Introduction to Auditory Rehabilitation

Carole E. Johnson is a professor in the Department of Communication Disorders at Auburn University and runs the Auburn Unviersity Auditory Rehabilitation Laboratory. She received her Ph.D. from the University of Tennessee at Knoxville and her Au.D. from the Pennsylvania College of Optometry, School of Audiology. Aside from publishing a number of articles and book chapters, she has co-authored two books, Guidebook for Support Programs in Aural Rehabilitation (Singular, 1999) and Handbook of Outcomes Measurement in Audiology (Singular, 2002). In addition, she was recipient of the Larry Mauldin Award for Excellence in Education in 2007.

SECTION I: FOUNDATIONS FOR AUDITORY REHABILITATION

 

CHAPTER 1: INTRODUCTION TO AUDITORY REHABILITATION

INTRODUCTION

LEARNING OBJECTIVES

DEFINING AUDITORY REHABILITATION

PROVIDERS OF AUDITORY REHABILITATION ACROSS SERVICE-DELIVERY SITES

REVIEW OF THE AUDIOGRAM

Degree of Hearing Loss

Type of hearing Loss

Configuration of Hearing Loss

Pure-tone Averages and Speech Audiometry

EFFECTS OF HEARING LOSS

Age of Onset

Effects of Degree of Hearing Loss

A Model for Describing the Effects of Hearing Loss

A MODEL FOR AUDITORY REHABILITATION

OTHER AREAS OF AUDITORY REHABILITATION

Auditory Processing Disorders

Tinnitus and Hyperacusis

Vestibular and Balance Disorders

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 2: PSYCHOSOCIAL ASPECTS OF HEARING IMPAIRMENT

INTRODUCTION

LEARNING OBJECTIVES

PSYCHOSOCIAL EFFECTS OF HEARING LOSS

Hearing Loss and Personality Development

Congenital Hearing Loss

Acquired Hearing Loss in Middle-Age and Beyond

Hearing Loss and Hearing Aid Stigma

Early Studies

Later Studies

COUNSELING

General Types of Counseling

Examples of Counseling Techniques

DEALING WITH RESISTANCE

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 3: MULTICULTURAL ISSUES IN AUDITORY REHABILITATION

INTRODUCTION

LEARNING OBJECTIVES

DEVELOPING CROSS CULTURAL COMPETENCE

Developing Cross-cultural Competence with the Deaf community

Developing Cross-cultural Competence with Racial and Ethnic Minorities

MULTICULTURALISM AND AUDITORY REHABILITATION

Patient Profiles

Access to Hearing Healthcare Services

Differential Effects of Hearing Impairment on Quality of Life

Cultural and Linguistic Appropriateness of Materials

Attitudes Toward Hearing Loss and Hearing Aids

International, Generational, and Gender Issues

TOWARD CULTURAL COMPETENCE IN AUDITORY REHABILITATION

Use of Interpreters

Challenging Western Expectations

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 4: PROFESSIONAL ISSUES IN AUDITORY REHABILITATION

INTRODUCTION

LEARNING OBJECTIVES

DEVELOPING CROSS-PROFESSIONAL COMPETENCE

DEVELOPING CLINICAL COMPETENCE

PROFESSIONAL ORGANIZATIONS

CONTEMPORARY PROFESSIONAL ISSUES IN AUDITORY REHABILITATION

Reimbursement

Evidence-based Practice

Ethics and Auditory Rehabilitation

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 5: EVIDENCE-BASED PRACTICE IN AUDITORY REHABILITATION

INTRODUCTION

LEARNING OBJECTIVES

LEVELS OF EVIDENCE

FOUNDATIONS FOR EVIDENCE-BASED PRACTICE IN AUDITORY REHABILITATION

Step 1:  Developing a Research Question

Step 2:  Searching for the Evidence

Generic and Discipline-Specific Sources of Evidence

Macro and Micro Search Strategies

Step 3:  Critical Appraisal of the Evidence

Determining the Level of Evidence

Class I: Well-designed Systematic Reviews with Meta-Analysis of More than One Double-blinded Randomized Controlled Clinical Trial

Class II: Prospective Double-blinded Randomized Controlled Clinical Trial

Class III: Non-randomized Intervention Studies

Class IV: Non-intervention Studies: Cohort Studies, Case-control Studies, and Cross-sectional Surveys

Class V: Case Reports

Class VI: Expert Opinion

Assessing the Quality and Rating the Risk of Bias

Grading the Clinical Recommendation

Step 4:  Integrating Scientific Evidence, Clinical Expertise, and Patient Factors into Decision-making

Step 5:  Evaluating the Process

MOVING THE PROFESSIONS TOWARD EVIDENCE-BASED PRACTICE

CHAPTER SUMMARY

LEARNING ACTIVITIES

MOVING THE PROFESSIONS TOWARD EVIDENCE-BASED PRACTICE

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

SECTION II: SENSORY AIDS FOR AUDITORY REHABILITATION

CHAPTER 6: AN INTRODUCTION TO AMPLIFICATION

INTRODUCTION

LEARNING OBJECTIVES

HISTORY OF HEARING AIDS

CONTEMPORARY STYLES OF HEARING AIDS

Hearing Aids Requiring Earmolds

In-the-ear Hearing Aids

Open-ear Fittings

CLASSIFICATION OF HEARING AIDS

Analog, Digitally Programmable, and Completely Digital Hearing Aids

Proportional Frequency Compression Hearing Aids

Hearing Aids for Unilateral or Asymmetrical Sensorineural Hearing Loss with an Unaidable Ear

Bone-conduction Hearing Aids and Bone-anchored Hearing Aids

Implantable Hearing Aids

THE AUDIOLOGISTS’ TOOLS

HEARING AID ELECTROACOUSTICS

AUDIOLOGIC MANAGEMENT OF ADULT HEARING IMPAIRMENT USING THROUGH AMPLIFICATION

Assessment and Goal Setting

Technical Aspects of Treatment

Hearing Aid Selection

Hearing Aid Style

External Features on Hearing Aids

Internal Features in Hearing Aids

Monaural versus Binaural Fittings

Quality Control

Fitting and Verification of Hearing Aids

Hearing Aid Assistive Technology

Orientation, Counseling, and Follow-up

Hearing Aid Orientation

Device-related Information

Patient-related information

Counseling and Follow-up

Assessing Outcomes

LEARNING ACTIVITIES

CHAPTER SUMMARY

 

CHAPTER 7: INTRODUCTION TO HEARING ASSISTIVE TECHNOLOGY

INTRODUCTION

LEARNING OBJECTIVES

CHARACTERISTICS OF ASSISTIVE TECHNOLOGY

CONTEXTS FOR ASSISTIVE TECHNOLOGY USE

MAJOR PIECES OF LEGISLATION AFFECTING THE USE AND FUNDING OF ASSISTIVE TECHNOLOGY

BASIC CATEGORIZATIONS OF ASSISTIVE LISTENING DEVICES

Devices that Assist with Telephone Communication

Devices that Assist with Environmental Awareness of Sounds

Devices that Assist with Television Viewing or Interpersonal Communication

Wired Systems

Hearing Aid Dependent Systems

Hearing Aid Independent Systems

Wireless Systems

Induction Loop Systems

Infrared Systems

Frequency Modulation (FM) Systems

ASSISTIVE LISTENING DEVICES AND CELL PHONES

OTHER ASSISTIVE TECHNOLOGY FOR THE DEAF AND HARD OF HEARING

Captioned Programming, Closed Captioning, and Real-time Captioning

Telephone Devices for the Deaf

AUDIOLOGISTS’ RESPONSIBILITIES IN EVALUATING, SELECTING, AND FITTING ASSISTIVE LISTENING DEVICES

ASSISTIVE TECHNOLOGY FOR DEAF-BLIND PERSONS

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 8:  INTRODUCTION TO IMPLANT TECHNOLOGY

 LEARNING OBJECTIVES

HOW DO COCHLEAR IMPLANTS WORK?

COCHLEAR IMPLANT MANUFACTURERS

PATIENT SELECTION CRITERIA AND PRE-IMPLANT EVALUATION

Patient Selection Criteria

Pre-Implant Evaluation

WHAT IS THE SURGERY LIKE?

WHAT TO EXPECT AFTER SURGERY

The “Hook-up”

School Follow-up

Selection of Communication Options

Examples of Therapy Programs for Adults

ASSESSMENT OF AUDITORY PROGRESS

WHAT ARE SOME LONG-TERM EXPECTATIONS FOR PATIENTS AFTER COCHLEAR IMPLANTATION?

Pediatric Expectations

Adults Expectations

OTHER OPTIONS FOR COCHLEAR IMPLANT WEARERS

Bimodal Stimulation

Bilateral Cochlear Implants

AUDITORY BRAINSTEM IMPLANTS

COCHLEAR IMPLANTS AND DEAF CULTURE

HOW DO YOU SELECT A COCHLEAR IMPLANT?

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

SECTION III: AUDITORY REHABILITATION ACROSS THE LIFESPAN

CHAPTER 9: AUDITORY HABILITATION OF YOUNG CHILDREN AND THEIR FAMILIES

INTRODUCTION

LEARNING OBJECTIVES

EARLY HEARING DETECTION AND INTERVENTION PROGRAMS

Screening for Hearing Loss

Diagnosis of Hearing Loss

Early Intervention

Phase I: Diagnosis to the Fitting of Amplification

Phase II: After Initial Fitting of Amplification and Hearing Aid Adjustment

Phase III: From Hearing Aid Adjustment to Formal Communication Intervention

SELECTION OF MODE OF COMMUNICATION

APPROACHES TO FACILITATING ORAL LANGUAGE DEVELOPMENT IN CHILDREN WHO ARE DEAF AND HARD OF HEARING

SPECIAL EDUCATION SERVICES TO CHILDREN WITH HEARING LOSS

Special Education Law

Receiving Special Education Services through the IDEA (2004)

DUAL SENSORY IMPAIRMENT IN YOUNG CHILDREN

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 10:  AUDITORY HABILITATION OF SCHOOL-AGED CHILDREN

 INTRODUCTION

LEARNING OBJECTIVES

EFFECT OF HEARING IMPAIRMENT ON SPEECH, LANGUAGE, AND PSYCHOSOCIAL DEVELOPMENT

Effects of Hearing Loss on Speech Production

Effects of Hearing Loss on Language Development

Effects of Hearing Loss on Psychosocial Development

INDIVIDUALS WITH DISABILITIES EDUCATION ACT

Individualized Education Programs

Related Services and Supplementary Aids and Services

ROLE OF AUDIOLOGISTS

Identification of Children with Hearing Loss

Audiologic Evaluation to Determine Type, Degree, and Configuration of Hearing Loss

Determination of Needs for Group and Individual Amplification

Prevention of Hearing Loss

Counseling and Guidance

ROLE OF SPEECH-LANGUAGE PATHOLOGISTS

ACCOMMODIATIONS FOR CHILDREN WHO ARE DEAF AND HARD OF HEARING

Environmental Modifications

Acoustic Environment

Acoustical Treatment

Classroom Design and Learning Style

Accommodations for Learning Style

Accommodations for Output of Information, Evaluation, and Grading

Behavioral and Social Accommodations

PERSONAL ADJUSTMENT COUNSELING FOR SCHOOL-AGED CHILDREN WHO ARE DEAF AND HARD OF HEARING

Helping Children Tell their Stories

Helping Children Clarify their Problems

Goal Setting: Ready, Set, Go!

Observing Implementation of the Plan

Helping Children Evaluate their Plans

DIRECT SERVICE DELIVERY

Auditory Verbal

The Verbotonal Method

Erber Approach

NEEDS ASSESSMENT

AUDITORY PROCESSING DISORDERS

DUAL SENSORY IMPAIRMENT IN SCHOOL-AGED CHILDREN

ABUSE AND NEGLECT IN SCHOOL-AGED CHILDREN WHO ARE DEAF AND HEARING OF HEARING

TRANSITION PLANNING

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

CHAPTER 11: AUDITORY REHABILITATION OF YOUNG TO MIDDLE-AGED ADULTS 

 INTRODUCTION

LEARNING OBJECTIVES

EFFECTS OF HEARING IMPAIRMENT ON THE HEALTH-RELATED QUALITY OF LIFE OF YOUNG-TO-MIDDLE-AGED ADULTS

Personal Fulfillment (Psychosocial Well-being)

Physical and Material Well-being (Health and Living Arrangements)

Adult Role Fulfillment (Education and Employment)

AUDITORY REHABILITATION OF YOUNG ADULTS WITH HEARING IMPAIRMENT

Transition to the World of Work

Enrollment in Colleges and Universities

AUDITORY REHABILITATION OF MIDDLE-AGED ADULTS WITH HEARING IMPAIRMENT

Role of Vocational Rehabilitation Counselor

Eligibility and Vocational Needs Assessments

Role of the Audiologist

TINNITUS REHABILITATION

DUAL SENSORY IMPAIRMENT IN ADULTS

VESTIBULAR REHABILITATION

HEARING CONSERVATION

Occupational Hearing Conservation

Noise Monitoring

Audiometric Testing

Hearing Protection Devices

Employee Training Programs, OSHA Accessibility, and Recordkeeping

Efficacy of Hearing Conservation Programs

Non-occupational Hearing Conservation

Prevention of Noise-Induced Hearing Loss

CHAPTER SUMMARY

LEARNING ACTIVITIES

 

 

CHAPTER 12:  AUDITORY REHABILITATION OF ELDERLY ADULTS

 INTRODUCTION

LEARNING OBJECTIVES

A TRANSDISCIPLINARY MODEL OF AUDITORY REHABILITATION OF THE ELDERLY

Communication Status

Physical Status

General Health

Hypertension

Heart Disease

Diabetes

Visual Status

Anatomy of the Eye

Visual Disorders in the Elderly

Vestibular Status

Sociological Status

Physical Environment

Social Environment

Financial Status

Psychological Status

Mental Status

Depression

Motivation, Attitude, and Expectations

THE ELDERLY AND THE HEARING HEALTHCARE SYSTEM

COCHLEAR IMPLANTS AND THE ELDERLY

Screening for Hearing Loss

Assessment and Goal Setting

Auditory Assessment and Diagnosis

Self-perception of Communication Needs, Performance, and Selection of Goals for Treatment

Hearing Aid Delivery

Hearing Aid Orientation Group

Andragogy and the Development of Hearing Aid Self-efficacy

Outcome Measures for Hearing Aid Orientation Group

HEARING HEALTHCARE IN LONG-TERM RESIDENTIAL CARE FACILITIES FOR THE ELDERLY

Patient Services

Facility Services

Special Services

HOME-BASED AUDITORY TRAINING PROGRAMS

FALL PREVENTION IN THE ELDERLY

ELDER ABUSE

DUAL SENSORY PERCEPTION

Effect on the Elderly

Implications for Audiologic Assessment and Auditory Rehabilitation

LEARNING ACTIVITIES

CHAPTER SUMMARY