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AAC | augmentative and alternative communication |
AAC makes up | all forms of communication other than oral |
Who uses AAC? | 4 mill people in the U.S, temporary or permanent |
What is assistive technology? | an umbrella term for any technology, device, or equipment designed to enhance the functional capabilities of individuals with disabilities. |
Unaided AAC | no external equipment used, use of gestures |
Aided AAC | some type of equipment or device--rages with sophistication |
No Tech AAC | does not involve technology and use readily available materias such as alphabet boards or paper and pencil |
Low Tech AAC | simple to use technology with limited pragmatics. few moving parts. |
Mid Tech AAC | have some amt of electrical power and speech generation capabilities--limited customization |
High Tech AAC | complex and sophisticated electronic devices that may require training |
Patient Assessments for AAC | depends on the cognitive and motor ability of the person, vocabulary, and use of the system |
Device Assessments for AAC | arrangement/size of symbols, types of symbols, portability,, output method |
Selection Assessments for AAC | vocab reflecting the users individual preferences and desires. |
Other considerations for AAC | positive AAC culture that individualizes content and uses meaningful interactions |
incidence of hearing loss | 20% of americans, 1/3 adults over 65 |
childhood hearing loss | interferes with school, speech, difficulties in listening environments, |
adulthood hearing loss | stress, irritability and fatigue, isolation |
deaf | when hearing loss reaches 90dB or higher |
deaf community | deaf indivuduals |
deaf culture | rich traditions, folklore, and contributions to the arts |
audiology | the prevention and assessment of auditory, vestibular, and related impairments |
habilitation | teaching skills that were never developed |
rehabilitation | relearning skills that were loss |
component one of hearing loss | energy source- air that is exhaled |
component two of hearing loss | vibrating object- larynx;vocal folds |
component three of hearing loss | medium to conduct vibrations-air to conduct |
component four of hearing loss | receptor to recieve information-ear and brain |
sound | series of compressions and rarefractions that move outward from a vibrating source |
amplitude | the distance the vibrating object travels in either direction |
frequency | refers to the number of cycles of vibration per second |
peripheral auditory system | made up of outer ear, middle ear, inner ear, the vestibulocochlear nerve |
central auditory system | auditory brain stem, auditory cortex of the brain |
outer ear | consists of the pinna and external auditory meatus |
pinna | enhances sound and facilitates localization |
cerumen | hair follicles and glands that produce earwax |
tympanic membrane (middle ear) | vibrates in response to sound waves |
middle ear space (middle ear) | air-filled, lined with mucous membranes, and includes the opening to the Eustachian tube. |
Eustacian tube (middle ear) | connects middle ear with the nasopharynx |
other parts of middle ear | melleus, incus, stapes (ossicles) |
cochlea (inner ear) 1ST COMPONENT | provides auditory input to central auditory system in brainsteam and brain |
perilymph & endolymph (innerear) | two networks or labyrinths that regulate the electrical impulses of hair cells. |
organ of Corti (inner ear) | produces nerve impulses |
basilar membrane(inner ear) | contains thousands of hair cells that connect to auditory nerve endings |
hair cells( inner ear ) | convert sound waves into electrical signals |
neuroelectrical energy | generated and transmitted to the acoustic branch of the vestibulocochlear nerve. |
vestibular system 2ND COMPONENT | controls balance through the vestibular branch of the vestibulocochlear nerve |
conductive hearing loss | outer and middle ear |
sensorineural hearing loss | inner ear |
mixed hearing loss | both conductive and sensorineaural hearing loss |
normal hearing range | 0-25dB |
profound range | > 90 dB |
conductive loss is from | deformation, malfunction, or obstruction of the outer or middle ear; impacts audibility |
three outer ear disorders | anotia, microtia, atresia |
anotia | absence of the pinna on one or both sides |
microtia | small, malformed pinna that does not result in loss of hearing sensitivity by itself |
atresia | closure of the auditory canal |
two middle ear disorder | otosclerosis and otitis media |
otosclerosis | replacement of healthy bone w/ spongy bone in the area of the stapes footplate; results in reduced mobility of the stapes |
otitis media | inflammation of the mucous membrane lining the middle ear--eustacian tube dysfunction |
inner ear disorders | absence, malformation or damage to inner ear structures that are permanent. |
sensorineural loss w/ hearing loss | factors that influence the effects of the loss on speech, language, and cognition |
causes of sensorineural loss | meningitis, ototoxic antibiotics, presbycusis, acoustic |
pure tone audiometry | determines the threshold of frequency within the ear from ranges of 250-8000Hz |
pure tones | sounds that contain energy at a single frequency |
threshold | lowest intensity at which a person can detect a stimulus 50% of the time |
hard of hearing/hearing impaired | hearing loss falls in the slight/mild-severe range |
deaf | auditory thresholds fall in profound range |
air conduction test | administered while the client wears headphones |
bone conduction | administered w/ a bone oscillator directly stimulating the cochlea |
hearing aids | contains a microphone, amplifier, reciever, and processor. |
whats the treatment for conductive? | hearing aids |
whats the treatment for sensorineural? | cochlear implants |
cochlear implants | bypasses damaged hair cells of cochlea and directly stimulate the auditory nerve fibers w/ electrical energy |
dysphagia | disordered swallowing |
impact of dysphagia | major social activity, parent-child relationship, isolation |
aspiration pnumonia | choking that leads into the lungs |
primary diagnosis of dysphagia | cerebral palsy, autism, cleft lip |
oral prep phase | tongue cups to hold food/drink > tongue lateralizes for bolus creation > bolus held in mouth by sofr palate |
bolus | mass of food shaped into a form to be swallowed in one collective piece. |
oral transport phase | bolus formed > front to back of the mouth > pharyngeal swallow |
pharyngeal phase | velum raises for bolus > base of tongue touches pharyngeal > upper esophageal segment opens for bolus |
esophageal phase | bolus enters esophagus > peristalsis moves bolus into stomach |
peristalsis | rhythmic, wavelike contractions |
reduced lip seal | drooling; spillage |
reduced chewing | poor bolus formation, poor anterior-posterior propulsion |
sensory aversions | structutes + capabilities may be related to sensitivity to textures |
delayed swallow trigger | penetration or aspiration |
penetration | food/liquid enters the airway about VF |
aspiration | food/liquid enters airway below VF |
poor velopharyngeal port closure | food/liquid escapes thru nose |
reduced base of tongue to pharyngeal wall approx. | residue in pharynx |
reduced hyolaryngeal elevation | epiglottis doesnt protect airway opening |
reduced pharyngeal muscle strength | residue in pharynx |
reduced opening of the upper esophageal segment | residue in the pharynx |
slow peristalisis | slowing of movement of food from esophagus to stomach |
major components of DX of swallowing disorders | 1. case history: symptoms & complaints 2. exampinaltion of oral 3. food trials |
aspiration | watery eyes, throat clearing, wet vocal quality, changes in breathing, coughing, burping, fevers, food "stuck in throat" |
videofluoroscopic swallow study (VFSS) | xray procedure |