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Aural Rehab > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What is Aural Rehab?

A

A rehab service that

  • Identifies HL
  • Manages medical issues
  • Gives technological support
  • Develops auditory skills
  • Gives counseling to patient and family
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2
Q

What is a Rehabilitation Service?

A

A service the provides the most appropriate technological and medical support and helps build skill level to improve function.

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3
Q

What are the goals of Aural Rehab?

A

To alleviate HL difficulties and minimize consequence, to enhance conversational fluency, and promote personal adjustment

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4
Q

*How many people suffer from hearing loss?

A

31 million

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5
Q

What is the range of loss in which an individual would be considered to have a hearing impairment?

A

26dB - 70dB

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6
Q

What range of loss puts an individual in the deaf category?

A

70+ dB hearing loss

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7
Q

What is an Audiogram?

A

A graph representing hearing thresholds as a function of frequency

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8
Q

What is a threshold?

A

The level of sound detected 50% of the time

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9
Q

What does air conduction test?

A

Outer and Middle Ear

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10
Q

How is hearing tested through air conduction?

A

Headphones, Insert Earphones, or a Soundfield (speakers)

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11
Q

What does bone conduction test?

A

Inner ear

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12
Q

How is bone conduction tested?

A

By placing a vibrator on the forehead or the mastoid

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13
Q

What is affected in a conductive hearing loss? How do you know this?

A

The problem lies in the outer and/or middle ear..

I know this because air conduction shows a hearing loss but bone conduction is normal.

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14
Q

What is the major feature indicating conductive hearing loss on an audiogram?

A

An air bone gap

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15
Q

Where is the problem in a sensorineural hearing loss? How do you know this?

A

Inner ear or Auditory nerve.. I know this because there is no air bone gap yet there are abnormal thresholds for both air and bone conduction.

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16
Q

*What does a soundfield used for?

A

To test for hearing loss by Air Conduction

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17
Q

What is a mixed hearing loss?

A

Abnormal thresholds for both air and bone conduction but there IS an air bone gap.

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18
Q

In a Mixed HL, which test is worse? AC or BC?

A

Air conduction is worse than bone conduction but bone conduction is still below 25dB

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19
Q

What does PTA stand for? What does it tell us?

A

PTA is the Pure Tone Avg… It predicts the softest level at which speech can be detected

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20
Q

How do you find a 2 tone PTA?

A

You avg. the two best readings between 500Hz, 1K Hz, and 2000 Hz

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21
Q

How do you find a 3 tone PTA?

A

Avg. 500Hz, 1KHz, 2KHz together

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22
Q

What does Pure Tone Audiometry evaluate? And through what method?

A

Evaluates the degree of hearing loss by air conduction and bone conduction

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23
Q

What could effect accurate Pure Tone Audiometry readings?

A
  • when it was last calibrated
  • experience of the person giving the test
  • test environment
  • patient state
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24
Q

*What is Speech Recognition?

A

Word Discrimination

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25
Q

How is speech recognition accomplished?

A

Lip reading, Auditory info/Listening, or both

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26
Q

What does SRT stand for?

A

Speech Recognition Threshold

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27
Q

How is the SRT obtained?

A

Spondee words

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28
Q

*What are spondee words? What are they good for?

A

2 syllable words with equal stress and same audibility
SPEECH RECOGNITION

i.e. baseball, hotdog, ice cream, football, cowboy

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29
Q

Speech Detection vs. Speech Recognition

A

Speech detection happens at a lower level than Speech recognition… Speech detection in knowing that someone is talking where speech recognition is being able to discriminate the words being said

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30
Q

*List stimuli

A 
Nonsense bisyllables (phonemes)
Monosyllable words
Bisyllabic words
Spondee words
Phrases
Sentences
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31
Q

*What are the levels of hearing loss? What are their ranges?

A 
Mild: 25-45dB
Moderate: 45-60dB
Moderate-Severe: 60-75dB
Severe: 75-90dB
Profound: 90+dB
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32
Q

*What range is most speech located in? What frequencies?

A

20dB-50dB

1K-3K Hz

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33
Q

*If a person has a 40dB hearing loss, how much speech do they miss?

A

50-75%

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34
Q

What is a bilateral HL?

A

HL in both ears

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35
Q

What is a unilateral HL?

A

HL in only one ear

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36
Q

What type of condition is HL considered?

A

HL is an INVISIBLE condition… but the effects are not

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37
Q

What are the three onsets of HL?

A

Prelingual
Interlingual
Postlingual

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38
Q

When can Post lingual onset of HL begin?

A

Age 5

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39
Q

*What powers hearing aids?

A

A battery (cell)

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40
Q

*True or False: All hearing aids run on batteries.

A

True

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41
Q

H*ow many parts does a hearing aid have? What are they?

A

Four: Microphone, Amplifier, Receiver/Speaker, Power Source

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42
Q

*What are the parts of the microphone?

A

Diaphragm

Metal back plate

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43
Q

*Explain the microphone.

A

It picks up the acoustic signal which moves the diaphragm. This generates a small (electrical) voltage between the diaphragm and the back metal plate which is passed along to the amplifier.

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44
Q

*What is the purpose of the Amplifier?

A

Amplifies the sound based on the degree of HL.

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45
Q

What is gain?

A

Gain is the amount of amplification applied to the signal.

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46
Q

What are the two types of amplification?

A

Analog Aid

Digital Aid

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47
Q

Analog Aid vs. Digital Aid

A

AA: signal stays in analog electrical waveform
DA: A/D converter changes the analog electrical signal to 1’s and 0’s for sound processing and then converts it back to analog

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48
Q

What does A/D converter stand for?

A

Analog to Digital converter

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49
Q

*What is the receiver’s job?

A

To receive the signal from the amplifier and convert the electrical signal back to an acoustic signal

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50
Q

*What is the receiver essentially?

A

A mini loudspeaker

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51
Q

*Name the features of a hearing aid.

A

On/Off switch
Volume control
Telecoil
Audio input

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52
Q

What is a telecoil? What does it do?

A

An inductive coil..It picks up the phone signal and amplifies it

53
Q

What does audio input allow for?

A

Connection between the aid and a TV, Computer, or FM station

54
Q

*What is the role of the earmold?

A

To connect the aid to the ear

55
Q

*Name the different styles of hearing aids.

A 
Body Aid
Behind the Ear
In the Ear
In the Canal
Completely in the Canal
56
Q

Explain the body aid

A

The mic, amp and battery are all located in a “box” which attaches to a cord connected to the receiver which connects to the earmold

57
Q

What is the BTE aid?

A

Behind the Ear aid: fits over the ear/ behind the pinna and connected to the aid with a short, clear tube in the earmold.

58
Q

What is the ITE aid?

A

In the Ear aid: all components of the aid fit in the ear.

59
Q

What is the ITC aid?

A

In the Canal aid: everything fits in the ear canal

60
Q

What is the CIC aid?

A

Completely in the Canal aid

61
Q

Which style hearing aid is most common?

A

The BTE aid

62
Q

What range hearing loss is the BTE aid used for?

A

Mild to Profound

63
Q

What range hearing loss is the ITE aid used for?

A

Mild to Severe

64
Q

Why does the range of hearing loss shrink with the smaller aids?

A

The smaller the aid, the more restrictive and the fewer features available

65
Q

What advantage does a ITE aid have over the BTE aid?

A

The mic of the ITE aid is closer to the canal opening and uses the pinna for better localization

66
Q

What range of hearing loss do aids work best for?

A

Mild to Moderate hearing loss

67
Q

What type of hearing loss are cochlear implants used to help?

A

Moderate-Severe to Profound Sensorineural HL

68
Q

How is a cochlear implant arranged?

A

Tonotopically

69
Q

How does a cochlear implant work?

A

Electrodes are inserted into the cochlea and directly stimulate the auditory nerve

70
Q

*Name the external components of a cochlear implant.

A

Microphone
Speech Processor
External Transmitter

71
Q

*Name the internal components of a cochlear implant.

A

Receiver

72
Q

What is the job of the microphone in a cochlear implant?

A

To pick up sound

73
Q

What is the job of the speech processor?

A

To convert and code acoustic sound into electrical pulses

74
Q

What does the external transmitter do?

A

Transmits info across the skin to the receiver

75
Q

Describe the job of the receiver.

A

It is placed under the skin and it’s electrode array is inserted into the cochlea

76
Q

What does ALD stand for?

A

Assisted Listening Device

77
Q

Name some ALDs.

A

Closed captioning on a TV
Texting
Email
Light flashing for the doorbell

78
Q

*List the four design principles.

A

Auditory Skill Level
Stimulus Unit
Activity Type
Difficulty Level

79
Q

*List and explain the four steps of Auditory Skill Level.

A

1) Sound Awareness- easiest/most basic level; the ability to recognize if a sound is present and begin to put meaning with a sound.
2) Sound Discrimination- the ability to tell if two sounds are the same or different
3) Identification- the ability to label and the awareness that objects have names
4) Comprehension- hardest level; the ability to understand the meaning of a spoken message

80
Q

What is the ultimate goal in the Auditory Skill Level design principle?

A

Comprehension

81
Q

Do you always start with sound awareness?

A

NO! This varies based on the individual’s auditory experience and language at the time of hearing loss

82
Q

Typically, what kind of patient starts with the sound awareness level?

A

A patient who has severe to profound pre-lingual hearing loss and now has hearing aids or cochlear implant

83
Q

When going through sound discrimination, what sounds do you start with?

A

Two very different sounds! /a/ and /s/

  • > different voicing
  • > high vs. low frequency
84
Q

How does the Stimulus Unit design principle work? What are the two types?

A

All the programs are combined together.. Analytic Activities and Synthetic Training

85
Q

Explain Analytic Activities

A

These focus on segments of the speech signal.. It is essentially training in isolation.

i.e. phonemes and syllables

86
Q

Explain Synthetic Training

A

Train to recognize meaning even if you don’t recognize every word or sound.

87
Q

What is the Activity Type design principle?

A

This is the optimal training program because it incorporates both formal and informal training.

88
Q

Explain formal vs. informal training.

A

Formal training is highly structured, drill type activities in a small group or even 1-on-1. Informal training incorporates daily routine activities.

89
Q

Explain the Difficultly Level design principle.

A

When an individual reaches 80% correct performance, the difficulty should be raised. If below 50%, the difficulty should be lowered.

90
Q

How many ways are there to change difficulty?

A

Six

91
Q

List the six ways to change difficulty. Explain them.

A

1- Stimulus Set: open ended vs. closed (choices)
2- Stimulus Unit: words vs. complete sentences
3- Stimulus Similarity: dissimilar vs. similar
4- Context: highly detailed vs. low/little detail
5- Task: structured vs. spontaneous
6- Alter listening environment: good Signal-to-Noise ratio vs. poor Signal-to-Noise ratio vs. distance

92
Q

What is analytic training used for?

A

To help those with low auditory skills learn sound awareness and the sound has meaning.. Usually young or new cochlear implant users

93
Q

In analytic training, what sounds should you start with and why?

A

Start with vowels because they are voiced and solely contrasted by the formants

94
Q

How is formant 1 determined vs. formant 2?

A 
1 = how far the mouth is open
2 = tongue position
95
Q

When moving on to consonant training, what should one keep in mind?

A

Start with voiced and nasal sounds- easiest

Pick consonants that differ in manner and voice and even place

96
Q

What are the most difficult consonants to pick up?

A

short, high frequency and unvoiced sounds

97
Q

What is cycling?

A

When you return to an objective previously achieved to refresh, reinforce and give additional learning.

98
Q

What does synthetic training focus on?

A

Prosodic speech aspects
Learning to discriminate between single words and sentences
Checking comprehension

99
Q

Explain formal auditory training.

A 
Stimuli are more challenging
Vary the talkers
More info over a short period of time
combines analytic and synthetic levels
Progress from closed to small open set
100
Q

What is a reinforcement?

A

A quick activity immediately following a correctly finished training activity

101
Q

What is informal training?

A

Auditory practice occurs in the context of the activity the child is interested in

102
Q

What is Interweaving?

A

Auditory training with speech therapy and speech reading training.

103
Q

What THREE benefits come with interweaving?

A

This builds an association between auditory and visual
Links speech perception to speech production Allows the client to feel the difference in production even if they do not hear it.

104
Q

What does Auditory Training affect?

A

Brain Development

105
Q

What is the purpose of auditory-oral training?

A

It enhances the speech recognition better than simultaneous communications

106
Q

What degree of hearing loss is auditory-oral training appropriate for?

A

Mild to Moderate

107
Q

What is simultaneous speech?

A

Speech with sign language at the same time

108
Q

When is simultaneous speech best?

A

With a severe to profound hearing loss

109
Q

True or False:
A child with hearing loss progresses through the same stages of hearing and speech development once amplification or implants are given to them.

A

True

110
Q

What is the difference between an activity limitation and a participation limitation?

A

Activity= the inability to hear speech and noise

Participation= things you don’t do due to hearing loss

111
Q

*What is avoiding restaurants an example of?

A

Participation limitation

112
Q

Does Aural Rehab always include Speech and Language therapy?

A

No, it depends on the patient.

113
Q

Hearing aids send what kind of signal?

A

Acoustic

114
Q

Cochlear implants create what kind of signal?

A

Electrical

115
Q

Pre-lingual is when?

A

birth

116
Q

*When can a post lingual hearing deficit begin?

A

Age 5

117
Q

What years are considered post lingual?

A

9-10 years

118
Q

What are the three categories of hearing loss?

A

1- Degree
2- Onset
3- Progression

119
Q

*Envelope means?

A

Duration

120
Q

*A case study is…

A

Correlational

121
Q

*What is a correlational case study?

A

subjects are exposed to a particular treatment and followed over time and compared to unexpected subjects

122
Q

*What is pitch NOT a feature in?

A

Pitch is not a feature in a consonant phoneme confusion analysis

123
Q

*Was Alexander Graham’s wife hearing impaired?

A

YES

124
Q

*When are cochlear implants implanted?

A

4-6 weeks after surgery

125
Q

What are the SIX levels of evidence from most credible to least credible?

A

1- Systematic meta-analysis of more than one randomized control trial
2- Well designed, randomized control trials
3- Well designed control trial without randomization
4- Well designed quasi-experimental studies
5- Well designed non-experimental studies
6- Expert committee report

126
Q

What is EBP?

A

Evidence Based Practice

127
Q

What should be considered in EBP?

A
  • clinical expertise
  • patient values
  • current and the best scientific evidence
128
Q

^ What is the purpose of the speech recognition test?

A

To dictate one’s choice of test

Aural Rehab (3 decks)

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