History of hearing testing
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HISTORY OF HEARING TESTING. Audiology. Audio - Latin…to hear, pertaining to hearing Logy - Greek…logus…science Therefore the science of hearing and hearing disorders. Facets of audiology. Discovery Evaluation Rehabilitation. Lineage of Audiology.

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HISTORY OF HEARING TESTING

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History of hearing testing

HISTORY OF HEARING TESTING


Audiology

Audiology

  • Audio - Latin…to hear, pertaining to hearing

  • Logy - Greek…logus…science

  • Therefore the science of hearing and hearing disorders


Facets of audiology

Facets of audiology

  • Discovery

  • Evaluation

  • Rehabilitation


Lineage of audiology

Lineage of Audiology

  • Originated during and just after WW II (1945-46)

  • Originally audiologists were SLP’s or ENT’s

  • Father of Audiology is Raymond Carhart (he and Norton Canfield coined the term “audiology


Reason for the field of audiology

Reason for the field of Audiology

  • The government became concerned with hearing disorders

    when VA hospitals had military with hearing problems due to:

    -direct injury—gunshot, shrapnel

    -disease—jungle rot

    -acoustic trauma—high intensity noise (cannons,guns,etc)

    -emotional disorders - “shell shock” (protective device)

  • Aural rehabilitation hospitals opened all over the nation and were interested in:

    -conservation of hearing

    -habilitation and rehabilitation programs

    -diagnosis (Dx) of hearing loss related to medical problems

    -educational placement and programs for the hearing impaired


Academic qualifications for audiologist

Academic Qualifications for Audiologist

  • BA/BS in Communicative Disorders or equivalent

  • MA/MS in Audiology

  • Pass national written examination (formerly NESPA)

  • Complete Clinical Fellowship Year (CFY)

  • Certificate of Clinical Competence in Audiology (CCCA)

  • State License (usually CCCA + fees)

  • Au.D. or equivalent will be needed by 2007

  • Ph.D. and FAAA is optional at this time


Other hearing health professionals

Other Hearing Health Professionals

  • Otolaryngologist

  • Hearing Conservationist

  • Hearing Aid Specialist

  • Audioprosthologist

  • Audiometrist


Professional opportunities for audiologists

Professional Opportunities for Audiologists

  • Teaching

  • Clinical

  • Research

  • Administration


Hearing tests and their development non audiometric

Hearing Tests and their Development (non-audiometric)

  • Watch tick

  • Coin-click

  • Conversational voice

  • Noise makers

  • Tuning fork tests (Demonstrate using tuning fork)

    • Schwabach Test (also called the time threshold test)

    • Rinne Test

    • Bing test

    • Weber


Pure tone audiometry

Pure Tone Audiometry

  • Normal hearing (intensity) = 0—25dB (ANSI)

  • We hear 20—20,000 Hertz (frequency)

  • We only test 250—8,000 Hertz (Hz)

  • 250, 500, 1000, 2000, 3000, 4000, 6000 & 8000Hz are the individual frequencies at which we test by AC

  • 250, 500, 1000, 2000 and 4000Hz are the frequencies for BC

  • Quiet environment needed (otocups, insert phones and booths

  • Occlusion effect—the increase of loudness of pure tones at 1000 Hz or lower. Happens in normal, sn—not in conductive losses.

  • Sweep check vs. threshold testing


Otoscope

Otoscope


Performing the pure tone test

Performing the Pure Tone Test

  • Check calibration of audiometer

  • Otoscopic inspection (wax, collapsed canal, drainage etc.)

  • Patient instructions

  • Question: Which is your better ear?

  • Hairdos, wigs, glasses and earrings

  • Correct placement of earphones (TDH 39)

  • Correct placement of the patient


Performing the pure tone test continued

Performing the Pure Tone Test (continued)

  • Pulsed or continuous signal

  • Present tone with about 1 second duration

  • Be aware of eye contact

  • Watch out for “rhythm system”

  • Red, right, round. Blue X’s for left (AC)

  • Bone conduction (BC) thresholds and symbols

  • Masking for AC and BC

  • Maximum output at each frequency


Patient responses

Patient Responses

  • False negative

  • False positive

  • Validity vs. reliability

  • Down 10; up 5 rule

  • Determine threshold

  • Test re-test reliability

  • Pure tone average (PTA)

  • Tactile responses (cutile)

  • Cross hearing and interaural attenuation (IA) AC & BC


Masking

Masking

  • Narrow band

  • White noise (broad band or wide band noise)

  • Effective masking

  • Over masking (OM

  • Speech noise

  • Complex noise

  • Other masking (saw tooth, pink noise etc.)

  • Plateau Method


Calculation of percentage of hearing loss

Calculation of Percentage of Hearing Loss

  • Average thresholds at 500, 1K, 2K and 3KHz

  • Subtract 25 dB

  • Multiply X 1.5 for each ear = % of loss per ear

  • Binaural loss %’age = better ear X 5 + poorer ear %age divided by 6 = binaural percentage loss


Audiograms

Audiograms

  • Table audiogram

  • Graph audiogram


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