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Audiology FINAL > Final > Flashcards

Final Flashcards

1
Q

COUNSELING remember to be:

A

 Sensitive
 Empathetic
 Humanistic (i.e. different cultures)
 In charge, but pt should feel comfortable to ask questions

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2
Q

Well-Patient Model

A

 No psychological problems
 Helping them deal w physiological issues
 Acceptance & (Re)Habilitation
 If deeper issues, must refer out to approp professional

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3
Q

Goals of counseling

A 
 Help those we treat
 Achieve independence
Learn how to solve or strategize problems associated
w HL
 i.e. Background noise, classroom, etc.
 Improve Quality of Life (QOL)
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4
Q

types of counseling

A

Diagnostic
Emotional Response
Personal Adjustment

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5
Q

Counseling: Diagnostic

Provide and follow…

A

Results and impressions are imparted to pt and families
Provide basic understanding of audiogram, degree &
nature of HL, and implications to follow
 Speech-language development
 Trouble in background noise
 Classroom acoustics
Tests serve merely as instruments to help explain, provide
advice and counsel

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6
Q

Counseling Diagnostic explaining:

A 
Appropriate Jargon
Knowing your scope practice
If you need to refer out and why
Elicit questions from the patient/parents/family, so they
feel their concerns are being addressed
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7
Q

Counseling Diagnostic: Amount of Info

A

Do not provide more than they can take it
 Initial diagnosis w a child – emotions are raw and
processing info is limited
 Provide patient/family w written info they can refer
back to
 Encourage them to call back w any q’s
 Schedule a f/u call once emotional response has settled

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8
Q

Counseling: Diagnostic provide info on

A 
Coming back for an appointment to discuss hearing aids or
assistive listening devices
 Strategies
 (Re)Habilitation Choices
 Technological Devices, etc.
 Arrangements to be made at school
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9
Q

Counseling Diagnostic children

A

Include them when they old enough to understand

 You want them to feel as of they have “a say” in process

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10
Q

Counseling Diagnostics Geriatrics

A

Don’t just address spouse/caregiver/family member
 Although they may be severely hearing impaired or present w cognitive decline, try to include them so they are motivated towards address their issues
 They should have “a say” in their healthcare

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11
Q

COUNSELING: EMOTIONAL

Various responses to diagnosis

A 
 Sorrow
 Shock
 Fear
 Denial
 Anger
 Helplessness
 Blame
Internalized or Externalized
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12
Q

Counseling: Emotional: Parents

A

 Just told them there is something wrong with their child, whom they see perfect in their eyes
 Dreams are shattered
 Roller coaster of Emotions

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13
Q

Counseling: Emotional: Adults/Geriatrics

A

Cannot gauge reaction based on affect alone
Helpful to have 3rd Party present
 Provide support
 Give insight as to how pt is struggling
 Acknowledges there is a problem, even though pt may deny it
HL is invisible – not as easily observed in adults vs. children
 Can fill in blanks when parts of message is missing, read lips

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14
Q

Counseling: Emotional: Children

A

 parents can see that their child is not responding during testing
 Speech & Language fails to develop

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15
Q

Counseling: Stages of Emotion

A

Denial
Mourning
Anger
Guilt

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16
Q

COUNSELING:

PERSONAL ADJUSTMENT

A

Help pts and families to make practical changes
in their lives
 Assist in developing a positive approach to their hearing loss
 Identify technology and strategies
 Review realistic expectations and limitations
Provide a supportive base

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17
Q

COUNSELING:
PERSONAL ADJUSTMENT
Nonprofessional Counselor

A

 Provide counseling directly related to primary services
 How can we improve their quality of life, which related to a
physiological issue
 Present information in an unbiased fashion

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18
Q

COUNSELING:
PERSONAL ADJUSTMENT
Teach them how to cope

A

 Strategies
 Continue to live as you would, and include whole family in normal activities and those that are geared towards hearing loss

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19
Q

COUNSELING:
PERSONAL ADJUSTMENT
Questionnaires – subjective information

A

 Provides info beyond audiogram
 Gives insight to how pt/parent feels and where they
think they are struggling most
 Informs us of daily activities we need to improve for
success

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20
Q

COUNSELING:
PERSONAL ADJUSTMENT
Questionnaires & Students

A

 Elicits counseling opportunities, as it will identify where the
individuals are struggling socially, educationally, and
psychologically
If a student divulges information out of our scoop of
practice, acknowledge it and refer out if needed

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21
Q

COUNSELING:
PERSONAL ADJUSTMENT
Self Advocacy

A

Individuals need to be able to describe their loss and what accommodations they need to succeed
 School: FM, Preferential Seating, etc.
 Home: Reducing background noise, facial cues for
communication, etc.
 Public Settings: i.e. Restaurant, putting noise behind you
and speaker in front of you

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22
Q

Support Groups

A

Lets patient/parent know that they are not alone
Learn from others
Lean on one another
May open new opportunities for success, activates, or life
changes
Provides an outlet
Gives them a voice to be heard

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23
Q

Support Groups: parents

A

Will learn from other parents and it will give them insight on what’s
to come and what to expect

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24
Q

Support Groups: Teens and Adults

A

 You are not alone
 Open up about feelings, difficulties, and experiences others without
hearing loss may not understand

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25
Q

Support Groups are found…

A 
Online
Regional/State
Family Counseling
Communities
Be sure to provide information in writing for all groups
and organizations available
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26
Q

Support Group Names:

A

Hearing Loss Association of America
Listening & Spoken Language Knowledge Center (Alexander
Graham Bell)
Social Media – Facebook Pages
 Hear Ya Now (18-40 years)
 International Federation of Hard of Hearing Young People (IFHOHYP)
 Hearing Impaired Singles

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27
Q

Inner Ear and Balance

A

 In order for our body to maintain balance there are many systems wn our body that must communicate
 These systems coordinate or work togetherby way of cerebellum

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28
Q

3 Main systems of inner ear and balance

A

 Visual
 Proprioceptive
 Vestibular

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29
Q

Balance systems: visual

A

Provides direct info from our surroundings and body’s orientation in relation to them

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30
Q

Balance systems:  Proprioceptive – Somatosensory

A

Stimuli received from the muscles and tendons of
body, which allow body-part positioning
 Knowing where you are in space

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31
Q

Balance systems: vestibular system

A

Gravity & Inertia

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32
Q

Vestibular-Ocular Reflex (VOR)

A

Coordination of your head and eye movements to maintain a stable image, even as your body moves
 Eyes move in an equal but opposite direction of head
 Work in a push-pull manner damage to vestibular sense organs, patients will complain of dizziness, lightheadedness, or spinning

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33
Q

Vestibule

A

 Oval Window – entry way to inner ear
 Vestibule
 Chamber/space that connects membranous labyrinths of cochlea and vestibular system
 Filled with perilymph

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34
Q

5 Sensory Organs

A

 Utricle
 Saccule
 3 Semicircular Canals

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35
Q

Utricle and Saccule

A 
 Responsible for Linear Acceleration
 Forward and backwards
 Up and Down
 Membranous sacs located w/n vestibule
 Filled w endolymph
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36
Q

Utricle

A

oriented horizontally

 Back & Forth

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37
Q

Saccule

A

oriented vertically

 Up & Down

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38
Q

Macula

A

Sensory structure

 Contains hair cells

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39
Q

Utricle & Saccule:

Macula

A

 Sensory portion
 Hair cells – cilia that project into a gelatinous layer
 Otoconia
 Calcium carbonate crystals that rest on top of gelatinous layer
 Crystals are heavier than endolymph
 Force of gravity always acting on cilia of hair cells

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40
Q

Physiology of the Macula

A

Otoconia weighing on hair cells
 Thus when we move otoconia lag behind due to inertia
 Due to this lag, it causes hair cells to bend in opposite direction of movement
 Bending/Shearing of hair cells – sends a signal to nerve

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41
Q

Semicircular Canals

A

Arise from membranous labyrinth of utricle
 Responsible for rotational acceleration
 Horizontal – shaking head “no”
 Anterior – shaking head “yes”
 Posterior – tilting head from shoulder to shoulder
 Filled w endolymph

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42
Q

Semicircular Canals:

Ampulla

A

 Sensory organ of canals
 Located at base of each canal
 Crista – sensory cells of ampula
 Cilia of cells project into a gelatinous mass, cupula (hangs from a stalk on top of ampulla)

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43
Q

Physiology of the Ampulla

A

Like macula of utricle and saccule
 As head rotates, the cupula lags behind
 Crista bend in opposite direction
 Shearing action sends signal to nerve

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44
Q

Vertigo

A

symptom of feeling like room or you is spinning
 Because the vestibular system is impaired, signals to brain are incorrect which may cause eyes to move when they
shouldn’t

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45
Q

Nystagmus

A

rapid rocking or snapping movement of the eyes
 Spontaneous
 Provoked
 Can be natural/normal at times

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46
Q

Vestibular System Assessment

A 
Videonystagmography (VNG)
 Computerized Dynamic posturography
(CDP)
 Vestibular-Evoked Myogenic Potential
(VEMP)
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47
Q

Videonystagmography (VNG)

A

Assessment of vestibular system and central motor function
 Measures movement of eyes through infrared cameras
 Battery of tests to document a patient’s ability to track an object, and how eyes respond when vestibular system
is excited

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48
Q

Computerized Dynamic

Posturography (CDP)

A

 Aka Sensory Organization Test
 Looks at how the body coordinates movements to maintain balance
 Provides more of functional assessment of daily life activities
-measure how the pt’s weight is distributed in specific testing conditions
 Stable or Unstable Floor
 Vision or Perturbed Vision
 Any combination of conditions can be put together to see where pt falls apart

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49
Q

Vestibular-Evoked Myogenic

Potential (VEMP)

A

 Sound-evoked muscle reflex
 Believed to be generated from utricle and saccule via acoustical stimulation
 Tells us more about linear acceleration abnormalities
 Controversial test
 FDA has not really approved

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50
Q

Vestibular Tests:

A 
VNG
 Semicircular Canals/Rotational Movement
 Central Nervous System
 Peripheral vs. CNS
 CDP/SOT
 Functional abilities
 VEMP
 Utricle & Saccule/Linear Movement
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51
Q

BENIGN PAROXYSMAL POSITIONAL

VERTIGO (BPPV)

A

Most common vestibular disorder
Otoconia of utricle dislodge and float around in semicircular canals
Usually affecting posterior canal

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52
Q

BENIGN PAROXYSMAL POSITIONAL

VERTIGO (BPPV) symptoms

A

Brief vertigo w head movements
 Head movement causes the otoconia to stimulate semicircular canals, sending a false signal to brain
 Unequal input, induces nystagmus
 Nausea and/or vomiting

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53
Q

BPPV causes

A

Head Injury

 Idiopathic

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54
Q

BPPV treatment

A

Maneuver patient to place otoconia back in correct anatomical position (Epley Manuever)

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55
Q

BPPV prognosis

A

High success rate 95%
 Limited movement post-maneuver to ensure proper placement of otoconia
 May reoccur

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56
Q

BPPV:

AUDIOLOGICAL FINDINGS

A 
Tympaometry
 Type A
 Acoustic Reflexes
 Present
 Air Conduction
 Normal
 Bone Conduction
 Normal
 Speech Recognition Scores
 Excellent
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57
Q

BPPV:

DIX HALLPIKE

A
  • Performed as part of the VNG
  • Considered to be a positioning test
  • Essentially trying to move suspected lose otoconia
  • Positive response when nystagmus is present
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58
Q

MENIERE’S DISEASE symptoms

A 
Disorder of inner ear
 4 Main Symptoms
 Vertigo (longer duration)
 Tinnitus
 Aural Fullness
 Fluctuating Hearing Loss
 Usually unilateral in nature
 Associated w nausea and vomiting
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59
Q

MENIERE’S DISEASE

causes

A

 Believed to be caused by improper regulation of fluids
of inner ear
 Specifically endolymph
 Too much is produced, causing pressure in inner ear
 aka Endolymphatic Hydrops

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60
Q

MENIERE’S DISEASE: prognosis

A

 Different for everyone
 Symptoms usually fluctuate/intermittent over time
 Can cause permanent hearing loss on affected side

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61
Q

MENIERE’S DISEASE: treatment

A

Medication: Meclizine, anti-anxiety, sedatives
 Reduced sodium diet
 Vestibular Therapy

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62
Q

MENIERE’S DISEASE:

AUDIOLOGICAL FINDINGS

A

 Tympanometry
 Type A
 Acoustic Reflexes
 Present, elevated or absent – dependent the amnt of
hearing loss
 Air Conduction
 Reduced in low frequencies of affected ear
 Bone Conduction
 Equally reduced as air
 Speech Recognition Scores
 Dependent on amount of hearing loss
• May have normal hearing in btwn episodes
•Hearing loss is sensorineural in nature
•Hearing loss may affect remaining frequencies over
time – more of a flat hearing loss
•Total loss of hearing is not very common

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63
Q

VESTIBULAR NEURITIS &

LABYRINTHITIS

A

 Disorder of inner ear
 Results from infection of inner ear, causing inflammation
 Disrupting transmission of the nerve signals
 Typically unilateral in presentation
 Viral in nature
 Symptoms
 Vertigo, off-balance/light headed, changes in hearing and/or tinnitus

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64
Q

VESTIBULAR NEURITIS

A 
Inflammation of nerve
 Off-balance → Severe Vertigo
Nausea and/or vomiting
 Difficulty with vision
 Impaired concentration
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65
Q

Vestibular Labyrinthitis

A

Inflammation of labyrinth

 Same as neuritis, but may also experience tinnitus and changes in hearing acuity

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66
Q

VESTIBULAR NEURITIS &

LABYRINTHITIS symptoms

A

 Symptoms are usually acute in onset
 Episodes last from several minutes to hours
 May occur in clusters for a few days
 Usually have one episode and then are symptom free or
experience a residual off-balance sensation
 Unlike Meniere’s disease, episodes typically do not reoccur over time

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67
Q

VESTIBULAR NEURITIS &

LABYRINTHITIS treatment

A

Meclizine, anti-depressant/anxiety, steroids

 Vestibular Therapy

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68
Q

VESTIBULAR NEURITIS &

LABYRINTHITIS prognosis

A

Full recovery
 Possible Hearing Loss – sensorineural in nature
 Impaired vestibular system

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69
Q

VESTIBULAR NEURITIS & LABYRINTHITIS:
AUDIOLOGICAL FINDINGS
VESTIBULAR NEURITIS & LABYRINTHITIS:
AUDIOLOGICAL FINDINGS

A 
Tympanometry
 Type A
 Acoustic Reflexes
 Present, Elevated or Absent – dependent upon hearing acuity in affected ear
 Air Conduction
 Normal or Reduced in affected ear
 Bone Conduction
 Normal or Equally reduced as air in affected ear
 Word Recognition Scores
 Dependent on hearing sensitivity
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70
Q

Rehabilitation

A

To restore or return to usual life through therapy

 Restoring a skill that was acquired previously

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71
Q

Habilitation

A

Assisting a child to achieve developmental skills when
impairments have caused a delay of initial acquisition of
skills

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72
Q

Acoustic Neuroma

A

Benign tumor of auditory nerve
 Arise from the myelin sheaths that cover nerve
 United States: 100,000/year
 Typically seen in adults
 Usually a unilateral lesion
 Early Symptoms: Tinnitus & Asymmetrical Hearing

73
Q

Acoustic Neuroma:

Other Signs & Symptoms

A

Discrepancy between amnt of hearing loss and word
rec scores
 Dizziness
 Facial Weakness or Numbness
 Abnormal sense of taste and smell
 Damage/symptoms occur by growth of tumor, causing
there to be pressure on brain and other cranial nerves

74
Q

Acoustic Neuroma:

Audiological Findings

A

 Tympanometry
 Type A
 Acoustic Reflexes
 Ipsilateral: Absent
 Contralateral: Present
 Air Conduction
 Reduced high frequencies in affected ear
 Bone Conduction
 Equally reduced as air in the affected ear
 Word Recognition Scores
 Depending on the stage of tumor growth, results can range from normal to significantly reduced

75
Q

Acoustic Neuroma:

Diagnosis & Treatment

A 
Diagnosis
 MRI of Internal Auditory Canal
 Treatment – dependent on size & location of tumor
 Monitor
 Gamma Knife
 Beams of gamma radiation
 Arrest growth of tumor
 Surgery
 Removal of tumor
76
Q

Other Causes of VIII Nerve Hearing Loss

A

 Acoustic Neuritis
 Inflammation of vestibular or cochlear portion of nerve
 Multiple Sclerosis
 Auto-immune disease affecting central nervous system
 Immune system attacks myelin sheaths that protect nerves, resulting in scar tissue, which alters transmission of electrical impulse along nerve
 Other neurological conditions
 Cerebral Vascular Accident (CVA)
 Parkinson’s
 Brain Injury, etc.

77
Q

Auditory Neuropathy/Dys-synchrony

AN/AD

A

Otologic Disorder where sounds enter ear normally, but
transmission from cochlea to brain is impaired
 Normal outer hair cell function
 Transmission of electrical impulses fail to occur in synchrony
 Level of dys-synchrony varies from person to person
 Site of lesion along the CANS may also vary from patient to pt

78
Q

Auditory Neuropathy/Dys-synchrony

(AN/AD) signs and symptoms

A

Hearing can range from normal to profound and can
fluctuate
 1/3 with AN/AD will display a severe to profound hearing
loss
 Hearing progressively worsens in time
 Deaf speech/behavior when normal hearing thresholds
are obtained on audiogram
 May present with other peripheral neuropathies

79
Q

AN/AD:

Audiological Findings

A 
 Tympanometry
 Type A
 Acoustic Reflexes
 Elevated and/or absent
 Air Conduction
 Range from normal to profound
 Bone Condition
 Same as air
 Word Recognition Scores
 Disproportionate with amount of hearing loss present
80
Q

AN/AD:

Site of Lesion Testing

A

OAE
 Normal – since outer hair cells are healthy
 ECoG
 Present response (measurement of cochlea)
 ABR
 Absent – no identifiable wave
 Absent/abnormal ABR reveals that there is no synchronous neural activity of cochlear nerve
 Present OAEs & Absent ABR – Hallmark for the disorder

81
Q

AN/AD:

Diagnosis & Treatment

A 
Diagnosis
 Rely solely on ABR & OAE findings
 MRI fails to display any lesions along VIII CN
 Treatment
 Hearing Aids
 Success varies
 Cochlear Implants
 Typically most beneficial outcome
 Electrical stimulation of nerve may be lead to a more
synchronous firing of nerve impulses
 Cued Speech
 Speech reading
82
Q

primary effect of hearing loss

A

Ability to communicate with others

83
Q

secondary effect of hearing loss

A

Impact/influences on education, vocational,

psychological, and social functions

84
Q

prelingually deaf

A

congenital or before language was acquired

85
Q

postlingually deaf

A

after speech and language has been fully or partially acquired

86
Q

deafened

A

– after education is complete (teens/twenties)

87
Q

hard of hearing

A

partial hearing loss either at birth or acquired

88
Q

auditory deprivation

A

Reduced, or lack of stimulation, in the auditory areas of brain
 Atrophy of VIII CN and the association areas in brain
 Leads to reduced word recognition ability

89
Q

World Health Organization – 2 Models

A

CORE

CARE

90
Q

AURAL REHABILITATION:

ADULTS - CORE

A

Communication Status
Overall Participation Variables
Related Factors
Environmental Factors

91
Q

AURAL REHABILITATION:

ADULTS - CARE

A

Counseling & Psychological Aspects
Audibility/Amplification Aspects
Remediation of Communication Activity
Environmental Participation

92
Q

AURAL REHABILITATION:

ADULTS/GERIATRICS

A 
Hearing loss signifies aging
 Depressing for most
 Provide with strategies for everyday life and communications situations
 Self advocating
 Using visual cues
 Dealing with background noise
 Making changes at home
93
Q

AURAL (RE)HABILITATION:

CHILDREN factors

A

Age of child at onset of HL
 Degree and nature of HL
 Age at which amplification was introduced

94
Q

AURAL (RE)HABILITATION:
CHILDREN
 Most debilitating consequence

A

disruption of speech and lang development, which then affects reading writing, learning, etc.
 Early Detection is best!

95
Q

AURAL (RE)HABILITATION:
CHILDREN
 Communication Options – 7 Approaches

A 
 Auditory-Oral
 Auditory-Verbal
 Listening & Spoken Language
 Cued Speech
 Manually Coded English
 Total Communication
 American Sign Language
96
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
Auditory-Oral

A

Spoken language concept that leads to language development
 No ASL or finger spelling
 Emphasizes consistent use of amplification everyday
 Visual cues can be used (i.e. lip reading)

97
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 Auditory-Verbal

A

Similar to Auditory-Oral, but NO visual cues
 During therapy the SLP will cover their mouth to ensure
auditory only input

98
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 Listening & Spoken Language (LSL)

A

Combination of Auditory-Oral and Auditory-Verbal
 Stresses Early Intervention
 Emphasizes more of an auditory-verbal approach
 Special Certification through Alexander Graham Bell
Association

99
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 Cued Speech

A

Uses spoken language and 8 visual hand cues around
speakers face
 Helps to discriminate between sounds that look similar when produced
 Amplification is encouraged
 Family needs training
 Benefit – child verbally misses a word, can use visual cues to fill in gaps

100
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 Total Communication

A

Incorporates multiple modalities
 ASL, finger spelling, lip-reading, auditory input, etc.
 Amplification is encouraged
 Similar benefits of Cued Speech – can fill in blanks if misses something

101
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 Manually Coded English

A

Visual mode of communication
 Finger spelling and signing
 Follows the same rules of English syntax
 Amplification does not always need to be used

102
Q

AURAL (RE)HABILITATION: CHILDREN
COMMUNICATION OPTIONS
 American Sign Language (ASL)

A

Visual/Manual communication
 No amplification
 Does not follow the rules of English syntax

103
Q

AURAL (RE)HABILITATION:
SCHOOL SETTING
 Educational Environment

A

Regardless of who delivers services, an educational
audiologist should be involved w development of
habilitation activities
 Both the SLP and educational audiologist should be present at all IEP meetings to support and advocate approp technology and accommodations for both academic and
extracurricular activates

104
Q

Speech Perception &
Production
 Input

A

Auditory Perception: ability to hear

 Auditory Processing: ability of brain to understand

105
Q

Speech Perception &

Production output

A

 Speech & Spoken Language Organization: ability
of the brain to organize speech and spoken
language
 Speech & Spoken Language Production: ability
to produce meaningful speech and language

106
Q

speech and language is…

A 
Redundant
 Communication context & intent
 Semantic content & noun-verb meanings
 Stress-time information
 Intonation Patterns
 Word order regularity
 Visual cues
 What is secondary to normal hearing individuals,
is pertinent to those with HL
 Compromised input = poor output
107
Q

4 Levels of Auditory Skill

Development

A

 Detection
 Discrimination
 Identification
 Comprehension

108
Q

Auditory Skill Development: detection

A

Ability to hear

 Be aware of a sound, but a verbal response is not required

109
Q

Auditory Skill Development: Discrimination

A

Perceive difference between 2 similar sounds

 Phonemes, words, phrases, sentences, environmental sounds

110
Q

Auditory Skill Development: Identification

A

Identify what has been
labeled or named
 Aka recognition

111
Q

Auditory Skill Development: Comprehension

A

 Highest level of processing
 What the brain does w what we hear
 Understanding the meaning of auditory input and
application to known info, experiences and language

112
Q

Key goal for auditory development

A

ensure family follows through w recommendations and strategies to achieve success

113
Q

6 strategies for auditory development

A 
 Auditory Access
 Daily Listening Check & Discrimination
 Acoustic Cues for Prosody & Redundancy in Speech
Signal
 Auditory Environment & Input
 Overhearing or Incidental Learning
 Talk Time
114
Q

Auditory Access

A

 Consistent wearing and appropriate device
 Monitoring of the child’s auditory learning w device
 Ongoing audiological management
 Sufficient auditory input of language

115
Q

Daily Listening Check &

Discrimination

A

 Monitoring device daily to ensure device is functioning well (parent & SLP)
 Perform Ling Six
 /u/, /m/, /a/, /i/, /sh/, /s/
 Represents all the speech sounds across frequency range
 Be sure child can repeat back accurately

116
Q

Acoustic Cues for Prosody &

Redundancy in the Speech Signal

A 
 Early Stages of Auditory Development
 Melody of message
 Suprasegmentals
 Intonation, stress, etc.
 Changes meaning
117
Q

Auditory Environment & Input

A

 Ensuring child ALWAYS has access (be sure parents follow through at home)
 Reducing background noise
 Moving closer to child
 Sitting close and being on same level

118
Q

Overhearing or

Incidental Learning

A 
 Goal: teach child how to develop spoken language
through listening
 Learn cues for redundancy
 Prosodic patterns
 Phonotactic probability
 Context of convo
 Word and knowledge
 Rules of syntax
 Distance listening & overhearing – desirable goal
119
Q

Talk Time

A

basically how frequently you talk to your child
Amount & Quality of Input
 Children who hear more, develop more
 Better vocabulary & IQ scores
 Encourage parents to speak often and become
confident w what they talk about with their child
 Don’t be afraid to expose them

120
Q

Hearing Age

A

 Calculated from when child consistently begins to wear hearing instrument(s)
 Helps put into perspective child’s length of
listening and how they are progressing
 Helps to determine what is appropriate for the
child

121
Q

Functional Auditory Assessment: intrinsic factors

A

cognitive ability, presence of other disabilities, learning style, auditory processing skills

122
Q

Functional Auditory Assessment: extrinsic factors

A

age of identification & intervention, appropriateness of hearing device(s), type & amnt of intervention, parental support

123
Q

Closed-Set Auditory Assessment

A 
 Fixed number of stimuli from which child chooses
correct answer (i.e. picture pointing)
124
Q

Open-Set Auditory Assessment

A

 Items on test are unknown

 Use words w/in child’s vocabulary/age-appropriate

125
Q

Hearing devices available

A 
Hearing Aids
 Traditional
 CROS
 Bone conduction – surgical and non-surgical
 Cochlear Implants
 Assistive Listening Devices
126
Q

history of hearing aids

A

First electronic hearing aid was introduced in the
late 1800’s
 Around 1947 – first commercial use of hearing
aids
 Now all newly manufactured hearing aids are
digital

127
Q

hearing aids: 3 primary components

A

 Microphone(s)
 Amplifier
 Receiver

128
Q

hearing aids: microphones

A

Main Purpose: convert acoustical energy in environment into electrical energy
 2 Types
 Omnidirectional – microphone response is equal from all directions
 Directional – more sensitive to where sound is coming
from by way of a 2nd port
 Front and Back ports

129
Q

hearing aids: amplifier

A

 Takes electrical signal, using a binary
system, and breaks down incoming signal into its components
 Then, based on the HL, it will amplify frequencies and sounds accordingly
 i.e. soft, moderate, or loud input

130
Q

hearing aids: receiver

A

Converts the electrical signal back into an
acoustic signal
 aka Speaker

131
Q

hearing aid styles

A

Essentially 4 Different Classes
 Behind-the-Ear (BTE)
 Receiver-in-the-Ear/Receiver-in-Canal (RITE/RIC)
 In-the-Ear (ITE)
 Completely-in-canal (CIC) or Invisible-in-canal (IIC)

132
Q

hearing aid style: BTE

A

Worn over the ear, or behind the ear, w a tube and ear
mold that is worn in ear
 All 3 components (microphone, amplifier & receiver) are housed within casing

133
Q

hearing aid style: RITE/RIC

A

 Similar to a BTE, but the receiver/speaker is in the canal

 Much smaller than a traditional BTE

134
Q

hearing aid style: ITC

A 
 3 Types of ITE
 Full Shell (largest)
 Half Shell (smaller)
 In-the-Canal (smallest)
 All 3 components are housed within a custom shell that is shape of the patient’s ear (like an ear mold)
135
Q

hearing aid style CIC or IIC

A

 Custom mold that sits much deeper in the canal

 Lose features (i.e. directionality)

136
Q

Hearing aid power source

A

 Battery Operated
 Different Sizes
 Battery life, battery strength, manipulation
 Battery door – opens and closes into casing of either BTE or custom aid
 Rechargeable –not as common

137
Q

hearing aid features

A 
Volume Control
 Programs
 Telecoil (T-coil)
 Direct Audio-Input (DAI)
 Bluetooth
138
Q

Hearing aid features: volume control

A

 Ability to raise or lower the volume
 Mute Option
 Not always enabled, or not available on all styles

139
Q

Hearing Aid features: Program button

A

 Allows the user to manually change setting of instrument
 i.e. omnidirectional, split directionality, mute, TV program
-much more common than volume control

140
Q

Hearing aid features: T-coil

A

Magnetic coil housed w/in casing to pick up and connect wirelessly to an external magnetic signal
 Initial Purpose – telephone
 Induction Loop System – meeting rooms, theatres,
schools, etc. are becoming more and more common
 Can be automatic or a manual program

141
Q

Hearing aid features: Direct Audio Input DAI

A

 Hardwire capability w aids
 Direct input from a sound source (i.e. TV, computer, ipod)
 Usually seen w BTEs

142
Q

Hearing aid features: bluetooth

A

 Wireless options
 Works with cell phones, computers, ipods, etc.
 Can be used w FM-like systems too

143
Q

Hearing aids: selection factors

A 
 Degree of hearing loss
 Age
 Cognitive Ability
 Dexterity
 Surgical/Draining Ear
144
Q

Hearing aids selection factors: degree of hearing loss

A

 The more profound the loss, the stronger and usually bigger the device
 High frequency hearing loss vs. Flat Hearing Loss
 Open Fit vs. Custom mold

145
Q

Hearing Aids: selection factors: age

A

 Infants/Children
 Ears are still growing
 BTE with ear molds that can be changed out as they grow

146
Q

hearing aids selection factors: cognitive ability/geriatrics

A

 Easier to manipulate the better / Ease of insertion
 ITE
 Battery size
 May take away features like volume control or program push button
 No extra accessories (i.e. blue tooth capabilities)

147
Q

hearing aids selection factors: dexterity

A

 How easily can they manipulate device
 Battery size
 Ease of insertion (BTEs vs. ITEs)
 Options like raised push button or volume wheel are available
 Magnetic tool to help inset/remove battery

148
Q

hearing aids selection factors: surgical/draining ear

A

 Stay away from instruments where receiver is in ear (RITE/RIC & ITEs)
 Use BTEs where the receiver is not ear, this way if ear drains, moisture is not going inreceiver, but rather just the ear mold that can be cleaned
 Moisture in the receiver = damage

149
Q

Hearing aids: maintenance and care

A

 Instruments should be cleaned on a somewhat daily basis
 Cleaning and maintenance tools can include:
 Wax pick
 Tubing blower
 Listening stethoscope
 Battery tester
 Dri-Aid Kit

150
Q

3 typical issues that may arise with hearing aids

A

 Dead Hearing Aid
 Feedback
 Signal is Distorted or Intermittent

151
Q

Dead Hearing Aids

A

 Change the battery

 Make sure tubing/ear mold and/or receiver is not occluded w debris

152
Q

Hearing Aids: Feedback

A

 Volume is too high
 Aid was not inserted properly into ear
 Ear mold is too small for the child – ears grow quickly, may need a new mold every 3 months
 Make sure there are no cracks in the casing or tubing
 Make sure the ear canal is not occluded w cerumen

153
Q

Hearing Aids: Signal is Distorted or Intermittent

A

 Inspect the instrument for any moisture
 Listening check with stethoscope
 Problem during humid months of the year – suggest
a dri-aid kit

154
Q

Hearing Aids: CROS style

A

 CROS – contralateral routing of offside signals
 Utilized for unilateral hearing loss/single sided deafness
 A microphone is worn on side of worse ear, which picks up sound patient otherwise wouldn’t hear and routes it to a device in good ear
 Providing patients w info from their nonfunctioning ear

155
Q

CROS

A

 Normal hearing in good ear

 Device worn on good side will not provide amplification

156
Q

BiCROS

A

 Hearing loss in good ear

 Device worn in good ear will amplify sounds in addition to providing missing info from worse ear

157
Q

Hearing Aids: Bone Conduction Styles

A

 Instead of using air conduction in traditional hearing aids, utilize bone conduction to transmit signal
 Useful for patients who have…
 Constantly draining ear
 Malformed pinna and/or ear canal

158
Q

Hearing Aids: Bone Conduction Styles: Non-surgical

A

 Head band with a bone oscillator attached

 Can also provide stimulation via the teeth

159
Q

Hearing Aids: Bone Conduction Styles: Surgical/Implanted

A

 Titanium screw is surgically placed in the mastoid bone
 Oscillator attaches to abutment
 Sends signals via bone conduction

160
Q

Cochlear Implants

A

 Electronic device that allows for direct stimulation of auditory nerve
 Internal Components
 External Components

161
Q

Cochlear Implants: External Components

A

 Behind the ear piece – picks up the acoustic signal
and processes sound into a digital signal
 Transmitter – receives input from the processor and
sends it the receiver under skin

162
Q

Cochlear Implants: Internal Components

A

Receiver – takes input from transmitter and sends signal to electrode array
 Electrode Array – thin wire coil with several electrode channels that will stimulate the auditory nerve

163
Q

Cochlear Implants: Team Approach

A 
 Otologist
 Audiologist
 Speech Pathologist
 Social Workers
 Primary Care Physician
 Early Intervention
 Teacher of the Deaf
164
Q

Cochlear Implants: Trouble Shooting

A

 One difficulty is that you cannot listening to device to see if it is working
 Check function light on processor
 If it is not flashing, the battery may need to be changed
 Usually rechargeable
 Do not last as long as HA batteries
 Check wires and magnet
 Looking for an fraying or disconnections

165
Q

Assisstive Listening Devices

A 
FM Systems
Induction Loop
Infrared Systems
Environmental Adaptations
Personal Listening Devices
166
Q

FM Systems

A 
Utilizes radio frequencies to carry the desired signal
Speaker wears microphone
Signal is delivered via…
 Speaker/Sound Field
 Ear Level device
 Desk Top Speaker
 Coupled to hearing aid
167
Q

Main purpose of FM systems

A

 Increase the signal-to-noise ratio (SNR)
 Direct comparison of the desired signal, i.e. teacher’s voice, to level of background noise
Multiple studies have revealed significant benefits to
device and increase in educational performance

168
Q

Induction Loop System

A

Electromagnetic field is created by a loop of wire around
a room
Microphone transmits signal to induction loop
Hearing aids or personal system picks up signal
 Hearing aid users can use a manual program, or they can automatically switch into this mode as soon as it recognizes magnetic field (T-coil)

169
Q

Induction Loop system can be used as

A

a personal device
 Speaker wears microphone
 Receiver wears a wired loop around their neck, which can send a wireless signal to their hearing aids, or it can be hardwired to headphones
Seen mostly in auditoriums, theatres, boardrooms, etc.
Starting to grow in popularity

170
Q

Infrared Systems

A

Uses light frequencies that are invisible to human eye
to carry signal
Drawback – objects will interfere with signal transmission
Best for smaller spaces, or open areas
Home use with TV
Can be seen in cinemas, theatres, etc.

171
Q

Environmental Adaptations

A

Amplified phone speaker and ringer
Alarm systems that utilize flashing lights or vibrations
 Emergency Signals – fire alarm, carbon monoxide
 Other: crying babies, door bells, alarm clocks, etc.
TDD – telecommunication devices for deaf
Closed Captioning for the TV

172
Q

Personal Listening Systems

A

Hardwired devices
Composed of a microphone, amplifier, and speaker/headphones
Good for patients in nursing homes, with dexterity issues,
cognitive decline, visual impairments, etc.
Easy to use and manipulate

173
Q

ASSISTIVE LISTENING DEVICES IN

SCHOOL

A

Educational Audiologist
 Determines, fits, and manages/monitors the device(s)
Absence of Educational Audiologist
 SLP – work w student’s private audiologists, who will determine appropriate device for child
 SLP & TOD – manage and monitor device and child’s progress
Schools may want to contract a private audiologist to help w selection, fitting and management

174
Q

ASSISTIVE LISTENING DEVICES IN

SCHOOL: MANAGEMENT

A

IDEA (2004) strengthened responsibility of device
management
Students’ IEPs should include a monitoring plan and who is
responsible

175
Q

ALD: MEASURING PERFORMANCE

A

Objective & Subjective Measures
Observe the classroom environment
 Seating arrangements, classroom design, acoustics
 Observe child’s performance & behaviors
 What is expected on the students, i.e. participation level
Questionnaires – students, teachers, and parents
Function Assessments – measures performance
Use these tools pre- and post-modifications to validate
and set goals

176
Q

SCHOOL SERVICES & HEARING LOSS

A

Children w HL are not automatically eligible for special
ed and related services
IDEA – eligibility requires an “educational manifestation”
of disability
Section 504 – impact on education would be “substantially limiting one or more major life function(s)

177
Q

School services and deafness

A

a hearing impairment that is so severe that child is
impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance

178
Q

school services and hearing impairments

A

an impairment in hearing, whether permanent
or fluctuating, that adversely affects a child’s educational
performance but that is not included under definition of deafness

179
Q

ASSISTIVE LISTENING DEVICES IN THE

SCHOOL

A

Remember that no 2 children are same
2 Children may present with the same degree and nature
of HL, but their educational consequences may be very
different
Auditory Processing, learning style, and behaviors will
have a large impact

Audiology FINAL (1 decks)

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