[tri-med] ABR test

Hi Karen and Michelle
I'm the resident "Audiologist" and just lurking and saw your posts re: ABRs.
Funny because my daughter Kelly just had a repeat ABR last week. She is 14
months.We were able to do air and bone conduction ABR after her 2nd set of
tubes.  She also has very small canals but that doesn't make any difference
with hearing or testing unless the ears are clogged. She tends to build up
alot of wax though.
The Bone conduction ABR is important because that is usually better. Kelly's
hearing fluctuates from mild to severe depending on the fluid etc. However
her bone conduction is basically mild.  I have also seen delays that I
expect are neurologic.
I would try the behavioral testing (VROA) also as that is more of a
functional test.  Kelly is not able to do that test yet.
Good luck to you. Hope everything works out. Feel free to contact me if you
have any questions.
Valerie
----- Original Message -----
From: Karen Schuler <karens@xxxxxxxxxxxxxxxx>
To: <tri-med@xxxxxxxxxxxxx>
Sent: Friday, November 30, 2001 6:59 AM
Subject: [tri-med] Re: karen, about ABR test


>
> ----- Original Message -----
> From: "Michelle Wilson"
> >>Why should they
> > put her under when the results may not be accurate due to the small
canals?
>
> I truly understand your concern about the sedation, and totally respect
the fact that its your choice sweet. I was just concerned
> that you weren't getting accurate information.
>
> Alex had many ABR's but he was never sedated for them because of the risk.
Instead we scheduled the ABR's so that he slept through
> them. It meant that we often only got one ear done at a time but that was
a small price to pay for no sedation.
>
> Why wouldn't the ABR's be accurate because of the small ear canals? Faren
hears through those same small ear canals and so the test
> would just be telling you what she hears, which is what they are after. An
ABR cannot differentiate between a neural and a
> conductive hearing loss anyway.
>
> The measuring for an ABR are electrodes placed on the head not in the ear.
And to "give" her the sound they use headphones.
>
> OAE's wouldn't be possible because of the small canals, and it also would
be hard to rule out fluid at the time of the test.
>
> Faren is now playing isn't she? Why can't they try getting her ready to do
a VROA?? This is a behavioural response test so no
> sedation is ever even considered.
>
> >>I don't know why they couldn't do the ABR then.
>
> Depends if they had access to the equipment in the ER.
>
> >>it took a long time for it to wear off and
> > her sats(?) were only in the 80's.  I think they were just being really
> > precaucious cause of her t18.  Doesn't bother me none.
>
> I do truly understand your caution sweet - I HATE anaesthetics with Alex.
Nothing scares me more.
>
> >>She had an ABR when
> > she was in the NICU and her right ear was fine, but her left ear
supposively
> > had a defecit.
>
> Unfortunately they are finding that neonatal ABR's are not all that
reliable..........
>
> >>This cannot be considered valid though because of her tiny
> > tiny canals.
>
> Again I dont understand why??? Where is our resident audiologist????
>
> > The other tests would not be good for her cause she most likely would
not
> > respond to sounds on command.
>
> A good audiologist can do a VROA without the child responding on command.
Alex was very consistent with his VROA's based on visual
> stimuli (puppets). He didn't have to respond on command per sa. Whenever
they played a sound the puppet (which was out of his line
> of sight) would dance. It took a few months of "conditioning" (for want of
a better word) for him to get the idea though.
>
> Before that they used a variety of special noisemaker toys. Bells,
whistles, drums etc that all had different frequencies. All he
> had to do was respond in any way to the noise. eg stop what he was doing,
turning slightly to see where it was coming from, even
> changing the pattern of his body movements. These gave us fairly good
results and let us know that he needed an ABR.
> Alex's had a huge jump in development once he was aided.
>
> If winter comes, can spring be far behind?
> -- Percy Bysshe Shelley
>
> Keep Looking for Rainbows!!!
> Karen, Mum to Alex (7, T-18 mosaic)
> Sydney, Australia
> http://members.optushome.com.au/karens
> http://www.trisomyonline.org
>
>                   Building ___ooOOoo__ Rainbows
>                        www.trisomyonline.org
>                   Families Helping Families On-line
>

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

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