Hearing

Question 1

overall goal of aural rehab

Answer 1

to alleviate difficulties related to hearing loss, minimize its consequences

Question 2

Degree of HL

Answer 2

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

Question 3

speech discrimination scores

Answer 3

• 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

Question 4

speech recognition threshold (SRT)

Answer 4

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

Question 5

effects of HI on conversation

Answer 5

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

—Tye-Murray

Question 6

2 types of comm strategies

Answer 6

1. facilitative — anticipate/manage enviornment, self, partner
2. repair – recover from a breakdown after it occurs

Question 7

environment oriented strategies

Answer 7

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

Question 8

pt oriented strategies

Answer 8

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

Question 9

partner oriented strategies

Answer 9

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

Question 10

receptive repair strategies

Answer 10

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 ___?

Question 11

expressive repair strategies

Answer 11

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

Question 12

encourage ______ type of conversation style

Answer 12

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

Question 13

WATCH

Answer 13

-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

Question 14

ALDs for the home

Answer 14

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

Question 15

Counseling with pt with HL

Answer 15

• 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

Question 16

range of conversational speech

Answer 16

• 20-50 db HL

- 250-6000 Hz`

Question 17

noise induced hearing loss

Answer 17

• 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

Question 18

functional hearing impairments assessments

Answer 18

• HHIA
• hearing handicap inventory for adults
• also have HHIA0SO.. for significant others

Question 19

communicative strategies therapy

Answer 19

• 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

Question 20

Auditory Training

Answer 20

• 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

Question 21

speech reading

Answer 21

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

Question 22

Hearing Aids

Answer 22

• 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