Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 3–10)

1. Observed early responses with hearing aids are

   • helpful in fine-tuning hearing aid fittings

   • helpful to parents in participating in their child's hearing management

   • helpful in developing interaction dynamics between infant and parents

   • all of the above

2. Hearing aid outputs derived using real-ear measurement in babies and young children are reported to be

   • close to prescription targets for hearing levels

   • lower than prescription targets for hearing levels

   • higher than prescription targets for hearing levels

   • unimportant as long as the child is wearing the hearing aids without discomfort or acoustic feedback (whistling)

3. The most important role of the earmold in early hearing aid fitting is

   • to allow appropriate hearing aid gain without feedback

   • to allow the child to hear his or her own vocalizations clearly

   • to be comfortable and secure in the ear

   • all of the above

4. Behavioral observations of hearing responses can

   • be reliably used to fit a hearing aid

   • part of a test battery of objective results in defining hearing levels for hearing aid fitting

   • have no role in fitting or fine-tuning of hearing aids

   • identify a baby with a hearing loss

5. An effective input for parents when listening to their child's hearing aid is

   • to say the Ling sounds

   • to say numbers

   • to say the child's name

   • to check that there is feedback from the hearing aid

   Article Two (pp. 11–18)

6. Parents report being confused at the time of screening because

   • they can't believe what the nurse is saying

   • they get so many explanations for the refer result

   • the nurse and doctor don't agree on the result

   • the nurse is not telling the result

   • they initially passed the screen

7. Parents want clear answers to their worries. It is important that professionals

   • don't answer all parents' questions, which would be overwhelming

   • provide clear answers to conceal uncertainty

   • clarify what they know, what they don't know, and reasons for uncertainty

   • do not answer until results are clear

   • A and D

8. The shift from the paternalistic professional to an informed choice approach means that parents

   • make their choice based on information and knowledge

   • are better informed about the professional's decision

   • choose what professionals should make the decision

   • need to make the decision alone after receiving information

   • always make the right decision

9. In a shared decision-making process, the parent and professional

   • share information before the parent makes the decision

   • choose the option that is best evidence based

   • make a decision they agree upon

   • share information to allow the professional to make the right decision

   • make the most cost-effective decision

10. Parents seeking information from the Internet and other sources

    • can be encouraged, as it may provide a sense of control

    • should be discouraged, as they may find conflicting information

    • are more insecure than other parents

    • are more often disagreeing with the professional

    • are more often young and highly educated parents

    Article Three (pp. 19–26)

11. During the first stage of the hearing aid fitting process, which of the following is considered?

    • Audiometric characteristics of the patient to be fitted with hearing aids

    • Acoustic characteristics of the patient to be fitted with hearing aids

    • Personality characteristics of the patient to be fitted with hearing aids

    • Both A and B

    • Both A and C

12. Real-ear-to-coupler difference values are used to

    • convert hearing level thresholds to sound pressure level thresholds at the ear canal

    • convert real-ear gain and output targets to 2-cc coupler targets

    • convert text box measurements of hearing aid output to estimated real-ear measurements

    • all of the above

    • none of the above

13. What are some options that should be considered when selecting a hearing aid for an infant?

    • Pediatric-sized filtered ear hook

    • FM system compatibility

    • Behind-the-ear style

    • Choice of bright colors

    • All of the above

14. What is the most appropriate way to verify a hearing aid for an infant?

    • Insertion gain measures

    • On-ear verification measures

    • Simulated real-ear verification measures

    • Functional gain measures

    • Sound field measures

15. The outcome evaluation tools included in the University of Western Ontario Pediatric Audiological Monitoring Protocol aim to measure outcomes in infants and young children such as

    • auditory development and performance

    • articulation and speech

    • language and literacy

    • motor development and function

    • social-emotional development

    Article Four (pp. 27–36)

16. Which of following is not a quality indicator of universal newborn hearing screening according to the Joint Committee on Infant Hearing (2007)?

    • More than 95% of babies have their hearing screened by 1 month of age using objective test methods.

    • More than 90% of babies with hearing loss are diagnosed by 3 months of age.

    • More than 90% of babies with hearing loss receive appropriate interventions by 6 months of age.

    • Surveillance for onset of hearing loss continues throughout childhood.

    • Babies with hearing loss due to medical interventions are exempt from goals A to C.

17. Congenital cytomegalovirus infection is symptomatic in what percent of babies who are infected prenatally?

    • 1%

    • 5 to 10%

    • 50%

    • 90 to 95%

    • 40,000

18. According to the time-to-event curves describing time course of onset of hearing loss for the three hearing loss risk indicators in graduates of extracorporeal membrane oxygenation (ECMO) therapy, which risk indicator had the highest number of children with hearing loss?

    • Having a primary diagnosis of congenital diaphragmatic hernia

    • Having ECMO run-times in the highest tertile

    • Having 14 days or more of aminoglycoside antibiotics before, during, or after ECMO therapy

    • Days of overlap of aminoglycoside antibiotics and loop-inhibiting diuretics

    • The use of cisplatin chemotherapy

19. According to the International Society of Pediatric Oncology Minimal Test Battery, which frequency should be tested next if 4,000 Hz is found to be 20-dB hearing loss or less and 8,000 k Hz is found to be 30-dB hearing loss?

    • 2,000 Hz

    • 500 Hz

    • 3,000 Hz

    • 6,000 Hz

    • 1,000 Hz

20. What is a potential benefit of having an international standard for chemotherapy grading scale?

    • A standard definition of severity of hearing loss will allow for comparison across studies investigating use of otoprotectants in minimizing the negative impact of chemotherapy on hearing.

    • An international standard grading scale will guide clinicians to fit FM, hearing aids, or cochlear implants to cancer survivors with hearing loss.

    • Children being monitored for cisplatin ototoxicity will not have to be tested as often.

    • The number of adverse events reported during clinical trials will decrease.

    • Oncologists will ask fewer questions of audiologists when trying to interpret the audiogram.

    Article Five (pp. 37–50)

21. A dead region is associated with

    • dysfunction of outer hair cells

    • dysfunction of the active mechanism in the cochlea

    • dysfunction of inner hair cells

    • dysfunction of the efferent system

    • dysfunction of cortical neurons

22. To determine a psychophysical tuning curve

    • the frequency and level of the signal are fixed and the frequency and level of the masker are varied

    • the frequency and level of the masker are fixed and the frequency and level of the signal are varied

    • the frequency of the signal and the level of the masker are fixed and the frequency of the masker and the level of the signal are varied

    • the frequency of the masker and the level of the signal are fixed and the frequency of the signal and the level of the masker are varied

    • none of the above

23. For a person with an extensive continuous high-frequency dead region, starting at frequency f _e , it is best to provide amplification

    • up to the highest frequency possible

    • up to f _e

    • up to about 1.7 f _e

    • up to about 4 kHz

    • up to 0.5 f _e

24. For children above 7 years of age, the criteria for diagnosing a dead region using the threshold equalizing noise (TEN) test should be

    • stricter than those for adults (requiring a higher masked threshold in the TEN)

    • the same as for adults

    • less strict than for adults (requiring a lower masked threshold in the TEN)

    • dependent on the age of the child

    • dependent on the severity of the hearing loss

25. In an adult or child with a restricted high-frequency dead region (a dead hole), with a lower edge frequency f _e , it is best to provide amplification

    • only up to f _e

    • up to about 2 f _e

    • up to about 1.7 f _e

    • up to the frequency where the hearing loss reaches 70 dB

    • up to at least 4 kHz

    Article Six (pp. 51–64)

26. The diagnosis of auditory neuropathy relies on

    • absence of auditory brainstem responses (ABRs)

    • presence of ABRs and absence of cochlear microphonic (CM)

    • the evaluation of several clinical and instrumental data

    • absence of both ABRs and CM

    • detection of otoacoustic emissions

27. Patients with auditory neuropathy

    • are good hearing aid users

    • use hearing aids before cochlear implantation

    • never use hearing aids

    • need individual assessment for effectiveness of hearing aid use

    • should always be selected for cochlear implantation

28. Patients with biallelic mutation in the otoferlin gene

    • are good hearing aid users

    • benefit from cochlear implantation

    • are not selected for cochlear implantation

    • never use hearing aids

    • use hearing aids in noisy environments

29. Patients with genetic auditory neuropathy (AN)

    • with non-isolated AN are good hearing aid users

    • always have a good rehabilitation outcome

    • are not selected for cochlear implantation

    • never use hearing aids

    • can be good hearing aid users in some cases with isolated AN

30. Children discharged from neonatal intensive care units showing the electrophysiological profile of AN

    • are mostly good hearing aid users

    • show normal hearing thresholds

    • should undergo cochlear implantation as soon as possible

    • show severe hearing loss

    • are poor users of both hearing aids and cochlear implants