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Introduction to Audiologic Rehabilitation

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  • Edition: 7th
  • Format: Paperback
  • Copyright: 2017-08-06
  • Publisher: Pearson
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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. 

Author Biography

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.

Table of Contents

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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