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148 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Auropalpebral reflex
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24-25 week fetus
Auditory Development |
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Arousal from sleep
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Auditory Development
Newborn – 3 months |
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Eye widening
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Auditory Development
Newborn – 3 months |
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Beginning sucking
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Auditory Development
Newborn – 3 months |
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Slow head turn toward sound
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Auditory Development
Newborn – 3 months |
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Cessation of sucking
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Auditory Development
Newborn – 3 months |
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Change in breathing
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Auditory Development
Newborn – 3 months |
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Startle reflex
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Auditory Development
Newborn – 3 months |
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Makes vowel sounds “oo” and “ahh”
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Speech/Lang. Development
Newborn – 3 months |
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Calms to familiar voices
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Speech/Lang. Development
Newborn – 3 months |
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Changes voice pitch at will
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4-7 months
Speech/Lang. Development |
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Makes a variety of sounds “ba-ba” and “ga-ba”
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4-7 months
Speech/Lang. Development |
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Enjoys babbling
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4-7 months
Speech/Lang. Development |
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Direct turn toward sound
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4-7 months
Auditory Development |
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Head turns on lateral plane only
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4-7 months
Auditory Development |
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Wobbly head turn toward sound
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4-7 months
Auditory Development |
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says “da-da” or “ma-ma”
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7-9 months
Speech/Lang. |
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Begins identifying the location of sound with direct head turn
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7-9 months
Aud. |
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Responds to own name
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7-9 months
Speech/Lang. |
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Localizes to side and directly below
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7-9 months
Aud. |
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Imitates speech with non-speech sounds
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7-9 months
Speech/Lang. |
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Plays with voice repetition, “la-la-la-la”
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7-9 months
Speech/Lang. |
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Understands “no” and “bye-bye”
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7-9 months
Speech/Lang. |
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Listens attentively to music and singing
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7-9 months
Speech/Lang. |
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Follows simple directions
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9-13 months
Speech/Lang. Development |
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Stops in response to “no”
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9-13 months
Speech/Lang. Development |
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Gives up toys when asked
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9-13 months
Speech/Lang. Development |
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Uses two or three simple words correctly
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9-13 months
Speech/Lang. Development |
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Jabbers in response to human voice
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9-13 months
Speech/Lang. Development |
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Turns head quickly toward loud or soft sounds
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9-13 months
Speech/Lang. Development |
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Responds differently to happy or angry talking
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9-13 months
Speech/Lang. Development |
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Localizes in any plane above or below eye level
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9-13 months
Aud. Development |
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Has a vocabulary of 20 words or more
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13 months and older
Speech/Lang. Development |
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Recognizes sounds in the environment
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13 months and older
Speech/Lang. Development |
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Follows simple commands
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13 months and older
Speech/Lang. Development |
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Speaks in understandable two word phrases
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13 months and older
Speech/Lang. Development |
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Willful inhibition of localization response
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13 months and older
Aud. Development |
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Gestures with speech appropriately
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13 months and older
Speech/Lang. Development |
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Talks in what sounds like sentences
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13 months and older
Speech/Lang. Development |
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Can tell you what he or she wants
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13 months and older
Speech/Lang. Development |
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Locates directly a sound at any angle
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13 months and older
Aud. Development |
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Bounces in rhythm with music
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13 months and older
Speech/Lang. Development |
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Identifies people, body parts, and toys on request
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13 months and older
Speech lang. development |
13 months and older |
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Localizes directly all signals to side below and above
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13 months and older
Aud. development |
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Cartilaginous stapes formed
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Fetal Week 15
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Ossification of malleus and incus begins
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Fetal Week 16
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Stapes begins to ossify
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Fetal week 18
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Maturation of inner ear; inner ear adult size
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Fetal week 20
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Auricle is adult shape but continues to grow until age 9
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Fetal week 20
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Meatal plug disintegrates, exposing tympanic membrane
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Fetal week 21
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pneumatization of tympanum
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Fetal week 30
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External auditory canal continues to mature until age 9
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Fetal week 30
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Malleus and incus complete ossification
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Fetal week 32
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Mastoid air cells develop
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Fetal week 34
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Antrum is pneumatized
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Fetal week 35
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Epitympanum is pneumatized; stapes continues to develop until adulthood; tympanic membrane changes relative position during first 2 years of life
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Fetal week 37
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Auditory placode; auditory pit begin to develop
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Fetal week 3
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tubotympanic recess begins to develop
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Fetal week 3
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Auditory vesicle (otocyst); Vestibular-cochlear division
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Fetal week 4
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Tissue thickenings begin to form
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Fetal week 4
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beginning of vestibular labyrinth present
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Fetal week 5
First Trimester |
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Primary auditory meatus begins
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Fetal week 5
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Utricle and saccule present; semicircular canals begin
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Fetal week 6
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Six hillocks evident; cartilage begins to form
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Fetal week 6
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One cochlear coil present; sensory cells in utricle and saccule (cristae & maculae)
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Fetal week 7
First trimester |
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Auricles move dorsolaterally
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Fetal week 7
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Ductus reunions present: sensory cells in semicircular canals
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Fetal week 8
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Incus and malleus present in cartilage; lower half of tympanic cavity formed including Eustachian tube
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Fetal week 8
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Outer cartilaginous third of external canal formed
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Fetal week 8
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Three tissue layers at tympanic membrane are present
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Fetal week 9
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Two and one-half cochlear coils present; nerve VIII attaches to cochlear duct
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Fetal week 11
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Sensory cells in cochlea; membranous labyrinth complete; otic capsule begins to ossify
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Fetal week 12
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When does the major formation of palate happen?
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Fetal week 6
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At what fetal week does the proper terminology change from embryo to fetus?
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Fetal week 8
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What do the letters in the acronym APGAR mean?
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Appearance, Pulse, Grimace, Activity, Respiration
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Stimulus and Level of Response
Auditory Behavior 0-6 weeks |
Noise Makers ( dB SPL):50-70
Warbled Pure Tones:75 Speech:40-60 Startle to speech: 65 |
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Stimulus and Level of Response
Auditory Behavior 6 weeks – 4 months |
Noise Makers ( dB SPL):50-60
Warbled Pure Tones:70 Speech:45 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 4-7 months |
Noise Makers ( dB SPL):40-50
Warbled Pure Tones:50 Speech:20 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 7-9 months |
Noise Makers ( dB SPL):30-40
Warbled Pure Tones:45 Speech:15 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 9-13 months |
Noise Makers ( dB SPL):25-35
Warbled Pure Tones:38 Speech:10 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 13-16 months |
Noise Makers ( dB SPL):25-30
Warbled Pure Tones:30 Speech:5 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 16-21 months |
Noise Makers ( dB SPL):25
Warbled Pure Tones:25 Speech:5 Startle to Speech:65 |
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Stimulus and Level of Response
Auditory Behavior 21-24 months |
Noise Makers ( dB SPL):25
Warbled Pure Tones:25 Speech:5 Startle to Speech:65 |
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Expected response
Auditory Behavior 0-6 weeks |
Eye-widening, eye-blink, stirring or arousal from sleep, startle
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Expected response
Auditory Behavior 6 weeks – 4 months |
Eye-widening, eye-shift, eye-blink, quieting; beginning rudimentary head turn by 4 months
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Expected response
Auditory Behavior 4-7 months |
Head-turn on lateral plane toward sound; listening attitude
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Expected response
Auditory Behavior 7-9 months |
Direct localization of sounds to side, indirectly below ear level
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Expected response
Auditory Behavior 9-13 months |
Direct localization of sounds to side, directly below ear level, indirectly above ear level
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Expected response
Auditory Behavior 13-16 months |
Direct localization of sound on side, above and below
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Expected response
Auditory Behavior 16-21 months |
Direct localization of sound on side, above and below
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Expected response
Auditory Behavior 21-24 months |
Direct localization of sound on side, above and below
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Ectoderm (Outermost layer) forms the...
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Epidermis of the skin
Much of the teeth Entire nervous system Hair Nails Epithelial tissue of mouth and pharynx Sense organs – Outer & Inner Ear (Every Monday Ella had noodles, eggplant, & sauce.) |
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Mesoderm (Intermediate layer) froms the
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Forms most of the connective tissue.
Bones (ossicles, bone surrounding inner ear) Muscles Blood vessels Cartilage Kidneys Reproductive organs (Both men & boys can kill rabbits) |
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Endoderm (Deepest layer)
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Forms epithelial lining of :
the entire digestive tract the entire respiratory tract |
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Embryo
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Greek word meaning to swell
Term for developing baby for the first 8 weeks of life |
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Fetus
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Latin word meaning offspring
Term used the remainder of gestation |
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Nervous system development
week 4 |
Ganglion cells from
VIII nerve arise |
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Nervous system development
week 5 |
Nerve fibers enter
expanding cochlea Cochlear portion fans out in synchrony with curving cochlea |
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Nervous system development
11th and 12th weeks |
Radial dendrites
contact IHCs |
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Nervous system development
14th Week |
Spiral fibers contact
base of the OHCs |
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Nervous system development
15th - 22nd Weeks |
Efferent 1st, then
afferent inneveration with axons |
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Neurological Development
7th Month |
All synapses formed
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Conditions for beginning to hear.
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Connections between the apex of hair cells
and the tectorial membrane Adequate internal structure of hair cells Mature synapses between base of hair cells and nerve fibers Maturity of ganglion cells Thinning of the basilar membrane Degeneration of pseudo stratified epithelium of the inner spiral sulcus Maturity of pillar cells Freeing of the inferior margin of the tectorial membrane from the organ of Corti Forming of spaces in the tunnel of Corti and around the OHCs |
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Sensorineural system mature enough to
experience sensation of sound near what month? |
6th 0r 7th
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1st Branchial Arch
Called Mandibular or Meckel’s Arch |
Lower lip
Muscles of mastication Mandible Anterior portion of the tongue Malleus Incus |
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2nd Branchial Arch
Called Hyoid or Reichert’s Arch Gives rise to: |
Upper body and lesser horns of the hyoid bone
Stapes Muscles of facial expression |
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3rd Branchial Arch
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Lower body of the hyoid bone
Posterior portion of the tongue |
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4th and 5th Branchial Arches Give rise to:
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Cricoid and arytenoid cartilages of the larynx
Cartilages of the trachea |
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6th Branchial Arch
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Intrinsic laryngeal muscles
Possibly the cricoid cartilage |
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Auropalpebral reflex
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An involuntary eyeblink in response to a loud
transient acoustic stimulus |
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Acute OM
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– Sudden onset
– Severe ear pain – Red TM, can be bulging – Fever – Usually a sequel to URI – Can be with or without effusion (OME vs. OM) – Lasts 0-21 days |
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• Subacute
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– Lasts 22 days – 8 weeks
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• Chronic OM
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– Persists for longer than 8 weeks
– Slow onset – Large TM perforation – Ear discharge |
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Early Hearing Detection and
Intervention goal- 1 month |
1 month: all newborns
should have access to hearing screening using a physiologic measure |
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Early Hearing Detection and
Intervention goal- 3 month |
– 3 months: all infants
who do not pass the initial hearing screen and rescreening should have a diagnostic audiologic evaluation |
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Early Hearing Detection and
Intervention goal- 6 month |
6 months: all infants
with confirmed hearing loss should receive intervention services |
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Birth through 6 Months
Screening criteria for passing |
Pass
• Reliable responses in BOTH ears • ABR 35 dBnHL or lower • OAE if acceptable reproducibility is reached |
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7 Months through 2 Years
Screening criteria for passing |
• Reliable responses in BOTH ears
• VRA with earphones at 1K, 2K, 4K Hz at 30 dB HL • Play audiometry at 1K, 2K, 4K Hz at 20 dB HL |
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What is the first age professionals other than AUDs can screen hearing?
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Age 3
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3-5 Years
Screening criteria for passing |
• Reliable responses at screening criteria 2/3 times at each
frequency in BOTH ears • Play audiometry at 1K, 2K, 4K Hz at 20 dB HL |
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5 through 18 Years
Screening criteria for passing |
• Reliable responses at screening criteria at each frequency in
BOTH ears • Audiometry at 1K, 2K, 4K Hz at 20 dB HL |
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When do you Refer for Complete
Audiological Evaluation? |
Child fails both pure tone and immittance
screening • Immittance screening is abnormal one week after initial screening or following medical treatment • Child fails pure tone screening but passes immittance • Child fails pure-tone rescreen with no immittance screening performed |
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Pediatric Case History includes...
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Birth history including:
Birth weight, APGAR scores, NBHS results, hyperbilirubinemia, other risk factors, etc. Medical history including: trauma, ototoxic meds, serious illnesses, middle ear pathology, surgery, noise exposure Physical and neurological development Communicative behavior and development When was hearing loss suspected and why Family history of hearing loss (BSL makes physical communication wonderfully fast) |
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BOA is...
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Doesn’t incorporate
reinforcement Active response from an infant passively involved in the task at hand |
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BOA Advantages
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Efficiency in time
Lack of special equipment |
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BOA disadvantages
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Difficult to eliminate tester bias
Responses quick to reach extinction Definition of response – wide variety Parameters of the acoustic stimulus State of the infant or child |
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BOA reflexive behaviors
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Startle response
Arm or leg jerks Slow limb movements Auropalpebral reflex (APR) Change in sucking behavior Eye-blinks Facial twitches (so as she already commented earlier friday...) |
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BOA Attentive Behaviors
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Quieting responses
Increase in ongoing activity Change in breathing or sucking rate Onset of vocalization Sudden stopping of vocalization Starting or stopping crying Eye widening Searching or localization Head turning Smiling or other change in facial expression Brow furrowing Shriek of surprise Look at parent |
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What is the most reliable response for BOA 0-6 months?
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sucking
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WHen can you start using conditioned responses?
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Between 6-8 months depending on the child.
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How is VRA done?
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Parents or assistants in the room
may need to wear hearing protection Speech stimuli are more effective than warble tones Can be used for aided responses as well Use only 1 reinforcer, usually placed on top of loudspeaker Can be performed via soundfield, inserts, or earphones! |
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What does VRA reinforcement do?
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Maintains the child’s responses longer
Reduces habituation to the stimulus New research trying to maintain the interest of the child longer “Frequency specific” animal sounds Paired with the corresponding animal Paired with a different animal Video reinforcement |
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Pediatric Case History includes...
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Birth history including:
Birth weight, APGAR scores, NBHS results, hyperbilirubinemia, other risk factors, etc. Medical history including: trauma, ototoxic meds, serious illnesses, middle ear pathology, surgery, noise exposure Physical and neurological development Communicative behavior and development When was hearing loss suspected and why Family history of hearing loss (BSL makes physical communication wonderfully fast) |
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BOA is...
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Doesn’t incorporate
reinforcement Active response from an infant passively involved in the task at hand |
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BOA Advantages
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Efficiency in time
Lack of special equipment |
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BOA disadvantages
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Difficult to eliminate tester bias
Responses quick to reach extinction Definition of response – wide variety Parameters of the acoustic stimulus State of the infant or child |
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BOA reflexive behaviors
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Startle response
Arm or leg jerks Slow limb movements Auropalpebral reflex (APR) Change in sucking behavior Eye-blinks Facial twitches (so as she already commented earlier friday...) |
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BOA Attentive Behaviors
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Quieting responses
Increase in ongoing activity Change in breathing or sucking rate Onset of vocalization Sudden stopping of vocalization Starting or stopping crying Eye widening Searching or localization Head turning Smiling or other change in facial expression Brow furrowing Shriek of surprise Look at parent |
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What is the most reliable response for BOA 0-6 months?
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sucking
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WHen can you start using conditioned responses?
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Between 6-8 months depending on the child.
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How is VRA done?
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Parents or assistants in the room
may need to wear hearing protection Speech stimuli are more effective than warble tones Can be used for aided responses as well Use only 1 reinforcer, usually placed on top of loudspeaker Can be performed via soundfield, inserts, or earphones! |
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What does VRA reinforcement do?
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Maintains the child’s responses longer
Reduces habituation to the stimulus New research trying to maintain the interest of the child longer “Frequency specific” animal sounds Paired with the corresponding animal Paired with a different animal Video reinforcement |
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COR
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Conditioning and Testing phases are
the same as for VRA Major difference is that 2 reinforcers are used and localization is expected before a response is recorded |
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VRA Order of Test Stimuli
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Assume each threshold is your last
Try to start with 2000 Hz If you think loss is SNHL Then go to 500 Hz Followed by 4000, 1000 and 250 Hz Or 1000 Hz first if big difference b/w 2000 and 500 Hz Earphones/inserts then bone conduction if possible |
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Tangible and Visual Reinforcement
Operant Conditioning Audiometry (TROCA) is... |
Child pushes button when sound is
heard and a tangible reinforcement is received, usually accompanied by secondary social approval Most useful with children 2-4 years Takes longer than VRA |
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CPA is appropriate for what age?
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Cognitive age of 30 months
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Conditioned Play Audiometry
(CPA) is... |
Ages 30 months up to 5
years ear-specific results frequency-specific stimuli AC and BC may need serial tests or long breaks conditioning phase and testing phase |
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Examples of CPA toys
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blocks in bucket
rings on pole pegs in board pieces in a puzzle computer pictures (BTNRH) |
