Hearing and Speech Services
|Documents||The service descriptions provided on this and the other service description pages are intended to give a general overview of the service. They cannot go into every detail of the service. .|
A comprehensive audiological evaluation includes several tests of the auditory system. A measure of hearing sensitivity is conducted in a soundproof booth, through earphones. An individual will be given pure tone stimuli that assess hearing sensitivity at various frequencies. The softest intensity that the person responds to (threshold) will be plotted on a frequency-loudness graph called an audiogram. The hearing test also include measures of word recognition (speech discrimination) ability. Other tests assess movement of the tympanic membrane (tympanometry), middle ear muscle tests, and otoacoustic emissions, the latter comprising the minimal test battery. An audiological evaluation provides information as to whether an individual has normal hearing sensitivity or if there is a hearing deficit. Results of the hearing test can provide information about whether the loss is due to mechanical involvement of the middle ear structures (conductive hearing loss), of it it involves the cochlea, auditory nerve (sensorineural hearing loss), or whether there is the possibility of auditory processing disorder (APD).
Individuals with hearing loss have communication difficulties. Aural rehabilitation involves working with the hearing impaired individual and their families to provide an understanding of: a) how one’s hearing loss impacts communication, b) how the hearing loss affects interaction with family, friends and colleagues, and in different settings, c) how family and friends can more effectively communicate with individuals who are hearing impaired, d) strategies and communicative approaches that are most beneficial for improving communication, e) suggestions for the use and care of hearing aids, and such. In some cases, the use of assistive listening devices will be considered to enhance communication. Aural rehabilitation often involves significant others and may require their participation. In the case of hearing impaired children, this may involve developing strategies for family, educators and other professionals who interact with the child.
Pediatric hearing evaluations often require techniques
that differ from those used with older, more mature children and adults.
Behavioral audiometry involves the use of a) visual reinforcement
audiometry (VRA) in which reinforcement is used to train a child to
localize to the sound using lighted toy animals, b) the use of non-verbal
or verbal stimuli in the sound field (audiological testing booth) to
determine assessment of hearing sensitivity, and/or c) behavioral play audiometry in
which a child is trained to respond to auditory stimuli using a
non-verbal, game-like format. Parents
are encouraged to join their child in the test booth for such testing
Processing Disorder (APD) Testing / Central
Auditory Processing Testing
processing disorder (APD) is a condition in which an individual has normal
hearing sensitivity but has difficulty comprehending or understanding
spoken language under unfavorable listening conditions.
In some cases, those with hearing loss may also have APD.
Following are some of the more common symptoms associated with APD:
Selected subsections of the comprehensive Auditory
Processing test battery, conducted in a sound proof room under headphones,
are used to determine if an individual is a candidate for Fast ForWord
auditory-language trainings. In
addition to determining if APD is present, selected tests of language
processing, working memory, and/or reading assessments may also be included.
These test results, in addition to information about the child’s
academic performance, listening profiles, and APD screening checklists
will be used to determine if Fast ForWord training is indicated, which
Fast ForWord training is most appropriate, or if both trainings should be
considered. Fast ForWord
Reading is a supplemental reading software program for elementary aged
children who are reading at least on the 3rd grade level.
This software reading program may be appropriate for some children
who do Fast ForWord, depending on the child’s academic profile and
Children, adolescents and adults who have problems with auditory processing, language processing and/or reading problems may be candidates for Fast ForWord training. These are CD-ROM, auditory-language training programs that were developed based on the research of four of the nation’s leading neuroscientists. Clinical field trials were done on 500 children from across the nation with results that were even better than the results reported from the research laboratory prototype of Fast ForWord. These intense programs can be done in the child’s home, using PC or Mac computers, and have the ability to improve auditory processing, language processing, and APD-related reading skills by 1½ to 2 standard deviations, following the 4 to 8 week training.
For more information on Fast ForWord trainings, research, and outcomes, visit the “Families” section of Scientific Learning.
in auditory assessment have produced a test that assesses the outer hair
cell function of the cochlea (the end organ of hearing). An Otoacoustic emissions (OAE) test is an
electrophysiological test whereby the stimuli are generated by and the
responses obtained automatically by audiological test equipment bypassing
the need for voluntary patient response.
It is a routine test procedure and part of the minimal test battery
for all hearing tests for children and adults.
Results can be obtained whether a child is awake or asleep as long
as they are in a quiet state. Used
in conjunction with other electrophysiological tests, OAE measurements can
assist in determining the functional status of the auditory system.
While it is not a test of hearing sensitivity, OAE tests are helpful
in determining the integrity of the auditory system in babies and children or
anyone who is unable to participate in behavioral audiological
The fitting of hearing aids can be facilitated by the
use of sophisticated computerized equipment that measures the frequency
response of the aids while they are being worn. A tiny microphone, attached to a spaghetti-thin tube, is
placed in a patient’s ear canal. With
the hearing aid seated in the ear canal, the equipment generates sounds
and the auditory responses in the ear canal are measured by the tiny
microphone in the ear canal. This
procedure is particularly important when fitting young, pre-verbal babies
and children with hearing aids and provides an accurate measurement of
frequency and volume as it enters the ear.
Tympanometry is an electrophysiological test that is
used to determine if there is abnormality in the middle ear system.
This system includes the ear drum (tympanic membrane), the ossicles
or three tiny middle ear bones, and their mechanical ability to conduct
sound into the cochlea (end organ of hearing).
A probe, placed at the entrance to the outer ear canal, generates
tonal stimuli and varying degrees of air pressure that automatically
registers middle ear mobility and function on audiometric equipment.
This is one of the three minimal procedures used in assessment of
all who require hearing testing and can be used in conjunction with OAEs
to help rule out auditory neuropathy.
Since middle ear disorders (fluid behind the ear drum, middle ear
infection, movement of the ossicles, etc.) are more common in babies and
children, the electrophysiological test is useful and does not require the
child (or adult) to volunteer a response.
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