Final Exam Flashcards
1
Q
What communication cues are gathered from viewing different facial locations while lipreading
A
Upper face: Prosodic judgements
Lower face: Phenomic judgements
2
Q
What communication cues are gathered from viewing upper face facial locations while lipreading
A
Upper face: Prosodic judgements
3
Q
What communication cues are gathered from viewing lower face facial locations while lipreading
A
Lower face: Phenomic judgements
4
Q
Factors influencing the visibility of speech sounds and limiting lipreading abilities
A
Visibility of Sound
Visemes and homophenes
Coarticulation and stress effects
* Appearance of a word varies based on how they’re spoken
Rapidity of speech
* Sequenced sounds occur faster than the eye can resolve them.
Speaker effects (Mouth movements vary by talker)
* Degree of mouth opening
* Facial animation
* accents
5
Q
Practical definition of visemes
A
sounds that look identical when produced
6
Q
sounds that look identical when produced
A
Visemes
7
Q
words that look identical on the mouth when produced
A
Homophenes
8
Q
Practical definition of homophones
A
Homophenes: words that look identical on the mount when produced
9
Q
Cognitive skills which may predict lipreading abilities
A
Integration
Lexicon
Context
Response
10
Q
Understand concepts related to the Neighborhood Activations Model of Integration
A
Spoken words and visual representation of words activate a set of lexical candidates automatically
11
Q
Dense Neighborhoods
A
Dense = word groups which contain many words that sound and/or look the same
* Dense neighborhoods are harder because there is a lot of options on what the word could be = slower processing
12
Q
word groups which contain many words that sound and/or look the same
A
Dense Neighborhoods
13
Q
____ neighborhoods are harder because there is a lot of options on what the word could be = slower processing
A
Dense Neighborhoods
14
Q
Sparse neighborhoods
A
Sparse = word groups which contain few words that sound and/or look the same
* Ex: elephant, no other words that look the same
* Sparse neighborhoods are easier to make connection = faster processing
15
Q
word groups which contain few words that sound and/or look the same
A
Sparse neighborhoods
16
Q
____neighborhoods are easier to make connection = faster processing
A
Sparse neighborhoods
17
Q
Sparse neighborhoods = ____ processing
A
Faster Processing
18
Q
Dense neighborhoods = ____ processing
A
Slower Processing
19
Q
How audio-visual integration improves identification of words in dense lexical neighborhood
A
Multiple auditory or visual possibilities exist for DENSE word populations
* Possibilities reduce with integration of the 2 sensory inputs. This shifts the word to sparser lexical population
* Knowledge of lexicon further reduces word options
* Context quickly narrows down the possible word options
20
Q
Speechreading factors influencing audio-visual integration
A
Factor 1: residual hearing
* The more audible the signal the easier speechreading becomes
Factor 2: familiarity of grammatical structure assists understanding
* Language is redundant
* Simplify speechreading by:
Get to the point.
Use common words
Use Clear Speech speaking techniques
* Make sure non-verbal gestures match your message
Factor 3: Context
* Awareness of context assets speechreading success
Factor 4: Viewing angle influences the speechreading process
Factor 5: How you feel influences speechreading abilities
21
Q
____ is reading the visual clues of a spoken message
A
Speechreading
22
Q
What is speech reading?
A
Speechreading is reading the visual clues of a spoken message
23
Q
Speechreading factors
how does residual hearing influence audio-visual integration?
A
Factor 1: residual hearing
* The more audible the signal the easier speechreading becomes
24
Q
Speechreading factors
how does familiarity influence audio-visual integration?
A
Factor 2: familiarity of grammatical structure assists understanding
- Language is redundant
- Simplify speechreading by:
Get to the point.
Use common words
Use Clear Speech speaking techniques - Make sure non-verbal gestures match your message
25
# Speechreading factors
how does context influence audio-visual integration?
Factor 3: Context
* Awareness of context assets speechreading success
26
# Speechreading factors
how does viewing angle influence audio-visual integration?
Factor 4: Viewing angle influences the speechreading process
* by having clear view of speakers face and visual cues
27
# Speechreading factors
how does how you feel influence audio-visual integration?
Factor 5: How you feel influences speechreading abilities
28
List speaker behaviors negatively impacting speech reading abilities
* Mumbles
* Doesn’t look at me when talking
* Chews gum
* Unusual accent
* Speech impediment
* Smiles too much
* Shouts
* No facial expression
29
facial expressions especially eyes help us read____ (anger, questioning, confused, etc.)
facial expressions especially eyes help us read **prosody** (anger, questioning, confused, etc.)
30
Prosodic (prosody)
Prosodic (prosody): facial expressions especially eyes help us read prosody (anger, questioning, confused, etc.)
31
where on the mouth is the phoneme being placed
Place of articulation
32
Place of articulation
where on the mouth is the phoneme being placed
33
visible elements will appear different depending on the surrounding sounds
Co-articulation
34
Co-articulation
visible elements will appear different depending on the surrounding sounds
35
combining both auditory and visual information
Audio-visual integration
36
Audio-visual integration
combining both auditory and visual information
37
language
Lexicon
38
Lexicon
Language
38
refers to a group of words that are similar in meaning, sound, or structure, and are typically related in some way
Lexical neighborhood
39
the way the sentence is structured/formatted
Syntactic structure
39
Lexical neighborhood
refers to a group of words that are similar in meaning, sound, or structure, and are typically related in some way
40
Syntactic structure
the way the sentence is structured/formatted
41
four primary sources of communication breakdown
* Listener’s speech recognition skills
* Speaker’s delivery of the message
* Environment
* Message complexity
42
List the three stages of communication repair
* Detect breakdown
* Choose a course of action
* Take course of action using; maladaptive strategies and facilitative strategies
43
Define maladaptive communication behaviors, the associated limitations and consequences
Maladaptive repair strategies: these coping behaviors yield short term benefit with long-term consequences
* Dominating the conversation
* Ignoring CP so they’ll repeat the message
* Bluffing and pretending to understand
* Overreacting to miscommunication
* Withdrawal from social interactions
44
maladaptive behaviors associated limitations and consequences
Withdrawal from social interactions
* Consequence - depression, loneliness, anxiety etc. and can lead to dementia
Dominating the conversation
* Consequence - friends may seem to avoid you leading to isolation
Ignoring the CP so they’ll repeat the message
* Consequence - person with HL is expending energy (passive aggressive energy)
Overreacting to miscommunication
* Consequence - increases tension, CP will avoid the conversation
Bluffing and pretending to understand
* Consequence - embarrassment, awkward, mess up the conversational flow
45
Specific facilitative repair strategies
Conversational repair strategies
* Instructional repair strategies
* Message-tailoring strategies
Supportive repair strategies
* Constructive strategies (go over and shut the fan off)
* Anticipatory strategies
* Adaptive strategies
46
Non Specific facilitative repair strategies
she is letting the communication partner know that she did not hear something, but gives no information about what exactly she missed.
* Non-specific repair strategies shows you misunderstood but don’t assist communication repair or conversational flow.
47
Specifc VS nonspecifc
* A **non-specific** response simply signals that you didn’t hear, without offering a communication strategy. This might sound like “What?” or “Huh?”—which often leads to simple repetition.
* A **specific** response provides the speaker with specific strategies to help improve your understanding. This could include asking them to rephrase, speak louder, or move to a quieter environment.
48
Define instructional repair strategies and the steps it involves
When the listener instructs the speaker on a specific way to change the delivery of the message
* **Explanation**: acknowledge hearing loss and explain the source of the difficulty
* **Specific direction**: Supply a concrete instructional suggestion of how to improve
* **Positive Reinforcement**: Express value for their efforts, acknowledge gesture
49
Define message-tailoring repair and the steps it involves
When the listener asks a close-ended question to limit potential answers and amount of repetition required by the speaker.
* Request repeat
* Clarify with a general question based on what was understood
* Ask a specific question which repeats the part that was misunderstood
50
Define constructive repair strategies and recall practical recommendations related to lighting, visual distraction, angle, distance, reverberation, and noise
Constructive Strategies: When actions are taken to change an environment for improved communication
Lighting impacts communication; balanced lighting across face is ideal for effective communication
Speechreading abilities reduce when:
Lighting is too dim, backlighting, shadow, glare
Visual distraction
51
When the listener asks a close-ended question to limit potential answers and amount of repetition required by the speaker.
message-tailoring repair
52
When actions are taken to change an environment for improved communication
Constructive Strategies:
53
When the listener instructs the speaker on a specific way to change the delivery of the message
instructional repair strategies
54
Explain the specific biologic changes of vision which occur with aging and describe
recommendations to improve speechreading for this population.
* It’s harder to focus. Eyes are slower to adjust, Muscles weaken; rigid lenses create more resistance.
* Less light gets through the lens. Pupils get smaller and let in less light
* Light entering the eye scatters. Opaque corneas scatter light in different directions.
* Colors become distorted. Lenses begin to yellow and absorb a higher amount of blue wavelength light.
55
How does dual-sensory loss impact the PHL (hearing-vision loss)
Makes communication difficult, increasing social isolation, and reducing independence. It also poses safety risks and adds mental strain. It requires specialized support to improve well-being and daily function.
56
Describe the specific impact of reverberation on signal clarity (discuss research of impact on short vs. long reverberations).
Short: Fast reverberation, may help HL hear even more; sound bounces off the wall and very quickly arrives to the ear (few Ms after sound is created)
Long: Slow reverberation is detrimental to a PHL due to the level of distortion that it adds
Causes: large rooms, high ceiling, hard furniture or flooring, hard surfaces(glass,stone,tile etc)
57
Describe the specific impact increasing distance has on signal intensity
For every doubling of distance, the intensity decrease by ~ 6dB
58
Describe the ideal distance and angle for improved communication
Communication partners should be w/in 6 ft of each other and have the full face visible
59
Define anticipatory repair strategies explain how this is accomplished
When the PHL prepared for conversational interaction in advance by anticipating conversational content and potential listening environments.
* **Learn the topic** before entering the conversation
* **Review names** of dinner and cocktail party guests before arriving
* Read about **current events** and movies
* Obtain agendas in advance of meetings
* **Investigate** an environment before the event
* Obtain a **synopsis** of a play or movie before going to see it
* Review the restaurant **menus** online
* **Symptom search** to learn potential diagnosis b/f doctor visit
60
Define adaptive repair strategies and prepare recommendations for techniques to recommend for patient use.
Methods to counteract maladaptive behaviors (emotions) that stem from hearing loss
Use of relaxation techniques in advance of a stressful interaction reduces communication breakdown
* Conscious relaxation
* Deep breathing techniques
* Purposely redirect thoughts away from emotion and towards the conversation
61
unhealthy or ineffective coping mechanisms that may temporarily reduce stress but can worsen problems in the long run, such as avoidance
Maladaptive strategy
62
Maladaptive strategy
unhealthy or ineffective coping mechanisms that may temporarily reduce stress but can worsen problems in the long run, such as avoidance
63
an attempt to identify & influence to avoid communication breakdown
facilitative repair strategy
64
facilitative repair strategy
an attempt to identify & influence to avoid communication breakdown
65
include using visual aids, sign language, written instructions, and ensuring clear speech or lip reading, to enhance communication and learning.
Instructional strategies
66
Instructional strategies
include using visual aids, sign language, written instructions, and ensuring clear speech or lip reading, to enhance communication and learning.
67
When the listener asks close-ended question to limit potential answers and amount of repetition required by the speaker
Message tailoring strategies
68
Message tailoring strategies
When the listener asks close-ended question to limit potential answers and amount of repetition required by the speaker
69
promote positive, clear, and respectful exchanges, aiming to resolve conflicts, and build understanding. Example: turning of fan to have better SNR
Constructive strategies
70
Constructive strategies
promote positive, clear, and respectful exchanges, aiming to resolve conflicts, and build understanding. Example: turning of fan to have better SNR
71
Preparing for an event before going into it.
Anticipatory strategies
72
Anticipatory strategies
Preparing for an event before going into it.
73
Methods to counteract maladaptive behaviors (emotions) that stem from hearing loss
Adaptive strategies
74
Adaptive strategies
Methods to counteract maladaptive behaviors (emotions) that stem from hearing loss
75
refers to lighting - you want to increase lumens - doing this makes the light brighter
Lumens
76
Lumens
refers to lighting - you want to increase lumens - doing this makes the light brighter
77
Condition where an individual has both hearing and vision impairments
dual sensory disability
78
dual sensory disability
condition where an individual has both hearing and vision impairments
79
Strategies used to help individuals stay focused on the present moment, often to manage anxiety or overwhelming emotions by connecting to their surroundings or body sensations.
grounding techniques
80
grounding techniques
strategies used to help individuals stay focused on the present moment, often to manage anxiety or overwhelming emotions by connecting to their surroundings or body sensations.
81
Explain the concept of 3rd Party Disability
“Third-party disability” describes a range of activity limitations and participation restrictions experienced by CPs
* Stress of lifestyle changes, communication difficulties, and emotional consequences.
82
create a list of the ways in which hearing loss impacts the CP
When looking at **activity limitations:** the ability to execute a task
* The communication partner has an activity limitation because they are not able to freely communicate with the person with hearing impairment.
**Participation limitations:** they do not go to the movies anymore, or go out to dinner because it is too challenging to overcome the limitations.
83
List AR goals for the CP
* Identify the impact of the hearing loss on the CP.
* Understand the activity limitations & participation restrictions that result from the hearing loss and its impact on the PHL & CP
* Acknowledge that both parties are partners in communication with an important stake in improving outcomes of the treatment.
* Realize they have a shared responsibility in managing the hearing loss and treatment approach
84
Describe steps involved in partner goals setting activities
* PHL and CP identify key listening situation
* Audiologist uses open-ended questions to let each party to reflect on their experiences while considering the others point of view
* After exploring problems with each party, the Audiologist has the couple discuss the problems they experience together.
* Create a set of achievable goals for each respective problem
* The PHL, CP, & audiologist brainstorm ideas and tactics to achieve each goal.
84
Describe the ways a CP can help the listener
* Get PHL **attention** before talking
* Move **closer** to PHL and face them
* Use **facial expressions** and gestures
* Inform the listener when the **subject changes**
* Don’t speak while chewing
* Stay **patient**, positive, and relaxed
85
Create a comprehensive list of hearing loss facts to explain to CPs.
* It’s possible to hear a voice, and still have **difficulty understanding** some words.
* Hearing loss causes people to be **sensitive to loud sounds**.
* Trying to understand all day takes effort and is **exhausting**!
* Explain that communication **breakdown** increases as **stress** and **anxiety** levels rise
* Explain that auditory **fatigue** can lead to social **withdrawal**
* Explain limitations associated with lipreading tasks
86
Describe research findings related to Clear Speech and the benefit associated with attendance of a formal training program
Research shows 45 minutes of intervention training session yielded changes in more speech paramters, more stable changes and better speech recognition
* Asking the speaker to speak clearly was ineffective
Clear speech improves intelligibility for normal and HI individuals
* It improves speech understanding by ~17%
* In quiet, noise, & reverberant environments
87
List instructional steps for each training level included in formal Clear Speech training.
* Level 1: **Identify** clear speech
* Level 2: **Practice** using clear speech
* Level 3: Use **natural** conversational speech to practice - Structured Interview
* Level 4: Practice the use of clear speech in the **real world**
| additonal details on each in study guide
88
Articulation
the formation of clear and distinct sounds in speech
89
List ways in which the CP can advocate for the communication needs of the PHL.
* Let people know speaking slower and only slightly louder is helpful
* Remind a group that only one person should speak at a time
* Sit next to them & have them turn to you to share the punch line if it’s missed.
* Share the topic of conversation when they join a group
* Share some tips and tactics to help foster more successful communication
89
the formation of clear and distinct sounds in speech
Articulation
90
point or area where two or more languages or dialects meet and differ, marking a transition in language use or linguistic features.
Linguistic boundary
91
Linguistic boundary
point or area where two or more languages or dialects meet and differ, marking a transition in language use or linguistic features.
92
Elements of assertive communication strategies
* Know your priorities
* Be simple, honest, and direct (instructional strategy)
* Fake it till you make it (confidence)
* Be an eagle not a turtle, stand tall, maintain eye contact
* Use “I” statements instead of “you” statements
93
Benefits associated with assertive communication behaviors
Being assertive makes you feel good afterwards.
* You feel honest, respected, and proud
Others see your assertive communications as:
* Mature and independent
Being assertive improves
communication w/o long-term consequences.
94
Name each maladaptive communication behavior
Passive, aggressive & passive aggresive
95
# Define each maladaptive communication behavior
Passive
Passive: My needs are less important than others
* I don’t have as many rights as others
* My contributions are not valuable
96
# Define each maladaptive communication behavior
Aggressive
Aggressive: My needs are more important and justifies than others
* I have more rights that others
* My contribution is more valuable than others.
97
# Define each maladaptive communication behavior
Pasive Aggressive
Passive aggressive: I believe my needs come first, but I can’t express that
* I am not responsible for my actions
* I am entitled to get my own way, even though I didn’t express that need
98
What emotions drive the passive maladaptive behavioral responses
Passive: Fear of rejection or conflict, people-pleaser, desired to cooperate at all cost, lacks self-confidence, anxiety over possible misunderstanding, futility or fatigue, depression
99
What emotions drive the passive- aggressive maladaptive behavioral responses
Passive-aggressive: Using sarcasm, Withholds responses until needs are met. Indirectly expresses anger and frustration. (Avoids discussion but then looks for ways to show their disagreement. Talks about one person behind their back) Exhibits stubbornness, sullenness, procrastination.
100
What emotions drive the aggressive maladaptive behavioral responses
Aggressive: Anger, frustration, violation of rights, past embarrassment, insecurity, hurt feelings, fear
101
List the associated costs the passive maladaptive behaviors
* Increased anxiety that they’ll be caught
* Judged by inappropriate responses
* Dependence due to increased reliance on CP
* Feelings of helplessness or inadequacy
102
List the associated costs the aggressive maladaptive behaviors
Aggressive:
* Perceived by others as trampling on their needs
* CPs feel hurt or humiliated
* Viewed as a bully or loudmouth
* Rarely solves long term communication problems b/c emotions cloud solutions
103
List the associated costs the passive- aggressive maladaptive behaviors
Passive-aggressive:
* Can lead to misunderstandings and conflict.
* May damage relationships
* Hinders effective communication and self-advocacy.
104
Become familiar with ADA requirements to prepare for counseling patients on these regulations
| Summazied version of notes
Hearing loss is **classified as a disability** if they can show that they are substantially limited in hearing in one or more life activities (home,work,learning etc)
**ADA Title II: State & Local Governments: Vocational Rehabilitation**
* VR , program that helps the PHL of working age to reach educational and career goals.
**ADA Title III: Places and Public Accommodations**
* Access in healthcare
* Apps to use
* Telecoil
* Accessible lodging
* Hearing Dogs
**ADA Title IV: Telecommunication Relay Services**
* Telephone services to communicate that is as close to functionally equivalent.
* Support Groups
105
Advantage of Group AR program over individual AR sessions
* Reduced activity limitations and participation restrictions
* Attainment of communication goals
* Speechreading benefits were better understood
* Improved emotional well-being and assertiveness
* Reduce 3rd party disability
* Improved quality of life for CPs
* Evidence of indirect financial benefit
* Improved hearing aid satisfaction
106
Develop a list of evidenced based benefits reviewed within this presentation
Patient benefit
* Fosters self-advocacy
* Improves socialization
* Recognition that you’re not alone with your hearing loss
* Increased self-sufficiency
* Promotes relationships with the audiologist
Practice benefit
* Fewer hearing aid returns
* Increase in the number of satisfied patients
* Increase in word-of-mouth referrals from loyal clients
* Distinguishes your practice from others
* Decreased drop-in appointments due to increased self-sufficiency
* Increase in sales of hearing assistive technology systems
107
Develop a list of evidenced based benefits reviewed within this presentation for group AR
(patient benefits only)
Patient benefit
* Fosters self-advocacy
* Improves socialization
* Recognition that you’re not alone with your hearing loss
* Increased self-sufficiency
* Promotes relationships with the audiologist
108
Develop a list of evidenced based benefits reviewed within this presentation for group AR
(pratice benefits only)
Practice benefit
* Fewer hearing aid returns
* Increase in the number of satisfied patients
* Increase in word-of-mouth referrals from loyal clients
* Distinguishes your practice from others
* Decreased drop-in appointments due to increased self-sufficiency
* Increase in sales of hearing assistive technology systems
109
Describe learning preferences of adults
| Summarized version of SG
Adult learners...
1. are internally motivated & naturally self-directed
2. bring life experiences & knowledge to learning experiences
3. are goal oriented
4. want to be sure what you’re teaching is relevant to what they want to achieve
5. are practical
110
Adult Learners want to feel respected
* **Interest** - listen to them
* **Acknowledgement**- include activities that relate to their life
* **Encouragement** - encourage expression of ideas, and reasoning at every opportunity.
* **Reinforcement** - Provide positive feedback showing how their thoughts supported the discussion
111
Define aided validation measurement
Validation: A process of assessing the effectiveness of audiological interventions.
* Measures the impact of hearing aids and other interventions on a patient's quality of life.
112
describe the purpose and benefits associated with monitoring aided validation measurments
Validation occurs after the patient has adjusted to the newly returned audibility
* Assessment is tailored to determine if an individual's goals were met
* Compares aided objective and subjective assessments to pre-fitting performance
* Demonstrates benefit
112
List the four key categories included in post-fitting validation assessments
* Assessment of treatment usage/adherence
* Measurement of objective aided performance
* Self-report measurements of subjective benefit
* Self-report measurement of subjective satisfaction
113
meaning, and evaluation criteria for optimized audibility when using SII
Speech Intelligibility Index (SII)
* The percentage of total speech information available to the listener's ear for a given speech material
* There is considerable individual variability in relating the SII to speech recognition, especially amongst impaired listeners
114
meaning, and evaluation criteria for optimized audibility when using RMSE
* Root Mean Squared Error is the difference b/w the probe measured output and prescriptive targets
* An RMSE criterion of 5dB from prescriptive target is attainable for most mild to severe hearing losses
115
the purpose of validation measures as it relates to patient’s plan of care, clinical decisions and provider responsibility, and healthcare reimbursement
* To demonstrate the value of audiological services.
* To improve clinical practice and patient outcomes.
* To justify reimbursement for services.
116
follow recommended validation protocols for
Documentation of usage
* Review datalogging to determine patterns of daily use
* Ask patients to submit a diary of use/experiences
* Address any unexpected deviations
117
follow recommended validation protocols for
Objective test methods
Conduct aided speech assessments in the soundfield.
* Test materials: (Syllables, Words & Sentences- recommended)
* Presentation level is typically 50 to 60 dBA (70 dBA for severe losses)
* Measure aided performance in quiet and in noise
* Compare results to unaided performance for each test condition
Aided performance checklist
* Confirm improved audibility of speech signal
* Confirm SNR loss did not degrade with omnidirectional microphones
* Confirm improved SNR loss with directional microphones enabled
* Confirm improved speech understanding with frequency lowering enabled
* Confirm Audio-visual integration benefit (optional)
* Discuss any residual performance limitations in noise for the purpose of realistic expectations
118
follow recommended validation protocols for Subjective benefit assessments
Measures subjective benefit two ways
* Relative benefit: assess degree of improvement experience for each COSI goal.
* Absolute benefit: assess percentage of time patient hears satisfactorily for each COSI goal, select a percentage representing how much you hear
119
follow recommended validation protocols for Subjective satisfaction assessments
* Device oriented subjective outcome scale (DOSO)
* Hearing Aid Skills and Knowledge Inventory - Self-administered (HASKI-self)
* International Outcome
* Inventory for Hearing Aids (IOI-HA)
* SADL (Satisfaction with Amplification in Daily Life)
* Shortened Hearing Aid Performance Inventory (SHAPI)
* Hearing Aid Use and Satisfaction Measure
120
When is it appropriate to complete validation measures?
Validation is measured @ 4-6 weeks post fitting adjustment period because this is considered a stable point in time to predict performance later in time.
121
# Vocab
* Regulatory bodies
* Health insurance industry
* Consumers
Stakeholders
122
Stakeholders
Regulatory bodies
* Food and Drug Administration
* Federal Trade Commission
Health insurance industry
Consumers
123
# vocab
* Documents Audiology services effectively reduce restrictions/improve quality of life to accrediting agencies
* Shows patients and families that professional intervention was beneficial
* Validates audiologist clinical decisions for hearing aid selection and fitting practices.
Healthcare Analytics
124
Healthcare Analytics
* Documents Audiology services effectively reduce restrictions/improve quality of life to accrediting agencies
* Shows patients and families that professional intervention was beneficial
* Validates audiologist clinical decisions for hearing aid selection and fitting practices.
124
* The difference b/w the probe measured output and prescriptive targets
* Aided audibility has been found to be significantly predicted by the proximity to prescriptive targets for a hearing aid fitting
RMSE (Root mean squared error)
125
RMSE (Root mean squared error)
* The difference b/w the probe measured output and prescriptive targets
* Aided audibility has been found to be significantly predicted by the proximity to prescriptive targets for a hearing aid fitting
* An RMSE criterion of 5dB from prescriptive targets has been the precedent in academic research and is attainable for most mild to severe hearing losses.
126
Code 92626 should not be reported for evaluations of auditory function lasting less than ____minutes.
Code 92626 should not be reported for evaluations of auditory function lasting less than **31 minutes.**
127
Evaluation of auditory function for surgically implanted device(s), candidacy or post-operative status of a surgically implanted device(s); first hour.
92626
128
92626
Evaluation of auditory function for surgically implanted device(s), candidacy or post-operative status of a surgically implanted device(s); first hour.
129
* Evaluation of auditory function for surgically implanted device(s), candidacy or post-operative status of a surgically implanted device(s); each additional 15 minutes.
* 15-minute unit has to be a minimum of 8 minutes, no more than 22 minutes
92627
130
Auditory Rehabilitation, post-lingual hearing loss - not reimbursable
92633
| Think post - L = 3
birth - 3, loss would occur after IV (3)
130
92627
Evaluation of auditory function for surgically implanted device(s), candidacy or post-operative status of a surgically implanted device(s); each additional 15 minutes.
131
92633
Auditory Rehabilitation, post-lingual hearing loss - not reimbursable
132
Auditory rehabilitation, pre-lingual hearing loss - not reimbursable
92630
| Think 0, birth = no lanaguge
133
92630
Auditory rehabilitation, pre-lingual hearing loss - not reimbursable
| Think 0, birth = no lanaguge
134
92627- ____ minute unit has to be a minimum of ___ minutes, no more than ____ minutes
92627- **15**-minute unit has to be a minimum of **8** minutes, no more than **22** minutes
135
Be aware of timed-code documentation regulations
* 92627- 15-minute unit has to be a minimum of 8 minutes, no more than 22 minutes
* Document the face-to-face start & end time in patient records!
136
Describe the research findings of the ACHIEVE project
* ACHIEVE is a multicenter randomized trial to determine if treating hearing loss in older adults reduces the loss of thinking and memory abilities (cognitive decline) that can occur with aging.
* Hearing intervention DID NOT change the rate of cognitive decline significantly over 3 years in the healthy volunteers group.
* **Hearing intervention PROVIDED SIGNIFICANT BENEFITS the heart healthy group of subjects
Cognitive decline reduced by 48%!!!**
137
Describe the audiologic rehabilitation methods utilized by audiologists associated with the ACHIEVE research.
**ACHIEVE’s Hearing Intervention Protocol**
* Objective: minimize activity limitations & participation restrictions due to hearing impairment.
* Prefitting protocol
**ACHIEVE’s Fitting protocol**
* Bilateral RIC aids
* Fit to NAL-NL2 prescriptive targets using real-ear measures
* Hearing assistive technologies (HAT) paired with the hearing aid
**ACHIEVE's Follow-up protocol**
* Self-directed rehabilitation - Subject utilized their “Hearing aid Toolkit” (C2Hear) (4 rehab sections)
* Post Fitting - Reinstruction in use of devices and hearing rehabilitative strategies every 6 mos, CP are encourged to attend HI
138
The human eye can only register ____ visemes/sec
We speak at a rate of ____ visemes per second
The human eye can only register 9-10 visemes/sec
We speak at a rate of ~15 visemes per second
139
Your understanding of how SNR/noise results in communication difficulties must move beyond the concept of masking. Explain how reduced frequency resolution, temporal resolution, and spatial processing impacts communication in noise. Prepare a script used to practice explaining why PHLs have more difficulty understanding speech in noise.
"People with hearing loss (PHLs) find it harder to understand speech in noise due to three main factors:
**Reduced Frequency Resolution:** They struggle to distinguish different pitches, making it harder to separate speech from background noise.
**Reduced Temporal Resolution:** They have difficulty processing rapid changes in sound, which makes it tough to follow fast or overlapping speech.
**Impaired Spatial Processing:** They struggle to locate the source of sounds, so they can't focus on speech amidst competing noises.
These issues combined make it challenging for PHLs to understand speech in noisy environments."
140
Describes a range of activity limitations and participation restrictions experienced by CPs
* Stress of lifestyle changes, communication difficulties, and emotional consequences.
3rd Party Disability
141
Be aware of the journey CP takes as the PHL moves towards diagnosis and rehabilitation
* Recognition
* Adapt
* Diagnosis
* Rehab & learning
* Advocacy & long-term support
142
Validation occurs after...
Validation occurs after the patient has adjusted to the newly returned audibility
* Assessment is tailored to determine if an individuals goals were adhered
* Measured 4-6 weeks after fitting
* Compares aided objective and subjective assessments to pre-fitting performance
* Demonstrates benefit (reduced activity limitations, increased participation) satisfaction and improved QoL
143
List the four key categories included in post-fitting validation assessments
* Assessment of treatment usage/adherence
* Measurement of objective aided performance
* Self-report measurements of subjective benefit
* Self-report measurement of subjective satisfaction
144
The percentage of total speech information available to the listener's ear for a given speech material
There is considerable individual variability in relating the SII to speech recognition, especially amongst impaired listeners
Speech Intelligibility Index (SII)
145
the difference b/w the probe measured output and prescriptive targets
* the precedent in academic research and is attainable for most mild to severe hearing losses.
Root Mean Squared Error (RMSE)
146
154
