Introduction to Audiologic Rehabilitation

About our authors Ronald L. Schow is coauthor of Communication Disorders of the Aged and six previous editions of this text. He is Professor Emeritus of Audiology at Idaho State University, where he continues to be involved in writing and research. His publications include the 20 most important referred articles, which can be located on Pub Med. He is coauthor of Multiple Auditory Processing Assessment (MAPA), available through Auditec of St. Louis. MAPA is currently in the process of a national normative study by Academic Therapy Publications, Navato, CA.He is a charter member of the International Collegium of Rehabilitative Audiology, in which he has been involved since 1988. Schow received his PhD training at Northwestern University, where his major professor was Raymond Carhart, who named the profession and is considered the Father of Audiology.Michael A. Nerbonne received his PhD at Michigan State University and is Professor Emeritus of Audiology at Central Michigan University. He has published widely in professional journals, is coauthor of Communication Disorders of the Aged, and is coeditor of seven editions of Introduction to Audiologic Rehabilitation. In addition to his ongoing commitment to audiology, Nerbonne is focused on family time and fishing.

• 1 Overview of Audiologic Rehabilitation 3Ronald L. Schow,Michael A. Nerbonne Chris A. SanfordIntroduction 4Definitions and Synonyms 4Providers of Audiologic Rehabilitation 4 Education Needs of Providers 5Hearing Loss Characteristics 5Degree of Hearing Loss and Configuration 5 Time of Onset 8Type of Loss 8Auditory Speech Recognition Ability 10Consequences of Hearing Loss: Primary and Secondary 11Communication Difficulties 11 Variable Hearing Disorder/Disability 11Rehabilitative Alternatives 13Historical Background 13Contemporary Issues 16Current Status 17Procedures in Audiologic Rehabilitation: An AR Model-;CORE and CARE 19Rehabilitation Assessment Procedures 22 Management Procedures 22Settings for Audiologic Rehabilitation 24Children 24Adults 25Elderly Adults 25Summary and Summary Points 26 Supplementary Learning Activities 27Recommended Reading and Recommended Websites 28 References 282 Hearing Aids and Hearing Assistive Technologies 33Holly KaplanAlice E. HolmesIntroduction 34History of Amplification 34Hearing Aid Components 35Microphone 36PART ONE: Fundamentals of Audiologic Rehabilitation 1Amplifier (Digital Processor) 36 Receiver 37Batteries 37Hearing Aid Styles 38Behind-the-Ear 38Receiver-in-the-Canal 39In-the-Ear/In-the-Canal/Completely-in-the-Canal 39 Extended-Wear Hearing Aids 39The Earmold 40Who Is a Hearing Aid Candidate? 41Degree of Hearing Loss 42Degree of Communication Disability 42 Motivation to Use Amplification 42Hearing Aid Fitting Protocol 42Selection 42Quality Control 44Fitting 45Hearing Aid Orientation 47 Verification/Validation/Outcome Measures 49Pediatric Fittings 51Special Fittings 53Contralateral Routing of the Signal (CROS) Fittings 53 Bone-Conduction Hearing Aids 54Bone-Anchored Devices 54Middle Ear Implantable Hearing Aids 56Cochlear and Brainstem Implants 57Hearing Assistive Technology, or When a Hearing Aid May Not Be Enough 57Types of Assistive Devices 57The Role of the Audiologist in Assistive Listening/Hearing Assistive Technology Systems 61Verifying and Validating the Fitting of HATS 61The Bottom Line: Cost Management and Payment for Hearing Aids and Hats 61Concluding Remarks 62Summary 62Supplementary Learning Activities 63Recommended Reading and Recommended Websites 64 References 653 Cochlear Implants 69Alice E. HolmesIntroduction 69How Does a Cochlear Implant Work? 70 History of Cochlear Implants 71 CurrentSystems 71The Cochlear Implant Team 74 Who Is a Candidate? 74Deaf Culture and Cochlear Implants 79Treatment Plans for Cochlear Implant Recipients 79 Variables Affecting Performance 83Bilateral Hearing with Cochlear Implants 83 Auditory Brain Stem Implant 84Electroacoustic Stimulation 85Summary Points 86Supplementary Learning Activities 87Recommended Reading and Recommended Websites 87 References 884 Auditory Stimulation in Communication 93Michael A. NerbonneRonald L. Schow Kristina M. BlaiserIntroduction 93A Communication Model 94 Auditory Perception 95Development of Auditory Skills 95 Basic Perception Abilities 95 Acoustics of Speech 95Speech Perception and Comprehension 100 Speech Perception and Hearing Loss 101The Auditory Training Process 105Definition and Application of Auditory Training 105 Early Efforts in Auditory Training 105Current Approaches to Auditory Training 107 Candidacy for Auditory Training 107Assessment of Auditory Skills 107Methods of Auditory Training 112Summary Points 122Supplementary Learning Activities 122Recommended Reading and Recommended Websites 123 References 1235 Visual Stimuli in Communication 127Nicholas M. HipskindIntroduction 127Factors Related to Speechreading 128Speaker 128Signal and Code 130 Environment 134Speechreader 135Speechreading and Hearing Loss 137Assessment of Speechreading Ability 137Visual Assessment and Speechreading Evaluation140 Hearing Loss and Dependence on Vision 140 Traditional Speechreading Methods 141Recent Trends in Speechreading Instruction 142Manual Communication 148Types of Manual Communication 148Summary Points 153Supplementary Learning Activities 153 Recommended Reading 153References 154Appendixes 157Language and Speech of the Deaf and Hard of Hearing 167Kristina M. Blaiser Gabriel A. BargenIntroduction 167Communication Options for Families of Children Who Are Deaf/Hard of Hearing 168Systems Emphasizing Listening and Spoken Language 168 Manual--Visual Systems 168Systems Combining Visual and Auditory Information 169Hearing as the Foundation for Speech and Language 170 Factors Affecting Speech and Language Acquisition 174Language Characteristics of Children with Hearing Loss 176 Impact of Hearing Loss on Language Components 177Language Assessment 180Formal Language Measures 180Language Sample and Narrative Analysis 183Speech Development in Children with Hearing Loss 183Speech Characteristics 184Speech Assessment 186Summary and Summary Points 188 Supplementary Learning Activities 189Recommended Reading and Recommended Websites 189 References 190Psychosocial Aspects of Hearing Loss and Counseling Basics 195Kris EnglishIntroduction 195Psychosocial Aspects of Hearing Loss 195 Growing Up with Hearing Loss 196 Acquiring Hearing Loss as Adults 201 About Being Deaf 204Deafness with a Capital “D” 204“Knowing Is Not Enough”: Counseling Basics 205Important Distinctions 206What We May Think Counseling Is 206 What Counselors Say Counseling Is 207 The Counseling Process 207When to Refer 210Does Counseling Make a Difference? 210 Concluding Remarks 211Summary 211Supplementary Learning Activities 211 Recommended Reading 212Audiologic Counseling 212 Psychology of Deafness 212 Deaf Culture 212Recommended Websites 212References 213Appendix 215Audiologic Rehabilitation Services in the School Setting 217Kris EnglishIntroduction 218Why AR Services Are Required in School Settings: The Educational Consequences of Hearing Loss 218Hearing Loss and Learning 218 Mandated by Law 219Key Components of IDEA 220 Least Restrictive Environment 220The Individualized Education Plan 223 Types of Communication Modalities 223AR Services Provided in Schools 225 Screening and Assessment 226 Management of Amplification/Audition 226Direct Instruction and Indirect Consultation 227 Evaluation and Modification of Classroom Acoustics 228 Transition Planning to Postsecondary Placements 230 How Services Are Provided 231AR Service Providers in School Settings 231Teachers 231Audiologists 231Speech-Language Pathologists 232 Related Support Personnel 232Services for Children with Auditory Processing Problems 233Diagnosis/Assessment of APD 234 Remediation of APD 235“A Day in the Life” of an Educational Audiologist 236 Summary 237Supplementary Learning Activities 237 Recommended Reading 238Recommended Resources 238Software 238Websites 238References 238Appendix 2419 Audiologic Rehabilitation for Children 247Mary Pat MoellerRonald L. Schow Mary M. WhitakerIntroduction 247Prevalence of Loss and Level of Service 248Contemporary Efforts to Strengthen the Evidence Base in Audiologic Rehabilitation 249PART TWO: Comprehensive Approaches to Audiologic Rehabilitation 330xiv ContentsTerms and Definitions 250Profile of the Client 251Hearing Loss 251Age 251Other Disabling Conditions 252Rehabilitation Settings and Providers 252Identification and Assessment Procedures with Children 252Early Identification 252School Screening 254Medical and Audiologic Assessment 254Aspects of AR: Early Intervention for Parent--Infant and Preschool 255Rehabilitation Assessment: IFSP 255 Management 256Aspects of AR: School Years 285Rehabilitation Assessment: Individualized Education Plan 285 Management 286Concluding Remarks 298Summary 298Supplementary Learning Activities 299Recommended Reading and Recommended Websites 299 References 300Audiologic Rehabilitation across the Adult Life Span: Assessment and Management 307M. Kathleen Pichora-Fuller Ronald L. SchowIntroduction 308Profile of the Adult Client 310Hearing Loss across the Life Span 310 Help Seeking and Screening 311Profile of the Older Adult Client 312Auditory Aging 312Physical, Psychological, and Social Aspects of Adult Aging 314 Personal and Environmental Factors 316Retirement, Leisure, and Economic Status 318 Living Environments 319Model for Rehabilitation 320CORE Assessment 322CARE Management 323Feedback Based on Outcome Measures 324Importance of the Conceptual Framework to AR Practice 324Rehabilitation Settings 325Research and Teaching Settings: Universities 325Military and Veterans Administration Medical Centers 326 Community Centers, Agencies, and Consumer Groups 326 Hospitals, Medical Offices, Private Practice Audiologists, and Hearing Instrument Specialists 327Rehabilitation Assessment 327Assessing Hearing Loss and Consideration of Comorbid Health Conditions 328Assessing Activity and Participation and Considerations of Social Factors 329CORE Assessment Summary 333Rehabilitation Management 334Counseling and Psychosocial Considerations with a Health-Promoting Approach 335Amplification and Instrumental Interventions to Achieve Audibility 343 Remediation for Communication Activities 356Environmental Interventions to Improve Participation 359Other Important Issues in the Scope of AR Practice 361Vestibular Assessment and Management 361 Tinnitus Assessment and Management 364Summary and Summary Points 366 Supplementary Learning Activities 368Recommended Reading and Recommended Websites 369 World Health Organization (WHO) Resources 369 Consumer Associations and Resources for the Public 370 Websites about AR Tools 370References 371 Appendix A to G 383PART THREE: Implementing Audiologic Rehabilitation: Case Studies 39311 Case Studies: Children 395Mary Pat MoellerCatherine Cronin CarottaIntroduction 395Case 1: Matthew-;Early Intervention, Multiple Disabilities 396Background Information 397Intervention Plan 397Environmental Coordination and Participation 399 Assessment: Postimplantation 399Psychosocial and Counseling Aspects 400Assessment and Intervention Postdiagnosis of Autism Spectrum Disorder 400Communication Rehabilitation Adjustment 401 Summary 401Case 2: Annie-;Routes to Spoken Language Following Cochlear Implantation 402Background Information 402Aural Rehabilitation Plan: Preimplantation 403 Aural Rehabilitation Plan: Postimplantation 403 Intervention Outcomes 405Summary 406Case 3: Amber-;Issues Affecting Educational Placement 407Background Information 407Assessment Findings 409 Recommendations for Management 410 Follow-Up Assessment 410Case 4: Greg-;Late Identification of a Child Who Is Hard of Hearing 411Background Information 411Communication Assessment 413Management 415Intervention Outcomes 416Summary 416Case 5: Sam-;Differential Diagnosis through Professional Teamwork: A Tool for Solving Complex Intervention Problems 417Assessment 418Management 420Chapter Summary and Summary Points 423 Supplementary Learning Activities 423 Recommended Website 424References and Recommended Reading 42412 Case Studies: Adults and Elderly Adults 427Michael A. NerbonneJeff E. Brockett Alice E. HolmesIntroduction 428Case 1: Dr. M.-;Progressive Hearing Loss 428Case History 428AR Assessment 429Management 429Summary 431Case 2: Mr. B.-;Hearing Loss, Depression, and Successful Hearing Aid Use 431Informational Counseling 431Rehabilitation Assessment 431Rehabilitation Management 432Summary 435Case 3: J.D.-;AR Featuring a Significant Other 435Introduction 435Informational Counseling 435Rehabilitation Assessment 436Rehabilitation Management 437Summary 441Case 4: Mrs. R.:-;Cochlear Implant User 441First Evaluation 441Rehabilitation Assessment 442Second Rehabilitation Assessment 443Post--Cochlear Implant Rehabilitation Management 444 Summary 445Case 5: Mrs. E.-;Nursing Home Hearing Aid User 446Case History 446Diagnostic Information 446AR 446Summary 447Case 6: Ashley-;New Technology for an Experienced User 447Introduction 447Informational Counseling 448Rehabilitation Assessment 448Rehabilitation Management 449Summary 452Case 7: Ms. C.-;Dizziness Issues 452Introduction 452Rehabilitation Assessment 453Informational Counseling 454Rehabilitation Management 455Summary 455Chapter Summary Points 455 Supplementary Learning Activities 456Recommended Reading and Recommended Website 456 References 456Author Index 000Subject Index 000