Pediatric Testing SPA 4302 Summer 2004 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 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 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.