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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.