1 Characteristics of Auditory Brainstem Response Latencies in Children with Autism Spectrum Disorders. Dr. ABEIR OSMAN DABBOUS Professor of Audiology (Audio-Vestibular Medicine), Kasr Al-Ainy Faculty of Medicine, Cairo University.
3 Autism spectrum disorders (ASD) are complex neuro-developmental disorders, characterized by social and communication impairments and rigid and repetitive behaviours (APA, 2000; WHO,1993).
4 One of the most commonly reported challenges and the most prominent auditory symptoms for people with ASD is hypersensitivity to loudness of sound with abnormal behavioural reactions to environmental sounds (Frith & Baron-Cohen, 1987; Khalfa et al., 2004). Stiegler & Davis, (2011) suggested that audiologists assess loudness discomfort levels as part of the routine audiologic assessment protocol for individuals with ASD, or when ASD are suspected.
5 In infancy and early childhood, it is difficult to obtain reliable subjective responses regarding the true uncomfortable loudness level, and in ASD, it is impossible due to lack of communication. So using ABR wave V latency intensity function curve, we can objectively get an idea about the loudness growth. Furthermore, ABR has been widely studied in autism, but yielded different results in different studies.
6 The assessment of any abnormality in the loudness growth objectively using auditory brainstem response (ABR), as well as to study the ABR latency characteristics in normal hearing autistic infants with delayed language development.
8 SUBJECTS 50 children: (1yr & 6 months - 3yrs & 3months): 25 ASD, 16 males and 9 females mean age : (range 18-39) months Diagnosis made by pediatricians, paediatric psychiatrists, and psychologists. Referred for hearing assessment for their delayed language development. All had intolerance to noise (reported by parents). Those with normal hearing thresholds using auditory brainstem response (20 db nhl or better) were included. 25 controls, 17 males and 8 females mean age : (range 19-40) months. Healthy, without any psychiatric or medical disorders.
9 Methods: Full history taking from the parents, Otological examination Auditory brainstem response (ABR). Tympanometry and acoustic reflex threshold.
11 All three ABR waves were obtained in all cases and controls with clear morphology. The electro-physiological hearing threshold for the controls was 20 db nhl, Eleven /25 (44%) of the autism group showed a lower threshold than their controls, i.e. hyperacute hearing, i.e. true hyperacusis. 5/25 (20%) : hearing threshold of 10 db nhl 6/25 (24%) : threshold of 0 db nhl
13 In comparison, Rosenhall et al. (1999) noted that 18% of subjects with ASD presented normal auditory thresholds and auditory hypersensibility with intolerance to clicks above 70 db nhl, when submitted to brainstem audiometry. Gomes et al. (2005) stated that adverse reactions to sound in individuals with ASD may not reflect a physiological difference in the auditory system, but rather a psycho-emotional-behavioural difference: a fear of sound stimuli, accompanied by hyper-reactive avoidance behaviours.
14 Figure 1: ABR traces for autistic and a control child.
15 Table 1: ABR Latency Values For Autistic And Control Children ABR* Autistic children (n=25) Controls (n=25) t-value p-value Mean SD Mean SD Wave I Wave III Wave V IPI: I - III IPI: I - V IPI: III - V ABR = auditory brainstem response; * at 90dBnHL; IPI: inter-peak interval. significantly different at p<0.05
16 The significantly earlier autistic children ABR wave I than the controls indicate quicker synaptic processes in the organ of Corti.
17 Coutinho et al. (2002) documented ABR findings showing a prevalent peak I over peak III and peak V in the four ears of two autistic children. They did not find any inter-peak latency abnormalities, and the latencies of peaks I, III and V were within the average range in both cases. They stated that these findings in the ABR could not be related to the unusual responses to auditory stimuli, which are often typical of children with autistic disorder.
18 The prolonged wave III and longer IPI: I- III reflects a retro-cochlear dysfunction in ASD that may be related to their difficulty discriminating, leading to difficulty communicating with others, and at the same time a normal peripheral auditory function that can hear the meaningless sounds which may be related to their abnormal reactions to sounds.
19 Prolongation of wave III latency in children with autism were also reported by Magliaro et al. (2010) and prolongation I III IPI by Magliaro et al. (2010), Maziade et al. (2000) and Wong and Wong (1991). Furthermore, Maziade et al. (2010) observed the same I - III IPL prolongation in the unaffected first degree relatives of the autistic probands compared with controls, which is a sign of retro-ochlear involvement indicating the presence of a slowing in nerve conduction in the auditory system.
20 However, Kwon et al. (2007), Magliaro et al. (2010), Rosenhall et al. (2003), and Wong and Wong (1991), found an increase in absolute latencies of wave V and inter-peak I-V and III - V in those with autism compared to controls. This indicate that children with ASD have a dysfunction or immaturity of the central auditory nervous system. Kwon et al. (2007) suggested that any children with prolonged III - V IPI, especially high functioning children, should be further evaluated for central auditory processing in order to set up a more appropriate treatment plan. But, Tharpe et al. (2006) did not find any differences in central transmission latencies in children with autism compared to their controls.
21 Prolongation of waves III and V and IPI I-III and I-V suggested that individuals with autism have a delay in the conduction of the acoustic stimulus at the low brainstem region, which was the most frequent type of alteration (83.3%) and considered statistically significant compared to the high brainstem region (0%), and both (16.7%) (Magliaro et al. 2010). Lengthening of the latency of wave V might reflect brainstem abnormality when combined with abnormal IPLs and/or in the presence of normal latencies of the earlier waves was observed in 37% of their cases. This supported the brainstem hypothesis (Rosenhall et al. 2003).
22 Roth et al. (2012) found that all absolute latencies and IPLs were significantly prolonged in the group with suspected ASD compared with the group with language delay, excluding IPL III- V, and compared with clinical norms. And significant prolongation of absolute and IPLs was also evident in the group with language delay compared with clinical norms, excluding IPL III-V. This provided first-time evidence for a neuro-developmental brainstem abnormality that is already apparent in young children with suspected ASD and language delay. The overlap in ABR findings supports the assertion that an auditory processing deficit may be at the core of these two disorders (Roth et al. 2012)
23 Aberrant functioning of auditory and auditory association regions would also have potential downstream effects on auditory brainstem regions via cortico-fugal and medial olivo-cochlear efferents (Palmer et al., 2007; Perrot et al, 2006 ; Zhang and Suga, 2000), ultimately affecting early encoding of auditory information (O Connor, 2012). So, brainstem lesion, occult cochlear dys-function and involvement of the cochlear efferent system, are probable factors that can explain the ABR abnormalities ( Rosenhall et al. 2003).
24 In this study there was no abnormal inter-aural latency difference in waves (i.e. ear side differences). This agreed with Fujikawa-Brooks et al. (2010) when a slower presentation rate was used, but they found that fast ABR click presentation rate resulted in significant prolongation of wave V latency, particularly in the right ear. In comparison, Kwon et al. (2007) observed that children with ASD in their study seem to have a left ear advantage (shorter wave I, III, and V latency values ) than those of the right, but not statistically significant.
25 Figure 5: Wave V latency-intensity graph of the cases compared to the controls 2 SD. Latency (msec) case1 case2 case3 case4 case5 case6 case7 case8 case9 case10 case11 case12 case13 case14 case15 case16 case17 case18 case19 case case21 case db 10 db 20 db 30 db 40 db 50 db 60 db 70 db 80 db 90 db case23 case24 case25 Intensity (dbnhl) control 2SD This reflects a normal loudness growth in the autistic group
26 Table 2: ABR Wave V latency values at different click levels for autistic and control children. Wave V at different click levels Autistic children (n=25) Controls (n=25) Mean SD Mean SD t-value p-value 90 db db db db db db db db db db
27 Figure 3: Linear regression analyses of the ABR wave V latency-intensity graph. 9 cases R Sq Linear = Cases Wave V Latency (msec) Intensity (dbnhl) Controls Wave V Latency (msec) controls R Sq Linear = Intensity (dbnhl) 80
28 Table 3: ABR Wave V latency -intensity function slope values for autistic and control children. ASD (n=25) Controls (n=25) Mean of the whole group SD SE t value p value 0.354
29 Figure 4: Mean 2 standard deviation of the ABR wave V latency-intensity graph of cases and controls Latency (msec) Autism Control 4 0 db 10 db 20 db 30 db 40 db 50 db 60 db 70 db 80 db 90 db Intensity (dbnhl)
30 Table 6: ABR absolute latencies of waves and inter-peak latency intervals for male and female autistic children. ABR Male Autistic children (n=16) Female Autistic children (n=9) Mean SD Mean SD Z* p- value Wave I Wave III Wave V IPI: I - III IPI: I - V IPI: III - V *: Z of the nonparametric Mann-Whitney and Wilcoxon test ABR=auditory brainstem response; IPI: inter-peak interval. * = significantly different at p<0.05
31 Table 7: ABR wave V latency values at different click levels for male and female autistic children. Wave V at different click levels Male Autistic children (n=16) Female Autistic children (n=9) Mean SD Mean SD Z* p- value 90 db db db db db db db db db (n=5)! db (n=6)!! *: Z of the nonparametric Mann-Whitney and Wilcoxon test! Male =3, females =2!! Male =2, females =4
32 Table 5: Comparison between autistic and control children with regard to the ABR wave V latency -intensity function slope values of both genders. Males Females Z p value Mean SD Mean SD ASD Controls *: Z of the nonparametric Mann-Whitney and Wilcoxon test
33 Figure 6: Mean of wave V latency-intensity graph of male and female control and autistic children Female Autism Male Autism Female Control Male Control 8 Latency (msec) db 10 db 20 db 30 db 40 db 50 db 60 db 70 db 80 db 90 db Intensity (dbnhl)
34 Table 4: Comparison between both genders children with regard to ABR wave v latency -intensity function slope values of autistic and control groups. ASD Controls Z p value Mean SD Mean SD Males Females *: Z of the nonparametric Mann-Whitney and Wilcoxon test
35 Table 7: ABR wave V latency values at different click levels for male and female autistic children. Wave V at different click levels Male Autistic children (n=16) Female Autistic children (n=9) Mean SD Mean SD Z* p-value 90 db db db db db db db db db (n=5)! db (n=6)!! *: Z of the nonparametric Mann-Whitney and Wilcoxon test! Male =3, females =2!! Male =2, females =4
36 The latency differences in wave V at lower intensity levels between both genders in this study may might reflect the smaller female head size or the lesser amount of soft tissue than in males that may absorb the sound energy. This may also reflect slower neural processing in male than female autistic children despite the absence of differences in loudness growth as reflected by the slope of the curve.
37 This, therefore, does not explain the intolerance to sounds that is present in both genders, and may be rather a phonophobic reaction to an external sensory stimulus, or the pathology could be efferent system affection or a more central pathology that needs further evaluation. However, this may account for the greater frequency of autism in males than females who have near normal processing and that may not easily manifest clinically.
39 Conclusion Autistic children with normal hearing showed a within normal loudness growth indicating that their abnormal reactions to sounds may either be phonophobia or an efferent system affection or a more central pathology that needs further evaluation. They also showed a retro-cochlear dysfunction that may be related to their difficult communication.
COCHLEAR NERVE APLASIA : THE AUDIOLOGIC PERSPECTIVE A CASE REPORT Eva Orzan, MD Pediatric Audiology University Hospital of Padova, Italy Congenital absence or underdevelopment of the cochlear nerve has
Hearing and Deafness 1. Anatomy & physiology Chris Darwin Web site for lectures, lecture notes and filtering lab: http://www.lifesci.susx.ac.uk/home/chris_darwin/ safari 1 Outer, middle & inner ear Capture;
Questions and Answers for Parents There are simple, inexpensive tests available to detect hearing impairment in infants during the first days of life. In the past, most hearing deficits in children were
The Accuracy of 0 db HL as an Assumption of Normal Hearing Introduction An operating assumption of diagnostic audiology is that hearing level of a young adult with no known hearing loss or history of noise
HEARING & HEARING LOSS Dr I Butler 2015 DISCLOSURE Sponsorship to attend local and international workshops Cochlear (Southern ENT) Med el TOPICS Anatomy Classification of hearing loss Congenital hearing
PURE TONE AUDIOMETRY Andrew P. McGrath, AuD Pure tone audiometry is the standard behavioral assessment of an individual s hearing. The results of pure tone audiometry are recorded on a chart or form called
FACULTY OF HEALTH PROFESSIONS School of Human Communication Disorders Speech-Language Pathology Curriculum Foundation Course Linkages Phonetics (HUCD 5020) a. Vowels b. Consonants c. Suprasegmentals d.
Continuous Performance Test 3 rd Edition C. Keith Conners, Ph.D. Assessment Report Name/ID: Alexandra Sample Age: 16 Gender: Female Birth Date: February 16, 1998 Grade: 11 Administration Date: February
Understanding Hearing Loss 404.591.1884 www.childrensent.com You just found out your child has a hearing loss. You know what the Audiologist explained to you, but it is hard to keep track of all the new
1~14fYl~t~lilliill ~~~~l~lll ~ I i?~l~i i J Am Acad Audiol 3 : 269-274 (1992) Effects of Notch Noise Bandwidth on the Auditory Brainstem Response to Clicks Randall C. Beattie* Debra L. Franzone* Kristen
A Guide to Otoacoustic Emissions (OAEs) for Physicians Introduction Hearing loss is not uncommon in children and adults. According to recent estimates, 31.5 million people in the United States report difficulty
TECHNICAL NOTES Fire Alarms and People with ASD: A Literature Summary Paul Kashmanian Fire Protection Research Foundation April 2014 The Fire Protection Research Foundation One Batterymarch Park Quincy,
Physiological Basis of Hearing Tests By Dr. Abdel Aziz Hussein Lecturer of Physiology Mansoura Faculty of Medicine Introduction Def: Hearing is the ability to perceive certain pressure vibrations in the
7. CATEGORIES and DEFINITIONS of EXCEPTIONALITIES Purpose of the standard To provide the ministry with details of the categories and definitions of exceptionalities available to the public, including parents
Education Adjustment Program (EAP) Handbook Current as at September 2015 The State of Queensland (2015) This document is licensed under CC-BY 4.0, with the exception of the government coat of arms, logos
Getting Started Kei Te Timata AN INTRODUCTION FOR THE FAMILIES AND WHANAU OF CHILDREN DIAGNOSED WITH A HEARING LOSS. THIS IS A JOINT PROJECT BY DEAF EDUCATION AOTEAROA NEW ZEALAND AND THE NATIONAL AUDIOLOGY
The Role of the Educational Audiologist 2014. Introduction: As the current CHAIR of the BAEA I felt that it was time for the Role of the Educational Audiologist to be updated. There has been a period of
Doctor of Audiology Transitional Degree Program Distance Education for Practicing Audiologists Au.D. Curriculum Guide Doctor of Audiology Transitional Program Currriculum Guide Course Descriptions Modules
The NAL Percentage Loss of Hearing Scale Anne Greville Audiology Adviser, ACC February, 2010 The NAL Percentage Loss of Hearing (PLH) Scale was developed by John Macrae of the Australian National Acoustic
Billing, Coding, & Calculating Fees: Finding Success Janet McCarty American Speech-Language-Hearing Association Today s Agenda BILLING: Learn how to bill for your services. CODING: Learn the codes that
Prevalence of otological disorders in diabetic patients with hearing loss Manche Santoshi Kumari *, Jangala Madhavi *, Koralla Raja Meganadh *, Akka Jyothy Institute of Genetics and Hospital for Genetic
For UKAS use only (Assessor Ref. Number) United Kingdom Accreditation Service 21-47 High Street Feltham, Middlesex TW13 4UN UKAS Technical/Peer Assessor Keyword List Name of applicant Applicant assessors
COMMUNICATION SCIENCES AND DISORDERS 2015-2016 COURSE OFFERINGS Version: 2015-08-10 COURSE TITLE FALL WINTER SPRING SUMMER GEN CMN 108-0 Communication Disorders X CSD 112-0 Scientific Exploration of Comm.
1/1/2015 Hearing Testing Coding Fact Sheet Coding Fact Sheet for Primary Care Pediatricians While coding for hearing screening is relatively straightforward, ensuring that appropriate payment is received
Deconstructing the DSM-5 By Jason H. King Assessment and diagnosis of autism spectrum disorder For this month s topic, I am excited to share my recent experience using the fifth edition of the Diagnostic
Unilateral (Hearing Loss in One Ear) Hearing Loss Guidance Indiana s Early Hearing Detection and Intervention Program Before universal newborn hearing screening, most children with unilateral hearing loss
Audiology Services Carolyn Dando Audiology Services Manager South Warwickshire NHS What are we going to cover today? General overview of the ear Hearing loss Hearing assessments, results Hearing aids Paediatric
DISABILITY-RELATED DEFINITIONS 1. The Americans with Disabilities Act (ADA) of 1990 is a civil rights law, which makes it unlawful to discriminate on the basis of disability. It covers employment in the
1 This is the flow diagram of a hearing aid that is currently under inves8ga8on at Essex University. The purpose of this talk is to explain how the design is linked to research using computer models of
AUDIOLOGICAL EVALUATIONS, FINDINGS AND RECOMMENDATIONS: A PARENT S GUIDE Nicole Raia, ScD, CCC-A, FAAA Clinical Audiologist University Hospital Newark, NJ AGENDA Anatomy of the Ear Types of Audiological
I. DEFINITION "Emotional disturbance" means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational
Special Education Coding Criteria 2014/2015 Mild/Moderate Gifted and Talented Severe Special Education Coding Criteria 2014/2015 ISBN 978-1-4601-1902-0 (Print) ISBN 978-1-4601-1903-7 (PDF) ISSN 1911-4311
The Health Professions Council of South Africa PROFESSIONAL BOARD FOR SPEECH, LANGUAGE AND HEARING PROFESSIONS STANDARDS OF PRACTICE IN AUDIOLOGY December 2002 The following are considered to be standard
Quick guide to autism What it looks like and how you can help What is autism spectrum disorder (ASD)? ASD is a lifelong neurodevelopmental disorder We don t know what causes ASD but we do know genetics
224 REGULATIONS FOR THE DEGREE OF MASTER OF SCIENCE IN AUDIOLOGY (MSc[Audiology]) (See also General Regulations) Any publication based on work approved for a higher degree should contain a reference to
WHAT IS CEREBRAL PALSY? Cerebral Palsy is a dysfunction in movement resulting from injury to or poor development of the brain prior to birth or in early childhood. Generally speaking, any injury or disease
CHILDREN, YOUTH AND WOMEN S HEALTH SERVICE JOB AND PERSON SPECIFICATION POSITION DETAILS Position Title: Paediatric Audiologist Classification: PO2 Position No: Cost centre: Reports to: Manager Newborn
Early Detection of Adult Hearing Loss: Next Steps to Clinical Practice Jonathan Siegel Sumitrajit Dhar Knowles Hearing Center Roxelyn & Richard Pepper Department of Communication Science & Disorders Northwestern
G/12.a HAMILTON LODGE SCHOOL & COLLEGE Audiology Policy June 2015 To be reviewed: June 2017 (Gov) 1 Introduction Hamilton Lodge School and College (HLSC) provides audiology services to all pupils and students.
3030. Eligibility Criteria. 5 CA ADC 3030BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS Barclays Official California Code of Regulations Currentness Title 5. Education Division 1. California Department
PRACTICE STANDARDS AND GUIDELINES FOR HEARING ASSESSMENT OF ADULTS 5060-3080 Yonge Street, Box 71 Toronto, Ontario M4N 3N1 416-975-5347 1-800-993-9459 www.caslpo.com Approved: March 2008 Reformatted: April
Ad Hoc Committee on in Audiology Reference this material as: American Speech-Language-Hearing Association. (2004). in Audiology . Available from www.asha.org/policy. Index terms: scope of practice doi:10.1044/policy.sp2004-00192
Practice Standards for Hearing Service Providers The WCB has been unsuccessful in obtaining input from the SASLPA for the development of practice standards and a fee schedule to cover hearing service providers
GONCA SENNAROĞLU PhD LEVENT SENNAROĞLU MD Department of Otolaryngology Hacettepe University ANKARA, TURKEY To present the audiological findings and rehabilitative outcomes of CI in children with cochlear
Applied Behavior Analysis for Autism Spectrum Disorders I. Policy University Health Alliance (UHA) will reimburse for Applied Behavioral Analysis (ABA), as required in relevant State of Hawaii mandates,
PART I DEPARTMENT OF PERSONNEL SERVICES 6.347 STATE OF HAWAII 6.348............................. 6.349 6.350 Class Specification for the SPEECH PATHOLOGY SERIES This series includes all classes of positions
ONTARIO INFANT HEARING PROGRAM AUDIOLOGIC ASSESSMENT PROTOCOL Version 3.1, January 2008 Otologic Function Unit Mount Sinai Hospital, Toronto, Ontario Contact: Martyn Hyde, PhD Voice 416.586.4510 Fax 416.586.8739
The Eclipse Designed to meet your every need AEP, ASSR, VEMP & OAE testing on one dedicated platform Design your own diagnostic solution for a perfect result The Eclipse is a modern and versatile platform.
Title of Immediate Supervisor: Assistant Director of Special Education Intermediate School District 917 Department: Special Education FLSA Status: Exempt Accountable For (Job Titles): None Pay Grade Assignment:
2015/2016 Special Education Program WORKPLAN INSTRUCTION BOOK Important Due Dates Workplan: October 9, 2015 Interim Report: February 5, 2016 Final Report: June 3, 2016 Special Education Program First Nations
AUDIOLOGY Type of program you would like to see: Describe. We are proposing a clinical doctorate program in audiology that meets the 2007 certification standards of both the American Speech-Language and
Image: http://physics.ust.hk/dusw/ Tonal Detection in Noise: An Auditory Neuroscience Insight Buddhika Karunarathne 1 and Richard H.Y. So 1,2 1 Dept. of IELM, Hong Kong University of Science & Technology,
Towards a contingent anticipatory infant hearing test using eye-tracking Iris-Corinna Schwarz 1, Atena Nazem 1, Sofia Olsson 1, Ellen Marklund 1, Inger Uhlén 2 1 Department of Linguistics, Stockholm University,
Indian Speech and Hearing Association Scope of Practice in Audiology & Speech-Language Pathology Statement of Purpose This document, drafted by the Indian Speech Language and Hearing Association (ISHA),
The Thirteen Special Education Classifications Part 200 Regulations of the Commissioner of Education, Section 4401(1) Student With a Disability: A student as defined in section 4401(1), who has not attained
Tennessee Department of Health Newborn Hearing Program Pediatric Audiology Assessment & Amplification Guidelines November, 2010 Table of Contents Introduction 2 Pediatric Audiology Assessment Guidelines
Position Statement Auditory processing disorder (APD) Draft document for consultation Date of this version: 19th November 2010 General foreword This Position Statement represents a synthesis of the current
Listening Therapy for Central Auditory Processing Disorders Susan Eichert, AuD, CCC A March 21, 2015 Presentation Abstract This presentation will review the need for deficit-specific treatment of central
The ability to hear is critical to understanding the world around us. The human ear is a fully developed part of our bodies at birth and responds to sounds that are very faint as well as sounds that are
The Eclipse Designed to meet your every need AEP, ASSR, VEMP & OAE testing on one dedicated platform. Design your own diagnostic solution for a perfect result The Eclipse is a modern and versatile platform.
3.42 STANDARDS FOR 3.42.1 INPATIENT INFANT HEARING SCREENING PROVIDER A. Definition An Inpatient Infant Hearing Screening Provider shall be a general acute care hospital with licensed perinatal services
Long-Term Findings from the NIDCD/VA Hearing Aid Clinical Trial Gene W. Bratt, Ph.D, Chair firstname.lastname@example.org Demographics and Audiometrics CSP #418-A Gene W. Bratt, Ph.D. Study Chair Barbara F. Peek,
EMG and the Electrodiagnostic Consultation for the Family Physician Stephanie Kopey, D.O., P.T. 9/27/15 The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Marketing Committee
Provider Handbooks January 2016 Vision and Hearing Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims administrator for Texas Medicaid under contract with the Texas Health
Acknowledgments This guideline was revised and updated in July 2012 to add more current information and resources. The Connecticut Birth to Three System would like to thank the following people who worked
Learners Who are Deaf or Hard of Hearing Kalie Carlisle, Lauren Nash, and Allison Gallahan Definition Deaf A deaf person is one whose hearing disability precludes successful processing of linguistic information
Headaches in Children How to Manage Difficult Headaches Peter Procopis Childhood headaches Differential diagnosis Migraine Psychological Raised Pressure Childhood headaches Other causes: Constitutional
A Professional Practice Profile for Hearing Health Professionals Hearing instrument dispensing includes several professions that overlap. There are traditional hearing aid dispensers, board certified hearing
Special Education Coding Criteria 2012/2013 ECS to Grade 12 Mild/Moderate (including Gifted and Talented) Severe Special Education Coding Criteria 2012/2013 ISSN 1911-4311 Additional copies of this handbook
1 Prescriptive Fitting Algorithms: New and Improved! Michelle Mattingly, Au.D. and Lisa Perhacs, Au.D. TM 2 What is the goal of a prescriptive algorithm? Optimize audibility Optimize speech intelligibility
Addiction: Disease or Choice? Presented by Michael Coughlin RN October 18, 2012 Introduced by Melanie Willows B.Sc. M.D. C.C.F.P. C.A.S.A.M. C.C.S.A.M. Assistant Professor University Of Ottawa Clinical
Interprofessional Study of Autism Spectrum Disorder (ASD) and Neurodevelopmental (ND) Disabilities 1 &2 A SC LEND Educational Program involving collaboration between: Medical University of South Carolina
Guidelines for Fitting Hearing Aids to Young Infants Version 2.0 February 2014 Rachel Feirn 1 (Editor) 1 Formerly of Children s Hearing Centre, University Hospitals Bristol, UK These guidelines were originally
Position Classification Standard for Speech Pathology and Audiology Series, GS-0665 Table of Contents SERIES DEFINITION... 2 EXCLUSIONS... 2 COVERAGE OF THE SERIES... 3 COVERAGE OF THE STANDARD... 4 OCCUPATIONAL
Hearing Loss in Geriatric Primary Care Mary Ann Forciea MD Josh Uy MD Q: In my office practice, I screen for hearing loss with A Level of difficulty in office conversation Questionnaire Hand held hldaudiometer
I. DEFINITION Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment (comprehension and/or expression), or a voice impairment, that
Introduction Noise and Occupational Hearing Loss Dr Steven Sadhra Senior Lecturer & Director of Education for Occupational Medicine PhD, MIOSH, MFOM, FFOM (Hon.) Institute of Occupational and Environmental
Document No. STATE BOARD OF EDUCATION CHAPTER 43 Statutory Authority: Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. 1400 et seq. (2004) 43 243.1. Criteria for Entry into Programs
Noise Induced Hearing Loss Parkes v Meridian Ltd  EWHC B1 (QB) 14 th Feb 2007. The case examined whether or not there was a duty of care to protect employees from exposure to noise of less than 90