4/1 SHS Lecture

Tympanometry focuses on assessing the tympanum or tympanic membrane's functionality within audiology.
In addition to tympanometry, audiologists perform further tests, including:
- Air conduction tests
- Bone conduction tests
Bone conduction:
- Involves vibrating the bone encasing the cochlea rather than using the ossicular chain.
- Hearing through bone conduction but not through air conduction indicates issues with the conductive system.

After identifying hearing loss, the next step involves measuring the impact of the loss on the individual.
Key considerations include:
- Resonance and harmonic frequencies play a significant role in speech perception.
- Speech perception differs from pure tone perception.
Factors influencing assessment of hearing loss:
- Age of the individual
- Language experience

An older individual with acquired language experiencing hearing loss will have different measurable impacts than:
- A one-year-old who has limited exposure to sound due to hearing deficits.
- Children aged two to three with hearing loss who have begun acquiring language.

Distinction is made between phonetic and phonemic inventories in assessing language.
Phonemic inventory:
- Analyzes sounds used in connected speech.
- Involves recording spoken language and creating a transcript of the used sounds.
- Effectively infers the sounds in one’s language use over time.
Phonetic inventory:
- Focuses on the ability to produce sounds.
- Includes assessments of sound production across:
- Initial
- Medial
- Final positions within words.
Example assessment activity:
- Recording a name and identifying phonemes present.
- Using a chart to track sounds:
- It may involve circling or marking absent phonemes for reference.

Checking and recording performance for each sound within phonetic assessments could employ:
- Plus and minus charts for data recording.
- More complex charts to track sounds across positions:
  - Initial, medial, and final.
Identifying misproduced sounds aligns with assessing auditory and motor abilities:
- Could be due to:
  - Inability to hear.
  - Lack of motor control or ability to produce sounds.

Evaluating a two-year-old:
- Expected productive vocabulary should be at least 50 words.
- Delays in production may indicate potential hearing issues, developmental disorders, or lack of social interaction.
Receptive vocabulary generally exceeds productive vocabulary:
- Building assessment tasks with visuals (e.g., identifying objects from phonetic prompts).
- Use concept of suprathreshold to measure sound recognition:
- The volume at which sounds and words are audibly perceived.

Discussing cochlear implants involves considering risk factors and hearing functionality:
- Indications for cochlear implant surgeries require severe impairment of cochlear function.
Modern cochlear implants:
- Approximately 20,000 channels in a normal cochlea compared to about 26 channels in CIs.
- Channels refer to pathways for information between the cochlea and the brain.
CIs function as transducers that convert mechanical sound pressure into electrical signals for processing.
Components of CIs include:
- An implanted portion directly wired to the auditory nerve.
- An external device connected via magnetic forces, managing computation and sound capture.

General anesthesia risks and considerations for candidates:
- Potential risks of not regaining consciousness vary across age demographics.
The implantation introduces foreign materials that could potentially lead to rejection by the body.
High cost of cochlear implants, approximately $120,000$ each.
- Costs are subjugated to insurance regulations and potential governmental support.

Critical age hypothesis influences cochlear implant surgery decisions:
- Early implantation leads to better language outcomes.
- Approved age for CI is as early as six months.
Teaching strategies post-implantation generally emphasize two approaches:
- Direct instruction on language components.
- Interaction-driven methods through normal developmental practices.

Emphasizing comprehension and understanding, rather than minuscule production, is pivotal in speech therapy contexts.
Each child’s individual needs necessitate tailored strategies in response to their hearing capabilities and communicative functions.
Critical discussions on CI arise emphasizing necessity, efficacy, and holistic listening enhancement practices.
Observations and understanding of variables impact effective communicative development strategies in children.