Aural Assessment and Intervention Flashcards

1
Q

Auditory system that is sensitive in the 500 - 4,000 Hz is an important element underlying the ______________ and ______________

A

Production and comprehension

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2
Q

True or False. A child with severe hearing loss will have difficulty decoding the sound signal, thus they will perceive words differently than normal hearing.

A

True

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3
Q

Children with hearing impairment learn speech discrimination and production by:

A

Watching how sounds look on the face
Vibrations
Distorted auditory signal → acoustic properties are incorrect

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4
Q

True or False. If a severe loss has been present since birth, normal acquisition of language is difficult.

A

True

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5
Q

True or False. If the age of onset is early and age of detection is late, specialized instruction and other interventions are necessary to develop speech and language. Such instruction may rely on visual, tactile, and kinesthetic cues and signing.

A

True

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6
Q

True or False. Children and adults with acquired hearing loss will retain speech sound production patterns for a time. However, when amplification is not present, their articulation skills deteriorate eventually.

A

True

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7
Q

According to Gold (1980) speakers with congenitally severe or profound hearing loss have _______ intelligibility

A

20% intelligibility

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8
Q

A person with hearing loss will have problems at both _______ and _______ levels.

A

Segmental and suprasegmental levels
Segmentals: errors on both consonant and vowels
Suprasegmental: Slower rate than normal-hearing speakers because of a longer duration during sound production

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9
Q

Most commonly seen speech errors seen in deaf speech

A

Errors of omission–omission of final consonants, /s/ in all contexts, initial consonants
Errors of substitution–voiced for voiceless consonants, nasal for oral consonants (hypernasal like), low feedback substitutions (substitution of sounds with easily perceived tactile and kinesthetic feedback for those with less; e.g., /w/ for /r/ substitution), substitution of one vowel for another
Errors of distortions–degree of force, hypernasality associated with vowel productions, imprecision and indefiniteness in vowel articulation, duration of vowels, temporal values in diphthongs
Errors of addition–insertion of a superfluous vowel between consonants, unnecessary of final stop consonants, diphthongization, superfluous breath before vowels

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10
Q

Speech sounds error patterns observed in both children who use hearing aids and children who use cochlear implants

A

Developmental patterns–assimilation errors, consonant cluster reduction, final consonant deletion, liquid simplification, palatal fronting, stopping, unstressed (weak) syllable deletion, velar fronting
Nondevelopmental patterns–initial consonant deletion, glottal stop substitution, backing, vowel substitution, diphthong simplification

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11
Q

For language form of a child with hearing loss

A

Sequence of phonemes roughly similar to that of hearing children
Protracted in development
More likely to produce voicing errors, extra nasality, and ICD

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12
Q

True or False. Early use of cochlear implants can alter the development trajectory → close to typical levels of receptive vocabulary.

A

True

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13
Q

True or False. In terms of language use, early exposure to language and communication in socially meaningful contexts is more important than hearing status per se.

A

t

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14
Q

Why do audiologists need to perform hearing measurement?

A

Purpose: describe what the patient hears and how they hear it, describe the communication ability, determining the site(s) of lesion(s) within the auditory system, basis from which a plan of habilitation can be developed

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15
Q

Vibrator placed behind the ear on the mastoid process rather than headphones. What conduction test is this?

A

Bone conduction test

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16
Q

True or False. Speech audiometry is an objective assessment.

A

False. Speech audiometry is a subjective assessment.

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17
Q

True or False. The stimulus used in speech audiometry are spoken materials that are provided at controlled sound pressure levels.

A

True

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18
Q

What is the speech recognition threshold (SRT)?

A

Minimum hearing level for speech at which an individual can recognize 50% of the speech material
Selects item from a closed set of choices
Repetition/indication of recognition 50% OTT

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19
Q

True or False. With SRT, spondee words are commonly used

A

True

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20
Q

What is speech/word recognition testing?

A

Estimate of ability to understand everyday speech
Phonetically balanced words presented
Phonetically balanced words, nonsense syllables, monosyllables
Response: Open (vocab), closed (multiple choice)

21
Q

What is the speech detection threshold?

A

Lowest intensity level that can be detected; also corresponds with PTA
No discrimination or identification needed only detection

22
Q

True or False. Objective measures only estimate auditory ability. They are an indicator of hearing ability, but cannot stand alone.

23
Q

What are the subjective assessments for young children?

A

Behavioral Observation Audiometry (BOA)
Visual Reinforcement Audiometry (VRA)
Conditioned Play Audiometry (CPA)

24
Q

What is behavioral observation audiometry (BOA)?

A

Loud stimulus through speakers
Observing the child’s response
Screening

25
What is visual reinforcement audiometry (VRA)?
Conditioning to look at visual reinforcer when audio stim (speech, warbled tone) are presented.
26
What is conditioned play audiometry (CPA)?
Conditioning to perform a task (e.g., shoot ball, etc) in response to stimuli (pure tones, speech)
27
What are the objective measures of hearing skills?
Immittance audiometry Otoacoustic Emission ABR ASSR Tympanometry
28
What does an immittance audiometry do?
Testing the middle ear function Differentiates cochlear from retrocochlear disorder (1) Acoustic impedance: opposition to transfer of AE (2) Acoustic admittance: ease of sound flow
29
Give a type of immittance audiometry
Tympanometry
30
What is tympanometry?
Measurement of the reflected sound energy from the ear drum Systematically changing air pressure in the ear canal Checks functioning at: middle ear Eustachian tube, tympanic membrane, ossicles
31
Can you use this to assess babies?
No. We don’t do this with babies. We use this to 2-3 years old up to adulthood
32
What are auditory evoked response?
Recorded using electrodes/compute Waveforms reflect neural synchrony and neural transmission to acoustic stimuli along the retrocochlear pathway. Ideal for newborns and young infants This detects damage to the cochlea, auditory nerve, and auditory pathways
33
What is an auditory steady state response?
Electrophysiologic response to rapid and continuous auditory stimuli Frequency and amplitude can be modulated Gives frequency specific information (objective algorithm) Not ideal for younger than 2 years old Frequency specific responses
34
What is auditory brainstem response (ABR)?
Electrophysiologic response to brief sounds with low repetition Responses are generated from the auditory nerve to the lateral lemniscus Examiner subjectively reviewing the waveforms and deciding whether a response is present Does not differentiate between levels of profoundness of deafness Not a true test of hearing–predictive only
35
What is otoacoustic emission?
Ideal for newborns and young infants OAE: sounds generated by cochlea that travel back to the middle ear. Sound produced by the shearing of the outer hair cells. Measure sound produced by hair cells in the cochlea Present OAE: suggest normal cochlear function in the presence of normal middle ear function Absent OAE suggest: some degree of hearing loss in the level of the cochlea if middle ear is functioning normally D/dx of cochlea vs neural hearing loss
36
0-6 months (what objective and subjective assessment should you use)
ABR/ASSR
37
6-2 years old
BOA and VRA Assess auditory and listening skills
38
2-5 years
Conditioned Play Audiometry SRT if language supports ling six sounds
39
5 years and above
Standard audiometry Speech reception Speech and word recognition
40
Cochlear implants
External sound processor – sound filter, converter (minicomputer) Internal unit - converts digital signal to electric signal Electrode array - surgically inserted into scala tympani: stimulates CN VIII and auditory pathways
41
Candidacy for CI
12 - 24 months - Profound SNHL; No medical lack of progression in auditory skill dev 2-18 years - Severe to profound SNHL ; Lexical neighborhood test score of 30% or less Adult - moderate to profound SNHL
42
What is Bone anchored auditory implant (BAI)
Conductive/mixed hear loss: patients with incomplete, blocked, or damaged OE, EAM Sound processor placed on ear with profound loss stimulates contralateral (normal hearing) ear via bone conduction
43
To select familiar speech sounds that would broadly represent the speech spectrum from 250-8000 Hz. Implies that amplification is working
Ling 6 sound test [m], [ah], [oo], [ee], [sh], [s]
44
Provide are the speech perception assessments
ELTL (Early learning to listen sounds)
45
Represents suprasegmental and segmental features of speech. Introduced in play. Clinician introduction, opportunities for imitation, spontaneous production.
ELTL
46
ASCO. What does this assess?
Discrimination Auditory memory Auditory feedback Figure ground
47
What does Glendonald’s Auditory Screening Procedure assess?
Assesses the auditory lip reading, detection, and identification skills
48
What does an early speech perception test assess?
Assesses pattern perception for both low verbal and verbal Pattern perception: Discriminates between 3 SS, 2 spondee, 3 trochee, 3 ps