Final exam Flashcards
1
Q
5 components of language
A
Form:
Morphology
syntax
Phonology
Content:
semantics
Use: pragmatics
2
Q
Factors affecting language acquisition
A
Other handicapping conditions Degree of loss Age of onset Cultural and linguistic diversity Early intervention Cochlear implant use
3
Q
Other handicapping conditions other than hearing loss
A
40% of deaf people have OTHER disabilities like: Cognitive impairment ** most common** Learning disability Intellectual disability ADHD Visual impairment Cerebral Palsy Emotional disturbance
4
Q
Predictors of our language development
A
greater hearing loss the greater the language delay is
Child’s ageHUGE predictor of how language development will be
Age of onsetHUGE predictor of how language development will be
Cognitive status
Often times(but not always) the greater the hearing loss the greater the languagedelay
3 key factors: increased client diversity, early intervention, availability of cochlear implants
5
Q
3 key factors that greatly impact speech language
A
increased client diversity, early intervention, availability of cochlear implants
6
Q
Cultural and linguistic diversity facts in language
A
- largest populations are white then Hispanic then African American then Asian American WHICH reflects the deaf communicatee also
- right now, are majority are still western European, but by 2050 various linguistic backgrounds in US will be up to 50%
- The number and impact of individuals from various linguistic and cultural backgrounds in the US are increasing.
The most common language spoken in homes of children with hearing loss, besides English, is Spanish.
Interpreter or appropriate referral may be required.
** clinical is NOT proficient in the patient native language it is best to hire interpreter or refer client to another clinician
7
Q
language acquisition: Early intervention
A
The earlier deaf individuals get identified the better their prognosis is. BUT early identification for the deaf individuals is NOT a strong predictor for speech intelligibility.
8
Q
Cochlear implant use in language acquisition
A
- 1990 FDA approved cochlear implant use in children
- age of implantation of 12 month’s is critical
- cochlear implant use results in spoken language development that surpasses what is typically seen with the use of power hearing aids
- Implanted before age 5, their potential for developing appropriate language skills Is good, but after they may have some difficulties.
- Spoken age of development is said to surpass individuals just using hearing aids if implanted before the age of 5.
9
Q
Schemas
A
- Typical developing child has typical sequences of events and communication at dinner time, bath time and bet time,over time the child stores and remembers a body of knowledge and can anticipate what is going to happen next (called schema) about these events and forms.
- Children with impaired hearing often have limited schemas! 2 main reasons: Can not hear mom and dad AND miss out on learning opportunities
10
Q
Early vocabulary in preschool children
A
HL identified BEFORE 6 months have a rate of vocab growth similar to normal hearing people
HL identified AFTER 6 months have significant delays in language acquisition rates
11
Q
Language characteristics in school aged children with hL
A
Significantly better language outcomes for early identified school age children with lesser degrees of hearing loss
- lexical-semantic skills
- syntactic morphologic skills
- pragmatic skills
12
Q
Lexical-Semantic Skills
A
varies depending on hearing impairment. Mildly to profoundly delayed, depends on age of onset. Reduced vocabulary and figurative language, more direct (wouldn’t understand its raining cats and dogs).
13
Q
Syntactic-Morphologic Skills
A
more difficulty with overuse nouns and verbs, and omit functional words like pronouns, prepositions, axillary verbs. Stick to just basic forms, nouns and verbs. With nouns and verbs they use subject, verb, object form. Plateau in expressive, skills. Misuse morphological markers such as ed, “me goed store”.
14
Q
Pragmatic skills
A
have difficulties with topic initiations, maintaining topics, turn taking, raping up a conversation. Research shows that there is a steady progression in their conversational skills as they get older.
15
Q
Plateau in language acquisition
A
Very little growth in semantic and syntactic skills of children with severe hearing loss AFTER 12-13 years
BUT as professionals it would be wrong to assume that no language growth is possible after age 12
We can try:
- to see have no other handicap disabilities
- work on something you notice some improvement on
- look at patterns to see if there can be some development
16
Q
preliteracy and literacy issues
A
- low reading and writing proficiency skills for children HL have been related to limited oral language skills
- poor phonological awareness (being able to manipulate sounds or words, blend sounds, decoding, rhyming)
- Literacy issues can be a possible sign of dyslexia.
- children with HL don’t have as much literacy exposure as their hearing peers
17
Q
Treatment goals for language development for deaf childre include the followingL
A
- Focused on a lot of parent-child communication, important to have parents be in therapy sessions.
- Understanding of increasingly complex concepts and discourse
- Acquisition of lexical and world knowledge
- Development of verbal reasoning skills as a foundation for literacy attainment
- Enhanced self-expression and acquisition of pragmatic, syntactic, and semantic language rules
- Development of spoken, written, and/or signed narrative skills
Typically a lot of what goals will enhance, but depends a lot on child, modify according to client.
18
Q
Tradition formants in language intervention
A
- Drill and practice
2. Working in their natural environment
19
Q
Drill and Practice Formant
A
For elementary and upper age kids
- may be boring for children not in school.
- do not allow children time for social interaction
- do not teach how to hold or maintain a conversation.
20
Q
Working in natural environment formant
A
Forms, functions or structures in everyday contexts.
- Gives them a reason to communicate.
- Language facilitation of everyday events is open to all children regardless of spoken or signed language.
- Important for children, parents or teachers to facilitate, rather than just teach or drill.
- Adults can learn to facilitate.
- True conversation is characterized by contingent, shared topics and mutual topics.
- Parents tend to over narratee, learn to give child opportunity to communicate to.
21
Q
Strategies for developing conversational skills
A
- Recasting: Adult is commenting on the Childs attempt of semantics utterances. Adult will recast utterance but with appropriate form or structure
EX: Daddy eated cookie DAD says: Yes daddy ate the cookie. NOT MAKE CHILD REPEAT - ## Developing Schema: Provide intentional schemes; if going to the doctor parents read a book on what will happen as the doctor with details. PUPUSEFULLY plan events that will happen in life.
22
Q
Preliteracy and literacy activities
A
** Individuals that have hearing impairment should still have labels, be read to, given opportunities to draw.
Just cause they have a hearing impairment doesn’t mean you don’t have to do these activities with them.
- words on labels or common signs can be pointed out
- story reading and retelling
- draw pictures
- trace letters
- watch their stories be written down by parents
23
Q
Bilingual education for children who are deaf
A
- Bilingual-bicultural approach to communicating with education of deaf children
- ASL would be used for academic instruction AND interpersonal communication in the classroom
- english skills would be taught through written language with explanations given using ASL
24
Q
Speech characteristic of individuals with postlingual profound HL
A
(1) decreased vowel space due to centralization of the first two formants
(2) inaccurate production of /s/ and /sh/
(3) similar voice onset time values for voiced and voiceless plosives
(4) substitution of /r/ with /w/
(5) tendency to omit consonants in the final position of words.
25
Speech management for individuals with severe to profound HL
Speech training needs to be as meaningful as possible
Speech targets should appear in words that a child would learn about in natural contexts.
approaches may enhance speech training in individuals with hearing loss:
(1) early and consistent use of devices to provide optimal use of residual hearing
(2) anatomic and pictorial monitoring
(3) visual cues
(4) use of complex feedback aids or devices
26
The hanen program
Company created in Canada to educate parents on how to facilitate communication with their children
Tool needed to hold parents workshops on how to facilitate communication
AAA:
Allow: take lead on what they want to talk about
Adapt: adapt your language to what child is doing
Add: adding to what a child produces
27
The hanen program: Allow
Allow the child to lead by:
Observing
Waiting
Listening
28
The hanen program: Adapt
Adapt to share in the activity by:
- being face to face (sit with the child on the floor)
- let the child know you are listening (BY imitating, interpreting, commnetingo n what you are doing and what they are doing
- using verbal or non verbal signals as well as appropriate questions to keep the conversation going (Appropriate because cultures and different, some things are appropriate and others are not. Putting hand on shoulder is fine, but never touch their face and turn it.)
- creating high interest activities
29
The hanen program: Add
- Imitating and adding a new word or action (child's says ball and you say play ball or bounce ball, to modify and model language)
- Interpreting the child’s non-verbal message
- Expanding on the topic
- Highlighting information by
- Emphasizing key words
- Using gestures
- Providing repetition
30
Hard of hearing:
having a mild, moderate, or severe hearing loss with some ability to understand speech with the use of hearing aids or other amplification.
31
Deaf
individuals that have a bilateral profound hearing loss where even with powerful hearing aids, speech generally is not perceived (no benefit) in auditory-only perceptual situations.
32
HL affect on self perception
Internalize their actions and allow other attitudes define who they are.
EX: if someone sees them as capable then they will believe they are capable. (and vise versa)
They are at risk are developing poor self perception of themselves. Society does not fully accept the HL or Deaf community.
Self-perception is learned by absorbing the input, feedback, and reactions from those around us.
Children with a hearing loss are typically:
Less socially accepted
Have lower self-esteem
Different than others (know they are different than others)
How to help: acknowledge that they are different. It would be a disservice to dismiss society ignorement and bad views. We should not let society define them by knowing they are different and need certain things like the hearing aids.
33
HL affect on emotional development
Language is used to describe ,interpret and understand their own emotions. Without language they struggle/ have a delay on the understanding of their emotions and the emotions of others.
They miss out on overhearing their family talk about the emotions and how handle them .
Children with hearing loss are less accurate at identifying person's emotional state.
34
HL affect on Family (concerns)
90% of children with hearing loss are born into families with normal-hearing parents. They have little to no experience with HL; diagnoses of HL is very devastating for them.
Parents often experience emotional reactions consistent with the stages or phases of the “grief cycle”.
Grief cycle:
Shock: Something that was not expected
Denial: Diagnosis does not match what they wanted for their child
Depressed: Helpless and depressed but they start thinking about the child's future life which gets them started on how to work with it.
Acceptance: Move on to work on it or ignore it
35
Poor and limited communication results in poor social competence, which includes these skills:
Capacity to think independently
Capacity for self-direction and self-control
Understanding the feelings, motivations, and needs of self and others
Flexibility
Ability to tolerate frustration
Ability to rely on and be relied on by others
Maintaining healthy relationships with others
36
Social competence for adolescents
- Peer relationships take paramount importance for teens, yet these relationships may be strained when hearing loss is involved.
- For teens with hearing loss, they have a desire to reject amplification for the sake of conformity. This desire may also represent a struggle to accept oneself as a person with a disability. Overall, it is agreed that “during adolescence, being different is generally not valued.”
- Professionals who serve adolescents face the challenge of helping with the here and now issues of self-identify, as well as concerns of the imminent future
- Self-consciousness and mood swings increases and they feel overwhelmed with the emotionas they do not know how to communicate; making this much harder for deaf children.
- Mothers say that children with HL children are less bonded to their friends. But when they have a friend with HL also then they feel less alone.
37
Acquiring a HL
- Most individuals acquire some degree of hearing loss as part of the aging process.
- Occasionally, adults also acquire hearing loss as a side effect of some medications or as a result of head injury or noise exposure.
- Adults also experience psychological, emotional, and the previous social effects described with respect to children.
38
Adult Self-Perception
- usually wait 7 yrs form the time they first noticed hearing problems
- usually go because a family member is making them
- like to place fault on other (they speak to quietly, they are mumbling etc)
- only about 20% of the population who would benefit from the use of a hearing aid actually obtain and use them. WHY? denial, cosmetics and costs
39
Psychoemotional Reactions in adults with HL
```
Adults have a full range of emotions and psychological reactions to a hearing loss such as:
Anger “why me?”
Anxiety and Insecurity
Stress
Resentment
Depression
Grief
```
Adults with hearing loss struggle regularly with conversational exclusion, which can lead to behaviors that would suggest paranoia.
40
Social concerns in adults with HL
An adult with hearing loss may seclude themselves out of favorite activities because listening challenges are too stressful. Leading to depression etc.
Regular attendance at family and leisure activities are lessened often with excuses about losing interest, rather than recognizing the root of the problem.
Acquiring hearing loss is a gradual process and is identified first by the family and friends before the patient it self. Family goes through the same cycle as they would in a children.
41
adults being deafened
- no pre-established ties to the Deaf community, yet also face challenges in maintaining their ties to the hearing world.
- sounds that are so basic to our lives that we are not aware of their occurrence. People who suddenly lose their hearing frequently report that the world has become “dead” to them.
- hearing aids and cochlear implants often provide much psychological relief to many deafened adults. Recovering some degree of sound perception, even if only at the primitive level, can result in reduced anxiety and depression.
* have an identify crisis
42
Psychotherapy:
intends to help patients explore unconscious behavior patters to alter ways of relating and functioning by examining and challenging personal history and by analysing the meanings of ones response
Views patient in being ill and searches for cause of that person's problems; routed form family problems or trauma.
43
Professional Counseling :
family counselors, school ,ministers, social workers: support personal adjustments by helping a person adjusting his or her feeling and negage in problem solving. How are they going to deal with it in certain situations. (NOT US)
44
nonprofessional counselors
What we do: SLP will counsel in speech and language disorders; informational counseling (content of that disorder) and personal adjustment counseling (bc of HL how can they adjust to certain situations).
45
The Counseling Process
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Help patients tell their story
Help patients clarify their problems
Help patients take responsibility for their listening problems (challenge themselves)
Help patients establish their goals
Develop an action plan
Implement the plan
Conduct ongoing evaluation
Long-term success in adjusting to hearing loss may ultimately depend on the effective management of the first three steps, because they usually involve an understanding of the psychosocial and emotional impact of living with a hearing loss (bc they involve more of physiological and emotional impact of living with a hearing loss)
```
46
Help Patients Take Responsibility For Their Listening Problems
There is a real risk at this stage for the professional to take over and tell the patient or parent what to do: obtain and use hearing aids, learn sign language, or enroll in speechreading classes.
Another behavior that indicates that patients are not yet assuming the responsibilities of living with hearing aids is placing blame on other for communication breakdowns. Audiological rehabilitation must take its cue from other helping professions and place responsibility for successful rehabilitation squarely on the patient.
Substituting "AND" for "BUT" when adults struggle with the cosmetics of hearing aids.
Patients will usually say “I want to hear my grandchildren, but I don’t want to wear hearing aids”. Helping the patients say and instead of but then they have a better chance of obtaining that goal.
47
when to refer to a professional counselor?
Marital problems, family dissension, parenting dilemma, financial or legal stress, fragile emotional and mental health, all these situations can be exacerbated by the presence of hearing loss.
Stick to scope of practice. Make appropriate referrals to the appropriate profession when necessary.
48
Why do we need to provide Audiological rehabilitation in the schools?
Early intervention is key
Parents are not invested/have the resources to help their kid or notice something is wrong
Work hand in hand with teachers
Education is given through auditory input; if not there they experience language difficulties (reduced vocabulary ,delay syntax) which can affect the cognitive learning
Helps them develop skills needed to be competitive in school and then later in college or job
49
Normal hearing VS profound HL comparison by age
18 months: Normal: consistency and intent when using 25 word HL: No words; they gaze more.
2-3 years: Normal: understand directions, short sentence & ask questions; being more curious HL: Few words, yells and points to express desires
3-4 years: Normal: Makeslong sentences HL: Some single words
4-5 years: Normal Uses “Why” and “how”; past and future tense, 2,00 word vocabulary HL: has more single words
5-6 years: Normal: Grammar and syntax used correctly HL: Asks the name of things
6-7 years: Normal: know about 16,000 words HL: asl questions
7-8 years: 22,000 words HL: Uses mostly nouns, sobe verbs, pronouns, articles
9-10 years” Sentence length of approximately 12 words HL: Reading vocabulary at approximately 15 percent of normal
17 years more than 80,000 words HL: Vocabulary less than 3rd grade
50
Hearing Impairment:
Non specific; only indicates some kind of hearing loss that is present. Does not tell us about degree of HL or nature of HL.
* HL are 10 times more likely to fail a grade than a child with normal hearing.
* Degree of hearing loss and degree of impact it has on education: Severe HL will have a severe time in school BUT it is not to say that mild hearing loss child will have the same difficulty in education.
51
Hard of Hearing:
A child has a mild to moderate or severe hearing loss; usually tell you if its bilateral or unilateral.
52
Deaf:
Severe hearing loss; perceive little to no benefit with hearing aids. Deaf with “D” culture and little ‘d’ is a person who just has severe to profound hearing loss
53
IDEA-(Individuals with Disabilities Education Act):
Ensures that children with HL receive appropriate education
3 components
- Guarantee of FAPE (Free Appropriate Public Education): The services needed to support a child with HL are paid by public funds instead of the parents. “appropriate” is left undefined because it is at individual based for each client.
- FAPE is provided in the least restrictive environment
- That a child's educational plan will be documented with the use of IEP (Individualized Educational Program).
54
Least Restrictive Environment (LRE)
LRE: is the requirement in federal and state law that students with disabilities receive their education, to the maximum extent appropriate, with nondisabled peers.
* to be included as much as possible with their peers
55
Educational Options
Regular education with in class support: In class support with SLP in classroom
Regular education with pull out support: Student will be pulled out for extra support
Part time special education: Part time in special ed room
Full time special ed sperate class: Full time in different classroom
In the past children with HL would be automatically placed in special education classrooms. They had to prove that were competent enough to be in regular classrooms.
56
LrE for a child with hearing impairment
A child with mild to moderately severe hearing loss MAY succeed in a regular education classroom if full support is provided to address the variety of language and listening needs that can impact learning.
The appropriate environment becomes a more complicated issue for the child who is deaf.
The US Department of Education (DOE) has stated that the following factors are of important when determining the LRE for a child who is deaf:
Communication needs and the child’s and family’s preferred mode of communication
Linguistic needs
Severity of hearing impairment and potential for using residual hearing
Academic level
Social, emotional, and cultural needs of the child, including opportunities for peer interactions and communications.
57
Individualized Education Program (IEP)
The services to be provided to a child with a hearing loss (or other disabilities) are described in a document called the IEP.
Committee includes: parents, teachers, school administrators, related service providers
Including SLP, OT, nurses, anyone that would be related to the child's services
Document required a lot of time, work to review the child and provide appropriate goals
Parents must be there to talk about their childs
58
AR services provided in schools
Screening of hearing impairment
Management of amplification
Direct instruction and indirect consultation
Hearing conservation
Evaluation and modification of classroom acoustics
Transition planning to postsecondary placements
59
SChool: Screening of hearing impairment
Newborns are screened @ born when not passed parents are instructed for further assessment; if they do have HL then they are referred to early intervention program for SLP etc.
Screening is required by law; every year. Now a days mild high frequency hearing loss because of headphones, iPad and phones. See how stable their HL is throughout the years.
* kinder - 12 grade
60
School: Management of amplification
- Amplification includes: personal hearing aids, personal FM systems, cochlear implants, sound field amplification, and assistive devices.
- Without systematic monitoring programs, hearing aids and personal FM systems can be expected to have a 50% failure rate of operation.
- Day to day management of amplification depends primarily on teachers, classroom aides, and SLPs.
There should be 0 tolerance for any malfunction of amplification devices. Should be day to day managements; which would depends on SLP, teachers, high school aids to make sure everything is working correctly.
61
Direct instruction and indirect consultation
- Direct instruction may be needed for children with hearing loss in developing their listening skills, speech production, and use of language.
Within classroom, one on one, in small groups, or children may leave the classroom to join a teacher, SLP or audiologist in another resource room.
- Direct instruction may not have much relevance for a child who is deaf.
If a child’s needs are not very involved or if personnel are not available for direct support, indirect consultation may take place among teachers and related service providers.
62
Evaluation and Modification of Classroom acoustics
Noise Level: The higher the noise level, the harder it is for children with hearing impairment to hear oral instruction.
Reverberation: echos or prolongation of sound waves that reflect off the hard surfaces in the classroom. It interferes with speech perception by overlapping with the energy of the direct signal of the teacher’s voice.
Distance: will affect the perceived sound level of the teacher’s voice. Sound level of typical speech is at 60 dB. If they walk further then that level drops and they can not hear.
Ideal solutions: wireless FM systems
Personal FM system
Sound Field FM system
63
Individualized Transition Plan (ITP).
AR services are expected to support a child through to a successful high school graduation, but even here planning for the future is required.
Purpose of transition is to make sure child is prepared to enter college, or vocational training, Even though students with HL enter college at normal rate. The dropout rate is higher. They need support system to help them be successful in college.
64
(Central) Auditory Processing Disorder (CAPD)
- Normal hearing but they struggle to understand what they hear
-difficulties in the perceptual processing of auditory information in the CNS as demonstrated by poor performance in…
Basically, their ears and brain don't fully coordinate.
Do not recognize subtle differences between sounds in words
Problems typically occur in background noise, which is a natural listening environment.
So kids with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.
sound localization and lateralization
auditory discrimination
auditory pattern recognition
temporal aspects of audition (e.g., temporal gap detection)
auditory performance in competing acoustic signals (including dichotic listening): most difficulty with if they hear something that distracts them then they might miss what the teacher says affecting their learning
auditory performance with degraded acoustic signals
65
Secondary behaviors to determine possible presence of CAPd
- Responding inconsistently to auditory stimuli: sometimes they will understand directions sometimes they will be confused by those same instructions
- Demonstrating a relatively short attention span become easily fatiequed when working with long tasks
- Appearing overly distracted by both auditory and visual stimuli. Not bale to filter out things that are relevant & irrelevant in their tasks.
- Frequently requesting information be repeated: saying huh?
- Having problems with short-and long-term memory skills
66
CAPD treatment
traditional auditory training
Detection: detect if sound is present or not
Discrimination: Determinate if sound are the same or different
Identification: To be able to label sound and source; where the sound is coming from
Comprehension: understand
Their self esteem is really low and fatigue is really high because they feel like all they do is fail.
67
Deaf Prevalence
1 in every 1000 children in the US are deaf
+ 20 to 40 in every 1000 are HOH (hard of hearing)
1 to 2 million school-age children are severely hard of hearing
3 million with mild hearing loss
10 million if birth to 5 population is included
68
Services vary by degree
Severe to profound loss – 92% served
Mild loss – 27% served (
Overall, for school-age children – 46% served
Less than 50% were amplified when needed
69
Management from birth to preschool
- family centered practices instead of child focused
- parents are experts in infants developtment
- focused on faamily involvement and decision making
- IF parent gives 10 interactions per hour in everyday activities a todtler would have more than 36,000 learning opportunitires between ages of 1-2 yrs old
- techniques to support quality relationships and interactions between infants and their family members
70
Principles of Family-Centered Practices:
- The primary goal of early intervention is to support care providers in developing competence and confidence in helping the infant learn.
- Family-identified needs should drive the intervention agenda; keep into considerations the parents' desires and wants including values, cultures and goals
- Family members are recognized as the constant and experts in the child's life and development.
- Families are equal team members
- Professionals respect the decision-making authority of the family
- Services should be conducted in the child's natural environment. WHY? Because using materials ,routines, environments they use in their everyday life it will help the skills you want them to learn and get the parents more involved.
71
Effectiveness of Early Intervention
Reduces familial stress: bc family tends to stress when they get the diagnosis)
Increased parental self-confidence: Social support is very important.
Better communication: between child and family members regardless of hearing loss, background or communication style
The earlier the intervention the better regardless of level of loss, background, communication mode: child approaches have limited success
72
What is the reason for early intervention?
Try maximize the sensitive period in speech development. The later they get help the more difficult it will be to learn and pick up the point. Critical period is also in danger.
73
SLP Roles
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information resource
coach/partner
joint discoverer
news commentator
partner play
Joint reflector and planner
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74
information resource
Providing information and sharing information about responsibilities within each family member. EX: teaching to play wit child's eye level
75
coach/partner
you are not the dictating expert: The clinician is on sideline providing tips and guidance to support the interaction between parent and child EX: Playing with cause & effect today; SLP tells parent to point to the toy when child makes it make a noise
76
joint discoverer
“try this and we’ll see what happens”: Both parents and clinician are performing experiments with child; try something and see if it works or not. EX: Baby not paying attention to you because of a toy; so decided to remove it and try again to see if baby pays attention
77
news commentator
observing and commenting on what’s working providing descriptive feedback on the actions they are doing “the baby is vocalizing more when you do __”
78
partner in play
take turns playing to model: Clinician demonstrates a skill and then parents tries to demonstrate the skill right after to see if they child gets it right after the same
79
Joint reflector and planner
what did we learn and what can we do next time” Talk about the behaviors that we tried elicit with the child, what worked or not, what did you learn from the child and planning for the next time.
80
Prelinguistic communication signals:
Crying, yelling, gestures, eye contact, pointing
81
Joint attention:
Sharing common focus on something; very important. Beginning skill, you need to learn how to turn take; a lot of kids do not have it.
82
Parallel park:
Filling in the blank for what the child is doing. Describing what the child is doing, seeing, thinking to go hand in hand on what the child is experiencing.
83
presbycusis
age related hearing loss
- high frequency sensory neural HL that progresses gradually
- damaged to the basal end of the cochlear (where high frequencies are) (apex/apical = low frequencies)
WE ALL HAVE IT to some extent
84
phonemic regression
- perceptual confusions and distortions of the phonetic elements of speech
- hearing aids not as helpful bc of central auditory processing disorder
- greater difficulties than would be expected given the degree of hearing loss
85
physical and mental health with aging
- physical and mental health are linked (EX: Finals week is when you get sick bc of how tired you are)
- CANT assess effect of aging based solely on someones chronological age
- Seniors adults eventually need to adjust to a certain amount of physical disability; which can affect their attitude toward self-fulfillment
- Senile: inattentiveness, inappropriate responding which result from clinically significant cognitive impairments OR depression or psychological stress
86
Personal and environmental factors affected with aging
- physical condition: changes in body causing poor health and emotional consequences (1st to decline)
- emotional and sexual life: death, health, personal preference or death of partner
- members of the family of origin: parents, brothers, sisters can pass away; which means they are alone
- marital relationship: illness of spouse, death, empty nest syndrome
- peer group: friends pass away, or move away
- occupation: they retire! identity crisis
- recreation: Physical limitation which makes this not as common. EX: things you used to do for fun you can't do it anymore SO you need to find something else
- economics: Income is reduced by retirement
87
Elderly living environments
- living at home: mentally & physically healthy enough to take care of themselves OR has someone to help
- retirement home: more independents LESS help from people. They receive less help. Individuals that have some independence, do things themselves. EX: they can still cook for themselves, clean room, laundry
- nursing home: require MORE assistance and are less independent. Nursing home will do ur laundry, give medications, will cook for you, make you be social
- palliative care: End of life care or called hospice. Not to improve function but make someone comfortable at the end of their lives. SLPs do not performer therapy to improve anything they just help to communicate with their families/doctors.
88
Rehabilitation Management for the elderly population
- counseling
- audibility and instrumental interventions
- remediation for communication activities
- environmental coordination and participation improvement
89
Elderly population: counseling
| CCSS
Identifying understanding and shaping the attitude and goals that influence health seacing, decision making and action taking with emphasis factors that reinforce their adjustment on hearing difficulties.
- Communication (exchange info & social interaction) goals and style
- coping behaviors to communicate: (controlling) (avoiding)
- stereotypes and adjustments
- setting objectives: encourage family to use independent behaviors EX: talking to daughter to encourage the person to continue talking. environmental factors, emotional factors
90
Elderly population: audibility and instrumental interventions
- amplification: are they ready? fit and function of device, cost, cosmetics
- modify procedures
- binaural fitting
- special device features
- beyond the hearing aid
- orientation to devices
- individual orientation/in groups
- significant other
- advocacy in restrictive environments
- alternative media
91
Elderly population: remediation for communication activities
- conversational therapy and tactics: restore trust; how person can manipulate the redundant resources in communications
- partner communication: Help to work on all 4 parts of communication which are (listener/watching, talker, message environment)
- simulations and role playing
- empathy and listening
92
Elderly population: environmental coordination and participation improvement
- participation in situations (cant hear in restaurants) and relationships (letting son down bc i cant have a communication with them): help figure out where they are now and where they want to be
- social environmental supports: Good support system,
- physical environmental supports: environments they can listen in or modify environments they can not listen from (EX: which restaurant is quieter and has good lighting)
93
HL coping mechanism: Controlling
problem focused coping
- changing social and psychical environment
- taking responsibility for actions
EX: given instructions to partner by using technology, lighting, seating
94
HL coping mechanism: avoiding
emotion-focused coping
- PREND to understand or remain silent
- minimises hearing loss by joking about it
- positive comparisons to other individuals
- avoid challenging communication
- would not say they have a HL problem, need speech reading
95
disability
is activity limitation
96
handicap
restrictive participation
| Tend to seek help sooner
