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Foreword by James Jerger for Third Edition

Madell et al., Pediatric Audiology: Diagnosis, Technology, and Management, 3rd Ed. (ISBN 978-1-62623-401-7), copyright © 2019 Thieme Medical Publishers. All rights reserved. Usage subject to terms and conditions of license.

There can be little doubt that the most important technological advances impacting audiology in the modern era have been the neurobiological advances in our understanding of brain function and the discovery and development of the auditory brainstem response (ABR) as a clinical tool

Throughout the decades of the 1940s, 1950s, and 1960s, audi-

ometers improved and hearing aids improved, but trying to get a

valid audiogram on a child less than 5 years old was dicey. There

were, to be sure, a variety of available observational techniques, but dealing with a shrieking three year old was always a struggle.

Suce to say, mistakes were made. But since the early 1970s, the

ABR has truly revolutionized pediatric audiometry. Now, for the

ﬁrst time, audiologists had an “objective” measure of hearing

status that could be carried out on sleeping children at virtually

any age—indeed, during the ﬁrst days of life itself. But ABR was

just the beginning of a burgeoning growth in tools for pediatric evaluation and treatment. Investigators and clinicians have since developed and applied middle-ear measurement, otoacoustic emissions, auditory evoked potentials, speech audiometry, and the assessment of auditory processing disorders in children.

Parallel advances in brain plasticity, early and late auditory potentials, auditory deprivation, and critical periods for language development have shifted the focus from the ear to the brain. Whereas it is important to understand how the middle ear, cochlea, and auditory nerve process the raw auditory signal, it is perhaps even more important to understand how the brain processes linguistic units. While the ear is certainly the doorway to the brain, it is the brain that processes language.

In this volume editors, Jane R. Madell, Carol Flexer, Jace Wolfe, and Erin C. Schafer meticulously document how this revolution in the audiologist’s pediatric toolkit, along with concomitant

advances in neurobiology, have advanced pediatric audiology to a new level, a construct that emphasizes the brain as the endpoint of all auditory input.

This new emphasis recognizes that, while the source of hearing

loss is almost always traceable to the structures of the auditory

periphery, actual “hearing,” in the sense of the processing and

interpreting meaningful linguistic messages, requires the active participation and interaction of many areas within the brain. Here, in the past two decades, there have been enormous advances, not only in our ability to identify and diagnose hearing loss but also in our understanding of the brain-mediated cognitive processes critical to the acquisition and successful use of language as the vehicle of communication.

The editors have assembled an impressive team of individual

contributors, each a respected authority in a speciﬁc area. Together

they cover virtually every dimension of pediatric audiology from diagnosis, through access technologies, to remote microphone technology, to educational and clinical management of hearing loss in children. Each chapter has been assigned to an experienced and authoritative author or team of authors. Coverage is broad, thorough, and complete. This will be an excellent textbook for a course in pediatric audiology, as well as a source book for experienced professionals.

ames Jerger, PhD

Distinguished Scholar-in-Residence-Ermitus

School of Behavioral and Brain Sciences

University of Texas at Dallas

Dallas, Texas

Lake Oswego, Oregon

Foreword by Marion Downs for the First and Second Edition

With this book, two master clinicians are expressing what has become a tremendous evolution—almost a revolution—in pediatric audiology. It seems only yesterday that we were still struggling to identify children with hearing loss as early as possible, when the terms auditory neuropathy and auditory dysynchony were not part of our vocabulary, when connexin 26 was the province only of obscure geneticists, when cochlear implants were still controversial, when no one had any idea how to habilitate a newborn baby, and when Jane R. Madell and I started our struggle to keep behavioral observation and visual reinforcement audiometry (VRA) in the audiology stream of consciousness.

Jane R. Madell and Carol Flexer are aware of the need for con-

stant updates of the rapidly evolving technology in the ﬁeld, as

well as the new understandings of genetics, early education, and surgical advances. In addition to drawing on their own extensive and distinguished experiences, they have assembled contributors who are most knowledgeable in speciﬁc areas of pediatric audiology. Speaking for myself, I can’t get enough information about all the advances that have appeared, seemingly overnight.

It begins with the sophisticated maturation of newborn hearing screening, with all the developments attendant on this aspect of the revolution (e.g., knowledge of diseases, genetics, medical

treatment, and assessments, which mark the identiﬁcation and

diagnosis of a hearing disorder in the infant) and follows with all the ensuing activities that make for a successful program in

identiﬁcation and management of the child with hearing loss

from birth. School children and teenagers are not neglected in this comprehensive report.

This vision of an ideal audiologic world is presented by two

people who know whereof they speak. Jane R. Madell has forever

fought the good ﬁght for appropriate hearing aid and cochlear implant ﬁttings for children, for behavioral testing of babies,

and for audiologists to foster a one-on-one relationship with the children they test. She shares my insistence that all the electronic and electrophysiological applications for children’s testing are only the beginning of the acquaintance one must establish with a child experiencing hearing loss. You can learn a great deal of pertinent information for habilitation by watching and playing with the child.

Carol Flexer has also fought the good ﬁght for the child with

hearing loss. She has concentrated on the auditory experience in speech and language training. Her book, Developing Listening and Talking, Birth to Six, expresses her message that children with hearing loss can best learn speech and language through listening

with well-ﬁtted, appropriate hearing aids. Cochlear implants are

also included in the emphasis on auditory development, and a chapter in this book is devoted to that experience. She has always represented what’s best in audiology.

I can’t think of anything they’ve missed in this presentation of what’s new and relevant in pediatric audiology, It’s going to be a great read.

Marion P. Downs, DrHS

Professor Emerita

Department of Otolaryngology

University of Colorado School of Medicine

Denver, Colorado

Preface

This Third edition is intended as a text for AuD and PhD courses

in pediatric and educational audiology and also as a ﬁeld guide

for audiologists working in pediatric and educational audiology settings. This is a practical how-to book about the diagnosis and technological and educational management of infants and children with hearing disorders.

Accordingly, this text is divided into four sections:

Hearing Loss: Essential Information

•

Diagnosing Hearing Disorders in Infants and Children

•

Hearing Access Technologies for Infants and Children

•

Educational and Clinical Management of Hearing Loss in

•

Children

Each chapter oers a wealth of information, and all are written by experts in speciﬁc target areas. We have also drawn on our over 128 collective years of experience as pediatric and educational

audiologists to enrich this book.

We want students to keep this book as a reference when they graduate. In addition, we hope that practicing audiologists will be able to use this book as a reference when they are approaching

techniques that are new to them or when they are performing behavioral diagnostic procedures that may be used only oc

casionally.

Even though this book cannot possibly explain every aspect of pediatric and educational audiology in detail, it can provide basic information, augmented by extensive resources, on how to move to the next level of diagnosis and management. In addition, this book includes a practical component: online video that demonstrates test techniques to assist both students and practicing audiologists in improving their clinical skills regarding behavioral and functional assessments of infants and children of all ages.

Other professionals working in related ﬁelds may also be

interested in this book, such as speech-language pathologists, listening and spoken language specialists, including auditory-verbal therapists (LSLS Cert. AVT) and auditory-verbal educators (LSLS Cert. AVEd), teachers of children who are deaf or hard of hearing, otolaryngologists, pediatricians, and families of children with hearing loss.

Jane R. Madell

Carol Flexer

Jace Wolfe

Erin C. Schafer

Acknowledgments

This third edition is a labor of love (in addition to a lot of hard work). It allows us to discuss, in detail, work that is near and dear to our hearts and to which we have contributed over 128 collective years of experience as pediatric and educational audiologists.

This book would not have been written without an amazing group of chapter authors who generously contributed their time and knowledge. We are most grateful for their collegiality and expertise; it has been a privilege to work with them.

We must thank our families who have, for many years, learned to put up with us not always being around to do parent things because we were doing audiology things. (Carol and Jane began our careers at a time when lots of moms were still staying home and not attempting to have a career outside the home.) We thank our amazingly supportive spouses, Rob Madell, Pete Flexer, Lynnette Wolfe, and Michael Schafer; our equally amazing children, Jody, Josh, Heather, Hillari, David, Hayden, Harper, Henley, Avery, and Keira; our children in-laws, James, Dawn, Joe, Josh, and Hilary; and the most special group of grandchildren, Eva, Rose, Trixie, Yehuda, Rachel, Yishai, Libby, Tikva, Rebekah, Binyamin, Jak, Yonah, Aitza, and Miriam and those still to come (from whom we continue to learn every day.)

We could not have accomplished this work were it not for the wonderful audiologists, auditory therapists, educators, and physicians who came before us and set the stage for work with young children—the women and men who taught us to believe that anything was possible and that a hearing loss should not stop anyone from being whatever he or she wants to be.

We would know much less than we know now were it not for all the very special families who have given us the privilege of allowing us to work with them day after day and the students who taught us as we taught them. Thanks to Dan Projansky, who made

the DVD possible. And ﬁnally, we want to thank our publisher,

Thieme, and editors Anne Sydor, Julie Montelbaum, Elizabeth

Palumbo, and Kenny Chumbley, who helped us ﬁnd our way.

We dedicate this book to all of them.

Jane R. Madell

Carol Flexer

Jace Wolfe

Erin C. Schafer

xiii

Contributors

Maryam Aghamolaei, PhD

Assistant Professor Department of Audiology School of Rehabilitation Shahid Beheshti University of Medical Sciences Tehran, Iran

Leslie Allen, MS

Secondary Team Leader Plano Regional Day School Program for the Deaf Deaf Education Plano Independent School District Plano, Texas, USA

Kathryn Laudin Beauchaine, MA

Audiology Coordinator Audiology and Vestibular Services Boys Town National Research Hospital Omaha, Nebraska, USA

Arthur Boothroyd, PhD

Distinguished Professor Emeritus Doctoral Program in the Speech and Health Sciences City University of New York New York, New York, USA

Siobhán Brennan, PhD

Manchester Centre for Audiology and Deafness University of Manchester Manchester, England Regional Department of Neurotology

Sheeld Teaching Hospitals NHS Foundation Trust Sheeld, United Kingdom

Teresa Y. C. Ching, PhD

Research National Acoustic Laboratories Sydney, Australia

Lisa Vaughan Christensen, AuD

Audiology Program Manager Department of Audiology Cook Children’s Medical Center Fort Worth, Texas, USA

Sumitrajit (Sumit) Dhar, PhD

Professor Roxelyn & Richard Pepper Department of Communication

Sciences and Disorders Northwestern University Evanston, Illinois, USA

M. Patrick Feeney, PhD

Director National Center for Rehabilitative Auditory Research Professor Department of Otolaryngology, Head and Neck Surgery Oregon Health and Science University Portland, Oregon, USA

Carol Flexer, PhD, FAAA, CCC-A, LSLS Cert AVT

Distinguished Professor Emeritus, Audiology School of Speech-Language Pathology and Audiology The University of Akron Consultant in Pediatric Audiology Akron, Ohio, USA

Richard E. Gans, PhD

Founder and Executive Director The American Institute of Balance Largo, Florida, USA

Kirsty Gardner-Berry, PhD

National Acoustic Laboratories Australian Hearing Hub Macquarie University Sydney, Australia

Kristin E. Gravel, AuD, CCC-A, PASC

Audiologist Lions Children’s Hearing and ENT Clinic University of Minnesota Masonic Children’s Hospital Lecturer Department of Speech-Language-Hearing Sciences University of Minnesota Minneapolis, Minnesota, USA

James W. Hall III, PhD

Professor Osborne College of Audiology Salus University Elkins Park, Pennsylvania, USA Professor Department of Communicative Sciences and Disorders University of Hawaii Honolulu, Hawaii, USA

Joan G. Hewitt, AuD

Pediatric Audiologist Project TALK, Inc. Pediatric Hearing Specialists, Inc. Encinitas, California, USA

Contributors

David L. Horn, MD, MS

Associate Professor

Department of Otolaryngology–Head and Neck Surgery

University of Washington Seattle, Washington, USA

Sanna Y. L. Hou, MClinAud

Audiologist National Acoustic Laboratories Sydney, Australia

Cheryl DeConde Johnson, EdD

The Audiology–Deaf Education Vantage Consulting

Leadville, Colorado, USA

Green Valley, Arizona, USA

Garima Kamo, BSc, MBA

Parent of a child with hearing loss Dallas, Texas, USA

Nina Kraus, PhD

Hugh Knowles Professor Department of Communication Sciences, Neurobiology,

Otolaryngology Northwestern University Evanston, Illinois, USA

Guy Lightfoot, PhD

Director ERA Training and Consultancy Ltd. West Kirby, United Kingdom

Jane R. Madell, PhD, FAAA, CCC A/SLP, LSLS Cert AVT

Director Pediatric Audiology Consulting New York, New York, USA

Karen Muñoz, EdD

Associate Professor and Interim Department Head Communicative Disorders and Deaf Education Utah State University Logan, Utah, USA

Andrea Pittman, PhD

Associate Professor Department of Speech and Hearing Science Arizona State University Tempe, Arizona, USA

Virginia Ramachandran, MSW, AuD, PhD

Education and Training Specialist Oticon, Inc. Somerset, New Jersey, USA

Aparna Rao, PhD, CCC-A

Clinical Associate Professor Department of Speech and Hearing Science Arizona State University Tempe, Arizona, USA

Ellen A. Rhoades, EdS, LSLS Cert AVT

Consultant Auditory-Verbal Training-Mentoring International Plantation, Florida, USA

Sylvia Roteisch, MScA

CEO, Founder Audiology and Habilitation Hear to Talk Los Angeles, California, USA

Jackson Roush, PhD

Professor Division of Speech and Hearing Sciences University of North Carolina School of Medicine Chapel Hill, North Carolina, USA

Jay T. Rubinstein, MD, PhD

Virginia Merrill Bloedel Professor and Director Virginia Merrill Bloedel Hearing Research Center Professor of Otolaryngology and Bioengineering University of Washington Seattle, Washington, USA

Chris A. Sanford, PhD

Associate Professor Department of Communication Sciences and Disorders Idaho State University Pocatello, Idaho, USA

Erin C. Schafer, PhD, FAAA, CCC-A

Professor Department of Audiology and Speech-Language Pathology College of Health and Public Service University of North Texas Denton, Texas, USA

Lisa A. Schimmenti, MD

Professor, Pediatrics

Department of Otorhinolaryngology, Clinical Genomics

and Biochemistry, and Molecular Biology Mayo Clinic Rochester, Minnesota, USA

Joseph Smaldino, PhD

Adjunct Professor Department of Audiology and Speech Pathology University of Tennessee-Knoxville Knoxville, Tennessee, USA

Donna L. Sorkin, MA

Executive Director American Cochlear Implant Alliance McLean, Virginia, USA

Carrie L Spangler, AuD, CCC-A

Lead Educational Audiologist Summit Educational Service Center Cuyahoga Falls, Ohio, USA

xvi

Contributors

Brad A. Stach, PhD

Director, Division of Audiology

Department of Otolaryngology–Head and Neck Surgery

Henry Ford Hospital Detroit, Michigan, USA

Joan Steyermark, MS, LGC

Licensed Genetic Counselor

University of Minnesota Masonic Children’s Hospital Minneapolis, Minnesota, USA

Brian A. Walker, MD

University of Washington School of Medicine Seattle, Washington, USA

Karl R. White, PhD

Director National Center for Hearing Assessment and Management Emma Eccles Jones Endowed Chair in Early Childhood

Education Professor of Psychology Utah State University Logan, Utah, USA

Gail M. Whitelaw, PhD

Clinical Associate Professor, Clinic Director Department of Speech and Hearing Science The Ohio State University Columbus, Ohio, USA

Travis White-Schwoch , BA

Senior Research Data Analyst Department of Communication Sciences Northwestern University Evanston, Illinois, USA

Uzma Shaheen Wilson, AuD

Roxelyn and Richard Pepper Department of

Communication Sciences and Disorders Northwestern University Evanston, Illinois, USA

Jace Wolfe, PhD, CCC-A

Director of Audiology Hearts for Hearing Foundation Adjunct Assistant Professor, Audiology University of Oklahoma Health Sciences Center and Salus

University Oklahoma City, Oklahoma, USA

Elizabeth A. Ying, MA, CCC-SLP

Co-Director, Speech-Language Pathologist Shelley and Steven Einhorn Audiology and Communication

Centers Center for Hearing and Communication New York, New York, USA

Zeina Zayat, AuD

Visiting Assistant Professor Medical Audiology Sciences Program Faculty of Health Sciences American University of Beirut Beirut, Lebanon

Vicky W. Zhang, PhD

Paediatric Research Audiologist Rehabilitation Procedures National Acoustic Laboratories Sydney, Australia

xvii

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