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Lecture 1

LING 4P27 Lecture Notes - Lecture 1: Pure Tone Audiometry, Auditory Brainstem Response, Otoacoustic Emission

Course Code
Barbra Zupan

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Lecture 1
September 13, 2016
Assistive Listening Devices and Aural Rehabilitation
Office hours: Tuesdays 12-1
Prevalence of HL in Canada
Prevalence of permanent childhood hearing impairment is about 1 in 1000
live births
o Includes only children who have an impairment greater than 40dB in
their better ear (about a mild moderate hearing loss)
o With IHP, average age of diagnosis is 3 months
Do test right in the hospital when born, but can’t say they failed
because sometimes there’s still fluid in the canal from birth so
we retest a few weeks later to do a full evaluation
Approximately 10% of the population has hearing loss
o 20% of people over 65
o 40% of people over 75
What is Auditory Rehabilitation?
Complementary, interrelated and overlapping services provided by
Audiologists and SLPs
o Primary role of SLP: once we know the hearing loss and know the
degree we set the goals, evaluate perceptive skills
o See figure 1.1 page 4
o To improve communication within the person’s environments
o Alleviate difficulties
o Minimize consequences
Rehabilitation people over 18. Goal is to restore lost function
o People who don’t get diagnosed until after  years old, because by
then all your speech and language is in place
o Giving strategies to be successful in your environments
Habilitation people below 18. Goal is to teach function
o Make sure you’re developing at the rate we might expect and make
sure you aren’t years behind your chronological age development
Who is Involved in Service Delivery?
Parents and family members
Audiologists and SLPs
Teachers of the deaf
o Would act like a resource teacher
Classroom teachers
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o )f they’re in the school, they need to know the child’s goals and
strategies to help the child be successful
o Educating them is useful
Early childhood specialists
Social workers
o Help with behavioural things
o Can be traumatic to find out
o To help parents choose a mode of communication (oral or ASL)
o Can help with paperwork
Hearing aid dispensers
o Also sometimes the audiologist
Physicians (e.g., ENT), nurses
Service Delivery Location
Schools, daycare centers
Hospitals, residential facilities
Doctor’s office
Clinics (SLP, audiologist)
Table 1.1 p. 8
The Basics of Audiometry
Non-behavioural vs. behavioural tests
Types of tests:
o Auditory brainstem response
o Otoacoustic emissions
o Immittance tests
o Pure tone audiometry
o Visual reinforcement
o Conditioned Response
o Play audiometry
Air and bone conduction
Interpreting Audiograms
Frequency X axis
Amplitude/loudness Y axis
o Sound-field (S) sometimes instead of using headphones, we use
speakers on either side of the room
Some children can’t tolerate headphones so speakers are used
Once they have their cochlear implant we want to test if it’s
o Aided sound-field (A)
Softest sound that can be heard with aids
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o X left ear (air)
o O right ear (air)
o [ - left ear (bone)
o ] right ear (bone)
Categorizing Hearing Loss: Degree
o Severity based on predefined categories
Moderately severe
Table 1.2 p 11
Hearing Loss Simulations
Google: audiogram of familiar sounds
Categorizing Hearing Loss: Type
o Problem is with outer or middle ear
Amplification function is reduced or eliminated and/or sound
is blocked
o Air-bone gap > 10dB
o Generally corrected with medical intervention
o Loss rarely exceeds 60dB (more on the moderate side)
o Most common is ear infection (otitis media)
o Typically temporary and can be treated with medication
o Sound gets blocked in some way and can’t travel through the ear the
way it was supposed to
o Problem is in inner ear and/or auditory nerve
May be due to absence or malformation of structures
o Cannot be corrected with medical intervention
o Affects clarity of sound
o Permanent hearing loss
o Inside the cochlea, some of the hair cells die. Depending on where
they are in the cochlea, if you’re missing certain hairs in certain areas,
the sound becomes distorted
o You get some of the information, not all of the information
o Once hair cells are dead, they can’t come back
However can replace with cochlear implants
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find more resources at
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