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36 Cards in this Set
- Front
- Back
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candidacy considerations
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1. comm problems (self percieved, as percieved by others)
2. hearing loss (thresholds, speech rec) 3. lifestyle/comm demands 4. motivations/expectations |
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the interview
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-comm diffs?
-priorities: size, $, quality -excuses: cost, denial, folklore, ability and support -motivations |
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For adult w/ mild-mod HL, which is usually the most important factor to consider when determining HA candidacy?
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self-percieved comm problems
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establishing goals
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establish comm-oriented goals
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what are the 2 goal setting questionnaires
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Client Oriented Scale of Improvement (COSI)
Glasgow Hearing Aid Benefit (or Difference) Profile (GHABP, GHADP) |
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advantages of goal-setting approach
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focus on specific goals
good counseling tool may be more sensitive than fixed scales for some patients |
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disability measures....
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-evaluate the extent to which a patient has difficulty hearing in different situations
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handicap measures
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evaluates the patients feeling about the HL (how much is patient prevented from doing what he or she WANTS to do)
ex. I feel upset when I can't hear the conversation at lunch. |
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COSI
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nominate comm situations targeted for improvement
*specific situations in which pt would like to hear better -disability based After fitting: measure benefit, evaluate final disability |
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GHABP
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evaluates both disability and handicap
-advantages: short, standarized -includes goal section like in COSI rate disability and handicap for different situations |
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determining priorites
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need to determine pt priorites
(performance, size, price) -determine whats most/least important - |
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making decisions
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-monaural v. binaural
-chosing styles -supp technology |
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T/F COSI evaluates satisfaction with HA’s?
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F
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T/F GHABP includes section which patient may identify sections (ie set goals) in which he/she would like to hear better?
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T
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majority of adults will report comm problems when avg HL is (PTA)
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40 dB HL or greater
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palmer showed that: when people were asked “on scale rate how you would rate your overall hearing ability”….75%-100% responded between ____ and ____ pursued hearing aids
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1-5
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results of NAL-R validation study (paired-comparison) indicated that?
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NAL-R response was judged to better as the alternatives in 3/4 the cases
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T/F mirroring the audiogram works better at high input levels than low input levels?
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F
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NAL-RP is appropriate for?
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any degree of HL
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avg convo level is approx
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65 dB SPL
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T/F hearing aid prescribed using NAL-R would be roughly the same as the gain using the half-gain rule
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False
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what was Palmer et all's question to predict hA uptake?
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On a scale of 1-10, 1 being the worst, and 10 being the best, how would you rate your overall hearing ability?
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Results of Palmer et all
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-75-100% with 1-5 will purse amp
-8-10: most will NOT pursue amp (80-100%) 6-7: somewhere in middle, may need more counseling/info, demo ext. |
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2 general questions for prescription?
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how much amp needed for general use?
what is the max amout of amp we should provide? |
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mirroring the audiogram
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every dB increase in HL requires 1 dB of additional gain
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problems with mirroring the audiogram
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-tolerance levels exceeded for higher level sounds
-excessive gain particularily for Hz with greatest loss -due to: increased HL=decreased DR |
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2 general approaches for prescription (list and quick description)
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Threshold-based approaches
-gain and max output based on pure-tone thresholds Loudness-based approaches -gain and max output based on loudness (MCL, UCL, full scales) |
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general prescription fitting things to remember
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-should be considered a starting point
-fine tuning may be necessary to optimize quality |
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2 general questions for prescription?
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how much amp needed for general use?
what is the max amout of amp we should provide? |
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NAL Loudness equalization
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goal: maximize speech intelligibilty at preferred listening level of HA user
assumptions: intell max when all fq equal loudness, prefrerred listening levels correspond to MCL -based on pure tone threshold |
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NAL prescriptive approach
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1/2 gain rule estimate is ONLY possible for 1 kHz
gain at other fqs-frequency shaping |
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LTASS
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speech signal has more energy in low fq,
response rolls off approx 6 dB/octave above 500 Hz |
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T/F NAL-RP is only for profound HL
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Not true! For all HL, mild-profoudn
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validation of NAL-R Byrne and Cotton
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approx 3/4 of listeners judged NAL-R to be as good or better than the alternative fq responses and the average preferred listening levels within 1 dB of prescribed
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how and why NAL-R modified further for severe-profound HL?
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????
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Speech dB SPL speakers v. earphones
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-13 dB higher in speakers than HL levels presented through speakers
-20 dB higher than HL presented through earphones |
