Essential Equipment
- Screening Tools:
- Otoscope
- Pneumatic attachment
- Various sized specula (2-8mm)
- Spare bulbs
- Rechargeable handle
- Tuning Forks
- 256 Hz (Low frequency)
- 512 Hz (Speech frequency)
- 1024 Hz (High frequency)
- Advanced Equipment:
- Portable OAE (Otoacoustic Emissions) Screener
- Disposable ear tips
- Calibration equipment
- Charging station
- Tympanometer
- Multiple probe sizes
- Printer for results
- Calibration kit
- Supplementary Tools:
- Age-appropriate noisemakers
- Visual reinforcement tools
- Reward toys/stickers
- Cleaning supplies
Examination Methods
1. Age-Specific Assessment Techniques
- Newborns (0-1 month):
- Automated ABR screening
- OAE screening
- Startle reflex observation
- Infants (1-6 months):
- Behavioral observation audiometry
- Visual reinforcement audiometry
- OAE testing
- Toddlers (6-24 months):
- Visual reinforcement audiometry
- Conditioned play audiometry
- Tympanometry
- Preschool (2-5 years):
- Play audiometry
- Speech discrimination testing
- Pure tone screening
2. Otoscopic Examination
- External Ear Assessment:
- Pinna position and appearance
- External canal patency
- Cerumen presence
- Signs of infection
- Tympanic Membrane Evaluation:
- Color and transparency
- Light reflex
- Landmark identification
- Mobility (with pneumatic otoscopy)
3. Objective Tests
- Tympanometry:
- Middle ear pressure
- Tympanic membrane compliance
- Ear canal volume
- Type classification (A, B, C)
- OAE Testing:
- DPOAE measurements
- TEOAE screening
- Response analysis
4. Behavioral Tests
- Sound Localization:
- Lateral sound awareness
- Vertical plane localization
- Distance perception
- Speech Testing:
- Age-appropriate word recognition
- Speech discrimination
- Language development assessment
Clinical Protocol
- Pre-examination Steps:
- Equipment calibration check
- Room sound level verification
- Age-appropriate material preparation
- Testing Sequence:
- History taking
- Otoscopic examination
- Tympanometry
- OAE screening
- Behavioral testing
Red Flags and Referral Criteria
- Immediate Referral Indicators:
- Failed newborn screening
- Abnormal tympanometry
- Recurrent ear infections
- Speech-language delay
- Family history of hearing loss
Documentation Requirements
- Essential Records:
- Screening results with date and time
- Type of testing performed
- Equipment used and calibration status
- Environmental testing conditions
- Child's behavior during testing
- Parental concerns and observations
Further Reading
