Communication Assessment Procedures in the Aural Rehabilitation Process

A primary objective of rehabilitative audiology is to improve the hearingimpaired person's communication ability to the maximum extent possible and to assist him fulfilling appropriate and various roles in a given environment (Alpiner, 1968). These roles often have been categorized as social, vocational, and familial. There is general agreement among audiologists that hearing loss frequently interferes with normal communication function and affects persons in any or all of the categories listed. The routine audiologic test battery offers information as to the type and degree of hearing impairment, but is limited in providing information about the effects of the deficit on communication function. Interpretations made from numeric audiologic data are those of the audiologist rather than of the individual with the hearing loss. During the past 30 years or so, a variety of assessment scales of communication function have been developed to determine the handicapping conditions resulting from hearing loss. Only a few of these scales have specifically addressed themselves for use with the elderly. Early thinking about the older population tended to generalize this group as one, unintentionally ignoring the fact that individuals were living in two kinds of environments—extended care facilities or private residences. Extended care facilities have been referred to as nursing homes, homes for the aged, retirement centers, and so forth. The private residence may mean living alone or with a spouse in an owned or rented dwelling, or with other family members in their residences. T h e extended care facility environment implies a living situation in which the person no longer functions independently of others. Private residence living may imply varying degrees of independence, ranging from those who are still gainfully employed to those who must be cared for by family members. In attempting to assess the effects of hearing loss on communication function, therefore, it becomes important to try to evaluate individuals according to their unique living situations. Some difficulties have been encountered in the use of assessment scales with the elderly. Not all scales can apply to all individuals, and all items within a given instrument may not be appropriate. As assessment procedures are discussed, there will be a need to consider this situation.