My experience that I am about to discuss is a situation that all audiologists will one day have to overcome: screening a child! When I was first informed that a child of three years would be the client in my observation, I was so excited! I had never observed a child in the audiological setting. I must admit, I was unaware of the true talent one must possess to accomplish such tasks on a child of such young age.
The child was referred by an SLP for a screening to rule out hearing loss as a cause for delayed speech and language. The child enterred with the father. The child seemed very attached to the parent but was all smiles! The clinician first tested the child to receive minimal response levels using 25dB intensity in warble tone frequencies of 500Hz, 1000Hz, 2000Hz, and 4000Hz. A block dropping conditioning activity was used to help elicit a response. The activity consisted of dropping small toy bears in a cup as the sound is heard. The child presented consistent results with rare false positives. The child would also show a giant grin when the sound was heard which further implied that the sound was being heard. The results suggested that the child's hearing was normal. The clinician could not evaluate sensitivity to speech due to equiptment malfunction.
The clinician then performed otoscopy and tympanometry on the child. Both tests revealed normal results. The clinician informed the father of the patient that there were no signs of middle ear disease.
What did I learn from this observation? First, I learned that there is certain lingo that must not be used while testing a child. It was suggested by an audiologist that any term relating to pain should be left out. If the child were to be exposed to this idea, the child may not participate as easily due to a fearful mentality. I also learned that a good way to get a child to participate in the testing is to involve interesting toys for the child to take their minds off of testing procedures such as otoscopy and tympanometry.
Below is a link for a webpage through ASHA that provides information for pediatric screenings. There is a ton of useful information. There is also pass and referral criteria listed which will help explain the decision making processes in screenings!
http://www.asha.org/docs/html/GL1997-00199.html#sec1.3
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2 comments:
I hope I get to see a child in the clinic too!! I think it would be a lot different testing a child than an adult. How did the client do when the clinician did otoscopy and tymps? Did they mind the otoscope in their ears? Thats what I'm nervous about. Its good to hear that you learned some tips on how to work with children!
The child did well with otoscopy and typms with the comforting verbal interaction. For otoscopy, the clinician excited the child by allowing the client to "see his/her ear on TV!" Also, the clinician informed the child that their ear is similar to an artist in that during the tymps it can "make mountains." Very good verbal encouragement!
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