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Aural Rehab Lectures > 1.02 - Speech Understanding > Flashcards

1.02 - Speech Understanding Flashcards

0
Q

Individuals “with an impairment in hearing will know that someone is speaking, but the message will be ______ or ______ such that the listener misses many acoustic cues.”

A

Distorted

Diminished

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1
Q

“Speech ______ and ______ are affected by the ability to hear and decode the acoustic information in speech. “

A

Perception

Production

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2
Q

For children with hearing impairments who are developing speech: “Often this will result in errors in their own ______.”

A

Speech production

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3
Q

What is Conversational Fluency?

A

How smoothly conversation flows

Do you respond quickly and appropriately

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4
Q

Why would an adult or child with HL experience reduced conversational fluency?

(5)

A

Not understanding the question

Must pause to figure out what is going on

Conversation dies if you miss a word or a sound

This is even worse in those who are afraid to guess because they might be wrong

This can cause depression and withdraw

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5
Q

Why is conversational fluency important ?

A

It shows the consequences of hearing loss

If we can’t have fluent conversation, it effects our relationships

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6
Q

Why is conversational fluency a beneficial goal and measurement tool for determining the effectiveness of AR intervention?

A

We may not reach 100%, but we want to move them in that direction

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7
Q

Is Word/Speech Recognition Testing synonymous w/ word understanding, word or sentence discrimination?

A

Yes

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8
Q

Does Word/Speech Recognition Testing help determine success with amplification?

A

Yes

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9
Q

Does Word/Speech Recognition Testing help counsel patients by showing them how their speech understanding compares to persons with normal hearing?

A

Yes

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10
Q

Does Word/Speech Recognition Testing help compare unaided performance to aided (implants, hearing aids, ALD’s) performance?

A

Yes

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11
Q

Does Word/Speech Recognition Testing help assess performance over time? How?

A

Yes

We can monitor the patient before and after treatments - this lets us know the effectiveness

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12
Q

Can Word/Speech Recognition Testing help determine the need for auditory training and/or speechreading training?

A

Yes

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13
Q

Can Word/Speech Recognition Testing help determines placement in a training curriculum?

A

Yes

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14
Q

Can Word/Speech Recognition Testing help demonstrate the benefits of visual information?

A

Yes

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15
Q

Can Word/Speech Recognition Testing help show differences due to environment-related listening issues? (Background noise, rapid or degraded speech)

A

Yes

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16
Q

Can Word/Speech Recognition Testing be used as an index for appropriateness of educational placement? (Size of class, room, what to put in IEP, etc.)

A

Yes

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17
Q

Can Word/Speech Recognition Testing be used to measure outcome/benefit following intervention?

A

Yes

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18
Q

What is Audibility?

A

Detection of overall speech

Discrimination of phonemes

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19
Q

What is Intelligibility?

3

A

Detection of individual phonemes

Identification of phonemes

Discrimination and identification of phoneme combinations (words and sentences)

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20
Q

If it’s not audible, it’s not ______.

A

Intelligible

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21
Q

To be intelligible, it has to be ______.

A

Above threshold

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22
Q

Measuring speech recognition provides a prediction of ______.

A

The limitations caused by the HL

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23
Q

Speech recognition holds a significant relationship to “______”

A

Conversational fluency

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24
Q

How does cochlear processing influence understanding for HI Listeners?

A

What does the cochlea do with the information that it has received

Something like loss of hair cells will affect cochlear processing

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25
Q

How does central auditory processing disorders influence understanding for HI Listeners?

A

These patients will have difficulty in quiet and in noise

This can only be diagnosed 7 years and up due to heavy language use of testing materials

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26
Q

What are three categories of factors that contribute to Disruptions in Communication?

A

Speaker/ Message

Communication Environment

Receiver / Listener

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27
Q

How does the Speaker/Message contribute to Disruptions in Communication?

A

Conveyance Of The Message (Is the speaker clear?)

Message Itself (Can everyone understand vocabulary?_

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28
Q

How does the Communication Environment contribute to Disruptions in Communication?

A

Auditory or Visual

Quiet Or Noisy

How can people modify their environment to get the greatest improvement?

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29
Q

How does the Receiver/Listener contribute to Disruptions in Communication?

(3)

A

Hearing

Cognition

Behavior

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30
Q

What works better in noise: audition, vision, or vision + audition?

A

Audition + Vision

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31
Q

Does the Variability in Speech Understanding affect Rehabilitation Planning & Clinical Decision Making?

A

Yes

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32
Q

Does the Variability in Speech Understanding affect Aided Performance & Benefit?

A

Yes

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33
Q

Do listening devices perfect hearing?

A

No. They just aid

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34
Q

Can you restore audibility to a dead region of the cochlea? Why or why not?

A

No

You need receptors to transmit the information

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35
Q

Does variability in Speech Understanding affect Oral Speech & Language Learning?

A

Yes

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36
Q

Does variability in Speech Understanding affect Developmental Potential?

A

Yes

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37
Q

Does variability in Speech Understanding affect Rate Of Progress?

A

Yes

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38
Q

Does variability in Speech Understanding affect Degree Of Success?

A

Yes

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39
Q

What do we need to consider when selecting test materials?

7

A

Patient variables

Stimulus units

Presentation conditions

Response format

Type of voice

Challenges

Test battery Approach

40
Q

What patient variables should we consider when selecting test materials?

A

Need to use materials that fit the vocabulary of the patient

Materials need to be age-appropriate

41
Q

What stimulus units should we consider when selecting test materials?

A

Are we using a picture, auditory, auditory + vision

42
Q

What presentation conditions should we consider when selecting test materials?

A

In quiet or in noise?

43
Q

What response format should we consider when selecting test materials?

A

Open vs. closed set

44
Q

What type of voice should we consider when selecting test materials?

(3)

A

Live voice

Recorded voice

Synthesized or altered speech

45
Q

Why is it important to use a test battery approach?

A

So that you are not left trying to pick the best of two test results

46
Q

Do open & closed sets use single words or sentences?

A

Both

47
Q

What are some benefits of using live voice?

A

Some children will only respond to live voice

For some elderly patients, we can’t slow down the recording enough

No equipment is required

The tester can vary the rate of presentation

48
Q

What are some benefits to using recorded voice?

A

Consistency

Standardization lets us know what is definitely client change

Test can transfer from one clinic to another with similar results

49
Q

What are some disadvantages to using live voice?

A

There is a lack of consistency in…

- Vocal Pitch
- Intonation
- Rate
- Clarity
50
Q

What are some disadvantages to using recorded voice?

A

You need special equipment

51
Q

What problem does the learning effect create? How can this be solved?

A

Performance improves as the patient learns the test items

Use equivalent lists of words

52
Q

What problem does test-retest variability create? How can this be fixed?

A

Clients’ performance varies from day to day

Test of two consecutive days

53
Q

What problem does clinical significance create? How can this be fixed?

A

Deciding whether two scores are significantly different

Use a within-subject statistical procedure

54
Q

Speech Recognition Testing Should Ideally ______ and ______.

A

Show how the person performs in natural situations

Be independent of confounding variables

55
Q

What are some confounding variables that might influence Speech Recognition Testing?

(4)

A

Cognitive skills

Language skills

Reading skills

Speech skills

56
Q

What are some variables that might cause bilingual individuals to perform differently from monolingual speakers?

A

The age their second language acquired (if this is the test language)

Spanish-English bilingual listeners may be more adversely affected by background noise

Fewer materials available for non-English-speaking patients

57
Q

Does the frequency perception of normal ear extend beyond audiometric test frequencies?

A

Yes

58
Q

What is the frequency perception of the normal ear?

A

20 Hz -20,000 Hz!

59
Q

When might we test the higher frequency ranges for patients? Why?

A

When they are taking something ototoxic like chemotheraputic drugs

To hopefully prevent high frequency HL before it effects speech comprehension

60
Q

Why do we select 250-8000 Hz for audiometry?

A

Speech sounds range from 100-8000 Hz

61
Q

What are the key frequencies for speech intelligibility? What percent of speech is in this range?

A

1000-2500 Hz (especially 2000 Hz)

Contributes 95% of speech intelligibility

62
Q

What percent of does loudness play into speech intelligibility? Where does the least amount of energy occur?

A

Contributes only 5% to the power of speech (loudness)

Least amount of energy occurs above 1000Hz

63
Q

What is the intensity range of a normal ear?

A

~0 – 140dB SPL

64
Q

What is 0 dB

A

Average threshold of hearing for normal adults

65
Q

The normal ear is capable of discriminating ______ in ______.

A

Minor differences

Sound characteristics

66
Q

What is the Intensity of Speech?

A

Typical overall loudness levels of speech at a distance of 1 meter (3 feet)

67
Q

What is a “Soft Conversational Level”?

A

~25-30 dB HL

45-50 dB SPL

68
Q

What is a “Normal Conversational Level”?

A

~40-50 dB HL

60-70 dB SPL

69
Q

What is a “Loud Conversational Level”?

A

~60-65 dB HL

80-85 dB SPL

70
Q

There is a range of ______ from soft to loud connected speech

A

40 dB

71
Q

SPL drops ______ with each doubling of distance.

A

6 dB

72
Q

______ affects the hearing impaired.

A

Distance from the speaker

73
Q

______ is used in the real world.

______ used for hearing testing.

A

dB SPL

dB HL

74
Q

Speech Understanding can be predicted from what kinds of Audiograms?

A

Speech spectrum audiograms

Speech “banana” audiograms

“Count the Dot” audiograms

75
Q

What is an example of a sound at 0-25 dB HL?

A

Barely audible

Threshold

76
Q

What is an example of a sound at 30 dB HL?

A

Whisper at 5 feet

77
Q

What is an example of a sound at 50 dB HL?

A

Average conversation

78
Q

What is an example of a sound at 90-110 dB HL?

A

Loud car horn, a person yelling

79
Q

What is an example of a sound at 100-110 dB HL?

A

Motorcycle engine

80
Q

What is an example of a sound at 150-170 dB HL?

A

Jet engine

81
Q

What does AI stand for?

A

Articulation Index

82
Q

Who came up with the Articulation Index? When? Where was it published?

A

Mueller and Killion

1990

The Hearing Journal

83
Q

What is the Articulation Index?

A

An expression of the proportion of the average speech signal that is audible to a given patient.

It consists of dividing the speech signal into several speech bands

Each band is weighted according to the theoretical contribution of that band to speech intelligibility

84
Q

The frequency region around ______ is rated the highest due to its importance in speech understanding.

A

2000 Hz

85
Q

What is the Count-the Dot Method?

5

A

Hearing is tested at points along the speech banana

Dots are given at any point past threshold

There are 100 total dots.

If 65 out of 100 dots are available, then your score is 65.

Software can now calculate this

86
Q

What is the purpose of the Count-the-Dot method?

A

They wanted to look at what what most important

Different frequencies are weighted differently according to their importance for understanding speech

87
Q

What are three uses for the Count-the-Dot method?

A

To predict from the audiogram the amount of the patient’s communication handicap for normal conversational speech

To predict the benefit that will be obtained from a hearing aid

To compare the benefit of two different hearing aids

88
Q

What does SII stand for?

A

Speech Intelligibility Index

89
Q

The frequencies _______ can be extremely important for recognizing the /s/ and /z/ especially in ______.

A

8000-9000 Hz

Female speakers

90
Q

Do hearing loss characteristics influence speech understanding for hearing impaired listeners?

A

Yes

91
Q

Does the etiology of HL influence speech understanding for hearing impaired listeners?

A

Yes

92
Q

Does the age of onset influence speech understanding for hearing impaired listeners?

A

Yes

93
Q

Does the age of intervention influence speech understanding for hearing impaired listeners?

A

Yes

94
Q

Do language and cognitive functioning influence speech understanding for hearing impaired listeners?

A

Yes

95
Q

Do memory processes influence speech understanding for hearing impaired listeners?

A

Yes

96
Q

Does attention influence speech understanding for hearing impaired listeners?

A

Yes

97
Q

Does the age of the patient influence speech understanding for hearing impaired listeners?

A

Yes

98
Q

Major goal of Aural Rehabilitation is to improve ______ and overall _______.

A

Communication fluency

Communication competence

Aural Rehab Lectures (8 decks)

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