Hearing Impairments

Front 1

What are three purposes of hearing aids?

Back 1

1) To amplify speech and environmental sounds
2)To optimize intelligibility and sound clarity
3) to assure loud sounds are not uncomfortable or distored

Front 2

In what decade was electrical amplification introduced?

Back 2

1920's

Front 3

In what decade did miniaturization begin?

Back 3

1960's

Front 4

In what decade were audiologists begining to be allowed to dispense?

Back 4

1970's

Front 5

what was the "digital/programmable" decade?

Back 5

1990's

Front 6

what was the "implantable" decade?

Back 6

2000's

Front 7

Name the 4 basic components of the hearing aid

Back 7

1) microphone
2) amplifier
3) receiver
4) battery

Front 8

Name the 3 basic controls of the amplifier

Back 8

1)gain control
2) tone control
3) input/output compression

Front 9

Name 5 controls and features of a hearing aid

Back 9

1) on/off switch
2) telecoil
3) volume control
4) compression
5) directional microphone

Front 10

Name the 6 styles of hearing aids

Back 10

1) body aid
2) behind the ear (BTE)
3) In the ear (ITE)
4) In the canal (ITC)
5) Completely in the canal (CIC)
6)ITD

Front 11

what specialized device works well for unilateral hearing loss?

Back 11

CROS/BICROS (Contralateral Routing of Signal)

Front 12

what specialized device works well for conductive hearing loss?

Back 12

Bone Conduction Aid

Front 13

What specialized device works well for conductive and/or unilateral loss?

Back 13

Bone Anchored Hearing Aid (BAHA)

Front 14

what is the style for earmolds?

Back 14

There is a variety of styles and materials

Front 15

mofifying low frequency is _____.

Back 15

Venting

Front 16

modifying mid frequency is ____.

Back 16

damping

Front 17

modifying high frequency is____.

Back 17

accoustic horn

Front 18

What 3 things determine if you are a hearing aid candidate?

Back 18

1) degree of hearing loss
2) degree of communication problem
3)motivation to use hearing aids
(i would say also type of hearing loss)

Front 19

How is criteria #1 for hearing aid candidacy (the degree of hearing loss) determined?

Back 19

Thresholds Audibility Index, Count the Dots

Front 20

How is criteria #2 for hearing aid candidacy (the degree of communication problem) determined?

Back 20

Self-assessment
Case history

Front 21

What are 4 preselction measures in choosing a hearing aid?

Back 21

1) Pure-tone thresholds
2) Speech reception
3) Speech recognition (quiet/noise)
4) Uncomfortable loudness (UCL)

Front 22

What 11 hearing aid components factor in to selection of a hearing aid model?

Back 22

1) Style
2) Gain and frequency response
3) Multiple channels
4) Multiple memories
5) Compression
6) Expansion
7) Directional microphone
8) Noise reduction
9) Feedback reduction
10) Linked hearing aids
11) Data logging

Front 23

Name 14 factors affecting the impact of HL

Back 23

1)Age at Onset,
2)Identification,
3)Intervention
4)Degree of HL
5)Permanence of Loss
6)Affected Ear(s)
7)Site of Lesion/Etiology
8)Sensory Device Use/Benefit
9)Extent and Type of Intervention
10)Cognitive Ability
11)Other Handicapping Conditions
12)Family,
13)Culture,
14)Socioeconomic Status

Front 24

describe brink and stone's chain reaction

Back 24

Hearing Loss →
Communication Problems →
Social Engagement →
Self-Concept (esp. for children) →
Mood

Front 25

describe the 7 components of Kubler-Ross' cycle of grief

Back 25

1) (Shock – even when diagnosis suspected)
2) Denial
3) Anger
4) Bargaining
5) Depression
6) Acceptance
7) Cyclical Process – renewed grief

Front 26

What did Vernon's 1965 review of intellectual development for the hearing impaired show?

Back 26

Vernon’s Review (1965)
Range of IQ among deaf same as hearing
Disproportionate prevalence of lower IQ’s
No relationship between degree of loss and IQ

Front 27

what are 7 changes in intellectual abilities

Back 27

1) Attention
2) Memory
3) Academic and everyday knowledge
4) Problem solving
5) Imagination
6) Creativity
7) Language

Front 28

What are 9 social/emotional development issues

Back 28

Attachment
Emotional communication
Self-understanding
Knowledge about others
Interpersonal skills
Friendships
Intimate relationships
Moral reasoning
Behavior

Front 29

describe HI's potential impact on attachment

Back 29

Emotional bond between infant and caregiver (later with familiar people)
Affected by audition, vision, tactile
Enhanced by communication competence
Failure to bond – long term implications

Front 30

describe potential communication between parent and HI child

Back 30

“Rigid, negative, more directive, less praise”
Child-Directed Communication
Mixed and missed signals
Native language
Natural interaction
Visual contact needed
Parent vs. surroundings

Front 31

Describe impact on self-regulation and emotional expressivement

Back 31

Newborn → Infant → Toddler
Develop ability to regulate feelings; retreat from negative situations; control negative emotional displays
Need language
Labels of feelings, consequences, shared meaning
Goal: adaptive functioning

Front 32

Dscribe the skills needed to develop satisfying relationships/ social competence

Back 32

Skills needed to develop satisfying relationships
Think independently
Self-direct and self-control
Understand feelings, needs of self and others
Flexibility
Tolerate frustration
Ability to rely on or be relied upon
Maintaining healthy relationships

Front 33

describe HIs potential impact on social and emotional development

Back 33

Inability to mediate experiences and feelings with language
Lack of motivation/initiative (learned helplessness?)
Low academic achievement
Underemployment
Social maladaption (violence, drugs, alcohol)

Front 34

Describe Impact on Incidental Learning: Learning Through Passive Exposure

Back 34

Reduces natural learning
Puts parent in role of “teacher”
Learning limited by language, communication skills, experiences

Front 35

describe the developmental tasks of adolescence

Back 35

Developmental tasks
Affiliation with peer group
Identify formation
Occupational preparation
Adjustment to physiologic changes

Front 36

Seek attention/help from others to satisfy needs/wants

Back 36

Instrumental dependence

Front 37

Desire for proximity, approval, affection from others

Back 37

Emotional dependence

Front 38

sense of belonging

Back 38

Intimate attachments

Front 39

Name 4 adoescent risks

Back 39

Less emotional bonding
Greater aggression
Rejection of amplification
Increased self-consciousness

Front 40

Discuss deafness's potential impact on personality

Back 40

Emotional immaturity
Egocentricity
Irritability
Impulsiveness
Suggestibility

Front 41

Name 3 advantages of being deaf of deaf

Back 41

Consistent parenting
Effective communication
Tolerant social environment

Front 42

name 4 positive outcomes of being deaf of deaf

Back 42

Better adjustment
Higher educational level
Better command of language
Higher teacher/counselor ratings (e.g., maturity, independence, sociability)

Front 43

Adult Adjustment to HL Affected By:

Back 43

Same factors that affect adjustment among children +
Internal responses
Cognitive appraisals
Emotional reactions
External behaviors
Positive and maladaptive

Front 44

A 2000 NOCA survey of hearing impaired adults measured emotional instability, anger/frustration,depression symptoms,paranoia, and denial in HI adults over age 50 (HA users and non-users in 5 categories of degree of HL).
It found

Back 44

1) Negative emotional effects increased with severity of HL
2) Negative effects greater among non-users of HA’s

Front 45

how long does it take for adult onset HI adult to take action

Back 45

7 years or more average

Front 46

adjustments to impairement in adult are impacted by____ and ____.

Back 46

1) deinal
2) stigma (hearing aid effect).

Front 47

name 8 potential negative reactions to hearing impairment

Back 47

Anxiety
Irritability
Frustration
Depression
Withdrawal
Lack of independence
Disrupted relationships
Paranoia

Front 48

describe 3 findings on HI impact on mental health

Back 48

1) Impact of HL on mental health inversely related to age
2) Mental health ratings increase 0.1SD per 10 dB of HL
3) Little or no impact of HL on mental health IF low frequency hearing maintained

Front 49

which hearing impaired people report the most depression symptoms(when thinking about hearing aids and adherence)

Back 49

non-adherent women

Front 50

who reported the least depression symptoms (when thinking about hearing aids and adherence)

Back 50

adherent women

Front 51

You must differentiate between choice to "disengage" and _______.

Back 51

handicap

Front 52

define 3 main cognitive functions and 3 other cognitive functions

Back 52

main: perceiving, remembering, thinking
other:Attention, Processing Speed, Memory

Front 53

when is cognitive function the best

Back 53

in your 30s and 40s

Front 54

when do changes in cognitive function become noticable

Back 54

not until your 70s

Front 55

what percentage of people in their 80s only have a small decline in cognitive function

Back 55

2/3

Front 56

define attention

Back 56

focus on information, determine relevance

Front 57

define processing speed

Back 57

time to perform a mental task

Front 58

discuss the impact of late onset deafness

Back 58

Cycle of grief
Impact on significant others, work
No ties to deaf community
Loss of primitive hearing ability

Front 59

What 3 aspects of counselling are within the ASHA scope of practice?

Back 59

1) Provide patient/client and family/caregiver with information and support
2) Make appropriate referrals to other professionals
3)Help patient/client develop problem-solving strategies to enhance rehabilitation

Front 60

Name 5 goals of counselling

Back 60

1) Appraise strengths and limitations
2) Increase confidence, knowledge, skill
3) Reduce stress
4) Facilitate access to support
5)Promote positive function

Front 61

Name 5 factors which may affect adaptation

Back 61

1) Family
2) Personality factors
3) Socioeconomic factors
4) Resources
5) Exposure to hearing loss

Front 62

compare and contrast professional versus non-professional counselling by descring 3 aspects of each

Back 62

Professional counselling:
1) focuses on reorganizing or reinterpreting personal conflicts
2) affect major personality changes
3) Explore the subconscious
Non-Professional counselling:
1) Not primary identity
2) Not trained as a professional counselor
3) Focus on coping with and adjustment to hearing-related problem

Front 63

hearing loss management counselling is based on the ______ model.

Back 63

Hearing loss management counselling is based on the well-patient model.

Front 64

is the patient psychological normal/abnormal in hearing loss counselling?

Back 64

normal

Front 65

Is hearing loss counselling typical long-term or short-term

Back 65

short term (and focused on practical changes)

Front 66

List 4 counselling theories or styles

Back 66

1) Person-focused
2) Empathic listening
3) Behavioral
4) Cognitive/Rational

Front 67

What is patient-focused counselling

Back 67

Patient knows best

Front 68

What is behavioral counselling

Back 68

Directive approach

Front 69

What is cognitive/rational counselling?

Back 69

Emotive
Patient learns to identify and modify irrational, self-defeating thoughts

Front 70

describe 4 aspects of the counselling process

Back 70

1) Help patient tell and clarify “story”; what do they see as their problem
2) Help patient take responsibility
3) Help patient set goals
4) Help patient develop, implement, and evaluate plan to solve problems

Front 71

5 Clinician Behaviors and Attitudes That Interfere or Reduce Effectiveness of Counselling

Back 71

Habituation
Generalization
Comparison
Being Right
Multitasking

Front 72

name 4 important boundaries for non-professional counselling

Back 72

1) Limited to problems related to hearing impairment
2) Guided by and supportive of individual and family
3) Does not foster dependency
4) Does not enter realm of clinical psychology

Front 73

name 4 appropriate hearing-related topics for non-professional counselling

Back 73

1) Feelings
2) Information
3) Concerns about treatment results or prognosis
4)Treatment planning or decision making

Front 74

name 3 borderline appropriate topics for non-professional counselling

Back 74

Intense negative reactions/feelings

Problems with relationships

On-going adjustment problems

Front 75

completely inappropriate topics for non-professional counselling

Back 75

Other medical
Chronic unhappiness
Marital problems
Violence and other illegal or maladaptive actions

Front 76

name the two main types of non-professional counselling

Back 76

informational and personal adjustment counselling

Front 77

define informational counselling

Back 77

content counseling

Front 78

define personal adjustment counselling

Back 78

social-emotional, support

Front 79

name 6 problems addressed by informational or content counselling

Back 79

Description of hearing
Causes of hearing problems
Treatment options
Sensory device options
Hearing aid problems
Service options

Front 80

name 4 Problems Requiring Personal Adjustment or Emotional Counseling

Back 80

Acceptance of HL
Participation in family activities
Psychological adjustment
Social-vocational difficulties

Front 81

Universal Newborn Screenings result in ________-driven counseling whereas the focus should be on ______needs and strengths

Back 81

Universal Newborn Screenings result in institution-driven counseling whereas the focus should be on family needs and strengths

Front 82

According to Roush & Harrison, what are the 3 groups pediatric counselling needs?

Back 82

1) Parents of children w/mild-moderate HI
2) Parents of children w/severe-profound HI
3) Pediatric Audiologists

Front 83

when should pediatric counselling occur?

Back 83

Needs at time of diagnosis and (w/i) 6 months later

Front 84

what are the 5 counselling needs during diagnosis of a mild-moderate pediatric hearing loss?

Back 84

1)causes
2)audiogram
3)timelines for learning speech/language
4) anatomy & physiology
5) coping

Front 85

what are the 4 counselling needs 6 mos. after a diagnosis of a mild-moderate pediatric hearing loss?

Back 85

listen/speak,

realistic timelines,

EI agencies,

legal rights

Front 86

what are the 4 counselling needs during diagnosis of a severe-profound pediatric hearing loss?

Back 86

1)causes
2)audiogram
3) anatomy & physiology
4) coping

Front 87

what are the 4 counselling needs 6 mos after a diagnosis for a pediatric with severe/profound hearing loss?

Back 87

listen/speak, cochlear implants, communication options, realistic timelines

Front 88

what are the 4 counselling needs at the time of diagnosis for pediatric audiologists?

Back 88

coping, causes, audiogram, anatomy and physiology

Front 89

what are the 4 counselling needs 6 mos after a diagnosis for a pediatric audiologist?

Back 89

listen/speak, expectations from HA, realistic timelines, coping

Front 90

List 7 steps for delivering bad news

Back 90

Privacy & Time
Choosing the Words
Determine What’s Understood
Encourage Expression of Feelings
Listen
Respond with Empathy
Plan What Comes Next

Front 91

name some counselling services in the delivery model

Back 91

1-on-1
Group – professional led
Group – self-help
Individual or Group with S.O.

Key: appropriate services that meet the needs of the individual