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COURSE SCHEDULE Summer, 2004 |
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Summer, 2004
UPDATED 1 June 2004
Instructor
Professor Michael R. Chial, Ph.D.
Office: 365 Goodnight Hall
Office Hours: 10:30 - 11:30 a.m., M and W; also by appointment or Email (mrchial@facstaff.wisc.edu)
This page: http://www.comdis.wisc.edu/facstaff/mrchial/cd700.htm
Course Meetings
Lecture / Discussion: 11:30 -2:00 M and W, Room B-62 Goodnight Hall
COURSE DESCRIPTION
This course is intended to prepare prospective speech/language pathologists with prior academic exposure to audiology for careers in which they will relate (1) to clients or patients who may have auditory disorders that influence either their speech-language status, or the likelihood they will benefit from speech-language services, and (2) to audiologists and others who may provide or be asked to provide clinical information about persons with auditory disorders. As such, it is intended to reinforce knowledge and skills needed by speech/language pathologists to provide (within the scope of practice in speech/language pathology) proper prevention, assessment, referral, and treatment.
INSTRUCTIONAL GOALS
The goals for this course are divided into three groups: awareness, knowledge and skill. Awareness goals designate the ability to accurately and correctly identify issues, principles and methods for seeking additional information. Knowledge goals designate the ability to accurately and clearly distinguish and explain to others facts, relations, concepts, methods, and standards of practice, as well as appropriate methods for securing additional information. Skill goals entail the ability to independently apply knowledge accurately, efficiently, and effectively, i.e., to perform appropriate clinical tasks.
Skills
- Audiogram interpretation
- Audiologic case history taking
- Basic otoscopy
- Hearing aid troubleshooting
- Middle ear screening
- Pure-tone screening and threshold testing
- Speech threshold and word recognition testing
Knowledge
- Aging processes in hearing
- Assistive listening systems
- Auditory disorders and pathologies
- Distinctions between auditory habilitation and rehabilitation
- Hearing aid types, components and functions
- Language characteristics related to hearing loss
- Licensure and certification issues
- Pediatric auditory assessment
- Prediction of functional auditory skills
- Professional scope of practice
- Masing for pure-tone threshold testing and speech testting
- Reading and interpreting medical reports
- Referral standards and protocols
Awareness
- Central auditory processing disorders
- Disability arising from hearing impairment
- Eletrophysiologic auditory assessment
- Ethical issues
- Evaluation of test and test protocol performance
- Methods for early (neonatal) hearing screening
- Prevention of adult hearing loss
- Relations with professions allied to speech/language pathology
- Speech perception and production error patterns related to hearing loss
Additional goals for the course include providing experience in group and team projects, identifying audiological information sources of value to speech/language pathologists and their clients, and gaining an understanding of how various professions cooperate to assess and treat persons with disorders of hearing.
Com. Dis. 320 (or equivalent), or consent of instructor. It is expected that students will enter this course with a reasonable background in (1) basic acoustics and (2) the anatomy and physiology of the auditory system. If you are rusty in the second area, you are encouraged to undertake an independent review using the online resource Ear Works provided by the UW-Madison Department of Neurophysiology. Check it out--review the anatomy material and take the quiz. If you feel you need to review the damned decibel, see the instructor's Poor Man's Tour of the Decibel (a PDF file). Similarly, you might want to consult a Poor Man's Tour of Medcial Terminology (another PDF file) to address issues of technical jargon. Or for that matter, reminders about the metric system at a Poor Man's tour of Physical Quantities and Units (yet another PDF file).
FORMAT
Class sessions will consist of lectures, discussions, demonstrations, exams and group work. Occasionally, class time will be devoted to laboratory projects.
At the end of each class session, students are asked to write, sign, and turn in a "1-minute paper" which identifies (1) any important "Aha!" experiences arising during the session, and/or (2) any questions or concerns arising during the class session. These will be reviewed by the instructor at the beginning of the following class meeting.
The following text is required. Copies should be available at the University Bookstore.
Gelfand, S. A. (2001). Essentials of Audiology, 2nd Edition. New York, NY: Thieme
The course schedule (below) indicates when reading assignments from Gelfand's text are due. Material in this book will clarify lectures, demonstrations and other activities. Thus, you are strongly encouraged to complete reading assignments when they are due. Most students who take this course also find it useful to consult the audiology texts they used as undergraduates.
Additional readings will be provided as handout materials, as downloadable PDF files, or as WWW sites. Due dates for these readings will be given when they are distributed or noted in class. Other resources available via the Internet will be recommended or required as adjunct information sources or study materials.
The following documents (most of which were deveoped by ASHA) are required reading. Each can be accessed by clicking on the underlined citation below. Once accessed, they can be printed. Please note that PDF ("portable document format") files require Adobe Acrobat or a Web browser capable of displaying and saving such files. Current versions of Microsoft Internet Explorer, Apple Safari and Netscape Navigator offer this ability.
Several additional Web sites hosted external to the University of Wisconsin may be of interest. Click on the listings to access.
Still another source that may be of interest is a Web page containing reviews of aural rehabilitation Web sites by students formerly enrolled in this class (or in a similar course offered at St. Xavier University (Chicago)). This site can be accessed at
If you come across additional Web sites that you consider useful, please let the instrutor know via Email (please include a URL). Your suggestions can be added to the list just noted.
LABORATORY ACTIVITIES
Five laboratory ("learn by doing") activities are intended to provide experience in collecting, interpreting and reporting applications of clinical auditory protocols typically performed by speech/language pathologists in a variety of settings. Documentation of these activities (described below) will include brief written reports of activities. Feedback (grading) forms have been distributed for each activity. Please use these to guide your work and to prepare your reports. Feedback forms must be stapled to other material submitted for each lab activity.
TEST SUMMARY LOG
Students will prepare brief descriptions of five basic auditory tests, plus three additional, more specialized tests. These are intended for future reference and will include clinical indications and contraindications for each test, test goals, a summary of important test variables and procedures, test norms and outcomes, and guidelines for interpretation. The five basic tests include
- Pure-tone, air-conduction screening test
- Pure-tone, air-conduction threshold test
- Speech sensitivity (SRT) test
- Acoustic immittance screening test
- Word recognition (discrimination) test
Identify any two (2) additional tests from those discussed in class or in the textbook. A reporting form is provided below and as a PDF file.
Two examinations are planned, a midterm and a final. Both will be
open-book, team-based exercises. The midterm is to be completed
outside of class. The final will be an in-class activity. Additional
details will be provided.
PARTICIPATION
Students are expected to attend class and engage in discussion and
group work. Participation is indexed by regular completion of
"1-minute papers," and by willingness to connect class topics to
current events and personal experience during class sessions.
Student performance will be based upon the following. Note that 50% of course grades will be determined by individual student work and 50% will be determined by team-based work for which each member earns the grade assigned to the team.
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Contribution |
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Team-Based Exams (2) |
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Individual Lab Projects (numbers 1-4) |
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Individual Lab Project (number 5) |
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Individual Test Summary Logs (5) |
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Individual Participation |
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Late work may result in lowered grades. Grades for laboratory
projects, the mid-term and final exams, and the entire course will be
determined as follows:
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Percentage of |
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HOW TO CONTACT THE INSTRUCTOR
Because I have other duties, I will not be at Goodnight Hall on
Tuesdays, Thursdays or Fridays. Consequently, I can't offer the "open door and
waiting" policy I would prefer. If my office hours don't work for
you, I'll be more than happy to meet with you elsewhen. You can reach
me best by Email. I check for messages several times a day, and
normally can respond within 24 hours. Please remember that the Email
system gets pretty clogged up during the last week of the session,
and that it works better for some things (making appointments) than
for others (stuff requiring long explanations, graphs, etc.).
The goal of these activities is to give you reasons to consult relevant guidelines, and to conduct, interpret, and report basic audiologic procedures all but one of which fall within the current SLP scope of professional practice. The materials, equipment, and forms needed to conduct these activities will be located in Room 32, Goodnight Hall. The door lock-box combination has been noted in class. Use the sign-up sheet on the door to the room to schedule use of the space. Be sure Room 32 is clean and in order when you leave it. Except as noted below, no equipment or materials are to be removed from this room.
1. Otoscopy
NOTE: consult the following reference prior to beginning this exercise: Carney, A. S., and Birchall, J.P. (1995). "How to Use an Otoscope" British Student Medical Journal. You can link to it here (a Web page). It also will be useful to see what ASHA has to say about otoscopy here (a PDF file).Using an otoscope, examine six ears of your classmates. Use fresh specula for each person to avoid cross contamination. Take care not to scrape the wall of the canal with the specula of the otoscope, nor to drive cerumen into the canal. For each ear you examine, write a descriptor of what you see, noting (1) "normal", or (2) any observed abnormalities of the TM or ear canal. Also note the time required to make your observations. If you cannot visualize the TM (due to subject discomfort, canal shape, or cerumen), simply say so in your description.
Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
2. Pure-Tone Screening and Threshold Audiometry
NOTE: you will find it helpful to complete a test summary log for screening audiometry and for threshold audiometry prior to beginning this exercise.Conduct both screening and threshold pure-tone, air-conduction audiometry for three subjects using appropriate procedures. Complete both screening and threshold measures during the same session for each subject. Results for both screening and threshold measures should be recorded on a single audiogram for each subject.
Screening will be done at 20 dB HL for air-conduction tones of 1000, 2000, and 4000 Hz. Threshold audiometery will be done for air-conduction tones of 250, 500, 1000, 2000, 4000, and 8000 Hz. Both ears should be tested for each subject. The Latin designation for the right ear is "arus dexter" (AD), and for the left ear "aurus sinister" (AD).
One of your three subjects should be tested twice, once while wearing an insert, formable hearing protector (available at most durg stores and hardware stores) in one ear. Inspect the ear canal prior to the test (to insure freedom from excessive cerumen) and have the subject insert an ear plug. This will serve to simulate a unilateral conductive hearing loss. By law, hearing protectors are labeled with a value called "NRR," which stands for "noise reduction rating" in decibels. For the subject tested with a hearing protector, compare this very rough estimate of effect to the difference you observe in screening test and threshold test results, with and with out the hearing protector.
Supplement your data with a brief written report that (1) summarizes your results, (2) screening test decision outcomes (i.e., pass-fail), (3) recommendations for follow-up procedures (if any), (4) compares results to relevant norms (i.e., the range of "normal hearing"), and (5) considers test procedures, and test or subject variables that may have influenced your results. Also note the time required to collect data.
Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
3. Speech Audiometry
NOTE: you will find it helpful to complete a test summary log for SRT and word recognition testing prior to beginning this exercise.Conduct spondee recognition threshold (SRT) and word recognition (WR) tests for one ear of each of three subjects. All measures are to be obtained using recorded materials (CD-audio) and the audiometers and sound chambers located in Room B-32. Use the CID-W-1 list for the SRT test and the NU-6 (female talker) list for the WR test. The presentation level for WR tests will be 40 dB re: the SRT result for the respective ear. For one of your three subjects, inspect the ear canal prior to the test (to insure freedom from excessive cerumen) and have the subject insert an ear plug. Repeat both tests (SRT and WR) with the ear plug in place. Document results.
Supplement your data with a brief written report that (1) summarizes results in terms of each person's ability to communicate, (2) recommendations for follow-up procedures (if any), (3) compares results to relevant norms, and (4) considers test environment, test procedures, and test or subject variables that may have influenced your results. Also note the time required to collect data.
Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
4. Acoustic Immittance Screening
NOTE: you will find it helpful to complete a test summary log for acoustic immittance screening prior to beginning this exercise.Following ASHA (1990) procedures, obtain a measurement-plane acoustic immittance typmanogram in one ear for each of three subjects using a 226-Hz probe tone. You should also perform visual inspection (otoscopy), but it is not necessary to perform screening audiometry. Determine the presence or absence of an ipsilateral acoustic reflex in the test ear using a 1000-Hz tone activator at 95 dB HL. Using the recorded typanogram, determine (1) peak typanometric pressure, (2) compensated static acoustic admittance, (3) tympanogram width and (4) equivalent ear-canal admittance (volume) for each subject.
Supplement your data with a brief report that (1) summarizes your results, (2) screening test decision outcomes (i.e., pass-fail), (3) recommendations for follow-up procedures (if any), (4) compares results to relevant norms, and (5) considers test environment, test procedures, and test or subject variables that may have influenced your results. Also note the time required to collect data.
Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
5. Patient / Client Interview
NOTE: you will find it helpful to review the current (2000) World Health Organization (WHO) terminology system prior to beginning the exercise.Identify a person with a known hearing loss (this may be a family member, friend, colleague). Conduct an informal interview of this person for the purpose of answering the following questions. Do not disclose the identity of the person you interview unless you have their written permission to do so. Note the age, gender, and employment or school status of your informant.
- What do you think caused your hearing loss?
- Why do you think it started when it did?
- What do you think your hearing loss does to you?
- How severe is it?
- What professionals have you consulted about it and what help, if any, did they provide?
- What are the chief difficulties (e.g., occupational, social, interpersonal, recreational, etc.), you experience as a result of your hearing loss?
- What do you do to deal with the loss and how effective are those actions?
Submit a brief report (no more than two typed pages) that summarizes the "predicament" (see your notes about the WHO terminology system) of the person you interviewed. Feel free to quote the person directly, but do not simply transcribe your interview.
Answer the following question in your report: How (if at all) does the 2000 revision of WHO terminology describe this individual or how they might be treated?
Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
Name of Test or Procedure _____________________________________________________________
Purpose (Strategic Goal)
Indications for the Test
Special Challenges and Responses
Test Outcomes and Interpretations
Follow-Up Procedures
Test Performance (if relevant and available)
Current References (use APA style)
NOTES
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_____________________________________________________________________________________________
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Before you turn in your work, attach (staple) a copy of the feedback (grading form) for this activity. Enter your name and date on the form.
COURSE SCHEDULE Summer, 2004
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TOPIC OR ACTIVITY WORK DUE READING ASSIGNMENT |
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June 14 |
Introduction / Overview / Goal-Setting/Simulation
Exercise |
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June 16 |
Scope of Practice, Ethics, the Medical Paradigm |
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June 21 |
Clinical Decision Analysis; Auditory Pathologies |
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June 23
June 28 |
Auditory Pathologies (cont.); Medical Referral Criteria;
Otoscopy Briefing & Demonstration LAB Session 1 |
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June 30
July 7 |
Pure Tone Screening and Threshold Audiometry: Air &
Bone; Demonstration; LAB Session 2 |
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July 12
July 14 |
Speech Audiometry; Audiologic Case Histories LAB Session 3 |
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July 19 |
Diagnostic Tests, Audiogram Interpretation |
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July 21
July 26 |
Acoustic Immittance; Tympanometry; Demonstration LAB Session 4 |
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July 28 |
Counseling Strategies |
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Aug. 2 |
Electrophysiologic Audiometry (ABR & OAE) |
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Aug. 4 |
Occupational Hearing Conservation |
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Hearing Aids and Amplification Systems; Hearing Aid
Troubleshooting |
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Issues in Pediatric Testing |
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Review and Catch-Up |
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In-Class Group Final Exam |
