EXAM 2 STUDYGUIDE

Hearing aids

•   Hearing aid selection: consider the degree and type of hearing loss

•     listener’s lifestyle and communication needs

•     cosmetic preference

    

•  Components of hearing aid:

  • microphone/transducer

  • amplifier

  • receiver/speaker

  • volume control

  • battery

Types of aids and why

    Behind-the-ear (BTE): Suitable for kids (tubing and ear mold), with mild to profound hearing loss

    RIC/MiniRITE: Receiver in the Canal: 70% of patients use it, does not plug up the ear, amplifies higher frequencies, connects to Bluetooth and music, audiobooks

• In-the-ear (ITE): Customized fit, discreet, good for mild to moderate loss

• In-the-canal (ITC)/Completely-in-canal (CIC): Very discreet, limited features, for mild to moderate loss

What is the matrix -

output: what dB SPL the hearing aid produces into the world.

the MPO (maximum power output is the greatest amount of sound pressure a hearing aid can produce.

input (sound picked up from the environment) + gain (amplification of hearing aid) = output (sound hearing aid produces)

gain: gain the amount of volume or intensity added to the original sound.

slope: based on the configuration loss. a flat loss will need more gain in the low frequencies while loss in high frequencies would need less.

3. Electroacoustic analysis: goal is to make soft sounds audible, average sounds comfortable and loud sounds tolerable

    MPO: Maximum power output: output ordered, measured by inputting 90 dB SPL to measure the output output level without distortion, ensuring that the produced sound remains clear and within safe listening limits.

gain (volume): how it is amplifying, measure by inputting different levels (soft 35 dB to the conversation, to loud)

equivalent input noise: every electronic device generates noise. input 0 dB ,measure output of hearing aid, should be less than 30 dB SPL

Hearing aid fitting: done AE and UCL, educate and counsel about hearing loss, and need for hearing aids, taken ear impressions and ordered aid.

education & counseling: spend at least 30 min,components of hearing aids (faceplate bodym baterry) what to expect (patients might hear their own voice louder, feedback, the world is louder)

practice: practice putting hearing aids on and off, volume control and how to clean, change filter and troubleshoot

Objective information: Real ear is the gold standard for fitting hearing aids. Only test that is objective and does not require the patients response. tiny plastic probe inserted into the ear canal measures the sound level and ensures optimal performance of the hearing aids.

functional gain:a method of evaluating hearing aids by measuring the difference in hearing ability with and without the device in place; it provides insight into the practical benefit of the hearing aid in real-world situations.

subjective information: “How does that sound?” give you insight on how the patient feels about the hearing aid and allows you to adjust settings to better suit their preferences and comfort level.

Ling 6: ah, oo, eee, sh, sss, mm,

    open fitting: less occlusions and less gain, more natural sound. Good if patient has good low-frequency hearing

    closed fitting: more occlusion and requires more gain, with less feedback, making it suitable for patients with severe hearing loss who benefit from amplified sounds.

Hearing aid monitoring: check before starting therapy, Ling sound test with kids (a, i, u, sh, s, m), check battery (feedback), listen with stethoscope (listen for noise, distortion weak)

Hearing aid troubleshooting: check baterym listen with stethoscope, run electroacoustic analysis, fix or send for repair

Speech reading; use din noisy situations (lip, facial expression, and body language cues to enhance understanding of speech). It is especially helpful for individuals who are hard of hearing and need visual context to complement auditory information.

    synthetic ability: being able to use vision to fill in the auditory gaps

    Perceptual proficiency: ability to perceive speech movement rapidly

    flexibility: ability to alter first thought when it doesn't make any sense

Communication strategies

    assertive: help patient understand it ti’s their responsibility to tell the speaker how to make speech more understandable (slowing down or louder)

    anticipatory strategies: anticipating problems that could occur and think how to solve them

    repair strategies: find a better way to fix rather than (what or huh?) repetition, clarification (what did you say?), spelling, writing

ALD's -

    personal/group systems: used 1:1 but mostly in group (church, theater) 4 parts: microphone, transmitter, receiver, amp on listener

    infrared systems: light carries audio signals, must be in the direct line of sight, blocked by sunlight (common in theaters)

    FM systems: radio waves, transmitter and receiver must be tuned on the same waveband, used in classrooms, more powerful than infrared, no direct line of sight needed

    loop system: only useful with telecoil; primarily designed for use with hearing aids that are equipped with telecoils, it transmits sound directly to the listener's device, minimizing background noise and enhancing audio clarity.

Cochlear implants: surgically implanted device that stimulates the 8th nerve directly so that the brain can hear sound. It enables those with severe to profound hearing loss to perceive sound, not a hearing aid.

an electrode array is surgically implanted in the cochlea delivers an electrical signal to the 8th nerve, bypassing the damaged cochlea

house in a BTE type device, with speech processor, transmitter, inside the persons head (above the skull), electrode array

how does it work? Sound enters ear level mic and goes through the speech processor where it is amplifies and coded then sent to the transmitted and across the magnet to the internal receiver, and along the electrode to stimulate the 8th nerve.

candidacy: for patients with little to no speech benefit with hearing aids, adults severe to profound loss in all frequencies (high frequencies)

pediateric: sever to profound in all frequencies FDA: 9 months

Be sure to review how to read audiograms and the first two columns on the chart of probable hearing related disability based on the PTA of the hearing loss. Degree chart will be given on exam, but not disability chart.

Be prepared for one case study - degree and type of loss (I'll provide audio). Probable hearing-related disability based on this loss from chart (look at the PTA), type of aid you would recommend and why, speech reading, communication strategies and ALD that would be useful with this loss. You will write these recommendations as if talking to the patient.