Aural+Rehabilitation

=Aural (Re)habilitation= Standards: III-C, III-D Please also see associated information on the Audiology and Acoustics pages Aural (Re)habilitation in schools
 * Screening and assessment
 * Teacher education, education of other students/peers
 * Classroom noise
 * environmental--carpet vs tile, air/heating units, hallway noise
 * teacher compliance--preferential seating, use of sound field or personal FM
 * teacher compliance--visual cues, facing students
 * troubleshooting equipment
 * student self-advocacy
 * direct instruction and consultation
 * speech and language therapy
 * phonological awareness and literacy skill development
 * auditory training
 * transition planning

Communication modes
 * Total communication
 * Bi-Bi First language ASL, 2nd written language
 * Auditory Verbal
 * Cued Speech

Speech Reading 60% of phonemes visible on lips Factors
 * familiarity with topic
 * distance
 * angles
 * lighting
 * amount of hearing

Auditory Neuropathy
 * normal OAE
 * abnormal ABR (poor development/degeneration of the auditory nerve)
 * fluctuating hearing loss
 * discrimination scores much lower than would be expected given hearing level
 * HA not effective, possibly Cochlear Implant, FM system
 * encourage speechreading, intensive speech and language tx

Central Auditory Processing Disorder
 * normal hearing, difficulty processing auditory info
 * short attention span, easily fatigued
 * requests repetitions
 * short and long term memory problems
 * Tx--auditory training, (Earobics, FastForWord) environmental modifications

Methods of auditory training 1) Analytic 2) Synthetic 3) Pragmatics 4) Eclectic--a combination
 * working with speech/listening at the phoneme, syllable, and single word level
 * discrimination of consonant or vowels sounds in syllables bi-ba, kip-kit
 * identify words in a closed set (run, money, bat, girl, boy)
 * more global approach using context and syntax clues
 * practicing sentence perception based on prior information
 * naming a topic and presenting related words that client must repeat back
 * training the listener to control situation, ask for repetition, ask questions, alter signal to noise ratio

Discrimination Hierarchy for Prelingually Deaf children
 * sound awareness
 * gross discrimination (environmental/speech sounds)
 * broad discrimination (simple speech patterns)
 * finer discrimination (speech)

Aural Rehabilitation with adults who have an acquired hearing loss Etiology: Seeking AR Assessment: Treatment: CLEAR (for patient with hearing loss) SPEECH (for communication partners)
 * accident
 * noise exposure
 * aging (presbycusis)
 * health status (hearing may not be first concern)
 * financial condition (may not be able to afford hearing aids or tx)
 * activity level (if they don't get out much, they may feel no reason to see tx)
 * psychosocial (must admit problem)
 * does hearing loss affect communication? to what extent?
 * does it affect participation--social, emotional, educational, vocational
 * attitude
 * other disabilities/health concerns
 * environment--context in which person lives and communicates
 * counseling--acceptance and strategies
 * Control the communication situation
 * Look at the speaker
 * Expectations are realistic
 * Assertiveness
 * Repair strategies
 * Spotlight face--keep visible
 * Pause between content portions of sentences
 * Empathize
 * Ease partner's listening
 * Control listening situation
 * Have a plan
 * amplification/hearing instrument orientation
 * expectations
 * instrument operation
 * insertion/removal
 * batteries
 * feedback
 * troubleshooting
 * care and cleaning
 * service

Ling 6 Sound Test /m/ low frequency /u/ low end of vowel formant range /a/ central vowel range /i/ one low formant, one high /sh/ moderately high /s/ very high (seventh "sound" silence)

American Speech-Language-Hearing Association. (2001). //// Knowledge and Skills Required for the Practice of Audiologic/Aural Rehabilitation //// [Knowledge and Skills]. Available from www.asha.org/policy. Doster, B. (2007). Lecture notes and coursepack for SPHI: 394, Eastern Michigan University.