Services

Pediatric Hearing Screening And Diagnostic Hearing Assessments

(Newborn Babies, Infants & Children)

Objective tests include Oto-Acoustic Emission Testing, Auditory Brainstem Testing and Tympanometry. Behavioural testing includes Conditioning Play Audiometry, Visual Response Audiometry, Pure Tone Audiometry, Speech detection and Speech discrimination testing.

Conditioning Play Audiometry

Assesses 4 – 24 month old infants’ using warble tones, pure tones and speech stimuli

Visual Response Audiometry

Assesses 24 months – 4 year old toddlers using behavioural responses and localization abilities to warble tones and speech stimuli in a free field environment

Closed – set Speech Discrimination Testing

School Hearing Screenings

Due to the fact that objective tests are being used, hearing screenings at schools are not limited to pre-primary age. Children of all ages can be screened. These screenings are performed at schools and are not limited to the amount of children in the school.

Diagnostic Hearing Assessments For Adults

Assessment includes Otoscopy, Pure Tone Audiometry, Speech Audiometry, Bone Conduction, place of lesion testing including Oto-Acoustic Emission testing and Acoustic Reflex testing. Auditory Brainstem testing for adults are also available.

Otoscopy

Bone Conduction Testing

Pure Tone Testing In Sound Proof Booth

Industrial Hearing Screening

Including Baseline testing, entry audiograms and exit audiograms. These tests are performed at the practice. On-site testing not possible.

Hearing Protection

Including custom-made ear protection (Noise Clipper/Variphone) most commonly used in factories; Music plugs for musicians with options for different filters; custom-made shotgun protection for hunting and professional shooting; custom-made ear protection for motorbikes.

Custom – Made Swimplugs

Also used for children with grommets.

Central Auditory Processing Disorder (CAPD)

What is CAPD?

Central Auditory Processing Disorder, or CAPD, refers to the way that the central nervous system uses auditory signals. In other words, CAPD has to do with how the brain uses sounds that the ears hear. CAPD usually presents itself more clearly in complex listening environments, such as noise, or in a classroom where there are multiple speakers, or a teacher with an unfamiliar accent or manner of speaking. About 5% of school-aged children are affected by CAPD.

There is no single agreed-upon definition of CAPD. However, the following guidelines are universally accepted:

With CAPD there is breakdown in receiving, remembering, understanding and using auditory information
With CAPD there is usually adequate hearing
There is a neurological basis to CAPD
CAPD impairs a child’s ability to listen

A child with CAPD often seems like a child with a hearing problem, and this is why it is very important to rule out hearing loss before testing. However, CAPD can also occur in conjunction with hearing loss. A child with CAPD can often be confused with a child with ADD, however, the treatment for ADD will not be effective on a child with CAPD.

How Do We Diagnose CAPD?

This testing is performed at our premises by an Audiologist from Graaff-Reinet, Izienne Van Jaarsveld whom travels to Port Elizabeth to perform the tests.

Appointments must be scheduled directly with Izienne Van Jaarsveld: 082 856 3654 or iziennevj@gam.co.za

Case History:

We meet with the parent or parents to discuss the child. Topics that may be covered include:

Your pregnancy and the birth of your child
Your child’s medical history
Your child’s developmental history
Your child’s academic history, and strengths and weaknesses
Your child’s social behavior
Your child’s personality
Any other assessments and therapies that your child has received

Be sure to bring any reports or results of other assessments that have been done. Also bring school reports if you have them. The more information we can use, the better we can diagnose and assist your child.

Assessment:

Before testing your child for CAPD, we screen their hearing using Otoscopy, Tympanometry (a middle ear measure) and Oto-Acoustic Emissions. This can confirm that your child has normal hearing, and normal functioning ears, before we attempt to assess the brain. For the CAPD assessments, your child is tested using our standardized testing techniques. The testing may include:

Auditory Closure: How well your child can ‘fill in the gaps’ when listening, or cope with a speaker they are not used to.
Auditory Figure-Ground: How well your child can cope in listening environments where there is competing sound or background noise.
Binaural Integration: How well your child can listen with both ears and integrate the sounds between the two. This will influence how a child copes in a multi-speaker situation.
Binaural Separation: How well your child can ‘tune in’ to one ear or the other, and ‘tune out’ of the opposite ear.

The testing will also identify if your child has a stronger and weaker ear, and which ear is the stronger. The results of the testing are processed and compared to age related norms. A report is compiled of the test results.

3. Results:

We meet with the parent or parents of the child to discuss the results. Any questions are addressed at this time, and the results will be explained in detail. A treatment plan will be recommended that has been custom designed for your child’s individual needs.

How Do We Treat CAPD?

There are three main approaches to the treatment of CAPD. Each child will require an individualized approach, tailor-made to their test results and the child’s history. Not every child will need all three techniques.

1. Classroom Modification:

An altered classroom set-up may be recommended. You will be advised on the best place to seat your child. Some children will benefit from sitting in the front row, and some will do better to the left or right of the classroom. We may also recommend an altered schedule, or the implementation of special procedures for the child. For example, a child with CAPD may need more regular ‘sound breaks’ in order to recover from Auditory Fatigue.

2. CAPD Therapy:

We may recommend that your child receive Auditory Processing Therapy. We usually recommend between 6 and 12 sessions, but your child may need more. Therapy usually involves weekly sessions of 30 minutes, working primarily on various computer programs designed to stimulate the auditory system. Your child will work in a one-on-one situation with an Audiologist. The therapy is focused specifically on your child’s individual needs. Your child’s progress will be monitored, and a reassessment will be recommended after a certain number of sessions.

3. Assistive Listening Devices:

We may recommend that your child receive Auditory Processing Therapy. We usually recommend between 6

and 12 sessions, but your child may need more. Therapy usually involves weekly sessions of 30 minutes, working primarily on various computer programs designed to stimulate the auditory system. Your child will work in a one-on-one situation with an Audiologist. The therapy is focused specifically on your child’s individual needs. Your child’s progress will be monitored, and a reassessment will be recommended after a certain number of sessions.

Oto – Acoustic Emission Testing (OAE)

The OAE test provides objective information about the functioning of the outer hair cells of the cochlea. It can be performed hours after birth. A miniature earphone and microphone is placed in the ear; sounds are then played and as response are measured. If a baby hears normally, an echo is reflected back into the ear canal and is measured by the microphone. When a baby has a hearing loss, no echo can be measured on the OAE test. This test is also useful during school screenings, adults with tinnitus, adults working in noisy environments, diagnostic hearing assessments of young children and adults as well as part of place of lesion testing.

Tympanometry

The purpose of tympanometry is to determine the point and magnitude of greatest compliance (mobility) of the tympanic membrane/eardrum. The results provide important information about middle ear function and helps detect different conditions and diseases of the middle ear. (Shipley & McAfee; 1998). This test can be performed as part of a test battery or as a routine assessment of the middle ear’s functioning, especially for children who had previously received grommets. This test is also used during school screenings.

Eustachian Tube Function

The procedure for the performance of this test is similar to that of tympanometry, except that the change in pressure in the middle ear is measured during swallowing and equalization.

Hearing Aid Recommendations & Assessments For Candidacy

Hearing aids are very specifically chosen according to each person’s hearing test results or hearing abilities, daily needs and function at work or socially as well as financial capabilities. The Audiologist should inform each client of various options available, including the model of the aids, size, technology and colour. Each client should know exactly why they are given a specific hearing aid.

Hearing Aid Fittings

Hearing aid fittings consist of the initial fitting, as well as two-three follow-up sessions where fine tuning of the sound may be required. It may be beneficial to bring along a family member who can help listen to all the information and provide emotional support. The initial fitting session involves an explanation of how the aid works, how to change batteries and how to maintain it. The fitting is computer-based and performed according to the client’s hearing test results and specifics of the aid. The session can take up to an hour and apart from all the information given to the client, is quite daunting as there will be many sounds the client will hear that he/she has not heard in a very long time.