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Amplification > Modules 1, 2 & 3 > Flashcards

Modules 1, 2 & 3 Flashcards

1
Q

What are the benefits of treating hearing loss in adults?

A

-Have less difficulty communicating
-Greater confidence in social situations
-Participate in more social activities
-Have a greater sense of overall physical health
-Have less generalized anxiety
-Report better cognitive ability
-Greater earning power potential
-Better communication in relationships
-More sense of control over life events
-Perception of better mental functioning

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2
Q

What are the benefits of treating hearing loss in children?

A

When treated early, children have better outcomes in education, better speech understanding, better literacy rates, improved cognition, and improved social skills

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3
Q

What is the 1-3-6 rule for identifying hearing loss in children?

A

Screening by age 1 month, diagnosis by 3 months, and intervention by 6 months

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4
Q

What does treating hearing loss reduce?

A

-Discrimination against the person with hearing loss
-Hearing loss compensation behaviours (e.g., over-talking, avoidance of situation)
-Depression and anxiety
-Social phobias
-Self-criticism

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5
Q

T/F: hearing loss consistently ranks among the top five causes of years lived with a disability

A

TRUE

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6
Q

T/F: hearing loss is the fourth most common disability in older adults following heart disease, arthritis, and lung disease

A

FALSE: hearing loss is the THIRD most common disability in older adults following heart disease and and arthritis

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7
Q

In Canada, what estimated percentage of adults have a mild hearing loss?

A

19%

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8
Q

According to the WHO, an estimated how many millions of people are living with hearing loss globally?

A

466 million, and that number is expected to grow to 900 million by 2050

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9
Q

Findings on hearing loss and cognitive decline from The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) in 2023

A

-Hearing intervention was associated with a 48% reduction in 3-year global cognitive decline in the at-risk group
-NOT a significant change in the overall study participant group

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10
Q

T/F: hearing loss is almost always perceived

A

FALSE: of those Canadians with some degree of hearing loss in the high frequency range, 77% of those did not perceive that they had any hearing loss. Even when it is suspected, Canadian adults tend to wait 7 years before seeking help

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11
Q

What factors lead to action/inaction?

A

-Coping strategies
-Triggers
-Barriers/access to care
-Tipping points/awareness
-Denial
-Stigma

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12
Q

What is the speech banana?

A

The speech banana estimates where speech sounds fall along the audiogram in terms of sound level and frequency in everyday conversation

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13
Q

T/F: vowels contribute mostly to the power of speech and less to intelligibility

A

TRUE

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14
Q

T/F: consonants contribute mostly to speech intelligibility and less to the power of speech

A

TRUE

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15
Q

Define Dynamic Range

A

The range of audible sounds between minimal audible levels, and loudest levels of discomfort

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16
Q

What is compression in hearing aids?

A

Compression compresses the range of sound levels in the environment so that this range can fit in the reduced dynamic range of the person with hearing loss

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17
Q

What are the challenges faced by those with hearing loss?

A

-Reduced audibility
-Difficulty in areas of background noise
-Difficulty in areas of reverberation
-Reduced dynamic range
-Obstacles in communication (i.e., social barriers)

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18
Q

As early as what time period were audiometers used to measure hearing?

A

Late 1800s

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19
Q

T/F: the audiology profession evolved and blossomed in the aftermath of WWI

A

FALSE: WWII

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20
Q

Who coined the term “audiology” and when? (2 possible people)

A

Norton Canfield (ENT) OR Raymond Carhart (SLP) in 1945. Both were involved in implementing aural rehab programs established for military personnel in the US

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21
Q

What are the basic components of a hearing aid?

A

-Microphone: picks up acoustic, environmental sounds
-Hearing aid chip: sound processing in the chip will modify the signal
-Receiver (speaker): delivery to the ear. Amount of sound we deliver is called gain

22
Q

What is gain in reference to hearing aids?

A

The difference between the input and output of the device

23
Q

T/F: digital hearing aids must first convert the signal to process it

A

TRUE: the analog signal converts to binary (digital), then back to analog again before going through the receiver

24
Q

What 3 factors are considered when looking at hearing aid candidacy?

A

-Audiological Profile: audiogram, speech testing scores, tinnitus, hyperacusis, etc.
-Communication Needs: how to positively impact patients in areas that are important to them
-Motivation: does the patient have the desire for assistance through amplification?

25
Q

What are some post-fitting rehabilitation needs?

A

Counselling appointments, involvement with family/friends, communication strategies, self-advocacy, support for patient in workplace

26
Q

How do we gauge success with amplification (2 things)?

A

Verification and validation measures with counselling & follow-up

27
Q

Audiological considerations for hearing aid candidacy (5 things)

A

-Pure tone audiogram
-Speech audiometry
-Speech in noise (QuickSIN)
-MCLs, UCLs
-Presence of tinnitus reported

28
Q

Physical considerations for hearing aid candidacy

A

-Can the ear support an aid?
-Is the canal occluded with debris (infection, cerumen, foreign body)?
-What does the canal look like (narrow, collapsed, surgically modified)?
-Dexterity of patients (insertion/removal, etc)

29
Q

Referral Guidelines (FDA)

A

-Visible congenital or traumatic deformity of the ear
-Growths on pinna, or unusual growths in canal
-History of active drainage from the ear within the previous 90 days
-History of sudden or rapidly progressing hearing loss within the pervious 90 days
-Acute or chronic dizziness
-Unilateral hearing loss of sudden or recent onset within the previous 90 days
-Audiometric air-bone gap equal to or greater than 15 dB at 500 Hz, 1000 Hz, and 2000 Hz
-Visible evidence of significant cerumen accumulation or a foreign body in the ear canal
-Pain or discomfort in the ear
-Child under 18 years of age

30
Q

What should be addressed medically before dispensing hearing aids?

A

-Any suspicions of retro-cochlear and/or ME issues must be addressed by ENT prior to fitting
-Active, acute medical concerns must be addressed
-Referral to ENT through family physician

31
Q

What do patients tell us (or not tell us) about their hearing loss in clinic?

A

-Blaming others for mumbling
-Difficulty following conversations (dependant on environment)
-Frustration (both from patients and those close to them)
-Avoidance strategies, negative social impacts
-Admitting to feigning understanding conversation (“smile and nod”)

32
Q

Transtheoretical Model (TTM) of Health Behavioural Change

A

-Pre-contemplation (NOT ready)
·No intention of taking action; unaware that hearing loss is problematic
-Contemplation (getting ready)
·Recognition that hearing loss may be problematic, evaluate the pros and cons of seeking help, may ask questions about rehabilitation process
-Action (moving forward)
·Modifying behaviour, using therapy, acquiring new “healthy” behaviours, open to assistance, and counselling

33
Q

What are the “quick six” questions to get a sense of patient hearing difficulty?

A
  1. “Tell me what brought you into the office”
  2. “How long have you been noticing difficulty with communication?”
  3. “Do other people notice you having difficulty with communication?”
  4. “Tell me about the areas you are having difficulty with communication?”
  5. “Would you be willing to accept help or assistance with the difficulties you are having?”
  6. “On a scale of 1 through 10, with 1 being ‘I don’t need help’, and 10 being ‘I need help right away’, how would you rate your ability to communicate?”
34
Q

How do we delicately manage reaction to hearing loss?

A

-Recognition that often times, patients need time to digest the information we have given them
-Patient-centric care in counselling means supporting patients in allowing them time, ask questions, and give space

35
Q

Hearing Handicap Inventories

A

-Self-assessment scale related to pre-fitting considerations (25 on standard and 10 on screening version)
-Scales focuses on the emotional and social aspects of living with hearing loss

36
Q

Client Oriented Scale of Improvement (COSI)

A

-The COSI is a frequently used outcome measure that evaluates pre-fitting needs, and post-fitting outcomes of amplification
-Goal is to have patients target 5 listening situations in which they would like to see improvement in their hearing with the use of amplification

37
Q

2 phases of COSI

A

1st: identify listening situations that the patient would like to experience improvement in (rated by importance)
2nd: rate the change in those performance indicators after fitting (and some experience), and a final listening ability

38
Q

Factors associated with amplification success

A

-Most configurations of hearing loss can be helped by amplification
-Conductive hearing losses have better outcomes with hearing aids than SNHL
-Degree of hearing loss and WRS
-Appropriate electroacoustical parameters (i.e: appropriate gain)
-Physically comfortable fit
-Appropriate level of technology for patient needs
-Patient expectations
-Patient motivation, and the acceptance of hearing loss

39
Q

CROS Device

A

-Contralateral routing of signals
-Device used for single-sided deafness that looks like a hearing aid and wirelessly transfers sound to the better ear

40
Q

What is a CROS device overcoming?

A

The head shadow effect: big decrease in high frequencies (above 1500 Hz) when sound is presented to the contralateral side of the skull

41
Q

List the 5 steps in the hearing aid fitting process

A
  1. Assessment
  2. Selection
  3. Fitting & Verification
  4. Orientation
  5. Validation
42
Q

Goals of assessment for hearing aid fitting

A

Evaluating patient candidacy: audiological profile, communication needs & motivation

43
Q

What decisions are made regarding the hearing aid selection process?

A

-Manufacturer
-Technology level
-Features and options
-Electroacoustic parameters
-Other: financial means, warranties offered, cosmetic preferences

44
Q

What are the “Big 5” manufacturers?

A

-GN Resound (Resound Beltone)
-WS Audiology (Siemens)
-William Demant (Oticon)
-Starkey (Starkey Audibel)
-Sonova (Phonak)

45
Q

Which hearing aid styles require impressions and which do not?

A

-Impressions needed: IICs, CICs, ITCs, ITEs, RIC custom shells, BTE earmolds
-Impression not needed: RICs, or RITAs with use of domes

46
Q

What 3 things are we looking at with verification and fitting?

A

-Quality control measures
-Physical fit
-Hearing aid performance based on audiological needs
·Real ear measures (REMs)
·Sound-field aided measures

47
Q

What do we need to teach patients to do with their hearing aids? (2 things)

A

Hearing instrument overview:
-Left vs right
-Microphone ports
-Receiver
-How to clean—review cleaning tools
-How to change parts of hearing aids
-Storage
-Batteries/charger

Adjusting to amplification:
-Is our patient a new or experienced user?
-What will sound different?
-Adjusting to wearing
-Handouts/apps to guide patients
-Opportunity to reaffirm appropriate expectations, and give additional communication strategies

48
Q

What will trial periods ensure?

A

-Both patient and audiologist are happy with selection, that the patient can handle the device(s), and that they are beneficial in aiding hearing loss
-Follow-ups are often necessary during the trial period to ensure progress is on-track, or clinicians can be proactive in meeting concerns
-Financial considerations: transaction of funds, third party claims, insurance, supplements, financing plans, warranty repair dates, loss and damage

49
Q

What does validation involve in the hearing aid selection process?

A

-Is the disability or handicap of hearing loss reduced?
-Is the patient meeting the goals they have set?
-Is the patient experiencing less “activity limitations” and “participation restrictions”?

50
Q

What are the 2 ways in which amplification benefits are assessed? (COSI)

A

-Degree of change: improvement provided by the hearing aids is rated as better or worse in a continuum
-Final hearing ability: an absolute measure of communication ability (percentage of ability to hear in identified situations)

51
Q

How does the road to amplification differ from testing in private vs public settings?

A

-If tested in a public setting initially, the patient must find a private clinic (dispenser) to purchase hearing aids
-If tested in public setting: testing —> patient seeks dispenser —> selection —> ear impression** —> order —> aids arrive in clinic —> fitting appointment

52
Q

How often do you follow-up for a first-time fitting?

A

-First follow-up by phone call/message: 24-48 hours post-fitting
-Then follow-up in clinic or through telepractice: 2-4 weeks post-fitting
-Final follow-up BEFORE trial period ends**
-After this, an annual evaluation will occur

Amplification (9 decks)

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