Aural rehabilitation

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Aural rehabilitation is the process of identifying and diagnosing a hearing loss, providing different types of therapies to clients who are hard of hearing, and implementing different amplification devices to aid the client's hearing abilities. Aural rehab includes specific procedures in which each therapy and amplification device has as its goal the habilitation or rehabilitation of persons to overcome the handicap (disability) caused by a hearing impairment or deafness.

Contents

Aural rehabilitation is frequently used as an integral component in managing individuals with hearing loss. It refers to services and procedures for facilitating adequate receptive and expressive communication in individuals with hearing differences. Aural rehabilitation is often an interdisciplinary endeavor involving physicians, audiologists and speech-language pathologists. [1]

Scope of practice

Audiologists and speech-language pathologists are professionals who typically provide aural rehabilitation components. The audiologist may be responsible for the fitting, dispensing and management of a hearing device, counseling the client about his or her hearing loss, the application of certain processes to enhance communication, and the skills training regarding environmental modifications which will facilitate the development of receptive and expressive communication. [2] The speech-language pathologist is typically responsible for evaluating the client's receptive and expressive communication skills and providing the services to anchor improvement. The speech-language pathologist also provides training and treatment for communication strategies, speech-perception training (e.g., speechreading, auditory training and auditory-visual-speech-perception training), speech and voice production, and comprehension of oral, written, and sign language. [2]

History

In the United States, adult aural rehab started as a result of the number of soldiers who incurred hearing loss in World War II and were in need of services. Back then, audiologists and speech-language pathologists would put emphasis on speech reading (lip-reading) auditory training, and would fit the soldiers with very primitive hearing aids. In the past, the main components of the rehab process were training clients in lip-reading techniques and listening exercises. Today, the list includes a thorough hearing evaluation, intervention with hearing instruments, and counseling for the client before and after the hearing device is selected.

Types of aural rehabilitation therapies

Hearing Aid Hearing aid cic.jpg
Hearing Aid

General steps included in the aural rehab of a child (infant, toddler, child)

Infant wearing hearing aid Hababy.jpg
Infant wearing hearing aid
  1. Identification of Hearing loss
  2. Audiological evaluation
  3. Hearing aid and or assistive listening device evaluation and use
  4. Parental guidance to select appropriate therapy program
  5. Early intervention program
  6. Communication skill development (auditory, speech/language, sign)
  7. Literacy development (cognition, writing, reading) [4]

Regardless of treatment method for an infant, toddler, or child, the following problems have to be considered:

  1. Perceptual problems
  2. Communication problems (aural, oral, manual)
  3. Literacy problems (cognitive, memory, dexterity)
  4. Social, emotional, psychological problems
  5. Education and vocational placement problems
  6. Family and societal problems [5]

General steps included in an aural rehab program for an adult

Adult programs differ from child programs because adults typically have a later onset of significant hearing loss; they have acquired a worldly knowledge, and have experienced normal speech/language development. Consequently, treatment and therapy strategies are much different compared with a child. [5]

  1. Assessment and impact of hearing loss
  2. Assessment for the use of hearing aids and or assistive listening devices
  3. Assessment of listening strategies and speech reading skills
  4. Developing a treatment program including the family
  5. Delivery of the treatment program
  6. Outcome measures [5]

Treatment strategies for adults center on:

Regardless of whether the aural rehab program is designed for a child or an adult, the members of the hearing care team are the same. The principal members are the audiologist, speech-language pathologist, otologist, and the family physician. Additional members of the hearing care team can include any of the following: educators of the child who is hard of hearing, has mental health counselors, school psychologists, sensory device manufacturers and distributors, social workers, telecommunication and captioning service providers , and vocational counselors . [5]

Notes

  1. ↑ "Treatment & Rehabilitation". Archived from the original on 2008-03-18. Retrieved 2008-04-02.
  2. 1 2 http://www.asha.org/public/hearing/treatment/adult%5B%5D
  3. 1 2 3 4 Nicolosi 2003.
  4. ↑ Winter 1999, p. 1051
  5. 1 2 3 4 5 Alpiner 1993.

Related Research Articles

This is a glossary of medical terms related to communication disorders which are psychological or medical conditions that could have the potential to affect the ways in which individuals can hear, listen, understand, speak and respond to others.

<span class="mw-page-title-main">Audiology</span> Branch of science that studies hearing, balance, and related disorders

Audiology is a branch of science that studies hearing, balance, and related disorders. Audiologists treat those with hearing loss and proactively prevent related damage. By employing various testing strategies, audiologists aim to determine whether someone has normal sensitivity to sounds. If hearing loss is identified, audiologists determine which portions of hearing are affected, to what degree, and where the lesion causing the hearing loss is found. If an audiologist determines that a hearing loss or vestibular abnormality is present, they will provide recommendations for interventions or rehabilitation.

The Doctor of Audiology is a professional degree for an audiologist. The AuD program is designed to produce audiologists who are skilled in providing diagnostic, rehabilitative, and other services associated with hearing, balance, tinnitus management, and related audiological fields. These individuals help patients with hearing problems primarily by diagnosing hearing loss and fitting hearing assistive devices.

A communicative disorders assistant (CDA) performs hearing and speech-language screenings, prepares therapy materials, implements speech therapy, reports on therapy outcomes, performs routine maintenance on clinical equipment, and works with speech-language pathologists (SLPs) and audiologists to adjust therapy goals. While CDAs cannot perform assessments or set therapy goals, they are a vital part of the therapy team. CDAs are supervised by and work in conjunction with SLPs and audiologists.

The American Speech–Language–Hearing Association (ASHA) is a professional association for speech–language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally. The association reported over 234,000 members and affiliates in its 2023 report.

Auditory integration training (AIT) is a procedure pioneered in France by Guy Bérard. Bérard promoted AIT as a cure for clinical depression and suicidal tendencies, along with what he said were very positive results for dyslexia and autism, although there has been very little empirical evidence regarding this assertion. AIT typically involves 20 half-hour sessions over 10 days listening to specially filtered and modulated music. It was used in the early 1990s as a treatment for autism. Since, it has been promoted as a treatment for ADHD, depression, and a wide variety of other disorders. AIT has not met scientific standards for efficacy that would justify its use as a treatment for any condition.

<span class="mw-page-title-main">Speech–language pathology</span> Disability therapy profession

Speech–language pathology (a.k.a. speech and language pathology or logopedics) is a healthcare and academic discipline concerning the evaluation, treatment, and prevention of communication disorders, including expressive and mixed receptive-expressive language disorders, voice disorders, speech sound disorders, speech disfluency, pragmatic language impairments, and social communication difficulties, as well as swallowing disorders across the lifespan. It is an allied health profession regulated by professional bodies including the American Speech-Language-Hearing Association (ASHA) and Speech Pathology Australia. The field of speech-language pathology is practiced by a clinician known as a speech-language pathologist (SLP) or a speech and language therapist (SLT). SLPs also play an important role in the screening, diagnosis, and treatment of autism spectrum disorder (ASD), often in collaboration with pediatricians and psychologists.

<span class="mw-page-title-main">Atlanta Speech School</span> School in Atlanta, Fulton County, Georgia, United States

The Atlanta Speech School is a language and literacy school located in Atlanta, Georgia, established in 1938. The school provides educational and clinical programs. The Atlanta Speech School's Rollins Center provides professional development for teachers and educators in partner schools and preschools. The Rollins Center focuses on the eradication of illiteracy. The Rollins Center has an online presence called Cox Campus, which is an online learning environment with coursework targeted for the education of children age 0–8.

Auditory processing disorder (APD), rarely known as King-Kopetzky syndrome or auditory disability with normal hearing (ADN), is a neurodevelopmental disorder affecting the way the brain processes sounds. Individuals with APD usually have normal structure and function of the ear, but cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech. It is thought that these difficulties arise from dysfunction in the central nervous system. This is, in part, essentially a failure of the cocktail party effect found in most people.

Stuttering therapy is any of the various treatment methods that attempt to reduce stuttering to some degree in an individual. Stuttering can be seen as a challenge to treat because there is a lack of consensus about therapy.

Speech and language impairment are basic categories that might be drawn in issues of communication involve hearing, speech, language, and fluency.

Speech-Language & Audiology Canada (SAC), formerly known as the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA), is a national organization supporting and representing speech-language pathologists, audiologists, and communication health assistants. The association adopted its new name and logo on February 5, 2014.

Prelingual deafness refers to deafness that occurs before learning speech or language. Speech and language typically begin to develop very early with infants saying their first words by age one. Therefore, prelingual deafness is considered to occur before the age of one, where a baby is either born deaf or loses hearing before the age of one. This hearing loss may occur for a variety of reasons and impacts cognitive, social, and language development.

Leo G. Doerfler (1919–2004) was the founder of the profession of audiology, the science of hearing and hearing disorders, in the early 1940s. He played a leading role in establishing professional bodies and educational standards for audiology practitioners.

Online speech therapy or telepractice is the use of technology to provide speech therapy via high speed internet, webcam, headset with microphone or any other form of communication. Online therapy is a clinical arrangement where the patient and a speech-language certified pathologist communicate and interact face-to-face over the Internet. The session involves a suite of therapeutic exercises including listening, speaking, reading and writing. The recorded videos are assessed by the pathologist to generate an activity report for evaluating progress and usage.

The International Institute of Rehabilitation Sciences and Research is managed by ASTHA Trust, founded by Mrs. Bishnupriya Mishra. The campus is located at KHANDAGIRI, in Bhubaneswar, Orissa, India. The institution provides 3 year +10 month degree course called BASLP.

<span class="mw-page-title-main">Real ear measurement</span>

Real ear measurement is the measurement of sound pressure level in a patient's ear canal developed when a hearing aid is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for a patient's hearing loss. The American Speech–Language–Hearing Association (ASHA) and American Academy of Audiology (AAA) recommend real ear measures as the preferred method of verifying the performance of hearing aids. Used by audiologists and other hearing healthcare practitioners in the process of hearing aid fitting, real ear measures are the most reliable and efficient method for assessing the benefit provided by the amplification. Measurement of the sound level in the ear canal allows the clinician to make informed judgements on audibility of sound in the ear and the effectiveness of hearing aid treatment.

Despite having the largest economy in South America or Central America, Brazil is still considered a developing country due to its low gross domestic product, or GDP, per capita, low living standards, high infant mortality rate and other factors. "With regard to hearing health, the Brazilian government established the national policy for giving attention to hearing health in 2004, in which the Ministry of Health, considering the social magnitude of hearing impairment in the Brazilian population and its consequences, presented the proposal to structure a network of services set up by regions and in hierarchy that aims to be implemented in all federative units of Brazil, with integrated actions to promote ear health, hearing impairment prevention, treatment and rehabilitation organized and managed by the National Health System, Sistema Único de Saúde (SUS), in Portuguese," writes Bevilacqua et al. (2010)

Audiology and hearing health professionals in India is made up of Indian healthcare professional that focus on audiological and hearing problems.

Sandra Gordon-Salant is an American audiologist. She is a professor at the University of Maryland, College Park, where she is also director of the doctoral program in clinical audiology. Gordon-Salant investigates the effects of aging and hearing loss on auditory processes, as well as signal enhancement devices for hearing-impaired listeners. She is the senior editor of the 2010 book, The Aging Auditory System. Gordon-Salant has served as editor of the Journal of Speech, Language, and Hearing Research.

References

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