Clinical Case Question: Emma, a 5-year-old girl, presents with concerns regarding her speech and language development. Her parents report that she has difficulty understanding speech in noisy environments and often seems to struggle with classroom interactions. Emma has a history of recurrent ear infections, and the physician suspects she may have hearing loss, particularly in the higher frequencies. She is unable to cooperate with behavioral pure-tone audiometry. The audiologist decides to use Auditory Steady-State Response (ASSR) testing to estimate Emma’s hearing thresholds. The following ASSR results are obtained for her right ear: 500 Hz: Response detected at 20 dB HL 1000 Hz: Response detected at 15 dB HL 2000 Hz: Response detected at 45 dB HL 4000 Hz: Response detected at 50 dB HL Question:Based on the ASSR results provided, which of the following is the most likely hearing profile for Emma?

Why ASSR is a better predictor of behavioral thresholds at 2 and 4 kHz than at 0.5 and 1 kHz? (HINT: two reasons from ASSR CourseNote)

Describe how intensity encoding occurs in the peripheral auditory system. (Hint: there are two types of intensity coding). NOTE: Include details on how the system manages to encode a dynamic range of up to 120 dB, addressing the mechanisms involved in representing different sound intensities and maintaining sensitivity across this broad range. 

How does the ASSR system enable simultaneous testing of both ears at four different frequencies, and how does this relate to the physiological properties of the cochlea and auditory nerve?

Which of the following correctly distinguishes the analytical approach between ASSR and ABR testing?

Clinical Question: A 7-year-old child is suspected to have CAPD based on behavioral assessments and reports of difficulty understanding speech in noisy environments. CAPD test results indicate a higher likelihood of a decoding deficit. Which ERPs would be most appropriate to confirm the presence of a decoding deficit in this child?

Case History Question: An adult patient, aged 28, presents with difficulty understanding speech in noisy environments despite having normal audiometric thresholds. The patient reports no history of ear infections or trauma. The following tests were conducted: ABR (Auditory Brainstem Response): Absent waveforms at all stimulus intensities. OAE (Otoacoustic Emissions): Present and normal at all frequencies. MLR (Middle Latency Response): Abnormal with delayed Na and Pa components. 1) Given these test results and a normal audiogram, what is the most likely diagnosis? (2 points) 2) Explain why the diagnosis you selected is most likely in this case. Discuss the underlying mechanisms related to the test results. (2 points)

Which of the following would not be found in the contract negotiation phase?  

Memorial Hospital has requested product demonstrations from both Epic and Cerner in their pathway to an EHR purchase.  Memorial Hospital is at what stage of vendor selection:

Darius is facilitating a group that is having trouble generating ideas on how to improve the patient registration process.  He asks them to describe the worst way the process could be redesigned to see if any new ideas can be generated.  Darius is using what group facilitation technique?