Aural Rehab Test #2
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By 4 years of age children of professional parents were exposed to _____ million words.
By 4 years of age children of working class paretns were exposed to _____ million words.
By 4 years of age children of welfare class parents were exposed to _____ million words.
By the age of 4 the difference between exposure to 46 million and 13 million words cannot be made up?
T or F
Children are not as able to compensate for the acoustic smearing effects of __________________,
Children need a better _________ to _________ __________ to perceive speech clearly?
signal to noise ratio
____________ and __________ work together to perceive speech clearly?
Noise and Reverberation
Sounds that don't dissipate are called?
The __________ or ________ difficult the task, the _____________ the change for noise interference?
newer or more: greater
Children with hearing loss are affected more by __________ and ____________ than children with normal hearing?
noise and reverberation
In the classroom you need to reduce noise and increase the signal for better reception?
T or F
Noise has to be 25 dB softer or I have to be 25 dB louder to overcome noise.
T or F
- not so sure about this one, it was on my notes???
What are the 3 boundaries to overcome in the classroom?
- 1. Distance: speaker to the mic of their aids
- 2. Reverberations: poor acoustics
- 3. Background noise
The typical SNR in class is ______?
6dB Adequate for kids WNL.
H.O.H. child needs at least _______ dB SNR.
H.O.H. child needs a ______ dB SNR to hear all consonants?
As distance doubles you lose ______ dB SPL?
Decreasing the distance by ______ equals a gain of 6 dB SPL.
SPL stands for
Sound Pressure Level
HTL stands for
Hearing threshold level
Conversational level speech spoken within a few inches of a H.O.H indvs. ear reaches their ear canal at about _________ dB SLP?
When you ___________ the intensity of the sound by ____ dB, perceptually you ___________ the loudness of the sound by ______?
decrease, 10, decrease, half
__________ intensity of the sound by ___dB makes it perceptually sound _____ as loud.
Increasing, 10dB, twice
In the classroom, the head shadow effect _______ frequencies aren't affected as much.
4 types of ALD's (assisted listening device)
- 1. Hardwire
- 2. Induction Loop
- 3. Infrared
- 4. Frequency Modulation (FM) systems
Which of the ALD's are the most expensive?
Frequency Modulation system (FM)
A hearing aid will not provide benefit to speech perception in environments with noise levels in excess of ____ dB.
Noise levels in public school classrooms average ____ db SPL and range from ______ dB SPL.
In acoustically treated rooms, noise from young children does not affect listening?
T or F
- Even in acoustically treated rooms, the noise can be so high that listening is affected.
Advantages of ALD's (FM/Mic)
- 1. Better SNR
- 2. Decreases distance- dont have to overcome physical distance
- 3. Decreases background noise
- 4. Decreases reverberation for wearer
- 5. Decreases intensity/ loudness problems
What are the components of ALD's?
- Tabletop or speaker
- lapel mics
The location of the mic is not vital to the amplified signal?
T or F
- The location of the mic is vital to the amplified signal?
Where should the mic be located?
6 in from the speakers mouth.
What are the different listening devices?
- 1. Headphones
- 2. Earbuds
- 3. Neck loops
- 4. Direct Audio Input (DAI)
- 5. FM Boots
The cheapest of the Assisted listening devices is the ______________?
With the Infrared System
- -Mic is place near speaker (acoustic or electrical)
- -Electrical signal converted to infrared
- - Infrared signal directed to reciever
- needs clear line of sight
- - Receiver converts light signal back into electrical signal
- - Converted again back into acoustic signal.
Advantages of Infared Systems
- Stays within a specified perimeter
Disadvantages of Infrared Systems
- -Requires direct line of sight
- -Wont work in direct sunlight
- -Confined to specified area
- -Direct wire from mic to amp and receiver
- - Mic near speaker
- - Signal routed to a direct audio input (DAI) to allow the signal to reach the listener
- *** primarily for personal use- pocket talker*******
- lightweight and portable
- - limited by length of component wires
- - reduced sound quality
- - Cant hear their own voice
- - No peer interaction (can only hear teacher)
- - Everyone receives the same strength of signal.
- -Wiring is looped around the perimeter of a room
- - mic is placed near speaker
- - sound source sent via wired connection or FM Signal to a receiver (electrial energy)
- - Electrical current transferred via wire loop (current created a mag. field)(telecoil)
- - Can be used by anyone in the room using a telecoil receiver unit.
Advantages of Induction Loop
- - wireless connection to listener
- - works with listeners existing telecoil
- - easy to operate
Disadvantages of Induction Loop
- - must install loop in room
- - not portable
- - dependent on strengh of telecoil
- - increased distance- decreased signal
- - multiple units in area can cause interference
FM Systems Operate under ____________?
Federal Communications Commission (FCC)
FM Systems use ______ _______ signals.
With FM Systems _____________ are allocated specifically for the hearing impaired?
bandwidths (shorter distances)
- - Speaker wears transmitter
- - reciever is worn or placed by listener
- - FM signal is transmitted to receiving device (signal is sent via a specific frequency)
Advantages of FM System
- easy operation
- indoors and outdoors
- no electromagnetic interference
- good sound quality
Disadvantages of FM systems
- Radio interference possible
- May not be cost effective
- Each listener requires a receiver
What are some things you can do as a speaker to make ALD's more successful?
- - speak clearly
- - don't cover mic
- - place mic within 6 in of mouth
- - keep background noise to a minimum
- - frequently complete system checks
- - Repeat questions from speakers not wearing transmitters.
- - Face audience to provide facial cues when speaking.
- -connects to audio output
- -can be wired, induction loop, FM and infrared.
- - transmitter placed near TV
- - Closed caption is also an option
ALD's and Telephones
- -Requires a better SNR due to an auditory only signal
- - HA users can use telecoli
- - can use an amp connected to telephone and a headset
- - May hve a volume control to increase output
- - may also use lights to provide a visual cue.
ALD's. telephones and severe to profound hearing loss......
- -may not be able to use amplified telephone
- - a t-coil may not provide enough amplification
- - use of a teletype device may be implemented- referred to as a text telephone (TT)
- - can only text other users of TT
- - Must use a relay system when calling indv. without a TT phone.
Alerting/Signaling Devices use ___________, __________ or an increased __________ sound.
vibration, lights, amplified
Alarm clocks use __________ in pillow, __________ connected to device to provide a visual.
Smoke alarms include a __________ light for visual cues.
What are the 3 companies approved by the FDA to manufacture and sell CI's?
- Advanced Bionics
The first implant was from what company? and was implanted in what year?
- Cochlear, 1985 (nucleus 22)
- 1990 for children(2-17 years)
- 1998 for children (18-24months) Nucleus 24
- 1998 for children Nucleus 24 Contour (12 month olds)
Advanced Bionics was ______ in the year __________ .
- 2nd, 1996 (Clarion)
- 1997 children 2-17
- 2003 HiRes 90K for 12 month olds
Med-El in _______ for 12 months to adults.
Cochlear implants have....
- - enhanced battery life (2 AAA lasts up to 5 days.
- - Simple to use push buttons
- - Take away form the guesswork- built in help function for troubleshooting
- - Two microphones
- - Designed for better performance
- - Comfort and peace of mind
Freedom has a digital reader to tell you what is wrong with the CI?
T or F
The N5 comes with a remote?
T or F
Internal Components of a Cochlear Implant
- 1. Magnet
- 2. Internal processor
- 3. Electrode Array
- 4. Ground electrode
What is the basic process of a cochlear implant?
- 1. external speech processor captures sound and converts to digital signal
- 2. Processor sends signals to interanl implant
- 3. internal implant converts signals into electrical engergy and sents it to electrode array
- 4. electrodes stimulate 8th nerve and the brain perceives it as sound.
What is done in the Pre-Operative Assessment
- - determine that the patient meets the candidacy criteria audiologically.
- - Assess the non-audilogic factors that influence candidacy
- - Select which ear(s) to implant
- - Assess appropriate expectations and counsel on potential benefits
- - build a positive rapport with the patient and family.
Who does an implant team consist of?
- Social Worker
What is the role of the ORL/ENT when on the implant team?
making medical decisions and surgery
What is the role of the audiologist when on the implant team?
to determine audiologic candidacy and programs the speech processor.
What is the role of the SLP when on the implant team?
performs rehabilitation process
What is the role of the psychologist when on the implant team?
What is the role of the teachers when on the implant team?
What is the role of the social workers when on the implant team?
follow up and proper care
If aided thresholds are poorer that 35 dB HL, it is very likely that detection can be improved with an implant.
T or F
What are 4 things that are done in the assessment process?
- 1. medical evaluation
- 2. CT scan/MRI
- 3. Vestibular testing (optional)
- 4. Conseling (for realistic expectations and device counseling)
Candidacy for Severe-profound Bilateral SNHL are as follows:
- -PTA > 70 dB in both ears
- - limited benefit from hearing aids
- - Sentence score <50% in the ear to be implanted
- - Healthy adult over 18 years
- - postlingual onset after age 6
Candidacy for Moderate-Profound Bilateral SNHL are as follows:
- - Limited benefit from hearing aids
- - sentence score < 50% in the ear to be implanted (<60% in best-aided condtion)
- - healthy adult over 18
- - Pre or post lingual onset of deafness after age 6.
______________ of the auditory system appears to decline rapidly after about 6 years of age.
Benefit and success mean different things to different people when talking about CI?
T or F
Candidacy Assessment in Pediatrics include .......
- - Detailed case history- medical and otological history, communication, educational and psycho-social factors
- - important factors include- age of onset, duration of deafness, etilogy, helath history, family support.
- - Thorough audiological assessment
- - Medical, otological and radiological examination -(CT scam standard, ut MRI becoming more common.
What test are done by the Audiologist in the Pediatric assessment?
- - ABR
- - ECochG/otoacoustic emmissions
- - tympanometry
- - Hearing Aid Assessment
- - Behavioral Audiometry ( Unaided left and right ear, aided binaural and if possible left and right.)
- - Speech Perception Testing - age appropriate and lingustically appropriate.
Candidacy criteria for pediatrics (Bionics)?????
- - 12 months - 17 years of age
- - Profound bilaterial SNHL
- - trial with hearing aids for at least 3 months.
- - little or no beneift from hearing aids.
Candidacy criteria for pediatrics (Cochlear)?????
- -12 months - 23 months- profound bilateral SNHL
- -2-17years Severe to profound bilateral SNHL
- - 3 month trial with hearing aids
- - little or no benefit from hearing aids
The trial period (3 months of wearing hearing aids) in pediatrics is waved if x-rays show ossification of the cochlea.
T or F
Assessment process for Pediatrics
- - Assessment of speech, language and listening development - may be the most important variable in many cases.
- - Assessment of cognitive and general development
- - PET scan
- - Psycho-social assess/ childs motivation
- - Asses. of parental expectations and motivation.
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