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Free AIOU Solved Assignment Code 683 Spring 2023
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Course: Audiology & Audiometry (683)
Semester: Spring, 2023
ASSIGNMENT No. 1
Q.1 Discuss the recent development in research into the causes of abnormal hearing. (Consult articles from journals or online resources).
Hearing health care is facing challenges similar to those being addressed in many other facets of health care in the United States. Hearing health care is often expensive and underutilized by many of the people who need it. Entry into the hearing health care system can occur by multiple pathways (audiologists, hearing instrument specialists, otolaryngologists, primary care providers, self-service, and others). Consumers can be left with no clear guidance on what will best fit their financial, health, social, and hearing needs. When left to traverse this complex system, even those patients who are fortunate enough to have the time, finances, knowledge, skills, and patience necessary to navigate the process may find the process and outcomes to be frustrating and unsatisfactory. Furthermore, there have been few randomized controlled trials that have examined the degree of relative effectiveness of and the quality of care provided by these various services; much remains unknown. For individuals in need of hearing health care but unable to overcome the time, financial, and information barriers, there is a lack of information about the options available regarding services and technologies and little support to help the consumer understand and compare the potential benefit of various services and technologies.
Understanding the range of hearing health care services can be challenging. Hearing problems sometimes develop rapidly along with other symptoms such as ear pain, dizziness, or tinnitus, which can herald the onset of infection or disease. Sometimes hearing problems develop so slowly that they are not recognized until a family member or friend expresses concern about difficulties carrying on a conversation with someone due to that person’s apparent poor listening or inattention. This is often the case in age-related hearing loss. Hearing health care ranges from the identification and management of diseases or conditions that may cause hearing loss, which sometimes require advanced medical or surgical care, to rehabilitation and the use of hearing aids and hearing assistive technologies to minimize the psychosocial and quality-of-life consequences of permanent hearing loss. As a result, the consumers of hearing health care services may require services from physician or nonphysician professionals, depending on the cause of the hearing problem, the ability of modern medicine to treat any underlying condition (if present) and restore hearing, and the person’s need for help coping with difficulties experienced in day-to-day listening activities and communication challenges. Individuals with lower levels of health literacy may not understand the different types of, causes of, and service providers for hearing loss, which adds to the confusion these individuals may face when seeking care for hearing problem. Furthermore, personal preferences, lifestyle, and communication needs, among other things, may drive different individuals with the same type of hearing loss to opt to use different services or different modes of service delivery (e.g., in-person, online, tele-health) to meet their needs.
Understanding the range of hearing health care is also important for identifying key indicators for the quality of care. Hearing loss can be understood in the context of disease, and quality can be defined as accurate diagnosis and appropriate and timely medical treatment within the context of the International Classification of Diseases. Hearing loss can also be understood within the context of communicative and psychosocial functioning, and in that case quality can be defined based on the International Classification of Functioning, Disability and Health (ICF). Therefore, defining quality depends on the dimension affected by the hearing impairment. Hearing health care refers to services that can be focused on treating disease, function, or both. If the problem is disease focused, quality can be measured in terms of a timely and successful medical or surgical intervention or reduced morbidity associated with the disease. When the problem is function focused, affecting everyday auditory and communicative activities, social participation, and quality of life, the quality of care can be judged by improvement in hearing and communication abilities and in overall function and quality of life; objective measures are difficult to obtain so an individual’s satisfaction remains the primary metric. The quality of audiological management might be defined in terms of the degree of restoration of activities and participation (relative to optimum potential). When the problem is multifactorial, a combined approach is indicated.
Under optimal conditions, hearing health care is a coordinated system, capable of addressing hearing loss from both a medical/disease focus and a functional/rehabilitative focus. Thus, the key to offering efficient and effective hearing health care services is assessing hearing-related problems from both a disease and function perspective and accessing the right services and technologies for the specific needs of the individual, at the lowest cost.
Most data available on the utilization of hearing health care are from surveys asking people if they have had a recent hearing test or about their use or nonuse of hearing aids. In the 2005–2006 and 2009–2010 National Health and Nutrition Examination Survey datasets, only 39.5 percent of adults ages 70 years and older had had a hearing test in the previous 4 years. Overall rates of recent hearing testing were similar for white Caucasians, African Americans, and Mexican Americans (39.1 percent, 43.3 percent, and 41.5 percent, respectively). Within the same study population of adults 70 years of age or older, a multivariable model controlling for age, degree of hearing loss, marital status, and self-reported health conditions found that African Americans, people who were widowed, and those with a college education were more likely to have had hearing tests than were white Caucasians, people who were married, and those with a high school education, respectively. There was no difference in the extent of recent hearing testing between Mexican Americans and white Caucasians. These national data do not address disparities for other minority groups and may not reflect regional or local variations in testing.
In the population-based Epidemiology of Hearing Loss Study cohort, whose participants had an average age of approximately 66 years, 36 percent had never had their hearing tested before the baseline examination in 1993–1995. More recently, in the study which followed up on the adult children (with and without hearing loss) of the participants in that study, 78 percent of those adult children had not talked with their doctors about a hearing problem in the past 5 years, and only approximately 34 percent of the adult children ages 23 to 69 years and approximately 55 percent of the adult children aged 70 years and older had had their hearing tested in the previous 5 years. Among those who had not had hearing testing in the previous 5 years, 9 percent had a mild to severe hearing loss according to the audiometric examination, which was part of the study. Because audiometric testing is not routinely performed in the United States, many adults with hearing loss remain unaware of a decline in their auditory function. With few published studies addressing hearing health care in the general U.S. population, little is known about the factors or types of symptoms or complaints that make individuals more likely to seek hearing health care.
It is well recognized that the prevalence of hearing aid use is quite low in the United States compared with the prevalence of hearing loss..
In 2011 the U.S. Preventive Services Task Force (USPSTF) examined the issue of screening for hearing loss as a population-wide measure during primary care visits for asymptomatic adults aged 50 years and older but did not recommend screening due to insufficient evidence to adequately weigh the balance of potential benefits and harms of screening for this asymptomatic population. The USPSTF noted that potential harms from screening could include anxiety, labeling, stigma, or other psychosocial effects but that no studies were available at the time of their analysis to evaluate these outcomes. The USPSTF added, “Because screening and confirmatory testing for hearing impairment are noninvasive and serious harms of treatment are rare, there are probably little to no adverse effects of screening for hearing loss”. The committee for the present report finds that lack of a USPSTF recommendation for population-wide screening for hearing loss in asymptomatic adults (such as has been recommended for colorectal screening) should not diminish the importance of discussing hearing health on an individual basis in primary care visits when patients present with complaints or the provider has reason to be concerned.
Hearing difficulties can negatively affect communication in any setting, and effective communication is particularly important in the health care setting both for patient safety and to enable the person-centered approach toward which the U.S. health care system is moving. For these reasons, it is important to consider changes in hearing ability during patient wellness and medical visits for those patients who express concern about their hearing and are seeking help. Because hearing tests are usually not a routine part of primary care visits, the onus often remains on the individual or family to recognize the symptoms and seek appropriate hearing health care. There are ongoing efforts to improve hearing health literacy, including the development of tools to help individuals determine when their hearing problems might stem from a medical condition and whether the problems can be managed by audiologists or other non-physician professionals. Development is ongoing, but initial results are encouraging.
AIOU Solved Assignment Code 683 Spring 2023
Q.2 What type of behavioral test of hearing would be used for a baby of eight months?
As part of a hearing evaluation, your child’s healthcare provider will do a complete health history and exam. In addition, there are many different types of hearing tests. Some of them may be used on children of all ages. Others are used based on your child’s age and level of understanding.
There are 2 main types of hearing screening methods for newborns. These may be used alone or together:
- Evoked otoacoustic emissions (EOAE). A test that uses a tiny, flexible plug that is put into the baby’s ear. Sounds are sent through the plug. A microphone in the plug records the otoacoustic responses (emissions) of the normal ear in reaction to the sounds. There are no emissions in a baby with hearing loss. This test is painless and often takes just a few minutes. It is done while the baby sleeps.
- Auditory brainstem response (ABR).A test that uses wires (electrodes) attached with adhesive to the baby’s scalp. While the baby sleeps, clicking sounds are made through tiny earphones in the baby’s ears. The test measures the brain’s activity in response to the sounds. As in EOAE, this test is painless and takes only a few minutes.
If the screening tests finds that your child has a hearing loss, more testing is needed. Babies with hearing loss should be identified by age 3 months. Then treatment can begin before the baby is 6 months old, an important time for speech and language development.
A baby’s hearing evaluation may include the EOAE and ABR tests above. This test may also be used:
- Behavioral audiometry.A screening test used in babies to watch their behavior in response to certain sounds. More testing may be needed. A toddler’s hearing assessment may include the tests mentioned above, along with these:
- Play audiometry. A test that uses an electrical machine to send sounds at different volumes and pitches into your child’s ears. The child often wears some type of earphones. This test is changed slightly in the toddler age group and made into a game. The toddler is asked to do something with a toy (such as touch or move a toy) every time the sound is heard. This test relies on the child’s cooperation, which may not always be possible.
- Visual reinforcement audiometry (VRA). A test where the child is trained to look toward a sound source. When the child gives a correct response, the child is rewarded through a visual reinforcement. This may be a toy that moves or a flashing light. The test is most often used for children between 6 months to 2 years old. A hearing evaluation for a child older than age 3 to 4 may include the tests mentioned above, along with these:
- Pure tone audiometry. A test that uses an electrical machine that makes sounds at different volumes and pitches in your child’s ears. The child often wears some type of earphones. In this age group, the child is simply asked to respond in some way when the tone is heard in the earphone.
- Tympanometry (impedance audiometry).A test that can be done in most healthcare providers’ offices to help find out how the middle ear is working. It does not tell if the child is hearing or not. But it helps to find any changes in pressure in the middle ear. This is a hard test to do in younger children because the child needs to sit very still and not be crying, talking, or moving.
AIOU Solved Assignment 1 Code 683 Spring 2023
Q.3 Discuss three of the criteria underlying the preparation of speech test material. Support your answer with examples.
There are a variety of types of support material which can be used to illustrate or prove points you make. The following kinds of materials are commonly used to support assertions in speeches:
- example — a concrete instance of the point you are making
- testimony — direct quotation or paraphrase of a credible source used to prove or illustrate a point
- statistics/surveys — quantitative information which proves or illustrates a point.
- definition — providing a dictionary or personal meaning for an unfamiliar or technical word. e.g., “A tariff is a tax placed on imported goods.”
- narration — A narration is a small story used in a speech or essay (usually appealing to the “mind’s eye,” told in chronological order).
- analogy – a comparison of the unfamiliar to the familiar.
- description/explanation — describing why your point is valid in your own words, usually in vivid concrete language
- Audio/Visual aids — anything the audience can see or hear (other than your words) which helps you make a point.
However, it is also valuable to use as many different types of support material as you can. A speech that is mostly statistics or only explanation is almost certainly going to be less interesting to the audience than a speech which includes stories, quotations, analogies, and examples as well as statistics or explanation. In fact, overuse of explanation is a very common weakness in speeches.
A variety of support types not only helps keep listener interest, it also builds your credibility. Research shows that speakers who use many kinds of support are judged to be more knowledgeable than those who don’t and are regarded as better speakers. Beginning with your second speech we ask you to label the type of each item of support you use in your outline as a way of encouraging you to avoid having only a limited variety of support in your speech. Your instructor will discuss ways you can increase the variety of support in your messages; however, the most important factor in getting a wide variety of support is obtaining several different kinds of information sources on your topic. By all means avoid speeches based solely on “personal knowledge.”
Use Support Material Effectively
Merely having a variety of good support material doesn’t guarantee that the audience will understand or be convinced of your point. You must use support well.
STEP 1. State the point (assertion) you wish to make/prove/illustrate. While this seems obvious sometimes speakers state a statistic or begin a story without indicating what THEIR point is, assuming the audience will draw the right conclusion. The problem is your audience may not see the point you think is obvious. Be clear. Make your point stand out as you deliver it so the audience will recognize it as important.
STEP 2. Present support material (one or more items) which clarifies, illustrates, or proves (convinces) your assertion. Use the support to develop your idea taking enough time to let the point “soak in.”
STEP 3. Show how the support material clarifies or proves your assertion by a) summarizing the point, or b) explaining the link between support and assertion. At the very least you should remind listeners of your point after you present the support material to reinforce what you want them to remember. This may seem repetitious to you but it won’t to your audience. They may not have gotten the assertion in step 1 and need a summary. Sometimes you may need to do more than summarize. The audience may not be able to see how your support proves your point (This is especially true when the support is statistical.). When that is possible you should be sure to explain the link as well as summarize.
Imagine a person was giving a speech on corporal punishment and wanted to use this information:
Psychologist H. Stephen Glenn said “Corporal punishment is the least effective method [of discipline]. Punishment reinforces a failure identity. It reinforces rebellion, resistance, revenge and resentment. And, what people who spank children will learn is that it teaches more about you than it does about them that the whole goal is to crush the child. It’s not dignified, and it’s not respectful.”
“The American Academy of Pediatrics strongly opposes striking a child. If the spanking is spontaneous, parents should later explain calmly why they did it, the specific behavior that provoked it, and how angry they felt. They might apologize to their child for their loss of control, because that usually helps the youngster understand and accept the spanking.”
AIOU Solved Assignment 2 Code 683 Spring 2023
Q.4 Inclusive education is hot topic in Pakistan. A child with unilateral hearing loss should attend a mainstream school or in inclusive education. What problems might the child and his/her teacher encounter?
Analysis by the National Deaf Children’s Society shows that deaf children struggle at every stage of their education: fewer than half reach the expected standard in Key Stage 2 English and maths SATs, compared to three quarters of other children.
And under half eventually leave education with two or more A levels, compared to almost two thirds of hearing students. Some of the problems they may encounter include:
- Difficulty hearing and understanding their teacher.For example, not all deaf children are able to lip read, and even if they can, only 30-40% of spoken English is distinguishable by lip reading.
- Problems with classroom acoustics.Background noise can affect children’s ability to hear, and certain sounds, like the buzz from fluorescent lighting, can cause interference with hearing aids and implants.
- Speech, language and literacy difficulties, including problems picking up phonics.
- Lack of resources.Because schools operate on such tight budgets, they may be unable to provide all the equipment and support deaf children need, such as one-to-one support and assistive technology.
- Tiredness and irritabilitycaused by the extra concentration they have to put in at school.
- Needing time off for appointments, which leaves them having to catch up on missed work.
- Social and emotional difficulties, including embarrassment about drawing attention to their issues, which can affect their learning, challenges in communicating with other children and forming friendships, and even bullying.
According to the National Deaf Children’s Society, 78% of deaf children attend mainstream schools, 6% attend mainstream schools with extra resources such as a specialist unit, 3% attend deaf schools and 12% attend other special schools.
You might wonder how your child will cope in a mainstream school, but very few deaf children have no useful hearing at all. Most can hear some sounds at certain frequencies and loudness, and with the use of hearing aids or implants, they are often able to hear more sounds.
This means that the majority of deaf children can be educated in a mainstream school, with the right support. Indeed, mainstream schools can’t refuse a child a place on the grounds of their additional needs.
Alternatively, you could consider a special school that caters for children with a range of special needs, including deafness. This might be your preferred option if your child has an additional need, such as autism or a developmental delay, or if you feel their hearing loss would be better catered for. There are also over 20 specialist schools for deaf children in the UK. When it comes to choosing a school for your child, you’ll want to weigh up lots of factors including:
- The severity of your child’s hearing loss and how it affects them.
- How they communicate.
- What sort of resources and support a school can offer, such as providing assistive technology or having staff members who can use sign language.
- Whether the school has a specialist unit that might benefit your child, for example a speech and language unit.
- The size of the school and average class sizes.
- The classroom environment and acoustics.
- Whether there are, or have been, other deaf children at the school.
- The location of the school: special schools may not be as local, and some deaf schools are residential.
Some of the ways in which schools can support children with hearing loss include:
Providing equipment such as a radio aids (a microphone worn by the teacher that work with hearing aids or implants) or a soundfield system to help them hear their teachers.
Providing support from a dedicated member of staff, for example a Teacher of the Deaf (ToD), communication support worker (CSW) or learning support assistant (LSA).
Improving the acoustics of the school or classroom, for instance by reducing background noise, and fitting carpets and curtains to help prevent echoing.
Training staff to teach in a deaf-friendly way, for example not turning away when talking, making sure your child has understood tasks, and making sure videos used in class have subtitles.
Allocating your child a ‘hearing buddy’ who can help to make sure they’ve understood instructions and rules, for example in PE when they may not be wearing their hearing aids or implants.
Ensuring your child sits at the front of the class: hearing technologies have an optimal range of one to three metres.
Providing a quiet space in the school where your child can go to communicate with their friends, for example at lunchtime.
Helping staff and other children learn to communicate through signing, such as British sign language (BSL) or Sign Supported English (SSE).
Meeting with you regularly to discuss your child’s needs, progress and any concerns. It’s important to involve your child in conversations about how they can be supported, if possible.
You might want to put together a ‘personal passport’ that details things like how your child communicates, how to get their attention, what they can and can’t hear, and any technology they use.
AIOU Solved Assignment Code 683 Autumn 2023
Q.5 Discuss the impact of modern hearing aids upon the education of children with hearing impairment. Support your discussion with examples/references.
Going through school with a hearing impairment or deafness can be a frustrating, isolating and ultimately unproductive experience for a child without the right support. As a teacher, it can be equally challenging to teach a hearing-impaired child effectively without adequate tools or training. For both it can sometimes feel like there’s an imaginary pane of glass keeping each from communicating effectively with the other. The ideal environment for many hearing-impaired children to learn is one in which they are not singled out as different, but instead benefit from the kind of adjustments which go unnoticed by others but are truly transformative for the child. At Engage Education we want to provide the information you need to handle hearing impairments with confidence.
While hearing impairments are often identified in babies, they may not develop or make themselves known for several years. This means that it’s important to keep an eye out for the signs of hearing impairment in the classroom, particularly in young children – as at some point in your career you could find that you are teaching a child with an undiagnosed hearing impairment.
Here are some of the common signs of hearing impairments that you can look for in young children:
- Not responding when their name is called
- Problems with concentration, excessive tiredness and frustration with work that starts to affect their behaviour
- Watching your lips intently as you speak
- Speaking too loudly or too quietly
- Watching others do something before attempting it themselves
- Becoming increasingly withdrawn from others in the classroom
- Delayed speech and communication development
- Mishearing or mispronouncing words
- Not being able to hear what’s happening if there is any background noise
- Making minimal contributions to classroom discussion
- Difficulty with reading and linking it to speech
Hearing-impaired children struggle at every stage of their education, with only 44% leaving school with two or more A Levels, and 43% reaching the expected standard for reading, writing and maths at key stage 2 (KS2) when finishing primary school. Hearing and learning go hand-in-hand, so the impairment of this function means much more for a child than simply struggling to hear. Any hearing impairment which is not handled effectively has an adverse effect on a child’s development, preventing them not only from taking in new information but learning to interact, relating to others and making friends.
A child whose hearing impairment negatively affects their learning is likely to withdraw further into themselves throughout their education, which has a knock-on effect throughout the rest of their life. The frustration of being unable to express themselves and communicate both inwardly and outwardly is highly damaging and can impact future employment and their relationships with both others and themselves.
Everyday frustrations in the classroom are not as simple as an absence of individual attention from the teacher. A child with a hearing impairment does not necessarily require constant additional help but rather a mindful and sensitive approach to teaching the whole class – not facing the whiteboard to speak, minimising background noise and using visual aids as much as possible.
It’s vital that children with hearing impairments are given the right support from as early a stage as possible. If you have a child with a hearing impairment in your class, teaching in a way that fully supports them may seem a daunting prospect, but there is plenty of support and many ideas available.
A radio aid is a microphone worn by the teacher that connects to a hearing aid, and can also be passed to other pupils during activities such as group reading. This will help the child to feel part of the class and ensure that they don’t miss any important information.
For schools that have the budget to employ one, a communication support worker or learning support assistant can provide hugely valuable help. Whether in the classroom all or some of the time, they can ensure the child is supported while you are able to give proportionate attention to other pupils.
Make sure that you don’t turn away from the class while talking and ensure that the child has understood every task or instruction (and they aren’t automatically looking to copy others after you have spoken). You can also sit the child right at the front of the class to give them the best possible chance of learning as hearing technologies only have an optimal range of one to three metres.
Meet with parents regularly
Having an open line of communication with the child’s parents will help to ensure that the child has consistent support both at school and home. Meeting with the parents face-to-face will enable you both to discuss any concerns you may have and track the child’s progress. Often the child may be confiding in the parents about issues that they are struggling with which they are too embarrassed to bring up in the classroom.
A ‘hearing buddy’
If the child has to take off their hearing aid at any point during the day (for example during a sports lesson) you can allocate them a ‘hearing buddy’ (perhaps their closest friend) who can help to repeat any information that the child may have missed.