SLP 332 - Aural Rehabilitation

aural rehabilitation

services that help a person with hearing loss restore, improve, or adapt their listening, speech, and communication skills after hearing loss has occurred

aural habilitation

services that help a person with hearing loss develop listening, speech, and communication skills that they have not yet learned

International Classification of Functioning, Disability & Health (ICF)

classification system that provides a biopsychosocial framework for describing consequences of health conditions

conductive hearing loss

• obstruction or damage in the outer or middle ear that causes hearing loss

• (AC = bad) (BC = normal) (air-bone gap present)

sensorineural hearing loss

• damage to the inner ear or auditory pathway that causes hearing loss

• (AC = bad) (BC = bad) (air-bone gap absent)

mixed hearing loss

• damage to the outer, middle, and inner ear (conductive + sensorineural)

• (AC = very bad) (BC = bad) (air-bone gap present)

outer ear

pinna, ear canal, and eardum

middle ear

ossicles (malleus, incus, stapes), eustachian tube, oval window

inner ear

cochlea, vestibule, semicircular canals, organ of corti, auditory nerve (CN VIII)

aid conduction

• sounds played through headphones/ear inserts traveling through ear

• (ear → eardrum → middle ear → inner ear → cochlea → brain)

bone conduction

• a vibrating device is placed on the mastoid bone (skull)

• (skill vibration → cochlea → brain)

air-bone gap

the difference between air conduction and bone conduction thresholds at the same frequency

auditory processing

how the brain receives, interprets, and makes sense of sounds

audiometer

screening device used for an auditory processing assessment

interaural attenuation

loss of sound energy while traveling from test ear to non-test ear (dB)

auditory masking

adding noise to the ear that is not being tested

acoustic reflex

tympanic muscles help with acoustic reflex; protect inner ear from acoustic trauma (reducing range of ossicle movement)

acoustic immittance

how the middle ear responds to sound energy

behavioral testing

• hearing tests that require the person to actively respond

• ex. pure-tone audiometry and speech audiometry

non-behavioral testing

• hearing tests that don’t require the person to actively respond

• measure automatic physiological responses from the ear or brain

• ex. tympanometry, otoacoustic emissions, auditory brainstem response

tympanometry

measures how the eardrum moves as air pressure changes in the ear canal

auditory brainstem response

auditory nerve function and the brain’s response to sound

otoacoustic emissions

soft sounds produced by the inner ear (by outer hair cells in cochlea)

auditory evoked potentials

electrical signals generated by the auditory pathway in response to sound (amplitude + latency)

pure-tone audiometry

a behavioral diagnostic hearing test that determines type, degree, and configuration of hearing loss

speech audiometry

a behavioral hearing test that measures speech perception and recognition

speech detection threshold (SDT)

lowest level (dB) an individual can detect the presence of speech

speech recognition threshold (SRT)

lowest level (dB) an individual can detect + understand speech

spondee words

words with two syllables (equal emphasis on each syllable)

battery approach (audiological evaluation)

is the use of multiple hearing tests to assess hearing and diagnose the type and degree of hearing loss (behavioral + nonbehavioral tests)

conventional hearing aids

small electronic devices worn in or behind the ear that amplify sounds

cochlear implants

surgically implanted devices that bypass damaged parts of the inner ear and directly stimulate the hearing nerve to help a person hear

middle ear implant

a device placed in the middle ear that helps transmit sound more directly to the inner ear

bone-anchored hearing aids (BAHA)

a hearing device that sends sound through the skull bone directly to the inner ear instead of the ear canal

telecoil

a small coil inside a hearing aid that picks up sound directly from compatible phones or loop systems

bimodal stimulation

using a hearing aid in one ear and a cochlear implant in the other ear to improve hearing, especially speech understanding and sound quality

FM system

a wireless listening system that sends a speaker's voice directly to a hearing aid or cochlear implant; helps reduce background noise

neuroplasticity

the brain's ability to adapt its structure and function in response to experience, learning, injury, or changes in hearing

auditory training

therapy that improves listening and speech understanding by teaching the brain to better process sound through practice

auditory skill progression

detection → discrimination → identification → comprehension

bottom-up focus

analytic; focusing on small segments (phonemes or syllables)

top-down focus

synthetic; focusing on recognition and overall meaning

analytic → synthetic continuum

a range of auditory training activities that progresses from identifying individual speech sounds (analytic) to understanding sentences and conversation (synthetic)

lipreading

the process of recognizing speech using only the visual speech signal and other visual cues, such as facial expression

speechreading

the process of recognizing speech using both auditory and visual cues

mcgurk effect

a perceptual illusion where conflicting visual and auditory speech cues cause your brain to hear a completely different sound

communication strategies

facilitative strategies that focus on environmental control, speaker modifications, and message tailoring to aid communication

adaptive strategy

a communication strategy that helps a person with hearing loss effectively manage communication challenges and improve understanding (ex. using visual cues, reducing background noise, or asking for repetition).

maladaptive strategy

a communication behavior that may reduce communication success or negatively affect adjustment to hearing loss (ex. avoiding social situations or pretending to understand when information was missed).

anticipatory strategy

a planned strategy used before a communication situation occurs to prevent or reduce difficulties (ex. sitting near the speaker, informing others about hearing needs, or choosing a quiet environment).

repair strategy

a strategy used during or after a communication breakdown to restore understanding (ex. asking to repeat, rephrase, or provide clarification).

early intervention

services provided as early as possible to help a child develop communication, language, learning, and social skills

bilingual-bicultural approach

an approach that uses ASL and spoken + written language while teaching and valuing both hearing cultures

total communication

an approach that uses all available methods of communication, such as sign language, speech, lip-reading, and writing, to support a deaf or hard-of-hearing student

cued speech

a communication system that uses visual speech patterns to help make spoken language sounds easier to understand