Final Flashcards
What kinds of communication problems do person’s w/ hearing loss demonstrate? (9)
– Disrupted taking of turns. – Modified speaking and listening styles. – Modified conversational style. – Less rich imagery. – Inappropriate topic shifts. – Superficial content. – Frequent clarification. – Violation of implicit social rules. – Disrupted grounding.
4 factors that we need to teach the hearing impaired to try to modify.
- Strategies that influence the talker
- Strategies that influence the message:
- Strategies that influence the environment
- Strategies that influence a message’s reception.
Instructional strategy (Strategies that influence the talker)
listener asks talker to make a change. Ex. Could you please face me when speaking? Or “ Can you talk a little slower?
Message-tailoring strategy
Strategies that influence the message
Asking specifics in the questions. Ex. Did you go swimming or biking today? Instead of “what did you do today?’
– This is a type of metacommunication- thinking in advance what you want to say and what is the best way to phrase it is in order to get the response desired.
Constructive strategy (Strategies that influence the environment)
What type of things can you change? – turning off the tv. Go to a quieter restaurant. Move closer to the listener.
Adaptive or anticipatory strategy
Strategies that influence a message’s reception
serve to counteract maladaptive behaviors. Relaxation techniques. Help hearing impaired deal with issues of anxiety and worry of not being able to keep up with the conversation. Stop and take a deep breath.
o In addition, those with hearing loss can anticipate potential vocabulary and conversational content.
• Example, prior to a job interview, a person might become familiar with typical interview questions, as well as the employer’s policies, or key staff.
Receptive and expressive repair strategies
– Receptive repair strategies feature the talker repeating a message, or providing additional clarifying information.
– Expressive repair strategies can help when the patient has trouble articulating a message (i.e. writing or hand signals).
3 stages of rectifying a communication breakdown
• Detect Communication Breakdown • Choose Course of Action: – Use repair strategy – Disregard utterance – Bluff
What is topic shading
– Studies suggest that the more conversations shift in topic, the more likely a communication breakdown will occur.
– Topic shading can further confuse, as a new topic is introduced, but it is a direct offshoot of something that was already being discussed.
• Ex: Topic shading
• Women w/ HL: “I’m going to Chicago tomorrow.”
• Gentleman: “Are you driving or flying?”
• Women: “”Flying.”
• Gentleman: “I’ve got to get my tickets for my NY trip.”
• Women: “Huh?”
• Topic is the same but the content/meaning has changed.
Consequences of using repair strategies (3)
– Research shows that when communication breaks down, the speaker usually repeats a statement.
– Studies have shown that messages become more clear following a breakdown if the speaker restructures statement with more context.
– In some cases, nonspecific repair strategies are appropriate (to preserve conversation flow).
Specific vs. non-specific repair strategies
– When those with hearing loss do not understand a message, responses such as “What?, Huh?, or Pardon?” are non-specific repair strategies.
– Specific repair strategies feature explicit instructions for clarifying the conversation.
Styles of conversation (4)
- Passive – avoids misunderstandings/conflict (must common in those with HL)
- Aggressive – exhibits hostility or intimidating demeanor.
- Passive-Aggressive – manipulates conversation for later vengeance.
- Assertive – communicates effectively, finds solutions (most desirable)
Incidence of hearing loss in newborns and then by school-age
- Three children per 1,000 births
* An additional six-per 1,000 acquire by school-age.
Universal newborn hearing screenings: Why do we do this, what tests do we use?
- Children who receive intervention services demonstrate significantly better language, speech, and social-emotional development than those who don’t.
- TESTS USED: (tests that doesn’t require the subject to do anything) OAE, ABR, BOA
BOA (Behavioral Observation Audiometry )
(Ages Birth to about 6 months (+/-) Observation of child’s response to sound.
• Consists of audiologist watching child for behavioral change
• Shows lowest level of responsiveness vs. hearing threshold
• Some babies may react to 20 dB HL sound levels and others will not react until 60 dB HL
• Large correction factors based on developmental age
• Can be highly subjective: i.e. observers expectations can basis outcome
• Responses to Sound:
• Reflexive (Startle, Limb jerks, Eye blinks)
• Attentive (Quieting/increased activity, Change in breathing rate, Onset/cessation of vocalizations, etc.)
Visual Reinforcement Audiometry (VRA)
(6 mons.-2.5 years) speaker in quiet room with a toy that lights up- must have head control to do this in order to turn to localize sound.
• Able to obtain individual ear information.
• SF, insert earphone, headphones, bone conduction or aided response testing as well as SRT/SDT
Conditioned Play Audiometry (CPA)
(Two or more years of age.)
• “Wait and listen” behavior.
• Use of familiar toys – E.g., puzzles, blocks.
• “Place a block in the bucket” in response to sound
• Can also be used for speech testing.
Risk factors for hearing loss in infants (10)
– Low birth weight (less than 3.3 pounds)
– Family history of hearing loss
– In utero infections such as cytomegalovirus, rubella, or herpes
– Ototoxic medications
– Low Apgar scores
– Need for ventilator for 5 days or longer
– Craniofacial anomalies
– Physical manifestations consistent with a syndrome
– Bacterial meningitis
– Hyperbilirubinemia (severe jaundice)
APGAR scoring
(0-2 scoring for each category) • A = activity (muscle tone) • P = pulse • G = grimace (reflex to irritability) • A = appearance (skin color) • R = respiration
Auditory development 0-2 months
Cries
Startles to loud and sudden sound
Auditory development 2-3 months
Laughs. Forms sounds in back of mouth (“gah”)
Responds to parents voice
Distinguishes change in tone of voice (happy vs. sad)
Auditory development 4-6 months
Turns head toward sound
Begins to put sound together
Usually consonant and vowel.
Makes nonspeech sounds playfully (“raspberries”)
Auditory development 6-12 months
Babbles strings of syllables (“bah-bah-bah”)
Attempts nonverbal comm through facial expression, eye gaze, vocalizations and gestures
By 12 mos., responds to name, understands “no” and simple instructions, gives a toy in response to request
Auditory development 12-18 months
Speaks 1st words
Understands phrases like “all gone”, “bye-bye” and starts to say them
Strings sounds together that have an adult-like speech rhythm
By 18 mos., understands about 50 words and speaks about 20 usually in isolation and begins repeating words over heard in conversation
Auditory development 18-24 months
Carries out verbal commands to select and bring a familiar object to you and understands commands (“sit down”, “stop that”)
Recognizes body parts
Enjoys nursery rhymes and songs and can join in
Understands simple requests and instructions
Asks simple questions (“Where’s Daddy?”)
Asks for the name of objects (“What’s this?”)
Non-genetic causes of hearing loss in children
Prenatal
Perinatal
Postnatal
Prenatal- Toxemia= while pregnant, the mother develops hypertension or a sharp spike in blood pressure which causes swelling of the hands and feet as a result of the excessive body fluid
Perinatal- anoxia= prolapse of the umbilical cord and a change in oxygen to the baby’s brain
Postnatal- meningitis or use of ototoxic medications
Genetic causes of hearing loss in children: Incidence and confirmation
- Represents half of congenital hearing loss.
- Confirmed by physical examination, family history, ancillary medical testing such as a computed tomography (CT) scan of the skull, and molecular genetic testing.
- Many hearing losses based in genetics are part of a syndrome (ex. Waardenburg, Usher’s or Alport).
Other disabilities that can occur with hearing loss (5)
- Cognitive delays.
- Vision impairment.
- Learning disabilities.
- Autism
- Attention deficit disorder.
CAPD (Central auditory processing disorder) (5)
– Central cause - not peripheral hearing loss.
– Transmission of signal from brainstem to cerebrum.
– May or may not know cause.
– Difficult to diagnose
– Difficulty with localizing sound, auditory discrimination, recognizing auditory pattern, and associating meaning to sound.
ANSD (Auditory Neuropathy Spectrum Disorders) (5)
– Affects peripheral auditory system. – Usually mild to moderate hearing loss. – Present, normal OAE’s – Abnormal or absent ABR. – May have poor speech recognition skills.
Tinnitus in children
– Affects 25-55% of children with hearing loss.
– May inflict insomnia, emotional trauma (fear and worry), physical symptoms, attention difficulties, and listening challenges.
– May be hard to detect in children as they lack context to normal hearing.
Circular pathway model of grieving (6)
- Shock and denial
- Guilt
- Bargaining
- Anger
- Depression and/or detachment
- Acceptance (the work begins)
Goals of early intervention (3)
– Enhancing development.
– Minimizing possibility of developmental delay.
– Enhancing accommodation of child’s needs.
Public Law 94-142: what did this cover? Who did it cover?
– Education for All Handicapped Children Act (1975)
• Guaranteed free and appropriate education for all children with disabilities, ages 6-21.
• Special education provided at public’s expense under public supervision.
