Unit 1 Flashcards
1
Q
impacts of hearing loss
A
psychological, educational, speech/lang development, vocational, emotional, social
2
Q
audiometric considerations
A
degree, configuration, type, age of onset, sudden/gradual hearing loss, pt’s lifestyle
3
Q
Why do high frequency hearing losses have more detrimental affect on word recognition abilities than low frequency hearing losses?
A
greater sensitivity to consonants, high frequency affects consonants to a greater extent; consonants give us more meaning than vowels
4
Q
sudden loss
A
greater than 30 DB hearing reduction over at least 3 frequencies occurring over a period of 72 hours or less
5
Q
gradual
A
idk…
6
Q
amplification options
A
hearing aids, cochlear implants, assistive listening devices
7
Q
typical candidate for hearing aid
A
hearing loss (usually sensorineural or conductive w/ chronic ear infections; no medical contra-indications (go to ENT to determine they’re medically clear, increased speech perception w/ hearing aid in place
8
Q
why fit hearing aid as soon as loss is identified?
A
lose neural plasticity as time goes on
9
Q
5 things to determine what kind of amplification device is best
A
1) severity of loss
2) lifestyle and comm. demands
3) manual dexterity
4) financial ability
5) something about cleaning
10
Q
5 main components of a hearing aid
A
1) microphone
2) amplifier
3) receiver
4) battery
5) volume
11
Q
3 basic hearing aid categories
A
1) analog
2) programmable
3) digital
12
Q
analog
A
$, microphone, amplifier, receiver
13
Q
programmable
A
$$, microphone, computer chip, amplifier, receiver
14
Q
digital
A
$$$, microphone, analog to digial conversion, computer chip, digital to analog conversion, receiver
15
Q
advantages to digital amplifiers
A
more precise fitting, feedback management, less background noise bc of directional microphones, program switches
16
Q
hearing aid styles
A
1) behind the ear
2) in the ear
3) in the canal
4) completely in the canal
5) bone conducted hearing aids
17
Q
behind the ear (BTE) parts
A
earmold, tubing, earhook, MTO (on, off, telecom, volume) switch, volume wheel, battery
18
Q
who is candidate for behind the ear?
A
mild to profound hearing loss, children, middle ear issues
19
Q
advantages to BTE (behind the ear)
A
durable, can use fm, best range of loss, less likely to have feedback, good variability with size, most powerful
20
Q
candidates for ITE ( in the ear)
A
mild to severe HL; teens+
21
Q
advantage to ITE
A
less bulky… mainly for aesthetics
22
Q
parts of ITE
A
microphone, program switch, vent, battery door, telecom, (fills concha)
23
Q
disadvantages to ITE
A
less durable, can easily shatter, not as powerful,
24
Q
who is cadidate for in the canal?
A
mild to moderate
25
advantage for in the canal
not as noticable
26
disadvantage for in the canal
hard to push
27
parts of completely in the canal (CIC)
microphone, receiver (NO volume control)
28
who is candidate for CIC?
mild HL
29
disadvantages for CIC
more susceptible to wax, not as durable, cannot use assistive devices,
30
advantages for CIC
cannot see it
31
types of bone conduction hearing aids
non implanted headband; implanted
32
candidate for bone conduction hearing aids
dead ear or medical problem (no pinna/canal) hl
33
why take ear mold impressions?
custom fit hearing aids, ear plugs
34
flags a hearing aid is possibly not working
not paying attention, asking "huh" or "what", decreased progress in tx, changes in bx, does not want to wear hearing aid
35
SLPs HA Troubleshooting/Maintenance kit
- stethoset
- battery tester
- extra batteries
- dollar bill
- brush, wire loop
- earmold tubing blower
- otoferm
- dir-aid kit
36
stethoset
stick end to ear mold/HA move volume and listen to HA quality
37
battery tester
test battery
38
extra batteries
different sizes, have extras on hand just in case
39
dollar bill
good to remove corrosion from batteries
40
brush, wire loop
clean out gunk
41
earmold tubing blower
blow out moisture
42
otoferm
pasty like material, rub onto hearing aid to bulk it up and fill in ear to prevent/lessen feedback
43
dri-aid kit
removes moisture from HA; drop it into the something crystals
44
how to perform listening check
- attach HA to stethoset
- make sure HA is on
- talk into HA using ling sounds
- rotate volume up and down
- rotate through programs
45
What are you listening for in a listening check?
- distortion
- crackling
- intermittence
- weak
- clarity
- feedback
- buzzing
46
What should you do before tx begins?
- perform listening check
- make sure aid is in right program
- make sure volume is on correctly
- make sure HA is in ear correctly
47
What are ling sounds/why are they the sounds used?
/m/, /oo/, /ah/, /ee/, /sh/, /s/... these span the frequency range
48
Problem: Intermittent Sound
- dirty battery contacts?
- dirty controls?
- wax in receiver?
- is battery door completely closed
49
Problem: no sound
- dead battery?
- battery inserted properly?
- obstrution in earmold, tubing, or receiver
- is hearing aid set on t-coil or FM instead of microphone?
- is volume control turned up?
50
what is feedback?
sound escapes from receiver and cycles back to microphone and causes a whistle sound
51
smaller distance from microphone to receiver results in _____
greater chance of feedback
52
gain
how much power it gives at specific frequencies; difference from input to output... ex/ 60dB goes in and 100dB goes out = 40dB gain
53
frequency response
what frequencies is it amplifying, the actual frequencies its amplifying
54
aided sound field testing
HA in ear; excellent for counseling parents
55
unaided sound field testing
HA not in ear
56
Assistive Technology
- Sound enhancement technology
- television enhancement technology
- telephone enhancement technology
- warning/alerting signal enhancing technology
57
sound enhancement technology
- FM systems
- Infrared Light wave system
- electromagnetic induction loop
- hardwire
- bluetooth
58
television enhancement technology
- closed captioning
| - television amplifiers
59
telephone enhancement technology
- telephone amplifier
- TTY or TDD machines (talk to you)
- CapTel
- Text messaging
60
Warning or Alerting Signal enhancing technology
- alarm clocks
- fire alarms/smoke alarms
- door bell lights
- telephone ringing
- baby crying
61
3 acoustic aspects to consider in listening environments
- reverberation: the echo of a room
- noise: anything that is not the signal
- distance: how far from the sound source (double the distance decrease the power by 1/2)
62
Signal to Noise Ratio (SNR)
difference b/w desired signal and noise that interferes w/ hearing the sound
63
negative SNR
noise is louder than the signal
64
does SNR affect kids or adults more?
kids
65
What is the SNR ratio needed for special population children?
+20 SNR
66
Why are hearing aids not enough? (aka why use assistive listening devices)
reverberation, noise, and distance
67
Components
- individual
- sound
- environment
- sound source
- microphone
- transmitter & receiver systems
- coupling devices
- telecoils
68
Components: Individual
- hearing loss
- age of onset
- acceptance of loss
- speech reading ability
- HA/T-coil use
- knowledge and comfort w/ ALDs
69
Components: Sound
- dimensions (frequency, loudness)
| - impact on speech intelligibility (distance, SNR, Reverberation)
70
Parts of any ALD system
- microphone (transmitting device) worn by speaker
| - receiver used by student
71
Components: Environment
- light/dark
- uncovered windows
- distance from speaker
- room acoustics & noise
72
Components: sound source
- instructor giving lecture
- panel of speakers
- video/audio recording
- Q&A from the audience
- hard of hearing student
- neighboring student
73
Communication tips
- face to face
- max lighting
- dont yell
- be pt
- don't be afraid to write
74
Components: microphone
- omnidirectional
- unidirectional (more $$)
- lavaliere or lapel
- table top/conference
* *Placement is vital (think effect of distance on sound)
75
Components: Transmitter & receiver systems
- FM
- Infrared
- Electromagnetic induction loop
- hardwired system
76
Components: coupling devices
- no hearing aid OR no t-coil (headphones, earbuds)
- hearing aid w/ t-coil (neckloop, silhouette, headphones)
- other methods (direct audio input, FM boot, cochlear implant)
77
Components: telecoil
- not all HA have t-coils
- t-coils are not as sensitive as HAs
- commonly found in telephones and speakers
78
Advantages of speech enhancing ALD devices
- speech is amplified over noise/reverberation
- distance b/w listening & speaker is constant
- some systems transmit up to 50 ft away
79
5 types of speech enhancing ALDs
- hardwire systems
- frequency modulated systems
- electromagnetic induction loop systems
- infrared light wave systems
- bluetooth
80
T/F: You can leave the room and still hear presentation w/ electromagnetic induction loop?
True (up to 50 ft)
81
T/F: Electromagnetic induction loop can be used indoors and outdoors
True
82
T/F: You must have a receiver to use electromagnetic induction loop
False
83
T/F: You must have a hearing aid to use electromagnetic induction loop
False (must have specialized headphones)
84
T/F: You can use induction loops in multiple rooms in a building
False (there'll be spillover if systems are too close)
85
T/F: I can use my loop receiver w/ your loop transmitter
True
86
Induction loop advantages
- low equipment cost after installation
- easly operation
- lasts forever
- induction receivers are compatible with ALL loop systems
- unobtrusive w/ t-coil hearing aid
87
Induction loop disadvantages
- installation $ may be high
- installation may not be possible in historic building
- can't assume everyone has a t-coil
- susceptible to electrical intererence & spill over
- must be w/in looped area
- possible dead areas w/in loop
88
Infrared advantages
- compatability
- no spillover means security
- can be used in adjacent rooms
- widest band wish and best sound reproduction
- appropriate for mild to mod/sev loss
- not affected by radio transmission
89
infrared disadvantages
- everyone must have receiver
- must have direct line of sight
- indoor/evening use only
- high intensity fluorescent lights can cause interference
- large areas require multiple panels
- quality varies
90
FM Systems
- Personal FMs (w/ HAs, CIs, w/o HAs/CIs)
| - Soundfield FMs (classroom acoustics are poor & kids do not get advantage to hear teacher)
91
T/F: You can leave the room and still hear presentation w/ FMs
True
92
T/F: FMs can be used indoors or outdoors
True
93
T/F: You must have a receiver to use FM
True
94
T/F: You must have a HA to use FM
False (there are receivers that go in the ear)
95
T/F: You can use FM in multiple rooms in a building
True (provided different channels)
96
T/F: I can use my FM receiver w/ your FM transmitter
True
97
FM advantages
- very portable
- very easy to use
- flexibility of movement
- indoor/outdoor use
- mild-profound loss
- receiver can be put in pocket
- no fluctuation of strength of signal
98
FM disadvantages
- receivers are required for everyone
- receivers vary in quality/durability
- potential for outside interference
- receivers and trasmitters must be on same channel
- must be 1 free channel b/w systems that are used in close proximity
99
Troubleshooting ALDs
- are both units on?
- is mic in correct position
- are batteries ok
- are channels same
- dead spots/static w/ volume wheel adjustment?
100
keys to success for the speaker
- avoid drawing attention to user
- repeat questions from the audience
- place mic close to mouth but not in front of mouth
- use unidirectional mic
- rephrase instead of repeat
- dont stand in front of windows/bright lights
- face audience when speaking
- avoid talking to class while retrieving materials
101
keys to success for the student
- batteries charged, t-coil working
- proximity to t-coil
- proximity to interference
- sit w/in 20ft of speaker if you use speech reading
- interact w/ others about coping techniques
102
TTY
teletypewriter: middle man to type as a form of communication assistant
103
CapTel
- other person talks, it is transcribed by captioning service, and delivered for you to read on CapTel display
104
What is a cochlear implant?
- surgically implanted device that directly stimulates auditory nerve (bypasses the hair cells & stimulates auditory nerve)
- provides better hearing sensitivity for pt's who cannot use typical/standard amplification
105
3 ways HAs and CIs differ in increasing hearing sensitivity
- Type of signal output (HA: amplifies acoustic signal; CI: output is electrical signal)
- Path of signal (HA: signal travels through entire auditory system; CI: stimulates auditory nerve through cochlea)
- Frequencies of Signal (HA: 250-4000 Hz; CI: 250-7000 Hz)
106
How does a CI work? (5 steps(
- microphone detects sound and converts to electrical signal
- signal passed to speech processor via cables where it is manipulated
- signal leaves speech processor and is passed to FM radio transmitter where signal is changed
- FM signal is broadcast across skin to internal receiver where signal is converted back to electrical signal
- signal sent to auditory nerve via electrodes
107
how does one hear w/ a CI?
- sound is not meaningful initially to the brain, tx is needed
- children who are pre-lingualy deaf... their brain has no idea what sound means
- they won't be able to discriminate sounds
- brain eventually adjusts
108
Channels
- number of stimulation sites w/in the cochlea, defined by a range of frequencies
109
Single channel vs. multi-channel
- single: all sound delivered to one channel
| - multi: signal divided into frequency bands, transmitted along the cochlea
110
Cochlear implant team
- otolaryngologist
- audiologist
- SLP
- psychologist
- social worker
- counselor
111
Who is candidate for CI?
- 12 mos: profound bilateral HL in both ears
- 2-17 years: severe to profound bilateral SN HL
- adults: severe to profound SN HL; limited benefit; healthy adult over 18 years; no upper age limit
- normal CT scan w/ intact 8th cranial nerve
112
Will everyone who is implanted benefit from CI?
- age of onset of HL
- age of implantation (earlier better)
- nerve survival
- length of implant use
- frequency/type of SLP services
- Parental support
113
Why are SLPS important for map information
- SLPs see the pt on a more regular bassi and can report progress and bx observations
114
How many maps can be stored?
3 maps
- can be changed by switch on the speech processor
- want to be set at the maximum level which is comfortable
- 1-3 increasing in loudness
115
Controls on CI
- water resistant
- two microphones
- indicator light
- in-built telecoil
- lockable controls
- smartsound 2
- battery life
- in built diagnostics
116
What should you avoid w/ CIs
static electricity
117
General CI care
- avoid electrical shocks
- take off CI when on plastic slides
- use static reducing spray
- ground yourself by touching metal first before handling CI
118
Other Care issues w/ CI
- no MRIs
- no metal detectors
- external components should not be exposed to water
- air travel
119
Visual inspection of CIs
- speech processor, cables, and transmitter for signs of damage (cables may split/tear, inspect speech processor *most impt)
- microphone port (make sure no clogs in mic)
- examine settings for sensitivity
- LEDs should indicate (green normally = working; dif colors indicate dif things)
120
What to keep on hand w/ CIs
- spare batteries
- battery charger
- extra cables
- wand
121
auditory checks of CI
- ling six sound test
- /m/ and /oo/ = low frequency sounds
- /ah/ and /ee/ = mid frequency sounds
- /sh/ and /s/ = high frequency sounds
- detection, identification, repetition*
- if pt does not pass all sounds, they need to get something re-mapped
122
What does a ling test say about hearing?
- 1,000 Hz: three vowels /ah/, /ee/, /oo/; spoken in quiet voice at distance of at least 5 yards
- 2,000 Hz: should also hear /sh/
- 4,000 Hz: should detect s from a distance of at least 2 yards
123
Troubleshooting CI
- check battery, battery contacts, and cords
| - look at owners manual
124
When should you refer child to see AuD (w/ CIs)
- changes in sound awareness
- changes in vocalizations, voice quality, vocal intensity, articulation
- shorter attention span
- changes in processor settings
- eye twitches
125
Reasons for deaf community's reactions to CIs
- lack of success w/ pre lingual deaf adults
- plasticity of auditory system
- less than 50% of pre lingual adults w/ CIs wear them
- most successful post lingual adults not part of deaf culture
126
CICI
Completely Implantable Cochlear Implant (Future)
| - speech processor & everything inside & not visible
127
Hybrid
(Future)
- preserve existing hearing and stimulate higher frequencies
- normally, electrodes kill all hair cells even in lower frequencies
128
waterproof cochlear devices
future
