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Aural Rehab Midterm
| Question | Answer |
|---|---|
| two important services that are closely related but distinct from the audio logic rehabilitation process | medical intervention and education of the deaf |
| efforts to assist children with hearing loss | audiologic habilitation |
| efforts to restore loss or function | audiologic rehabilitation |
| important characteristic of hearing loss as they relate to aud rehab | degree and configuration of loss time of onset type of loss auditory speech recognition ability |
| audiometrically deaf | PTA or SRT of 80 to 90 dB HL |
| postlingual deafness | loss that occurs after about age 5 |
| deafened persons | lose hearing after their schooling is completed |
| generally _______ are amenable to medical intervention | conductive losses |
| ________ are primarily aided through audiologic rehab | sensorineural loss |
| 1st known teacher of persons with severe to profound hearing loss | pedro ponce |
| introduced deaf education to France employed fingerspelling and sign language in addition to speech reading | Abbe de LEpee |
| Heinicke and Braidwood | stressed oral speech |
| ad concham | speaking directly in the ear |
| Raymond Carhart | pioneered aud. rehab. first said audiology |
| issues help audiologists consider relevant factors that should be evaluated before treatment | the CORE assessment |
| CORE assessment | Communication status Overall participation variables Related personal factors Environmental factors |
| management CARE (WHO terminology) | Counseling and psychosocial Audibility and amplification Remediate communication activities Environmental/coordination/participation improvement |
| suggested that rehab candidates can be categorized into four types according to attitude | goldstein and stephens |
| amplification fitting | hearing aid evaluation |
| hearing instrument orientation (HIO basics) | clients learning about hearing aids |
| chief providers of AR | audiologists |
| four groups that deaf may be divided into | prelingually deaf perilingually deaf postlingually deaf deafened |
| prelingually deaf | who are born deaf or acquire |
| preilingually deaf | who acquire deafness while acguiring a first language |
| postlingually deaf | acquire hearing loss after age 5 through the school years |
| deafened | acquire hearing loss after their education is copmpleted |
| the most serious and primary consequence of HL is | the effect on verbal (oral) communication referred to as disability |
| a device that takes acoustic energy or sound pressure and changes or transducers it to electric energy | microphone |
| hearing aid microphones are mere millimeters in size divided in half by a thin metal-coated layer called the | diaphragm |
| a device that changes one form of energy to another | transducer |
| microphones are equally sensitive to sounds coming from all directions | omnidirectional |
| microphones permitting varying sensitivity to sound coming from a given direction usually greater sound from the front | directional |
| where the manipulation and amplification of the signal takes placde | the processor |
| ____________ are often integrated into the receiver and are efficient in battery use and produce very low distortion of the signal even at high intensity output levels | Class D amplifiers |
| formulae designed to alter the signal in hearing aids based upon the goal of improving speech perception | algorithms |
| another transducer that takes the amplified electrical signal and converts it back to an acoustic signal | receiver |
| perception caused by bone-conducted sound | occlusion effect |
| feedback can be caused by | hearing aid malfunction or due to the hearing aid microphone picking up the receiver's acoustic output of the hearing aid |
| collectively the earhook, tubing, and earmold are referred to as the __________ of the behind-the-ear hearing aid system | plumbing |
| a calculation that can predict the amount of speech information that is audible with a given audiogram | articulation index (AI) |
| the difference between the hearing aid user's pure tone or speech thresholds and his or her uncomfortable listening level | dynamic range |
| what kind of a microphone can help in some background noise situations | directional microphones |
| the difference in dB between the input signal from the testing equipment and the output signal from the hearing aid. | gain |
| a graphic representation of the gain at each frequency. This is done by sweeping a test tone across the frequencies at a given input level. | frequency response curve |
| the dB SPL produced by the hearing aid with the gain control in the full-on position with an input of 90 dB SPL. This measurement is an indication of what the mazimum power output of the hearing aid is. | Output sound pressure level 90 |
| information that is important to ensure the output of the hearing aid will not reach unsafe levels for the patient | output sound pressure level 90 |
| a measurement of new frequencies generated by the hearing aid that are harmonics of the original signal. typically reported as a percent of the total output of the hearing aid | harmonic distortion |
| a reading of the overall internal noise of the hearing aid | equivalent input noise level |
| measurements of the time it takes for compression to turn on and off when the signal increases in volume | attack and release times |
| provides the frequency response of the hearing aid in the telecoil position with an electromagnetic input | telephone magnetic field response |
| a period of adjustment to a hearing aid usually four to six weeks in duration after the initial fit | the acclimatization process |
| QuickSIN | one example of an adult test used to determine how the patient can perform with hearing aids in a quiet or noisy situation |
| Auditory steady-state response (ASSR) | test for very young children to provide an objective measure of the child's auditory sensitivity with frequency specific information |
| occurs when sound is presented to one side of the head and has to travel through or around the hear reducing the overall intensity | head shadow effect |
| what type of individuals have been difficult to successfully fir with amplificaiton | unilateral hearing loss or extreme differences in hearing threshold levels |
| CROS or contralateral routing | microphone only on the poorer ear, very mild gain to the normal ear |
| Bi-CROS | microphone on both ears with more amplification provided to the better albeit impaired ear |
| atresia | absence of the ear canal |
| individuals that need bone-conduction hearing aids | patients with atresia or chronic middle ear infections because they do not block or use the ear canal |
| microphone and amplifier housed either in a behind the ear or body aid attached with a metal headband to a bone vibrator on the mastoid | bone-conduction hearing aids |
| surgically implanted titanium vibrator unit into the mastoid bone | bone-conducted amplification |
| how do implantable hearing aids in the middle ear work | by vibrating the ossicular chain |
| HATS or hearing assistive technology systems can | improve the ability to listen in background noise by reducing the distance to the microphone of the speaker, wake the client up by shaking the bed or bark loudly when a car comes up the driveway. |
| wireless frequency modulated sound systems (FM) | operate in open space by sending radio waves from a transmitter to a receiver or speaker worn by or near the individual with hearing loss. |
| these systems use the invisible infrared portion of the electromagnetic spectrum to transmit the signal from the microphone to headset receivers or any hearing aid equipped with a telecoil. | infrared systems |
| a simple wire that surrounds a seating area to pick up the talkers microphone signal and transmit it to hearing aids | audio loop system |
| a hearing aid in both ears | improves listening in background noise and helps in sound localization |
| simply knowing that a sound is present | detection |
| the ability to distinguish when two separate sounds are different | discrimination |
| ________ are produced with greater intensity than _______ and ____ tend to peak louder than _______ | vowels consonants males females |
| voiced consonants generally possess a greater amount of _______ energy | low and mid frequencies |
| unvoiced consonants are made up of _________ frequencies | mid and high frequencies |
| the duration of _______ are generally longer | vowels |
| transitional cues results from | the influences of coarticulation of individual speech sounds when combined into words, phrases, and so on. |
| what kind of perception tends to be disrupted more by hearing loss | consonant |
| constraints that refer to the fact that every language is governed by a set of grammatical rules | syntactic constraints |
| constraints that refer to the fact that words used in a sentence are usually related to each other in a meaningful way | semantic constraints |
| constraints that refer to the fact that language usually takes place within a physical and social context | situational constraints |
| who considered auditory training a process of teaching the child or adult with hearing impairment to take full advantage of available auditory clues | Carhart |
| the hearing abilities that a person with hearing loss has left are often referred to as | residual hearing |
| analytic auditory training employs a | "bottoms up" approach that focuses mainly on enhancing perception of small segments of speech |
| Word Intelligibility by Picture Identification (WIPI), Northwestern University Children's Perception of Speech (NU-CHIPS), Six Sound Test by Ling are | formal tests that require the child to respond a prescribed manner to individual words or phonemes presented at a comfortable listening level |
| a closed-set format test is | a test of speech perception involves presenting a test item and having the listener choose the correct response from a limited set of options |
| an open-set format test is | a test of speech perception format when the listener can respond with any word he or she feels is correct |
| the ability to perceive a target signal that is presented simultaneously with other competing signals | figure-ground |
| Early Speech Perception Test (ESP), Glendonald Auditory Screen Procedure (GASP), and Developmental Approach to Successful Listening (DASL II) are | test batteries are designed to assess varied aspects of auditory skills development in children |
| involves presenting a 25 or 50 word list of monosyllabic words at a comfortable intensity level for the listener. A percent correct score is calculated. | word recognition testing |
| Northwestern University Auditory Test No. 6 | monosyllabic word list used to evaluate overall word-recognition abilities |
| California Consonant Test (CCT) | more in-dept assessment of the perception of consonants which can be especially difficult for persons with hearing impairment to perceive accurately |
| testing in which speech babble is used and the listener has to identify the last word of the sentence | Speech Perception in Noise (SPIN) |
| Speech Babble | a recording of several people talking at once |
| Central Institute for the DEAF (CID) Everyday Speech Sentences | used to evaluate a listener's ability to perceive connected discourse |
| the Minimal Auditory Capabilities (MAC) Batter is used to | assess auditory and visual skills of patients with severe-to-profound hearing loss (easier test) |
| Iowa Vowel and Consonant Confusion Test and the Bandord-Kowal-Bench (BKB) sentences and the HINT are | used in the evaluation of cases considered for a cochlear implant |
| attempts to break speech into smaller components and incorporate these seperately into auditory training exercises | analytic auditory training |
| emphasizes a more global approach to speech perception, stressing the use of clues derived from the syntax and context of a spoken message to derive understanding | synthetic auditory training |
| involves training the listener to control communication variables | pragmatic auditory training |
| comparing the intensity of the signal you wish to hear with all the other auditory signals present in that listening situation | signal-to-noise ratio |
| a flexible and widely used approach to auditory training designed primarily for use with children | Erber |
| includes training that combines most or all of the strategies for auditory training | eclectic |
| Glendonald Auditory Screening Procedure (GASP) | evaluating a child's auditory perceptual skills |
| the GASP takes into account two factors | complexity of the speech stimuli response required from the child |
| erbers levels of perception model | detection discrimination identification, comprehension |
| -teacher eliminates visible cues and speaks as natural as possible | natural conversational approach |
| teach applies a closed-set aud identification task but follows this approach activity with some basic speech development procedures and a related comprehension task. (flexibility) | moderately structured approach |
| teacher selects the set of acoustic speech stimuli and also the child's range of responses, prepares relevant materials, and plans the development of the task all according to the childs specific needs for auditory practice | practice on specific tasks |
| sequential, highly structured auditory-training curriculum developed by stout and windle for preschool and school-aged youngsters with a placement test to start the program | DASL II- Developmental Approach to Successful Listening II |
| Three specific areas on the DASL II | sound awareness, phonetic listening, auditory comprehension |
| comprehensive identification and home intervention treatment curriculum for infants with hearing impairment and their families | SKI-HI |
| provides a guide for clinicians in evaluating and developing auditory skills in children with severe-to-profound hearing loss | Speech Perception Instructional Curriculum and Evaluation (SPICE) |
| connected or running speech | natural or conversational speech |
| Sound and WAY beyond, AUDITRAIN, ADVANCED BIONICS, and Nucleus Hear We Go are examples of | at home programs for learning to use cochlear implants |
| this common form of audiologic rehab emphasizes the role of communication strategies and pragmatics to facilitate successful communication | communion training and therapy |
| things the listener can do to better prepare for communication or ensure that it will be successful | anticipatory strategies |
| techniques used to overcome a breakdown in communication | repair strategies |
| a technique developed by DeFilippo and Scott which can be used in therapy to provide practice in utilizing communication repair strategies in a conversation. | speech tracking |
| HIO BASICS is a handout that | focuses on info on care and effective use of hearing aids |
| CLEAR is a handout that | provides suggestions for the person with a hearing loss regarding the communication process |
| SPEECH is a handout that | gives helpful suggestions for the significant other that are designed to facilitate communication |
| a program involving computer-assisted speech perception testing and training at the sentence level | CasperSent |
| CAST and LACE are both | computerized approaches to auditory training |
| five key components of basic oral communication | speaker, message, listener, feedback, environment |
| auditory training is intended to | facilitate auditory perception in the listener with impaired hearing |
| attempting to perceive speech by using visual cues to supplement whatever auditory information is available | speechreading |
| differences among speakers have a greater effect on _______ than on ________ | speechreading than on listening |
| rate of normal speech | 15 phonemes per seconds |
| ideal conditions for speechreading | speakers who use a slightly slower to normal speech rate accompanied by precise not exaggerated articulation |
| unique characteristics of a given phoneme that distinguish one phoneme from another | distinctive features |
| a group of phonemes in which each looks alike when spoken | viseme |
| words that look alike when spoken even though they sound different | homophenes |
| some talkers are easier to speechread than are other talkers because | they produce more distinctively different viseme groups |
| in conversational speech nearly _______ of the words are indistinguishable visually (they look like other words) | 50 percent |
| there are fourteen total visemes, but under usual conditions there are nine, as compared to about forty phonemes | under ideal conditions |
| under ideal conditions about _____ percent of speech is visible. with usual conditions about __ to ___ percent is visible | 33 10 to 25 |
| features like ____ are not visible at all | voicing |
| how many of the english phonemes are not readily visible | 60 percent |
| ____ determines the predictability of a spoken message | redundancy |
| Albright, Hipskin, and Schuckers demonstrated that speechreaders actually obtain more total information from ________ than from phoneme and word visibility | redundancy and linguistic rules of the spoken language |
| ____ consistently achieve higher speechreading scores | females |
| ____ has little effect on speechreading as long as | IQ as long as it is not below the normal range |
| _______ clients tend to speechread more effectively | highly motivated |
| _________ can have a major impact on speechreading success | visual acuity |
| involves an ability to focus on and perceive a target stimulus, or figure, from a background of other stimuli, or ground | figure-ground patterning |
| being able to combine or pull bits of information together in order to figure out what was said is termed | closure |
| in general, those with HL are ___________ than those with normal hearing | not better speechreaders |
| term used to describe information obtained from speech that is seen | audiovisual integration |
| speechreading centers around visually perceiving the details found in speech | analytic |
| speechreading involves grasping the general though of the speaker through intuitive thinking | synthetic |
| procedure developed by DeFilippo and Scott is being used in speechreading assessment and therapy | Continuous Discourse Tracking (CDT) |
| derived by counting the number of words per minute the listener-viewer correctly identifies | performance score |
| auditory abilities are developed to the fullest extent possible | auditory-verbal approach |
| rather than using a single technique for all young clients, it focuses on each individual child's motivation, tolerance, and sense of responsibility for communicating | holistic approach |
| CLEAR, WATCH are | methods designed to illustrate the importance of seeing as well as listening during conversation |
| SPEECH is | a program designed to help normally hearing people communicate effectively with individuals who have a hearing loss |
| the most basic and visually distinct units of sign language | cheremes |
| manual communication is comprised of | specific gestural codes (ex. sign language) |
| first form of manual communication | American Sign Language |
| independent language, visual manual mode, own grammar, own syntax, signs are meaning based | American Sign Language |
| A combination of elements from ASL and the sign systems, ranging from more ASL-like to more English-like. | Pidgin Signed English |
| signed in accordance with English grammar, but signs are meaning based; specially invented sign markers for important affixes in English | Signed English |
| essentially the same as SEE II, but has a method of writing each sign, used in education, usage is diminishing | Linguistics of Visual English (LOVE) |
| signs are word based special signs for all affixes in English, signed in strict accordance with English widely used in education very influential | Signing Exact English (SEE II) |
| signs are based on word roots and extreme form of word-based signs. not popular in US but still common in Iowa and Colorado schools for the deaf | Seeing Essential English (SEE 1) |
| manual representation of the written language, one hand shape for each letter of alphabet, used to borrow English words in ASL, when used with speech and speech reading it is called the Rochester Method | Finger-Spelling |
| Employs 8 hand shapes in 4 positions on the face, used in conjunction with lip movements to enable a deaf person to lipread more easily, based on sound with the syllable as the basic unit | Cued Speech |
| independent language, aural-oral mode, own grammar, own syntax, words are meaning based, contains dialects, regionalisms, slang, puns, can be written, wide range of vocab covering minute differences in meaning,borrow from other languages, verbal/nonverbal | English |
| signs that closely represent the respective actions or things. | Iconic signs |
| The prosodic features of ASL are provided by | facial expressions, head tilts, body movement, and eye gazes |
| having a mild, moderate, or severe hearing loss and some ability to understand speech with the use of hearing aids or other amplification | hard of hearing |
| even with powerful hearing aids, speech generally is not perceived in auditory-only perceptual situations | deaf |
| a cultural identification with a community, this distinction and the unique concerns of the culture | Deaf |
| a psychological reaction to the presence of a hearing aid. the viewer has negative assumptions about the hearing aid user | hearing aid effect |
| words and phrases that describe feelings or emotional reactions | affective vocabulary |
| more than 95 percent of children with hearing loss are born into families with at least | one normal-hearing parent |
| only about __________ of the population who have hearing loss actually obtain and use hearing aids | 25 percent |
| shaping or raising children according to values defined by a culture | enculturation process |
| Abbreviated Profile of Hearing Aid Benefit (APHAB), Self-Assessment of Communication (SAC) | self-assessments used to help patients clarify their problems |
| a loss in structure or function | impairment |
| occurs as a result of the impairment | disability/handicap |
| _________ of hearing loss at birth is genetic | half |
| ALDs | assistive listening devices |
| most hearing aids sold are | digital |
| binaural squelch | improved listening in noise |
| analytic aka | bottom-up |
| synthetic aka | top-down |
| theoretical framework useful conceptual tool for predicting given the particular situation, whether speech will be intelligible to a listener, and what might be done to improve understanding | information (or communication) theory |
| describes the conditions under which successful transmission could ocur | Shannon's Theorem |
| information measured in bits | binary digits |
| bit are used to specify the | number of alternatives |
| anything that reduces capacity of the channel in bits/sec will potentially reduce intelligibility including | reducing bandwidth, reducing power of the signal, or increasing the power of the noise reduces capacity of the channel |
| most people with sensorineural hearing loss hear better in the ________ and poor in the _____ | low frequencies high frequencies (falling configuration) |
| Shannon's theorem is essentially | a loss in bandwidth, which reduces channel capacity and reduces intelligibility |
| hearing aids boost signal level thereby | increasing channel capacity |
| most people with moderate sensorineural loss hear okay | in quiet or at least better than they hear in noise |
| increasing noise reduces | channel capacity causing poor intelligibility |
| the auditory nervous system is | highly redudant |
| increasing redundancy will | enhance the intelligibility of the message |
| block coding aka | chunking of the meaningful spondees |
| ___________ increases intelligibility (one of many things) | word familiarity and highly probable words: longer words tend to be less familiar |
| S/N (signal-to-noise ratio, SNR) is | the dB level of the speech minus the dB level of the noise |
| corner audiogram: no useable hearing beyond _____ Hz even with hearing aid | 1000 |
| reverberation | echoes |
| transient distortion | ringing in a hearing aid, oscillation just prior to feedback |
| peak clipping aka harmonic distortion | reaches the limits so the tops of the peaks get clopped off, get only odd harmonics, makes the sound sound bad, doesn't effect intelligibility that much only higher freq. |
| Intermod. Distortion | includes lower frew., extram freqencies get added into the signal, worse than peak clipping |
| OHCs provide audibility for | soft sounds |
| IHC loss | more of a problem, poor understanding of speech, profound deafness, hearing aids don't work as well |
| sharply sloping audiograms with thresholds in the 3-6 kHz region at 60-70 dB HL or more probably reflect | dead zones |
| 95% of the afferent fibers synapse with | IHCs |
| only 25% of hair cells are | IHCs |
| losing OHC reduces | audibility |
| losing IHCs | -creates distortion -poor sounjd quality -poor intelligibility -trouble listening in noise |
| ANSD (neural asynchrony, dys-synchrony) | may be caused by damage to the IHC, the synapse, or the nerve (perhaps a loss in myelin, which slows neural conduction) -hyperbilitubinemia |
| the main characteristics of ANSD are | poor word recognition in the absence of substantial hearing l--loss -present OAEs, absent ABR -absent acoustic reflexes |
| typical conversational speech has can average of ____ dB | 65 only 1% of speech is louder |
| the lower frequencies convey | the melody of the language - suprasegmentals |
| the higher frequencies convey | the meaning, but sound "thin and tinny" by themselves |
| when 65% to 70% of words in sentences are recognized people feel | they can understand speech |
| speech banana | hearing loss in dB on y-axis vs. frequencies in cycles per second on the x-axis |
| the articulation index (AI) | a procedure to determine the audibility and intelligibility of speech |
| to calculate the articulation index you must know | the spectrum of the speech signal delivered to the listener, the amount of hearing loss of the listener, and the spectrum level of the noise present |
| you can use the articulation index to obtain an estimate of the ___________ | audibility of the speech spectrum (the AI) |
| the result of the AI calculation is a number ranging from | 0-0.1 or 0-100% (a good idea of how intelligible speech will be when presented to the average listener |
| 2K contributes to intelligibility by | 33% -- the most |
| the band sensation level is | just the number of dB that band is above or below threhold |
| the AI calculations can also be used to | determine how well speech is understood in background noise, predict how amplification will improve intelligibility, estimate the amount of intelligibility loss due to auditory processing disorders |
| the K-Amp is a circuit designed to | counteract problems created by recruitment |
| recruitment is a common symptom of | sensorineural hearing loss |
| a conventional hearing aid amplifies all sounds by the same amount its called a | linear hearing aid |
| LDL is also called the | threshold of discomfort |
| circuitry that monitors the input level to the hearing aid | K-Amp curcuitry |
| K-Amp circuitry: when the input level is low the gain is | increased (then if input level increases the gain is turned down) |
| the K-Amp processing is called "compression" becayse | a wide range of input levels is squeezed into a narrower range of output levels |
| Gain = | output - input |
| SNR (signal to noise ratio) is just the dB level of | signal (speech) minus the dB level of the noise |
| negative SNRs | mean the noise is higher than the speech, and positive SNRs mean the speech is higher than the noise |
| higher SNRs | are associated with better intelligibility |
| SNRs of +20 dB | or more are associated with very good intelligibility |
| as noise level increase we increase | vocal effort, and increases the SPL of our own voice, in an attempt to maintain a constant SNR |
| type of mic that is equally sensitive to sounds coming from all directions, but when people are talking to one another the listener is facing the speaker | omnidirectional (not directional at all) |
| a ______ mic has only one port, a ______ mic has two ports | conventional directional |
| There are two time delays on a directional mic internal and external. The ratio of the external to internal delay | is what creates the directional pattern |
| There are two time delays on a directional mic internal and external. The external delay depends on the | distance between the ports and the direction sound is coming from |
| the directional microphones in digital hearing aids are usually | -two omnidirectional mics -one at the front port and the other at the rear port |
| type of mic that automatically adjusts to the main speak moving | adaptive directionality |
| with a cardioid mic you | can't hear ppl behind your back |
| supercardioid | can't hear from the back angles (hear mostly in the front and a tiny in the back) |
| hypercardioid | can't hear from the back sides (hear mostly in the front and some in the back more than in the back of the supercardioid) |
| bidirectional | cant hear from the sides (hear front and back) (hear from the front and back equally well) CAB DRIVER |
| the DI (directivity index) is measure as a ratio of | the sound coming from the front and the sum of the sound coming from all directions |
| Killion's D-mic is made from what? | overlapping of omni and directional mics |
| problem with directional mics | -add internal noise so need to switch to omnidirectional in quiet |
| low power ADCs are | essential for hearing aids |
| low bit rate converters | sample the analog signal very rapidly |
| a DSP (digital signal processing) waveform is built up by | summing the output |
| the DSP (digital signal processing) algorithms can | do virtually anything to the signal |
| DSP algorithms | a filter that is a series of statements executed as a computer program that creates a simple band-pass filter. |
| in a DSP algorithm the ________ are enhanced and the ________ are attenuated | -mid-frequencies -lows and highs |
| 12 phonemes per second, 5 syllables per second, 2.5 words per second | normal speech |
| how does voice activity detection work | the sound is analyzed to determine if it's primarily speech or noise (if its speech it turns it up if not it turns it down) doesn't work well |
| Lou Ferrigno (hulk) had this implanted into the space above his ear. uses the natural parts of the ear instead of an external component. feedback is reduced | esteem implantable |
| uses 6 omnidirectional mics in different directions producing a very narrow beam and the output is electromagnetically coupled to the T-coil of the user's hearing aid | Starkey (or stealth) microphone (10.8 dB improvement) |
| current moving through a wire generates a magnetic field. fluctuations in the magnetic field mirror the signal waveform | electromagnetic induction |
| flexibility to change programs, multiple channels compensate for recruitment, feedback suppression, and better performance in noise are all benefits of | DSP - digital signal processing |
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