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Audiology Final Exam/Exam III


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Body Aids:
Describe, Benefits, Limitations
-box attaches to receiver and ear mold by cord
-used with CP kids-less feedback
-microphone on Box, not earpiece
--cosmetically ugly, cord prone to break, hard to localize sound
-+ less feedback
BTE Aids:
Describe, Benefits, Lmitations
-earmold attached w/tubing to piece behind ear
-+ small, more cosmetcially appealing, good for many levels of HL, feedback not often problem,
--can be hard to manipulate, bad for poor dexterity
ITE Aids:
Describe, Benefits, Lmitations
-Full shell, half shell, canal, CIC (completely in canal)
-microphone in ear
-+ better localization, eisier to manipulate
--lots of feedback, not good for severe/profound HL, small batteries, more expensive, eaiser to break
Parts of a hearing aid: Microphone
-omnidirectional: pick up sound from any angle
-directional: designed NOT to get sound from certain angle (reduce background noise)
-switchable: go between omni/directional
Parts of a hearing aid:
-smaller aid, smaller battery, smaller battery life
-5 sizes, 1.3-1.5 volts
-zinc air: don't activate until tab pulled off (longer shelf life)
-last 3 days - 3 weeks
Adjusting Hearing Aids
-older have volume controls, newer does automatically
-have many programs (music, noise, phone, etc)
-telecoil: setting for picking up electromagnetic energy (induction loop system, less feedback on phone)
Parts of a hearing aid:
-all aids have them, funnel sound into ear and changes it
-hard=lucite, soft=PVC, silicone
Why do we use...
...horn effects
in hearing aids?
vent: pressure relief, hear some sound naturally, reduces background noise/occlucion effect
damp: smooth out 'peaks' in frequency response curge
horn: shifts resonances up in frequency, more high F amp.,
How to check if HA's are working right?

Info collected when measuring function?
-test box: attach HA to 2cc coupler, microphone on coupler

-freq. response analyzed
How do HAs limit the max amount of sound delivered to the user?
-peak clipping: filters to sqaure wave, sounds very distorted

-compression: compress signal to sine wave within a range, less distortion, more common method
Why do we recommend biaural hearing aids to the majority of our hearing aid users?
-more amplified sounds (less amp needed, less feedback)
-eaiser to localize
-elimiates head shadow
-can be easier to hear in noise
-better hearing quality
-auditory deprivation- lose speech perception over time in unaided ear
What happens during a hearing aid orientation?
-turn aid on, see how close we are to meeting targets
-measure sound at eardrum as loudspeaker plays sound picked up by mic
-Rx program calculates real ear targets based on measurements
-check again in few days/2 weeks
Assistive Devices:
Group Listening Devices:
-Hard Wire:
-Induction Loop
-FM System
-Infrared System
Hard wire listening system
-out dated
-speaker has mic, signal amp'd and given to headphones for child
-hard to hear person w/o mic
Induction loop listening system
-speaker had mic, wireless connection to loop amp
-current runs thru loop around room/area, leaks EM energy
-telecoil setting picks up sound
-system prone to interference, distrubance from computers
-signal weaker farther from wire
FM System listening system
-most common
-speaker wears mic and FM transmitter
-HL person wears FM reciever; attach to own BTE HA
-little distortion, easy to hear own voice and peers
-teacher can assign different children different channels
Infrared group listening system
-used in theatres/churches
-bright lights interfere w/system
-mic attached to transmitter, receiver worn by HL person (universal)
-nice quality sound
-must align transmitter/reciever
Personal Listening Devices: list, describe
-Hard wire: mic-> amp-> headphones

-FM: mic-> wireless reciever
TV and Radio Devices: list, describe
-personal listening device: plug into TV, mic near TV
-inductin loop
-infrared (universal attachment for TV)
-telecaptioning: all tvs over 13" must decode captioning
Telephone assistance
-telecoil (setting in HA)
-amplifiers attach to phone
-public phone: amp, or blue grommet=EM energy
-TDD/TTY, relay service
-ring transducers: change F/I of ring, make light/vibrate etc
-cell phone: neck loop or blue tooth reduce interferance
Warning Devices
-change audio signal to visual
-alarm clock-vibrate, shake bed
-fire alarm- strobe light
-car- blinker buddy, siren detector
-peep hole in door
-full length rear view mirror
-signal dogs
Componants of Coch. Implant
-microphone on BTE, speech processor (body or BTE), trasmitter (outside head), reciever (under skin), electrodes in cochlea
How a Coch. Implant works
sound percieved and transmitted by BTE device, signals trasnmitted directly to hair cells in cochlea
Problems with Cochlear Implant use
-equipment malfunction--fix with surgury
-medical risk (anesthesia, infection)
-temporary paralysis/facial symptoms
-electrical stimulation near brain may have long-term effects
-one brand higher risk of meningitis
Group vs Individual hearing rehab
G- build support network, work on AV skills with sympathetic group, help each other/share info, cost effective for clinician, fun
I-better for those in denial, with cognitive impairments, or sudden severe HL
Why is speech-reading never 100% accurate?
-can't see all phonemes (k, n, ng, h)
-homophonetic appearance (pbm, fv, th TH)
-speech rate, too fast for eyes to follow
Environmental conditions that influence lipreading
-lighting (how much, where it falls)
-distance from speaker (want 6'-9')
-angle from speaker (want 0-45)
Activities used for audio-visual training with adults: speechreading
-analytic approach: focus on lip movements for individual sounds, work at syllable or word level, train to identify phonemes rapidly
-synthetic approach: focus on meaning of utterance, use context to figure out phonemes, work on sentence level
-often involve both kinds of training
Telephone training
-general strategies: confirmation, repeat, rephrase
-word strategies: spell it, code words (b for Boy), alphabet, keyword (spell important ones)
-number strategies: digits, (24, 2-4), spell, counting
Other A/V training techniques
-practice with commercial CDs or recordings in noise/low vocal level
-practice with common phrases/words with job/hobbies
-start easy and get harder with practice (change body position, vocal I, choices in task)
-teach conversational repair
-context excersizes
Methods of Conversation repair
-HL must realize that convo broke down
-be specific in requesting clarity (be louder, clearer, face me, slow down)
-use tracking (read passage quickly, if messed up, use repair strategy to fix)
Describe how metacommunication to improve heaing
-get pt. to realize own communication ability/power
-use contingent pairs: a certain response is expected after comment
-choose lower-level questions for easy answers (y/n, give choices
Importance of a partner with hearing rehab
-part. learns about HL experience
-helps pt. to hear sounds from familiar voice
-partner can help notify of comm. breakdown
-help set rules for comm. in family/house
What is 'stage management' and how is it used?
-setting up a listening environment to your best advantage
-decompose problem: map out room, role play, observe pt in setting
-find ways to optimize listening
How does pediatic rehab differ from adults?
-may be a prelingual HL (no basis for language yet)
-HL can affect relationship with parents, educational acheivement, reading level
-affects social/emo development
-responsibility of school system after age 3
What can we tell parents of HL kids to do to improve comm skills with child?
-teach how HA helps, works, when/how to use it
-modify daily activities to talk all about clothes/food/sounds
-praise vocalizations
-get whole family involved
-keep log of receptive auditory behavior
Oral method of communication
-no sign; only speech reading, use residual hearing
-Alex. G Bell--really liked
-less limiting socially, vocationally, etc
-hearing parents want kids to be like them
-not all deaf kids can succeed with this
Manual method of communication
-ASL use
-Gallaudet--really liked
-deaf parents raise deaf children like this
-believe oral lang is psychologically harmful
-many see as part of Deaf culture
-wider communication base, easier to learn
Combines method of communication
-Total Comm: sign, talk, lip read, MCE
-Cued Speech: clears confusion of homophoneity, may be used in school/therapy/home, not really in real world
Education options for deaf children
-Residential schools: historically important to Deaf, no stigma, lots of peers, facilities accomodating, lower achievement levels
-Day school: special for deaf, deaf peers, special teachers
-self-contained class: stigma, SPED teacher (not spec. deaf)
-Mainstreaming: oral, interpreters, limit access to communication, no like peers
what do teachers need to know/work on with HL kids>
-need specific, concrete details for specific child
-tell about express/recept lang abilities
-oral? how can child learn new vocab in class?
-kid must know how to work thru interpreter
-how to operate HA technology
-know child may need to move seat throughout day
-need to face class when talking
-help socialize HL kid in class
-buddy system to get assignments
-comm. with audiologist, SLP, etc

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