Special Groups for Hearing Aid Fittings Flashcards
(100 cards)
1
Q
How do people with both tinnitus and hearing loss typically perceive their condition?
A
People with both tinnitus and hearing loss often perceive tinnitus as the more overwhelming problem.
2
Q
Is there a specific cure for tinnitus?
A
There is usually no specific “cure” for tinnitus, but various approaches can help manage it.
3
Q
What do physiological models of tinnitus focus on?
A
Physiological models relate the physiological changes in the auditory system to the perception of tinnitus.
- Examples include the Neurophysiological Model by Jastreboff et al. (1988) and Turner et al. (2006).
3
Q
When should someone with tinnitus be referred to a specialist clinic?
A
If tinnitus significantly affects a person’s life, it is worth referring them to a specialist tinnitus clinic.
3
Q
What other condition might people with tinnitus experience, and what might it require?
A
People with tinnitus may also experience hyperacusis, which may need additional treatment.
4
Q
What do psychological models of tinnitus explain?
A
Psychological models explain the psychological processes that cause some people to find their tinnitus troubling.
- An example is the Cognitive Model by McKenna et al. (2014).
4
Q
Is there a single model that fully explains the variation in the experience of tinnitus in the general population?
A
No, there is no single model that fully explains the variation in the experience of tinnitus in the general population.
4
Q
What do social models of tinnitus address?
A
Social models explain the impact of cultural and healthcare attitudes on people’s experience of tinnitus.
- An example is the study by Li et al. (2015).
5
Q
How are troublesome tinnitus experiences thought to arise?
A
Troublesome tinnitus experiences are thought to arise from the interaction of physiological, psychological, and social processes.
6
Q
On what basis are most tinnitus treatment approaches developed?
A
Most tinnitus treatment approaches are based on a combination of models and possible causes.
6
Q
What is the purpose of sound enrichment in managing tinnitus?
A
Sound enrichment uses sound to distract the brain from the tinnitus.
7
Q
What are some common background sound techniques used for tinnitus relief?
A
*Common background sound techniques include:
- White Noise: Continuous sound covering all frequencies.
- Nature Sounds: Sounds like rain, ocean waves, or forest ambiance.
- Music: Soft instrumental or classical music.
7
Q
How do hearing aids help with tinnitus?
A
Hearing aids amplify external sounds, reducing the prominence of tinnitus. Some advanced models include built-in sound generators for added masking.
8
Q
What are noise generators and how do they work?
A
Noise generators produce sounds designed to cover up tinnitus. They can be standalone devices or integrated into hearing aids, offering various sounds to mask the tinnitus noise.
8
Q
What are combination devices in tinnitus management?
A
Combination devices integrate hearing aids with noise generators, providing both sound amplification and masking in one unit, which is particularly useful for those with both hearing loss and tinnitus.
9
Q
What do patients who do Tinnitus Retraining Therapy report a reduction in?
A
- awareness of the tinnitus
- tinnitus annoyance
- negative impact on life
- Evidence that people show benefit within 3 months and continue to improve after this time.
- However, the treatment doesn’t work for everyone.
10
Q
What is Cognitive Behavioral Therapy (CBT) in the context of tinnitus management?
A
CBT for tinnitus is based on the cognitive model of tinnitus and aims to change a person’s negative thoughts about tinnitus to more realistic, positive ones.
11
Q
How does mindfulness help patients with tinnitus?
A
Patients learn to observe the tinnitus experience without trying to control or react to it. This is done by focusing on the present moment and calmly acknowledging their feelings and body sensations.
11
Q
Is CBT used only for tinnitus?
A
No, CBT is used for a variety of conditions, including anxiety, depression, and other mental health issues, not just tinnitus.
12
Q
What is the goal of CBT for tinnitus sufferers?
A
The goal is to change the person’s negative thoughts about tinnitus into more realistic and positive ones, thereby reducing the distress associated with tinnitus.
13
Q
How effective is CBT in treating tinnitus?
A
CBT has been shown to be an effective treatment for tinnitus. It improves emotional distress, reduces tinnitus annoyance, and enhances quality of life and reduces depression.
13
Q
What are some specific benefits of CBT for individuals with tinnitus?
A
CBT can improve emotional distress, reduce the handicap and annoyance caused by tinnitus, and enhance overall quality of life and alleviate depression.
14
Q
What is mindfulness in the context of tinnitus management?
A
Mindfulness is based on the cognitive model of tinnitus and is used to help individuals observe their experiences without reacting to them. It is also applied to various conditions and general mental well-being.
15
Q
What does early research indicate about the effectiveness of mindfulness for tinnitus?
A
Early research indicates that mindfulness can improve tinnitus symptoms, reduce the perception and annoyance of tinnitus, and alleviate depression.
15
What is the core practice involved in mindfulness for tinnitus?
The core practice involves focusing awareness on the present moment and acknowledging thoughts and sensations without judgment, which helps reduce the distress caused by tinnitus.
16
Who should patients with distressing tinnitus see for appropriate management?
Patients with distressing tinnitus should ideally be seen by a Specialist Audiologist or Hearing Therapist for appropriate management.
16
What are some common issues when seeing adults with learning difficulties in an audiology clinic?
- Inability to complete audiometry.
- Difficulty understanding instructions or maintaining concentration during testing.
- Reluctance to undergo otoscopy or impression taking.
- Wariness of strangers.
- Inability to report difficulties with hearing or with hearing aids.
17
What is the first step in managing mild tinnitus in an audiology clinic?
Explaining the likely cause of tinnitus, identifying situations that may worsen it, and discussing management options may be sufficient for individuals with mild tinnitus.
17
What role does sound enrichment play in managing tinnitus?
Sound enrichment, such as using environmental noise, noise generators, or fitting hearing aids, can help manage tinnitus symptoms.
18
Why might tinnitus require referral to experienced professionals?
Tinnitus can be associated with significant psychological overlays such as depression and anxiety, necessitating referral to experienced professionals for comprehensive care.
18
What is the typical NHS referral pathway for tinnitus management?
The typical NHS referral pathway usually starts with a GP, who then refers the patient to an ENT specialist, followed by referral to Audiology. In some cases, the GP may refer the patient directly to Audiology.
18
When should a person with tinnitus be referred to a specialist clinic?
If someone reports that their tinnitus is distressing or interrupts their sleep, it is advisable to refer them to a specialist clinic.
19
How can audiologists better support adults with learning difficulties during appointments?
By using clear, simple instructions, creating a calm and reassuring environment, being patient, and possibly involving caregivers or familiar persons to facilitate communication and comfort.
19
Why might an adult with learning difficulties be unable to complete audiometry?
They might not understand the instructions or may not be able to concentrate long enough to complete the testing.
19
What types of services are available for adults with learning difficulties in NHS-based audiology clinics?
- Consistent use of the same staff and clinic environment for each visit.
- Assessments carried out in day care centers or the patient’s home.
- Use of additional forms of testing tailored to the individual's needs.
- Extra time allocated for appointments.
- Strong collaboration with the client’s carers and social services.
20
How can reluctance to undergo otoscopy or impression taking be addressed?
It might help to explain the procedures in simple terms, use a gentle approach, and ensure a comfortable and familiar environment to reduce anxiety.
21
What challenges arise from a client being wary of strangers?
The client may feel uncomfortable or anxious, making it difficult to perform necessary tests or procedures.
21
What is a significant communication barrier when working with adults with learning difficulties in audiology?
The client may not be able to effectively report difficulties with hearing or with their hearing aids, complicating accurate diagnosis and treatment.
22
Why is it important to use the same staff and clinic environment for each visit for patients with learning difficulties?
Consistency with staff and the clinic environment helps build trust and familiarity, reducing anxiety and improving the client's comfort during visits.
22
Where else can assessments be carried out apart from the clinic?
Assessments can also be conducted in day care centers or in the home where the patient lives.
23
What modifications might be made to the testing process for these clients?
Additional forms of testing that are more suitable for the client's abilities may be used to ensure accurate assessment.
24
How do audiology services ensure effective communication and support for these clients?
By maintaining excellent links with the client’s carers and social services, ensuring coordinated care and comprehensive support.
24
Why is extra time allowed for appointments with adults with learning difficulties?
Extra time is allowed to ensure that the client feels comfortable, understands the process, and can complete the necessary tests without feeling rushed.
25
What are the risks of cognitive impairment in people with hearing loss compared to those without?
People with hearing loss have a 30-40% greater chance of cognitive impairment than those without hearing loss
26
How do hearing loss and cognitive disorders interact with each other?
Hearing loss and cognitive disorders interact in ways that exacerbate each other, leading to increased communication difficulties and social isolation.
27
What impact do cognitive disorders have on communication for people with hearing loss?
People with cognitive disorders may struggle more with effective communication, leading to frustration, social isolation, and depression.
27
How does hearing loss affect the development and progression of dementia?
People with hearing loss have an increased rate of developing dementia and experience more rapid cognitive decline compared to those without hearing loss
28
What is the theory behind sensory deprivation and brain tissue loss in the context of hearing loss?
There are suggestions that sensory deprivation due to hearing loss causes accelerated brain tissue loss, potentially contributing to cognitive decline
29
what is dementia?
Dementia is an umbrella term for diseases
characterised by a decline in memory, language, and
problem-solving skills that affect a person’s ability to
perform everyday activities
29
How does dementia affect communication in the early stage?
In the early stage of dementia, individuals experience difficulties with learning, thinking, planning, and short-term memory.
30
What communication challenges are common in the moderate stage of dementia?
In the moderate stage, individuals often struggle with speaking and understanding speech, which can hinder effective communication.
31
What happens to communication abilities in the late stage of dementia?
In the late stage, communication becomes severely impaired, and individuals may have disordered language, making it very challenging to express themselves or understand others.
31
Why is it important to value their words and not correct dementia patients?
Valuing their words and avoiding correction helps maintain their dignity and reduces frustration, promoting a positive and supportive interaction.
32
How can you build rapport and initiate person-centered care for people living with dementia and hearing impairment?
- Be nice and sincere
- Read their physical expressions
- Ensure the environment is appropriate
- Value their words
- Acknowledge their feelings
33
What role does the environment play in effective communication with individuals who have dementia and hearing impairment?
An appropriate and familiar environment can make the individual feel more comfortable and secure, facilitating better communication and reducing anxiety.
34
What challenges might arise if a person with dementia is fitted with a hearing aid?
- Not remembering that they have a hearing loss.
- Not remembering that they have a hearing aid.
- Forgetting to put the hearing aid in.
- Forgetting how to use the hearing aid.
35
What behaviors might a person with dementia exhibit regarding their hearing aid?
- Continuously adjust the hearing aid controls.
- Refuse to wear the hearing aid.
36
What additional support might be needed for a person with dementia who uses a hearing aid?
Additional and regular appointments may be needed to ensure proper use and maintenance of the hearing aid.
36
Why are strong links with carers and/or family important for effective hearing aid management in dementia patients?
Strong links with carers and/or family are crucial to ensure the person receives consistent and effective care, including reminders and assistance with using the hearing aid.
37
Why is the process of providing appropriate hearing aids more complex for patients with profound hearing loss?
The severity of the loss requires specialized hearing aids and precise adjustments to maximize residual hearing, which is more complex than fitting standard hearing aids.
37
What role do family members play in the rehabilitation process for someone with profound hearing loss?
Family members often need to provide support, encouragement, and practical assistance. Their involvement is crucial for effective rehabilitation and coping strategies.
37
What are key issues faced by patients with profound hearing loss?
- Poor frequency resolution and speech discrimination.
- Complexity in providing appropriate hearing aids.
- Hearing aids are unlikely to fully restore hearing and communication function on their own
- Need for additional management strategies.
- Significant psychological needs.
- Family members likely need support and involvement in the rehabilitation process.
37
Can hearing aids fully restore hearing and communication function in individuals with profound hearing loss?
no, additional management is needed, Strategies may include auditory training, speech reading (lip-reading) classes, sign language, assistive listening devices, and psychological support.
38
Why is frequency resolution and speech discrimination often poor in patients with profound hearing loss?
Profound hearing loss typically damages the inner ear structures, impairing the ability to distinguish different frequencies and understand speech.
39
Why are longer appointment times necessary for patients with profound hearing loss?
1- Communication difficulties.
2- Additional testing.
3- Extra counselling and advice.
4- Consideration of alternative management options.
39
Why do individuals with profound hearing loss often have significant psychological needs?
The impact of severe hearing loss can lead to social isolation, frustration, depression, and anxiety, necessitating psychological support.
40
What role does extra counselling and advice play in managing profound hearing loss?
Extra counselling and advice are crucial to help patients and their families understand the extent of the hearing loss, the limitations of hearing aids, and to provide emotional support and coping strategies.
40
What types of additional testing might be required for patients with profound hearing loss?
Additional testing may include advanced audiometric evaluations, speech perception tests, and assessments for assistive listening devices.
41
What are some alternative management options that might be considered for patients with profound hearing loss?
Alternative management options can include cochlear implants, bone-anchored hearing systems, assistive listening devices, and sign language training.
42
What is the purpose of testing for dead regions in patients with profound hearing loss?
- Provide realistic expectations of hearing for speech.
- Determine whether hearing aids (HAs) are appropriate.
- Aid in choosing appropriate hearing aids and settings.
42
Why is it important to identify dead regions in the cochlea?
Identifying dead regions helps clinicians understand the areas of the cochlea that no longer respond to sound, guiding the selection and adjustment of hearing aids to maximize remaining hearing function.
43
How should non-organic hearing loss be managed?
Non-organic hearing loss, where there is no identifiable physiological basis, requires different management approaches, such as psychological evaluation and counseling, to address potential underlying issues.
44
What is the role of an additional needs assessment for patients with profound hearing loss?
An additional needs assessment ensures a comprehensive understanding of the patient's requirements, which may involve input from a multi-disciplinary team to address all aspects of the patient's hearing loss and overall well-being.
45
Why might a multi-disciplinary team be needed for patients with profound hearing loss?
A multi-disciplinary team can provide a holistic approach, offering expertise from audiologists, speech therapists, psychologists, and other specialists to address the diverse needs of the patient.
46
What key factors need to be considered when setting hearing aids for severe-profound hearing loss?
- Choice of prescription fitting rule.
- Inclusion of bone conduction (BC) thresholds in the prescription software.
- Compression characteristics.
- Use of omnidirectional vs. directional microphones.
- Noise management.
- Frequency lowering.
- Feedback management.
- Adjusting gain if dead regions are present.
- Regular reviews of hearing aid benefit.
- Ensuring earmoulds fit well and are updated regularly.
47
Why is it important to measure real-ear measurements (REMs) at three intensity levels?
Measuring at three intensity levels ensures that the hearing aids provide appropriate amplification across a range of listening environments.
48
When might RECDs be more efficient than REMs?
Real-Ear to Coupler Difference (RECD) measurements can be more efficient for verifying hearing aid performance, especially in challenging cases, as they allow for more flexibility and less patient cooperation.
48
What additional management strategies should be considered for profound hearing loss?
- Advising on technology and communication support.
- Counseling on acceptance and understanding of hearing loss.
- Training in assertiveness and communication strategies.
- Counseling and communication skills training for family and friends.
- Auditory training.
- Speech reading training.
- Speech and language therapy, especially with frequency lowering.
- Peer support through groups or mentoring.
- Psychological support.
- Occupational and benefits advice.
- Referral for cochlear implantation.
49
How can speech testing be useful for individuals with severe-profound hearing loss?
Speech testing can identify issues with speech processing that may impact the benefit derived from hearing aids, helping to tailor the management plan.
49
What is the difference between REAR and REIG, and which is more appropriate for severe-profound losses?
REAR (Real-Ear Aided Response) measures the amplified sound in the ear, while REIG (Real-Ear Insertion Gain) measures the gain provided by the hearing aid. REAR is more appropriate for severe-profound losses as it directly measures the sound reaching the eardrum.
50
Why might standard outcome measures be inappropriate for this group, and what alternative is available?
Standard outcome measures may not fully capture the unique challenges faced by individuals with severe-profound hearing loss. There is a specialized questionnaire designed specifically for this group to provide more relevant feedback.
51
What should be done to manage severe-profound hearing loss effectively when fitting hearing aids?
- Setting appropriate expectations.
- Using suitable fitting tools and hearing aid settings.
- Employing relevant outcome measures.
- Advising on a range of management options.
- Referring to specialists when needed.
- Utilizing integrated services linking to social services, psychology, and ENT/audiological medicine where available.
52
What are assistive listening devices (ALDs), and how do they help individuals with hearing loss?
ALDs amplify specific sounds, especially in noisy environments, and can be used with hearing aids or cochlear implants to improve hearing.
52
What are alerting devices, and how do they work?
Alerting devices connect to doorbells, telephones, or alarms, emitting loud sounds or blinking lights to alert individuals with hearing loss to events.
53
How can individuals with hearing aids or cochlear implants use telecoil systems?
They can wear a receiver compatible with their device or use a wire around the neck or behind the aid to convert signals into magnetic ones picked up by the telecoil.
53
What is a telecoil (induction loop) system, and how does it function?
A telecoil system involves a sound source, an amplifier, a loop of wire around a room, and a receiver worn in the ears or as a headset, transmitting sound using electromagnetic energy.
54
How do FM systems work, and where are they commonly used?
FM systems use radio signals to transmit amplified sounds, often employed in classrooms where an instructor wears a microphone connected to a transmitter, and the student wears a receiver.
55
What are TV streamers and Bluetooth streamers, and how do they assist individuals with hearing loss?
TV streamers connect to TV sets to transmit audio directly to hearing aids, while Bluetooth streamers allow streaming from Bluetooth devices like music players or radios.
55
What is speech-to-text software, and how can it benefit individuals with hearing loss?
Speech-to-text software transcribes spoken words into text, aiding in group meetings or work situations, and is available as apps for smartphones and tablets.
56
How does a remote microphone assist individuals with hearing aids in conversations?
A remote microphone, placed near the source of sound or given to a conversational partner, picks up desired sounds and transmits them directly to the user's hearing aids, improving signal-to-noise ratio.
56
What is the definition of sudden hearing loss?
Sudden hearing loss is defined as a hearing loss of 30dB or more at 3 neighboring frequencies occurring over a period of up to 3 days.
57
What are some possible causes of sudden hearing loss?
It may be associated with specific causes such as infections, surgery, head trauma, ototoxicity, or barotrauma, but can also occur with no known cause.
57
Why can sudden hearing loss be particularly shocking for patients?
Sudden hearing loss is often unexpected and can be a shock, especially if the cause is unknown, requiring significant emotional support in addition to traditional management.
58
What is the role of audiology in the management of sudden hearing loss?
- Audiology assesses the extent of the loss and provides amplification, advice, counseling, and communication training.
- Hearing therapists can also play a crucial role in managing these cases.
59
What additional referrals might be necessary for patients with sudden hearing loss?
Patients may be referred to psychology for management of the emotional consequences of the loss or to programs like the Hearing Link intensive rehabilitation program.
60
What is single-sided deafness (SSD) and what are its impacts?
SSD is a severe to profound hearing loss in one ear, causing significant difficulties in speech understanding in noise, sound localization, and awareness of sounds in the affected ear.
60
What is dual sensory loss?
Dual sensory loss refers to adults with vision disorders in addition to hearing loss, which can impact their ability to use hearing aids, assistive technology, and lipreading.
60
How is single-sided deafness managed?
- Management options include CROS (Contralateral Routing of Signals), BAHA (Bone Anchored Hearing Aid), or cochlear implantation for the worse ear.
- However, rerouting devices may degrade speech understanding, particularly in noise.
61
What additional needs arise in appointments for individuals with dual sensory loss?
Appointments require appropriate communication, understanding of changes in vision, involvement of significant others, and input from various professionals such as hearing therapists, psychologists, occupational therapists, and social services.
61
How is dual sensory loss managed?
Management strategies may include tactile assistive devices, formal needs and lifestyle assessment, additional communication techniques, support groups, and charities, as well as advice on work and income.
