Case 1.

Mr. Gandalf Grey is 82 years old and has arrived for an audiological appointment with you. You are working on a case history intake and he points to his ear and tells you, “I can’t hear anything anymore.” While you are testing him, you give him a break while you clean up the results to start counseling. He looks at you and says,” no one wants to talk to a dumb old man anymore.” His audiogram is shown above. His speech understanding at PBmax is 72% for the right ear and 60% for the left ear.

Mr. Gandalf Grey was accompanied by his daughter who thinks a hearing aid would benefit him greatly in his daily living. She is concerned about his quality of life and the frustration he has been demonstrating with unsuccessful communication. He would be a first-time hearing aid wearer. He has some dexterity issues. He has been isolating himself more and more from social activities. They have a large family and he is often in group settings, out to dinner, attending his grandchildren’s events. He used to be extremely active with his church community.

How would you explain Mr. Gandalf Grey’s audiogram? (1 points)

Mr. Gandalf Grey is interested in pursuing amplification. Based on the case history you have in front of you, suggest a possible hearing aid style for him. Explain why you suggested that hearing aid. (1 point)

What would your approach be toward hearing aid orientation for Mr. Gandalf Grey and his daughter? (Discuss how much information you would share and when). (2 points)

Mr. Gandalf Grey is interested in pursuing amplification. He has heard about some research about a low cost option, something similar to hearing aids. What is he talking about? How would answer his questions based on EBP? (2 points)

What other technology you might consider for Mr. Gandalf Grey in addition to hearing aid use? Why? (1 point)

In sharing information to Mr. Gandalf Grey, you may want to provide some counseling to his daughter as well (or any other family member who attends his appointments with him). What are Grice’s maxim’s of conversation? Why are they important to share? (2 points)

What are some “non-technological” recommendations you might make to Mr. Gandalf Grey? (1 point)

Case 2.

The audiogram above is for Peregrin Took who is 10 years of age. Peregrin’s classroom teacher complains that he is easily distracted in class, and does not follow oral instructions. Peregrin’s mother reported that Peregrin appears very tired by the end of the day, when he returns home from school. She added that he says, “huh” all the time, especially when he is watching TV or playing with his siblings. Peregrin passed his newborn hearing screening, as well as every other school hearing screening conducted thus far. His mother is very concerned since his schoolwork is suffering. Based on recommendations from the school psychologist, Peregrin has been tested for ADHD, and his scores on the ACPT (the test conducted for ADHD) were well within the acceptable limits. He has no other known medical history or behavioral issues. He has been referred for an audiology appointment now, but his mother is skeptical. “After all, he has passed every hearing test so far!” she said to the audiologist at the beginning of the appointment.

How would you explain Peregrin’s results to his mother who is accompanying him? (1 point)

What might you suspect is going on with Peregrin, if it is indeed an audiologic issue? (1 point)

What clues from the audiogram and Peregrin’s behavior lead you to this conclusion? (2 points)

Would you recommend a hearing aid or ALD for Peregrin? Why? (2 points)

Name 4 accommodation strategies that can be employed by the teacher in the classroom to optimize Peregrin’s performance. (2 points)

How would this change if Peregrin was not 10 years of age but 6 years of age? Why? (2 points)