Quiz 1 (Ch 14, 17, acoustics) Flashcards
top 5 primary medical diagnoses of acute care patients
- cerebrovascular accident (stroke)
- head injury
- hemorrhage/injury
- respiratory illnesses
- CNS diseas
acute care settings deal with?
medically complex individuals; patients in this type of setings are usually treated for a sudden episode or illness
3 characteristics the MEDICAL model of health care
- interdisciplinary team (trained group of professionals and paraprofessionals working with an individual)
- primary care physician - head of the team (manages overall care)
- Written Doctor’s Orders required for other services
in acute care facilities, the consulting audiologist:
- may or may not?
- may or may not?
- SLP must always? (2)
- be on staff
- be on site
- 1) have access to this professional; 2) beware of requests that may cause them to function outside scope of practice
In terms of acute care, many hospitals have a pediatric or adult ________
speciality
specialty clinics run on?
- how does it work?
- an SLP should?
scheduled days
- screenings related to the disorder of specialty occur at a rapid pace
- always refer to an audiologist when they suspect a hearing loss
largest health care provider in the US?
Veteran’s Affairs Hospital
largest employer of audiologiists
VA
VA typically has large what?
audiology departments
More VA facts:
- first VA audiology clinic opened in ____ in ____
- largest purchaser of ___ in the US?
- provides routine grant opportunities for?
- first recorded materials for speech audiometry came from?
- 1946, NY
- hearing aids
- Mountain Home VA Hospital in TN
what type of patients are in subacute facilities?
patients who are medically stable and no longer in need of acute care
in subacute facilities, you’re more likely to see a ____ model of audiology services
consultative
subacute facilities involved a ____ relationship with a single patient
longer (rehabilitative)
subacute facilities are designed for someone recovering from?
- example?
- acute illness
- intensive therapy after stroke
subacute treatment is _____ treatment when?
GOAL-oriented, immediately after or instead of hospitalization
in subacute facilities, there’s a greater need to have?
comprehensive case history info
what case history info do you want when working in a subacute facility? (3)
- hospital records
- cognitive ability of patient
- input from family members
things to consider when attempting to get case history info in a subacute facility:
- patient may not be?
- family members are?
- records may be?
- SLP may find themselves in role of?
- best historian
- dealing with a lot of emotion; accuracy of info may not be best
- difficult to obtain from acute care facility
- counselor, getting family started in rehab process
guidelines for questions for getting ACCURATE case history info? (7)
- what’s patients dx?
- secondary or tertiary dx?
- how long were they in acute care facility?
- anything in chart that may be red flag for hearing loss?
- pharmacological potential for hearing loss?
- is patient complaining of tinnitus (ringing in ears)? - lose high frequencies first when you start losing hearing, can cause tinnitus
- do you see hearing aids? don’t assume they don’t have them
with Americans with Disabilities Act says that deaf patients have the right to?
- rights are protected under ___?
- communicatino access in all medical facilities
- Federal Guidelines and CANNOT be reinterpreted by individual states like IDEA can
In terms of deaf patients rights under the ADA, the SLP may have to?
- never assume?
- advocate for the patient to exercise their rights
- that if they don’t ask for their rights they are waiving them
the universal sign for deafness should always be?
- may be ____ to post?
- used to ID a hearing impaired/deaf patient
- SLP’s responsibility
in nursing homes, it’s the responsibility of ____ to manage the patient/client with hearing loss
- what is key?
the SLP
- working with all staff
when working in a nursing home, the SLP should locate and define the roles of who?
- remember?
- an audiologist and a hearing aid dispenser
- they may be the same individuals or 2 separate contractors
what has to be administered to all nursing home residents in nursing homes receiving federal funding?
- what made this a requirement?
- what does this do?
- includes?
the Minimum Data Set for Nursing Home Residents’ Assessment and Care Screening Tool (MDS)
- the Omnibus Budeget Reconciliation Act
- drives patient care and treatment while in the home
- includes speech/language hearing services
list 4 hearing screening tools used in nursing homes
- Hearing Handicap Inventory for Edlerly (HHIE)
- Hearing Handicap Inventory for the Edlerly - Screener version (HHIE-S)
- International Outcome Inventory for Hearing Aids (IOI-HA)
- Whispered Voice Screening Test
SLPs roles in providing service to patients with hearing loss in nursing homes (4)
- monitor amplification
- consider alternate forms of amplification
- aural rehab groups
- staff training
if a tree falls in the forest and no one is around to hear it, does it make a sound?
YES
- sound is still sound even if it’s too loud, soft, or someone isn’t around to hear it
acoustics vs. psychoacoustics?
kylie
what is acoustics?
the study of sound, a branch of physics
what is sound?
a physical phenomenon which describes a movement (or vibration) of an elastic medium without permanent displacement of the particles
3 prerequisites for sound
- a source of energy (force)
- a vibrating object which generates an audible pressure wave
- a medium of transmission (e.g., air)
explain generation
- give example
- explain condensation and rarefaction in the example
sound waves are generated by any vibrating source
- ex/ a violin vibrates and causes the crowding together (condensation) and spreading apart (rarefaction) of air molecules
why can’t sound waves travel through a vacuum?
because sound waves travel by disturbing the particles of a material medium
what does propogation mean?
- how does this apply to sound?
movement through
- for sound to be generated and heard, it must have a medium to pass through
what receives a sound?
the ear
three basic parts of the ear and their roles in sound reception
- outer ear: collects and channels sound to middle ear
- middle ear: transforms energy of sound wave into internal vibrations of the bone structure of the middle ear, and ultimately transform these vibrations into a compression wave in the inner ear
- inner ear: transform the energy of a compression wave into nerve impulses that can be transmitted to the brain
5 steps of the speech chain
- generation of speech
- feedback link to the speaker
- propagation of sound waves
- reception by the listener
- transmission of info to the brain
SPEECH CHAIN PIC (slide 7) SOUND WAVE PIC (slide 11) WAVE pic (slide 12) TRANSVERSE wave (slide 15) slide 17 slide 19 slide 28 slide 35 slide 39 slide 50 slide 70 slide 76 slides 101-104
no idea about this
sound is created when:
1.
2.
- air molecules are set into vibration
- air molecules are disturbed, causing compression (air molecules tightly grouped together) and rarefaction (molecules are spread apart)
a tuning fork is a visual analogy to?
air molecule displacement
graphic depiction of waves is done as a function of ____.
- x axis =
- y axis =
time
- time
- amplitude
what’s a transverse wave?
a wave in which particles move in a direction perpendicular to the direction the wave moves
transverse wave motion, vibration is at ___ degrees regarding the direction of wave propagation
90
what is a longitudinal wave?
a wave in which particles move in a direction parallel to the direction which the wave moves
transverse = waves move? longitudinal = waves move?
- up and down
- left and right
sound waves are longitudinal, but are graphically represented by?
transverse waves
pure tones are represented by ____? what does it mean for it to be a pure tone?
sine waves
- only 1 frequency present
- if an oscillation begins at any points and ends on the identical point on the next wave = sine wave
5 dimensions of sine waves with formulas
- amplitude (displacement or intensity)
- frequency (cycles per second - 1/T)
- Period (time for one cycle - 1/f)
- phase (point in time on waveform)
- wavelength (distance traveled in one cycle: speed of sound/frequency = s/f)
four parameters describing simple harmonic motion as a function of time
- frequency
- amplitude
- period
- phase
define frequency
the number of complete vibratory cycles per unit time
define amplitude
a derived unit of measurement describing an object’s distance from rest to maximal displacement
define period
amount of time needed to complete one cycle of vibration
define phase
describes the relative timing of compressions and rarefactions of waves (ie/ how cycles relate to each other)
- sound is CHARACTERIZED as?
- sound is DEFINED as?
- propagation of density changes through an elastic medium
- transfer of energy through an elastic medium
if your period is in seconds, how do you figure out milliseconds?
multiply it by 1000
3 properties of all media that affect the behavior of sound propagation
- relationship between density and pressure (impacted by temp, determines speed of sound)
- motion of medium (if medium is moving, sound is further transported)
- viscosity of medium (determines rate at which sound is dampened)
is water or air a more efficient transmitter of sound? Why?
water
- sound travels faster in water
speed of wave propagation is governed by properties of what?
the MEDIUM
order of how fast sound can travel through these: steel, air, water
- steel
- water
- air (344 m/s)
practice with frequency on slide 35
practice
frequency is determined by characteristics of the ____
- effect of length?
source
- longer = higher
humans perceive frequency as?
pitch
usually it’s more difficult to perceive differences between pitches at ___ frequencies
higher
range of human hearing is ___ to ___ Hz
20-20,000
maximum sensitivity (BEST hearing) is ____ to ____ Hz
WHY???
1000-5000
because this is where most speech sounds fall
why use pure tones for aduiologic testing? (3)
- easy to produce
- consistent results for normative sampling
- can isolate which frequencies are difficult for individual to perceive
audiometry only tests which frequencies and why?
250-8000 hz
- most speech falls in that range
we only test ___ in audiology
- what is this?
octaves
- twice the stated Hz
wavelength changes with ____
- how?
- implications?
frequency
- longer wavelength = lower frequency
- vowels are easier to hear
what makes a sound complex?
it has more than one frequency
2 types of complex sounds wtih main differences
- periodic
- fundamental frequency (lowest common Hz, harmonics) - Aperiodic
- no repeating patterns, no F0, perceived as noise
if fundamental frequency is 2000 hz, what is f2? f3?
4000, 6000
define phase
displacement location expressed in degress
how many degress is covered in a 2 Hz sine wave? How do you know this?
720 degrees
- 360 degrees covered in 1 sec
- 180 degrees covered in .5 sec
how is the physical property of phase perceived psychoacoustically?
it impacts TIMING
what happens to the period of a wave as its frequency increases? give formula
it decreases
f = 1/T (period)
intensity relates to?
- explain
how hard a wave vibrates
- if a greater force is applied to air molecules, they will move further from their points of rest, causing greater compressions and rarefaction, increasing the particle displacement, and therefore the amplitude (intensity)
increased force = increased ____
amplitude (intensity)
psychoacoustically, intensity is perceived as ____
loudness
the distance the mass moves from the point of rest is called?
amplitude
why do we use the decibel?
because the range of human hearing is huge (20 micropascals to 200,000,000 micropascals)
- decibel is a ration scale that uses logarithms to deal with the huge numbers involved in intensity
with decibels, the range for hearing intensity is?
0 (barely audible) to 140 (painfully loud)
is the decibel scale linear?
- it’s expressed in terms of ___ which must be specified
- it is a ____ unit of measure
NO
- various reference levels which must be specified
- relative
difference between a linear scale and a logarithmic scale
- linear = like a ruler, equal spaces between, based on addition (1,3,5,7,9)
- logarithmic = like keys on a piano, spaces increase between, based on multiplication (2,4,8,16,32)
a tenfold increase in sound pressure, yields a ___ dB increase in intensity
20
logarithm is simply a ___ expressed as an ____, which tells how often another number (the base) will be ____
number, exponent, multiplied by itself
2 most common ways to express decibels
- sound pressure level (SPL)
2. hearing level (HL)
a sound at 50 dB, is ____ times louder than a 10dB sound
10,000
a sound at 30 dB, is ___ times louder than a 10dB sound
100
SPL is a ____ reference
physical
0 dB SPL = ____ micropascals
20
with SPL, 0 means?
lowest audible sound for human ear to hear
how does a hearing test work?
see what sound level certain frequencies are just barely audible
on slide 70, we need to make ___ and ___ frequencies louder in order for the person to be able to hear them
low, high
the normal average person needs ____ dB SPL to barely hear a 250 Hz tone
they need ____ db SPL to barely hear a 1000 Hz tone
- 26.5
- 7.5
why don’t we use dB SPL in audiometric testing?
- there’s different sound pressure value for each frequency, so testing becomes very difficult
dB HL is a ___ reference
- 0dB HL is what sound?
- 0 dB HL = ?
normative
- the softest sound average person can detect 50% of the time
- audiometric zero
each of the SPL levels in table correspond to a hearing level of _____
- SO to figure out amount of SPL, do what?
- 0 dB HL
- add the amount of SPL needed for that frequency
HL to SPL example
slide 76
what is the threshold of audibility
the intenity at which a sound is just barely audible
if Todd doesn’t hear until 70 dB HL, his threshold is ____
70 dB HL
anchor points for dBHL
- just barely audible
- uncomfortably loud
- painfully loud
- conversational speech
- 0
- 90
- 140
- 50
dB SL is a ____ reference
individual
threshold = 50 dBHL. sensation level = 45 dBSL. At what level does sound become uncomfortable?
95 dBHL
sensation level is the number of dB ____?
- so 0 dB means?
- 20 dB means?
dB above threshold
- at threshold
- 20 dB above threshold
what is dynamic range?
smallest unit of sound just audible to highest level of sound that is tolerable (individual)
what is reverberation?
created when?
the persistence of sound in a particular space after the original sound is removed
- created when a sound is produced in an enclosed space causing a large number of echoes to build up and then slowly decay as the sound is absorbed by the walls and air
what is reverberation time
amount of time it takes for a sound, at a specific frequency, to decay 60 dB after termination of the signal
if component frequencies are 500, 550, 1000, 1050, what’s the fundamental frequency? why? which harmonics are they?
50- the largest number that can be evenly divided
- 500: 10
- 550: 11
- 1050: 21
define harmonics
whole number multiples of fundamental freq.
define resonance
increase in amplitude of an oscillator caused by having a driving frequency at one of the natural frequencies of the oscillator
define resonant frequency
natural vibratory frequency of the receiving object
define resonator
system that is set into vibration by another vibration
beats occur when?
when a complex wave is formed from two sine waves whose amplitudes are the SAME but whose FREQUENCIES differ slightly
- two ppl playing an E note. Tod is at 330 Hz. Bob is at 332 Hz. what frequency will audience hear?
- how often will the audience hear the sound getting louder and softer?
- 331 Hz (avg)
- twice each second (beat frequency is 2 hz, since the 2 guitars differ in frequency by that amount)
a sound with instantaneous amplitude that varies over time in a random manner
noise
composite wave consisting of an equal amount of every possible frequency within a bandwith
white noise
device that allows only certain sine frequency components to pass through and suppresses any others
filter
passes all sinusoids with values between 2 particular values
bandpass filter
gives the range of frequencies as filter will pass
band reject
block out certain frequencies of sounds
acoustic filters
blocks high frequency components of a waveform; passess sinusoids with frequencies below a certain value
low-pass filter
blocks low frequency components of a waveform; passes frequency above a certain value
high-pass filter
blocks both around a band
band-pass filter
what to block - ?
what to let through - ?
- band reject
- pass band
the frequency values above, below, or in between which the filter passess the sinusoid and does not alter the amplitude
cut off frequencies
According to the IDEA, audiology includes (6)
- ID of children with hearing loss
- determining range, nature, degree of hearing loss
- providing habilitation activities (language, auditory, lip-reading, etc.)
- Create and administer PREVENTION programs
- Counsel those affected
- Determining need for amplification, selecting and fitting it, evaluating effectivenes
mass hearing screenings are considered _____. NOT part of ____
population-based (role of school nurse)
- IDEA
what is “child find”?
IDEA’s policy that says that it’s the school district’s responsibility to locate, identify, and evaluate children suspected of having disabilities (hearing loss)
explain the academic model
- driven by federal and state education law
- no services w/o written consent from parent/guardian
- must prove need
- services may occur in general education/inclusive setting/self-contained
- interdisciplinary team
Under IDEA, eligibility for services requires?
educational manifestation of the disability
- there must be proof that the disability adversely affects a child’s educational performance
under section 504, the impact on education is defined as:
substantially limiting one or more major life functioning
ideally, a ____ is performed as part of the IEP assessment on all student with hearing impairment who have auditory potential
Classroom Listening Assessment
components of a classroom listening assessment (4)
- classroom observation
- classroom acoustics
- functional assessment
- self assessment
what info might you want out of a classroom observation?
classroom design, seating arrangements, classroom acoustics, how a teacher manages instruction, expectation of student participation, etc.
as far as classroom acoustics goes, you wanna know ___ and ____
background noise & reverberation time
reverberation time causes ____ in speech signal and therefore?
distortion, may result in significant auditory fatigue for the child
teacher needs to have a ____ dB SNR. what does this mean? is this usually achieved throughout the day?
15 dB. Needs to be 15 dB above background noise
- rarely achieved throughout the day
classroom noise levels should not exceed ____
- typical classroom noise levels range from ____
35 dBA
- 41 to 51 dBA
IDEA’s policies on assistive devices and services?
- schools are responsible for evaluating need for this, getting it, fitting it, and coordinating other services necessary
slides 37 and 38 on CH 14/17 pp
Assistive technology
______ means any service that directly assists a a child with a disability in the selection, acquisition, or use of an assistive technology device
assistive technology service
cochlear implant monitoring based on IDEA?
- public agency must ensure that the external components are working properly
- not responsible for surgically implanted internal components
types of auditory training devices (slide 41)
- FM systems
- DAI
- body worn infrared loops
assistive listening technology
- classroom soundfield systems (sound projection system in classroom)
- tabletop personal systems (adjust to how loud they need it)
- ear level assistive listening devices (attach to hearing aid, teacher wears microphone)
school-based audiologists are also responsible for _____ for parents, children, etc.
counseling related to hearing loss
preventing hearing loss in the school (7)
- ID at-risk and dangerous noise sources
- mandatory noise safety instruction
- mandatory use of hearing protection
- mandatory monitoring of hearing levels of employees and teachers who work in noise hazardous areas
- training school employees in hearing loss
- policies to limit dB levels and expoure time at school-sanctioned events
- require hearing screenings of students
what does hearing impairment mean?
an impairment in hearing, whether permanent or fluctuating, that adversely affects a child’s educational performance but that is not included under the definition of deafness
what does deafness mean?
a hearing impairment that is so severe that the child is impaired in processing linguistic info through hearing, w/ or w/o amplification, that adversely affects a child’s educational performance
different service options for hearing impaired/deaf?
- RTI: little extra help
- 504: mainstream but need FM system
- self contained program for deaf and hard of hearing
2 primary methods that schools may utilize to deliver audiology services
- employment directly by local education agency responsible for providing special edu and related services
- a contract with an individual, organization, or agency for specified audiology services
____ provides alot of resources regarding school aduiology services
educational audiology association
difference between ADA and IDEA
- IDEA can be changed state to state
difference between medical model and academic model
- past cards
roles of SLP/audiologist in these 2 models
read
educational audiologists have distinctive roles and responsibilities to __________
ensure that students with hearing loss are identified, properly assessed, and managed so that they have the same opportunity to acess their educational program as all students
SLP plays an imortant role in ______ for the success of the student with hearing loss or APD
facilitating services and working collaboratively with the educational audiologist
