KISII UNIVERSITY

SCHOOL OF EDUCATION AND HUMAN RESOURCE MANAGEMENT

DEPARTMENT OF SPECIAL NEEDS
UNIT NAME: AUDIOLOGY
UNIT CODE: SPED 411
NAME: Joy Lilian Atieno
REG NO : ED13/00090/21
CONTACT: 0757464655
1. Hearing Assessment
Hearing assessments are integral to diagnosing hearing loss, and determining its type, degree,
and configuration, which aids in planning appropriate treatment strategies.

Methods of Hearing Assessment:

 Pure-tone Audiometry: This test measures the hearing threshold (the faintest sound a
person can hear) at different frequencies, typically ranging from 250 Hz to 8,000 Hz. It
helps determine the type (conductive, sensorineural, or mixed) and degree (mild,
moderate, severe, profound) of hearing loss. The test is usually performed using
headphones in a soundproof room, and results are plotted on an audiogram.
 Speech Audiometry: This test evaluates an individual’s ability to understand speech at
different loudness levels. The Speech Reception Threshold (SRT) determines the quietest
speech a person can hear, while the Word Recognition Score (WRS) assesses clarity in
understanding speech at a comfortable volume. This test helps assess both the peripheral
hearing mechanism and the central processing of speech.
 Tympanometry: Tympanometry measures the movement of the eardrum in response to
changes in air pressure in the ear canal. It helps diagnose middle ear conditions such as
fluid in the ear (otitis media), ear infections, or Eustachian tube dysfunction. It is used
alongside pure-tone audiometry to differentiate between conductive and sensorineural
hearing loss.
 Otoacoustic Emissions (OAEs): OAEs are sounds generated by the cochlea when
stimulated by auditory signals. The presence of OAEs typically indicates healthy cochlear
function, while their absence may suggest sensorineural hearing loss. This test is
particularly useful for newborn screening or patients who cannot respond behaviorally
(e.g., infants or those with cognitive impairments).
 Auditory Brainstem Response (ABR): This test measures the electrical activity in the
auditory pathway up to the brainstem. Electrodes are placed on the scalp to record
responses to sound stimuli. It is often used for diagnosing issues related to the auditory
nerve or brainstem, as well as for newborn hearing screening and assessing hearing in
non-cooperative patients.
 Clinical Application: Hearing assessments help audiologists determine the extent and
type of hearing loss, guiding decisions for further intervention such as hearing aids,
medical treatment, or surgical referral. For example, pure-tone audiometry may show a
conductive hearing loss, leading to the consideration of medical interventions (e.g.,
tympanoplasty), while sensorineural loss may result in the recommendation of hearing
aids or cochlear implants.
Equipment Used:
 Audiometers: Used to perform pure-tone audiometry and speech audiometry.
 Tympanometer: A device used to measure the compliance of the eardrum.
 OAE Equipment: Specialized probes that assess cochlear function.
  ABR Equipment: Electrodes, computer software, and sound stimuli to record brainstem
responses.

2. Pediatric Audiology
Pediatric audiology focuses on the early identification and management of hearing loss in infants
and children, which is crucial for speech, language, and social development.
 Newborn Hearing Screening:
o Importance: Newborn hearing screening is critical because early identification of
hearing loss allows for timely interventions, which significantly improve
outcomes in language acquisition and social development. The sooner hearing
loss is identified, the better the chances for effective communication skills, which
are essential for academic success.
o Techniques: Screening is usually done using Otoacoustic Emissions (OAEs) or
Auditory Brainstem Response (ABR), which can detect hearing loss in infants
before they are able to respond behaviorally. These tests are non-invasive and can
be conducted while the infant is sleeping.

 Behavioral Assessment Techniques:

o Visual Reinforcement Audiometry (VRA): This technique is used with children as
young as 6 months to 2 years. When the child hears a sound, a visual reward (such
as a moving toy or light) is presented. This encourages the child to turn towards
the sound, helping audiologists assess hearing thresholds.
o Play Audiometry: For children aged 2-5 years, play audiometry is used. It
involves engaging the child in a game, such as dropping a block into a container
when a sound is heard. This method helps assess the child’s ability to detect
sound through interactive play.

 Early Identification and Intervention:

o Impact on Development: Early identification of hearing loss is crucial for the
development of speech, language, and social skills. Research has shown that
children who receive appropriate interventions before 6 months of age have
significantly better outcomes in terms of speech and language development
compared to those diagnosed later.
o Interventions: Interventions may include hearing aids, cochlear implants, and
speech therapy. Cochlear implants are often recommended for children with
profound hearing loss who do not benefit from hearing aids. The goal of early
intervention is to maximize communication and educational opportunities.

 Hearing Loss in Children:

 o Causes: Hearing loss in children can be caused by genetic factors, infections (e.g.,
rubella, cytomegalovirus), prematurity, or postnatal conditions such as meningitis
or head trauma.
o Multidisciplinary Approach: Pediatric audiologists often work with speech-
language pathologists, educators, and psychologists to provide comprehensive
care that includes not only auditory intervention but also speech therapy and
social support for both the child and their family.

3. Hearing Aids and Assistive Technology

Hearing aids and assistive technologies are essential tools for managing hearing loss and
improving communication in different environments.
Hearing Aids:
Types:
I. Behind-the-Ear (BTE): These hearing aids are worn behind the ear and are suitable for
most types of hearing loss, including profound loss. They are easy to adjust and have a
longer battery life.
II. In-the-Ear (ITE): These are custom-molded to fit inside the ear and are typically used for
mild to moderate hearing loss. They are more discreet but may have a shorter battery life.
III. In-the-Canal (ITC): Smaller than ITEs, these are placed further inside the ear canal and
are used for mild to moderate hearing loss. They offer better cosmetics but may be harder
to handle for people with dexterity issues.
IV. Components: Hearing aids generally consist of a microphone (to pick up sound), an
amplifier (to increase the volume), and a receiver (to deliver amplified sound into the
ear). They can also include digital signal processing that improves sound quality, reduces
background noise, and adjusts the amplification based on environmental factors.

 Assistive Listening Devices (ALDs):

o FM Systems: These systems use a microphone to capture the speaker's voice and
transmit it to the listener's hearing aid via radio frequency. They are beneficial in
classrooms, theaters, or other noisy environments.
o Induction Loop Systems: These use electromagnetic fields to transmit sound
directly to hearing aids with telecoil functionality. Induction loops are often
installed in public spaces like theaters, churches, and airports.
o Personal Amplifiers: Portable devices that amplify sound, useful for one-on-one
communication, phone calls, or conversations in noisy environments.
 Cochlear Implants:
o Function: Cochlear implants are used for individuals with profound sensorineural
hearing loss who do not benefit from hearing aids. The implant bypasses the
 damaged parts of the ear and directly stimulates the auditory nerve, allowing the
person to perceive sound.
o Process: The process involves the implantation of an internal device in the
cochlea and an external component (microphone and processor) worn behind the
ear. Cochlear implants provide a different experience from hearing aids as they
stimulate the auditory nerve directly.
 Telecommunication Devices:
o Captioned Phones: These phones provide real-time captions of phone
conversations for individuals who are deaf or hard of hearing. This ensures that
users can read the spoken words in addition to hearing them.
o Video Relay Services: Video relay allows sign language users to communicate via
a video call, with an interpreter facilitating the conversation. This is particularly
important for deaf individuals who communicate using American Sign Language
(ASL) or other sign languages.

4. Audiological Rehabilitation
Audiological rehabilitation aims to improve the quality of life of individuals with hearing
loss, focusing on communication strategies, emotional support, and social integration.

 Rehabilitation Techniques:
o Auditory Training: This is a therapeutic process that helps individuals improve
their ability to recognize and interpret speech. It involves exercises that enhance
the brain's ability to process auditory information, particularly in noisy
environments.
o Speechreading (Lipreading): This technique teaches individuals to use visual cues
(facial movements, lip shapes) to understand speech. It can be especially useful
for individuals who are hard of hearing in addition to using hearing aids or
cochlear implants.
o Communication Strategies: These strategies include tactics such as speaking
clearly, reducing background noise, and ensuring good lighting for speechreading.
Additionally, patients may be taught how to manage difficult communication
situations, like asking others to repeat themselves or using gestures.
 Speech-Language Therapy:
o Speech Therapy: Essential for children who experience hearing loss at a young
age, speech-language therapy focuses on helping the child develop language
skills. For adults with hearing loss, therapy may involve rehabilitation of speech
and language skills lost due to hearing impairment.
o Therapy for Auditory Processing Disorders (APD): Some individuals may
develop difficulty processing speech even with normal hearing thresholds.
Audiologists may use specialized auditory therapy techniques to help these
individuals better understand speech in noisy or complex environments.
  Multidisciplinary Approach:
Teamwork: Successful audiological rehabilitation often involves a team of professionals,
including audiologists, speech-language pathologists, psychologists, and educators. This
collaborative approach ensures that all aspects of the patient’s needs are addressed, from
hearing and communication to emotional well-being and educational support.
 Impact of Hearing Loss:
Social and Emotional Impact: Hearing loss can lead to isolation, frustration, and
depression, particularly if communication becomes difficult. Audiological rehabilitation
also focuses on managing the social and emotional aspects of hearing loss, providing
counseling and support groups to help individuals cope with the psychological effects.

5. Research Methods in Audiology

Research in audiology is essential for advancing our understanding of hearing mechanisms,
diagnosing hearing disorders, and developing treatment options.

Types of Research:
This may include studies on the anatomy of the cochlea, the function of the auditory pathways,
and the biology of hearing.
I. Applied Research: Basic Research: Aims to understand the fundamental mechanisms of
hearing and auditory processing. Focuses on practical applications, such as testing new
hearing aid technology, evaluating rehabilitation strategies, or studying the effectiveness
of cochlear implants.
II. Quantitative Research: Involves collecting numerical data and using statistical methods
to analyze it. Examples include measuring hearing thresholds in different groups of
patients or comparing the outcomes of different treatment modalities.
III. Qualitative Research: Involves gathering non-numerical data, often through interviews or
case studies, to explore patients’ experiences with hearing loss or treatment options.
 Data Collection Methods:
o Questionnaires and Surveys: Used to collect subjective data on patient
satisfaction, quality of life, or the impact of hearing loss on daily activities.
o Case Studies: In-depth analysis of individual cases to understand the clinical
manifestations of hearing disorders or the effectiveness of particular treatments.
o Experimental Studies: Conducting controlled trials to assess the efficacy of new
technologies, such as a new hearing aid or speech therapy technique.
 Statistical Analysis:
o Descriptive Statistics: Measures like mean, median, standard deviation, and range
describe the basic characteristics of the data.
o Inferential Statistics: Used to make conclusions about populations based on sample data.
Common tests include t-tests (to compare two groups) and ANOVA (to compare more
than two groups).
  Ethical Considerations:
o Informed Consent: It is critical that participants understand the purpose of the
research, any potential risks, and their right to withdraw at any time.
o Confidentiality: Researchers must ensure that personal data is kept confidential
and that participants’ privacy is respected.

6. Pathology of Hearing Disorders

Hearing disorders can arise from a variety of causes, including genetic factors, infections,
trauma, and age-related changes. Understanding the pathology behind these disorders is essential
for diagnosis and treatment.
Types of Hearing Loss:
I. Conductive Hearing Loss: Caused by problems in the outer or middle ear, such as otitis
media, earwax blockage, or eustachian tube dysfunction. This type of loss can often be
treated medically or surgically.
II. Sensorineural Hearing Loss: Results from damage to the cochlea or auditory nerve, and
is often permanent. Common causes include presbycusis (age-related hearing loss), noise
exposure, and genetic conditions.
III. Mixed Hearing Loss: A combination of both conductive and sensorineural hearing loss,
which can occur when a person has both middle ear issues and cochlear damage.
 Common Pathologies:
o Otitis Media: A middle ear infection, often caused by bacteria or viruses, leading
to fluid buildup and hearing impairment. It is common in children and may lead to
temporary conductive hearing loss.
o Presbycusis: Age-related hearing loss, typically beginning around age 60. It
affects the high frequencies and is a result of the degeneration of the cochlea and
auditory nerve fibers.
o Acoustic Trauma: Caused by exposure to loud noises, leading to permanent
damage to the cochlea. It is common among people exposed to industrial noise or
music at high volumes.
o Meniere’s Disease: A disorder of the inner ear that causes fluctuating hearing
loss, tinnitus, and vertigo. It is believed to result from abnormal fluid pressure in
the inner ear.
o Auditory Neuropathy: A condition where the auditory nerve does not process
sound correctly, even if the cochlea is functioning properly.
 Causes and Risk Factors:
o Genetic Factors: Genetic conditions such as Usher syndrome or Waardenburg
syndrome can cause congenital hearing loss.
o Environmental Factors: Noise exposure and infections such as meningitis or
measles can lead to sensorineural hearing loss.
o Age-Related Hearing Loss: Presbycusis is one of the most common causes of
sensorineural hearing loss in older adults.
o Diagnostic Approach: Audiologists diagnose hearing loss using a combination of
audiometric testing, imaging (CT or MRI), and medical referrals. In some cases, a
referral to an otolaryngologist (ENT) is needed for surgical intervention or to
manage complex cases such as Meniere’s disease.