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Flashcards in Aural Rehabilitation Exam 3 Deck (313):
1

Travis and Tian were two ASL children.

true

2

Keira was a girl with a cochlear implant who had a language/speech delay. Mom imitates what the therapist is doing.

true

3

Solomon was a boy with bilateral cochelar implants who accepted the cochlear implants fairly easily. He grabbed his head when the implants were turned on.

true

4

___ was generated due to the educational shortcomings in the residential
schools and recommended “universally applied procedures for early id and
evaluation of hearing impairment.

Babbidge Report (1965)

5

____ recommended use of High-risk register and investigated the possibility of testing children 5 – 12 months.

National Conference on Education of the Deaf (1967)

6

____ estabilished stages from diagnosis of hearing loss to the beginning of formal communication intervention, including important steps for auditory habilitation.

Robbins (2002)

7

___ found the average age at identification = 2 ½ years.

The Commission on Education for the Deaf (1988)

8

____ recommended all infants be screened before leaving the hospita

The National Institutes of Health Consensus Statements (1993)

9

The Joint Committee on Infant Hearing's 1990 report established what?

– high risk infants screened by prior to d/c and no later
than 3 months of age

10

The Joint Committee on Infant Hearing's 1994 report established what?

All infants with HL id prior to 3 mos and begin
intervention by 6 mos.

11

The Joint Committee on Infant Hearing's 2000 report established what?

created guidelines and principles for EDHI programs

12

The Joint Committee on Infant Hearing's 2007 report established what?

2 different process for well-baby nurseries vs. NICUs; recommends pediatric ENT; referral for genetics consultation and pediatric ophthalmologist

13

What was the order of the 5 developments of EHDI?

1 Babbidge Report (1965)
2 National Conference on Education of the Deaf (1967)
3 The Commission on Education for the Deaf (1988)
4 The National Institute of Health Consensus Statements (1993)
5 Joint Committee on Infant Hearing (1990; 1994; 2000; 2007)

14

What made the EHDI possible? When was it?

Otoacoustic Emissions Testing (1993)

15

What are the 8 principles of the Joint Committee on Infant Hearing? 123; hi-risk, rights x2, data, regulation

1 Universal Newborn Hearing Screening
2 Rescreen/confirm loss by 3 months of age
3 Receive services prior to 6 months of age
4 Hi-risk babies monitored in hearing & sp/lang dev
5 Protection of infant and family rights through informed choice, decision-making, and consent
6 Privacy and Confidentiality are maintained
7 EDHI data systems - reporting
8 EDHI programs continuously assess effectiveness, compliance with regulations, and fiduciary aspects of the program.

16

What are risk factors for infant hearing loss? 6

hyperbilirubemia, NICU, syndromes (downs, etc.), atresia/stenosis, anotia/microtia, family history

17

What percent of babies were screen w/in 1 month of age (in '99, '04, and '08)

1999- only 25%
2004- 89.8%
2008- 92%

18

Of the babies who "fail" screen, ___ are lossed to follow-up.

65%

19

Of those infants ID'd w/ HL, ___ are referred for services and ___ receive services.

87%; 53%

20

We know that hearing loss can be ___, ____, or ____.

SNHL, permanent conductive HL, auditory neuropathy spectrum disorder (ANSD)

21

What is the prevalence of Well baby?

1 per 1,000 births

22

What is the prevalence of NICU?

1 per 100 (10x more common than well-baby)

23

Any bayin the NICU _____ (length of time) should also have an ABR prior to leaving

> 5 days

24

If a screening is failed, we should ____, prior to d/c.

repeat the screening

25

___ and ___ are possible causes of failed screening.

Cerumen; vernix caseosa

26

____ is a fatty cream that covers a baby right after birth.

Vernix caseosa

27

Babies readmitted to the hospital w/in ____ should be rescreened (freq readmits due to hyperbilirubemia).

1st month

28

If baby doesn't pass a screening, should be referred to a ___.

pediatric audiologist (who you should know)

29

As SLPs, we will have a lot to do with ANSD diagnosis.

false

30

___ is patent in pt with speech perception scores that do not match levels on audiogram,and sores are poorer than those w/ same degree of SNHL and scores are variable.

Auditory Neuropathy Spectrum Disorder (ANSD)

31

Who conducted research on what should we present to parents from hearing screens?

1997 - 10 question survey, parents had positive attitudes
2000 - both fails and passes had equal degrees of stress
2001 - found no significant degree of concern btw mothers whose babies failed first screen and second screen
2006 - more tests more stress

32

What are the 5 steps to increase adherence to follow up?

1 Newborn Hearing Loss managers need to communicate info
2 Dev a sys for scheduling follow-up appts
3 Audiologists need to build relationships w/ birthing facilities and provide on-going training and alliances w/ staff
4 min. the # of return appts needed
5 Empower families by providing edu and encouragement to be active in the EHDI process

33

What are the substeps for newborn hearing loss managers need to commmunicate information? 4

1 be available
2 explain results accurately
3 stress the importance of follow up
4 educate on the impact of hearing loss

34

If the infant fails the screening, the joint commission on infant hearing (2007) determined that if the ABR is normal and there are no risk factors, ___

no further scheduled follow-up needed (but notify pediatrician)

35

If the infant fails the screening, the joint commission on infant hearing determined that if the ABR is normal and there ARE risk factors, ___

follow-up by 2-2.5 years of age; more frequent follow-ups may be appropriate

36

What are some risk factors for HL in infants? 9

1 ECMO (oxygen adder to blood)
2 Chemotherapy
3 Syndromes w/ HL as component
4 Neurodegenerative disorders
5 Trauma
6 Infections associated w/ HL
7 CMV
8 Caregiver concerns
9 family history of HL

37

How has the newborn hearing screening changed the game?

it used to be the parent-initiated, now it is the "surprise model"

38

What are factors that happening with infant hearing loss in a hearing family? 9

1 Familiar party to break the news
2 Plan for enough time for counseling
3 Assess family's understanding
4 Encourage honest sharing of feelings
5 Accept family’s reaction with unconditional
positive regard
6 Allow ample time for decision processes
7 Clear plan for between visits
8 Schedule follow ups
9 Begin habilitation ASAP

39

Why should a familiar party break the news of a hearing loss?

someone should be building the trust and keeping the role structure clear

40

Why should we plan enough time for counseling?

cannot do back to back scheduling; if you go long, need to have an open period after

41

What are the parts to assessing the family's understanding of the screening results? 4 When should this be done?

1 results
2 their responsibilities
3 your responsibilities
4 next steps
at the end of the session

42

What goes into encouraging honest sharing of feelings? 2

1 people who are grieving say a lot of things
2 some of what they say is an accurate portrayal of their true feelings (the rest is just pain expressed)

43

What should to accept the family's reaction?

Never presume you know how someone feels: Outward expressions of grief may not be accurate; And, grief takes time and patience

44

What goes into allowing ample time for decision and processes? 2

Within reason – we need to have a decision re: communication options as soon as possible, but that doesn't mean a week or two or before the “before the
next visit”
- Instead, plan on having the family bring additional questions about each decision to each subsequent visit
= Once the questions dry up, a decision can be encouraged

45

What goes into having a clear plan for btw visits? 3 for family;

for Family
1 Journaling (see positive dev)
2 Reading (not to dark or light)
3 Exercises (find ways to expose kid to sound)

46

What goes into having a clear plan for btw visits? 3 for SLP/audiologist

for Audiologist/SLP
1 Preparing for decision discussions
2 Gathering of further education materials
3 Setting up connections/referrals

47

What goes into scheduling follow-ups? 3

1 few pts will go home and make an appts
2 encourage pts to make an appts b4 they leave
3 facilitate appts w/ referral sources

48

What goes into to beginning habilitation? 2

• Not pushing the decision, but encouraging
family to see what the child CAN do
• Help them to focus on positive changes that
development will push regardless of
disorders/disabilities

49

What is the difference in the response of HL in a deaf family? 2

1 pride in geneology
2 ease of visual communication (which can also be used w/ hearing ch)

50

What goes into Early Intervention? 2

• Amplification ought to be fitted within one
month of diagnosis
• Establishment of a medical home - means
(May already have an established relationship with a pediatrician; Work in concert with the pediatrician to
coordinate comprehensive care)

51

What should we do to educate the pediatricians in our area? 5

1 Overview of the EHDI process
2 Newborn screening and referral procedures
3 Options for amplification and parameters of those options
4 Procedures for Early Intervention referrals
5 Points to monitor in hearing health

52

____ is a place to go for all of your medical needs. The point person to contact with worries.

Medical home

53

How do you educate families regarding Early intervention? 9

1 Causes of hearing loss
2 Coping with the emotional aspects of HL (grieving process)
3 Understanding the audiogram
4 How the baby will learn to listen and speak
5 Understanding the ear and hearing
6 Realistic timelines for expectations
7 Amplification options
8 Communication options
9 Legal rights/laws that protect people with HI

54

What is Robbins (2002) timeline for early intervention?

Phase 1: Diagnosis to fitting
Phase 2: Adjusting to amplification
Phase 3: Adjustment to habilitation

55

What goes into phase 1 (diagnosis to fitting) in the timeline? 4

1 encourage parents to cont. auditory stimuli (esp lang)
2 journal ch's progress and parent's emotion
3 edu themselves
4 amplification (don't need full audiogram, just worst diagnosis on worst ear) (follow protocols for electro-acoustic analysis; modifications will be ongoing as ch grows and devs)

56

What goes into phase 2 (adjusting to amplification) in the timeline?

1 HAT and incidental learning
2 Journaling communication development 3 Orientation to the hearing aid may need to include multiple family members
(Maximize use, Manage humidity, Daily care, Troubleshooting, Visual and listening checks)

57

What are the recommendations for fitting on early intervention hearing aids? (6 reasons)

Generally a BTE is best bet for inf:
1 Best range of amplification options
2 Most durable
3 Remake of earmolds is easily managed
4 Easiest to manage and maintain
5 Easiest to adapt to use with TVs, telephone, radio, etc
6 Trial period of 3-6 months before CI implantation

58

What goes in to phase 3 (adjustment to habilitation) in the timeline? 2

1 Facilitative language techniques (now we need to be focused on development) - Variegated Babbling; Jargon into first words;
2 Pre-literacy exposure

59

____ must be administered in a standarized manner.

Standardized tests

60

______ assumes your patint is like the norming population.

comparison to norms

61

What are different language assessment?

Formal
- Standardized tests
- Compared to “norms”
- Informal
- Language sample
- MLU/semantic relations analysis

62

A formal test is a ___ or a moment of time and it is a specific set of skills.

snapshot

63

A formal test gives a range of what the patient can do.

false

64

Children with HL begin with ___ because there is a feedback loop for it.

babbling

65

If children are not well amplified, what will happening to child's babbling?

their feedback loop will be interrupted, babbling could cease

66

Early amplification can reduce or eliminiate the differences in comm development, but what? 2

1 vocabulary growth maybe slowed
2 phonological development may be different and or disordered

67

What are the modes of communication? Do parents have to know about them?

Auditory-Oral
Total Communication
American Sign Language (ASL); yes with minimal bias

68

What is the auditory oral approach?

uses residual aural function to stimulate auditory sense consistently; there is also the AV approach with 9 principles

69

What is the A-V approach? 9

1 early ID of hearing loss (screening at infancy throughout childhood)
2 prompt and vigrous medical and audiological management of the HL (incl amplification and HAT)
3 coach parents as primary communication models (part of screening process; appropriate edu re: hearing and comm)
4 integrate of hearing and listening into daily activities (enhance the opportunities for incidental learning)
5 one-to-one intervention with a-v principles
6 encourage monitoring of their own speech and the speech of others (including prosody)
7 follow typical developmental trajectories (developmental approach)
8 Continuous diagnosis and monitoring of
progress to inform program adaptations
9 Facilitate mainstream integration

70

What goes into the Total Communication? 3 (pros/cons)

1 Teaching English using sign, voice, fingerspelling, lipreading, amplification, vibrotactile simulation, gestures, and pictures
2 pros: any method of getting lang, can help lip reading
3 cons: not really English or ASL, mainstream classroom may not be possible.

71

__ is a language specifically used and husbanded by the Deaf.

American Sign Language

72

What are the aspects (1 pro/2 cons) of ASL?

Pros: strong sense of identity in the Deaf
community
Cons: 1 No written form – hard to make transition from ASL to written English
2 May have difficulty ‘fitting in’ to either (hearing or deaf) culture

73

Who plays a role in facilitating oral language? 7

1 skilled providers
2 hierarchical curricula (dev related)
3 mass practice
4 unisensory stimulation
5 parent partnerships
6 integration into ADL
7 capitalize on auditory language (which relates back to #1)

74

What are the special education provisions for ch w/ HL? 4

Individuals with Disabilities in Education Act
1 Free and Appropriate Public Eduction
2 Least Restrictive Environment
3 Procedural Safeguards
4 Individual Family Service Plans

75

What is dual sensory impairment?

either blind and deaf; or visual impaired and hearing impaired

76

What are some examples where dual sensory impairment is common?

syndromes like CHARGE and Usher

77

What does the SLP need to do with dual sensory impairment?

vision screening is very importatn to the pop of ch w/ hearing impairment (if optometrist who specializes in ch w/ hearing loss; opthomologist may be better bet)

78

What are some examples of assessment tools to use with infants and toddlers? 4

1 FAPI (Functional Auditory Performance Indicator)
2 IT-MAIS - Infant-Toddler Meaningful Auditory Integration Scale
3 COSI-C - Client Oriented Scale of Improvement for Children
4 ELF - Early Listening Function

79

When working on infant assesments what do we rely upon?

parent report

80

Which is the easiest way to assess?

formal test

81

When can it be difficult a language sample?

young children are difficult to understand, difficult to get talking

82

_____ must be administered in a standardized manner.

Standardized test

83

What do norms mean?

when you look at things a certain way, certain things should be observed

84

What is considered "school-aged"for aural rehab?

3-18 (21)

85

Who defines what are school-aged children?

Federal definitions of hearing impairment and deafness

86

What is the difference in Hearing Impairment and Deafness?

degree of HL and success of amplification

87

Why isn't there specific audiometric criteria for HI and deafness?

b/c of states descisions: ea ch w/ HL will need prescriptive guidelines not just based on the audiogram but many other variables in addition

88

What are the 3 main categories of speech affected by HL? 3

voice, prosody, and artic

89

How does HL/HI affect voice? 2

1 dependent upon respiration and phonation (needs feedback)
2 dependent on auditory feedback

90

What are voice quality issues common to people with HL/HI? 4

breathiness, harshness, hypernasality, and degree is somewhat dependent upon the nature and degree of HL

91

What are the effects of HL/HI on prosody? 3

1 subtle change (prosody is subtle)
2 may be difficult to detect other's prosody
3 therefore difficult to produce in his/her own speech

92

____ is intonation changes signaled by changes in a pseaker's fundamental frequency.

Prosody

93

What are the effects of HL/HI on articulation? 5

1 deletions, distortions, substitutions
2 both vowels and consonants- vowel neutralizations,
3 consonant voicing errors,
4 consonant errors are more common with consonants that are more difficult to see,
5 consonant errors are more common with consonants in medial and final positions of words- most of acoustic energy at the beginning of the word

94

____ the understanding of the sound system of a language is dependent upon repeated incidental exposure.

Phonology

95

____ relates to vocabulary and lexical deficits.

Semantic deficits

96

What is the difficult in treating semantics in kids with HL?

must be taught in context, dependent on incidental learning, and its organization of the lexicon is dependent upon strong phonological representations

97

What are the two types of morpho-syntactical deficits in pts with HL? 2

1 Production of agrammatical forms (Inaccurate morphological combinations, Clausal errors)
2 Production of simpler than typical forms
(Over reliance on SVO structure)

98

What are 3 types of pragmatic deficits for ch with HL?

1 Conversational turn lags
2 Atypical eye contact
3 Over-reliance on touch to get a partner’s attention

99

What are several negative psychosocial effects of HL? 4

1 Parental emotions of grief, anger, guilt may impede child’s development
2 Learned helplessness
3 Risk aversion
4 Better with exposure/interaction with typically hearing peers

100

What are federal laws which have provisions for school-aged ch with HL? 2

1 IDEA – Section 504 of the rehabilitation act
2 ADA

101

___ is a range of different situations that a child with HL can be schooled from a regular school to a separate school for ch w/ HL/disabilities.

Continuum of Mainstreaming

102

What are the two extremes on the continuum of mainstreaming?

Complete segregation (school for the deaf)
Complete integration (in regular ed classroom with typically hearing peers)

103

What are the characteristics of successful mainstreaming for HL for the teachers? 2

1 Willingness/ability to adapt curricular materials
2 Willingness/ability to use HAT (not avail in some rural areas)

104

What are the characteristics of successful mainstreaming for HL for the classroom/school? 3

1 Adequately funded for staff and technology
2 Small class size
3 Appropriate classroom acoustics and lighting

105

What are the characteristics of successful mainstreaming for HL for the students? 4

1 Appropriate behaviors for age and grade
2 Adequate speech and language for success
3 Realistic expectations of parents and self
4 Self-advocacy skills

106

____ is tailored to each student’s specific needs and parents take part in construction.

Individualized Education Plan

107

What are two characteristics of an IEP? What age are IEPs for?

1 Tailored to each student’s specific needs
2 Parents take part in construction
- School-age (ages 3-21)

108

What accommodations should be included with IEPs? 2

1 Adaptations to educational practices that allow access to the curriculum for children with disabilities
2 Individually tailored to meet the needs of each child

109

What are related services/supplementary aids for ch with HL/HI? 2

1 interpreting services
2 HAT

110

What is the role of the educational audiologist? 5

1 identification
2 diagnosis
3 selecting, fitting, and managing amplification
4 prevention of HL
5 counseling and guidance

111

What are some aspects to identiying HL by educational audiologists?

* NOT usually done by audiologists in TX!*
1 “Screening should be done liberally” - Need to be well trained
2 Children with (C)APD
3 May pass hearing screen
- Behave as if they have a hearing loss
-Difficult to differentiate from a garden-variety receptive language disorder

112

What goes into diagnosis of HL by educational audiologist? 2

1 In conjunction with the medical home (more limited power than traditional audiologist)
2 Collaboration with ENTs, Other Audiologists, GPs (usually confirm audiologist's diagnosis)

113

Children with ___ may pass a hearing screening but behave as if they have a HL.

(C)APD

114

What goes in to selecting, fitting, and managing amplification for educational audiologists? 5

1 Selecting both personal and group amplification systems
2 Determining their effectiveness in meeting the child’s educational needs (Parts and service)
3 Listening checks, monitoring function/condition of personal devices
4 Provision of “loaner” devices
5 Other HAT concerns re:
(FM systems, Remote microphone hearing assistance technology - RMHAT)

115

What goes in to prevention of HL for educational audiologists? 2

1 Managing noise around the school
2 Educating students, parents and teachers about proper use of personal listening devices

116

What goes in to counseling and guidance for educational audiologists? 3

1 Informational counseling
2 Personal adjustment counseling
(Helping children tell their stories, clarify their problems, and set goals, devise and use strategies)
3 Staff inservices

117

What is the role of the SLP for HL/HI in the school-aged population? 2

Garden variety sp & lang treatment with:
1 Different types of disorders (HL is different!)
2 Different focus of treatment (HL is different!)

118

What different accommodations are available to HL/HI children? 6

1 Acoustic environment
2 Acoustical treatment
3 Classroom type and teaching style
4 HAT
5 Grading Accommodations
6 Behavioral and Social Accommodations

119

What accommodations for acoustic environment for HL/HI school-aged children? 6

1 Level of ambient noise
2 SNR measurements – and remedies!
3 What is the signal in a classroom?
4 What is the noise?
5 Reverberation measurements
6 Assurance that auditory signals (fire alarms, bells, announcements) are paired with visual signals

120

What accommodations for acoustic treatment for HL/HI school-aged children? 2

(Building materials)
1 Noise absorbing
2 Noise barriers

121

What accommodations for Classroom type and for HL/HI school-aged children? 6

1 Closed classrooms
2 Open area concepts
3 Split grade levels
4 Portable classrooms
5 Square foot to student ratio
6 Use devices that allow for visual (lipreading) cues

122

What accommodations for teaching style and for HL/HI school-aged children? 5

1 Interactive
2 Didactic
3 Small group instruction
4 Team teaching
5 Independent work periods

123

What accommodations for HAT and for HL/HI school-aged children? 4

1 Sound field amplification (Not just beneficial for the kids- Teachers’ voices benefit too)
2 Personal FM systems (with the goal of improving SNR)
3 Interpreters - ASL If the student uses sign
4 Interpreters - Provide notes for the child

124

What accommodations for Grading accommodations for HL/HI school-aged children? 5

1 Modified vocabulary
2 Graphic cues
3 Alternative forms of response
4 Reduced length of tests and assignments
5 Grading adaptations (Narratives, Contract grading - grading based on agreement, Grading of parts of assignments)

125

What accommodations for Behavioral and Social Accommodations for HL/HI school-aged children? 3

1 Children who are deaf or hearing impaired
probably don’t misbehave any more than children who hear typically
2 Teachers and p gy arents need to work together to lay boundaries and enforce consequences
3 Bullying (power differential; cyber-x)

126

What are the direct service delivery methods? 3

1 Auditory-Verbal
2 Verbotonal
3 The Erber Approach

127

The main goal of ___ is to restore hearing impaired people into a hearing community, must use audition all the time.

Auditory-verbal

128

What are the goals and method of auditory verbal?

goal: restore them to the hearing community
method: unisensory - hearing only, cannot use vision to help communication ( also use parent coaching and direct treatment
 Manage the environment)

129

What are 10 skills in AVT?

1 Auditory awareness and perception (pointing to sounds and draw attention to sounds)
2 Auditory attention and Inhibition
3 Auditory feedback and monitoring
4 Auditory memory
5 Distance hearing
6 Localization
7 Discrimination
8 Auditory memory span and sequencing
9 Auditory processing
10 Auditory understanding (taking old information and applying it to new information)

130

What is the Verbotonal approach? 5

1 Predominantly unisensory – although visual cues are allowed
2 Parent involvement is key – although they’re not often included in treatment sessions
3 May include a vibratory panel to enhance the input of the timing components of speech
4 Situational teaching
5 Learn sounds in hierarchy of “tonality”

131

What is the Erber method? 3

1 Also auditory
2 Parents important, but do not participate in treatment sessions routinely
3 Every day activities

132

What is Erber's Hierarchy of Auditory Skills? 4

1 Detection
2 Discrimination
3 Identification
4 Comprehension

133

What is Erber's Hierarchy of Stimulus items? 6

1 Speech elements
2 Syllables
3Words
4 Phrases
5 Sentences
6 Discourse

134

What is required for assessments? 3

1 Standardized tests administered in a standardized way
2 Informal assessments
3 Both are necessary both are valuable

135

What is (C)APD? 3

1 Central Auditory Processing Disorder - Fair amount of over diagnosis
2 Evaluation must be comprehensive and
multidisciplinary
3 Differential diagnosis with Receptive Language disorder (SLI), Attention deficit disorder (or ADHD) & Behavior disorder

136

What is AN/AD? 3

1 Auditory Neuropathy/Auditory Dysynchronicity - Best to rely on your audiologist for diagnosis and guidance with this disorder
2 Difficult to diagnose accurately
3 Difficult to manage given shifts in performance over time

137

What is Tinnitus? 3

A constant buzz or hum:
1 Children who complain of tinnitus need to be immediately referred to a physician.
2 Not uncommon in children with CIs
3 Fairly uncommon in typically hearing children

138

What is Dual Sensory Impairment? 4

Both visual and auditory deficits:
1 Limited opportunities to explore their environments
2 Difficulty with new experiences
3 Assessment and treatment needs to be
multidisciplinary
4 Focus on input of sensory information by whatever means necessary - vibrotactile aids; hand mats, augmentative/assistive technology

139

What do we need to know about abuse and neglect? 5

1 School employees and healthcare workers are mandatory reporters
2 You will have a lot more opportunity to learn about this topic in your careers
3 Allegations must be founded on real evidence
4 You may be asked to testify concerning your observations
5 Consequences of reporting are significant Consequences of NOT reporting are even more significant

140

Situations in which children could solve one type of problem using mature thinking skills, but could not accomplish this for less familiar problems, a phenomenon he called ___.

horizontal decalage

141

What is HRQoL?

Health Related Quality of Life

142

_____ adults btw 18-64 years of age are HOH.

3.8 million

143

____ adults are functionally deaf.

440,000

144

What are the aspects of HRQoL?

1 personal fullfilment (Satisfaction w/ self)
2 physical and material well being (health and ability to care for one's self)
3 adult role fullfilment (education and career)

145

One of the parts of IDEA is that at 16, there has to be a ___ on their ____.

transition plan; IEP

146

What is a problem with IDEA's transition aspect?

many kids drop out well before 16

147

What goes into Vocational Rehab? 5

1 Guide and counsel toward job goals
2 Refer and collaborate with physician and other healthcare professionals
3 Supports training and education
4 Assists in finding: Short-term job placement, Transitional support, Securing regular employment)
5 Assist w/ obtaining assistive technology

148

What goes into enrolling in college for students with HL? 4

1 Need to provide supporting documentation (Recent (w/in last year to 3 years)) - SINCE IT'S UP TO THE PARENTS/STUDENTS TO ASK
2 How and by whom the diagnosis was made
3 How the diagnosis affects FUNCTIONING in ADLs
4 Need to request specific accommodations - TRANSITION TO SELF-ADVOCACY

149

Over the next 50 years, the number of elderly persons with hearing loss is expected to…
Decrease
Stay the same
Increase
None of the above

Increase

150


Which of the following has the characteristic of poor speech recognition when compared against the audiogram?
Mechanical presbycusis
Metabolic presbycusis
Sensory prebycusis
Neural presbycusis

Neural Presbycusis

151

Hearing loss is the ___ most common chronic healthcare condition in the elderly.
Ninth
Sixth
Third
None of the Above

Third

152

The ability to raise and lower the arms is known as ...
Proximal manual dexterity
Fine motor coordination
Distal manual dexterity
None of the above

proximal manual dexterity

153

Photoreceptors in the eye are known as ...
Retinal vessels
Rods and cones
The lens
None of the above

Rods and cones

154

Clouding of the lens of the eye is known as ...
Glaucoma
Cataracts
Macular degeneration
None of the above

Cataracts

155

Which of the following medications may increase the risk of falling?
Antihypertensive drugs
Cardiac medications
Major tranquilizers
Corticosteroids
All of the above

All of the above

156

Which of the following facts about Alzheimer's is/are NOT true?
Most often starts after age 60 years
100 million Americans have it
Prevalence increases with age
None of the above

100 million Americans have it

157

Which of the following has the capacity of 5 to 7 items permitting the retention of small bits of information?
Short-term memory
Long-term memory
Sensory memory
None of the above

Short-term memory

158

Which of the following has a characteristic of an essentially positive attitude toward hearing aids and auditory rehabilitation, but the patient presents with some complicating factor?
Type I
Type II
Type III
Type IV
None of the above

Type II

159

When a patient says, “I may have a problem (hearing), but I don’t need to get treatment for it yet?,” they are at what level of acknowledgement?
nonacknowledgement
complete acknowledgement
partial acknowledgement
none of the above

partial acknowledgement

160

Which of the following principles are not consistent with Smith and West’s (2006) suggestions for developing self-efficacy?
Setting vague and ambiguous goals
Starting with simple skills and progressing toward more difficulty tasks
Suggesting practice of skills at home
Engaging in role play
None of the above

setting vague and ambitious goals

161

Which of the following principles is not consistent with Adult Learning Theory?
Experience is used as a tool
Self-concept promotes self-direction
Motivation is external
All of the above
A and B
B and C
A and C
None of the above

motivation is external

162


Which of the following pairs of phonemes are not members of the same viseme group?
/f/ and /m/
/p/ and /b/
/t/ and /d/
None of the above

/f/ and /m/

163

Which of the following is not part of speechreading?
Facial expressions
Situational cues
Residual hearing
Lipreading
None of the above

none of the above

164

Which of the following levels is the one in which patients are primarily responsible for the care and maintenance of their hearing aids, but may need assistance with such things as insertion and removal?
Full assistance level
Partial Assistance level
Independent level
Supervised-use level

Partial assistance level

165

Which of the following may cause falls in nursing homes?
Poor foot care or poorly fitting shoes
Walking or gait problems
Environmental hazards
Weakness
All of the above

all of the above

166

Appropriate written materials for elderly persons with dual sensory impairment should include all of the following BUT:
Widely spaced letters
Size 12 font
High contrasting between font and background
None of the above

Size 12 pt font

167

What are the main things that a college/university for a student with HL/HI? 5

1 Major
2 Entrance reqs
3 Accomodations for kids with HI
4 Self-identify HI on the application
5 Visit school (6 months prior)

168

What are good questions for a student to ask a college/university he/she is considering? 8

1. How does the school determine accommodations? Individualized? One-size fits all?
2. How does one ask for accommodations?
3. What documentation is required? Audiogram? Speech perception thresholds?
4. What accommodations can be made for persons with HI?
5. Are note taking services available?
6. Available sign-language interpreters? (ASL or Transliterations)/Making sure the interpreters are available when you need them
7. Dormitories equipped w/ HAT? (Smoke detectors w/ visual, Televisions w/ closed captioning)
8. What are policies and procedures for notifying and interacting with the faculty?

169

What are different note taking services? 3

CAN; C-Print; CART

170

___ if I sign and another person writes down exactly what I am saying in sign - not interpreting.

Transliterations

171

What is the biggest part of preparing a HL/HI student for child?

teaching them how to advocate for themselves

172

What are the two main different kinds of middle-aged adults with HI, which require different techniques?

Gradual or Sudden HL

173

What are causes of sudden HL?

aterosclerosis
meniere's disease
meningitis

174

What goes into vocational rehab? (Basic 2)

1 Help secure and maintain employment
2 Eligibility requirements for disability

175

What are the eligibility requirements like for receiving disability? 4

1 Mental or physical disability
2 Requires assistance to obtain and maintain a job
3 Receives SSI or SSDI
4 Desires to obtain a job

176

What is the role of the vocational rehab professional? 4

1 Collects information about patient’s current abilities, resources, difficulties, and goals
2 Assists patient in establishing priorities
3 Assists in managing resources available, both in community and what might be available to the patient through other entities
4 Assists in problem solving communication difficulties that may be experienced on the job

177

# of Americans who experience some form of tinnitus

= > 50 million

178

# that require medical attention for tinnitus

12 million

179

# of people that report tinnitus to be debilitating.

2 million

180

What are causes of tinnitus? 8

1 Noise-induced hearing loss
2 Cerumen build up middle ear
3 Some medications - aspirin; ototoxic meds
4 Ear or sinus infection
5 Jaw misalignment
6 Heart disease
7 Tumors
8 Head/Neck trauma

181

What are treatments of tinnitus? (6)

No specific treatment recommended:
1 Masking devices
2 Fan or radio noise while sleeping
3 Drug therapy
4 Biofeedback
5 Acupuncture
6 Tinnitus Retraining Therapy*

182

What goes into Tinnitus Retraining Therapy? 3

1 Provides education and sound therapy
2 Based on Neurophysiological Model of Tinnitus
3 Habituation

183

What are the steps in Tinnitus Retraining Therapy? 3

1 Understand neurophysiological rationale behind this treatment takes away the “mystery” of tinnitus
2 Avoid silence by having sounds occurring- but not to point of masking tinnitus
3 Self-examinaiton of negative reactions during brief periods of time while practicing relaxation techniques that manages both
the emotional and physiological reactions

184

___ provides information sent to other parts of the nervous system responsible
for eye-movement, vestibular-ocular reflex, and posture.

Vestibular system

185

___ integrates information from vestibular, visual and somatosensory systems.

Brainstem

186

What happens when vestibular, visual and somatosensory systems do not work in unison? 3

1 Imbalance
2 Vertigo
3 Nausea

187

What are causes of vestibular issues? 8

1 Benign paroxysomal positional vertigo (BPPV)
2 Cerebellar degeneration (disease or normal aging)
3 Chemical and pharmacological vestibular toxins (aspirin or environmental toxins)
4 Head trauma
5 Labyrinthitis
6 Meniere’s disease
7 Strokes and vascular problems
8 Vestibular Neuritis

188

What are contraindications for vestibular rehab? 2

1 Migraines
2 Demyelinating diseases - MS, Myasthenia Gravis

189

_____ is a hearing issue related to a leisure or vocational situation which causes loss.

Noise induced hearing loss

190

_______ is what happens when exposed to loud sounds for a short time (2-3 hours). Over time can result in permanent shift.

Temporary Threshold Shift

191

______ is what happens when exposed to loud sounds over longer periods of time.

Permanent Threshold Shift

192

_____ is one is exposed to in the workplace.

Occupational noise exposure

193

What are 3 different hearing conservation methods?

1 In house Programs - employed by the company
2 Out (of) house Programs - private practice comes in and assesses
3 Combined Programs

194

_____ include audiologists, managers, data collectors/management, physicians, plan managers, and safety specialists.

Hearing conservation program team members

195

____ is a tool for measuring noise.

Sound level meter

196

what are 3 different types of noise?

1 Continuous sound - buzz, which is eventually tune out
2 Intermittent - more noticeable, but you have to catch it to make sure for temporary threshold shift
3 Impulse

197

What are 2 levels we look for on sound level meters?

1 Action level - something has to change!
2 Permissible level (5 dB time-intensity trade-off law, if over time

198

What are controls for NIHL? 3

1 Engineering Controls (with trade-offs; less quickly, move to a different location, work remotely)
2 Administrative Controls (work times with breaks from noise)
3 Hearing Protection (ear plugs; ear muffs)

199

What is considered "school-aged"for aural rehab?

3-18 (21)

200

Who defines what are school-aged children?

Federal definitions of hearing impairment and deafness

201

What is the difference in Hearing Impairment and Deafness?

degree of HL and success of amplification

202

Why isn't there specific audiometric criteria for HI and deafness?

b/c of states descisions: ea ch w/ HL will need prescriptive guidelines not just based on the audiogram but many other variables in addition

203

What are the 3 main categories of speech affected by HL? 3

voice, prosody, and artic

204

How does HL/HI affect voice? 2

1 dependent upon respiration and phonation (needs feedback)
2 dependent on auditory feedback

205

What are voice quality issues common to people with HL/HI? 4

breathiness, harshness, hypernasality, and degree is somewhat dependent upon the nature and degree of HL

206

What are the effects of HL/HI on prosody? 3

1 subtle change (prosody is subtle)
2 may be difficult to detect other's prosody
3 therefore difficult to produce in his/her own speech

207

____ is intonation changes signaled by changes in a pseaker's fundamental frequency.

Prosody

208

What are the effects of HL/HI on articulation? 5

1 deletions, distortions, substitutions
2 both vowels and consonants- vowel neutralizations,
3 consonant voicing errors,
4 consonant errors are more common with consonants that are more difficult to see,
5 consonant errors are more common with consonants in medial and final positions of words- most of acoustic energy at the beginning of the word

209

____ the understanding of the sound system of a language is dependent upon repeated incidental exposure.

Phonology

210

____ relates to vocabulary and lexical deficits.

Semantic deficits

211

What is the difficult in treating semantics in kids with HL?

must be taught in context, dependent on incidental learning, and its organization of the lexicon is dependent upon strong phonological representations

212

What are the two types of morpho-syntactical deficits in pts with HL? 2

1 Production of agrammatical forms (Inaccurate morphological combinations, Clausal errors)
2 Production of simpler than typical forms
(Over reliance on SVO structure)

213

What are 3 types of pragmatic deficits for ch with HL?

1 Conversational turn lags
2 Atypical eye contact
3 Over-reliance on touch to get a partner’s attention

214

What are several negative psychosocial effects of HL? 4

1 Parental emotions of grief, anger, guilt may impede child’s development
2 Learned helplessness
3 Risk aversion
4 Better with exposure/interaction with typically hearing peers

215

What are federal laws which have provisions for school-aged ch with HL? 2

1 IDEA – Section 504 of the rehabilitation act
2 ADA

216

___ is a range of different situations that a child with HL can be schooled from a regular school to a separate school for ch w/ HL/disabilities.

Continuum of Mainstreaming

217

What are the two extremes on the continuum of mainstreaming?

Complete segregation (school for the deaf)
Complete integration (in regular ed classroom with typically hearing peers)

218

What are the characteristics of successful mainstreaming for HL for the teachers? 2

1 Willingness/ability to adapt curricular materials
2 Willingness/ability to use HAT (not avail in some rural areas)

219

What are the characteristics of successful mainstreaming for HL for the classroom/school? 3

1 Adequately funded for staff and technology
2 Small class size
3 Appropriate classroom acoustics and lighting

220

What are the characteristics of successful mainstreaming for HL for the students? 4

1 Appropriate behaviors for age and grade
2 Adequate speech and language for success
3 Realistic expectations of parents and self
4 Self-advocacy skills

221

____ is tailored to each student’s specific needs and parents take part in construction.

Individualized Education Plan

222

What are two characteristics of an IEP? What age are IEPs for?

1 Tailored to each student’s specific needs
2 Parents take part in construction
- School-age (ages 3-21)

223

What accommodations should be included with IEPs? 2

1 Adaptations to educational practices that allow access to the curriculum for children with disabilities
2 Individually tailored to meet the needs of each child

224

What are related services/supplementary aids for ch with HL/HI? 2

1 interpreting services
2 HAT

225

What is the role of the educational audiologist? 5

1 identification
2 diagnosis
3 selecting, fitting, and managing amplification
4 prevention of HL
5 counseling and guidance

226

What are some aspects to identiying HL by educational audiologists?

* NOT usually done by audiologists in TX!*
1 “Screening should be done liberally” - Need to be well trained
2 Children with (C)APD
3 May pass hearing screen
- Behave as if they have a hearing loss
-Difficult to differentiate from a garden-variety receptive language disorder

227

What goes into diagnosis of HL by educational audiologist? 2

1 In conjunction with the medical home (more limited power than traditional audiologist)
2 Collaboration with ENTs, Other Audiologists, GPs (usually confirm audiologist's diagnosis)

228

Children with ___ may pass a hearing screening but behave as if they have a HL.

(C)APD

229

What goes in to selecting, fitting, and managing amplification for educational audiologists? 5

1 Selecting both personal and group amplification systems
2 Determining their effectiveness in meeting the child’s educational needs (Parts and service)
3 Listening checks, monitoring function/condition of personal devices
4 Provision of “loaner” devices
5 Other HAT concerns re:
(FM systems, Remote microphone hearing assistance technology - RMHAT)

230

What goes in to prevention of HL for educational audiologists? 2

1 Managing noise around the school
2 Educating students, parents and teachers about proper use of personal listening devices

231

What goes in to counseling and guidance for educational audiologists? 3

1 Informational counseling
2 Personal adjustment counseling
(Helping children tell their stories, clarify their problems, and set goals, devise and use strategies)
3 Staff inservices

232

What is the role of the SLP for HL/HI in the school-aged population? 2

Garden variety sp & lang treatment with:
1 Different types of disorders (HL is different!)
2 Different focus of treatment (HL is different!)

233

What different accommodations are available to HL/HI children? 6

1 Acoustic environment
2 Acoustical treatment
3 Classroom type and teaching style
4 HAT
5 Grading Accommodations
6 Behavioral and Social Accommodations

234

What accommodations for acoustic environment for HL/HI school-aged children? 6

1 Level of ambient noise
2 SNR measurements – and remedies!
3 What is the signal in a classroom?
4 What is the noise?
5 Reverberation measurements
6 Assurance that auditory signals (fire alarms, bells, announcements) are paired with visual signals

235

What accommodations for acoustic treatment for HL/HI school-aged children? 2

(Building materials)
1 Noise absorbing
2 Noise barriers

236

What accommodations for Classroom type and for HL/HI school-aged children? 6

1 Closed classrooms
2 Open area concepts
3 Split grade levels
4 Portable classrooms
5 Square foot to student ratio
6 Use devices that allow for visual (lipreading) cues

237

What accommodations for teaching style and for HL/HI school-aged children? 5

1 Interactive
2 Didactic
3 Small group instruction
4 Team teaching
5 Independent work periods

238

What accommodations for HAT and for HL/HI school-aged children? 4

1 Sound field amplification (Not just beneficial for the kids- Teachers’ voices benefit too)
2 Personal FM systems (with the goal of improving SNR)
3 Interpreters - ASL If the student uses sign
4 Interpreters - Provide notes for the child

239

What accommodations for Grading accommodations for HL/HI school-aged children? 5

1 Modified vocabulary
2 Graphic cues
3 Alternative forms of response
4 Reduced length of tests and assignments
5 Grading adaptations (Narratives, Contract grading - grading based on agreement, Grading of parts of assignments)

240

What accommodations for Behavioral and Social Accommodations for HL/HI school-aged children? 3

1 Children who are deaf or hearing impaired
probably don’t misbehave any more than children who hear typically
2 Teachers and p gy arents need to work together to lay boundaries and enforce consequences
3 Bullying (power differential; cyber-x)

241

What are the direct service delivery methods? 3

1 Auditory-Verbal
2 Verbotonal
3 The Erber Approach

242

The main goal of ___ is to restore hearing impaired people into a hearing community, must use audition all the time.

Auditory-verbal

243

What are the goals and method of auditory verbal?

goal: restore them to the hearing community
method: unisensory - hearing only, cannot use vision to help communication ( also use parent coaching and direct treatment
 Manage the environment)

244

What are 10 skills in AVT?

1 Auditory awareness and perception (pointing to sounds and draw attention to sounds)
2 Auditory attention and Inhibition
3 Auditory feedback and monitoring
4 Auditory memory
5 Distance hearing
6 Localization
7 Discrimination
8 Auditory memory span and sequencing
9 Auditory processing
10 Auditory understanding (taking old information and applying it to new information)

245

What is the Verbotonal approach? 5

1 Predominantly unisensory – although visual cues are allowed
2 Parent involvement is key – although they’re not often included in treatment sessions
3 May include a vibratory panel to enhance the input of the timing components of speech
4 Situational teaching
5 Learn sounds in hierarchy of “tonality”

246

What is the Erber method? 3

1 Also auditory
2 Parents important, but do not participate in treatment sessions routinely
3 Every day activities

247

What is Erber's Hierarchy of Auditory Skills? 4

1 Detection
2 Discrimination
3 Identification
4 Comprehension

248

What is Erber's Hierarchy of Stimulus items? 6

1 Speech elements
2 Syllables
3Words
4 Phrases
5 Sentences
6 Discourse

249

What is required for assessments? 3

1 Standardized tests administered in a standardized way
2 Informal assessments
3 Both are necessary both are valuable

250

What is (C)APD? 3

1 Central Auditory Processing Disorder - Fair amount of over diagnosis
2 Evaluation must be comprehensive and
multidisciplinary
3 Differential diagnosis with Receptive Language disorder (SLI), Attention deficit disorder (or ADHD) & Behavior disorder

251

What is AN/AD? 3

1 Auditory Neuropathy/Auditory Dysynchronicity - Best to rely on your audiologist for diagnosis and guidance with this disorder
2 Difficult to diagnose accurately
3 Difficult to manage given shifts in performance over time

252

What is Tinnitus? 3

A constant buzz or hum:
1 Children who complain of tinnitus need to be immediately referred to a physician.
2 Not uncommon in children with CIs
3 Fairly uncommon in typically hearing children

253

What is Dual Sensory Impairment? 4

Both visual and auditory deficits:
1 Limited opportunities to explore their environments
2 Difficulty with new experiences
3 Assessment and treatment needs to be
multidisciplinary
4 Focus on input of sensory information by whatever means necessary - vibrotactile aids; hand mats, augmentative/assistive technology

254

What do we need to know about abuse and neglect? 5

1 School employees and healthcare workers are mandatory reporters
2 You will have a lot more opportunity to learn about this topic in your careers
3 Allegations must be founded on real evidence
4 You may be asked to testify concerning your observations
5 Consequences of reporting are significant Consequences of NOT reporting are even more significant

255

Situations in which children could solve one type of problem using mature thinking skills, but could not accomplish this for less familiar problems, a phenomenon he called ___.

horizontal decalage

256

What is HRQoL?

Health Related Quality of Life

257

_____ adults btw 18-64 years of age are HOH.

3.8 million

258

____ adults are functionally deaf.

440,000

259

What are the aspects of HRQoL?

1 personal fullfilment (Satisfaction w/ self)
2 physical and material well being (health and ability to care for one's self)
3 adult role fullfilment (education and career)

260

One of the parts of IDEA is that at 16, there has to be a ___ on their ____.

transition plan; IEP

261

What is a problem with IDEA's transition aspect?

many kids drop out well before 16

262

What goes into Vocational Rehab? 5

1 Guide and counsel toward job goals
2 Refer and collaborate with physician and other healthcare professionals
3 Supports training and education
4 Assists in finding: Short-term job placement, Transitional support, Securing regular employment)
5 Assist w/ obtaining assistive technology

263

What goes into enrolling in college for students with HL? 4

1 Need to provide supporting documentation (Recent (w/in last year to 3 years)) - SINCE IT'S UP TO THE PARENTS/STUDENTS TO ASK
2 How and by whom the diagnosis was made
3 How the diagnosis affects FUNCTIONING in ADLs
4 Need to request specific accommodations - TRANSITION TO SELF-ADVOCACY

264

Over the next 50 years, the number of elderly persons with hearing loss is expected to…
Decrease
Stay the same
Increase
None of the above

Increase

265


Which of the following has the characteristic of poor speech recognition when compared against the audiogram?
Mechanical presbycusis
Metabolic presbycusis
Sensory prebycusis
Neural presbycusis

Neural Presbycusis

266

Hearing loss is the ___ most common chronic healthcare condition in the elderly.
Ninth
Sixth
Third
None of the Above

Third

267

The ability to raise and lower the arms is known as ...
Proximal manual dexterity
Fine motor coordination
Distal manual dexterity
None of the above

proximal manual dexterity

268

Photoreceptors in the eye are known as ...
Retinal vessels
Rods and cones
The lens
None of the above

Rods and cones

269

Clouding of the lens of the eye is known as ...
Glaucoma
Cataracts
Macular degeneration
None of the above

Cataracts

270

Which of the following medications may increase the risk of falling?
Antihypertensive drugs
Cardiac medications
Major tranquilizers
Corticosteroids
All of the above

All of the above

271

Which of the following facts about Alzheimer's is/are NOT true?
Most often starts after age 60 years
100 million Americans have it
Prevalence increases with age
None of the above

100 million Americans have it

272

Which of the following has the capacity of 5 to 7 items permitting the retention of small bits of information?
Short-term memory
Long-term memory
Sensory memory
None of the above

Short-term memory

273

Which of the following has a characteristic of an essentially positive attitude toward hearing aids and auditory rehabilitation, but the patient presents with some complicating factor?
Type I
Type II
Type III
Type IV
None of the above

Type II

274

When a patient says, “I may have a problem (hearing), but I don’t need to get treatment for it yet?,” they are at what level of acknowledgement?
nonacknowledgement
complete acknowledgement
partial acknowledgement
none of the above

partial acknowledgement

275

Which of the following principles are not consistent with Smith and West’s (2006) suggestions for developing self-efficacy?
Setting vague and ambiguous goals
Starting with simple skills and progressing toward more difficulty tasks
Suggesting practice of skills at home
Engaging in role play
None of the above

setting vague and ambitious goals

276

Which of the following principles is not consistent with Adult Learning Theory?
Experience is used as a tool
Self-concept promotes self-direction
Motivation is external
All of the above
A and B
B and C
A and C
None of the above

motivation is external

277


Which of the following pairs of phonemes are not members of the same viseme group?
/f/ and /m/
/p/ and /b/
/t/ and /d/
None of the above

/f/ and /m/

278

Which of the following is not part of speechreading?
Facial expressions
Situational cues
Residual hearing
Lipreading
None of the above

none of the above

279

Which of the following levels is the one in which patients are primarily responsible for the care and maintenance of their hearing aids, but may need assistance with such things as insertion and removal?
Full assistance level
Partial Assistance level
Independent level
Supervised-use level

Partial assistance level

280

Which of the following may cause falls in nursing homes?
Poor foot care or poorly fitting shoes
Walking or gait problems
Environmental hazards
Weakness
All of the above

all of the above

281

Appropriate written materials for elderly persons with dual sensory impairment should include all of the following BUT:
Widely spaced letters
Size 12 font
High contrasting between font and background
None of the above

Size 12 pt font

282

What are the main things that a college/university for a student with HL/HI? 5

1 Major
2 Entrance reqs
3 Accomodations for kids with HI
4 Self-identify HI on the application
5 Visit school (6 months prior)

283

What are good questions for a student to ask a college/university he/she is considering? 8

1. How does the school determine accommodations? Individualized? One-size fits all?
2. How does one ask for accommodations?
3. What documentation is required? Audiogram? Speech perception thresholds?
4. What accommodations can be made for persons with HI?
5. Are note taking services available?
6. Available sign-language interpreters? (ASL or Transliterations)/Making sure the interpreters are available when you need them
7. Dormitories equipped w/ HAT? (Smoke detectors w/ visual, Televisions w/ closed captioning)
8. What are policies and procedures for notifying and interacting with the faculty?

284

What are different note taking services? 3

CAN; C-Print; CART

285

___ if I sign and another person writes down exactly what I am saying in sign - not interpreting.

Transliterations

286

What is the biggest part of preparing a HL/HI student for child?

teaching them how to advocate for themselves

287

What are the two main different kinds of middle-aged adults with HI, which require different techniques?

Gradual or Sudden HL

288

What are causes of sudden HL?

aterosclerosis
meniere's disease
meningitis

289

What goes into vocational rehab? (Basic 2)

1 Help secure and maintain employment
2 Eligibility requirements for disability

290

What are the eligibility requirements like for receiving disability? 4

1 Mental or physical disability
2 Requires assistance to obtain and maintain a job
3 Receives SSI or SSDI
4 Desires to obtain a job

291

What is the role of the vocational rehab professional? 4

1 Collects information about patient’s current abilities, resources, difficulties, and goals
2 Assists patient in establishing priorities
3 Assists in managing resources available, both in community and what might be available to the patient through other entities
4 Assists in problem solving communication difficulties that may be experienced on the job

292

# of Americans who experience some form of tinnitus

= > 50 million

293

# that require medical attention for tinnitus

12 million

294

# of people that report tinnitus to be debilitating.

2 million

295

What are causes of tinnitus? 8

1 Noise-induced hearing loss
2 Cerumen build up middle ear
3 Some medications - aspirin; ototoxic meds
4 Ear or sinus infection
5 Jaw misalignment
6 Heart disease
7 Tumors
8 Head/Neck trauma

296

What are treatments of tinnitus? (6)

No specific treatment recommended:
1 Masking devices
2 Fan or radio noise while sleeping
3 Drug therapy
4 Biofeedback
5 Acupuncture
6 Tinnitus Retraining Therapy*

297

What goes into Tinnitus Retraining Therapy? 3

1 Provides education and sound therapy
2 Based on Neurophysiological Model of Tinnitus
3 Habituation

298

What are the steps in Tinnitus Retraining Therapy? 3

1 Understand neurophysiological rationale behind this treatment takes away the “mystery” of tinnitus
2 Avoid silence by having sounds occurring- but not to point of masking tinnitus
3 Self-examinaiton of negative reactions during brief periods of time while practicing relaxation techniques that manages both
the emotional and physiological reactions

299

___ provides information sent to other parts of the nervous system responsible
for eye-movement, vestibular-ocular reflex, and posture.

Vestibular system

300

___ integrates information from vestibular, visual and somatosensory systems.

Brainstem

301

What happens when vestibular, visual and somatosensory systems do not work in unison? 3

1 Imbalance
2 Vertigo
3 Nausea

302

What are causes of vestibular issues? 8

1 Benign paroxysomal positional vertigo (BPPV)
2 Cerebellar degeneration (disease or normal aging)
3 Chemical and pharmacological vestibular toxins (aspirin or environmental toxins)
4 Head trauma
5 Labyrinthitis
6 Meniere’s disease
7 Strokes and vascular problems
8 Vestibular Neuritis

303

What are contraindications for vestibular rehab? 2

1 Migraines
2 Demyelinating diseases - MS, Myasthenia Gravis

304

_____ is a hearing issue related to a leisure or vocational situation which causes loss.

Noise induced hearing loss

305

_______ is what happens when exposed to loud sounds for a short time (2-3 hours). Over time can result in permanent shift.

Temporary Threshold Shift

306

______ is what happens when exposed to loud sounds over longer periods of time.

Permanent Threshold Shift

307

_____ is one is exposed to in the workplace.

Occupational noise exposure

308

What are 3 different hearing conservation methods?

1 In house Programs - employed by the company
2 Out (of) house Programs - private practice comes in and assesses
3 Combined Programs

309

_____ include audiologists, managers, data collectors/management, physicians, plan managers, and safety specialists.

Hearing conservation program team members

310

____ is a tool for measuring noise.

Sound level meter

311

what are 3 different types of noise?

1 Continuous sound - buzz, which is eventually tune out
2 Intermittent - more noticeable, but you have to catch it to make sure for temporary threshold shift
3 Impulse

312

What are 2 levels we look for on sound level meters?

1 Action level - something has to change!
2 Permissible level (5 dB time-intensity trade-off law, if over time

313

What are controls for NIHL? 3

1 Engineering Controls (with trade-offs; less quickly, move to a different location, work remotely)
2 Administrative Controls (work times with breaks from noise)
3 Hearing Protection (ear plugs; ear muffs)