Living with Hearing Difficulties The process

ls"Living with Hearing Difficultiesrs" is a source-book for professionals who encounter and support individuals with hearing difficulties. It will also be of interest to people with hearing difficulties themselves and those close to them. The book highlights the concept of audiological enablement as being an interactive process requiring the active involvement of both clinician and patient. The thirteen chapters encompass four sections which broadly follow the categories of the World Health Organizationrs"s ICF (2001): Section 1 addresses types of hearing disorders, the impairments they cause and also the process of help seeking. Section 2 deals with the effects of hearing impairment on communication and psychosocial functioning. Section 3 considers the individual in their environment; their family, work, and leisure. Section 4 elaborates on the process of enablement in a non-prescriptive manner. The authors approach the problems and needs from the standpoint of what the patient/client is seeking. Enablement is seen as a team effort between the professionals, the patient and their family in an ever-changing environment. This entails using any relevant techniques to ensure the well-being of the individual with hearing impairment; that end remains very much their goal. The book also has a companion website www.wiley.com/go/stephens which hosts additional downloadable documents as well as a demonstration of the concept of the signal-to-noise ratio.

Dafydd Stephens FRCP, is Honorary Professor of Audiological Medicine at Cardiff University, Wales, UK.

Sophia E. Kramer, PhD, is Senior Researcher and Psychologist at the Department of E.N.T. / Audiology / EMGO Institute for Health and Care Research at the VU University Medical Centre in Amsterdam, the Netherlands.

Foreword	p. viii
Preface	p. x
Acknowledgements	p. xiii
Introduction	p. 1
The need for this book	p. 1
Terminology	p. 2
Layout of the book	p. 4
The World Health Organization classifications	p. 5
Theoretical/management models in the general rehabilitation literature	p. 8
Models of audiological enablement	p. 11
The Goldstein-Stephens model	p. 13
The role of positive experiences associated with hearing impairment	p. 19
Relevant measures in assessing patients' needs and the outcomes of interventions	p. 21
Development of a preliminary model appropriate to hearing impairment	p. 24
Conclusion	p. 25
Seeking help	p. 26
Introduction	p. 26
Becoming aware of hearing difficulties	p. 27
The decision to seek help	p. 31
Referral for hearing help	p. 36
Ethics/philosophy of adult screening	p. 38
Conclusion	p. 42
Types of hearing impairment and their consequences	p. 43
Introduction	p. 43
Basic anatomy and physiology and their implications	p. 43
Purposes and process of assessment	p. 47
Types of hearing impairment and their consequences	p. 50
Severity of hearing impairment	p. 54
Unilateral/asymmetrical hearing impairment	p. 55
Age of onset	p. 55
Genetic issues	p. 57
Progressive/sudden onset	p. 58
Conclusion	p. 58
The influence of other factors on assessment and goals of enablement	p. 60
Introduction	p. 60
Auditory symptoms	p. 60
General aural symptoms	p. 63
Vision	p. 66
Cognitive and intellectual factors	p. 67
Neuromusculoskeletal problems	p. 68
Conclusion	p. 69
Communication	p. 71
Introduction	p. 71
Ecological audiology	p. 71
Ramsdell's classification	p. 73
Attitudes of the Deaf	p. 81
Conclusion	p. 82
Social and emotional aspects of hearing impairment	p. 83
Introduction	p. 83
Participation in life	p. 83
Psychosocial dysfunction	p. 84
Psychosocial consequences of Deafness	p. 90
Demographic factors	p. 91
Conclusion	p. 94
Hearing impairment in the family	p. 96
Introduction	p. 96
Impact of hearing impairment on significant others	p. 96
Coping strategies	p. 98
Inclusion of significant others in enablement programmes	p. 100
Hearing impairment arising from genetic causes or with a familial basis	p. 100
Impact of having a family history of hearing impairment	p. 102
Discussion	p. 107
Conclusion	p. 108
The process of enablement at work	p. 109
Introduction	p. 109
Statistics	p. 109
Impact of hearing impairment on occupational performance	p. 110
Impact of work-related hearing impairment on significant others	p. 113
Vocational enablement	p. 114
Vocational Enablement Protocol (VEP)	p. 115
Discussion	p. 120
Conclusion	p. 121
Leisure and the wider social environment	p. 122
Introduction	p. 122
Prevalence	p. 122
Solitary versus interactive pastimes	p. 123
The role of leisure	p. 123
Opportunities for entertainment and leisure	p. 124
Community life	p. 125
Recreation and leisure	p. 126
Religion and spirituality	p. 131
Human rights, political life and citizenship	p. 132
Conclusion	p. 133
The process of enablement 1: Evaluation and decision-making	p. 134
Introduction	p. 134
The evaluation process	p. 134
Integration and decision-making	p. 156
Conclusion	p. 159
The process of enablement 2: Short-term remediation	p. 160
Introduction	p. 160
Instrumentation	p. 160
Strategy	p. 174
Ancillary help	p. 178
Conclusion	p. 180
Enablement 3: Ongoing remediation and outcome assessment	p. 181
Ongoing remediation	p. 181
Effectiveness of group programmes	p. 194
Outcome assessment	p. 196
Conclusion	p. 201
Overall conclusions	p. 202
Appendix: Longitudinal changes in enablement needs of older people with hearing impairment	p. 205
References	p. 209
Index	p. 237
Table of Contents provided by Ingram. All Rights Reserved.

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Living with Hearing Difficulties The process of enablement

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