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CSDI2100 ECU Test 1 Terms
Terms in this set (213)
impairs the ability to both receive and send, and also process and comprehend concepts or verbal, nonverbal, and graphic information
atypical production of speech sounds, interruption in the flow of speaking, or abnormal production and/or absences of voice quality (pitch, loudness, resonance, and/or duration)
impairment in comprehension and/or use of spoken, written, and/or other symbol systems
a result of impaired sensitivity of the auditory or hearing system
central auditory processing disorders
deficits in the processing of information from audible signals
augmentative/alternative communication systems
attempts often taught by SLPs to compensate and facilitate for impaired communication using, for example, signing or digital methods
provision of language assessment and intervention via the Internet
measure hearing ability and identify, assess, manage, and prevent disorders of hearing (including auditory processing disorders) and balance. they may dispense hearing aids.
identify, assess, treat, and prevent expressive and receptive communication disorders in all modalities. they provide services for swallowing disorders and may be involved in modifying dialects.
speech, language, and hearing scientists:
extend knowledge of human communication processes and disorders. they usually have doctorate degrees and are employed by universities, government agencies, industry, and research centers, some may also work clinically
related professions: a team approach
teams can include family members, regular and special education teachers, psychologists, social workers, physicians and other medical personnel, and occupational, physical, and music therapists; they may collaborate with physicists and engineers
how old do individuals with communication disorders have to be?
statistics for disabilities
1 in 5 people, the likelihood increases as we age
statistics for hearing loss
2 out of 10 people, 20% of all Americans
combination of scientific evidence, clinical experience, and client needs
assumptions of EBP
clinical skill grows from experience and current available data; the SLP or audiologist seeks new therapeutic information to improve efficacy
what is the best source of clinical evidence?
professional, peer-reviewed journals
the probability of benefit from an intervention under ideal conditions
what are the 3 key elements of efficacy?
refers to an identified population, not specific individuals; the treatment should be focused and the population should be clearly identified; the research should be conducted under optimal intervention conditions, although actual clinical conditions may be less than ideal
the probability of benefit from an intervention method under average conditions, it is what works in real-world application of intervention
the quickest and least effortful method resulting in the greatest positive benefit
primary biological functions of the respiratory system
supply oxygen to the blood and remove excess carbon dioxide; also serves as the generating source for speech production
structures of the respiratory system
pulmonary apparatus: lungs, trachea, pulmonary airways, chest wall (thorax): rib cage, abdominal wall, abdominal content, diaphragm
pair of air-filled elastic sacs that change in size and shape and allow us to breathe
air moves into the lungs via the trachea and branches into bronchi
muscles of the respiratory system
inspiratory and expiratory
generally above the diaphragm
generally below the diaphragm
resting tidal breathing
breathing to sustain life
the process of inspiration
diaphragm contracts, rib cage and lungs expand, lung volume increases and alveolar pressure drops, causing air to rush in and equalize with atmospheric pressure
the process of expiration
decrease in the size of the rib cage wall, compression of the lungs, increase in pressure in the lungs, air rushes out to achieve equilibrium with atmospheric pressure. does not require muscle contraction
what is one respiratory cycle?
one inhalation and one exhalation
during resting tidal breathing, what is the duration of the inspiration and expiration?
contraction of diaphragm leads to rapid, forceful inspirations; inspirations are much shorter than expirations; the amount of air inspired is greater than during resting tidal breathing; inspiratory and expiratory muscles are both activated during speech
lifespan issues of the respiratory system
resting tidal breathing rate decreases from birth to adulthood, related to more alveoli; maximum lung capacity is reached in early adulthood, remains constant until middle age; respiratory function is affected by exercise, health, and smoking
the primary biological function of the larynx
to prevent foreign objects from entering the trachea and lungs
the structures of the laryngeal system
larynx, thyroid cartilage, thyroid prominence, vocal folds, glottis
can impound air for forceful expulsion of foreign objects that threaten the lower airways; an air valve composed of cartilages, muscles, and other tissue, it is the main sound generator for speech production
where is the larynx located?
sits on top of the trachea and opens up into the pharynx
what is the larynx suspended from?
the hyoid bone
the point of attachment for laryngeal and tongue muscles
what does the larynx consist of?
the thyroid, arytenoid, and cricoid cartilages, which are attached via ligaments and membranes
the largest laryngeal cartilage; it forms the front and sides of the laryngeal skeleton and protects the inner components of the larynx
a protrusion referred to as the 'Adam's apple,' which is located just below the thyroid notch
what does the larynx house?
the vocal folds
attached at the front near the midline of thyroid cartilage and at the back to the arytenoid cartilage via the vocal ligament
the space between the vocal folds
what are the muscles of the larynx?
thyroarytenoid, cricoarytenoid, lateral cricoarytenoid and arytenoid, posterior cricoarytenoid
the bulk of each vocal fold, contraction shortens and thickens the vocal folds
stiffens and lengthens the vocal folds, increases vocal pitch (fundamental frequency)
lateral cricoarytenoid and arytenoid muscles
contraction results in vocal fold adduction
posterior cricoarytenoid muscle
primary muscle of vocal fold abduction
lifespan issues of the laryngeal system
the larynx is small and high in the neck in newborns, it reaches its final position between 10 and 20 years of age; the laryngeal cartilages increase in size and become less pliable with age; the vocal folds increase in length differentially for males and females, reaching a final average length of 21 mm in females and 29 mm in males; female laryngeal cartilage never completely ossifies; the vocal folds atrophy and lose elasticity with advancing age; men notice an increase in pitch with advanced age, and women experience decreased pitch with the contribution of hormone-related changes in menopause
what is the articulatory/resonating system composed of?
the oral cavity, nasal cavity, and pharyngeal cavity
the vocal tract
a resonant acoustic tube that shapes the sound energy produced by the respiratory and laryngeal systems into speech sounds
the structures of the articulatory/resonating system
22 bones of the facial skeleton and cranium, 32 teeth within alveolar processes of the mandible and maxilla, the hard palate, tongue, velum
what is the hard palate composed of?
the horizontal bones of the maxilla
a muscular hydrostat; it has no bone or cartilage; it provides its own structural support through contraction of its muscles and has a soft skeleton of connective tissue that surrounds and separates its components
also called the soft palate and is located in the pharynx
the termination of the velum
contact of the velum with the lateral and posterior pharyngeal walls
why is velar elevation necessary?
to prevent air (or food) escaping through the nose and to build up air pressure for production of pressure sounds
what does the speech production process begin with?
the air pressure that builds up beneath adducted vocal folds
what do the elastic properties result in?
the vocal folds colliding, closing off the airway
the number of cycles of vocal fold vibration per second
whole-number multiples of the fundamental frequency
what changes the shape of the vocal tract and modify sound?
movement of the tongue, lips, and larynx
what kind of sound results from vocal fold vibration?
statistics for Americans reporting some degree of hearing loss
statistics for births resulting in a child with hearing loss (most common birth defect)
approximately 3 in 1,000
statistics for births resulting in a child with a severe to profound degree of hearing loss
approximately 1 in 1,000
statistics for children in the U.S. having an "educationally significant" hearing loss
approximately 83 in 1,000
the WHO recommends the following to prevent hearing loss:
immunizing children to prevent disease and screening to identify disease early, greater access to medications to treat infections, improved hygiene practices, avoidance of medications that damage inner ear structures, early hearing testing, better information to young people regarding noise-induced hearing loss
a loss of structure or function
term that includes the impairment as well as the environmental factors that interfere with functioning
the functional consequences associated with a particular impairment
what are the effects of hearing loss in children?
an individual demonstrating a profound hearing loss would have no access to the speech sounds in our language without amplification; all degrees of hearing loss in children can interfere with their ability to succeed in school, both academically and socially; children with profound hearing loss have more difficulty in social interactions, but did better when hearing loss was diagnosed early and amplification was provided early
the effects of untreated hearing loss in adults include:
increased irritability and fatigue due to extra cognitive effort required to process information, increased stress, greater likelihood of becoming isolated, increased risk of injury, reduced earning power and less confidence of ability to perform job duties, reduced self-esteem, overall reduced psychological health
what do parents of children with hearing loss often experience before they are finally able to accept the reality of the situation?
shock, denial, anger, and depression
adults who acquire hearing loss can experience what?
inadequacy, guilt, decreased self-sufficiency, and reduced self-worth
why must professionals pay attention to these psychosocial issues?
to determine the full impact of a hearing problem on an individual client and his or her family members
when a person's hearing loss reaches 90dB or greater
some individuals who are deaf do not see their deafness as a disability but as a what?
deaf people make up what?
the Deaf community
what is the language of the Deaf community?
American Sign Language (ASL)
has a rich history, traditions, folklore, and various contributions to the arts
what was the overall change in leaders in the Deaf community's opinion on cochlear implants?
were originally quite forceful in their opposition, but it is recently more accepted that this is a personal choice and should be respected
what is the role of audiologists?
not to tell the clients what to do, but rather to listen to their goals and priorities and coach them in ways that are consistent with those beliefs and with their culture
what is the definition of audiology?
the discipline involved in "the prevention of and assessment of auditory, vestibular, and related impairments as well as the habilitation/rehabilitation and maintenance of persons with these impairments."
what is equally important to assessment being a critical part of audiology?
treatment and management of a client diagnosed with a hearing problem
another aspect to audiology is prescribing and fitting what?
for sound to occur and be perceived there must be what?
an energy source, an object capable of vibrating, a medium, and a receptor
sound is a series of what?
compressions and rarefactions that move outward from a vibrating source
what is amplitude?
the distance the vibrating object travels in either direction; determines intensity, measured in decibels (dB)
what is frequency?
refers to the number of cycles of vibration per second, measured in Hertz (Hz)
what can the auditory system be divided into?
the outer ear, middle ear, inner ear, the vestibulocochlear nerve, the auditory brain stem, and the auditory cortex of the brain
what makes up the peripheral auditory system?
the outer ear, middle ear, inner ear and the vestibulocochlear nerve
what makes up the central auditory system?
the auditory brain stem and the auditory cortex of the brain
what is the structure of the central auditory system?
consists of nuclei, nerve fibers, and nerve tracts; includes pathways that carry auditory information to the brain (ascending) and pathways that receive information from the brain (descending)
what do the anatomical structures leading to the brain ensure?
that information about the frequency, intensity, and duration of the auditory stimuli remains intact until it reaches the auditory cortex for interpretation
the outer and middle ears comprise the what?
the cochlea and auditory nerve make up the what?
what does conductive hearing loss result from?
deformation, malfunction, or obstruction of the outer or middle ear
what does conductive hearing loss prevent?
usually low- to moderate-intensity sounds from being heard at all and higher-intensity sounds being perceived as much softer than normal
what does conductive hearing loss impact?
audibility but does not result in a total loss of hearing
most conductive hearing losses are permanent or not?
disorders of the outer ear include
anotia, microbial, atresia
what is anotia?
absence of the pinna on one or both sides
what is microtia?
a small, malformed pinna that does not result in loss of hearing sensitivity by itself
what is atresia?
complete closure of the auditory canal; significant hearing loss is inevitable
disorders of the middle ear include
otosclerosis, ossicular discontinuity, otitis media, Eustachian tube dysfunction, otitis media with effusion (OME), myringotomy, pressure equalization (PE) or tympanostomy tubes
the replacement of healthy bone with spongy bone in the area of the stapes footplate, resulting in reduced mobility of the stapes and hearing loss
a break somewhere in the ossicular chain
an inflammation of the mucous membrane lining the middle ear cavity
what does otitis media generally result from?
Eustachian tube dysfunction
otitis media with effusion (OME)
the vacuum can lead to the secretion of fluid
an incision is made in the eardrum and fluid within the middle ear is drained
pressure equalization (PE) or tympanovstomy tubes
inserted into the eardrum, which save the same purpose as the Eustachian tube
what is the disagreement in the literature regarding?
whether early otitis media with hearing loss has negative effects on a child later in life
what does sensorineural hearing loss result from?
the absence, malformation, or damage to the structures of the inner ear
when may the sensorineural hearing loss be present?
at birth or develop over time and is usually permanent
what range is sensorineural hearing loss predominantly in?
the higher frequency range
age of onset for sensorineural hearing loss is?
congenital or acquired, or prelingual (before 2), or postlingual (after 5)
disorders of the inner ear include
aplasia/dysplasia, Usher's syndrome, Waardenburg's syndrome, Alport's syndrome, maternal rubella, meningitis, Meniere's disease, auditory neuropathy spectrum disorder, vestibular schwannoma/acoustic neuroma, noise-induced hearing loss, temporary threshold shift, permanent threshold shift
hearing loss due to absence or malformation of inner ear structures during embryonic development
genetic disorder characterized by sensorineural hearing loss and degenerative visual changes
genetic disorder characterized by sensorineural hearing loss and changes in the coloring of the hair, skin, and eyes
marked by sensorineural hearing loss and kidney disease
maternal rubella, HIV, and CMV can be causes of what?
congenital sensorineural hearing loss
sexually transmitted bacterial diseases seriously damage the what?
CNS of a developing fetus
acquired hearing loss may be due to what?
viral or bacterial infections
inflammation of the fluids and layers of tissue covering the brain
bacterial meningitis requires treatment with potent antibiotics that can be what?
fluctuating and progressive sensorineural hearing loss, tinnitus, vertigo, and a feeling of fullness in the ear. symptoms typically come and go unpredictably
what is Meniere's disease caused by?
pressure resulting from the buildup of endolymph fluid within the membranous labyrinth of the inner ear
treatment of Meniere's disease may include?
drug therapy, surgical intervention, or diet regulation
auditory neuropathy spectrum disorder
normal outer hair cell function and abnormal responses from the inner hair cells or auditory nerve fibers. characterized by a lack of synchrony in the firing of auditory nerve fibers with normal outer hair cell function
auditory neuropathy spectrum disorder may exhibit what level of hearing?
pure ton hearing within normal limits to profoundly impaired, and usually have considerable difficulty understanding speech even when the pure tone loss is not significant
hearing aids are helpful for some, but what is another option?
vestibular schwannoma/acoustic neuroma
a non-malignant growth that develops on the cells near CN VIII. symptoms include decreased hearing, tinnitus, balance difficulty, and a plugged feeling on the affected side. surgery is usually recommended
noise-induced hearing loss
a leading cause of acquired sensorineural hearing loss in young and middle-aged adults
temporary threshold shift
temporary hearing loss due to short-term noise exposure; however even when hearing turns to normal after TTS, permanent damage to the cochlea and auditory nerve can be measured
permanent threshold shift
causes a loss of high frequency sensitivity due to frequent exposure to high levels of noise
mixed hearing loss
the presence of both conductive and sensorineural hearing loss
(central) auditory processing disorders interfere with the ability to what?
efficiently and effectively use and interpret acoustic information
(central) auditory processing disorders may have difficulty hearing what?
subtle differences between similar sounding words and misunderstanding of speech when presented in noise; in individuals with normal peripheral hearing, this may be an indication of (C)APD
what are early hearing detection and intervention programs designed to do?
identify significant hearing loss in newborn babies and follow up with prompt audiological intervention services
children who are diagnosed with hearing loss and receive hearing aids and early intervention by what age develop significantly better language skills?
6 months old
newborns and preschoolers are susceptible to hearing loss due to what?
Eustachian tube dysfunction and otitis media
screening is used to determine what?
which individuals are likely to have a hearing loss
failing a hearing screening indicates that?
additional assessment is warranted
what is part of the scope of practice of both and audiologist and an SLP?
performing hearing screenings
what is an otoscopic examination conducted with?
what is an otoscope's purpose?
allowing visual inspection of the canal and eardrum
what does an otoscopic examination alert the audiologist to?
any conditions that may interfere with sound conduction during testing
how does the video otoscope work?
projects the image of the ear onto a television or computer monitor
what do electroacoustic measures do?
record acoustic signals from the client's external auditory canal
what do electrophysiological tests do?
record neuroelectric responses that are generated by the auditory system in response to sound
what do BOTH the electroacoustic measures and electrophysiological tests do?
evaluate the integrity of the peripheral and central auditory systems, without requiring the client to provide any observable behavioral responses
when is acoustic immittance testing useful?
in the diagnosis of conductive pathology
how does acoustic immittance testing work?
performed using an electronic device that assesses the admittance of the middle ear as a function of changes in air pressure within the ear canal
the acoustic immittance testing results in a graph called a what?
what can a tympanogram distinguish between?
a break in the ossicular chain, otitis media with effusion, or a perforation of the eardrum
what are otoacoustic emissions (OAEs)?
low intensity sounds ("echoes") generated within the cochlea as a result of outer hair cell movement; they can be measured with a microphone
when OAEs are present, hearing sensitivity is presumed to be?
normal or no worse than a mild loss
what are OAEs important in?
newborn screening programs
auditory evoked potentials (AEPs)
electrophysiological tests record neuroelectric responses generated by the auditory system
the auditory brain stem response (ABR)
a type of AEP that measures neuroelectric activity of the auditory nerve and structures of the lower brain stem
ABR can be used to identify what?
neurological issues, such as a tumor on CN VIII or auditory neuropathy/dyssynchrony disorder
the ABR can be used to estimate what?
the auditory thresholds in individuals who are unable or unwilling to be evaluated using behavioral techniques
equipment used for selection, manipulation, and presentation of stimuli during hearing assessment
where is behavioral testing usually carried out?
in a specially treated sound booth
what is behavioral observation audiometry (BOA)?
the audiologist presents a stimulus through a loudspeaker and observes a child's reaction; the reliability and validity of BOA has been criticized; electroacoustic and electrophysiological measures are preferred when assessing children younger than 5 months of age
what is visual reinforcement audiometry (VRA)?
a child is rewarded for a head-turn response to sound by an animated or lighted toy; can be used after 5-6 months of age; VRA is more reliable than BOA and is an effective tool for accurately assessing hearing sensitivity in young children
conditioned play audiometry (CPA)
the use of toys such as blocks, puzzle pieces, or stacking rings to engage the child in a listening game
pure tone audiometry
one of the most fundamental behavioral tests in the standard audiometric assessment
what are pure tones?
sounds that contain energy only at a single frequency
what is the purpose of standard practice?
to test a range of frequencies from 250 Hz to 8000 Hz; to determine a person's threshold at each test frequency for right and left ears
what is threshold?
the lowest intensity at which a person can detect a stimulus 50% of the time
how do audiometry assessments work?
a tone is presented for 1-2 seconds, and the client is observed for a response (e.g., hand raise)
air conduction testing
administered while a client wears headphones
bone conduction testing
administered with a bone oscillator, directly stimulating the cochlea
by comparing the results of air conduction testing to bone conduction testing, the what can be identified?
type of hearing loss
speech audiometry includes
speech recognition threshold (SRT) and word recognition test (WRT)
what is speech recognition threshold (SRT)?
the lowest intensity where a person can recognize two-syllable words
what is word recognition test (WRT)?
assesses how well the client is able to identify one-syllable words
behavioral testing includes
audiometer, behavioral observation audiometry (BOA), visual reinforcement audiometry (VRA), pure tone audiometry, speech audiometry, and auditory processing assessment
what is aural habilitation/rehabilitation?
intervention aimed at minimizing and alleviating the communication difficulties associated with hearing loss
what is informational counseling?
the process of giving a client information
how much information conveyed by health care providers is actually remembered by clients?
50%, and approximately half of this information is remembered inaccurately; it is important to provide information in writing
what is personal adjustment counseling?
providing assistance to the client and family in dealing with the emotional consequences of hearing loss
in most cases, amplification consists of?
personal hearing aids
what is a bone anchored hearing aid?
consists of a screw surgically implanted in the skull and an external device the converts sound to mechanical vibration, stimulating the cochlea
what is not in the client's best interest in regard to having successful hearing aid fitting?
companies that sell hearing aids over the internet and expect clients to fit and program the hearing aid themselves are appearing
what is a cochlear implant?
a prosthesis that bypasses the damaged hair cells of the cochlea and directly stimulated the surviving auditory nerve fibers with electrical energy
what are the EXTERNAL components of a cochlear implant?
a microphone, speech processor, and external transmitter
what are the INTERNAL components of a cochlear implant?
the receiver-stimulator that is surgically attached to the skull, and the electrode array that is inserted into the cochlea
what has become more common for cochlear implants?
what is hearing assistive technology?
assistive devices used to overcome problems hearing in various situations; the microphone is positioned close to the desired sound source and the signal can be delivered wirelessly
what is a FM system?
the talker speaks into a microphone attached to a transmitter that broadcasts on a designated frequency or channel
what is sound field amplification?
loudspeakers are used rather than a broadcast to one receiver
what is the goal of auditory training?
to maximize a person's use of residual hearing
what is neural plasticity?
for the purposes of this chapter- physiological and functional changes within the central nervous system in response to auditory stimulation
what is the continuum for the options in visual approaches for visual communication modality?
with manually coded English on one end and ASL on the other
what is the difference between manually coded English and ASL?
in manually coded English, much of the vocabulary comes from ASL, but the word order is the same as English, and grammatical markers are added
what is Pidgin Signed English?
new users of PSE tend to communicate using a structure that is more English-like, and more experienced used incorporate more features of ASL
what is fingerspelling?
hand shapes used to visually represent each of the 26 letters in the English alphabet
what are environmental accommodations referring to?
changes we can make to the environment that will prove the listener's ability to receive auditory information clearly
compensatory strategies strengthen what?
broader cognitive areas, such as attention and language
what does direct therapy consist of?
intensive auditory training designed to strengthen the specific auditory deficits identified during assessment
what is the lack of evidence about direct therapy?
that direct therapy can result in changes in the functional communication abilities of students with CAPD
even if an auditory processing diagnosis is valid and does apply to a student, one of the primary methods of supporting this student's listening and learning will be by doing what?
INCREASING his language competence
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