AHS2046F

Diagnosis in Audiology

Lucretia Petersen
[email protected]
021 406 6993
083 556 3327
Diagnosis in Audiology:
 

What is diagnosis?
  The process of hearing and ear function
evaluation through which the audiologist arrives
at an audiological diagnosis (i.e. type, degree
What is and severity of the hearing loss).
Diagnostic
Audiology?

 This information will assist in determining a

possible site of lesion and predicting speech
perception difficulties.
 The diagnostic process involves:

 A case history interview

What is An audiological test battery
Diagnostic Feedback
Audiology? Management and referral
(where necessary)
  Determine whether or not a hearing or
auditory-related impairment is present

Audiological  Identify the likely impacts of that

Diagnostic hearing or auditory-related
impairment on the client (including
Assessment prognosis/anticipation of need)
is undertaken
to:
 With the client, plan a pathway for
further management of the client’s
auditory disorder and impact on
activities of daily living (ADL).
  Behavioural
 Case history
 Tuning fork tests
 Pure tone audiometry: air and bone conduction
 Speech audiometry: detection, recognition, identification

Assessments  Objective
 Tympanometry
 Acoustic reflexes
 Purpose and Aim
 To measure the degree and configuration of
hearing impairment
 To establish site/s of lesion within the
Standard peripheral auditory system
 To establish the impact of hearing impairment
Audiological
on the client
Assessment  To monitor the stability (degree) and impacts
of an established hearing impairment
  To determine whether an individual would
benefit from further investigation and/or
rehabilitation for hearing impairment

 To monitor the health of peripheral auditory

Standard
system components
Audiological
Assessment
 To determine a pathway for auditory
cont... rehabilitation as required by the individual
  Additional assessments may include
behavioural, often modified test
procedures, as well as objective tests.
 Are required when:
Additional  the client is unable or unwilling to
assessments comply with standard test protocols
 standard assessment results identify
risk factors or inconsistencies
  Behavioural test examples:
 Loudness balancing
 Tone decay
 Bekesy
 Short increment sensitivity index
(SISI)
 Stenger
 Central auditory processing tests
Additional
assessments  Objective test examples
 Acoustic reflex decay
 Eustachian tube dysfunction tests
 Auditory evoked potentials, e.g.
EcochG, ABR, MLR, LLR
 Otoacoustic emissions
 Two summative in-course assessments
 MCQ & Short answer questions (60%)
 Written report (40%)
Formative assessments:
 Peer assessment of roleplay
Course Assessments  Automated computer feedback of
simulated computer cases
 Peer assessment of testing procedures
 Peer assessment of feedback sessions
 Quizzes
Course mark = in course work: 60%
+ examination (MCQ): 40%
  Katz, J., Chasin, M., English, K., Hood, L., & Tillery, K. (2015).
Handbook of Clinical Audiology. 7 th ed. Baltimore: Lippincott
Williams & Wilkins
 Gelfand, S. (2016). Essentials of Audiology. 4 th Ed. New York:
Thieme
Reference
list:
  Boyle, et al. (2005). Invite, listen and summarise: A patient-centred
communication technique. Academic Medicine, 80 (1).
 Carmo, M. P., de Oliviera Costa, N. T., Momensohn-Santos, T. M.
(2013). Tympanometry in infants: a study of the sensitivity and
specificity of 226 Hz and 1000 Hz probe tones, International archives
of otorhinolaryngology, 17, 395-402.
Recommended readings:
 Macguire, P. & Pitceathly, C. (2002). Clinical review: Key
communication skills and how to acquire them. BMJ, 325:697–700
 Mueller, H. G. & Hall., J. (1998). Audiologists’ desk reference. Vol. I.
San Diego: Singular Publishing.
 Ogut, F., et al. (2008). Results of multiple-frequency tympanometry
measures in normal and otosclerotic middle ears. International
Journal of Audiology, 47, 615-620.
 Remenye, J., et al. (2009). The prognostic value of speech
recognition scores at diagnosis of vestibular schwannoma. Journal of
Clinical Neuroscience, 16, 1460-1463.
  Sanford, C., Schooling, T., & Frymark, T. (2012). Determining the
Presence or Absence of Middle Ear Disorders: An Evidence-
Based Systematic Review on the Diagnostic Accuracy of
Selected Assessment Instruments, American Journal of
Audiology, 21, 251-268.
 Shahnaz, N. (2007). Multi-Frequency Tympanometry and
Recommended readings: Evidence-Based Practice. Hearing and hearing disorders:
Research and Diagnostics, ASHA
 Stach, B. (2010). Clinical Audiology: An introduction. 2 nd ed. Chapter
11: Communicating audiometric results. New York: Delmar Cengage
Learning
 Wiley, T., et al. (1996). Audiologic Practices: What Is Popular
Versus What Is Supported by Evidence. American Journal of
Audiology, 4, 26-34.
 Wong, L., & Hickson, L. (2012). Evidence-based practice in
Audiology: Evaluating interventions for children and adults with
hearing impairment. San Diego: Plural Publishing.