Transcription of Protocol for the Provision of Amplification - DSLio
1 Page | 1 2014 Version Ontario Ministry of Children and Youth Services Ontario Infant hearing Program November 17, 2014 Protocol for the Provision of Amplification Page | 2 Child Amplification Laboratory National Centre for Audiology Western University London, Ontario CORRESPONDENCE Marlene Bagatto, AuD, PhD Room 2262J Elborn College Child Amplification Laboratory National Centre for Audiology Western University London, ON, CANADA N6G 1H1 Voice: ext. 88949 Fax: Email: ACKNOWLEDGE MENTS The evidence-based clinical Protocol statements in this document are the responsibility of the Child Amplification Laboratory at the University of Western Ontario and detailed endorsement of any specific product or by any other person is not implied.
2 The programmatic, process and outcome review, and contractual statements in this document are the responsibility of the Ministry of Children and Youth Services. EDITORS Marlene Bagatto, AuD, PhD Susan Scollie, PhD CONTRIBUTORS Susan Scollie, PhD Marlene Bagatto, AuD, PhD Sheila Moodie, PhD Richard Seewald, PhD Martyn Hyde, PhD Stacey Weber, MSc Vanessa Martin, MSc Danielle Glista, PhD Anne Marie Tharpe, PhD Jeff Crukley, PhD Marianne Hawkins, PhD Charla Levy, MSc Sahar Zimmo, MSc Shane Moodie, MSc Frances Richert, MSc Vijay Parsa, PhD Page | 3 C ON T EN T S CONTENTS.
3 3 SECTION 1: INTRODUCTION .. 6 AMENDMENT HISTORY .. 6 UPDATES TO THE Protocol .. 6 FORECAST CHANGES .. 7 SECTION 2: 7 IHP CORE PRINCIPLES .. 7 Amplification GOALS .. 7 Amplification OBJECTIVES .. 7 TARGET IMPAIRMENTS .. 7 Amplification CANDIDACY .. 8 Amplification PERSONNEL .. 8 NON-IHP Amplification SERVICES .. 8 SECOND OPINIONS .. 8 INSTRUMENTATION, CALIBRATION & SUPPLIES .. 8 IHP PROTOCOLS & CASLPO GUIDELINES .. 9 PROCEDURAL CONCERNS .. 9 DEVIATIONS FROM Protocol .. 9 PERFORMANCE AUDITS .. 9 TYPES OF ASSESSMENT.
4 9 TIMING OF Amplification .. 10 INFECTION CONTROL STANDARDS .. 10 CALIBRATION .. 10 OTOSCOPY & CERUMEN/DEBRIS .. 10 Amplification COMPONENTS .. 11 CLINICAL RECORDS & REPORTS .. 11 PERSONAL HEALTH INFORMATION .. 12 SECTION 3: ASSESSMENT CONSIDERATIONS .. 12 AUDITORY CHARACTERISTICS .. 12 CONSULTATION BY AN OTOLARYNGOLOGIST .. 12 ACOUSTIC 12 RECD MEASUREMENT .. 13 AGE-APPROPRIATE PREDICTED RECD VALUES .. 13 SECTION 4: SELECTION AND FITTING OF Amplification .. 13 EAR IMPRESSIONS .. 13 NON-ELECTROACOUSTIC CHARACTERISTICS.
5 13 ELECTROACOUSTIC CHARACTERISTICS .. 13 DEVICE SELECTION .. 14 OTHER ASSISTIVE TECHNOLOGY .. 14 SECTION 5: VERIFICATION OF AMPLIFCATION .. 14 RECD VALUES .. 14 ELECTROACOUSTIC ANALYSIS .. 14 ELECTROACOUSTIC VERIFICATION .. 15 Page | 4 APPLICATION OF ADVANCED TECHNOLOGIES .. 15 SIMULATED REAL-EAR MEASUREMENTS .. 15 VERIFICATION STIMULI .. 15 SECTION 6: INFORMATION AND INSTRUCTION .. 16 ORIENTATION .. 16 INFORMATION .. 16 FAMILY SUPPORT .. 16 SECTION 7: OUTCOME EVALUATION .. 16 FOLLOW-UP SCHEDULE .. 16 FOLLOW-UP VISITS.
6 17 OUTCOME MEASURES .. 17 SECTION 8: TRAINING AND CLINICAL DECISION SUPPORT .. 17 TRAINING REQUIREMENTS AND SUPPORT MECHANISMS .. 17 IHP WEBSITE .. 17 SUPPLEMENT 1: PROGRAM CONTENT .. 18 ONTARIO INFANT hearing PROGRAM CORE PRINCIPLES .. 18 Amplification OBJECTIVES .. 19 TARGET IMPAIRMENTS .. 19 INSTRUMENTATION, CALIBRATION & SUPPLIES .. 20 DEVIATIONS FROM Protocol .. 21 PROCESS AND OUTCOMES REVIEW .. 21 TIMING OF Amplification .. 21 SUPPLEMENT 2: ASSESSMENT CONSIDERATIONS .. 23 AUDITORY CHARACTERISTICS .. 23 ACOUSTIC CHARACTERISTICS.
7 24 RECD MEASUREMENT .. 24 AGE-APPROPRIATE PREDICTED RECD VALUES .. 24 SUPPLEMENT 3: PRESCIPTION OF Amplification .. 25 NON-ELECTROACOUSTIC CHARACTERISTICS .. 25 ELECTROACOUSTIC CHARACTERISTICS .. 26 DEVICE SELECTION .. 26 OTHER ASSISTIVE TECHNOLOGY .. 26 SUPPLEMENT 4: INFORMATION AND INSTRUCTION .. 27 ORIENTATION .. 27 SUPPLEMENT 5: OUTCOME EVALUATION .. 27 OUTCOME MEASURES .. 27 SECTION 9: REFERENCES .. 28 SECTION 10: APPENDICES .. 31 APPENDIX A: IHP INSTRUMENTATION .. 31 APPENDIX B: ESTIMATED hearing LEVELS (EHLS) AND hearing AID FITTING.
8 33 APPENDIX C: COUPLING INSERT EARPHONES TO PERSONAL EARMOLDS .. 34 APPENDIX D: PROCEDURE FOR OBTAINING AN EAR IMPRESSION .. 35 APPENDIX E: ELECTROACOUSTIC VERIFICATION .. 37 APPENDIX F: INSTRUCTION AND INFORMATION .. 38 SECTION 11: Protocol ADDENDA .. 40 ADDENDUM 1: AMERICAN ACADEMY OF AUDIOLOGY PEDIATRIC Amplification GUIDELINES .. 40 Page | 5 ADDENDUM 2: FREQUENCY LOWERING hearing AIDS .. 44 ADDENDUM 3: NOISE MANAGEMENT IN hearing AID FITTING .. 63 ADDENDUM 4: DECISION SUPPORT GUIDE FOR hearing AID USE IN INFANTS AND CHILDREN WITH MINIMAL/MILD BILATERAL hearing LOSS.
9 78 ADDENDUM 5: MANAGEMENT OF INFANTS AND CHILDREN WITH UNILATERAL hearing LOSS .. 90 ADDENDUM 6: REMOTE MICROPHONE hearing ASSISTANCE TECHNOLOGIES .. 96 Page | 6 SEC T I ON 1: I N T RODUCTI ON This Protocol addresses the Provision of Amplification (' Amplification ') to infants and pre-school children registered in the Ontario Infant hearing Program (IHP). Providing Amplification includes the process of prescribing a hearing instrument based on appropriate assessment information, verification that the specified acoustical performance targets have been achieved, and evaluation of device effectiveness in daily life.
10 Dispensing includes obtaining ear impressions for earmold fabrication, electroacoustic analysis of the prescribed hearing instruments (ANSI test), adjustment of the hearing instruments to the settings provided, and hearing instrument orientation. This document addresses the Provision of Amplification (hereafter: ' Amplification ') to infants and pre-school children registered in the Ontario Infant hearing Program (IHP). The document specifies context and procedures for the Provision of Amplification , including specification of key procedures and equipment requirements.
