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86 Cards in this Set
- Front
- Back
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What are the keys to success in regards to amplification?
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Support of family/friends/co-workers
Knowledge about HL and hearing help Professional intervention (auditory training, speech reading, communication/self-help strategies) Appropriate use of tech |
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What are the categories of assistive tech?
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conventional hearing aids
assistive listening/alerting devices cochlear implants other sensory devices |
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What is the purpose of hearing aids and assistive devices?
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To make speech and environmental sounds "audible" not just detectable
Relating audibility to intelligibility (?) |
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What are the two primary acoustic goals of amplification?
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Provide good intelligibility of speech
Optimize sound quality |
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What aspects of speech intelligibility should be attended to by the assistive device chosen?
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Allow aided performance in QUIET and NOISE
Preserve balance between low and high frequency regions of the average speech spectrum that is appropriate to the clients audiogram |
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What makes a hearing aid work?
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microphone receives sound (acoustic signal)
converts it into electrical signal amplifier increases strength of signal receiver converts electrical signal back to sound wave (acoustic signal) amplified sound wave channeled from receiver directly to EAC via tubing/earmold powered by battery |
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List the traditional hearing aid styles from largest to smallest/oldest to newest...
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body aid
eyeglass aid BTE-behind the ear w. custom earmold BTE RIC/RITE- behind the ear w. receiver in the canal ITE- in the ear ITC- in the canal CIC- completely in the canal |
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With which traditional amplification devices would you use a custom ear mold?
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all traditional styles:
body aid eyeglass aid BTE BTE- RIC/RITE ITE ITC CIC |
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Name two functions of a custom earmold
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to provide support for the hearing aid on the ear
to direct and modify the amplified sound |
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What areas do we want to address in helping a client select a hearing aid style?
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power needs
cosmetic considerations controls and features dexterity issues pinna and EAC geography age (these tie in to acoustic goals) |
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What areas do we address in optimizing the acoustic goal of sound quality in amplification?
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soft speech= soft but audible
average speech is comfortable loud inputs (speech & environmental) are loud but not uncomfortable |
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What are the 3 goals of electroacoustic amplification
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increase signal strength
shape signal (selective amplification) limit output |
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Define 'selective amplification'
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to give amplification to sounds that need it but not to sounds that don't
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What are the three types of assistive device circuit options that are available?
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analog (conventional)
programmable (analog) digital (all programmable) |
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T/F
Any circuitry can be put into any size device. |
True
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T/F
Analog circuitry amplifies sound in a non-linear fashion. |
False.
They amplify sounds in a LINEAR fashion. They can distort sounds but have a limited means to filter out background noise, therefore EVERYTHING is amplified. |
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Which are the least flexible hearing aid?
-programmable analog - conventional analog -digital programmable |
conventional analog
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What is the function of a 'trimmer'?
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to change the intensity of frequencies
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In conventional ANALOG hearing aids, how do you adjust the intensity of the frequencies amplified?
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manually, by turning a screw on the device with a tiny screwdriver
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What is the difference between a (conventional) ANALOG and a PROGRAMMABLE (analog)?
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PROGRAMMABLE- more flexibility, has computer programmed processor, two independently controlled channels, better able to 'match' frequency response of HL, AuD adjusts with computer.
ANALOG - linear, least flexible, manually adjusted trimmers, CHEAP |
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T/F
A digital hearing aid has no more than two channels. |
False. The programmable (analog) has two channels, but a digital has AT LEAST two channels.
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Describe what happens to acoustic energy from the pinna to the TM when using a digital hearing aid.
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acoustic signal hits microphone and gets converted into an analog signal.
The analog signal is converted to a digital signal and is then processed by mathematical parameters to alter it to the specifications of the individuals HL. It is then returned to a digital signal that is changed back to analog and sent to the TM |
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Digital hearing aids contain computer chips that...
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convert the continuous electronic signal into numeric coded signals.
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T/F
A digital hearing at does not amplify background noise to the same degree as the primary signal. |
True.
They totally rock in that respect. =) |
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A digital hearing aid can perform ______ processing of the sound at an extremely ______ rate with a _______ degree of precision.
a. simple, fast, high b. complex, slow, moderate c. complex, fast, high |
c. complex, fast, high
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T/F
The digital hearing aid can adjust the intensity of sounds at specific frequencies although these are not based upon any preset parameters. |
False. It is specifically programmed to the individuals degree and configuration of HL
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What types of flexibility are offered to the AuD and client when choosing a digital hearing aid?
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multi channel
multi memories multi circuitry/signal processing options adaptive microphones automatic telecoils data logging |
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Matching
1.__ great speech clarity in quiet and noise 2.__minimal flexibility 3.__moderate flexibility/good speech understanding a.conventional b. mid-range c. premium |
1. c
2. a 3. b |
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T/F
Mid-range programmable hearing aids only use analog circuitry. |
False.
Some are 100% digital |
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What types of user controls are available for hearing aids?
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on-off switch
volume control remote control |
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What does a Telecoil do?
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Allows the device to p/u electromagnetic signals from ALDs (assistive listening devices), personal FM systems, cellphones, direct audio input.
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What questions might an AuD ask when helping the client determine their best option for a hearing aid?
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What are your lifestyle needs?
What types of social or vocational listening environments are you exposed to? |
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T/F
An assistive device is chosen by determining which device best fits the audiologic needs of the client based upon their audiogram. |
False.
Many factors go into this decision. If the person can operate it or it makes them uncomfortable to use it, they will not benefit. Even though tech has made great leaps and bounds, the persons' lifestyle/vocational requirements may not justify the expense of going "premium". |
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list the electroacoustic properties of hearing aids
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gain
frequency response frequency range output sound pressure level harmonic distortion equivalent noise input |
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Describe "gain"...
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how much the input signal is amplified by the hearing aid
(more hearing loss = more gain needed) |
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define 'frequency response'..
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how much gain is available per frequency.
(this should mimic the opposite of the configuration of HL) |
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define 'frequency range'...
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the useful range of the frequency response (the low and high frequency limit of the hearing aid)
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define 'output pressure level'...
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maximum output resulting from harmonics generated by the hearing aid
(how much dB SPL can aid put out?--> we want output to cease at 120dB) |
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T/F
It is important for the output pressure level to exceed 120dB SPL. |
False.
We want it to cease at 120dB SPL so the client does not sustain further damage to their hearing. |
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define 'harmonic distortion'...
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the total output resulting from the harmonics generated by the hearing aid.
(see page 49 in Schow & Nerbonne) |
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define 'equivalent noise input'...
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level of internal noise generated by the hearing aid.
(it is an electronic device, after all) |
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Name the two types of non-traditional hearing aids.
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CROS- Contralateral Routing of Offside Signal
BICROS- Bilateral Routing of Offside Signal. |
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CROS-
BICROS- |
CROS- Contralateral Routing of Offside Signal
BICROS- Bilateral Routing of Offside Signal. |
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T/F
A person with an asymetrical bilateral hearing loss would use a CROS hearing aid to help them localize. |
False.
They would use a BICROS |
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CROS hearing aids are used by...
for the purpose of... |
for use by people with a unilateral unaidable hearing loss for the purpose of providing awareness of sound on the side of the dead ear. Helps with localization.
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How does a CROS hearing aid work?
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By sending radio wave signals from the unaidable (dead) ear over to the good ear.
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T/F
CROS hearing aids provide significant amplification to the affected ear. |
False.
They provide no signal to the affected (dead) ear and no/very limited amplification to the good ear. |
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How does a BICROS hearing aid work?
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BICROS are for people with bilateral hearing loss where one ear is unaidable (dead). The signal from the dead side is sent via radiowave to the aidable ear with amplification to improve localization and speech recognition.
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How do CROS and BICROS differ?
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BICROS amplifies the signal to compensate for the hearing loss in the aidable ear.
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Specifically, where is a MEI implanted?
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on the stapes
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MEI=
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Middle Ear Implant
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T/F
An MEI is similar to a conventional hearing aid in that it picks up a sound signal via microphone and amplifies it. |
True.
But there is more... |
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Describe what happens to the sound signal when using a MEI...
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sound picked up by microphone
amplified this signal sent to implanted vibrational device device provides 'direct drive vibration transduction' without distortion or feedback |
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List the advantages of MEI
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HIGHER FUNCTONAL GAIN (reduced feedback provides higher output)
HIGHER FIDELITY SOUND (due to direct drive of ossicles) ELIMINATES OCCLUSION EFFECT IMPROVES COSMESIS IMPROVES PHYSICAL COMFORT (traditional hearing aids can cause irritation... or what if person has chronic otitis externa!) |
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What device may be appropriate for a person with significant SNHL, who has normal middle ear function yet cannot use traditional hearing aids due to feedback and insufficient high frequency amplification?
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Vibrant Soundbridge MEI
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VORP=
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vibrating ossicular prothesis
(implant used in the Vibrant Soundbridge MEI) |
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FMT=
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Floating Mass Transducer
(vibratory part of the Vibrant Soundbridge MEI that is attached to incus) |
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T/F
an MEI is an appropriate option for a child. |
False.
It is generally only used with adults |
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List the implanted parts of the Vibrant Soundbridge MEI
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Receiver (magnet and receiver coil)
Connecting conductor link Floating Mass Transducer (FMT) |
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What is included in the external part of the Vibrant Soundbridge MEI?
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Audio Processor that houses:
transmitting coil microphone digital signal processor standard HA battery |
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How does the Vibrant Soundbridge work?
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The acoustic signal is processed through the Audio Processor (AP)
Transmitted across skin to internal receiver. Electomagnetic energy from processor drives transducer into vibration. |
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How does a bone conduction (BC) hearing aid work?
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Sound is picked up by microphone and amplified to cause a vibration.
This vibrates the mastoid bone which houses the cochlea. The cochlea vibrates in accordance the frequency given, thus simulating natural hearing. |
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BC hearing aids:
1. List the positives. 2. List the negatives. |
1. great when faced with conductive components such as:
atresia ossicular chain anomalies chronic ME pathology 2. Uncomfortable (especially for children) difficult to keep in place assumes normal/near normal cochlear function. |
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BAHA=
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Bone Anchored Hearing Aid
A sound processor/receiver that is surgically implanted in the temporal bone, behind the middle ear cavity |
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BAHAs were originally designed for people who had...
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atresia
severe stenosis other malformations chronic ME pathologies surgically altered ears (cholesteatoma) |
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What are some reasons that a person would prefer a BAHA over ITE/BTE?
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ME drainage from chronic otitis media can plug up aid & cause re-infection
earmold can act as irritant causing otitis externa frequent downtime to let ear recover (BTE) or to repair aid (ITE) |
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Why would someone prefer a BAHA over a conventional BC hearing aid?
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conventional are:
uncomfortable have variable performance can cause placement issues |
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Who can use a BAHA?
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Those with:
chronic otitis media chronic otitis externa congenital atresia unilateral sensorineural HL (as a BC alternative to traditional CROS) |
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unilateral sensorineural HL is sometimes referred to as...
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single sided deafness (SSD)
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What are some etiologies of unilateral sensorineural HL?
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acoustic neuroma
sudden idiopathic SNHL mumps trauma inner ear malformations surgery |
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T/F
Candidates for a BAHA cannot have a mixed HL. |
False.
Candidates can have mixed, CHL (conductive HL), or unilateral HL (SSD=single sided deafness) |
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Age candidate for a BAHA must be at least ___ years of age.
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5+
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To qualify for a BAHA, a person must have a _______ air/bone gap.
a. small b. large |
b. Large
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A BAHA candidate with a mixed or CHL must possess the following qualities...
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5+ years old
45dB HL or less BC PTA (.5, 1, 2, 3 kHz) 60% or above Speech Recognition scores motivated by realistic expectations are compliant with treatment approach (psychosocial aspects) |
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A BAHA candidate with SSD (single sided deafness) must possess the following qualities...
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5+ years old
Other ear is NORMAL (good ear has BC thresholds at 20dB HL or less @ .5, 1, 2, 3 kHz) Patient CANNOT or WILL NOT wear CROS hearing aid |
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T/F
3 year old Billy has a unilateral sensoryneural HL that renders him completely deaf in his left ear. He has chronic otitis media and has tubes placed in both ears, therefore he should have a BAHA implanted before his fourth birthday. |
False.
BAHAs are not implanted until age 5... but other than that, he's a great candidate! |
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How does a BAHA work?
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titanium fixture implanted into mastoid where it bonds to living bone.
a percutaneous abutment is attached to the fixture sound processor can then be connected and disconnected at will processor transmits sound directly via fixture to inner ear using bone conduction |
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what term means "bonds to living bone"?
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osseointegrates
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percutaneous=
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through the skin
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Name the 6 issues addressed in selecting and fitting a hearing aid
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candidacy
pre-selection measures aid selection and fitting process verification of performance post-fitting orientation, training and counseling outcome validation measures |
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When selecting and fitting a hearing aid, an SLP find him/herself assisting the client with...
a. hearing aid selection and fitting b. verification of performance and fitting c. post-fitting orientation, training and counseling |
c. Post-fitting orientation, training, and counseling
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T/F
Significant others should not be present when the patient is receiving their orientation to their new hearing aid. |
False. Try to include them as much as possible!
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instrument orientation =
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use and care of hearing aid
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T/F
Patents should be given the instructions for care of their hearing in writing. |
True. They won't remember most of your instructions
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T/F
Patients are always thrilled with their amplification device. |
False. Sometimes their HEARING EXPECTATIONS may not match up with the reality of the amplification provided.
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What does the client need to know about care and use of their new hearing aid?
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Instrument operation (on/off, telecoil use)
Batteries (size, where to buy, how long is battery life) Acoustic feedback (what it sounds like and how to deal with it) Troubleshooting (provide worksheet) Insertion and Removal (how to put it in, use a mirror) Cleaning and Maintenance (cleaning ears and earmold, Dri-Aid kit, hazards) Service, warranty, repairs |
