1. Wendy D. Hanks, Ph.D. Molly A. Kinder, M.S. Gallaudet University
Tympanometry Protocols Used In Early Intervention Services In the United States: A Pilot Survey of Early Intervention and Pediatric Audiologists
Wendy D. Hanks, Ph.D.
Molly A. Kinder, M.S.
Gallaudet University

2. The Purpose What tympanometry protocols are being used?
Is the 1000 Hz probe tone in use?
Audiologist’s 1000 Hz probe tone knowledge?

3. Our Respondents Sent survey via email on: 153 audiologists responded
EHDI listserve
Educational Audiology Association listserve
AAA “SoundOff” listserve
153 audiologists responded

4. The Survey Began with demographics 13% male; 87% female
35 states, Washington D.C., and the Commonwealth of the Marina Islands represented

5. Demographics – Highest Degree
Other – 6 Au.D. Students, 2 M.Eds, and 1 M.S.C
Striking that majority have the Au.D – when we look at experience too, we see that a majority have 21 or more years experience - thought there would be more MA/MS degrees

6. Demographics – Practice Setting
Other - medical clinic (2), out-patient clinic (2), private non-profit rehab center (1), HMO audiology clinic (1), outreach clinic (1), multi-specialty clinic (2), public health clinic (1), school for the deaf (2), outpatient rehab clinic (4), government facility (4), mobile outpatient clinic (1), title V state agency (1), non-profit hearing and speech center (1), early intervention program (1), non-profit private pre-school (1), university hospital (1), state hospital (1), children's clinic for rehab services (1), and pediatric hospital (1).

7. Experience with Pediatrics

8. Experience with 0-3 Year Olds

9. Experience – How Many Children Per Week?

10. Equipment Used…
Those that have 1000 Hz capability – tympstar VII, 33 VII, madsen otoflex, interacoustics 235h

11. Probe Tones by Age

12. 1000 Hz Tympanometry
Number of audiologist who use the 1000 Hz probe tone for screening and diagnostic modes
Correlates with equipment data – most used equipment has only diagnostic capability
Hope that this and more data will show a need for more screening equipment/screening use of 1000 Hz so may be the babies won’t have to referred for a full diagnositic

13. Parameters - Pump Speed

14. Parameters – Sweep Pressure Direction

15. Parameters - Starting Pressure

16. Parameters – Stopping Pressure

17. Parameters – Use of Tympanometric Width

18. Parameters – Type of Display Used

19. Parameters – Type of Immittance Used

20. Parameters used to Determine if Tympanogram is Normal

21. Norms Used
ASHA does not include 1000 Hz tympanometry in guidelines; Jerger types not classified for 1000 Hz tymps
Kei and Marglois are only ones that have specific 1000 Hz calculated norms

22. Current Studies and Data
In 2003, two studies published with normative data for 1000 Hz tympanometry
Kei et al., 2003
SAA compensated at +200 daPa
Refer if SAA less than .39 ml
Margolis et al., 2003
SAA compensated at -400 da Pa
Refer if SAA less than .6 ml

23. 1000 Hz Tympanometry Knowledge
Other - These responses included: NCHAM courses (3 respondents), equipment manufacturer (3 respondents), in school (2 respondents), clinical experience/discussions (2 respondents), only use 226 or 678 (1), "don't know enough about benefits" (1), Capstone project work (1) and Audiology Online (1 respondent).

24. 1000 Hz Probe Tone Use
Other - do not screen/test infants (2), do not have 1000 Hz capability (6), not used (1), when child is less than 6 months old (2), with infants (1), and for failed newborn hearing screening (1).

25. Is 1000 Hz Tympanometry Useful With Children 0-6 Months?
Why those 2 people who said no is not known, did not ask why they did not feel it was not useful

26. Additional Information 26 of 153 respondents
1000 Hz tympanometry is crucial/important in the testing of young children (6)
Do not have the capability of 1000 Hz probe tone (7)
Interpretation of 1000 Hz can be difficult (4)
The protocol for using immittance was described (3)
1000 Hz data is needed (2)
Use 1000 Hz as a cross check only (1)
226 Hz can be used reliably with the infants population (1)
“Could not answer all the technical questions (1)
"I work part-time and don't see many children (1).
“Please add any additional information that you feel is important in the use of tympanometry in the 0-3 year old population?”

27. Conclusions – Further study of this topic is needed
More training on the appropriate use of tympanometry is needed
1000 Hz tympanometry normative data should be used consistently