Hearing loss affects one out of every ten people in the world. Hearing loss is so subtle that even after the birth parents realise it after one year when they notice that the child is not speaking anything. Hence it is very important to follow universal hearing screening programme and to have a carefull plan for rapid, accurate and comprehensive audiological evaluation and further treatment and rehabilitation which will let the child to achieve better quality life.
Lists of Diagnostic tests available :-
Behavioral Observation Audiometry (BOA)
Age Range (0 to 5 months). Child's responses may consist of quieting, eye widening, startle, etc.
Visual Reinforcement Audiometry (VRA)
Age Range (6 months to 2 years).Child turns to the sound stimulus and a puppet lights-up to reward (reinforce) the child's listening behavior.
Conditioned Play Audiometry (CPA)
Age Range 2 years and consistent between developmental ages of 2 to 3 yearsA listening game that uses toys to maintain the child's attention and focus to the listening task. For example, the child holds a block, waits and listens for the sound. When the child hears the sound, they drop the block in a bucket. This "listening game" is demonstrated to the child by the audiologist, and once the child understands the game testing is underway.
Otoacoustic emission (OAE)
Provides indices of outer hair cell function in the inner ear (cochlea) and takes about 3 minutes per run. A probe tip is placed in the ear canal. Sounds are presented and an elicited response recorded. The response is very faint so the child must be extremely quiet during the test. Because the response is so faint, it may be obscured by the presence of ear wax, middle ear pathology (for example, fluid, pressure) or the presence of pressure equalization (PE) tubes.
Auditory Brainstem Response (ABR)
It is an electrophysiological test. It is used in two ways: to assess auditory nerve function and to estimate hearing levels. Sounds are presented through an earphone while three small surface electrodes pick-up the response to sound from the inner ear (cochlea) and auditory nerve. A computer averages the auditory responses and the audiologist interprets the results. When this test is used to estimate hearing levels for children 6 months and older, sedation is required for ABR recording.
ASSR(Auditory Steady State Response)
The auditory steady-state response (ASSR) can be thought of as an electrophysiologic response to rapid auditory stimuli. The goal of ASSR is to create an estimated audiogram from which questions regarding hearing, hearing loss, and aural rehabilitation can be answered. ASSR allows the hearing care professional to create statistically valid audiograms for those unable or unwilling to participate in traditional behavioral tests.
Acoustic immittance measures (tympanometry and acoustic reflex thresholds) provide important information about the presence of a conductive component. Abnormal tympanometric results signify the need for medical assessment, the presence of normal tympanometry does not rule out a conductive component, as normal tympanograms can be recorded in ears with ossicular abnormality.
Speech audiometry has become a fundamental tool in hearing-loss assessment. In conjunction with pure-tone audiometry, it can aid in determining the degree and type of hearing loss. Speech audiometry also provides information regarding discomfort or tolerance to speech stimuli and information on word recognition abilities.and can help determine proper gain and maximum output of hearing aids and other amplifying devices for patients with significant hearing losses and help assess how well they hear in noise. Speech audiometry also facilitates audiological rehabilitation management.
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