I. Course Description: Study of the anatomy of hearing and diagnostic techniques to determine hearing loss.

Transcription

1 Stephen F. Austin State University College of Education Department of Human Services Communication Sciences & Disorders Program Introduction to Audiology SPH Summer Session I 2014 Instructor: Dr. Kelly Jobe Course Time & Location: M-Th 2:30-4:30 HSTC 314 Office: Human Services 205J Office Hours: M-Th 8:00-9:00 am & others by appointment Office Phone: (936) Other Contact Information: (936) Credits: 3 Semester hours jobekd@sfasu.edu Prerequisites: SPH 130 & 210 I. Course Description: Study of the anatomy of hearing and diagnostic techniques to determine hearing loss. Readings Required Text: Martin, F.N. and Clark, J.G. Introduction to Audiology, 12 th ed., Prentice Hall Live Text account, ISBN# Live Text may be purchased at the bookstore or purchased online at If you have already purchased LiveText, you will use that account and do not need to buy it again. NOTE: If you plan to use financial aid to purchase this account, you must purchase within the time period determined by the Financial Aid Office. LiveText is the data management system used by the Perkins College of Education for program improvement and accreditation. All students are required to purchase a LiveText account, either through the University Bookstore or at This is a one-time purchase, and the account will be used throughout your program. Required program assignments must be submitted through LiveText. Successful completion of the course and program are dependent on submission of all required LiveText assignments. Failure to purchase and complete LiveText assignments will result in a grade of WH in the course. II. Intended Learning Outcomes/Goals/Objectives: This course reflects the following core values of the College of Education: Academic excellence through critical, reflective, and creative thinking Life-long learning Collaboration and shared decision-making Openness to new ideas, to culturally diverse people, and to innovation and change Integrity, responsibility, diligence, and ethical behavior Service that enriches the community. This course also supports the mission of the Speech-Language Pathology Program. The mission of the Speech-Language Pathology Program is to prepare knowledgeable professionals committed to enhancing the quality of life of persons with communication disorders. To meet this mission, the program emphasizes the importance of scientific study, critical thinking skills, interdisciplinary collaboration, ethical principles, the responsibility to educate the public about communication disorders, and the importance of continued professional development throughout one s career. This course addresses the following standard(s) of the Council for Clinical Certification of the American Speech-Language-Hearing Association: Standard III-C. The applicant must demonstrate knowledge of the nature of speech, language, hearing, and communication disorders and differences and swallowing disorders, including their etiologies, characteristics, anatomical/physiological, acoustic, psychological, developmental, and linguistic and cultural correlates. Standard III-D. The applicant must possess knowledge of the principles and methods of prevention, assessment, and intervention for people with communication and swallowing disorders, including consideration of anatomical/physiological, psychological, developmental, and linguistic and cultural correlates of the disorder.

2 Standard IV-G. The applicant for certification must complete a program of study that includes supervised clinical experiences sufficient in breadth and depth to achieve the following skills outcomes (in addition to clinical experiences, skills may be demonstrated through successful performance on academic course work and examinations, independent projects, or other appropriate alternative methods): 1. Evaluation (must include all skill outcomes for each of the nine major areas) and 2. Intervention (must include all skill outcomes for each of the nine major areas). This course is designed to familiarize the student with the field of audiology and KASA standards which are addressed in parentheses and includes the study of: 1. sound 2. hearing, anatomy and physiology of 3. hearing, disorders of 4. hearing, measurement of 5. hearing loss, measurement of 6. hearing loss, differential diagnosis of 7. hearing loss, medical treatment of 8. hearing loss, prevention of 9. hearing loss, habilitation and rehabilitation III. Course Assignments, Activities, Instructional Strategies, use of Technology: Day Date Session Page Assignment M June Audiology Profession T June Ear & Testing W June Sound Th June Sound M June Sound Measurement T June 10 6 TEST # 1 W June Outer Ear Th June Middle Ear M June Inner Ear T June Inner Ear Disorders W June Auditory Neural System Th June TEST # 2 M June Pure-Tone Testing T June Speech Testing & Masking W June Physiological Testing Th June TEST # 3 (File Due) M June Pediatric Audiology (Kit Due) T July Amplification W July Treatment of Hearing Loss Th July 3 20 Test # 4 Comprehensive Final

3 IV. Evaluation and Assessments (Grading): Class requirements include a study of the text and: Points 1. Three unit Comprehensive Final Audiology website notebook (file) (Due June 27) Attendance & completion of online course assessment 5 TOTAL 100 Grading: A exceptional B good C minimally acceptable D poor, not acceptable as credit toward graduate degree F no credit You are encouraged to contact me relative to any matter you wish to discuss. My office hours are posted, and you may also make an appointment at other times for conferences. EXTRA CREDIT: Up to 5 points applied to final average. Due in class on Monday, June 30 th. Make a kit that has: 1. battery tester 2. stethoscope to listen to hearing aid 3. otoscope 4. noisemaker that can be used to produce a 60 db a noise & sound level app. 5. desiccant jar 6. stiff dental floss V. Course Evaluations: Near the conclusion of each semester, students in the College of Education electronically evaluate courses taken within the COE. Evaluation data is used for a variety of important purposes including: 1. Course and program improvement, planning, and accreditation; 2. Instruction evaluation purposes; and 3. Making decisions on faculty tenure, promotion, pay, and retention. As you evaluate this course, please be thoughtful, thorough, and accurate in completing the evaluation. Please know that the COE faculty is committed to excellence in teaching and continued improvement. Therefore, your response is critical! In the College of Education, the course evaluation process has been simplified and is completed electronically through MySFA. Although the instructor will be able to view the names of students who complete the survey, all ratings and comments are confidential and anonymous, and will not be available to the instructor until after final grades are posted. VI. Student Ethics and Other Policy Information: Attendance: One point will be deducted for each unexcused absence (maximum of three). Absences will be excused only on documentation and approval. Three tardies will constitute one absence. Failure to complete the online course assessment will result in a loss of 5 points. Students with Disabilities To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact the Office of Disability Services (ODS), Human Services Building, Room 325, (936) / (936) (TDD) as early as possible in the semester. Once verified, ODS will notify the course instructor and outline the accommodation and/or auxiliary aids to be provided. Academic Honesty It is the policy of Stephen F. Austin State University that academic dishonesty is a completely unacceptable mode of conduct and will not be tolerated in any form. All persons involved in academic dishonesty will be disciplined in accordance with University regulations and procedures. Discipline may include suspension or expulsion from the University. (see Academic Integrity A-9.1)

4 AUDIOLOGY STUDY QUESTION, #1 Introduction and Tuning Fork Tests pp. xiii Define audiology. 2. Define audiologist. 3. Define otology. 4. When did audiology develop as a field and what were the circumstances? 5. Identify Raymond Carhart. 6. Identify Norton Canfield. 7. What is AAA? 8. What is ASHA? 9. Briefly describe the three divisions of the ear. 10. What is a conductive hearing loss? 11. What is a sensori-neural hearing loss? 12. What is a mixed hearing loss? 13. Briefly describe the Schwabach Test. 14. Describe the Rinne Test. 15. What is indicated by a positive Rinne? A negative Rinne? 16. Describe the Bing Test. 17. What is indicated by a positive Bing? A negative Bing? 18. What is the occlusion effect? 19. Describe the Weber Test? 20. What is the Stenger principle? AUDIOLOGY STUDY QUESTION, #2 CHARACTERISTICS OF SOUND pp Define sound. 2. What are the essentials for production of a sound? 3. Name and describe the two components of a sound wave. 4. Describe a cycle of a sound wave. 5. Describe the two primary physical characteristics of a sound. 6. What is the unit of measurement for frequency? 7. Define resonance. 8. What is the speed of sound? 9. Define phase. 10. Define amplitude. 11. What is the unit of measurement of intensity? AUDIOLOGY STUDY QUESTION, #3 Acoustics pp Define decibel. 2. Why is the B in db capitalized? 3. How is the db scale a logarithmic scale? 4. How great is the pressure of 100 db SPL compared to 0 db SPL? 5. At 1000 Hz, 0 db HL = db SPL. 6. What is the reference level for o db SPL? 7. What is the reference level for 0 db HL? 8. Define absolute threshold. 9. What is the standards organization for audiometric calibration? 10. What is the reference level of 0 db SL? 11. What is pure tone? 12. What is a complex sound? 13. What is periodicity?

5 14. What is fundamental frequency? 15. What is a harmonic? 16. What is a formant? 17. What is resonance? 18. What is immittance? 19. What are the two components of impedance? AUDIOLOGY STUDY QUESTION, #4 Sound Measurement pp Define absolute threshold. 2. What frequencies are usually on a pure tone audiometer for air conduction testing? 3. What is the frequency range of an octave? 4. What intensity range is provided on most pure tone audiometers? 5. What is the db SPL level for audiometric zero for speech? 6. How is sound field (SF) testing performed? 7. Define phon. 8. What is the reference level for phon? 9. At wht frequency range is the best human hearing? 10. What is an artificial ear? 11. Why is the volume of an artificial ear 6 cc? 12. What is MAP? 13. What is MAF? 14. What is the allowable intensity deviation of pure tone? 15. Define mel. 16. What is the reference level for the mel? 17. Define sone. 18. What is the reference level for the sone? 19. Define localization. 20. Define lateralization. 21. Define masking 22. Define free field. AUDIOLOGY STUDY QUESTION, #5 Outer Ear pp What are two parts of the outer ear? 2. You should be able to identify on the auricle: a. tragus b. antitragus c. intertragal notch d. helix e. antihelix f. the fossae g. concha h. lobe 3. What contribution is made to human hearing by the auricle? 4. What are the two divisions of external auditory canal (E.A.M.)? 5. What are the two glands in the E.A.M.? 6. What are the two dimensions in the E.A.M.? 7. What is TMJ? 8. At what Hz does the E.A.M. resonate? 9. What serves as the medial boundary of the E.A.M.? 10. What are the three layers of the tympanic membrane? 11. What are the dimensions of the T.M.? 12. Which bone (ossicle) of the middle ear is embedded in the T.M.? 13. Which is the point of greatest retraction on the T.M.? 14. What device is used to visualize the T.M.? 15. What are the two parts of the T.M.? 16. By what gestational age is the E.A.M. canalized?

6 17. What is the maximum db hearing loss likely to occur with a conductive hearing loss? 18. What is lack of development of the pinna? 19. What is lack of development of the E.A.M.? 20. What is closing of the E.A.M.? 21. What is infection of the external ear? 22. What is the simplest form of surgical repair of the T.M.? 23. What is thickening of the T.M.? 24. What is the prognosis for a conductive hearing loss? AUDIOLOGY STUDY QUESTION, #6 Middle Ear Anatomy pp What is the tympanic cavity? 2. What is the function of the middle ear (M.E.)? 3. What connects the M.E. and the nasopharynx? 4. What is the function of the Eustachian tube? 5. What is the bony bulge behind the ear? 6. What are the three membranes of the M.E.? 7. What are the bones of the ossicular chain and how is each situated? 8. What is the effective ratio of the area of the tympanic membrane (T.M.) to that of the oval window? 9. What db is regained by the middle ear mechanism? 10. What is the function of the chorda tympani? 11. Where is the stapedial muscle and what is its function and innervation? 12. Where is the tensor tympani muscle and what is its function and innervation? AUDIOLOGY STUDY QUESTION, #7 Middle Ear Disorders pp What is the most common cause of hearing loss in young children? 2. Define purulent. 3. What is the most common cause of S.O.M.? 4. Define mastoiditis. 5. Define cholesteatoma. 6. Define Bell s palsy. 7. Define myringotomy. 8. Define myringoplasty. 9. Define tympanoplasty. 10. Define mastoidectomy. 11. What is indicated by a type C tympanogram? 12. Define valsalvate. 13. What is seous effusion of the M.E.? 14. What is adhesive otitis media? 15. What is the P.V.T.? 16. What is P.E. tube? 17. What is otosclerosis? 18. What is Carhart s notch? 19. What is a stapedectomy? 20. Who developed the stapedectomy? When? Where? AUDIOLOGY STUDY QUESTION, #8 The Inner Ear pp What is the function of the inner ear? 2. What are the two divisions of the inner ear and the basic function of each?

7 3. Define vertigo. 4. Define nystagmus. 5. What are two tests of vestibular dysfunction? 6. What are the three division (scalae) of the cochlea and what fluid does each contain? 7. Where do the scala vestibule and the scala tympani join? 8. What is the window of the scala vestibule? 9. What is the window of the scala tympani? 10. What connects the endolymphatic spaces of the cochlea and the vestibular apparatus? 11. What membrane separates the scala vestibule and the scala media (cochlear duct)? Scala tympani and scala media? 12. What is the end organ of hearing and on what membrane does it rest? 13. What membrane overhangs the hair cells of the Organ of Corti? 14. What is the central core of the cochlea? 15. What separates the inner and outer hair cells? 16. How many inner and outer hair cells are there in each cochlea? 17. How many afferent neural fibers serve each cochlea? 18. How many efferent neural fibers serve each cochlea? 19. What is the cochlear microphonic the result of? 20. Where does the action potential occur? 21. Name four theories of pitch perception and give the proponent of each. 22. By what gestational age is the cochlea mature? AUDIOLOGY STUDY QUESTION, #9 Sensory Hearing Loss pp Where is the damage in a sensori-neural hearing loss? 2. What kind of hearing does one with a sensori-neural hearing loss experience? 3. What are the pure-tone test results with a sensori-neural hearing loss? 4. List some causes of prenatal, sensori-neural hearing loss. 5. List some causes of preinatal, sensori-neural hearing loss. 6. List some causes of postnatal, sensori-neural hearing loss. 7. What common, nonprescription drug may cause hearing loss? 8. What audiogram configuration is seen in noise-induced hearing loss? 9. What db A level is allowed for an eight-hour noise exposure by OSHA? 10. What is a likely cause of sudden unilateral hearing loss? 11. What are the three components of Meniere s disease? 12. How is Meniere s treated in the early stages? 13. What is extreme treatment for Meniere s? 14. Define presbycusis. AUDIOLOGY STUDY QUESTION, #10 Auditory Neural Anatomy and Disorders of the VIIIth Cranial Nerve (Auditory) pp What peripheral nerve transmits the electrical signal from the hair cells of the Organ of Corti to the brain? 2. Where do the cell bodies of the auditory nerve collect? 3. Through what hole in the skull does the auditory nerve pass? 4. How many nerve fibers are there in each auditory nerve? 5. What frequencies are carried by the outer portion of the auditory nerve? 6. Where does the auditory nerve enter the brain? 7. Describe the auditory center in the medulla. 8. Describe the auditory center in the pons. 9. Describe the auditory center in the thalamus. 10. What is the function of the R.A.S.? 11. What is the auditory function of: a) temporal lobe? b) Island of Reil? c) parietal lobe? d) frontal lobe? 12. What is the function of the efferent auditory pathway?

8 13. By what gestational age does the auditory nerve mature? 14. What is the primary auditory indicator of early VIIIth nerve involvement? 15. List three possible causes of VIIIth cranial nerve involvement. 16. List the non-auditory tests for VIIIth C.N. involvement. AUDIOLOGY STUDY QUESTION, #11 (C)APD pp Define extraaxial. 2. What audiometric symptoms are expected in extraaxial lesions? 3. Define intraaxial. 4. What audiometric findings are expected in intraaxial? 5. What type of audiometric tests are generally not successful in identifying lesion of the central auditory pathway? 6. On what has the emphasis for testing the central auditory system been placed? 7. How may the PI-PB function indicate a C.A.D.? 8. What is ABR? 9. What general observations may be made about the waves of the ABR and the site of lesion? AUDIOLOGY STUDY QUESTION, #12 Air and Bone Conduction Audiometry pp Testing with earphones is testing. 2. Testing with a vibrator placed on the skull is testing. 3. Why is maximum output for bone conduction less than for air conduction? 4. What is Bekesy audiometry? 5. What are the two basic ways to attenuate (lessen) noise in the test environment? 6. What kind of sound treated room is necessary for audiometric testing? 7. Define absolute threshold. 8. What are some responses a patient is asked to make when hearing a tone? 9. What should be done when a patient responds inappropriately during hearing testing? 10. What instructions should be given the patient for pure-tone testing? 11. How should the patient be positioned for hearing testing? 12. What precautions should the tester take during hearing testing? 13. What is the purpose of pure-tone, air-conduction testing? 14. On what kind of graph are hearing test results recorded? 15. List the four steps in obtaining the AAOO percentage of hearing loss? 16. What are the seven levels of hearing loss (including none) in children? 17. What symbols are used of pure-tone, air-conduction test results? 18. What is the purpose of pure-tone, bone-conduction testing? 19. What is distortional (compressional) bone conduction? 20. What is inertial bone conduction? 21. Where are the two positions for placement of the bone oscillator? 22. What is the occlusion effect? 23. What symbols are used for bone-conduction testing? 24. What three factors should be considered in the interpretation of pure-tone audiograms? 25. What pure-tone test results indicate a conductive hearing loss? 26. What are: AC, BC, ABG? 27. Can hearing by air conduction truly be better than by bone conduction? 28. What is tactile response to pure tones? 29. Define interaural attenuation (IA). 30. What should be considered the minimum IA for air-conducted tones? 31. What should be considered the minimum IA for bone-conducted tones? 32. What db is significant air-bone (ABG)? AUDIOLOGY STUDY QUESTION, #13

9 Clinical Masking pp Define masking. 2. Define clinical masking. 3. When should masking be used? 4. What is interaural attenuation? 5. What is a conservative estimate for IA by air conduction? By bone conduction? 6. What is the best noise to use for pure tone masking? 7. Define critical band. 8. How much masking should be delivered to the non-test ear? 9. What should be the initial level of masking? 10. Which ear determines the initial level of masking? 11. Which ear determines the final level of masking? 12. Define effective masking (EM). 13. Define central masking. 14. Define overmasking. 15. List the steps in the plateau method of masking. 16. Describe the audiometric Weber test. AUDIOLOGY STUDY QUESTION, #14 Speech Audiometry pp What are two procedures routinely used for speech testing? 2. Define absolute threshold for speech. 3. Define SRT. 4. Define SDT. 5. Define spondee. 6. Define monaural. 7. Define binaural db HL for speech = db SPL. AUDIOLOGY STUDY QUESTION, #15 Speech-Masking and Discrimination pp What is the IA for speech? 2. What is the best masking noise for speech? 3. What is the MCL, and at what level does it usually occur for listeners with no hearing loss? 4. What is the UCL, and at what level does it usually occur for listeners with no hearing loss? 5. What is the dynamic range, and what is a normal dynamic range? 6. What are the purposes of discrimination testing? 7. What are PB words and how are PB word lists constructed? 8. How is a discrimination score obtained? 9. At what db level are PB words presented? 10. What is a PI-PB function (articulation curve)? 11. What is closed-set testing? 12. At what level should masking be for discrimination testing? 13. What is a speech-in-noise test? 14. What is the S/N ratio?

10 AUDIOLOGY STUDY QUESTION, #16 Immittance pp What is immittance? 2. Define impedance. 3. Define admittance. 4. Outline the components of immittance. 5. Describe the three basic measurements made in immittance. 6. What is the physical volume principle? 7. What are the three primary components of an immittance meter? 8. What is the normal range for static compliance and why? 9. Describe and give the implications of three basic types of tympanograms. 10. Describe the pathway for the contralateral acoustic reflex. 11. At what level should the acoustic reflex occur. AUDIOLOGY STUDY QUESTION, #17 Site of Lesion, Cochlear and Nerve pp What is the basis for test of choclear dysfunction? 2. What is the basis for test of VIIIth C.N. dysfunction? 3. Define recruitment. 4. What is the ABLB test? 5. On what kind of graph is the ABLB test recorded? 6. What site of lesion is indicated by a positive ABLB test? 7. What rehabilitation difficulty is presented by recruitment? 8. What site of lesion is indicated by a diminished DL for intensity? 9. What is the SISI test? 10. What is indicated by a positive SISI? 11. What percentage is positive SISI score? 12. What is the Olsen-Noffsinger Tone Decay Test? 13. What site of lesion is indicated by a type III (positive) tone decay test? 14. How much tone decay is positive? AUDIOLOGY STUDY QUESTION, #18 Bekesy Test Types pp What is Bekesy testing? 2. What two type tones are used in typing Bekesy audiograms? 3. What is sweep frequency Bekesy testing? 4. What is fixed frequency Bekesy testing. 5. Describe a Type I Bekesy. 6. What type hearing loss is indicated by a Type I Bekesy? 7. Describe a Type II Bekesy. 8. What site of lesion is indicated by a Type II Bekesy? 9. Describe a Type III Bekesy. 10. What site of lesion I indicated by a Type III Bekesy? 11. Describe a Type IV Bekesy. 12. What is indicated by a Type IV Bekesy? 13. Describe a Type V Bekesy. 14. What is indicated by a Type V Bekesy?

11 AUDIOLOGY STUDY QUESTION, #19 Otoacoustic Emmissions (OAE) pp , 192, , 339, What is the OAE? 2. Who first demonstrated EOAEs? 3. What device made observation of EOAEs possible? 4. What is the source of otoacoustic emissions? 5. What is indicated by the presence of OAEs? 6. What is indicated by the absence of OAEs? 7. What is the typical frequency range of EOAE? 8. What frequency range is the most sensitive to elicitation of EOAEs? 9. What major differences in the outer and inner hair cells account for OAE s? 10. How many stimuli are generally presented in an EOAEs run? 11. What is the latency range for EOAEs? 12. What is the law in Texas relative to neonatal screening and EOAEs? 13. What stimulus is used in observing the transient EOAE? 14. What stimulus is used in observing the distortion product EOAE? 15. List the four major anatomic regions involved in OAEs? 16. How frequency specific is TEOAEs? 17. How frequency specific is the DPEOAE 18. What is the maximum SPL of the SOAE? AUDIOLOGY STUDY QUESTION, #20 Auditory Evoked Potentials pp , Define: a. auditory evoked potential b. auditory brain-stem response c. auditory middle latency responses d. late evoked responses e. electrocochleography 2. What are the three components of an AEP device? 3. Although there is no clear consensus for the generator of the five waves (peaks) of the ABR, what source for each is suggested by Moller? What is the normal latency for wave V at 60 db HL? 4. A complete ABR test will provide what information about each ear? 5. What stimuli are most commonly used for ABR testing? 6. Which wave of the ABR is evaluated to infer the auditory threshold in the frequency range 1000 to 4000 Hz? 7. What effect does a conductive hearing loss have on wave V of the ABR? 8. What effect does a typical sensory loss have on the latency-intensity function for wave V of the ABR? 9. What effect does a lesion of the auditory nerve have on all waves of the ABR? 10. What effect might an auditory brain-stem tumor have on all the waves of an ABR? 11. What is the latency-intensity function of an ABR? 12. What is the latency for auditory MLR? 13. What is the latency for auditory LER? 14. What is the auditory event-related potential? AUDIOLOGY STUDY QUESTION, #21 1. Make a chart giving: a. age b. appropriate stimuli c. expected response For: Audiological Treatment pp

12 a. neonate b. 3-6 months old infant c months old infant d months old infant e. 3-5 year old child 2. Describe the five basic components of an aural-oral program for a hearing-impaired child. 3. Outline the features of: a. Aural-Oral Method b. Acoupedic Method c. Total Communication d. Dactylogy e. ASL f. Signed English (SE) g. Seeing Essential English (SEE1) h. Signing Exact English (SEE 2) i. Linguistics of Visual English (LOVE) j. Pidgin Sign English (PSE) k. Cued Speech 4. Describe CAPD. 5. What is the most critical feature for managing most types of CAPD? AUDIOLOGY STUDY QUESTION, #22 Amplification/Sensory Systems pp What is hearing aid? 2. What are the three basic components of a hearing aid and the function of each? 3. What are the two functions of a hearing aid ear mold? 4. Define: a. SSPL 90 b. acoustic gain c. frequency response d. distortion 5. Describe the three basic styles of hearing aids in common use. 6. What is a CROS hearing aid? 7. What is a cochlear implant? 8. What is a vibro-tactile aid? 9. What are ALDSs? 10. What is tinnitus? 11. Describe the two basic components of an adult aural rehabilitation program. AUDIOLOGY STUDY QUESTION, #23 Erroneous Hearing Loss pp Define: a. pseudohypacusis b. non-organic hearing loss c. functional hearing loss d. psychogenic hearing loss e. hysterical hearing loss (hysterical conversion) f. malingering 2. List signs that should alert the audiologist to the possibility of pseudohypacusis. 3. What findings on hearing tests indicate pseudohypacusis? 4. How would the Stenger test indicated pseudohypacusis? 5. What is the basis for the Doerfler-Stewart test in testing for pseudohypacusis? 6. How would the Lombard test indicate pseudohypacusis?

13 7. How would the Delayed-Auditory Feedback test indicate pseudohypacusis? 8. What type Bekesy (Jerger and Jerger) would indicate pseudohypacusis and what are its characteristics? 9. What are the features of the Swinging Story test? 10. What results on the SPAR indicate pseudohypacusis? 11. What is PGSR? 12. What is the most effective test for pseudohypacusis? 13. List principles for management of the patient with pseudohypacusis.