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Adult Aural Rehabilitation- Spring 2006 AUD 6316 Thursday 1:00 – 3:45 p.m.

Instructor: Carol Cokely, Ph.D. Office: A.238 Phone: x 3125 E-mail: Office Hours: Mon 1 -2 p.m.; Thurs 10 – 11 am; & by appointment Teaching Assistant: Laura Cantu Lab Instructor: Tara Reed, B.S. Course Objectives: Course content will be presented via learning modules listed below. This course is designed to foster active participation in the preparation and learning of content material. Directed activities and assigned experiences are intended to facilitate learning of course content. Development of written and oral communication skills commensurate with a doctoral degree is emphasized in all assignments.
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Counseling/Listening Identification of Rehabilitation Needs Intervention Models of Service Delivery

Course Grades: Students' grades will be determined based upon works completed for each content area. Each student will need to establish a goal based upon a menu of options. Each student will prepare a course contract that outlines the intended works and the point values. Contract forms must be agreed upon by January 27, 2005. Grades will be assigned as follows:
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A 900-1000 points B 800-899 points C 700-799 points F <700 points

Pending ASHA Standards: AUD 6316 provides academic and practical preparation towards the acquisition of the following required knowledge and skills: Standard IV-A- Prerequisite Knowledge and Skills A1. Oral and written or other forms of communication Standard IV-B – Foundations of Practice D2. Evaluate information from appropriate sources to facilitate assessment planning D3. Obtain Case History D6. Administer clinically appropriate and culturally sensitive assessment measures

D10. D12. D13. D14.

Perform aural rehabilitation assessment Interpret results of evaluation to establish type and severity of disorder Generate recommendations and referrals resulting from the evaluation process Provide counseling to facilitate understanding of the auditory or balance disorder

Standard IV-E- Treatment E1. Interact effectively with patients, families, other appropriate individuals, and professionals. E2. Develop and implement treatment plan using appropriate data E3. Discuss prognosis and treatment options with appropriate individuals E6. Collaborate with other service providers in case coordination E7. Perform hearing aid, assistive device and sensory aid assessment E8. Recommend, dispense and service prosthetic and assistive devices E9. Provide hearing aid, assistive listening device and sensory aid orientation E10. Conduct aural rehabilitation E11. Monitor and summarize treatment progress and outcome E12. Assess efficacy of intervention for auditory and balance disorders E13. Establish treatment admission and discharge criteria E14. Serve as an advocate for patients, families and other appropriate individuals Independent Learning Opportunities: The learning opportunities below will provide potential to investigate, observe and participate in activities that will enhance your knowledge and skills in rehabilitative audiology. With the exception of opportunity #6, all work should be completed independently. Independent learning opportunities must total 1000 points. ASHA standards denoted in brackets [ ] Grading for all written assignments will follow the following criteria. Expected content is described for each Independent Learning Opportunity: Content: 60 points Writing Style: 20 points Grammar/spelling: 20 points 1A)Counseling Module –(200 points total) [A1, E14, D13, D14] Essay Questions: 100 points - Due January 26, 2006 Answers to each question should not exceed 2 pages, double spaced. 1. Compare and contrast the behavioral, cognitive, humanistic, and existential approaches to counseling. How might each be used in the field of communication disorders? Defend your answer. 2. Describe the various emotions that a clinician might encounter in a person with a communication disorder or a family member. For each emotion, provide an example of a behavior that might interfere with the client-clinician relationship. Be sure to discuss denial and its role in the coping mechanism.

B Learning to Listen (100 points) Due March 2, 2006 Observe a videotaped clinician-patient interaction (to be provided). Complete the following exercises adapted from Clark and English (2004). The videotape and worksheet will be provided. 1. Case history/Information Gathering Audiologists’ interviewing style may have a profound impact not only on the type of information gathered but on the patient-clinician relationship as well. A clinician’s requests for information may be categorized in a number of ways: open-ended; closed; neutral; leading.For this part of the exercise, record only the supervisor’s statements as close to verbatim as possible. Indicate whether the example reflects an open-ended or closed inquiry and is neutral or leading. Support your choices. If you are unable to categorize a statement, state the reason. 2. Differentiating Patient’s Comments For this part of the assignment, gather patient comments. Audiologists must learn to recognize the true nature of a patient’s concern. Whereas the patient’s intent is not always easily understood, the true nature of the inquiry becomes easier to discern with listening practice and observation. Patient’s inquiry may be related to: Content (Information); Confirmation (affirm a preexisting belief); Affect - (pertains to an emotional need). Briefly justify your designations. Provide a paragraph describing your reaction to this exercise.

2) Needs assessment of an adult with hearing loss- (100 points) - [A1, D2, D3, D6, D10, D13, D14, E1, E3] -due March 16, 2006 Complete a comprehensive assessment of communication function and disability for an adult with suspected (or confirmed) hearing loss. A confirming audiogram is NOT necessary. You must choose self-assessment tool(s) that adequately address an appropriate scope of individual’s needs without substantial redundancy. Your completed assessment, placed securely in a folder, must include the following: • • • • original history forms, scales and inventories evidence of interpretation/scoring where appropriate a 3 -5 page summary that includes: summary of case history, integrative summary of patient’s self assessment(s), including which domain(s) you assessed; at least 3 recommendations for further action and support for your plan adherence to patient privacy

3) Accommodations for individuals with hearing loss –Total 100 points Access Guide to Public Accomodations in Metroplex (100 points) - due April 6, 2006- [A1,
E2, E8, E9, E14]

As a group, you will decide which public venues to investigate. Select a public venue where listening/hearing is expected [e.g. places of worship, theatres, movies, hotels, medical facilities, federal/state services, etc]. At least 6 venues should be addressed (more than 1 student may be assigned to a venue if it is deemed large). Once venues are selected, each student works independently. For selected venue, investigate at least 10 sites within the metroplex as regards to communication access for individuals with hearing loss (investigation may be by phone call). Prepare in form of patient handout that includes a rating system. For each facility, determine: • • • • • type(s) of technology available for individuals with hearing loss Indicate if/how device may be coupled with hearing aid how target population is informed about its availability whether a staff member has appropriate training/knowledge of device(s) whether facility adheres/cognizant of ADA requirements

4) Adult Hearing Loss Support Group (100 points) due one week after visit; by March 16 . [A1, D14, E1, E6, E9, E14] Attend one Hearing Loss Support Group meeting (e.g. HLAA (formerly SHHH); Cochlear Crusaders.). [Cochlear Crusaders: 3rd Sat of month- Deep Ellum; HLAARichardson: 2nd Thurs eve of month; HLAA Ft. Worth: 2nd Sat of month] Provide a 2 page, double-spaced summary in which you: • • • summarize the content of the meeting indicate how the information might be beneficial in counseling and managing your patients discuss how meeting content and/or experience is related to you have learned/observed in this course

5) Review of the Literature (100 points) [A1; E12] Due-date April 7, 2006 Audiologists who provide aural rehabilitation do so because they believe the intervention is beneficial. Three articles, cited below, address the timely and important issue of evidenced-based practice as it pertains to rehabilitation of adults with hearing loss. Based upon these works, write a 2 - 3 page paper that addresses the following question: “Is Adult Aural Rehabilitation Beneficial?” This is not an “opinion” essay but should reflect the integration of information presented in the three articles. Sweetow, R. and Palmer, C.V. (2005). Efficacy of individual auditory training in adults:a systematic review of the evidence. J Am Acad Audiol.,16, 494-504. Hawkins, D.B. (2005). Effectiveness of counseling-based adult group aural rehabilitation programs: a systematic review of the evidence. J Am Acad Audiol. 16, 485-493. Fabry, D.(2005). Creating the evidence: lessons from cochlear implants. J Am AcadAudiol 16, 515-522.

6) Adult Aural Rehabilitation Practical Experience (200 points) –4/17 – 4/28, 2006 [A1, D3,D6,D10,D14,E2,E9,E10,E14] You will participate in the development and implementation of small-group, auralrehabilitation services in one of a number of possible venues (assisted living center, adult activity center, workplace). You will prepare:
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A 1 ½ hour program with clearly delineated goals and methods Patient handouts. (Copy materials only w/ author permission) Patient resources. Program evaluation tool Two page summary of your experience

7) 10 quizzes (200 points)- (11 in-class quizzes, each worth 20 points. The lowest grade will be dropped. There are no make-ups, and missing quizzes will be graded as 0 OR final examination April 27, 2006 1 – 3 p.m. Group Decision. Required Texts: Copies of pertinent chapters are on reserve at the Callier library.
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Luterman, D.M. (2001) Counseling Persons with Communication Disorders, 4th Ed. Austin: Pro Ed. Tye-Murray, N. (2004). Foundations of Aural Rehabilitation, 2nd edition San Diego: Singular Publishing Group, Inc. Valente, M., Hosford-Dunn, H., and Roeser, R. (2000). Audiology: Treatment. New York: Thieme. Hosford-Dunn, H, Roeser, R and Valente, M. (2000). Audiology: Practice Management, New York: Thieme.

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Clark, J.G. and English, K.M. (2004). Counseling in Audiologic Practice, Boston: Pearson Education, Inc. (text on reserve) Hogan, A. (2001). Hearing Rehabilitation for Deafened Adults, Philadelphia: Whurr Publishers (text on reserve)

Supplementary readings will be assigned for each module. Access to items on reserve is obtained by 1) going to the UTD library catalog and selecting "Course Reserves" and then filling out as many drop down boxes as one wishes or 2) using the following URL: You will be given a class-password needed for either access method. Students trying to access from home should be advised that some things cannot be gotten to without first going through the library's proxy server (those

articles that require this have been noted). Access to the proxy server requires a valid Comet Card and is obtained through either the home page of McDermott or Callier Libraries.

Additional Information: 1) You will have a formal opportunity to evaluate the course but feel free to stop by to discuss any concerns regarding this course. 2) Additional Information - Incompletes will be given only in extenuating circumstances and must be requested in writing. Late assignments WILL NOT BE ACCEPTED and evidence of academic dishonesty will result in no credit for the exam or assignment. Academic dishonesty includes cheating, plagiarism, collusion, and falsifying academic records. Please consult the course schedule and catalogue for information on withdrawals, incompletes, and academic dishonesty. 3) Accommodations - If you require any modification to the class activities including lectures, discussions, exams, and assignments in order to accommodate specific learning needs, please notify me by the end of the first week of class in person or by e-mail and provide appropriate documentation. I will be happy to make whatever arrangements are needed to facilitate learning and participation in the class.

The course content outlined below contributes to development of knowledge and skills outlined in the ASHA standards denoted in brackets [ ].

MODULE I - Counseling [D13, D14, E14] Date Week Readings Jan. 12 Week 1,2 Listening/Counseling Luterman, Ch. 1,2, 4 Jan 19 Clark & English Ch 1- 4, HAO Margolis, Valente, Ch 7,14 Tye-Murray Ch 5 (Hogan Ch 1,6)

MODULE II - Identifying Rehabilitation Needs [D2, D3,D6,D10,D12, D13, D14] Date Jan. 19 Jan 26 Feb 2 Week Week 2 Why AR? Week 3, 4, 5 Impairment, Functioning, Disability, Health

Abrams; McArdle; Prendergast; Tye-Murray Ch 1 Tye-Murray Ch 11 Valente, pp 562-568 ASHA; WHO, (Hogan, Ch 3) Dr. Clayton Tye-Murray, Ch 6; Killion; Nilsson; Hosford-Dunn, Ch 5; Cox; Demorest; Dillon; Donabedian; Gatehouse; Humes; Ventry Tye-Murray, Ch. 13 (Hogan, Ch 7)

Feb. 9 Feb. 9 Feb 16, 23 March 2

Week 5 Information Systems Week 5 Speech Measures Week 6, 7,8 Inventories & Outcome Measures

March 2 March 9

Special Considerations: Elderly, Week 9 –Spring Break

MODULE III - Aural Rehabilitation Intervention Date Mar. 16 Week 10 Tinnitus- Intervention Hearing Assist. Tech. Readings Tye-Murray, Ch 12(473-7)TBA Tye-Murray, Ch 7, Valente, Ch 19 (Hogan, Ch 8) DARS, DAC Tye-Murray, Ch 12(470-3)

Mar. 23

Week 11 HATs/ADA; Post-Secondary Education Needs/ Workplace Week 12, 13, 14 Auditory Training Auditory/Visual Training Communication Skills/Coping Strategies Service Delivery Work on Project #6 Week 15 Service Delivery More Hands-on Summer Intensive Rehab Conference (SIARC)

Mar. 30 Apr 6 Apr 13

Tye-Murray, Ch 7; Valente, Ch. 14 ;Tye-Murray, Ch. 8, 9 Bradlow; DeFilippo; Owens; Preminger, Rubinstein; Walden Fabry, Hawkins, Sweetow

April 13

April 20