PEDIATRIC AUDIOLOGY QUIZ AND
ANSWERS.
What have studies shown about infant hearing? - Answers-Human infant has been
listening, analyzing, and processing sound several months before birth.
What will prove to be useful in the clinical evaluation of infants? - Answers-The ability to
respond to speech early in life will prove very useful. The point is that infants are
auditorily sophisticated even though they need CNS and peripheral physical maturation
to use or demonstrate those abilities.
In clinical audiology facilities what is one not prepared to evaluate? - Answers-The
discrete discrimination abilities of infants, by monitoring cardiac rate, respiration
changes, and sucking behavior.
What will be useful to us in our clinical setting? - Answers-Some of the principles
discovered in these studies, as well as knowledge of CNS maturity, will be useful in our
clinical setting.
What age is Behavioral observation (BOA) used? - Answers-Infants under six months,
as well as some children even up to two years of age, are evaluated using an BOA.
What is BOA? - Answers-A passive approach whereby an examiner observes changes
in behavior that are time-locked to auditory signals.
What is the Law of initial value? - Answers-The magnitude of response change clearly
depends on the state before stimulation. There may be an initiation or the cessation of
activity as a response to auditory stimuli on initial state.
When is it best to test babies? - Answers-During low levels of activity in order to get a
positive response change.
What is the most useful state for testing newborns? - Answers-Will provide clearest
responses in a light sleep. An arousal from sleep. Acceptable in a hospital setting, but in
a clinic may be hard to guarantee that the infant will be asleep. Still can be tested when
awake, but not when newborn is irritable, tired, uncomfortable, the responses will be
difficult to determine.
What are the expected responses 0-4months? - Answers-Arousal from sleep by sound
signals of 90db SPL in a noisy environment, 50-70db SPL in quiet.
When is the CNS mature in the normal infant? - Answers-Not until 28months of age, So
in neonates 0-3 months, motor responses to sound are largely reflexive, mediated in the
brainstem and spinal cord.
, What is Moro reflex? - Answers-A whole body response involving extensions of both
arms and legs, finger-spreading,and the head is thrown back.
What elicits the moro reflex response? - Answers-A sudden, relatively loud sound or
speech stimuli will elicit the response. There may be a partial moro reflex or in the older
infant if only a small jump or "startle" reflex.
What is the auropalpebral reflex? - Answers-A quick contraction of the muscles around
the eyes causing an eye-blink or a tightening of the lids if the eyes are closed.
BOA: attending behaviors:4-7 months of age? - Answers-Eye-widening
Initiation or cessation of gross body movement.
Hands opening and closing
Attending
Eyebrow raise
Quizzical or questioning look
Searching without localizing.
BOA: Beginning to localize 4-7 months of age? - Answers-Localizing is to attempt to
make direct determination of a sound source, in a horizontal or lateral plane for the 4-
7months old. Eventually we will see a full 90 degree head turn with a turn latency of 2.5
seconds that ends at 5.5 seconds.
Does localization occur in neonates? - Answers-Slows down at 2 months and returns at
4 months (visual dominates).
What is the stimuli used in BOA testing? - Answers-Speech is the primary stimuli.
Other broadband stimuli such as music and noisemakers.
Warbled pure tones (less effective below 6 months of age)
Narrow band noise (less effective below 6 months of age)
What is the qualification for broadband signals? - Answers-Broadband signals can be
misleading since the child may be responding to the low frequency components. There
is other test methodologies to help define the reality of the child's hearing.
What is the BOA testing procedure? - Answers-1. Stimuli is presented through the
speaker system without any reinforcement.
2. Parent is seated with the infant on his/her lap between two speakers (45 degrees)
3. First attempt to determine a speech awareness threshold with a speech signal and
say something like "Uh oh, Hi Baby", "where am i", "Hi Baby's name."
4. The speech signal is presented every 15-20 seconds with a drop in 5db steps starting
at about 40-50db until there is no behavioral response.
BOA responses are observed if presented.
ANSWERS.
What have studies shown about infant hearing? - Answers-Human infant has been
listening, analyzing, and processing sound several months before birth.
What will prove to be useful in the clinical evaluation of infants? - Answers-The ability to
respond to speech early in life will prove very useful. The point is that infants are
auditorily sophisticated even though they need CNS and peripheral physical maturation
to use or demonstrate those abilities.
In clinical audiology facilities what is one not prepared to evaluate? - Answers-The
discrete discrimination abilities of infants, by monitoring cardiac rate, respiration
changes, and sucking behavior.
What will be useful to us in our clinical setting? - Answers-Some of the principles
discovered in these studies, as well as knowledge of CNS maturity, will be useful in our
clinical setting.
What age is Behavioral observation (BOA) used? - Answers-Infants under six months,
as well as some children even up to two years of age, are evaluated using an BOA.
What is BOA? - Answers-A passive approach whereby an examiner observes changes
in behavior that are time-locked to auditory signals.
What is the Law of initial value? - Answers-The magnitude of response change clearly
depends on the state before stimulation. There may be an initiation or the cessation of
activity as a response to auditory stimuli on initial state.
When is it best to test babies? - Answers-During low levels of activity in order to get a
positive response change.
What is the most useful state for testing newborns? - Answers-Will provide clearest
responses in a light sleep. An arousal from sleep. Acceptable in a hospital setting, but in
a clinic may be hard to guarantee that the infant will be asleep. Still can be tested when
awake, but not when newborn is irritable, tired, uncomfortable, the responses will be
difficult to determine.
What are the expected responses 0-4months? - Answers-Arousal from sleep by sound
signals of 90db SPL in a noisy environment, 50-70db SPL in quiet.
When is the CNS mature in the normal infant? - Answers-Not until 28months of age, So
in neonates 0-3 months, motor responses to sound are largely reflexive, mediated in the
brainstem and spinal cord.
, What is Moro reflex? - Answers-A whole body response involving extensions of both
arms and legs, finger-spreading,and the head is thrown back.
What elicits the moro reflex response? - Answers-A sudden, relatively loud sound or
speech stimuli will elicit the response. There may be a partial moro reflex or in the older
infant if only a small jump or "startle" reflex.
What is the auropalpebral reflex? - Answers-A quick contraction of the muscles around
the eyes causing an eye-blink or a tightening of the lids if the eyes are closed.
BOA: attending behaviors:4-7 months of age? - Answers-Eye-widening
Initiation or cessation of gross body movement.
Hands opening and closing
Attending
Eyebrow raise
Quizzical or questioning look
Searching without localizing.
BOA: Beginning to localize 4-7 months of age? - Answers-Localizing is to attempt to
make direct determination of a sound source, in a horizontal or lateral plane for the 4-
7months old. Eventually we will see a full 90 degree head turn with a turn latency of 2.5
seconds that ends at 5.5 seconds.
Does localization occur in neonates? - Answers-Slows down at 2 months and returns at
4 months (visual dominates).
What is the stimuli used in BOA testing? - Answers-Speech is the primary stimuli.
Other broadband stimuli such as music and noisemakers.
Warbled pure tones (less effective below 6 months of age)
Narrow band noise (less effective below 6 months of age)
What is the qualification for broadband signals? - Answers-Broadband signals can be
misleading since the child may be responding to the low frequency components. There
is other test methodologies to help define the reality of the child's hearing.
What is the BOA testing procedure? - Answers-1. Stimuli is presented through the
speaker system without any reinforcement.
2. Parent is seated with the infant on his/her lap between two speakers (45 degrees)
3. First attempt to determine a speech awareness threshold with a speech signal and
say something like "Uh oh, Hi Baby", "where am i", "Hi Baby's name."
4. The speech signal is presented every 15-20 seconds with a drop in 5db steps starting
at about 40-50db until there is no behavioral response.
BOA responses are observed if presented.
