SB Chapter 68, Hearing Test in Children
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Transcript of SB Chapter 68, Hearing Test in Children
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Scott-Brown’s Chapter 68:Hearing Tests in Children
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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