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Structural- Hearing, Language & Multicultural

Structural- Hearing, Language & Multicultural

memorize.aimemorize.ai (lvl 286)
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Section 1

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Data to suggest that surgical outcomes may not be as good for African-American populations

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Last updated

6 years ago

Date created

Mar 1, 2020

Cards (44)

Section 1

(44 cards)

Data to suggest that surgical outcomes may not be as good for African-American populations

Front

Keloid scarring common

Back

Hubbard et al. / comparison of children with early insertion vs late - Did it make a difference?

Front

Yes, made a difference. Better acuity and arctic scores

Back

What is biggest auditory issue for those with CLP?

Front

otitis media

Back

Study by Toliver-Weddington

Front

- may not reflect African-American culture - researchers may be influenced by biases

Back

T/F: The auditory system is developing concurrently with the palate.

Front

True

Back

If cleft [palate or lip] is involved OME, PE tubes, and conductive HL is more common.

Front

cleft palate

Back

Children with clefts who felt more social acceptance tended to look at the peer's face during the interaction more often.

Front

Back

No significant differences in mother language, however:

Front

- tended to use fewer utterances overall - tended to use fewer declarative utterances

Back

OME Eustachian tube

Front

functions poorly or not at all

Back

Considerations: Native-Americans

Front

- child rearing usually responsibility of everyone in extended family - strong decision making role for women - different sense of time - words are powerful (can heal and/or harm) - direct eye contact usually considered aggression (avoid)

Back

Cleft palate only scored significantly poorer than CLP and controls on several measures of play.

Front

Recall etiology of CP vs CLP - suggested differences between in brain morphology between groups

Back

Immigrating cultures may bring their own beliefs about cleft lip and palate

Front

Remember to not jump to conclusions based on ethnicity

Back

T/F: All who are diagnosed with OME result in liquid accumulation.

Front

False

Back

Children with clefts (and their parents) were significantly less likely to be satisfied with appearance.

Front

Back

Language issues for clefts associated with syndromes

Front

may be cognitive involvement that is impacting language

Back

Otitis media

Front

inflammation of middle ear space (swelling of mucosal tissue)

Back

Considerations: African-Americans

Front

- least likely to have cleft lip and/or palate - when present, more common in females (reverse of general pattern!) - higher incidence among those of lower SES (as with most cultures) - extended family involvement (provide support for all) - women usually have major role in decisions - usually willing to accept surgical solutions if recommended

Back

Carrie et al. study revealed that children who had conductive HL also had...

Front

a narrower skull base angle.

Back

Reason for increased OME?

Front

bottom line: position of Eustachian tube or the attachment of the muscle

Back

When are PE tubes inserted?

Front

early - given high incidence of OME there is a tendency to use tubes preventively

Back

T/F: If liquid is present, there will always be a hearing loss.

Front

False - Even if liquid is present, there may not be any hearing loss.

Back

Why do individuals with CLP have increased OME?

Front

- generally assumed to be anatomical

Back

Result of OME

Front

negative pressure (a vacuum) which pulls liquid out of the mucosa into the space

Back

Effects of OME

Front

- usually temporary loss - conductive (ossicles not functioning properly) - *few cases of permanent, conductive and/or permanent, SNHL associated with frequent - *some emerging evidence of extended high frequency SNHL associated with frequent OME

Back

T/F: The hearing loss as result of OME is almost always temporary.

Front

True

Back

(Chapman) Is early speech delay related to later lexical development?

Front

Suggested that some articulation is related to development of vocabulary

Back

OME

Front

otitis media with effusion - escape of fluid into middle ear

Back

Reduced intelligibility of speech in early years for CLP

Front

may reduce length of interactions, which reduces the practice time as well as feedback with language

Back

Controversies about tube use:

Front

- should they be used at all? - should they be inserted earlier of later?

Back

Robson et al./ 70 children with CLP with about half with PE tubes - no significant difference found

Front

tubes might not always be necessary

Back

Language issues concerning all time spent in hospital:

Front

- quality of parent-child interaction - amount/quality of language stimulation

Back

Lower SES can have impact because...

Front

poorer access to medical insurance - may have a tendency to avoid medical care unless it is an emergency

Back

CLP language assessment and intervention

Front

most typical language tools can be used - nothing special, just remember to consider the cognitive and/or hearing impairments

Back

Differences in incidence for cleft LIP

Front

Native Americans: 1 per 1700 Asian Americans: 1 per 1600-4000 European Americans: 1 per 1500-3000 African Americans: 1 per 200-5000

Back

It is far more likely to have a problems with external, middle, and inner ear in cleft lip palate when...

Front

clefts associated with syndromes

Back

Considerations: Asian-Americans

Front

- diverse: 100s of languages and cultures - Chinese, Vietnamese, Hmong: extended family and male dominated - Lao, Khmer, and Indian: nuclear family and parents more equal - attitude toward Western medicine varies - variety of beliefs concerning cause of problem [karma (Buddhists), fate (Taoists), wrongdoings of ancestors (Animists), part of life (Koreans)] - view professionals with great respect - being too direct is considered impolite

Back

Considerations: Hispanic-Americans

Front

- quite a diverse group (many dialects, much variety in cultural practice) - many identify Spanish as native language: especially if recent immigrants (language barrier) - family is important institution in this culture (strong roles) - children often dependent well into adolescence - healthcare access often limited to: SES and immigration status - often strong identification with Catholic Church (could view child with disability as punishment from God or test of faith) - failure to shake hands may limit future cooperation

Back

Definite racial/ethnic differences in incidence of non-syndromic cleft lip (with or without cleft palate)

Front

African Americans least likely, Asian Americans at greatest risk (Native Americans with few studies, skewed number)

Back

Possible reasons for increased OME for individuals with CLP

Front

1. Structural differences in the anatomy of Eustachian tube 2. Abnormal insertion of tensor veli palatini into Eustachian tube

Back

As clinician, it is recommended that the best way to learn more of a cultural group you are not familiar with is to:

Front

- try to get to know the members of the culture - try to participate in their community activities - try to fit into their cultural life

Back

Effects of OME

Front

- negative pressure can reduce mobility of middle ear ossicles - usually results in mild conductive hearing loss (~30 dbHL)

Back

Visible clefts and scars may result in psycho-social problems due to the reactions of others

Front

- tendency to avoid communication - may be passive communicators

Back

What should be considered for CLP language assessment?

Front

- cognitive impairments - hearing impairments

Back

Operation Smile

Front

performs cleft lip and palate surgeries to children in low and middle income countries

Back