Speech Path & Hearing Imp Child Final

Normal hearing range

-10-15

Slight hearing loss range

16-25

mild hearing loss range

26-40

moderate hearing loss range

41-55

moderately severe hearing loss range

56-70

severe hearing loss range

71-90

profound hearing loss range

91 and up

What is the normal hearing range for children?

-10-15 dB HL

What is the normal hearing range for adults?

-10-20 dB HL

Borderline normal hearing can be up to ____

25 dB HL

What is the soft conversational level?

35-45 dB HL

What is the normal conversational level?

55-65 dB HL

What is the loud conversational level?

75 dB HL and greater

minimal/slight degree of hearing loss 16 dB HL to 25 dB HL and its impact on speech

not hearing endings of words

mild degree of hearing loss 26 dB HL to 40 dB HL and its impact on speech

can miss 25% to 40% of a speech signal

• difficulty in reading skills

moderate degree of hearing loss 41 dB HL to 55 dB HL and its impact on speech

can miss up to 80% of average-level conversational speech

• flat speech

moderately severe degree of hearing loss 56 dB HL to 70 dB HL and its impact on speech

miss 100% of average conversational speech

severe/profound degree of hearing loss and its impact on speech

can miss 100% of ALL speech

What is a high-frequency sensorineural hearing loss?

greater loss in higher frequencies than in lower

What is a noise-notch hearing loss?

high-frequency hearing loss that is classically associated with an individual who has been exposed to high-intensity noise

What is a “cookie-bite” pattern of hearing loss?

a midfrequency sensorineural loss

• HL in 1000-3000 Hz range

What is a reverse curve pattern of hearing loss?

a hearing loss in lower frequencies

What is a progressive hearing loss?

loss of hearing over a period of time

What is a conductive hearing loss?

a hearing loss where air conduction is abnormal and bone conduction is normal

• presence of an air-bone gap

• result of damage to outer/middle ear

What is a sensorineural hearing loss?

hearing loss where both air conduction and bone conduction are abnormal

• no air-bone gap

• damage to inner ear/auditory nerve

What is a common characteristic of a sensorineural hearing loss?

ability to hear in lower frequencies better than higher

What is a mixed hearing loss?

a combination of conductive and sensorineural components

• there is an air-bone gap, but both are abnormal

What is speech audiometry?

measures and qualifies a person’s ability to recognize and understand the content of a speech signal

speech reception threshold (SRT)

repeating of specific words with accuracy

Digital ear level devices do things like

• noise suppression

• frequency shifting

• feedback control

What characterizes the behind-the-ear (BTE) style hearing aid?

it utilizes an earmold coupled to the body of the hearing aid or receiver in the canal

• usually for profound hearing losses

• processing of acoustic sound occurs in the body of the hearing aid and sits behind the ear

behind the ear style hearing aids are most appropriate for

• children

• those with neuropathy

• long time users of BTE

What is in an in the ear (ITE) and completely in the canal (CIC) style hearing aid?

programming nestled inside the ear canal portion of the hearing aid

• usually for mild to moderate degrees of hearing loss due to size constraints

• processing sound occurs in the receiver in the earpiece

In the ear and completely in the canal style hearing aids are most appropriate for

adults

The placing of earmolds is important because it

• reduces feedback

• optimizes sound transduction

• provides proper retention

completely in the canal hearing aid

picture in the canal style hearing aid

In the ear style hearing aid

full shell ITE style hearing aid

Half shell ITE style hearing aid

In the canal style hearing aid

What are some hearing aid accessories?

• direct audio input cables

• FM boot

• connectivity device

these are important to connect devices at home or school

What are bone-conduction hearing aids?

• headband style

• bone anchored

bone conduction hearing devices are used for

• single sided deafness

• conductive hearing losses

Cochlear implants are used for patients who do not benefit from traditional forms of hearing aids.

true

FM systems are an assistive technology

true

FM systems

• can be for classroom use

allows all people to benefit from a boost in signal or directly to students through microphones

What are a few assistive technologies

• closed captions

• TV amplification systems

• induction loops in large meeting spaces

  • theatres conference halls

Hearing assistive technology includes a variety of devices that help an individual with or without hearing loss communicate more effectively in adverse listening situations

true

Assistive listening devices are prescribed by

audiologist

what is the purpose of assistive listening devices?

to improve signal to noise ratio

Assistive listening devices

a unit with a limited amount of volume that is used for individuals with auditory attention difficulties within the classroom

Auditory training device

a unit designed to train an impaired auditory system

FM systems are used to

transmit a speaker’s voice or a specific sound DIRECTLY to an individual

DM system works similarly to an FM system but

the audio signals are digitized and packaged in very short bursts of code and broadcast several times

frequency transmission for FM device is regulated by the

Federal Communication Commission

FM/DM devices are beneficial when

educational settings are noisy

• extraneous talking

• AC and heat running

• student/teacher movement

FM/DM systems aid in diminishing the effects of background noise

true

FM/DM systems couple directly to the ear via earphones, induction loop, or earbuds or through a HA or CI

true

A “tabletop” listening device provides amplification

in close proximity to the listener

• can easily move with student

What is a personal ear-level assistive listening device?

looks similar to a hearing aid

• may be used for someone with a slight HL that doesn’t use aids

What is an induction loop device?

it loops around the neck when a person has telecoil circuitry options in their hearing aids

Portable sound field devices (speakers) are designed to increase signal-to-noise ratio throughout a single room.

true

Portable sound field devices benefit all listeners as they distribute sound throughout the room.

true

What is remote hearing technology?

hearing amplification devices that are often bluetooth compatible and allow the user to connect to other bluetooth devices

Closed captioning and telecommunication devices for the deaf are supportive technologies.

true

In a school system, what is the role of an SLP for a child with hearing impairments?

• check devices

• troubleshoot issues

• work with manufacturer

In school or private therapy, what is the role of an SLP for a child with hearing impairments?

to work towards age-appropriate self-advocacy in the classroom

• devices working

• ensuring usage of devices

• build skills to communicate

The audiogram

provides a scaled graphic description of a person’s hearing perceptibility

What are the components of an audiogram?

Frequency (pitch)

• measure in Hz

Intensity (loudness)

• measured in HL

Air conduction tests the entire system such as the outer, middle, and inner ear.

true

What transducers are used to test air conduction?

• headphones

• insert earphones

• soundfield testing

Bonce conduction only tests the inner and neural parts of the system.

true

What type of transducer is used to test bone conduction?

an oscillator placed on mastoid process

When testing masked bone conduction what transducers are used?

oscillator, insert earphones, or headphones

What is a ski slope type of hearing loss?

characterized by a rapid decrease in threshold response after 250-500 HZ

What is speech detection/awareness threshold (SDT)?

when a patient indicates the detection of a words at barely audible level

What is word discrimination testing?

this tests the understandability above SDT

• an assessment of clarification

Tympanometry is not a hearing test, cannot tell us whether a person has normal or impaired hearing.

true

What does tympanometry test?

how the conductive mechanism (middle ear) is physically functioning

• ear canal volume/ TM mobility

What is otoacoustic emissions used for?

an indirect measure of hearing

• elicits brief stimulation to the cochlea

• cannot rule out mild HL

What is auditory brainstem response?

where there is an auditory response to an electronic stimulation

• most commonly used at newborn screening

pure tone audiometry

determines the loudness threshold in dB HL at which a person begins to hear sound

Otoscopy includes procedures like

• choosing the speculum

• positioning otoscope

• positioning pinna

What does an otoscopy monitor?

the external health of the ear

Is it within the practice of an audiologist or SLP to diagnose otitis media?

no

The middle ear test battery

• evaluates the physical properties of the ear

• rules out inner/outer ear pathologies that may contribute to hearing loss

Acoustic reflexes

involuntary muscle contraction in the middle ear cavity

Speech audiometry tests the person’s ability to detect and understand speech signals.

true

After air conduction testing, if a loss is present, what should happen?

further testing must be completed to determine conductive and sensorineural pathology

• air conduction cannot localize site of damage

Behavioral observation audiometry

• 6-7 months

• responses are reflexive like blinks, startles

Visual reinforcement audiometry

• 6-7 months

• based on child’s natural instinct to turn for an interesting sound when it is heard

• child gets rewarded

conditioned play audiometry

• 2.5 - 5 years of age

• make audiometry into a game

What is the purpose of audiology screening?

to identify those who need further testing

After a visual inspection/otoscopy, you should make note of any obvious signs of abnormality or concern.

true

you do not reach conclusions you just refer

After pure tone screening, when results are received you can

• retest and refer

After an otoacoustic screening what recommendations should be made?

• immediate referral for any failures or any concerns

Otoacoustic emissions (indirect form of hearing sensitivity)

a sound is sent into the ear and in response, the ear produces a sound and sends it back

• evoked responses from cochlea

The presence of otoacoustic emissions does not mean normal hearing sensitivity.

true

ABR should never be used in isolation to identify hearing loss.

true