Aural Rehab Exam 2 Flashcards
1
Q
The principal aim of any hearing aid fitting or strategy is to….
A
ensure environmental sound, especially conversational speech, is audible without being excessively loud
2
Q
How to troubleshoot a hearing aid
A
1, Check battery
- Check volume and programs
- Check tubing
- Check for excess wax
3
Q
A hearing aid must
A
- Provide good sound quality
- Maximize speech recognition
- Provide comfortable amplification
4
Q
The 5 steps in the HA selection and fitting process are:
A
- Candidacy
- Fitting protocol
- Fitting
- Hearing aid orientation (Counseling and follow up)
- Validation and outcome measures
5
Q
What 3 things are important for HA candidacy?
A
Degree of HL
Degree of communication difficulty
Motivation of patient
6
Q
Before getting a HA a child should always get
A
clearance from an ENT
7
Q
To understand a persons degree of communication difficulty, they are given:
A
a self assessment questionnaire
8
Q
In a self assessment questionnaire a person
A
lists their difficult situations or rates the difficulty of situations
9
Q
For “motivation of a patient” you want someone who
A
is open to the process, open to recommendations and will follow them
10
Q
Appropriate style is based on:
A
- degree/type of HL
- Shape of canal
- Dexterity & vision
- final say of patient
11
Q
What are 4 reasons you should do binaural HAs?
A
- better sound quality
- no bad ear
- better sound localization
- do better in background noise
12
Q
What does compression do?
A
Limits the amount of gain/output
13
Q
Compression is…
A
Special circuitry built into the HA that doesn’t allow HA to produce too much amplification
Adjusted on a patient basis
Now common in all digital HAs
14
Q
What do “multiple channels” do?
A
Divide frequency region into sections
15
Q
Explain what “linked HAs” means
A
What you do to one HA happens to the other. Binaural HAs are “paired”
16
Q
Explain “Quality control”
A
Want to make sure HAs are working correctly and working how the manufacturer said they would work
17
Q
What are 4 electroacoustic characteristics?
A
OSPL90
gain
harmonic distortion
equivalent input noise
18
Q
The 9 parts of HA protocol are:
A
- selection of style
- directional mic
- Binaural
- Compression
- Multiple channels
- Multiple memories
- Linked HAs
- Quality control
- Evidence based practice
19
Q
HA fitting is a combination of:
A
Science & Art
20
Q
Even the best HAs will fail the patient, without what?
A
HA orientation (counseling and follow up)
21
Q
This is a written physical aid for HA instruction
A
HIOBASICS
22
Q
What do you need to address during the HA fitting process?
A
Emotional reactions
23
Q
3 Validation/ outcome measures are:
A
- Electroacoustic outcome measures
- Audiologic measures
- Self-report outcome measures
24
Q
For pediatric HA fitting a ______ approach is necessary
A
Team
25
For pediatrics, as soon as HL is diagnosed
Intervention must begin immediately
26
On children, we need to use DSL fitting formulas because they
account for the smaller sized ear canal
| calculate average ear canal resonance and dynamic range levels based on the child’s age
27
In children _______ is a must and _________ are recommended
compression; directional mics
28
What style of HA is recommended for a child and why?
Behind the ear because it can grow with the child
29
When should HAs not be worn?
Sports
Sleeping
Humidity
30
What is the goal of pediatric amplification?
Have the child wearing HAs as much as possible as soon as possible
31
Why are there more frequent follow-ups with children?
Because they are growing the fitting needs to be adjusted frequently
Because we would like to get as much diagnostic information as possible
32
For a child, who should dictate when the HAs are worn?
The parent
33
Audiologic follow up should occur every ________ during first ______ of hearing aid use
3 months; 2 years
34
Visits should include:
Behavioral hearing testing
Hearing aid adjustments/earmold checks
Electroacoustic evaluation of hearing aids
35
What problematic situations may remain even after amplification is provided?
Telephones, large meetings, school
36
What are ALDs?
Assistive listening devices
| Refers to devices to help a person in a certain listening situation.
37
What are HATS?
Hearing Aid Assistive Technologies
| Broader term that encompasses ALDs and devices for safety/alerting.
38
ALDs and HATS can be used
with or without HAs
39
What are ALDs designed to do?
reduce the effects of noise, distance and reverberation on hearing and improve the user’s ability to communicate.
40
By placing the mike close to the sound source and the receiver next to the patient’s ear
Signal to noise ratio is improved
41
8 categories of ALDs/HATS
1. hardwire systems
2. audio loop systems
3. infrared systems
4. FM systems
5. Telephone devices
6. Alert/Alarm devices
7. Television assistive technologies
8. Auditory trainers
42
PSAPs
Personal sound amplification products
| “intended to amplify environmental sound for non-hearing impaired consumers.”
43
Need to stress the importance of including the family in the AR process to
help identify the needs of a child and better meet those needs
44
Factors to be considered for child AR
HL (congenital, prelingual, postlingual)
Age
Other disabling conditions
45
OAE/ABR are critical for
early identification
46
testing/retesting should occur within
1st 3 months of life
47
is needed to clarify medical aspects of HL
medical referral
48
Prior to start of AR program, child should have a complete
medical evaluation
49
Audio info needed for children includes these 7 things
1. Otoscopic results
2. Degree and configuration
3. HL type and cause (if possible)
4. Speech recognition ability
5. MCL
6. Threshold of discomfort
7. HA performance and audibility measures
50
For children, with a HA recommendation you need..
medical clearance
51
Reevaluation should occur:
Infant:
Preschooler:
School-age:
Infant: every 3 months
Preschooler: Every 6 months
School-age: Annually
52
A child cannot be effectively evaluated outside
The family system
53
Best models for children are
Family centered early evaluation models
54
We have to empower the caregiver/ parent
with knowledge and skills to promote the infant’s development
55
Early intervention services should be performed in
the child's natural environment
56
Why is ongoing assessment of a child necessary?
we need to determine priority intervention needs, determine outcomes and best approaches for child
57
What is the purpose of early intervention?
To support / assist families in providing learning opportunities for the infant within everyday activities, routines and occurrences.
58
3 things family centered focuses on:
Family centered needs
Partnering with parents
Empowering family in decision making process
59
2 things child centered focuses on
Provides direct service to child
| Limited parent involvement in intervention
60
What is IFSP?
Individualized family service plan
road map for intervention—created by professionals and family members
61
What 3 things does IFSP do?
It describes the infant’s present levels
Identifies the family’s strengths/needs related to the infant’s development
Identifies what outcomes are expected for the family and child
62
Primary goal of early detection HL and intervention is to
maximize language development during the critical periods of language learning by promoting a responsive social and communicative environment and to support family adjustment to the diagnosis
63
Early intervention should be: (3)
Consistent
Strategic
Adaptive
64
6 tools of the trade in early intervention are:
1. information resource
2. coach/partner
3. joint discoverer
4. news commentator
5. Partner in play
6. Joint reflector and planner
65
No 1 person or profession...
will have all the answers so it should be transdisciplinary
66
5 step decision making process
1. Get to know the infant
2. Get to know what strategies work for communication
3. Set clear goals
4. Support systems
5. Keep current with technology, etc.
67
What are the 4 basic options of communication methods?
1. listening/spoken language
2. Total communication
3. Cued speech
4. Sign only
68
Hearing aids will allow hard of hearing child to maximize
their residual hearing and develop speech and language skills
69
What is auditory feedback loop?
child can self monitor speech production.
70
What is SKI-HI?
deaf mentor program that teaches ASL to families, provides info on deaf culture.
71
Family needs to understand that deafness is...
a unique human experience instead of a pathology or problem.
72
Parents go through different stages when HL is diagnosed, what are they?
1) Shock: may react as if they lost a loved one. May be numb.
2) Denial: HL isn't visible, so many parents try this. Parents might be confused, want to tell the family and them exactly what is going on with realistic expectations.
3) Anger: towards the family, parent doesent know how to help child. A good thing, since first step towards acceptance.
4) Bargaining: “I’ll do anything for my child’s disorder to disappear”
5) Depression and guilt: why did this happen? What did I do? How did I cause this?
6) Acceptance: Parent is supportive and involved and wants to do whatever they can to advocate for their child.
73
Auditory skill development model from Eber includes:
detection, discrimination, identification, comprehension
74
Listening/ Spoken language
Emphasizing the oral/aural part of communication
Use residual hearing to best of their abilities
Want child to speak
Will have speech therapy
Not focused on leaning sign
Most students with hearing loss are educated in this manor
“Auditory Verbal Approach”
75
Total Communication
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Incorperating everything
Sign
Speech
Speech reading
Nonverbal communication (Body language/Facial expressions)
ESL and pidgin used
Using residual hearing
```
76
Cued speech
Visual support system to help someone learn to speech read
| Handshapes made close to the face and neck that represent groups of phonemes.
77
Sign only
Very small percentage is told to sign only.
Usually taught ASL as 1st language and written English as 2nd
Speech production and listening skills are not heavily emphasized
78
Clinician as Information Resource
Provide information in an objective manner
| Suggest a website
79
Clinician as Coach/ Partner
Parent is in the driver’s seat
Professional is on the sidelines giving guidance
Give guidance, provide input, but don’t tell them what to do
80
Clinician as Joint Discoverer
Key in the partnership process
Any question can be addressed as an experiment
Ideas can be expressed as an experiment
81
Clinician as News commentator
Promotes partnership
Providing objective, descriptive feedback about the child’s behaviors
Clinician comments on behavior and family gives their interpretation
Help understand what is best for the child
82
Clinician as Partner in Play
Clinician demonstrates a new strategy/skill
Parents practice it in playful interactions with child/baby
Makes parents more comfortable with the new activity/skill
83
Clinician as Joint reflector and planner
Review at the end of each session
| Partners list key observations and successes
84
3 components of HAs
Microphone
Amplifier
Reciever
85
What is acoustic feedback?
High pitched squealing sound emitted from aid.
86
Acoustic feedback can result from:
Poorly fitting earmold
Crack in tubing
Volume set too high
Excessive wax in EAC
87
6 styles of HAs are
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Body aid
Eyeglass aid
BTE
Receiver in canal
In the canal
In the ear
Completely in the Canal
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