Test 2 Flashcards
What are visemes?
Speech sounds that look alike on the face /p/ /b/ /m/
What are homophones?
Words that look the same on the face
i.e. grade and yes
What does lip reading entail?
Visual cues only
What does speech reading entail?
Auditory and visual cues
Which type of reading do ALL people subconsciously do?
Speech read
What factors influence speech reading? (4)
Talker
Message
Environment
Speech Reader
Manner, Place, Voicing: which are easier and which are harder?
Manner and Voicing are easier to hear
Place is easier to visualize but harder to hear
Which training does speech reading training entail?
Some combination of analytic and synthetic
What does speech reading training begin with?
Vowel training
What are the objectives of analytic vowel speech reading training?
Discriminate between letters i, u, a through their different formants and different mouth positions
Identify words in open set formants
What are the objectives of analytic consonant speech reading training?
Discriminate between consonants that differ in place but share manner and voice
Identify words in an open set format
Why do you focus on place and not manner and voice?
Because manner and voicing cues are primarily auditory
What is the ending objective of synthetic consonant speech reading training?
Speechread a paragraph
What makes vowels easier to discriminate?
The further apart they are on the vowel quad, the easier it is to tell them apart
What are the effects of hearing loss on “the rules”? (6)
- Disruption in turn taking
- Modification of speaking style (slower rate)
- Inappropriate topic shifts
- Superficial content
- Frequent clarifications (what)
- Violations (too loud, dominate convo)
What are the two classes of communication strategies?
1- Facilitative
2- Receptive
What is a facilitative communication strategy?
The individual with the HL instructs the talker and structures the environment
What is a receptive communication strategy?
The individual with the HL provides explicit instruction immediately following a communication breakdown
Name the four factors in communication.
1- Talker
2- Message
3- Environment
4- Listener
What type of strategies are used to influence these four factors?
Facilitative Strategies
What factors pertaining to the talker can affect the conversation? (5)
- Speed
- Chewing gum
- Hand over mouth
- Looking/walking away
- Too loud
How is message a factor? (4)
- Simple sentences/ syntax is easier than a long complicated one
- Repeat key words
- Eliminate ambiguous references
- Avoid colloquialisms
What is a colloquialism?
A phrase specific to a certain area
In what ways can the environment effect communication? (4)
- Background noise level
- Lighting
- Distance (not too far or too close)
- Viewing angle
In what ways can the listener effect the conversation? (4)
- Use all cues (visual and auditory)
- Severity of the HL
- Alertness vs. Fatigue
- Self defeating emotions (I’m stupid)
What are the three categories for repair strategies?
- receptive
- extended
- expressive
What are the types of receptive repair strategies?
Specific
Non-specific
What’s the difference between a specific and a non-specific receptive repair strategy?
Specific = specific things that maintain the convo
i.e. repeat, rephrase, simplify, elaborate, write
Non-specific = a repeat strategy “what” “huh” smile and nod…
What is an extended repair?
One strategy is not successful, so you try another to continue the conversation
What does a hearing impaired individual tend to do if the strategies don’t work?
- blame others
- blame environment
- bluff (difficult to admit)
What is an expressive repair strategy?
The hearing impaired replays with an unintelligible response
Who most commonly uses expressive repair strategies and why?
Children because they cannot monitor their own speech
How does one go about when an expressive repair has occurred?
Ask them to repeat, rephrase, slow down so their speech is clearer
What is Topic maintenance?
Stay with one topic.. Do not abruptly shift to another
What is Topic shading?
A new topic that it direct off shoot.. Subtle changes in topic
Which repair strategy is most common?
Non-specifc
Which repair strategy is the least effective?
Non-specific
As the speaker, what is the best way to repair when someone says what?
Rephrase or restructure
Do people bluff because they are uncooperative?
No.. They bluff because it is difficult to admit they have a problem
What are adjacency pairs?
Predictable patterns of responses when a hard of hearing interacts with normal hearing that keeps the convo flowing
i.e. greeting-greeting; question-answer
What are the three conversational styles?
Passive
Aggressive
Assertive
What is a passive convo style?
Individual withdraws from conversation, bluffs, and avoids social situations
What is an aggressive convo style?
Individual is hostile, belligerent, blames others, and has a bad attitude. This person often times dominates the conversation.
What is an assertive convo style?
Individual takes responsibility and is considerate of others. These people acknowledge what they do and don’t get.
Which style is most effective in the flow of a conversation?
Assertive
Name the three types of conversational styles along with the behavior that comes with it.
Passive= non interactive Aggressive= dominating Assertive= Interactive
What makes conversational fluency better?
Less time spent in repair, shorter duration of repair; NOT DOING THE SAME THING OVER AND OVER AND EXPECTING A DIFFERENT RESPONSE
Who would a HL individual have a better conversation with? Why?
A speech-hearing professional because they know what to do in order to make the conversation go more smoothly
In what ways is it harder to identify input?
Open sets
Longer sentences
Can unstructured conversations be assessed formally?
YES!
How can unstructured conversations be assessed formally?
Compare the performance with a familiar partner and a “naive” partner
Review and rate on a 1-4 scale
What is the difference between an interview and a questionaire?
Interview- comparison, tracks progress with no standard
Questionaire- gives standardized data
In which strategy training level can yes/ no questions be asked?
Questionaire
What are the perks of having a group setting when working on communication strategies?
Encourages interaction
Give an oppurtunity to see others also struggle
What is the cardinal rule of a group session?
cater to the needs of the group
What type of data is given through an audiogram vs. a person’s perception of themself?
Audiogram= Quantitative Individual= Qualitative
Why does shouting make speech reading harder?
Overemphasizing movements
How many residents of nursing homes generally have HL? To what degree?
Half of the residents
Severe HL
What is the WATCH program?
A short tutorial for a short term training program
What does WATCH stand for?
Watch the person's mouth Ask specific questions Talk about your hearing loss Change the situation Health care knowledge
What is the SPEECH program?
Used for communication partners
What does SPEECH stand for?
Spotlight face
Pause in between phrases and sentences
Emphasize and be patient
Ease listening, get the person’s attention
Control the environment and circumstances
Have a plan for difficult situations (i.e. restaurants)
What does the SPEECH program emphasize?
The burden should not and does not fall only on the person with the hearing loss
What should be done when training children? (5)
Focus on facilitative and repair strategies Formal instruction Review effective listening behaviors Guided learning through modeling Real world practice
What is formal instruction?
write down a situation the client wants to improve
group generates 15 possible solutions
How is formal instruction most effective?
As a dialog! NOT A LECTURE
What are the two types of counselling?
Informational
Personal Adjustment Counseling
How does counseling help?
Individual learns to manage HL and communication difficulties while using optimum communication strategies and structuring the listening environment
What does counseling target?
The head and the heart and the behaviors of the HL individual
What is the goal and outcome of informational counseling?
Goal: person learns about HL and technology to minimize the impact
Outcome: understanding and realistic expectations of HL and what amplification can and cannot do
What is the goal and outcome of Personal Adjustment counseling?
Goal: patient works through negative feelings about HL and self-worth
Outcome: view disability as seperate from self; more positive self image; focus on what they can do
What are the 3 general counseling techniques?
Cognitive
Behavioral
Affective
What are cognitive couseling techniques?
Educate the person to improve self worth
Give info to counteract false assumptions
Eliminate cognitive distortions
Cognitive Counseling Goal?
Modify the thought process
What are behavior counseling techniques based on?
Skinner: Reinforcing rats
What are behavioral counseling techniques?
Focus on the observable and measurable behaviors
Focus on response to a stressful situation
Relaxation techniques
Behavioral Counseling goal?
Modify behaviors
What are affective counseling techniques based on?
Rogers: congruence with self, unconditional positive regard, empathetic understanding
What are affactive counseling techniques?
Unconditional positive regard
Centers on feeling
Developing appropriate emotional adjustment to the HL
Affective Counseling Goal?
Modify emotions
What was the Hearing Loss Association of America formally known as? What kind of program is this?
SHHHH
Informal
What are the three componants of Aural Rehab?
- Evaluation
- Strategy
- Implementation
Explain Evaluation.
Assess the patient
- demographic
- stage of life
- culture
- gender
- economical status
- psychosocial status
- audiological considerations: degree, onset
Explain Strategy.
Determine the AR plan
- needs and wants of patient
- services available
- willingness to comply
- ownership
- specific goals developed based on patient
What is COSI? Explain.
Client Oriented Scale of Improvement
- guides the overall AR plan
- client identifies 5 difficult listening situations that are important to them
- rates difficulty level pre and post treatment
Explain Implementation.
Final Stage:
- set specific goals
- tailer core services to meet needs
- determine success benchmarks
- evaluate outcomes
- refine goals
As a client begins to adapt and improve, what occurs?
They begin to go out and do more things
**requires goals to be refined
What are the three types of counseling in all stages of Aural Rehab?
Informational- audiogram
Rational Acceptance- accepting limitations and HL
Adjustment
What is an ALS?
Assistive Listening Device
What is the characteristics of a Traditional Old?
- less active
- value trust, service and quality
- resistant to technology
- save and bargain
- price conscious
- avoid debt
- believe the “expert”
What are the characteristics of Boomer Old?
- more active
- diverse: different ethnic groups
- technologically savvy
- use credit
- bargain and spend
- question authority and “experts”
What is Presbycusis?
elder hearing: natural loss of hearing with age
THIRD MOST CHRONIC CONDITION
What factors affect impact of HL? How?
Economic- finances
Social- family/friends, home vs. center
Emotional- mental health, self concept, indepent
Cognitive- working memory, processing speed
Physical- vision, arthritis, dementia
Audiogram Scale!
Mild: 25-45 Moderate: 45-60 Moderate to Severe: 60-75 Severe: 75-90 Profound: 90<
Language in a dense neighborhood vs. sparse?
Dense= words that look ad sound the same Sparse= less words to confuse it with i.e. orange
Lexical neighborhood?
predictabilty of words
Speech reading maxs out at?
30%- not a huge help
Open vs. Closed set?
Open= more challenging Closed= choices
Noise Induced affected at what frecency?
4000 Hz
