Clinical Audiology : An Introduction

by Stach, Brad A.

• ISBN13: 9781565933460
• ISBN10: 156593346X
• Edition: 1st
• Format: Paperback
• Copyright: 1998-03-01
• Publisher: Cengage Learning

Summary

Clinical Audiology: An Introduction is a stimulating, introductory - level textbook that provides a "big-picture" overview of the field of audiology. It introduces the user to the broad scope of the field, with the aim that they will be better prepared to understand the relevance of what they learn later on. This text provides general familiarization with the many different evaluative and rehabilitative technologies and demonstrates how these technologies are integrated into answering the many challenging clinical questions facing an audiologist. Focusing on the clinical nature of audiology, this essential book provides users with questions, challenges, and technologies available to address issues of hearing impairment and rehabilitation.

Table of Contents

Preface	xv	(2)
Acknowledgments	xvii
Chapter 1 The Profession of Audiology in the United States	1	(36)
What is an Audiologist?	3	(1)
What is an Audiologist's Role?	3	(7)
Evaluation	3	(1)
Rehabilitation	4	(1)
Education	5	(1)
Prevention	5	(1)
Related Activities	5	(1)
Scope of Practice	6	(4)
Where do Audiologists Practice?	10	(7)
Private Practice	11	(2)
Physician's Practice	13	(1)
Hospitals and Medical Centers	13	(1)
Hearing and Speech Clinics	14	(1)
Schools	15	(1)
Universities	15	(1)
Hearing Instrument Manufacturers	16	(1)
Industry	16	(1)
Relation to Other Professions	17	(6)
Otolaryngology	17	(2)
Other Medical Specialities	19	(1)
Speech-Language Pathology	20	(2)
Non-Audiologist Hearing Aid Dispensers	22	(1)
Other Professionals	22	(1)
Professional Requirements and Issues	23	(6)
Certification and Licensure	23	(1)
Academic and Clinical Requirements	24	(1)
Academic Models	25	(4)
The Educational Model	26	(1)
The Professional Doctorate Model	27	(2)
A Perspective on the Past and the Future	29	(4)
Audiology's Beginnings (before 1950)	29	(1)
Audiology as an Academic Discipline (1950s and 60s)	30	(1)
Audiology as a Clinical Profession (1970s and beyond)	31	(2)
Summary	33	(1)
Information Sources	34	(3)
Chapter 2 The Nature of Hearing	37	(52)
The Nature of Sound	38	(14)
What is Sound?	39	(3)
Properties of Sound	42	(10)
Intensity	43	(4)
Frequency	47	(2)
Phase	49	(1)
Spectrum	50	(2)
The Auditory System	52	(18)
Outer Ear	53	(2)
Middle Ear	55	(3)
Anatomy	56	(1)
Physiology	57	(1)
Inner Ear	58	(8)
Anatomy	58	(5)
Physiology	63	(3)
Auditory Nervous System	66	(4)
The VIIIth Cranial Nerve	67	(1)
The Central Auditory Nervous System	67	(3)
How We Hear	70	(15)
Absolute Sensitivity of Hearing	71	(7)
The Nature of Hearing Sensitivity	72	(1)
The Audiogram	73	(5)
Differential Sensitivity	78	(3)
Properties of Pitch and Loudness	81	(2)
Measurement of Sound	83	(2)
Summary	85	(2)
Suggested Readings	87	(2)
Chapter 3 The Nature of Hearing Impairment	89	(28)
Types of Hearing Impairment	90	(14)
Hearing Sensitivity Loss	91	(7)
Conductive Hearing Loss	91	(3)
Sensorineural Hearing Loss	94	(3)
Mixed Hearing Loss	97	(1)
Auditory Nervous System Impairments	98	(5)
Retrocochlear Hearing Disorder	99	(1)
Central Auditory Processing Disorder	100	(3)
Functional Hearing Loss	103	(1)
Impact of Hearing Impairment	104	(11)
Patient Factors	104	(1)
Degree and Configuration of Hearing Sensitivity Loss	105	(6)
Type of Hearing Loss	111	(4)
Conductive Hearing Loss	112	(1)
Sensorineural Hearing Loss	113	(1)
Retrocochlear Hearing Loss	114	(1)
Central Auditory Processing Disorder	114	(1)
Summary	115	(1)
Suggested Readings	116	(1)
Chapter 4 Causes of Hearing Impairment	117	(46)
Auditory Pathology	118	(2)
Outer and Middle Ear Disorders	120	(15)
Microtia and Atresia	120	(1)
Impacted Cerumen	121	(3)
Tympanic-Membrane Perforation	124	(2)
Other Outer Ear Disorders	126	(1)
Otitis Media	126	(5)
Otosclerosis	131	(1)
Cholesteatoma	132	(1)
Other Middle Ear Disorders	133	(2)
Sensorineural Hearing Loss From Cochlear Disorder	135	(20)
Syndromes and Inherited Disorders	135	(2)
Acoustic Trauma	137	(5)
Other Trauma	142	(1)
Infections	142	(3)
Congenital Infections	142	(1)
Acquired Infections	143	(2)
Ototoxicity	145	(3)
Meniere's Disease	148	(1)
Presbyacusis	149	(3)
Other Causes	152	(3)
Central Auditory Nervous System Disorders	155	(5)
VIIIth Nerve Tumors	156	(2)
Neural Disorders	158	(1)
Brain Stem Disorders	158	(1)
Temporal Lobe Disorder	159	(1)
Other Nervous System Disorder	159	(1)
Summary	160	(1)
Suggested Readings	161	(2)
Chapter 5 Introduction to Hearing Assessment	163	(30)
The First Question	165	(8)
Referral-Source Perspective	165	(2)
Importance of the Case History	167	(6)
The Audiologist's Challenges	173	(17)
Evaluating Outer and Middle Ear Function	173	(5)
Estimating Hearing Sensitivity	178	(1)
Determining Type of Hearing Loss	179	(3)
Measuring Speech Recognition	182	(1)
Measuring Auditory Processing	183	(2)
Measuring Hearing Disability and Handicap	185	(1)
Screening Hearing Function	186	(4)
Summary	190	(1)
Suggested Readings	191	(2)
Chapter 6 The Audiologist's Assessment Tools: Behavioral Measures	193	(64)
The Audiometer	194	(4)
Pure-Tone Audiometry	198	(31)
The Pure-Tone Audiogram	198	(15)
Establishing the Pure-Tone Audiogram	213	(15)
Air Conduction	214	(1)
Bone Conduction	215	(1)
Masking	216	(12)
Summary	228	(1)
Speech Audiometry	229	(23)
Uses of Speech Audiometry	230	(3)
Speech Thresholds	230	(1)
Pure-Tone Cross Check	230	(1)
Speech Recognition	231	(1)
Differential Diagnosis	231	(1)
Central Auditory Processing	232	(1)
Estimating Communicative Function	232	(1)
Speech-Audiometry Materials	233	(5)
Types of Materials	233	(1)
Redundancy in Hearing	234	(3)
Other Considerations in Speech Materials	237	(1)
Clinical Applications of Speech Audiometry	238	(11)
Speech Thresholds	238	(2)
Speech Awareness Threshold	240	(1)
Word Recognition	240	(4)
Sensitized Speech Measures	244	(3)
Speech Recognition and Site-of-Lesion	247	(1)
Predicting Speech Recognition	248	(1)
Summary	249	(3)
Other Behavioral Measures	252	(4)
Suggested Readings	256	(1)
Chapter 7 The Audiologist's Assessment Tools: Electroacoustic and Electrophysiologic Measures	257	(66)
Immittance Audiometry	258	(34)
Instrumentation	260	(1)
Measurement Technique	261	(2)
Basic Immittance Measures	263	(10)
Tympanometry	263	(4)
Static Immittance	267	(3)
Acoustic Reflexes	270	(3)
Principles of Interpretation	273	(17)
Clinical Applications	274	(1)
Middle-Ear Disorder	275	(5)
Cochlear Disorder	280	(6)
Retrocochlear Disorder	286	(4)
Summary	290	(2)
Evoked Potential Audiometry	292	(20)
Measurement Techniques	293	(5)
Recording EEG Activity	295	(2)
Signal Averaging	297	(1)
Family of Auditory Evoked Potentials	298	(4)
Electrocochleogram	299	(1)
Auditory Brainstem Response	300	(1)
Middle Latency Response	301	(1)
Late Latency Response	301	(1)
Clinical Applications	302	(9)
Prediction of Hearing Sensitivity	302	(4)
Neonatal Hearing Screening	306	(2)
Diagnostic Applications	308	(2)
Surgical Monitoring	310	(1)
Summary	311	(1)
Otoacoustic Emissions Audiometry	312	(10)
Types of Otoacoustic Emissions	313	(5)
Spontaneous Otoacoustic Emissions	313	(1)
Evoked Otoacoustic Emissions	314	(4)
Relation to Hearing Sensitivity	318	(1)
Clinical Applications	318	(3)
Infant Screening	319	(1)
Pediatric Assessment	319	(1)
Cochlear Function Monitoring	320	(1)
Diagnostic Applications	320	(1)
Summary	321	(1)
Suggested Readings	322	(1)
Chapter 8 Different Assessment Approaches for Different Populations	323	(78)
Otologic Referrals	324	(27)
Outer-or Middle-Ear Disorders	325	(8)
Evaluative Goals	325	(1)
Test Strategies	326	(1)
Illustrative Cases	327	(6)
Cochlear Pathology	333	(9)
Evaluative Goals	333	(1)
Test Strategies	333	(2)
Illustrative Cases	335	(7)
Retrocochlear Pathology	342	(9)
Evaluative Goals	342	(1)
Test Strategies	342	(3)
Illustrative Cases	345	(6)
Adult Audiologic Referrals	351	(10)
Younger Adults	352	(3)
Evaluative Goals	352	(1)
Test Strategies	352	(3)
Illustrative Case	355	(1)
Older Adults	355	(6)
Evaluative Goals	355	(3)
Test Strategies	358	(1)
Illustrative Case	358	(3)
Pediatric Audiologic Referrals	361	(26)
Infant Screening	362	(6)
Evaluative Goals	362	(1)
Test Strategies	362	(5)
Illustrative Case	367	(1)
Pediatric Evaluation	368	(12)
Evaluative Goals	368	(2)
Test Strategies	370	(7)
Illustrative Case	377	(3)
Central Auditory Processing Assessment	380	(7)
Evaluative Goals	380	(1)
Test Strategies	381	(3)
Illustrative Case	384	(3)
Functional Hearing Loss	387	(11)
Indicators of Functional Hearing Loss	388	(2)
Nonaudiometric Indicators	388	(1)
Audiometric Indicators	389	(1)
Assessment of Functional Hearing Loss	390	(8)
Strategies to Detect Exaggeration	390	(1)
Strategies to Determine "True" Thresholds	391	(4)
Illustrative Case	395	(3)
Summary	398	(1)
Suggested Readings	399	(2)
Chapter 9 Reporting and Referring	401	(38)
Reporting	402	(29)
Report Destination	403	(1)
Nature of the Referral	404	(1)
Information to be Communicated	405	(18)
The Report	407	(10)
The Audiogram and Other Forms	417	(2)
Supplemental Material	419	(4)
Sample Reporting Strategy	423	(8)
Referring	431	(6)
Lines and Ethics of Referral	431	(1)
When to Refer	432	(5)
Summary	437	(2)
Chapter 10 Introduction to Hearing Rehabilitation	439	(26)
The First Questions	442	(10)
The Importance of Asking Why	443	(3)
Assessment of Rehabilitative Candidacy	446	(6)
Audiological Assessment	446	(2)
Rehabilitation Assessment	448	(4)
The Audiologist's Challenge	452	(10)
Amplification-Yes or No?	452	(4)
Amplification Strategies	456	(3)
Approaches to Fitting Hearing Instruments	459	(2)
Approaches to Defining Success	461	(1)
Treatment Planning	462	(1)
Summary	462	(1)
Suggested Readings	463	(2)
Chapter 11 The Audiologist's Rehabilitative Tools: Hearing Instruments	465	(50)
Hearing Instrument Components	468	(12)
Microphone	468	(2)
Amplifier	470	(4)
Receiver	474	(1)
Controls	474	(6)
Manual Control	475	(2)
Programmable Control	477	(3)
Electroacoustic Characteristics	480	(14)
Frequency Gain Characteristics	480	(2)
Input-Output Characteristics	482	(5)
Linear Amplification	483	(1)
Nonlinear Amplification	484	(3)
Output Limiting	487	(2)
Peak Clipping	487	(1)
Compression Limiting	487	(2)
Signal Processing	489	(5)
Analog	490	(1)
Digitally Controlled Analog	490	(2)
Digital	492	(2)
Hearing Instrument Systems	494	(18)
Conventional Hearing Aids	494	(7)
Behind-the-Ear	494	(1)
In-the-Ear	495	(2)
In-the-Canal	497	(1)
Completely-in-the-Canal	497	(1)
Style Considerations	498	(3)
Assistive Listening Devices	501	(7)
Personal FM Systems	502	(2)
Other Remote Microphone Systems	504	(1)
Personal Amplifiers	505	(3)
Other Assistive Technologies	508	(1)
Cochlear Implants	508	(4)
Internal Components	509	(1)
External Components	510	(1)
Signal Processing	511	(1)
Summary	512	(1)
Suggested Readings	513	(2)
Chapter 12 The Audiologist's Rehabilitative Strategies	515	(22)
Hearing Instrument Selection	516	(6)
Frequency Gain Characteristics	516	(4)
Maximum Output	520	(1)
Input-Output Characteristics	520	(1)
Other Characteristics	521	(1)
Hearing Instrument Fitting and Verification	522	(6)
Ear Impressions	522	(1)
Quality Control	523	(1)
Assessment of Physical Fit	524	(1)
Assessment of Performance	525	(3)
Verification Techniques	525	(2)
Verification of Outcomes	527	(1)
Hearing Instrument Orientation	528	(2)
Topics	528	(1)
Performance Expectations	529	(1)
Hearing Instrument Validation	530	(3)
Aided Speech Recognition Measures	530	(2)
Self-Assessment Scales	532	(1)
Postfitting Rehabilitation	533	(1)
Auditory Training and Speechreading	533	(1)
Educational Programming	533	(1)
Summary	534	(2)
Suggested Readings	536	(1)
Chapter 13 Different Rehabilitative Approaches for Different Populations	537	(36)
Adult Populations	538	(10)
Adult Sensorineural Hearing Loss	538	(3)
Rehabilitative Goals	538	(1)
Rehabilitative Strategies	539	(1)
Illustrative Case	540	(1)
Geriatric Sensorineural Hearing Loss	541	(7)
Rehabilitative Goals	541	(2)
Rehabilitative Strategies	543	(2)
Illustrative Case	545	(3)
Pediatric Populations	548	(10)
Pediatric Sensorineural Hearing Loss	548	(5)
Rehabilitative Goals	548	(1)
Rehabilitative Strategies	548	(2)
Illustrative Case	550	(3)
Central Auditory Processing Disorder	553	(5)
Rehabilitative Goals	553	(1)
Rehabilitative Strategies	554	(1)
Illustrative Case	555	(3)
Other Populations	558	(13)
Conductive Hearing Loss	558	(5)
Rehabilitative Goals	558	(1)
Rehabilitative Strategies	558	(2)
Illustrative Case	560	(3)
Profound Sensorineural Deafness	563	(8)
Rehabilitative Goals	563	(1)
Rehabilitative Strategies	563	(2)
Illustrative Cases	565	(6)
Summary	571	(1)
Suggested Readings	572	(1)
Index	573