Transcript Introduction to Aural Rehabilitation

Introduction to Aural Rehabilitation
Lisa Bowers, Ph.D. CCC-SLP
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EI / IDEA - ASHA
AR for Adults
Chapter Ten
Hearing loss over the life span
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by age 75, 50% of the population will have a clinically
significant hearing loss
average age of first-time HA users – 70
65% of people with a hearing loss are below the age of 65
CORE and CARE
Communication Status:
Audiometry and Self Report
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Interview and case history
Otoscopy and cerumen management
Immittance testing
Comprehensive hearing evaluation
Speech testing
Referral to physician and medical clearance (if needed)
Overall Participation Variables
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Interviews and self-report questionnaires
Hearing-related difficulties
Identification of communication difficulties
Social, psychological, educational, vocational issues
Related Personal Factors
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Health status
Activity level
Manual dexterity
Cognitive status
Environmental Factors
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Identification of environments where difficulties occur
Social circumstances
After CORE Assessment,
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Now is the time to talk amplification and AR options!
Counseling
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Counsel client, family of results and recommendations
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is ongoing and occurs throughout AR process
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Discussion, Priority, Expectation, Solution
Discuss hearing and speech tests results
Confirm hearing loss
Use nonprofessional jargon
Affirm person’s frustrations
Candidacy for amplification
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Audibility / Instrumental interventions
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Hearing aid
Cochlear implants
Hearing assistive technology
Remediation for communication activities
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Develop a broad strategy to guide the AR Efforts
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Develop AR plan together with patient
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Define plan objectives and goals
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What needs to be considered?
Goals define effective intervention
Identify how to evaluate outcomes
Environmental coordination
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Social supports
Community
Family
Formulating Objectives
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Objectives will be in direct response to the individual’s
particular problems
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All participants must be committed
Guidelines for formulating AR objectives
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Define the following:
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Roles and responsibilities
Conditions to accomplish objectives
Criteria for evaluation
Time frame to reach objectives
Problems Reported by HA Users
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Difficulty understanding specific speakers
Difficulty understanding speech in the following
situations:
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In background noise
In noise at distance
In quiet at distance
In general
HA Use Pattern
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Increase wear time to all waking hours
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Abandon after brief trial use
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Ideally want them wearing them all of the time
Only use consistently for several weeks/months
Intermittent wear in specific situations
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Only wear aids in certain situations (church, with family)
CI Recipients
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Obtain information during initial contact
View demos during pre-implant counseling
Determine candidacy during formal evaluation
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Evaluation with HAs to determine benefit (with AUD and SLP)
Eval with MD for medical candidacy
Discussion of psychosocial aspects of CI (expectations,
limitations, reasons why want device, etc)
Be aware of time and complications regarding surgery
CI Recipients (cont.)
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Fit/map device
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Schedule regular follow-ups
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How is device adjusted and possible sound quality
Will be seen at least once a week for 1st 6 wks
Typically, once a month for 1st 6 months following initial
series
Receive auditory training and psychosocial support
during AR
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Typically performed by AUD and SLP
HAT/ ALDs
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Used with or in place of HAs or CI
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FM system, adapters for TV/telephone, pocket talker,
alerting devices
Devices for telephone and television
Listening situations where needed
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Interactive and non-interactive communicative situations
Warning signals or lifestyle-specific
Circumstances for ALDs
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Interactive communication
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E.g., face-to-face, telephone, group, etc.
TAPS (Telecommunication Access Program)
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Provides amplified telephones, TTY, CapTel to individuals with HL
TTY (Telecommunication device for deaf)
Non-interactive communication
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E.g., television, radio, workplace, concerts, conferences, etc.
Circumstances for ALDs (cont.)
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Warning signals
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E.g., smoke alarms, doorbells, etc.
Lifestyle-specific
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E.g., sirens, alarm clocks, baby monitors, etc.
Follow-Up
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AR program should be flexible to modification
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Person’s hearing predicaments change
As one goal is met, new goal emerges
Regular visits with audiologist
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If new problems arise or intervention proves unsuccessful,
the plan should be adjusted
Typically annual
American Disabilities Act (ADA)
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Familiar with rights
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IDA Institute