Aural Rehabilitation Exam 1

Approximately what percentage of children born deaf/HH have hearing parents?

95%

Main Areas of Aural (Re)habilitation

Sensory Aids/Hearing Technology: finding the right tech for client

Instruction demonstration and coaching: how to maintain and use tech

Perceptual training: hands on training

Counseling: helping adjust to changes both families and individuals

Atypical hearing can be influenced by what factors?

Age of child

Age of onset

Age when detected

Degree of severity

Type of atypical hearing

Age of child when first introduced to HAs or amplification

Percentage of hearing loss that is sensorineural

90%

Hearing is a ____ event.

brain

Types of tympanograms

Type A = normal

Type B = flat, otitis media

Type C = negative, post-cold

Type As = shallow/stiff

Type Ad = deep/disarticulated

Another word for compliance (tympanometry)

flexibility

What kind of hearing loss can be caused by these:

Boney growth, foreign objects, earwax

Conductive

What kind of hearing loss can be caused by these:

Head trauma, virus/infection, genetic disease

Mixed

What kind of hearing loss can be caused by these:

Loud sound exposure, aging, drugs/medications

Sensorineural

Right ear specific symbols:

circle, triangle, <, [ (red)

Left ear specific symbols:

X, square, >, ] (blue)

Ear unspecified on tympanogram:

S (unmasked sound field) and A (aided sound field)

Speech Recognition Threshold (SRT) and Severity

Minimum hearing level at which an individual can REPEAT two-syllable words 50% of the time the speech is presented.

Excellent or within normal limits = 90 - 100% on whole word scoring

Good or slight difficulty = 78 - 88%

Fair to moderate difficulty = 66 - 76%

Poor or great difficulty = 54 - 64 %

Very poor is < 52%

Speech Awareness Threshold (SAT)

Softest intensity level at which an individual is AWARE and/or can detect the presence of speech, 50% of the time the speech is presented.

Word Recognition Score (WRS)

Uses monosyllabic words to assess one's ability to accurately identify different words presented to each ear at the comfortable listening level.

Speech Banana

A visual representation on an audiogram of the range of frequencies most important for speech sounds.

String Bean

The upper portion of the speech banana, representing the ideal hearing level for a child to hear most speech sounds clearly.

Main components of a hearing aid:

microphone, amplifier, receiver

Types of hearing aid microphones:

Directional - more sensitive to sound in the front of the user

Omnidirectional - respond to sounds from all directions

Automatic directional - switch between modes

Why is early screening and detection important?

Impact a child's development of speech and language, critical developmental years, and finding timely intervention

What are the two methods commonly used to screen babies?

Otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR). OAEs measure the natural response of the inner ear to sounds played through an earbud (PASS or NO-PASS). AABR measures the presence or absence of brainstem response to sound administered through earphones (Tells you more about the degree and specific frequencies)

T/F: The FDA has approved cochlear implants as young as 1 month.

FALSE (9-12 months is usually the youngest)

Cochlear implant components

Internal: implanted in skull

External: Behind the ear or directly on the head (microphone, processor, transmitter, etc)

Adults who benefit from CIs

Those who used aural/oral communication in childhood

Those who used a hearing aid in the to-be-implanted ear up until the time of implantation

Those who experienced a progressive hearing loss

Children who benefit from CIs

12 months of age (Advanced Bionics and MED-EL), with some exception (e.g., meningitis)

Beginning in early 2020, 9 months of age (Cochlear Americas)

Trial period with hearing aids (typically 3 months)

Limited or no benefit from hearing aids

Family seeking LSL

Early Hearing Detection and Intervention (EHDI) program

Every child born with a permanent hearing loss is identified before 3 months of age and provided with timely and appropriate intervention services before 6 months of age.

Every family of an infant with hearing loss receives culturally-competent family support as desired.

Effective newborn hearing screening tracking and data management systems are linked with other relevant public health information systems.

Medical Home

NOT a building. Refers to the partnership with clinical specialists, families, and community resources.

Most common congenital condition?

Hearing loss

T/F: HL is even more common in infants admitted to intensive care units at birth

True

Genes are responsible for approximately ____% of children with hearing loss

50%

Approximately _____ to ______% of babies with genetic hearing loss have a “syndrome” (Down syndrome, Usher syndrome, etc).

20-30%

____is the most common cause of permanent, non genetic atypical hearing.

Cytomegalovirus (CMV) during pregnancy

About ____ in _____ children with HL are born at less than 2,500 grams (about 5 1/2 pounds).

1 in 4

The most common developmental disability to co-occur with hearing loss is ___________ (23%), followed by ________ (10%), ________ (7%), and/or_________ (5%).

Intellectual disability, CP, ASD, vision impairment

Most common cause of nonsyndromic hearing loss

Connexin 26

Highest rates: Caucasians, Ashkenazi Jewish, Japanese

Early onset – either at birth or early childhood

Degree can be variable, even within the same family, and most often loss is bilateral

Syndromes with HL

Alport syndrome

Crouzon's syndrome

Treacher Collins syndrome

Waardenburg syndrome

Jarvell and Lange-Nielsen syndrome

Pendred syndrome

Usher syndrome

CHARGE

______% of babies identified had hearing loss bilaterally

60%

More than half of babies identified at birth with atypical hearing are classified as having what severity of hearing loss? (give range)

slight, mild, moderate, and moderately-severe hearing loss.

Ways to support families

Informational counseling

Personal adjustment counseling

Family/Caregiver Focused

Desired outcomes (discuss)

Communication Approaches Continuum (visual to audiotory)

Sign language

Total communication

Simultaneous communication

Sign-supported speech & language

Cued speech

Auditory oral

Auditory verbal

What do we assess in children who are DHH?

Auditory skills

Receptive/Expressive Language

Articulation

Play

Pragmatics/Social language

Oral Mechanism Screening/assessment

Language Assessments

REEL-4

PLS-5

SKI-HI

MB-CDIs inventory (infants and toddlers)

Auditory Assessments

LittlEARS Questionnaire (ages 0-24 months)

IT-MAIS - Scale

ELF - Early Listening Function

FAPI

Developmental Assessment

Battelle Developmental Inventory Second Edition - BDI

(birth through 7;11)

Progress Monitoring Evaluations

Daily Listening Check/Ling 6 Test

Questionnaires from various manufacturers

CASLLS

Auditory Learning Guide

Auditory Skills Checklist

Chronological age minus the age the child received amplification = ________________

hearing age

Name the hearing aid manufacturers

Phonak

Oticon

Widex

Starkey

ReSound

Signia/Siemens

Name the cochlear implant manufacturers

Advanced Bionics

Cochlear Americas

MED-EL

Oticon Medical (not yet FDA approved in US)