Disability of Hearing loss:

Normal Hearing (-10-15 dB HL):

No disability.

Slight loss (16-25 dB HL):

May not notice hearing loss or may have difficulty with faint or distant speech and hearing in noise.

Mild loss (26-40 dB HL):

Difficulty with faint or distant speech and when listening in noise.

Moderate loss (41-55 dB HL):

Difficulty with all speech, except one-on-one conversations.

Moderately severe loss (56-70 dB HL):

Cannot understand speech at normal conversational level - must be a shout to be understood.

Severe loss (71-90 dB HL):

Cannot understand speech unless shouting level at 1-3' from the ear; may hear some environmental sounds.

Profound loss (91+ dB HL):

May not rely on hearing as the primary mode of communication; may use auditory/visual or manual only.

Unilateral hearing loss

One normal hearing ear and one impaired ear; may have difficulty with faint or distant speech, localizing, and with noise.

Informational Counseling

giving information about hearing loss, educational, does not use clinical language

Rational Acceptance

educate patients on how to manage hearing loss and adapt to changes in communication and daily life.

Emotional Adjustment

works through negative feelings and affect on their lives

Cognitive approach (ellis)

helps change faulty thought process, uses counter questions

behavioral approach (skinner)

changing behavior then mindset will change

Affective Approach (rogers)

provides supportive environment for patient to solve their own problems

Congruence

clinicians acts on themselves, empowering patients

Unconditional positive regard

assume patient knows best & believe them that they have the tools & resources inside themselves

empathetic understanding

just listen & understanding the situation

4 principles of counseling (Kris English)

1. Don’t dominate the talk, listen

2. match emotional comment with emotional response

3. surrender the role of expert= allow patient to talk

4. surrender conversational control to patients

Effective, reflective listening (English)

minimal encouragers (aha, really, mmm, wow!)

paraphrasing

acknowledge feelings

Hearing Disability (4 factors)

1. hearing impairment: how well will they do with hearing aids

2. psychological: good attitude & realistic expectations, acceptance

3. occupation & lifestyle

Components of AR program

• education & counseling

• amplification

• speech reading

• communication strategies

• Assistive listening devices

• Cochlear Implants

Aural Rehab

Any tool, device, or therapy, used to help the hearing impaired overcome & adjust to their hearing disability. For adults/patients who have prior language

Communication Scales

Used for insurance purposes (justifies hearing aids) & Counseling

1. situational: how they feel doing in a specific situation (ex: how well do you hear in a noisy situation)

2. psychosocial: how the patient feels about their hearing loss

3. combination: both aspects of situational & psychosocial

Basic Audiological Evaluation

1. Sweep Screen

2. Air conduction threshold

3. impedance

4. pure tone testing

5. speech testing

6. UCL