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On average how long does it take someone to admit to hearing loss? Why?
- Lack of information- how and where to seek help
Why is hearing loss so difficult for some?
creates a barrier to communication- prevents a person from:
- having a normal conversation
- enjoying TV, movies, theater and music
- participating in public activities, meetings and group assemblies
What are some early signs for hearing loss?
- can hear but not understand
- ask people to repeat what they say or answer questions inappropriately
- difficulty understanding in noisy environments where several people are talking at the same time
- difficulty hearing at movies or theater
- difficulty understanding in group or social setting
- can't understand young children
- hear better in one ear than the other when on the telephone
- dizziness, pain or ringing in the ears
- turn tv or radio louder than other people like
- difficulty understand speech if the speaker's face can't be seen
- turning head to one side to hear what is said
- Family may notice:
- blank face
- speaking too loudly or softly
- can't understand what is being said when someone is talking from another room
- avoid social situations
- tune out/fall asleep at group gatherings
What does dB stand for? What is it?
decibels- a measure of loudness
In what unit of measurement is the degree of hearing loss measured?
- dB- decibels
- 1/10 of a bel
A mild hearing loss is indicated at what decibel range?
- may have problems understanding someone from distance or soft voice
- problem with noisy background
A moderate hearing loss is indicated at what decibel range?
Problem understanding even in quiet background
A severe hearing loss is indicated at what decibel range?
all speech is a problem
A profound hearing loss is indicated at what decibel range?
greater than 90 dB
may not hear loud speech or environment sounds
What are the two parts of hearing loss- explain each.
loudness- easier to understand speech is sounds are made loud enough but some sounds may never be loud enough
clarity- sounds are unclear or cannot be understood even when amplified
What is frequency (pitch)?
speed at which sound travels
*hearing loss for older people is usually greater in the higher frequencies.
How is frequency measured?
What frequency range is normal speech?
What frequency are vowels? Consonants?
- Vowels- below 1,000 Hz
- Consonants- above 1,000 Hz
Myths about hearing loss:
- 1. A mild hearing loss is nothing to be concerned about.
- 2. You will be the first person to notice that you have a hearing loss.
- 3. Your hearing loss is normal for your age.
- 4. You have a sensorineural hearing loss (nerve deafness) there is nothing you can do about it.
- 5. You would understand people if you listened more carefully.
- 6. Your hearing loss is not bad enough for a hearing aid.
- 7. A hearing aid will correct your hearing.
- 8. A hearing aid will damage your hearing.
- 9. Your hearing loss is not bad enough for two hearing aids.
- 10. Behind the ear hearing aids are old fashioned.
- 11. You should have your hearing tested in your own home where you spend most of your time.
- 12. You can save a lot of money ordering your hearing aids through the mail.
- 13. Your hearing loss will not change in the future.
- 14. Learn to speechread and you will understand just fine.
What percentage of speech is visible on the lips?
Parts of the ear- outer
ear/pinna/eardrum/middle ear/Eustachian tube/hammer and anvil and stirrup/inner
ear/labyrinth/cochlear/hair cells/auditory nerve/acoustic nerve
Outer Ear includes which three important parts of the ear?
- 1. Pinna- the ear we see
- 2. Ear canal-passage 3/4 of an inch long in which sound travels
- 3. Eardrum-a thin membrane that separates the outer ear from the middle ear
Middle Ear includes which two important parts of the ear?
- 1. the connected bones called the malleus (hammer), the incus (anvil) and the stapes (stirrup)- when the eardrum vibrates these bones all vibrate conducting the sound to the inner ear
- 2. eustachian tube- leads to the nose and throat, main function is to keep the air pressure in the middle ear equal to the surrounding environment
Inner Ear includes which five important parts of the ear?
- 1. labyrinth- part of the ear used for balance
- 2. cochlea- plays role in hearing
- 3. hair cells- found in the cochlea, transform vibrations into nerve impulses
- 4. acoustic nerve- picks up impulses from the hair cells in the cochlea and sends them to the brain
- 5. auditory nerve- attaches to the labyrinth and cochlea and connects hearing and balance functions to appropriate parts of the brain
How does the brain participate in hearing?
The acoustic nerve sends the nerve impulses produced by the hair cells in the cochlea to the brain which it then interprets the signals as words and other sounds.
The brain also interprets information from the auditory nerve to assess movement, position and balance.
Which is the most common type of hearing loss?
Sensorineural (nerve deafness)
List the 6 types of hearing loss, explain each.
- 1. Conductive- caused by blockage
- 2. Sensorineural- damage to hair cells in inner ear
- 3. Mixed- both conductive and sensorineural
- 4. Tinnitus- ringing in ears or other head noises
- 5. Menieres- unknown cause, causes vertigo, dizziness, may be abnormality from fluids of inner ear
- 6. Autoimmune inner ear disease- inner ear triggers inflammatory response that can damage parts of the ear; the body itself is attacking as a foreign agent even if there is no infection
What is Presbycusis? How many people over the age of 65 does it affect?
slow progression of hearing loss due to age
1 of 3 people over 65
What are the 6 common causes of hearing loss?
- 1. Hereditary
- 2. Accidents
- 3. Disease
- 4. Drugs
- 5. Noise pollution
- 6. Aging
What are ototoxic medications?
drugs that may cause damage to inner ear resulting in temporary or permanent hearing loss and tinnitus
Which 6 types of medications are known to be ototoxic?
- 1. salicylates (aspirin)
- 2. nonsteriodal anti-inflammatory
- 3. Antibiotics
- 4. Loop Diuretics
- 5. Chemotherapeutic Agents
- 6. Quinine
How many Americans suffer from tinnitus?
What is tinnitus?
Perception of sound when no external sound is present (ringing in ears)
What percentage of people with hearing loss have tinnitus?
What are 8 treatments for tinnitus?
- 1. Drug therapy
- 2. Masking
- 3. Hearing aids
- 4. TMJ Treatment
- 5. Biofeedback
- 6. Relaxation
- 7. Cognitive Therapy
- 8. Retraining Therapy
What is an otolaryngologist?
- ear, nose and throat specialist
- -provides medical and surgical treatment for hearing disorders
What is an audiologist?
someone with a minimum of a master's degree in evaluation and non-medical treatment of hearing loss
Should be certified by ASHA, CCC-A
What is a hearing aid specialist or dealer?
Licensed to test hearing and sell hearing aids
What is a Pure-Tone Air Conduction hearing test?
Measures your ability to hear different tones of sound (frequency), measured in HZ and your ability to hear the loudness or intensity of these tones, measured in decibels.
What is a Pure-Tone Bone Conduction hearing test?
Tester sends a sound directly to your inner ear, the results determine whether you have a conductive, sensorineural or mixed hearing loss.
What is a Speech Reception and Speech Discrimination hearing test?
Listen to a list of nonsense syllables and one syllable words and simple sentences
What is a Threshold of Awareness, Comfort and Discomfort hearing test?
Tests range of hearing- soft to loud and helps with sensitivity to loud sounds
What is Impedance Testing?
Measures the ability of eardrum to reflect sound waves
can detect conductive loss
What is hearing threshold?
very softest sound you can detect at particular frequency on an audiogram grid
What is an ALDS?
Assistive Listening Device
What 4 components do all ALDS have?
- 1. microphone
- 2. transmitter
- 3. receiver
- 4. coupler - reduces background noise
What is an audio induction loop system?
a coil of electrical wire that is placed around a selected area which creates a magnetic field that can transmit sound, is connected to an amplifier and to the sound source
What is an infrared system?
similar to using a remote control- signal is sent out in a sixty-degree cone like the beam from a flashlight.
The person who does not wear hearing aids wears a headset with a receiver that picks up sound from the infrared light beam
What is an FM system?
Frequency Modulation- can be used in large areas
FM transmitter can be hooked into an existing PA system
a headset receiver can be worn
What is closed captioning?
Text display of spoken dialogues and sounds that are visible with use of a decoder
What is CART?
Communication Access Realtime Translation
instant conversion of the spoken word into English text using a stenotype machine
What is C-Print?
Computer aided speech to print provides a near verbatim readout
What is CAN?
Computer Assisted Notetaking
done by a fast, accurate typist who can summarize materials well
What is ASR?
Automatic Speech Recognition
recognizes and converts the spoken word into text
What are signaling devices? Give examples.
detects sound and gives visual signals or vibrations that supplement auditory signals
- wake up devices
- paging systems
- hearing dogs
- visual devices in the car
What is a T-Switch?
also known as telecoil, induction coil
special feature on hearing aids that uses principle of inductive coupling
can be used with phone and ALDS
What are the phone systems used by hard of hearing and deaf?
- amplified phones
- TTY- Text telephone
- voice carryover
- telecommunication relay services
- voice messaging
- caller id
- cell phones
What is a Cochlear Implant?
a device that is partially implanted into the cochlea to directly stimulate the auditory nerve
How does a Cochlear Implant work?
sound waves enter the implant through a microphone located in an earpiece, they are converted to electronic signals.
Signals are set to wearable speech processor which transforms sounds into digital code, each sound has a "fingerprint" or energy peaks.
- Peaks can be differentiated by electrodes implanted in cochlea , digital signals via radio waves to electrodes which convert information to electrical impulses that stimulate nerve fibers of auditory nerve.
- Impulses are transmitted to brain where they're interpreted as sound.
How is a Cochlear Implant surgery done?
Surgeon makes incision behind the ear. Raises skin flap to expose part of mastoid bone. Drills a small depression in bone to hold receiver and simulator (internal coil) in place.
Surgeon threads array of electrodes into cochlea
What are the internal parts of a Cochlear Implant?
What are the external parts of a Cochlear Implant?
- Speech Processor
- External Transmitter
What is an oral interpreter?
Sits near person and repeats silently what is said at the time, usually 2-3 words behind.
Convey mood and meaning with expression and natural gestures, may rephrase or substitute words.
What is the international symbol for hearing loss?
What is Title I of the 1990 American's with Disablities Act (ADA)?
Employment: Right to work
What is Title II of the 1990 American's with Disablities Act (ADA)?
Transportation: Public Services and Public Transportation
What is Title III of the 1990 American's with Disablities Act (ADA)?
- Public Accommodations:
What is Title IV of the 1990 American's with Disablities Act (ADA)?
Telecommunications: Relay Service
What is a stressor?
Stress response that kicks in when in a demanding situation (real or perceived) disrupts normal state of equilibrium
What are some ways to manage stress?
- time management
What is SHHH?
Was- Self Help for Hard of Hearing
Now- HLAA Hearing Loss Association of America
What is Hear Now?
Provides hearing aid to children and adults in need
What is NIDIC?
National Institute on Deafness and Other Communication Disorders
What is RERC?
Rehabilitation Engineering Research Center on Hearing Enhancement and Assistive Devices