Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
47 Cards in this Set
- Front
- Back
|
diagnostics
|
counsel the client through the testing procedures and what should be expected, through the test results, and by encouraging them to tell their story (case history
|
|
|
treatment
|
potential treatment options limitations of each allow the patient to choose a treatment realistic expectation
|
|
|
counsel
|
important part of any plan,implemented throughout diagnosis and treatment, accept hearing loss motivate to develop treatment
|
|
|
Parameters of therapy planning
|
Stimuli, response, condition
|
|
|
Stimuli
|
• Spondees
• mono-syllabic words • simple sentences • multi-syllabic words, • connected discourse • numbers |
|
|
Response
|
• detection
• discrimination • identification • comprehension |
|
|
Condition
|
• noise
• rate • articulation • distortion |
|
|
Vary stimuli
|
• redundant
• familiarity of stimuli • level of complexity of vocabulary • length of sentences • amount of context • rate of speech |
|
|
Modify response
|
• length of response required
• closed/open set response • require verbal/non-verbal response • ask for main idea/details |
|
|
Modify condition
|
• changing the amount of background noise
• changing the amount of distortion • change lighting • change angle from speaker • change distance from the speaker. |
|
|
refer for prof. counseling
|
unrealistic expectations, underlying psychological issues, or if guilt, anger, denial or depression does not lessen with aural rehabilitation
|
|
|
Informational counseling sig other
|
importance of non-verbals, environmental controls, understand care of HA and use, not to enable, assertiveness training, comm. strategies
|
|
|
Experiential sig other
|
play a speech reading CD, watch TV w/ volume turned down, attend speech reading training to help with empathy and address any coexisting speech problems
|
|
|
char. of clear speech
|
• Longer pauses
• Increased durations of speech sounds • Longer vowels • Longer sibilants • Consonant vowel ratio-vowel intensity relative to consonant intensity-in clear speech consonants are produced louder leading to more comprehension |
|
|
Advantages of clear speech
|
• More words in the middle of a sentence are understood w/ clear speech
• Inter-word pauses increase • Fewer phonological modification such as vowel reduction and stop burst deletion. • Vowel formants tend to achieve ideal values more often • Intelligibility is increased by 70% in background noise • More beneficial in an environment with reverb |
|
|
90 day treatment plan
|
Functional outcome goals,functional categories, 90 day focus goals, may include pretesting
|
|
|
Functional outcome
|
o Improve aural encoding and comprehension skills-receptive
o Analytic and synthetic |
|
|
• Functional categories
|
o Analytic
Discrimination Identification Awareness Phoneme viseme correspondence o Synthetic o Word recognition o Context for sentence closure o Communication strategies |
|
|
90 day focus/goals
|
• Behavioral objective: Corrinne will repeat ten spoken words by the clinician without voice in the presence of speech babble with decreasing signal to noise ratio with 80% accuracy over three consecutive sessions.
|
|
|
Levels of hearing aid care
|
Independent, partial assistance,full assistance,supervised use
|
|
|
Independent use
|
• Individual knows how to care for hearing aid
• Report own problems • Replace batteries • Cleaning • Storage • Changing programs for specific situations • Removal and insertion |
|
|
Partially assisted use
|
• Remind when to change battery
• Ask if everything is working okay • Remind to clean and care • Offer assistance when struggling |
|
|
Full assisted use
|
• Hearing aids kept at a nurses stations
• Staff does everything o Cleaning o Battery changes o Report problems o Storage o Removal and insertion |
|
|
Supervised use
|
• Hearing aids are only used when someone is there to supervise
• Call company if there are problems • Only provided when patient needs the hearing aid |
|
|
Type of long term care facilities
|
Rehabilitation centers and nursing homes
|
|
|
Rehab center
|
• Short term
• Seen as a step forward • Dealing with emotional issues • Ability to communicate is crucial • Hearing loss is often overlooked |
|
|
Nursing home
|
• Longer length of stay
• Loneliness, other emotional issues • only 10% of patients who need a hearing aid have one |
|
|
Why nursing home short HA
|
no audiologist
• hearing aids get lost • compliance on part of patient is low. why? already dealing with so many new • things, he/she does not want to deal with new hearing aids • little or no family involvement, and no money for hearing aid • no one to clean the wax out of patient's ear can be a problem |
|
|
Presbycusis
|
The decline in hearing associated with various types of auditory system dysfunction that accompanies aging-high frequency sensory neural loss (neural, sensory, metabolic, and mechnical)
|
|
|
Neural presbycusis
|
loss off neurons in the cochlea results in poor speech recognition
|
|
|
Sensory presbycusis
|
Loss of outer hair cells and supporting cells in the basal turn of the cochlea-high frequency loss
|
|
|
Metabolic-
|
lack of oxygen and release of free radicals genetically linked-affects the organ of corti
|
|
|
Mechanical-
|
causes a stiffening of the basilar membrane
|
|
|
Prevelence presbycusis
|
25-30% age 65 have some hearing loss, 50% by 70
|
|
|
Population diff presbycusis
|
Gender differences-Men lose at about 3dB/decade lose as early as thirty-70-80% of nursing home pop.
|
|
|
characteristics of hearing loss that affect communication
|
Degree of hearing loss
2. Age of onset-this is key because it tells you how much experience the person has had with language before hearing loss |
|
|
Psychological impact HL
|
Denial
Frustration and inadequacy Rather than confront the problem, some choose to withdrawal Isolation and loneliness May lead to depression Procrastination in diagnosis and treatment Wait 7-9 years before get hearing test and treat it Feelings of anxiety Perception that others will treat one differently if they know the person has a hearing aid May become withdrawn or arrogant (aggressive) |
|
|
models of vestibular rehab
|
Substitution therapy, habituating exercises
|
|
|
Habituating exercise
|
-help the patient adapt through repetition of the provoking activity-working to retrain the brain by rebuilding neural pathways
• Reaching to get a glass at of the cupboard-start a small levels then move toward the goal. |
|
|
Substitution therapy
|
strengthen the balances system help use other systems to compensate for the vestibular problem
• Strengthen proprioception to help compensate for the loss of balance-ie sit on an exercise ball and work to maintain balance • Strengthen use of vision-walking while maintaining focus on a particular object and using different ranges of head movement horizontally and vertically. Difficulty can be increase by making the client walk on a an unstable surface while focusing on the object. This coordinates proprioception and vision together along with challenging the vestibular system |
|
|
Physical compensation mechanism
|
can lead to other problems such as muscle stiffness
• Turn the whole body instead of just the head • Look at the floor • Hip sway |
|
|
Tinnitus retraining therapy-decrease
|
response to repeated stimuli-retrain brain,annoyance factor,perception
|
|
|
Tinnitus retraining therapy-aid
|
AVOID silence-sound therapy at night, mod->severe sound therapy all the time, mild-counseling maybe sound therapy
|
|
|
Tinnitus retraining therapy-change
|
change patient view-understanding auditory system, hearing loss and tinnitus-inc understanding dec fear.
|
|
|
Tinnitus retraining therapy-brain
|
Remove fear, realistic expectations, remove from consciouness, change view, hyperacoustic/phonaphobic must fix first.
|
|
|
Counsel patient-therapist skills
|
establish rapport, empathy, expert on normal and disordered, realistic exp.,motivate, enhance clients well being, self concept and social relations
|
|
|
Counsel a patient-help
|
help w/ accept HL, help adjust to treat and lifestyle, help cope w/ changes and probs that won't go away,
|
