Glossary
Definitions of some common terms you might encounter
ABR Test
– ABR stands for Auditory Brainstem Response. This is a hearing test that measures an electrical response of the inner ear and auditory nerve. Young children are usually sleeping or sedated for this test. Small disk-shaped sensors are placed behind each ear and on the child’s forehead. Sounds are then presented to the ears using miniature earphones.
ASL (American Sign Language)
- ASL is an independent language that has its own grammar and syntax; it is not simply a manual version of English. ASL uses hand shapes, positions, movements, facial expressions, and body movements to convey meaning. ASL uses an alphabet (finger spelling), sign representing ideas, and gestures.
Atresia
– Atresia is the lack or narrowing of an ear canal opening where sound normally travels by air waves to the middle ear. Complete atresia results in a conductive hearing loss.
Audiogram
– A chart or graph that shows how well a person hears. An audiogram can be thought of as a picture of your child’s hearing. The audiogram shows the quietest level of sound your child can hear at each frequency (pitch) in each ear. Go to the page on how to read an audiogram for more information.
Audiologist
– An audiologist is a health professional who identifies people who have hearing problems, and works with these people to help to improve their communication. This includes diagnosing hearing loss, and fitting hearing aids. Audiologists in Canada have a minimum of a Master’s Degree and are certified by the Canadian Association of Speech-Language Pathologists and Audiologists.
Audiometer
– Electronic equipment used to test hearing.
Auditory Nerve
– The hearing nerve that connects the inner ear (cochlea) to the brain, sending messages from the ear to the brain.
Auditory Neuropathy (Spectrum Disorder) (ANSD)
– The child’s external, middle and inner ear (or cochlea) seems to receive sounds normally, but signals leaving the cochlea may be disorganized or the auditory nerve might not be processing sound normally. A child with auditory neuropathy often has more difficulty understanding speech than would be expected from his or her audiogram. The child’s hearing may also seem to fluctuate. Go to the page on Auditory Neuropathy for more information.
Bilateral Hearing Loss
– hearing loss in both ears.
Bone-Anchored Hearing Aid (BAHA)
– The BAHA is for children who benefit from bone conduction hearing aids, such as children with absent ear canals (atresia). The BAHA is a small rectangular hearing aid that snaps directly onto a titanium screw that is inserted surgically into the skull. There is also a "softband BAHA" that does not require any surgical implantation, which is usually used by young children and babies. Sound vibrations are transmitted directly through the hearing aid to the bone and from there to the inner ear (cochlea).
Bone-conduction Testing
– A bone vibrator is placed behind the child’s ear. The vibrator stimulates the inner ear directly and bypasses the middle ear. This helps to determine where the child’s hearing problem is located. If the problem is located in the outer or middle ear (conductive hearing loss), then it may be helped with medical intervention. If the problem is located in the inner ear (cochlea) then it is a permanent type of hearing loss (sensorineural).
Bone Oscillator
– The vibrating headphone used in bone-conduction testing.
BTE hearing aids
– BTE stands for "behind the ear" hearing aids.
Cochlea
– The cochlea is a spiral-shaped bony casing that forms the inner ear. It has many nerve endings inside of it.
Cochlear Implant
– A surgically implanted electronic device that bypasses damaged structures in the inner ear and directly stimulates the auditory nerve, allowing some deaf children to learn to hear and interpret sounds and speech.
Comfort Level (C level)
– The maximum comfort level is the highest electrical stimulation level that does not produce an uncomfortable sensation for a child using a cochlear implant.
Conditioned Play Audiometry (CPA)
– This is a kind of hearing assessment for children around aged 3 and above that involves playing a game. The child is taught to respond to sound by performing an action, such as putting a block in a bucket or a peg in a pegboard, after he detects a sound.
Conductive Hearing Loss
– With this type of hearing loss, something is wrong with the outer or middle ear. An example of a problem with the outer ear is atresia, where there is no opening to the ear canal. Problems with the middle ear can be the result of fluid in the middle ear, or there can be something wrong with the three little bones in the middle ear. Sometimes a conductive hearing loss is temporary when it is the kind of problem that can be medically treated, such as middle ear fluid.
Congenital Hearing Loss
– A hearing loss present at birth or associated with the birth process, or which develops in the first few days of life.
Cued speech
- Cued Speech is a sound-based visual communication system which in English, uses eight hand shapes in four different locations (cues) in combination with the natural mouth movements of speech to make all the sounds of spoken language look different.
Deaf Culture
- the everyday lives of Deaf people who consider themselves to be culturally Deaf - people with their own unique language, history, traditions, perspective and culture.
Decibels (dB)
– Intensity (loudness) of sound is measured in decibels. For instance, 100dB is a very loud sound, and 10 dB is a very quiet sound.
Dynamic Range
– The difference in decibels (dBs) between the softest level that can be heard, and the loudest level that a person can listen to without it being uncomfortable. For a child using a cochlear implant, the dynamic range is the number of electrical stimulation units between the threshold (T) levels and comfort (C) levels.
Electrode Array
– This is the part of the cochlear implant device that is surgically inserted into the inner ear. Electrodes along the array are activated to transmit high-pitch and low-pitch information to the auditory nerve.
Eardrum
– The eardrum is situated at the end of the ear canal, between the outer ear and the middle ear. It is a membrane that consists of 3 thin layers of skin. If your child has "tubes", these were inserted in the eardrum.
ENT
– An ENT is a doctor who is an ear, nose and throat specialist. Another name for an ENT is an otolaryngologist.
Eustachian tube
- The Eustachian tube is the passage from the back of the nose to the middle ear. Sometimes it can become inflamed such as during a cold, which can lead to middle ear fluid (otitis media).
Frequency / Pitch of Sound
– Frequency is measured in Hertz (Hz). For instance, 250 Hz is a low frequency (or pitch) sound, and 4,000 Hz is a high frequency sound. On a piano keyboard, the low frequency keys are on the left, and the high frequency keys are on the right.
Hearing threshold
– The hearing threshold is the quietest sound that a person can hear. An aided threshold is the quietest sound a person can hear with hearing aids on.
Impedance/immittance testing
– A small probe is placed in your child’s ear. The graph that is created during this test is called a tympanogram. This test shows if there is a problem in the middle ear, such as middle ear fluid which may accompany or follow an ear infection. Impedance testing gives the audiologist information about:
- The flexibility of the eardrum;
- Middle ear pressure;
- Functioning of middle ear bones;
- Functioning of the Eustachian tube; and
- The reflex contraction of a small muscle in the middle ear.
Inner ear
– The inner ear is the part of the ear that contains the cochlea and the auditory nerve, as well as the balance organ.
Localized
– When a child turns his head towards the direction of a sound.
MAP
– The "listening program" stored in the memory of the cochlear implant processor.
Middle ear
– The middle section of the ear that contains three tiny bones, through which sound is conducted from the eardrum to the inner ear. This is where ear infections are usually located.
Mild Hearing Loss
– A child is unable to detect sounds until they are in the loudness range of 26 dB to 40 dB.
Moderate Hearing Loss
– A child is unable to detect sounds until they are in the loudness range of 41 dB to 55 dB.
Moderately Severe Hearing Loss
– A child is unable to detect sounds until they are in the loudness range of 56 dB to 70 dB.
Otitis Media
– An inflammation (swelling) in the middle ear which can result in a temporary slight-to-moderate hearing loss. It occurs when the Eustachian tube becomes blocked repeatedly (or remains blocked for long periods) due to allergies, multiple infections, ear trauma, or swelling of the adenoids.. Fluid build-up can sometimes become infected. When otitis media is chronic, children may be treated surgically with ventilation tubes. For a child who has a permanent hearing loss, having middle ear fluid will cause hearing to temporarily become worse. These children should see an Ear, Nose and Throat (ENT) doctor.
Otoacoustic Emissions (OAEs)
– This is a test where a sensitive microphone is placed in the child’s ear while the audiologist presents several soft clicks or tones. If the inner ear (cochlea) is normal, it makes sounds back (called otoacoustic emissions) that are picked up by the microphone. When the responses are present it usually means that the hearing is normal. If the responses are absent, this may indicate hearing loss. Responses may also be absent due to things like wax in the ear canal, or the presence of middle ear fluid.
Outer Ear
– The visible part of the ear that we can see, as well as the ear canal, which channels sound from outside through to the eardrum.
Profound Hearing Loss
– A child is unable to detect sounds until they are 90 dB or louder.
Sensorineural Hearing Loss
–Sensorineural hearing loss results from a problem in the cochlea (inner ear). Your child may have been born with this type of hearing loss. It can also be the result of damage, disease, injury, or certain medications. Sensorineural hearing loss is almost always permanent and cannot be improved with medicine or surgery. Usually, hearing aids or other listening devices are the best treatment for sensorineural hearing loss.
Severe Hearing Loss
– Child is unable to detect sounds until they are in the loudness range of 71 dB to 90 dB.
Single-sided Deafness
– This refers to hearing loss in one ear only, with the degree of loss being in the severe to profound range. Single-sided deafness is sensorineural - that is, either the inner ear (cochlea) and/or auditory nerve are affected. A child with single-sided deafness hears very little if at all from this ear. Another term for this is unilateral deafness (go to the page about unilateral/one-sided hearing loss for more information).
Slight Hearing Loss
– A child is unable to detect sounds until they are in the loudness level of 16 – 25 dB.
Sloping Hearing Loss
– A child’s hearing loss is not the same across all frequencies (pitch). In most cases, a child with a sloping hearing loss has better hearing in the lower frequencies than in the higher frequencies. On such a child’s audiogram (graph), you would see a sloping downward line that connects the symbols (X, O or < and >) which mark the loudness of sounds heard at different pitches. See below for an example of a audiogram showing a downward-sloping hearing loss. In the audiogram below, the hearing loss slopes downward from a mild hearing loss in the low frequencies (at the left of the graph), to a severe hearing loss in the high frequencies (at the right of the graph). Go to the page on how to read an audiogram for more information.
Sound Field
– Sound is presented through loud speakers instead of headphones. Testing in a sound field tells what the child can hear with both ears. If one ear is better than the other, testing in soundfield will only show how the better ear hears.
Speech Awareness Threshold
– the quietest level at which the child responds to speech (such as by turning to the sound, or eye-widening) 50 per cent of the time when tested by the audiologist.
Speech Banana
– When all the sounds necessary for speech were initially graphed on an audiogram and a circle was drawn around them, the shape looked like a banana, and the term "speech banana" was coined. It is important that children hear all the sounds in this area, as it will affect how well they can understand speech. For children who have hearing loss, hearing aids provide a boost of volume to make as much of the speech banana audible ("hear-able") to the child as possible. The consonant sounds like "f", "s", and "th" are most often the sounds that children with hearing loss have trouble hearing, as they are the softest speech sounds (closest to the top of the graph). Vowel sounds tend to be louder (further down the graph), so are usually easier to hear. Below is a picture of an audiogram showing some of the different speech sounds, and where they are in terms of loudness and pitch (frequency).
Speech Reception Threshold Test
– this test shows the quietest level at which the child can understand words spoken by the audiologist. The audiologist may ask the child to point to familiar toys or pictures of objects, for example, "show me the airplane". Older children are usually asked to repeat the words that they hear.
Threshold Level (T level)
- The minimum level of electrical stimulation required at each electrode along the cochlear implant electrode array for a child to first hear a sound.
Total Communication (systems):
- This refers to a communication system where a combination of visual/manual and auditory/spoken systems are used. Variations of combined communication approaches include (but are not limited to) simultaneous communication or "sim-com", Conceptually Accurate Signed English (CASE), sign supported speech, and Cued Speech.
Tympanogram
– The results of tympanometry testing (mobility of the eardrum) are recorded on a graph or chart. A graph with a flat line indicates middle ear problems such as presence of fluid (no mobility). A graph with a curve like a mountain indicates normal mobility.
Tympanometry Testing
- A small probe is placed in your child’s ear while the movement of the eardrum is measured. The graph that is created during this test is called a tympanogram. This test shows if there is a problem in the middle ear, such as middle ear fluid which may accompany or follow an ear infection. A tympanogram gives the audiologist information about:
- The flexibility of the eardrum;
- Middle ear pressure;
- Functioning of middle ear bones;
- Functioning of the Eustachian tube; and
- The reflex contraction of a small muscle in the middle ear.
Unilateral Hearing Loss
– A child has hearing loss in only one ear.
Visual Reinforced Audiometry (VRA)
– This hearing test is typically used for infants over six months of age, up to about 2 or 3 years of age. This test takes advantage of your child’s natural head turn to look for the source of sounds. It involves teaching your child to turn to sounds with the use of toys that light up as a reward. Sounds are presented through headphones and/or speakers. In this way, we can find the softest sound that your child will respond to for different kinds of sounds.
Word Recognition Test
– Shows how well a child can repeat back words that are presented at different loudness levels. This test can also be done by having the child point to pictures instead of repeating the words out loud. This is most often used with a child who has developed speech and oral language. This test used to be called the Speech Discrimination Test.