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AR > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

impacts of hearing loss

A

psychological, educational, speech/lang development, vocational, emotional, social

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2
Q

audiometric considerations

A

degree, configuration, type, age of onset, sudden/gradual hearing loss, pt’s lifestyle

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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

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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

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5
Q

gradual

A

idk…

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6
Q

amplification options

A

hearing aids, cochlear implants, assistive listening devices

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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

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8
Q

why fit hearing aid as soon as loss is identified?

A

lose neural plasticity as time goes on

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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

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10
Q

5 main components of a hearing aid

A

1) microphone
2) amplifier
3) receiver
4) battery
5) volume

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11
Q

3 basic hearing aid categories

A

1) analog
2) programmable
3) digital

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12
Q

analog

A

$, microphone, amplifier, receiver

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13
Q

programmable

A

$$, microphone, computer chip, amplifier, receiver

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14
Q

digital

A

$$$, microphone, analog to digial conversion, computer chip, digital to analog conversion, receiver

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15
Q

advantages to digital amplifiers

A

more precise fitting, feedback management, less background noise bc of directional microphones, program switches

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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

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17
Q

behind the ear (BTE) parts

A

earmold, tubing, earhook, MTO (on, off, telecom, volume) switch, volume wheel, battery

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18
Q

who is candidate for behind the ear?

A

mild to profound hearing loss, children, middle ear issues

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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

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20
Q

candidates for ITE ( in the ear)

A

mild to severe HL; teens+

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21
Q

advantage to ITE

A

less bulky… mainly for aesthetics

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22
Q

parts of ITE

A

microphone, program switch, vent, battery door, telecom, (fills concha)

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23
Q

disadvantages to ITE

A

less durable, can easily shatter, not as powerful,

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24
Q

who is cadidate for in the canal?

A

mild to moderate

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25
Q

advantage for in the canal

A

not as noticable

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26
Q

disadvantage for in the canal

A

hard to push

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27
Q

parts of completely in the canal (CIC)

A

microphone, receiver (NO volume control)

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28
Q

who is candidate for CIC?

A

mild HL

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29
Q

disadvantages for CIC

A

more susceptible to wax, not as durable, cannot use assistive devices,

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30
Q

advantages for CIC

A

cannot see it

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31
Q

types of bone conduction hearing aids

A

non implanted headband; implanted

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32
Q

candidate for bone conduction hearing aids

A

dead ear or medical problem (no pinna/canal) hl

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33
Q

why take ear mold impressions?

A

custom fit hearing aids, ear plugs

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34
Q

flags a hearing aid is possibly not working

A

not paying attention, asking “huh” or “what”, decreased progress in tx, changes in bx, does not want to wear hearing aid

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35
Q

SLPs HA Troubleshooting/Maintenance kit

A
  • stethoset
  • battery tester
  • extra batteries
  • dollar bill
  • brush, wire loop
  • earmold tubing blower
  • otoferm
  • dir-aid kit
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36
Q

stethoset

A

stick end to ear mold/HA move volume and listen to HA quality

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37
Q

battery tester

A

test battery

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38
Q

extra batteries

A

different sizes, have extras on hand just in case

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39
Q

dollar bill

A

good to remove corrosion from batteries

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40
Q

brush, wire loop

A

clean out gunk

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41
Q

earmold tubing blower

A

blow out moisture

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42
Q

otoferm

A

pasty like material, rub onto hearing aid to bulk it up and fill in ear to prevent/lessen feedback

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43
Q

dri-aid kit

A

removes moisture from HA; drop it into the something crystals

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44
Q

how to perform listening check

A
  • attach HA to stethoset
  • make sure HA is on
  • talk into HA using ling sounds
  • rotate volume up and down
  • rotate through programs
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45
Q

What are you listening for in a listening check?

A
  • distortion
  • crackling
  • intermittence
  • weak
  • clarity
  • feedback
  • buzzing
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46
Q

What should you do before tx begins?

A
  • perform listening check
  • make sure aid is in right program
  • make sure volume is on correctly
  • make sure HA is in ear correctly
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47
Q

What are ling sounds/why are they the sounds used?

A

/m/, /oo/, /ah/, /ee/, /sh/, /s/… these span the frequency range

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48
Q

Problem: Intermittent Sound

A
  • dirty battery contacts?
  • dirty controls?
  • wax in receiver?
  • is battery door completely closed
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49
Q

Problem: no sound

A
  • 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?
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50
Q

what is feedback?

A

sound escapes from receiver and cycles back to microphone and causes a whistle sound

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51
Q

smaller distance from microphone to receiver results in _____

A

greater chance of feedback

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52
Q

gain

A

how much power it gives at specific frequencies; difference from input to output… ex/ 60dB goes in and 100dB goes out = 40dB gain

53
Q

frequency response

A

what frequencies is it amplifying, the actual frequencies its amplifying

54
Q

aided sound field testing

A

HA in ear; excellent for counseling parents

55
Q

unaided sound field testing

A

HA not in ear

56
Q

Assistive Technology

A
  • Sound enhancement technology
  • television enhancement technology
  • telephone enhancement technology
  • warning/alerting signal enhancing technology
57
Q

sound enhancement technology

A
  • FM systems
  • Infrared Light wave system
  • electromagnetic induction loop
  • hardwire
  • bluetooth
58
Q

television enhancement technology

A
  • closed captioning

- television amplifiers

59
Q

telephone enhancement technology

A
  • telephone amplifier
  • TTY or TDD machines (talk to you)
  • CapTel
  • Text messaging
60
Q

Warning or Alerting Signal enhancing technology

A
  • alarm clocks
  • fire alarms/smoke alarms
  • door bell lights
  • telephone ringing
  • baby crying
61
Q

3 acoustic aspects to consider in listening environments

A
  • 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
Q

Signal to Noise Ratio (SNR)

A

difference b/w desired signal and noise that interferes w/ hearing the sound

63
Q

negative SNR

A

noise is louder than the signal

64
Q

does SNR affect kids or adults more?

A

kids

65
Q

What is the SNR ratio needed for special population children?

A

+20 SNR

66
Q

Why are hearing aids not enough? (aka why use assistive listening devices)

A

reverberation, noise, and distance

67
Q

Components

A
  • individual
  • sound
  • environment
  • sound source
  • microphone
  • transmitter & receiver systems
  • coupling devices
  • telecoils
68
Q

Components: Individual

A
  • hearing loss
  • age of onset
  • acceptance of loss
  • speech reading ability
  • HA/T-coil use
  • knowledge and comfort w/ ALDs
69
Q

Components: Sound

A
  • dimensions (frequency, loudness)

- impact on speech intelligibility (distance, SNR, Reverberation)

70
Q

Parts of any ALD system

A
  • microphone (transmitting device) worn by speaker

- receiver used by student

71
Q

Components: Environment

A
  • light/dark
  • uncovered windows
  • distance from speaker
  • room acoustics & noise
72
Q

Components: sound source

A
  • instructor giving lecture
  • panel of speakers
  • video/audio recording
  • Q&A from the audience
  • hard of hearing student
  • neighboring student
73
Q

Communication tips

A
  • face to face
  • max lighting
  • dont yell
  • be pt
  • don’t be afraid to write
74
Q

Components: microphone

A
  • omnidirectional
  • unidirectional (more $$)
  • lavaliere or lapel
  • table top/conference
  • *Placement is vital (think effect of distance on sound)
75
Q

Components: Transmitter & receiver systems

A
  • FM
  • Infrared
  • Electromagnetic induction loop
  • hardwired system
76
Q

Components: coupling devices

A
  • 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
Q

Components: telecoil

A
  • not all HA have t-coils
  • t-coils are not as sensitive as HAs
  • commonly found in telephones and speakers
78
Q

Advantages of speech enhancing ALD devices

A
  • speech is amplified over noise/reverberation
  • distance b/w listening & speaker is constant
  • some systems transmit up to 50 ft away
79
Q

5 types of speech enhancing ALDs

A
  • hardwire systems
  • frequency modulated systems
  • electromagnetic induction loop systems
  • infrared light wave systems
  • bluetooth
80
Q

T/F: You can leave the room and still hear presentation w/ electromagnetic induction loop?

A

True (up to 50 ft)

81
Q

T/F: Electromagnetic induction loop can be used indoors and outdoors

A

True

82
Q

T/F: You must have a receiver to use electromagnetic induction loop

A

False

83
Q

T/F: You must have a hearing aid to use electromagnetic induction loop

A

False (must have specialized headphones)

84
Q

T/F: You can use induction loops in multiple rooms in a building

A

False (there’ll be spillover if systems are too close)

85
Q

T/F: I can use my loop receiver w/ your loop transmitter

A

True

86
Q

Induction loop advantages

A
  • low equipment cost after installation
  • easly operation
  • lasts forever
  • induction receivers are compatible with ALL loop systems
  • unobtrusive w/ t-coil hearing aid
87
Q

Induction loop disadvantages

A
  • 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
Q

Infrared advantages

A
  • 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
Q

infrared disadvantages

A
  • 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
Q

FM Systems

A
  • Personal FMs (w/ HAs, CIs, w/o HAs/CIs)

- Soundfield FMs (classroom acoustics are poor & kids do not get advantage to hear teacher)

91
Q

T/F: You can leave the room and still hear presentation w/ FMs

A

True

92
Q

T/F: FMs can be used indoors or outdoors

A

True

93
Q

T/F: You must have a receiver to use FM

A

True

94
Q

T/F: You must have a HA to use FM

A

False (there are receivers that go in the ear)

95
Q

T/F: You can use FM in multiple rooms in a building

A

True (provided different channels)

96
Q

T/F: I can use my FM receiver w/ your FM transmitter

A

True

97
Q

FM advantages

A
  • 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
Q

FM disadvantages

A
  • 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
Q

Troubleshooting ALDs

A
  • are both units on?
  • is mic in correct position
  • are batteries ok
  • are channels same
  • dead spots/static w/ volume wheel adjustment?
100
Q

keys to success for the speaker

A
  • 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
Q

keys to success for the student

A
  • 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
Q

TTY

A

teletypewriter: middle man to type as a form of communication assistant

103
Q

CapTel

A
  • other person talks, it is transcribed by captioning service, and delivered for you to read on CapTel display
104
Q

What is a cochlear implant?

A
  • 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
Q

3 ways HAs and CIs differ in increasing hearing sensitivity

A
  • 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
Q

How does a CI work? (5 steps(

A
  • 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
Q

how does one hear w/ a CI?

A
  • 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
Q

Channels

A
  • number of stimulation sites w/in the cochlea, defined by a range of frequencies
109
Q

Single channel vs. multi-channel

A
  • single: all sound delivered to one channel

- multi: signal divided into frequency bands, transmitted along the cochlea

110
Q

Cochlear implant team

A
  • otolaryngologist
  • audiologist
  • SLP
  • psychologist
  • social worker
  • counselor
111
Q

Who is candidate for CI?

A
  • 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
Q

Will everyone who is implanted benefit from CI?

A
  • age of onset of HL
  • age of implantation (earlier better)
  • nerve survival
  • length of implant use
  • frequency/type of SLP services
  • Parental support
113
Q

Why are SLPS important for map information

A
  • SLPs see the pt on a more regular bassi and can report progress and bx observations
114
Q

How many maps can be stored?

A

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
Q

Controls on CI

A
  • water resistant
  • two microphones
  • indicator light
  • in-built telecoil
  • lockable controls
  • smartsound 2
  • battery life
  • in built diagnostics
116
Q

What should you avoid w/ CIs

A

static electricity

117
Q

General CI care

A
  • avoid electrical shocks
  • take off CI when on plastic slides
  • use static reducing spray
  • ground yourself by touching metal first before handling CI
118
Q

Other Care issues w/ CI

A
  • no MRIs
  • no metal detectors
  • external components should not be exposed to water
  • air travel
119
Q

Visual inspection of CIs

A
  • 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
Q

What to keep on hand w/ CIs

A
  • spare batteries
  • battery charger
  • extra cables
  • wand
121
Q

auditory checks of CI

A
  • 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
Q

What does a ling test say about hearing?

A
  • 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
Q

Troubleshooting CI

A
  • check battery, battery contacts, and cords

- look at owners manual

124
Q

When should you refer child to see AuD (w/ CIs)

A
  • changes in sound awareness
  • changes in vocalizations, voice quality, vocal intensity, articulation
  • shorter attention span
  • changes in processor settings
  • eye twitches
125
Q

Reasons for deaf community’s reactions to CIs

A
  • 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
Q

CICI

A

Completely Implantable Cochlear Implant (Future)

- speech processor & everything inside & not visible

127
Q

Hybrid

A

(Future)

  • preserve existing hearing and stimulate higher frequencies
  • normally, electrodes kill all hair cells even in lower frequencies
128
Q

waterproof cochlear devices

A

future

AR (2 decks)

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