Aural Rehab Exam 3 Review

Variables that influence a patient’s AR plan

  • age

  • gender

  • SES

  • stage of life

  • race/ethnicity/culture

  • life factors

  • deaf or hard of hearing

  • psychological well being

  • other hearing related complaints

  • social, vocational, home difficulties

AR Plan (know all 6 and what can go into each)

  1. assessment - pure tone testing

  2. informational counseling - device orientation

  3. development of a plan

  4. implementation

  5. assessment of outcome -

  6. follow-up

Health variables - know how these impact AR plan

  • arthritis - hard time handling HA

  • cardiac disease

  • hearing loss

  • hypertension

  • orthopedic problems

  • cataracts/vision - hard time seeing small parts to their HA

  • dementia - hard time remembering to wear HAs

Early intervention is CRITICAL

  • first 3 years are most intensive stage for listening, speech, and lang development

  • Consequences of not doing early intervention

    • listening, lang, speech delays

    • eventual literacy delays

  • 3 goals

    1. enhance infant/toddler’s development

    2. minimize possibility of developmental delay

    3. enhance the family’s ability to accommodate the child’s needs and promote the child’s development - teach family how to advocate for child

EHDI & EHDA 1-3-6

  • Early Hearing Detection & Intervention Act

    • legislation that mandates hearing screenings for all infants

    • supports full diagnostic evaluation if needed

    • provides for enrollment in early intervention

  • 1-3-6

    • screening by 1 month

    • diagnosis by 3 months

    • intervention by 6 months

Risk factors for HL in infants

  • low birth weight

  • family history

  • ototoxic medications

  • in-utero infections

  • craniofacial abnormalities

  • bacterial meningitis

non genetic causes of SNHL

  • prenatal: occurs before birth

    • intrauterine infections - rubella, CMV, herpes

    • prematurity

    • toxemia

    • complications with Rh factor

    • maternal diabetes

  • perinatal: occurs at birth

    • anoxia

    • syphilis

  • postnatal: occurs after birth

    • meningitis

    • ototoxic drugs

Educational acronyms

  • FAPE - Free Appropriate Public Education

  • IDEA - Individuals with Disabilities Education Act

  • IEP - Individualized Education Program (3 to 21)

  • IFSP - Individualized Family Service Plan (birth to 3)

  • IAT - Intervention Assistance Team

  • LRE - Least Restrictive Environment

  • SST - Supplemental Services Teacher

Key Provisions of IDEA

  1. identification

  2. evaluation - evaluation has to occur prior to placement in a program, must be in child’s primary language

  3. IFSP or IEP - anyone who is involved in providing services for that child

  4. Parents: equal partners

  5. related services

  6. LRE

  7. private school - a child is still entitled to Special education services at a private school for free

  8. early intervention and preschools - early intervention is available to all qualifying kids for free

  9. due process - the parent has a right to make an appeal if they don’t agree with IEP (school districts can get sued!)

  10. advisory board - board of teachers/parents who oversee special education program

  11. funds - schools are provided funds

  12. records - schools must keep records on child’s progress, parents have access to records

IDEA today - outcomes

  • 200,000 eligible infants and toddlers are served

  • 6 million children receive special education

  • other accomplishments

    • post-school employment increase

Early intervention programs - coaching v direct therapy

  • center based

  • home based - more naturalistic

  • coaching model - coaches family

  • direct therapy

  • goals

    • enhance infant/toddler’s development

    • minimize possibility of developmental delay

    • enhance the family’s ability to accommodate the child’s needs and promote the child’s development - teach family how to advocate for child

IEP team members

  • audiologist

  • SLP

  • Educator

  • Psychologist

  • Interpreter

  • itinerant teacher

Classroom acoustics

  • reverberation - hard floors

  • distance

  • background noise - fans, lights humming, etc.

  • minimum SNR is 6 dB

  • goal is >15 dB SNR (ASHA)

Lang development with hearing loss

  • HA users struggle more with form and content than CI users

  • they both struggle the same with pragmatics

Fostering pre-literacy skills

  • engagement

  • literacy strategies

  • teaching techniques

  • interactive reading