An Update on the External Ear Resonance in Infants and Young Children

Kruger, Barbara

doi:10.1097/00003446-198712000-00008

Cited by 80 publications

(79 citation statements)

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“…We know that the infant ear canal is narrower and shorter than the adult ear (Keefe et al, 1994); it has also been shown that the resonant frequency of the ear canal is higher infants than adults (Keefe et al, 1994;Kruger, 1987;Kruger & Ruben, 1987). We also know that the ear canal wall is thinner and more compliant than in adults up to 2 mo of age (Holte, Margolis & Cavanaugh, 1991).…”

Section: Unoccluded Versus Occluded Earsmentioning

confidence: 99%

Effects of Bone Oscillator Coupling Method, Placement Location, and Occlusion on Bone-Conduction Auditory Steady-State Responses in Infants

2007

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Objective: The aim of these experiments was to investigate procedures used when estimating boneconduction thresholds in infants. The objectives were: (i) to investigate the variability in force applied using two common bone-oscillator coupling methods and to determine whether coupling method affects threshold estimation, (ii) to examine effects of bone-oscillator placement on bone-conduction ASSR thresholds, and (iii) to determine whether the occlusion effect is present in infants by comparing bone-conduction ASSR thresholds for unoccluded and occluded ears.Design: Experiment 1A: The variability in the amount of force applied to the bone oscillator by trained assistants (n ‫؍‬ 4) for elastic-band and handheld coupling methods was measured. Experiment 1B: Bone-conduction behavioral thresholds in 10 adults were compared for two coupling methods. Experiment 1C: ASSR thresholds and amplitudes to multiple bone-conduction stimuli were compared in 10 infants (mean age: 17 wk) using two coupling methods. Experiment 2: Bone-conduction ASSR thresholds and amplitudes were compared for temporal, mastoid and forehead oscillator placements in 15 preterm infants (mean age: 35 wk postconceptual age (PCA)). Experiment 3: Bone-conduction ASSR thresholds, amplitudes and phase delays were compared in 13 infants (mean age: 15 wk) for an unoccluded and occluded test ear. All infants that participated had passed a hearing screening test.Results: Experiment 1A: Coupling method did not significantly affect the variability in force applied to the oscillator. Experiment 1B: There were no differences in adult bone-conduction behavioural thresholds between coupling methods. Experiment 1C: There was no significant difference between oscillator coupling method or significant frequency x coupling method interaction for ASSR thresholds or amplitudes in the young infants tested. However, there was a nonsignificant 9-dB better threshold at 4000 Hz for the elastic-band method. Experiment 2: Mean bone-conduction ASSR thresholds for the preterm infants were not significantly different for the temporal and mastoid placements. Mean ASSR thresholds for the forehead placement were significantly higher compared to the other two placements (12-18 dB higher on average). Mean ASSR amplitudes were significantly larger for the temporal and mastoid placements compared to the forehead placement. Experiment 3: There was no difference in mean ASSR thresholds, amplitudes or phase delays for the unoccluded versus occluded conditions. Conclusions:Trained assistants can apply an appropriate amount of force to the bone oscillator using either the elastic-band or hand-held method. Coupling method has no significant effect on estimation of bone-conduction thresholds; therefore, either may be used clinically provided assistants are appropriately trained. For preterm infants, there are no differences in ASSRs when the oscillator is positioned at the temporal or mastoid placement. However, thresholds are higher and amplitudes are smaller for the forehead placement, consequ...

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Section: Unoccluded Versus Occluded Earsmentioning

confidence: 99%

Effects of Bone Oscillator Coupling Method, Placement Location, and Occlusion on Bone-Conduction Auditory Steady-State Responses in Infants

2007

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“…The same 27 audiograms were used during the generation of both the pediatric and adult prescriptions. (Kruger, 1987), accordingly. The high-level speech input was then systematically decreased in 5-dB steps.…”

Section: Efficient Frontier Of Normal Hearing Sensitivitymentioning

confidence: 98%

Modern Prescription Theory and Application: Realistic Expectations for Speech Recognition With Hearing Aids

Johnson

2013

Trends in Amplification

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A major decision at the time of hearing aid fitting and dispensing is the amount of amplification to provide listeners (both adult and pediatric populations) for the appropriate compensation of sensorineural hearing impairment across a range of frequencies (e.g., 160-10000 Hz) and input levels (e.g., 50-75 dB sound pressure level). This article describes modern prescription theory for hearing aids within the context of a risk versus return trade-off and efficient frontier analyses. The expected return of amplification recommendations (i.e., generic prescriptions such as National Acoustic Laboratories-NonLinear 2, NAL-NL2, and Desired Sensation Level Multiple Input/Output, DSL m[i/o]) for the Speech Intelligibility Index (SII) and high-frequency audibility were traded against a potential risk (i.e., loudness). The modeled performance of each prescription was compared one with another and with the efficient frontier of normal hearing sensitivity (i.e., a reference point for the most return with the least risk). For the pediatric population, NAL-NL2 was more efficient for SII, while DSL m[i/o] was more efficient for high-frequency audibility. For the adult population, NAL-NL2 was more efficient for SII, while the two prescriptions were similar with regard to high-frequency audibility. In terms of absolute return (i.e., not considering the risk of loudness), however, DSL m[i/o] prescribed more outright high-frequency audibility than NAL-NL2 for either aged population, particularly, as hearing loss increased. Given the principles and demonstrated accuracy of desensitization (reduced utility of audibility with increasing hearing loss) observed at the group level, additional high-frequency audibility beyond that of NAL-NL2 is not expected to make further contributions to speech intelligibility (recognition) for the average listener.

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“…Therefore, a different skewed audiogram would be required for each age increment and for each transducer type. Furthermore, these illustrations were constructed based on average acoustic transforms from published data (Kruger, 1987;Bentler and Pavlovic, 1989;Seewald et al, 1993;Dillon, 2001) and may only approximate the relation between the dB DL and dB HL scales for an individual child. The transformation between these scales, and hence the calculation of the EAT, should be performed using individual data of the child's acoustic transforms.…”

Section: Eat = DL + Retspl 2 Cc + Recd 2 Cc (Child) -Map Eat = Dl + Rmentioning

confidence: 99%

Ensuring Accuracy of the Pediatric Hearing Aid Fitting

Marcoux

Hansen

2003

Trends in Amplification

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Considerable effort has recently been dedicated towards early detection of hearing loss in infants. The goal is to subsequently fit hearing aids to hearing-impaired infants so that they can develop speech and language as early and as well as possible. The responsibility of the audiologist is to provide the child with the optimal amplification from the hearing aid. This paper gives an overview of aspects involved in correctly assessing the hearing loss and optimally fitting and verifying the performance of the child's hearing aids. Special emphasis is directed towards differences that exist between children and adults, and how these differences can be considered during a pediatric fitting. We suggest a stringent terminology that can help avoid ambiguous terms and connotations in the child's domain which are derived from those that have become established in adult audiometry and hearing aid fittings. The quantification of hearing thresholds and their appropriate representation is reviewed. An appropriate threshold-based prescription of gain or output of the hearing aid is described. Issues of verification and the actual programming of the hearing aid are discussed.

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An Update on the External Ear Resonance in Infants and Young Children

Cited by 80 publications

References 0 publications

Effects of Bone Oscillator Coupling Method, Placement Location, and Occlusion on Bone-Conduction Auditory Steady-State Responses in Infants

Effects of Bone Oscillator Coupling Method, Placement Location, and Occlusion on Bone-Conduction Auditory Steady-State Responses in Infants

Modern Prescription Theory and Application: Realistic Expectations for Speech Recognition With Hearing Aids

Ensuring Accuracy of the Pediatric Hearing Aid Fitting

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