Aural Rehab: Mod. 1 Quiz Prep

Who Are Audiologists?

licensed healthcare professionals trained to assess and manage hearing loss, auditory processing disorders, tinnitus, and balance issues across the lifespan.

Audiology is

the branch of healthcare focused on the evaluation, diagnosis, treatment, and management of hearing and balance disorders.

Audiologist Roles & Responsibilities (3)

Diagnosis & Evaluation, Intervention & Treatment, Rehabilitation Services

Diagnosis & Evaluation:

• Perform diagnostic assessments for hearing and vestibular (balance) disorders.

• Conduct newborn hearing screenings.

Intervention & Treatment:

Prescribe, fit, and manage hearing aids and assistive technologies, Support cochlear implant programs, Cerumen (earwax) management (if trained).

three main interventions

hearing aids, cochlear implants, cerumen management

Rehabilitation Services:

auditory training, speechreading, and listening skill development, vestibular rehab, and tinnitus management

Educational Requirements:

audiologists hold a Doctor of Audiology (Au.D.

Work Settings (7):

Hospitals, private practices, ENT offices, Schools (K–12), universities, VA hospitals, nursing homes

Audiologic Rehabilitation (AR):

Aims to restore communication abilities lost due to acquired hearing loss, focusing on diagnosis, amplification, training and counseling

Audiologic Habilitation:

individuals (often children) with congenital or pre-linguistic hearing loss, Focuses on developing listening, speech, and language skills that never existed before

Key Difference: Rehabilitation = ; Habilitation = .

regain lost skills; build new skills.

Core Components of AR/Habilitation:

Diagnostic evaluation > Hearing aids, cochlear implants, assistive listening devices > Auditory training and speechreading > Speech-language therapy > Communication strategies and counseling > Manual communication > Family/caregiver education and involvement > Psychosocial support and coping strategies > Educational/vocational support

Goals of Audiologic (Re)habilitation

Improve communication and participation > Reduce psychosocial, educational, and vocational impact > Enhance independence, empowerment, and quality of life > Support both individuals with hearing loss and their significant others

If You Learn Nothing Else, Remember

EMPOWERMENT, INDEPENDENCE, QUALITY OF LIFE

Impact of Hearing Loss on Communication

Affects hearing and oral communication: abnormal voicing, reliance on lip reading, etc.

Types of Hearing Loss

1. Conductive

2. Sensorineural

3. Mixed

4. Pseudohypacusis: Functional/nonorganic

5. Auditory Processing Disorder (APD)

Consequences of Hearing Loss - PRIMARY AND SECONDARY (4)

Primary: Difficulty in verbal/oral communication development or sustaining

Secondary: Educational, Vocational, Psychological/Emotional, Social

Hull's 11 potential impacts if untreated:

Perceptual, Speech, Communication, Cognitive, Social, Emotional, Educational, Intellectual, Vocational, Parental, Societal

Impairment:

Body structure/function issue

Activity Limitation

Difficulty in communication (primary consequence)

Participation Restriction

Broader life impact (secondary consequence)

Disability

Communication-related difficulty (e.g., can’t detect /s/)

Handicap

Social/emotional/vocational impact (e.g., must quit job)

First educator of the deaf

Pedro Ponce de Leon

Gallaudet

Adopted manual method after being denied oral training

Modern Philosophies in Deaf Education (5)

Emphasis on Speech and Hearing, Manual supplement, language & communication, Cognitive Emphasis, Focus on child/parent well-being

Audiologist Roles (ASHA, 2010):

hearing aid dispensin, ALD fitting/orientation, communication counseling, auditory training, cochlear implants, speechreading

AR for Children (5)

Parental Guidance, Audiologic Services, Auditory Development, Cognitive/Language Development, Speech Development

AR for Adults (4)

Family/Significant Other Support, Audiologic Services, Coping Strategies, Environmental Modifications

Models of AR

CORE & CARE

CORE – Assessment

• Communication Status

• Overall Participation

• Related Personal Factors (attitude types I-IV)

• Environmental Factors

CARE – Management

• Counseling & Psychosocial: explain

• Audibility & Amplification (HIO BASICS for orientation): hearing aid

• Remediation of Communication Activities: tactics to control situations

• Environmental Coordination & Participation Improvement: assess improvement

Evidence-Based Practice (EBP)

clinical decisions guided by researched Efficacy (lab success), Effectiveness (real-world outcomes), Efficiency, Patient Safety, Cost-Effectiveness

Multicultural & Deaf Culture Sensitivity

DEAF community is a distinct culture, Do not push cochlear implants; provide unbiased information

time of onset - Prelingual

onset at birth or prior to onset of speech and language

Perilingual

deafness is acquired while developing a first language

Postlingual

hearing loss is after the age of 5 (although speech not as affected, education is certainly affected, especially for the younger children)

Deafened

lose their hearing after schooling is complete (late teens or later) – may experience difficulty in verbal communication, social, emotional, and vocational situations.

Hard of Hearing

born/developing a partial loss of hearing, have acquired speech through hearing and oral communication, may be affected abnormal voicing of speech, watching lips, etc

What does "configuration of hearing loss" refer to?

The shape of the hearing loss across frequencies (e.g., flat, sloping, rising, cookie-bite).

What does it mean to be "hard of hearing"?

person has limited hearing but may still use their auditory system for communication.

What does it mean to be "deaf"?

person has extensive hearing loss (usually 80–90 dB HL or worse) and minimal to no auditory function.

What is the starting threshold for mild hearing loss in adults?

26 dB HL (range: 26–40 dB HL).

What is the starting threshold for mild hearing loss in children?

21 dB HL (range: 21–40 dB HL).

Why is the threshold for mild hearing loss lower in children than adults?

Because even slight hearing loss in children can significantly impact speech, language, and educational development.

stages of dealing with hearing loss include

Grief, denial, depression, anger, guilt, anxiety, acceptance

some statistics

3/1000 newborns are born with HL & 1/3 persons over 65 has decreased hearing

Speech Detection Threshold (SDT) aka Speech Awareness Threshold (SAT)

 for a child who cannot repeat or an individual who cannot discriminate words but can detect the speech sound. cant get words out of them

Speech Discrimination/Speech Recognition

percentage of monosyllabic words correctly repeated when presented at a level above the SRT (usually 30 or 40 dB SL).

What is the Speech Reception Threshold (SRT)?

lowest level (in dB HL) where a person correctly repeats 50% of spondee words—usually 2 out of 4 correct.

What is the difference between SRT and Speech Recognition testing?

SRT uses spondee words to find the softest level for 50% accuracy; Speech Recognition uses monosyllabic words at louder levels to assess clarity of hearing.

3 levels of hearing:

sound pressure level (SPL), hearing level (HL) and sensation level (SL)

What is Sound Pressure Level (SPL)?

An absolute way to measure sound, like using Celsius for temperature. Used in hearing aid testing.

What is Hearing Level (HL)?

A relative sound scale based on average normal hearing. 0 HL means "normal" hearing.

What is Sensation Level (SL)?

The number of decibels above a person's hearing threshold.

What is a Threshold?

The quietest sound a person can hear 50% of the time.

What is Air Conduction (AC)?

A hearing test through headphones, using air to deliver sound.

What is Bone Conduction (BC)?

hearing test using a vibrator on the bone behind the ear, testing the inner ear directly.

What is Masking?

Playing noise in the opposite ear to keep it from helping during a hearing test.

Air conduction tells you

the degree of severity of hearing loss (mild, moderate, severe, profound).

Bone conduction tells you

the type of hearing loss (conductive, mixed, sensori-neural).

Speech discrimination gives you

idea of how well they will do with remediation so counseling is appropriate.

normal degree of loss in dB

-10 to 25

mild (early hearing loss) in dB

25 to 40

moderate HL in dB

40 to 60

severe HL in dB

60 to 90

profound HL in dB

90 and above

RED is always

right ear

BLUE is always

left ear

outer ear

pinna collects sound and ear canal channels sound

middle ear

eardrum changes sound to vibrations and ossicles amplify/carry vibrations to fluid of inner ear

inner ear

cochlea hearing, har cells change wave energy to electrical impulses

semicircular canals

balance

vestibule

balance

types of energy in outer ear > middle ear > inner ear > auditory nerve

acoustic > mechanical > hydraulic > electrical

4 causes of permanent hearing loss

noise, aging, vascular insult, meniere’s

4 causes of non permanent hearing loss

perforated eardrum, middle ear infection, disarticulation of ossicles, Eustachian tube dysfunction

3 ossicles

incus, malleus and stapes

2 windows

oval and round