Hearing means learning

Many tests are done to determine why a student cannot learn, but sometimes a dollar probe tip inserted in a child’s ear may discover a physiological reason within about 10-35 seconds. It is all part of a science called audiology — the study of hearing disorders and the rehabilitation of people with hearing impairments. Four audiologists working for the Kern County Superintendent of Schools (KCSOS) spend their days probing the ears of children as young as infants all the way up to high school age looking for clues to hearing deficiencies.

According to KCSOS Audiologist Lane West, “It doesn’t take much of a hearing loss, even mild, to affect a child’s classroom achievement. It is very important to identify those losses, let the school know, help the school work with the child and get the child on the right track to hearing better.”

West says one computerized test involves inserting an electronic probe tip in an ear and is called “tympanometry.” It takes about 10 seconds and measures middle ear function to see, among other things, if “the ear drum is perforated or intact and mobile. A stiff eardrum is usually an indicator of ear infection.”

Another test probes for “otoacoustic emissions” in the inner ear. That one takes about 25 seconds, and discovers permanent or sensory-neural hearing loss. “The inner ear actually makes sounds of its own, which are only detectable through testing,” Lane said. “Those are called otoacoustic emissions, and, if they are detected during testing, it means there is normal hearing. If they are not – that indicates hearing loss and further testing determines how much of a loss.”

All public school children in the county are eligible to have their hearing assessed for free. Audiometrists and school nurses administer free hearing screenings, as required by the state, usually in kindergarten, second, fifth and eighth grades. If a student fails two screenings, he or she can be referred to a KCSOS audiologist to assess the causes and extent of hearing loss.

While the tympanometry and ottoacoustic emissions testing determines cause, audiologists take it several steps further. Students enter an audio booth, where they are fitted with a pair of headphones. Outside the booth, the audiologist works with a machine that emits low and high frequency sounds, transmitted into the child’s headphones, one-by-one at intervals. The child is instructed to demonstrate in some way to the audiologist every time a frequency is heard. Similarly, audiologists read a pre-determined list of words fluctuating between a very low to normal speaking voice. Again, the child must either indicate understanding by repeating the word or pointing to it on a set of standardized picture cards.

“Inside the booth is where we can discover what type and how much hearing loss there is,” West said. “We use frequency testing because all the different speech sounds, vowels and consonants, are at different frequencies. When a child can hear all the tones at different frequencies, their hearing is generally considered to be normal.”

Since there is a wide range in ages between infancy and high school, West and his KCSOS audiologist peers, Richard Sarff, Linda Schmunk and Amy Robertson, have to gauge their testing times accordingly. The very young are often very apprehensive about having something put in their ear and sitting still. It can take varying amounts of time to assure them and gain their confidence. Then, there is the language barrier. Many children come into the assessment with little or no understanding of English. In those cases, the audiologists work with staff translator/interpreters to relay instructions to parents and children, jointly carry out tests and evaluate results. Parents are advised of the findings in English or Spanish at the conclusion of testing and suggestions and/or referrals for treatment are made at that time.

“Spanish-speaking parents expect to receive the information and have it explained clearly,” said translator/interpreter Maria Isabel Quintanilla. “They always thank me. I give them my card and tell them to call back, if they need to get a hold of Mr. Lane.”

KCSOS Audiologists Video