Exam 1 Flashcards
Intro to AR
What is aural rehabilitation?
-AR & AH are intended to mitigate the risks of HL
-Any device, procedure, info, interaction, or therapy that lessens the communicative & psychosocial consequences of a HL
Intro to AR
What is aural rehabilitation - Audiological
-Sometimes used to place emphasis on provision & follow-up for listening devices
Intro to AR
What is aural rehabilitation - Intervention
-Action taken to improve an individual’s functioning
Intro to AR
What is aural rehabilitation - Aural/audiologic habilitation
-Intervention for individuals who are born w impaired hearing
Intro to AR
What is aural rehabilitation - Aural/audiologic rehabilitation
-Intervention for individuals who have lost intact hearing
Intro to AR
Underlying goals of AR
-Alleviate or improve the difficulties related to hearing impairment
-Minimize effects of hearing impairment
Anything that facilitates
1. Hearing
2. Understanding for HL
3. Coping strategies
4. Acceptance of HL
5. Involving comm partners
Intro to AR
Who does AR - AuDs
-Diagnose (including screening) & management of all aspects of hearing & balance
-Ex. tinnitus, cognition, auditory processing
Intro to AR
Who does AR - SLPs
-Provide: collaboration, counseling, prevention & wellness, modalities, technology, instrumentation, population & systems in the areas of speech, language, & swallowing
-Speech, language, literacy therapy
-Takes lead role for child/schools
Intro to AR
ICF - Health & function
- Body function
- Activity
- Participation
- Personal
- Environmental
Intro to AR
ICF - Body function
-Physiological functions
Intro to AR
ICF - Activity
-Execution of a task/action by the individual
Intro to AR
ICF - Personal
-Age
-Gender
-Education
-Marital status
-SES
-Occupation
-Peronsality
Intro to AR
ICF - Environmental
-Assistive devices
-Support networks
-Social services
-Attitudes of others
Intro to AR
What is disability?
-Not just health related
-Complex interaction btwn the individual’s body & the society & environment they live in
Intro to AR
To use evidence-based practices, SLPs & AuDs must
-Recognize the needs, abilities, values, interests of individuals & families & integrate those factors w research evidence & their clinical expertise to make clinical decisions
-Acquire & maintain knowledge & skills to provide quality services
-Evaluate prevention, screening, & diagnostic procedures to identify maximally info & cost effective diagnostic & screen tools
-Evaluate the efficacy, effectiveness, efficiency of clinical protocols for prevention, treatment, & enhancement
-Evaluate the evidence prior to incorporating such evidence into clinical decision making
-Monitor & incorporate new & high quality research evidence
Cultural responsivity
Evidence-based practice
- Clinical expertise/expert opinion
- Evidence (external & internal)
- Client, patient, caregiver perspectives
Cultural responsivity
EBP - Clinical expertise & expert opinion
-The knowledge, judgment, & critical reasoning acquired through your training & professional experiences
Cultural responsivity
EBP - Evidence (external & internal)
-The best available info from scientific literature (external) & from data/observations collected on your client (internal)
Cultural responsivity
EBP - Client, patient, caregiver perspectives
-The unique set of personal & cultural circumstances, values, priorities, & expectations identified by your client & their caregivers
Cultural responsivity
Cultural dimensions
-Family life
-Child-rearing practices
-Education
-Employment
-Health care practices
Cultural responsivity
Cultural dimensions - Individualism-collectivism
-Relates to societal characteristics; identifies the extent to which ppl are integrated into groups
Cultural responsivity
Cultural dimensions - Power-distance
-Refers to the extent to which less powerful members of organizations accept & except unequal power distribution
-Ex. AuD comes into the room & their coat says “Dr.” – patient shows respect
Cultural responsivity
Cultural dimensions - Masculinity-femininity
-Refers to the distribution of values btwn genders
-Ex. Feminine society: there’s not a difference between emotional & social roles
-Ex. Masculine society: men & women are both assertive & competitive
Cultural responsivity
Cultural dimensions - Uncertainty avoidance
-Refers to the level of comfort ppl have w unstructured situations. Not risk avoidance, but tolerance for ambiguity
-Ex. Low ambiguity = client wants to know milestones, precise #s, prognosis
Cultural responsivity
Cultural dimensions - Long-term orientation
-Whether a society exhibits a pragmatic future-oriented perspective or a conventional historic point of view
-Ex. Short term: client really cares about status & the “now”
-Ex. Long term: client cares less abt their job/skills bc they care more about their children & the future
Cultural responsivity
Cultural dimensions - Indulgence vs restraint
-The extent to which a society allows relatively free gratification of basic & natural human desires related to enjoying life & having fun
Cultural responsivity
Cultural competence
-Acceptance & respect for difference
-Continuing self-assessment regarding culture, careful attention to the dynamics of difference
-Continuous expansion of cultural knowledge & resources
-Variety of adaptations to service models
Theories of counseling
Informational counseling
-Info is imparted to the patient about the HL, related restrictions & the recommended steps for management
-Telling the patient how hearing works
Inform patient about
-Nature & degree of HL, review audiogram: child can’t hear mom if she’s behind
-Listening device technology: using an Fm system in school
-Relevant steps of AR plan: what are you comfortable doing
-Services/resources available: referrals to support groups
Theories of counseling
Informational counseling
-Present in an easy to understand way
-Info presented first is retained best (primacy effect)
-The more presented, the less retained
-Categorization is helpful
-Written material can be helpful
-Recommendations should be SPECIFIC
-Clear language, simple sentences.
-Emphasize importance
-Be confident & empathetic
-Need to assess how much patient WANTS to know
-Repeat if necessary
Theories of counseling
Personal adjustment counseling
-Focuses on the permanency of the HL & on psychological, social, & emotional acceptance
-Management of communication difficulties
-Decrease stress-related issues
Theories of counseling
Personal adjustment counseling - Management of communication difficulties
-Identify communication difficulties
-Identify best strategy or tool to address it
Theories of counseling
Personal adjustment counseling - Decrease stress-realted issues
-HL can be a chronic stressor
-Identification of the stressors
-Relaxation techniques
Theories of counseling
Stages of grief
1.Shock & denial
2.Anger
3.Depression & detachment
4.Dialogue & bargaining
5.Acceptance
6.Return to meaningul life
Theories of counseling
Approaches to counseling
1.Cognitive behavioral therapy
2.Fully behavioral therapy
3.Affective approach
Theories of counseling
Approaches to counseling - Cognitive behavioral
-Use logic to direct & redirect individuals’ thoughts, belief, values, ideas, & opinions
-“I need to stop spiraling, this is how I’m going to stop & what I’m going to do instead”
-Working w someone on how to say to themselves: “I feel stressed right now bc I feel stupid, but I’m not & these people are my friends & don’t mind repeating themselves so I can hear”
Theories of counseling
Approaches to counseling - Fully behavioral
-Ex. Telling the patient to remove themselves from the noisy room so they’re not stressed out by it
-Not the most effective
Theories of counseling
Approaches to counseling - Affective
-You’re listening to the patient & they’re supposed to come up with the places that are causing them stress
Motivational interviewing
Transtheoretical model of behavioral change
-Integrative model of intentional behavior change
-Considers readiness to be the result of a temporal progression of stages that are predicted by shifts in cognition
Arose from “common factors” orientation:
-Client & their environment contribute more to change than therapy techniques or approach
Motivational interviewing
Motivational interviewing
-A style of interpersonal interaction that facilitates client’s readiness to change & compliance w therapy participation
-Rooted in the therapist’s ability to LISTEN & skill in initiating & maintaining a direct, constructive & neutral discussion about behavior change & how it can be achieved
- Collaborative
-Not the same as ‘patient centered’ approach, but instead focusing on specific behavior change that is needed - Evocative
-‘What’s right with you’ focus to activate resources for achieving personal goals - Honors patient autonomy
-Requires detachment & recognition that people make choices about their lives
Motivational interviewing
Motivational interviewing
DARN
Desire – “What do you want?”
Ability – “What is possible?”
Reasons – “What are the benefits?”
Need – “How important is this change?”
Motivational interviewing
Goal setting - SMART
Specific, Meaningful, Assessable, Realistic, Timed
-What is your next step?
-What will you do in the next one or two days?
-Have you ever done any of these things before?
-Who will help and support you?
-On a scale of 1-10, what are the chances that you will do your next step? (and…rate self-efficacy)
A public health approach to hearing
What is public health?
-Health-centric, rather than disease-centric
-Community-centric, rather than individual-centric
-Concern w determinants of health & risks for poor health
– Risk is multi-faceted:
– Ex. loud work environ inc risk of HL then HL inc risk of dementia
-Important to understand both risk and resilience
- Values prevention
- Values scientific evidence
- Values equity
A public health approach to hearing
A public health approach to hearing
A public health approach to hearing
A public health approach to hearing
A public health approach to hearing
