Treatments & Therapies

Pediatric audiology – treatment, effects and risks

Pediatric audiology

Pediatric audiology deals with children’s hearing, voice, swallowing and speech disorders as well as disorders in language development. Together with phoniatrics , pediatric audiology forms an independent specialist area, which was managed as a sub-area of ​​ear, nose and throat medicine ( ENT ) until 1993.

Pediatric audiology as well as phoniatrics have a strong interdisciplinary character, because the problems that arise are often not of purely organic origin, but pediatric audiology independently provides interdisciplinary diagnoses and therapies.

What is pediatric audiology?

Central issues in diagnostics and therapy in pedaudiology are voice, speech and language development disorders in children as well as hearing and perception disorders. Swallowing disorders in children also fall within the treatment and diagnosis spectrum of pediatric audiology because the issues are often causally related to one another. In its diagnostic and therapeutic procedures, pediatric audiology often pursues interdisciplinary, holistic approaches that go beyond the examination and treatment of organic abnormalities.

There are links with the medical fields of ENT, orthodontics , neurology and psychiatry and with non-medical fields such as psychology, speech therapy, phonetics, pediatrics and many others. Together with phoniatrics, pediatric audiology forms an independent specialist area. The original name was specialist for phoniatrics and pediatric audiology. From January 2004, the new designation is Specialist for Speech, Voice and Children’s Hearing Disorders . The specialist medical training lasts a total of 5 years and includes specialized further training in childhood development disorders with regard to hearing, voice, speaking, speech and swallowing .

Hermann Gutzmann sen. was the first to take up the interdisciplinary character of this medical specialty. 1905 in his habilitation thesis. Pediatric audiology in particular received further impetus in 2009 with the introduction of newborn hearing screening. Babies with abnormal hearing screening are referred to pediatric audiology for further treatment.

Treatments & Therapies

One of the main concerns of pediatric audiology is to identify the causes of developmental disorders in children in the area of ​​hearing perception and in voice and language development in order to apply targeted therapies in a mostly holistic and interdisciplinary approach. The subject area also includes the act of swallowing, which is closely linked to voice and language development and therefore falls within the diagnostic and treatment spectrum of pediatric audiology.Since January 2009, audiometric newborn screenings have been carried out as standard , in which congenital, i.e. primarily genetic, hearing disorders are uncovered so that they can be recognized and treated at an early stage. Only methods that allow an objective measurement are considered for hearing screening. Hearing disorders can have many causes; the entire spectrum of hearing disorders ranges from blockages in the external auditory canal caused by earwax plugs or foreign bodies to sound conduction problems in the middle ear and sensorineural disorders .

While sound conduction problems can usually be traced back to organic-physical reasons, sensorineural disorders are problems with the conversion of sound waves into electrical nerve impulses in the cochlea in the inner ear or functional impairments of the auditory nerve (vestibulocochlear nerve) due to lesions or illness or to Problems in the brain when processing the nervous auditory impulses. Anomalies found in children’s language development can be due to reduced hearing performance, but are often based on other causes such as voice disorders, which can also be of organic origin, or speech and fluency disorders such asStuttering , articulation disorders (dyslalia), or a variety of acquired or inherited voice disorders.

An example of an absolutely necessary interdisciplinary approach with regard to diagnostics and therapy is selective or total mutism , the partial or complete loss of speech after complete language learning, although no direct organic causes for the no longer speaking are recognizable. Functional or neurogenic dysphagia or dysphagia after certain surgical procedures often interact with voice and speech formation.

Diagnosis & examination methods

The spectrum of possible developmental disorders that lead to acquired or inherited organic anomalies or to interdisciplinary problems with the further processing of sensory impressions and the development of language skills is very broad and diverse. Equally diverse is the corresponding range of diagnostic procedures in order to develop efficient and targeted therapies based on them. In the hearing screening for newborns that has been planned since January 2009, brainstem audiometry and/or methods using otoacoustic emissions are mainly used.

With the brain stem method BERA (brain stem evoked response audiometry), slight acoustic stimuli are applied to the newborn’s ear and the brain waves are measured using a few recording electrodes. They allow conclusions to be drawn about the function of the auditory nerve and the processing centers in the brain. The examination, which lasts about 20 minutes, is carried out during the baby’s normal sleep and does not disturb the child. The other method – called TEOAE (transitory otoacoustic emissions) – makes use of the fact that the outer hair cells in the cochlea respond to sound stimuli like an amplifier with their own sound stimuli that can be measured. For the examination, a tiny probe containing a loudspeaker and a microphone is inserted into the external auditory canal.

So-called clicks are generated with the loudspeaker and the sound waves, which the outer hair cells produce a few milliseconds later, are measured with the loudspeaker. Both methods are largely automated, but have the disadvantage that detected anomalies are not always based on problems with the further processing of sound stimuli or problems with the conversion of mechanical sound stimuli into electrical nerve impulses. Positive diagnoses therefore require careful further clarification using other diagnostic methods.

A large number of objective and subjective audiometric methods are available for measuring hearing impairments in children from around 3 years of age and older. Hearing problems can also arise as side effects of certain antibiotics and diuretics (water pills). In the case of swallowing disorders, the fiber endoscopic swallowing examination (FEES) has established itself as an imaging diagnostic method, in which the nose and throat can be inspected via an optical fiber. In some cases, the FEES must be supplemented by a video-supported VFS.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.