A need has been established for aural rehabilitation (AR) sessions throughout the years. The literature reviewed here demonstrates that new hearing aid users do benefit from a structured follow-up AR program. However, this need is often not met for a variety of patient and audiologist related factors. Therefore, an AR program that could be viewed at home has been suggested. I have developed a prototype for a CD-ROM based aural rehabilitation (AR) program. Included in the program are communication and speechreading strategies, which are the most prevalent materials in AR. The instructional and interaction portions of the prototype were created to be understood by the average person. The prototype includes the use of video, graphics, and audio to support the written information and to incorporate a sense of excitement into the CD-ROM based program.

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Objective: To expand the access to culturally relevant hearing health services in a rural U.S. border community with already limited healthcare resources, community health workers (Promotoras de Salud) were trained to provide peer-facilitated hearing education classes. Design: A specialized three-phase training process for community health workers was developed, implemented, and evaluated. The training process included: 1) Focus groups with community health workers and residents from the community to raise awareness of hearing loss among community health workers and the community; 2) A 3-hour workshop training to introduce basic topics to prepare community health workers to identify signs of hearing loss among community members and utilize effective communication strategies; and 3) A 24-hour multi-session, interactive training over 6 weeks for community health workers who would become facilitators of educational and peer-support groups for individuals with hearing loss and family members. Study Sample: Twelve Spanish-speaking local community health workers employed by a federally qualified health center participated in a focus group, 12 received the general training, and four individuals with prior experience as health educators received further in-person training as facilitators of peer-education groups on hearing loss and communication. Results: Community health workers increased their knowledge base and confidence in effective communication strategies and developed skills in facilitating hearing education and peer support groups. Through case study practice, community health workers demonstrated competencies and applied their learning to specific situations related to effective communication with hearing loss, family support, assistive technology, use of hearing protection, and making referrals for hearing health care. Needs were identified for ongoing training in the area of assistive technology and addressing situations of more severe hearing loss. Conclusions: It is feasible to train community health workers to begin to address hearing loss and facilitate peer health education and support groups for individuals with hearing loss and their family members. In efforts to increase access to audiologic services in rural or hard-to-reach areas, application of the community health worker model with a partnership of audiologists deserves further consideration as a viable approach.

Professional research project (Au.D.)--University of South Florida, 2002. / Title from PDF of title page. / Document formatted into pages; contains 35 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: A need has been established for aural rehabilitation (AR) sessions throughout the years. The literature reviewed here demonstrates that new hearing aid users do benefit from a structured follow-up AR program. However, this need is often not met for a variety of patient and audiologist related factors. Therefore, an AR program that could be viewed at home has been suggested. I have developed a prototype for a CD-ROM based aural rehabilitation (AR) program. Included in the program are communication and speechreading strategies, which are the most prevalent materials in AR. The instructional and interaction portions of the prototype were created to be understood by the average person. The prototype includes the use of video, graphics, and audio to support the written information and to incorporate a sense of excitement into the CD-ROM based program. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

abstract: In the noise and commotion of daily life, people achieve effective communication partly because spoken messages are replete with redundant information. Listeners exploit available contextual, linguistic, phonemic, and prosodic cues to decipher degraded speech. When other cues are absent or ambiguous, phonemic and prosodic cues are particularly important because they help identify word boundaries, a process known as lexical segmentation. Individuals vary in the degree to which they rely on phonemic or prosodic cues for lexical segmentation in degraded conditions. Deafened individuals who use a cochlear implant have diminished access to fine frequency information in the speech signal, and show resulting difficulty perceiving phonemic and prosodic cues. Auditory training on phonemic elements improves word recognition for some listeners. Little is known, however, about the potential benefits of prosodic training, or the degree to which individual differences in cue use affect outcomes. The present study used simulated cochlear implant stimulation to examine the effects of phonemic and prosodic training on lexical segmentation. Participants completed targeted training with either phonemic or prosodic cues, and received passive exposure to the non-targeted cue. Results show that acuity to the targeted cue improved after training. In addition, both targeted attention and passive exposure to prosodic features led to increased use of these cues for lexical segmentation. Individual differences in degree and source of benefit point to the importance of personalizing clinical intervention to increase flexible use of a range of perceptual strategies for understanding speech. / Dissertation/Thesis / Doctoral Dissertation Speech and Hearing Science 2015

Syftet med studien var att utifrån specifika frågeställningar systematiskt granska vetenskapliga studier av audiologisk grupprehabilitering. I studien undersöktes själva definitionen av audiologisk grupprehabilitering, hur olika variabler påverkar resultatet, hur utvärderingen bör ske samt hur den förhåller sig till de uppställda målen.     Den metod som tillämpats är litteraturstudie. För litteratursökningen till denna studie användes databaserna PubMed och Cinahl. Vissa artiklar söktes även från vetenskapliga studiers referenslistor samt tips från handledare.       Resultaten från de olika studierna visar att nytta med rehabilitering varierar då många aspekter spelar in och påverkar utgången av rehabiliteringsinsatsen. Rehabiliteringen bör ses som en patientcentrerad problemlösande process för att nå alla individers önskemål. När patienten själv är mer aktiv i utvärderingen ökar möjligheten att uppnå målen gällande grupprehabilitering. Hänsyn måste tas till varje enskild individs sociala bakgrund för att skapa ett audiologiskt rehabiliteringsprogram som möter deras krav vid lyssnande och kommunikation. Individens livsstil, kommunikationsvanor, krav och egenheter interagerar med fysiska begrepp såsom graden och formen på hörselnedsättningen.    Audiologisk grupprehabilitering är en åtgärd för att förbättra eller lindra problem vid hörselnedsättning och de olika studierna visar på varierande resultat. Grupprehabiliteringens mål skall möta patientens behov. För att nå dit behövs utvärderingsmetoder som är personcentrerade och problemlösande. Användandet av öppna frågeformulär är ett sätt att nå det kriteriet. / The purpose with this study was to systematically examine scientific studies of audiologic group rehabilitation. The definition of audiological rehabilitation was explored, different variables that influence the result and how the outcome measures should be done and its relationship with the goals of audiologic rehabilitation.    The method used was a literature study. Pubmed and Cinahl were used for the search of literature. Some articles were searched from scientific studies reference lists and also advice from the supervisor.   The result from the different studies shows that the effect of rehabilitation varies as there are many aspects that have an affect on the outcome measure. Rehabilitation should be seen as a patient centered problem solving process in order to reach the goals of all the individuals. When the patient is more active in the outcome measure procedure the goals also comply with the group rehabilitation. Consideration must be taken to social background of each and every individual in order to create an audiological rehabilitation program that meets their hearing and communication requirements.  The lifestyle, communication habits and singularity of the individual interact with physical conceptions as well as the grade and shape of the hearing impairment.   Audiological group rehabilitation is a mean to improve or relieve problems due to hearing impairment and the different studies show that the result varies. The goals of group rehabilitation should meet the need of the patient. In doing so there is a need of outcome measures that are person centered and problem solving. Using open questionnaires is a method to reach that criterion. / <p>Examensarbete inom audionomprogrammet, Göteborgs universitet. </p>

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Made available in DSpace on 2016-04-27T18:12:28Z (GMT). No. of bitstreams: 1 Aline Neves Pessoa.pdf: 4984178 bytes, checksum: d99c1ef907dc4b911ae372a955638bc2 (MD5) Previous issue date: 2008-02-22 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introduction: Very few studies discuss speech development in hearing impaired children in the first years of life due to methodological difficulties and the number of variables involved. Acoustic inspection of articulatory adjustments and attempts to imitate a model made by the infant in different contexts can be a method to comprehend the manner in which first oral motor skills occur. The understanding of this process can provide strategies concerning intervention programs for infants in stages when motor gestures of speech are being acquired. The objective of this longitudinal study was to describe samples of speech production from a hearing impaired child, extracted from interactive situations in auditory rehabilitation, seeking to discuss phonetic development in different therapeutic contexts. The study also sets out to characterize and reflect upon the effects of therapist mediation in situations of longitudinal and transversal samples, particularly situations of spontaneous production and in immediate repetition facilitated by auditory feedback. Method: A case study design was used. The subject was 2y 11mo in the beginning of the study, and 3y 6mo at the last recording. I is a girl, with severe progressive bilateral sensory neural hearing loss with descending audiometric configuration. She had been using hearing aids since six months of age, and FM system since 3y 1mo of age. The effect of the use of FM system was also analyzed. Audio recordings of the child s therapy session were obtained and samples were selected based on auditory perception. These fragments were analyzed using a qualitative acoustic inspection. The PRAAT 4.0 software used for speech synthesis and analysis was utilized for acoustic inspection. Results and discussion: The data allows for discussion of the child s possibilities regarding adjustments of vocal source and filters in relation to her auditory feed back possibilities. Segmental and supra-segmental aspects were studied, as was modulation, tonal spectrum, fundamental frequency, and formants. The processes of substitution, omission, distortion, and odd solutions for articulatory adjustments, such as sudden vocal attack and nasalization, or systematic substitution of fricative for plosive phonemes were evident, especially spontaneous speech. Therapeutic strategies aimed at the multiplication of the possibilities of auditory feedback moments in which the child had greater possibility for adjustment in the form of its vocabulary we noticed that the articulators and source began to adjust in the direction of the target, and the articulatory gesture became more consistent. Also, after using the FM system in addition to hearing aids for five months, fricative phonemes, flaps, and other consonants that were previously less audible in the child s daily life became more frequent since she was able to perceive the form and meaning of speech in a more stable and accessible manner. Conclusions: Clinical strategies based on the need to more audibility aiming at speech development occur in the context of dialogues with the therapist. Multiple opportunities for auditory feedback are directed towards oral motor abilities in the acquisition of different phonemes. Therefore, acoustic inspection allowed for the establishment of relationship with auditory perception, enhancing the understanding of phonetic and phonological features, as well as symbolic and discursive aspects of oral language. Implications of the findings for clinical management are discussed. Acoustic inspection and its relation to auditory feed back seems to be a powerful method for understanding on the phonetic development in young children contributing to the development of therapeutic strategies / Introdução: Poucos estudos discutem a fase inicial do desenvolvimento de fala em sujeitos deficientes auditivos devido às dificuldades metodológicas e ao número de variáveis envolvidas. A inspeção acústica diante dos ajustes realizados na produção de fala em diferentes contextos propiciados pelo enquadre terapêutico pode ser uma possibilidade para compreendermos as primeiras hipóteses acerca das habilidades motoras de fala, a partir das condições sensoriais auditivas. A compreensão deste processo traz conhecimento acerca do desenvolvimento de linguagem de deficientes auditivos, repercutindo nas formulações de estratégias de intervenção/tratamento nessas crianças. Objetivo: Descrever amostras de produção de fala em uma criança com deficiência auditiva; caracterizar e refletir sobre a produção de fala em situações do enquadre terapêutico visando discutir os ajustes fonoarticulatórios na produção de fala dos sons do português brasileiro (PB), através da interpretação dos dados acústicos em relação à audição residual. Material e método: Trata-se de um estudo de caso, sendo o sujeito do sexo feminino, no início da pesquisa com 2a11m, e no término, com 3a6m de idade, portador de deficiência auditiva neurossensorial progressiva de grau profundo bilateral. A criança usava aparelhos de amplificação sonora individual (AASIs) desde 6 meses de idade e Sistema de Freqüência Modulada (Sistema FM) desde 3a1m de idade. Gravações de áudio da produção de fala em sessão terapêutica de abordagem verbaloral e os recortes transversais e longitudinais de sons de fala em diferentes contextos permitiram a inspeção acústica (através do software Praat v 4.0). Resultados e Discussão: Os dados trouxeram discussões acerca das hipóteses e dos ajustes de fonte e filtro realizados pela criança a partir da sua condição de utilização da audição residual. Aspectos segmentais, supra-segmentais e de qualidade vocal puderam ser estudados, tais como modulação, gama tonal, freqüência fundamental e formantes. Processos de ajustes, caracterizados também por substituições, omissões e distorções, e recursos, como o de golpe de glote e nasalização, dentre mudanças sistemáticas no modo de produção de consoantes (plosão no lugar de fricção) caracterizaram algumas das produções de fala da criança nos primeiros momentos da análise; as instabilidades e imprecisões articulatórias foram mais acentuadas nos momentos de emissão espontânea do que nos momentos por repetição imediata. A partir das estratégias terapêuticas, compostas por multiplicação de possibilidades de feedback auditivo, notou-se que os articuladores e fonte começaram a se ajustar mais precisamente em direção ao alvo, e assim, o gesto articulatório se mostrava menos frágil. O Sistema FM acoplado aos AASIs também ofereceu melhores condições de multiplicação de evidências sensoriais para a percepção auditiva; no decorrer dos meses, percebemos que as hipóteses e ajustes para formar engramas dos fones fricativos, laterais flapes, dentre outros começaram a se constituir no repertório lingüístico, definindo uma nova condição de a criança perceber a forma e o significado da língua de maneira lúdica, estável e acessível. Considerações Finais: O manejo clínico do fonoaudiólogo traz especificidades nas estratégias terapêuticas e oferece maiores e melhores oportunidades de a criança com deficiência auditiva construir suas hipóteses acerca da construção na/da linguagem no processo de aquisição dos sons do PB. Isso se dá, principalmente, a partir de múltiplas oportunidades de feedback auditivo e, portanto, acesso e oportunidades de experiências para a formação de engramas motores de fala. Por isso, consideramos que lançarmos mão da inspeção acústica, relacionando esses dados com a percepção auditiva, nos dá subsídio para um possível entendimento das características fonéticas/fonológicas (além das discursivas e simbólicas) da fala de um sujeito e das possibilidades de percepção e produção de fala, sendo que esses processos implicam em manejos no enquadre terapêutico