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Amplification 1, Exam 1
Hearing Aid Candidate, Speech Acoustics, and Pre-fitting Testing
61
Audiology
Graduate
09/18/2015

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Cards

Term
What is the MarkeTrak survey?
Definition
Survey that gives information about patients and their feelings about HAs and consumer feedback
Term
What is the relationship between self-reported hearing loss, age, and hearing aid penetration?
Definition
As people get older, they are more likely to acknowledge their loss and are more likely to use hearing aids
Term
Hearing loss tx shown to improve...
Definition
1. earning power
2. communication
3. intimacy/warmth in family relationships
4. emotional stability
5. sense of control
Term
Hearing loss tx shown to reduce...
Definition
1. discrimination due to hearing loss
2. negative compensatory behaviors
3. anger and frustration in relationships
4. feelings of paranoia
5. anxiety
Term
What does "in-the-drawer rate" refer to and how has it changed over the years?
Definition
1. ITDR refers to those who own HAs but do not use them
2. ITDR has decreased from 12% in 2008 to 3% in 2015
Term
What are the reasons people do not use HAs?
Definition
1. type of loss
2. financial
3. need
4. attitude towards HAs
5. knowledge
6. stigma
Term
When are HA users more satisfied?
Definition
1. one-on-one
2. small groups
3. TV
4. outdoors
5. leisure activities
Term
When are HA users least satisfied?
Definition
1. school
2. work
3. place of worship
4. large groups
5. sporting events
Term
What is motivational interviewing?
Definition
counseling style for eliciting behavior change by helping clients explore and resolve ambivalence.
Term
Four Habits Model
Definition
bedside manner is more important to client than our knowledge!
Term
Habit 1: Invest in Beginning
Definition
1. create rapport quickly
2. elicit patient's concerns
3. plan the visit with the patient
Term
Habit 2: Elicit the patient's perspective
Definition
1. ask for patient's ideas
2. elicit specific requests
3. explore impact of loss in patient's life
Term
Habit 3: Demonstrate empathy
Definition
1. be open to patient's emotions
2. make at least one emphatic statement
3. convey empathy nonverbally
4. be aware of your own emotions
Term
Habit 4: Invest in the End
Definition
1. deliver diagnostic information
2. provide education
3. involve patient in making decisions
4. complete the visit
Term
Relationship between satisfaction and age of HA?
Definition
Patient becomes less satisfied in listening situations when their HA is more than 5 years old
Term
How does age factor into the relationship between hearing difficulty and HA adoption?
Definition
Old groups are more likely to adopt HAs and that they report higher hearing difficulty
Term
Key factors that distinguish satisfied and non-satisfied respondents
Definition
1. sound quality
2. enhanced features
3. value
Term
How is vocal effort related to SPL of speech?
Definition
1. soft: 50-55 SPL
2. normal: 60-65 SPL
3. loud: 75-85 SPL
Term
LTASS definition
Definition
vocal effort required for its production rather than being based on perceived sound level
Term
What is the dynamic range for LTASS at a single vocal effort (normal vocal effort)?
Definition
A. 30dB
B. 12+dB maxima, -18dB minima
Term
What is the spectral level and how does it relate to 3rd octave and octave bandwidths?
Definition
Recall that an octave has a wider frequency bandwith than one-third octave and the latter has a wider frequency bandwidth than spectral level when we are comparing a sound with the same center frequency.
Term
What does the Articulation Index/Audibility Index (AI) allow us to do?
Definition
helps us predict the proportion of speech that is audible to listener with hearing loss
Term
How does band importance functions change as we increase or decrease context of speech materials?
Definition
As context decrease, higher frequencies have more weight; as context increases, lower-frequencies have more weight
Term
Formula for defining AI
Definition
[image]
Term
How does AI relate to different speech materials?
Definition
When a speech material has more context, the AI increases and % correct increases quicker than those with less context
Term
Amplitude envelope and fine structure
Definition
An amplitude envelope highlights general outline of speech sound (average of peaks); fine structure looks at all parts of a sound (not general)
Term
Approximate duration of phonemes, syllables, and sentences
Definition
1. phonemes (50-120ms)
2. syllables (200-400ms)
3. sentences (2-6s)
Term
Modulation depth
Definition
how large of a change in amplitude is there from the maxima to the minima
Term
Modulation frequency
Definition
peaks/s
Term
Reverberation time
Definition
time required for a signal to decrease in a level by 60dB after its onset
Term
How do reverb and noise affect waveform?
Definition
The longer the reverb time, the more modulation depth is filled in. Noise fills in valleys so lowest portions of speech are masked
Term
Signal-to-noise ratio
Definition
How much you need to increase speech over noise to understand; how much to decrease noise over speech to understand
Term
How does speech output relate to background noise?
Definition
Not one-to-one ratio. The more intense the background noise, the less favorable the SNR despite raised vocal effort.
Term
How does STI differ from AI?
Definition
Has different weightings and incorporates transfer function
Term
Why would STI be used over AI?
Definition
takes into account reverb and distance and how noise can affect transmission of speech information
Term
What is the name of the clinical AI procedure developed by Mueller and Killion?
Definition
Count the Dots audiogram
Term
Pavolic's AI procedure
Definition
1. Make square for 20-50dB and 500-4000Hz.
2. Mark thresholds within this range.
3. Count amount from threshold to 50 for each freq and add all freqs together
4. Take this over 120 to get your AI.
Term
Speech banana with symbols
Definition
can tell patient that banana is where we hear our speech sounds
Term
Count the dots method
Definition
can give patient idea of how much speech they are able/or not able to hear (client like percentages!)
Term
How do manufacturers of HAs and/or probe-microphone equipment integrate clinical methods for audiogram-based counseling and AI into their software?
Definition
1. SPL-o-gram can show how thresholds compare to speech banana
2. measure speech spectrum into patient's ear canal (carrot passage)
3. can use family member's voices/live speech
Term
Purpose of LDL testing
Definition
finding LDLs helps up find the best MPO level (so loud sounds are loud, but not too loud)
Term
Acronyms for LDL?
Definition
UCL, UL, TD, ULL, HCL
Term
How are LDL & MPO related
Definition
If LDL is set at a reasonable level, MPO should be fine
Term
Can we accurately predict LDLs from hearing thresholds using average data? if yes, how? If no, why not?
Definition
No because there is such a wide range of LDLs for each of the thresholds.
Term
How do LDLs relate to hearing thresholds?
Definition
1. From 20-60dB, no average changes
2. Above 60dB, LDLs rise 5dB for each 10dB in hearing loss
3. Range of LDLs for different individuals with the same hearing loss is 40-50dB or greater for most hearing loss levels
Term
Are LDLs affected by gender, age, or frequency?
Definition
No.
Term
Effects of setting MPO too high
Definition
1. patient will turn down gain
2. patient to use HA only when loud sounds are not around
3. having initial negative experiences and stop wearing aids
Term
Effects of setting MPO too low
Definition
1. speech may sound distorted
2. music may sound dull
3. range of loudness perception will be limited
Term
How do manufacturers use LDL data to set MPO? Is the behavior consistent?
Definition
1. Based on mean for patient's hearing thresholds
2. Based on HL to 2-cc corrections
3. Behavior not consistent due to 1988 data from Pascoe rather than 2001 data from Bentler/Cooley ('88 data 10dB higher)
Term
Cox Contour Testing
Definition
1. 1-2 increments above threshold
2. Present tone and have patient rate
3. Increase in 5dB steps until score of 7
4. Repeat again (can use lowest HL level of 7 for score; or mean of 3)
5. Do two runs/freq/ear (3 if scores inconsistent)
Term
How many freqs tested with Cox Contour? How are these picked?
Definition
You can normally pick 2 frequencies. Should pick a low and high frequency (500 and 3K, perhaps)
Term
Do instructions for LDL test really matter?
Definition
Yes! If you give consistent instructions, scores should remain consistent. Clients have better understanding on how to score.
Term
Correction factor to transform coupler HL to coupler SPL?
Definition
RETSPL (reference equivalent threshold in SPL)
Term
Correction factor to transform SPL coupler to SPL eardrum?
Definition
RECD (real ear coupler difference)
Term
Correction factor to transform coupler HL to eardrum SPL?
Definition
REDD (real ear dial difference) (RETSPL+RECD)
Term
Does age affect RECD correction factors?
Definition
Yes. RECD corrections based on frequency and age.
Term
How would age affect REDD?
Definition
Since REDD=RECD+RETSPL, and if RECD is affected by age, so should the REDD
Term
How does variability in the RECD measurement relate to variability in the prescribed frequency-gain hearing aid response?
Definition
Variability in RECD decrease when you decrease variability in prescription
Term
Errors with real ear portion of RECD is negative
Definition
1. wrong ear for probe tip
2. insufficient seal
3. perforation
Term
What is in-situ testing?
Definition
Refers to measurement of hearing
thresholds and LDLs using hearing aid for
stimulus generation and delivery
Term
Practical uses for in-situ audiometry
Definition
1. for HA verification of gain and output
when traditional microphone measures are not available
2. can do testing during fitting of HA
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