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ANSD - Coggle Diagram

- - - - -Diagnostic OAEs- TEOAE are recommended. If result is robust OAE, clearly present and repeatable, assume ANSD may be present.
    - - -Cochlear Microphonic- perform click CM with separate runs of condensation and rarefaction at the same stimulus level, using insert earphones. If CM is present and there is still no later true neural ABR response, assume ANSD may be present.
- - - - Total communication
      - Cued speech
      - Auditory/aural with lip-reading and natural gesture
      - Sign language
  - - - Provide greater neural synchrony and better speech perception outcomes for children with ANSD.
      - Evaluate CI candidacy based on the audiological findings,hearing aid benefit, status of speech language development and overall development skills.
    - - Beneficial for children with ANSD with normal hearing or with personal aid that have residual speech recognition in quiet but experience difficulty in noise.
      - Should be considered when the child is involved in day care or educational setting with poor acoustic conditions.
    - - Recommended on child whose behavioural threshold elevated.
      - Decision to aid based on behavioural result, CAEP, observation from family, early intervention and early communication.
- - - - Absent OAE
  - - - Absent or severely abnormal ABR test results
        
        Implications
        
        Limited, unclear or no speech
        
        Facing learning problems
        
        May be able to hear sounds, but would still have difficulty recognizing spoken words.
        
        difficulty following conversation
        
        Have trouble understanding speech clearly
        
        Poor speech perception
  - - - Audiogram does not predict functional hearing or speech perception ability in patients with ANSD
- - - - Neurodegenerative conditions
        e.g Charcot Marie Tooth(CMT
      - Metabolic conditions
        e.g Maple syrup urine disease(MSUD)