Nonorganic HL

Question 1

List the three terminology that for nonorganic hearing loss?

Answer 1

1. Nonorganic HL
2. Pseudohypacusis
3. Functional Hearing Loss

Question 2

Define nonorganic hearing loss

Answer 2

An apparent loss of hearing without an organic disorder or with insufficient pathological evidence to explain the hearing loss

Question 3

Define pseudohypacusis

Answer 3

False hearing loss

Question 4

Define Functional Hearing Loss

Answer 4

Hearing loss that is not organic in nature and individual functions as if you have HL but do not have one

Question 5

What are the subsections of an Nonorganic HL?

Answer 5

a. Psychogenic Hearing Loss/hysterical deafness

b. Malingering

Question 6

Define psychogenic hearing loss

Answer 6

Nonorganic hearing loss with psychological origin

Question 7

Define malingeres

Answer 7

Deliberate falsifier of physical or psychological symptoms for some some special gain and can be complete falsehood or exaggeration of a symptom

Question 8

Is their a specific age, sex, and socioeconomic background?

Answer 8

NO

Question 9

Why does an adult have a nonorganic hearing loss?

Answer 9

For financial gain

Question 10

Why does a child have a nonorganic hearing loss?

Answer 10

For attention

Question 11

What are some indicators of Nonorganic HL before they enter our booth?

Answer 11

1. Exaggeration of HL during interview
2. Function fine in waiting room, but demonstrate significant hearing loss when they are testing
3. Any compensation claim

Question 12

What are the three sections that indicates Nonorganic HL during a test?

Answer 12

1. Inconsistency on tests
2. No shadow curve for unilateral loss
3. Unnatural/exaggerated struggling during testing

Question 13

What indicators falls within inconsistency on tests?

Answer 13

a. Test-rest variability
b. SRT does not line up with pure-tone testing
c. Acoustic reflexes present at reduced SL

Question 14

For no shadow curve for unilateral loss, what should we consider

Answer 14

Interaural attenuation/cross hearing

Question 15

For unnatural/exaggerated struggling during test, what are things to look out for?

Answer 15

1. Repeating only one half of spondees

2. Exaggerated ‘listening’ pose

Question 16

What can you do to confirm your suspicion when you see these indicators?

Answer 16

Objective Measures: Acoustic Reflex, OAE, & ABR

Question 17

What can you do to confirm your suspicion when you see these indicators?

Answer 17

Behavioral Test: Stenger for unilateral or grossly asymmetrical HL, Lombard Test, Yes-No, Speak to/about patient at level below admitted SRT

Question 18

What is the Stenger principle?

Answer 18

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

Question 19

How do you setup the Stenger principle for audiogram purposes?

Answer 19

1. Present a 10dB below their threshold bad ear’s threshold
2. Present a 10dB sound above their threshold the good ear threshold

Simultaneously

Question 20

What does a negative Stenger mean?

Answer 20

A person w/a true unilateral HL, they will not hear the tone the bad ear but in the good ear and respond

Question 21

What does a positive Stenger mean?

Answer 21

A person w/a nonorganic HL, they will not respond to the loud sound that’s introduce to the bad ear

Question 22

What is the Lombard test?

Answer 22

You speak louder in the presence of a BG noise that’s softer than their threshold. This is a natural reflex

Question 23

For behavioral nonorganic HL testing, which test can be used for children/individuals with lower cognitive functioning?

Answer 23

Yes-No test

Question 24

What is the management of patients with Nonorganic Hearing Loss?

Answer 24

1. Confrontation is last resort
2. Usually give patient an out
3. Can “scare” them by talking about next steps
4. Make proper referrals