SLP/Audiologists

Hi,

I'm working on an assignment for my audiology class. We each got a patient and have to write a letter to the referring doctor about whether or not the person needs or can respond to Speech Therapy. My guy has a 4k Hz. notch, so I was going to recommend speech therapy to compansate for the hearing loss. Should a hearing aid be used?

TIA,
Kelly

Here's my letter:


I saw your patient, ------, today at Bellevue Hospital Center to evaluate him for language competency after he suffered from a psychotic breakdown. He has a history of noise exposure due to shotgun use while hunting, as well as a history of cardiac problems.

Pure tone thresholds were consistent with essentially normal hearing bilaterally, with the exception of a bilateral moderate 4k Hz. sensorineural notch. His Speech Reception Thresholds were in acceptable agreement with the pure tone averages, bilaterally. His speech discrimination ability scores are excellent bilaterally at normal conversational level of 50 dB.

According to immitance testing, ---- tympanograms were type A, normal middle ear compliance, bilaterally. Acoustic reflexes were consistent with pure tone averages, with no response at 4k Hz. bilaterally. Acoustic reflex decay was negative bilaterally.

Based upon this information and my meeting with ---, I would recommend therapy at this time.

Re: SLP/Audiologists

My audiology class was a while ago and I haven't really been working with any patients with hearing loss lately...

but I'm not sure why you're recommending speech therapy. I think that I'd recommend hearing aids over speech therapy.

I'm not 100% though...

Re: SLP/Audiologists

I agree with Haley- I even pulled out one of my old Audiology texts.

From what Im reading, you have a pt with a sensorineural hearing loss bilaterally at 4K Hz? At 4000 Hertz, the only speech sounds he'd be "missing" would be fricatives such as the /s/ and /f/. Now, considering how much the /s/ occurs in English speech, it might be slightly confusing, but as long as the pt. knows the context of the conversations, he should be fine.

With a young child, a 4KHz hearing loss would be more serious and warrant more attention as they are still learning speech sounds and developing their language.

The only type of speech services I MIGHT recomend would be dealing with the social aspects of having a hearing loss. Working on conversation repair (instead of saying, "WHAT?" or "HUH?" when the pt misses information, teach him to say, "Did you say _____ or _____?"). In this case though, his hearing seems relatively mild at such a high frequency and would likely have little impact on his ability to communicate. I don't think it would warrant speech services.

Re: SLP/Audiologists

Re: SLP/Audiologists

Thanks so much for your input. I was thinking of therapy for speech repair, but I wanted to know if a hearing aid eliminate that need.

Re: SLP/Audiologists

I might be wrong (hey-it's been a few years since I took Audiology course), but can sensorineural hearing loss be improved with hearing aids? For some reason I'm thinking only conductive can.

Message edited 4/26/2008 1:30:34 PM.

Re: SLP/Audiologists

Yes, most elderly people have sensorineural hearing loss. There is also some kind of cochlear implant and cilia implants that can be done.

Re: SLP/Audiologists

Re: SLP/Audiologists

I agree w/ everyone else. No need for Tx.

You don't mention any deficits in speech or language, so you can't justify speech Tx.

From what I remember (and please correct me if I am wrong), a HA is still beneficial for someone w/ a sensorineural HL. From what I remember it would just not benefit from someone w/ damage to the 8th cranial nerve. Again, it's been a while, so if I am incorrect, please let me know.

Message edited 4/26/2008 2:52:01 PM.

Re: SLP/Audiologists