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aural rehab > exam 3 > Flashcards

exam 3 Flashcards

1
Q

what are the 9 different factors that influence an individual’s AR plan

in the patient centered approach (for ADULTS)

A
  1. stage of life
  2. life factors
  3. socioeconomic status
  4. race, ethnicity, & culture
  5. psychological well-being/adjustment
  6. gender
  7. social, vocational, and home communication difficulties
  8. deaf or hard of hearing
  9. other hearing related complaints

some lesser socks run past great socks doing otherstuff

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2
Q

stage of life

factor that influencing an individual’s AR plan

A

what are they doing at this time?
- school, college, marriage, children, careers, almost retiring, retiring, etc

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3
Q

life factors

factor influencing an individual’s AR plan

A
  • home (spouse, parent, provider)
  • work (manager, team player, professional)
  • recreation and community (volunteer, church, politics, hobbies)
  • family life cycle (see other card)

lots of different identities in different areas-> with hearing loss the roles start decreasing and so does self-efficacy

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4
Q

family lifecycle

factor influencing an individual’s AR plan (life factors)

A

family lifecycle described in terms of:
- age
- marital/partner status
- presence or absence of children (children’s ages)

also–empy nester or retiree? what resources has the family accumulated?

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5
Q

socioeconomic factors

factor influencing an individual’s AR plan

A
  • financial status ^
  • education level (can determine what type of job they have)
  • employment and/or health insurance

^ if someone can’t afford hearing aids, it’s your responsibility to know what resources are available to them

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6
Q

culture and ethnicity

factor influencing an individual’s AR plan

A
  • different ways of speaking to them
  • be conscious of their beliefs and how thye feel about certain things

(ie keep your hands of their hijab)

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7
Q

psychological adjustment

factor influencing an individual’s AR plan

A
  • degradation of self-image, self-esteem, and sense of being
  • damaged conversational interactions
  • ostracization
  • some patients beome embarrased
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8
Q

gender

factor influencing an individual’s AR plan

A
  • women are more likely to acknowledge a hearing loss than are men, and more likely to use communication strategies
  • men are more likely to fear stigmatization
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9
Q

social, vocational, and home

factor influencing an individual’s AR plan

A

activities in all of these locations and sounds that go with them
- how do you spend your time? -> in each situation what are the activities you do, the communication partners you are with, and the sounds that you need to hear

two-ringed model

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10
Q

deaf or hard of hearing

factor influencing an individual’s AR plan

A

which one
- deaf with a capital d
- not determined by level of hearing loss
- determined by one’s identification with Deaf people

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11
Q

other hearing/ear related complaints

factor influencing an individual’s AR plan

A

tinnitus; vertigo

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12
Q

stages of grief and what they look like

A
  • shock: if it’s sudden
  • denial: doesn’t believe you
  • bargaining: if i take supllements/do these things…
  • anger
  • guilt: also often for a kid
  • depression: especially for your kid or what you lost
  • acceptance

SADDBAG

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13
Q

6 categories in an ar plan for adults

and what is done in each

A
  1. assessment
  2. informational counseling
  3. development of a plan
  4. implementation
  5. assessment of outcome
  6. follow-up

at informal dinners, imaginings arise frequently

  1. impairment (testing); difficulties; individual factors (case history)
  2. about what their hearing loss is and later ha or something
  3. what are they doing to address their hearing loss, use ebp
  4. hearing aids; alds; group follow-up; tinnitus management; other (trainings/counseling)
  5. performance; benefit; usage; satisfaction
  6. schedule return visits; address new hearing-related difficulties; provide information
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14
Q

assessment

what could happen in this stage of the AR plan

A

pure tone and speech testing; hearing related difficulties (activity limitations and participation restrictions); case history

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15
Q

informational counseling

what could happen in this stage of the AR plan

A

explain their hearing loss and audiogram; later explain how to use hearing aids if needed

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16
Q

development of a plan

what could happen in this stage of the AR plan

A

formulate objectives and goals; what are they doing to address their hearing loss

use EBP

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17
Q

implementation

what could happen in this stage of the AR plan

A

hearing aid candidacy, evaluation, fitting, & orientation; group follow up; tinnitus management

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18
Q

assessment of outcome

what could happen in this stage of the AR plan

A

assess performance of device; benefit they receive; their satisfaction

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19
Q

follow-up

what could happen in this stage of the AR plan

A

schedule return visit; address new difficulties; provide info

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20
Q
A
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21
Q

tinnitus

A

the perception of sound in the head without an external cause
- buzzing, ringing, rushing, roaring

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22
Q

prevalence of tinnitus in persons with HL

A

present in 70-80% of persons with HL

(10-15% of adult population -> prevalence rises with age)

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23
Q

treatment options for tinnitus

what to tell a patient that can help

A
  1. education (it’s normal, list causes, not dangerous)
  2. hearing aids (best thing for it, can mask sound)
  3. masking noise (helps with sleep– fan, tv, white noise)
  4. foods to cut out (worsened by : salt, alcohol, caffeine, tobacco)
  5. relaxation techniques (more stressful if focused on it)
  6. psych referral (rare– for if they can’t function)

tinnitus can’t be cured, but it CAN be treated!!!!!

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24
Q

current generation of senior (baby boomers) v. traditional seniors

A

traditional seniors: in their 80s & 90s
- the ‘just good enough generation’
- wwii
- stay out of debt & buying things of the best value
- value trust and service
- value medical advice (medical model)

baby boomer: born 1946-1964 ~ mide 60s ish
- approaching aging differently than prior generations (redefining meaning and purpose of the older years)
- more physically active
- value youthful active lifestyle
- embrace technology
- willing to pay for convenience and cosmetic upgrades (and for a youthful lifestyle)
- wealthiest generation in our country

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25
Q

presbycusis

A

global term referring to age-related hearing loss (starts in 50s)
- affects 30% of people over 65 and the percent increases with age (sloping, high frequency loss)
- speech recognition abilities decline (can hear but not understand)
- cause can be neural or metabolic
- neural= loss of sensor cells, nerve fibers, neural tissue
- metabolic (strial)= loss of blood supply to the cochlea (atrophy of the stria vascularis)

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26
Q

health variables or ar plans in older adults

A

cardiac disease; hearing loss; hypertension; orthopedic problems; caataracts/vision; dementia

see tables for specifics on visual impariment, arthritis, and dementia

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27
Q

dementia

cognitive decline

A
  • generic term for 70-80 conditions that cause irreversible decline in cognitive function
  • gradual memory loss, disorientation, decline in ability to perform everyday tasks

(HL is a large risk factor for dementia)

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28
Q

alzheimer’s

A
  • form of dementia
  • progressive, degenerative, & irreversible
  • decline initially in memory
  • decline in reasoning
  • unable to recognize family members
  • loss of language skills
  • can lead to depression
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29
Q

reduced cognition

and three parts of it

A

normal process of aging-> change in perception, memory, thinking skills, and attending abilities
- declines in attention, processing, and working memory

  • attention= difficulty with:
  • extracting limited info from whole
  • focusing on info and processing further
  • distinguishing relevant vs irrelevant information
  • listening in presence of background noise
  • processing speed= difficulty:
  • visual-spatial info
  • verbal info
  • fast speech
  • difficulty if instructed to respond quickly
  • working memory= difficulty:
  • holding formation in memory
  • recalling from short-term memory
  • recalling parts of complex sentences
  • understanding ambiguous sentences
  • word retrieval
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30
Q

why is early intervention critical

A

1-3 years are most intensive stage for listening
- prelingual loss, without intervention, could lead to listening, alnguage, and speech delays and eventually literacy delays

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31
Q

early intervention goals

generally

A

if a patient is on the high-risk registry they should be monitored every 6 month until age 3 (even if they pass)

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32
Q

what is newborn hearing screening/ehdi and its purpose

A

95% of newborns have hearing screenings before they leave the hospital
- EHDI act: early hearing detection and intervention-> legislation that mandates federal funds to state to develop infant hearing screening and intervention programs
- supporst full diagnostic evaluation if needed; also provides for enrollment in early intervention

want 0% false negatives

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33
Q

OAE

what is it, and what is it used for

A
  • OAE: inaudible sounds that are by-products of movement of the outer hair cells→ this vibration produces a sound that is measured using a small probe in the ear canal
    • doesn’t require cooperation of patient; also can be diagnostic when frequency specific
    • people with normal hearing produce OAEs, those with a loss greater than 30db do not
      • frequencies important for speech are tested (2,3,4, and 5,000)
    • if they are normal, up to the outer hair cells is normal
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34
Q

ABR

what is it and what is it for

A

type of auditory evoked potential test; for babies and older children who can’t participate in behavioral testing
- surface electrodes measure electrophysiological response to acoustic stimulus in 8th cranial nerve and auditory brainstem
- child must be still (asleep or sedated)
- can be used to determine degree of HL
- wave five is most robust and so you look at that one and its latency (its threshold)

  • a-abr: automated-auditory brainstem response→ compares baby’s abr response to a stored template of expected brain waveform
    • can either rule out or implicate significant hearing loss
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35
Q

risk factors associated with being born with hearing loss

A
  • low birth weight (<3.3 lbs)
  • family history of HL
  • in utero infections like cmv, rubella, or herpes (torch)
  • ototoxic medication
  • low apgar scores (reflects normalcy or appearance, pulse, grimace, activity, and respiration at time of birth)
  • need for use of ventilatory for at least 5 days
  • craniofacial anomalies
  • physical manifestations consistent with a syndrome
  • bacterial meningitis
  • severe jaundice (hyperbilirubinemia), at levels that require an exchange

know 4 of them

  1. low birth weight
  2. family history
  3. in-utero infections
  4. ototoxic medication
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36
Q

1-3-6 model EHDI

A
  • hearing screening occurs by 1 month
  • diagnosis occurs by 3 months
  • enroll in early intervention programs by 6 months

KNOW THIS WELL

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37
Q

behavioral testing methods

boa, vra, cpa

A
  • boa= behavioral/observational audiometry
  • vra= visual reinforcement audiometry
  • cpa= conditioned play audiometry
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38
Q

BOA

A

behavioral/observational audiometry: aud presents a stimulus and then observes child’s responses
- for infants 0-6 months
- doesn’t test hearing thresholds
- responses vary among babies
- habituation to sound can be problematic during boa
- observe the child’s overall response/behavioral change when sounds is presented: change in sucking pattern, eye widening, head turn, cessation of activity

moro reflex-> acoustic startle response

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39
Q

VRA

A

visual reinforcement audiometry: providing an acoustic signal and reinforcing a head turn with a light stimulus or activated and illuminated toy reinforcement
- 6 mths – 2 1/2 yrs
- uses operant-conditioned responses (a new or modified response to a previously neutral stimulus)
- leads to being able to test different frequencies and find the child’s thresholds

(held in a sound booth with light up stuff when there’s a sound)

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40
Q

CPA

A

conditioned play audiometry: child is trained to perform a task in response to the presentation of sound (such as stacking blocks/inserting a peg) when a stimulus is played
- 2 1/2 yrs – 5 yrs
- parent remains with child (but doesn’t provide cues) and aud is in an adjacent room
- speech detection thresholds (sdt): level at which speech is just audible
- provides a means to cross-check the CPA
- you can typically get speech testing at 2 yrs old

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41
Q

what are the categories of nongenetic hearing loss

A

prenatal, perinatal, postnatal

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42
Q

prenatal causes of hearing loss

A
  • TORCH
  • intrauterine infections (rubella, cmv, herpes simplex virus)
  • complication associated with the rh factor
  • prematurity
  • diabetes
  • parental radiation
  • toxemia
  • anoxia
  • syphilis
  • ototoxic medication

  1. prematurity
  2. maternal diabetes
  3. parental radiation
  4. toxemia
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43
Q

perinatal causes of hearing loss

A
  • anoxia (prolapse of umbilical cord)
  • syphilis
  • rarely-> use of forceps during birth may cause damage ot the cochlea
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44
Q

postnatal causes of hearing loss

non-genetic

A
  • meningitis
  • other infections: measles, mumps, chicken pox, influenza
  • ototoxic drugs
  • APD caused by TBI, degenerative diseases, seizures, and brain tumors

25% of bilateral HL is postnatal

  1. meningitis
  2. otoxic drugs
  3. measles/chicken pox
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45
Q

autosomal dominant v autosomal recessive

& associated syndromes

A
  • recessive: usher syndrome
  • dominant: brachial-oto-renal syndrome & waardenburg syndrome
46
Q

commonly co-occurring disabilities with HL

A

prescense of other disabilities can increase probability of lang and speech delays
- intellectual disability
- visual impairment
- learning disabilities
- autism
- add
- emotional and behavioral problems
- cerebral palsy
- apd
- auditory neuropathy

40% of children have an additional disability in addition to HL

47
Q
A
48
Q

what % of children have an additional disability in addition to HL

A

40%

49
Q

ANSD

what is it, how to identify it, what is it associated with

A

kids with a diagnosis of auditory neuropathy may have:
- audiometrically normal hearing or a HL ranging from mild to severe
- normal OAEs
- absent, negligible, or abnormal ABRs
- poor word recognition, poorer than that which would be predicted by their audiologic thresholds

what is it?
- transmittal through the nervous system is impaired
- any degree of HL with pure tone testing, normal OAE, and absent/degraded ABR
- can be similar or associated with APD
- scientists believe in many cases the cause is impaired inner hair cell functioning
- hearing aids are not ehlpful but cochlear implants are
- variable prognosis

associated with: jaundice, premature birth, family genetics, anoxia at birth

50
Q

what are the goals of early intervention

3

THIS IS IMPORTANT TO KNOW SPECIFICALLY

A
  1. to enhance the infant’s or toddler’s development
  2. to minimize the possibility of developmental delay
  3. to enhance the family’s ability to accommodate the child’s needs and promote the child’s development (fam centered instead of child bc they are too young)
51
Q

what will happen to a hearing-impaired child without appropriate intervention?

A

could lead to listening, language, and speech delays; and eventually literacy delays

52
Q

FAPE

A

free appropriate public education

53
Q

IDEA

A

individuals with disabilities education act

54
Q

IEP

A

individualized education program

3 yrs and up

55
Q

IFSP

A

individualized family service plan

birth to 3 yrs

56
Q

IAT

A

intervention assistance team
(a multipdisciplinary group of professionals who work together to provide intervention for a child)

57
Q

LRE

A

least restrictive environment

58
Q

SST

A

supplemental services teacher (interacts with a child’s regular teacher to help the child)

59
Q

EI

A

early intervention

60
Q

LEA

A

local educational agency (rep will be at meeting to ensure school is doing everything so there’s no lawsuits)

61
Q

PIP

A

preschool intervention program (preschool children ages 3-5-> small group speech and language instruction to support language development and improvement of articulation skills)

62
Q

key provisions of IDEA

know a handful of the provisions and how they impact special education services

A
  1. identification
  2. evaluation
  3. IFSP or IEP
  4. parents
  5. related services
  6. least restrictive environment
  7. private school
  8. early intervention and preschools
  9. due process
  10. advisory board
  11. funds
  12. records

in each individual persons real life plan each day always feels real
1. all kids have to be identified at all schools
2. prior to placement; must be in primary langugae or mode of communication and have multiple tests -> be comprehensive
3. depends on age 3 or below
4. equal partners-> huge part of plan, their child’s advocates
5. slp, psychologist, counselor, interpreter, ot, aud, recreational and physical therapist, social worker)
6. lre
7. if the public school near them doesn’t have appropriate services they can go to a private school with services for free
8. ones that will continue to include early intervention
9. often contention in iep-> parents think their child is not getting enough services (big deal if school isn’t in compliance); they will try to figure it out at a local level, & have the right to an attorney
10. every state has one: group of individuals with disabilities, teacher, parents
11. tax dollars pay for IDEA (if a school isn’t complying, their funding will be pulled and they might have to pay it back)
12. parent can ask for access to their child’s records and for them to be amended

63
Q

outcomes of IDEA (accomplishments attributable to IDEA)

A
  • 200,000 eligible infants and toddlers & their families are served; 6 million children receive special education
  • educating more children in their neighborhood schools
  • contributing to improvement in rate of high school graduation
  • post-secondary school enrollment increase
  • post-school employment increase
64
Q

what is an IFSP

A

federally mandated plan for children up to 3 yrs old
- ensures appropriate early-intervention services for infants and toddlers and their families
- has legally required components including a service coordinator (they schedule/organize services)

65
Q

what should a written ifsp consider

A
  • child’s current level of development
  • family’s resources, concerns, priorities
  • goals
  • services necessary for achieving the goals
  • time course (start date, duration of service)
  • plan for transitioning to preschool
66
Q

communication modes

options for dhh kids

A
  • ASL
  • MCE
  • aural/oral communication
  • cued speech
  • total communication

decide on communication mode -> appropriate amplification -> initiating early intervention services of auditory training and parent support

67
Q

ASL

A

manual system of communication with different grammar than spoken english (fingerspelling if a sign doesn’t exist or to clarify)
- bilingual/bicultural mode –1st language sign, 2nd language english (or national language) [good option]
- challenge is that parents don’t know sign -> deaf mentors can help

68
Q

MCE

A

manually coded english: signs correspond to english words and follow english syntax rules
- can speak english simultaneously with signs
- aka signed exact english or pidgin signed english

69
Q

aural/oral communication

A

oral approach, same language used by persons with normal hearing
- speech and speechreading:
- multisensory approach= use vision and hearing and touch (orton gillingham)
- unisensory (auditory-verbal)= use residual hearing only (lsl= listening & spoken language)

70
Q

cued speech

A

uses phonemically based hand gestures to supplement/enhance speechreading (talker speaks while cuing the message)
- individually, the hand signals are uninterpretable; they are used to distinguish viseme members (used internationally)
- not super common (cue kids)

71
Q

total communication

A

child uses every available means to receive a message-> including sign, residual hearing, and speechreading
- (aka simultaneous communication)

72
Q

what are the two models of early intervention programs

A

direct therapy model & coaching model

73
Q

direct therapy model

A
  • speech/hearing professional gives therapy to child directly (works with child)
  • good for working on very specific targeted things

does not carry over to home like the coaching model so the kid is only getting the therapy time with the clinician

74
Q

coaching model

A
  • speech/hearing professional coaches the parent on how to incorporate the activities into daily activities
  • parents need to know how to help their child so the kids can get more time a week
75
Q

what does and IEP consist of

A

IEP= written statement eveloped by a team for children who have a disability
- includes their current function and strengths and weaknesses for each of 4 categories
- academic; social development; physical developemnt; classroom needs
- and SMART goals for each category

topics typically included in an IEP:
1. statement of present level of performance
2. statement of annual goals
3. short-term instructional objectives
4. special education and related services to be provided
5. extent of participation in the regular educational program
6. projected date for services to begin
7. anticipated duration of services
8. appropriate criteria to determine if objectives are achieved
9. evaluation procedure to determine if objectives are achieved
10. schedules for review
11. assessment information
12. placement justification statement (especially if they aren’t in the regular classroom)
13. a statement of how special education services are tied to the regular education program

76
Q

IEP meeting

A

a team made of all professionals providing expertise related to the specific child’s need
- LEA rep: local educational agency rep (maybe principal)–> want to make sure everything is being follwoed and avoid a lawsuit
- teacher
- parents/guardians (be sensitive to their stress)
- may also include–> child, and advocate requested by parents, psychologist, counselor
- for speech/language/hearing needs–> SLP and/or AUD

77
Q

multipdisciplinary team

purpose and members

A

each professional provides–> a different perspective of the child’s abilities and needs ; service in their area of expertise ; contribution to the assessment, intervention, and mangagement of the child’s needs
- audiologist
- slp
- educator
- psychologist
- other roles

78
Q

role of audiologist

in multipdisciplinary team

A
  • assess HL
  • select, fit, and maintain devices
  • communication strategies
  • ALDs-> fit, maintain, teach everyone working with child how to use them
  • classroom modification
  • overseeing hearing screenings (if anyone is caught we do diagnostic test-> if 1st time refer to ENT as needed)
  • testing for APD (only AUD can diagnose this)
  • often this person is the educational audiologist

  1. assess hl,
  2. select/fit/maintain hearing devices
  3. communication strategies
79
Q

the SLP’s role

in multipdisciplinary team

A
  • auditory training
  • pre-literacy skills
  • liason between school parents
  • provide asl
  • ling 6 (everytime you meet)
  • visual inspection and listening check of amplification devices
  • advise AUDs about appropriate language levels for tests
  • communication strategies
  • ALDs-> select, maintain, teach everyone working with child how to use them
  • collaborate in APD assessment
  • hearing screening

  1. auditory training
  2. pre-literacy skills
  3. hearing screening
80
Q

educator’s role

in multipdisciplinary team

A
  • inclusion
  • learn about devices and ALDs
  • modify curriculum
  • managing behavior
  • ling 6
  • liaison between child, family and school district

  1. managing behavior
  2. modify curriculum
  3. learn about hearing devices and ALDs
81
Q

psychologist’s role

in multipdisciplinary team

A
  • counseling-> express feelings; coping skills; facilitate positive interactions with other classmates
  • assessments (intelligence, social/emotional functioning, problem solving, attention, behavior)
  • might be the school sounselor
  • as the child gets older they can help with post secondary activities (employment, living)

help after highschool until 22nd birthday

  1. counseling (feelings, coping)
  2. assessments
  3. post-secondary activities
82
Q
A
83
Q

other roles

in multipdisciplinary team

A
  • interpreter (if the child signs and the teacher doesn’t)
  • itinerant teacher (contracted with lots of schools and provides 1 on 1 instruction–push in vs pull out model)
84
Q

classroom placement options

A
  • self-contained classrooms
  • resource room
  • mainstream cclassrooms (partial selective, co-enrollement, inclusion)
85
Q

selective mainstreaming

A

attend self-contained for part of the school day and mainstreams for some subjects (ie art and pe)

86
Q

partial mainstreaming

A

usually occurs when a kid is about to transition from a self-contained class to a mainstream or from a school for kids with HL to one for kids without

during final semester in self-contained classroom, the kid may spend 1 day a week in the general ed setting

87
Q

inclusion

classroom

A

child participates in all aspects of the classroom (it adapts to them)

88
Q

co-enrollment

A

classroom is conducted by 2 teachers -> regular classroom teacher and one of kids with HL

89
Q

ling six sound test

and its purpose

A

six isolated phonemes to target low, middle, and high frequency sounds and silence (to tell if the kid is guessing or not)–> ah, oo, ee, sh, s, m
- familiar speech sounds that broadly represent speech spectrum from 250–8000 hz (makes sure they can hear all the sounds of speech)

have to do it before teaching as and slp or teacher so you know their device is working and they can hear
- it tests awareness, discrimination, and identification (not comprehension)

required by IDEA part B

90
Q

IDEA part B

A

each public agency must ensure that hearing aids worn in school by chidren with hearing impairment including deafness, are functioning properly
- the job of anybody who is working with the child (they have to know how to troubleshoot and know the device is working)
- there can be a checklist to make sure the ling 6 happens before school day or any intervention/teaching

91
Q

what is the level of background noise in a typical classroom

A

about 50-60 dB

92
Q

what are the main issues in classroom acoustics and how do you improve them

A

background noise, distance, & reverberation
- add rugs, turn fan off, close door, acoustic tiles, FM system

93
Q

what is the minimum SNR for hearing impaired individuals to understand speech

and what is ASHA’s standard

A
  • minimum speech level for child with HL is 6 dB SNR
  • ASHA’s standard (the goal) is 15 dB or more SNR
94
Q

what do children with mild or moderate HL have difficulty with and benefit from

A
  • have difficulties listening in noise or reverberations
  • have reduced speech recognition of quiet speech
  • benefit from amplification
  • benefit from developing an IEP (if don’t qualify get a 504)
  • benefit from FM system
  • undergo speech language evaluation to determine need for AR

15% of kids in the US are affected

95
Q

what % of children are affected by mild or moderate HL in the US

A

15%

96
Q

speech acquisition for children with HAs vs CIs

A

hearing aids
- historically reasearch shows specific patterns fo speech acquisiton for kids who are hard of hearing
- children with HA and children with cochlear implants ahve different speech acquisition styles

cochlear implants
- speech acquired at a faster rate
- improved vowel production and increased repertoire
- consonant acquisition good
- acquisition of fricatives and affricates slower
- production of visual consonants beter than palatals, velars, and glottals

97
Q

how does hearing help us learn to speak

A
  1. regulate their speech breathing and how to flex and extend their tongue (vowel counds)
    - less words per breath, moving jaw instead of tongue to make vowel sounds
  2. differentiation and timing of articulatory movements
    - quick/slow — p versus w
  3. they learn the phonemes of their language community (imitation)
  4. informs children about the consequences of their articulatory gestures and how they compare to sounds produced by other talkers
    - loud p sounds etc
  5. self-correction -> see went vs she went
98
Q

what are the categories of speech characteristics with HL

with HA

A

articulation of segmental sounds
suprasegmental effects

99
Q

articulation of segmental sounds

with HL and a HA

A

vowels
- neurtralization & nasalization
- substitutions and diphthongization
- prolongations

consonants
- voiced/voiceless confusions
- substitutions, ommissions, and distortions
- consonant cluster errors
- visible consonants produced better

- lots better with CI (70-90% intelligible)

100
Q

suprasegmental effects

of HL on speech with HA

A
  • better with most prosody things with CI (timing and loudness)
  • fewer words per breath cycle
  • excessive force on plosives
  • equal stress on all syllables
  • speech sounds staccato or arrhythmic
  • slower speaking rate 70 wpm (compared to 164)
  • distinctive vocal quality (may sound strained, hoarse, harsh, strident, nasalized or denasalized, breathy)
101
Q

form

difficulties Language Development with HL using HAs

simple sentence structures with few words–> errors of syntax & morphology

A
  • overuse nouns
  • rarely use adverbs, pronouns, and prepostition
  • omit function words
  • rarely use or omit morphemes that mark plurality, possession, or tense
  • poor understanding of various sentence structures

with CI more of a normal progression just delayed

102
Q

content

difficulties Language Development with HL using HAs

A
  • limited vocabulary –> simplistic
  • difficulty identifying synonyms, antonyms, and idioms
  • understanding of words limited to single context
  • learn more concrete than abstract words

increased vocab development with CI

103
Q

pragmatics

difficulties Language Development with HL using HAs

A
  • incorrect language use
  • inappropriate asking of questions
  • lack of initiation skills
  • absence of communication breakdown repair
  • poor turn taking

affected with ci and ha

104
Q

why are childrens pragmatics affected by hearing loss?

A
  • they don’t get enough practice using language
  • often have fewer communication partners (so they learn less through communicating with people)
  • can’t overhear conversations as well (less incidental learning)
  • lack of instruction of rules of communicating
105
Q

overal literacy characteristics with HL and HA

A
  • restricted language system
  • word decoding is affected due to lack of phonological awareness
  • deficits in experience and world knowledge
106
Q

characteristics of reading with HL

A
  • today with early identification and modern HA’s, lag behind 2 yrs (historically avr HS students tapered off at 3-4th grade reading level)
  • 35–65% of students read at grade level (both ha and ci users)
107
Q

characteristics of writing with HL

A
  • syntactic errors: omission of articles–incorrect pronouns use–omission of bound morphemes
  • rare use of synonyms, antonyms, and metaphors
  • difficulty writing narratives with beginning, middle, and end
108
Q

what are the categories of tips for fostering pre-literacy skills while reading

A
  • engagement
  • interactive reading
  • teaching techniques
  • literacy strategies

LITE

109
Q

engagement

tips for fostering pre-literacy skills while reading

A
  • positive feedback
  • read/comment with emotional language and intonation
  • expend effort to ENGAGE the child
  • maintain close proximity
  • monitoring child’s comprehension
110
Q

interactive reading

tips for fostering pre-literacy skills while reading

A
  • child holds book and turns pages
  • respond to child’s remarks about book
  • let child take the lead
  • allow child to process the content
111
Q

teaching techniques

tips for fostering pre-literacy skills while reading

A
  • relate content to previous experiences
  • elaborate on child’s remarks about the book
  • define new vocabulary
  • ask “what do you think will happen next”
112
Q

literacy strategies

tips for fostering pre-literacy skills while reading

A
  • point to and label pictures
  • ask questions about the book
  • point to words, letters, and sentences

aural rehab (3 decks)

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