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Nonorganic Hearing Loss. SPA 4302 Summer 2007. Some Terminology. __________________ – False hearing loss Functional – Loss with no organic disorder detected. _________________ – Loss/disorder arising from psychological conditions, older synonym was hysterical deafness

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Nonorganic hearing loss

Nonorganic Hearing Loss

SPA 4302

Summer 2007

Some terminology
Some Terminology

  • __________________ – False hearing loss

  • Functional – Loss with no organic disorder detected.

  • _________________ – Loss/disorder arising from psychological conditions,

    • older synonym was hysterical deafness

  • ______________ – Apparent loss with no known disorder or insufficient evidence to explain it

  • Malingering– deliberately faking a loss

Patients with nonorganic hearing loss
Patients with Nonorganic Hearing Loss

  • Adults seeking financial or other gain (predominantly ______________)

  • Children seeking attention or ?

  • Persons with psychological disorders

    • ________________________

What are the first signs
What are the first signs?

  • Disagreement:

    • among test results

      • _______ vs _______

      • Audiometric vs AR thresholds, etc)

    • between test results and behavior

  • Lack of __________________

    • no shadow curve in the unmasked results

  • Odd results

    • Repeating half of ______________?

Tests for nonorganic hearing loss
Tests for Nonorganic Hearing Loss

  • The __________ – for unilateral HL

  • Delayed Auditory Feedback Tests

    • ___________ Test

    • ________________ Test

  • Varying Intensity Story Test

  • Objective tests (AR, AEPs, OAEs)

The stenger
The Stenger

  • Based on the “________________” When a listener is presented with the same type of sound in both ears, s/he will only hear a single sound and hear it in the ear in which it is louder.

  • 2 tones:

    • At + 10 dB SL in good ear

    • At – 10 dB SL in “bad” ear

  • If no response: you’ve caught them! --why?

    • Part II: reduce level in “bad” ear until they respond: “minimum ___________ interference level” --an estimate of the true threshold.

Delayed auditory feedback tests
Delayed Auditory Feedback Tests

  • ________ speech test: Have pt talk while you play back their own voice to them with a 200 ms delay. Gradually ______ level: when they hear their own voice, they will change their speech (intensity, rate, fluency)

  • Pure tone _______ (Tone Tap Test): Have pt tap out a rhythm on a pressure transducer. Each tap will generate a tone. Gradually raise level of tone: when they hear the delayed tones, they will change their pattern of tapping.

Varying intensity story test
Varying Intensity Story Test

  • Patient is asked to listen to a story in one ear, parts are presented above the threshold and some parts are presented below the threshold

  • The story is presented ______________ difficult for listeners to distinguish what they can admit to have heard and what they should not

  • The listener is then asked questions about the story

  • The topic of discussion changes based on whether or not they could hear the parts of the story presented below their threshold

    • Information on china (dishes) is presented above threshold

    • Information on China (the country) is presented below the threshold and fits into the other story line

    • thus the story ___________ if the patient is faking a hearing loss

Objective tests ar aeps oaes
Objective tests (AR, AEPs, OAEs)

  • AR Өs at extremely low SL’s

    • e.g., pure tone Ө of 60 & AR Ө of 80.

    • SPAR: calculating ___________ from AR Өs

  • AEP’s : objective Ө estimation

    • Tests we’ve already discussed

    • ____________________________ (ASSRs)

  • OAEs: measures of ___________ health

    • Valuable in noise exposure cases in particular

Management of patients with nonorganic hearing loss
Management of Patients with Nonorganic Hearing Loss

  • Once you have identified the problem:

    • let them know you know

    • shift blame onto _____________

  • If they don’t come ‘round?...

    • don’t report audiometric thresholds if you don’t believe them

    • In your report, be careful about _____________ you choose.