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Aural Rehab Exam - 2
Exam 2
| Question | Answer |
|---|---|
| What are the 5 communication options? | 1) Auditory verbal uni-sensory 2) Oral auditory - oral 3) Cued speech 4) Total communication 5) ASL/English as a 2nd lang...bilingual/bicultural |
| What does "auditory verbal unisensory" communication approach emphasize? Discourage? Goal? | Emphasizes auditory skills; discouraged from relying on visual cues; goal - develop speech through use of aided hearing alone |
| What does "auditory verbal unisensory" communication approach use for development of receptive language? Expressive language? | Receptive language - use of personal amplification system (HA, CI, FM system); Expressive language - spoken and written English |
| What does "oral auditory-oral" communication approach emphasize? Discourage? Goal? | Emphasizes the use of one's residual hearing and the use of speech reading and lip reading; Manual communication is discouraged, however, natural gestures supported; Goal - develop speech and communication necessary to function in the hearing community |
| What does "oral auditory-oral" communication approach use for development of receptive language? Expressive language? | Receptive lang - amplification and speech reading; Expressive lang - spoken and written English |
| What is cued speech? | Visual communication system of 8 hand shapes that correspond to different speech sounds. Makes spoken lang clearer through vision |
| What is the goal of cued speech? | Develop speech and communication necessary function in the hearing community |
| What does "cued speech" communication approach use for development of receptive language? Expressive language? | Receptive lang - amplification, speech reading, visual cues which represent different sounds; Expressive lang - spoken (sometimes with the use of cues) |
| What is total communication? Goal? | Use of all means to communicate; Goal - to provide the least restrictive access to communication |
| What does "total communication" approach use for development of receptive language? Expressive language? | Receptive lang - formal sign lang, finger spelling, amplification, oral speech, natural gestures...; Expressive lang - spoken English and/or sign lang, finger spelling, written English |
| What is ASL/English as a 2nd lang bilateral/bicultural communication approach? Goal? | Manual lang that is distinct from spoken English; Goal - to allow the child to communicate before learning to speak as some children will never learn to speak effectively. |
| What does "ASL" communication approach use for development of receptive language? Expressive language? | Receptive - use of ASL and English is taught as a second lang; Expressive - ASL and written English |
| What is speechreading? | The method of using visual cues from a speakers face to decode the speakers message. Also using lip-reading, contextual cues, body lang. |
| What are the two approaches of speechreading aural rehab technique? | analytic and synthetic approaches |
| What is the analytic approach to speechreading? | FOCUS ON DISCRIMINATION. Bottom-up approach to piece the sounds together. Based on the premise that individual parts (syllables) must be identified prior to understanding the entire message. (ie - "beet" v. "boot") |
| What is the synthetic approach to speechreading? | Top-down approach. Based on the premise that the general understanding of a message is most important regardless of individual parts. Work from highly contextual, familiar content to novel content. (ie - "speechread a story and answer questions about it) |
| Who should be encouraged/discouraged from using speechreading? | Encouraged for adults who developed HL later in life; Discouraged for children. |
| What is the prevalence of HL in adults? | 3.8 million adults b/w the ages of 18-64 years old. About 440,000 are functionally deaf |
| What is the prevalence of HL in elderly adults? | 314 of every 1,000 people over the age of 65 years old and about 40-50% of those who are 75 years old and up |
| What are the onsets of HL? | Pre-lingual; gradual; and sudden |
| What is presbycusis? What are the four kinds? | Age-related HL; gradual progressive loss of hearing; Sensory, neural, metabolic, and mechanical |
| Describe sensory presbycusis. | Involves loss of sensory and supportive vells at the basal end of the cochlea that progresses toward the apical end and is first manifested by a precipitous high-freq SNHL usually starting around middle age. |
| Describe neural presbycusis. | Results from atrophy of cochlear neurons throughout the cochlea (basal more than apical) and central auditory pathways with unexpectedly poor speech recognition performance when compared with the pt's pure-tone audiogram. |
| Describe metabolic presbycusis. | Results from a degeneration of the stria vascularis (which maintains chemical and bioelectric and metabolic health of the cochlea) that occurs from the base to apex in the cochlea, manifesting itself as a relatively flat audiometric configuration. |
| Describe mechanical presbycusis. | Also known as a cochlear conductive HL, results from the stiffening of the BM and a gradually sloping high freq hearing loss. |
| What are the three "health-related quality of life" aspects that can effect one's life? | Personal fulfillment; physical and material well-being; adult role fulfillment |
| What are the personal fulfillment HQoL aspects for adults who are pre-lingually deaf? Acquired deafness? | Pre-lingual - Bond w/ their peers, find a mate and start a family..may have difficulty IDing with neither Deaf culture nor hearing world. Acquired - can trigger psychological trauma b/c it represents a loss of self...may go through grieving process |
| What are the physical and material wellbeing HQoL aspects for adults? | Adults who are deaf or HoH reported lower subjective health status and a higher degree of physician use; many report difficulty communicating w/ physicians; historically, ind w/ HL have lower net worth compared to peers w/ normal hearing. |
| What are the adult role fulfillment HQoL aspects for adults? | Being satisfied as an adult; HA-effect; high school dropout rate of 44% among young adults who are deaf compared to 19% of normal hearing peers; career counseling during high school |
| What is the overall goal of aural rehab with adults? | Communication competence (dev. of communication strategies, remap new auditory percepts to existing auditory memory, may recommend speechreading, coaching in self-advocacy, maintaing HAT, prev of HL |
| What are some colleges/universities for the deaf? | Gallaudet University, National Technical Institute for the Deaf, Rochester Institute of Technology |
| What are some laws regarding accommodations for students? | Section 504 or the Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990 |
| What are some accommodations that a student can have? | Note takers, teacher providing ppts, preferential seating, interpreter, living quarters, FM system not considered "essential") |
| Who must secure the accommodations for school? | The student must seek out the accommodations. |
| What are some things to consider when selecting a college/university? | Does the college have your program, det. if you meet the entrance requirements, quality of program for students with disabilities, follow-up with officials, schedule campus visit 6 months prior |
| What is the goal of Vocational Rehab? | Assisting and empowering persons with disabilities to attain and maintain productive and meaningful employment. |
| What does VocRehab provide? | Assistive technology, counseling and guidance, medical and psychological treatment, training and education, job placement |
| What is the governing body for work safety? | Occupational Safety and Health Administration (OSHA) - mission to prevent work-related injuries, illness, and death |
| What is the "action level" for noise exposure at work for an 8-hr day? | 85 dBA |
| What is the permissible exposure level that workers can safely be exposed to for 8 hrs a day? | 90 dBA |
| What is the 5-dB tome intensity trade-off law? | For every 5 dB increase in noise over 90 dB there the exposure is cut in half. |
| What is the holistic model of auditory rehabilitation? | Social status, physical status, communication status, psychological status |
| Who is involved in the social status of AR? Physical status? Communication status? Psychological status? | Social status - PCP and audiologist; Physical status - Support personnel; Comm status - Environment; Psychological status - Allied Health Prof |
| What are things to consider for the "comm. status" for AR? | type, degree, and configuration of HL, effect on activity limitation and part. restriction, speechreading, audiovisual speech reception, and conversational fluency |
| What do elderly adults experience in communication? | Decreased speech recognition in reverberation and noise, demonstrate poorer speechreading performance, reduce the distance b/w themselves and speaker, need higher SNR |
| What are some things to consider for "physical status" for AR? | General health (hearing may not be their primary concern), visual status, manual dexterity (manipulating tech), fine-motor skills, vestibular balance issues |
| What are some things to consider for "social status" in AR? | Place of residence (comm strategy based on where the pt lives), support system, financial status |
| What are some things to consider for "psychological status in AR? | Mental status (dementia, Alzheimer's), memory, depression, motivation |
| What are the various levels of motivation/attitude/expectations? | Type I - positive attitude toward HA/AR; Type II - generally positive toward HA/AR but has complicating factor(s) present; Type III - essentially negative toward HA/AR, but is willing to consider; Type IV - strongly negative toward HA/AR |
| What is the "audiovisual speech reception technique for AR? | Speech tracking - have partner read the newspaper with spouse following along or pt reading to themselves (matching sounds with words); computer assistive technology |
| What are "visemes?" Give some examples. | A representational unit used to classify speech sounds in the visual domain. Examples - "p"/"b" (closed lip); "r"/"wh" (lips rounded); "s"/"z" (teeth together, lips smile) |
| What is "conversational fluency?" | The ability to participate in a discussion with one or more individuals with a minimum of requests for clarification. |
| What are "communication repair?" | Helps adults with HL to realize that everyone who has breakdowns in communications. Repair strategies - repetition, rephrasing, elaboration, simplification, indication of topic, conf. of message, provision of feedback, writing message down, fingerspelling |
| What are the provisions of AR? | Individual (limited b/c of # visits); Group (HA orientation training); Home-based (independent to long-term residential facilities) |
| Describe "elder abuse." | Can occur in many forms, such as physical, emotional, sexual, exploitive, neglect, and/or abandonment, and it affects people of all ethnic backgrounds and all socio-economical levels. |
| What are some signs of elder abuse? | Visible injuries, sudden changes in behavior, bedsores, unattended medical needs, verbal abuse, strained relationships, and sudden changes in financial situations. |
| What are some effects of a dual sensory HL in the elderly? | Can effect their activities of daily living, cognition, HRQoL. |
| What are some implications on dual sensory impairments? | Modify approach to communication (slow rate, introduce oneself, speak to them before touching them, approach them from the side of better hearing, speak directly to the pt), avoid glare, manipulate HA over high contrast towel |
Created by:
duda713
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