ABA Audiologic Assessment & Diagnosis 3 — Questions and Answers
Question 1: Word recognition scores of 0% in one ear with normal audiometric thresholds in the same ear most strongly suggest:
- Cochlear dead regions
- Pseudohypacusis (non-organic hearing loss) (Correct answer)
- Noise-induced hearing loss
- Meniere's disease
Correct answer: Pseudohypacusis (non-organic hearing loss)
Normal thresholds with 0% word recognition is a pattern inconsistent with organic pathology and strongly suggests non-organic hearing loss.
Question 2: During pure-tone audiometry, the Stenger test is used when:
- Interaural attenuation is exceeded
- Unilateral non-organic hearing loss is suspected (Correct answer)
- Sensorineural vs. conductive loss must be differentiated
- Middle ear pressure is abnormal
Correct answer: Unilateral non-organic hearing loss is suspected
The Stenger test exploits the binaural Stenger effect to detect feigned unilateral hearing loss by presenting tones to both ears simultaneously.
Question 3: A Type Ad tympanogram is characterized by:
- Absent peak with flat trace
- Normal peak with reduced compliance
- Abnormally high peak compliance (Correct answer)
- Negative peak pressure beyond -200 daPa
Correct answer: Abnormally high peak compliance
Type Ad (deep) tympanograms show abnormally high static admittance, often associated with ossicular discontinuity or a flaccid eardrum.
Question 4: Rollover on a performance-intensity function for word recognition is defined as a PI-PB max minus PI-PB score at high intensities greater than:
- 5%
- 10%
- 20% (Correct answer)
- 45%
Correct answer: 20%
A rollover index exceeding 0.45 (or a drop >20 percentage points) at high intensities is considered significant for retrocochlear pathology.
Question 5: Which behavioral hearing test technique is most appropriate for a typically developing 8-month-old infant?
- Conventional audiometry
- Visual reinforcement audiometry (VRA) (Correct answer)
- Conditioned play audiometry (CPA)
- Behavioral observation audiometry (BOA)
Correct answer: Visual reinforcement audiometry (VRA)
VRA is most appropriate from approximately 6 months to 2.5 years of age, using head-turn responses reinforced by animated toys.
Question 6: The supra-aural earphone calibration standard requires audiometric zero at 1000 Hz to be set to:
- 0 dB SPL
- 7 dB SPL (Correct answer)
- 16.5 dB SPL
- 26.5 dB SPL
Correct answer: 7 dB SPL
For TDH-type supra-aural earphones, audiometric 0 dB HL at 1000 Hz corresponds to approximately 7 dB SPL per ANSI standards.
Question 7: High-frequency audiometry (above 8000 Hz) is particularly useful for monitoring ototoxicity because:
- High frequencies are processed in the auditory cortex
- Cochlear damage from ototoxic drugs begins at the base and progresses apically (Correct answer)
- High frequencies are less variable between individuals
- Standard audiometry cannot detect loss above 6000 Hz
Correct answer: Cochlear damage from ototoxic drugs begins at the base and progresses apically
Ototoxic drugs damage the basal (high-frequency) cochlear region first, so extended high-frequency audiometry detects early changes before speech-frequency loss occurs.
ABA Audiologic Assessment & Diagnosis 3
Word recognition scores of 0% in one ear with normal audiometric thresholds in the same ear most strongly suggest: