1. Desensitisation……….. A long term perspective Denny Fransman SLT/Audiologist HALD SIG April 2010 University of Leeds

2. Contents: Morning session “How” Morning session “How” What? What? Why? Why? When? When?

3. Why would anyone be a “reluctant hearing aid wearer”

4. Tactile de-sensitisation To increase tolerance to having a mould in ear To increase tolerance to having a mould in ear

5. Auditory de-sensitisation Getting used to amplified sound Getting used to amplified sound

6. Why could mould be rejected? unfamiliar sensation unfamiliar sensation mould could be poor fit mould could be poor fit unable to verbalise discomfort unable to verbalise discomfort unable to remove??? unable to remove??? general hyper-sensitivity general hyper-sensitivity no comprehension of function no comprehension of function

7. Why could amplified sound be rejected? Used to relative silence Used to relative silence No meaning No meaning confusing confusing frightening frightening unfamiliar unfamiliar Poor audiometric data – poor aid setting Poor audiometric data – poor aid setting

8. Essential considerations Is the loss congenital or acquired? Is the loss congenital or acquired? If acquired If acquired age of onset age of onset severity of loss severity of loss time lapse between onset and intervention time lapse between onset and intervention Regarding the learning disability Regarding the learning disability what does sound mean to this person? what does sound mean to this person? Severity of Learning Disability (LD) Severity of Learning Disability (LD)

9. Other potential complications Autistic spectrum disorder Autistic spectrum disorder Hypersensitivity Hypersensitivity Sensory integration problems Sensory integration problems Central auditory processing disorders Central auditory processing disorders Hyper-reactivity associated with neurological damage e.g. cerebral palsy Hyper-reactivity associated with neurological damage e.g. cerebral palsy

10. Back to basics Why fit a hearing aid in the first place? Why fit a hearing aid in the first place? What are the potential benefits of aiding ? What are the potential benefits of aiding ? Improvement in communication Improvement in communication Environmental sounds Environmental sounds Pleasure or leisure Pleasure or leisure

11. Is full time hearing aid use indicative of a successful outcome? yes or no ?????? yes or no ??????

12. Don’t loose sight of your objectives for aiding Improve communication Environmental sounds Aiding objectives Enjoyment

13. Questions ????