Hughes Michelle L, Sevier Joshua D, Choi Sangsook
Boys Town National Research Hospital, Omaha, NE.
Am J Audiol. 2018 Nov 19;27(3S):385-390. doi: 10.1044/2018_AJA-IMIA3-18-0002.
The purpose of this report is to describe the equipment setup and techniques for successfully testing behavioral thresholds in young children with cochlear implants (CIs) using telepractice. We will also discuss challenges associated with pediatric CI programming that are unique to the use of distance technology, and we will describe ways to overcome those challenges. Last, we will review the results from 2 recent studies specifically targeted toward testing behavioral thresholds in young children with CIs.
Conditioned play audiometry or visual reinforcement audiometry was used to measure behavioral thresholds (T levels) for 35 young children with CIs (n = 19 for conditioned play audiometry and n = 16 for visual reinforcement audiometry). Participants were tested in the traditional in-person condition and in the remote condition using an AB-BA study design over 2 visits.
There was no significant difference in T levels between the in-person and remote conditions, indicating that it is feasible to test young children using conventional pediatric testing procedures via remote technology. The primary challenges encountered were in regard to proper camera and video monitor placement at the remote site and the timing of communication between the audiologist and test assistant.
The results from studies to date suggest that distance technology can be used successfully to program CI sound processors for young children using standard, age-appropriate testing techniques. The alternative of remote testing has substantial implications for reducing time and travel burdens for families, potentially leading to the construction of appropriate maps for young children with CIs in a timelier manner.
本报告旨在描述使用远程医疗成功测试小儿人工耳蜗(CI)行为阈值的设备设置和技术。我们还将讨论小儿CI编程中与远程技术使用相关的独特挑战,并描述克服这些挑战的方法。最后,我们将回顾两项近期专门针对测试小儿CI行为阈值的研究结果。
采用条件性游戏测听法或视觉强化测听法测量35名小儿CI患者的行为阈值(T值)(条件性游戏测听法19例,视觉强化测听法16例)。采用AB - BA研究设计,在两次就诊中对参与者在传统面对面条件和远程条件下进行测试。
面对面条件和远程条件下的T值无显著差异,表明通过远程技术使用传统儿科测试程序测试幼儿是可行的。遇到的主要挑战是远程站点摄像头和视频监视器的正确放置以及听力学家与测试助手之间的通信时间。
迄今为止的研究结果表明,远程技术可成功用于使用标准、适合年龄的测试技术为小儿CI声音处理器进行编程。远程测试的替代方案对减轻家庭的时间和旅行负担具有重大意义,有可能更及时地为小儿CI患者构建合适的图谱。