Clinical Use of Middle Ear and OAE Assessments with Infants and Children

Audiology

Intermediate

Self-Study

10hr 18min

Continuing Education

1.00 AAA CEUs
10.00 AG Bell CEUs
1.00 ASHA CEUs

Register until Dec. 30, 2026

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Course Overview
Course Outline

Course Overview

This course will cover causes of conductive hearing loss, both temporary and permanent, from infancy through childhood. Measures of middle ear function, including tympanometry, acoustic reflexes, and wideband immittance will be covered. Measures of inner ear function (otoacoustic emissions) will be compared and contrasted with middle ear measures. Development of these measures from infancy through childhood will be discussed. Interpretation of actual cases that are commonly seen by pediatric audiologists will be covered, with individual practice and group discussion.

Course Timeline

30 Days

Primary Audience

AuD and LSL Professionals

Key Outcomes

Describe at least two anatomical differences between the newborn external and middle ear as compared to the adult external and middle ear.
Classify types of conductive hearing loss, and distinguish between temporary and permanent types.
Describe developmental differences between infants as compared to the children for acoustic reflexes and wideband immittance.
Describe acoustic reflex and wideband immittance results to distinguish between temporary and permanent types.
Describe how aspects of otoacoustic emissions change with age from infancy through childhood.
Interpret otoacoustic emission results and risk for hearing loss.
Compare middle ear and inner ear measures to arrive at differential diagnoses.
Compare at least two advantages and two disadvantages of distortion product otoacoustic emissions versus transient otoacoustic emissions for the assessment of auditory function in infants and young children.

Course Outline

Session 1
2h 35m
[embed:36efd594-647a-47a1-9350-90a1e89aac01:8bb158e3-ccbd-4dc7-a70e-f41b24d164dc:title=Basic%20Primer%20of%20Middle%20Ear%20Anatomy%20and%20Physiology&duration=1200&itemdetails=%3Cul%3E%0A%3Cli%3EBrief%20Review%20of%20Middle%20Ear%20Anatomy%20and%20Physiology%20Including%20Acoustic%3Cbr%20%2F%3E%26nbsp%3B%20Reflex%20Arc%3C%2Fli%3E%0A%3Cli%3EMaturation%20of%20the%20External%20Ear%20and%20Middle%20Ear%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:9ca9d6e1-5016-4c61-9496-e920a57aecf3:title=Causes%20of%20Conductive%20Hearing%20Loss%20%28CHL%29&duration=1200&itemdetails=%3Cul%3E%0A%3Cli%3ETemporary%20CHL%20%26ndash%3B%20Newborn%20congenital%20middle%20ear%20fluid%3C%2Fli%3E%0A%3Cli%3EFluctuating%20CHL%20%26ndash%3B%20Otitis%20media%2C%20head%20and%20neck%20conditions%20associated%20with%3Cbr%20%2F%3Eotitis%20media%3C%2Fli%3E%0A%3Cli%3EPermanent%20CHL%20%26ndash%3B%20Congenital%20anomalies%2C%20syndromes%2C%20progressive%20conditions%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:324bc04c-d403-4a69-88b9-e526021ae20a:title=Fundamental%20Principles%20of%20Tympanometry&duration=1500&itemdetails=%3Cul%3E%0A%3Cli%3EImmittance%2C%20Impedance%2C%20Admittance%3C%2Fli%3E%0A%3Cli%3ETympanometer%20Hardware%3C%2Fli%3E%0A%3Cli%3EEquivalent%20Ear%20Canal%20Volume%3C%2Fli%3E%0A%3Cli%3EPeak%20Compensated%20Static%20Acoustic%20Admittance%3C%2Fli%3E%0A%3Cli%3ETympanometric%20Peak%20Pressure%3C%2Fli%3E%0A%3Cli%3EBasic%20Analysis%20of%20226%20and%201000%20Hz%2C%20Single-Component%20Tympanometry%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:8e45c90a-b149-4bcd-953b-c51b8aa15938:title=Interpretation%20of%20Tympanometry%20Results&duration=1500&itemdetails=%3Cul%3E%0A%3Cli%3ENormal%20Cases%3C%2Fli%3E%0A%3Cli%3EAbnormal%20Cases%3Cbr%20%2F%3E%3Cbr%20%2F%3E%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:37c5f91c-697b-4001-b04d-9f07964c274c:title=Live%20Session%20Recording&duration=3600&itemdetails=]
Basic Primer of Middle Ear Anatomy and Physiology
20m
- Brief Review of Middle Ear Anatomy and Physiology Including Acoustic
  Reflex Arc
- Maturation of the External Ear and Middle Ear
Causes of Conductive Hearing Loss (CHL)
20m
- Temporary CHL – Newborn congenital middle ear fluid
- Fluctuating CHL – Otitis media, head and neck conditions associated with
  otitis media
- Permanent CHL – Congenital anomalies, syndromes, progressive conditions
Fundamental Principles of Tympanometry
25m
- Immittance, Impedance, Admittance
- Tympanometer Hardware
- Equivalent Ear Canal Volume
- Peak Compensated Static Acoustic Admittance
- Tympanometric Peak Pressure
- Basic Analysis of 226 and 1000 Hz, Single-Component Tympanometry
Interpretation of Tympanometry Results
25m
- Normal Cases
- Abnormal Cases
Live Session Recording
1h
Session 2
2h 31m
[embed:36efd594-647a-47a1-9350-90a1e89aac01:ecec53d9-4f7b-4346-a1c9-600083e43a7f:title=Acoustic%20Reflex%20Assessment%20and%20Interpretation&duration=1200&itemdetails=%3Cul%3E%0A%3Cli%3EPrimer%20on%20Acoustic%20Reflex%20Assessment%3C%2Fli%3E%0A%3Cli%3EStimulus%20Type%20for%20Acoustic%20Reflex%20Assessment%20%28Tonal%20vs.%20Noise%29%3C%2Fli%3E%0A%3Cli%3EProbe%20Tone%20Frequency%20and%20Acoustic%20Reflex%20Results%3C%2Fli%3E%0A%3Cli%3EAnalysis%20and%20Interpretation%20of%20Acoustic%20Reflex%20Results%20in%20Infants%20and%20Young%20Children%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:476bf8f3-c4a9-4428-ada0-8a35ee9246db:title=Interpretation%20of%20Acoustic%20Reflex%20Results&duration=1500&itemdetails=%3Cul%3E%0A%3Cli%3ENormal%20Cases%3C%2Fli%3E%0A%3Cli%3EAbnormal%20Cases%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:b3134a38-9d50-40df-8fa3-574e516d6c09:title=Wideband%20Acoustic%20Immittance%20%28WAI%29&duration=1200&itemdetails=%3Cul%3E%0A%3Cli%3EFundamental%20Introduction%20to%20WAI%3C%2Fli%3E%0A%3Cli%3EHardware%20for%20Measurement%20of%20WAI%3C%2Fli%3E%0A%3Cli%3EAmbient%20and%20Pressurized%20WAI%3C%2Fli%3E%0A%3Cli%3EDevelopment%20of%20WAI%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:92f70f8b-fcdd-4275-a516-45ebed37effb:title=Analysis%20and%20Interpretation%20of%20WAI%20Results&duration=1500&itemdetails=]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:a880a594-b44b-4b30-bf4e-ee2bd31ce27e:title=Live%20Session%20Recording&duration=3600&itemdetails=]
Acoustic Reflex Assessment and Interpretation
20m
- Primer on Acoustic Reflex Assessment
- Stimulus Type for Acoustic Reflex Assessment (Tonal vs. Noise)
- Probe Tone Frequency and Acoustic Reflex Results
- Analysis and Interpretation of Acoustic Reflex Results in Infants and Young Children
Interpretation of Acoustic Reflex Results
25m
- Normal Cases
- Abnormal Cases
Wideband Acoustic Immittance (WAI)
20m
- Fundamental Introduction to WAI
- Hardware for Measurement of WAI
- Ambient and Pressurized WAI
- Development of WAI
Analysis and Interpretation of WAI Results
25m

Live Session Recording
1h
Session 3
2h 31m
[embed:36efd594-647a-47a1-9350-90a1e89aac01:d06f5773-0f0a-4d14-a96d-f946e04df0b5:title=Basic%20Primer%20on%20Cochlear%20Anatomy%20and%20Physiology&duration=900&itemdetails=]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:fcd2e0fc-3291-45cc-90a2-3bb7342aec25:title=Fundamentals%20of%20Otoacoustic%20Emission%20%28OAEs%29%20Measurements&duration=600&itemdetails=%3Cul%3E%0A%3Cli%3EHistory%20%28Kemp%2C%20Brownell%2C%20etc.%29%3C%2Fli%3E%0A%3Cli%3EHardware%3C%2Fli%3E%0A%3Cli%3EBasic%20Description%20of%20OAE%3Cstrong%3E%3Cbr%20%2F%3E%3C%2Fstrong%3E%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:f811f70a-bc01-4084-8af3-74b9ddbe12ea:title=Distortion%20Product%20OAEs&duration=1800&itemdetails=%3Cul%3E%0A%3Cli%3EDescription%3C%2Fli%3E%0A%3Cli%3EStimulus%20Parameters%3C%2Fli%3E%0A%3Cli%3EAcquisition%20Parameters%3C%2Fli%3E%0A%3Cli%3EAge%20Effects%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:d173e279-5cf4-4bfb-8fdf-f04c4cfe8225:title=Evidence-based%20Test%20Protocol&duration=900&itemdetails=]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:d80aac00-d7f3-4060-92fe-b90b143a2100:title=Analysis%20and%20Interpretation%20of%20Results&duration=1200&itemdetails=%3Cul%3E%0A%3Cli%3E%3Cspan%3EA%3C%2Fspan%3Ebsolute%20Amplitude%3C%2Fli%3E%0A%3Cli%3ESNR%3C%2Fli%3E%0A%3Cli%3ENormative%20Values%20Based%20on%20Age%3C%2Fli%3E%0A%3Cli%3EInterpretation%20of%20Cases%20-%20Present%20and%20Normal%20vs.%20Present%20with%3C%2Fli%3E%0A%3Cli%3EReduced%20Amplitude%20vs.%20Absent%20vs.%20Inconclusive%3C%2Fli%3E%0A%3C%2Ful%3E]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:815ca023-05b5-4dca-abbc-be5c42090881:title=Live%20Session%20Recording&duration=3600&itemdetails=]

Basic Primer on Cochlear Anatomy and Physiology
15m
Fundamentals of Otoacoustic Emission (OAEs) Measurements
10m
- History (Kemp, Brownell, etc.)
- Hardware
- Basic Description of OAE
Distortion Product OAEs
30m
- Description
- Stimulus Parameters
- Acquisition Parameters
- Age Effects
Evidence-based Test Protocol
15m
Analysis and Interpretation of Results
20m
- Absolute Amplitude
- SNR
- Normative Values Based on Age
- Interpretation of Cases - Present and Normal vs. Present with
- Reduced Amplitude vs. Absent vs. Inconclusive
Live Session Recording
1h
Session 4
2h 32m

[embed:36efd594-647a-47a1-9350-90a1e89aac01:285194ba-377c-4ab3-9e7d-5675c4529bc1:title=Learning%20Content&duration=5400&itemdetails=]

[embed:36efd594-647a-47a1-9350-90a1e89aac01:40c6874d-25a7-4233-9583-3c213d17a484:title=Live%20Session%20Recording&duration=3600&itemdetails=]

Learning Content
1h 30m

Live Session Recording
1h

Featuring

Lisa Hunter
PhD, FAAA
View Profile

Lisa Hunter, PhD is the Scientific Director for Audiology at Cincinnati Children’s Hospital Medical Center, a Primary Investigator in the Communication Sciences Research Center, and Professor of Otolaryngology at the University of Cincinnati. Dr. Hunter’s clinical and research interests are physiologic tools for assessment of ototoxicity, and detection and intervention for hearing loss in newborns. She has authored >130 peer-reviewed and invited articles, as well as numerous chapters and books in audiology. She is funded by the National Institutes of Health for her work in ototoxicity and prematurity in relation to hearing, speech, and language outcomes. She is President-Elect of the American Auditory Society and has been awarded the Presidential Award of the American Academy of Audiology for her service as chair of the Accreditation Commission for Audiology Education.

Financial Disclosures: Dr. Hunter receives compensation from Cincinnati Children's Hospital Medical Center, University of Cincinnati as Scientific Director for Audiology. She also receives royalties from Plural Publishing. She receives several grants from the NIH and NIDCD. She also receives compensation from Hearing First to teach this course.

Non-financial Disclosures: Dr. Hunter is Executive Board Member and President-Elect of the American Auditory Society. She is Chair of the American Academy of Audiology ACAE Review Committee. She is also an author for Acoustic Immittance Measures.

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