SB Chapter 68, Hearing Test in Children

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Scott-Brown’s Chapter 68: Hearing Tests in Children

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Transcript of SB Chapter 68, Hearing Test in Children

Page 1: SB Chapter 68, Hearing Test in Children

Scott-Brown’s Chapter 68:Hearing Tests in Children

Page 2: SB Chapter 68, Hearing Test in Children

ELECTROPHYSIOLOGICAL TESTING• Key developmental age: 0-6 months, up to adult if appropriate• Include: otoacoustic emission (OAE), auditory brain stem response (ABR)

and cortical evoked response audiometry (CERA)• Dilakukan utk:

– newborn screening– tes diagnostik pada infant – 6 bulan– anak” dgn usia berapapun, jika Behavioural testing tidak memberikan hasil yg

dpt dipercaya, khususnya yg kesulitan berat dalam belajar dan komunikasi– Menentukan ambang pendengaran pd anak-anak dengan gangguan

pendengaran yang mendalam, sebelum pemasangan high power hearing aids, implantasi koklea, atau krn faktor nonorganik

• Butuh anastesi umum• Electrophysiological testing lbh objektif, sdgkn behavioural or speech

discrimination testing hny menilai fungsional dr complete auditory system

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BEHAVIOURAL OBSERVATION AUDIOMETRY (BOA)

• Key developmental age: 0-6 months• Menilai perubahan aktivitas sbg respon thdp stimulus• Response behaviours in infants – 4bulan:

– eye widening, eye blink (auropalpebral reflex), bangun dr tidur, badannya kaget atau gemetar, gerakan nyata dari lengan, kaki atau badan.

• 4bulan – 7 bulan:– kepala miring lateral ke arah suara atau sikap mendengarkan

atau tenang/diam• Posisi: anak terbuai dalam pangkuan orang tua (dipeluk)

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• The sound stimulus is:– presented for < 2 seconds– in a horizontal plane– 15 cm from the child's ear– out of peripheral vision

• A wide variability in judgement of response between testers misinterpretation of random movements and a tendency to underestimate hearing thresholds

• Utk kurangi bias pengamat prosedurnya direkam video, dinilai kembali tanpa dengar suaranya

• Penggunaan BOA utk infant – 6bulan udah diganti sm teknik Electrophysiological.

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THE DISTRACTION TEST

• Key developmental age: 6-18 months• Respon normal jika ada suara kepala bayi akan

berpaling ke sumber suara• 6 – 18bulan sesuai dgn tahap ketika anak bisa

duduk tegak tanpa pegangan dan bs melakukan gerakan kepala yg berubah pada bidang horizontal

• Habituasi semakin mungkin terjadi setelah 12 bulan, meskipun terbukti bermanfaat pada anak-anak yang lebih tua dengan kesulitan belajar atau komunikasi, dimana metode lain telah gagal.

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* Test method

Di ruang yg rapi, teratur, ukuran sesuai (min. yang disarankan >16m2), tingkat kebisingan <30 dB.Child sits on the parent’s knee.

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• Asymmetric hearing levels difference in response thresholds or difficulty in localizing the sound source.

• The sound stimulus should continue up to 10 seconds if there is not an immediate response.

• During this interval, the distractor should maintain the fine attention control at the front until a response is observed.

• Respon normal yg diharapkan:– full head turn in the direction of the sound