Hearing Flashcards
overall goal of aural rehab
to alleviate difficulties related to hearing loss, minimize its consequences
Degree of HL
mild: 20-45dB HL
moderate: 45-65
Severe: 65-85 db HL
Profound: >85 db HL
speech discrimination scores
- patient ability to repeat words from list of 25 auditory presented single syllable words presented in 2 ears separately in sound treated room
- expressed as a % correct for each ear
speech recognition threshold (SRT)
level at which patient can repeat 50-75% of spondaic words in dB HL (baseball)
-should correspond to pure tone average threshold at 500, 1000, 2000 Hz
effects of HI on conversation
- disrupted turn-taking (missing aud cues)
- inappropriate topic shift as a resultd of misunderstanding word or phrase
- communication breakdowns disrupt flow
- choice of topic simplified/limited for fear of communication breakdowns
—Tye-Murray
2 types of comm strategies
- facilitative — anticipate/manage enviornment, self, partner
- repair – recover from a breakdown after it occurs
environment oriented strategies
- light source should illuminate face of comm partner
- direct view of speaker
- 3-6 ft optimal distance
- reduce background noise
- reduce reverberation
pt oriented strategies
- increase self-confidence
- prepared for comm situations (visual attention to partner, world knowledge, paper and pencil)
- speech-reading skills
- encourage pts to role play fears and come up with solutions
partner oriented strategies
- instructional strategies for partners – request clear speech
- “please speak clearly and slowly”
- “I need to your face when speaking”
4 “Do you mind not chewing your gum”/…etc
receptive repair strategies
TEACH the patient…
- rephrase - could you say that in another way?
- elaborate – please tell me more…
- request topic — I missed that completely what were you talking about?
- confirmation — did you say ___?
expressive repair strategies
TEACH the patient/comm partner:
- teach interpretation of facial cues (puzzled look = confusion)
- repeat message verbatim or with no info
- talker takes hold of the repair
encourage ______ type of conversation style
interactive — stating needs in a friendly manner, clear, assertive
WATCH
-basic principles of aural rehabilitation:
W = watch the talker’s mouth
A = ask for clarification
T = talk about your hearing loss
C = change the situation - background noise or move to another place
H = healthcare knowledge – be informed
ALDs for the home
- loud ringers, phone amplifiers, loud amplified doorbell ringers
- flashing lights/vibrating alarm and alert systems
- TV captioning
Counseling with pt with HL
- help pt to tell their story, clarify problems, take responsibility
- establish goals, develop plan, implement plan
- ongoing eval
*** need both informational counseling and personal adjustment counseling