Educational Audiology (11_30_16)

Question 1

Difference between EHDI and Early Intervention

Answer 1

EHDI: federally funded umbrella program accounting for NBHS results and data of follow up- enter results into EHDI until kids are school age - not a set age limit for entering things in EHDI - things get entered into EHDI SO THAT THEY CAN GET EARLY INTERVENTION

Early Intervention: ages 0-3, services, home visits, work on ling sounds, learning to listen, parent support, HA checks (if applicable), etc.

Question 2

Legal basis for education of students with disabilities is based on two principles:

Answer 2

1. Exclusion from public education is unacceptable 2. Separate is inherently unequal

Question 3

“Educational Audiology”

Answer 3

 Recognized and defined in 1975
 Critical components of audiology services in the
Schools
◦ Delivery of services in child’s school environment ◦ Address child’s individual needs
◦ Support services are often needed
◦ Assessment and rehab must comply with scope of
practice and all federal/state/local mandates (can’t fit a hearing aid without medical clearance)

Question 4

IDEA Part C

Answer 4

Age 0-3!
Early intervention in the home
Infants and Toddlers, Smart Start, etc.
kids can receive early intervention 0-3 and are entitled to an IFSP and once school aged entitled to an IEP

Question 5

IDEA Part B

Answer 5

Ages 3-21!
Kids should be removed from the classroom as little as possible but when necessary to maximize educational success; this is the responsibility of the school system.
Educational assistance for all children with disabilities

Question 6

“Educational Audiology”

Answer 6

Term recognized and defined in 1975 and includes the critical components of audiology services in the
schools.

Delivery of services in child’s school environment- Address child’s individual needs- Support services are often needed- Assessment and rehab must comply with scope of practice and all federal/state/local mandates (i.e. can’t fit a hearing aid without medical clearance, etc.)

Question 7

Who makes up the craniofacial team?

Answer 7

Plastic Surgeon, SLP (speech and swallowing), Dentist, ENT, Audiologist, Pediatrician, Genetics, etc.

Question 8

Roles and Responsibilities of Educational Audiologists

Answer 8

1. Identification
2. Evaluation and management
3. (Re)habilitative activities
4. Conservation and Programs
5. Counseling
6. Amplification

Question 9

Roles and Responsibilities of Educational Audiologists

Answer 9

IERCCA

1. Identification
2. Evaluation and management
3. (Re)habilitative activities
4. Conservation and Programs
5. Counseling
6. Amplification

Question 10

IEP

Answer 10

It’s a written legal document that is developed between school and family and outlines child’s needs and how school will address needs (i.e. what services will be
provided).
 Current performance
 Goals for the school year
 How child will participate in regular ed
programs
 Criteria for evaluating the child’s progress
IEP=services, 504 = accmodations
Having an IEP implies you don’t need a 504

Question 11

IEP Team

Answer 11

Parent, Regular education teacher, Special education teacher, Psychologist, Related service personnel (Audiologist, SLP, OT, PT), Educational/parent advocate

Question 12

Education for all Handicapped Children Act

Answer 12

1975 Special Education Law that laid the groundwork for IDEA- guaranteed a free and appropriate education to all school age children with disabilities; in 1986 it was ammended to include ages 0-5 and was separated into part B (3-21 years) and C (Birth-3); in 1990 this would become IDEA (individuals with disabilities education act)

Question 13

Changes to IDEA in 1997

Answer 13

include children age 3-9 with developmental delays

Question 14

Changes to IDEA 2004

Answer 14

Amendments made after passing No Child Left Behind

Question 15

What is special to kids over age 9?

Answer 15

they can no longer be diagnosed with the generic “developmental delays” to receive services; if they are still delayed at this point there is something to be diagnosed more specifically

Question 16

FAPE

Answer 16

Free and Appropriate Education; cornerstone of the law (IDEA); to allow children with disabilities full access to education while addressing their learning/access needs
EX: mild hearing loss, APD, etc.

Question 17

Least restrictive environment

Answer 17

learning environment most like a typical child- emphasized in IDEA part B; child should only be removed from the classroom to the extent NEEDED to provide services; in part C- early intervention provided in home

Question 18

Roles of Educational Audiologists: Identification

Answer 18

Collaborate with EHDI, Develop and manage screening programs, document effectiveness

Question 19

Roles of Educational Audiologists: Evaluation and Management

Answer 19

Medical and educational referrals, peripheral and central tests of auditory function, follow-ups from referrals, counseling and guidance of teachers and parents, IEP/IFSP planning and writing

Question 20

Roles of Educational Audiologists: (Re)habilitative Activities

Answer 20

Functional assessments such as CAPD, testing for IEP documentation, progress management, training and information sessions

Question 21

Roles of Educational Audiologists: Conservation and Prevention

Answer 21

develop programs, collaborate with other school professionals

Question 22

Roles of Educational Audiologists: Counseling

Answer 22

Ensure proper academic and social environment in school for deaf and HoH; info and counseling for students parents peers and teachers, collaboration and referral for other services not provided by the school, assist in transition planning

Question 23

Roles of Educational Audiologists: Amplification

Answer 23

HA eval and analysis (verification, speech testing, daily listening checks); CIs (daily maintenance, relationship with CI audiologist); HAT; classroom acoustics and modifications

Question 24

Communication and Education for Children with HL

Answer 24

1. Aural Oral
2. Manual Communication
3. Total Communication

Question 25

Auditory-Oral Auditory-Verbal

Answer 25

Listening and spoken language; success relies on parental involvement, amplification, the educational program, and SLP Tx

Pro: essentially mainstreamed, good peer langauge models, not limited by school choices, and maximum cmmunication parters
Con: limited by how good their access to sound is they might have problems even with amplification

Question 26

Manual Communication

Answer 26

Sign language is the common natural language of the deaf

Pro: not limited to access and providing a community for the kid
Con: restriction on schools and communication partners

Question 27

Total Communication

Answer 27

Educational philosophy; gestures, finger spelling, lip-reading, and speech; essentially use anything you can to instill language into a kid

Pro: getting all supplementation of language and accommodation of different learning styles
Cons: the kid doesn’t always get enough of one mode, different grammar, eventually have to pick one and stick to it

Question 28

Who is likely to need accommodations?

Answer 28

Bilateral SNHL; unilateral SNHL, HF SNHL, minimal SNHL, etc.

Question 29

Bess et al (1998)

Answer 29

Children with minimal SNHL had poorer performance- 66% difficulty in academics, 48% difficulty in attention, 79% difficulty in communication; Functional status- reported less energy, more tired, lower self-esteem, higher stress, etc.

Question 30

Hicks (2002)

Answer 30

Fatigue study: measured reaction times on a dual-task paradigm- children with hearing loss were recommended to wear their hearing aids all the time and not just at school

Question 31

Classroom Acoustics

Answer 31

Level of the speech from the teacher, Distance from the teacher, Room reverberation

Question 32

Reverberation time and speech perception

Answer 32

how quickly a sound decays in the room after initial onset; ANSI 2002 criteria- 0.6 seconds maximum RT for classrooms, most classrooms do not meet ANSI standards; reverberation causes masking effect of direct sound energy by reflected sound energy, reverberation typically causes prolongation of the spectral energy of vowel phonemes which leads to masking of consonants, highly reverberant rooms may result in reverberant sound energy replacing or filling in pauses between words

Question 33

the “learning environment”

Answer 33

incidental learning is happening in classrooms, hallways, auditoriums, recess, gym class etc.

Question 34

Auditory Processing Disorder

Answer 34

Definition: deficiency in the perceptual processing of auditory information in the central auditory nervous system

Weaknesses: auditory discrimination, temporal aspects of audition, performance in noise, auditory memory

Treatment: auditory training, environmental modifications, technology

Question 35

FM Systems

Answer 35

ANSI recommended unoccupied classroom noise is 35 dB- average classroom is +4 dB SNR, sometimes even 0 dB SNR- Listening effort if minimal at 10 to 15 dB SNR- FM aims to provide better SNR and reduce effects of background noise;

Question 36

FM System Transmitter Microphones

Answer 36

Transmitter microphones should be no more than 6 inches from the mouth and can be lavalier, boom mic, or lapel style; Boom mic is the most constant input (most recommended), Lavalier neck loops swing around a lot and hit other things

Question 37

FM Systems Receivers

Answer 37

Ear level (ideal for children that don’t wear hearing aids such as CAPD or ANSD cases, two receivers [one for each ear], look like hearing aids); Soundfield (speakers throughout the classroom, entire class can benefit, desk speaker for a child who needs it); Lavalier (not common, worn around the child’s neck nothing plugged into hearing aids, need a telecoil); DAI (audioboots that attach directly to hearing aids without anything around the neck)

Question 38

FM Fitting Protocol

Answer 38

ASHA (2002) and AAA (2009)- both recognize audiologists as uniquely qualified to dispense and fit FM systems; both recommend verifying transparency with 65 dB SPL input, both outline guidelines for EA and behavioral testing of FM, both do not recommend SF threshold testing (doesn’t make sense to know the lowest level these work for)

Question 39

IDEA and FM

Answer 39

Local Education Agency (LEA) is responsible - make sure FM system is always functioning, account for troubleshooting, always determined by IEP team on a case by case basis per child; FM is considered an accommodation; you don’t need an IEP to qualify for an FM system (can have a 504 plan)