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SHS 496 > unit 1 > Flashcards

unit 1 Flashcards

1
Q

aural rehabilitation (AR)

A

seeks to restore a person’s ability to communicate (re-teaching)

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2
Q

aural habilitation

A

seeks to establish or improve a child’s ability to communicate (cannot re-teach what they never had)

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3
Q

what is the AR plan?

A

assessment, informational counseling, develop a plan, implementation, outcome assessment, and follow up

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4
Q

what are the two models for AR?

A

evaluation (activity limitations/restrictions, audiologic status, and life factors) AND intervention (AR strategy, listening devices, other services, and outcome assessment

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5
Q

goals of AR

A

minimize, alleviate hearing related difficulties ; improves conversational fluency, improved feeling of self-concept, better quality of life

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6
Q

disabiling hearing loss

A

there is a loss of function imposed by hearing loss and denotes a multidimensional which many include pain or discomfort (only about 30% of adults will do something about their hearing loss)

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7
Q

what does ICF stand for

A

international classification of functioning, disability and health

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8
Q

ICF framework

A

body structure, activity, body functions, participation, environmental factors, activity limitations, personal factors, participation limitation

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9
Q

impact of hearing loss on family members

A

“third party disabilities” in their own lives

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10
Q

why is AR needed for infants and toddlers

A

early identification, and prevention of speech and language delays

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11
Q

why is AR needed for school age children

A

academics and communication with peer groups are high priorities
-educational planning, accommodation in the classroom with assistive technology. and support in transition

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12
Q

why is AR needed for adults

A

adults can continue to make contributions in workplace and communities

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13
Q

why is AR needed for older persons

A

many want to continue career or desires to communicate with friends and family
-with health advances, hearing loss is the only thing holding them back

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14
Q

evidence based practice

A

clinical decisions for patient care should be based on :
-clinical expertise
-patient values
-best research evidence (real ear measurements)
-not “this is what we’ve always done”

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15
Q

what does PICO stand for

A

patient intervention comparison outcome

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16
Q

prelingual

A

HL acquired before acquisition of spoken language

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17
Q

perilingual

A

HL during acquisition of spoken language

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18
Q

postlingual

A

HL after acquisition of spoken language

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19
Q

congential

A

HL present at birth

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20
Q

acquired

A

HL from prevocational, early working age, later working age, retirement age

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21
Q

progressive hearing loss

A

occurs over the course of several months

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22
Q

sudden hearing loss

A

individual loses hearing suddenly, possibly due to an injury

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23
Q

speech clarity

A

dominated by high frequency volumes (CONSONANTS)

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24
Q

speech volume

A

dominated by low frequency volumes (VOWELS)

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25
Q

what conveys the most word information

A

consonants - therefore more important for speech intelligibility

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26
Q

speech perception testing

A

determine need for amplification, compare performance with and without listening device, compare different listening devices, determine needs for AT/placement in training program/expected benefit

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27
Q

speech recognition tests

A

assesses how well someone understands, often referred to as word recognition scores
-sound segregation and sound localization

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28
Q

speech awareness threshold/speech detection threshold (SAT/SDT)

A

the lowest level that the patient can just detect the presence of speech 50% of the time
-spondee words
-should be within 5-10 dB HL of pure tone threshold

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29
Q

speech recognition threshold (SRT)

A

lowest level at which the patient can perceive words with 50% accuracy (repeat the words back)
-spondee words
-should be within 6-12 dB of pure tone average

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30
Q

word recognition scores (WRS)

A

pure tone thresholds determine degree and type of hearing loss
-used to find a reduction in clarity

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31
Q

most comfortable level (MCL)

A

level that is most comfortable for the listener

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32
Q

uncomfortable loudness level (UCL)

A

intensity at which speech becomes uncomfortably loud

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33
Q

dynamic range (DR)

A

difference between the softest level that words can be understood and the level where speech starts to be uncomfortable

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34
Q

signal to noise ratio (SNR)

A

difference between the level of the signal and the level of noise
signal - noise = SNR

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35
Q

basic components of hearing aid

A

microphone, amplifier, receiver, battery, body of hearing aid, wax protector, telecoil, and program switch

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36
Q

omnidirectional microphone (omni)

A

sensitive to sound coming from all directions

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37
Q

directional microphone

A

more sensitive to sound originating on front of the user than to sound coming from behind the user (fixed vs. automatic vs. adaptive)

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38
Q

fixed directional microphone

A

picking up sound from the specific area

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39
Q

automatic directional microphone

A

switch in and out of directionally automatically (condenses into one area based on hearing background noise)

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40
Q

adaptive directional microphone

A

will change the direction of the way it is pointing (moves where speech is)

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41
Q

amplifier

A

gain = output - input
-how much sound comes out of the hearing aid

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42
Q

linear gain

A

one to one

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43
Q

compression

A

a nonlinear forms of amplifiers gain used to determine and limit output gains as a function of input gain

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44
Q

gain regulation

A

limit output of HA without distortion, minimize loudness discomfort, prevent further damage, restore normal perception, maintain listening comfort, reduce adverse effects of noise, provide varying amount of gain as a function of input level

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45
Q

recievers

A

like a speaker (pumps out the sound)
-low power = low HL
-high power = high HL

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46
Q

what do we fit domes based on

A

fitting based on acoustics

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47
Q

function of dome

A

are put on ends of receivers to fit in the ear (come in packs)
holes on domes - allows sound to go in normally
full domes - restrict all bass and sound from coming in

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48
Q

function of earmold

A

will help seal off the ear so leaking of sound (whistling) will not occur
-used for higher hearing loss patients since they need more sound output

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49
Q

what do we use to fit a earmold

A

patients hearing loss

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50
Q

how do we determine a dome or earmold

A

case by case
-look at hearing loss
-if they have a latex allergy
-if they have other situations that prevent from putting domes in

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51
Q

how to determine the style of hearing aids

A

based on the anatomy, hearing loss level, and what the patient wants

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52
Q

in the ear hearing instruments (ITE)

A

custom made
completely in the canal, in the canal, and in the ear

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53
Q

behind the ear hearing instruments (BTE)

A

behind the ear and receiver in the canal

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54
Q

completely in the canal (CIC)

A

-fits deeply inside the ear canal
-for mild to moderate losses
-reduces feedback and improves sound localization
-virtually invisible

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55
Q

in the canal (ITC)

A

-small enough to fit almost entirely in canal
-generally for mild to moderately sever losses
-easy for patients with arthritis

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56
Q

in the ear (ITE)

A

-fits in external ear
-generally for mild to severe losses
-similar to ITC, but a little bigger

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57
Q

behind the ear (BTE)

A

-fits snugly behind the ear and is attached to a custom earpiece
-for mild to profound hearing loss
-fewer problems with feedback and easy maintenance

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58
Q

receiver in the canal (RIC) or receiver in the ear (RITE)

A

-smallest BTE style
-for mild to profound hearing loss
-comprised of a smaller body that sits behind the ear with receiver in the ear
-most popular style

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59
Q

levels of hearing aid technologies

A

basic, essential, advanced, and premium

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60
Q

other features of a hearing aid

A

on/off control, direct audio input (DAI), wireless capability, telecoil, volume control, remote control (now used alongside an app). memories and programs, fall detection, and some waterproof models are coming out

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61
Q

one hearing aid vs. two hearing aids

A

-localization is impacted (need information from both ears to learn where sound is coming from)
-listening in noise (we use two ears to separate sound in noise ; if only using on, it can overwhelm the ear)
-loudness summation (two input levels of same frequency in the same ear will give it the same boost)

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62
Q

contralateral routing of signal (CROS)

A

sound will be transferred from bad side to the good side
-normal hearing in one ear and no hearing in the other ear

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63
Q

bilateral contralateral routing of signal (BiCROS)

A

amplifies the loss in the better of the two sides plus transferring noise from the worse side to the better side
-impaired hearing in one ear and no hearing in the other ear

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64
Q

limitations of hearing aids

A

only makes sound louder, cannot bypass the site of lesion, cannot selectively amplify speech versus noise, and other devices may be needed for warning sounds and alarms

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65
Q

verification

A

means to determine the hearing aid meeting a set of standards, including standards of basic electroacoustic, real ear measurements and comfortable fit

66
Q

validation

A

determining the extent to which hearing related disability has been reduced
-speech recognition testing in soundfield (with and without hearing aid)

67
Q

real ear measurments

A

gold standard for hearing aid verification
-speech map that represents what they hear at a certain level

68
Q

functional gain (FG)

A

the difference between aided and unaided

69
Q

basic care of hearing aids

A

-clean off skin and/or cerebrum
-do not get them wet
-do not sleep with hearing aids in
-do not drop them
-keep away from children and pets
-turn them off when not in use

70
Q

cochlear implant (CI)

A

electronic device that stimulates the auditory nerve through electrodes placed in the cochlea
-directly stimulating auditory nerve
-acoustic to acoustic
-permanent

71
Q

frequency at the cochlea

A

sensitivity with higher at the base and lower at the apex

72
Q

patients hear through ______________, not mechanical energy

A

electronic stimulation

73
Q

parts of the cochlear implant

A

receiving antenna, internal magnet, receiver and electrode array (each electrode will stimulate a certain frequency)

74
Q

parts of a speech processor (external CI)

A

microphone, external magnet, and transmitter (gives the sound to interior implant parts)

75
Q

how does a cochlear implant work

A

bypasses non functioning hair cells through pulses to send through auditory nerve
-temporal cues

76
Q

steps of a cochlear implant

A

sound gets picked up by the microphone then its transmitted inward (band filters for each electrode)

77
Q

biomodal CI

A

wears a cochlear implant on one ear and a hearing aid on the other ear

78
Q

hybrid CI

A

wears a cochlear implant and a hearing aid combined

79
Q

CI candidacy

A

if they fall into certain hearing threshold ranges they can be a candidate
-use speech scores to determine as well
-severe to profound hearing loss when hearing aids will not help to improve hearing

80
Q

adult indication for CI

A

different manufacturers each have their own thresholds and also speech recognition thresholds
-specific on type of test (open set - nothing to read off of)
-best aided listening (HA for at least 6 months and using real ear measurements to help prove you have done it to the best)

81
Q

pediatric candidacy for CI

A

based on the audiogram and auditory progress
-varies on age
-HAVE to hit the criteria
-more cautious for implantation

82
Q

predicting factors for success with CIs

A

we don’t know who will do well or not but :
-length of hearing loss
-age hearing loss was acquired
-age of implementation
-length of time using implant’s and/or hearing aids
-quality of learning/support structure

83
Q

contraindications

A

-hearing loss originating in auditory nerve or central auditory pathways
-cochlear ossification preventing electrode insertion
-cochlear nerve deficiency
-prone to ear infections
-TM perforations from middle ear infections
-allergy or intolerance of device materials
-lacking cognitive ability to use auditory cues and/or unwillingness to undergo an extended program of rehab

84
Q

bone anchored hearing aids (BAHAs)

A

a type of hearing aid that delivers sound via bone conduction
-electromagnetic transducer
-NOT permanent

85
Q

electromagnetic transducer

A

converts an electrical current into mechanical energy
-acoustic information into vibrations (electrical current)

86
Q

parts of a BAHA

A

microphone, programming port cover, battery compartment attachment for safety line, program button, snap connector, processor (snaps on abutment), abutment (attaches to implant), and titanium implant (goes into skill and attaches to abutment)

87
Q

candidates for BAHA

A

conductive hearing loss, single sided deafness, some degree of SNHL, cannot wear hearing aids. congenital malformations of the external/outer ear

88
Q

BAHAs and audiometric thresholds

A

test how normally would
-bone conduction thresholds can determine candidacy
-devices have different strengths to accommodate different hearing loss

89
Q

percutaneous implant

A

titanium fixture is surgically implanted into skull
-directly vibrating the skull

90
Q

transcutaneous implant

A

titanium component that is implanted into the skull is coupled to magnetic plate that rests on the top of the skull at the mastoid bone

91
Q

hearing assistive technology (HAT)

A

listening, alerting, and/or signaling devices that facilitates a patients communication with the environment
-enhances persons safety

92
Q

assistive listening device (ALD)

A

are a part of HAT

93
Q

hardwired systems

A

listener wears a headphone and they hold it out to whatever they want to hear or have the speaker hold it and speak into it
-good for one on one conversations
-not prescribed for hearing loss

94
Q

wireless systems

A

wireless transmission of a signal to a receiver

95
Q

frequency modulation (FM)

A

device transmits sounds through radio waves to the receiver
-often seen is educational settings
-large systems : i.e. Gammage or churches
-personal systems : i.e. one on one

96
Q

infrared systems

A

transmitter/emitter send the signal through infrared light signals

97
Q

bluetooth

A

wireless technology standard used for exchanging data between fixed and mobile devices
-loud and clear for both ears
-most HA today have a way to connect to any devices

98
Q

telecoil (t coil)

A

a tiny coil inside a HA or CI that picks up electromagnetic signals given off by other devices
-orientation DOES matter !!
-will transfer the signals directly to the listener

99
Q

what do HAT deliver sound to

A

the patients prescription

100
Q

auditory training (AT)

A

training the brain to listen and interpret what the ears hear by developing listening activities and strategies
-retraining the brain to interpret the signal

101
Q

candidates for AT

A

individuals with hearing loss using HA, cochlear implant users, auditory processing needs, APD, and ESL

102
Q

what does SNHL impair

A

impairs clarity of speech

103
Q

what does conductive hearing loss impair

A

impairs sensitivity of speech

104
Q

goals of AT for adults

A

develop the ability to recognize and understand speech using the auditory signal, and to interpret auditory experiences

105
Q

what are the estimates of hearing loss individuals

A

-only about 40-60% of hearing aid users are satisfied with their overall experience
-only about 25% of adults with hearing loss use hearing aids

106
Q

frequency selectivity

A

ability to respond differentially to different frequencies or bands of frequencies
-complex sound into frequency components

107
Q

temporal resolution

A

ability to discriminate sound segments occurring closely in time as separate events
-if a person requires longer silent gap between two sounds to recognize the gap

108
Q

perceptual effort

A

perceptual effort is needed to encode speech into memory
-people with hearing loss often expend MORE perceptual effort when listening to speech

109
Q

working memory and long term memory

A

cognitive systems needs to temporarily store information needed to perform speech perception task
-maintain information for extended periods of time
-fewer cognitive resources may be available to process what is being heard

110
Q

neural pruning (atrophy or neural reorganization)

A

when pathways in the brain are clipped or damaged
-sometimes there is too much damage to bring back ‘normal’ hearign

111
Q

listening to speech with hearing aids

A

only assist with audibility
-cannot resolve problems with peripheral issues of frequency and tempora

112
Q

plasticity

A

physiological changes in the central nervous system that occur asa result of sensory experiences
-reorganizing to make up for lost of tracts
-the ability to change

113
Q

neuroplasticity is the brains ability to change as a result of…

A

experiences, behavior, environment, and sensory deprivation or stimulation

114
Q

hearing vs. listening

A

-listening is the process of breaking down what is being said
-hearing is involuntary, it is automatic

115
Q

benefits of AT

A

may accelerate and supplement the process of brain recognition after receiving a HA or CI

116
Q

analytic approach of AT

A

emphasizes the recognition of individual speech sounds and/or syllables

117
Q

synthetic approach of AT

A

emphasizes the understanding of meaning and not necessarily the comprehension of every spoken word

118
Q

bottom up processing and AT

A

sound processing influenced mainly by sound input from the auditory periphery, with minimal cognitive processing

119
Q

top down processing and AT

A

use expectations based on contextual evidence, prior social linguistic knowledge

120
Q

erber’s hierarchy

A

defines different levels of auditory processing
-detection : you hear it or don’t
-discrimination : telling one sound from another
-identification : recognizing object/word in enviornment
-comprehension : taking in a bigger picture meaning/understanding

121
Q

form vs. meaning

A

-form : no semantic information
-meaning : semantic information
-can do it through phoneme, word, sentence, and discourse based

122
Q

transfer appropriate processing theory (TAP)

A

greater the overlap between what is trained and what the desired outcomes are, the greater the training benefits will be
-most effective with a single talker
-train with stimuli that is most important

123
Q

lipreading

A

when a person relies only on visual signal provided by talkers face
-visual speech signal!

124
Q

what makes lipreading difficult

A

visibility of sound, rapidity of sound, coarticulation/stress effect, visemes and homophenes, and talker effects

125
Q

visemes

A

groups of speech sound that appear similar on the lips/face (i.e. b, m, p)

126
Q

homophones

A

words that appear similar on the mouth (i.e. matt tracked its dog, bess stacked hotdogs)

127
Q

visual fixation

A

eyes fixate gaze on a single target

128
Q

saccade

A

rapid and intermittent eye movement

129
Q

speechreading

A

combines vision and hearing to produce an improvement in speech understanding
-all visual clues accompanying speech

130
Q

crossmodal enhancement

A

occurs when the response to a stimulus presented through one modality is augmented or modulated by another stimulus presented through a different modality

131
Q

the greater the _______, the greater the ________ on visual cues for communication

A

hearing loss ; reliance

132
Q

factors that influence speechreading

A

the talker, the message, the environment/communication situation, and the speech reader

133
Q

goals for speechreading

A

decrease depending on listening (allow to focus on whole picture), assist in the differentiation of speech sounds)

134
Q

what is important to teach ?

A

self-advocacy

135
Q

conversational style

A

the set of behaviors and methods that a person implements to relay and receive information during communication activities

136
Q

communication strategy

A

a course of action taken to enhance communication
-teaching what things can do to enhance

137
Q

emblematic hand gestures

A

culturally specific gestures

138
Q

iconic hand gestures

A

depict an item, action, or feature of something being described

139
Q

metaphoric hand gestures

A

gestures that depict a metaphor

140
Q

deictic hand gestures

A

gestures that locate items, places, or people in space
-ASL

141
Q

beat hand gestures

A

provide emphasis and serve an evaluative or orienting function

142
Q

regulatory hand gestures

A

gestures that help guide the flow of conversation

143
Q

successful communication with hearing loss is influenced by

A

-effectiveness of their listening device
-speechreading skills
-amount of residual hearing

144
Q

some common concerns in a group discussion

A

talking on the phone, impatience on the part of a spouse, avoidance by old friends, isolation/loneliness, feelings of being left out, conversation in a noisy setting

145
Q

passive conversational styles

A

taking what happens and not speaking up for themselves
-bluffs
-withdraws from conversation
-avoids social interactions to avoid difficulties

146
Q

agressive conversational styles

A

acts demanding, hostile, and intimidating
-shifting blame
-excessive or expansive body gestures
-defense mechanism in a way

147
Q

passive aggressive conversational styles

A

expressing aggression in a passive way
-use sarcasm and exhibit stubbornness

148
Q

assertive conversational styles

A

what we want the patients to get towards
-takes responsibility for difficulties
-respects right of communication partners while honestly and openly express their needs and emotions

149
Q

interactive communication behaviors

A

uses cooperative tactics, share responsibility for advancing conversation
-move forward together

150
Q

noninteractive communication behaviros

A

passive conversational style, little contribution
-starting to go in the background

151
Q

dominating communication behaviors

A

aggressive behavior takes extended speaking turns, interrupts

152
Q

communication breakdown

A

when one communication partner does not recognize the message

153
Q

factors for breakdown

A

speaker, environment, listener, and message

154
Q

strategies to correct breakdowns

A

proactive : facilitative and anticipatory
reactive : repair

155
Q

facilitative communication strategies

A

influence the talker, message, environment, or patients to enhance listening performance
-before breakdown occurs
-message tailoring strategies
-acknowledgment gestures
-constructive, adaptive, and anticipatory strategies

156
Q

constructive strategy

A

elements that can be modified or exploited to optimize communication

157
Q

adaptive strategies

A

counteracting bad effects of hearing loss
-help ease anxiety of certain situations

158
Q

anticipatory strategies

A

doing things in anticipation of a breakdown

159
Q

anticipatory communication strategies

A

can anticipate potential vocabulary and conversational content
-receive readily
-recognize genuinely

160
Q

repair communication strategies

A

implemented by a participant in a conversation to rectify a breakdown in communication
-repeat
-rephrase
-elaborate
-simplify
-topic
-confirm
-provide feedback
-write
-fingerspell

161
Q

social stigma

A

having a condition that is devalued because it deviates from the norm and results in a negative status being placed upon a person or group of persons

162
Q

self stigma

A

occurs when a person stigmatizes ones own condition by feelings of embarrassment, and develops a spoiled self identity by virtues of having a shortcoming or disability

SHS 496 (4 decks)

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