1.00 - Overview and Introduction Flashcards
Aural Rehabilitation is “understanding & addressing the needs of individuals and their family with hearing loss to ______ in everyday life.” Tye-Murray
Achieve maximum communication success
Aural Rehabilitation is “any device, procedure, information, interaction, or therapy which lessens the ______ & ______ consequences of a hearing loss”. Ross, Mark 1999
Communicative
Psychosocial
“Audiologic/aural rehabilitation (AR) is an ecological, interactive process that facilitates one’s ability to minimize or prevent the limitations and restrictions that auditory dysfunctions can impose on well-being and communication, including ______ functioning.” (ASHA Working Group on Audiologic Rehabilitation, 2001)
Interpersonal, psychosocial, educational, and vocational
What is Aural Rehabilitation?
Any intervention that minimizes and alleviates communication difficulties associated with hearing loss.
What is the difference between Aural Habilitation vs Rehabilitation?
Aural Habilitation: used when working with persons (e.g. children) who have not developed a skill.
Rehabilitation: when working on restoring a skill that was loss
What are the Goals of AR Intervention?
Help individuals and families overcome challenges posed by the hearing disability
Is minimizing and alleviating the communication difficulties associated with an auditory disorder a goal of aural rehab?
Yes
Is assisting the individual to function to the highest potential a goal of aural rehab?
Yes
Is facilitating “independent living” a goal of aural rehab?
Yes
What is the difference between congential and acquired HL?
Congenital HL is HL that was present at birth
What do we see so many more children with hearing loss?
The higher survival rate of premature babies
Younger clients due to early identification
Does being born prematurely increase your risk of hearing loss?
Yes
The ADA requires equal access in ______ and ______.
Public facilities
Workplaces
Can you be fired for having a hearing loss?
No. You must be given either accommodations or an new position
Doesn’t always happen easily, usually employee must fight for it
Why do we se so many seniors with HL?
Baby Boomers are a large segment of the us
Longer lifespan means more people with HL
Who receives AR?
6
Infants
School-age children
Adults
Seniors
Parents
Significant Other(s)
What the earliest age that a child can receive a cochlear implant?
12 months
Can be as early as 6 months if due to meningitis (There is a risk of boney cochlear growth)
Do adults and children with mild to profound SNHL, CHL, MHL (unilateral or bilateral) use AR services?
Yes
Do adults and children with auditory neurological/central disorders use AR services?
Yes
How does the Deaf community use AR services?
Should they need accommodations at home, school, or work
Oral/manual language development
How do hearing children of deaf parents use AR services?
Oral communication development
Are people who receive AR services similar?
No. They are a heterogeneous group
What is a Hearing Disorder?
An impairment
A problem of structure or function of auditory system
What does a hearing disorder include?
All types hearing loss
CAPD and other auditory neurological disorders
How is a hearing disorder diagnosed?
Through readily measurable through diagnostic testing
What are Activity Limitations (Disability) and Participation Restrictions?
How the hearing loss affects someone’s day-to-day life
This may change over time
Are Activity Limitations/Participation Restrictions the same for everyone with the same degree of hearing loss?
No. It varies from person to person
How might a person’s life be affected by hearing impairment?
Conversing with others in everyday life
How does WHO differ between Activity Limitation and Participation Restriction?
Activity Limitation is a change caused by hearing loss (a physical impairment) that results in a reduction in function (e.g. difficulty hearing high frequency sounds and understanding speech)
Participation Restriction is the effect of this limitation on the broader scope of patient’s life (e.g. Person may avoid social gatherings)
What does WHO stand for?
World Health Organization
What is WHO?
Coordinating health authority within the United Nations
What does ICF stand for?
International Classification of Functioning, Disability, and Health (ICF)
What does WHO ICF focus on?
The impact rather than the cause
Looks at the social aspects of disability (versus only the biologic/medical dysfunction)
Looks at impact of the environment on person’s functioning (contextual factors)
What does WHO say are four factors that contribute to Participation Restrictions?
Limitations in Communication Activity
Lifestyle
Frequent Communication Partners
Psychosocial factors
What are some psychological factors that might affects someone’s attitude towards HL?
Self-image
Motivation
Assertiveness
What are some social factors that might affects someone’s attitude towards HL?
The viewpoints of one’s society
Can someone’s Degree, Progression, Type, and/or Configuration of Hearing Loss affect their Activity Limitations?
Yes
Can someone’s present age affect their Activity Limitations?
Yes
Can someone’s age of onset affect their Activity Limitations?
Yes
Can the age someone’s HL was first discovered affect their Activity Limitations?
Yes
Can the Provision of Listening Aids and Treatment affect Activity Limitations?
Yes
Can the amount of treatment already received affect Activity Limitations?
Yes
Can the success of treatment affect Activity Limitations?
Yes
Can someone’s Physical Environment affect their Activity Limitations?
Yes
Can someone’s communicative needs & nature of the settings communication occurs affect their Activity Limitations?
Yes
Can Individual Factors affect Activity Limitations?
Yes
Can someone’s reaction to hearing impairment (self and others) affect their Activity Limitations?
Yes
Can the effects on expressive communication affect Activity Limitations?
Yes
Why is Hearing Loss sometimes referred to as “Invisible”?
Consequences manifest across all aspects of life
Where can HL affect daily communication?
Home
School
Work
Social activities
Environmental awareness
Can HL affect Speech and Language Development?
Yes
Can HL affect Educational achievement?
Yes
Can HL affect Vocational achievement?
Yes
Can HL affect Socialization?
Yes
Can HL affect Psychological / emotional functioning?
Yes
Who receives Aural Habilitation and who receives Aural Rehabilitation?
Aural Habilitation = children who have had hearing loss since birth
Aural Rehab = children and adults designed to restore a lost state or function. (Implies hearing previously existed)
Are diagnostics and quantification of HL a Primary Component of AR?
Yes
Is provision of appropriate primary listening devices, secondary assistive listening devices, and assistive technology equipment a Primary Component of AR?
Yes
Is Auditory training a Primary Component of AR?
Is structured and unstructured listening practice a Primary Component of AR?
Yes
Are Communication Strategies training a Primary Component of AR?
Yes
Is facilitative and repair strategies a Primary Component of AR?
Yes
Is environmental control a Primary Component of AR?
Yes
Is assertiveness and advocacy a Primary Component of AR?
Yes
Is informational/educational counseling a Primary Component of AR?
Yes
Is helping the individual and family to become knowledgeable about hearing loss and the potential impact a Primary Component of AR?
Yes
Is providing resources about available services a Primary Component of AR?
Yes
Is Emotional Support a Primary Component of AR?
Yes
Is Personal Adjustment Counseling a Primary Component of AR?
Yes
What is Personal Adjustment Counseling?
Enhancing acceptance of hearing loss and self-management
Is psychosocial support a Primary Component of AR?
Yes
What is psychosocial support?
Addressing social and psychological aspects e.g. family issues, stress management
Support groups
Is Frequent Communication Partner Training a Primary Component of AR?
Yes
Is Speechreading Training a Primary Component of AR?
Yes
Is Training Speech Recognition via auditory and visual channels a Primary Component of AR?
Yes
Is Speech-Language Therapy a Primary Component of AR?
Yes
Is choosing appropriate communication method a Primary Component of AR?
Yes
Is speech therapy for oral communication (children and adults) a Primary Component of AR?
Yes
Why do people participate in speech therapy for oral communication (children and adults)?
Development
Intelligibility improvement
Maintenance of speech skills for late-deafened adults
Are language enhancement programs and methods a Primary Component of AR?
Yes
Is In-Service Training a Primary Component of AR?
Yes
What is In-Service Training?
Specialized training for other professionals who work with individuals with HL
(teachers, caretakers, senior citizen centers, etc)
Is a multi-disciplinary approach used to provide AR Services?
Yes
Does the Audiologist provide AR Services?
Yes
Do speech/language pathologists provide AR Services?
Yes
Do Teachers of the Hearing Impaired/Deaf provide AR Services?
Yes
Do Parents provide AR Services?
Yes
Do Communication partners provide AR Services?
Yes
Can the early intervention specialist be a member of a multi-disciplinary AR team?
Yes
Can the Auditory Verbal therapist be a member of a multi-disciplinary AR team?
Yes
Can the classroom teacher be a member of a multi-disciplinary AR team?
Yes
Can psychologists and counselors be members of a multi-disciplinary AR team?
Yes
Can Vocational Rehabilitation Counselors be members of a multi-disciplinary AR team?
Yes
Can physicians be members of a multi-disciplinary AR team?
Yes
Does the Team Leader / Case Manager vary depending on the age of client?
Yes
Does the Team Leader / Case Manager vary depending on the stage of diagnosis and treatment?
Yes
Does the Team Leader / Case Manager vary depending on the location of service provision?
Yes
Does the Team Leader / Case Manager vary depending on the needs of individual and family members?
Yes
What are some factors influencing the impact of hearing loss?
(6)
Degree, configuration, & type of hearing loss
Age of onset
Time course or progression
Ability to use residual hearing
Degree of family support
Presence of other conditions
More than ______ adults with hearing loss in the USA. That’s about _____ of general population.
37 million
8 -10%
In the US, more than _____ children are born with HL annually.
____/_____ are born w significant HL. ______% are born deaf. This percent increases with age.
12,000
1 to 6 / 1000
1-2%
____% of young adults have hearing loss.
5%
Only ____% adults who need hearing aids actually use them
20%
Do Individuals Who are Hard-of-Hearing have mild to profound degrees of hearing loss?
Yes
Can Individuals Who are Hard-of-Hearing use hearing/speechreading as primary receptive mode?
Yes
Can Individuals Who are Hard-of-Hearing use speech as their primary expressive mode?
Yes
Do Individuals Who are Hard-of-Hearing demonstrate varied levels of speech intelligibility?
Yes
Do Individuals Who are Hard-of-Hearing usually demonstrate normal expressive spoken language skills?
Yes
Do Individuals Who are Hard-of-Hearing demonstrate varied educational needs?
Yes
Did some Adults with Acquired Hearing Loss lose their hearing after schooling was completed (late teens or older)?
Yes
Do Adults with Acquired Hearing Loss usually demonstrate normal expressive spoken language skills?
Yes
Do Adults with Acquired Hearing Loss experience substantial effects on their social, emotional, vocational, and interpersonal communication?
Yes
Do individuals who are deaf typically have hearing loss >90dB HL?
Yes
Do individuals who are deaf typically not rely primarily on hearing to understand speech (unless have acquired HL and use cochlear implant)?
Yes
Do individuals who are deaf typically use visual and/or tactile input as receptive mode?
Yes
What are some visual and/or tactile communication methods used by deaf individuals?
(3)
Speechreading
Sign language/cued speech
Vibrotactile stimulation
What are some expressive communication methods used by deaf individuals?
Speech approximations
Sign language
Do Individuals who are Culturally Deaf identify themselves as members of Deaf culture?
Yes
Do Individuals who are Culturally Deaf view deafness as an impairment or handicap?
No
Does Deaf culture has its own language, values, and traditions?
Yes
Do Individuals who are Culturally Deaf use American Sign Language (ASL)?
Yes (In the US and Canada)
Do Individuals who are Culturally Deaf attend residential schools for the Deaf (“least restrictive environment”)?
Sometimes
Do Individuals who are Culturally Deaf use hearing/hearing aids for signal warning or to maintain contact with the auditory environment?
Yes
Is there are a greater need for AR in children because there are higher survival rate of premature babies?
Yes! This creates a higher incidence of hearing impairments
Is there are a greater need for AR in children due to early identification and intervention?
Yes
Is there are a greater need for AR in children due to an earlier age of cochlear implantation resulting in more deaf children in regular ed programs?
Yes
Does the fact that people are living longer mean that there are more people with HL?
Yes
Evidence-Based Practice is a clinical decision making based on a review of ______ and ______ of ______.
Scientific evidence
Critical examination
Best practices
What does EBP stand for?
Evidence-Based Practice
Does ASU use EBP?
Yes
What are some variables that factor into choosing what components to include in an AR plan?
(3)
Needs and desires of patient
Availability of Services
Cost effectiveness
When designing an EBP, the Clinician develops a ______ and ______ to support the choice of treatment.
Question
Examines research evidence
Should services should not be provided just because “this is what we have always done” or “this is the way we have always done it”? If not, what should happen?
The selection of services should be driven by
Relevant and valid data obtained from Clinically oriented studies
Who was the first group to be tested with cochlear implants? Why?
What was the next group chosen?
Adults who had lost their hearing as adults. This group was chosen because they have nothing to lose.
Next were adults that had no hearing above 90 dB.
What are the 5 steps to an EBP Approach?
1 - Ask question
2 - Find best evidence
3 - Critically assess the evidence (Does it apply? What is its level of credibility?)
4 - Integrate evidence, clinical judgment, patient needs/values
5 - Evaluate progress and adjust decision if needed
Aural Rehabilitation is ______ and ______.
Multifaceted
Multidisciplinary
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