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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Audiologic assessment in infants
1Division of Head & Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, USA. ysininger@mednet.ucla.edu
Insights
This review outlines standards for infant audiology, detailing essential tests like auditory brainstem response (ABR) and otoacoustic emissions for accurate hearing assessment in newborns and young children.
Area of Science:
- Audiology
- Pediatric audiology
- Hearing science
Background:
- Infant hearing screening is crucial for early detection of hearing loss.
- Standard audiologic assessments require modifications for infants and toddlers.
- Accurate diagnosis is vital for timely intervention and development.
Purpose of the Study:
- To present current standards for audiologic assessment in infants and young children.
- To emphasize the importance of a tailored test battery for this age group.
- To provide information on appropriate diagnostic and rehabilitative procedures.
Main Methods:
- Utilizing frequency-specific threshold tests (air and bone conduction).
- Employing electrophysiologic measures like Auditory Brainstem Response (ABR) and Auditory Steady State Response (ASSR).
- Conducting immittance measures, including tympanometry and acoustic reflexes with high-frequency probe tones.
Main Results:
- ABR accurately predicts hearing levels in newborns using frequency-specific stimuli.
- Immittance measures and otoacoustic emissions are key components of the test battery.
- Newer techniques like ASSR show promise but require further validation.
- Infants with hearing loss can be fitted with amplification using prescriptive formulas like Desired Sensation Level (DSL).
Conclusions:
- Audiologists can provide comprehensive audiologic data for infants failing newborn screenings.
- Early identification and fitting of amplification are possible in the newborn period.
- Audiologic procedures must be specifically adapted for the unique needs of infants and toddlers.
Purpose:
The purpose of this review is to provide the reader with current information regarding the standards for audiologic assessment of infants and very young children. The nature of the appropriate test battery and the need for adjusting test procedures to meet the specific needs of infants and toddlers are emphasized.
Recent Findings:
The basic measures in the audiologic test battery include frequency-specific threshold tests by air and bone conduction, predicted by electrophysiologic measures when necessary; immittance measures including tympanometry and acoustic reflex using a high-frequency probe tone for infants under 4 months of age; and otoacoustic emissions. The ABR can be used with frequency-specific stimuli to predict the audiogram in newborns with a great deal of accuracy. Newer techniques, such as Auditory Steady State Response, are promising but need further study before they can be used reliably to predict hearing levels in infants. Finally, infants with hearing loss can be fit with amplification using prescriptive formulae, such as the Desired Sensation Level, which give appropriate hearing aid characteristics for infants based on their hearing thresholds. These fittings must be verified using objective electro-acoustic measures tailored to infants.
Summary:
Infants failing newborn hearing screenings can be evaluated by audiologists to predict all necessary audiologic data and those found to have hearing loss can be fitted with appropriate amplification in the newborn period. Procedures must be carefully tailored to this age group.
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