SPEECH: Lip- reading, auditory training and hearing tactics Flashcards
(34 cards)
what is the objective of fitting hearing aids?
to restore a range of loudness experience, to make speech audible without introducing distortion as amplifying sounds can make them more audible but also make the intense portions of sound too loud causing distortion
how do hearing aids address the issue of distortion caused by modification?
Modern hearing aids use techniques such as frequency shaping, graduated compression, multichannel compression, directional microphones, and noise reduction circuits to mitigate distortion.
what is a disadvantage of compression circuitry?
compression circuitry in the aid limits amplification of more intense vowel sounds making them harder to hear too
how might the improvements in hearing aids impact the understanding of speech?
The improvements may also reduce frequency and timing information, making speech harder to understand.
why are hearing aids a good choice for people with mild to moderate HL?
-the basic nature of the sound signal is unchanged from the original so keeping the essential features of normal sound with minimal distortion
1-the hearing aid makes an acoustic signal louder overall
2-it can make sounds relatively more intense in some frequencies to match the audiogram
3-it is possible to limit its maximum intensity level to fit within individual dynamic ranges (ULL) so the sound is comfortable
- people can adapt quickly to the sound without further training
why are hearing aids less helpful for people with severe HL?
-people with this level of HL need more amplification to hear sounds which increases distortion in the ear and sometimes in the aid
1- increasing the intensity of sounds increases the risk that low frequency background noise will mask high frequency speech sounds
2- damage to the cochlea increases the risk of recruitment so people cannot tolerate loud sounds requiring more sound processing in the aid… which increases the risk of distortion
why are implantable devices (CI) more effective than hearing aids for people with profound HL?
-hearing aids are unlikely to help people with profound HL
- An implant replaces the basilar membrane in the cochlea and stimulates the auditory nerve directly
- Many people have significantly improved speech perception compared to hearing aids
- But not everybody is suitable for an implant so we need to provide them with appropriate support
what are some thing sa hearing aid user can do to make things easier?
-be near the sound they wanna hear and look at the person speaking to them (Lip reading)
-where possible, get rid of background noise as they can only process 1 sound at a time
how can we help patient decide what they want to do about their hearing?
-encourage them to ask the following questions and use options grid to answer
why is it important to signpost and encourage patients to use other communication strategies other than technology
-most peoples strategies are ineffective or nonspecific which can reduce the quality of their interactions and can increase social anxiety and withdrawal from social settings
-signposting and encouraging other communication strategies can help minimise such difficulties and help patients communicate more effective
what are the barriers to developing new communication strategies?
-people don’t want to step out their comfort zone, no chnage, don’t wanna learn
-the discomfort zone can have uncertainty and require learning
-people are scared to e in their panic zone where they freeze up, don’t change and don’t learn
what is the stages of change model?
- The Stages of Change model provides a framework, which helps in understanding how people change when faced with a health issue
- It was developed as an integrative model of change drawing on a range of theoretical schools
- It suggests there are distinct stages that people go through to change behaviour
Individuals can remain at one stage or another for a long time but will work their way through them - Our role is to identify the patient’s stage and support them through the process of change
how do we enhance effective communication?
-lip shapes
-gestures
-hearing
-body language
-topic/ subject
-facial expression
-putting 2+2 together
-intelligent guesswork
what are the rules to social interactions?
- So we tacitly agree to share interests – at least for as long as we talking together
- We select what to talk about, and try to be relevant in our content
- We try to provide the right amount of information, dependent on the situation
- We don’t hog the conversation but take turns
- Both of us would expect the conversation to be mutually beneficial – so building our social capital
why might hearing impaired people risk breaking the rules of conversation?
They might miss important cues and :
- interrupt or introduce topics unexpectedly
- disrupt turn taking in conversation and need frequent clarification of the conversation
- People may modify how they speak to them so the conversation becomes superficial because it is too difficult to convey information
what are hearing impaired people advised to do?
- Tell people they have a hearing impairment
- Ask the topic of conversation
- Use hearing tactics
- Stop the speaker as soon as they have missed something
- Write things down
- Keep relaxed!
how do our senses help us communicate in difficult listening situations?
-lip reading (speechreading skill develops early in babies and younger people are better at it than older
-gestures
-facial expressions
-visual cues
-body lanaguage
-situational cues
why do people with hearing loss need to use lip reading skills systematically?
- because the SNR (signal to noise ratio) needs to be improved by 1dB for every 10dB of hearing loss
how many dB can lipreading increase the SNR (signal to noise ratio by)
Lip-reading can increase SNR by about 6dB
how is effective lip reading carried out?
Effective lip readers use context, guesswork, and flexibility of interpretation of the signal to improve communication
what is the percentage of speech that is not visible?
It needs to be remembered that 60% of speech is not visible
what limits the help provided by lip reading?
-the clarity and speed of the speaker’s speech;
-number of speakers;
-visibility of speaker etc
why are we not able to lip read every letter?
Many parts of speech give particular shapes to the lips, but not everything can be seen - such as ‘k’ or ‘g’ or ‘…ing’, and nothing can be seen of ‘h‘
why is lip reading challenging?
most people recognise less than 20% of the words they see
-Some speech sounds look the same – ‘b’, ‘m’ and ‘p’, ‘buy my pie’ – will look in fact look the same. These are known as homophenes as they look alike on the lips bur are pronounced differently.
So if you say pat, bat, mat for example without using your voice they will look the same on the mouth.
- For this reason, lip readers may substitute one word or phrase because they guess at what they have misheard
