SLP Hearing and Aural Rehabilitation 5 — Questions and Answers
Question 1: Which self-assessment scale is specifically designed to measure the psychosocial impact of hearing loss in older adults?
- Abbreviated Profile of Hearing Aid Benefit (APHAB)
- Hearing Handicap Inventory for the Elderly (HHIE) (Correct answer)
- Speech, Spatial, and Qualities of Hearing Scale (SSQ)
- Hearing in Noise Test (HINT)
Correct answer: Hearing Handicap Inventory for the Elderly (HHIE)
The HHIE is a validated self-report questionnaire that measures the emotional and social/situational handicapping effects of hearing loss in elderly individuals.
Question 2: During speechreading training, a clinician teaches a patient to use context to predict missing words. This strategy is best described as:
- Bottom-up auditory processing
- Top-down linguistic processing (Correct answer)
- Signal enhancement
- Auditory closure
Correct answer: Top-down linguistic processing
Using linguistic context and prior knowledge to predict speech content represents top-down processing, which supplements incomplete acoustic/visual information.
Question 3: An infant fails a newborn hearing screening. According to EHDI (Early Hearing Detection and Intervention) guidelines, the diagnostic audiological evaluation should be completed by:
- 1 month of age
- 3 months of age (Correct answer)
- 6 months of age
- 12 months of age
Correct answer: 3 months of age
EHDI guidelines follow the 1-3-6 model: screen by 1 month, diagnose by 3 months, and enroll in early intervention by 6 months of age.
Question 4: A patient with moderate hearing loss demonstrates loudness recruitment. How should hearing aid gain be programmed to accommodate this?
- Apply linear amplification with high gain across all levels
- Use compression to provide more gain for soft sounds and less for loud sounds (Correct answer)
- Reduce gain uniformly across all frequencies
- Increase output limiting only for low frequencies
Correct answer: Use compression to provide more gain for soft sounds and less for loud sounds
Wide dynamic range compression (WDRC) applies greater gain to soft sounds and progressively less gain to louder sounds, accommodating the narrowed dynamic range caused by recruitment.
Question 5: An SLP working with a deaf child who uses American Sign Language (ASL) is planning aural rehabilitation goals. Which principle best guides the clinician's approach?
- Prioritize oral-only communication to maximize auditory development
- Respect the family's communication philosophy and integrate it into intervention (Correct answer)
- Defer all rehabilitation until cochlear implant candidacy is determined
- Limit ASL use to avoid interference with auditory skill development
Correct answer: Respect the family's communication philosophy and integrate it into intervention
Ethical aural rehabilitation practice respects the family's chosen communication approach, whether oral, ASL, or bimodal, and incorporates their philosophy into collaborative goal-setting.
Question 6: Which intervention approach for tinnitus combines sound therapy with cognitive-behavioral counseling to reduce the emotional reaction to tinnitus?
- Auditory integration training (AIT)
- Tinnitus Retraining Therapy (TRT) (Correct answer)
- Auditory brainstem implant programming
- Contralateral routing of signals (CROS)
Correct answer: Tinnitus Retraining Therapy (TRT)
Tinnitus Retraining Therapy (TRT) uses directive counseling and broadband sound generators to promote habituation to tinnitus and reduce its negative emotional impact.
Question 7: A bilingual adult patient with moderate hearing loss reports greater difficulty understanding speech in their second language than in their first. Which factor primarily accounts for this difference?
- Greater cochlear sensitivity to native language phonemes
- Reduced top-down linguistic knowledge and vocabulary in the second language (Correct answer)
- Asymmetrical pure-tone thresholds between languages
- Directional microphone bias toward the dominant language
Correct answer: Reduced top-down linguistic knowledge and vocabulary in the second language
Less robust phonological, lexical, and syntactic representations in a second language reduce the top-down processing resources available to compensate for degraded acoustic input.
SLP Hearing and Aural Rehabilitation 5
Which self-assessment scale is specifically designed to measure the psychosocial impact of hearing loss in older adults?