Clinic - Week 12

This week in clinic I saw an adult male who was brought in by his caregiver from REM for his annual hearing evaluation. He had previously been diagnosed with MR, blind, and deaf. The caregiver reported that he did not have any current ear infections or other illnesses such as diabetes, etc. The caregiver reported that sometimes this patient would laugh appropriately during conversations, while at other times he would completely ignore his caregivers. She said that he has selective listening. The caregiver also mentioned he could see things farther away from him rather than up close. If the patient was asked to pick up a piece of paper he was able to do so.

Otoscopy was normal bilaterally. Tympanograms were normal Type A in the right ear and flat, Type B in the left. OAE's were attempted but the patients vocalizations and stomping made the results inaccurate. Speech Awareness Thresholds were obtained under ear phones and were found to be 50 dB in the right and 60 dB in the left. These results were similar to the results obtained last year during his annual hearing evaluation.

It was recommended that the patient be checked by a doctor due to the flat tympanogram obtained in the left ear. It was also recommended that he continue annual evaluations.

I found this article that talks about elderly hearing aid use and communication difficulties of those adults in residential homes. It brought to my attention how many people could actually benefit from hearing aids but do not have them. Also, as we know, there are many people who do have hearing aids but do not wear them due to improper care, no batteries, etc. Check it out !!!

Erber, N. & Heine, C. (1996) Screening receptive communication of older adults in residential care, American Journal of Audiology, 5, 38-46.

http://aja.asha.org/cgi/reprint/5/3/38?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=earmolds&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Clinic - Week 11

This week in clinic I saw an older male who came in for a hearing evaluation as part of the Hearing Conservation Program. He had previously been in the Navy for four years, and then spent 30 years working as a firefighter. He said, "back then, we never even thought about our ears or wearing hearing protection." He also reported that he enjoys target shooting and hunting. He said within the past 2-3 years he has started wearing hearing protection whenever he can and has become better at remembering!

Otoscopy was performed and the tympanic membrane was visible and appeared intact bilaterally. Immittance was performed next and the results obtained were normal, Type Ad tympanograms bilaterally. Puretone thresholds were within the normal limits up to around 2000 Hz, and then sharply sloping to a moderate loss bilaterally. Bone conduction thresholds were not tested.

This patient asked to see his results from last year because he wanted to compare and make sure that his hearing had not changed. The results were explained to him and compared to last years audiogram. The transparent "speech banana" was also used in helping the client understand some of the sounds he was missing. He said that it all made sense to him now. He reported that he can hear is wife, but she sounds like she is mumbling and he cannot understand what she is saying.

Information about amplification and the Oticon Delta was then given to this patient and we explained that if he wanted to pursue amplification he could return at any time. He was impressed at how small and compact the hearings aids had become.

I found this article that investigates speech audibility of listeners with high frequency hearing loss. It was performed on 5 listeners with normal hearing and 11 listening with hearing loss. The results were that when adding audible speech to frequencies above ~2000 Hz were most hearing loss exceeded 55 dB, little or no benefit was seen. On the other hand, providing a listener with a flat, severe to profound loss with audible speech sounds in the lower frequencies did provide benefit and better speech recognition scores. This study concluded that providing amplification to frequencies above ~2000-3000 Hz with persons who had severe to profound loss does not provide benefit.
Hope you like it, check it out!!!

Turner C., & Cummings K. (1999) Speech audibility for listeners with high-frequency hearing loss, American Journal of Audiology, 8, 47 - 56.

http://aja.asha.org/cgi/reprint/8/1/47?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=speech+banana+&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Clinic - Week # 10

This week in clinic I saw an adult, male who worked for the Manette Steel Drums. He was coming in for his annual hearing evaluation. He had been in previously, but the testing could not be completed because of excess cerumen in both of his ears. Not only does he play but he also builds drums. He reported wearing hearing protection when playing and also when building. Today, he was scheduled for the hearing evaluation as well as to get earmold impressions for custom ear ear protection plugs.

Due to equipment malfunctioning, immittance testing could not be performed. Speech recognitions thresholds and puretone tone thresholds were done in the sound booth using inserts. SRT and puretones results were within the normal limits. Ear mold impressions where them made for custom ear protection plugs.

I found this article that was related to noise induced hearing loss. Thirty people participated in the study. They were given portable walkman's in order to assess the effect that music has on hearing loss. Thresholds were taken before using the walkman and within one hour after using it. They found no difference in thresholds after one hour of use of the portable walkman stereo. What does this mean? When listening to music at a preferred level, and for limited time, a minimal effect on hearing will be seen. Watch those iPods!!!! Check it out :)

Pugsley, S., Stuart, A., Kalinowski, J., & Armson, J. (1993). Changes in hearing sensitivity following portable stereo system use, American Journal of Audilogy, 2, 64 - 67.

http://aja.asha.org/cgi/reprint/2/3/64?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=noise+induced+hearing+loss&andorexactfulltext=and&searchid=1&FIRSTINDEX=10&sortspec=relevance&resourcetype=HWCIT

Clinic - Week 9

This week in clinic I saw a 20 year old male. He was referred to our clinic for CAPD testing. This client reported some fullness and felt like his right ear was better than the left. He also reported severe allergies and was a little congested on the day of testing. This client mentioned he had some difficulty when talking one-on-one with somebody, especially in the presence of background noise. He had previously been diagnosed with ADHD and was currently taken medication.

First, a complete hearing evaluation was performed. Normal otoscopy and tympanograms were obtained. Puretone testing resulted in thresholds within the normal limits at most frequencies, although borderline at 25 dB around 1000 Hz. The importance of hearing protection was discussed with this patient when working on his truck and being in the presence of loud noise.

Next, the SCAN-A, Auditory Fusion Test, and the SSW were administered. Some time was spent discussing the results with the client. A quick over view if the tests showed that this client did have some auditory processing disabilities. A complete report would be sent to him as well as the doctor who referred him. Management such as seating in the classroom, etc was mentioned to him.

In this article is suggests that tasks used in the assessment of auditory processing may also assess attention. This study was done on 38 children and looked at the correlation between children with impaired SSW performance with other auditory measures, cognitive ability,
language functioning, and behavioral ratings specific to inattention, impulsivity, and hyperactivity. The results were suggestive that CAPD and ADHD are not the same.
Check it out :)

Riccio, C., Hynd, G., Cohen, M., & Molt, L. (1996). The staggered spondaic word test: performance of children with attention-deficit hyperactivity disorder, American Journal of Audiology, 5, 55 - 62.
http://aja.asha.org/cgi/reprint/5/2/55?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=CAPD+and+ADHD&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT