Audio prosthesis, class 23-05

Muss Questionnaire:
There are 10 questions, the parents are the ones who give the scores based on what they observe in their children. They see 3.
very specific items:

1. The assessment of the child's control over their own voice.

2. See if there is the creation of sounds similar to those of language.
3. And to see if it requires any type of communication strategy.

This scale is applicable to children of all ages and, like the previous one, it is administered in the form of a survey.
interviewer asks and the dad responds, on a likert-type scale ranging from 0 = never to 4 = when the behavior
it is always observed.

The chart used is the same as the previous one, where the y-axis represents the type of response.
(from zero to always) and on the horizontal axis is the numbered question from 1 to 10.

We are tabulating the response that the father gives regarding the basically linguistic behaviors of the
child and the idea is then to make comparisons, it is a very good way to assess the therapy we do
us and what we do with the parents. Remember that the central axis of this approach is the parents, because in the
They need to create acoustic environments at home to make the most of residual hearing.

Questions:

- Does the child use vocalizations to attract the attention of others?

- Do you articulate during interactive communication?
- Do vocalizations vary with the content of the message?
- Does only the child want to speak to communicate with their parents and loved ones when the topic is
known or familiar?
- The same question, but when the topic is not familiar.
- Do you voluntarily wish to engage in speech for social interactions with hearing people?
- Is the child's speech understandable to people who are not familiar with him?
- Does the child spontaneously use oral correction and clarification strategies when not understood?
by known people?
- Does he/she spontaneously use oral clarification strategies when he/she does not understand the speech of people?
that are not familiar with it?

There is no one scale better than another; the idea is to complement the information, the idea is to use both.

The first test that needs to be done is the:

Alert test on the name:

As its name suggests, it is speaking to the child in a conversational voice, it's free-range (more natural environment),
it is to call the child by his name and see if he has any kind of reaction. Since they are children who have just
listening experience, it is important to emphasize what the child's name is, in the end, everyone should call him that
by their name (without nicknames or diminutives because it is their first listening experience).
You must note the intensity level, as it is conversational speech, it should be approximately 45-50-55 dB and the
distance when it is seen that the little one indeed has a reaction when called.

Ling sound test:

When we want the child to have some reaction when we call them by their name. auditory habit that
what we are measuring is the DETECTION.

The idea is for the child to be able to detect the 6 sounds of 'ling' and what is measured is the ability to detect those 6.
phonemes that are found there m-u-a-i-sh-s.

When we say that a good PTP is enough to listen well, it's not quite like that because essential phonemes
they are found from 250 to 4000 Hz, so the idea of a hearing prosthesis or a cochlear implant being able to
to provide coverage achieve the audibility of these 6 sounds, that if achieved the child is already trained to make the
therapy, because we know that it is covering a sufficient frequency range.
The child is positioned so that he never sees our faces, and we are producing those sounds at 30 cm, 1 meter, and 3 meters.
mts. (has undergone modifications, you may find it at 5 mts. in some practices).

When the child has the ability to do a play audiometry, we place the toy, we make the sound.
and the child puts the toy in a bucket and needs to go through all the phonemes. When the child is younger
some type of reaction is sought (which is super complicated because in observation a lot of expertise is required)
regarding that).

It is not a test that is done only once; every time the child goes to their session with their family member, it is a mandatory condition.
The a priori of each session is to make the sounds of the independent ling regardless of age, because if the child does not respond to
Some of these sounds mean that the hearing aid is not covering that frequency band.

This test is for screening, but it can also measure identification; when the children are older, they
you can ask them to repeat m-s-sh-a-u… And if I am asking you to repeat, this case is exceptionally
identification.

Formant 1 leads us to detect.

Formant 2 it leads us to identification.

It is always important to have the formants of each of the phonemes on hand.

The tabular form: There are sounds and they have to be randomly repeated 5 times, and some do them 4 times.
sometimes, but we do it 5 times at 30 cm, at 1 meter, and at 1.5 meters.

Important do not position behind, but diagonally when the child uses unilateral hearing aids.
And remember that this approach is carried out where there is the best audibility or audioprosthesis.

This test, like the previous one, measures detection ability.

ESP tests, early speech perception tests:

They are a set of tests, we will have ESP to measure suprasegments, monosyllables, and bisyllables.

The test format is the same. drawings, images, therapist asks and the child must choose the answer
adequate.

- ESP of suprasegmental patterns: to recognize the suprasegmental patterns of speech. 12 are presented.
words in a closed format, corresponding to monosyllabic, grave and acute bisyllabic words, and words
 bisyllabic. Any image that the child shows in this closed format is considered adequate,
as long as the image shown has the same accent pattern and duration as the word
stimulus.
This test has a total of 24 items because each stimulus must be asked 2 times.
12 drawings that should be asked twice.
When there are children with a lot of difficulty, what is done is take 4 representative objects from the
words, and the type of response is exactly the same as that of the original test, fundamentally perceiving the same
accent and duration pattern; each stimulus is repeated 3 times, so the total on a low verbal scale
It will change, instead of being a total of 24 points, it will have half.
- ESP for identifying bisyllabic words: ability to identify words, there are 12 words.
bisyllabic, each word is repeated 2 times randomly (24 points in total). This test is important.
because if the child performs well the child would be in category 3 start of word identification.
- Identification of monosyllabic words: Characteristics the same as the previous one. There will also be a scale.
verbal low, 4 monosyllabic objects, in this case the correct answer is the word stimulus
(identify the object of the word stimulus) and it is reduced to 12 items. The drawing or the word is accepted (according to
who it applies to because if the child does not read, obviously they will not provide the words.

PIP-S (word identification test through suprasegmental segmentation:

Identify words according to accentuation patterns and duration.

It applies from 3 years old.

There will also be 12 stimuli, but with different duration and emphasis. Monosyllables, grave bisyllables and
sharp and trisyllabic.

All stimuli in general must have certain characteristics:

- Frequently used (we are with children who are just starting to communicate with the environment).
- Images use common nouns because they have representativeness in the real world.
- Plosive consonants are well balanced (because they give greater intensity to certain segments)
of the stimulus because they try to manage that variable.

The 12 stimuli are repeated 2 times, but it is not random; the test has its own order that must be respected.

A proper performance is 18 out of 24 words, and that is 75% or more.

All these tests vary between 75 to 80% at the baseline level, of achievement criteria to say if the child is capable.
to identify words through the acoustic features of suprasegments.

So here is the stimulus that you provide, the child's response; and it's not very clear but here are some boxes.
that are darker (as long as it is within that box it will be correct).

You should learn to use the rule of three for these tests.

PIP-V test (word identification through vowels):

It can be applied from 3 years old.

In general, these tests are for children with severe and profound hearing impairment.

Closed format.
There are 2 versions: the standard (PIP-V 40) and the low (PIP-V30).
The type of stimulus used is bisyllabic, which has the same intonation pattern, the structures of the
consonants are equivalent to each other, and the differentiation is the vowels.

There must be a balance between the suprasegmental and the consonantal segmental part, because we are interested in knowing
if the child is able to identify words solely by the acoustic components of the vowels that are
contained in the stimuli.

In this case, there are 5 forms.

To say that a child is capable of identifying words through the acoustic features of the vowels, we will need
that has 80% or more in the results of this test.
If the child manages to do well on the PIP-V test and therefore on all the previous ones, and then performs poorly on the ones that follow, we
we will find in the category 4.

Return from recess

PIP-V

The test sheet is shown and each stimulus is repeated 2 times and follows the same pattern as the previous one. The
Correct answers go inside the highlighted square.

- Regardless of the category in which the child ended up, the full battery of tests is applied.
For example: If you pass this test, you move on to PIP-C; if in this test you score less than 80%, you are removed.
conclusion that is in category 4

PIP-V40

- Each stimulus is repeated 2 times. The sheet is presented to the child and they are told to show what is given to them.
It will ask. There is no strict criterion that says each object must be named, because already a priori in
the conduct of the instrument took common nouns, therefore, on the subject
lexicon should not be a barrier in these cases.

Matrix of isolated vowels

- The PIP-V and the isolated vowel matrix are passed, because the latter gives us a more qualitative assessment.
What to say whether the child is normal or not.
- Here, the vowels are simply presented randomly, each vowel 4 times alternately.
stimuli) and the idea is to see how the child responds. Here, in the same way, the % is recorded.
correct answers.
- Qualitative information is important as there are indeed vowels that have the same formant.
1, but here the identification is important, therefore, another characteristic is requested. This will provide information
valuable in terms of the calibration of the audio prosthesis.
- Here it will not say the %, although it can be derived; however, the most important thing in the
The evaluation of this test is the qualitative traits.
PIP-C (Word Identification Test through Consonants)

- Identification of words in closed format, but that which will lead the child to the information.
The acoustic for the correct identification of the word is the consonants.
We need to see how residual hearing works.
- Differentiated stimuli by various traits, maintaining the same accentual pattern, vowel structure and
number of syllables. What varies are the consonants
- There are 4 PIP-Cs that will be applied to different ages, and each number indicates the amount of
words to evaluate
- Tests: PIP-C 10, 20, 25, and 50.
- 80% and above: adequate performance for identifying words by the acoustic feature of consonants.

PIP C-10:

It can be applied from 2 years old.

10 forms
2 drawings per sheet
They are representatives of 20 concrete objects.
Presentation of pairs
For example: In the sheet there are 'plato' and 'pato', if the child identified only by vowels they wouldn't be able to say which is which.
since I would only hear 'ao' in both words as they have the same duration, the same accent pattern, because
Therefore, it will be the consonants that he has to process to indicate the correct stimulus.

There will be a list A and a list B, it is up to each person which one to apply.

Each stimulus has a weighting of 10%

If there is a child who has bilateral hearing aids, the test is not done with both turned on; this is because
the answer would be from the best ear. Therefore, one must turn off a hearing aid and place it on the side of the ear.
to evaluate (if the right ear was evaluated, position towards the right side of the child). In this case, list A is applied to
one ear and the list B in the other.

In terms of time, it is faster to evaluate with both headphones on, but this will not indicate if there is
any significant difference between one ear and another. Otherwise, an ear can be categorized into
a certain level of speech perception can be found in one, while the other may be in another, therefore, it is evaluated by
separated.

PIP C-20:

- It is evaluated from the age of 4 years.

- There are 20 sheets (5% for each stimulus)

- 3 drawings for each sheet (list A, B, and C).

Example: Motorcycle, chicken, fat. The words have the same pattern of stress, duration, and the same vowels, but
they differ in the consonants.

This test gives the option to evaluate: right ear, left ear, or both ears.
It is important to complete if you have an implant, hearing aid, FM system.

The ideal is not to use the same list of stimuli.

PIP C-25:

- It applies from 6 years old

- 25 forms (4% each stimulus)
- 4 drawings for each sheet (they translate into 4 lists)

PIP C-50:

- Applies from 8 years old

- 50 sheets (2% each stimulus)
- 4 drawings per sheet
- As they become older children, drawings can be replaced by written stimuli.

If the child can read, there is no problem, because what matters is what comes in through hearing.

Matrix of Consonants

- Presentation of a medial consonant between two vowels /a/, in this case, the child is told to show me.
hada, ama, I, etc. in all phonetic combinations.
- Each consonant appears 4 times
- The percentage of correct answers can be recorded.
- The correct answers are in a more shaded area.
- This data provides us with valuable information about whether the child is able to discriminate each of them or has any.
confusion, so that when the time comes to calibrate, the necessary adjustments can be made so that this
audibility is effectively good for what we are interested in putting the headphones for, which is speech production.
- IMPORTANT: It must be between 2 vowels /a/.
Up to here it is possible to evaluate up to category 5.
The GASP and OFA-N tests are the only two tests that are conducted in an open format, where
Obviously the child does not know what he has to repeat and does not know what he will be asked.

GASP (Glendonald Auditory Screening Procedure)

- Ability to recognize questions.

- It applies from the age of 4
- The test is administered only by hearing.
- Each sentence is said once and the child is asked to respond.
- The child can respond by repeating phrases or answering the questions (which are simple).
The protocol records whether the child responded or if they imitated the phrase.
 In the case of the question: What number comes after 7? And the child says: 9. It remains to be determined.
of the evaluator, because although their response is incorrect, they are answering coherently to the question.
A single test does not provide us with enough data; it must be complemented with the medical history and other tests.
One must be judicious with some items.
- If the child does not answer the question correctly, they should be scored zero.

OFA-N (Open Format Sentence List for Children)

- It is an assessment of speech perception with simple sentences and everyday vocabulary.

characteristics

- There are 120 stimuli

- Each sheet has 10 sentences (12 lists)
- Sentence presented orally (distance +/- 1.50 m), in conversational voice.
- The boy must repeat the sentence exactly. Any list can be chosen; there is no need to take a specific one.
specific.
- Assessment: accurately account for each repeated word.
If there are 56 words in list 1, the percentage is calculated using simple rule of three.
Within the relevant qualitative information, it will be interesting to see if there are any omissions of articles or prepositions.
The first words that appear are nouns. Therefore, aside from the quantitative analysis, it can be
conduct a qualitative analysis.
Then all the corresponding batteries are applied, respecting the issue of age. Once
After analyzing all the tests, it is decided to determine in which category the child is placed. It is
it is important to know this, because if the child is just starting to identify suprasegmental patterns, they do not
I hope that in an activity I have to identify words. To work on suprasegmental patterns are
Good songs, very expressive oral language with inflections and repetitions.