COMD Final

Hearing Loss

Deviation or change for the worse in auditory structure or function

Hearing Impairment

Loss that prevents an individual from carrying out activities of daily living, including communication

You can have hearing ____ without hearing __________.

loss, impairment

More than __ _______ Americans over age 12 experience hearing loss.

31 million

___ of the population report a hearing loss.

10%

Almost ____ of adults over 80 report a hearing loss.

half

Sensorineural hearing loss = most common in ______

adults

Sensorineural hearing loss typically affects ____ ___________ more than ___ __________

high frequencies, low frequencies

Sensorineural hearing loss interferes with ability to __________ ______

understand speech

Sensorineural hearing loss = _______/_______ sounding

unclear/muffled

Accompanying Conditions of sensorineural hearing loss

recruitment, tinnitus, signal to noise ration loss

Recruitment

reduced tolerance to loud sounds

Tinnitus

Ringing, roaring, buzzing, or hissing in the ear

Signal to noise ratio loss

Signal (what a person is trying to hear) needs to be louder than noise (background)

Unmanaged hearing loss is associated with:

depression, anger and frustration, paranoia, feeling loss of control, loss of conversational responsiveness

Loss of conversational responsiveness

off topic, interrupt, not responding

Causes hearing loss in adults: onset can be...

sudden (trauma) or gradual (disease)

Causes of sensorineural hearing loss

presbycusis, noise, ototoxic drugs, head trauma, barotrauma, tumor, infection or disease

Causes of conductive hearing loss

cerumen blockage, foreign objects, otitis media, otosclerosis

Assessment of hearing loss should account for:

hearing acuity, type of loss, likely cause, speech perception ability

Hearing Loss testing

behavioral testing (audiometry), objective testing, assessment of functioning

Hearing loss Treatment

comprehensive approach, neural plasticity

Hearing loss comprehensive approach

amplification, aural rehabilitation, counseling

Hearing loss treatment: amplification

hearing aids and assistive devices, cochlear implants

Hearing aids and assistive devices

many types of hearing aids, FM or amplification systems

Cochlear implants

complex issue for adults

Hearing loss treatment: aural rehabilitation

Therapy designed to improve the fluency and effectiveness of communication for individuals with hearing loss and their communication partners

Aural rehabilitation focuses on:

communication partners, social communication, strategies to facilitate communication, strategies to repair breakdowns

Hearing loss prevention

Protect your hearing, don't put anything in your ears (besides earplugs), look for competent help when you need it, educate others

Protect your hearing

turn down the volume, use ear protection in loud environments

Cotton swabs can damage the...

tympanic membrane

Ear candles can drip onto the...

tympanic membrane

The ear is composed of three main parts:

outer ear, middle ear, inner ear

The outer ear is compose off:

auricle or pinna (visible portion of the ear), external auditory canal/meatus

The middle ear is composed off:

tympanic membrane (eardrum), ossicles, eustachian tube

Ossicles

malleus, incus, stapes

Inner ear is composed of:

vestibule, cochlea, spiral canals, auditory nerve

Hearing loss

condition in which a person is unable to detect or distinguish the range of sound normally available to the human ear

Bilateral Hearing loss

affects both ears

Unilateral Hearing loss

affects one ear

"Deaf"

refers to a person who identifies with the Deaf community

"deaf"

refers to a person with a severe hearing loss who does not identify with that community

Hearing loss can impact

acquisition of language

Difficulty learning language caused by hearing loss..

depends on the type of loss, severity of loss and when the loss occurred and/or was identifies (prelingual/postlingual)

Hearing loss can significantly affect the ______

family

______ of deaf children are born to hearing parents

80-90%

Parents of deaf children must decide

communication mode, orientation

_ or _ children in 1000 in the USA have hearing loss

5 or 6

_ to __ of children have "educationally significant" hearing loss

1 to 2%

Hearing loss is often associated with...

other kinds of disabilities

Causes of pediatric hearing loss

genetic factors, environmental factors

Genetic factors of hearing loss

Parents can carry a gene (dominant or recessive) for hearing loss

Environmental factors of hearing loss

infection, injury, disease, noise

Threshold of hearing

lowest dB level at which a sound is heard

Audiogram

Graph that shows one's hearing thresholds

Hearing loss

objective term used to describe hearing status

Hearing disability

subjective term used to describe impact on life

Conductive hearing loss

Sounds cannot get through the outer and middle ear

Conductive hearing loss causes a ____ to ________ hearing loss

mild, moderate

Conductive hearing loss primarily affects ___ frequencies

low

Conductive hearing loss causes

blockage of the auditory canal, malformation of the outer/middle ear, damage to the outer/middle ear, otitis media (middle ear infection)

Conductive hearing loss treatment

Medical interventions, surgery

Sensorineural Hearing Loss

Damage to the cochlea or auditory nerve (inner ear) that leaves outer and middle ear intact

Sensorineural Hearing loss affects some _________ more than others

frequencies

Sensorineural hearing loss results in...

loss of volume and clarity

Sensorineural Hearing loss can be...

milt to profound (deaf)

Sensorineural Hearing Loss causes

illness, in-utero infections, genetic factors-inherited (23%), unknown (57%)

Sensorineural Hearing loss treatment

amplification, cochlear implants

Mixed hearing loss

Both conductive and sensorineural loss

Objective Hearing Tests

do not require the patient to indicate whether or not they heard something

Behavioral Hearing Loss

Require that the patient indicates whether or not they heard something

Audiometry

behavioral measure (pure tone/speech testing)

Audiometry: person responds to...

tones or words

Audiometry: air conduction

tested with speakers or headphones

Audiometry: bone conduction

testing with vibrating device placed on the mastoid bone

Play audiometry

used with children

Early infant screening: objective measures

immittance testing, otoacoustic emissions, auditory brainstem response, evoked auditory potentials

Immittance testing

Tests the acoustic flow of energy through the middle ear space (acoustic flow will be abnormal when conductive hearing loss is present) ex. tympanometry

Otoacoustic emissions

Evaluates cochlear functioning

Otoacoustic emissions testing

an earplug-like device with a microphone measures the cochlea's response to sound, or otoacoustic emissions (echo coming from the cochlea) If no otoacoustic emissions present, possible hearing loss

Auditory brainstem response

evaluates the brain's response to sound (a device near the ear makes clicking sounds, earpieces in ear canals conduct the sound, electrodes on the scalp track sound moving to the brain)

Evoked auditory potentials

test's auditory nervous system's electrical response to sound and integrity of the auditory pathway (damage beyond the cochela)

Hearing aids types

Analog hearing aids, digital hearing aids, bone conduction

Amplification devices

do not fix hearing loss

Analog and digital aids helpful for individuals with

sensorineural hearing loss

Bone conduction aids helpful for individuals with

conductive hearing loss

Amplification devices are

calibrated by an audiologist to amplify certain/all frequencies

Analog hearing aids convert

sound waves into electrical signals and then make them louder

Analog hearing aids amplify

all sounds/frequencies equally

Analog hearing aids have

simple volume controls

Analog hearing aids are typically

less expensive than digital hearing aids

Digital hearing aids convert

sound waves into numerical codes similar to computer codes, amplify them

Digital hearing aids code

includes information about the direction of a sound and its pitch or volume

Digital hearing aids amplify

different frequencies at different intensities

Digital hearing aids have

intricate volume controls, though may adjust automatically

Digital hearing aids are typically

more expensive than analog hearing aids

Bone conduction hearing aids transfers

sound by bone vibration directly to the cochlea (bypassing the outer and middle ear)

For bone conduction hearing aids, inner ear

must function properly

Bone conduction hearing aids can be

bone anchored (surgery) or worn on a headband

Cochlear implants bypasses

the outer ear, middle ear, and cochlea to stimulate the auditory nerve