This document provides an overview of audiology, speech language pathology, and rehabilitation. It discusses the relationship between otology and audiology in diagnosis and treatment of ear disorders. It describes various diagnostic tests in audiology, including pure tone audiometry, speech audiometry, tympanometry, and auditory brainstem response testing. The document also covers hearing assessment and management using hearing aids, cochlear implants, and other devices. Additionally, it discusses areas addressed by speech language pathology such as voice, language, and neurological disorders. Finally, it mentions the multi-disciplinary rehabilitation approach used at the MAA Institute.

1. Audiology, Speech Language
Pathology & Rehabilitation
Dr Udit Saxena
PhD - Hearing Sciences (National Centre for Audiology Canada)

2. Today’s presentation
• Audiology
– Details because of close relation with Otology
• Speech Language Pathology
• Rehabilitation
• It will help
 Deciding assessment and management.
 Make optimum use of the resources.

3. Relation between Otology and Audiology?
Diagnosis
Otology
• Treatment of outer, middle and inner ear disorders
Audiology
• Functional assessment of outer, middle and inner ear
• Assessment of progress during the course of
treatment

4. Relation between Otology and Audiology?(Cont.)
Hearing: Assessment and Management
Otology
• Treatment of outer, middle and inner ear disorders
• Implants
Audiology
• Hearing Threshold
• Assessment of the benefits of devices
prescribed/implanted: hearing aids, BAHA, MEI, CI,ABI and
MBI.
• Auditory Training

5. Audiology in Diagnostics
• Pure-tone (single frequency) audiometry
– Hearing Thresholds
– Type of hearing loss
– Audiogram pattern
Conductive Sensori-Neural Boilers notch (NIHL)
Carhart notch (Otoscerosis)

6. Audiology in Diagnostics (cont.)
• Speech audiometry
– Real world condition
– Speech Recognition Thresholds (50%)
• Relation with PTA + 12 dB
– Speech Discrimination Scores (% intelligibility)
• Cochlear Pathology vs Retro Cochlear Pathology
– Speech Awareness Threshold
• Infants/newborns

7. Audiology in Diagnostics (cont.)
• Special tests
– Cochlear vs Retrocochlear pathology
– SISI (Short Increment Sensitivity Index)
– Tone Decay Test

8. Audiology in Diagnostics (cont.)
• Tympanometry
– Static Compliance (acoustic admittance; ease of acoustic
energy flow). 1980’s: Impedance.
– Equivalent ear canal volume
– Tympanometric peak pressure

9. Audiology in Diagnostics (cont.)
• Tympanometry
– Middle ear resonance (800 and 1200 Hz)
• OCD (mass increase) = Decrease
• Otosclerosis (stiffness increase) = Increase
– Eustachian tube functioning
• Valsalva Maneuver

10. Audiology in Diagnostics (cont.)
• Acoustic Reflex
– Stapedial muscles pulls stapes on acoustic stimulation
with loud sounds; stiffness increase, static compliance
decreases.
– Ipsilateral and Contralateral ear
– Acoustic reflex threshold: Relation with PTA (70 dB SL)

11. Audiology in Diagnostics (cont.)
• OAEs
– Functioning of OHCs
– Newborn screening
– It will be absent if middle ear disorders.
– IHC? Important because 95% of afferent auditory nerve
fibers are contacted to them.
• If loss exceeds 55 dB
• Cochlear Dead regions
• TEN test
• Very minimum benefits with hearing aids.

12. Audiology in Diagnostics (cont.)
• Auditory Brainstem Responses (ABR) /Brainstem
Evoked Response Audiometry (BERA)
– Is not a test of hearing threshold
• Synchronicity of auditory nerve
– Amplitude, Absolute latency and Inter-peak latency
– Estimation of hearing threshold
• Newborn
• Infants
• Children
• Difficult to test population; MR, Autism, ADHD, etc
• To catch functional hearing loss
– Site of hearing testing

13. Audiology in Diagnostics (cont.)
• Middle Latency Response: Midbrain, MGB, Thalamus
• Long Latency Responses: Auditory Cortex
• Cognitive Responses: MMN; P300.

14. Audiology in Diagnostics (cont.)
• Vestibular testing
– Spontaneous nystagmus
– Romberg test
– Gait
– Hallpike Manoeuvre
– Tests of Cerebellar Dysfunction
– Caloric test
– Video/Electronystagmography
– VESTIBULAR EVOKED MYOGENIC POTENTIALS (VEMP)

15. Audiology in Diagnostics (cont.)
• Tinnitus
– Tinnitus matching
– Tinnitus retraining
• Hyperacusis
– Uncomfortable levels
– Ear protective devices

16. Audiology in Hearing
(Assessment and Management)
• Speech audiometry
– Speech in noise tests
• Absorbance: alternative of tympanometry

17. Audiology in Hearing
(Assessment and Management)Cont.
• Hearing aids
– Selection of hearing aids according to loss
– Fitting of hearing aids
– Programming
– Verification of hearing aids benefits
• Aided/Un-aided threshold: Pure-tone
• Aided/Un-aided threshold: Speech
– Counseling
– Auditory training

18. Audiology in Hearing
(Assessment and Management) Cont.
• Cochlear Implant/Auditory Brainstem Implant/
Auditory Midbrain Implant/ Bone Anchored Hearing
aids/Middle Ear Implants
– Candidacy
– Assessments of benefits from these devices
– Impedance check
– Mapping
– Auditory training

19. Audiology in Hearing
(Assessment and Management) Cont.
• Auditory dysynchrony
• Auditory Processing Disorders
– Hearing thresholds: Normal
– Problem understanding speech (in noise)

20. Speech Language Pathology
• Assessment and Management of all Speech and
Language problems
 Voice Disorders
 Delayed Speech and Language
 Autism
 ADHD
 Learning Disability
 Aphasia
 Dysarthria
 Stuttering
 Misarticulation

21. MAA Institute of Speech and Hearing

22. MAA Multi Rehabilitation Institute
• Psychology
• Occupational Therapy
• Physiotherapy
• Special Education

23. MAA Multi Rehabilitation Institute
• Rehabilitation of children
 Autism
 Learning disability
 Delayed Speech and Language
 ADHD
 Mental Retardation
 Cerebral Palsy
 Technology addiction
 Sensory deficit

24. Thank You!