CSD 425 Midterm

To obtain reliable estimates of hearing thresholds, play audiometry and visual reinforcement audiometry use __________________ to make children and infants more likely to respond.

conditioning (positive reinforcement)

Audiometry is always performed with the patient wearing headphones.

False

In which of the following situations is masking recommended

When an asymmetry on hearing sensitivity between the ears is suspected

Pure tone air conduction audiometry reveals the site of damage along the auditory pathway (i.e., inner ear, middle ear etc.).

False

________ conduction stimulates the cochlea directly by vibrating the skull.

Bone

A 15-20dB threshold (or below) is typically considered to reflect normal hearing

True

Children with "slight" or "minimal" hearing loss that DO NOT receive amplification... (Mark all that apply)

May have difficulties hearing the endings of words

May have academic difficulties

May have difficulties understanding speech in noise

Tend to experience listening fatigue

When air conduction thresholds are outside of the normal range but the bone conduction thresholds are completely within normal limits the patient is likely experiencing ____________________

Conductive Hearing Loss

Sensorineural hearing loss occurs as a result of damage to the...(Mark all that apply)

Cochlea

Auditory Nerve

Which among the following devices amplifies sound and provides the amplified sound to its wearer's ear canal?

Hearing aid

Which among the following is not a part of a typical hearing aid?

Electrode array

Behind-the-ear (BTE) hearing aids have most of the components housed in a small case that fits the pinna and are the most prevalent hearing aid style nowadays.

True

In adults, cochlear implants are ONLY recommended for adults with unaided hearing thresholds > 80dB

False

Bone Anchored Hearing Aids (BAHAs) (a.k.a., bone conduction transducers) work best for _______________________ hearing loss.

Conductive

Which among the following devices does not typically require any surgical procedures?

Hearing aids

Cochlear implants directly stimulate the ___________________ using electrical current.

auditory nerve

Except for some exceptions, the FDA has approved cochlear implantation in children...

>12 months of age

The ability to localize sounds is impaired in individuals with cochlear implants

True

Cochlear implants are recommended for patients with _______________________ hearing loss

Sensorineural

Which of the following tests will most likely be abnormal in cochlear hearing loss? Choose all that apply.

Otoacoustic emissions, audiometry, auditory brainstem response

You perform audiometry on a patient and find the following thresholds:

500 Hz: 45 dB HL

1000 Hz: 50 dB HL

2000 Hz: 65 dB HL

PTA? Severity?

53.3, moderate

What is the primary perceptual complication associated with sensorineural hearing loss that is not present in conductive hearing loss?

Loss of frequency selectivity

Damage to which part of the ear would not cause a conductive hearing loss?

Outer hair cells

Which of the following hearing devices would be most adequate for a child with atresia (occluded ear canal)

BAHA

The Speech Reception Threshold (SRT) in Noise is always related to performance on the pure-tone audiogram (PTA)

False

A 9-month-old baby is referred to your clinic with a suspicion of hearing loss. Which among the following tests would you perform on this baby? (Choose all that apply.)

OAE, VRA

Speech Audiometry is used clinically to validate the results fom the pure-tone audiometry

True

One advantage of the Words in Noise (WIN) test when testing SPIN skills is that it uses monosyllabic words instead of sentences. This limits the influence of cognitive and linguistic factors when completing the task, allowing us to test directly auditory function or bottom-up processing.

True

Which of the following tests allows us to test directly the effects of semantic context on the patients ability to understand speech in noise?

Revised Speech Perception in Noise (R-SPIN)

Visual Reinforcement Audiometry hinges on the assumption that (choose all that apply):

- children can be conditioned to provide reliable response to sound

- children will turn their head toward the sound source

Which among the following causes of hearing loss would be considered congenital?

Genetic

Which parts of the auditory system the ABR does NOT evaluate directly? (mark all that apply)

Middle ear, auditory cortex

The most effective cochlear implants are those with higher number of electrodes

False

Imagine you're designing an experimental task for a research study to test Speech Perception in Noise (SPIN) skills in adults with hearing loss. You aim to evaluate which real-world listening conditions are most challenging for your participants keeping the speech-to-noise ratio constant (e.g., +3 dB). You plan to test the effects of the type of noise (energetic vs. multi-talker babble), the type of sentence (high vs. low predictability), and the masker location (co-located vs. spatially separated). Given these variables, which condition would you expect to be the most challenging for your participants?

Type of noise: Multi-talker babble, Type of sentence: Low predictability, Masker location: Co-located

Based upon the American Speech-Language-Hearing Association's position statement on evidence-based practice in communication disorders, the term evidence-based practice refers to an approach in which current, ____ evidence is integrated with _____, and ____ and values into the making of clinical decisions.

Research evidence, practitioner expertise, client preferences

The viewpoint of the family has always been included in evidence based practice clinical decisions

False

Which of the following is NOT recommended by ASHA when making clinical practice evidence based?

Rely only on the information taught in graduate school classes when treating patients

It is easy for a school speech language pathologist to implement evidence based practices for each student.

False

Which of the following is NOT a reason why evidence based practice (EBP) is important for the field of communication of sciences and disorders?

EBP allows for a a clear division between clinical practice and research

What was the most common reported barrier for evidence based practice for speech language pathologist, as reported by the participants of the study?

Lack of time

Considering what your learned about neuroplasticity, it can be stated that the purpose of hearing technology is to get auditory input to the brain.

True

It is highly unlikely that hearing loss would affect the organization of a newborn's brain

False

What's NOT true about the primary auditory cortex

It is visible from the surface of the brain

The secondary auditory cortex.... (mark all that apply)

- Projects to higher-order cortical areas

- Is involved in forming auditory objects

- Projects back to the primary auditory cortex via efferent connections

- Plays an important role in speech understanding

The connectome model suggests that the brain's wiring is established during ___ through ___.

The first years of life, stimulus-driven

Which of the following processes are characteristic of neural development (mark all that apply)

Synaptic pruning, arborization, synaptogenesis

In the presence of auditory deprivation, primary and secondary auditory cortices get "decoupled", leaving the secondary auditory cortex available for processing information from other senses (e.g., vision). This is know as cross-modal reorganization.

True

Sharma and colleagues provided evidence to support that critical periods of auditory and spoken language development could potentially be established at ________ years of age

3

When would you recommend a family to provide amplification (hearing aids, cochlear implants etc.) to their child with congenital hearing loss (assuming they want the child to develop spoken language)

As early as possible

The presence of hearing loss at birth means that the auditory brains of these children have not benefited from pre-natal auditory experiences. As result, it is crucial to: (mark all that apply)

- Detect hearing loss early

- Provide intervention as early as possible

In the utero, a baby with typical hearing is able to...

Listen to mother's voice

On average, at what age does a child with typical hearing start to respond to his own name?

5 months

On average, at what age, do children with typical hearing start producing sounds that have sound-meaning relationships?

10-16 months

Children with hearing loss, even minimal hearing loss, are at risk of not achieving all the essential auditory skills for language development

True

Early Hearing Detection and Intervention (EHDI) programs state that detection of hearing loss should be provided by 1 month of age, hearing loss diagnosis/confirmation by 3 months of age, and intervention by _______months of age

6

At least 50% of children with hearing loss have parents that also suffer some sort of hearing loss

False

The framework for auditory skill development states that the four levels of skills are: (mark all that apply)

- Detection

- Identification

- Comprehension

- Discrimination

Children with hearing loss tend to have more difficulties accessing __________frequency sounds

high

Which of the following are important factors to consider when optimizing auditory environments for children with hearing loss (mark all that apply)

- Providing access to quantity and quality language

- Reducing background noise

To ensure that all children with disabilities receive special education and related services schools must implement ___ plans while early intervention providers must implement ___.

IEP, IFSP

Which part of IDEA states that all children with disabilities must receive early intervention services?

Part C

According to the hierarchy of auditory skills, the most complex auditory skill is:

Comprehension

Kevin is 36 months old. He received bilateral cochlear implants at age 16 months. What's Kevin's listening age?

20 months

The evidence-based principles state that to provide high-quality services SLPs and audiologists should integrate the following into their clinical practice [mark all that apply]

Clinical experience, patient values, best scientific evidence

In the presence of auditory deprivation, cortical "decoupling" takes place between...

The primary auditory cortex and the secondary auditory cortex

Lack of axon myelination leads to...(mark all that apply)

Synaptic pruning and apoptosis

Strategies to maximize cultural competency include (mark all that apply)

Practicing cultural humility, using a cultural broker, increasing cultural awareness

The scientific community deals with limitations of the scientific method by relying on (mark all that apply)

Replication of results, Continuous revision of the evidence (aggregate of research-based evidence), peer review

The brain maintains experience-dependent plasticity properties into adulthood

True

Critical periods for auditory and spoken language development refer to the fact that _____ , and are typically established around ____.

Beyond that period, if no auditory stimulation is received, the development of auditory and language skills is highly unlikely, 7 years of age

Data-driven research leads to a deeper understanding of the data than hypothesis-driven research

False

Which regions of the auditory brain/pathway receive input from other sensory areas of the brain....(mark all that apply)

Inferior colliculus, secondary auditory cortex, higher-order auditory areas of the cortex

Strong results from a single study are generally sufficient to support a new intervention

False

Audibility is defined as the degree to which a sound is...

audible

Auditory-oral communication approaches/systems include...(mark all that apply)

- Auditory-verbal methods

- Traditional oral methods

- Cued speech

Children using oral communication approaches seem to acquire spoken language at an age-appropriate pace when...(mark all that apply)

- No additional disabilities are present

- Amplification devices are used consistently

- Early intervention is provided

- Effective amplification is obtained at an early age

- Parents are highly committed to the therapy

Children raised in sign language environments acquire sign language skills at much the same pace and in much the same sequence as hearing children acquire spoken language skills

True

There is enough scientific evidence to support that all children will develop age-appropriate spoken language if they are enrolled in auditory-verbal therapy

False

Cued speech differs from total communication in that while cued speech uses manual information to provide cues about speech ___, total communication uses any form of manual information to provide visual support to spoken language.

Phonemes

Communication approaches/systems that allow some sort of visual input include...(mark all that apply)

- Sign language

- Bilingual / bicultural methods

- Total communication

There is strong evidence to support that using any form of manual approach/system is detrimental to children's speech and spoken language development

False

The bilingual/bicultural language approach assumes that sign language will be the child's ___ method of communication, while spoken language will be the ___ method of communication.

Primary, secondary

The main difference between auditory-verbal methods and traditional oral methods relies on the fact that....

Auditory-verbal methods limit access to visual input (e.g., lipreading)

Regardless of the communication approach/system used, children with hearing loss are at risk of poor literacy and academic outcomes

True

Enriched home communication environments promote activities/dynamics that are likely to stimulate language and vocabulary for children with hearing loss

True

The family environment affects language outcomes of children with hearing loss

True

Which of the following could be a drawback of Newborn Hearing Screening as currently conducted

Hospital personnel with a minimum of audiological information and perhaps limited counseling skills provide parents screening results

When providing early intervention services to children with hearing loss, working one-on-one with the child during therapy sessions allows you to focus 100% on the child's needs. This is more effective than having parents join the sessions. They tend to distract the child which does not allow you to optimize your time.

False

Which of the following factors are critical to obtaining strong outcomes in children with hearing loss (mark all that apply)

Using the best technology, working closely with parents

Childhood hearing loss interferes with spoken language development, as well as any language-mediated skill including...(mark all that apply)

Social skills, emotional skills, neurocognitive skills

Research clearly shows that exposing the child to sign language prior to cochlear implantation is detrimental to spoken language development

False

What type of language seems to be more characteristic of caregivers with children with hearing loss than in those with children with normal hearing

Use of directive utterances

Select three characteristics of the natural approach in auditory intervention

- Goals are established based on the child's listening age

- Spoken language is taught through audition

- Use of motherese

The communication approach used to disambiguate lip reading by using different handshapes close to the speaker's mouth is called:

Cued speech

When making decisions about the communication approach that will be used with a child with hearing loss...

Caregivers decide the approach based on unbiased information provided by professionals

Family system theory assumes that the family is a dynamic system in which the child is at the center

True

The communication approach that incorporates multiple modalities (e.g. ASL, manually coded English, signing exact English - SEE, finger spelling, lip reading, nonverbal cues, amplification) is called:

Total communication

We can use speech therapy sessions to inform the audiologist about hearing aid and cochlear implant performance/programming

True

Research has shown that parental involvement and self-efficacy are negatively associated with children's language outcomes

False

The LENA system is a recording device that allows the therapist to collect information about...(mark all that apply; please assume that you use the commercial LENA software)

- Child vocalizations

- Amount of adult words

- Conversational turns