CD444- Test 1
CD444- Test 1 CD 444
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This 10 page Study Guide was uploaded by Leah Larabee on Tuesday January 27, 2015. The Study Guide belongs to CD 444 at University of Alabama - Tuscaloosa taught by Dr. Brooks in Spring2015. Since its upload, it has received 257 views. For similar materials see Aural Rehabilitation in Language at University of Alabama - Tuscaloosa.
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Date Created: 01/27/15
Aural Rehabilitation Test 1 Terminology Aural rehabilitation intervention for individuals with hearing loss Prelingual before language was acquired Postlingual after language was acquired Congenital present at birth Audition hearing Auditory perception interpretation of auditory signal at brain leverl Auditory skills listening skills requires combo of audition and auditory perception Amplification hearing aid Auditoryverbal communication based on verbal speech and language Sign language use of hand symbol to represent words Finger spelling use of a symbol to represent alphabet Manual communication the use of signs and finger spelling Total communication use of manual communication and speech Speech reading use of body language gestures and lip reading to aid communication Hearing Impaired Population person with any type or degree of hearing loss Hard of hearing person with sufficient residual hearing often through use of hearing aids to use audition as primary channel for communication 0 Speech is not always normal equate it to mechanical sounds o Speechlanguage intervention is often necessary 0 HOH individual might function as deaf without early identification consistent use of amplification and appropriate intervention 0 Benefit from visual ques Deaf person with hearing impairment so severe that audition is not primary channel for communication 0 Might have some intelligible speech but often use signs as primary mode of communication 0 Usually benefit from hearing aids but aided signal is limited and often inadequate for audition to be primary channel for communication 0 Often candidates for cochlear implant Hearing loss vs Hearing handicap Hearing loss Type degree configuration symmetry of hearing loss Prevents individual from hearing specific sounds Intervention is medical method to HL or use of amplification Type 0 Conductive I Middle ear temporary I Loss ofloudness I Refer client to physician for medical treatment 0 Sensorineural I Inner ear permanent I Loss of loudness clearness I Fit client with hearing aid or refer for cochlear implant 0 Hearing handicap o Psychosocial disadvantages of hearing loss 0 Based on person s ability to function in everyday life I Learn in typical educational environment PI OblemS I Communicate from these Establish relationships results 1n HH Integrate into family I Work I Take advantage of normal activities such as use telephone or go to movie I Beindependent Intervention o Amplification 0 Communication skills training 0 Educationalvocational opportunities Hearing aids vs Cochlear implants 0 Hearing aids 0 Work by providing an amplified signal to inner hair cells 0 Amplification is to stimulate residual hair cells to compensate for damaged hair cells 0 Works well for hard of hearing clients or individuals who have significant residual hair cells mild to moderatelysevere losses 0 Cochlear implants surgical procedure 0 Bypass damaged hair cells in inner ear and stimulate intact auditory nerve 0 Works better than hearing aids for individuals with negligible residual hair cells usually persons with severe to profound hearing loss 0 Recommended for individuals who do not receive significant benefit from hearing aids Average human hearing g g De Fee 0f Hearin L055 0 Minimal 20 25dB Frequency range is 2020000 Hz Mild 2540dB Intensity range is 10 dB through 140 dB Moderate 4055d13 o 120dB typical threshold for discomfort Moderately Severe 5 570d13 o 50 dB is conversation Severe 7090d13 O 30 dB is Whisper Profound 90dB and above 0 80 dB is shouting o 0 dB is average normal hearing 0 10 dB is better than average normal hearing Audibility of Speech Sounds Phonemes vary in frequency and intensity 0 Have various amounts of acoustic energy or different loudness I quotawquot is the most intense phoneme I Voiceless th is the least intense phoneme 0 Hearing must be present in frequency region where sound occurs 0 Speech sound must be loud intense enough for audibility Audibility of phonemes is affected by listening environments Vowels generally Consonants generally Have more energy 0 Have less intensity Lower in frequency 0 Higher in frequency Contribute to rhythm and speech 0 Are necessary for intelligibility of Contributes more audibility of speech rather speech than intelligibility 0 Allow speech sounds to be crisp Contain peaks of energy called formants different from each other Contribute most to meaning of speech Goal of Aural Rehabilitation 0 Can be voiced or voiceless Provide maximum access to auditory signal Intervention Maximize auditory perception train the brain 0 Brain must learn what sound means 0 Enhance auditory closure skills 0 Better if postlingual Retrain brain to focus on important sounds and tune out ones not needed Acoustics Speech Perception and Hearing Loss Terminology Signal sound the listener should listen to Noise any unwanted auditory signal Signalnoise ratio relationship of intensity level of signal relative to noise Reverberation echo prolongation of sound as it re ects off hard surfaces Factors that in uence listening environment Signal to noise ratio 0 SNR speech is louder than noise 0 SNR noise is louder than speech 0 Classroom SNR I Normal hearing 10dB I HI need minimum of 15dB I Most have a negative SNR 10dB ZOdB I Solution use sound absorbing materials Reverberation 0 When sound is transmitted some is absorbed and some is re ected 0 Re ection is reverberation or echo caused by sound re ection 0 Causes speech to be distorted high ceilings I Increasing absorption decreases reverberation carpet small room I Use sound absorbing materials Distance between listener and speaker o Intensity decreases as the listener moves further from sound source I HOH hear best no more than 23 feet away from speaker I More severe HL best no more than 8 12 inch away I Preferential seating helps with loss of intensity EHDI Early Hearing Detection and Intervention Incidence of Hearing Loss Pediatric HL 12000 babies a year have HL Only 50 of babies that fail receive follow up US Dept of Education est 40006000 babies acquire late onset HL by 3 years age 89 of Deaf or Hard of Hearing come from multilingual homes High Risk Register Established by Joint Committee on Infant Hearing 0 Infection 0 Low birth weight 0 Genetic disorder 0 Craniofacial abnormalities HHR will miss late onset and progressive loss 0 Meningitis H in uenza bacterial 0 Some neurological disorders Genetic Hereditary HL 1993 7 known genes to cause 2002 more than 50 known genes 2010 over 1000 0 Genetic does not need parent carrier I Gene more likely to be prone to NIHL o Hereditary carry gene by 1 or both parents Syndormic VS Nonsyndromic 70 of genetic HL is nonsyndromic 0 most but not all are recessive gene 30 of genetic HL is syndromic 0 HL occurs in conjunction with other Atypical symptoms 0 Over 200 syndromes are associated with HL Newborn Screening Joint Committee ICIH recommends OAE first test ABR on babies who fail OAE 0 Before newborn screening 25 was average age of identification EHDI Process 1 Newborn hearing screening a OAE 2 Reevaluation a ABR 3 Confirmation of HL by 3 months a Using ABR or Behavioral testing i Visual reinforcement audiometry or play audiometry 4 Fit HA by 6 months 5 Cochlear implant if indicated by 1218 months a Activation is 24 weeks postsurgery Auditory Processing Skills learning to listen Incidental learning naturally learning Learning through exposure and experience 0 Bombarding with words to stimulate Social routines Events that occur in natural environments as part of normal routine 0 Eating bathing dressing playing listening to surroundings Babies Learn Best in natural environment through repetition and routine Development of Auditory Skills Critical period is birth through 3 years Infants learn basic sounds of language by 6 months of age and dialectical differences Developmental Sequence of Auditory Skills Birth to 1 month Auditory response 0 Re exive responses Deaf baby will not 39 Startle make comfort sounds 39 Au1 0palpeb1 al eye bllnk Will not hear mother 0 Eye w1den1ng in stomach 0 Stop sucking Vocal Production 0 Cry 0 Comfort sounds 24 months Deaf baby will not receive aud Feedback from cooing Auditory response 0 Aware of sound 0 Rudimentary searching head turn begins 0 Distinguish familiar from not angry from friendly Vocal Production 0 Cooing M Auditory response 0 Head turn to search for sound Deaf baby babb ng o Responds to voices environmental sounds and does not emerge toys Vocalization might stop 0 Smlles 1n response to sound Vocal Production 0 Cooing becomes babbling 0 Speech sounds intonation incorporated into babbling 812 months Auditory responses Deaf baby jargon 0 Good at localization absent 0 Recognize familiar voices 39 Obtains information 0 Understand speech is communication Visual 0 Understand voice is to get attention 39 DOGSn39t understand Vocal production speech is communication 0 Iargon is abundant and varied 0 First words emerge Hearing Aids Purpose Amplify frequencies where HL occurs provides intensity Ideally 0 Make soft sounds audible 0 Make average sounds comfortable 0 Make loud sound tolerable Dynamic Range of Hearing Recruitment reduced tolerance for loudness Dynamic range of hearing range of hearing between threshold and discomfort level range of usable hearing Normal dynamic range 0 120dB threshold 0 0120dB is dynamic range Reduced dynamic range 0 105dB threshold 0 55105dB is dynamic range Components of HA Input signal Microphone picks up signal and converts from acoustic to electric Amplifier signal is amplified Receiver converts signal back to acoustic energy Output output signal is delivered into ear canal Levels of Hearing Instrument Technology Digital microchip based technology 2006 96 0 Multiple memories and more sophisticated 0 Can be manipulated with remote controls Analog traditional transistorized electronic circuits no longer commonly used Types of HA Behind the Ear 0 Traditional with earmold o Earmold is custom made for individuals I Must be replaced periodically I Baby outgrows every 6 weeks 0 Most powerful and can fit anyone 0 Mostly children 0 Lowest repair rate and longest life expectancy I Slim tube technology is beginning to be used instead of mold I Less occlusion effect In the Ear 0 Full shell the largest of in the ear aids o All components fit in the shell which is in the concha and ear canal 0 Higher repair rate In the Canal 0 Fills the opening of the ear canal 0 Medium sized Completely in the Canal 0 Fills the ear canal and fits deeper o The smallest o No earear wireless connection Binaural fitting Is considered best practice unless 0 Physical complications prevent use of aid on both ears 0 Ear difference makes aiding one ear preferable 0 Want both ears to be stimulated Auditory Deprivation If you don t use it you loose it Can lead to dementia because it impacts cogitative functioning Cochlear Implants Stimulates undamaged fibers of CN VIII auditory nerve o Stimulates fibers and bypasses the damaged hair cells Electrode is threaded through cochlea and stimulates nerve Parts of Cochlear Implant Behind the Ear or Body Worn Magnetic disk receiver 0 Imbedded in temporal bone behind the ear and attached to the electrode that is threaded through the cochlea Small transmitter attaches to temporal bone 0 Held in place by magnet o Mic picks up signal and sends to transmitter Speech processor mini computer 0 Worn behind the ear or at the waist o Attaches to transmitter by cord 0 Converts it to electrical impulses MIC a Processore Transmittere Receivere Electrode Arraye Nerve Fibers Candidacy for Cochlear Implant Residual hearing in implanted ear might be lost Cochlea has to be adequate for insertion of electrode Worst ear implanted do it in the ear that has least to loose M3 1 Audiological assessment 2 Trial period with HA 3 Psychologicalsocial assessment 4 CT scan or MRI to determine if cochlea is adequate Binaural implants are usually done one ear at a time Brain stem implants are being done for individuals who do not have an intact auditory nerve Deaf culture does not approve BAHA Bone Anchored HA Get due to malformations of outer ear or ear canal Unilateral HL Chronic middle ear problems 0 Typically covered by insurance Procedure Small titanium fixture is surgically implanted in temporal bone behind ear And abutment much like a snap is attached through skin Sound processor is attached to abutment Listening Systems Terminology FM frequency modulation radio frequency band set aside by FCC for devices used by HI Infrared signal delivered by infrared light beam Direct audio input signal delivered directly to HA by earphone cord Tcoil HA circuitry option that picks up only electromagnetically signal 0 Ex telephone Why use a Listening System To reduce loss of intensity over distance To improve signaltonoise ratio 0 It needs to be written in the IEP and schools should provide a listening system but not HA Can be freestanding or connect to the aidimplant Components Microphone Transmitter Receiver 0 The signal is transmitted depends on type of system m Most used for personal devices Most expensive but best option 0 Teacher wears mic and it is directly sent to the receiver Boot System It attaches to personal HA Need two boots Requires wearing everyday Made specifically for type of HA Contained Personal System BTE HA and FM system all in one Must be programmed for specific HL More expensive Kept at school Desktop System Speaker sits on students desk Can be taken from class to class Good with Milder HL 0 People that don t need HA Infrared Most used for classroom room amplification 0 Receiver can be speakers or headphones Sound Field Room Systems Used for classroom amplification Benefits every child in class 0 Also children who have ADD learning problems or English as second language Important that people have 360 degree amplification and not one direction 0 Best for MildModerate HL or Unilateral Personal System with Earphones Student listens through earphones Best for Mild or uctuating HL and Unilateral HL 0 Used when amplification is not needed but good signalnoiseratio is important ADD Assistive Listening Devices Alerting devices 0 Alarm clock smoke alarm doorbell baby monitor 0 Usually a ash of light or vibrator Telephone devices 0 Amplified and speaker phones are good option for HI 0 TTY teletype I Used by most deaf people 0 Public telephones are federally required to be HA compatible TV and media amplifiers 0 Infrared TV amplifier 0 TV ears infrared device 0 Cut battery life of HA by a lot Computer technology 0 Bluetooth technology is becoming HA compatible with device Eli
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