A renowned team of experts presents a thorough introduction to aural rehabilitation across the lifespan.

Introduction to Audiologic Rehabilitation provides a cohesive introduction to the basics of audiologic rehabilitation in an easy-to-read style that resonates with undergraduate students. Highly regarded as experts in the field, the authors introduce the fundamentals, present the important methods and procedures, and include two case study chapters that address the rehabilitation needs of both children and adults. They examine the changing state of audiology through coverage of important contemporary issues such as professional documents, evidence-based practice, multicultural issues, and advances in computer and web-based rehabilitation activities. Based on a proven model framed within the concepts of the World Health Organization, this book helps students prepare to provide high-quality, state-of-the-art services to clients of any age.

The Seventh Edition features an enhanced focus on cochlear implants in Chapter 3 and revised discussions of vestibular and tinnitus treatments. New chapter learning outcomes, supplementary learning activities, references, and recommended websites keep readers focused and engaged with the material.

Ronald L. Schow is co-author of Communication Disorders of the Aged and six previous editions of this text. He is Professor Emeritus of Audiology at Idaho State University where he continues to be involved in writing and research. His publications include the 20 most important refereed articles which can be located on Pub Med www.ncbi.nlm.nih.gov/pubmed. He is co-author of Multiple Auditory Processing Assessment (MAPA) available through Auditec of St. Louis. MAPA is currently in the process of a national normative study by Academic Therapy Publications, Navato, CA. He is a charter member of the International Collegium of Rehabilitative Audiology in which he has been involved since 1988. Schow received his Ph.D. training at Northwestern University where his major professor was Raymond Carhart who named the profession and who is considered the Father of Audiology.

Michael A. Nerbonne received his Ph.D. at Michigan State University and is Professor Emeritus of Audiology at Central Michigan University. He has published widely in professional journals, is co-author of Communication Disorders of the Aged, and is co-editor of seven editions of Introduction to Audiologic Rehabilitation. In addition to his ongoing commitment to audiology, Nerbonne is focused on family time and fishing.

₁ Overview of Audiologic Rehabilitation 3

Ronald L. Schow,

Michael A. Nerbonne Chris A. Sanford

Introduction 4

Definitions and Synonyms 4

Providers of Audiologic Rehabilitation 4 Education Needs of Providers 5

Hearing Loss Characteristics 5

Degree of Hearing Loss and Configuration 5 Time of Onset 8

Type of Loss 8

Auditory Speech Recognition Ability 10

Consequences of Hearing Loss: Primary and Secondary 11

Communication Difficulties 11 Variable Hearing Disorder/Disability 11

Rehabilitative Alternatives 13

Historical Background 13

Contemporary Issues 16

Current Status 17

Procedures in Audiologic Rehabilitation: An AR Model–CORE and CARE 19

Rehabilitation Assessment Procedures 22 Management Procedures 22

Settings for Audiologic Rehabilitation 24

Children 24

Adults 25

Elderly Adults 25

Summary and Summary Points 26 Supplementary Learning Activities 27

Recommended Reading and Recommended Websites 28 References 28

₂ Hearing Aids and Hearing Assistive Technologies 33

Holly Kaplan

Alice E. Holmes

Introduction 34

History of Amplification 34

Hearing Aid Components 35

Microphone 36

PART ONE: Fundamentals of Audiologic Rehabilitation 1

Amplifier (Digital Processor) 36 Receiver 37

Batteries 37

Hearing Aid Styles 38

Behind-the-Ear 38

Receiver-in-the-Canal 39

In-the-Ear/In-the-Canal/Completely-in-the-Canal 39 Extended-Wear Hearing Aids 39

The Earmold 40

Who Is a Hearing Aid Candidate? 41

Degree of Hearing Loss 42

Degree of Communication Disability 42 Motivation to Use Amplification 42

Hearing Aid Fitting Protocol 42

Selection 42

Quality Control 44

Fitting 45

Hearing Aid Orientation 47 Verification/Validation/Outcome Measures 49

Pediatric Fittings 51

Special Fittings 53

Contralateral Routing of the Signal (CROS) Fittings 53 Bone-Conduction Hearing Aids 54

Bone-Anchored Devices 54

Middle Ear Implantable Hearing Aids 56

Cochlear and Brainstem Implants 57

Hearing Assistive Technology, or When a Hearing Aid May Not Be Enough 57

Types of Assistive Devices 57

The Role of the Audiologist in Assistive Listening/Hearing Assistive Technology Systems 61

Verifying and Validating the Fitting of HATS 61

The Bottom Line: Cost Management and Payment for Hearing Aids and Hats 61

Concluding Remarks 62

Summary 62

Supplementary Learning Activities 63

Recommended Reading and Recommended Websites 64 References 65

₃ Cochlear Implants 69

Alice E. Holmes

Introduction 69

How Does a Cochlear Implant Work? 70 History of Cochlear Implants 71 Current Systems 71

The Cochlear Implant Team 74 Who Is a Candidate? 74

Deaf Culture and Cochlear Implants 79

Treatment Plans for Cochlear Implant Recipients 79 Variables Affecting Performance 83

Bilateral Hearing with Cochlear Implants 83 Auditory Brain Stem Implant 84 Electroacoustic Stimulation 85

Summary Points 86

Supplementary Learning Activities 87

Recommended Reading and Recommended Websites 87 References 88

₄ Auditory Stimulation in Communication 93

Michael A. Nerbonne

Ronald L. Schow Kristina M. Blaiser

Introduction 93

A Communication Model 94 Auditory Perception 95

Development of Auditory Skills 95 Basic Perception Abilities 95 Acoustics of Speech 95

Speech Perception and Comprehension 100 Speech Perception and Hearing Loss 101

The Auditory Training Process 105

Definition and Application of Auditory Training 105 Early Efforts in Auditory Training 105

Current Approaches to Auditory Training 107 Candidacy for Auditory Training 107 Assessment of Auditory Skills 107

Methods of Auditory Training 112

Summary Points 122

Supplementary Learning Activities 122

Recommended Reading and Recommended Websites 123 References 123

₅ Visual Stimuli in Communication 127

Nicholas M. Hipskind

Introduction 127

Factors Related to Speechreading 128

Speaker 128

Signal and Code 130 Environment 134

Speechreader 135

Speechreading and Hearing Loss 137

Assessment of Speechreading Ability 137

Visual Assessment and Speechreading Evaluation 140 Hearing Loss and Dependence on Vision 140 Traditional Speechreading Methods 141

Recent Trends in Speechreading Instruction 142

Manual Communication 148

Types of Manual Communication 148

Summary Points 153

Supplementary Learning Activities 153 Recommended Reading 153

References 154

Appendixes 157

Language and Speech of the Deaf and Hard of Hearing 167

Kristina M. Blaiser Gabriel A. Bargen

Introduction 167

Communication Options for Families of Children Who Are Deaf/Hard of Hearing 168

Systems Emphasizing Listening and Spoken Language 168 Manual—Visual Systems 168

Systems Combining Visual and Auditory Information 169

Hearing as the Foundation for Speech and Language 170 Factors Affecting Speech and Language Acquisition 174

Language Characteristics of Children with Hearing Loss 176 Impact of Hearing Loss on Language Components 177

Language Assessment 180

Formal Language Measures 180

Language Sample and Narrative Analysis 183

Speech Development in Children with Hearing Loss 183

Speech Characteristics 184

Speech Assessment 186

Summary and Summary Points 188 Supplementary Learning Activities 189

Recommended Reading and Recommended Websites 189 References 190

Psychosocial Aspects of Hearing Loss and Counseling Basics 195

Kris English

Introduction 195

Psychosocial Aspects of Hearing Loss 195 Growing Up with Hearing Loss 196 Acquiring Hearing Loss as Adults 201 About Being Deaf 204

Deafness with a Capital “D” 204

“Knowing Is Not Enough”: Counseling Basics 205

Important Distinctions 206

What We May Think Counseling Is 206 What Counselors Say Counseling Is 207 The Counseling Process 207

When to Refer 210

Does Counseling Make a Difference? 210 Concluding Remarks 211

Summary 211

Supplementary Learning Activities 211 Recommended Reading 212

Audiologic Counseling 212 Psychology of Deafness 212 Deaf Culture 212

Recommended Websites 212

References 213

Appendix 215

Audiologic Rehabilitation Services in the School Setting 217

Kris English

Introduction 218

Why AR Services Are Required in School Settings: The Educational Consequences of Hearing Loss 218

Hearing Loss and Learning 218 Mandated by Law 219

Key Components of IDEA 220 Least Restrictive Environment 220

The Individualized Education Plan 223 Types of Communication Modalities 223

AR Services Provided in Schools 225 Screening and Assessment 226 Management of Amplification/Audition 226

Direct Instruction and Indirect Consultation 227 Evaluation and Modification of Classroom Acoustics 228 Transition Planning to Postsecondary Placements 230 How Services Are Provided 231

AR Service Providers in School Settings 231

Teachers 231

Audiologists 231

Speech-Language Pathologists 232 Related Support Personnel 232

Services for Children with Auditory Processing Problems 233

Diagnosis/Assessment of APD 234 Remediation of APD 235

“A Day in the Life” of an Educational Audiologist 236 Summary 237

Supplementary Learning Activities 237 Recommended Reading 238

Recommended Resources 238

Software 238

Websites 238

References 238

Appendix 241

₉ Audiologic Rehabilitation for Children 247

Mary Pat Moeller

Ronald L. Schow Mary M. Whitaker

Introduction 247

Prevalence of Loss and Level of Service 248

Contemporary Efforts to Strengthen the Evidence Base in Audiologic Rehabilitation 249

PART TWO: Comprehensive Approaches to Audiologic Rehabilitation 330

xiv Contents

Terms and Definitions 250

Profile of the Client 251

Hearing Loss 251

Age 251

Other Disabling Conditions 252

Rehabilitation Settings and Providers 252

Identification and Assessment Procedures with Children 252

Early Identification 252

School Screening 254

Medical and Audiologic Assessment 254

Aspects of AR: Early Intervention for Parent—Infant and Preschool 255

Rehabilitation Assessment: IFSP 255 Management 256

Aspects of AR: School Years 285

Rehabilitation Assessment: Individualized Education Plan 285 Management 286

Concluding Remarks 298

Summary 298

Supplementary Learning Activities 299

Recommended Reading and Recommended Websites 299 References 300

Audiologic Rehabilitation across the Adult Life Span: Assessment and Management 307

M. Kathleen Pichora-Fuller Ronald L. Schow

Introduction 308

Profile of the Adult Client 310

Hearing Loss across the Life Span 310 Help Seeking and Screening 311

Profile of the Older Adult Client 312

Auditory Aging 312

Physical, Psychological, and Social Aspects of Adult Aging 314 Personal and Environmental Factors 316

Retirement, Leisure, and Economic Status 318 Living Environments 319

Model for Rehabilitation 320

CORE Assessment 322

CARE Management 323

Feedback Based on Outcome Measures 324

Importance of the Conceptual Framework to AR Practice 324

Rehabilitation Settings 325

Research and Teaching Settings: Universities 325

Military and Veterans Administration Medical Centers 326 Community Centers, Agencies, and Consumer Groups 326 Hospitals, Medical Offices, Private Practice Audiologists,

and Hearing Instrument Specialists 327

Rehabilitation Assessment 327

Assessing Hearing Loss and Consideration of Comorbid Health Conditions 328

Assessing Activity and Participation and Considerations of Social Factors 329

CORE Assessment Summary 333

Rehabilitation Management 334

Counseling and Psychosocial Considerations with a Health-Promoting Approach 335

Amplification and Instrumental Interventions to Achieve Audibility 343 Remediation for Communication Activities 356

Environmental Interventions to Improve Participation 359

Other Important Issues in the Scope of AR Practice 361

Vestibular Assessment and Management 361 Tinnitus Assessment and Management 364

Summary and Summary Points 366 Supplementary Learning Activities 368

Recommended Reading and Recommended Websites 369 World Health Organization (WHO) Resources 369 Consumer Associations and Resources for the Public 370 Websites about AR Tools 370

References 371 Appendix A to G 383

PART THREE: Implementing Audiologic Rehabilitation: Case Studies 393

₁₁ Case Studies: Children 395

Mary Pat Moeller

Catherine Cronin Carotta

Introduction 395

Case 1: Matthew–Early Intervention, Multiple Disabilities 396

Background Information 397

Intervention Plan 397

Environmental Coordination and Participation 399 Assessment: Postimplantation 399

Psychosocial and Counseling Aspects 400

Assessment and Intervention Postdiagnosis of Autism Spectrum Disorder 400

Communication Rehabilitation Adjustment 401 Summary 401

Case 2: Annie–Routes to Spoken Language Following Cochlear Implantation 402

Background Information 402

Aural Rehabilitation Plan: Preimplantation 403 Aural Rehabilitation Plan: Postimplantation 403 Intervention Outcomes 405

Summary 406

Case 3: Amber–Issues Affecting Educational Placement 407

Background Information 407

Assessment Findings 409 Recommendations for Management 410 Follow-Up Assessment 410

Case 4: Greg–Late Identification of a Child Who Is Hard of Hearing 411

Background Information 411

Communication Assessment 413

Management 415

Intervention Outcomes 416

Summary 416

Case 5: Sam–Differential Diagnosis through Professional Teamwork: A Tool for Solving Complex Intervention Problems 417

Assessment 418

Management 420

Chapter Summary and Summary Points 423 Supplementary Learning Activities 423 Recommended Website 424

References and Recommended Reading 424

₁₂ Case Studies: Adults and Elderly Adults 427

Michael A. Nerbonne

Jeff E. Brockett Alice E. Holmes

Introduction 428

Case 1: Dr. M.–Progressive Hearing Loss 428

Case History 428

AR Assessment 429

Management 429

Summary 431

Case 2: Mr. B.–Hearing Loss, Depression, and Successful Hearing Aid Use 431

Informational Counseling 431

Rehabilitation Assessment 431

Rehabilitation Management 432

Summary 435

Case 3: J.D.–AR Featuring a Significant Other 435

Introduction 435

Informational Counseling 435

Rehabilitation Assessment 436

Rehabilitation Management 437

Summary 441

Case 4: Mrs. R.:–Cochlear Implant User 441

First Evaluation 441

Rehabilitation Assessment 442

Second Rehabilitation Assessment 443

Post—Cochlear Implant Rehabilitation Management 444 Summary 445

Case 5: Mrs. E.–Nursing Home Hearing Aid User 446

Case History 446

Diagnostic Information 446

AR 446

Summary 447

Case 6: Ashley–New Technology for an Experienced User 447

Introduction 447

Informational Counseling 448

Rehabilitation Assessment 448

Rehabilitation Management 449

Summary 452

Case 7: Ms. C.–Dizziness Issues 452

Introduction 452

Rehabilitation Assessment 453

Informational Counseling 454

Rehabilitation Management 455

Summary 455

Chapter Summary Points 455 Supplementary Learning Activities 456

Recommended Reading and Recommended Website 456 References 456

Author Index 000

Subject Index 000

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