exam 3 Flashcards

Question

presbycusis

Answer 1

global term referring to age-related hearing loss (starts in 50s) - affects 30% of people over 65 and the percent increases with age (sloping, high frequency loss) - speech recognition abilities decline (can hear but not understand) - cause can be neural or metabolic - neural= loss of sensor cells, nerve fibers, neural tissue - metabolic (strial)= loss of blood supply to the cochlea (atrophy of the stria vascularis)

Answer 2

cardiac disease; hearing loss; hypertension; orthopedic problems; caataracts/vision; dementia | see tables for specifics on visual impariment, arthritis, and dementia

Answer 3

- generic term for 70-80 conditions that cause irreversible decline in cognitive function - gradual memory loss, disorientation, decline in ability to perform everyday tasks | (HL is a large risk factor for dementia)

Answer 4

- form of dementia - progressive, degenerative, & irreversible - decline initially in memory - decline in reasoning - unable to recognize family members - loss of language skills - can lead to depression

Answer 5

normal process of aging-> change in perception, memory, thinking skills, and attending abilities - declines in attention, processing, and working memory ## Footnote - attention= difficulty with: - extracting limited info from whole - focusing on info and processing further - distinguishing relevant vs irrelevant information - listening in presence of background noise - processing speed= difficulty: - visual-spatial info - verbal info - fast speech - difficulty if instructed to respond quickly - working memory= difficulty: - holding formation in memory - recalling from short-term memory - recalling parts of complex sentences - understanding ambiguous sentences - word retrieval

Answer 6

1-3 years are most intensive stage for listening - prelingual loss, without intervention, could lead to listening, alnguage, and speech delays and eventually literacy delays

Answer 7

if a patient is on the high-risk registry they should be monitored every 6 month until age 3 (even if they pass)

Answer 8

95% of newborns have hearing screenings before they leave the hospital - EHDI act: early hearing detection and intervention-> legislation that mandates federal funds to state to develop infant hearing screening and intervention programs - supporst full diagnostic evaluation if needed; also provides for enrollment in early intervention | want 0% false negatives

Answer 9

- OAE: inaudible sounds that are by-products of movement of the outer hair cells→ this vibration produces a sound that is measured using a small probe in the ear canal - doesn’t require cooperation of patient; also can be diagnostic when frequency specific - people with normal hearing produce OAEs, those with a loss greater than 30db do not - frequencies important for speech are tested (2,3,4, and 5,000) - if they are normal, up to the outer hair cells is normal

Answer 10

type of auditory evoked potential test; for babies and older children who can't participate in behavioral testing - surface electrodes measure electrophysiological response to acoustic stimulus in 8th cranial nerve and auditory brainstem - child must be still (asleep or sedated) - can be used to determine degree of HL - wave five is most robust and so you look at that one and its latency (its threshold) ## Footnote - a-abr: automated-auditory brainstem response→ compares baby’s abr response to a stored template of expected brain waveform - can either rule out or implicate significant hearing loss

Answer 11

- low birth weight (<3.3 lbs) - family history of HL - in utero infections like cmv, rubella, or herpes (torch) - ototoxic medication - low apgar scores (reflects normalcy or appearance, pulse, grimace, activity, and respiration at time of birth) - need for use of ventilatory for at least 5 days - craniofacial anomalies - physical manifestations consistent with a syndrome - bacterial meningitis - severe jaundice (hyperbilirubinemia), at levels that require an exchange | know 4 of them ## Footnote 1. low birth weight 2. family history 3. in-utero infections 4. ototoxic medication

Answer 12

- hearing screening occurs by 1 month - diagnosis occurs by 3 months - enroll in early intervention programs by 6 months | KNOW THIS WELL

Answer 13

- boa= behavioral/observational audiometry - vra= visual reinforcement audiometry - cpa= conditioned play audiometry

Answer 14

behavioral/observational audiometry: aud presents a stimulus and then observes child's responses - for infants 0-6 months - doesn't test hearing thresholds - responses vary among babies - habituation to sound can be problematic during boa - observe the child's overall response/behavioral change when sounds is presented: change in sucking pattern, eye widening, head turn, cessation of activity ## Footnote moro reflex-> acoustic startle response

Answer 15

visual reinforcement audiometry: providing an acoustic signal and reinforcing a head turn with a light stimulus or activated and illuminated toy reinforcement - 6 mths -- 2 1/2 yrs - uses operant-conditioned responses (a new or modified response to a previously neutral stimulus) - leads to being able to test different frequencies and find the child's thresholds | (held in a sound booth with light up stuff when there’s a sound)

Answer 16

conditioned play audiometry: child is trained to perform a task in response to the presentation of sound (such as stacking blocks/inserting a peg) when a stimulus is played - 2 1/2 yrs -- 5 yrs - parent remains with child (but doesn't provide cues) and aud is in an adjacent room - speech detection thresholds (sdt): level at which speech is just audible - provides a means to cross-check the CPA - you can typically get speech testing at 2 yrs old

Answer 17

prenatal, perinatal, postnatal

Answer 18

- TORCH - intrauterine infections (rubella, cmv, herpes simplex virus) - complication associated with the rh factor - prematurity - diabetes - parental radiation - toxemia - anoxia - syphilis - ototoxic medication ## Footnote 1. prematurity 2. maternal diabetes 3. parental radiation 4. toxemia

Answer 19

- anoxia (prolapse of umbilical cord) - syphilis - rarely-> use of forceps during birth may cause damage ot the cochlea

Answer 20

- meningitis - other infections: measles, mumps, chicken pox, influenza - ototoxic drugs - APD caused by TBI, degenerative diseases, seizures, and brain tumors | 25% of bilateral HL is postnatal ## Footnote 1. meningitis 2. otoxic drugs 3. measles/chicken pox

Answer 21

- recessive: usher syndrome - dominant: brachial-oto-renal syndrome & waardenburg syndrome

Answer 22

prescense of other disabilities can increase probability of lang and speech delays - intellectual disability - visual impairment - learning disabilities - autism - add - emotional and behavioral problems - cerebral palsy - apd - auditory neuropathy | 40% of children have an additional disability in addition to HL

Answer 23

kids with a diagnosis of auditory neuropathy may have: - audiometrically normal hearing or a HL ranging from mild to severe - normal OAEs - absent, negligible, or abnormal ABRs - poor word recognition, poorer than that which would be predicted by their audiologic thresholds what is it? - transmittal through the nervous system is impaired - any degree of HL with pure tone testing, normal OAE, and absent/degraded ABR - can be similar or associated with APD - scientists believe in many cases the cause is impaired inner hair cell functioning - hearing aids are not ehlpful but cochlear implants are - variable prognosis associated with: jaundice, premature birth, family genetics, anoxia at birth

Answer 24

1. to enhance the infant's or toddler's development 2. to minimize the possibility of developmental delay 3. to enhance the family's ability to accommodate the child's needs and promote the child's development (fam centered instead of child bc they are too young)

Answer 25

could lead to listening, language, and speech delays; and eventually literacy delays

Answer 26

free appropriate public education

Answer 27

individuals with disabilities education act

Answer 28

individualized education program | 3 yrs and up

Answer 29

individualized family service plan | birth to 3 yrs

Answer 30

intervention assistance team (a multipdisciplinary group of professionals who work together to provide intervention for a child)

Answer 31

least restrictive environment

Answer 32

supplemental services teacher (interacts with a child's regular teacher to help the child)

Answer 33

early intervention

Answer 34

local educational agency (rep will be at meeting to ensure school is doing everything so there's no lawsuits)

Answer 35

preschool intervention program (preschool children ages 3-5-> small group speech and language instruction to support language development and improvement of articulation skills)

Answer 36

1. identification 2. evaluation 3. IFSP or IEP 4. parents 5. related services 6. least restrictive environment 7. private school 8. early intervention and preschools 9. due process 10. advisory board 11. funds 12. records ## Footnote in each individual persons real life plan each day always feels real 1. all kids have to be identified at all schools 2. prior to placement; must be in primary langugae or mode of communication and have multiple tests -> be comprehensive 3. depends on age 3 or below 4. equal partners-> huge part of plan, their child's advocates 5. slp, psychologist, counselor, interpreter, ot, aud, recreational and physical therapist, social worker) 6. lre 7. if the public school near them doesn't have appropriate services they can go to a private school with services for free 8. ones that will continue to include early intervention 9. often contention in iep-> parents think their child is not getting enough services (big deal if school isn't in compliance); they will try to figure it out at a local level, & have the right to an attorney 10. every state has one: group of individuals with disabilities, teacher, parents 11. tax dollars pay for IDEA (if a school isn't complying, their funding will be pulled and they might have to pay it back) 12. parent can ask for access to their child's records and for them to be amended

Answer 37

- 200,000 eligible infants and toddlers & their families are served; 6 million children receive special education - educating more children in their neighborhood schools - contributing to improvement in rate of high school graduation - post-secondary school enrollment increase - post-school employment increase

Answer 38

federally mandated plan for children up to 3 yrs old - ensures appropriate early-intervention services for infants and toddlers and their families - has legally required components including a service coordinator (they schedule/organize services)

Answer 39

- child's current level of development - family's resources, concerns, priorities - goals - services necessary for achieving the goals - time course (start date, duration of service) - plan for transitioning to preschool

Answer 40

- ASL - MCE - aural/oral communication - cued speech - total communication ## Footnote decide on communication mode -> appropriate amplification -> initiating early intervention services of auditory training and parent support

Answer 41

manual system of communication with different grammar than spoken english (fingerspelling if a sign doesn't exist or to clarify) - bilingual/bicultural mode --1st language sign, 2nd language english (or national language) [good option] - challenge is that parents don't know sign -> deaf mentors can help

Answer 42

manually coded english: signs correspond to english words and follow english syntax rules - can speak english simultaneously with signs - aka signed exact english or pidgin signed english

Answer 43

oral approach, same language used by persons with normal hearing - speech and speechreading: - multisensory approach= use vision and hearing and touch (orton gillingham) - unisensory (auditory-verbal)= use residual hearing only (lsl= listening & spoken language)

Answer 44

uses phonemically based hand gestures to supplement/enhance speechreading (talker speaks while cuing the message) - individually, the hand signals are uninterpretable; they are used to distinguish viseme members (used internationally) - not super common (cue kids)

Answer 45

child uses every available means to receive a message-> including sign, residual hearing, and speechreading - (aka simultaneous communication)

Answer 46

direct therapy model & coaching model

Answer 47

- speech/hearing professional gives therapy to child directly (works with child) - good for working on very specific targeted things ## Footnote does not carry over to home like the coaching model so the kid is only getting the therapy time with the clinician

Answer 48

- speech/hearing professional coaches the parent on how to incorporate the activities into daily activities - parents need to know how to help their child so the kids can get more time a week

Answer 49

IEP= written statement eveloped by a team for children who have a disability - includes their current function and strengths and weaknesses for each of 4 categories - academic; social development; physical developemnt; classroom needs - and SMART goals for each category ## Footnote topics typically included in an IEP: 1. statement of present level of performance 2. statement of annual goals 3. short-term instructional objectives 4. special education and related services to be provided 5. extent of participation in the regular educational program 6. projected date for services to begin 7. anticipated duration of services 8. appropriate criteria to determine if objectives are achieved 9. evaluation procedure to determine if objectives are achieved 10. schedules for review 11. assessment information 12. placement justification statement (especially if they aren’t in the regular classroom) 13. a statement of how special education services are tied to the regular education program

Answer 50

a team made of all professionals providing expertise related to the specific child's need - LEA rep: local educational agency rep (maybe principal)--> want to make sure everything is being follwoed and avoid a lawsuit - teacher - parents/guardians (be sensitive to their stress) - may also include--> child, and advocate requested by parents, psychologist, counselor - for speech/language/hearing needs--> SLP and/or AUD

Answer 51

each professional provides--> a different perspective of the child's abilities and needs ; service in their area of expertise ; contribution to the assessment, intervention, and mangagement of the child's needs - audiologist - slp - educator - psychologist - other roles

Answer 52

- assess HL - select, fit, and maintain devices - communication strategies - ALDs-> fit, maintain, teach everyone working with child how to use them - classroom modification - overseeing hearing screenings (if anyone is caught we do diagnostic test-> if 1st time refer to ENT as needed) - testing for APD (only AUD can diagnose this) - often this person is the educational audiologist ## Footnote 1. assess hl, 2. select/fit/maintain hearing devices 3. communication strategies

Answer 53

- auditory training - pre-literacy skills - liason between school parents - provide asl - ling 6 (everytime you meet) - visual inspection and listening check of amplification devices - advise AUDs about appropriate language levels for tests - communication strategies - ALDs-> select, maintain, teach everyone working with child how to use them - collaborate in APD assessment - hearing screening ## Footnote 1. auditory training 2. pre-literacy skills 3. hearing screening

Answer 54

- inclusion - learn about devices and ALDs - modify curriculum - managing behavior - ling 6 - liaison between child, family and school district ## Footnote 1. managing behavior 2. modify curriculum 3. learn about hearing devices and ALDs

Answer 55

- counseling-> express feelings; coping skills; facilitate positive interactions with other classmates - assessments (intelligence, social/emotional functioning, problem solving, attention, behavior) - might be the school sounselor - as the child gets older they can help with post secondary activities (employment, living) | help after highschool until 22nd birthday ## Footnote 1. counseling (feelings, coping) 2. assessments 3. post-secondary activities

Answer 56

- interpreter (if the child signs and the teacher doesn't) - itinerant teacher (contracted with lots of schools and provides 1 on 1 instruction--push in vs pull out model)

Answer 57

- self-contained classrooms - resource room - mainstream cclassrooms (partial selective, co-enrollement, inclusion)

Answer 58

attend self-contained for part of the school day and mainstreams for some subjects (ie art and pe)

Answer 59

usually occurs when a kid is about to transition from a self-contained class to a mainstream or from a school for kids with HL to one for kids without ## Footnote during final semester in self-contained classroom, the kid may spend 1 day a week in the general ed setting

Answer 60

child participates in all aspects of the classroom (it adapts to them)

Answer 61

classroom is conducted by 2 teachers -> regular classroom teacher and one of kids with HL

Answer 62

six isolated phonemes to target low, middle, and high frequency sounds and silence (to tell if the kid is guessing or not)--> ah, oo, ee, sh, s, m - familiar speech sounds that broadly represent speech spectrum from 250--8000 hz (makes sure they can hear all the sounds of speech) have to do it before teaching as and slp or teacher so you know their device is working and they can hear - it tests awareness, discrimination, and identification (not comprehension) | required by IDEA part B

Answer 63

each public agency must ensure that hearing aids worn in school by chidren with hearing impairment including deafness, are functioning properly - the job of anybody who is working with the child (they have to know how to troubleshoot and know the device is working) - there can be a checklist to make sure the ling 6 happens before school day or any intervention/teaching

Answer 64

about 50-60 dB

Answer 65

background noise, distance, & reverberation - add rugs, turn fan off, close door, acoustic tiles, FM system

Answer 66

- minimum speech level for child with HL is 6 dB SNR - ASHA's standard (the goal) is 15 dB or more SNR

Answer 67

- have difficulties listening in noise or reverberations - have reduced speech recognition of quiet speech - benefit from amplification - benefit from developing an IEP (if don't qualify get a 504) - benefit from FM system - undergo speech language evaluation to determine need for AR | 15% of kids in the US are affected

Answer 68

hearing aids - historically reasearch shows specific patterns fo speech acquisiton for kids who are hard of hearing - children with HA and children with cochlear implants ahve different speech acquisition styles cochlear implants - speech acquired at a faster rate - improved vowel production and increased repertoire - consonant acquisition good - acquisition of fricatives and affricates slower - production of visual consonants beter than palatals, velars, and glottals

Answer 69

1. regulate their speech breathing and how to flex and extend their tongue (vowel counds) - less words per breath, moving jaw instead of tongue to make vowel sounds 2. differentiation and timing of articulatory movements - quick/slow --- p versus w 3. they learn the phonemes of their language community (imitation) 4. informs children about the consequences of their articulatory gestures and how they compare to sounds produced by other talkers - loud p sounds etc 5. self-correction -> see went vs she went

Answer 70

articulation of segmental sounds suprasegmental effects

Answer 71

vowels - neurtralization & nasalization - substitutions and diphthongization - prolongations consonants - voiced/voiceless confusions - substitutions, ommissions, and distortions - consonant cluster errors - visible consonants produced better | - lots better with CI (70-90% intelligible)

Answer 72

- better with most prosody things with CI (timing and loudness) - fewer words per breath cycle - excessive force on plosives - equal stress on all syllables - speech sounds staccato or arrhythmic - slower speaking rate 70 wpm (compared to 164) - distinctive vocal quality (may sound strained, hoarse, harsh, strident, nasalized or denasalized, breathy)

Answer 73

- overuse nouns - rarely use adverbs, pronouns, and prepostition - omit function words - rarely use or omit morphemes that mark plurality, possession, or tense - poor understanding of various sentence structures | with CI more of a normal progression just delayed

Answer 74

- limited vocabulary --> simplistic - difficulty identifying synonyms, antonyms, and idioms - understanding of words limited to single context - learn more concrete than abstract words | increased vocab development with CI

Answer 75

- incorrect language use - inappropriate asking of questions - lack of initiation skills - absence of communication breakdown repair - poor turn taking | affected with ci and ha

Answer 76

- they don't get enough practice using language - often have fewer communication partners (so they learn less through communicating with people) - can't overhear conversations as well (less incidental learning) - lack of instruction of rules of communicating

Answer 77

- restricted language system - word decoding is affected due to lack of phonological awareness - deficits in experience and world knowledge

Answer 78

- today with early identification and modern HA's, lag behind 2 yrs (historically avr HS students tapered off at 3-4th grade reading level) - 35--65% of students read at grade level (both ha and ci users)

Answer 79

- syntactic errors: omission of articles--incorrect pronouns use--omission of bound morphemes - rare use of synonyms, antonyms, and metaphors - difficulty writing narratives with beginning, middle, and end

Answer 80

- engagement - interactive reading - teaching techniques - literacy strategies | LITE

Answer 81

- positive feedback - read/comment with emotional language and intonation - expend effort to ENGAGE the child - maintain close proximity - monitoring child's comprehension

Answer 82

- child holds book and turns pages - respond to child's remarks about book - let child take the lead - allow child to process the content

Answer 83

- relate content to previous experiences - elaborate on child's remarks about the book - define new vocabulary - ask "what do you think will happen next"

Answer 84

- point to and label pictures - ask questions about the book - point to words, letters, and sentences

exam 3 Flashcards

(112 cards)