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Hearing Screening in Preschool Children (3-5 years)

Hearing Screening in Preschool Children (3-5 years). GOAL. T o identify children most likely to have hearing loss that may interfere with communication, development, health, or future school performance.

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Hearing Screening in Preschool Children (3-5 years)

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  1. Hearing Screening in Preschool Children (3-5 years)

  2. GOAL • To identify children most likely to have hearing loss that may interfere with communication, development, health, or future school performance

  3. Because hearing loss in this age range is so often associated with middle ear disease, it is also recommended to screen for outer and middle ear disorders (acoustic immittance screening).

  4. SCREENING • Screening procedures to detect unilateral or bilateral sensorineural and/or conductive hearing loss greater than 20 dB HL in the frequency region from 1000 through 4000 Hz are applicable to this age group

  5. SCREENING TESTS • Conditioned Play Audiometry (CPA) • Acoustic Immittance screening - Tympanometry - Acoustic Reflex - Static Acoustic Impedance

  6. Conditioned Play Audiometry • Most commonly used screening test • A behavioral audiometric test obtained in a sound-treated room. • The child is shown how to perform a repetitive play task, such as placing a peg in a pegboard, each time he or she hears a sound. • The child is tested in a sound-treated room. • Accurate separate-ear audiograms by air and bone conduction may be obtained.

  7. Tympanometry • Used to test the condition of the middle ear, mobility of the TM, and conduction bones • Procedure: - Introduces air pressure into the ear canal making the eardrum move back and forth. - A special machine then measures the mobility of the eardrum. • Results: - Tympanograms, or graphs, are produced which show stiffness, floppiness, or normal eardrum movement.

  8. Acoustic Reflex • Mainly useful as a crude but non-subjective method of evaluating hearing, as the stapes should tighten for a given level of perceived loudness. • Can also be a sign of brainstem dysfunction. • Procedure: -A soft probe to apply a small amount of pressure is placed into the ear canal and a small and then the movement of the tympanic membrane in responses to the pressure changes is measured • Results: -The result of the test is recorded in a tympanogram. - Fluid in the middle ear – the TM will not vibrate properly and the line on the tympanogram will be flat - Air in the middle ear (the normal condition) but at a higher or lower pressure than the surrounding atmosphere - line on the tympanogram will be shifted in position

  9. Normal tympanogram. Normal pressure in the middle ear with normal mobility of the eardrum and the conduction bones.

  10. Tympanograms may reveal fluid in the middle ear, perforation of the tympanic membrane, scarring of the tympanic membrane, lack of contact between the conduction bones of the middle ear or a tumor in the middle ear.

  11. Static Acoustic Impedance

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