Nonorganic HL Flashcards
List the three terminology that for nonorganic hearing loss?
- Nonorganic HL
- Pseudohypacusis
- Functional Hearing Loss
Define nonorganic hearing loss
An apparent loss of hearing without an organic disorder or with insufficient pathological evidence to explain the hearing loss
Define pseudohypacusis
False hearing loss
Define Functional Hearing Loss
Hearing loss that is not organic in nature and individual functions as if you have HL but do not have one
What are the subsections of an Nonorganic HL?
a. Psychogenic Hearing Loss/hysterical deafness
b. Malingering
Define psychogenic hearing loss
Nonorganic hearing loss with psychological origin
Define malingeres
Deliberate falsifier of physical or psychological symptoms for some some special gain and can be complete falsehood or exaggeration of a symptom
Is their a specific age, sex, and socioeconomic background?
NO
Why does an adult have a nonorganic hearing loss?
For financial gain
Why does a child have a nonorganic hearing loss?
For attention
What are some indicators of Nonorganic HL before they enter our booth?
- Exaggeration of HL during interview
- Function fine in waiting room, but demonstrate significant hearing loss when they are testing
- Any compensation claim
What are the three sections that indicates Nonorganic HL during a test?
- Inconsistency on tests
- No shadow curve for unilateral loss
- Unnatural/exaggerated struggling during testing
What indicators falls within inconsistency on tests?
a. Test-rest variability
b. SRT does not line up with pure-tone testing
c. Acoustic reflexes present at reduced SL
For no shadow curve for unilateral loss, what should we consider
Interaural attenuation/cross hearing
For unnatural/exaggerated struggling during test, what are things to look out for?
- Repeating only one half of spondees
2. Exaggerated ‘listening’ pose
What can you do to confirm your suspicion when you see these indicators?
Objective Measures: Acoustic Reflex, OAE, & ABR
What can you do to confirm your suspicion when you see these indicators?
Behavioral Test: Stenger for unilateral or grossly asymmetrical HL, Lombard Test, Yes-No, Speak to/about patient at level below admitted SRT
What is the Stenger principle?
When you present 2 tones that has the same frequency but different intensity levels and present them simultaneously, you’ll only perceive the louder sound
How do you setup the Stenger principle for audiogram purposes?
- Present a 10dB below their threshold bad ear’s threshold
- Present a 10dB sound above their threshold the good ear threshold
Simultaneously
What does a negative Stenger mean?
A person w/a true unilateral HL, they will not hear the tone the bad ear but in the good ear and respond
What does a positive Stenger mean?
A person w/a nonorganic HL, they will not respond to the loud sound that’s introduce to the bad ear
What is the Lombard test?
You speak louder in the presence of a BG noise that’s softer than their threshold. This is a natural reflex
For behavioral nonorganic HL testing, which test can be used for children/individuals with lower cognitive functioning?
Yes-No test
What is the management of patients with Nonorganic Hearing Loss?
- Confrontation is last resort
- Usually give patient an out
- Can “scare” them by talking about next steps
- Make proper referrals
