Management Flashcards
What is the role of the audiologist?
Evaluation and/or interpretation of test results for educational relevance
Communicate with members of multidisciplinary team
Monitoring classroom environment
Recommendation and management of FM system(s)
Auditory training
What are the four broad recommendations for management for CAPD?
Managing the auditory environment
Auditory training
Music training
Training with phonemes and words
Do children with CAPD struggle with a lot of the same things as children with hearing loss?
Yes
Have difficulty understanding in the classroom
May have difficulty understanding speech even with low level background noise
Difficulty following rapid speech, speech degraded by distance or poor acoustics, and accented speech
What are individual FM systems?
Personalized signal enhancement systems that direct the teachers voice directly to the child’s ear(s)
Often worn in conjunction with conventional hearing aids and CIs
What do you need to get a sound field or personal FM system?
Medical clearance from the student’s physician prior to a personal FM fitting
Permission from parents to use FM in the school
Trials with an FM system through an evaluation period of 30 to 45 school days (pre and post evaluation forms are recommended to be completed by the classroom teacher (CHAPS or SIFTER))
Training on FM use to teachers
How can you improve the speaker in the auditory environment?
Ask speakers to speak clearly
Teachers should speak after writing on the board or looking at notes to provide necessary visual cues
Ensure proper lighting of the speaker, no backlighting
Place the child closer to the speaker (aka preferential seating) - this without other recommendations is not effective
Decrease visual and audible distractions
What does ASHA say the ambient noise levels of an unoccupied classroom should be?
Not exceed 35 dBA
dBA is a weighted scale measured from a sound level meter based on human hearing
What are some expensive changes to achieve the 35 dBA goal?
Infrastructure changes like double-paned windows, noise control devices on heating and cooling equipment, modify lighting fixture types, or lowing ceiling levels, acoustic tiles, etc.
What are cheap modifications to achieve the 35 dBA goal?
Carpeting, curtains, cork boards, felt or rubber tips on chairs, use of bookcases, etc.
Do signal enhancement systems reduce the disadvantage of distance and improve the SNR?
Yes, reduces the cognitive load
Without this, the level of sound decreases by 6 dB SPL for every doubling of distance
What is the optimal reverberation time for a classroom?
0.3 to 0.4 s for small classrooms
~ 0.6 s for middle to large sized classrooms
Exceeding this exacerbates hearing difficulty especially in noisy classrooms
In a reverberant classroom, overall signal level may decrease less over distance because of reverberation enhancement, but excessive reverberation decreases intelligibility
What are the goals of signal enhancement systems?
To improve the SNR and reduce effects of reverberation
Optimal classroom SNR is ≥ 15 dB
For young children with normal hearing, an SNR of > 20 dB is needed in environments with interfering noise and reverberation
Difficult to achieve in a classroom
What are remote mic hearing aids?
Devices that are hybrid radio and hearing aid systems designed for children with normal hearing
The child wears the typically ear level HA receiver and teacher (parents, etc.) wear the radio transmitter mic
They are not accessories to other hearing instruments as they deliver the signal directly to the child’s ear
The remote microphone hearing aids are designed for people without hearing loss but difficulty understanding speech in noisy and adverse environments
Currently available devices include the Phonak Roger Focus II receiver and the Oticon Amigo Star receiver
What is the roger focus?
It is a discreet and comfortable behind-the-ear Roger receiver for children with normal hearing, unilateral hearing loss , ASD, and (C)APD
It delivers the teacher’s voice directly to the child’s ear
It features a SlimTube, a volume control, and uses a 312 battery (or rechargeable)
Looks like a hearing aid
All roger mics are compatible with it