Pediatric Audiology Essay

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One objective of pediatric audiology is to estimate hearing thresholds so that hearing loss can be identified, quantified, and remediated during critical language-learning years. Although the goal is to closely estimate hearing thresholds, not all infants and children are able to provide behavioral responses that are close to threshold. Because audiologic test methods may not result in threshold estimates, Matkin (1977) coined the term Minimum Response Level (MRL), which is now widely used in the field of pediatric audiology. Matkin recommended using the term MRL to refer to audiologic behavioral responses obtained from pediatric clients when using techniques such as visual reinforcement audiometry “…until the reliability and the validity …show more content…

For infants, valid behavioral thresholds can be obtained when evidenced-based test protocols are used for operant conditioning. The validity of the test measures should also be assessed by examining reliability and by using cross-check …show more content…

Correspondence between behavioral tonal responses and objective measures of physiologic function are also important to consider as part of the cross-check battery approach. In their original article, Jerger and Hayes (1976) emphasized the importance of impedance audiometry and the auditory brainstem response to confirm behavioral test results. In addition to these cross-checks, otoacoustic emissions (OAE) testing currently plays a significant role in the test battery approach. Figure 1 displays audiometric findings obtained in a one year old child with developmental delays. Distortion product otoacoustic emissions (DPOAEs), with amplitudes within the range typically obtained for normal-hearing ears (Gorga, Neely, Ohlrich, Hoover, Redner, & Peters, 1997), were obtained for both ears. Ipsilateral acoustic reflexes were present at 90 dB HL, 500-4000 Hz, bilaterally. The child’s speech detection threshold (SDT), obtained in soundfield, was 25 dB HL. The SDT was 20 dB better than the best response to narrowband noise (NBN) suggesting that responses to NBN were MRLs. For this child, the poor inter-test reliability and the physiologic cross check measures, acoustic reflexes and DPOAEs, were both critical for the interpretation of the audiometric findings and subsequent recommendations. DPOAE amplitudes, that are consistent with those obtained from normal-hearing ears, indicate good outer hair cell function in both cochleae. The presence of

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