Lecture 10- Pediatric Audiology Flashcards
Why are classroom acoustics important?
Students may spend at least 45% of the day in activities requiring listening
Central auditory system doesn’t reach full maturity until early adolescence
o Children in school are listening with immature auditory systems
Factors that affect a student’s ability to hear the intended message
○ Integrity of the listener’s auditory system
○ Intensity of signal (teacher’s voice)
○ Reverberation properties of the room
○ Background noise present
(The last 3 can be controlled to some extent)
What are the characteristics of classroom acoustics (3)?
- Intensity and Distance
- Background Noise
- Reverberation
What is typical background noise in a classroom?
Children are inherently “noisy”
Some noises are unavoidable (e.g., HVAC, hallway noise, traffic or lawn mower outside)
○ But may be able to be managed
Some noises are avoidable (e.g., class aquarium)
Combined effects of various noise sources create more difficulty in a classroom environment
What is reverberation?
- Reflected sound energy
- Occurs when sound continues in a space due to repeated reflection or scatter from the surfaces &/or objects in that space
- RTs longer than 0.5 seconds appear to degrade speech recognition for most listeners in educational environments
- RTs for unoccupied classrooms range from 0.4 to 1.2 seconds (Crandell, 1992; Knect et al., 2002)
Describe the relationship between the signal, background noise, & reverberation.
Combined effects are synergistic
○ More problematic than the sum of individual effects
When SNR decreases in a classroom, speech intelligibility decreases for students
SNR in typical classrooms is anywhere from +5 to -7 dB
What are the ANSI standards for classroom acoustics?
Unoccupied classroom levels must not exceed 35 dBA
SNR must be at least +15 dB at the child’s ears
Unoccupied classroom reverberation must not surpass:
o 0.6 seconds in core learning space with a volume < 10,000 ft3 or 0.7 seconds in larger rooms
o 0.7 seconds in core learning space with a volume >10,000 ft3 and <20,000 ft3
Why are classroom acoustics usually poor?
Some classroom designs are inherently poor listening environments
Open-plan/ open concept classrooms
- Fewer of these are being built but many still exist
Tall ceiling made of hard material (e.g., plaster), hard walls, and many hard surfaces
- Hard surfaces tend to increase reverberation times to the point where speech intelligibility is difficult even for the best listeners
What are the desirable classroom acoustics?
- Install sound-absorptive material on ceiling and walls
- Place a rug or carpeting on the floor
- Constructing the midsection of the classroom’s ceiling with hard surfaces to reflect sound to the back of the classroom
What are some solutions to improving classroom acoustics?
- Reduce or eliminate unnecessary noise sources
- Apply sound absorbing surfaces to ceilings & walls
- Install carpet on floors of classrooms
- Construct classrooms with good acoustic properties
- Reduce the listening distance between the teacher and the students
- Encourage the use of sound field amplification in the classroom
Are HATs available with a 504 plan?
- Inconsistency in terms whether assistive tech is provided under 504
- Section 504 requires public schools to provide students with disabilities appropriate educational services designed to meet their individual needs to the same extent of students without disabilities
Ed. AuD could argue that a D/HH student doesn’t have the same access to auditory info without a personal FM
What are some verification procedures?
May differ depending on whether the FM is used with a hearing aid, CI, bone-anchored device, or by itself
Electroacoustic analysis
Real ear
Behavioral procedures
○ Speech recognition in noise w/ & w/o FM
What are some validation procedures?
Objective and subjective measures
○ Self-assessments
○ Observation questionnaires (teachers & parents)
○ Functional evaluations completed in the student’s learning environment
How can the AuD train teachers, students, and school staff?
- Basic function of the device (e.g., on/off)
- Appropriate use of the device (e.g., when it should be used)
- Care and maintenance
- Basic troubleshooting
- School AuDs should frequently check in with students and personnel to ensure consistent, proper device use.
How can FM be used for sound transmission?
A specific band of frequencies has been set aside for personal FM systems in the US
○ Older systems used 72-76 mHz, newer systems use 216-217 mHz
AuDs need to keep a record of which FM channels are being used at any given time ○ E.g., if student A is on channel 01, student B can’t use it at the same time. ○ If 2 students are in the same class and using one transmitter may use the same channel
What is classroom sound field amplification?
Mainstream Amplification Resource Room Study (Ray, 1988) showed:
o Improved SNR
o Less vocal fatigue for teachers
o Improved academic achievement
Infrared or FM Sound transmission?
How is CAPD detected/handled in school settings?
Suspicions of CAPD in school-age children typically arise from observed academic and hearing difficulties
○ Much of the learning in classrooms is auditorily based
Many professionals are responsible for meeting the needs of children with CAPD
○ Identification and tx is a multidisciplinary effort
AuD will dx and determine necessary tx
SLP often screens to determine need for dx eval and administers tx
What are the primary CAPD symptoms?
Difficulties hearing in noise
○ Can be caused by a breakdown in nearly any auditory process
○ Ideal acoustics and SNRs are difficult to maintain in the classroom setting
Academic difficulties
○ Often related to a speech-language or reading issue
○ CAPD has been linked to phonemic/phonological awareness difficulties, but relationship may not be causal
What are additional CAPD symptoms?
Difficulty following multistep directions
Frequent requests for repetitions
Trouble understanding degraded speech
Difficulty with localization
o *These symptoms can overlap with other disorders
o *Primacy may be more of an indicator than presence for certain symptoms (Chermak et al., 1998)
What are comorbidites with CAPD?
Frequently comorbid with other disorders
○ Only occurs in isolation in ~5% of cases
More often occurs with a speech-language issue or reading disability (Sharma et al., 2009)
What are classroom modifications for students with CAPD?
Generally fall into 3 categories:
o Physical modification of the environment
o Improving listening conditions with beneficial behavioral changes
o Adding amplification and assistive listening devices
What are amplification options for CAPD?
Often considered a short-term solution
Improvements in speech perception don’t last after amplification is (Johnston et al., 2009; Lemos et al., 2009)
Soundfield FM
Personal FM
Mild gain hearing aids (Kuk et al., 2008)
What is auditory training for CAPD?
Can improve performance on auditory training measures (Amitay et al., 2006; Moore et al., 2009)
○ Auditory discrimination
○ Temporal processing
○ Dichotic processing
Various computer-based protocols
Informal training methods
How can the AuD prepare for an inservice presentation?
Targeting the audience
○ Knowledge base
○ Experience hearing loss
○ Number of people in the audience
Select appropriate content
○ Prioritize the information
○ Consider the amount of time
○ Will a follow up session be necessary?
How can the AuD present their inservice presentation?
Personalize information
Be flexible
○ Allow time for questions
Be alert to physical and mental limits
Use ice breakers and humor
Equipment demonstration
Hand outs
How can the AuD follow-up after the inservice presentation?
- Evaluation at the conclusion of the presentation
- Continue contact
- Follow-up small group sessions
- Classroom Observations
- Individual Consultation
