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SHS 496 > unit 2 > Flashcards

unit 2 Flashcards

1
Q

conversational fluency (CF)

A

how smoothly conversation unfolds
-high and low fluency

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2
Q

factors that define CF

A

-time spent repairing communication breakdowns
-exchange of information and ideas
-sharing of speaking time
-time spent in silence

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3
Q

procedures for measuring CF

A

interviews, questionnaires, daily logs, and group discussion

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4
Q

interviews

A

basic assessment procedure used to elicit specific information about an individual’s hearing related communication difficulties
-prepared with specific questions
-want your provider to “know” you

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5
Q

questionnaires

A

open ended questions - elicit qualitative data
closed ended questions - used to gather quantitative data

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6
Q

daily logs

A

self reports of behavior used by respondent for self monitoring
-can give insight into strategies, difficulties, and overall conversational fluency

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7
Q

group discussions

A

provides a forum for patient to discuss communication ideas
-patients make the syllabus

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8
Q

development of communication strategies training (CST)

A

a quality AR training program should be tailored to accommodate a patients : expectations, age, socioeconomic background, lifestyle, communication problems
-making printed materials available
-presenting a weekly program

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9
Q

creation of a program of CST

A

program length (12-40 hours), intensive instruction or spread over time, develop objective, assessment materials, one-on-one, couples, group

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10
Q

benefits of CST

A

-studies may have reported a reduction in perceived hearing loss related disability
-research suggesting benefits generally show : good patient participant, change in communication strategies usage, change in perceived hearing related disability, reduced rate of hearing aid returns, reported benefit by frequent communication partners
-enhancing self-efficacy

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11
Q

models for CST

A

formal instruction, guided learning, real-world practice, individual training

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12
Q

formal instruction

A

participants learn various types of communication strategies and other listening and speaking behaviors, and are exposed to examples
-can suggest strategies they have found to be helpful
-group leader can share specific suggestions
-courtesy, explanation, and direction

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13
Q

guided learning

A

patients are encourage to use conversational strategies in a structured setting
-modeling
-role playing
-analysis of videotaped scenarios
-attention

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14
Q

real world practice

A

includes activities that participants have performed successfully in the classroom/clinic and also some activities that require them to communicate in a setting that is highly motivating (such as office of social gathering)
-report success and problems

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15
Q

individual training

A

includes difficulties associated with patient specific hearing loss

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16
Q

training for communication partners

A

training may foster empathy for the difficulty of the speechreading task, and encourage behaviors that will reduce communication breakdowns
-generally provided at the same time, and sometimes in the same class
-may also receive support and counseling about adjusting to the changes in life quality

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17
Q

group programs

A

provides the opportunity for the individual with hearing loss, their spouses, children or caregivers to participate in understanding the larger effect of quality of life caused by hearing loss

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18
Q

counseling

A

help patients understand and solve their hearing related problems
-acceptance of hearing loss
-understanding of hearing loss and effects
-decreased stress

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19
Q

informational counseling

A

professional instructs, guides, and gives expert information in the format of give and take dialogue
GOAL : patient learns about hearing loss, listening, device technology, and services
DESIRED OUTCOMES : patient has an understanding of hearing loss and knows more about technology and available services

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20
Q

personal adjustment counseling

A

GOAL : patient works through negative feelings about hearing loss and self worth and learns to accept the permanency of hearing loss
DESIRED OUTCOME : patient begins to regain positive self image and becomes willing to engage in aural rehabilitation intervention plan

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21
Q

psychosocial support

A

help patients achieve long term self sufficiency in managing the psychological and social challenges that result from hearing loss
GOAL : focus on the permanency of the hearing loss and on psychological, social, and emotional acceptance

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22
Q

cognitive approach

A

modify thought process
GOAL : eliminate misunderstandings and assumptions by replacing them with positive thoughts and positive perspectives
-rational emotive behavior therapy (REBT) : replacing the irrational belief with a rational one

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23
Q

behavior approach

A

modify behavior
-desensitization : reduce negative reaction through repeated exposure
-identify physical systems of stress
-introduce relaxation techniques

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24
Q

affective approach

A

modify emotions
-phenomenological : patient changes how they view themselves and their place in the world, even though their circumstances remain the same
-the clinician : utilized congruence with self, used unconditional regard, employs empathetic and understanding

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25
Q

assertiveness training

A

teaching patients to express themselves assertively in their communication interactions and to state negative and positive feelings directly
-enhance communication between patient and communication partner

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26
Q

targeting counseling

A

ensuring that the counseling addresses the patient’s particular concerns

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27
Q

reframing

A

provides the patient with an alternative frame of reference from which to view a problem

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28
Q

normalizing

A

patient realize their feelings are normal and helps decrease negative emotion

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29
Q

cost benefit analysis form (CBAF)

A

benefits of not taking action, costs of not taking action, costs of taking action, benefits of taking action

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30
Q

problem solving model

A

-problem identification
-problem exploration through creating scenarios
-problem exploration through reading self profiles
-problem resolution

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31
Q

patient centered approach

A

-treats patients with dignity and respect, promoting control, and independence
-dictates that highly successful aural rehab plans : best determine patients background, needs, and wants ; accommodates those through the design and delivery of appropriate interventions

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32
Q

patient centered approach includes

A

effective treatment, patient involved decision, respect for patient preference, gives clear information, empathy, involvement of family, continuity of care

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33
Q

prevalence of HL in adults

A

age 21-34 - 3%
age 34-55 - 6%
age 45-54 - 11%
age 55-64 - 22%
-onset is gradual
-typically mild to moderate SNHL
-mild to high frequency loss is most common

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34
Q

individual factors to think about

A

family life circle, life factors, community factors, socioeconomic factors, culture, psychosocial well being, stigmatization, emotional state, gender, home/social/vocational hearing related difficulties

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35
Q

AR journey in six steps

A

pre-awareness, awareness, movement, diagnosis, rehabilitation, and resolution
-diagnosis, rehabilitation, and resolution sometimes move backwards as a result of the resolution (give and take and overlap)

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36
Q

pre-awareness

A

“i’m not the issue, you are”
-can last longer for younger adults
-family or friends point out issues first
-may be frustrated with issues

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37
Q

awareness

A

“yeah I might have a problem”
-knows about it but won’t do anything
-occurs gradually
-shift in blame from others onto self

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38
Q

movement

A

“i think i need help”
-reaches the tipping point when they decide to consult a professional
-psychological costs (acceptance of hearing problem, anxiety of getting old, awkwardness from having to ask for time away, embarrassment)

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39
Q

diagnosis (and action)

A

knows what is causing the hearing loss, going to get help
-may expect rapid solutions, treatment, or complete cure
-anxiety common for those with permanent loss

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40
Q

rehabilitation

A

-some will be successful and some will need more help
-patients can shift between rehabilitation and resolution

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41
Q

resolution

A

-exit or relapse
-patients can shift between rehabilitation and resolution

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42
Q

american with disabilities act (ADA)

A

equal opportunity law which guarantees people with disabilities the same opportunities as other americans
-title 1 : employment
-title 2 : public services and transportation
-title 3 : public accommodations and commercial facilities
-title 4 : telecommunications
-title 5 : miscellaneous provisions

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43
Q

who is covered by ADA

A

protects people who :
-have a physical or mental impairment that substantially limits one or more major life activities
-have a record of such an impairment
-or are regarded as having such an impairment

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44
Q

presbycusis

A

age related hearing loss
-central auditory pathways decline due to age related (loss of neural connections are thinning of myelin sheath)
-neural : loss of sensory and supporting cells, nerve fibers, and neural tissue
-metabolic : change in the blood supply to the cochlea

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45
Q

circular chain of events

A

-social withdrawal : patients may withdraw from social interactions
-negative reactions : family and friends may perceive the person with hearing loss as unsociable, forgetful or preoccupied with health matters
-perceptions may lead to person with hearing loss mistakenly being labeled as demented, confused
-emotional distress : person with hearing loss may increasingly experience anger, frustration or may cause further withdrawal

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46
Q

hearing loss and dementia

A

with untreated hearing loss, there is a higher risk for decline in cognitive abilities
-identified as a risk factor for dementia
-hearing aids may help delay cognitive decline and even dementia

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47
Q

hearing aids and dementia

A

cascade theory - if you get HA, you are more social involved, reduced depression, promote self-efficacy, promotes physical activity which helps promote cognitive function
neurobio theory - reduce adverse effects of sensory deprivation because you can engage with their surroundings
atrophy theory - slow the decline in brain function or degeneration of the brain (neural connection and brain on level of muscle)

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48
Q

visual impairment

A

cannot be compensated through corrective lenses
-speechreading may not be an option
-communication strategies training may emphasize the environment and how individuals arrange themselves
-patient cannot see smaller components or visual indicators of hearing aids

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49
Q

arthritis

A

inflammation of joints, connective tissue, or surrounding tissue
-chronic condition seen in about 20% of individuals 75 and older
-reduced fine motor control, decreased sensitivity, loss range of motion, pain, stiffness

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50
Q

the vestibular system

A

provides information to the CNS for control of skeletal muscles for postural adjustments
-provides CNS with spatial information about linear and angular acceleration

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51
Q

balance problems

A

sensory component : loss of hair cells in the vestibular part of the inner ear, vision decrease, decreased sensation
motor component : muscles get weaker, joints get stiffer

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52
Q

dizziness

A

used to describe a range of sensations : unsteadiness, feeling faint, feeling weak, increases risk of falling and injuries

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53
Q

vertigo

A

false sensation that the individual or the environment is moving
-increases risk of falling and injuries

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54
Q

considerations for elderly adult patients

A

economic status and retirement, living environments

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55
Q

focus of AR for elderly adults

A

-continued hearing aid/sensory aid orientation
-adjustment to life with hearing loss and sensory aids
-assessment of communication abilities
-intervention for communication abilities

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56
Q

who is on the team for AR with elderly adults

A

audiologist, speech pathologists, counselors or social workers or medical personnel

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57
Q

within a nursing home or assisted living many face challenges with

A

-managing hearing loss and dementia
-preventing hearing aids from being lost
-proper hearing aid care and maintenance
-training staff about hearing aids
-frequency in service

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58
Q

group setting addresses

A

hearing and hearing loss, sensory aids, speechreading training, communication strategy training

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59
Q

group setting advantages and disadvantages

A

advantages : produce gains in speechreading, allows for group sharing of feelings, provides an emotionally safe environment
disadvantage : some training may be too general for certain clients

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60
Q

tinnitus

A

-it is a symptom
-1-2% of population experiences severe tinnitus that negatively impacts sleep, work, concentration or quality of life
-prevalence increases with age
-can be a variety of different noises/sound
-there is no cure, but we can help manage the response

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61
Q

transient tinnitus

A

temporary reduction in hearing sensitivity that resolves in a few minutes

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62
Q

persisten or chronic tinnitus

A

lasts longer than 5 minutes, occurs more than once a week or is constant

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63
Q

oddities of tinnitus

A

-can occur without damage to the cochlea
-persons with profound hearing losses don’t always have tinnitus
-some tinnitus suffered can control intensity and pitch
-tinnitus and phantom limb syndrome share similar neural characteristics

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64
Q

loudness of tinnitus

A

-70% report loudness at less than 6 dB SL at matched pure tone frequencies
-22% say equally loud in both ears

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65
Q

pitch of tinnitus

A

-half report one sound, half report two or more
-97% report ringing or clear tone

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66
Q

spatial lateralization of tinnitus

A

34% report one side, more often than not left ear

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67
Q

effects of tinnitus

A

quality of life : unable to enjoy quiet time, sleep deprivation, cognitive impairment, emotional responses, chronic stress
psychological disorder : annoyance, anxiety, depression, sleep disorders

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68
Q

tinnitus intake

A

interview and/or questionnaire
-tinnitus handicap inventory (THI) - will answer based on yes, sometimes, or no

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69
Q

audiologic assessment or medical assessment for tinnitus

A

standard test battery : may need to be mindful of loud inputs
medical assessment : necessary when tinnitus is unilateral and/or pulsatile
tinnitus psychoacoustic assessment : loudness and pitch matching

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70
Q

what is unilateral tinnitus a redflag for?

A

vestibular schwannoma

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71
Q

what does pulsatile tinnitus mean

A

blood supply

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72
Q

hearing aids as tinnitus treatment

A

tinnitus maskers are available in most hearing aids
-can be used with and without hearing loss
-masking sounds option vary greatly to personalize for the patient

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73
Q

cognitive behavioral therapy for tinnitus

A

addresses the negative responses towards their tinnitus
-referral to a specialist

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74
Q

sound machines

A

-will help mask noise in the background
-will help mask on the day to day (to some degree)

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75
Q

general counseling tips for tinnitus

A

-avoid high levels of noise
-avoid situations that cause excessive anxiety
-get adequate sleep
-limit alcohol, caffeine, nicotine

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76
Q

tinnitus retraining therapy (TRT)

A

GOAL : reduce or eliminate the annoyance of tinnitus
-addresses emotional reaction and inappropriate beliefs

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77
Q

universal newborn hearing screening (UNHS)

A

signed into law in 1999
-97% of babies receive screening
-screening is a pass or refer protocol

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78
Q

early hearing detection intervention

A

funded to provide resources to aid in establishing and operating UNHS programs and to connect them to early intervention services

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79
Q

importance of early detection of hearing loss

A

birth to 3 years is a critical time for speech and language development

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80
Q

why the need for early intervention

A

to have better language outcomes
-there is evidence for having better outcomes

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81
Q

1998 study for early intervention

A

150 deaf and hard of hearing infants and toddlers
-found those that had EI would have speech development at or near normal to those normal hearing peers when compared to children without EI

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82
Q

1, 3, 6 month approach

A

at 1 month : if you do not pass, you will come back at 3 months
at 3 months : there will be a diagnosis unless they pass
at 6 months : there will be intervention approaches that begin
GOAL : identify early, enhance development, enhancing accommodation of child needs

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83
Q

typical protocol for screening

A

if the baby does not pass on the first screening in at least one ear, they will get screened a second time
-if they do not pass on that second time, they will be referred for evaluation

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84
Q

objective tests

A

otoacoustic emissions (OAEs) and automatic auditory brainstem response (AABR)

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85
Q

otoacoustic emissions (OAEs)

A

only captures a certain range of frequencies
-2,000 to 5,000 Hz
-present or absent
-looking at hair cell function

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86
Q

automatic auditory brainstem response (AABR)

A

putting stickers on the forehead and sounds in the ear to watch sound go to auditory nerve
-if it is received there, there is more likely that it is heard
-sound will start at the cochlea then will go to the auditory nerve
-can capture auditory neuropathy disorder (one thing OAEs cannot)

87
Q

behavioral evaluations

A

behavioral observation, visual reinforcement audiometry (VRA), conditioned play audiometry (CPA)
GOLS STANDARD : have to recognize the sound and decide what to do with it
-use these to assist in programming hearing aids or hearing loss levels

88
Q

behavioral observation

A

birth to 6 months
-depends on if the baby can give consistent responses
-looking for a change in breathing, eyebrow movement, and eyes looking in a specific direction

89
Q

visual reinforcement audiometry (VRA)

A

6 months to around 3 years
-child is in the center of a sound booth with puppets on both sides (with or without headphones)
-looking for reflex of looking the right way of sound
-if they look the right way, the puppet will light up
-if they look the wrong way, nothing will happen

90
Q

conditioned play audiometry (CPA)

A

around 3 years to 5 years
-conditioning them to ask
-every time they hear a sound, they can do something with a toy
-determines ear specific and frequency specific hearing sensitivity

91
Q

hearing care follow up

A

parent counseling (stages of grief can occur any time), referral to otolaryngologist, enrollment in early intervention, audiologist counsels parents about test results

92
Q

referral to otolaryngologist

A

-medical evaluation
-assessment of other debilities
-genetic testing
-medical clearance for HA or CI

93
Q

why is there a need for a medical clearance for HA or CI?

A

need for up to the age of 18 to investigate if there are other reasons for needing a HA or CI
-they go back to receive a new one when needed

94
Q

follow up schedule with audiologist

A

testing is every 3 months for babies and every 6 months after age 3

95
Q

hearing loss causes in children

A

genetic (50%) - syndromic is 30, non syndromic is 70
idiopathic (25%)
non genetic (25%) - infections
-most common is non syndromic genetic

96
Q

early intervention programs

A

programs and services for children from birth to 3 years who have been identified as having a developmental delay or who are at risk for developing a delay

97
Q

why are early intervention programs designed

A

to meet physical, intellectual, language, speech, social, and emotional needs

98
Q

who qualifies for early intervention?

A

-having a delay in one or more areas
-having a diagnosed condition with high probability of developmental delay

99
Q

family centered approach

A

intervention approach that places the family as central to a child’s well being
-using families strengths and weaknesses
-patterns of communication and interaction affect one another
-infants and toddlers learn best through everyday interactions
-work to support families and caregivers

100
Q

how is early intervention funded

A

provided under IDEA part C
-screening, evaluation, and assessment procedures
-individualized family service plan

101
Q

early intervention services for birth to 3 years

A

an intensive stage of listening, language, and speech development
-family approach care

102
Q

questions to ask for early interventions for child with hearing loss

A

-who can provide services
-what is medical home (approach to provide healthcare that is accessible and family centered)

103
Q

services provided with early intervention

A

-family, training, counseling, and home visits
-special instruction
-audiology
-speech pathology
-physical and occupational therapy
-psychological services
-case management

104
Q

effective early interventionist

A

-provides unbiased information and instruction
-provides empathetic listening and unconditional positive regard
-IFSP : ready to enter plan (before IEP plane)

105
Q

what do parents desire?

A

according to hands and voices
-wish for choices
-wish for information

106
Q

counseling for families

A

-support and guidance
-the adjustment of having a child with hearing loss
-family support with developing and implementing AR plans
-parent support groups !

107
Q

things needed for early intervention

A

-normal development
-understanding ramifications
-understand how to read audiograms and explain results to families
-have knowledge of communication modes and pros/cons for each
-know laws pertaining to service provision in early childhood
-know local services available in the community

108
Q

early identification outcomes with expressive and receptive language

A

-no difference between aural/oral mode and ASL mode
-mode of communication was not a predictor of outcomes
-significant relationships were found in preschool-age children

109
Q

early identification outcomes and speech production

A

-mild to severe HL was small discrepancies in speech production
-severe to profound HL was 2/34 children developed intelligible speech

110
Q

early identification outcomes and language

A

-children with mild to severe HL performed better on reading, academic achievement, and language when compared to sever to profound HL
-children with hearing loss had similar language development in the first 3 years of life

111
Q

facilitative learning strategies for infants and toddlers

A

coaching and communication techniques

112
Q

coaching of parents

A

parents are the experts of their children
-work with family
-emphasis is placed on child family interaction, function of communication, embedding learning within ongoing routine interactions

113
Q

auditory training for infants and toddlers

A

goal with hearing loss and goal with cochlear implants

114
Q

AT goal for children with HL

A

due to having residual hearing, children are processing a degraded speech signal. auditory training may begin with more difficult tasks

115
Q

AT goal for cochlear implants

A

accelerate auditory learning and to raise level of speech recognition

116
Q

pyramid directional representation of AT

A

-awareness (easier)
-discrimination
-identification
-comprehension (more difficult)
-with small children, there is no specific timeline for when they move between levels

117
Q

informal training for children

A

incorporated into everyday routines to encourage and enhance language enrichment

118
Q

formal training for children

A

in person, computerized or web based programs
-moments of positive reinforcement and possible a reward system for in person

119
Q

activities for sound awareness

A

peek a boo, musical chairs, marching to beat of a drum

120
Q

activities for sound discrimination

A

play a game with toy animals, respond to commands, repeat what you hear

121
Q

activities for identification

A

play game candy land and listen for name of colors, play with postcards or stickers

122
Q

activities for comprehension

A

listen to read aloud story then answer questions

123
Q

why is there a wide age range for school age children (3-22 years)

A

-no child left behind act
-IDEA part B focuses on the idea that everyone has access to free and public education

124
Q

least restricted environment

A

kids should be placed in a classroom with equal peers if they have a disability
-will be placed that best supports the child

125
Q

individualized education plan (IEP)

A

legal binding document that will travel with the child and will have goals/services that will need to be met

126
Q

members of an IEP team

A

-parents/caregivers
-audiologist
-SLP
-teacher of child
-teacher of DHH children
-psychologist
-interpreter (depending on language of family and child)

127
Q

push in model for teaching

A

will work with student in general education classroom one on one or a small group

128
Q

pull out model for teaching

A

remove the child and take them to a quiet location to review and go over work

129
Q

hearing impaired eligibility

A

hearing acuity that interferes with child’s performance in the educational environment and requires the provision of special education and related services
-starts with child find (around 2- 3 years)
-can they see or can they hear?

130
Q

hearing impaired eligibility involves what aspects

A

audiological evaluation, evaluation of communication/language proficiency, academic performance, and observation from parents and school staff

131
Q

IEP timeline

A

takes about 60 days from time of referral
-initial evaluation
-determination
-IEP creation
-re-evaluation

132
Q

initial evaluation of IEP

A

review of existing evaluation data (RED)
-review existing evaluation data, information or evaluations
-determine need for further evaluation

133
Q

IEP creation

A

development of measurable goals, how they will be delivered, and where will it occur
-direct services : working on those goals (routine)
-related services : things that need to occur but not as routine

134
Q

re-evaluation of IEP

A

annual IEP meeting : within 1 year of last meeting
3 year reevaluation : complete assessment, determine eligibility, develop goals based on assessment

135
Q

types of eligibility

A

a child who is at least 3 years but under 22 who :
-have been evaluated and found to have at least one disability
-because of their disability, needs special education and related services

136
Q

accommodations vs. services

A

accommodations are not services, they are things that are done to help improve the child’s environment
-examples include : technology, seating arrangement, visual support, allow extra time

137
Q

evaluation of communication and language proficiency

A

speech skills : speech intelligibility, speech testing
language skills : formal testing of language, receptive and expressive language
literacy evaluation : reading and writing

138
Q

types of classroom placement

A

self contained, part time self contained and mainstream classroom, part time mainstream and resource classroom, and mainstream

139
Q

what needs to be decided with a mainstream classroom

A

-direct vs. indirect services
-accommodation
-no services

140
Q

advantages of a inclusion classroom for children with disabilities

A

improved academic achievement, social competence, communication skills, opportunity for skills and abilities, positive self concept

141
Q

advantages of a inclusion classroom for children with no disabilities

A

wider social acceptance and understanding of disability, increased awareness of and respect for diversity, increased tolerance and social cognition, enhanced self concept

142
Q

speech/language impairment

A

an evaluation by a certified speech language pathologist or speech language technician

143
Q

504 plan of rehabilitation act of 1973

A

designed to eliminate discrimination on the basis of handicap in any program or activity receiving federal financial assistance
-with respect to public school services, a handicap person of any age
-with respect to postsecondary and vocational education services

144
Q

what does 504 plan of rehabilitation act cover

A

-evaluation results
-504 plan
-used for primary, secondary, and post secondary education
-evaluation procedures
-placement decision
-re-evaluation

145
Q

team members of a 504 plan

A

parents, child, general education team, counselor, audiologist

146
Q

evaluation procedures for a 504 plan

A

-tests have been validated and tailored to specific areas of need
-review academic achievement performance
-teacher recommendations
-documentation of physical or mental condition

147
Q

acquisition of speech skills depends on

A

auditory input from surroundings, auditory articulatory loop, information from other modalities

148
Q

auditory input from surroundings

A

kids with HL : there is not input from auditory system

149
Q

auditory articulatory loop

A

kids with HL : bubbles from sounds around you will get smaller
-ex. hearing the door open you will not hear so you will not know anyone came in

150
Q

information from other modalities

A

kids with HL : will use other systems to gain information from what is occurring around them
-such as visual, proprioceptive input

151
Q

what is considered when describing a child’s speech

A

overall intelligibility, segmental production, and suprasegmental production

152
Q

factors affecting speech development

A

-age of identification
-degree or type of HL
-secondary disabilities
-family support
-speech and language therapy
-multi language learners
-age of amplification
-aided hearing levels
-consistency of device use
-acoustic environment

153
Q

early speech development in infants with HL

A

-pre speech vocalizations (range is similar, but become less frequent over time)
-consonants (smaller inventory, does not expand over time)
-vowels (reduced F2 ranges)

154
Q

suprasegmental characteristics of speech in children with HL

A

-poor breath control
-strained or tense voice
-hypo or hyper nasality
-poor prosody (ex. inappropriate rate)

155
Q

what factors affect intelligibility

A

breath control, prosody, voice quality, and resonance

156
Q

summary of speech characteristics for D/HH children

A

-may have suprasegmental errors affecting intelligibility
-shows delay in phonological development compared to same age peers
-have difficulty producing full range of consonants accurately

157
Q

summary of speech skills and cochlear implants

A

-higher levels of intelligibility
-speech acquired at a faster rate
-improved vowel production
-good consonant acquisition

158
Q

intelligibility rating

A

based on % of words understood
-# of words understood/total # of words
-controlled by breath control, prosody, voice quality, and resonance

159
Q

language characteristics

A

form, content, and pragmatics

160
Q

form issues

A

-simple structure with few words (overuse of nouns, omit function words)
-poor understanding of various sentence structures (the cat was chased VS. the cat chased)

161
Q

content issues (words and meanings used during communication)

A

-limited vocabulary
-cannot identify synonyms or idioms
-understanding of words limited to subtle meaning
-learn more concrete than abstract words
-more general than specific

162
Q

pragramtics issues (use of language in context)

A

-incorrect language use
-inappropriate asking of questions
-lack of initiation skills
-absence of communication breakdown skills
-poor turn taking

163
Q

reasons for lack of pragmatics

A

-unfamiliar with language structure
-reduced vocabulary
-few conversational partners
-unable to overhear conversations
-lack of instruction on rules

164
Q

incidental learning

A

SES status impacts the total variety of words young child were exposed to, resulting in a estimated 30 million word gap
-approx. 80% of new words are learned from incidental learning

165
Q

summary of language skills for cochlear implant users

A

-accelerated language acquisition
-higher rated of acquisition of grammar
-syntax may catch up with normal hearing
-increased vocabulary development
-before 5 years of age, growth of 4 years in 3 years

166
Q

reasons for literacy deficits

A

-reading and writing difficulties
-limited development of an auditory basis for mapping sound
-deficits in experience and world knowledge

167
Q

reading

A

delays are common
-with consistent HA use, they can correct the normal lag that occurs compared to their peers
-with consistent CI use, they will be able to read better than impaired peers but worse than normal hearing peers

168
Q

writing

A

writing samples often contain errors, such as omission or inappropriate use of certain words
-CI improve the prognosis

169
Q

summary of literacy in D/HH children

A

-language and literacy development occurs simultaneously
-development follows those of their normal hearing peers

170
Q

three reasons for speech and language assessment

A

-determining the need for intervention
-developing intervention goals
-evaluating progress of intervention

171
Q

what to consider when testing speech and language of children with hearing loss

A

-task type
-communication mode
-rapport
-procedures for testing
-test norms

172
Q

assessing speech skills

A

-can be informal or standardized
-will be measured as a percent correct score
-provides measures of intelligibility, segmental speech, and suprasegmental production

173
Q

assessing language skills

A

can be standardized or can feature a collection of spontaneous or structured language samples
-using a story re-tell task or play session followed by sample analysis

174
Q

literacy evaluation importance

A

-helps with classroom placement and need for services
-shows a child’s strengths and weaknesses

175
Q

advantages and disadvantages of having the same literacy assessment for normal hearing and hearing loss

A

advantages : comparisons to children with normal hearing in a mainstream classroom
disadvantages : difficult test items

176
Q

what do D/HH children need

A

-appropriate technology plus acoustic accessibility
-enriched auditory ecposure

177
Q

what do the needs of D/HH children result in

A

auditory brain development

178
Q

listening bubble

A

within certain bubbles around the child, they will hear acoustic information and in other bubbles they will not hear that information
-beyond the range of listening speech will not be caught

179
Q

best practice for speech recognition abilities

A

word recognition scores :
-average speech is 45/50 dB HL
-soft speech level is 30/35 dB HL

180
Q

if the child cannot hear soft speech, they will

A

-not hear peers in the classroom
-not overhear conversations
-have reduced language and literacy skills

181
Q

the string bean

A

-top portion of the speech banana
-functional gain
-aided hearing at 0 dB HL is not the goal because it can cause distortion

182
Q

speech audibility audiogram

A

tool to improve the professional’s ability to estimate listening under varying speech loudness conditions present in typical classrooms

183
Q

classroom noise

A

-can impact speech recognition
-can lead to annoyance, learned helplessness, isolation, and identity and self concept

184
Q

role of audiologists, SLPs, and D/HH teachers

A

-provide interventions to minimize classroom listening and learning barriers
-educate members of the school team
-establish efficacy of improvements made of classrooms

185
Q

types of intervention or therapy

A

speech therapy (auditory training), language therapy, and pragmatics and social skills training

186
Q

speech and language therapy

A

-children with HL benefit from receiving speech and language therapy
-long term attention must be placed on developing skills if a child is to develop

187
Q

approaches for therapy

A

uni-sensory approach and multi-sensory approach

188
Q

uni-sensory approach

A

auditory only cues OR visual only cues

189
Q

multi-sensory approach

A

combines auditory and visual cues

190
Q

goals of speech therapy

A

-increase vocalizations
-expand phonetic and phonemic repertoires
-establish link between audition and speech production
-improve suprasegmental aspects of speech
-increase speech intelligibility

191
Q

hearing vs. listening

A

hearing : is acoustic access to the brain
listening : is attention to acoustic events with intentionality
-hearing must be made available before listening can be taught

192
Q

the skill of _________ must be learned

A

listening
-“for a child with HL, listening is often hard without proper training” (CDC)

193
Q

auditory training is defined as

A

instruction designed to maximize an individuals use of residual hearing or electrical hearing by formal and informal listening practice
-auditory skills can be developed with informal or formal training

194
Q

goals of AT

A

-improves persons ability to utilize sound
-use auditory signal to recognize speech
-develop meaningful auditory integration

195
Q

auditory integration

A

use listening skills in real world environments

196
Q

auditory listening promotes

A

-phonetic development
-underlying development of linguistic structure for language acquisition
-child’s knowledge of phonology

197
Q

principles of auditory development and training

A

auditory skill level, stimulus unit, activity type, difficult level

198
Q

auditory skill level

A

detection, discrimination, identification, comprehension

199
Q

detection

A

aware of sound
-easier

200
Q

discrimination

A

can tell one sound if different from another

201
Q

identification

A

understands what a word or sentence represents

202
Q

comprehension

A

understands the meaning of connection speech
-more difficult

203
Q

speechreading and AT

A

build association between auditory and audiovisual representations of speech
GOALS : recognize and understand spoken language, achieve increased reliance on using auditory signal to recognize speech

204
Q

goals of language therapy

A

-increase communication between parent and child
-promoting complex concepts
-enhancing vocabulary growth and use of language syntax
-develop narrative skills

205
Q

structured language therapy

A

teacher modeling and student imitations

206
Q

naturalistic language therapy

A

taking any opportunity to explain or make meaningful connections using language

207
Q

techniques for developing a child’s listening skills

A

-acoustic highlighting (the difference between incorrect and correct)
-auditory sandwich
-auditory bombardment
-parentese (changing duration,pitch, or intensity)
-leaning in
-hand cues
-turn taking
-self talk
-experience books/storytelling

208
Q

auditory sandwich

A

emphasis auditory input without sacrificing comprehension
-present information with auditory first
-add visual cues if the child does not understand next
-restate with only auditory presentation

209
Q

pragmatic auditory skills training

A

training introduces facilitative and communication repair strategies
-want to play different scenarios and have them practice social interactions

210
Q

communication strategies training for children

A

formal instruction, guided learning, real world practice
-practice communication with images or pictures

211
Q

receptive repair strategies for children

A

assess how much knowledge they have take in
-tailor questions to how much they understood

212
Q

communication strategies training for parents

A

receive instruction on ways to repair communication breakdowns when they are the talking
-rephrasing, simplifying, elaborating, and building from the known

213
Q

self advocacy specific areas

A

-self-knowledge
-preferential seating
-secure accommodations
-equipment management
-communication repair

SHS 496 (4 decks)

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