Audiology, speech language pathology & rehabilitation

This depicts summary of the field of Audiology, Speech Therapy and Rehabilitation

1. Audiology, Speech Language Pathology & Rehabilitation Dr Udit Saxena PhD - Hearing Sciences (National Centre for Audiology Canada)

2. Today’s presentation Audiology Details because of close relation with Otology Speech Language Pathology Rehabilitation It will help Deciding assessment and management. Make optimum use of the resources.

3. Relation between Otology and Audiology? Diagnosis Otology Treatment of outer, middle and inner ear disorders Audiology Functional assessment of outer, middle and inner ear Assessment of progress during the course of treatment

4. Relation between Otology and Audiology? (Cont.) Hearing: Assessment and Management Otology Treatment of outer, middle and inner ear disorders Implants Audiology Hearing Threshold Assessment of the benefits of devices prescribed/implanted: hearing aids, BAHA, MEI, CI,ABI and MBI. Auditory Training

5. Audiology in Diagnostics Pure-tone (single frequency) audiometry Hearing Thresholds Type of hearing loss Audiogram pattern Conductive Sensori -Neural Boilers notch (NIHL) Carhart notch ( Otoscerosis )

6. Audiology in Diagnostics (cont.) Speech audiometry Real world condition Speech Recognition Thresholds (50%) Relation with PTA + 12 dB Speech Discrimination Scores (% intelligibility) Cochlear Pathology vs Retro Cochlear Pathology Speech Awareness Threshold Infants/newborns

7. Audiology in Diagnostics (cont.) Special tests Cochlear vs Retrocochlear pathology SISI (Short Increment Sensitivity Index) Tone Decay Test

8. Audiology in Diagnostics (cont.) Tympanometry Static Compliance (acoustic admittance; ease of acoustic energy flow). 1980’s: Impedance. Equivalent ear canal volume Tympanometric peak pressure

9. Audiology in Diagnostics (cont.) Tympanometry Middle ear resonance (800 and 1200 Hz) OCD (mass increase) = Decrease Otosclerosis (stiffness increase) = Increase Eustachian tube functioning Valsalva Maneuver

10. Audiology in Diagnostics (cont.) Acoustic Reflex Stapedial muscles pulls stapes on acoustic stimulation with loud sounds; stiffness increase, static compliance decreases. Ipsilateral and Contralateral ear Acoustic reflex threshold: Relation with PTA (70 dB SL)

11. Audiology in Diagnostics (cont.) OAEs Functioning of OHCs Newborn screening It will be absent if middle ear disorders. IHC? Important because 95% of afferent auditory nerve fibers are contacted to them. If loss exceeds 55 dB Cochlear Dead regions TEN test Very minimum benefits with hearing aids.

12. Audiology in Diagnostics (cont.) Auditory Brainstem Responses (ABR) /Brainstem Evoked Response Audiometry (BERA) Is not a test of hearing threshold Synchronicity of auditory nerve Amplitude, Absolute latency and Inter-peak latency Estimation of hearing threshold Newborn Infants Children Difficult to test population; MR, Autism, ADHD, etc To catch functional hearing loss Site of hearing testing

13. Audiology in Diagnostics (cont.) Middle Latency Response: Midbrain, MGB, Thalamus Long Latency Responses: Auditory Cortex Cognitive Responses: MMN; P300 .

14. Audiology in Diagnostics (cont.) Vestibular testing Spontaneous nystagmus Romberg test Gait Hallpike Manoeuvre Tests of Cerebellar Dysfunction Caloric test Video/ Electronystagmography VESTIBULAR EVOKED MYOGENIC POTENTIALS (VEMP)

15. Audiology in Diagnostics (cont.) Tinnitus Tinnitus matching Tinnitus retraining Hyperacusis Uncomfortable levels Ear protective devices

16. Audiology in Hearing (Assessment and Management) Speech audiometry Speech in noise tests Absorbance: alternative of tympanometry

17. Audiology in Hearing (Assessment and Management)Cont. Hearing aids Selection of hearing aids according to loss Fitting of hearing aids Programming Verification of hearing aids benefits Aided/Un-aided threshold: Pure-tone Aided/Un-aided threshold: Speech Counseling Auditory training

18. Audiology in Hearing (Assessment and Management) Cont. Cochlear Implant/Auditory Brainstem Implant/ Auditory Midbrain Implant/ Bone Anchored Hearing aids/Middle Ear Implants Candidacy Assessments of benefits from these devices Impedance check Mapping Auditory training

19. Audiology in Hearing (Assessment and Management) Cont. Auditory dysynchrony Auditory Processing Disorders Hearing thresholds: Normal Problem understanding speech (in noise)

20. Speech Language Pathology Assessment and Management of all Speech and Language problems Voice Disorders Delayed Speech and Language Autism ADHD Learning Disability Aphasia Dysarthria Stuttering Misarticulation

21. MAA Institute of Speech and Hearing

22. MAA Multi Rehabilitation Institute Psychology Occupational Therapy Physiotherapy Special Education

23. MAA Multi Rehabilitation Institute Rehabilitation of children Autism Learning disability Delayed Speech and Language ADHD Mental Retardation Cerebral Palsy Technology addiction Sensory deficit

24. Thank You!