Csd 486- Infants With Hearing Loss- Exam 2

Front 1

The human cochlea has reached normal adult function after what week of gestation?

Back 1

20th

Front 2

What part of the ear has reached normal adult function after the 20th week of gestation?

Back 2

cochlea

Front 3

After the 20th week of gestation, the fetal heart rate respond to what type of tones?

Back 3

High frequency

Front 4

Auropalpebral reflex is otherwise known as "____."

Back 4

Eyeblink

Front 5

At what weeks of gestation does eyeclenching and auropalpebral reflex (eyeblink) show up as a response to sound?

Back 5

24-25

Front 6

According to Bench (1968), the least attenuation of sounds audible to the fetus occur at ___ Hz; successfully higher octaves are attenuated more and more.

Back 6

200 Hz

Front 7

According to Bench (1968), what kinds of sounds does the fetus respond? At what frequencies?

Back 7

Maternal speech/voice cues comprised of frequencies below 1000 Hz.

Front 8

T/F
Attenuation of the higher frequencies makes what the fetus hears in the uterus different then what they experience once they are born.

Back 8

True

Front 9

According to Querleu, Renard, and Crepin (1981), when external speech was recorded through the uterus, 2 observers could recognize ___% of the mother's phonemes, and ___% of the male's speech.

Back 9

64%
57%

Front 10

what age is considered Neonate

Back 10

Birth to 1 month

Front 11

How long has a full term infant been hearing inutero?

Back 11

approx. 4 months

Front 12

T/F
An infant is able to discriminate a mother's voice from others at birth?

Back 12

True

Front 13

DeCasper and Fifer (1980) demonstrated discrimination capability in newborns using what paradigm?

Back 13

sucking paradigm

Front 14

T/F
According to DeCasper and Fifer (1980), Babies produced the sucking response more often to a nonmaternal voice.

Back 14

False
Sucking response more often to mother's voice!

Front 15

According to DeCasper and Fifer (1980), babies learned that if they produced a specific sucking pattern, they could elicit who's voice?

Back 15

Their mother's voice.

Front 16

The normally hearing, alert infant will respond in very predictable ways to _______ stimulation

Back 16

auditory

Front 17

Name some reflexive behaviors/responses

Back 17

startle response
arm and leg jerks
slow limb movements
auropalpebral reflex
changes in sucking behavior
facial twitches

Front 18

All normally hearing infant younger than 3 mos. will respond to a sudden onset stimulus of ___ dB SPL +

Back 18

65

Front 19

To test for a startle response, present signal at ___ dB SPL. A sleeping baby needs a louder stimulus at ___ dB SPL.

Back 19

65
90

Front 20

A reflexive, whole body response in normal neonates and infants up to 6 months old

Back 20

moro reflex

Front 21

List attentive behaviors/ responses to sounds

Back 21

-Quieting/decreasing in ongoing activities
-Increase in ongoing activities
- breath holding
-increase in breathing rate
-onset of vocalizations
-cessation of vocalization
-starting or stopping of crying
-eye widening
-brow furrowing
-smiling/changes in facial expression
-searching, headturning, localizations

Front 22

The kind of responses an infant will give to auditory stimulation is specific to ___.

Back 22

age

Front 23

Auditory localization response from birth to 4 mos., might include eye blink and eye widening, but they are highly variable. What is the only reliable response?

Back 23

startle response

Front 24

At 3-4 mos., the infant might show a slow, rudimentary ____ toward a sound source, but this response is not stable

Back 24

head turn

Front 25

At 4-7 mos., the auditory localization response should be that the infant begins to _______ more consistently

Back 25

turn head toward sound source

Front 26

By 7 mos., neck muscles are strong enough to permit a direct turn towards the sound source, but only on a _____ plane.

Back 26

lateral

Front 27

T/F
At 7 mos., baby will look directly at sound source above or below eye level.

Back 27

False.
they will look at sound source at eye level, not above or below eye level

Front 28

When does the infant begin to identify the precise location of the sound source with a direct head turn to the side and below?

Back 28

7-9 mos.

Front 29

The auditory localization response at 7-9 mos. is brisk and firm, but unlikely they will look directly at sound on a higher plance or ____ eye level

Back 29

above

Front 30

By what age is there quick localization evidenced for sounds to the side & below and indirectly above?

Back 30

13 mos.

Front 31

By 16 mos., the infant is able to localize sounds directly on ___ plane.

Back 31

any plane
(above or below eye level)

Front 32

By what age is there full maturity of auditory localization or child is able to directly locate a sound at any level?

Back 32

21 mos.

Front 33

T/F
Auditory development is a short process

Back 33

False
It's a long process even though I.E. is developed by birth

Front 34

T/F
Auditory development continues well into the school years

Back 34

True
Child becomes more selective and flexible in ways s/he processes sounds

Front 35

T/F
Developmental milestones provide clues about how the brain refines its control over the body and about the ways we learn to interact with the world

Back 35

True

Front 36

NIDCD

Back 36

National Institute on Deafness and Communication Disorders

Front 37

what age does the baby startle to loud noise, calm to familiar voices, and make vowel sounds like "ooh" and "ahh"?

Back 37

Birth to 3 mos.

Front 38

when do babies make a variety of sounds, "baba" or "gaba" and enjoy babbing?

Back 38

3-6 mos.

Front 39

when do babies like sound making toys, change voice pitch at will, and turn eyes and head toward sound?

Back 39

3-6 mos

Front 40

According to NIDCD, at 6-10 mos., babies respond to his/her own ____, telephone ringing, someone's voice (even when not loud), knows words for common things, makes _____ sounds even when alone, starts to respond to ______ ("come here"), and looks at things/pictures when someone talks about them

Back 40

name; babbling; requests

Front 41

List some things that a 6-9 mos. old does

Back 41

-responds to own name
-imitates speech w/ nonspeech sounds
-plays with voice repetition
-understands "no" and "bye bye"
-says "dada" and "mama"
-listens attentively to music and singing

Front 42

According to NIDCD, at 10-15 mos., plays w/ own voice, enjoying the sound and feel of it, points to or looks at _____ objects or people when asked to do so, imitates simple words and sounds, may use a few words meaningfully, and enjoys games like "____" and "____."

Back 42

familiar;
pat-a-cake;
peek-a-boo

Front 43

List some things a 9-12 mos. old can do

Back 43

-respond differently to happy or angry talking
-turns head quickly toward loud or soft sounds
-jabbers in response to human voice
-uses 2-3 simple words correctly
-gives up toys when asked
-stops in response to "no"
-follows simple directions

Front 44

at what age can a baby follow directions such as, "give me the ball."

Back 44

15-18 mos.

Front 45

T/F
A 15-18 mos. old can use words s/he has learned often and use 2-3 word sentences to talk about and ask for things

Back 45

True

Front 46

how many words does a 15-18 mo. old know?

Back 46

10-20

Front 47

how old is a baby who can identify people, body parts, and toys on request?

Back 47

12-18 mos.

Front 48

when can a baby turn his/her head briskly to source of sounds in all directions?

Back 48

12-18 mos.

Front 49

T/F
A 12-18 mos. old can tell you what s/he wants and talk in what sounds like sentences

Back 49

true

Front 50

when can a child gesture w/ speech appropriately, repeat some words you say, and bounce in rhythm w/ music?

Back 50

12-18mos.

Front 51

list some things 18-24 mos. old can do

Back 51

-follow simple commands (yes/no, "in the cup")
-speak in understandable 2 word phrases
-recognize sounds in environment
-has a vocab of 20+ words

Front 52

Typically, when does a baby like being read to and can point to pictures when asked?

Back 52

18-24 mos.

Front 53

List some things a 24-36 mos. old can do.

Back 53

-understand "not now" and "no more"
-chooses things by size(big, little)
-follows simple directions such as "get your shoes" and "drink your milk"
-understands many action words (run, jump)

Front 54

who are the most important sources of information about infant/young child's use of hearing in natural situations?

Back 54

parent and/or caregiver

Front 55

when obtaining a case hx and conducting a parent interview, what sorts of things do you want to know?

Back 55

-developmental concerns
-speech/lang. concerns
-educational concerns
-social issues

Front 56

we need as much information as possible so that if a child does not have a HL, we can make appropriate referrals for things like:

Back 56

--developmental delay
-oral motor problems
-specific lang. problems
-autism spectrum

Front 57

what topics should be covered in the case hx/parent interview?

Back 57

-chief complaint/purpose of visit
-family hx
-prenatal/pregnancy hx
-birth hx
-infant/newborn factors
-infant/childhood hx
-medical hx
-communication hx (hearing and speech)
-social hx
-education hx

Front 58

examples of questions would you ask for auditory information

Back 58

-what types of sounds does s/he react to at home? (tv, stereo, dog, parents)
-how does child react to sounds?
-what loudness of sounds evoke a response?
-does infant respond to his/her name?

Front 59

examples of questions would ask about their speech/lang.

Back 59

-what type of sounds does the infant make? (babbling, pitch, loudness, pattern)
-can child imitate sounds, words?
-what does s/he understand?

Front 60

the case hx/parent int. allows for ______ or further detail of previously completed responses to checklists, questionnaires, and case hx forms

Back 60

clarification

Front 61

The case hx/ parent int. allows for: (5 things)

Back 61

-observation of parent-child interaction
-observation of child's auditory and speech behaviors
-observation and determination of child's developmental age
-getting information useful for selecting appropriate test protocols
-establishment of rapport and trust w/child and family

Front 62

what is the simplest audiologic test and doesn't require reinforcement of responses?

Back 62

BOA
behavioral observation audiometry

Front 63

what age is BOA an appropriate test?

Back 63

6 mos. and younger or older children with disabilites

Front 64

T/F
BOA is a useful for initial hearing screenings because it is a first level indicator of the presence of normal hearing or suggestion of HL

Back 64

true

Front 65

provides an estimate of hearing in the better ear when sound presented through speakers

Back 65

BOA behav. observ. audiom.

Front 66

advantages of BOA

Back 66

--efficiency in time required to accomplish
-can be done w/ or w/out specialized equip/calibrated stimuli
-infant responses to sound toys will differ from those to familiar sounds
-provides basic inform. on hearing

Front 67

disadvantages of BOA

Back 67

-requires skillful observations of infant responses
-difficult to eliminate tester/observer bias
-wide variance in responses
-responses influenced by infants state (sleep, awake)
-responses influenced by types of sound stimuli presented
-responses reach extinction quickly

Front 68

why might by 24 mos. the child inhibit responses to auditory stimuli?

Back 68

-stimuli not interesting
-confused by presence of voice from loudspeaker
-time to move on to reinforced/conditioned response tests

Front 69

3 types of reinforcement audiometric procedures

Back 69

-visual reinforcement audiometry (VRA)
-Tangible reinforcement/operant conditioning audiometry (TROCA)
-conditioned play audiometry (CPA)

Front 70

VRA=

Back 70

visual reinforcement audiometry

Front 71

test that has more reliable results than BOA

Back 71

VRA, visual reinf. aud.

Front 72

appropriate for children 6-24 mos. with children whose unconditioned behavioral responses quickly extinguish/habituate and with children who cannot be conditioned to participate in play audiometric procedures

Back 72

VRA, visual reinf. aud.

Front 73

how does VRA work?

Back 73

The child is conditioned to respond to a sound using light, animated toys, and video as conditioning stimuli and reinforcer

Front 74

In VRA, in the conditioning/ training phase, the auditory stimulus is paired with what?

Back 74

the visual stimulus

Front 75

In VRA, in the testing phase, does the auditory stimulus and conditioned response precede delivery of reinforcement?

Back 75

yes

Front 76

T/F
In VRA, reinforcement is never provided when the desired response is produced

Back 76

false
rein. is provided when desired response is produced

Front 77

In VRA< typically how long after the stimulus onset does a valid response occur?

Back 77

within 4 seconds

Front 78

In VRA, when stimuli is presented in a sound field, the responses indicate hearing in which ear?

Back 78

the better ear

Front 79

In VRA, when stimuli presented via bone conduction oscillator, response indicate sensorineural hearing sensitivity in which ear?
what about when stimuli presented in earphone?

Back 79

better ear;
ear specific information

Front 80

TROCA=

Back 80

Tangible Reinforcement Operant Conditioning Audiometry

Front 81

when is TROCA used (age)?

Back 81

between 2-4 years

Front 82

How does TROCA work?

Back 82

child conditioned to produced a specific behavior in response to sound (e.g. push a button)

Front 83

In TROCA, positive reinforcement is usually a _____ item (stickers, toys, edibles), but can also be ______ stimulus (blinking light arrays, lighted animated toys, cartoon)

Back 83

tangible,
visual

Front 84

As with VRA, TROCA...
when stimuli presented in soundfield, which ear can hear?
When use bone conduction oscillator, which ear?
when presented in earphone, which ear?

Back 84

better ear;
better ear;
ear specific

Front 85

CPA=

Back 85

Conditioned Play Audiometry

Front 86

Most consistent behavioral technique to determine ear specific and frequency specific hearing thresholds in young children from 3 years old and up.

Back 86

CPA cond. play aud.

Front 87

How does CPA work?

Back 87

child is conditioned to indicate that they heard a sound by completing a task/playing

Front 88

In CPA, what is the reinforcement?

Back 88

a task or "fun" activity (pegs on a board, blocks in a bucket, rings on tower, pennies in bank, food for a puppet)

Front 89

First, child instructed on what they need to do--->how to play
Then, practice trials are given to assure child understands task/behavior (tones should be loud enough to hear easily)
-Remember, there should be a variety of toys/activities

Back 89

CPA cond. play aud.

Front 90

As with VRA, CPA...
stimuli in soundfield, which ear hears?
stimuli w/bone oscillator, ear?
earphones, ear?

Back 90

better ear;
better ear;
ear specific

Front 91

In CPA, the strategy is to get ear specific _____ conduction hearing information and to get ____ specific information

Back 91

air;
frequency

Front 92

what freq. should you test first in each ear? Then what frequ. do you "fill in"? what kind of noise do you use?

Back 92

-500 Hz and 2000 Hz
-1000 Hz, 250 Hz, 4000 Hz
-Narrow bands of noise and speech

Front 93

what are the most important frequency for speech?

Back 93

500, 1000, and 2000 Hz

Front 94

If a child has otitis media, it will affect which freq. the most?

Back 94

500 Hz

Front 95

The next strategy for CPA is to get _____ conduction hearing information in each ear, which frequ. do you start with?

Back 95

bone;
500 and 2000 Hz

Front 96

____ audiometry is a critical part of every audiologic evaluation

Back 96

speech

Front 97

what age can be tested using speech stimuli?

Back 97

even the youngest infants

Front 98

T/F
If an infant can respond to tones or narrow bands of noise using BOA or VRA then they can respond to speech stimuli

Back 98

True

Front 99

Types of speech stimuli

Back 99

-cold running speech
-child's name
-animal sounds, environmental noises

Front 100

what are the ling-6 sounds?

Back 100

-oo
-ah
-ee
-sh
-s
-m

Front 101

responses to speech stimuli/ ling sounds should be in agreement with tones or noise bands in what frequencies?

Back 101

500, 2000, and 4000 Hz

Front 102

hearing to 1000 Hz, hear what sounds?
hearing to 2000 Hz, hear what sounds?
hearing to 4000 Hz, hear what sounds?

Back 102

1000- oo, ah, ee, m
2000- oo, ah, ee, m, sh
4000- s from 1-2 yds. away

Front 103

behavioral responses to speech sounds may be obtained at slightly less or slightly more intense levels than for pure or warbled tones since speech is a complex signal and also more interesting

Back 103

slightly less

Front 104

results from speech audiometry can provide important information about _____ development

Back 104

auditory

Front 105

very young children (as young as 1 yr.) may be bale to point to _____ pictures and toys and body parts (potato head task)
-as children get older, vocab increases, and speech tests which incorporate picture pointing/_____ tasks are useful.
-because they are _____ set, the child's speech production is not a factor in setting accurate test results

Back 105

familiar;
identification;
closed

Front 106

test developed by Elliott Kats (1980) for use with children 3-6 years old

Back 106

NU-CHIPS
Northwestern University- Children's perception of speech test

Front 107

NUCHIPS uses _____ (#) monosyllabic words documented to be in the recognition vocab. or normal children older than 2.5 years

Back 107

50

Front 108

how many picture alternatives does the NUCHIPS test include for each test item?

Back 108

4 alternative closed picture set

Front 109

PSI=

Back 109

Pediatric Speech Intelligibility test

Front 110

developed by S. Jerger (1980), for use w/ children 3-6 yrs. old

Back 110

PSI pediatric speech intelligibility

Front 111

what is PSI used for?

Back 111

used for
-basic speech audiometry audiologic testing presented at various levels of PI function
-and for central auditory processing screening/assessment

Front 112

MCR-CCM?
MCR-ICM?

Back 112

Message to competition ratio- contralateral competing mode

Message to competition ratio- ipsilateral competing mode

Front 113

what age can most children of normal intelligence cooperate in performing "adult-level" tasks?

Back 113

5 years

Front 114

speech aud. testing s usually conducted at what loudness level under earphones?

Back 114

comfortably loud levels

Front 115

To understand how a child hears in daily listening situations and get a complete picture of a child's auditory skills, testing should also be conducted under earphones and in a soundfield at what levels?

Back 115

-soft conversational levels in quiet
-normal and soft conversational levels in competing noise

Front 116

T/F
if a child use technology, testing is only conducted with technology

Back 116

false
testing with and without technology

Front 117

a pure tone signal of a constant sound pressure level is delivered into the ear canal through a mechanical probe that is seated at the entrance of the ear canal. what type of testing is this?

Back 117

immittance audiometry

Front 118

the dB SPL of the pure tone signal, referred to as the _____, is monitored by an immittance meter.

Back 118

probe tone

Front 119

any change is noted as a change in _____through the ME system

Back 119

energy flow

Front 120

Benefits of Immittance Audiometry

Back 120

-non behavioral responses
-"objective" tests
-can test despite patient's age, mental status, state of consciousness, ability to respond
-provides information on mechanical function and status of ME
-can be used to assess the integrity of cochlea, auditory nerve, brainstem, facial nerve
-site of lesion/differential diagnosis
-some information on "hearing"

Front 121

2 basic immittance tests

Back 121

-tympanometry and static acoustic admittance/compliance
-Acoustic reflex threshold testing

Front 122

what can tympanometry and static acoustic admittance/ compliance measure?

Back 122

-ear canal volume
-the peak amplitude of eardrum and ME system
-the point of maximum pressure compliance

Front 123

ear canal volume helps determine whether the _____ is intact.

Back 123

tympanic membrane

Front 124

the peak amplitude of eardrum and ME system helps determine _____ and ____ of the ME system

Back 124

resistance and compliance

Front 125

the point of maximum pressure compliance helps assess the function of the _____.

Back 125

eustachian tube

Front 126

5 typical responses noted on tympanometry

Back 126

Type A
Type AD
Type AS
Type B
Type C

Front 127

indicates normal compliance of the system

Back 127

Type A

Front 128

seen w/ an overly compliant ME system, such as monomeric tympanic membrane or disarticulation of ossicles

Back 128

Type AD

Front 129

seen with an overly stiffened ME system, such as with otosclerosis, tympanosclerosis or resolving serous effusion

Back 129

Type AS

Front 130

found when there is fluid present behind the tympanic membrane, obstruction in the ear canal, or a TM perforation

Back 130

Type B

Front 131

seen when Eustachian tube is not functioning properly, causing the pressure behind the tympanic membrane to become less than the pressure in front of the membrane

Back 131

Type C

Front 132

some protection is afforded when the _____ muscle contracts in response to loud sounds.
(decreased amt. of energy flows into the IE from the ME)

Back 132

stapedius

Front 133

immittance audiometry can be stimulated in what 2 ways?

Back 133

ipsilaterally and contralaterally

Front 134

immittance measures provide some information on "____" and allow for site of _____ diagnosis.

Back 134

"hearing"
lesion/differential