SHS 451 1st EditionExam # 1 Study Guide Lectures: 1 – 3Lecture 1 (Week 1)Hearing Loss Characteristics o How are the following terms defined and applied: prelingual, hard-of-hearing, congenital onset, fluctuating, bilateral, sensorineural, conductive, progressive, postlingual, disability, impairment, habilitation?Prelingual: The onset of hearing loss prior to the acquisition of spoken language. Either born without hearing or lost hearing before the development of speech. Hard of hearing: Sensitivity is either mild, moderate, or severe; recognition is fair to good.Congenital onset: Hearing loss present at birth.Fluctuating: Hearing loss that frequently changes. This type of loss is often associated with conductive HL and may be progressive in nature.Bilateral: Hearing loss in both ears.Sensorineural: Hearing loss in inner ear or nerve of hearing.Conductive: Damage in outer ear or middle ear.Progressive: When a hearing loss is already present and it becomes worse. Postlingual: The onset of hearing loss after spoken language has been acquired. Become profoundly deaf after the age of 5-10 years but had normal hearing long enough to establish fairly well developed language skills. Disability: A physical or mental condition that limits a person's movements, senses, or activities. Impairment: A symptom of reduced quality or strength.Habilitation: Refers to remedial efforts with children having a hearing loss at birth. Rehabilitation and this are used interchangeably. o What are the parameters of hearing loss?Sensorineural-->AC: worse than 25 dB BC: worse than 15 dB A-B gap: less than 10 dBConductive--> AC: worse than 25 dB BC: better than 15 dB A-B gap: more than 10 dBMixed--> AC: worse than 25 dB BC: worse than 15 dB A-B gap: more than 10 dBConfiguration of Loss– Flat– High frequency (sloping)– Low frequency (rising)– Cookie-bite (saucer shaped) – Noise-notchedo What is the range of normal hearing? Is it different for a child versus an adult? Children: The range of normal hearing extends only to 15 dB HL. A threshold of 16 dB HL or higher indicates a hearing loss. Pure tone audiometric testing is conducted in 5 dB steps, so on the audiogram hearing thresholds of 20 dB or higher indicate a hearing loss of some type for a child. Thresholds of 16 to 25 dB HL are in the “minimal” or “slight” loss category. Adults: Thresholds in the range of 16 to 25 dB HL might still be said to represent a “minimal loss” or a “slight loss”. Some audiologists don’t consider an adult to have a hearing loss until the thresholds are 26 dB HL or higher (on the audiogram, that is 30 dB or higher). o What constitutes a basic audiological examination? Air-conduction testing: Tested either through headphones or speakers. -Goes through outer ear-->middle ear-->inner ear. -It tells us the total amount of loss, and is what we use to classify loss severity. Both conductive and sensorineural losses cause air conduction thresholds to be abnormal. Bone-conduction testing: Tested with bone oscillator. -Sends the sound directly to the inner ear, bypassing the sound conducting apparatus. -It stimulates the inner ear hair cells in a manner just like air conduction, and nerve will becreated. 2-It tells us how much of the loss is due is due to problems in the inner ear, or with the nerve pathways. Without also knowing the air conduction thresholds, you can't tell if part of the loss is conductive.History and Demographics of Hearing Losso What were the major milestones in the history of AR and birth of audiology?-1500s Pedro Ponce de Leon of Spain: 1st identified teacher of the deaf -1600s other teachers of the deaf began to emerge-1700s first school for the deaf: Thomas Gallaudet eventually began the 1st successful school forthe deaf in America based on teachings from Laurent Clerc-Periere (France) introduced education to the deaf-Thomas Braidwood (England) & Heinicke (Germany) focused on speech and speech reading-early 1900s electric amplification-1920s electronic hearing aid-1900-1930 schools of lipreading-WWII had a major impact on audiology-1970s audiologist involved with direct dispensing of hearing aid, not the governmento What are the demographics of hearing loss in the USA? -More men than women in the USA have hearing loss -Approximately 17% (36 million) American adults have some degree of hearing loss-1 in 22 infants in America have some kind of hearing problem-1/1000 have severe to profound hearing loss-26 million Americans (20- 69 yrs) have irreversible hi-frequency noise induced hearing loss. -Roughly 25 million Americans have experienced tinnitus. -Approximately 4,000 new cases of sudden deafness occur each year in the United States. The majority experience unilateral deafness. Only 10-15 % know what caused their deafness.Lecture 2 (Week 2) Aural Rehabilitationo What are the components of the Aural Rehabilitation (AR) process?Functions: Diagnostic and Rehabilitation1. Differential Diagnosis2. Evaluate Need for Habilitation or Rehabilitation3. Case Management4. Additional Referrals3o What are goals of AR?-Enhance the activities and participation of a person with hearing loss to improve quality of life-Achieving adequate receptive and expressive communication is a means to get to this goalo What are C.O.R.E. and C.A.R.E. ?Assessment CORE: Communication status, hearing loss and activity limitations: auditory, visual, language, manual, communication self report, previous rehabilitationOverall participation variables: psychological (emotional), social, vocational, educationalRelated personal factors: Attitude types; I, II, III, IV, personality, IQ, age, race, genderEnvironment factors: services, systems, barriers, facilitators, acoustic conditions -C: Both traditional audiometric tests and questionnaires may be used to assess auditory abilities and self reported consequences of hearing loss. Visual abilities assessment should include a simple screening and also consider language. If the patient understands a manual gesture system, this needs to be evaluated, as does any prior treatment. Included in overall communication are combined sensory abilities, such as audiovisual and tactile-kinesthetic capacities. Expressive and receptive communication skills should both be considered. -O: Patient's level and form of education must be considered. The vocational domain includes position, responsibility, and competence.-R: Type I: have a strongly positive attitude toward management and are