V: Special Considerations in Speech-Language Pathology Practice (AAC & Audiology) Flashcards
AAC
AAC (1)
forms of communication that either supplement and/or replace more conventional means of communication (typically referring to speech)
AAC
F2F (1)
face-to-face communication (refers to spoken communication)
AAC
developmental and congenital disorders associated with need for AAC (7)
autism spectrum disorders (ASD), cerebral palsy (CP), down syndrome, severe and refractory phonological disorders, childhood apraxia of speech (CAS), intellectual disability, spina bifida
AAC
acquired disorders associated with need for AAC (8)
brain tumor, stroke (cerebrovascular accident or CVA), spinal cord injury (SCI), traumatic brain injury (TBI), multiple sclerosis (MS), guillain-barre syndrome (muscle weakness caused by PNS damage), huntington’s disease (HD), head and neck cancers (HNCs)
AAC
FAPE, 1975 (3)
free appropriate public education, guaranteed by rehabilitation act of 1973 and IDEA 1990, requires that children with disabilities receive support free of charge as is provided to nondisabled students
AAC
IDEA, 1990 (1)
individuals with disabilities education act, stipulates that assistive technology must be provided if it is required as a part of a child’s special education, related services or supplementary aids and serviced
AAC
assistive technology act amendments of 2004 (2)
PL-108-364, mandated assistive technology centers in each state and territory
AAC
ADA (2)
americans with disabilities act, hospitals must provide effective means of communication for patients, family members and hospital visitors who are deaf or hard of hearing
AAC
unaided vs aided (1::1)*
use of only the body to communicate without external aids or equipment :: use of external equipment to assist with communication
*aided AAC devices may be: no, low, mid and/or high-tech
AAC
dedicated vs nondedicated devices
sole purpose is to assist with communication (typically face-to-face) by providing speech output :: commercially available and support a range of functions in addition to speech output
AAC
iconicity (2)
the association a person makes between a symbol and its referent, can be: opaque (symbol does not resemble referent), translucent (symbol resembles referent), transparent (symbol can be readily guesses)
AAC
static vs dynamic displays
display doesn’t change :: screen changes following use input
AAC
cosmesis (1)
aesthetic appeal of a device and whether it can be modified/personalized (colors, designs)
AAC
direct selection vs alternate access
select via touch or other means (eye gaze) :: scan choices and the user indicates a choice using a predetermined signal
AAC
common scanning patterns (5)
circular (simplest type of scanning where icons highlight in a circle until a selection is made), linear (row-by-row, left to right), row-column, top-bottom, group item (icons grouped into themes)
AAC
selection control techniques (3)
direct (inverse) scanning (hold and release), automatic (regular) scanning (cursor moves automatically and a selection is made when switch is activated), step scanning (1:1 correspondence between cursor movement and switch activation)
AAC
partner-assisted scanning (1)
communication partner presents choices to the AAC use
AAC
auditory scanning (2)
used when visual interaction with the device is not possible, choices are provided auditorily
AAC
switches (3)
used with scanning to make selections, may use multiple switches to tailor functionality specific to the patient, types: mechanical, electrical, pneumatic (uses inhalation/exhalation to activate), electronic
AAC
switch site hierarchy (7)
hands -> head -> mouth -> feet -> lower extremities -> upper extremities -> mind
AAC
types of AAC communicators (4)
vary by skill while using device, types: emerging, contextual, independent
AAC
four main reasons for communicative interaction
communication of wants/needs, information transfer, social closeness, social etiquette
AAC
four core competencies of communicative competence for AAC user
linguistic, operational (maintenance of device), social, strategic (compensatory strategies to circumvent limitations of device)
AAC
types of rate enhancement (3)
prediction (autocorrect), coding (alpha, alphanumeric, letter-category, numeric codes), message coding (alpha-letter encoding, abbreviation expansion, icon prediction, color coding)
AAC
organization strategies using types of displays (3)
grid displays (fitzgerald key system, schematic grid, pragmatic organization dynamic display or PODD), visual scene displays, alphabet displays (QWERTY, ABCD, vowels on the left and consonants following)
AAC
CCN (1)
complex communication needs
AAC
participation model (2)
a systematic approach on assessment and intervention focusing meeting participation requirements for routines and activities of typical peers, identifies barriers of opportunity and access
AAC
opportunity barriers (5)*
policy, practice, knowledge, skill, attitude
*these barriers are external
AAC
tangible symbol systems (2)
aka symbol assessment, used to determine: most abstract level of symbol representation that can be reliably used, smallest size symbol(s) that can be reliably used
AAC
feature matching (1)
the process by which the skills and needs of the client are matched against the features of various AAC systems (process to find the best/most fitting device for the individual)
AAC
vocabulary selection (5)
critical component of AAC intervention, use of core vocabulary (high-frequency words and phrases that are highly functional for the individual, use of fringe vocabulary (words and phrases that are specific to a topic/activity/individual, not used as frequently as core), also includes: developmental vocabulary (new words installed for training/vocabulary growth), coverage vocabulary (basic needs)
AAC
keyguard (2)
a plastic/plexiglass overlay used to help isolate each key/cell to improve accuracy of icon selection (avoids selecting the wrong icon), useful for people who use pointers and/or have tremor
AAC
types of speech output (3)
synthesized speech (computerized, test to speech or TTS), digitized speech (prerecorded messages), hybrid
aud
outer ear (5)
pinna, external auditory meatus (EAM), tympanic membrane (TM), auditory function:collect sounds and channel them to the middle ear :: non auditory function:protection
aud
TM (4)
tympanic membrane, a thin oval membrane that forms a partition between the outer ear and the middle ear, three layers (lateral epidermal, intermediate fibrous, medial mucosal), transduces sound aka acoustic vibration transformed into mechanical energy
aud
parts of the middle ear (4)
a six-walled air-filled cavity within the petrous portion of the temporal bone, houses three bones (malleus, incus, stapes) held into an ossicular chain via tensor tympani and stapedius muscles, ossicular chain suspended in the middle ear via five ligaments, eustachian tube
aud
eustachian tube
a mucosal-lined pathway (part of the middle ear) that ventilates the middle ear through the connection to the nasopharynx
aud
middle ear function (2)
overall function is to compensate for impedance mismatch (loss of sound energy) between the acoustic signals from the outer ear and the cochlear fluids of the inner ear, middle ear muscles serve to increase sensitivity of the auditory system for speech (for example, stiffens in background noise)
aud
inner ear (6)
resides in the petrous portion of the temporal bone, two functions (sense of hearing:cochlea :: sense of balance:semicircular canals and otolithic organs), portions include: bony labyrinth, cochlear structures, organ of corti (outer and inner hair cells)
aud
osseous labyrinth (4)
aka bony labyrinth, includes: semicircular canals (three canals responsible for angular movement), vestibule (chamber of sensory organs responsible for detecting linear movement), cochlea (contains end-organ of hearing)
aud
cochlear structures (4)
bony canal (base of cochlea:largest turn :: apex:smallest turn), membranous labyrinth: scala vestibuli (upper canal containing perilymph), scala tympani (lower canal containing perilymph), scala media (middle canal containing organ of corti and endolymph)
aud
organ of corti (2)
outer hair cells (tube shaped):serves as a biologic modifier increasing or decreasing sensitivity to sounds by changing length of hair cells :: inner hair cells (flask shaped):serve to process frequency, time and intensity information to the auditory pathway
aud
inner ear membranes (3)
reissner’s membrane (forms roof of scala media, risk of erupting), basilar membrane (forms floor of scala media, high frequencies processed at the base and low frequencies processed at the apex), tectorial membrane (responsible for shearing the steriocilia of the hair cells)
aud
inner ear function (6)
overall function is to change mechanical energy into hydromechanical energy and then into neural impulses: (1) stapes moves fluid in the scala vestibule to create a wave -> (2) fluid pushes on reissner’s membrane and creates a wave in scala media -> (3) tectoral and basilar membranes move and shear agains stereocilia -> (4) exciting hair cells converts energy to electrochemical -> (5) hair cells release neurotransmitter to create nerve impulses -> (6) neural impulses picked up by CN VIII
aud
coding frequency (3)
place theory (frequencies are encoded based on their place along the basilar membrane), temporal theory (auditory nerve is phase-locked to stimulus pattern and brain encodes that timing pattern), missing fundamental frequency (the absent fundamental frequency in a complex sound is what is heard)
aud
coding intensity (2)
as intensity increases: individual nerve fibers fire more often, a wider area of the basilar membrane is stimulated (greater number of nerve fibers activated)
aud
CN VIII (2)*
vestibulocochlear nerve (includes three fibers: inferior vestibular nerve, superior vestibular nerve, cochlear nerve), affarent fibers carry information (frequency, temporal, intensity) from the cochlea to the cochlear nucleus
*nerve innervation patterns: IHCs:one hair cell to many nerve fibers (divergent) :: OHCs:many hair cells to one nerve fiber (convergent)
aud
otoscopy (2)
a systematic visual inspection of the outer ear and surrounding tissue (external auditory meatus and tympanic membrane), pass criteria: normal appearance of all structures and no complaints of pain when pinna and/or surrounding tissue is manipulated
aud
intensity measures (4)*
decibel (dB – unit of measurement of intensity used in acoustics and audiometric testing), sound pressure level (dB SPL – intensity level based on absolute pressure measurement), hearing level (dB HL – reference of normal human hearing thresholds for each audiometric frequency tested), sensation level (SL – any measurement made above an individual’s threshold)
aud
audiogram x-axis vs y-axis
x-axis:aka abscissa expressed in Hz :: y-axis:aka ordinate expressed in dB HL