Aural Rehab Final

copy of Felicia's cards

What are the parts and purposes of an air-conduction hearing aid?

Amplify sound before it reaches the middle ear.

Microphone

Picks up acoustic sound.

Amplifier

Increases volume and shapes the sound.

Receiver:

 Converts amplified signal back into acoustic sound sent into ear.

Bte meaning

behind the ear

Earmold/tubing

Directs sound into ear canal (BTE devices) and provides retention.

CROS

• Microphone on the unaidable/deaf ear, receiver on the better ear.

BiCROS:

• Microphone on both ears, but receiver sends all signals to the better but impaired ear.

What are the components of a cochlear implant? External:

 Speech processor, transmitter coil, external magnet.

What are the components of a cochlear implant? Internal

: Internal magnet/coil, stimulator, electrode array in the cochlea.

Air-Conduction HA

Acoustic → electrical → amplified acoustic → ear canal → middle ear → cochlea.

Bone-Conduction HA:

Vibrations → skull bone → cochlea directly (bypasses outer/middle ear).

Cochlear Implant:

Acoustic → electrical coding → electrodes stimulate auditory nerve directly.

Verification:

Objective measure (e.g., real ear measures) to ensure device meets prescriptive targets.

Validation:

• Functional benefit—parent/child/pt report, questionnaires, aided performance.

How do you describe pure tone audiogram findings?

 Identify degree (mild → profound), type (conductive, sensorineural, mixed), and ear (right/left).

Who is a candidate for AC HA, BC HA, or CI?

AC HA: Mild–severe SNHL or mixed HL with manageable air-bone gap.

Who is a candidate for AC HA, BC HA, or CI?

BC HA: Conductive HL, microtia/atresia, chronic drainage, SSD (depending on device).

Who is a candidate for AC HA, BC HA, or CI?

CI: Severe–profound SNHL unaided benefit limited; SSD CI (improved localization, speech in noise).

Can you connect an aided speechmap to access to linguistic input?

Yes. Aided speech-map shows whether amplified speech (soft/average/loud) falls within the person’s audible hearing range (speech banana). If portions of speech fall below threshold, the child lacks access to those sounds.

What are the two main components of a remote microphone (RM) system?

1. Transmitter worn by speaker/teacher.
   

2. Receiver worn by the listener or attached to hearing aids.

How do you calculate signal-to-noise ratio (SNR)?

SNR = Signal Level − Noise Level.
Example: Speech 65 dB, noise 55 dB → SNR = +10 dB.

Advantages of CI over CROS or BC HA for SSD?

• CI provides true binaural hearing,
  
  

• Improved localization,
  
  

• Improved speech-in-noise,
  
  

• Restores input to deaf ear (CROS/BC do not restore hearing).

Classroom supports for a student with SSD

• Preferential seating toward good ear
  
  

• Reduce background noise
  
  

• Visual supports
  
  

• Teacher facing the child
  
  

Frequent comprehension checks

How can classroom spaces be modified to reduce noise?

• Add rugs, curtains, soft materials
  
  

• Tennis balls on chair legs
  
  

• Close doors/windows
  
  

• Seat child away from HVAC/projector

What is the purpose of alerting HAT? Give two examples.

 Purpose: Provide visual/tactile alerts for safety and accessibility.
Examples: Vibrating alarm clock, flashing doorbell, vibrating smoke alarm.

What is CapTel?

A captioned telephone that displays real-time captions while the person speaks and listens.

What is VRS and when is it used?

Video Relay Service: Deaf person signs to an interpreter who voices to the hearing caller; interpreter signs back the hearing person’s response. Used when ASL is primary language.

What is TTY and when is it used?

Text telephone—Deaf person types → relay operator speaks → hearing person speaks → operator types back. Used when text-based communication is preferred or ASL not required.

What is CART and when is it used?

Communication Access Realtime Translation: A captioning system used in classrooms, lectures, meetings for real-time text display.

Constructive Strategies

Modify environment (reduce noise, move closer).

Anticipatory Strategies

Planning ahead (review vocabulary before appointment).

Adaptive Strategies

Emotional/behavioral coping (“deep breaths,” “ask for repetition”).

Repair Strategies

Fix communication breakdown (“Can you repeat the last part?”).

Message-tailoring strategies:

Speaker simplifies or pauses, rephrases.

What is the progression of listening skills?

1. Detection – “Was there a sound?”
   
   

2. Discrimination – “Same or different?”
   
   

3. Identification – “Which sound/word is it?”
   
   

Comprehension – Understanding the message.

 Why is identification more important than detection?

Detection only shows the child heard something. Identification shows access to specific phonemes, including high-frequency sounds (/s/, /ʃ/), which matter for language development.

What is the purpose of auditory training?

To improve speech perception through structured practice using the person’s available auditory input.

Bottom-up:

Focus on acoustic details (phonemes, discrimination, stress).

Top-down:

Use language knowledge, context, vocabulary to understand speech.

What factors influence pediatric outcomes?

• Audibility (aided & unaided)
  
  

• Age at intervention (before 6 months = better outcomes)
  
  

• Parent involvement & quality interactions
  
  

Consistency of device use (≥10 hrs/day)

What is the purpose of validation for children?

Shows the device is providing functional benefit in real-world listening situations.

Quantitative difference:

Child has same order of skill acquisition but slower rate.

Qualitative difference:

Skill is learned differently, not just slower.

Research finding: Phonological awareness

shows a qualitative difference for d/hh children.

For a child with fluctuating hearing loss, what physical changes reduce noise?

Rugs, curtains, soft surfaces, closing doors/windows, reducing hard surfaces.

Where should the child sit?

Near the teacher, away from noise sources (projector, HVAC, hallway).

What should the teacher do to support access?

Face the child, gain attention, check understanding, speak clearly.

What are social determinants of health for D/HH individuals?

• School/education environment
  
  

• Neighborhood noise, safety, resources
  
  

• Economic stability
  
  

• Access to healthcare
  
  

Social inclusion/community support

How do these interact in the ICF model?

Hearing loss (body function) → impacts activity (listening, communication) → impacts participation (school/social life), influenced by environmental and personal factors (family support, technology access).

What is the SLP's role in aural rehab?

• Speech perception training
  
  

• Language therapy
  
  

• Communication strategies
  
  

• Classroom recommendations
  
  

• Working with families/teachers

What is the audiologist’s role?

• Diagnostic hearing evaluations
  
  

• Device fitting/programming
  
  

• Verification/data logging
  
  

• RM system setup
  
  

Auditory access monitoring

Similar

Both support communication, counsel families, collaborate, and address outcomes.

Different

Audiologists manage hearing technology; SLPs manage speech/language and communication.

What are the characteristics of Single-Sided Deafness (SSD)?

Permanent HL, difficulty localizing sound, difficulty hearing in background noise, difficulty hearing from a distance.

What are the characteristics of fluctuating hearing loss?

Hearing varies day to day; some good days and bad days; may have difficulty hearing from far away but not consistent challenges.

What is an IEP?

A legal plan for students who qualify for special education services (e.g., dyslexia). Includes specific services they have qualified for.

What is a 504 plan?

plan for students with medical or attention-related needs who do not necessarily receive special education services (e.g., HL, attention difficulties). Includes accommodations such as remote microphone systems.

What type of hearing aids do young children commonly use and why?

Behind-the-ear (BTE) HAs with earmolds—easy to insert/remove and earmolds can be remade as the child grows.

What hearing aids might adolescents use and why?

RICs—more cosmetically appealing.

What is a limitation of very small devices for children?

May not provide enough power or full technology features to match the child’s HL.

Who can purchase OTC hearing aids?

Adults 18+.

What does bilingual-bicultural mean?

Using ASL to communicate (visual language) while learning to read/write English; belonging to Deaf culture with some access to hearing culture.

What does bimodal-bicultural mean?

Using both spoken language and ASL (two modes) and belonging to Deaf culture with some access to hearing culture.

How does consistent use of amplification affect outcomes?

≥10 hours/day of device use leads to better language outcomes.

What is the purpose of a validation measure?

To show that devices are providing functional benefit and meeting their intended purpose.

What are the Ling 6 sounds?

/a/, /i/, /u/, /m/, “sh”, /s/.

Where are the Ling 6 phonemes placed?

On the speech banana (each occupies a specific frequency range).

“Tea, too; tea – identify the repeated word”—analytic or synthetic?

Analytic (requires phoneme-level discrimination).

“Fill in the blank using sentence context”—analytic or synthetic?

Synthetic (uses language knowledge/context).

Child points to a toy snake when clinician says /s/. What skill is this?

Identification.

Child says “sh” after clinician says “sh.” What skill is this?

Identification.

Child puts a checker in a board after hearing /i/. What skill is this?

Detection.

Child decides whether “oo” vs. “sh” are same/different using buttons. What skill is this?

Discrimination.

Why is identification more important than detection?

Detection only shows that the child heard a sound; identification shows access to specific phonemes and high-frequency cues.