Western Washington University
Department of Communication Sciences and Disorders
CSD 462 AUDIOMETRIC TESTING – Spring 2013
(MTWF 10:00-10:50 a.m. AIC West #210)
Laboratory and Clinical Observation/Testing Times as assigned
INSTRUCTOR:
PHONE:
Rieko Darling, Ph.D.
650-3143 (w)
650-0966 (h)
Rieko.Darling@wwu.edu
OFFICE:
AIC East #372
Office hours: As posted or by
appointment
GENERAL COURSE DESIGN AND OBJECTIVES:
Students will understand the principles and become competent with procedures that
comprise the basic audiological evaluation. Students who successfully complete this
course should be able to:
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Describe the reasons for audiometer calibration and what this may entail
Describe the rationale for otoscopy
Demonstrate otoscopic examination with a hand-held otoscope
Describe the fundamentals underlying pure tone audiometry and the components
of a reliable audiogram
Demonstrate how different pure tone tests are performed
Interpret pure tone audiometric test findings
Describe the fundamentals underlying speech audiometry
Demonstrate how different speech tests are performed
Interpret speech audiometric results and relate them to pure tone threshold tests
Describe the concepts of cross hearing and when masking signals should be
employed
Describe the purpose of acoustic immittance testing
Describe the expected pure tone, speech, immittance test results for different ear
pathologies
The course is presented in a lecture format, supplemented by demonstrations, handouts,
tutorials, and visual media. Class lectures will also be reinforced with laboratory
experiences, patient testing simulation assignments, clinical observation, and by
undergoing a basic evaluation in the audiology clinic.
Specific CSD 462 course learning outcomes and related ASHA certification standards:
III-B: Biological, Neurological, Developmental/Lifespan, Acoustical;
Psychological
Standard III-C: Characteristics, Assessment, Etiology
Standard III-D: Prevention, Assessment, Intervention
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REQUIRED TEXTS AND MATERIALS:
o Stach, B., (2003) Comprehensive Dictionary of Audiology (2nd edition). Thomson
Delmar Learning
o Martin, F. & Greer Clark, J., (2012) Introduction to Audiology (11th edition),
Allyn & Bacon
Both books were required for CSD 372 Hearing Disorders and should
therefore be in your personal library.
o Abbreviated versions of PowerPoint lectures on Blackboard
o Supplemental handouts posted on Blackboard or given in class.
COURSE REQUIREMENTS:
1.
Lecture class attendance
Class attendance is expected. You are also expected to arrive on time and be prepared for
each class. This means that readings and assignments have been completed as
appropriate. Abbreviated versions of my PowerPoint lecture slides will be available on
Blackboard. Materials may be presented in class that may not be covered or covered as
thoroughly in the textbooks. I encourage you to obtain the lecture notes from your
classmate(s) if you miss a class.
2.
Lab attendance
Lab attendance on your assigned date/time is mandatory. An unexcused absence from a
lab means that you cannot satisfactorily complete the course. If you miss your assigned
lab due to an emergency, you can make arrangements to re-schedule the missed lab or
attend another scheduled lab session. Obtain my permission first. It is your
responsibility to make the arrangements and inform your assigned lab instructor that an
alternate lab has been attended. Otherwise you will be marked down by your assigned
lab instructor as being absent (unexcused) from that lab. You will be allowed to attend
an alternate lab session only once during the quarter.
3.
Reading Assignment
Complete reading assignments as indicated on the syllabus. It is highly recommended
that you also peruse the reading materials and other supplemental information presented
on the companion website to your textbook.
4.
Hearing Assessment/Clinic Observation Assignment
You will be assigned to specific dates and times when you will either undergo a basic
audiologic evaluation (i.e. be the patient) or observe the assessment procedures.
Attendance on your assigned dates/times is mandatory. An unexcused absence from your
evaluation or observation session means that you cannot satisfactorily complete the
course. If you miss your assigned evaluation or observation session due to a verifiable
emergency, it is your responsibility to see me as soon as possible so that an alternate
session can be arranged.
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The OBSERVATION SUMMARY REPORT (see attached) must be filled out with all
pertinent information, signed by the session supervisor and turned in to me no later than
4:00 pm on Friday June 7, 2013. Observers must adhere to dress codes and rules of
confidentiality and professional conduct while in the clinic. The clinician and/or
supervisor will let you know when it is appropriate for you to ask questions, where you
should be, etc.
5.
Written Examinations
Exams will be based on information presented in class lectures, handouts, class textbook
& software, demonstrations and labs. Make-up exams will only be allowed for cases of
verifiable emergencies, must be taken within 2 days of the original scheduled exam.
Make up exams may consist of both written and oral components.
6.
Computer Simulation Assignment:
You will be required to complete a computer simulation case. This case must be
accomplished/recorded/saved on a memory stick/thumb drive that you will provide. This
memory stick/thumb drive must be turned into my mailbox in AIC East #392 no later
than 4:00 p.m. on Friday June 7, 2013. The simulation case will be accomplished by
using The Audiology Clinic simulation program available on various computers located in
AIC East building. Details on how to use the simulation program and access to
computers will be provided.
SUMMARY OF DUE DATES:
1.
2.
3.
5.
6.
Observation report - by 4:00 p.m. Friday 6/7/13
Simulation assignment – by 4:00 p.m. Friday 6/7/13
Exam #1 – Monday 5/6/13
Exam #2 – Wednesday 5/29/13
Take home Final exam – Due by 10:00 am Thursday 6/13/13
GRADING:
The final course grade is based on:
a.
Exam #1- 25 pts max
b.
Exam #2- 25 pts max
c.
Cumulative Takehome Final exam - 35 pts max
d.
Simulation assignment – 5 pts max
e.
Practicum score - 10 pts max
**
(lab attendance - 5 pts)
**
(hearing test/observation with report – 5 pts)
-------------------------------------------------------------TOTAL POSSIBLE = 100 pts
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GRADING SCALE:
A
AB+
B
=
=
=
=
92.5-100
89.5-92.49
86.5-89.49
82.5-86.49
BC+
C
C-
=
=
=
=
79.5-82.49
76.5-79.49
72.5-76.49
69.5-72.49
D+
D
DF
=
=
=
=
66.5-69.49
62.5-66.49
59.5-62.49
below 59.5
NOTE: Students with specific disabilities requiring special accommodations must
contact the Office of Disability Resources for Students (OM 110, ext. 3083) for
verification, necessary forms, and coordination of services.
ACADEMIC HONESTY
Academic integrity is demanded throughout all aspects of coursework. Students are
required to have read and to understand the Western Washington University Academic
Dishonesty Policy and Procedure, as listed in the 2012-2013 Western Washington
University Catalog (Appendix D). This policy states, in part: “All Western Washington
University students have an obligation to fulfill the responsibilities of their particular
roles as members of an academic community. Honesty is essential to learning. Without it,
fair evaluation for all is impossible. Academic integrity is demanded, and academic
dishonesty at Western Washington University is a serious infraction dealt with severely.
No student shall not claim as their own, the achievements, work or arguments of others,
nor shall they be a party to such claims”. For complete information and a list of examples
illustrating academic dishonesty and plagiarism and procedures for academic dishonesty
cases, refer to the 2012-2013 Catalog (Appendix D).
Page 5 of 9
COURSE OUTLINE
WEEK 1
(4/1/13)
Class Overview
Case History and Otoscopic Exam
Assigned Readings: Chp 9 pages 229-231
Dr. Darling @ American Academy of Audiology Convention
No classes on 4/2 & 4/13 but some students will be tested/observing
testing in the Audiology Clinic during class times
WEEK 2
(4/8, 9, 110, 12/13)
Case History and Otoscopic Exam (continued)
The Audiometer, Calibration, and Test Environment
Assigned Readings: Chp 3 pages 55-68
WEEK 3
Pure Tone Threshold Audiometry
(4/15, 16, 17, 19/13) Assigned Readings: Chp 4
LAB #1 HAND HELD and VIDEO-OTOSCOPY
WEEK 4
Pure Tone Threshold Audiometry (cont.)
(4/22, 23, 24, 26/13) School Based Pure Tone Screening
Assigned Readings: Chp 8 pages 214-222
LAB #2 PURE TONE AC SCREENING
PURE TONE AC & BC THRESHOLD AUDIOMETRY
WEEK 5
Speech Audiometry
(4/29, 30 & 5/1, 3/13 Assigned Readings:
Chp 5
LAB #3 PURE TONE THRESHOLD AUDIOMETRY (continued)
PURE TONE AUDIOMETRY SIMULATION PROGRAM
WEEK 6
(5/6, 7, 8, 10/13)
Speech Audiometry (cont.)
Clinical Masking
Assigned Readings: Chp 6
EXAM #1 Monday, 5/6/13
LAB#4 SPEECH AUDIOMETRY
Page 6 of 9
WEEK 7
Clinical Masking (continued)
(5/13, 14, 15, 17/13) Immittance Testing
Assigned Readings: Chp 7 pages 153-167
LAB #5 MASKING
PURE TONE MASKING SIMULATION PROGRAM
WEEK 8
Immittance Testing (continued)
(5/20, 21, 22, 24/13)
LAB #6 IMMITTANCE SIMULATION PROGRAM
WEEK 9
(5/28, 29, 31/13)
Pediatric and Difficult to Test Populations
Assigned Readings: Chp 8 pages 190-213
Chp 13 pages 354-367
MEMORIAL DAY (5/27/13) HOLIDAY – NO CLASS
EXAM #2 Wednesday, 5/29/13
WEEK 10
(6/3. 4, 5, 7/13)
Selected Auditory Pathologies and Basic Audiometric Test
Findings
Suggested Review Readings: Chp 9 pages 233-242
Chp 10 pages 251-279
Chp 11 pages 293--323
Chp 12 pages 328-353
TAKE HOME FINAL EXAM
DUE BY 10:00 a.m.
THURSDAY 6/13/13
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CSD 462 LAB SCHEDULE
Lab instructors will go over the material in the sequence identified below to ensure that everyone
is receiving the same material at the same time.
LAB#1
Week 3
Otoscopy (hand-held and video)
Demonstrate and practice of basic otoscopic examination procedures
LAB#2 & #3
Week 4 & 5
Pure Tone Audiometry (manual screening and threshold testing)
a.
Demonstrate and practice instruction for pure tone AC screenings
b.
Demonstrate and practice proper placement of earphones (for AC
testing)
c.
Demonstrate and practice procedure for pure tone AC screenings
d.
Demonstrate and practice instructions for AC and BC threshold testing
e.
Demonstrate and practice proper placement of bone vibrator (for BC
testing)
f.
Demonstrate and practice procedure for establishing pure tone thresholds
(bracketing, maximum levels by air and bone, frequencies tested by air
and bone, reliability check at 1000 Hz, etc.)
g.
Demonstrate and practice how to record results on the audiogram
h.
Demonstrate how to use pure tone audiometry simulation program
i.
Demonstrate how to save and record results on the simulation program
LAB#4
Week 6
Speech Audiometry( threshold and supra-threshold testing)
a.
Demonstrate and practice instructions for SRT and WR testing
b.
Demonstrate and practice calibration of recorded speech materials
c.
Demonstrate and practice VU monitoring of live voice speech materials
Demonstrate and practice procedure for recorded SRT testing
d.
Demonstrate and practice calculation of pure tone average (PTA) and
comparison to the SRT
e.
Demonstrate and practice procedure for recorded WR testing.
f.
Demonstrate and practice how to calculate suprathreshold WR test scores
g.
Demonstrate how to record speech audiometric results on the audiogram
LAB#5
Week 7
Clinical Masking (pure tone testing)
a.
Demonstrate how to set up the audiometer for pure tone masking
b
Demonstrate and practice correct earphone placement when masking
c
Demonstrate and practice correct BC oscillator and earphone placement
when masking
d
Demonstrate and practice the plateau seeking method and use of masking
chart
e.
Demonstrate how to record masked results on the audiogram
f.
Demonstrate how to mask on the simulation program
e.
Demonstrate how to save and record results on the simulation program
LAB#6
Week 8
Acoustic Immittance Measures
a.
Demonstrate how to do tympanometry and acoustic reflex threshold
testing on the simulation program.
d.
Demonstrate how to save and record results on the simulation program
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HEARING EVALUATION
OBSERVATION SUMMARY REPORT
************************************************************************
DATE:______ TIME:_______
NAME OF OBSERVER:_____________________
AGE OF PATIENT:______
NAME OF CLINICIAN(S):___________________
SUPERVISOR SIGNATURE:__________________________________
************************************************************************
CASE HISTORY
Referral source:
_____
_____
_____
_____
self
friend
physician
nurse
_____
_____
_____
_____
audiologist
speech lang. pathologist
hearing aid dispenser
other_____________________
Hearing problems:
yes/no
gradual/sudden
Lt./Rt./Both
constant/intermittent
Cause of HL:
_____
_____
_____
_____
_____
unknown
aging
noise exposure
otitis media
family history
_____ other (specify______________
_________________________
_________________________
_________________________
_________________________)
Other symptoms:
_____
_____
_____
_____
_____
_____
tinnitus
dizziness
blurred vision
aural pain/numbness
facial pain/numbness
allergies
_____
_____
_____
_____
aural fullness
nausea
headaches
other (specify______________
_________________________
_________________________)
AUDIOLOGICAL TESTS ADMINISTERED
____
____
____
____
Pure tone air conduction
____ Pure tone air conduction with masking
Pure tone bone conduction
____ Pure tone bone conduction with masking
Speech audiometry
____ Speech audiometry with masking
____ SDT
____ SDT
____ SRT
____ SRT
____ Recognition (Disc.)
____ Recognition (Disc.)
____ MCL
____ MCL
____ UCL
____ UCL
____ Other
____ Other
Immittance audiometry
____ Tymps
____ Ipsilateral acoustic reflex
____ Contralateral acoustic reflex
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OTHER AUDIOLOGICAL TESTS (Identify the test procedure or describe what was
done)
AUDIOLOGICAL FINDINGS/INTERPRETATION OF RESULTS
____
____
____
____
____
Normal hearing
Hearing within normal limits bilaterally
Conductive HL
____ Unilateral (Rt./Lt.)
____
Degree of HL: mild
moderate
mod-severe
severe
profound
Sensorineural HL
____ Unilateral (Rt./Lt.)
____
Degree of HL: mild
moderate
mod-severe
severe
profound
Mixed HL
____ Unilateral (Rt./Lt.)
____
Degree of HL: mild
moderate
mod-severe
severe
profound
Bilateral
Degree of HL: mild
moderate
mod-severe
severe
profound
Bilateral
Degree of HL: mild
moderate
mod-severe
severe
profound
Bilateral
Degree of HL: mild
moderate
mod-severe
severe
profound
RECOMMENDATIONS
____
____
____
____
____
____
____
____
None
Have hearing tested annually
Return to referring physician
Make an appointment to see a physician
Return to WWU clinic for further testing
Return to WWU for hearing aid evaluation
Return to HA Dispenser
Other (please specify)__________________________________