Ms. Kibby received her master's degree in Audiology with honors from California State University, Long Beach, and is currently pursuing her doctorate at the University of Florida. She completed her clinical fellowship and spent seven years at Texas Children's Hospital in Houston, where she trained for her pediatric specialty.
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Bredenkamp recieved his medical degree from the University of California, San Francisco School of Medicine. He then went on to serve a six year residency at the University of California, Los Angeles School of Medicine in the department of Surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A specialist who tests a person's hearing is called an audiologist. An audiologist has an advanced degree (minimum of master's degree) in diagnostic hearing testing techniques and auditory rehabilitation for children and adults. However, because testing hearing in children requires specific equipment, setup,
and training, not all audiologists test children. When a child is referred for a hearing evaluation, it should be confirmed at the time of scheduling that the testing audiologist has a pediatric specialty and the appropriate setup to test hearing in children.
Can very young children have their hearing tested?
A child of any age can be tested with the appropriate hearing test. The type
of test utilized depends on the child's age in years or developmental level.
Some hearing tests require no behavioral response from the child, while other
tests utilize games that entice a child's interest. The key is to find the
right test method for each child.
How is hearing tested in an older infant or young child who cannot
follow specific instructions?
Cooperative and alert infants or young children (ages 5 months to 2 and a half years)
are frequently tested using a method called visual reinforcement audiometry (VRA).
For this test, the child sits on a caregiver's lap in the center of a room.
Speakers are situated to the child's right and left side. The speakers have
toys (usually mounted inside boxes) hung below, which can be animated by the
tester. The child is then "conditioned" to turn his or her head toward the
side from which the sound is presented. When the child turns to the correct
side, the toy is lit up, providing positive reinforcement that encourages the
child to continue participating in the task. Children (and adults) will
instinctively turn toward a novel sound without having to think about the
response, which is why this test is effective for children as young as 5
months of age. This method can also be used with small insert earphones, which allow
the hearing of each ear to be tested individually. Below is a diagram of the
setup for the VRA test.
There are, however, some limitations to the VRA test. For an accurate test,
the child must participate and needs to be cooperative and alert. Additionally,
if only speakers are used for testing, the results can only be used to predict
hearing for the "better" ear. There is no way to tell if both ears are
hearing the test sounds, or if only one ear is hearing all of the sounds, unless
a device is utilized to isolate the ears (for example, earphones). It is not unusual,
however, to achieve test results for individual ear information by having the
child wear earphones during portions of the VRA test. The ability to localize
sound even with one impaired ear can be quite good. Often, otoacoustic emission (OAE)
tests are completed in conjunction with VRA testing to obtain
some ear-specific results (OAE tests will be discussed later in this article).
Children 3-5 years of age who are capable of more complicated tasks are
often tested using a technique called play audiometry, in which sounds are
paired with a specific response or task. For example, a child is taught to hold
a peg next to his or her cheek. When the child hears the sound, the child places
the peg on a Peg-Board.
Speech testing can be completed using pictures, for example, the child points
to the correct picture as the tester's voice is presented at softer and softer
levels. Once again, the child needs to be a willing participant. The advantage
of this format is that results obtained are often as detailed as an adult test
session.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Jaundice is a yellowish staining of the skin and whites of the eyes (sclerae) with bilirubin, the pigment found in bile. Jaundice can be an indicator of liver or gallbladder disease, or it may result from the rupture of red blood cells (hemolysis).
Down syndrome is a chromosomal disorder that results in the presence of an additional third chromosome 21, also referred to as trisomy 21. Most individuals with Down syndrome have widely recognizable physical characteristics. The severity of Down syndrome ranges from mild to severe. Diagnostic testing for Down syndrome include amniocentesis, chorionic villus sampling, and percutaneous umbilical cord sampling. The most common risk factor for Down syndrome is a woman's age.
Middle ear infection or inflammation (otitis media) is inflammation fo the middle ear. There are two types of otitis media, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point. Treatment depends upon the type (chronic or acute).
Hydrocephalus is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The fluid is often under increased pressure and can compress and damage the brain. Symptoms of hydrocephalus vary with age, progression of the disease, and individual tolerance to the condition. Hydrocephalus is most often treated by surgery in which a shunt system is inserted.
Measles (rubeola) is a highly contagious disease that's caused by a virus. Symptoms include a rash, high fever, cough, runny nose, and red eyes. Treatment focuses on symptom relief. The disease can be prevented with the measles, mumps, and rubella vaccine.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Autism in children and adults is a developmental disorder, characterized by impaired development in communication, social interaction, and behavior. Autism is classified as a pervasive developmental disorder (PDD), which is part of a broad spectrum of developmental disorders affecting young children and adults. There are numerous theories and studies about the cause of autism. The treatment model for autism is an educational program that is suitable to an individual's developmental level of performance. There is no "cure" for autism.
Learning disabilities can cause an individual to have trouble learning and using skills such as reading, listening, writing, reading, speaking, reasoning, and performing mathematics. There is no cure for learning disabilities. Parents and teachers working together to properly diagnose learning disabilities can properly plan a course of education. For some, medication may be appropriate as complimentary treatment.
Ear was is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
Swimmer's ear (external otitis) is an infection of the skin that covers the outer ear canal. Causes of swimmer's ear include excessive water exposure that leads to trapped bacteria in the ear canal. Symptoms include a feeling of fullness in the ear, itching, and ear pain. Chronic swimmer's ear may be caused by eczema, seborrhea, fungus, chronic irritation, and other conditions. Common treatment includes antibiotic ear drops.
Pervasive development disorders (PPDs) are conditions involving developmental delays in children. There are five types of PDDs: autism, Asperger's syndrome, childhood disintegrative disorder, Rett's syndrome, and pervasive development disorders not otherwise specified (PDDNOS).
German measles is a disease that's caused by a virus. Symptoms include rash and fever for two to three days. The MMR (measles, mumps, and rubella) vaccine prevents this disease.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
Jaundice in infants occur when the baby's liver may not be developed enough to efficiently rid the body of bilirubin. Symptoms of jaundice include yellowish colored eyes, and yellowing of the skin. Some babies are more at risk to develop jaundice. Kernicterus is a type of brain damage that occurs when a baby has jaundice and is not treated. Treatment of infant jaundice is generally with phototherapy so that kernicterus should not develop.
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