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E-zine.com July 2012 J-J-J-July Jitters Yes, it is still icy cold and yes, we still can’t get over it. Welcome to another chilly e-zine...chilly due to our current climate and not because of our content of course. With the schools starting up again we’ve initiated our thaw-phase from our winter holiday lethargy and moving into higher gears to change the world one patient at a time. City. The Speech-Language Therapy program will include 8 distinguished researchers from the International Association of Logopedics and Phoniatrics (IALP) that will be presenting a series of lectures on Motor Speech Disorders in adults and children. Visit www. ialp. info/motor -speechdisorders-committee-pg16135.html for more information. The Audiology program will have Prof.Larry Humes from the University of Indiana as keynote speaker this year. Dr. Humes is an expert in auditory perception, with an special interest in the effects of hearing impairment and aging on auditory perception. Visit the congress website for more information as well as registration forms . Blessings for the week. INSIDE THIS ISSUE: Word of welcome 1 Academic Corner: HIV and 1 Hearing Loss TECH Talk: 3 More on i-Pads New Middle 5 Ear Microphone gets research attention Fun Facts 6 Contact your Counsel 6 With the year going at the speed of light we are also speedily approaching the 2012 SASLHA/SAAA/ ENT Conference which will be held from 3-6 November 2012 at Sun Enjoy the e-zine. Dirk Lourens & Cara Hollander Editors: E-zine Hang on guys. We’ll beat the freeze! Academic Corner: Children Exposed to HIV in the Womb at Increased Risk for Hearing Loss Children exposed to HIV in the womb may be more likely to experience hearing loss by age 16 than are their unexposed peers, according to scientists in a National Institutes of Health research network. The researchers estimated that hearing loss affects 9 to 15 percent of HIV-infected children and 5 to 8 percent of children who did not have HIV at birth but whose mothers had HIV infection during pregnancy. Study participants ranged from 7 to 16 years old. The researchers defined hearing loss as the level at which sounds could be detected, when averaged over four frequencies important for speech understanding (500, 1000, 2000, and 4000 Hertz), that was 20 decibels or higher than the normal hearing level for adolescents or young adults in either ear. "Children exposed to HIV before birth are at higher risk for hearing difficulty, and it's important for them―and the health providers who care for them―to be aware of this," said George K. Siberry, M.D., of the Pediatric, Adolescent, and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that leads the research network. The study was published online in The Pediatric Infectious Disease Journal. Compared to national averages for other children their Continued on pg. 2 PAGE 2 age, children with HIV infection were about 200 to 300 percent more likely to have a hearing loss. Children whose mothers had HIV during pregnancy but who themselves were born without HIV were 20 percent more likely than to have hearing loss. More than 200 children and teenagers participated in this study conducted as part of the Pediatric HIV/AIDS Cohort Study network, led by NICHD. All had been exposed to HIV before birth, and about 60 percent were HIVpositive at the time of the study. Researchers conducted hearing tests on the children if their par- Continued from pg 1 ents or caregivers had reported hearing problems, they had low scores on a standard test of language or their health care providers detected hearing problems during standard hearing screenings. The researchers classified participants who could not hear tones below a certain volume as having hearing loss with difficulties in quiet and noisy settings. The researchers documented a greater proportion of hearing loss cases among HIV-positive children and found that those who had developed AIDS at any point were even more likely to have hearing loss -- even if the disease was under control at the time of the study. Earlier studies have found that children with HIV are susceptible to middle ear infections. Repeated middle ear infections can cause hearing loss. However, in 60 percent of cases in the study, hearing loss was the result of problems with the transmission of sound from the nerves of the ear to the brain, rather than to damage in the middle ear resulting from ear infections. www.sciencedaily.com/ releases/2012/06/12 PAGE TECH TALK: iPad Technology in Speech Therapy After receiving some very positive responses to our previous TECH article about practical ways of using i-Pads as a therapy modality, we decided to investigate and share some more resources in this continuously expanding therapy tool. We visited http://communicationtherapy.wordpress.com/2011/02/27/ipadtechnology-in-speech-therapy-overview/ and came across the Communication Therapy Blog which offers insight, resources and guidance in rems of i-Pad use in Speech-Language Therapy. We have included an excerpt from the site to wet your appetite... 3 PAGE 4 SPEECH THERAPY POSITION: Pretoria, Gauteng The Baby Therapy Centre in Pretoria requires a part time Speech- Language Therapist (15 hours per week). The candidate must be fluent in both English and Afrikaans and have 1-2 years experience handling babies and toddlers under the age of three years. Must be able to work independently and as part of a therapy team with a transdisciplinary and interdisciplinary approach. Evidence in the Field of Communication Pathology Tuesday 7 August 2012 EVIDENCE in the field of COMMUNICATION PATHOLOGY: half-day course on 7 AUGUST 2012 at Department of Communication Pathology in TUKS - 5 CPD points Register now !!! Presented by PROF DR EDWIN MAAS, Department of Speech, Language and Hearing Science University of Arizona Organised by Department of Communication Pathology (University of Pretoria) Course Coordinator: Nathalie van Waeyenberge E-mail: [email protected] RESTORING HEARING WITH DISCRETE DEVICE: A MIDDLE-EAR MICROPHONE FOR MORE CONVENIENT COCHLEAR IMPLANTS ScienceDaily (Apr. 30, 2012) — Cochlear implants have restored basic hearing to some 220,000 deaf people, yet a microphone and related electronics must be worn outside the head, raising reliability issues, preventing patients from swimming and creating social stigma. Now, a University of Utah engineer and colleagues in Ohio have developed a tiny prototype microphone that can be implanted in the middle ear to avoid such problems. The proof-of-concept device has been successfully tested in the ear canals of four cadavers, the researchers report in a study just published online in the Institute of Electrical and Electronics Engineers journal Transactions on Biomedical Engineering. The prototype -- about the size of an eraser on a pencil -- must be reduced in size and improved in its ability to detect quieter, low-pitched sounds, so tests in people are about three years away, says the study's senior author, Darrin J. Young, an associate professor of electrical and computer engineering at the University of Utah and USTAR, the Utah Science Technology and Research initiative. The study showed incoming sound is transmitted most efficiently to the microphone if surgeons first remove the incus or anvil -- one of three, small, middleear bones. U.S. Food and Drug Administration approval would be needed for an implant requiring such surgery. The current prototype of the packaged, middle-ear microphone measures 2.5by-6.2 millimeters (roughly one-tenth by one-quarter inch) and weighs 25 milligrams, or less than a thousandth of an ounce. Young wants to reduce the package to 2-by-2 millimeters. Problems with External Parts on Cochlear Implants The National Institutes of Health says almost 220,000 people worldwide with profound deafness or severe hearing impairment have received cochlear implants, about one-third of them in the United States, where two-fifths of the recipients are children. In conventional cochlear implant, there are three main parts that are worn externally on the head behind the ear. Implanted under the skin behind the ear are a receiver and stimulator to convert the sound signals into electric impulses, which then go through a cable to between four and 16 electrodes that wind through the cochlea of the inner ear and stimulate auditory nerves so the patient can hear. "It's a disadvantage having all these things attached to the outside" of the head, Young says. "Imagine a child wearing a microphone behind the ear. It causes problems for a lot of activities. Swimming is the main issue. And it's not convenient to wear these things if they have to wear a helmet." Young adds that "for adults, it's social perception. Wearing this thing indicates you are somewhat handicapped and that actually prevents quite a percentage of candidates from getting the implant. They worry about the negative image." As for reliability, "if you have wires connected from the microphone to the coil, those wires can break," he says. How Sound Moves in normal ears, Cochlear Implants and the new device Sound normally moves into the ear canal and makes the eardrum vibrate. The stapes or stirrup touches the cochlea. Hair cells on the cochlea's inner membrane move, triggering the release of a neurotransmitter chemical that carries the sound signals to the brain. In profoundly deaf people who are candidates for cochlear implants, the hair cells don't work for a variety of reasons, including birth defects, side effects of drugs, exposure to excessively loud sounds or infection by certain viruses. In a cochlear implant, the microphone, signal processor and transmitter coil worn outside the head send signals to the internal receiver-stimulator, which is implanted in bone under the skin and sends the signals to the electrodes implanted in the cochlea to stimulate auditory nerves. The ear canal, eardrum and hearing bones are bypassed. The system developed by Young implants all the external components. Sound moves through the ear canal to the eardrum, which vibrates as it does normally. But at the umbo, a sensor known as an accelerometer is attached to detect the vibration. The sensor also is attached to a chip, and together they serve as a microphone that picks up the sound vibrations and converts them into electrical signals sent to the electrodes in the cochlea. The device still would require patients to wear a charger behind the ear while sleeping at night to recharge an implanted battery. Young says he expects the battery would last one to several days between charging. Young says the microphone also might be part of an implanted hearing aid that could replace conventional hearing aids for a certain class of patients who have degraded hearing bones unable to adequately convey sounds from conventional hearing aids. Testing the Microphone in Cadavers Conventional microphones include a membrane or diaphragm that moves and generates an electrical signal change in response to sound. But they require a hole through which sound must enter -- a hole that would get clogged by growing tissue if implanted. So Young's middle-ear microphone instead uses an accelerometer -- a 2.5-microgram mass attached to a spring - that would be placed in a sealed package with a low-power silicon chip to convert sound vibrations to outgoing electrical signals. The package is glued to the umbo so the accelerometer vibrates in response to eardrum vibrations. The moving mass generates an electrical signal that is amplified by the chip, which then connects to the conventional parts of a cochlear implant: a speech processor and stimulator wired to the electrodes in the cochlea. "Everything is the same as a conventional cochlear implant, except we use an implantable microphone that uses the vibration of the bone," Young says. To test the new microphone, the researchers used the temporal bones -- bones at the side of the skull -- and related ear canal, eardrum and hearing bones from four cadaver donors. The researchers inserted tubing with a small loudspeaker into the ear canal and generated tones of various frequencies and loudness. As the sounds were picked up by the implanted microphone, the researchers used a laser device to measure the vibrations of the tiny ear bones. They found the umbo -- where the eardrum connects to the hammer or malleus -- produced the greatest sound vibration, particularly if the incus or anvil bone first was removed surgically. The experiments showed that when the prototype microphone unit was attached to the umbo, it could pick up medium pitches at conversational volumes, but had trouble detecting quieter, low-frequency sounds. Young plans to improve the microphone to pick up quieter, deeper, very low pitches. In the tests, the output of the microphone went to speakers; in a real person, it would send sound to the implanted speech processor. To demonstrate the microphone, Young also used it to record the start of Beethoven's Ninth Symphony while implanted in a cadaver ear. It is easily recognizable, even if somewhat fuzzy and muffled. "The muffling can be filtered out," says Young. Example of the middle ear mic. 2012 National Council Contact Details DESIGNATION NAME EMAIL ADDRESS President Vice-President Treasurer Cathy Pringle Dirk Lourens Cornel du Preez [email protected] [email protected] [email protected] Professional Liaison Officer Jane Herbert [email protected] Office Manager Claudine Emmerick [email protected] Ethics and Standards Chair Prof Development Officer SAJCD Editor in Chief Susan Swart Anita Edwards Janan Dietrich [email protected] [email protected] [email protected] CPD University Alliance Communiphon Editor Academic Conference Program Co-ordinator Anita Edwards Sandra du Plessis Cara Hollander Dr.Anna-Marie Olivier [email protected] [email protected] [email protected] [email protected] Coding Chairperson Alison Dent [email protected] PR and Marketing Chairperson Nicole de Rocha [email protected] Zone One Representative Dr.Priya Rajaram [email protected] Zone Two Representative Erica Bostock [email protected] Zone Three Representative Ingrid von Bentheim [email protected] Zone Four Representative Anneline Jack [email protected] SASLHA OFFICE DETAILS OFFICE MANAGER: Mrs Claudine Emmerick OFFICE HOURS: Mondays - Fridays 8h00 - 15h00 (During School Holidays: Mondays – Fridays 07h00 -14h00) POSTAL ADDRESS: PO Box 10813, Linton Grange, 6015 Port Elizabeth LOCAL TEL: 0861 113 297 INT TEL: +27 (0)41 3794253 FAX: +27 (0)41 3795388 EMAIL: [email protected]