AR Delivery Methods Flashcards
Does incorporating comprehensive AR into clinical practice take time?
Yes
The challenge is to get information, complete clinical tasks, and move on to negotiating outcomes
Don’t forget to take time to develop a relationship with the patient
What are the different AR delivery methods?
Individual counseling
Refer to another professional for services: Speech perception training, Visual perception training, Auditory-Verbal Therapy, Communication Strategy training, etc.
Group Counseling
Community workshops
Telehealth services
What does the patient learn from the 5 keys to communication success book?
Technology alone will not resolve their activity limitations
Both the PHL and CP are responsible for improved conversational fluency
They’ve learned facilitative strategies for the listener, the speaker, the environment, and specific listening environments
What is the next step in identifying residual activity limitations?
Patient completes a needs assessment questionnaire at the beginning of each follow up visit
This step tracks improvement while identifying situations that remain problematic despite hearing aid use.
5 Keys to Success Needs Assessment or COSI goal validation procedure
Follow up visit counseling focuses on addressing communication strategies for the residual activity limitations first
Reprogramming is not ignored, but minimized b/c the auditory processing system is STILL ADAPTING to the amplified signal
What step is after the needs assessment?
Create a communication plan for the visit
For residual activity limitations, identify source of communication breakdown, suggest facilitative strategies (which they learned in the book), don’t ignore the need to reprogram the device (ask about sound quality when you reach the technology section)
Plan program modifications to reduce complaints at this time
Recommend Hearing Assistive Technology (HAT) to support environmental breakdown
At the end of the appointment offer handouts with practical exercises to try IRL
Let the pt. know you’ll discuss how this plan and exercises worked during the next appointment
Can you refer to a local AR program?
Yes, such as HLAA
What are some benefits of group AR?
Atmosphere of peer support
Participants learn with and from one another
The group itself becomes a venue for practicing communication skills
Group sessions provide a space for people to share and learn from one another’s psychosocial experiences of hearing loss (such as embarrassment and loneliness)
This delivery model is time and financially efficient
Meets ASHA 2022 recommendations to include informational and personal adjustment counseling in rehab plans
What did research find about the ACE group AR program?
Reduced activity limitations and participation restrictions
Tracked these improvements through Reduced Hearing Handicap Index, Improvement on the Quantified Denver Scale of Communicative Function, Improvements on the Self Assessment of Communication (SAC), Improvements on the Ryff Psychological Wellbeing Scale, and COSI improvements
Benefits remained present 6 months later
What is the I-ACE program?
Done on participant who were not fit with hearing aids
Completed on their own at home
Reported positive outcomes and goal attainment, but no change in hearing disability
The effects remained present 3months later
Increased recognition and awareness of hearing difficulties
Increased ability to develop potential solutions to these difficulties
Participants also enjoyed the opportunity to involve communication partners
Were there speechreading benefits present at a home based program?
Yes, delivered to PHL and CP
Participants completing the program report increased awareness of benefits of speechreading, improved interaction with the CP, and favorable attitudes towards the program
Follow-up measures showed improved quality of life and satisfaction
Did those who participated in Group AR sessions employed communication strategies better than individuals who did not participate?
Yes
These results remained present when reassessed 1 year later
Did those with CIs experience improvements with group AR?
Yes
Experienced cochlear implant users who participated in Group AR programs experienced improvements on measures of assertiveness, emotional well-being, and coping behaviors
Did AR group reduce 3rd party disability?
Yes
PHLs & CPs judged their communication problems as being significantly less severe after their participation in the session
Group interviews showed:
Although they were more conscious of their hearing difficulties, they agreed on being much more confident in dealing with them
Different steps were taken towards improving their situation, including disclosure of their hearing impairment to others, making requests to conversational partners to facilitate communication, and acquiring instrumental aids
Do AR programs improve quality of life for CPs?
Yes
Reported improved understanding of PHL experiences with hearing loss.
Improved quality of life (QOL)
Congruence (as defined by similar scores) between CP and PHL assessments of Hearing Loss-QOL
Does underutilized amplification waste personal finances?
Yes, when treatment plans only recommended hearing aids
Only 69.1% new and experienced hearing aid users report wearing hearing aids > 4 hr/day
23.4% use them < 2 hr/day
3.5% do not use them at all
Is the unemployment rate higher for PHL with untreated HL?
Yes
Unemployment rates are twice as high for people with severe untreated hearing loss (2010)
Unemployment rate for a normal hearing population- 7.8%
Unemployment rate for those with severe hearing loss- 15.6%
Unemployment results for aided severe hearing loss- 8.3%
What is the societal cost of untreated hearing loss?
Reduces in the amount of federal taxes collected
The Hearing Health Foundation estimates that untreated hearing loss leads to an income loss of $176 billion annually due to underemployment
Estimates that the cost to society from unrealized federal taxes is as high as $26 billion
Can untreated hearing loss decrease a person’s annual income?
Yes, by as much as $30,000
Individuals with hearing loss make about 25% less
Audiologic rehabilitation reduces the risk of income loss by 90 to 100% for those with milder hearing loss, and from 65 to 77% for those with moderate to severe hearing loss
Does untreated hearing loss result in higher healthcare costs?
Yes
Untreated hearing loss is associated with 46% higher total health care costs over a 10-year period
When healthcare utilization of the hard of hearing is compared to those without hearing loss:
Health care utilization increases
More inpatient stays
Longer hospital stays
Increased risk of hospital readmissions
More outpatient visits
Is there a code for AR services?
Yes, but it’s not reimbursable for audiologists
However, many PHLs will opt to self-pay for service after learning associated benefits
Do AR sessions result in fewer returned hearing aids?
Yes
You are still being paid for those services by keeping that revenue
Does AR and amplification result in greater adherence to the plan of care?
Yes
Which means less office visits resulting in more cost-effective treatment
Did new hearing aid users who participated in group AR get benefits?
Yes
Showed improved daily ratings of hearing aid satisfaction, as compared to those who did not
What are the evidence based patient benefits from group AR?
Fosters self-advocacy
Improves socialization
Recognition that you’re not alone with your hearing loss
Increased self-sufficiency
Promotes relationships with the audiologist