History of Aural Rehab

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1 Combined Benefits for SLP and AuD Graduate Students in an Adult Auditory Rehabilitation Group Marsha Kluesing, AuD CCC A Assistant Clinical Professor Dept. Of Communication Disorders 1199 Haley Center Auburn University, AL Phone: History of Aural Rehab World War II and military aural rehabilitation ASHA Aural Rehab Training Requirements and Procedures 1984 Guidelines: Identify and evaluate sensory capabilities Interpret, counsel, and refer Intervene for communication difficulties Re evaluate client s status Evaluate and modify intervention program 1

2 Interdisciplinary Nature Speech Language Pathologists can perform AR without CCC A, or audiology license Some Medicare and third party payers only reimburse S LP, not audiologists Confusing terminology for audiologists Currently: Audiologic Rehabilitation No right answer for what to call the process Audiologists have knowledge skills and tools Rehab does not begin or end with surgery Cochlear Implants Implantable hearing aids Dispensing of hearing aids Hearing assistive technology Speech Pathologists have knowledge, skills and tools Speech production Voice Swallowing Knowledge of psycho social effects of a communication disorder Address activity limitations Environmental and personal factors that may affect communication 2

3 Alternative Teaching Methods to Keep Pace with Demand for SLPs Broaden the 1:1 supervision model to include other types mentoring. Have two or more students working together with one field supervisor and allow both students to count the contact hours for that specific patient/client. Mancinelli, M.M., & Amster B. (2014) Rethinking clinical education. The ASHA Leader, 20, 6 7. Forming a Group for Clinical Practicum Clinical Supervisor, ASHA Certified Audiology Students Speech Language Pathology Students Hearing Aid Patients Need to motivate for first time visit Encouraging continued attendance Bring spouse Importance of the Communication Partner 3

4 Auburn University Adult AR Group Patient Centered Model (Adult Audiologic Rehabilitation, 2 nd Ed. Ch. 2, from JJ Montano,2011, ENT and Audiology 20(4). Consumer Support Patient Story Self Assessment Verification Communication Strategies Auditory Visual Training Technology Skills for Caring Professionals Assisted Living Hospital 4

5 Anticipatory Strategies for Better Communication Related to the speaker: Ask them to speak more slowly Ask to trim moustache Become accustomed to the speaker s pattern of speech Discuss not using exaggeration Avoid a difficult speaker in a bank or store Communication Repair Strategies Repetition Rephrasing Clarification Key Words Spelling and Code Words Oral interpreters Use of amplification system by the speaker Environmental Adjustments Spatial Relationships Lighting Should be on face of speaker Acoustics Avoid hard walls, tiled floors Comfort Level Too hot, too cold, too drafty 5

6 Causes of Hearing Loss Genetic information: 50%...Age :50 % Noise exposure Ototoxicity Trauma to head or ears Infection Foreign object in ear canal, cerumen Audiologists say CERUMEN Everyone else says: Wax Look in ear canal (Otoscopy) HA tube blocked with wax 6

7 Inside the Organ of Corti: Inner and Outer Hair Cells with Cilia on Top of Each Damaged Cilia Resulting in Hearing Loss 7

8 Behind the Ear Hearing Aid Earmolds Best Impressions Get the Best Results In the Ear Hearing Aids 8

9 Hearing Aids with Thin Tubes and Domes Hearing Aid Insertion Maintenance and Care Otoscopy, cerumen, eardrum condition, etc. Dirt, wax on hearing aids Broken, missing parts Batteries, dead, inserted incorrectly, wrong size When to refer to the audiology clinic Cerumen in ear canal Aids do not work with new battery, general cleaning 9

10 Batteries Sounds of Speech Vowels Consonants Manner of speech Place in mouth where consonant is made 10

11 Vowel Triangle Lips Hump of the Tongue Front Central Back Narrow Opening see suit sit put Wide say serve so Opening set up saw sat star Consonants & Speech Reading Visible 1. /f/ and /v/ 2. /w/ and /r/ 3. /p/, /b, and /m/ 4. /TH/, as in then and/ th/ as in thank 5. /sh/, /ch/, /j/, and /zh/ as in measure All Other consonants Difficult to see Made inside the mouth Rely on context Homophenes Make it Difficult Consonants that look alike /f/ and /v/ /w/ and /r/ /p/, /b/, and /m/ /TH/, and /th/ /sh/, /ch/, /j/, and /zh/ Words that look alike File vile Rice rise Merge perge Chirp germ Shows chose Pay bay 11

12 Behind the Scenes of the Real Time MRI Holiday Greeting, Beckman Institute Hearing Loss and Vocal Strain With hearing impairment there can be strain on the voice to speak louder to hear one s own voice Use of hearing aids may help reduce this strain The Mind, Ear, Eye Connection to Adult Auditory Rehabilitation 12

13 Posit Science Brain HQ Seeing and Hearing Speech LACE Listening and Communication Enhancement Neurotone.com 13

14 Read My Quips Speech Comprehension Training System Process of learning that uses videos and puzzles Holistic approach Context Facial expressions Body language Adapts to user s skills Helps you go from Clinician to Caregiver References 1. Kaplan, Harriet. Speechreading: a way to improve understanding, Second Edition Revised Clerc Books, Gallaudet University Press, Washington D. C. 2. Mancinelli, M.M., & Amster B. (2014) Rethinking clinical education. The ASHA Leader, 20, Montano, J. J. (2011) Building relationships: An important component to the aural rehabilitation process. ENT and Audiology, 204 (4), LACE ReadMyQuips 7. Sensimetrics Corporation (2008). Seeing and hearing speech: Lessons lipreading and listening. Somerville, MA: Sensimetrics. 14

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