Test 1 Flashcards
(128 cards)
1
Q
What is Aural Rehab?
A
A rehab service that
- Identifies HL
- Manages medical issues
- Gives technological support
- Develops auditory skills
- Gives counseling to patient and family
2
Q
What is a Rehabilitation Service?
A
A service the provides the most appropriate technological and medical support and helps build skill level to improve function.
3
Q
What are the goals of Aural Rehab?
A
To alleviate HL difficulties and minimize consequence, to enhance conversational fluency, and promote personal adjustment
4
Q
*How many people suffer from hearing loss?
A
31 million
5
Q
What is the range of loss in which an individual would be considered to have a hearing impairment?
A
26dB - 70dB
6
Q
What range of loss puts an individual in the deaf category?
A
70+ dB hearing loss
7
Q
What is an Audiogram?
A
A graph representing hearing thresholds as a function of frequency
8
Q
What is a threshold?
A
The level of sound detected 50% of the time
9
Q
What does air conduction test?
A
Outer and Middle Ear
10
Q
How is hearing tested through air conduction?
A
Headphones, Insert Earphones, or a Soundfield (speakers)
11
Q
What does bone conduction test?
A
Inner ear
12
Q
How is bone conduction tested?
A
By placing a vibrator on the forehead or the mastoid
13
Q
What is affected in a conductive hearing loss? How do you know this?
A
The problem lies in the outer and/or middle ear..
I know this because air conduction shows a hearing loss but bone conduction is normal.
14
Q
What is the major feature indicating conductive hearing loss on an audiogram?
A
An air bone gap
15
Q
Where is the problem in a sensorineural hearing loss? How do you know this?
A
Inner ear or Auditory nerve.. I know this because there is no air bone gap yet there are abnormal thresholds for both air and bone conduction.
16
Q
*What does a soundfield used for?
A
To test for hearing loss by Air Conduction
17
Q
What is a mixed hearing loss?
A
Abnormal thresholds for both air and bone conduction but there IS an air bone gap.
18
Q
In a Mixed HL, which test is worse? AC or BC?
A
Air conduction is worse than bone conduction but bone conduction is still below 25dB
19
Q
What does PTA stand for? What does it tell us?
A
PTA is the Pure Tone Avg… It predicts the softest level at which speech can be detected
20
Q
How do you find a 2 tone PTA?
A
You avg. the two best readings between 500Hz, 1K Hz, and 2000 Hz
21
Q
How do you find a 3 tone PTA?
A
Avg. 500Hz, 1KHz, 2KHz together
22
Q
What does Pure Tone Audiometry evaluate? And through what method?
A
Evaluates the degree of hearing loss by air conduction and bone conduction
23
Q
What could effect accurate Pure Tone Audiometry readings?
A
- when it was last calibrated
- experience of the person giving the test
- test environment
- patient state
24
Q
*What is Speech Recognition?
A
Word Discrimination
25
How is speech recognition accomplished?
Lip reading, Auditory info/Listening, or both
26
What does SRT stand for?
Speech Recognition Threshold
27
How is the SRT obtained?
Spondee words
28
*What are spondee words? What are they good for?
2 syllable words with equal stress and same audibility
SPEECH RECOGNITION
i.e. baseball, hotdog, ice cream, football, cowboy
29
Speech Detection vs. Speech Recognition
Speech detection happens at a lower level than Speech recognition... Speech detection in knowing that someone is talking where speech recognition is being able to discriminate the words being said
30
*List stimuli
```
Nonsense bisyllables (phonemes)
Monosyllable words
Bisyllabic words
Spondee words
Phrases
Sentences
```
31
*What are the levels of hearing loss? What are their ranges?
```
Mild: 25-45dB
Moderate: 45-60dB
Moderate-Severe: 60-75dB
Severe: 75-90dB
Profound: 90+dB
```
32
*What range is most speech located in? What frequencies?
20dB-50dB
| 1K-3K Hz
33
*If a person has a 40dB hearing loss, how much speech do they miss?
50-75%
34
What is a bilateral HL?
HL in both ears
35
What is a unilateral HL?
HL in only one ear
36
What type of condition is HL considered?
HL is an INVISIBLE condition... but the effects are not
37
What are the three onsets of HL?
Prelingual
Interlingual
Postlingual
38
When can Post lingual onset of HL begin?
Age 5
39
*What powers hearing aids?
A battery (cell)
40
*True or False: All hearing aids run on batteries.
True
41
H*ow many parts does a hearing aid have? What are they?
Four: Microphone, Amplifier, Receiver/Speaker, Power Source
42
*What are the parts of the microphone?
Diaphragm
| Metal back plate
43
*Explain the microphone.
It picks up the acoustic signal which moves the diaphragm. This generates a small (electrical) voltage between the diaphragm and the back metal plate which is passed along to the amplifier.
44
*What is the purpose of the Amplifier?
Amplifies the sound based on the degree of HL.
45
What is gain?
Gain is the amount of amplification applied to the signal.
46
What are the two types of amplification?
Analog Aid
| Digital Aid
47
Analog Aid vs. Digital Aid
AA: signal stays in analog electrical waveform
DA: A/D converter changes the analog electrical signal to 1's and 0's for sound processing and then converts it back to analog
48
What does A/D converter stand for?
Analog to Digital converter
49
*What is the receiver's job?
To receive the signal from the amplifier and convert the electrical signal back to an acoustic signal
50
*What is the receiver essentially?
A mini loudspeaker
51
*Name the features of a hearing aid.
On/Off switch
Volume control
Telecoil
Audio input
52
What is a telecoil? What does it do?
An inductive coil..It picks up the phone signal and amplifies it
53
What does audio input allow for?
Connection between the aid and a TV, Computer, or FM station
54
*What is the role of the earmold?
To connect the aid to the ear
55
*Name the different styles of hearing aids.
```
Body Aid
Behind the Ear
In the Ear
In the Canal
Completely in the Canal
```
56
Explain the body aid
The mic, amp and battery are all located in a "box" which attaches to a cord connected to the receiver which connects to the earmold
57
What is the BTE aid?
Behind the Ear aid: fits over the ear/ behind the pinna and connected to the aid with a short, clear tube in the earmold.
58
What is the ITE aid?
In the Ear aid: all components of the aid fit in the ear.
59
What is the ITC aid?
In the Canal aid: everything fits in the ear canal
60
What is the CIC aid?
Completely in the Canal aid
61
Which style hearing aid is most common?
The BTE aid
62
What range hearing loss is the BTE aid used for?
Mild to Profound
63
What range hearing loss is the ITE aid used for?
Mild to Severe
64
Why does the range of hearing loss shrink with the smaller aids?
The smaller the aid, the more restrictive and the fewer features available
65
What advantage does a ITE aid have over the BTE aid?
The mic of the ITE aid is closer to the canal opening and uses the pinna for better localization
66
What range of hearing loss do aids work best for?
Mild to Moderate hearing loss
67
What type of hearing loss are cochlear implants used to help?
Moderate-Severe to Profound Sensorineural HL
68
How is a cochlear implant arranged?
Tonotopically
69
How does a cochlear implant work?
Electrodes are inserted into the cochlea and directly stimulate the auditory nerve
70
*Name the external components of a cochlear implant.
Microphone
Speech Processor
External Transmitter
71
*Name the internal components of a cochlear implant.
Receiver
72
What is the job of the microphone in a cochlear implant?
To pick up sound
73
What is the job of the speech processor?
To convert and code acoustic sound into electrical pulses
74
What does the external transmitter do?
Transmits info across the skin to the receiver
75
Describe the job of the receiver.
It is placed under the skin and it's electrode array is inserted into the cochlea
76
What does ALD stand for?
Assisted Listening Device
77
Name some ALDs.
Closed captioning on a TV
Texting
Email
Light flashing for the doorbell
78
*List the four design principles.
Auditory Skill Level
Stimulus Unit
Activity Type
Difficulty Level
79
*List and explain the four steps of Auditory Skill Level.
1) Sound Awareness- easiest/most basic level; the ability to recognize if a sound is present and begin to put meaning with a sound.
2) Sound Discrimination- the ability to tell if two sounds are the same or different
3) Identification- the ability to label and the awareness that objects have names
4) Comprehension- hardest level; the ability to understand the meaning of a spoken message
80
What is the ultimate goal in the Auditory Skill Level design principle?
Comprehension
81
Do you always start with sound awareness?
NO! This varies based on the individual's auditory experience and language at the time of hearing loss
82
Typically, what kind of patient starts with the sound awareness level?
A patient who has severe to profound pre-lingual hearing loss and now has hearing aids or cochlear implant
83
When going through sound discrimination, what sounds do you start with?
Two very different sounds! /a/ and /s/
- >different voicing
- > high vs. low frequency
84
How does the Stimulus Unit design principle work? What are the two types?
All the programs are combined together.. Analytic Activities and Synthetic Training
85
Explain Analytic Activities
These focus on segments of the speech signal.. It is essentially training in isolation.
i.e. phonemes and syllables
86
Explain Synthetic Training
Train to recognize meaning even if you don't recognize every word or sound.
87
What is the Activity Type design principle?
This is the optimal training program because it incorporates both formal and informal training.
88
Explain formal vs. informal training.
Formal training is highly structured, drill type activities in a small group or even 1-on-1. Informal training incorporates daily routine activities.
89
Explain the Difficultly Level design principle.
When an individual reaches 80% correct performance, the difficulty should be raised. If below 50%, the difficulty should be lowered.
90
How many ways are there to change difficulty?
Six
91
List the six ways to change difficulty. Explain them.
1- Stimulus Set: open ended vs. closed (choices)
2- Stimulus Unit: words vs. complete sentences
3- Stimulus Similarity: dissimilar vs. similar
4- Context: highly detailed vs. low/little detail
5- Task: structured vs. spontaneous
6- Alter listening environment: good Signal-to-Noise ratio vs. poor Signal-to-Noise ratio vs. distance
92
What is analytic training used for?
To help those with low auditory skills learn sound awareness and the sound has meaning.. Usually young or new cochlear implant users
93
In analytic training, what sounds should you start with and why?
Start with vowels because they are voiced and solely contrasted by the formants
94
How is formant 1 determined vs. formant 2?
```
1 = how far the mouth is open
2 = tongue position
```
95
When moving on to consonant training, what should one keep in mind?
Start with voiced and nasal sounds- easiest
| Pick consonants that differ in manner and voice and even place
96
What are the most difficult consonants to pick up?
short, high frequency and unvoiced sounds
97
What is cycling?
When you return to an objective previously achieved to refresh, reinforce and give additional learning.
98
What does synthetic training focus on?
Prosodic speech aspects
Learning to discriminate between single words and sentences
Checking comprehension
99
Explain formal auditory training.
```
Stimuli are more challenging
Vary the talkers
More info over a short period of time
combines analytic and synthetic levels
Progress from closed to small open set
```
100
What is a reinforcement?
A quick activity immediately following a correctly finished training activity
101
What is informal training?
Auditory practice occurs in the context of the activity the child is interested in
102
What is Interweaving?
Auditory training with speech therapy and speech reading training.
103
What THREE benefits come with interweaving?
This builds an association between auditory and visual
Links speech perception to speech production Allows the client to feel the difference in production even if they do not hear it.
104
What does Auditory Training affect?
Brain Development
105
What is the purpose of auditory-oral training?
It enhances the speech recognition better than simultaneous communications
106
What degree of hearing loss is auditory-oral training appropriate for?
Mild to Moderate
107
What is simultaneous speech?
Speech with sign language at the same time
108
When is simultaneous speech best?
With a severe to profound hearing loss
109
True or False:
A child with hearing loss progresses through the same stages of hearing and speech development once amplification or implants are given to them.
True
110
What is the difference between an activity limitation and a participation limitation?
Activity= the inability to hear speech and noise
Participation= things you don't do due to hearing loss
111
*What is avoiding restaurants an example of?
Participation limitation
112
Does Aural Rehab always include Speech and Language therapy?
No, it depends on the patient.
113
Hearing aids send what kind of signal?
Acoustic
114
Cochlear implants create what kind of signal?
Electrical
115
Pre-lingual is when?
birth
116
*When can a post lingual hearing deficit begin?
Age 5
117
What years are considered post lingual?
9-10 years
118
What are the three categories of hearing loss?
1- Degree
2- Onset
3- Progression
119
*Envelope means?
Duration
120
*A case study is...
Correlational
121
*What is a correlational case study?
subjects are exposed to a particular treatment and followed over time and compared to unexpected subjects
122
*What is pitch NOT a feature in?
Pitch is not a feature in a consonant phoneme confusion analysis
123
*Was Alexander Graham's wife hearing impaired?
YES
124
*When are cochlear implants implanted?
4-6 weeks after surgery
125
What are the SIX levels of evidence from most credible to least credible?
1- Systematic meta-analysis of more than one randomized control trial
2- Well designed, randomized control trials
3- Well designed control trial without randomization
4- Well designed quasi-experimental studies
5- Well designed non-experimental studies
6- Expert committee report
126
What is EBP?
Evidence Based Practice
127
What should be considered in EBP?
- clinical expertise
- patient values
- current and the best scientific evidence
128
^ What is the purpose of the speech recognition test?
To dictate one's choice of test
