Aural Rehab Nova Capstone

Front 1

Manual methods

Back 1

Using hands to express concepts, ideas and/or words.

Front 2

Types of manual methods

Back 2

American Sign Language (ASL)
Seeing Essential English (SEE 1)
Signed Exact English (SEE 2)
Finger spelling
Rochester method

Front 3

Oral methods

Back 3

using spoken language to communicate concepts, ideas, and/or words.

Front 4

Types of oral methods

Back 4

Cued speech
Auditory verbal
Auditory Oral

Front 5

Auditory verbal

Back 5

an educational approach that is intended to maximize use of residual hearing by denying visual or tactual input to listener.

Front 6

Auditory oral

Back 6

uses spoken language while incorporating speech reading, facial expressions, and natural gestures.

Front 7

Cued Speech

Back 7

Designed to supplement speechreading, hand gestures are used to let the listener know what phoneme is being spoken.

Front 8

Hearing impairment is measured by

Back 8

a pure tone threshold

Front 9

Normal hearing for adults

Back 9

20 dB or better across a frequency range of 250-8000 Hz

Front 10

Normal hearing for children

Back 10

15 dB or better across a frequency range of 250-8000 Hz

Front 11

How is severity of hearing loss measured?

Back 11

By looking at the pure tones on the audio gram

Front 12

A person's communication handicap depends on...

Back 12

The individual's activities and demands of his/her daily life and how s/he is able to compensate for and adjust to the impairment.

Front 13

Residual hearing

Back 13

the amount of usable hearing a hearing impaired person has.

Front 14

Speech perception/recognition

Back 14

the ability of the person to understand the speech of others, specific tests are used to measure this skill

Front 15

Pre-lingual deafness

Back 15

hearing loss that occurs before language is developed

Front 16

Adventitious

Back 16

hearing loss that is acquired, usually later in life, after language has developed.

Front 17

Deaf

Back 17

a culture, which has it's own language, customs, and traditions. They are against cochlear implants and do not use hearing aids or any other type of amplification. Many have gone to residential schools for the Deaf. The decision to join the Deaf community is a personal one and not based on the degree of hearing loss.

Front 18

deaf

Back 18

refers to the numbers on an audio gram. People having hearing loss greater than 90 dB are considered audiometrically deaf.

Front 19

BTE

Back 19

behind the ear hearing aid, seen mostly in babies and children

Front 20

ITE

Back 20

in the ear, mostly worn by adults

Front 21

ITC

Back 21

in the canal, worn mostly by adults

Front 22

CIC

Back 22

completely in the canal, worn mostly by adults.

Front 23

Digitally programmable aids

Back 23

hearing aids which are hooked up to a computer to make adjustments. This can allow one hearing aid to have various programs, ex: one program is acceptable for watching TV while another programs is acceptable for listening in at a noisy cocktail party.

Front 24

Parts of hearing aids

Back 24

Microphone: takes acoustic energy and change it to an electrical setting
Battery: power source
Amplifier: increase magnitude of sound, which will result in increasing the loudness of the output sound.
Receiver: transforming amplified electrical signal back to sound energy.
Telecoil: only seen in BTE, ITE, and sometimes ITC, it allows the user to talk on the phone, eliminating background noise while focusing only on the signal coming from the phone.
Tone control switch: can adjust the emphasis of frequency...this is usually used for high frequencies
Ear mold: used with BTE hearing aids, to deliver sound from the hearing aid into the listener's ear, can alter acoustic characteristics of the hearing aid by adding vents and making other changes.

Front 25

Cochlear implant

Back 25

Surgically inserted into the ear, converts acoustic energy into electrical energy which directly stimulates the CN VIII (auditory nerve). A treatment used with both children and adults, who have severe to profound hearing loss.

Front 26

Parts of the cochlear implant

Back 26

Microphone: worn at ear level, looks like a BTE hearing aid.
Speech processor: worn on the body and receives signal from microphone through cables.
Transmitting coil: visible as a round disc, located on or near the mastoid bone.
Signal is sent to the implanted receiver/stimulator and then to the electrode array.
Electrode array has 22 or 24 evenly based electrode bands, threaded through the cochlea during implant surgery. Cochlear implant must be "mapped" out a few weeks after surgery.
Mapping: consists of hearing and a maximum comfortable loudness level. Can be adjusted as necessary.

Front 27

Candidacy for cochlear implants: adults with post lingually deafness

Back 27

1, Bilateral, profound sensorineural hearing loss
2. No benefit from wearing hearing aids.
3. Extensive medical exam
4, Radiological studies to rule out anatomical contra indications for implant.
5. Psychological evaulation to test patient's motivation and readiness for the adjustment

Front 28

Candidacy for cochlear implant:pediatric

Back 28

1. Done by various professionals, otolaryngologist, audiologist, SLP, psychologists, and educational specialists
2. Family plays a BIG role, it's their decision to agree with the implant and commit to the follow-up plan, post surgery.
3. It's highly recommended for children to be enrolled in schools that use the auditory/oral communcation

Front 29

A mother wants her 16-month-old son to get a cochlear implant...

Back 29

NO! Children under the age of 2 are NOT candidates for cochlear implantation.

Front 30

Auditory training for those with cochlear implants

Back 30

1. Should be done as soon as the speech processor has been turned on adn implant has been mapped.
2. Training must be individualized.
3. Length of tranining should be a few months for post lingual deafened adults to long-term for prelingual deaf children.

Front 31

Assessments for training those with cochlear implants

Back 31

1.Should be done to decide at the level to begin the training.
2. Focus should be put on auditory skill development; awareness, attention, discrimmination, identification, memory, sequencing, closure.
3. Speech should be used as the stimuli for training (ex: use speech in auditroy modes first and move to auditory only as client progresses unless the auditory verbal approach is being used),

Front 32

Therapy exercises for those with cochlear implants

Back 32

1. Use both analytic and synthetic exerices and activities may be utilized during auditory training.
2. For childrenm using a synthetic approach integrating listening into all daily activites will yield the greatest auditory skills gains and result in greatest generalization.

Front 33

Goal of Assistive listening devices

Back 33

1. To improve signal to noise ratio, to make the primary signal (speech) stand out against background noise.

Front 34

Types of assistive listening devices

Back 34

1. Hand wired system: speaker and listener both are directly connected to each other, using wires, inexpensive, good to have for emergency situations and in ERs, also for facilitate conversations in noisy restaurants.
2. Infra red systems: transform acoustic signal to infra red light and tramsit it through the light waves from the speaker to the listener, the most common type of system used in large theaters and houses of worship, however, natural light can interfere with transmission and receiver must be direct line fo sight to the transmitter for system to work.
3. Loop induction: works only when listeners have access to telecoils (in hearing aids, using silhouette adapters), rooms can be wired with loops or individual spaces and electromagnetic leakage from loop in picked up by the telecoil, inexpensive system but other systems that are nearby can cause interference.
4. FM: transmits acoustic signal over FM radio waves, used in schools, can be personal or sound field systems, and there is no interference from o ther systems if different frequencies are used.

Front 35

Other types of assistive listening devices

Back 35

1. TDDs to help hearing impaired people use the phone, it gives a written display of the telephone conversation, both sender and receiver have to have a TDD or a relay system can be used. (TDD's need has decreased with increase use for emails, faxing, and texting)
2. Other devices for a hearing impaired can be amplifying handsets, in line amplifiers.
3. Watching TV for hearing impaired people can be made better by hearing infra red systems, FM or loop induction systems, direct audio input from telephone into their hearing aids, or by reading closed captions on TV sets.
4. Signal alerting devices, which keep the hearing impaired person alert to dangers in the home, phone or doorbell ringing, alarm clock, etc. Devices work by increasing loudness of the sigfnal (a very loud doorbell) or by transforming signal to visual or tacticle modality (a blinking light to signal fire alarm is ringing or a vibrator to signal the alarm clock is ringing).
5. Hearing dogs function as signal alerting systems for hearing impaired people.

Front 36

Parent Infant Programming

Back 36

1. Identifying hearing loss in an infant is a CRITICAL FIRST STEP.
2. Several states have universal newborn hearing screening implemented in their hospitals, oto acoustic emissions (OAE) have become a popular choice for newborn screening, ABR is used in some places or as a follow-up tool. Babies that fail an intial screening and a re-screening should be scheduled for a full audiologic evaluation.
3. SLPs must be unbiased when making suggestions, present all options in regards to communcation adn educational choices, suggest parents visit schools using each method and talk to other parents and professionals before making a decision, suggest parents attending support groups, which can be a BIG source of comfort
4. Empower parents, strongly encourage them to be primary language facilitators for their child, share info about hearing aids, have parents take advantage of any opporunity to encourage language development during daily situations and routines should be a primary goals

Front 37

Information packet with parents of children who are hearing impaired.

Back 37

1. Normal stategies and order of auditory, speech, and language skills
2. Relationship of hearing to speech and language development
3. Future acadmeic performance in school/

Front 38

Stages of auditory development

Back 38

1. auditory awareness
2. auditory attention
3. auditory localization
4. auditory discrimination
5. auditory identification
6. auditory sequencing
7. auditory memory
8. auditory closure
Understand hearing language, which is different from chronolgocial language....a baby born deaf who receives hearing aids at 15 months of age is only 9 months in hearing age at the c hronological age of 24 months., expectations for speech, language, and auditory skills development are different for a 9 month olg children than for a 24 months old child.

Front 39

Program Delivery Parent-Infant Programs
Clinic based model

Back 39

30-60 minute sessions, 2-3 times a week, parents and people who have regular contact with the child are involved in therapy, this occurs in a speech clinic

Front 40

Simulation home situation

Back 40

In the clinic room is set up to simulate the baby's home environment with the following, equipment, crib, changing table, baby bathtub, SLP models language stimulation techniques using natural daily routines and objects of the baby's life.

Front 41

Therapy in the home

Back 41

The ideal situation in which SLP uses baby's actual items, in the real environment, to show the parents language facilitation techniques

Front 42

Vowel sounds

Back 42

Low frequency, high energy, spectrographic anaylses will show a high energy concentration in the lower frequency ranges, making them easier for hearing impaired people to hear