Hearing Measurement Lecture l

Question 1

What are the two types of Diagnosis?

Answer 1

Physiological
Rehabilitative
(We tend to focus more on this one as audiologists)

Question 2

What is our focus as audiologists?

Answer 2

Our focus and goal is the assessment and rehabilitation of receptive communication

Question 3

Disability is___________________________

Answer 3

Biopsychosocial

Question 4

What would you call the body of rehabilitative diagnosis?

Answer 4

An impairment (hard of hearing)

Question 5

What would you call the person of rehabilitative diagnosis?

Answer 5

Activities limitation

Question 6

What would you call the person in context of rehabilitative diagnosis?

Answer 6

Participation restriction

Question 7

What issues do we address at the body level (structure and function) during of physiological diagnosis? (4)

Answer 7

Normal/Abnormal
site of lesion
cause
prognosis

Question 8

What issues do we address person level (activities and participation) during of physiological diagnosis? (5)

Answer 8

• problematic or unproblematic
• hearing capacity (how well can they do)
• is this person having trouble understanding speech
• can we mitigate the effects of the loss
• can we help this person overcome any limitations

Question 9

Which test is this?

Answer 9

Otoacoustic emissions

Question 10

Which test is this?

Answer 10

Auditory Brainstem Response

Question 11

Which tests are these? (2)

Answer 11

Audiogram and Tympanogram

Question 12

What is this device?

Answer 12

Cochlear Implant
20 Channels, limitation to the number of frequencies it can transfer

Question 12

What is this device?

Answer 12

Cochlear Implant
20 Channels, limitation to the number of frequencies it can transfer

Question 13

What was Harvey Fletcher’s experiment? (3)

Answer 13

Experimented by removing parts of the spectrum, and measuring how intelligible the speech was

Foundational research important for the telephone, audiometry, and hearing aid fitting

Developed a method for detecting where speech is.

Question 14

What can we see from Harvey Fletcher’s result?

Answer 14

Most of the speech information 300 to 3000 Hz most important is at 2000 Hz

Question 15

What are the general Findings from Harvey’s study?

Answer 15

To understand speech, you need to hear speech features (e.g., formants), which are distributed across the spectrum

Question 16

Harvey’s study led to the development of an index, what is the name of the index?

Answer 16

The Articulation Index (now the Speech Intelligibility Index)

Question 17

What does the Articulation Index predicts?

Answer 17

predicts intelligibility from a weighted sum of the audibility (or S/N ratio) in a number of frequency bands

Question 18

What does the Articulation Index predicts?

Answer 18

predicts intelligibility from a weighted sum of the audibility (or S/N ratio) in a number of frequency bands

Question 19

How did Harvey conduct his experiment? (2)

Answer 19

Fletcher divided the spectrum into 20 bands

Each band was about 1 mm on the basilar membrane… about 114 IHC

Question 20

How does Harvey’s study relate to hearing measurement? (2)

Answer 20

You need about 4 features per speech sound
You need about 4 octaves per speech sound

Question 21

What is an Octave?

Answer 21

Series of notes occupying the interval between (and including) two notes, one having twice or half the frequency of vibration of the other.

Question 22

What can we conclude from distribution of speech information from Harvey’s study? (3)

Answer 22

1. speech information is distributed
2. Each phone requires
   4 audible octaves or
   4 speech features
3. intelligibility is best predicted by audibility across a wide range

Question 23

What should we retain about speech perception? (2)

Answer 23

1. You need to hear across a wide range of frequencies for speech perception
2. Very little detail is needed in any frequency region, so the comparison across frequencies is most important

Question 24

What do formants reflect and how are they distributed?

Answer 24

Formants or “shape” information reflects the movements of the articulators – this information is distributed across frequency

Question 25

What is the site of Frequency intergration on the brain (NOT EAR)?

Answer 25

Planum temporale (association cortex) in green

Question 26

What is the planum temporale involved in?

Answer 26

Tasks that require spectrotemporal integration

Question 27

What types of potentials does the planum temporale give rise to?

Answer 27

Gives rise to evoked potentials that depend on spectrotemporal integration (the MMN)

Question 28

Which part on the brain is important for phonology?

Answer 28

Superior temporal sulcus (yellow area)

Question 29

What are some functions associated with the planum temporale? (give 4)

Answer 29

duration sequences (-silence)
harmonic complexes (-pure tones)
frequency modulated (-pure tones)
amplitude modulated (-steady noise)
spectral motion (-stationary)
pitch sequences (-silence)
melodies (-noise)
speech (-noise)
speech (-complex non-speech)
speech (-tones)
consonant-vowel (-vowel)
unvoiced consonant (-voiced)!!!!
dichotic (-diotic)
lip-reading (-meaningless facial mov’t)
source mov’t versus stationary

Question 30

What is the name of the ability that shows that details are required for disentangling and tracking voices?

Answer 30

Auditory Scene Analysis

Question 31

What is the consequence of hearing loss?

Answer 31

Hearing loss produces a disproportionate problem with hearing in noise

Question 32

What are two problems that hearing loss creates?

Answer 32

1. An audibility problem
2. A scene analysis problem

Question 33

What details are important for understanding speech perception in noise?

Answer 33

Fine details are required for hearing noise, tracking voices in space, and disentangling overlapping sounds

Question 34

What can we say about intelligibility in quiet?

Answer 34

Intelligibility in quiet is best predicted by audibility across the frequencies (details are not necessary)

Question 35

What do we base our diagnosis of speech limitations?

Answer 35

Primarily based on audibility (pure tone tests)

Question 36

What are other ways to determine speech understanding problems except with pure tone tests?

Answer 36

Direct testing (Speech in quiet/noise)
Ask them if they can hear in certain context (case history)

Question 37

The Auditory system is complex – many types of problems can lead to hearing dysfunction, what are they? (5)

Answer 37

1. Acoustic system (external ear)
2. Mechanical system I (middle ear)
3. Mechanical system II (cochlea)
   
   • active and highly-non-linear
4. Metabolic system (cochlea)
5. Neural system (hair cell transduction, auditory nerve, brainstem, cortex)

Question 38

Diagnosis is Detective Work

• Used to get dizzy, but no longer
• Tinnitus in right ear
• Asymmetric hearing loss (right worse)
• Reflexes absent with sound to right ear
• ABR I-III and I-V extended (III-V normal)
• Speech perception poorer at high levels
• Reflex decays more than half of its strength within 3 seconds

Answer 38

Right Vestibular schwannoma (Tumor on right side)

Question 39

Diagnosis is Detective Work

young female athlete
hearing suddenly poorer in left ear after trauma
very high tympanic compliance
word discrimination corresponds to hearing loss

Answer 39

Mechanical issue, Ligament rupturing, Disarticulation

Question 40

Diagnosis is Detective Work
young woman with an infant
hearing deteriorating over last few years (left ear only)
moderate mixed loss left (normal right), although BC thresholds normal everywhere circa 2 kHz
ipsi reflexes present right, elevated left
word discrimination corresponds to hearing loss

Answer 40

Otosclerosis/ Caharts Notch

Question 41

Diagnosis is Detective Work

Hears own footsteps
Hears eyeballs moving
Dizzy when loud sounds are presented
Difficulty began after mild trauma to the head
otoacoustic emissions present bilaterally

Answer 41

Crack in the superior semi circular/ superior canal dehiscence