Aural Rehabilitation Plan for an Adult

Aural Rehabilitation Plan for an Adult

General Directions:

Make an aural rehabilitation plan for an adult (see below). Compose your plan in a word doc, then copy/paste into the Canvas Midterm quiz in the appropriate question. Each section should cover the points below and should be written in complete sentences: Points will be deducted for misspellings or poor sentence structure. The framework follows the Stages in the Design of an Aural Rehabilitation plan framework shown in Chapter 10 (see Fig. 10-11).

You will make your own fictitious adult “patient” for this plan. Your “patient” should have AR intervention needs; pretend that the patient has just received hearing aids and/or a cochlear implant, or has had a progression to their hearing loss and uses spoken language for communication. You may use the same “patient profile” that you used in a Yellowdig assignment, or make up another adult patient profile. (Note: Following HIPAA patient confidentiality guidelines, do not use a real name or initials). If you choose a person from HearStrong.com or another webpage, change the name.

Note: The Figure 10-11 flow chart has hearing aids and cochlear implants within the Implementation stage of an AR plan, but do not include these in your plan. This course does not provide the requisite training needed to choose hearing aids/cochlear implants and it is “out of your scope of practice” as more advanced training is required. Do assume that an audiologist fitted or will soon fit your client with new hearing aids or cochlear implants.
Copy and paste each section of your plan into the Quiz: Module 4-5: Midterm Project on or before the due date. Each question in the quiz will follow the following format.
__________________________________________________________________________________________
The Aural Rehabilitation plan will contain the following components:

Case History (Question 1=6 points)
Describe your “patient/client” case history and a brief narration of their “journey with hearing loss”. Follow ASHA Case History-AR for Adult for areas to cover. Include the person’s hearing related environmental or personal factors (positive or negative) that may affect the treatment (e.g., work duties, supervisor’s support, office noise, personal attitudes, coping styles, etc.)
Describe any other factors impacting the patient and how they are managing their hearing difficulties (such as motivation, self-stigma, partner’s attitude, etc.)

Description of Hearing Loss to the PHL and FCP (Q2=2 points and Q3=4 points)
Plot the patient’s pure tone thresholds (this should show a bilateral sensorineural hearing loss) on a familiar sound or speech banana audiogram Audiogram Template. You will need to upload it to the quiz (Q2). In addition you may plot your patient’s aided thresholds using their hearing aids or cochlear implants (note: aided hearing is more closely related to functional hearing for the person with a severe-profound HL). (2 pts)
Write a narration of how you would describe the audiogram findings to your patient and FCP in layman terms. Pretend you were showing them the audiogram. Also describe how their ability to understand a conversation may be impacted by the hearing thresholds shown. (This is the first part of “informational counseling” given to your client.) Be sure to include which speech features may or may not be audible because of the hearing loss and how this affects the clarity and understanding of conversations. (For guidance see information from Module 2.) (4 pts)

Assessment of Hearing-Related Communication Difficulties (Q4, Q5 & Q6=8 pts)
Describe and give (fill-in) a self-assessment scale (s) to your client to obtain their viewpoint on hearing-related difficulties experienced. You will need to upload the completed scale to your quiz in Q5. (This is similar to YD week 4. You may use the same scale you used in YD here.)
Describe any other assessments you might give (if you decide they are needed) and why you choose it. Use a scale that you think will help develop a comprehensive AR plan such as a self-efficacy scale, speechreading test, or a scale for the FCP. (upload to Q6)
Briefly describe the results of the assessments and describe the patient’s needs (activity limitations and subsequent participation restriction) revealed by the case history information and the above assessments.

Development of a Plan: (Q7=15 pts)

Write at least three AR goals for your patient based on joint goal setting (see Fig. 10-13). (You did this Module 1 assignment on making goals using the LWHL COSI.) These should be the top communication needs your client would like to have addressed in AR treatment. You may add a psychosocial goal if you feel social-emotional factors impact how the patient is managing their hearing difficulties and a goal for their FCP/significant other. The goals should arise from the case history and the patient’s WHO personal and environmental factors as well as the answers you found from your assessment scales in the section above. (5 points)

List the possible options (interventions) to reach each goal that may be chosen by your client. For example: Goal 1: options X, Y, and Z. Goal 2: options Y and Z. Goal 3: options X and Z. Assertiveness and Communication Strategies Training included as an option is required. ( 5pts)

Write a narration of what you would say with your client to explain the options you listed to reach their goals. (see section on Shared decision making in textbook for guidance). Goals/solutions should reflect a shared understanding of their problems and solutions. E.g., “Mr. Z we could work on xxx to help you xyz. I will explain these further” (define what are Communication Strategies, what are constructive or instructional strategies, what is speechreading, etc.) (5 pts)

Implementation/Treatment: (Q8=20 points, + Q9=2 points for uploaded #C)
Summarize your overall AR treatment plan. Write a paragraph, which includes a summary of your plan based on the mutual decisions as to how to proceed. What will the plan cover and will treatment happen in individual and/or group AR sessions? (5 pts)

Example: “Treatment plans include sessions of individual AR for ____ and group AR focused on _______.” and or “Based on the results of the assessments, and Mr./Ms. “patient” and spouse’s goals , the AR plan will include _________, ___________, ___________, to manage Mr./Ms. Patient’s hearing-related communication difficulties.”

Provide details of your treatment in at least three of the following four AR Areas: Instruction (Communication strategies must be included), Sensory management, Perceptual Training, and Counseling (Boothroyd, 2007). Your descriptions should show learning/application of course materials. (4-6 pts for each area of treatment)

Instruction section: Be specific when describing the type of communication strategies training (facilitative/constructive/repair strategies, disclosure, and assertiveness training).
Sensory Management: may include assistive technology (TV device, Bluetooth connection to mobile phone, BT Remote mic technology) and instruction in their use.
Perceptual Training: Explain how you would provide this training. (analytic, synthetic practice, at home or in individual sessions, etc.)
Counseling:

Find a short handout or provide a website you would give your client to promote use of new skills/strategies in real-life for the PHL/FCP to review/practice at home. Upload the handout or a “print screen” of the site with the web address to the quiz. (2 pts)

Outcome Assessment (Q10=4 pts)
Describe the outcome measure(s) you may use to track treatment progress and benefit (amount of change after intervention) and why you chose this measure.

You do not have to fill this out, but if you fill it out and explain the improvements that are seen and/or new or residual hearing-related difficulties remaining for your patient you will get 2 extra credit points.

Note: Some questionnaires are used before and after treatment (e.g. a COSI or SAC), and others are used only after treatment (e.g. IOI-AI). See Module 4 resource page on self-assessment measures.
Some ideas and Examples from ASHA Adult AR Practice Portal
Periodic review of short- and long-term treatment goals and objectives (which are functional in nature and have been determined by interactive and collaborative decision making).
Self-assessment questionnaires.
Surveys or questionnaires completed by significant others.
Post measure of speechreading skills or communication fluency
Auditory skills post measure of speech recognition

Follow-up (Q11=4 pts)
Support Group Information: Make a handout for your client(s) of three support groups or blogs that they may want to join (use the guide in YD Module 2). Upload this to the quiz question.

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