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Flashcards in Hearing Deck (22):

overall goal of aural rehab

to alleviate difficulties related to hearing loss, minimize its consequences


Degree of HL

mild: 20-45dB HL
moderate: 45-65
Severe: 65-85 db HL
Profound: >85 db HL


speech discrimination scores

-patient ability to repeat words from list of 25 auditory presented single syllable words presented in 2 ears separately in sound treated room
-expressed as a % correct for each ear


speech recognition threshold (SRT)

level at which patient can repeat 50-75% of spondaic words in dB HL (baseball)

-should correspond to pure tone average threshold at 500, 1000, 2000 Hz


effects of HI on conversation

1. disrupted turn-taking (missing aud cues)
2. inappropriate topic shift as a resultd of misunderstanding word or phrase
3. communication breakdowns disrupt flow
4. choice of topic simplified/limited for fear of communication breakdowns



2 types of comm strategies

1. facilitative --- anticipate/manage enviornment, self, partner

2. repair -- recover from a breakdown after it occurs


environment oriented strategies

1. light source should illuminate face of comm partner
2. direct view of speaker
3. 3-6 ft optimal distance
4. reduce background noise
5. reduce reverberation


pt oriented strategies

1. increase self-confidence
2. prepared for comm situations (visual attention to partner, world knowledge, paper and pencil)
3. speech-reading skills
4. encourage pts to role play fears and come up with solutions


partner oriented strategies

1. instructional strategies for partners -- request clear speech
2. "please speak clearly and slowly"
3. "I need to your face when speaking"
4 "Do you mind not chewing your gum"/...etc


receptive repair strategies

TEACH the patient...
1. rephrase - could you say that in another way?
2. elaborate -- please tell me more...
3. request topic --- I missed that completely what were you talking about?
4. confirmation --- did you say ___?


expressive repair strategies

TEACH the patient/comm partner:
1. teach interpretation of facial cues (puzzled look = confusion)
2. repeat message verbatim or with no info
3. talker takes hold of the repair


encourage ______ type of conversation style

interactive --- stating needs in a friendly manner, clear, assertive



-basic principles of aural rehabilitation:
W = watch the talker's mouth
A = ask for clarification
T = talk about your hearing loss
C = change the situation - background noise or move to another place
H = healthcare knowledge -- be informed


ALDs for the home

1. loud ringers, phone amplifiers, loud amplified doorbell ringers
2. flashing lights/vibrating alarm and alert systems
3. TV captioning


Counseling with pt with HL

-help pt to tell their story, clarify problems, take responsibility
-establish goals, develop plan, implement plan
-ongoing eval

*** need both informational counseling and personal adjustment counseling


range of conversational speech

-20-50 db HL
-250-6000 Hz`


noise induced hearing loss

-exposure to 85-140 dB SPL
-increases over months and is usually painless
-begins as knowtch at 4-6 Hz... spreads to lower frequencies over time
-most common cause of tinnitus
-SLP role in HL prevention: counseling, education, hearing screenings, aud referrals


functional hearing impairments assessments

-hearing handicap inventory for adults
-also have HHIA0SO.. for significant others


communicative strategies therapy

-for all hearing impaired clients who use spoken language
-therapy ranges from one 1-hour session to 12 weeks
-individual or group
-frequent communication partners should be included when possible


Auditory Training

-candidates: adults with peripheral hearing loss or new hearing aids, new BI, sudden hearling loss
-assessment and therapy should be AUDITORY ONLY
-go through auditory skill heirarchy
1. awareness
2. discrimmination
3. identification
4. comprehension

tools: Fast ForWord, Earobics
-generally requires comp level of auditory skill

LACE: syntehtic computer training for adults (listening and communication enhancement)// good for adults with new aids or CI


speech reading

emphasizes importance of visual and auditory facial expression, context cues, loooking at lips
(not used for mild losses)


Hearing Aids

-refer to audiologist for hearing aid fitting
-SLP can do re-orientation and troubleshooting
-ALWAYS REQUEST TO SEE AIDED AUDIOGRAM!!!! so you know what to expect from client when weearing HAs
-counsel patent and family about use