Aural Rehabilitation Flashcards
What is AR?
professional process used when working with a client + HR to achieve better communication & minimize difficulties caused by HL
Goals of AR
Enhance activities and participation of a person with hearing loss so as to improve his/her quality of life
-adequate receptive and expressive communication = a major means pf reaching this goal
Providers of aural rehabilitation
- teachers of the deaf/ hard-of-hearing
- audiologists
- speech-language pathologists
Family-centered care revolves around
partner/spouse
parents
Providers must know & understand the
characteristics of HL
effect of it on persons
competencies needed for providing audiologic rehabilitation
slight to mild HL (dB)
Children: 21-40
Adults: 6-40
Mild-moderate HL
41-55 dB
Moderate HL
56-70 dB
Severe HL
71-90 dB
Profound HL
91+ dB
Prevalence of HL in the US
14-40 M with HL
Most of the 10% American population are considered ….. more than …..
hard-of-hearing rather than deaf
WHO estimates ……. worldwide have …..
360 million/ a disabling HL
A disabling HL
more severe than 40 dBHL in the better-hearing ear in adults
more severe than 30dBHL in the better-hearing ear in children
Time of onset
Prelingual
Perilingual
Postlingual
Deafened
Difference between postlingual and deafened
Postlingual: after 5 (speech can be affected substantially, but less chance for language)
Deafened: after completing schooling
speech recognition
ability to repeat/ identify
speech discrimination
same/different judgement
Speech recognition in persons with cochlear implants is usually comparable to those ….
with only mild HL
s
Speech recognition also is an important variable in
describing a HL as it tells you a little about functional skills
Consequence of HL
communication difficulties
- impact on verbal communication
- underdeveloped oral communication skills
- educational, vocational, psychological and social implication difficulties
EHDI is
Early Hearing Detection and Intervention
Evidence-based practice is
the integration of clinical expertise, patient values, the best research evidence into the decision making process for patient care
Boothroyd (2007) - best approach to AR is ….
Holistic
Airal Rehabilitation
- Combination of technology
- Various types of training
- Counseling
- Combination of technology
Personal FM
Pairing hearing aids with devices
- Various types of training
- computer-based AR programs
- family-centered AR
- Counseling
- changing attitudes toward HL
- positive communication behaviors
Assessment core areas
Communication impairmeny & activity limitation
Overall participation variables
Related personal factors
Environmental factors
Examples of Communication impairment & actovity limitation
Pure tone audiometry
speech audiometry
Self-report
Examples of overall participation variables
social, emotional, educational, vocational, health, & other issues that are important to the client and significant others
Examples of related personal factors
attitudes, motivation & other disbilities or personal conditions that may affect treatment
Environmental factors
physical and social aspects of the environment
Care management
Counseling
Audibility-amplification
Remediation for communication activities
Environmental coordination and participation issues
Counseling includes
info on the assessment findings, client helps set goals for treatment (social validity)
treatment goals fall into the next 3 areas
Rehabilitation management
varies between people
varies over time
work with person with HL & communication partners to find a combination of solutions that enable listening goals to be achieved and maintained across environments with various communication partners
Settings for AR (children)
Early intervention Clinic School/preschool Inclusion classroom Pull-out services Residential schools for the deaf
Settings for AR (adults)
universities VA hospitals ENT practices Community hospitals Community programs Clinics SNFs (skilled nursing facilities)
Inner ear contains ….
sense organs for balance & sound
Conductive disorders
- outer or middle ear
- otitis media
- structural
- trauma
- wax
Number-one reason for visits to the doctor’s office by children under age 15
accouns for 15-20% of childhood HL
prolonged or frequent bouts of OM can cause significant speech and language problems (especially if they occur in the first few years of life)
Otitis media (ear infections)
PE tubes
- a small incision is made in the tympanic membrane
- tube inserted to drain fluid
Causes of obstructed ET
swelling from infection, allergies or irritants neurologic problems (muscle weakness) steuctural problems (cleft palate, enlarged tonsils or adenoids)
Auditory neuropathy
normal cochlea, abnormal nerve function
“Auditory dys-synchrony”
Causes of auditory neuropathy
Juandice (hyperbilirubin)
Hereditary neuropathies
Difference between behavioral tests and objective tests
Behavioral tests: require the child to do sth in response to the sound ( cooperation and physical state)
Objective tests: do not require a response from the child
Examples of objective tests
tympanometry (tymps) acoustic reflexes (AR) otoacoustic emissions (OAE) auditory brainstem response (ABR)
Tympanometry tests
middle ear function
Acoustic reflexes (AR) tests
auditory nerve function
OAE tests
inner ear function
ABR tests
auditory pathway
How does tympanometry work?
measures movement of the eardrum as air pressure is changed in the ear canal
(Pressure & vol.)
Type A tympanogram
Normal eardrum mobility
Normal pressure
Normal volume
Type C Negative tympanogram
Normal eardrum mobility
Negative pressure
Normal volume
ABR us done during ….
sleep/ sedation
Otoacoustic emissions (OAE): cochlear function test characteristics
echo analayzed to determine how well the inner ear is working
measures the function of the outer (inner ear)
NOT a hearing test
OAEs tests …. while …. test the nerve and brainstem
the cochlea / ABR
OAE can diagnose HL?
Yes but it is not a hearing test
Examples of Behavioral tests
behavioral observation
VRA
Play audiometry
Evaluating infants and yound children»_space;> valid and reliable test resuls
We need to be able to control the child’s behavior
get info about difficulties, capabilities and attention span
Factors that influence type of test
chronological & developmental age neurological status hearing level willingless to perform test environment
Behavioral observation audiometry (BOA)
age newborn- 4 months Epicit reflexes (startle, eyeblink, eye widening)
Mixed losses audiogram
Sensori + Earwax
Otitis media
Atresia
Auditory neuropathy
4 major parts of hearing aids
microphone
battery
amplifier
receiver
5 major types of hearing aids
- BTE
- less visible BTE
- ITE
- ITC
- CIC
