Amp II Flashcards
3 examples of structure and body function limitations
Cochlear hair loss at the base = severe SNHL
Ossification of stapes in oval window = OTSC
Dislodging of otoconia = BPPV
Structure and body function limitations are our actual diagnoses. One example of structure and body function limitations we encounter with our patients is cochlear hair cell loss at the base, like a severe high frequency sensorineural hearing loss. Another example of structure and body function limitation we encounter with our patients is the stiffening of our stapes footplate in the oval window, which is otosclerosis. A third example of structure and body function limitations is the dislodging of the otoconia in our vestibular system which results in BPPV.
3 examples of activity limitations a person with HL has.
Difficulty hearing the TV
Difficulty hearing in noise
Difficulty hearing the symphony & distortion
Activity limitations are restrictions experienced when executing an activity or a specific task. One example of an activity limitation is difficulty hearing in background noise. Another example of an activity limitation is difficulty localizing a sound source. A third example of an activity limitation is difficulty hearing and understanding what is being said on the TV.
3 examples of participation restrictions a person with HL has.
Avoid noisy environments
Avoid watching tv because they cannot hear or understand it
Avoid symphony because it is distorted
A participation restriction is when a person avoids certain situations or experiences that they would usually participate in due to their activity limitation. One example of a participation restriction a patient may experience is not attending dinners with family members because they cannot follow the conversation in noise. Another participation restriction they may experience is avoiding watching their TV or turning it up really loud because they struggle to hear it. A third participation restriction they may experience is avoiding the symphony that they used to always attend because they cannot hear it or it is distorted now than it was before.
WRS is 63%. Speech Intelligibility Index (SII) is 45%. What is the persons ability to understand conversations in quiet environments.
The Speech Intelligibility Index is the percentage in which the speech is audible to the person in quiet. In this patient’s case, the percentage of speech that is audible to them and that they are understanding is only 45% when they are in quiet environments. This means that they are missing 55% of the information that is being said to them in quiet environments and possibly struggle a good deal with understanding and use a lot of other cues in order to understand in everyday environments.
However, word recognition scores should not be used alone as a method of determining a person’s communication abilities as research has shown and discussed in class. In order to have a better understanding of how this individual is communicating in their everyday life, we should assess how they do with sentences as opposed to a single word presented with no contextual clues in quiet, we should assess their abilities with and without visual cues, and we should present in a sound field at a normal conversation level. Doing these assessments outside of just a word recognition score can give us a better understanding of how well this patient is doing in the real world with speech intelligibility.
3 systemic comorbidities associated with progressive SNHL
Leukemia, shingles, diabetes
Acceptable Noise Level (ANL) test purpose. High ANL score and what it means, and the evidence-based recommendations for HA amp in this case
The Acceptable Noise Level (ANL) test is used to determine how much background noise a person is able to withstand and handle. It is beneficial to use to determine if a patient may need additional time to adjust or if other counseling tools would be beneficial to use for them. A high ANL score indicates that a patient does not tolerate a lot of background noise and are easily bothered by it. Previous research shows that these individuals would not be successful with hearing aids and are not candidates for amplification. However, these patients based on evidence-based recommendations for hearing aid amplification may benefit from digital noise reduction and directional microphones both enabled and premium tech
signal-to-noise ratio (SNR) loss based on the following QuickSIN results. What digital hearing aid features are recommended, according to research evidence, for this SNR loss?
5,4,2,1,0 = 15
25.5-15 = 10.5
SNR is 10.5 and rec is beamforming and standard directional mics
monaural QuickSIN under headphones at 70 dB HL, was SNR loss of +5 dB in R and +4 dB in L. binaural QuickSIN assessment under headphones at 70 dB HL had SNR loss of +10 dB. What is the reason for significant score change in the bilateral condition.
The possible explanation for the increase in the SNR loss from monoaural to binaural is the binaural interference. This happens in 1/6 patients in our elderly population. The binaural interference is when speech scores worsen in the presence of binaural input as opposed to listening with just one ear.
The degradation of the ability to understand speech in noise is due to binaural interference. This happens in about 16% of elderly patients. The hypothesis suggests this is caused by deterioration of the corpus callosum.
3 benefits to using self-report questionnaires as part of a communication needs analysis
One benefit of using self-report questionnaires is that it can help you to better understand what the patient’s main concern is and situations they struggle most in and how to better support that concern with your recommendations of rehabilitation. Another benefit to using self-report questionnaires is that they can be filled out at home before they come in for their evaluation, which provides you with more in-depth information and it is time beneficial. A third benefit of using self-report questionnaires is that you can better understand their attitudes towards amplification and have an understanding of whether or not they would be successful with technology or it can even help you to decide what type of technology and style to recommend to them based on their attitudes towards them reported in the questionnaire.
Documentation of chronic health conditions related to progressive HL supports medical necessity of annual hearing assessments.
true
Differentiate cognitive COSI goals from affective COSI goals
Cognitive COSI goals are goals that are specific to the situations the patient would like to see improved. For example, a cognitive COSI goal for a patient could be that they would like to hear better when they are at dinner with their family in noisy restaurants. Or it could be that they would like to hear and understand what is being said on their TV better. An affective COSI goal relates to their emotional feelings and focuses on a more positive emotion they would like to experience with their hearing loss and amplification. For example, an affective COSI goal could be that they would like to have less anxiety towards their hearing loss and going into noisy environments.
Define SNR-50:
The SNR required to understand 50% of words in the presence of noise
Select the acoustic parameter settings that are MOST appropriate for this hearing loss. (25dB at 250 & 45 dB at 500)
RIC Receiver type: moderate gain/output
Earpiece: open dome
BTE Sound bore: #13 tube
Earpiece: custom mold
Vent: 3.5 mm
BTE Sound bore: #13 tube
Earpiece: custom mold
Vent: 1mm
BTE Sound bore: thin tube
Earpiece: closed dome
BTE Sound bore: #13 tube
Earpiece: custom mold
Vent: 1mm
Which statement best describes the use of a Type 1 signal during the hearing aid verification protocol?
Type 1 signals supply broadband signals consisting of random frequencies occurring at different intensities
Type 1 signals supply LTASS data that is matched to prescriptive targets
Type 1 signals show the effect of compression on the output signal
Type 1 signals drive a higher input signal to accurately verify MPO
Type 1 signals drive a higher input signal to accurately verify MPO
Which of the following probe tube placement methods describes “Geometric positioning”?
A probe tube is threaded through the vent until it extends 3-5 mm beyond the tip of the device
A probe tube placement depth is predetermined using average ear canal lengths
A probe tube is positioned and attached to an earmold with its tip extending 3-5 mm beyond the end of the canal
An acoustic signal guides probe tube placement depth within 2-5 mm of the tympanic membrane
A probe tube is positioned and attached to an earmold with its tip extending 3-5 mm beyond the end of the canal
