Aural Study Guide 1

What is aural rehabilitation

helps people hear better and restores lost function (the ability to hear) and hearing loss that happened in later life

What is aural habilitation

develops a skill that was not present (learning how to hear) and hearing loss is congenital or pre-lingual onset

what is the incidence of infant permanent severe hearing loss

1-3/ 1000 births

what is the incidence of infant moderate hearing loss

4-6 / 1000 births

What is the incidence of infant permanent hearing loss in the NICU

8/1000 births

What is the incidence of infant permanent hearing loss in well-baby nurseries

1/1000 births

What are the causes of hearing loss

• Age

• genetics

• noise exposure

• ototoxic medications

What are the functional impacts of hearing loss

• difficulty hearing

• trouble understanding speech

• difficulty communicating

• difficulty hearing alerting tones-

What are the educational & occupational impacts of hearing loss

• Lack of access within the classroom

• higher unemployment rate

• lower wages

• feelings of incompetency

What are the physical impacts of hearing loss

• Falls

• cognitive decline / dementia

• increased healthcare costs

• unintentional injuries

What are the psychosocial impacts of hearing loss

• depression

• anxiety

• social isolation

• lower self esteem

What is on the x-axis of an audiogram

frequency in hertz

What is on the y axis of an audiogram

hearing level in decibels (dB)

What color represents the right ear

red

What color represents the left ear

blue

What are the degrees of hearing for normal hearing? 

-10 to 20 dB HL

What are the degrees of hearing for mild hearing loss?

21 to 40 dB HL 

What are the degrees of hearing for moderate hearing loss?

41 to 60 dB HL

What are the degrees of hearing for moderately-severe hearing loss?

61 to 70 dB HL

What are the degrees of hearing for severe hearing loss?

71 to 90 dB HL

What are the degrees of hearing for profound hearing loss?

91 to 120 dB HL

What is the speech banana?

A visual representation that contains most of the sound elements of spoken speech

What is a threshold?

The lowest level at which a response to sound occurs in 50% of presented ascending trials

What is normal hearing for adults?

0 to 20 dB HL

What is normal hearing for children (age 0-18 years old)?

0 to 15 dB HL

What are the three things that describe hearing loss?

• Degree

• configuration

• type

What is configuration of an audiogram?

Is classified in accordance with the shape of air conduction thresholds across tested frequencies

What determines configuration?

Air conduction

What is flat configuration? 

Thresholds are relatively equal across all frequencies, usually within a range of 20 dB across all frequencies, it looks like a flat line 

What is a sloping configuration

Thresholds decline as frequency increases, slope typically exceeds 20 dB difference between low and high frequencies, it looks like a slope

What is a precipitously sloping configuration?

Thresholds decline by 25 dB (or more) in between at least one octave, it looks like a sharp slope, a precipitous slope must drop 25 db or more between octaves

What is an octave?

A doubled frequency

What is an interoctave?

A frequency in between an octave

What is reverse slope/ rising configuration?

Thresholds increase as frequency increases, more hearing loss in low frequencies, slope typically exceeds 20 dB difference between low and high frequencies

What is a cookie bite / trough configuration?

Thresholds decline and then rise approaching high frequencies, more hearing loss in middle frequencies, there must be several middle frequencies with more hearing loss than low or high frequencies, it looks like a smile

What is a notch configuration?

Sharp decline at one frequency, with an improvement at an adjacent frequency, notches are usually in high frequencies, it looks like a “v”

What does type of hearing loss mean? 

Types of hearing loss are classified depending on where along the auditory system the dysfunction occurs

How is the type of hearing loss determined? 

Compare the bone conduction and air conduction thresholds

What is conductive hearing loss

Caused by a problem in the outer and/ or middle ear

What is sensorineural hearing loss?

Caused by a problem in the inner ear

What is sensory loss? 

Caused by a problem in the cochlea

What is neural loss?

Caused by a problem in the auditory nerve

What is mixed hearing loss?

Caused by a combination of problems in both the outer/ middle ear and the inner ear

What is an air-bone gap?

Air-bone gap is noted when AC and BC thresholds differ by greater than 10  dB HL (or greater than or equal to 15 dB HL)

How is the air-bone gap determined?

Determined by evaluating the difference between AC and BC thresholds

When is sensorineural hearing loss reported?

When thresholds fall in within the ‘hearing loss’ range and there is no significant difference between AC and BC thresholds

When is conductive hearing loss reported?

When there is a clinically significant air-bond gap. Usually, BC thresholds are in the normal hearing range, but AC thresholds are in the hearing loss range

When is mixed hearing loss reported?

When AC thresholds in the hearing loss range, a clinically significant air-bone gap is present. BC thresholds are in hearing loss range

What is unilateral hearing loss

1 ear has hearing loss and 1 ear has normal hearing

What is bilateral hearing loss?

2 ears have hearing loss

What is symmetrical hearing loss

Both ears have the same degree of hearing loss within 10 dB

What is asymmetrical hearing loss

2 ears have hearing loss that differ 15 dB or more across several frequencies

What determines the degree

Air conduction

What determines the type

Bone conduction

What determines the symmetry?

Air conduction

What determines lateralness?

Air conduction 

What is speech recognition threshold

The minimum hearing level for speech at which an individual can recognize 50% of spondee words

What is the purpose of an SRT?

To access reliability of pure tone results, used as a reference point for presentation of words for other speech testing, testing children or others when pure tone testing cannot be completed 

What is speech detection threshold (SDT)/ speech awareness threshold (SAT)?

The minimum hearing level for speech at which an individual can just discern the presence of speech material 50% of the time

What is the purpose of SDT/SAT?

Can be used when a speech recognition thresholds cannot be obtained

What is Word Recognition Testing (WRT) / Word Recognition Score (WRS)?

Word repetition ability assessed at comfortable levels above the persons SRT

What should be considered during WRT/WRS?

Consider entire audiogram and audibility for all sounds at the presentation level, Consider conversational level 

What is the purpose of WRT/WRS?

Helps to determine what counseling and aural rehabilitation is needed for the patient

What is the result of a WRS of 90-100 %

Excellent

What is the result of a WRS of 80 to 89 %

Good

What is the result of a WRS of 70-79%

Average

What is the result of a WRS of 0-69%

Poor 

What is a decibel (dB) ?

Measurement of the intensity of a sound

What is the softest sound?

0 dB

What dB is 10 times greater than 0 dB

10 dB

What dB is 100 times greater than 0 dB?

20 dB

When there is a 3 dB increase what happens to sound energy?

Sound energy is doubled

What is dBA

Average weighting and is common measurement for noise

What does dBA average

dB’s across 20 hertz to 20 kHz

What is LAeq?

Long term equivalent average, slow sample, meaningful if over 60 second, average dB for your recording 

What is LAmax?

Slow average over one second, time weighted, more representative of potential damage or hazard

What is LCpeak?

The loudest it ever gets, peak dB, impulse sounds (milliseconds)

What is TWA?

Time weighted average, the most likely level you would experience in this environment on an 8 hours shift of work

What happens if you’ve had too much noise?

Tinnitus, temporary threshold shift, permanent hearing loss

What can you do to prevent permanent hearing loss?

Turn down the volume, limit your noise exposure, use a sound level meter app, move away from the sound source, wear earplugs 

When does the outer ear begin to develop?

5 weeks gestational age

What does the outer ear develop out of?

Hillocks of His

When does the cochlea structure form?

By 15 weeks gestational age  

When is the cochlea structure functional

By 20 weeks gestational age