compression or special feature settings, volume setting, earmold style and quality of fit
- FM system identification and settings
- Interpretive information regarding relationship of audiological findings to acoustic phonetics, especially with respect to distance hearing and message competition
- Analysis of auditory behavior and development of the listening function