midterm 1 Flashcards
PBmax
highest percent correct score
-the best they can do
3 components of evidence based practice
client perspective, clinical experience and external scientific evidence
word recognition score (WRS)
percent correct of a given word list at a supra threshold level
-PBmax, discrimination
-presented above threshold
diagnostic uses of word recognition testing
site of lesions testing (cochlear vs. retrocochlear) and to compare ability over time
-only if tested correctly
treatment uses of word recognition testing
sense of impact of HL on speech understanding, monaural vs. binaural amplification, unaided vs. aided and CI candidacy
how is WRS administered?
calibrate materials, determine presentation level, confirm not too loud, determine if masking is needed, instruct patient what they will hear and what they should do (try their best, no repeating of the words)
-keep track of correct and incorrect responses
speech material for WRS
single words (monosyllabic)
-phonetically balanced
-often with carrier phase
-homogeneous
-closed or open set
what does it mean to say a word list is phonetically balanced
the word list encompasses all the sounds of the language
open-set and closed- set
open - choices are one of many words with no context, not familiar, single syllable words
closed - choices are limited, single digits, familiarized
what type of set is easier (gaining a higher percent correct score)
closed set
why is WRS not a test of communicative function
it can overestimate : obtained in quiet can have higher hearing levels than normal conversational levels
it can underestimate : no cues that are found in conversational speech, often obtained in auditory only rather than bimodal conditions and is monaural whereas speech is binaural
PI-PB function
performance intensity phonetically balanced function
-shows that word recognition performance increases as presentation level increases up until a maximum point, then will steady off/decrease
importance of finding the PBmax
able to compare their abilities over time
-must test correctly
how to use the SPRINT chart to determine if you did find the PBmax
using the PTA and % correct, follow the box’s to find the intersection
-if it falls within the shaded area score was too low and will have to retest
-if it falls within the unshaded area the score is close to their PBmax
how to find the WRS presentation level
+40 dB above SRT, consider audibility at 2000 Hz, MCL and UCL-5
class protocol for finding WRS presentation level
-add 40 dB to SRT level (ensure audible at every level, so at least 10 dB above all levels)
-if level is not audible at higher, present at the 2000 Hz frequency +15
-if level is not audible at lower levels increase so it is audible
-if patient has severe to profound and cannot achieve audibility, present UCL-5
what level to not exceed with WRS presentation
100 dB
is it okay to repeat words when administering a WRS test
no. move the word list between ears and sets to ensure different words
what site of lesions can be differentiated based on WRS
retrocochlear vs. cochlear
how to use the SPRINT chart to find significant asymmetries between two scores?
take one score on the Y and one on the X and trace them on the graph
-of they are within the arrow, they are symmetrical
-if they are outside the arrow line, there is a significant asymmetry (significantly different)
how to interpret WRS scores for site of lesion testing
asymmetry in scores, PI-PB rollover and low scores relative to PTA
-we use these to rule out a retrocochlear pathology
asymmetry in scores (using SPRINT chart)
comparing two scores with both ears, 2 ears 2 levels
use when : you have symmetrical HL (within 15 dB)
how to : using both WRS on the SPRINT chart to if it is within the arrow line
what it tells us : if the scores are statistically different (retrocochlear) or equivalent (cochlear)
PI-PB rollover
compares scores at two levels within the same ear, 1 ear 2 levels
use when : PBmax was presented below UCL-5 and can test at two levels, so cannot test for this if you are already at UCL-5
how to : present at a moderate level and present at UCL to gain both PBmax and PBmin and then calculate the RI
what it tells us : low is cochlear and high is retrocochlear
low scores relative to PTA
single presentation level WRS, 1 ear 1 level
use when : PTA is 30 dB HL or better (smaller number)
how to : use PBmax and PTA level (if below 80% PBmax with a PTA greater than 30, it’s at risk for retrocochlear)
what it tells us : suggestive for a retrocochlear pathology
