Visual Reinforcement Audiometry
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Visual Reinforcement Audiometry
Visual reinforcement audiometry (VRA) is a key behavioural test for evaluating hearing in young children. First introduced by Liden and Kankkunen in 1969, VRA is a good indicator of how responsive a child is to sound and speech and whether the child is developing awareness to sound as expected. Performed by an audiologist, VRA is the preferred behavioral technique for children that are 6 – 24 months of age. Using classic operant conditioning, a stimulus is presented, which is followed by a 90 degree head turn from midline by the child, resulting in the child being reinforced with an animation. The child is typically seated in a high chair or on a parent's lap while facing forward. A loud speaker or two are situated at 45 or 90 degrees from the child. As the auditory stimulus is presented, the child will naturally search for the sound source, resulting in a head turn and reinforcement is followed shortly after through an animated toy or video next to the speaker where the auditory ...
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Audiologist
Audiology (from Latin , "to hear"; and from Greek , ''-logia'') is a branch of science that studies hearing, balance, and related disorders. Audiologists treat those with hearing loss and proactively prevent related damage. By employing various testing strategies (e.g. behavioral hearing tests, otoacoustic emission measurements, and electrophysiologic tests), audiologists aim to determine whether someone has normal sensitivity to sounds. If hearing loss is identified, audiologists determine which portions of hearing (high, middle, or low frequencies) are affected, to what degree (severity of loss), and where the lesion causing the hearing loss is found (outer ear, middle ear, inner ear, auditory nerve and/or central nervous system). If an audiologist determines that a hearing loss or vestibular abnormality is present, they will provide recommendations for interventions or rehabilitation (e.g. hearing aids, cochlear implants, appropriate medical referrals). In addition to diagnos ...
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Audiogram
An audiogram is a graph that shows the audible threshold for standardized frequencies as measured by an audiometer. The Y axis represents intensity measured in decibels and the X axis represents frequency measured in hertz. The threshold of hearing is plotted relative to a standardised curve that represents 'normal' hearing, in dB(HL). They are not the same as equal-loudness contours, which are a set of curves representing equal loudness at different levels, as well as at the threshold of hearing, in absolute terms measured in dB SPL (sound pressure level). Audiograms are set out with frequency in hertz (Hz) on the horizontal axis, most commonly on a logarithmic scale, and a linear dBHL scale on the vertical axis. For humans, normal hearing is between −10 dB(HL) and 15 dB(HL), although 0 dB from 250 Hz to 8 kHz is deemed to be 'average' normal hearing. Hearing thresholds of humans and other mammals can be found with behavioural hearing tests or physi ...
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Tympanogram
Tympanometry is an acoustic evaluation of the condition of the middle ear eardrum (tympanic membrane) and the conduction bones by creating variations of air pressure in the ear canal. Tympanometry is an objective test of middle-ear function. It is not a hearing test, but rather a measure of energy transmission through the middle ear. It is not a measure of TM or middle ear mobility. It is an acoustic measure, measured by a microphone, as part of the ear canal probe, inserted into the ear canal. The test should not be used to assess the sensitivity of hearing and the results of this test should always be viewed in conjunction with pure tone audiometry. Tympanometry is a valuable component of the audiometric evaluation. In evaluating hearing loss, tympanometry permits a distinction between sensorineural and conductive hearing loss, when evaluation is not apparent via Weber and Rinne testing. Furthermore, in a primary care setting, tympanometry can be helpful in making the diagnosis ...
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Otoacoustic Emissions
An otoacoustic emission (OAE) is a sound that is generated from within the inner ear. Having been predicted by Austrian astrophysicist Thomas Gold in 1948, its existence was first demonstrated experimentally by British physicist David Kemp (physicist), David Kemp in 1978, and otoacoustic emissions have since been shown to arise through a number of different cellular and mechanical causes within the inner ear. Studies have shown that OAEs disappear after the inner ear has been damaged, so OAEs are often used in the laboratory and the clinic as a measure of inner ear health. Broadly speaking, there are two types of otoacoustic emissions: spontaneous otoacoustic emissions (SOAEs), which occur without external stimulation, and evoked otoacoustic emissions (EOAEs), which require an evoking Stimulus (physiology), stimulus. Mechanism of occurrence OAEs are considered to be related to the amplification function of the cochlea. In the absence of external stimulation, the activity of the coc ...
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Auditory Brainstem Response
The auditory brainstem response (ABR), also called brainstem evoked response audiometry (BERA), is an auditory evoked potential extracted from ongoing electrical activity in the brain and recorded via electrodes placed on the scalp. The measured recording is a series of six to seven vertex positive waves of which I through V are evaluated. These waves, labeled with Roman numerals in ''Jewett'' and ''Williston'' convention, occur in the first 10 milliseconds after onset of an auditory stimulus. The ABR is considered an ''exogenous response'' because it is dependent upon external factors. The auditory structures that generate the auditory brainstem response are believed to be as follows: *Wave I through III – generated by the auditory branch of cranial nerve VIII and lower *Wave IV and V – generated by the upper brainstem *More in depth location – wave I and II originates from the distal and proximal auditory nerve fibers, wave III from the cochlear nucleus, IV showing acti ...
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Conditioned Play Audiometry
Conditioned play audiometry (CPA) is a type of audiometry done in children from ages 2 to 5 years old, in developmental age. It is the test that directly follows visual reinforcement audiometry when the child becomes able to focus on a task. It is a type of behavioral hearing test, of which there are many. Conditioned play audiometry uses toys to direct the child's attention on the listening task and turns it into a game. Instead of raising one's hand in response to the sound, as an adult would, the child might drop a toy into a bucket every time he or she hears a sound. This keeps the child interested in the listening task for longer. Common games include dropping balls in buckets, placing rings on a stick, feeding coins in a play pig, among many others. The first part of CPA involves conditioning the child. The audiologist presents a loud sound that the child can comfortably hear, while encouraging the child to "drop the ball in the bucket every time you hear the sound," or whic ...
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Acoustics
Acoustics is a branch of physics that deals with the study of mechanical waves in gases, liquids, and solids including topics such as vibration, sound, ultrasound and infrasound. A scientist who works in the field of acoustics is an acoustician while someone working in the field of acoustics technology may be called an Acoustical engineering, acoustical engineer. The application of acoustics is present in almost all aspects of modern society with the most obvious being the audio and noise control industries. Hearing (sense), Hearing is one of the most crucial means of survival in the animal world and speech is one of the most distinctive characteristics of human development and culture. Accordingly, the science of acoustics spreads across many facets of human society—music, medicine, architecture, industrial production, warfare and more. Likewise, animal species such as songbirds and frogs use sound and hearing as a key element of mating rituals or for marking territories. Art, ...
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Hearing
Hearing, or auditory perception, is the ability to perceive sounds In physics, sound is a vibration that propagates as an acoustic wave, through a transmission medium such as a gas, liquid or solid. In human physiology and psychology, sound is the ''reception'' of such waves and their ''perception'' by the ... through an organ, such as an ear, by detecting Vibration, vibrations as periodic changes in the pressure of a surrounding medium. The academic field concerned with hearing is auditory science. Sound may be heard through solid, liquid, or gaseous matter. It is one of the traditional five senses. Partial or total inability to hear is called hearing loss. In humans and other vertebrates, hearing is performed primarily by the auditory system: mechanical waves, known as vibrations, are detected by the ear and transduction (physiology), transduced into nerve impulses that are perceived by the brain (primarily in the temporal lobe). Like touch, audition requires sen ...
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