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erroneous hearing loss (EHL) |
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functional HL pseudohypacusis psychogenic deafness (unconscious psychodynamics) malingering (conscious or deliberate) |
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functional HL and pseudohypacusis |
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both are referring to someone who is consciously showing a hearing loss that isn't there |
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psychological issue that is causing a physical problem |
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also conscious showing usually a negative term don't like to use this term anymore |
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signs to alert audiologist to the possibility of NOHL |
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nonaudiometric indicators audiometric indicators |
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nonaudiometric indicators |
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often late for appointments exhibit behaviors that are exaggerated reason for referral (usually late because then they think that the audiologist will be rushed and won't look too much into it to see what's actually going on- exaggerate behaviors beginning in the waiting room: cup ear or say what? when their name is called; usually those who have an actual HL do not try to draw attention to themselves and will pay extra attention to make sure they hear their name being called) |
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poor test-retest reliability speech recognition that is good to excellent at admitted threshold SRT is not within 10 dB of PTA presence of unilateral HL without crossover to the other ear (lack of shadow curve) acoustic reflexes present in an ear with thresholds that are in the severe or greater range -usually exaggerate an already existing HL (for unilateral or fake)= very hard to determine this kids with many ear infections will often use HL to get special attention |
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1. stenger 2. delayed auditory feedback (DAF) 3. lombard 4. swinging story (varying intensity story) 5. ABR or OAE |
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used whenever a unilateral loss is expected present tone at a level that they're responding to in the test ear, start at a lower level and begin to increase it in steps get to the point where it's the same because they're now hearing it in their bad ear and they're trying to pretend they have a HL, they will stop responding |
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the stenger principle states that |
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if two sounds are presented to both ears simultaneously, only the louder of the stimuli will be perceived, even if you have normal thresholds |
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delayed auditory feedback
present material slightly delayed, they begin to stutter and stammer evidence of when they can hear their voice at that level |
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as noise in the background increases, you automatically raise your voice white noise presented in the background and increases in level and if clients voice starts to get louder, they obviously hear that background noise even if they're saying that they don't hear it |
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need to have an audiometer with two channels and presenting it at various times either at one ear or both ears, and it switches back and forth |
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advantage of ABR: can use stimuli for both low freq sounds and another tone is for high freq broadband |
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tell me when you hear a sound and when you don't hear a sound they'll say no when they do hear it if they're trying to get you to think that they have a hearing loss however, they wouldn't say no after a beep that they didn't actually hear |
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behavior vs test results SRT vs PTA ABG and Type A tymp -never want to blame the patient= want to blame yourself re-instruct and check equipment some people think "oh okay i can get out of this by doing it right the next time" and then nobody has to be confronted about anything role of psychologist or refer back to pediatrician write down that there are inconsistencies in the test results if it's unconscious- definitely in the realm of a psychologist |
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