Graduation Year

2003

Document Type

Dissertation

Degree

Au.D.

Degree Granting Department

Audiology

Major Professor

Theresa Chisolm, Chair

Committee Member

Lewis Barness

Committee Member

Ann Barron

Keywords

Auditory development, Otoacoustic emissions, Auditory brainstem response

Abstract

This paper provides an overview of developmental timetables relevant to hearing and of current pediatric audiological techniques and practices. The first sections summarize structural and functional development of the auditory pathway and the development of primary auditory processing. These developmental sequences appear to follow similar paths in humans and animals. Speech and music perception involve more complex processing and are strongly influenced by experience. Hearing disorders affect the perception of complex sounds in a variety of ways, depending on the site(s) of lesions. Early onset hearing impairment, including conductive loss from chronic otitis media, can seriously impede language development.

Language cannot develop normally without adequate speech stimulation. Sensitive and inexpensive techniques are available for performing neonatal hearing screening, and early intervention has a positive effect on development of language skills in hearing-impaired children. Thus, the National Institute of Health has recommended nationwide universal newborns hearing screening. The rationale and methodology of universal screening programs is summarized in the chapter.

Advances in the field of the genetics of hearing impairment are also reviewed

Recent advances in the field of auditory physiology - coupled with longstanding concerns about delayed identification of hearing impairment - have precipitated public health initiatives (National Institute of Health, 1993) and legislation for neonatal hearing screening programs (Blake & Hall, 1990). Pediatric audiology, once more “art” than science, is now largely based on physiologic methods rather than observed behavior. With current techniques, it is not only possible to detect hearing impairment at birth but also to determine the site of the lesion and to obtain close estimates of hearing threshold at specific frequencies (Werner, Folsom, & Mancl, 1993). Habilitative measures, including amplification, can begin within weeks of birth. Protocols for the management of hearing impairment are guided not only by the site of the lesion but by the developmental sequences and interactions among all of the child’s sensory modalities.

This chapter provides an overview of developmental timetables relevant to hearing and of current pediatric audiological techniques and practices.

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