Putting it all together课件.ppt

Putting it all together;Per popular request……..;Agenda;Why we need to do something different?;Expectations vs. Goals;Why do patients seek our help? ;Elements of Communication (Kiessling, et al, 2003; Sweetow and Henderson-Sabes, 2004);Goal is to relieve HANDICAPPING effects (WHO, 1997);What constitutes a “typical” evaluation? ;亭锡黔核猿佛格厚泵蛀耀烬斤即阻盖茄英辙悉摄么嚣考循暇豺栖岁社学陋Putting it all together课件Putting it all together课件;Cox’s 2005 Evidence Based Practice Review of …;Pre-Fitting Speech Audiometry;Post-Fitting Speech Audiometry;Post-Fitting Speech Audiometry (cont.);Speech intelligibility, satisfaction, and RFC;Are we really testing communication?;Current speech perception tests….;Hearing aid patients by age;Perceptual and cognitive declines (resource limitations) in elderly;Working Memory;Knowledge is preserved in long-term memory;Threshold elevation can account for nearly all of the changes in speech perception with age…. (in quiet or in less demanding listening environments.);In complex perceptual tasks, older listeners are more likely to demonstrate supra-threshold deficits in addition to the effects of reduced audibility. It is less certain exactly what factors contribute to these deficits.;Impact of aging on speech perception;Pichora-Fuller, 2006;Potential impediments to achieving mastery of these elements;Are we properly instructing our patients to assess outcome?;The biggest mistake we currently make may be…;How to do it?;Relevant Domains for CNA;Measures beyond the audiogram that can be used to define residual auditory function. Objective procedures QuickSIN BKB-SIN Hearing in Noise Test (HINT) Words in Noise (WIN) Acceptable Noise Levels (ANL) Binaural interference Dichotic testing Listening span TEN Rapid (compressed) speech test Speechreading Dual-tasking ;Measures beyond the audiogram that can be used to define residual auditory function. Subjective measures Hearing Handicap Inventory for the Elderly – Screening HHIE-S The Hearing Handicap Inventory for A