Aural Rehabilitation and Barriers to Rehab Flashcards
Strategy Based Problem Solving
1) Hearing aid fitting and orientation
2) Demonstration and fitting of ALDs
3) Ongoing counselling - informational, client centred, emotional
4) Hearing tactics and other strategies
5) Communication training
6) Group involvement
What is Aural/Audiological Rehabilitation?
The reduction of hearing-loss-induced deficits of function, activity, participation, and quality of life through a combination of sensory management, instruction, perceptual training, and counselling (Boothroyd, 2007)
ASHA definition of Aural rehab
The process as the ability to minimise or prevent, across the life span, the limitations and restrictions that auditory dysfunctions can impose on well-being, and on communicative, interpersonal, psychosocial, educational, and vocational functioning
History of AR
1) Speechreading/lipreading
- not much in the way of amplification so.. e.g. School of vocal physiology
2) Auditory training & HAs
3) HAs
What are Visemes?
Groups of phonemes which look similar on the lips when they are articulated
4 vowel groups
4-7 consonant groups
So, vision can cut down potential targets but not completely
Why do people with severe HI had issues hearing without seeing/seeing (lipreading) without hearing?
Manner of articulation hard to see: most cues for manner of articulation are in the first formant/low frequencies
Place of articulation easy to see: hard to hear because generally cues in the second and third formants
Speech Reading: An activation competition model
Visual cues -> activation of multiple competing words in mental lexicon -> compared on perceptual similarity and frequency (of occurrence) -> word recognition
Problems with tradition AR
Boring: Too much bottom up training
Artificial: efficacy vs. effectiveness
More top-down training needed: Clarification, communication partners, use of context, etc.
Training must be relevant to the client needs/goals
More likely to get aids when
Greater PTA impairment Perceive more participation restriction Perceive problem as more severe Older White Higher education status Retired Living alone Poorer physical status Perceive partner as supportive Have positive views about amplification
Health Belief Model
Individual Perception ----> perceived susceptibility ----> perceived seriousness Modifying factors ----> demographic variables ----> sociopsychological Variables ----> access ----> perceived threat ----> cues to action Likelihood of action ----> perceived benefit of action ----> perceived barriers to preventative action ----> likelihood action is taken
Auditory Ecology
Less challenging environments = lower motivation for hearing aid
BUT also related to likelihood of success - reduced success when the primary needs are difficult listening situations
Things that can effect accessibility
1) Finance
2) Remote location
3) Mobility
4) Process/Language/Societal barriers
Cues
Significant others/family Others bad experiences Experience of a friends HL or social pressure Audiologist/ENT GPs barrier
Perceived benefit
Influenced by peers/families experience
Advertising
Health practitioners
Perceived severity of loss/impact of loss
Psychological characteristics or attribution style (optimism, locus control.. )
What should you do if you feel your client is being hampered by stigma?
Main recommendation is to get them involved in group rehab
