Pediatric Vestibular Assessment for Children Who Are Deaf or Hard of Hearing
|
|
- Gilbert Johnathan Glenn
- 7 years ago
- Views:
Transcription
1 Kristen Janky, Au.D., Ph.D., CCC-A Vestibular Audiologist Vestibular Services, Clinical Coordinator Pediatric Vestibular Assessment for Children Who Are Deaf or Hard of Hearing Kristen Janky Au.D., Ph.D., CCC-A Coordinator, Vestibular Services Director, Clinical Vestibular Laboratory 1
2 Questions? For any questions during this broadcast, please send an to: Questions will be answered at the end of the presentation. Learner Objectives At the conclusion of this presentation, the participant will be able to: Describe the signs and symptoms associated with vestibular dysfunction List the etiologies of hearing loss that are commonly associated with vestibular dysfunction List commonly used vestibular assessments What Is The Vestibular System? How do we maintain balance? Somatosensation Visual Vestibular System 2
3 What Is The Vestibular System? What Is The Vestibular System? What Is The Vestibular System? Vestibulo-spinal Reflex (VSR): helps to maintain head and postural stability Vestibulo-collic Reflex (VCR): Righting reflex, stabilize the head Vestibulo-ocular Reflex (VOR): stabilize vision during head movement All reflexes originate in the vestibular system and are modulate by the brain 3
4 Vestibulo-Ocular Reflex (VOR) Vestibulo-Ocular Reflex (VOR) Vestibulo-Ocular Reflex (VOR) 4
5 Vestibulo-Ocular Reflex (VOR) The vestibular balance system is primarily responsible for maintaining steady and clear vision during head movement Implications: overall balance as well as reading, writing, and development What Is Oscillopsia? Visual phenomenon in which the visual environment appears to oscillate Oscillopsia only occurs in response to head movement Subsequently, oscillopsia is associated with poor visual acuity Associated with vestibular loss in both ears What Is Oscillopsia? 5
6 Vestibular Loss - Adults Adults Imbalance Gait abnormalities (wide-based, slow) Greater disability when visual and somatosensory cues are not present Greater risk of falling Blurred vision with movement (i.e., walking, head turns, avoidance of driving, etc.) Limit social interactions Vestibular Loss - Adults Treatment: Physical therapy Compensatory eye movements to help improve gaze stability Improve overall balance ability Functional effects are not well understood When vestibular loss occurs congenitally or during early development, it can effect motor development When looked at over time, this delay was found to be progressive (Rine et al., 2000) 6
7 Specific problematic activities: Sitting unsupported Standing Walking Navigating in the dark Clumsiness Riding a bike Hopping Children with sensorineural hearing loss and bilateral vestibular loss found to have significantly worse visual acuity during head movement (Rine & Braswell, 2003) Visual acuity found to have a relationship with reading acuity Children need larger print size for comfortable reading (Braswell & Rine, 2006a & 2006b) 7
8 Specific problematic activities: Reading (skipping words or letters) Schoolwork Develop fine and gross motor control Age of onset: Congenital demonstrate more deficits Degree of impairment: Valente et al report on two children: one with mild and the other with profound vestibular loss, both exhibiting functional deficits Other variables In spite functional consequences, not all facilities perform vestibular testing Awareness of risk factors and symptoms 8
9 The incidence of vestibular dysfunction estimated between 30 91% (Shinjo et al., 2007; Tribukait et al., 2004; Zhou et al., 2009) Incidence higher as severity of hearing loss increases (Angeli et al., 2003) Post-natally acquired cases Meningitis Cytomeglovirus (CMV) Ototoxicity Rubella Anoxia Some syndromic deafness Usher s Waardenburg Pendred Alport s Labyrinthine dysplasia Auditory Neuropathy (some cases) 9
10 Secondary to Cochlear Implantation General anesthesia and/or temporary disturbance of inner ear fluids (Licameli et al., 2009) Secondary to cochlear implantation Range incidence of vestibular dysfunction following implantation Estimate vestibular dysfunction in 40-86% following CI (Licameli et al., 2009; Vibert et al., 2001, Krause et al., 2012, Melvin et al., 2009, Jin et al., 2006) Demonstrate developmental delay 10
11 Signs And Symptoms Signs and symptoms associated with vestibular dysfunction (Cronin & Rine, 2010) Dizziness Nystagmus Signs And Symptoms Signs and symptoms associated with vestibular dysfunction (Cronin & Rine, 2010) Difficult with visual acuity Difficulty with spatial relationships Presence of Hearing loss Motion sickness or sensitivity (avoids or craves) Headaches (family history of migraine headaches) Developmental and reflex delays (slow to learn to ride a bike, swim, hop, stair climb, etc) Difficulty with dancing or certain sports Diagnosing Vestibular Loss Caloric Testing Rotary Chair Testing Vestibular Evoked Myogenic Potential (VEMP) Testing Dynamic Visual Acuity (DVA) testing 11
12 Caloric Testing Right ear calorics Caloric Testing Left ear calorics Rotary Chair Children < 5 years When bilateral vestibular loss suspected Chair oscillates back & forth Electrodes (infrared camera) or goggles Sing Songs 12
13 Rotary Chair Rotary Chair VEMP Vestibular Evoked Myogenic Potential (VEMP) Electromyogram: measuring modulation of muscle activity A good alternative to caloric testing which is not generally tolerated in the pediatric population Ear specific information, as opposed to rotary chair 13
14 Ocular VEMP Ocular VEMP Ocular VEMP Utricle and superior branch of the vestibular nerve 14
15 Cervical VEMP Cervical VEMP Saccule and inferior branch of the vestibular nerve Dynamic Visual Acuity How clear is vision during head movement? Rine & Braswell (2003) developed DVA for ages % sensitivity and specificity for identifying bilateral weakness (Rine & Braswell, 2003) 15
16 Referring For Vestibular Testing When to refer: Hearing Loss High risk population Signs and Symptoms Developmental Delay Pre and Post cochlear implantation Suspect vestibular loss Parent Concern Treatment When vestibular loss is diagnosed, then what? Visual System Assessment Somatosensory System Assessment Vestibular Rehabilitation Vestibular Rehabilitation Preliminary studies demonstrate that children with vestibular loss improve: Developmental Milestones (Rine et al., 2004) Progressive delay was halted and performance moved into the normal range with therapy (Rine et al., 2004) Critical print size and reading acuity (Braswell & Rine, 2006) 16
17 Vestibular Rehabilitation Vestibular loss is treated with gaze stabilization exercises - ability to stabilize the visual environment during movement Repeated head and body movements both with and without visual targets Full range of head movement Varying speed, repetitions and sets to build endurance Vestibular Rehabilitation In children, incorporate imagination in play Activities with a ball Finger painting TV and video games Again increasing speed, repetitions, and complexity of environment Vestibular Rehabilitation Balance Systems Integration Integrating Visual, Vestibular, and Somatosensory Challenging the systems to optimize benefit Setting up home and school environment Compensation 17
18 Other Recommendations Night lights Scuba Diving Swimming Sports Child play: learning to ride a bike, roller/ice skate Summary Primary purpose of the vestibular balance center is to maintain steady vision during head movement If vestibular loss is suspected, vestibular testing can be completed Summary If vestibular loss is diagnosed, appropriate therapy should be initiated Vestibular rehabilitation can improve both developmental milestone delay and visual acuity 18
19 References Braswell J, Rine RM. Preliminary evidence of improved gaze stability following exercise in two children with vestibular hypofunction. Int J Pediatr Otorhinolaryngol 2006;70: Braswell J, Rine RM. Evidence that vestibular hypofunction affects reading acuity in children. Int J Pediatr Otorhinolaryngol 2006;70: Cronin, GW, Rine, RM (2010). Pediatric vestibular disorders: Recognition, evaluation, and treatment. VEDA. Herdman SJ (2007). Vestibular Rehabilitation 2 nd Ed. F.A. Davis Co., Philadelphia. Jin Y, Nakamura M, Shinjo Y et al. Vestibular-evoked myogenic potentials in cochlear implant children. Acta Otolaryngol 2006;126: References Krause E, Louza JP, Wechtenbruch J et al. Influence of cochlear implantation on peripheral vestibular receptor function. Otolaryngol Head Neck Surg 2010;142: Licameli G, Zhou G, Kenna MA. Disturbance of vestibular function attributable to cochlear implantation in children. Laryngoscope 2009;119: Melvin TA, Della Santina CC, Carey JP et al. The effects of cochlear implantation on vestibular function. Otol Neurotol 2009;30: O Reilly, RC, Grindle, C, Zwicky, EF, Morlet, T (2011). Development of the vestibular system and balance function: Differential diagnosis in the pediatric population. Otolaryngol Clin N Amer, 44 (2): References O Reilly, RC, Morlet, T, Nicholas, BD, Josephson, G, Horlbeck, D, Lundy, L, Mercado, A (2010). Prevalence of vestibular and balance disorders in children. Otol Neurotol, 31: Rine, RM (2009). Growing evidence for balance and vestibular problems in children. Audiological Med, 1-5. Rine RM, Braswell J, Fisher D et al. Improvement of motor development and postural control following intervention in children with sensorineural hearing loss and vestibular impairment. Int J Pediatr Otorhinolaryngol 2004;68: Rine RM, Braswell J. A clinical test of dynamic visual acuity for children. Int J Pediatr Otorhinolaryngol 2003;67:
20 References Rine RM, Cornwall G, Gan K et al. Evidence of progressive delay of motor development in children with sensorineural hearing loss and concurrent vestibular dysfunction. Percept Mot Skills 2000;90: Shinjo Y, Jin Y, Kaga K. Assessment of vestibular function of infants and children with congenital and acquired deafness using the icewater caloric test, rotational chair test and vestibular-evoked myogenic potential recording. Acta Otolaryngol 2007;127: Tribukait A, Brantberg K, Bergenius J. Function of semicircular canals, utricles and saccules in deaf children. Acta Otolaryngol 2004;124: References Valente, LM (2011). Assessment techniques for vestibular evaluation in pediatric patients. Otolaryngol Clin N Amer, 44 (2), Valente LM, Goebel JA, Sinks B. Pediatric vestibular evaluation: two children with sensorineural hearing loss. J Am Acad Audiol 2012;23: Vibert D, Hausler R, Kompis M et al. Vestibular function in patients with cochlear implantation. Acta Otolaryngol Suppl 2001;545: Zhou G, Kenna MA, Stevens K et al. Assessment of saccular function in children with sensorineural hearing loss. Arch Otolaryngol Head Neck Surg 2009;135: Kristen Janky 555 North 30 th Street Omaha, Nebraska kristen.janky@boystown.org 20
21 A production of the Lied Learning & Technology Center at
BEST PRACTICES Pediatric Bilateral Sensorineural Hearing Loss
BEST PRACTICES Pediatric Bilateral Sensorineural Hearing Loss Christina L. Runge, PhD, CCC-A Associate Professor Chief, Division of Communication Sciences Director, Koss Cochlear Implant Program Resources
More informationThe Human Balance System
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG The Human Balance System A Complex Coordination of Central and Peripheral Systems By the Vestibular
More informationLess common vestibular disorders presenting with funny turns
Less common vestibular disorders presenting with funny turns Charlotte Agrup, Department of Neuro-otology, The National Hospital for Neurology and Neurosurgery, London Making the diagnosis Making the diagnosis
More informationThe Human Balance System
5018 NE 15 TH AVE PORTLAND, OR 97211 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG VESTIBULAR.ORG The Human Balance System A Complex Coordination of Central and Peripheral Systems By the Vestibular
More informationBALANCE AND VESTIBULAR REHABILITATION THERAPY MANUAL
BALANCE AND VESTIBULAR REHABILITATION THERAPY MANUAL Copyright AMERICAN HEARING & BALANCE CENTERS, INC., 2010 2010 Revision 3.01 TABLE OF CONTENTS Description Page Five Indications For Therapy... 1 Treatments
More informationDiagnostic Tests for Vestibular Problems By the Vestibular Disorders Association
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Diagnostic Tests for Vestibular Problems By the Vestibular Disorders Association The inner ear
More informationVestibular Rehabilitation
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Vestibular Rehabilitation An Effective, Evidence-Based Treatment By Anne Shumway-Cook, PT, PhD;
More informationThe Role of Physical Therapy in Post Concussion Management. Non Disclosure
The Role of Physical Therapy in Post Concussion Management. Cook Children s Sports Medicine Symposium Ryan Blankenship, PT, SCS Non Disclosure No conflicts of interest. 1 Course Objectives Participants
More informationThe Influence of a Vestibular Dysfunction on the Motor Development of Hearing-Impaired Children
The Laryngoscope VC 2012 The American Laryngological, Rhinological and Otological Society, Inc. The Influence of a Vestibular Dysfunction on the Motor Development of Hearing-Impaired Children Alexandra
More informationBenign Paroxysmal Positional Vertigo. By Mick Benson
Benign Paroxysmal Positional Vertigo By Mick Benson Definition Benign - not life-threatening Paroxysmal - a sudden onset Positional - response provoked by change in head position Vertigo - sensation of
More informationDURATION OF HEARING LOSS
When your child is diagnosed with a hearing loss, it may be very overwhelming. This may be a difficult time for you and your family. However, gaining a greater knowledge in this area is crucial in helping
More informationUsing the Balance Board in Therapy
Using the Balance Board in Therapy Practical applications for linking somato-sensory and vestibular systems to the collaboration between the eyes and brain. Vision Therapy establishes and supports visual
More informationConcussions and Mild Head Injury. Post Concussion Syndrome. Whiplash Injuries
Concussions and Mild Head Injury Post Concussion Syndrome Whiplash Injuries Treat the cause, not just the symptoms NeuroSensory Center of Eastern Pennsylvania 250 Pierce Street, Suite 317 Kingston, PA
More informationVestibular Rehabilitation What s the Spin?
Vestibular Rehabilitation What s the Spin? Carolyn Tassini, PT, DPT, NCS Vestibular Certified Rehabilitation Supervisor Bancroft NeuroRehab Objectives Attendees demonstrate a basic understanding of the
More informationVestibular Disorders: An Overview
5018 NE 15 TH AVE, OR 97211 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG VESTIBULAR.ORG Vestibular Disorders: An Overview By the Vestibular Disorders Association The vestibular system includes
More informationWHAT IS CEREBRAL PALSY?
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
More informationCerebral Palsy. In order to function, the brain needs a continuous supply of oxygen.
Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Up to 5000 children in the United States are diagnosed with cerebral palsy every year. This reference
More informationEnlarged Vestibular Aqueduct Syndrome
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Enlarged Vestibular Aqueduct Syndrome (EVAS) By Hamid, MD, PhD, EE, The Cleveland Hearing & Balance
More informationQuestions and Answers for Parents
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
More informationCerebral Palsy. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com nr200105 Last reviewed: 06/17/2014 1
Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Thousands of children are diagnosed with cerebral palsy every year. This reference summary explains
More informationHearing Tests for Children with Multiple or Developmental Disabilities by Susan Agrawal
www.complexchild.com Hearing Tests for Children with Multiple or Developmental Disabilities by Susan Agrawal Hearing impairment is a common problem in children with developmental disabilities or who have
More informationProposed Treatment for Vestibular Dysfunction in Dogs By Margaret Kraeling, DPT, CCRT
Proposed Treatment for Vestibular Dysfunction in Dogs By Margaret Kraeling, DPT, CCRT Vestibular dysfunction in the dog can be a disturbing condition for owners, as well as somewhat confounding for the
More informationInsights into Visual Impairments
Insights into Visual Impairments Definition of Visual Impairment Washington State WAC 392 172A 01035 Child with a disability or student eligible for special education. (n) Visual impairment including blindness
More informationFetal Alcohol Spectrum Disorder
Workshop F5: Fetal Alcohol Syndrome/Fetal Alcohol Spectrum Disorder: The Invisible Disability FAS/FASD Handout: Therapies that Help Children with Fetal Alcohol Spectrum Disorder Presenters Jerry Larson,
More informationGAZE STABILIZATION SYSTEMS Vestibular Ocular Reflex (VOR) Purpose of VOR Chief function is to stabilize gaze during locomotion. Acuity declines if
GAZE STABILIZATION SYSTEMS Vestibular Ocular Reflex (VOR) Purpose of VOR Chief function is to stabilize gaze during locomotion. Acuity declines if slip exceeds 3-5 deg/sec. Ex: Head bobbing and heel strike
More informationG. Shashidhar Pai, MD MUSC Children s Hospital Department of Pediatrics Division of Genetics
G. Shashidhar Pai, MD MUSC Children s Hospital Department of Pediatrics Division of Genetics One of every 500 newborns has bilateral permanent sensorineural hearing loss 40 db which makes it the most common
More informationSo, how do we hear? outer middle ear inner ear
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
More informationSpeaker: Shayla Moore, BMR(PT) Relationship with commercial interests: Employee at Creekside Physiotherapy Clinic
Speaker: Shayla Moore, BMR(PT) Relationship with commercial interests: Employee at Creekside Physiotherapy Clinic 1 Vestibular Rehabilitation Managing dizziness to maintain mobility in the elderly" Dizziness:
More informationVestibular Neuritis and Labyrinthitis
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Vestibular Neuritis and Labyrinthitis Infections of the Inner Ear By Charlotte L. Shupert, PhD
More informationDirections for construction used with permission from Pacific Science Center - Brain Power
Directions for construction used with permission from Pacific Science Center - Brain Power The Vestibular System The vestibular system within the inner ear detects both the position and motion of the head
More informationCORTICAL VISUAL IMPAIRMENT
Idaho Project for Children and Youth with Deaf-Blindness Fact Sheet CORTICAL VISUAL IMPAIRMENT Definition: Cortical Visual Impairment (CVI) is a temporary or permanent visual impairment caused by the disturbance
More informationEARLY INTERVENTION: COMMUNICATION AND LANGUAGE SERVICES FOR FAMILIES OF DEAF AND HARD-OF-HEARING CHILDREN
EARLY INTERVENTION: COMMUNICATION AND LANGUAGE SERVICES FOR FAMILIES OF DEAF AND HARD-OF-HEARING CHILDREN Our child has a hearing loss. What happens next? What is early intervention? What can we do to
More informationClinical Medical Policy Outpatient Rehab Therapies (PT & OT) for Members With Special Needs
Benefit Coverage Rehabilitative services, (PT, OT,) are covered for members with neurodevelopmental disorders when recommended by a medical provider to address a specific condition, deficit, or dysfunction,
More informationCochlear Implant, Bone Anchored Hearing Aids, and Auditory Brainstem Implant
Origination: 06/23/08 Revised: 10/13/14 Annual Review: 11/12/15 Purpose: To provide cochlear implant, bone anchored hearing aids, and auditory brainstem implant guidelines for the Medical Department staff
More informationEXECUTIVE SUMMARY OF JOINT COMMITTEE ON INFANT HEARING YEAR 2007 POSITION STATEMENT. Intervention Programs
EXECUTIVE SUMMARY OF JOINT COMMITTEE ON INFANT HEARING YEAR 2007 POSITION STATEMENT Principles and Guidelines for Early Hearing Detection and Intervention Programs The Joint Committee on Infant Hearing
More informationVestibular Assessment
Oculomotor Examination A. Tests performed in room light Vestibular Assessment 1. Spontaneous nystagmus 2. Gaze holding nystagmus 3. Skew deviation 4. Vergence 5. Decreased vestibular ocular reflex i. Head
More informationLearn the steps to identify pediatric muscle weakness and signs of neuromuscular disease.
Learn the steps to identify pediatric muscle weakness and signs of neuromuscular disease. Guide for therapists/specialists Questions and comments to: info@childmuscleweakness.org Surveillance and Referral
More informationStudent name: Lesson Objective(s):
Lesson Objective(s): 1. Describe the processes at work in the vestibular system when the human body responds to circular motion. 2. Describe the role of the vestibular system when the human body responds
More informationGlossary of commonly used Occupational Therapy terms
Glossary of commonly used Occupational Therapy terms Adaptive Response: An action that is appropriate and successful in meeting some environmental demand. Adaptive responses demonstrate adequate sensory
More information3-1 THE NERVOUS SYSTEM
C A S E S T U D Y 3 : T o d d l e r Adapted from Thomson Delmar Learning s Case Study Series: Pediatrics, by Bonita E. Broyles, RN, BSN, MA, PhD. Copyright 2006 Thomson Delmar Learning, Clifton Park, NY.
More informationOtologic (Ear) Dizziness. Fistula Other. SCD Bilateral. Neuritis. Positional Vertigo BPPV. Menieres
Otologic Dizziness (Dizziness from Ear) Ear Structures of importance Timothy C. Hain, MD Northwestern University, Chicago t-hain@northwestern.edu The ear is an inertial navigation device Semicircular Canals
More informationMODEL SUPERBILL for AUDIOLOGY
MODEL SUPERBILL for AUDIOLOGY The following is a model of a superbill which could be used by an audiology practice when billing private health plans. This sample is not meant to dictate which services
More informationPost-Concussion Syndrome
Post-Concussion Syndrome Anatomy of the injury: The brain is a soft delicate structure encased in our skull, which protects it from external damage. It is suspended within the skull in a liquid called
More informationBalance and Vestibular Center Programs to treat dizziness and reduce your risk of falling
Balance and Vestibular Center Programs to treat dizziness and reduce your risk of falling Helping you overcome dizziness and vertigo Most people will experience dizziness at some point in their lives.
More informationA Note to Physical, Occupational and Speech Therapists
D Page 1 of 5 A Note to Physical, Occupational and Speech Therapists Treating Children with Hurler Syndrome Because Hurler syndrome is such a rare disease, we have provided some basic information to assist
More informationClumsy Child Syndrome/ Academic Difficulties for the School Age Child
Clumsy Child Syndrome/ Academic Difficulties for the School Age Child Gross motor proficiencies in a baby provide a foundation for success in school.. School Age Problems Children may be identified as
More informationLecture Plan. Anatomy and Pathophysiology of the Vestibular System. Vestibular Overview. Vestibular Physiology. Vestibulo-ocular reflex V.O.R.
Anatomy and Pathophysiology of the Vestibular System Lecture Plan 1. Vestibular Physiology 2. Anatomy and clinical syndromes Timothy C. Hain, MD Vestibular Physiology Vestibular Overview Vestibular sensors
More informationUnilateral (Hearing Loss in One Ear) Hearing Loss Guidance
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
More informationNikki White Children s Occupational Therapist Barnet Community Services
Nikki White Children s Occupational Therapist Barnet Community Services What is Occupational Therapy (OT)? An occupation is anything you do in your daily life. Anything meaningful or purposeful Eg. Getting
More informationUsher Syndrome Genetics
Usher Syndrome Genetics October 2012 Page 1 of 20 Introduction Usher syndrome is a genetic or inherited condition that affects hearing, vision and balance The sight loss is caused by an eye condition known
More information1/26/2011. 50% of deafness and hearing impairment is avoidable through prevention, early diagnosis, and management.
Hearing Impairment Roseann Mulligan, DDS, MS Herman Ostrow School of Dentistry of the University of Southern California 1 JAMA, July 4, 2007 Vol 298, No. 1 2 278 million - moderate to profound bilateral
More informationRegister of Students with Severe Disabilities
Department of Education Learners first, connected and inspired Register of Students with Severe Disabilities Department of Education Register of Students with Severe Disabilities 1. Eligibility Criteria
More informationProviding Professional Care in Rehabilitation Services
For more information about Inspira Rehab Care or for a patient evaluation, please contact any one of our facilities: Inspira Rehab Care Bridgeton Health Center 333 Irving Avenue Bridgeton, NJ 08302 (856)
More informationOtotoxicity Monitoring
Ototoxicity Monitoring Aaron Jones, Au.D., M.S. Doctor of Audiology May 12, 2011 Agenda Background Antineoplastic ototoxicity monitoring Case study Company overview Gross Anatomy of the Ear Image: http://en.wikipedia.org/wiki/file:anatomy_of_the_human_ear.svg
More informationVision Problems Children
Vision Problems Children in with Sensory Processing Disorder Lynn F. Hellerstein, OD, FCOVD, FAAO 10 Sensory Focus Magazine Fall 2014 Sensory Processing Disorder (SPD) affects a wide variety of people.
More informationHearing Screening Coding Fact Sheet for Primary Care Pediatricians
Hearing Screening Coding Fact Sheet for Primary Care Pediatricians While coding for hearing screening is relatively straightforward, ensuring that appropriate payment is received for such services is a
More informationAUTISM SPECTRUM DISORDERS
AUTISM SPECTRUM DISORDERS JAGWINDER SANDHU, MD CHILD, ADOLESCENT AND ADULT PSYCHIATRIST 194 N HARRISON STREET PRINCETON, NJ 08540 PH: 609 751 6607 Staff Psychiatrist Carrier clinic Belle Mead NJ What is
More informationAutism and Intellectual Disabilities
Autism and Intellectual Disabilities (DSM IV & V) Accessibility Politecnico di Milano Autism (I) A total of six (or more) items from (A), (B), and (C), with at least two from (A), and one each from (B)
More informationLearners Who are Deaf or Hard of Hearing Kalie Carlisle, Lauren Nash, and Allison Gallahan
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
More informationTHE EYES IN CHARGE: FOR THE OPHTHALMOLOGIST Roberta A. Pagon, M.D. Division of Medical Genetics, CH-25, Children's Hospital /Medical Center, Box C5371, Seattle, WA 98105-0371 bpagon@u.washington.edu (206)
More informationVestibular Rehabilitation Therapy. Melissa Nelson
Vestibular Rehabilitation Therapy Melissa Nelson What is Vestibular Rehabilitation Therapy (VRT)? VRT is an exercise-based program designed to promote CNS compensation for inner ear deficits. The goal
More informationPresented by: Paul G. Vidal, PT, MHSc, DPT, OCS, FAAOMPT Specialized Physical Therapy, LLC 2015 AOASM Annual Clinical Conference Philadelphia, PA
Presented by: Paul G. Vidal, PT, MHSc, DPT, OCS, FAAOMPT Specialized Physical Therapy, LLC 2015 AOASM Annual Clinical Conference Philadelphia, PA Concussion The Role of the Physical Therapist Valuable
More informationDevelopmental delay and Cerebral palsy. Present the differential diagnosis of developmental delay.
Developmental delay and Cerebral palsy objectives 1. developmental delay Define developmental delay Etiologies of developmental delay Present the differential diagnosis of developmental delay. 2. cerebral
More informationDizziness and Vertigo
Dizziness and Vertigo Introduction When you are dizzy, you may feel lightheaded or lose your balance. If you also feel that the room is spinning, you may have vertigo. Vertigo is a type of severe dizziness.
More informationConcussion/MTBI Certification Series. Featuring: Frederick R Carrick, DC, PhD Distinguished Professor of Neurology, Life University
Concussion/MTBI Certification Series Featuring: Frederick R Carrick, DC, PhD Distinguished Professor of Neurology, Life University Please note that spaces are limited for this specialty certification program.
More informationEsotropia (Crossed Eye(s))
Esotropia (Crossed Eye(s)) Esotropia is a type of strabismus or eye misalignment in which the eyes are "crossed," that is, while one eye looks straight ahead, the other eye is turned in toward the nose.
More informationPrimary Motor Pathway
Understanding Eye Movements Abdullah Moh. El-Menaisy, MD, FRCS Chief, Neuro-ophthalmology ophthalmology & Investigation Units, Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia Primary Motor Pathway
More informationUniversal newborn hearing screening: the experience of the University Hospital of Parma
Acta Biomed 2015; Vol. 86, N. 3: 273-277 Mattioli 1885 Original article Universal newborn hearing screening: the experience of the University Hospital of Parma Cinzia Magnani 1, Giovanna Bacchi 2, Anna
More informationNevada Division of Public and Behavioral Health
Nevada Division of Public and Behavioral Health Early Hearing Detection and Intervention (EHDI) Program GUIDELINES FOR INFANT AUDIOLOGIC ASSESSMENT STATE OF NEVADA BRIAN SANDOVAL Governor CODY L. PHINNEY,
More informationDISABILITY-RELATED DEFINITIONS
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
More informationA STUDY OF THE EFFECTS OF A VESTIBULAR REHABILITATION PROGRAM ON PATIENTS WITH PERIPHERAL VESTIBULAR DYSFUNCTIONS
The Indian Journal of Occupational Therapy : Vol. XXXVI : No. 1 (April - July 04) A STUDY OF THE EFFECTS OF A VESTIBULAR REHABILITATION PROGRAM ON PATIENTS WITH PERIPHERAL VESTIBULAR DYSFUNCTIONS * Pina
More informationFourth Nerve Palsy (a.k.a. Superior Oblique Palsy)
Hypertropia Hypertropia is a type of strabismus characterized by vertical misalignment of the eyes. Among the many causes of vertical strabismus, one of the most common is a fourth nerve palsy (also known
More informationAGE Iowa Midwest Nation N % N % N % Total students 256 100.0 9272 100.0 37500 100.0 Information NOT reported 7 2.7 229 2.5 841 2.2
202-651-5575 * 1-800-451-8834 ext 5575 Page 1 of 9 AGE Iowa Midwest Nation Information NOT reported 7 2.7 229 2.5 841 2.2 Total known information 249 100.0 9043 100.0 36659 100.0 Under 3 years 16 6.4 201
More informationDoctor of Audiology Transitional Degree Program. Distance Education for Practicing Audiologists. Au.D. Curriculum Guide
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
More informationCOMPLEX LEARNING DIFFICULTIES AND DISABILITIES RESEARCH PROJECT (CLDD)
Page 1 This is a general overview of the implications of vision impairment, hearing impairment and multi-sensory impairment. The impact of impairments for individual students with complex learning difficulties
More informationSection 4. Hearing loss and hearing tests
Section 4 Hearing loss and hearing tests How we hear Outer Ear Middle Ear Inner Ear 4. 7. 8. 1. 3. 6. 2. 5. 1. 2. 3. 4. 5. 6. 7. 8. Ear canal Ear drum Middle ear cavity Middle ear bones the malleus, incus,
More informationICD-10 Codes Utilized by Audiologists
ICD-10 Codes Utilized by Audiologists Introduction Beginning with the first claim filed to all payers on or after October 1, 2015, the ICD-10 codes must be utilized in box 21 A-L on the CMS 1500 claim
More informationVestibular Injury. Vestibular Disorders Association www.vestibular.org Page 1 of 5
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Vestibular Injury Compensation, De-compensation, and Failure to Compensate By Thomas E. Boismier,
More informationUNILATERAL SPATIAL NEGLECT Information for Patients and Families
UNILATERAL SPATIAL NEGLECT Information for Patients and Families What is unilateral spatial neglect? Unilateral spatial neglect (USN) is the inability to pay attention to things on the side that is affected
More informationCerebral Palsy. www.teachinngei.org p. 1
Cerebral Palsy What is cerebral palsy? Cerebral palsy (CP) is a motor disability caused by a static, non-progressive lesion (encephalopathy) in the brain that occurs in early childhood, usually before
More informationHow To Know If A Cochlear Implant Is Right For You
MEDICAL POLICY SUBJECT: COCHLEAR IMPLANTS AND PAGE: 1 OF: 6 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy
More informationBalance and Aging By Charlotte Shupert, PhD, with contributions by Fay Horak, PhD, PT Oregon Health & Science University, Portland, Oregon
PO BOX 13305 PORTLAND, OR 97213 FAX: (503) 229-8064 (800) 837-8428 INFO@VESTIBULAR.ORG WWW.VESTIBULAR.ORG Balance and Aging By Charlotte Shupert, PhD, with contributions by Fay Horak, PhD, PT Oregon Health
More informationCheck List for identifying Special Needs Children among School age children. Cerebral Palsy
Check List for identifying Special Needs Children among School age children Cerebral Palsy Sl. 1. The child has drooling? 2. The child has problems in controlling voluntary movements? 3. The child has
More informationTechnology in Music Therapy and Special Education. What is Special Education?
Technology in Music Therapy and Special Education What is Special Education? Disabilities are categorized into the following areas: o Autism, visual impairment, hearing impairment, deaf- blindness, multiple
More informationSeeing, Thinking, and Doing in Infancy
Seeing, Thinking, and Doing in Infancy How Children Develop Chapter 5 Infant Development Perception Action Learning Cognition Motor Development Reflexes Motor Milestones Current Views of Motor Development
More informationCOCHLEAR IMPLANTATION IN A PATIENT WITH LARGE VESTIBULAR AQUEDUCT SYNDROME: A CASE REPORT GENİŞ VESTİBÜLER SENDROMLU HASTADA KOKLEAR İMPLANTASYON
CASE REPORT COCHLEAR IMPLANTATION IN A PATIENT WITH LARGE VESTIBULAR AQUEDUCT SYNDROME: A CASE REPORT Ufuk Derinsu, Ayça Çiprut, Sezer Külekçi, Ferda Akdaş Sub-department of Audiology, Department of Otorhinolaryngology,
More informationOccupational & Physical Therapy Guidelines for Service Provision within the Schools
1 Occupational & Physical Therapy Guidelines for Service Provision within the Schools 2012 2 Introduction* Purpose The purpose of this document is to provide guidance regarding school-based Occupational
More informationIntroduction. Defining comorbidities. Introduction. Defining comorbidities. Defining comorbidities 9/5/2013
Introduction YOUNG CHILDREN WITH HEARING LOSS AND ADDITIONAL/ MULTIPLE DISABILITIES Talita le Roux Department of Communication Pathology University of Pretoria 7 September 2013 CHRIB seminar I just didn
More informationVestibular Injury: Compensation, Decompensation, and Failure to Compensate
VESTIBULAR DISORDERS ASSOCIATION PO Box 13305 Portland, OR 97213 fax: (503) 229-8064 toll-free voice-mail: (800) 837-8428 info@vestibular.org http://www.vestibular.org/ VEDA Publication No. F-26 Vestibular
More information2011-12 STATE SUMMARY Gallaudet Research Institute * 800 Florida Avenue, NE * Washington, DC 20002 202-651-5575 * 1-800-451-8834 ext 5575 Page 1 of 12
202-651-5575 * 1-800-451-8834 ext 5575 Page 1 of 12 AGE Louisiana South Nation Information NOT reported 2 1.4 210 2.2 588 2.5 Total known information 137 100.0 9172 100.0 23143 100.0 Under 3 years of age
More informationPrevalence of otological disorders in diabetic patients with hearing loss
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
More informationVestibular Rehabilitation: A Competency-Based Course
Vestibular Rehabilitation: A Competency-Based Course Emory Conference Center and Hotel 1615 Clifton Road, NE Atlanta, Georgia 30329 Course Description This intense, evidence- based, six- day course is
More informationOfficial CPT Description
s CPT 69210 Removal impacted cerumen (separate procedure), one or both ears 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual 92516 Facial nerve
More informationNormal and Abnormal Development in the Infant and Pre-School Child
Normal and Abnormal Development in the Infant and Pre-School Child Steven Bachrach, M.D. Co-Director, Cerebral Palsy Program A.I. dupont Hospital for Children Development in the Infant and Child A newborn
More informationDizziness and balance problems
Dizziness and balance problems Dizziness and balance problems, Action on Hearing Loss Information, May 2011 1 Dizziness and balance problems This factsheet is part of our Ears and ear problems range. It
More informationNational Hospital for Neurology and Neurosurgery. Inner ear balance problems. Department of Neuro-otology
National Hospital for Neurology and Neurosurgery Inner ear balance problems Department of Neuro-otology If you would like this document in another language or format or if you require the services of an
More informationCOCHLEAR NERVE APLASIA : THE AUDIOLOGIC PERSPECTIVE A CASE REPORT. Eva Orzan, MD Pediatric Audiology University Hospital of Padova, Italy
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
More information[Adapted from Fed. Reg. 52530; NAIC Glossary of Health Insurance and Medical Terms: 3]
New York State Benchmark Plan Recommendations Introduction The Patient Protection and Affordable Care Act (ACA) includes Rehabilitative and Habilitative Services and Devices as one of the ten categories
More informationCerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments.
The Face of Cerebral Palsy Segment I Discovering Patterns What is Cerebral Palsy? Cerebral palsy (CP) is an umbrella term for a group of non-progressive but often changing motor impairment syndromes, which
More informationBenign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) UHN Information for Patients Patient Education Improving Health Through Education You have been told by your doctor that you have Benign Paroxysmal Positional
More information