Comd 402 Exam 3

Front 1

Why do we mask?

Back 1

1. when you need ear specific info

2. when there is possible crossover [inter-aural attenuation]

Front 2

WHAT IS HEARING AND WHERE DOES IT OCCUR?

Back 2

HEARING IS A PERCEPTUAL EVENT WHIC HAPPENS IN THE BRAIN

Front 3

Narrow Band Noise

Back 3

used for tones to put noise into non-test ear via air conduction

Front 4

WHY CROSS HEARING?

Back 4

INTERAURAL ATTENUATION; THE AMOUNT OF SOUND REQUIRED TO BRIDGE ACROSS THE HEAD AND STIMULATE THE OPPOSITE COCHLEA VIA BC

Front 5

SHADOW CURVE

Back 5

UNMASKED THRESHOLDS TRACE THIS OUT FROM THE NON-TEST EAR BY THE SIZE/AMOUNT OF IA. SIMILARITY IN CONFIGURATION.

Front 6

AT WHAT LEVELS DO INTERAURAL ATTENUATION OCCUR FOR TDH, BONE VIBRATOR, AND INSERT?

Back 6

TDH: APPROX 40 DB

BONE VIBRATOR: APPROX 0 DB

INSERT: APPROX 60-70DB

Front 7

WHEN DO YOU MASK AIR CONDUCTION?

Back 7

WHEN THE UNMASKED THRESHOLD IN TE IS >BC THRSHOLD IN NTE BY THE MINIMUM IA VALUE OR MORE

Front 8

WHEN TO MASK BONE CONDUCTION?

Back 8

1.MASK ANY SIGNIFICANT AIR BONE GAP

2.MOST OFTEN CALCULATED AT > 10DB

3. AIR BONE GAP=

ACte - BCte

Front 9

WHEN IS MASKING NOT NEEDED?

Back 9

WHEN TEST RESULTS

1. ARE ALL SYMMETRICAL

2. THERE IS NO SIGNIFICANT AIR-BONE GAP.

Front 10

TIME WHEN YOU CAN'T MASK

Back 10

1. CHILDREN

2. COGNITIVE DELAY

Front 11

MASKING

Back 11

INSURING THAT THE NON-TEST COCHLEA IS NOT HELPING OUT. MAKING SURE THAT THE EAR YOU WANT TO TEST IS THE ONE THAT IS RESPONDING.

Front 12

EFFECTIVE MASKING

Back 12

CONDITION WHEN THE NOISE PRESENTED TO THE NON-TEST-EAR IS SUFFICIENT TO KEEP IT FROM CONTRIBUTING TO THE RESPONSE AND IS NOT INTENSE ENOUGH TO INFLUENCE THE ABILITY OF THE TEST EAR TO RESPOND.

[PUTTING IN ENOUGH NOISE IN THE NON-TEST EAR TO KEEP IT FROM HEARING THE NOISE]

Front 13

UNDERMASKING

Back 13

CONDITION WHEN NOISE PRESENTED TO THE NON-TEST EAR IS NOT SUFFICIENT TO KEEP IT FROM CONTRIBUTING TO THE RESPONSE. [NOT USING ENOUGH NOISE DURING MASKING]

Front 14

OVERMASKING

Back 14

CONDITION WHEN THE NOISE PRESENTED TO THE NON-TEST EAR IS INTENSE ENOUGH TO CROSS OVER TO THE TEST EAR AND MASK IT. [USING TOO MUCH SOUND]

Front 15

THE OCCLUSION EFFECT

Back 15

ENHANCEMENT OF BONE CONDUCTION PRODUCED BY COVERING OR CLOSING OFF THE EXTERNAL EAR CANAL.

Front 16

TWO TYPES OF EVALUATIONS

Back 16

BEHAVIORAL AND PSYCHOLOGIC

Front 17

CROSS-CHECK CONCEPT

Back 17

IF YOU LOOK AT THE BEHAVIOR AND PHYSIOLOGICAL RESULTS YOU WANT THEM TO AGREE. CHECKS FOR ACCURACY AND PATHOLOGIES. SIMPLY SAID OFTEN A SINGLE TEST IS NOT GOOD ENOUGH TO ANSWER ALL OF THE QUESTIONS

Front 18

BEHAVIORAL TESTS/ESTIMATES

Back 18

1. MEASURE AN OBSERVABLE BEHAVIOR [ASSOCIATED WITH HEARING PERCEPTION]

2. UTILIZE;STIMULUS-RESPONSE CONSEQUENCE

3. MOST COMMON TEST USED TO ESTIMATE HEARING [PURE TONE AUDIOMETRY] PROVIDES A BEHAVIORAL ESTIMATE OF HEARING

Front 19

PHYSIOLOGIC TEST

Back 19

1. TONE IS BEING PRESENTED BUT NOT ASKING FOR BEHAVIORAL RESPONSE [JUST READING THE RESULTS ON A GRAPH]

2. TEST THE FUNCTION/STATUS OF THE SYSTEM

Front 20

PURE TONE AVERAGE

Back 20

1. PART OF THE MOST COMMON INTER-TEST RELIABILITY STATEMENT SPECIFICALLY

2. IT'S COMPARED TO THE SPEECH THRESHOLD VALUE [SRT]

3. ACCEPTABLE RELATIONSHIP BETWEEN PTA AND SRT

Front 21

SPEECH THRESHOLD TEST

Back 21

PURPOSE IS TO COMPARE TO PURE-TONE AUDIOMETRIC RESULTS. SHOULD AGREE WITH PTA +/- 10 DB.

Front 22

WHAT HAPPENS WHEN THERE IS A GREATER THAN 10 DB VARIATION BETWEEN TEST?

Back 22

YOU HAVE A VALIDITY ISSUE. YOU WOULD EITHER RETEST OR LOOK AT NON-BEHAVIORAL TEST RESULTS.

Front 23

PHYSIOLOGIC TEST

Back 23

AUDITORY BRAIN STEM RESPONSE TESTS [ABR], OTO-ACOUSTIC EMISSIONS [NEWBORN]

IMMITTANCE TESTS [TYMPANOMETRY; ACOUSTIC REFLEX TESTING]

Front 24

FUNDAMENTAL POINT OF THE CROSS-CHECK PRINCIPLE

Back 24

ORIGINAL APPLICATION WAS IN PEDIATRIC ASSESSMENT.

Front 25

CO-EXISTING LESIONS

Back 25

THE POSSIBILITY THAT THE LISTENER COULD HAVE MULTIPLE PROBLEMS WITHIN THEIR AUDITORY SYSTEM[S]

Front 26

WHAT ARE THE MEDICAL APPLICATIONS OF AUDIOLOGY?

Back 26

1. DETECT PRESENCE OF DISEASE

2. TRACK PROGRESS OF DISEASE [TRIGGER FOR TREATMENT]

3. AS OUTCOME MEASURE OF EFFECTS OF TREATMENT [PRE-OP/POST-OP,POST MECD]

4. TRACK PROGRESS OF TREATMENT

5. TRACK UNDESIRED EFFECTS OF TREATMENT

Front 27

WHAT ARE THE NON-MEDICAL APPLICATIONS OF AUDIOLOGY?

Back 27

1.TO DETECT A SIGNIFICANT HEARING CONDITION

2. TO DETERMINE NEED FOR NON-MEDICAL INTERVENTION

Front 28

INTRA VS INTER

Back 28

INTRA: WITHIN THE SAME TEST

INTER: MULTIPLE TESTS

Front 29

WHY DO WE USE SPEECH AUDIOMETRY?

Back 29

1. FOR COMPREHENSIVE TESTING

2. WE INCORPORATE SPEECH ASSESSMENT

3. SPEECH THE MOST IMPORTANT AUDITORY STIMULUS BECAUSE SPEECH IS BASIS FOR SPOKEN LANGUAGE

Front 30

PRINCIPLE OF THE LEVEL OF COMPLEXITY OF MATERIAL

Back 30

SPEECH MATERIAL FORMS A CONTINUUM FROM WHAT IS CONSIDERED.

ANALYTIC-LEVEL TO SYNTHETIC-LEVEL MATERIALS

DEPENDING ON THE POSITION ALONG THIS CONTINUUM, DIFFERENT SOURCES OF INFORMATION ARE AVAILABLE

Front 31

ANALYTIC

Back 31

PHONE SOUNDS IN SPEECH

PHONEMES [SMALLEST UNIT OF MEANINGFUL SOUND]

BASIC

Front 32

SYNTHETIC

Back 32

MULTI-SYLLABIC WORDS, PHRASES, SENTENCES, CONVERSATIONS

Front 33

SPEECH AUDIOMETRY

Back 33

TRADE OFF IN ASSESSMENT OF A PERSON'S ABILITY TO PROCESS SPEECH. AUDIBILITY VS. UNDERSTANDING/DETECTION VS. FAMILIARITY.

Front 34

DETECTION

Back 34

IS THE SOUND THERE?/ HEARING

Front 35

DISCRIMINATION

Back 35

IS IT THE SAME OR DIFFERENT?/UNDERSTANDING

Front 36

RECOGNITION

Back 36

REPEAT THE WORD OR IDENTIFICATION [POINT TO]

Front 37

COMPREHENSION

Back 37

MEANING [DEPENDENT ON MEMORY, ATTENTION, CLOSURE] MORE CENTRAL AUDITORY PROCESSING

Front 38

SPEECH RESPONSE THRESHOLD

Back 38

SOFTEST VOICE TONE THAT IS AUDIBLE TO THE LISTENER 50% OF THE TIME. LISTENER HAS TO BE FAMILIAR OR UNDERSTAND THE WORDS

Front 39

SPEECH DISCRIMINATION SCORE

Back 39

MEASURED IN PERCENTAGE/AMOUNT OF CORRECT RESULTS. WHEN MEASURING IT HAS TO BE AUDIBLE [NO LONGER TESTING THE DB OF HEARING RATHER IF THE LISTENER HEARS THE WORDS]

Front 40

GROWTH OF UNDERSTANDING

Back 40

ONCE SOMETHING IS AUDIBLE/LOUD ENOUGH IT SHOULD BE AUDIBLE/LOUD ENOUGH. AS THE INTENSITY INCREASES SO DOES THE ACCURACY. ONCE YOU CAN HEAR IT'S GOING TO PLATEAU

Front 41

TWO BASIC TESTS IN SPEECH AUDIOMETRY

Back 41

1. SPEECH THRESHOLD TEST

2. WORD RECOGNITION TEST

Front 42

PRIMARY PURPOSE OF A SPEECH THRESHOLD TEST

Back 42

TO COMPARE TO PURE TONE AUDIOMETRIC RESULTS. SHOULD AGREE WITH PURE TONE AVERAGE +/- 10 DB.

Front 43

SRT

Back 43

SPEECH RESPONSE THRESHOLD

Front 44

SPONDEE

Back 44

2 SYLLABLE WORD THAT CAN BE SEPARATED INTO TWO DIFFERENT WORDS

Front 45

IF THE LISTENER CAN'T PERFORM SRT WHAT TEST DO YOU USE?

Back 45

SAT-SPEECH AWARENESS THRESHOLD

SDT-SPEECH DETECTION THRESHOLD

Front 46

WHY DO WE USE MONOSYLLABIC WORDS IN SRT?

Back 46

BECAUSE MONOSYLLABIC WORDS HAVE A GRADUAL GROWTH THEY HAVE A STRONGER INDICATION OF WHERE THE LOSS MIGHT BE. IE. IF PTA AND SRT SHOW SYMMETRY BUT SPEECH DISCRIM SHOWS ASYMMETRICAL RESULTS CAN INDICATE A PATHOLOGY MEASURED IN PERCENTAGE CORRECT

Front 47

WHAT FACTOR HEAVILY IMPACTS WORD RECOGNITION SCORE?

Back 47

PRESENTATION LEVEL OUTCOME/AUDIBILITY OF MATERIAL.

Front 48

THRESHOLD

Back 48

USED TO DETERMINE IF THE PATIENT'S PERFORMANCE AGREES WITH HIS OR HER PURE TONE HEARING LOSS

Front 49

DISCRIMINATION

Back 49

TO IDENTIFY UNUSUAL ASYMMETRY THAT IS NOT PREDICTED BY THE HEARING LOSS.

TO MONITOR PERFORMANCE OVER TIME, THROUGH SEQUENTIAL TESTING.

TO ASSIST IN MAKING AMPLIFICATION DECISIONS.

Front 50

TYPICAL RANGE OF HEARING IN A HEALTHY ADULT

Back 50

20-20K HZ

Front 51

PEDIATRIC HEARING LOSS

Back 51

A CONDITION IN WHICH A CHILD OR ADOLESCENT IS UNABLE TO DETECT OR DISTINGUISH THE RANGE OF SOUNDS AT THE LEVEL NORMALLY POSSIBLE BY THE HUMAN EAR.

Front 52

PEDIATRIC AUDIOMETRY

Back 52

IMPORTANCE OF HEARING. RECOGNIZE FAMILIAR VOICES, DIFFERENTIATE AMONG WIDE RANGE OF SOUNDS [IE. FAMILIAR VOICES]. THIS IS WHY IT IS SO IMPORTANT TO IDENTIFY COMMUNICATION DISORDERS ASAP.

Front 53

PEDIATRIC TESTING

Back 53

1. STAKES ARE MUCH HIGHER THAN ADULT

2. HISTORY VERY IMPORTANT AND MORE EXTENSIVE

3. USE FAMILY-CENTERED APPROACH IN BOTH DIAGNOSTIC AND INTERVENTION

Front 54

HEARING LOSS AND COMMUNICATION

Back 54

-IT VARIES IN THE EXTENT THAT IT AFFECTS SPEECH, LANGUAGE, AND COMMUNICATION.

-AFFECTS ABILITY TO DEVELOP RELATIONSHIPS, SUCCEED ACADEMICALLY AND BE INVOLVED

Front 55

VARIETIES OF HEARING LOSS

Back 55

LOCATION, SYMMETRY, EXTENT OF IMPACT ON COMMUNICATION, PERSISTENCY, TIMING, LATERALIZATION

Front 56

location

Back 56

peripheral:damage to the outer, middle, or inner ear, or the auditory nerve

central: hearing loss due to problems after the auditory nerve hits the brain stem

Front 57

auditory processing disorder

Back 57

hearing loss resulting from damage to the processing centers of the brain. can be present without peripheral hearing loss

Front 58

edhi

Back 58

early hearing detection and intervention programs are present in most states, with the goal to detect hearing loss while the infant is still in hospital at birth.

Front 59

early identification

Back 59

family needs to respond early, proactively, and responsively. newborn hearing screenings increase likelihood of early identification. parental decision: communication mode. BEST AGE FOR IDENTIFICATION AND INITIATION OF INTERVENTION PRIOR TO 6 MONTHS.

Front 60

When are toddlers and preschoolers referred?

Back 60

1. if they show signs of developmental delay

2. have hereditary disposition for hearing loss

3. develop disease or disorder that affects that auditory mechanism

Front 61

pediatric audiology screening and evaluation steps

Back 61

1. screening

2.pediatric techniques used in diagnostic testing

Front 62

who is typically screened in schools?

Back 62

k,2,5,8,10

special eduction

teacher/parent referrals

new students

Front 63

procedure for hearing screening in schools

Back 63

screening levels: 500, 1k, 2k, 4k all at 20 or 25 dbhl

pass=child heard all 8 tones

fail=child did not hear any single 1 or more

Front 64

when do we need more extensive evaluations?

Back 64

the younger the child the more dependent of physiologic test; however comprehensive assessment is not complete until behavioral assessment is also done. [always with children]

Front 65

behavioral observation [boa]

Back 65

age: birth to 6 mos.

outcome: yields a minimal response level not threshold

stimuli: noisemakers, speech, warble tones, narrow bands of noise typically in sound field

unconditioned response

Front 66

limitations of a boa

Back 66

1. if done in a sound field not ear specific

2. will miss mild to moderate hl

3. cant get a lot of data

4. judgement of whether child responded to stimuli is highly subjective

Front 67

visual reinforcement audiometry [vra]

Back 67

age: 6 mos to 2 years [some suggest 3 yrs]

outcome: yields a minimal response level not threshold

stimuli: speech, warble tones, narrow bands of noise typically in sound field

conditioned/trained response

Front 68

limitations of vra

Back 68

1. if done in sound field not ear specific

2. need special equipment

3. best done with assistant

4. children get bored with procedure

5. judgement of whether child responded to stimulus is still an issue however response if more obvious

Front 69

conditioned play audiometry [cpa]

Back 69

age: 2.5 to 4/5 years

outcome: should be closer to threshold

stimuli: using earphones and/or bone vibrator, can deliever speech, pure/pulsed/warble tones;

conditioned/trained response using a play response

Front 70

limitations of cpa

Back 70

1. cognitive level of child and behavior are critical

2. needs appropriate toys/tasks

3. best done with assistant

4. children get bored with procedure

Front 71

modified conventional audiometry

Back 71

age: 5 years and older

outcome: should be a threshold

stimuli: using earphones and/or bone vibrator, can deliver speech, pure/pulsed/warble tones

response: more like adult; verbal reinforcement

Front 72

how is pediatric hearing loss treated?

Back 72

communication choices, amplification and listening devices, aural habiliation

Front 73

hearing aid evaluation

Back 73

if family decides on this option, it requires fitting and monitoring use of hearing aids. hearing aids in children usually have behind the ear hearing aids [btes]

Front 74

probe microphone measurement

Back 74

computerized method of measuring hearing aid function in a child's ear

Front 75

electroacoustic evaluaiton

Back 75

electronic verification of sound properties of hearing aid [gain, output, frequency response]

Front 76

cochlear implants

Back 76

provides direct electrical stimulation to the auditory nerve, for children with severe to profound sensorineural loss

Front 77

additionally assistive listening devices

Back 77

improve a person's ability to hear in difficult listening situations [eg. fm system, soundfield system]

Front 78

aural habilitation

Back 78

individualized intervention to achieve fluent communication in manual and/or oral modality. involves activities such as tactile training, auditory, training, speech reading and visual cues, and education and counseling.

Front 79

three principles of aural habilitation

Back 79

1. ensure an appropriate listening environment

2. maximize audition

3. support the continuum of listening development

Front 80

intervention principles: infants, toddler, and preschoolers

Back 80

1. early intervention

2. parental involvement

3. naturalistic environments

4. social interaction

5. functional outcomes

Front 81

intervention principles: school aged children

Back 81

1. effective means of communication

2. self-advocacy

3. literacy