Training Transcripts

Transcript for Otoacoustic Emissions Training

– [Instructor] In this segment of the video, you’ll be introduced to the otoacoustic emissions equipment and how hearing screening is done. Let’s look at some features common to all handheld OAE units. The screening unit. This is a sensitive piece of equipment, so treat it gently and avoid exposing it to extreme hot or cold temperatures. The power supply, battery or adapter cord. The probe assembly. This is an expensive part that can be damaged easily. You’ll wanna handle it carefully. Notice any visual indicators that help you align the two components to avoid bending the connecting pins. Whenever possible, leave the probe attached to the screening unit rather than detaching it after each use. Also, it’s very helpful if a clip is supplied to attach the probe cord to the child’s clothing during screening. The cord connecting the probe and the screening unit should be about four to five feet long, to reach from the child’s ear to the table. Finally, the probe tips or covers that are designed to fit snugly on the probe and form a seal in the child’s ear canal. Use a new probe cover for each child being screened. Be sure to select a piece of equipment that has been demonstrated to work effectively for screening children, birth to three years of age. As you get to know your specific equipment, refer to information provided by the manufacturer regarding probe care and cleaning, power supply maintenance, equipment calibration, and modifications that may be needed when screening children with pressure equalization or PE tubes. ♪ La, la, la, la ♪

– [Instructor] In addition, successful screening depends on conducting the screening in a relatively quiet setting. The equipment is trying to pick up very faint signals generated by the inner ear. So it’s best to limit the noise within the room, maintaining the cooperation of the child with the comforting assistance of parents and the use of quiet toys. Unlike some other procedures, the OAE screening cannot be accomplished if a child is crying or physically resistant. You’ll find screening will typically progress faster if the child is not actively sucking or chewing, but if it’s necessary, you can offer a pacifier, bottle, or a cracker. Obviously, it’s critical that you complete hearing screening prior to procedures that are likely to make the child upset, like immunizations. Now, let’s walk through the screening process step by step. Before beginning the screening, complete a brief case history of the child’s hearing health. Note any parental concerns about hearing or language development. Explain to the parent that you’re going to place a small microphone covered by a soft tip into the child’s ear canal, and that the child will hear a series of quiet sounds. Look down into the probe to make sure it’s not clogged with debris. Clean or exchange the probe nozzle if it’s necessary. If some wax is present, you can proceed with a screening, unless the canal appears to be totally blocked. Note the size of the ear canal, and choose a probe tip that is as large as or slightly larger than the ear canal opening. Place the tip over the end of the probe, pressing down firmly. If you’re using a soft foam tip, compress it into a mushroom shape before inserting it into the ear canal. Turn on the equipment, clip the probe cord to the back of the shirt where the child can’t see or reach it easily. This keeps the cord out of the way and also helps keep the probe in the ear during screening. Make sure the child is comfortable and content. With one hand, grasp the ear, pulling it out to open the canal. With the other hand, take the probe and insert the tip into the ear canal toward the nose. Then turn it slightly back, pushing it firmly into the canal. If you have chosen the correct size of probe cover, the probe will stay firmly inserted in the ear canal after you let go of it. Never be tempted to hold the probe in the ear during the screening. Learning how to select the right-size tip and how to insert the probe firmly into the ear canal is key to reliable screening. Let’s watch this again. Now, push the button to start the screening. Watch the displays. They’ll often help you know if you have a secure probe fit. Help the child sit quietly while the screening is progressing. Some equipment will indicate the progress of the test, showing sound frequencies or pitches, while others will simply indicate the test is in progress. When the screening is complete, the unit will display either a pass or a refer. Remove the probe. Check to make sure that it’s not blocked with wax, and test the other ear.

– You’re doing so good. You wanna hold these for me again?

– [Instructor] As you practice screening, notice how external noise can disrupt the procedure. For example, if someone is speaking loudly near the ear being screened, the equipment cannot continue to screen, because the signal to the ear becomes mixed with a louder outside sound. The screening unit has to wait until the excess noise stops before proceeding with the screening. Also, notice how the screening stops when the child becomes restless and moves a lot. This is called internal noise. Again, the equipment has to wait until the movement has stopped before continuing the screen. Of course, if the child moves too much, the probe may become completely dislodged and the test has to be started again. Both internal and external noise will be reduced by a good probe fit. The more firmly the probe fits into the ear canal, the less external noise will leak into the ear, and the less likely it is that the probe will be dislodged by the child’s movements. Therefore, the three keys to effective screening are ensuring a good probe fit, minimizing external noise in the environment and minimizing internal noise caused by the child’s movement. Here are some hints for successful screening that you may find helpful. Check the equipment at the beginning of the day by screening your own ear, or by running the equipment’s manual calibration check. Elicit help from the parent in keeping the child quiet and content while the screening is being done. The parent may need to gently hold the child’s hands and redirect them to touch and play with a quiet toy.

– [Parent] That’s good.

– Look, the bear’s ears.

– Aw.

– Engage the child in a listening game.

– Okay, Gracie’s ears. Just gonna touch your ear.

– Gently tell the child what you’re about to do rather than ask permission.

– Here they come.

– Questions are usually met with a no or an uncooperative response. Keep a variety of visually interesting toys appropriate for different ages with your screening unit. Be creative, find out what works for you. Screen while the child is asleep. If the child arrives asleep or relaxed in a car seat, perform the hearing screening before he or she awakens. Okay, now you’re ready to get started. Practice screening other adults and your own ears. Don’t be alarmed if you do not pass the OAE screening. Adult ears often don’t have the strong emissions that children’s do. After you’ve gotten proficient screening adults, you’ll be ready to start screening children.