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167 Multiple choice questions

  1. CI in one ear
    Normal hearing in the other
  2. Face-to-face is best
    Within 45 degrees of speaker
    To the right of speaker is best
  3. 2-4 hours
  4. Focus on supporting personal adjustment
    May need to refer to a professional
    We only focus on the HL
  5. Articulatory Style
    Facial Expression
  6. Addresses communication problems of people with HL
    Serve as guide for developing signal processing strategies
    Framework of AR
  7. Ease of Communication (EC)
    Reverberation (RV)
    Background Noise (BN)
    Aversiveness (AV)
  8. Slightly slower speech
    exaggerated lip movement
  9. Loss of residual hearing in implanted ear
    Risk associated with every surgery
  10. Process of using hearing and eyes to understand speech
    AV scores are better than A and V alone
    Do not add A and V to get AV
  11. A prosthesis that provides direct electrical stimulation to auditory never
    Bypasses the ME
    Used with individuals who have severe to profound HL who receive little benefit from HA
  12. Profound bilateral HL
    Receive minimal "benefit" from HA
    Speech recognition < 50% (private insurance) <40% (Medicare)
  13. FDA lowers age to 12 months
  14. what would be expected based on their audiometric thresholds
  15. Cognitive/Linguistic Information
  16. 50% of Words
  17. Maintaining Positive relationships
    Self Control
    Knowing the Feelings of Others
  18. Unilateral CI and Deaf
    Bilateral CI
    Unilateral CI and HI (Bimodal)
    Unilateral CI and Normal Hearing (SSD)
    Hybrid CI
  19. Good for children
    Bad for Adults it doesn't test thier everyday listening
  20. Receives input from external device and sends it to electrode array
  21. Family based
    Parents more assertive now
  22. Two different surgeries to get two CI's
    Helps with localization of sound
    Insurance may not cover the second CI
  23. 12 and Older Clients
    Used for HA and CI
    3-12 Sentences
    Scored by % Correct
    SNR Environment
  24. Advanced Bionics
    Cochlear Corp
  25. Meet criteria for CI
    Patient has obsolete internal device
    Patient wants benefits of bilateral hearing
  26. Each ear needs to meet CI candidacy individually
    Does insurance cover this surgery?
  27. FDA lowers age to 18 months
  28. 12 months of age
    Profound bilateral HL
    Receive minimal benefit from HA
  29. Varied among individuals
    Many people are reluctant to seek treatment
    People don't want to look old
    Social withdrawal
  30. Improve sound awareness
    Improve speech perception and production
    Improve language development
  31. Easy to administer
  32. Initial fitting 1 month after surgery
    Follow ups 2 weeks after and 1 month after
    Additional follow ups in 3 month intervals for first year
    Then annual visits
    Starts sound signal soft to not scare the patient
    Audiologist slowly increases the sound volume
  33. No HL is the same
    Negative reactions can develop on misperception
    Social Dysfunction perceived
    Harder for children with a HL to socialize
  34. Lighting
    Background noise/distractor
    Viewing angle
  35. Change their own verbal behavior
  36. Randomized Controlled Trial
  37. 10 lists of 50 words
    60 dBA
    Client Repeats
    Whole word correct or phoneme correct
  38. Not much current research because of technology
  39. ENT
    Social Worker
    teacher of Deaf/ Hard of hearing
  40. CNC
  41. Denial
  42. COSI
  43. Determined by an array of exams
    Steady state evoked potential
    More test on children to see if they have residual hearing
  44. Facial Expression and events help you predict what is being said
  45. Early implanted children do better at A-only and AV
    Later implanted children do better at V only
    If child gets implanted 2.5 years or later they are more reliant on visual cues
  46. Depends more on clients percpetions of limitations on activities and articipation restrictions than the actual degree of HL
    If they feel like an outcast they will seek help
  47. Audiologic Evaluation
    Otological Examination
    CT/MRI to see for abnormalities
    For children: Require a 3 month HA trial and Speech/Language Evaluation
  48. Advancement in internal/external Components
    Speech Coding Strategies
    More liberal criteria for who can get a CI
  49. Visemes can change depending on neighboring phonemes
    Limits perception
  50. SNR of -10 dB to begin and adjust until client gets 100% correct
    Surrounded by speakers and locate the sound
    Recorded, Reliable, Valid
  51. Helps determine teaching methods
    May predict CI benefit in kids
    Live speech test preferred
    Want visual acuity
  52. 5 feet
  53. Take their time accepting their childs HL
  54. Exaggerated mouth movement is harder to understand
    Mumbling is hard because you can't see articulator placement
    Accents are a struggle as well
  55. System Information: SpEd laws, available services
    General Information: Child's prognosis, treatment options
    Parents role at home
    Family assistance: Counseling network
    Resources: Financial, medical, emotional, respit care
  56. California Consonant Test is sensitive to speech perception problems for this population
  57. HINT
  58. McGurk Effect
    Seen more in females
    Combine auditory and visual cues and get something in the middle
  59. Most common in High Frequencies
    With a SNHL
    Progresses gradually
  60. Graded phenomenon
    Depends on listener and talker
    Gender: Females integrate more
    Individuals with an array of disorders don't get effected
  61. FDA lowers the approved age to 2 years
  62. Speaker
    Speech reader
  63. More related with communication problems rather than the HL
  64. CROS
    HA that transmits sound from bad ear to good ear
  65. Varies on CI manufacturers and Health Insurance
  66. SADL
  67. Activity Limitations posed by HL
    Participation restrictions posed by HL
    Efficacy of AR Groups
  68. Questionnaire
    Results may change over time
  69. Speech Processor
    Transmitter Coil
  70. 1957
    Implanted the VIIIth Nerve stump in a patient with bilateral temporal bone resection
    Patient could differentiate between high and low frequencies
  71. Quality of sound
    Speech in noise
    Directional Hearing
    Natural Hearing Experience
    Ease of listening
    Still have functioning ear if one device breaks down
    Helps avoid auditory deprivation
  72. Visual Only
  73. Positive Effects
    SErvice and Cost
    Negative Features
    Personal Image
  74. 7 years
  75. Improved Speech perception abilities
    Better frequency selectivity
    Helps with background noise
    Helps with music
    Helps with sound localizaiton
  76. Shorter electrode array
    Stimulates only basal end of cochlea
    Preserves residual hearing of low frequencies
    FDA clinical trials
    Profound HL > 1500 Hz
  77. APHAB
  78. Immediately after the client's response
  79. Earlier implanted children do better on outcome measures
    Kids were 3 years older than early implanted children at the time of testing
    had small sample group of early implanted group
  80. Words that look a like when spoken even though they sound different
    Lips and tongue look the same
    Different speech sounds that look the same
  81. 20% of words are recognized through vision alone
    Place is visible
    Voicing and manner are invisible
  82. Longer the message harder to speech read
    Grammar helps with predicatbility
  83. Elderly make up majority of people with HL
    Accidents, Illness, Age factors of HL
  84. House (HEI)
    Michelson (UCSF)
    Simmons (Stanford)
    Graeme Clark (Melbourne)
  85. Grief Cycle, Stages of Grieving
    Often seen as a re-cycling
    Pattern and reaction to loss
  86. Use minimal encouragers (uh-hh, hmm) keeps person talking
    Paraphrase-this helps lead to solutions without directly acknowledging them
    Acknowledge/ reflect feelings
    HL children don't have feeling vocabulary
  87. Parent that is around the child has the most
    Reaction to loss
    Rage directed towards child, family, professionals
    Professional response: Acknowledge frustration, depersonalize attack
  88. If the patient follows their recommendation
  89. Classify phonemes by place of articulation and shape of mouth
    Not a 1:1 correspondance
    9-12 groups
  90. Auditory stimulation might prevent deterioration of auditory pathways on non implanted ear
    Helps with localization
    Increases SNR
  91. Hard to localize sound
    CROS and OI do little to restore binaural auditory processing
  92. S12=10 mm
    L24=24 mm
  93. Techniques that allow Audiologist to test integrity of Internal Device
  94. Insures that "the best" ear will be implanted
    Increases access to sound
    Helps with sound localization and speech understanding
  95. Perception of sound through CI differs from acoustic hearing
    People report a tactile sensation rather than hearing initially
    People need time to adjust to CI
  96. Cost
    Two devices
    Might have poor fusion of auditory signal
  97. Face-to-Face or 45 degree angle
    to the speakers right is prefered
  98. Evaluated the performance n individuals with profound HL
  99. Picks up acoustic signal
  100. Americans want their child to succeed
    Will my child talk?
    Certain values are more important than others depending on the family
  101. IT MAIS
  102. Electronic Hearing for High frequencies by CI
    Acoustic hearing with amplification for low frequencies
  103. How they are using their body and help add redundancy to message
  104. Do more than just watch lips
    Look at facial expression
    Use residual Hearing
    Linguistic Constraints
    Modify Environment
  105. Help Child/parent tell their story
    Help them to clarify their problems
    Help children to take responsibility for listening problems
    Help them establish goals
    Develop an action plan
    Implement the plan
    On going reassesment
  106. If client gets 100% you don't know what they have difficulty with
  107. Perception with auditory or visual stimuli
    Integrate auditory and visual cues
    Applying cognitive and linguistic constraints
    Working memory
  108. Increasing gain of hearing aid is useful strategy for dealing with phonemic regression because the damage involves peripheral auditory patways
  109. Ci's introduced in clinical trials
    Only implant post-lingual adults
    Bilateral profound SNHL and 0% speech perception
    Received 1 CI
  110. Present ~20 weeks old
    Prefer when auditory matches visual cues
  111. Two CI's implanted in 1 surgery
    Patient has two "working" cochleas now
    Helps with localization of sound
    Insurance may not cover second CI
  112. Not representative for Real World listening Situation
    May inflate Scores
    Exclude people who would benefit from CI
  113. Encourage HA use for maximum language exposure
    Want to keep ear stimulated for future technology
  114. Bone Anchored Hearing AId
    Called this for insurance reasons
  115. Most central aspect of counseling is listening
    Delay Judgement
    Accept what the client has to say
  116. Have better balance and localization when using both CI and HA
    Some stop using HA and cite interference
  117. Sends the electric signal from the external device to the internal device
  118. Stimulates auditory nerve
  119. Ultimate goal
    First evidence of resolved grief
    Professional Response: Energies and constructive actions of parent can now be more focused on intervention
  120. 1984
    House-3M Single electrode Array for adults
  121. Greater benefit from two CI
    Duel implantation is more expensive though
    Insurance doesn't reimburse equally for second CI
  122. Stereotyping what a response might be
    Transference: Strong reaction possitiveor negative to parent
    Projecitons; Responding ot predicaments as if they were our own
    Implicit Expectation
  123. Doesn't restore binaural hearing
    Provide no improvement in sound localization
    Modest improvement in SNR
    CI is only method to restore auditory perception to deafened ear
  124. Reality is painful
    Reoccurs at life milestones
    Professional response: Listen quietly
    If severe enough may reffere to professional
  125. CI in one ear
    HA in the other ear, residual hearing is in this ear
    Helps with localization of sound
    Some people may stop wearing their HA
  126. 30% or Less W0rd Recognition Measures
  127. Listen to what they say to you
    Be honest: Be fair, objective, yet understanding
    Provide information: Regulate level, amount, level of understanding on parents part
    Focus on what family does well
    Respect family decision
    Seek information if you do not know
    Agree to try something
    Watch jargon use
    Give families time
    be sensitive to culture
    Reiterate, Rephrase, Repeat
  128. To be Deaf
  129. Patient is deaf in both ears
    CI attached to one cochlea
  130. Is the cochlea an abnormal shape
    Is a cochlea present
    Is an auditory nerve present
    Surgical anatomy anomalies
  131. 3 Major Sections, including specific needs degree of change, and final ability
    Reliable, Normed, Valid
  132. Cope with their HL in an AR Therapy
  133. General Anesthesia
    2-4 hours in length
    Typically overnight stay for observations
  134. AKA Mapping
    Requires frequent adjustments "tune-ups"
    Many things affect a persons success with a CI
    Need to readjust after every appointment to CI
  135. Only attending to position and movement of lips
  136. Implant/Receiver
    Electrode Array
  137. Use this and visual cues to help understand speaker
  138. 50% or less in implanted ear
    60% or better in unimplanted ear
  139. Something they/you did caused the problem
    Multicultural differences: Religious, cultural
    Punishment for transgression
    Don't condeme, provide scientific rationale
  140. Children with HL struggle to "read" people
    Harder to make friends
    Language abilities effect perception
  141. With self, God
    Superparent Syndrom
    Professional Response: Help parents establish realistic goals
  142. Need to remove internal magnet before MRI because MRI would disrupt internal magnet placement
  143. Woman are easier then men
    Facial Hair is an issue because they hide the mouth
  144. Segmental and Suprasegmental
    Auditory Cues
    Visual Cues
  145. Converts the acoustic signal from the microphone to an electric signal
  146. To learn more about the clients' perceptions of restricted activites
  147. AzBio
  148. Good hearing at low frequencies
    Poor hearing at high frequencies
  149. Controlling the social scene
    Avoiding the social scene
  150. 10 and older clients
    Tested unaided and aided
    Available in other languages
    Reliability and validity not mentioned
    very realistic
    Easily Administerred
  151. Oral Communication
    Audiovisual Testing
  152. 1790
    First person to stimulate auditory nerve electrically
    Connected a battery of 30 couples to two metal rods and inserted them into his ears
  153. Ceiling Effects
  154. No ties to Deaf Community
    Limited Communication Skills
    Can't Speech Read
  155. W-Watch Talker's Mouth
    A-Ask Specific Questions
    T-Talk about HL
    C-Change the situation
    H-Healthcare knowledge
    Use during the HA fitting Process
  156. Auditory Oral
  157. 1964
    Inserted an array of electrode into a cochlea of a totally deaf person
    Patient was able to repeat phrases with lipreading cues
  158. Medical Contradiction to getting a CI
    Need this to send audio signal to the brain
  159. Communication Stratagies and Psychosocial training Group
  160. Place of Articulation
  161. Need both signals for optimum recognition and comprehension
    Use sight to help in loud environments
  162. Speech perception performance in quiet and noisey is similar with CI and CI
    Localizaiton is better with CI-CI
  163. Control Group
  164. Words relate to each other if we have a good vocabulary it is easier to fill in the blanks
  165. Don't assume their HA fits
    May need to remove HA to acclimate CI
    Fit independently
  166. Initial reaction, helps them mobilize
    HL is invisible
    Professional Response: Accept and offer service to child and family
  167. Length
    Morphosyntax and semantic constraints