CSD 431 Quiz 4

Why are AR Services Required in School Settings?

- Hearing loss is considered an educationally significant disability - Most academic success depends on competent use of language. Deficits in language can have a direct effect on cognitive development - Audiologic rehabilitation services are needed to help children stay competitive in school.

Reducing Classroom Reverberation

-Avoid parallel-facing reflective surfaces -Add carpet/carpet area -Cover windows -Cover walls -Add bookshelves -Cushioned chairs

Sources of Classroom Reverberation

-Black/white boards -Desk/table tops -Uncarpeted floors -Plaster/masonry walls and ceilings -Windows

Reducing Classroom Noise

-Classroom management choices -HVAC service -Tennis ball on chair feet -Pads on desktops that open/close -Upgrade fluorescent lighting -Turn off computers when not in use -Add doors to open-plan buildings -Close doors -Close windows -Upgrade windows, add sealant

IDEA- Part B Qualifying Conditions

-Deafness (HL so severe that processing linguistic info through hearing is impaired, with or without amplification) -HI, other than Deaf (HL, whether permanent or fluctuating, that adversely affects educ performance; in Mich = any type, degree, configuration) -Visual Impairment (incl. partial sight & blindness; adversely affects educ. performance even with correction) -Deaf-Blindness -Emotional Impairment (e.g., mood disorders, depression) -Intellectual Disability (e.g., low IQ) -Multiple Disabilities (more than one of the IDEA conditions) -Orthopedic (Physical) Disability (e.g., cerebral palsy) -Speech-Language Impairment -Traumatic Brain Injury -Autism -Specific Learning Disability (umbrella term for learning problems; e.g., dyslexia; APD can go here) -Other Health Impaired (conditions that limit strength, energy, alertness, e.g., ADHD; APD can go here)

IDEA: Individuals with Disabilities Education (Improvement) Act

-Federal law since 1975 (many re-authorizations & amendments) -Guarantees a free and appropriate public education (FAPE) to all children with disabilities -Cost of services provided by public funds and not parents -Guarantees children with disabilities will be placed in the least restrictive environment (LRE)

Self Advocacy Training

-Know how to talk about their hearing loss. -Assertiveness skills -Repair strategies for communication breakdowns -Change their environment to make communication easier.

IDEA- Part B and IEP

-Legal contract for needed special education and supplemental services for qualifying children at no cost to families -Services provided based on comprehensive multidisciplinary evaluation -Annual review; 3-year re-evaluation cycle; amendments allowed -Plan for transition to post-secondary included at age 16 -Parents must consent -To qualify, child must have one of 13 disabilities and must show a negative impact of that disability on their education

Classroom Strategies

-Use of CLEAR SPEECH -Enhancing visual communication: -Gain Student attention before instructing -Support student's use of facial and gestural cues Increase redundancy and predictability incontent -Use of written materials -Notetakers, buddy system -Calendar of assignments on the board Preferential Seating Work with teacher to create specific classroom strategies for their student with hearing loss

What is Counseling?

-a two way conversation -patient is given time, room and permission to tell their story -encourage people to teach us what life with HL is like for them and any concerns they have in the moment -parents and patients are the experts of their lives and requires professionals to drop assumptions that we know how they feel

Causes of APD

-central auditory maturational delay -head injury -stroke -aging -lesions -epilepsy -tumor -degenerative diseases -chronic ear infection

AR in Schools Includes

-communication-skills development training -self-advocacy training -classroom strategies -classroom acoustics -identifying HL -assessments -device management -HL prevention

What does psychotherapy do?

-help clients explore unconsciousness behavior patterns in order to alter ways of relating and functioning by examining and challenging personal history by analyzing the meaning of one's responses -counseling-designed to help people develop "here-and-now strategies" for coping with life, decision making, and current problems -focuses on supporting personal adjustment and not major personality changes -nonprofessional counseling-involves content or informational counseling as well as nonprofessional personal adjustment support

Self Concept

-how one sees oneself -learned by absorbing the input, feedback, and reactions from those around us -children with hearing loss at risk for developing poor self-concept -negative reactions from communication ability -perceived as different due to hearing aid or CI use -children perceive themselves as less socially accepted

Family Concerns

-many parents experience emotional reactions similar to the grief cycle -parents may report moving back and forth from these emotional reactions -mother-child interactions are more rigid and more negative when a child has a hearing loss -clinicians should be aware of different emotional states of families and try not to perpetuate or contribute to their stress

When to Refer

-many patients present with difficulties that cannot be accounted for by the HL alone -refer anytime there is a situation outside your expertise area of scope of practice

Acquired Hearing Loss as Adults

-most individuals, if they live long enough, acquire some degree of hearing loss as part of the aging process -psychological, emotional, and social effects -self concept -psycho-emotional reactions -family concerns -social concerns

IDEA- Part C

-part of federal law that outlines services for birth to 3 students with disabilities, early intervening services

Psychoemotional Reactions

-reaction to hearing loss include anger, anxiety, and stress, resentment, depression, and grief -adults may experience the grief cycle -conversational exclusion

Family Concerns-adults

-significant others assume the responsibility of "hearing" for family members -in benefit questionnaires, spouses typically reports more problems prior to a hearing aid fitting and more benefit after -families tend to not talk to family members where communication is difficult

Social Competence

-skills for successful and satisfying personal relationships -fewer opportunities for peer interactions due to delays in communication skills -difficult to learn social rules (turn taking, eye gaze) -poor social competence due to limited communication skills

Special Issues in Adolescence

-stage of life with important developmental tasks, including peer group affiliation, identity formation, occupational preparation, and adjustment to physiologic changes -peer relationships become paramount -teens with HL may be the only students with HL in their school -may reject amplification/FM systems to be more like their peers -learns skills on how to advocate for their needs as they transition into college and work settings

Adults with more significant HL

-studies show the more severe the HL, the more severe the psychosocial and emotional problems -children and adults who are deaf have been described as impulsive, compulsive, egocentric, and rigid -deficits in empathy -high anxiety -psychological issues not caused by the hearing loss itself but by communication problems are a result of the hearing loss

Rationale

-to develop supportive relationship with someone who is culturally different: -must be able to overcome natural tendency to view one's own beliefs, values, and world view as superior -instead, be open to beliefs, values, worldview of the diverse client problem: viewing self as superior

Emotional Development

-use of language to describe, interpret, and understand the nature of his or her emotions -children with hearing loss may have limited experiences in self-expression and subsequent delay in awareness and understanding of their own emotions -children with HL are often less accurate in identifying others' emotional state than children without HL and poorer understanding of affective words

Self-Concept Adults

-wait 7-10 years to seek help -adults who do not seek treatment seek cost and cosmetic concerns -older women who wear hearing aids are perceived and less attractive, friendly, confident, and intelligent

Social Concerns

-when communication becomes gradually more difficult, our social world can constrict -adults may opt out of favorite activities -social withdrawal has been shown to lead to depression -embarrassment when misunderstood -blame communication partner -avoidance techniques -not common for adults to not make a connection between social withdrawal and their HL

What is Auditory Processing Disorder?

A type of hearing loss that adversely affects an individual's processing, or interpretation, of auditory messages

Racial Concordance

Clinician and patient are of same race (disparities are less likely to occur)

How do students get AR services in school?

IDEA Part-B and Part-C Section 504 of the Rehab Act of 1973 American with Disability Act (ADA)

Communication-Skills Development

Improve Speech -Phoneme use, voice quality, breath control, speaking rate and loudness Improve Language -language understanding (receptive) and usage (expressive) for concepts, vocabulary, word knowledge, use in different social situations, narrative skills, expression through writing and understanding rules of grammar Improve Auditory Perception -Detection, Discrimination, Identification and Comprehension Improve Speech Reading

Americans with Disabilities Act (ADA)

Legislation passed in 1990 that prohibits discrimination against people with disabilities. Under this Act, discrimination against a disabled person is illegal in employment, transportation, public accommodations, communications and government activities.

Hearing Aid Effect

Psychological reaction to the presence of a hearing aid where the viewer has negative assumptions about the hearing aid user.

Classroom Reverberation

Reverberation is the persistence of a sound after its source has stopped, primarily due to reflection of the sound within a close space.

Least Restrictive Environment (LRE)

a legal requirement that children with special needs be assigned to the most general educational context in which they can be expected to learn

504 Plan

a plan developed to ensure that a child who has a disability identified under the law and is attending an elementary or secondary educational institution receives accommodations that will ensure their academic success and access to the learning environment

The Rehabilitation Act of 1973

added people with disabilities to the list of Americans protected from discrimination

Why is it important to know about psychosocial aspects of HL?

adjusting to hearing loss is difficult and accepting recommendations can be a difficult process for many individuals. -more than 32 million individuals with HL -95% of people with hearing loss are hard of hearing

Racial Discordance

clinician and patient of differing race

IDEA-Part B

covers children and young adults with disabilities ages 3-21

Auditory Processing Disorder

hearing loss that results from damage to the centers of the brain that process auditory information

Growing with Hearing Loss

the most significant consequence when growing up with HL is the difficulty in perceiving others' words because the limitation has a direct effect on the ability to produce one's own words and language

Psychotherapy

treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth