Speech Audiometry, OAE, AMR,

• better estimate of hearing handicap then pure tones because it incorporates sensitivity and acuity
• -they are not great diagnostic tools

A measure of sensitivity, it is the lowest level in dB that a subject can detect speech. The speech does not need to be understood just need to be able to hear someone talking

• Better than SDT and is also a sensitivity measure.  The difference is the speech must be understood and is often tested with Spondees. (greyhound, sidewalk, mailman)
• -you test it in the same fashion as pure tones but the client must repeat the word.
• -this measure should agree with your pure tone average at 500, 1000 and 2000

most comfortable listening leve

• the % correct supra measures
• -how well can acoustic cues of speech above threshold be distinguished

• not a discrimination task and cannon be predicted by the pure tone audiogram
• -not good reliability or validity
• -can help with amplification, how much struggle, lesion site
• -the more words the better or more reliable it is

• sounds produced by the cochlea, it is the sound of outer hair cells dancing. rules out middle and outer ear problems (conductive loss)
• -could still be an inner ear problem
• -they are used for neonatal screenings, early signs of NIHL, Malingering, ototoxicity monitoring
• -Spontaneous OAEs happen in the absence of input
• -evoked OAEs is when there is a response to our manipulation

• 2(f1)-f2= where to measure the DPOAE
• -not a test of hearing, only a test of OHC functioning. we use them to infer normal hearing. good for infants and dif populations 
• -If there is no activity at the area we calculated(in the above equation) then there is an OHC malfunction
• -we measure the amplitude(dB)

• sounds can cause certain centres of the auditory system to create a measurable output
• -ABR is a type of AEO: we measure them based on shape and latency

• not a test of hearing, they test IHC and brainstem function
• -early latency response and happens automatically after stimulus in a healthy system
• -we use them for threshold estimates in hard to test populations
• OAE + ABR = good idea of problem area

• 1. Cochlea + VIII CN function
• 2. VIII CN
• 3. Pons
• 4. Pons
• 5. Midbrain

• At high intensities (70db) we should have clear responses from 1,3,5
• -then intensity is lowered until wave 5 (midbrain) is undetectable which is your ABR threshold

• 1. absolute latencies of all waves
• 2. interpeak intervals
• 3.wave amplitudes
• 4 threshold of wave V (midbrain)=as you near it the latency goes up and amplitude goes down

will elevate thresholds by air and slow all waves down by the same amount

Prolong and elevate wave V threshold

• -prolong interpeak intervals,
• -wave V latency different between ears
• -amplitude ratios are abnormal (wave 5 is usually larger than wave 1)
• -wave V is prolonged or absent at high intensities

kid turns to sound then is reinforced with a toy of some sort that is lit up in a box. appropriate for kid 7-30 months.  Must condition the response first

• 30m-5 years approx
• start at 50db to teach the game then start the test