Hearing Aid Information

Hearing Aid Dispensing

• Audiologists:
  • Doctoral training.
  • Part of the scope of practice.
  • Generally part of the state license.
  • Some states require a separate dispensing license.
• Hearing Instrument Specialists:
  • Education requirements vary by state.
  • Only deals with hearing aids; cannot diagnose hearing issues.
  • Must have a dispensing license.
  • Some states require dispensers to have certification, such as Board Certified in Hearing Instrument Services (BC-HIS).

Over-the-Counter (OTC) Hearing Aids

• Approval Date: October 17, 2022, OTC hearing aids were approved by the FDA.
• Candidacy:
  • Individuals 18 years of age or older.
  • Those with perceived mild to moderate hearing loss.
• Features:
  • True hearing aids rather than amplifiers.
  • Many features similar to clinically available hearing aids.
  • User controls are available.
  • Many have accompanying apps for control and customization.
• Cost & Marketing:
  • Can still be expensive.
  • Marketing may include exaggerated claims about features.
• Price Range:
  • Typically range from 1,000 - $3,000 per pair.

Reflection

• ASHA used to consider it unethical for audiologists to sell hearing aids in the past because it could be seen as a conflict of interest where the professional's objectivity might be compromised by the potential for financial gain.

Components of a Hearing Aid

• Case (shell).
• Microphones: Convert sound into electrical signals.
• Receiver (Speaker): Converts electrical signals back into sound.
• Processor: Amplifies and modifies the electrical signal.
• Amplifier.
• Volume Control.
• Program Button: Allows switching between different settings.
• Battery Compartment.
• Optional FM receiver: Replaces the battery door; used for remote microphone input, signal boosted.

Hearing Aid Styles – Ways They Are Worn

• Behind the Ear (BTE)
  • Traditional BTE.
  • Slim Tube/Micro.
• Receiver in Canal (RIC) / Receiver in the Ear (RITE).

Earmolds for Traditional BTE

• Connected to the hearing aid with a tube.
• Attaches to the bigger side of hearing aids.
• Brings the sound from the hearing aid into the ear.

Slim Tube/RTC Traditional BTE

• Traditional BTEs
  • Filling the entire concha.
  • Allows for maintaining staying on the ear.
  • Allows children to be more attentive.
    • If earmold hard piece, can be an injury.
    • Always replaced when mold in have warranty.
    • Audiologists help pay for mold ~ if Mold doesn't fit in ear, they get a new one.

Hearing Aid Styles – Ways They Are Worn

• In the Ear (ITE).
• In the Canal (ITC).
• Completely in the Canal (CIC).
• In the Ear (ITE)
  • noticeable
• In the Canal (ITC)
  • deep into ear canals
• Complete in the Canal (CIC)

ITE Variations

• Smaller sizes can limit technology and power.
• Battery life is affected by size.
• Loudness capabilities are limited.
• Custom hard shell.
• Wax can interfere with the receiver.
• Not interchangeable with the growth of the ear (not suitable for children).

Hearing Aid Fitting Workflow

• Manufacturers work to meet individual needs.
• Important to monitor progress and ensure proper care.

Candidacy for Hearing Aids

• Perceived hearing loss.
• Lifestyle considerations.
• May not be suitable for high-frequency hearing loss or those needing a cochlear implant.
• Fungal infection.
• No making organ of hearing function work increased loudness.

Fundamental Concept: Input and Output of a Hearing Aid

• Sounds from the environment enter the hearing aid (Input).
• The hearing aid amplifies the sounds.
• Amplified sounds are delivered to the ear (Output).

Basic Hearing Aid Technologies

• Noise cancelling headphones.

Hearing Aid Selection – Fitting Range

• Severity of hearing loss dictates hearing aid features.
• Size - Small hearing aids may not have enough room for necessary components.
• Style - different styles are suitable for different levels of hearing loss.
• Available additions (FM).

Digital Features

• Multiple Channels: Able to adjust hearing aid output in discrete frequency regions.
• Multiple Programs: Automatic or user-controlled programs based on patient’s needs in various settings.
• Compression (Automatic Gain Control (AGC)):
  • Limit how loud sounds get and minimize distortion.
  • Wide Dynamic Range Compression (WDRC): Preserve the experience of loudness.
• Environmental Volume Control: adjusting the compression based on the environment and preferences.

Digital Features

• Directional Microphones:
  • One forward-facing and one rear-facing microphone.
  • Allows the hearing aid to determine the location of speech versus noise.
• Digital Noise Reduction:
  • Reduces background noise based on its frequency range and location.
• Feedback Reduction:
  • Phase cancellation of feedback sounds.
• Linked Hearing Aids:
  • Sounds from one hearing aid can be transmitted wirelessly to the opposite ear.
• Data Logging: Important!
  • How long hearing aids worn.
  • User adjustments to volume and programs.
  • Assessment of patient’s environments throughout the day.

Contralateral Routing of Signal (CROS)

• Unilateral profound hearing loss (Single Sided Deafness).
• Way to collect sound from the side with hearing loss and send it to the better hearing ear.
• One “hearing aid” is worn on the normal hearing ear.
• Microphone is worn on the ear with hearing loss (looks like hearing aid).
• The sound from the microphone is sent to the normal hearing ear.

Profound Hearing Loss

• Normal Hearing.
• Microphone Only.
• Receiver and Microphone.

Frequency Lowering

• Microphones can collect a wide range of sound frequencies, approximately 20-10,000 Hz.
• Hearing aids can typically only output a limited range of frequencies, such as 20-6,000 Hz.
• If a patient can’t hear certain high-frequency sounds, frequency lowering can be used.

Frequency Lowering

• The hearing aid "squishes" the extra collected sounds into the range that the hearing aid can produce.
• This makes sounds different; for example, the "S-Sh" sound may be lowered in pitch so it can be heard.

Programming

• Older methods used quiet, medium, and very loud settings to judge comfort.
• Modern programming aims to satisfy the patient's wants by adjusting loudness according to environmental needs and volume preferences.

Programming

• Quieter conversations and speech require big boosts for lower frequencies.
• It is essential to know the limits of the hearing aid and adjust loudness to match the prescription.

Verification

• Programming software indicating perfect programming does not guarantee correct real-world settings.
• Ear acoustics affect hearing aid output, potentially over-amplifying or reducing certain sounds.
• Verification ensures the hearing aid functions as intended in the wearer's ear.

Verification Methods

• Test Box Verification
  • Uses ear simulators to estimate how sounds behave based on programming
• Real-Ear Verification
  • Most accurate method: measures hearing aid output in the ear canal

Test Box Verification

• Hearing aids placed in sound treated chamber
• Connected to ear simulator (coupler)
• Speech sounds are played into the hearing aids
• Can ESTIMATE how sounds are likely to behave based on programming
• Fake ear- average adult ear.

Real-Ear Verification

• BEST way to measure hearing aid output
• Microphone placed in ear canal
• Hearing aid placed on ear and turned on
• Speech sounds are played from a speaker
• Can objectively measure EXACTLY how sounds are likely to behave based on individual ear acoustics
• Tube microphone sound gain.

Speech Map

• Plus signs are prescriptive targets.
• Soft speech (green).
• Average speech (pink).
• Loud speech (teal).
• Yellow dots = targets for highest output.
• Black Asterisks = maximal output (too loud) - Don’t want to get near that!

Orientation

• Introduce patient to parts of the hearing aid.
• Explain use, care, and cleaning procedures.
• Demonstrate battery placement.
• Explain programming options.
• Teach program navigation.
• Explain volume control.
• Provide basic troubleshooting guidance.
• Discuss warranty and repair policies.
• Set realistic expectations.
  • It takes about 30 days of continuous use to adjust to wearing hearing aids.
  • The sound will not be normal.
  • Noise and wind can still be problems.

Batteries

• Hearing aid batteries typically last 3-4 years with proper care.
• Supervision might be needed for battery changes, especially in children, to prevent accidental ingestion.
• Shallow orientation.
• Largest.
  • 675.
• 13.
• 312.
• 10.

Validation

• Aided testing in a soundfield with speech stimuli.
  • Use the Ling 6 Sounds for thresholds.
  • Word Recognition in Quiet.
  • Speech in noise testing.
• DO NOT Use pure tone stimuli or narrowband.
  • Hearing aid processor may view as feedback or noise.
  • The hearing aid would make them quieter.

Validation – Continued

• Self-report tools.
  • Standardized forms allow to track patient perceptions and progress.
  • Client Oriented Scale of Improvement (COSI).
    • Pre-test to define goals and manage expectations.
    • Filled out over time to determine if goals are met or adjustments needed.
  • Abbreviated Profile of Hearing Aid Benefit (APHAB).
    • Evaluate patient’s perception of benefit in different listening environments.
    • Can do pre and post test.
    • Lots of normative values.

Hearing Aid Troubleshooting

*Ask about any recent events:
* Exposure to water.
* Drops.
* Missing.

• Visual inspection:
  • Cracks in casing.
  • Plugged earmold/canal.
  • Loose parts.
• Check the battery.
  • Incorrect installation.
  • Corrosion Audidosist listen to sounds through perform a biologic check on wear Sound may be sell what's happening present in a sound with distortion.

Poor Sound Quality

• Check the battery/ Batteries.
• Biologic Check (Listening Check):
  • Using listening scope, how does it sound?
  • Clicking.
  • Distortion.
  • Intermittency.
  • Crackling.
  • Beeping when it shouldn’t.
  • Internal feedback
• listening check may Surf Neg syllabi Playing its not round loud and custing weird whifling.

Biologic Check: The Ling 6 Sounds

• /A/, /I/, /U/, /S/, /Sh/, /M/
• Say these sounds while listening to the output:
  • What do you notice?
  • Clarity.
  • Distortion.
• different Treshold frequency test listen to distortion.

Battery Corrosion

• Chemicals if left in hearing aid.

Feedback – The Whistle

• Output becomes the input!
• Microphone is collecting sounds coming from the hearing aid.
• Creates a noise called feedback.
• Feedback is normal if the hearing aid is not in the ear.

Most common cause of problematic feedback

• Poor fit of the earmold/poor insertion depth of hearing aid.
• Other causes:
  • Wax.
  • Middle ear fluid.
  • Programming problem/settings not fitting correctly.

The hearing aid got wet!

• Place in a container with a moisture-absorbing substance.
• Don’t have that? Try dry rice!

HEARING LOSS TREATMENT: IMPLANTABLE DEVICES

Different Implantable Hearing Devices

• Bone-conduction hearing device (BCHD)/Bone-anchored implant (BAI).
• Middle ear implants (MEI).
• Cochlear implants (CI).
• Auditory brainstem implant (ABI).

Bone Conduction Hearing Devices (BCHD)

• Fundamental Concept: Physical vibration of sound to the inner ear via bone conduction.
• A small implant is placed in the mastoid bone.
• The healing process includes osseointegration.
• Bone grows into the titanium implant.
• Strong adherence to the skull allows for direct translation of vibrations into the mastoid.
• Takes roughly 4-6 weeks for osseointegration to be completed.

BCHD – Sound processor attachment

• Two methods of attaching a processor.
  • Percutaneous: an abutment is attached to implant and comes through the skin (Direct Drive).
    • Provides best sound quality.
    • More prone to infection.
  • Transcutaneous: a magnet is attached to the implant and is completely under the skin (Skin Drive).
    • Poorer sound quality (less access to high pitches).
    • Less likely for infection.
    • Prone to fall/be knocked off of the head.

Percutaneous BCHD

• Can be cold in winter
• Leadband
• 5 Painful Screws into implant
• sticks out a little
• Vibration

Transcutaneous BCHD

• Magnet and external magnet. This vibrates outside.
• Processor skin. You clipped the then impana andrateintothe under Sein.

BCHD – Fully Implanted

• Cochlear Co., Osia 2 Implant Med-El BoneBridge with Samba 2 Processor
• These devices are relatively new.
• Also send sound via bone conduction.
• Provide the clearest signal

BCHD Candidacy

• Conductive or mixed hearing loss in at least one ear
• Air-bone gap of at least 30$$ dB
• Mixed – must have sensorineural component of mild to moderate
• Single-Sided Deafness for use as CROS system
• Profound hearing loss in one ear
• Normal hearing in the opposite ear
• Surgical considerations:
  • Bone thickness must be 2.5 mm
  • Children not eligible until age 5 years

Middle Ear Implants (MEI)

• Transducer is placed on the ossicles in order to increase vibratory action to the inner ear.
• Several components:
  • External Processor with microphone
  • Internal implant
  • Prosthesis (some designs)
• Some devices have special type of microphone implanted under the skin
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MEI Candidacy

• Must have stable sensorineural hearing loss in the moderate to severe range
• Word recognition greater than 40 to 60%
• Unable to wear traditional hearing aids
• Many devices on the market with different designs
• Candidacy is different depending on the device
• Surgical candidacy will vary

Hearing Aids v. Cochlear Implants

• Hearing Aids/BCHD/MEI
  • Drive the natural hearing system to create neural responses in the cochlea
• Cochlear Implants
  • Bypass the natural hearing system to stimulate the auditory nerve directly

Cochlear Implants (CI)

• Bypass the outer, middle ear, and function of the hair cells
• Provides direct stimulation of the auditory nerve
• Consists of external part and internal components
• Hybrid CI and hearing aid can drive the natural system and stimulate the nerve

CI Components

• Radio Coil.
• Magnet.
• Receiver Stimulator.
• Electrode Array.
• Transmitter Coil.
• Sound Processor.

CI Candidacy Evaluation

• Basic criteria:
  • Severe to profound bilateral sensorineural hearing loss
  • Little to no benefit from hearing aids
• Comprehensive Team Evaluation:
  • Audiologist
  • ENT
  • SLP
  • Psychologist
  • Social worker
  • Educator

Candidacy Evaluation Continued

• CT or MRI.
  • Evaluate structures of the inner ear.
  • Evaluate nerve formation and size.
• Audiologic evaluation – type of implant.
  • If low-frequency hearing is preserved – Hybrid may be appropriate
  • Implants can destroy all remaining natural hearing, though improvements have been made in preserving hearing

CI Candidacy

• Adults (18+ Years)
  • Individuals 18 years of age or older
  • Moderate to profound sensorineural hearing loss in both ears
  • Limited benefit from amplification defined by preoperative test scores of ≤ 50% sentence recognition in the ear to be implanted and ≤60% in the opposite ear or binaurally
• Children (2-17 Years)
  • Severe to profound sensorineural hearing loss in both ears
  • Limited benefit from binaural amplification
  • Multisyllabic Lexical Neighborhood Test (MLNT) or Lexical Neighborhood Test (LNT) scores ≤ 30%
• Children (9-24 Months)
  • Profound sensorineural hearing loss in both ears
  • Limited benefit from binaural amplification

Single Sided Deafness - CI

• 5 years of age or older
• Severe to profound sensorineural hearing loss defined as a 4 frequency PTA at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz of > 80 dB HL.
• In the contralateral ear, normal or near-normal hearing is defined as a PTA at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz ≤ 30 dB HL.
• Unilateral hearing aid trial demonstrates limited benefit via word recognition testing Localatia do better with Coheren implant.

Can we know what a cochlear implant sounds like?

• Simulation of cochlear implant – Do we know if it really sounds like this?.
• Sound matching exercise– An experienced listener with normal hearing in one ear and a cochlear implant in the other demonstrates her perception of the sound quality of the cochlear implant (Start at 3:07) turning if on and off muffred burger generationthing W of brain thejaves i Sand Speaker -off Speech andcanguage hear.

Cochlear Implant Timeline – Pre-lingual Children

Age

• Activation 3 Weeks Post Surgery

• Hearing Program Initial Fitting 1 Week Post Activation

• Each Month for 3 Months

• Every 3 Months for 1st Year

• Checks every 3-6 months during 2nd year

• Every 6 months in older children Speech Language evaluations are performed in conjunction with visits have to have Profound me ar ins Loss and access sound hearing aids Prossess program vibrate.

Auditory Brainstem Implant

• An external speech processor is worn similarly to a standard CI
• The internal receiver stimulator works similarly BUT.
• The electrode array is not placed in the cochlea.
• A paddle-shaped electrode is placed on the brainstem in the area which processes auditory input.

Aural (Re)Habilitation

• The goal is to improve access to auditory information by:
  • Improving auditory access
  • Having an expanded repertoire of communication methods
  • Making behavioral changes
  • Developing environmental assessment skills
  • Identifying technologies that enhance access to:
    • Media
    • Alerting and emergency
    • Telephone
    • Important services and public programming

Aural Habilitation vs. Rehabilitation

• Habilitation: To provide someone skills they have not previously developed on their own.
  • Pre-lingual or early onset hearing loss
  • Awareness of environmental auditory stimuli
  • Ensuring best access to speech information (visual and auditory)
  • Cause and effect
• Rehabilitation: To provide someone with previously developed skills the ability to regain function after late onset hearing loss
  • Presbycusis/Ototoxicity/Genetic condition
  • Restore access to environmental auditory stimuli
  • Ensure best access to speech stimuli
  • Provide skills for addressing communication breakdown
  • Create plans for employment
• - Why we dothin tell deaf Jared.

Needs Assessment

• The creation of a patient-specific profile of listening and communication needs and wants.
• The assessment should reveal key areas in need of intervention through the use of various technological and behavioral means.

Communication-Based AR

Informational Counseling

• Knowledge is power.
• Clients need to understand their hearing.
• Audiologic test results (interpret their own audiogram).
• Understand which sounds are impacted by their hearing.
• Understand the physical mechanism for the hearing difference.
• Clients need to recognize the features of communication difficulties.
• Clients need to recognize the limitations of their equipment.
• Clients need to be aware of the emotions that can come with acquiring a hearing loss
• Clients AND Clinicians need to know the laws reach. sound-

Relevant Laws

• Rehabilitation Act of 1973, Section 504
• Disability Bill of Rights
• Federal government cannot discriminate for employment based on ability
• Services must be accessible to people with disability if the provider receives any federal funding
• Americans with Disabilities Act (ADA) of 1990
• Protection against employment discrimination at non-federal locations
• Access to public services including telecommunications and entertainment
• Strongest protections for Deaf and hard of hearing communication rights Acsessibility same work but with more technologies movie theures provide accommodations.

Goal Setting

All AR is based on the individual’s goals which often revolve around:

• Improved audibility of sound
• Noise reduction strategies
• Articulation of speech
• Speechreading skills
• Self-advocacy skills
• Communication strategies
• Access to telephone
• Access to media
• Access to services
• Work or school accommodations

Speechreading

• The observation of a variety of visual communication cues:
  • Facial expression
  • Gestures
  • Body language
  • Context cues
• Relies on language skills to fill in blanks
• Not ”lipreading” What they near difficult.

Speechreading

• Requires “Synthetic Ability”
  • Someone must be able to synthesize the limited information they have, fill in the blanks, identify what was said
• Analytic Ability:
  • When someone tries to identify every sound (lipreading)
  • Counterproductive /.

Things that interfere with speechreading

• Problems relating to the speaker
  • Limited facial expression, body language, rate of speech
• Problems relating to the environment
  • Distance, lighting, visual distractions
• Problems relating to the speechreader
  • Lack of attention, unfamiliarity with language, limited knowledge of the topic, attitude, and beliefs
• Problems relating to the nature of speech
  • Most sounds are not visible, normal speech is rapid, many words look the same / L M ~.

Speaker Problems: Role Play

1. Break into groups of 3
2. Observe the vignette and answer the following:
   • How am I being a good communicator?
   • What communication behaviors might be difficult?

Speechreading Instruction

• Teaching context-based strategies
• Understanding that words look alike (homophenes)
• Using language and context cues to fill in blanks
• Identify that you missed
• Identify the missing information
• Work to anticipate what will be said
• Self-advocacy skills Speak slower

Homophenes

• Words that appear identical on the lips
  • Pay – Bay – May
• Using these in instruction can be highly valuable
• Used within the framework of utilizing context. But Bud Bun Buzz Putt Pun Pus Mud Muss look the same help guess which word -breaking down context.

Speech Reading Instruction

• Going to the Beach
  *Identify the word or guess.
  Ice cream
  Picnic
  Sunshine
  Beachball
  Water
  Shovel
  Blanket
  Bucket

Speech Reading Instruction

Going to the Beach

*This Model:
* Single words related to topic
* Homopheneity
* Equal syllabic structure
* High challenge: limited context
*How to use:
* Select meaningful topic based on client’s needs
* Familiarize each word verbally/sign language
* Say one word at a time and score their responses
* Set specific goal for trials correct
* Can be adapted to sentence level
* Ask to identify key words
* Ask to provide general meaning of the sentence differene difference..

Communication Strategies

• Communication Partner: Whoever you are talking to
• Communication Styles:
  • Assertive: Tell communication partner that you need their help to understand what was said in a polite manner.
  • Passive: Pretend to understand what was said or don't tell them that you missed what they said .
  • Aggressive: Rude and demanding request that your communication partner restate what they said polite lie disrespectful.

Communication Strategies

• There are a wide number of strategies that can be used to prevent communication breakdown and repair communication when breakdown occurs

• Communication Strategies:

  • Clarification/Confirmation
  • Repetition/Rephrasing
  • Spelling
  • Code Words
  • Visual Cues
  • Pre-Planning/Pre-Teaching

• Environmental Controls:

  • Background noise reduction
  • Lighting adjustments

• Behavioral Modifications:

  • Eye contact
  • Self-Advocacy for communication sal that in a different way Spell again apply understand.
    #Self-Advocacy

• It is incredibly hard

• Requires disclosure of reason for misunderstanding

  • E.g.: “I have a hearing loss”
  • “I wasn’t able to catch what you said”

• Requires acceptance of one’s hearing loss.

Hearing Assistive Technology and AR

Traditional Needs Assessment

Evaluate:

1. Face to Face Communication
2. Telephone Access
3. Reception of Electronic Media
4. Reception of Alerting Signals Adults (Compton-Conley, 2006)

Signal Types to Overcome Background Noise

• FM – Radio waves
• Magnetic waves
• Electrical signals
• Infrared light Sound can be encoded in magnetic waves heat

Signal type pros/cons :

Radio waves.

• Clear signal
  • Many configurations (sound field, ear-level)
  • Able to cover large distances (Not Bluetooth.)
  • Can transmit through walls.
    • Requires clear channels (Multiple mics can interfere with each other.
      Electrical signals (wired connection)
      Very clear signal and tethered by length of cord.
      Magnetic waves
      Telecoil, Good for eliminating background noise, Inexpensive, Can cover large areas, Does not require specific channels, Can transmit through walls, Can pick up ambient magnetic waves, Overhead lights and Metal detectors
      Infrared light
      Many configurations (sound field, ear-level), Able to cover large distances, Does not transmit through walls, Does not work in bright rooms and Light from transmitter can be blocked by objects

Face to Face Communication

• Can be one on one or group (large or small)
• Hearing Aids/Cochlear Implant
• Personal FM
• Minimize background noise
• Behavioral strategies.

FM System

Telephone Access

• Improved Audition:
  • Telecoil setting
  • FM transmitter with or without Bluetooth
  • Manufacturer transmitters
• Visual supports
  • Telephone captioning relay systems
• Video relay operations
• Text message relay

Telecoil

• Detects magnetic energy.
• Small iron bar with copper wire – Detects magnetic waves produced by phone speakers -
• Translates the magnetic waves to electrical signal, then acoustic signal
• Eliminates background noise if the microphone is off or quieter

Telephone Captioning – Voice Carry Over (VCO)

• Free service for people with hearing loss.
• Call is first answered by a relay caption operator.
• Relay operator calls the desired party.
• Person with hearing loss speaks through phone.
• Response from other person is both audible AND captioned.

Video Relay Systems (VRS) - Interpreting

*Call is placed by person with hearing loss who uses sign -
*Call intercepted by ASL interpreterInterpreter calls desired party and Interpreter signs response. from other party.

Electronic Media

• TV
• Music
• Computers
• Movie theater

Electronic Media

Best access to sound would be FM or other direct system, Can be connected to TVs and computers easily.
Loop systems are easy to install in public places. Set up, Plug in, Instruct users and All set!
Infrared systems are often used in movie theaters and courtrooms, Does not transmit through walls and Generally not bright Bright

Adult Rehabilitative Needs Assessment for HAT

1. Evaluate deficits and their impact on function
2. Create an action plan to meet needs:
   • Technological interventions
   • Environmental controls
   • Behavioral modifications

Pediatric Habilitative Needs Assessment

To curb the effects of sensory deficits on growth and development.
Evaluate deficits or risk for deficits and their impact on development and functionCreate action plan to meet needs

• Parent and patient behavioral modifications
• Environmental control
• Technological interventions

Age-Specific HAT Assessment

1. Use the job description to determine communication needs.
2. How will the individual’s communication profile impact their ability to perform job functions?

Age-Specific HAT Assessment

For a child, how do you decide which accommodations are needed?

• Use the job description to determine communication needs
• Job description is typical developments.

Developmental Milestone Approach

1. Use developmental milestones to determine the needs at specific age intervals.
2. Commonly used and widely published educators
3. Physicians Nurses
4. Early interventionists Speech therapists Occupational therapists
5. Physical therapy

Pediatric HAT Needs Assessment

How can we integrate developmental milestones and traditional needs assessment?

• Take into account the tasks and functions of daily living and how they change with ageTake into account where they occur (home daycare school Beyond) Discuss/personal safety Stranger play, playground. safety and emergency response.

Habilitative Needs Assessment

1. Identify Hearing loss
2. Identify other Developmental concerns Impact Identify. Impacted milestones. Impact of. Achieved milestones on intervention Age-Specific Intervention.

Age-Specific Recommendations

4 Categories:
B: Behavioral
E: Environmental
S: Safety
T: Technology

Age-Specific Recommendations

• Birth through adolescence Concise and easy to implement. Work alongside of . Must be adaptable to patient needs, Pertinent to milestones and flexible Counselinyguidelines Onus Age 12+ Years Patient Responsilbility. Independence Transitions to and Parents 1-2 years.

Behavioral Modifications/Com. Strategies

Age Behavioral Modifications/Communication Strategies.
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To for Parents Transition to and for -Years months years:.

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Positive Listening Space

• Environment that includes considerations for positive communication exchange. May start Expand within the. Home May . Extend. Extra . And the .

Age Environmental

Technology Age Technology

1