Lecture 2.2 Flashcards
How was hearing loss identified in the early days of audiology?
100 dB signal played directly into the babies ear at the newborn phase
determines if the baby responded at all to see if they can hear
- only really ruling out profound deafness - signal is so loud
What recommendations emerged from 1967 National Conference on Education of the Deaf?
children with higher likelihood of developing hearing loss are tested
- high risk register to facilitate identification
testing of infants and children 5-12 months should be investigated
What did White 2010 studies show about screening based on high risk register?
if you only screen children with a risk factor, only going to catch 50% of children
other 50% don’t have a risk factor
need to screen early and universally
How has the view on deafness changed over the years?
16th century - recognized deafness was a barrier to communication not an intellectual deficit
late 19th century - deafness viewed as a problem belonging to the field of education
1960s - acknowledge significant delays if hearing loss not identified early
- screened high risk infants first
What is JCIH?
joint committee on infant hearing
formed in early 1970s
addresses populations to be screened, methods and protocols to be used for screening, and later guidelines for early ID and intervention
What are soundfield systems? How were they used?
speaker systems set up in classroom, connected to microphone for speaker
early versions used in educational settings
later determined children with hearing loss benefit from sound access throughout the day
- children later able to wear binaural hearing aids on the body using a harness
What developments in prescriptive formulae occurred in the 1980s?
appropriate hearing aid gain, output, and frequency response was studied extensively
prove mic systems became available
CIs approved for use with children
What is gain?
prescribed amount of volume provided by hearing aid based on hearing thresholds and ear canal volume
we adjust to meet targets
in dB SPL
What is the goal of rehabilitative and educational management of children with hearing loss?
overcome or minimize the barriers to communication imposed by hearing loss in order to enable learning and participation to society
What 2 categories did children with hearing loss historically fall into?
those who had considerable access to acoustic speech signals
those who had limited or no access to speech despite the best technology
What 2 parallel rehabilitaiton and educational management philosophies evolved?
manual approach - visual-based system, natural for those who are deaf (those who can’t or chose not to access speech through technology)
oral approach - spoken communication
What was the average age of hearing loss identification before the infant hearing program? What are the impacts of this?
2.5 years
late identification = window to access/learn speech, language, and literacy closes, impairs social and cognitive development
What factors result in good language outcomes?
good hearing aid fittings
consistent hearing aid uses
language input (quality and quantity)
What is UNHS?
population screening of all babies, regardless of the presence/absence of risk, for the possibility of hearing loss
component of EHDI programs
What are EHDI programs?
Early hearing detection and intervention
comprehensive public health program including UNHS, audiology assessment, hearing loss management, family support, language development support, and monitoring of infants and outcomes
go beyond population screening and offer services to confirm presence of hearing loss and provide intervention services
What is the importance of early detection and intervention?
saves society money on more intense remediation
supports language development, child development, psychosocial well-being, behaviour, and academic success
What is the prevalence of children born with hearing loss?
1-3 / 1000 births
progressive and late onset losses underestimated
What is screening?
a strategy used to identify the possible presence of a yet undiagnosed condition in a population without signs or symptoms
not diagnostic or therapeutic - no resources for follow up
What is assessment?
evaluation of health status to detect disease or condition
What is intervention?
the act of intervening with the intent of modifying outcome
technology and/or language services
What is the definition of deaf?
condition where a person has little or no hearing in both ears
also used to describe a person with this condition whose preferred mode of communication is spoken language
the audiological term - but usually profound bilateral hearing loss used
What is the definition of Deaf?
members of a sociolinguistic and cultural group whose preferred method of communication is sign language
involvement in Deaf community is distinctive feature
- don’t need to have hearing loss (ex. spouse who uses signs to partner)
What is the definition of hard of hearing?
permanent partial or total inability to hear in one or both ears
this term is used to describe a person who has the condition and whose usual method of communication is spoken language
What is the definition of permanent hearing loss?
hearing loss of a particular degree (target level) in any ear caused by disorders of the cochlea, brainstem auditory pathways, or structural abnormalities affecting sound conduction through the external or middle ear structures
hearing loss is permanent if it will not resolve spontaneously and will present a loss of hearing sensitivity in the absence of intervention
What is the importance of EHDI programs?
critical in lives of Deaf/deaf or hard of hearing children to ensure optimized language, literacy, and social skill development