Long Island Jewish Medical Center - Hearing & Speech Center

The Hearing and Speech Center provides comprehensive diagnostic and therapeutic services for all types of communication disorders. The Center serves all age groups from infancy through geriatric. Special features of the Hearing and Speech Center include a full service Hearing Aid Dispensary specializing in state-of-the art hearing aid technology, a Voice Center for the care of the professional voice, and New York States largest Universal Newborn Hearing Screening Program. The Hearing and Speech Center is fully accredited by the Professional Services Board of the American Speech-Language-Hearing Association and is approved by the Early Intervention Program and Physically Handicapped Children's Program for diagnosis and treatment of speech and hearing disorders.

History

The Hearing and Speech Center, a division of the Department of Otolaryngology and Communicative Disorders, is supported by the Long Island Hearing and Speech Society. Founded in 1952, the Society first opened a small clinic in Mineola, Long Island. In 1966, it affiliated with Long Island Jewish Medical Center and built the Jean Leigh Pavilion, a two story, 9,960 square foot building which houses the Hearing and Speech Center. Today, through the generosity of the Hearing and Speech Society, its friends and supporters, the building has been expanded to house the Hearing & Center, the Apelian Cochlear Implant Center, the Schein Voice Center, the Zucker Sinus Center and the Department of Otolaryngology and Communication Disorders.

Professional Training

The Hearing and Speech Center accepts graduate students in speech pathology and audiology from local universities for clinical practicum. The Center also provides post-graduate training for clinical fellows in speech pathology and 4th year clinical placements for Au.D students. Professional staff provides training for residents in otolaryngology, pediatrics, radiology, and dental medicine.

Programs

Audiology Service

Audiologists use the most advanced diagnostic equipment to assess hearing and balance disorders. The Center is equipped to test all ages form newborn to geriatric patients.

Newborn Hearing Screening Program

The LIJ screening program ,designed to conform with recommendations of the1993 NIH Consensus Statement on Universal Newborn Hearing Screening, was begun in 1995. All newborns and NICU graduates are screened before discharge using a two stage screening protocol. The otoacoustic emissions (OAE) test is administered to all newborns. Infants failing the OAE test are re-tested using an automated screening version of the Auditory Brain stem Response (ABR)test. Infants who fail both stages of the screening, or who are missed before discharge are referred for out-patient re-screening at the Hearing and Speech Center.

Pediatric Evaluations

Complete diagnostic and rehabilitative services are available for infants and children who are suspected of being hearing impairment. The test method chosen for a pediatric patient is based on the developmental age of the child.Infants less than 6 months of age are most reliably tested using electrophysiological test methods. These tests are completely objective and are performed while the infant sleeps. Older infants and children are tested behaviorally using conditioning techniques. Each child's developmental level is carefully assessed to determine his or her readiness to perform the necessary tasks before a test method is chosen.

Adult Evaluations

A full range of tests is available for the diagnosis of hearing disorders in adult and geriatric patients. In addition to complete hearing assessment, evaluations are available for tinnitus, vestibular disorders, neurotological disorders, and central auditory processing disorders.

Tests

The following audiological tests are routinely performed at the Hearing and Speech Center:

Auditory Brain Stem Response (ABR)

• Threshold Search using air and bone conducted click stimuli establishes auditory thresholds in 2-3K Hz region.
• Threshold Search using air and bone conducted tonal stimuli provides frequency specific thresholds.
• Neurotological ABR evaluates the status of the auditory nerve and brain stem auditory pathways when acoustic neuroma or brain stem lesion is suspected.
• Pediatric ABR testing under sedation is available at the Center. Sedation is administered by an anesthesiologist assisted by a nurse.

Otoacoustic Emissions:
Screening of cochlear (outer hair cell) function

Acoustic Immittance:
Test of middle ear function

Electronystagmography (ENG and VNG):
Test of vestibular function

Central Auditory Test Battery:
Test for school age children and adults suspected of having central auditory processing disorder (CAPD)

Hearing Aid Evaluation:
The most up-to-date, computerized prescriptive methods are used to fit hearing impaired infants, children, and adults with appropriate amplification

Therapeutic Hearing Service

Habilitative and rehabilitative services for individuals with hearing impairment are provided by an interdisciplinary team consisting of audiologists with expertise in amplification for both children and adults, speech-language pathologists who specialize in childhood and adult hearing impairment, and asocial worker who assists families negotiate the system to obtain appropriate services, school placement, funding, etc.

Hearing Aid Dispensary

Amplification devices are selected based on results of the diagnostic audiological evaluation and consultation with the patient to determine personal preferences and physical limitations. Each device is custom fit and adjusted to meet the needs of the individual. All types of amplification are available from the Hearing Aid Dispensary including:

• Digital Hearing Aids
• Programmable Hearing Aids
• Conventional Hearing Aids
• Bone Conduction Hearing Aids
• Bone anchored hearing device (Baha)
• FM Trainers: traditional and ear level devices.
• Assistive Listening Devices

Other devices available in the Dispensary include:

• Hearing protection
• Musician Ear Plugs
• Swim molds
• Tinnitus Maskers

Adult Aural Rehabilitation

Therapy sessions are designed to provide instruction in the proper use, care, and trouble shooting of hearing aids and other assistive devices. Patients improve communication skills by learning lip reading techniques and listening skills. Advice and support is also available for family members.

Pediatric Aural Habilitation

Orientation to amplification: A speech-language pathologist who specializes in infant and childhood hearing impairment trains the infant or child to use the new auditory information provided by the hearing aid to develop speech and language. Parents are taught how to operate and troubleshoot their child's hearing aids and how to facilitate development of speech, language, and auditory skills at home.

Speech and Language Therapy: The speech-language pathologists at the Hearing and Speech Center are committed to an oral-aural approach to the training of deaf and hearing impaired infants and children.

Cochler Impants (see cochlear implant program)

Speech Pathology Services

Specialists conduct speech, language, and voice evaluations and provide treatment for a full range of disorders. Habilitation or rehabilitation and on-going family counseling are the keys to helping patients achieve their maximum communication potential. The use of sophisticated instrumentation to facilitate diagnosis and treatment is essential to the program.

Diagnostic Program

This program was designed to provide comprehensive assessment of all types of communicative disorders. These include delayed speech and language, articulation disorders, dysarthria, disfluency, voice disorders, swallowing disorders, and speech and language disorders associated with hearing loss, aphasia, cleft palate, laryngectomy and other craniofacial disorders. Sophisticated instrumentation is used, along with pragmatic measures, to provide the most complete information needed to make an accurate diagnosis and plan for effective treatment. Patient population ranges from early childhood through the geriatric age.

Therapy Program

Those who have been identified through diagnostic evaluation with a communication disorder are placed in a therapy program. Functional outcomes depend on the nature and severity of the disorder. The ultimate goal of this program is to help the patient develop his maximum communication ability. All of the disorders named in the diagnostic program section can be treated in a therapy program.

Swallowing Program

The swallowing program has grown significantly in recent years because of the increased awareness of dysphagia and the risks that are present if left untreated. Patients are initially evaluated at bedside and then scheduled for a modified barium swallow study in the Radiology suite. This study is conducted jointly by a radiologist and speech pathologist who investigate the etiology and site of lesion of the swallowing difficulty. The Hearing & Speech Center also offers Fibroendoscopic Evaluation of Swallowing with Sensory Testing (FEESST) for out-patients. Initial treatment focuses on facilitation techniques designed for the ultimate goal of developing a "safe swallow." Therapy is continued on an outpatient basis when needed. Use of EMG biofeedback instrumentation for developing tolerance for a variety of food textures and electrical stimulation of the swallowing musculature are important parts of outpatient swallowing therapy.

The Voice Institute

The Schein Voice Institute is housed at the Hearing and Speech Center. This program, utilizing the latest diagnostic equipment and advanced technology, is dedicated to the diagnosis, treatment of all types of voice disorders, including total care for the professional voice. A team consisting of physicians and surgeons, speech pathologists and a nurse clinician evaluate and treat hard to diagnose laryngeal and vocal disorders.