Music and Hearing in the Older Population: an Audiologist's Perspective

Transcription

1 Music and Hearing in the Older Population: an Audiologist's Perspective Dwight Ough, M.A., CCC-A Audiologist Charlotte County Hearing Health Care Centre Inc. St. Stephen, New Brunswick

2 Anatomy and Physiology of the Ear Types of Hearing Loss Frequency and Intensity How you and I see it! The Audiogram Samples of Audiograms and Hearing Losses Demo of Music Session w/ Pt

3 Are you achieving the expected outcomes of your session if your patients cannot hear the full auditory signal? Would it be a good idea to know what your patient s hearing acuity is before starting a therapy session? What degree of hearing loss do you think the Pt. in the video has?

4 The ear is fully developed to adult size by 3 months gestation and is no bigger than the end of your thumb so yes your baby can hear enutero, The PRIMARY function of the ear is your balance system, hearing a secondary, 18 % of adults years old, 30 % of adults years old, and 47 % of adults 75 years old or older have a HL. (NIDCD), Very few people are completely deaf, 20% or 1 out of 5 people who could benefit from a hearing aid actually wear one!

5 Outer Ear : Capture, amplify and direct sound onto TM, Middle Ear: Protection(by stapedius reflex) & Impedance match of large amplitude vibration in air into a small mechanical amplitude vibration, Inner Ear & CNS : Frequency analysis & Transduction

6 Three-chambered tube: Two chambers are separated by the basilar membrane, on which sits the organ of Corti. The arch in the middle of the organ of Corti separates the inner from the outer hair cells

7

8 The end organ of hearing contains:. Stereocilia & receptor hair cells. 3 rows OHC. 1 row IHC. Tectorial and Basilar Membranes. Cochlear fluids On top of the hair cells sits the tectorial membrane which is attached only along its inner edge. The stereocilia (hairs) of the outer hair cells are embedded in the tectorial membrane, but those of the inner hair cells are moved by movement of the fluid in the space between the hair cells and the tectorial membrane.

9 6000 : 1 9

10 6000 : 1 10

11 2200 : 1 11

12 1) Conductive: Problem in the Outer and middle ear. 2) Sensori: Problem in the Inner Ear. 3) Mixed: Combination of both Conductive and Sensori. 4) Neural: Problem w/ the auditory nerve itself.

13 Sound Waves Sound = vibrating energy waves which creates an auditory sensation in our ears. Sound is produced anytime any material vibrates in such a manner as to produce waves in the media (usually air) surrounding it. 13

14 Strike a metal sheet with a hammer: - Hammer blow distorts the sheet outwardly compressing the air on the other side. - Metal sheet wants to spring backward and in doing so by-passes the original position permitting the air to expand behind the sheet as it does so - rarefaction. This movement of air or sound wave is pressure energy which causes the TM to move. 14

15 Position of Vibrating Body - one cycle Compression Rarefaction Mid-Position 15

16 Frequency or Pitch Intensity or Loudness Time 16

17 Is the physical measure of the number of vibrations (cycles) which occur during a given period of time. Example: If the sheet of metal were to vibrate 100 times each second, it has a frequency of 100 Hertz. Hertz: (Hz) = vibrations or cycles per second. Psychological correlate = Pitch 17

18 ( one second ) One cycle Two cycles Two Hertz tone 18

19 A one Hertz or frequency sound wave. Most sounds are a composition of many frequencies and are referred to as complex noises or speech or music! 250 Hz Hz - most commonly tested when measuring hearing. 31Hz - 31,500 Hz when measuring noise. 19

20 20 Hertz to 20,000 Hertz in a normal healthy cochlea. The mid frequency of a male voice is about 125 Hz and a woman s is 250 Hz. 20

21 In music, an octave (Latin: octavus: eighth) or perfect octave is the interval / time between one musical pitch and another with half or double its frequency.

22 In music, the term note has two primary meanings: A sign used in musical notation to represent the relative duration and pitch of a sound (, ) Pitch or frequency of the sound itself.

23

24 Note-Frequency Conversion Table: This table gives the frequency (in hertz) of every note on an 88-key piano keyboard, except for the left most two keys below the lowest C ("C0"). The frequencies are rounded to the nearest whole number (no decimals). Note: C4 is middle C, and A4 is the A used to tune an orchestra.

25 Instrument Starts Stops Guitar E2 (82 Hz) E6 (1319 Hz) Seven String Guitar B1 (61 Hz) E6 (1319 Hz) Cello C2 (69 Hz) A6 (1760 Hz) Bass Guitar B0 (62 Hz) D4 (294) Piano A0 (27 Hz) C8 (4435 Hz) Piccolo C5 (554 Hz) C8 (4435 Hz) Violin G3 (196 Hz) E7 (2637 Hz)

26

27 Strength or pressure of the air exerted by the sound wave. Physical measure is the decibel (db). Relative measure, not an absolute # 1 db - pressure the sound wave exerts is equal to the weight of dynes per square centimeters. Psychological correlate is loudness. 27

28 Small Movement Large Movement of Vibrating body Intensity 28

29 0 db db intensity levels can far exceed this maximum level, i.e. 165 db Normal speech level is db. Usual threshold for pain is about 135 db - is different for everyone however. 29

30 1 Hr. before TTS 7 mins before TTS

31 Most provinces have OHS standards regarding noise exposure, Generally accepted 85 db for 8 hrs., Doubling rate of 3 db half the time exposure; 85 db 8 hrs 88 db 4 hrs 91 db 2 hrs 94 db 1 hr 97 db 30 mins. 100 db 15 mins. 103 db 7 mins. 31

32

33 Low Pitch High Pitch Quiet Human ear 20Hz 20K Hz Loud

34

35

36

37 In linguistics, a word is the smallest element that may be uttered in isolation with semantic or pragmatic content (with literal or practical meaning). This contrasts with a morpheme, which is the smallest unit of meaning but will not necessarily stand on its own. A word may consist of a single morpheme (for example: oh!, rock, red, quick, run, expect), or several (rocks, redness, quickly, running, unexpected), whereas a morpheme may not be able to stand on its own as a word (in the words just mentioned, these are -s, -ness, - ly, -ing, un-, -ed

38 is a basic unit of a language's phonology, which is combined with other phonemes to form meaningful units such as words or morphemes. The phoneme can be described as "The smallest contrastive linguistic unit which may bring about a change of meaning.

39 is a region in which all the phonemes of the world's languages fall on an audiogram.

40 40

41

42

43

44 An art form whose medium is sound and silence. Its common elements are pitch (which governs melody and harmony), rhythm (and its associated concepts tempo, meter, and articulation), dynamics, and the sonic qualities of timbre and texture.

45

46

47

48 O O O O O O O O

49

50 Speech and Music contain many common properties in the acoustical world, another is communication. The Pt. does not have to hear the entire auditory signal to benefit from listening to music. The more residual hearing you maximize the more benefit(s) the Pt. receives. So, yes, knowing what the audiogram looks like may change your music selections or instrument! MT has the secondary effect of improving socialization and self-esteem. 50