EARLY IDENTIFICATION AND

MANAGEMENT OF HEARING IMPAIRMENT

Prepared by,
Sruthi Jinoy
Audiologist
IMPORTANCE OF HEARING
•Awareness

•Localization
Communication skills
•Identification

•Discrimination
FUNCTION OF HEARING
 SIGNS & SYMPTOMS OF HI
•Difficulty in following simple instructions

•Gives the wrong answers to questions

•Does not respond to name call

•Difficulty in identifying different sounds

CAUSES OF HEARING LOSS

PRE-NATAL PERI-NATAL POST-NATAL

Maternal infections Trauma at birth Infections

Pre mature birth hypoxia High level of noise
Age of the Response
baby
A few weeks Open eyes, eye blinks, look alert
old
About 6 Head turns towards the sound source
months
About 9 Listening to loud and soft sounds
months and making all sorts of sounds
About 1 year Responds to name call, starts 1st
word
About 18 Responds to simple commands and
months point familiar things
 IMPORTANCE OF EARLY
IDENTIFICATION OF HI
•Good hearing is important for speech and language
development.

•Good speech and hearing are important for

communication.

•Good communication is important for learning in the

home and at school.

•Learning is important if a child is to develop to their full

potential.
 BASIC HEARING ASSESSMENT
•Oto Acoustic Emission(OAE) Special testes
UCL,MCL
•Pure Tone Audiometry (PTA) SISI,TDT
•Speech Audiometry SAT,SRT,SDS
•Immitance Audiometry

BEHAVIOURAL HEARING ASSESSMENT

•Free Field Audiometry/Behavioural Observation Audiometry
•Visual Reinforcement Audiometry

ADVANCED HEARING ASSESSMENT

•Brainstem Evoked Response Audiometry (BERA)
•Auditory Steady State Response(ASSR)
•Vestibular Evoked Mayogenic Potential (VEMP)
•ECochG
 OTOACOUSTIC EMISSION
Otoacoustic emission (OAE) tests is to determine cochlear status,
specifically hair cell function.Quick screening tool.

•Spontaneous OAE

•Transient evoked OAE

•Distortion product OAE

•Stimulus frequency OAE

Healthy hair cells

 PURE TONE AUDIOMETRY
•Audiometer is an electronic device which produces pure tones.

PURE TONE AUDIOMETRY PROCEDURES

•AC thresholds are measured from 250 to 8000Hz

•BC thresholds from 250 to 4000Hz

This is charted on a graph called audiogram

 SPEECH AUDIOMETRY

•Speech audiometry is a test to see how well hear and

distinguish words.

•Speech audiometry generally confirms pure

tone audiometry results.

•It is an important part of your overall hearing assessment.

 LIMITATIONS OF PTA

•Improper test condition

•Improper test instrument-calibration

•Malingering

•Not able to do in new borns

•Subjective and time consuming test

BERA, ASSR & ECochG
VESTIBULAR EVOKED MYOGENIC POTENTIAL [VEMP]
 IMPEDANCE AUDIOMETRY
•Tympanometry is a test of middle ear functioning.

• Impedance testing is crucial in distinguishing a conductive loss

from a sensorineural hearing loss.

•A typical tympanometry result indicates the ear canal volume

(cm3), the max pressure (daPa) and the peak compliance (ml).
 HEARING LOSS

Partial or total inability to hear.

Types of hearing loss

Conductive hearing loss

Sensorineural hearing loss

Mixed hearing loss

Conductive Hearing Loss
 Sensorineural Hearing Loss

•Age

•Noise

•Diseases and Infections

•Tumor

•Ototoxicity

•Radiations
Grade of Level tested with Level tested with Recommendations
impairment an Audiometer the Voice Test

Normal hearing 25 dB or better Able to hear whispers _

Mild 26-40 dB Able to hear and repeat Counselling.

impairment words spoken in Hearing aids may
conversational voice in be needed
1 metre
Moderate 41-70 dB Able to hear and repeat HA usually
impairment words using loud voice recommended
at 1 metre
Severe 71-90 dB Able to hear only loud HA needed. Use of
impairment sounds lip reading or sign
language if HA is
not available
Profound > 90 Db Unable to hear and HA can be used for
impairment understand even loud sound awareness,
sounds speech reading can
be used.
MANAGEMENT
EAR PROTECTIVE DEVICES
BODY WON HA BTE
 CIC

ITE

CIC
RECEIVER IN THE CANAL HEARING AIDS
 PUTTING WAX CLEANING
GUARD TOOL

BATTERY DEHUMIDIFIER KIT

Where to place the phone while using hearing aid?
 COCHLEAR
IMPLANT

ONDUCTION IMPLANT SYSTEM

 REASON TO GO BINAURAL

•Better understanding of speech

•Better ability to tell the direction sounds are coming from

•Greater listening comfort

•Better understanding in group & even noisy situations

•Better sound quality

 AUDITORY VERBAL THERAPY

•This treatment helps HI child to develop listening skills

•Treatment beginning as young as 3 months of age

•Sign language and other visual methods of intervention are not used

•Hearing aids and cochlear implant(s) are the child’s link to the hearing-speaking
world

•Half hour therapy session including parents

•Materials are often provided for home practice and carry-over

•Goals are created to address your child’s speech, language, listening, cognitive,
and literacy development
 Hearing is one of the important of 5 senses
Don’t be delay for early identification and management

THANK YOU