Topic Area 3 - Effect of HL on Speech Production/Perception

Question 1

Why might one need to have a way to focus on auditory training?

Answer 1

-improve their ability to recognize speech, particularly in the presence of background noise
-often are those who have experienced a recent change in hearing status (e.g., if patient is using a HA for the first time, or received a new model of HA)
New HA users realize greater benefits from training compared to experienced HA users, although experienced HA users too have shown benefits from training

Question 2

Define acoustic highlighting

Answer 2

using exaggerated prosodic contours to emphasize parts of speech and language

Question 3

Define listening hoop or hoop or speech screen or acoustic screen

Answer 3

A screen used to block the visual cues of mouth movements, without blocking or changing the speech signal

Question 4

Define hearing age

Answer 4

How long in years the client has had access to appropriate amplification fitting for all waking hours

Question 5

Detection or Awareness:

Answer 5

client can indicate that they hear something, but doesn’t have to indicate what they hear. Used during audiometry. May be indicated by lifting a hand, putting a block in a bucket, looking around for the sound, saying “I hear that”, etc.

Question 6

Discrimination

Answer 6

The auditory ability to discern one signal from another. It requires enough short term memory to hold one or more signals against which to compare against each other. Usually done with a small, closed set of possibilities

Question 7

Identification

Answer 7

The auditory ability to discriminate one signal from all others

Question 8

Comprehension

Answer 8

The ability to understand the language encoded in the auditory signal

Question 9

Self-efficacy

Answer 9

Confidence that a person has for performing a particular task; belief in one’s ability to do something

Question 10

The difference between self-efficacy and self-worth or self-concept

Answer 10

Self-efficacy-
Judgement of confidence
Context-sensitive
Can be task specific
Made and used in reference to some type of goal
Domain-specific
A question of can (can I do this?)

Self-Concept -
Judgement of self-worth
Not context sensitive
Not task- specific
Cognitive self-appraisal, independent of a goal
Can be domain specific
A question of being or feeling (Who am I? how do I feel?)

Question 11

What self-efficacy looks like in a client with hearing loss

Answer 11

The beliefs patients have about their abilities to manage difficult communication situations and problem solve
The beliefs that they can plan and execute a course of action that will improve their communicative interactions in a given environment
Influences their willingness to engage and the time they are will to invest in activities and challenging communication situations
The higher the sense of self-efficacy, the determined and perseverant in the face of challenges and obstacles

Question 12

Ways to bolster self-efficacy

Answer 12

Mastery experience
Vicarious experience
Verbal persuasion
Emotional arousal

Question 13

Mastery Experience

Answer 13

direct experience in a successful communication interaction. Practicing repair strategies in a safe and comfortable setting, experiencing success

Question 14

Vicarious experience

Answer 14

Direct observation of others succeeding can bolster patient’s belief that he/she too can succeed

Question 15

Verbal persuasion

Answer 15

Clinician might tell or logically explain to the patient that communication difficulties can be managed and patient has tools necessary to change them

Question 16

Emotional arousal

Answer 16

• Activities that lower person’s arousal, such as relaxation or breathing activities might enhance perceived self-efficacy
• If patient breaks down into cold sweat at the very thought of attending social events, then that patient probably judges his/her self-efficacy to be low

Question 17

Model for Communication Training (3 stages)

Answer 17

Formal Instruction
Guided Learning
Real-World Practice

Question 18

Why is stage 2 most important?

Answer 18

The means by which we can bring individuals with hearing loss to a status of improved communication and a reduced sense of “handicap”

Question 19

What is continuous discourse tracking?

Answer 19

Clinician or a frequent communication partner plays the role of the sender (= participant who presents the message) and the patient plays the role of the receiver (= participants who receives the message and attempts to repeat it back)

Sender reads a selection from a book, phrase by phrase; after each phrase receiver attempts to repeat it verbatim
If receiver cannot recognize phrase they’re responsible for using a repair strategy

Recommended text: fiction written for older children and teenagers “Read” well when spoken and sound natural e.g., Harry Potter

Question 20

Xtics of Clear Speech

Answer 20

• SPEECH
• Spotlight your face and keep it visible, face the speaker when you are talking, be within 5-10 ft.
• Pause slightly between content components of sentences, speak at a moderate rate, pausing between phrases and sentences (allows hearing impaired person to process info in chunks)
• Empathize and be patient with the individual who is hearing-impaired, rephrase when necessary, clarify if you need to
• Ease their listening, get their attention before you speak, ask how you can facilitate communication, encourage feedback – make it as easy as possible for the hearing impaired listener
• Control the circumstances and the listening conditions in the environment, avoid background noise and find good lighting
• Have a plan, anticipate difficult listening situations and have predetermine strategies for communicating in them, e.g., you might have to communicate with the server in a restaurant instead of the individual with the hearing loss

Question 21

Gaols of communication strategies training for frequent communication partners

Answer 21

1) help them understand how difficult the speechreading task can be for someone who is hearing impaired,
2) encourage them to use appropriate speaking behaviours,
3) learn how to produce messages that are easy to comprehend, and
4) learn how to repair breakdowns

• Train speaking partners to use the above characteristics (SPEECH) through coaching, instructing them about clear speech and providing a description. Give demonstrations, provide opportunities to practice with clinician and give meaningful feedback about performance.

Question 22

Content that may be included in a communication strategies training program for communication partners:

Answer 22

Appropriate speaking behaviours (slow, clear)
Empathy
Organized messages (avoid ambiguity/verbosity)
Comprehension (verify)
Breakdown repair (repeat, simplify)

Question 23

Clear Speech evidence

Answer 23

Caissie et al. (2005): utterances spoken by a spouse who received communication strategies training (description of clear speech, demonstrations, practice, feedback, etc.) were significantly more intelligible than those by a spouse who received no training (was just told to “speak clearly”) as judged by 15 research participants with typical hearing and 15 research participants with HL.