SEMESTER III B3.1 Voice and its Disorders

Hour - 60                                                                                                        Marks -100

Objectives:

·         After completing this course, the student will be able to

·         describe characteristics of normal voice and identify voice disorders

·         explain etiology related to voice problems, and its pathophysiology

·         assess voice disorders

·         provide counselling and therapy to individuals with voice disorders

Unit 1: Basic concepts in voice and its production

·         Definition and functions of voice – biological and non-biological

·         Parameters of voice

·         Structures and function of respiratory system for the purpose of phonation

·         Laryngeal anatomy – Structural support of larynx, muscles, vocal fold

·         microstructure, blood supply, and innervations

·         Vocal tract resonance and voice quality

·         Development of voice: Birth to senescence; structural and voice related changes

·         Aerodynamic myo-elastic theory of voice production

·         Voice mechanics – Physiologic, acoustic and aerodynamic correlates of voice

·         Pitch and loudness changing mechanism, voice registers and voice quality

·         Description of normal and abnormal voice: Parametric, pathologic/perceptual, social

Unit 2: Characteristics and pathophysiology of voice disorders

·         Pathologies of the laryngeal mechanism: classification of voice disorders, incidence,

·         and prevalence

·         Etiology of voice disorders: voice misuse and abuse, medical related etiologies,

·         primary disorder etiologies and personality related etiologies

·         Pathologies of vocal fold cover (infective and trauma related secondary conditions)

·         and muscular dysfunction

·         Non-organic voice disorders: functional disorders, psychosomatic- functional

·         aphonia and physiological- voice abuse, puberphonia)

·         Congenital voice disorders

·         Neurological voice disorders

·         Voice problems in systemic illnesses and endocrine disorders

·         Voice problems in transgenders

·         Voice problems in the elderly

·         Voice problems in professional voice users: teachers and singers

Unit 3: Assessment of voice

·         Referral sources, medical examination and team approach

·         Protocol for voice assessment: components and philosophies (ICF, ICD)

·         Clinical voice laboratory: principles of instrumental measurements – electrical error,

·         electrical safety, hygiene safety; recording of data; storage; patented soft wares, free

·         wares

·         Perceptual evaluation of voice: GRBAS, CAPE -V

·         Visualization procedures- indirect laryngoscopy, video laryngoscopy & stroboscopy

·         Acoustic analysis of voice: F0 related measures, intensity related measures, quality

·         related measures, phonetogram, DSI

·         Electroglottography and inverse filtering procedures

·         Aerodynamic analysis of voice: static & dynamic measures

·         Self-evaluation of voice : PROM, VHI, V-DOP

·         Reporting of voice findings, normative comparisons, differential diagnosis

Unit 4: Management of voice

·         Voice therapy orientation: basic principles, goal setting and approaches

·         Vocal hygiene and preventive counselling

·         Symptomatic voice therapy – voice facilitation techniques

·         Psychological approaches to voice therapy – psychoanalysis, rational emotive

·         therapy and cognitive behavior therapy

·         Physiological approach – breathing and postural techniques

·         Holistic voice therapy approaches -1: accent therapy, confidential voice therapy,

·         Holistic voice therapy approaches - 2: vocal function exercises, resonant voice

·         therapy, Lee Silverman voice therapy

·         Medical and surgical procedures in the treatment of benign vocal fold lesions:

·         pharmaceutical effects on voice, phono surgery : re-innervation techniques, laryngeal

·         framework surgeries, micro laryngeal excision

·         Professional voice care

Unit 5: Intervention strategies for voice disorders

·         Vocal trauma related disorders

·         Functional voice disorders – inappropriate vocal components

·         Functional aphonia

·         Puberphonia/mutational falsetto

·         Muscle tension dysphonia

·         Sulcus vocalis

·         Vocal fold palsy

·         Spasmodic dysphonia

·         GERD/LPR

·         Benign vocal fold lesions requiring surgical intervention

·         Post-operative care for benign vocal fold lesions disorders

·         Documenting voice therapy outcomes

Practicals

Record phonation and speaking samples (counting numbers) from five children, adult

men, adult women, geriatric men and geriatric women. Note recording parameters

and differences in material.

Make inferences on age and sex differences across the samples obtained in the

previous experiment using perceptual voice profiling. Make a note of differences in

pitch, loudness, quality and voice control. Explain how voice reflects ones

personality and other social needs.

Perform an acoustic voice analysis on phonation sample and generate a voice report

based on acoustic findings. Compare findings between men & women.

Perform MPT and s/z ratio. Infer differences across age and sex.

Perform spirometry or any other appropriate aerodynamic procedure. Infer

differences across age and sex.

Perform acoustic analysis on five abnormal voice samples.

Observe and document findings from five laryngeal examinations (pre-recorded or

live) such as VLS, stroboscopy or any other relevant.

Administer a PROM on five individuals.

Prepare a vocal hygiene checklist.

Demonstrate therapy techniques such as vocal function exercise, resonant voice

therapy, digital manipulation, push pull, relaxation exercises.

Recommended Reading

1.      Stemple, J. C., Glaze, L. E., & Gerdeman, B, K. (2014). Clinical voice pathology: Theory & Management (5th Ed.). San Diego: Plural publishers.

2.      Aronson, A.E. & Bless, D. M. (2009). Clinical Voice Disorders.(4th Ed.). New York: Thieme, Inc.

3.      Boone, D. R., McFarlane, S. C, Von Berg, S. L. & Zraick, R, I. (2013): The Voice and Voice Therapy. (9th Ed.). Englewood Cliffs, Prentice-Hall, Inc. New Jersy.

4.      Professional Voice: Assessment and Management. Proceedings of the national workshop on “Professional Voice: Assessment and management”, 9-10 Dec 2010.

5.      All India Institute of Speech & Hearing, Mysore. 2010. Andrews, M. L. (2006). Manual of Voice treatment: Pediatrics to geriatrics (3rd Ed.) Thomson Delmar Learning.

6.      Colton, R. H, Casper, J. K. & Leonard, R. (2006). Understanding voice problems Baltimore: Williams & Wilkins. Sapienza, C. M., & Ruddy, B H. (2013). Voice Disorders.(2nd Ed.). San Diego: Plural Publisher.

7.      Voice: Assessment and Management. Proceedings of the national workshop on “Voice: Assessment and management”, 14-15 Feb 2008. All India Institute of Speech & Hearing, Mysore. 2008.

B3.2 Speech Sound Disorders

Hour - 60                                                                                                        Marks -100

Objectives:

·         After completing this course, the student will be able to

·         describe normal speech sound development and characterization of individuals with

·         speech sound disorders.

·         perform phonological analysis and assessment of speech sound disorders.

·         plan intervention for individuals with speech sound disorders.

Unit 1: Speech sound acquisition and development

·         Fundamentals of articulatory phonetics - phonetic description of vowels & consonants.

·         Phonology & phonological theories – generative phonology, natural phonology.

·         Phonology & phonological theories – non-linear phonology, optimality theory.

·         Methods to study speech sound acquisition – diary studies, cross sectional studies and longitudinal studies.

·         Speech sound acquisition

·         birth to one year (development of infant speech perception, early speech production).

·         one to two years (consonant inventories, influence of phonological knowledge on vocabulary acquisition).

·         two to five years (growth of phonetic, phonemic, phonotactic inventory – consonants, clusters, phonological patterns). above five years (speech sound mastery and development of literacy – phonological awareness).

·         Factors influencing speech sound acquisition

·         Acoustics of speech sounds

·         Speech intelligibility, factors affecting speech intelligibility, assessment of speech intelligibility

·         Co articulation: types and effects

·         Phonological development in bilingual children.

·         Phonological development in Indian languages.

Unit 2: Assessment of speech sound disorders - I

Current concepts in terminology and classification of speech sound disorders

·         Organically-based speech sound disorders, childhood apraxia of speech.

·         Speech sound disorders of unknown origin, classification by symptomatology.

Factors related to speech sound disorders

·         structure and function of speech & hearing and oro-sensory mechanisms.

·         cognitive – linguistic, psychosocial and social factors.

·         metalinguistic factors related to speech sound disorders.

·         Introduction to assessment procedures: aims of assessment, screening and comprehensive assessment.

·         Speech sound sampling procedures - issues related to single word and connected

·         speech samples; imitation and spontaneous speech samples, contextual testing, recording of speech samples.

·         Review of tests in English and other Indian languages - Single word articulation tests, deep articulation of articulation, and computerized tests of phonology.

·         Influence of language and dialectal variations in assessment.

·         Transcription of speech sample - transcription methods –IPA and extension of IPA; broad and narrow transcription.

Unit 3: Assessment of speech sound disorders – II

·         Introduction to independent and relational analysis.

·         Independent analyses – phonetic inventory, phonemic inventory and phonotactic inventory (utility of independent analysis for analysis of speech of young children and children with severe speech sound disorders).

·         Relational analyses – SODA, pattern analysis, (distinctive features, phonological process analysis).

·         Phonological processes analyses - language specific issues, identification and classification of errors.

·         Assessment of oral peripheral mechanism.

·         Speech sound discrimination assessment, phonological contrast testing.

·         Stimulability testing.

·         Determining the need for intervention – speech intelligibility and speech severity assessment.

·         Factors influencing target selection – stimulability, frequency of occurrence, developmental appropriateness, contextual testing, and phonological process analysis.

·         Case study – Documenting the assessment findings and determining the need for intervention.

Unit 4: Management – I

·         Basic considerations in therapy – target selection, basic framework for therapy, goalattack strategies, organizing therapy sessions, individual vs. group therapy.

·         Treatment continuum – establishment, generalization and maintenance; measuring clinical change.

·         Facilitation of generalization.

·         Maintenance and termination from therapy.

·         Motor-based treatment approaches – Principles of motor learning.

·         Discrimination/ear training and sound contrast training.

·         Establishing production of target sound – imitation, phonetic placement, successive approximation, context utilization.

·         Traditional approach, contextual/sensory-motor approaches.

·         General guidelines for motor-based treatment approaches.

Unit 5: Management – II

·         Core vocabulary approach.

·         Introduction to linguistically-based treatment approaches- Distinctive feature therapy.

·         Minimal pair contrasts therapy.

·         Metaphon therapy, Cycles approach.

·         Broad-based language approaches.

·         General guidelines for linguistically-based approaches.

·         Phonological awareness and phonological disorders.

·         Phonological awareness intervention for preschool children.

·         Adapting intervention approaches to individuals from culturally and linguistically diverse backgrounds.

·         Role of family in intervention for speech sound disorders.

Practicals

List the vowels and consonants in your primary language and provide phonetic and

acoustic descriptions for the speech sounds.

Identify the vowels and consonants of your language on the IPA chart and practice

the IPA symbols by transcribing 25 words.

Make a list of minimal pairs (pairs of words which differ by only one phoneme) in

English.

Make a list of minimal pairs in any language other than English.

Identify the stages of speech sound acquisition by observations from videos of

children from birth to 5 years of age.

Record the speech of a two year old typically developing child, transcribe and

analyze the speech sample.

Record the speech of one typically developing child from 3-5 years of age (include

single word and connected speech samples), transcribe the sample, and perform

phonological assessment.

Analyze transcribed speech samples of typically developing children – practice

independent and relational analysis.

Practice instructions for phonetic placement of selected sounds.

Develop a home plan with activities for any one section of phonological awareness in

English and in one Indian language.

Recommended Reading

·         Bernthal, J.E., Bankson, N.W., & Flipsen, P. (2013). Articulation and phonological

disorders.(7th Ed.). Boston, MA: Pearson.

·         Dodd, B. (2013). Differential diagnosis and treatment of children with speech

disorder.(2nd Ed). NJ: Wiley.

·         Rout, N (Ed)., Gayathri, P., Keshree, N and Chowdhury, K (2015). Phonics and

Phonological Processing to Develop Literacy and Articulation; A Novel Protocol. A publication by NIEPMED, Chennai. Freely downloadable from

http://niepmd.tn.nic.in/publication.php. ISBN 978-81-928032-9-5

B3.3 Diagnostic Audiology: Behavioural Tests

Hours – 60                                                                                                                  Marks – 100

Objectives:

After completing this course, the student will be able to

choose individualized test battery for assessing cochlear pathology, retro cochlear

pathology, functional hearing loss, CAPD, vestibular dysfunctions, tinnitus and

hyperacusis independently run the tests and interpret the results to identify the above conditions and also use the information for differential diagnosis make adjustments in the test parameters to improve sensitivity and specificity of tests. make appropriate diagnosis based on the test results and suggest referrals.

Unit 1: Introduction to diagnostic audiology

·         Characteristics of a diagnostic test, difference between screening and diagnostic test, functions of a diagnostic test in Audiology

·         Need for test battery approach in auditory diagnosis and integration of results of

           audiological tests, cross-check principle

·         Concept of sensitivity, specificity, true positive, true negative, false positive, false negative, hit rate

·         Definition of behavioural and physiological tests and their characteristics in diagnostic audiology

·         Theories and physiological bases of recruitment

·         Theories and physiological bases of adaptation

·         Clinical indications for cochlear pathology, retro-cochlear pathology, central auditory processing disorders, functional hearing loss, vestibular disorders

Unit 2: Tests to identify cochlear and retro cochlear pathology

·         ABLB, MLB and SISI tests

·         Behavioural tests of adaptation

·         Bekesy audiometry

·         Brief tone audiometry

·         PIPB function

·         Glycerol test

·         Test to identify dead regions of cochlea

Unit 3: Tests to diagnose functional hearing loss

·         Behavioural and clinical indicators of functional hearing loss

Pure tone tests including tone in noise test, Stenger test, BADGE, puretone DAF

Speech tests including Lombard test, Stenger test, lip-reading test, Doerfler-Stewert

test, Low level PB word test, Yes-No test, DAF test,

·         Identification of functional hearing loss in children: Swinging story test, Pulse tone methods

Unit 4: Assessment of central auditory processing

·         Definition, different behavioral processes

·         Behavioral and clinical indicators of central auditory processing disorders

·         Bottle neck and subtlety principles and their implications in

·         Tests to detect central auditory processing disorders

Monaural low redundancy tests - filtered speech tests, time compressed speech test,

speech-in-noise test, SSI with ICM, other monaural low redundancy tests.

Dichotic speech tests – Dichotic digit test, Staggered spondaic word test, Dichotic

CV test, SSI with CCM, Competing sentence test, other dichotic speech tests.

Binaural interaction tests – RASP, BFT, MLD, other binaural interaction tests

Tests of Temporal processing – pitch pattern test, duration pattern tests, other

temporal ordering tests, gap detection test, TMTF

·         Variables influencing the assessment of central auditory processing: Procedural  and subject variables

·         Test findings of important tests in subjects with central auditory disorders: brainstem lesion, cortical, CAPD in children.

Unit 5: Assessment of persons with vestibular disorder, tinnitus, hyperacusis

·         Introduction to structure and function of vestibular system

·         Vestibular ocular reflex and vestibulo spinal reflex

·         Overview on other systems involved in balance

·         Signs and Symptoms of vestibular disorders

·         Team in the assessment and management of vestibular disorders

·         Behavioral tests to assess vestibular functioning: Fukuda stepping test, tandem gait test, finger nose pointing, Romberg test, Sharpened Romberg test, Dix-Hallpike test, Log-roll test

·         Overview of tinnitus and hyperacusis and tests for assessment

·         Pitch matching, loudness matching, residual inhibition, Feldman masking curves Johnson Hyperacusis Dynamic Range Quotient

Practicals

Administer ABLB, MLB and prepare ladder gram (ABLB to be administered by

blocking one ear with impression material)

Administer classical SISI on 3 individuals and note down the scores

Administer tone decay tests (classical and its modifications) and note down the

results (at least 3 individuals)

Administer Bekesy audiometry

Administer Brief tone audiometry

Plot PIPB function using standardized lists in any 5 individuals

Administer the tests of functional hearing loss (both tone based and speech based) by

asking subject to malinger and having a yardstick of loudness.

Administer CAPD test battery to assess different processes on 3 individuals and note

down the scores

Administer Fukuda stepping test, Tandem gait test, Finger nose pointing, Romberg

test, Sharpened Romberg test, Dix-Hallpike test, Log-roll test on 5 of the individuals

each and note down the observations.

Estimate the pitch and loudness of tinnitus in 2 persons with tinnitus (under

supervision). Assess the residual inhibition in them.

Plot Feldman masking curves for a hypothetical case

Administer Johnson Hyperacusis Dynamic Range Quotient on any 2 of the

individuals and note down the scores.

Recommended Reading

·         Gelfand, S. A. (2009). Essentials of Audiology. Thieme.

·         Hall, J. W., & Mueller, H. G. (1996). Audiologists’ Desk Reference: Diagnostic

audiology principles, procedures, and protocols. Cengage Learning.

·         Jerger, J. (1993). Clinical Audiology: The Jerger Perspective. Singular Publishing

Group.

·         Katz, J., Medwetsky, L., Burkard, R. F., & Hood, L. J. (Eds.). (2007). Handbook of

Clinical Audiology (6th revised North American edition). Philadelphia: Lippincott

Williams and Wilkins.

·         Martin, F. N., & Clark, J. G. (2014). Introduction to Audiology (12 edition). Boston:

Pearson.

·         Roeser, R. J., Valente, M., & Hosford-Dunn, H. (2007). Audiology: Diagnosis.

Thieme.

·         Stach, B. A. (2010). Clinical audiology: an introduction (2nd ed). Clifton Park, NY:

Delmar Cengage Learning.

B.3.4 Amplification Devices

Hours - 60 Marks - 100

Objectives:

After completing this course, students will be able to

assess the candidacy for hearing aids and counsel accordingly

evaluate the listening needs and select the appropriate hearing aid

independently program digital hearing aids as per the listening needs of the client

independently assess the benefit from the hearing aid using subjective and objective

methods

make all types of ear molds

counsel the parents/care givers at all stages

Unit 1: Types of hearing aids

·         Historical development of hearing aids: development of concept of amplification,

·         development of different types of amplification devices

·         Review of basic elements of hearing aids: Microphone, Amplifier, Receiver/vibrator,

·         Cords, Batteries.

·         Classification and Types of hearing aids

·         Body level, ear level, in the ear, ITC, invisible in the canal, CIC

·         Binaural, pseudo binaural, monaural

·         Programmable, trimmer digital and digital hearing aids

·         Directional hearing aids, modular hearing aids

·         RIC hearing aids

·         Implantable hearing aids

·         Master hearing aids

·         CROS hearing aids

·         Group amplification – hard wired, induction loop, FM, infrared

·         Assistive listening devices – types and selection (Telephones, Television, typing technology)

Unit 2: Technological aspects in hearing aids

·         Routing of signals, head shadow/baffle/diffraction effects

·         Output limiting and issues related to them: peak clipping, compression

·         Concept and use of compression in hearing aids: BILL, TILL, PILL, Wide Dynamic

·         Range Compression, Syllabic Compression, Dual Compression

·         Signal processing in hearing aids – BILL, TILL, PILL

·         Signal enhancing technology

·         Noise reduction algorithms

·         Extended low frequency amplification, frequency lowering technology

·         (transposition, compression)

·         Recent advances in hearing aids

Unit 3: Electro-acoustic measurements for hearing aids

·         Purpose and Parameters to be considered: OSPL90, SSPL90,HFA SSPL90, Gain,

            Full on Gain, HFA Full on Gain, Reference test Gain, Basic Frequency Response,

            Total Harmonic distortion, Intermodulation Distortion, input Output functions,

            instrumentation, procedure, variables affecting EAM

·         Electro-acoustic measurements, BIS, IEC and ANSI standards

·         Environmental tests.

·         Care, maintenance and troubleshooting of hearing aids

·         Counselling and orienting the hearing aid user (Client and significant others)

Unit 4: Selection of hearing aids

·         Pre-selection factors; Prescriptive and comparative procedures; Functional gain and

insertion gain methods; Use of impedance, OAEs and AEPs audiometry; Hearing

aids for conductive hearing loss; Hearing aids for children; Hearing aids for elderly;

Selection of non-linear programmable and digital hearing aids

·         Hearing aid programming

·         Methods for assessing hearing aid benefit

·         Real ear insertion measurements for verification of hearing aid benefit: REIG,

REUR, REAR, REOR, RESR, REIG, REAG, RECD

·         Acoustic feedback in hearing aids

Unit 5: Mechano-acoustic couplers (Ear molds)

·         Different types of molds

·         Procedure for hard molds and soft mold

·         UV curing methods

·         Special modifications in the ear molds: Vents (diagonal and parallel), deep canal molds, short canal, horns, Libby horn, reverse horn, acoustic modifier

·         Effects of mechano-acoustic couplers on the hearing aid output

Practicals

Listen to the output of different types and classes of hearing aids (monaural, binaural,

analog, digital hearing aids), in different settings

Troubleshoot hearing aids: Check the continuity of the receiver cord using multi

meter, measure the voltage of different sized batteries using multi meter, Check

voltage of batteries different types and sizes

Carry out electroacoustic measurements for the body level and ear level hearing aids

Program the hearing aid for different configuration and degrees of hearing loss (at

least 5 different audiograms) using different prescriptive formulae

Program the hearing aid for different listening situations (at least 3 different

situations)

Vary the compression settings in a digital hearing aid and note down the differences

in the output

Perform real ear insertion measurements using different hearing aids (body level and

ear level, hearing aids of different gains)

Compare speech perception through conventional BTE and RIC hearing aids using a

rating scale

Observe assistive listening devices such as telephone amplifier, vibro-tactile alarms,

note down the candidacy and their utility.

Administer a questionnaire to assess hearing aid benefit on 2 persons using hearing

aids.

Carry out a role play activity of counselling a hearing aid user

Ear Molds

Take impression for the ear mold using different techniques, different methods

and using different materials

Make hard mold for any 2 ears

Make soft mold for any 2 ears

Make vent in hard molds you made

Recommended Reading

·         Dillon. (2012). Hearing Aids (2 edition). Thieme Medical and Scientific Publisher.

·         Hall, J. W., & Mueller, H. G. (1998). Audiologists’ Desk Reference: Audiologic management, rehabilitation, and terminology. Singular Publishing Group.

·         Kates, J. M. (2008). Digital Hearing Aids (1 edition). San Diego: Plural Publishing Inc.

·         Metz, M. J. (2014). Sandlin’s Textbook of Hearing Aid Amplification: Technical and Clinical Considerations. Plural Publishing.

·         Mueller, H. G., Hawkins, D. B., & Northern, J. L. (1992). Probe Microphone Measurements: Hearing Aid Selection and Assessment. Singular Publishing Group.

·         Mueller, H. G., Ricketts, T. A., & Bentler, R. A. (2007). Modern Hearing Aids: Prefitting Testing and Selection Considerations: 1 (1 edition). San Diego, CA: Plural Publishing Inc.

B3.5 Clinicals in Speech Language Pathology

Marks – 100

General considerations:

Exposure is primarily aimed to be linked to the theory courses covered in the

semester.

After completion of clinical postings in Speech –language diagnostics, the student

will know (concepts), know how (ability to apply), show (demonstrate in a clinical

diary/log book based on clinical reports/recordings, etc), and do (perform on patients/

client contacts) the following:

Know:

Procedures to obtain a speech language sample for speech & language assessment

from children of different age groups such as, pre schoolers, kindergarten, primary

school and older age groups.

Methods to examine the structures of the oral cavity/organs of speech.

The tools to assess language abilities in children (with hearing impairment, specific

language impairment & mixed receptive language disorder).

Development of speech sounds in vernacular and linguistic nuances of the language.

Know-how:

To evaluate speech and language components using informal assessment methods.

To administer at least two standard tests for childhood language disorders.

To administer at least two standard tests of articulation/ speech sounds.

To assess speech intelligibility.

Show:

Analysis of language components – Form, content & use – minimum of 2 samples.

Analysis of speech sounds at different linguistic levels including phonological

processes – minimum of 2 samples.

Transcription of speech language samples – minimum of 2 samples.

Analyse differences in dialects of the local language.

Do:

Case history - minimum of 5 individuals with speech & language disorders.

Oral peripheral examination - minimum of 5 individuals.

Language evaluation report – minimum of 5.

Speech sound evaluation report – minimum of 5.

Evaluation:

Internal evaluation shall be based on attendance, clinical diary, log book and learning

conference.

External evaluation: Spot test, OSCE, Record, Viva-voce, case work

B3.6 Clinicals in Audiology

Marks - 100

General considerations:

Exposure is primarily aimed to be linked to the theory courses covered in the

semester, however, not just limited to these areas.

After completion of clinical postings in auditory diagnostics and auditory

rehabilitation, the student will Know (concept), know how (ability to apply), show

(demonstrate in a clinical diary/log book), and do (perform on patients/ client

contacts) the following:

Know:

Methods to calibrate audiometer.

Materials commonly employed in speech audiometry.

Calculation pure tone average, % of hearing loss, minimum and maximum masking

levels.

Different types of hearing loss and its common causes

Know-how:

To obtain detailed case history from clients or parents/guardians.

To carryout commonly used tuning fork tests.

To administer pure tone audiometry including appropriate masking techniques on

adults using at least techniques

To administer tests to find out speech reception threshold, speech identification

scores, most comfortable and uncomfortable levels on adults.

Show:

Plotting of audiograms with different degree and type with appropriate symbols – 2

audiograms per degree and type

Detailed case history taken and its analysis

Calculation degree, type and percentage of hearing loss on 5 sample conditions

Do:

Case history on at least 5 adults and 3 children with hearing disorders

Tuning fork test on at least 2 individuals with conductive and 2 individuals with

sensori-neural hearing loss

Pure tone audiometry with appropriate masking on 5 individuals with conductive, 5

individuals SN hearing loss and 3 individuals with unilateral/asymmetric hearing loss – 5

Evaluation:

Internal evaluation shall be based on attendance, clinical diary, log book and learning

conference.

External evaluation: Spot test, OSCE, Record, Viva-voce, case work