JD CGSC ASSIGNMENT (1)

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University of New England *

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Medicine

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Apr 3, 2024

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Jaida Damato Audiology Write Up 13 Wednesday 2023 Audiologist Observation On December 7th, from 1 PM-3 PM, I was given the opportunity to observe Michelle Ciancia (#O2-0000256), an Audiologist at Nemours Children's Hospital. I sat in while she saw two patients for appointments. The first patient, CP, was a 17-month-old child who was referred to Nemours for a speech delay. CP is a Twin A who was born prematurely. He had to be held in the NICU for 38 days where he received oxygen for an extended period of time. Dr. Ciancia started the tests by having CP and his mother sit in a soundproof booth. Using a tympanometer, she saw what the outer ear looked like. After doing so, she performed a Visual Reinforcement Audiology (VRA) with puppets; The patient sat in a chair on his mothers lap while using both ears to respond to the softest sound they could hear. Dr. Ciancia used an audiometer to adjust the frequency and amplitude of the noises coming out from the speakers. She would increase/decrease the frequency and amplitude of the sounds. When CP correctly turned his head, a puppet would dance as a reward. After the test was over, she informed the parent that his hearing is normal and that they should return in about a year to follow-up. The second patient Dr. Ciancia tested was a 5-year-old twin (MK) brought in by his father with concerns of ear infections in Eustachian Tube Dysfunction. There had previously been a lot of backed up cerumen in his left ear that could be resulting in hearing loss. She used a tympanometer to check the status of his outer ears. He received normal tympanometry results in the right ear, but not in the left ear. The tympanogram displayed a combination of Type C and Type As waves, telling her that there is stiffness and negative pressure in the left ear. She then used a conventional audiometer using audio through inserts. Then, Dr. Ciancia used SRT with pictures. Once she noticed MK was having a hard time on the left side, air and bone conduction tests were performed. After the series of tests, the clinician concluded that MK has mild conductive hearing loss in the left ear, along with Eustachian Tube Dysfunction.
For both appointments, Dr. Ciancia would set the patient up in the booth and then sit in a separate room with a window and talk to the child through a microphone. When we would learn about testing in class, I always thought the clinician would be face to face with the patients. The audiologist used many of the technologies covered in our classes. She performed tympanometry and used an audiometer for both patients. She used an ascending/descending technique to determine the patients' thresholds. Many of the verbal notes she made aligned with class information, and I felt well-prepared for the discussions with her. It was pretty apparent that my clinician was unhappy in the field. She didn’t convey this through her interactions with the patients, rather subtle comments when we would talk. If I was more comfortable with her, I would ask her what it is about the field that draws her away. As someone that aspires to be a Speech/Language Pathologist, I would want to know if its the setting, the patients, or the healthcare field as a whole.
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