SCHEME OF CURRICULUM FORTHIRD YEAR B. Sc. (HLS)

(Applicable from 2003-2004 I.e. from the batch to gets admitted to the Ist B.Sc.(HLS) Course in the year 2001-2002)

 

 

_________________________________________________________________________________

________

 

 

 

 

 

 

Credits

   Scheme of the Examination

 

 

 

 

 

 

 

(Clock

 Duration

                  Marks      

 

Sr. No.

Subject

                 Subjects

 

 Hours)

of the

Univ.

Internal

 

 

 

Code

 

 

 

(Minimum

Paper

Exam.

Assess-

Total

 

 

 

 

 

 

required)

 

 

ment

 

________

________________________________________________________________________

________

 

 

 

 

 

 

 

 

 

 

 

 

1

B 3.1.4

Adult Neurogenic Lang. Dis.

50

3

80

20

100

 

 

 

 

 

 

 

 

 

 

 

 

2

B 3.1.5

Voice Dis., Laryngectomy &

50

3

80

20

100

 

 

 

Cleft Palate

 

 

 

 

 

 

 

3

B 3.1.6

Neurogenic Speech Disorders

50

3

80

20

100

 

 

 

 

 

 

 

 

 

 

 

 

4

B 3.2.4

Diagnostic Audiology II

50

3

80

20

100

 

 

 

 

 

 

 

 

 

 

 

 

5

B 3.2.5

Management of Hrg. Impaired II

50

3

80

20

100

 

 

 

 

 

 

 

 

 

 

 

 

6

B 3.2.6

Prevention of Hearing Loss and

50

3

80

20

100

 

 

 

Conservation of Hearing

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

B 3.4.4

Clinical Psy., Psy. Of Exceptional

50

3

80

20

100

 

 

 

Psychodiagnostics

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

B 3.C1.3

Clinical Work (Speech Pathology)

150

3

100

 

100

 

 

 

(Practical & Oral)

Internal Assessment

(Practical & Oral)

 

 

 

 

 

50

 

 50

 

 

 

 

 

 

 

 

 

 

 

 

9

B 3.C2.3

Clinical Work (Audiology)

(Practical & Oral)

150

3

100

 

100

 

 

 

Internal Assessment

(Practical & Oral)

 

 

 

 

 

50

 

  50

 

 

 

 

 

 

   ______

 

   ______

   ______

   ______

 

 

 

 

 

 

650

 

760

240

1000

 

_________________________________________________________________________________

________

 

 

 

 

 

The following are the syllabi for the Third Year B. Sc. (HLS) subjects:

(Applicable from 2003-2004 I.e. from the batch to gets admitted to the Ist B.Sc.(HLS) Course in the year 2001-2002)

 

Paper I: B 3.1.4   Adult Neurogenic Language Disorders

 

1.  Hemispheric Functions and Cerebral  Dominance. Bi/Multilingualism, Models of language

     processing.

 

2.  a) Dysphasia; Definition, aetiology, Symptomatology (including linguistic , non linguistic,

         psychosocial and neurobehavioral)

    b) Classification based on Anatomical; Linguistic aspects; Psycholinguistic aspects      

        (Eisenson;  Schuell;  Wepman; Jakobson, Geschwind,  Luria, Benson).

    c) Appraisal and Evaluation: Assessment of Communication - Language-Non verbal

        abilities:  Methods of Testing - Tests such as MTDDAE, BDAE, WAB, PICA, FCP,

        Revised Token Test.  Differential Diagnosis in neurocommunication disorders and within

        Aphasia.

    d) Prognostic Indicators Spontaneous Recovery: General Principles in Therapy;

        Candidacy for Therapy and the type of therapy approaches - Specific Therapy  Approaches -

        Schuell's stimulation Therapy. Wepman's Thought-Centred Therapy ; Psycholinguistic

        Therapy , PACE, Programmed - Instruction   Approaches  like M.I.T., HELPSS, etc.

   e)  Role of Family/Spouse in Aphasia Rehabilitation

        - Psychoneurobehavioural problems and their Management

        - Psychosocial, Socioeconomic and communicative difficulties

        - Family members as facilitators of communication,

    f)  Group Therapy.  Team Approach

    g)  Other Neurological Language Disorders

          - Subcortical Aphasia; Primary Progressive Aphasia, Language impairment  subsequent to

            TBI.

         - Agnosias, Dysgraphias and Dyslexias; Dementia; Language Impairment following Right

           Hemisphere Impairment.

 

Suggested Readings:

 

Brookshine.R.H. (1992). An Introduction to Neurogenic Communication Disorders, ed. 4.

 Mosby Year Book Inc. St Louis.

Chapcy, R.(Ed.) (1986) 'Language Intervention Strategies in Adult Aphasia, ed. 2. Williams &

Wilkins. Baltimore.

Darley, F.L. (1982)  Aphasia. W.B. Saunders Company, Philadelphia.

Love, R.J. and Webb,W.G. (1992)'Neurology for the Speech-Language Pathologist, ed. 2.

          Butterworth-Heinemann, Stoneham, M.A.

Jenkins, J.J., Pabon, E.J., Shaw, R.E., and Sefpu, J.W. (1975) Schuell's Aphasia in Adults, ed. 2.

NY: Harper and Row, Publishers.

Johns, D.F. (Ed.) (19   )   Clinical Management of Neurogenic Communicative Disorders, ed. 2.

 Little, Brown and Company, Boston.

 

Paper II: B 3.1.5   Voice Disorders, Laryngectomy and Cleft Palate

 

1. Normal Aspects of Voice:- Review of anatomy and physiology of voice, Review of

    development  of voice; Theories of phonation; characteristics of normal voice (Physical and

    perceptual/psychological attributes of voice) Physiological; acoustical and aerodynamic

    correlates of  normal voice.

 

2. Perceptual and instrumental analysis of voice.

 

3. Disorders of voice:

    a) Aetiology and classification of voice disorders organic and functional.

    b) Evaluation and differential diagnosis of voice disorders based on acoustical, aerodynamic

        and perceptual analysis.

    c) Therapeutic management: i) Behavioural  ii) Symptomatic & iii) Psychological approaches.

    d) Medico-surgical management of voice problems. Phonosurgery.

 

4. Voice Problems in children- Diagnosis and Management

5. Voice Therapy for Professional Voice users.      

 

II. Laryngectomy:- Cancer of Larynx - Signs and symptoms:

     - Pre-operative and post-operative counselling

     - Methods of teaching esophageal speech.

     - Phono-surgical management of laryngectomee

     - TEP: candidacy; voice therapy

     - Types of surgeries.

     - Artificial larynx with types, advantages and disadvantages.

 

6.  Evaluation, assessment and management of phonation, articulation & language problems in

     cleft lip and palate cases. Associated  Problems

 

7.  Surgical management

 

8.  Prosthodontic and Orthodontic management of cleft lip and palate cases and VPI cases.

 

9.  Team approach.

 

III.  Cleft Palate:-

 

       1) Review of anatomy & Physiology of speech & hearing mechanism.

       2) Embryology associated syndromes parent-counselling

       3) Aetiology and Classification

       4) Assessment of velopharyngeal incompetence,  palatography; Cine-flourography;

           acoustic analysis.

 

Suggested Readings:

 

1.  Boone D.A. McFeulare, S.C. (1988) Voice & Voice Therapy. ed. 4. Prentice- Hall,

Englewood Cliffs, New Jersey.

2. Colton, R.H., Casper, J.K.(1996) Understanding Voice Problems, Ed. 2.  Williams &

Wilkins.

3. Daniloff R., Schuckers, G. Feth L, (1980) The Physiology of Speech & Hearing.  Prentice-

          Hall Inc., Englewood Cliffs, N.J.

4. Gould W.J., Stataloff, R.T.,  Piegd, J.R. (1993) Voice Surgery, Mosby - year book Inc.

5. Green MCL (1980) The Voice and Its Disorders, ed. 4. Pitman Medical Ltd.

6. Mc Williams, J. (1986) `Cleft Palate'. In Shames, G.H. & Wigg E.H. (Eds.): Human

Communication Disorder. Charles E.Merill Publishing Company.

7. Prober R.J. Swift R.W. (1984) Manual of Voice Therapy. Little, Brown & Company

          Boston/Toronto.

8. Stemple J.C. (1993) Voice therapy, Mosby Year book Inc.

9. Wilson D.K. (1987) Voice Problems of Children,  ed. 3.  Williams & Wilkins.

 

3. Paper III : B 3.1.6  Neurogenic Speech Disorders

 

1.A-    Dysarthrias

         -  Dysarthrias according to Mayo Clinic Classification

         -  Review of Neuroanatomical correlation with  Motor Speech Production

         -  Signs and symptoms of Dysarthria. Objective and Perceptual observations

         -  Differential Diagnosis within and between  dysarthrias; and Other NCD

         -  Medical diagnosis as an aid in differential diagnosis.

         -  Speech problems in GPI, Multiple Sclerosis, Parkinson disease, Chorea.

               Myasthenia Gravis Disease. Spastic Quadriplegia, ALS-Management-

 

1-B     Apraxias

           -  Physiology of Speech Production

               Speech Programmer - Clinical Features AOS

           -  Types of Apraxias - Appraisal, Assessment, Evaluation, Diagnosis and Differential

              Diagnosis of Apraxia from Motor Speech Disorders and other NCD especially Broca's

              Aphasia-Treatment Planning.

           -  Management - Specific Therapy Approaches.   

 

2.       Mental Retardation

          -  Definition

         -  Classification

          -  Clinical types

         -  Causes

         -  Diagnosis

         -  Associated problems

         -  Speech problems

         -  Therapy Techniques

         -  Prognosis

         -  Counselling

 

3.       Cerebral Palsy

 

         -  Definition

         -  Types

-  Causes

         -  Associated problems

-  Speech problems

         -  Diagnosis

         -  Methods of Training

         -  Bobath's (RIP), Sensory Integration  Training and PNF  Programme

         -  Speech Therapy Techniques

         -  Physical therapy, Occupational therapy.

 

Suggested Readings:

 

Bernstein D.K. and Tiegerman E. (1985) Language and Communication Disorders in Children.

Charles E. Merrill  Publishing Company. Columbus (Chapter VIII pp. 172 to 215)

Brookshire.R.H. (1992). An Introduction to Neurogenic Communication Disorders, ed. 4.

 Mosby Year Book Inc. St Louis.

Crickmay, M.C.(1972) Speech Therapy and the Bobath. Approach to Cerebral Palsy. Charles

C. Thomas Springfield, Illinois, U.S.A.

Huskins, S. (1986) Working with Dyspraxics. AWishlaw Press Ltd., U.K.

Johns, D.F. (Ed.) (1978) Clinical Management of Neurogenic Communicative Disorders, ed. 2.

 Little, Brown and Company, Boston.

McDonald, E.T. and Chanch, B. J. (1965) Cerebral Palsy. Englewood Cliffs, NJ: Prentice-Hall.

Mysak E.D. (1986). Cerebral palsy, pp. 53-56. In Shames G.K. and Wiig E.H. (Eds.) Human

Communication Disorders - An Introduction. Charles E. Merill Company, Columbus.

Rondal J.A. (1988) Down's Syndrome, pp. 165-176. In Bishop, D. and Mogford K. (Eds.)

Language Development in  Exceptional Circumstances. Churchill Livingstone,

Edinburgh.

 

4. Paper  IV: B 3.2.4  Diagnostic Audiology II

 

  1.  Importance of and indications for special diagnostic test battery.

 

  2.  Biophysical tests

    a) Terminology: Objective, Electrophysiological, Physiological and Biophysical.  Need

        for  comparison with psychoacoustic tests.

    b) Acoustic Immittance Audiometry: Introduction.  Impedance vs. immittance. 

        Terminologies. Electrical, mechanical and acoustical analogues. Series and parallel

        combinations of  impedances/ admittances.  Resonance.  Frequency dependence of

        immittance and its  components. Acoustic impedance of the ear. Electroacoustic immittance

        instruments:  Principle and working. Bridge vs. Meter. Single probe frequency vs. Multi-

        tone. Single  component vs. Multicomponent instruments. 

    Review of basic immittance test battery:  tympanometry,  static immittance, acoustic

        reflex threshold and reflex decay. Jerger's Box Patterns. Eustachian tube evaluation. Non-

        acoustic reflexes.

    Clinical applications of immittance test battery for differential diagnoses and

        prediction  of hearing  sensitivity.  Factors affecting the reliability and validity.

    c) EDA (in brief). Principle.  Applications. Pros and cons.                         

    d) Electric/Evoked  Response Audiometry (ERA) (with special reference to ABR). 

        Introduction.  Classification and characteristics.  Basic instrumentation.  Salient features.

        Variables affecting normal Auditory Evoked Potentials (AEPs).  Importance of norms. 

        Clinical applications.  Factors affecting the reliability and validity.

    e) OAEs.  Types. Origin.  Instrumentation and clinical applications. Reliability and validity.

    f) Concept of objectivity.  Relative merits and demerits.

 

3. a) Sensorineural hearing loss: Need for differential diagnosis of cochlear vs. retrocochlear

        sites of lesion.  Review of physiology of the cochlea and VIII nerve with special reference

        to  loudness  and pitch perception.

    b) Tone Decay Tests (TDT): Terminology. Different procedures: Carhart, Rosenberg, Owen, 

        Green,  Olsen and Noffsinger, and Jerger's Supra-Threshold Adaptation Test (STAT).

        Continuous Tone Masking - Advantages & Disadvantages. Masking of the NTE.  Theories

        of tone decay (in brief). Adaptation and fatigue.

   c) Recruitment: Definition.  Loudness and its measurement. Growth of loudness in normal

       ears.  Loudness Balance Tests: ABLB (Hood) and Modified ABLB (Jerger). Monaural

       Loudness  Balance Test. Median  Plane Localisation. Administration.  Theories of

       recruitment (in brief).

  d)  Difference Limen Tests for intensity and frequency: Weber's Law.  Zwislocki, Denes and

       Naunton’s  tests.

  e)  SISI - Introduction, parameters, presentation, interpretation, and modifications

  f)  Bekesy Audiometry: Introduction, description, types, critical off time (COT), lengthened off

       time (LOT), Bekesy Ascending- Descending Gap Evaluation (BADGE), Forward-backward

       tracing. Controversies, Bekesy comfortable level, Brief-tone Bekesy Audiometry (BTBA).

  g) Speech audiometry: PI-PB function.  Roll-over Index. 

  h) Biophysical tests: Immittance, ECochG, ABR  and OAE test findings.

  i)  Findings in Meniere's, acoustic tumour and auditory neuropathy. Epidemiology. Glycerol

      test. Reliability and validity of the tests.. Concepts of Sensitivity and Specificity.  Predictive

      value  and efficiency.

 

4.   Central Auditory Disorders (CAD)

   a) Definition.  Central auditory pathway.  Role of CANS in hearing and the effect of  CANS

       lesions on hearing.  Need for more refined tests: Jerger's Subtlety and Bottleneck Principles. 

       Concept of redundancy: intrinsic and extrinsic. Monotic and dichotic non-speech and speech

       tests for the differential diagnoses of VIII nerve, low brainstem, high brainstem and cortical

       lesions of dominant and non-dominant hemispheres.  Reliability and validity of the tests.

   b) Central Auditory Processing Disorders (CAPD) in children.  Signs and symptoms.  Tests.

        Management.

 

5.    Functional Hearing Loss (FHL) in adults and children: Definitions and terminologies. 

       Causes. When to  suspect? Behavioural clues,  Intra- and inter-test variability,  Absence of

       shadow curve,  Discrepancy between PTA and SRT, etc.  Qualitative and quantitative

       behavioural and biophysical tests based on nonspeech and speech stimuli for unilateral and

        bilateral cases of suspected FHL.  Management of cases confirmed/diagnosed as FHL. 

       Reliability and validity of the tests.  Medicolegal implications.

 

6.a) Calibration of diagnostic instruments. Standardisation and calibration: Definition of and

       need for. Types of calibration: Instrumental and biological.

   b) Calibration of pure tone audiometers. IEC, ANSI and BIS standards. Instrumental

       calibration of frequency, linearity of attenuator and accuracy of output of AC transducers.

       Other  parameters of calibration.  Biological calibration of AC & BC transducers.  Relative

       merits  and demerits of instrumental and biological methods of calibration.

  c)  Calibration of Speech, Immittance and EP instrumentation of SF systems.

 

Suggested Readings:

Arlinger, S (Ed.) (1994) Manual of Practical Audiometry. Vol. I. Indian Reprint Edition. New

Delhi: A.I.T.B.S

Arlinger, S (Ed.) (1995) Manual of Practical Audiometry. Vol. II. Indian Reprint Edition. New

Delhi: A.I.T.B.S

Jacobson, J.T. and Northern, J.L.(Eds.) (1991) Diagnostic Audiology. Austin, Terms: Proed.

Jerger, S. and Jerger, J. (1981) Auditory Disorders. Boston: Little Brown & Co.

Lass, N.J., et al. (Eds.) (1988) Speech, Language and Hearing. Philadelphia: W.S. Sanders.

..... 31

Bess, F.H. and Humes, L.E. (1990) Audiology: The Fundamentals. Balti­more: Williams &

Wilkins.

Hodgson, W.R. (1980) Basic Audiologic Evaluation. Baltimore & London: Williams & Wilkins.

Kaplan, H., Gladstone, V.S., and Lloyd, L.L. (1993)  Audiometric Interpretation: A Manual of

Basic Audiometry, ed. 2. Boston: Allyn & Bacon.

Katz, J. (ed.) (1994) Handbook of Clinical Audiology, ed. 4. Balti­more: Williams & Wilkins.

Martin, F.N. (1991) Introduction to Audiology, ed. 4.  Englewood Cliffs, N.J.: Prentice-Hall.

McCormick, B. (Ed.) (1994) Paediatric Audiology 0 - 5 Years.  Indian Edition, New Delhi:

A.I.T.B.S. Publishers.

Newby, H.A. and Popelka, G.R. (1985) Audiology, ed. 5. Englewood Cliffs, N.J.: Prentice-Hall.

Northern, J.L. & Downs, M.P. (1991) Hearing in  Children, ed. 4.  Baltimore: Williams &

Wilkins.

Rintelmann, W.F. (Ed.) (1991) Hearing Assessment, ed. 2.  Boston: Allyn & Bacon.

Rose, D.E. (Ed.) (1978) Audiological Assessment,  ed. 2.  Englewood Cliffs, N.J.: Prentice-Hall.

 

5. Paper V: B 3.2.5  Management of the Hearing Impaired - II

 

1.  Speech Correction, Characteristics of the Speech of a deaf child (a) intelligibility  b) Time and rhythm  c) Voice    d) Articulation    e) Breathing. Practical instructions for working on the different aspects of speech.  Speech training for the deaf and hard of hearing children. Different methods of speech training.

 

a) Educational Placement of the hearing impaired . Integration, Reverse integration, Segregation,

    Normal plus special classes- Methods of communication; Verbal oral , Aural, Acoupedic,

    Nonverbal - sign language.  Other Manual alphabet, curved speech, fingerspelling, Total

    communication.

b) Parent-Infant Training Programmes.

 

3. a) Output limiting in hearing aids. Automatic signal processing. Digital and Programmable

        hearing aids.

     b) Hearing aid preselection and selection for young hearing impaired children.

     c)  Objective methods for hearing aid selection for older children and adults

     d) Earmoulds: Types,  Procedure for earmold making; Modifications.

     e) Hearing aids for the aged population

 

4.  a) Problems faced by unilateral hearing loss Management.

     b) Management of progressive hearing loss.

 

5.  Concept of speech insurance and speech conservation.  Management of postlingual hearing

     loss.

 

6.  Cochlear implants - Parts and function; Types of electrodes, electrode sites; Candidacy

     surgical techniques,  postoperative complications, Mapping rehabilitation and patients

     with cochlear implant- Role of audiologist and counselling parents.

 

Suggested Readings:

 

  1.  Cooper, H.C. (1991). Cochlear Implants - A Practical Guide. Whurr Publisher Ltd.

  2.  Davis, J.M. & Hardick, E.J. (1981). Rehabilitation Audiology for Children and Adults.

         John Wiley and Sons.

  3.  Davis, H & Silverman, S.R. (1978), Hearing and Deafness, ed. 4. Holt, Rinehart, and

 Winston. N.Y.

  4.  Hodgson, W.R. & Skinner, P.H. (1981 ). Hearing Aid Assessment & use in Audiological

           Habilitation ed. 2. Baltimore: William & Wilkins

  5.  Hull, R.H. (1977). Aural Rehabilitation- Serving Children and Adults, ed. 3. Singular

           Publishing Group, Inc.

  6.  Katz, J. (1994) Handbook of Clinical  Audiology, ed. 4. Baltimore: Williams & Wilkins.

  7.  Lass, N.J.,  McReynolds, L.V. Northern, J.L. & Yoder, D.E. (1988). Handbook of

           Speech  Language Pathology and Audiology. B.C. Decker, Inc.

  8.  Lynas, W. (1994). Communication Options. Whurr Publishers Ltd.

  9.  Maurer, J.F. & Rupp, R.R. (1979). Hearing & Ageing.  Grune & Stratton, Inc.

10.  Northern, J.L. & Downs, M.P. (1991), Hearing in Children, ed.4 Baltimore: W & W.

11. Pollack, M.C. (1988). Amplification for the Hearing Impaired, ed. 3. Grune & Stratton.

12. Skinner, M.W. (1988). Hearing Aid Evaluation. Englewood Cliffs, N.J. Prentice-Hall.

 

6. Paper VI: B 3.2.6 Prevention of Hearing Loss  and Conservation of Hearing

 

1. Prevention: Types and definitions with examples. Hearing Impairment, Disability and

    Handicap: Definition with examples. Concepts of Incidence and Prevalence.

 

2. Primary Prevention of Congenital and hereditary types of hearing loss. Consanguinous

    marriages.  Rh-Incompatibility.  Care of mother during pregnancy.  Secondary and Tertiary

    Prevention: Importance of and methods of early detection in neonates and infants; diagnosis

    and intervention. Concept of critical period. Screening tests and High Risk Register: Pros  and

    Cons. Concept of false positives and false negatives.

 

3. Prevention of hearing loss in early childhood. Immunisation against infectious diseases.

    Public education regarding the need for early treatment of upper respiratory tract and ear

    infections .  Role of G.P.'s and Paediatricians.

 

4. Prevention of hearing loss and conservation of hearing in school going children. Importance of

    and methods of early detection of hearing loss.  Individual and group screening  tests.  Criteria

    for medical referral.  Follow up programmes planning and hearing conservation programme.

 

5. a) Hearing impairment in the elderly - Presbycusis. Structural changes. Effects on the

    individual and family.  Is presbycusis preventable? Tertiary prevention: Hearing Aids and

    other intervention/management strategies.

 

     b) Conservation of Hearing in Industry. Noise. Insidious onset of hearing loss due to noise.

    TTS and PTS. Acoustic trauma and noise induced hearing loss Other effects of noise-

    physiological other than hearing loss, effect on work performance, on speech.  Annoyance  of

    noise'  Measurement of noise - sound level meter, dosimeter, wave analyser. Noy and PN dB.

    Mechanism of deafness due to noise exposure. Histological findings.

 

    Noise induced hearing loss and presbycusis - typical audiograms.

 

    Factors that are critical. Damage risk criteria: How much noise is too much? Individual   

    variability in susceptibility to noise.  Tests for noise susceptibility.

 

    Prevention of noise induced hearing loss. Control of noise: a) Environmental: improved 

    engineering design, acoustic treatment  b) Personal: Use of ear protectors.  c) Proper

    placement of employees.  Importance of and methods of early detection of loss due to

    exposure to noise.   Individual hearing conservation programmes. Pre-placement  audiograms.

    Periodic-retesting.    Monitoring and screening audiometry.

 

Suggested Readings:

 

  1. Bess, F.H. & Humes, L.E. (1990) Audiology- The Fundamentals. Baltimore: Williams &

Wilkins.

  2. Gerber, S.E. (1990). The Etiology of Communicative Disorders in Children.  Prentice-Hall,

Englewood  Cliffs, N.J. (Chapter 9, Appendix A, B & D) (For chapter 1).

  3. Harges, D. & Northern, J.L. (1996). Infants & Hearing, Singular Publishing Group ,Inc.

  4. McCormick, B. (Ed.) (1994) Paediatric Audiology 0 - 5 Years.  Indian Edition, New Delhi:

A.I.T.B.S. Publishers.

  5. Newby, H.A. and Popelka, G.R. (1985) Audiology, ed. 5. Englewood Cliffs, N.J.: Prentice-

Hall.

  6. Northern, J.L. & Downs, M.P. (1991). Hearing in Children,  ed. 4. Baltimore: W & W.

  7. Park, K. (1997) Park's Textbook of Preventive and Social Medicine, ed. 15. Jabalpur:

Banarsidas Bhanot

  8. Rose,D.E. (1978). Audiological Assessment, ed. 2. Englewood cliffs, N.J.: Prentice Hall.

  9. Sataloff, R.J. (1987) Occupational Hearing Loss. New York Marsh.

10. Weiss,C.E. & Lillywhite H.S. (1981) Communication Disorders-Prevention & Early

Intervention, ed. 2. The  C.V. Mosby  Company. (Chapters 6 and 7). (For chapter 1)

..... 33

7. Paper VII: B 3.4.4 Clinical Psychology 

           (including  Psychology of the Exceptional, Psychodiagnostics and Therapeutics)

 

 1. Definition of clinical psychology. Historical introduction. Methodology in clinical

     psychology.

 2. Concept of normality and abnormality.  Criteria for abnormality. Dynamics of adjustment.

 3. Unconscious process (briefly) Id-Ego-Superego. 

 4. Psychodiagnostics.  Its meaning and scope.

 5. Psychometrics.  Development of Norms and standardisations of tests.  Requirement of good

     test.

 6. Measurement of intelligence, nature of intelligence.  Various classifications.  Developmental

     schedule.  Commonly used verbal and performance tests of intelligence.  Indian Adaptations. 

     Limitations of intelligence  testing.

 7. Personality and its measurement.

 8. Introduction to classification of mental disorders, Broad areas, neuroses and psychoses, brief

     discussion of symptomatolgy and diagnosis.

 9. Psychological and Physical methods in treatment.  Psychotherapies, briefer forms of

     psychotherapy.   Psychodramas, Group Therapy.  Play therapy, Behaviour therapy.

     Supportive Therapy.   Treatment  of the individual and the  group in the social context. 

     Trends and prospects.

10. The normal and the exceptional.  Criteria of exceptionality.  The various types of

      exceptionality.  A brief account of causes and diagnosis.

 

a. The Intellectually exceptional: Mentally Retarded and Gifted.

b. Sensory Exceptionality.

c. Multiple Handicapped.

d. Children with learning disabilities.

e. Emotionally exceptional etc.

f. Neurologically  exceptional.

 

11. Testing the exceptional child (with special reference to speech and hearing impaired) -

      problems in.  Problems of communication.  Development of rapport.  Reliability and validity

      of  the tests.

12. Parents of the exceptional children.  Parent-child relationship.  Abnormal reaction or

      attitudes.

13. Psychotherapy, Guidance and counselling the parents of the exceptional children.

14. Educational and vocational assessment and management of the exceptional.

Clinical Practicum requirement:

NOTE: Practical and clinical work will carry no marks.

Further to the inputs in the Second Year, the trainees should be able to -

a) Take a detailed case history

b) Carry out routine assessments, independently or with minimal supervision.

c)  Carry out minimal guidance for decisions regarding  placement,  stimulation,   guidance/

     remediation for common behaviour problems using simple  behaviour modification 

     techniques.

d) Write a psychological/psychoeducational report giving relevant details.

e) Make appropriate recommendations & referrals.

 

Suggested Readings:

 

 1. Coleman, J.C. (1976)  Abnormal Psychology and Modern Life, ed. 5. Bombay: D.B.

Taraporevala Sons & Co. (Indian reprint edition of the original fifth U.S. edition by

Scott, Foresman & Co.)

 2. Shaffar and Lazarus (1952) Fundamental Concepts in Clinical  Psychology. New York:

 McGraw-Hill.

 3. Oltmanns, T.F. and Emery, R.E. (1995) Abnormal Psychology.  New Jersey: Prentice-Hall.

 

     More references to be added later.

..... 34

8.  B 3.C1.3 Clinical Work (Speech Pathology) 

 

I Goals: The student clinician shall , at the end of the third year , achieve the following goals :-

 

1.     The student –clinician will have  the prerequisite information related to the  neuroanatomy and neurophysiology related to speech-language functions

2.     The student clinician will be able to :-

      A) Differentially diagnose a client with Neurocommunication Disorders (NCD) in terms of

the following disorders.

                      Adults                                                               Children

 

Aphasia -  Cortical                                                  Acquired childhood Aphasia

              -  Subcortical

              -  Primary Progressive (Slow)

Apraxia                                                                   Developmental Verbal Apraxia

 

Dysarthrias                                                             Dysarthria Subsequent to Cerebral Palsy

 

Language of Generalised                                       Children with Cognitive Impairments

Intellectual Impairment

 

 - Dementia

 

 - Alzheimer's /Pick's Disease                                Pervasive Developmental Disorders

 

Language of Confusion Subsequent                     SLI / LD   ADHD  

to Traumatic Brain Injury

Language Impairment following Right

Hemisphere Damage

 

       B)  Differentially diagnose  between  phonation disorders occuring due to Organic and

             non-Organic factors and  manage them.

       C) Differentially diagnose between  Articulation Disorders and  between  Fluency Disorders

            and manage them.

II Clinical Skills  and Minimum Requirements                                 No.of hours / No.of cases

                   A -  Diagnostics

The student clinician shall , at the end of  the third year, be able to :

 

1.i)   Do objective analysis ( acoustic & aerodynamic ) of voice-                 04                     04

        disordered individuals 

  ii)  Administer and interpret  battery of language tests for the                    06                     02 Ch.

        diagnosis of  childhood and language disorders (Knowledge                                         02 Ad.

        of  3 DLAT , LPT, WAB; BDAE is compulsory)

 iii)  Execute Motor Speech Examination of children and Adults                  03                    01 Ch.

        with Neurogenic Speech Disorders                                                                                 02 Ad

iv)   Analyse and differentially diagnose the dysfluencies and                       04                    01 Ch

        calculate their percentage and administer the Attitude                                                   02 Ad.

        Questionnaire.

2.    Do narrow transcription of the clients managed in clinics                       02                    01 Ch.     

                                                                                                                                                 01 Ad.

3.   Make Diagnostic formulations of the clients managed, with

      appropriate referrals to be presented in a written format to                      02                     4.

      the Clinical Supervisor.

 

                   B. Treatment Planning and Therapeutic Intervention

1.  Manage the following variety of clients                 No

      

         i)  Neurocommunication Disorders                        4

        ii)  Phonation Disorders                                          4

       iii) Fluency Disorders                                              4

       iv) Childhood Language Disorders                          2

        v) Articulation/Phonological Disorders                  2                               

 

Comprehensive Report for each of the above clients to be neatly maintained in the specified format in a Speech-Language Journal. The audio recordings of Speech Samples of  the above clients should be transcribed in IPA and maintained in the Journal.                                               2

2.  Consider the option of AAC

3. Acquire knowledge from recent literature for treatment planning

    for cases other than routine (e.g. Adults with TBI /Children with PDD )           02                    1

4. Make a presentation in the weekly  Clinical Conference, of client using           03                    2

    the specified format.     

 

III Break up of Internal Assessment:                       50 Marks

 

          Oral Exam                                                 -        20

          First Term Clinics                                     -       25

          Second Term Clinics                                -        25

          Journal with Minimum Requirements:     -       10

          Case presentation                                     -        10

           Poster presentation in the department     -       10

                                                                                     -----

                               Total:                                          100

                                                                                   -----

            It will be computed for 50 by dividing the  marks obtained as above by 2.

 

IV Conduct of Practical Examination

 

PROCEDURE  STATIONS:

 

A)  Preparation of a list of questions based on the lists of presenting symptoms of a

       particular Speech-Language disorder.

       Any of the following  could be used.

       Voice Disorders; Aphasia; Right Hemisphere Impairment; Dementia;

       Acquired Childhood Aphasia , Learning Disabilities etc.

       Clinician will be required to come to a conclusion regarding  Diagnostic possibilities and                                            

      Therapy planning and  techniques.

 

    - The student-clinician will prepare a list of questions needed based on which he/she

       will be questioned.

       (Minimum Requirement at least 2 cases /student)                                                 (40)

 

B) Description of the Audio recording presented to them of clients with speech-language

     disorders based on which the student will be questioned.                                   (5x2 = 10)

 

    i) Voice-Disorders in Hoarseness, Spastic Dysphonia, Breathiness, Hypernasality, etc.

   ii)  Dysarthrias:- Flaccid/Spastic Dysarthria

  iii)  Language Disorders:  Wernicke's Aphasia, Broca's Aphasia; Language of  confusion.

        (Minimum requirement at least 1 recording from (i) (ii) (iii)

 

C)  Preparation of an Audio recording of a 5-10 minute counselling session for a given aspect

      of a given disorder  e.g. To explain vocal hygiene to an adult with hyperfunctional voice 

      disorder. (Minimum requirement recorded sample)                                                (10)

 

       PROCEDURE AND RESPONSE STATIONS:

 

D)  Response - evaluation of A, B & C                                                                    (10)

E)  Identification and Naming functions of the various anatomical  parts/prosthesis/charts/  

      models/diagrams of Larynx, Neuroanatomy                                                          (10)

F)  Speech-Language Journal-based questions will be asked, based on the diagnostic and       

      therapy reports filed in the Journal.                                                                   (10)

 

G)    i)   Viva Voce

         - Questions related to Cranial Nerve Testing

         - Other clinical questions in areas of Voice Disorders, NCD                                  (15)

 

      ii)   Overall use of professional language and professional attitude and knowledge

            related to ASLP profession  will be evaluated.                                                    (5) 

 

B 3.C2.3 Clinical Work (Audiology) 

 

I -  GOALS:

 

      Following are the list of clinical skills the students should have acquired by the end  of the

      3rd year:

      (Confirmation of acquisition of these skills will be done by supervision, cross-checking

        and checklist)

 

 1. Calibration

 

      The students should be familiar with

       i) knowledge of equipment used for AC and BC calibration of audiometer.

      ii) Procedure for physical calibration of audiometers including  trimpot adjustments

          and making of correction charts.

     iii) Biological calibration of audiometers

 

2.  Immittance Test Battery

 

     i)   Should be well-versed in the administration, interpretation and documentation  of: 

          Tympanometry,  Reflex testing, Testing for decay,  Eustachian tube assessment.

    ii)   Should be able to correlate these findings with pure tone findings and TF test results.

 

3. ABR:  The student should be familiar with the administration and interpretation of

     i) ABR for threshold testing

    ii) ABR for site of lesion testing

   iii) Student should be able to correlate these findings with other test results in the

         test battery.

 

4.  SPECIAL TESTS:  The students must be well-versed in giving instructions for;

     administration,  interpretation  and documentation of following tests:-

 

    i) ABLB - Hood's procedure and Jerger's procedure

   ii) SISI

  iii) Tone Decay: Carhart,s, Rosenberg's, Olsen and Noffsinger's, Owen's,, Green's  and

                              Jerger's STAT tests

             

        - The students should be able to correlate these findings with those of other tests in the

           test battery.

 

5. Functional loss: The students must be well-versed in

    i) identifying functional overlay, functional hearing loss

   ii) Modify the test procedure or select appropriate tests so as to estimate the extent of organic

       involvement

 iii) Administration and interpretation of the tests used for unilateral and bilateral functional

      hearing losses.

 iv) Communicating the test findings to the referral source.

 

6.  SAL Test: The student should be familiar with

      - equipment used for SAL test

      - administration and interpretation of SAL test,

7.  Student must be well versed in

     - reaching to a holistic topological diagnosis based on the entire test battery

    - writing  synopses of the test findings.

 

8.  Hearing aid selection:

 

   - The student must be well-versed in

     - selection of appropriate hearing aid  for adults and  geriatric clients

       (using subjective and objective methods)

     - selection of appropriate amplification for children.

 

9.  Aural Rehabilitation:     Same as those for the  2nd year.

 

II.  Minimum Requirements:

 

1.  Calibration:   Observation of calibration of audiometers for AC & BC  - 1 audiometer

 

2.  Immittance Test Battery: (Full battery)

 

      Normal subjects - 5

      Cases with different M.E. pathologies - 5

      Cases with S.N. Loss                           - 5

 

3.  ABR

 

      Normal subjects - 2 ( 1 for threshold testing  & 1 for differential diagnosis)

      Clinical cases: Threshold testing - 2 cases;   Differential diagnosis  - 2 cases

 

4.   Special Tests:  ABLB, SISI, Tone Decay and SAL

 

       Normal subject   - 1

       Conductive loss  - 1 case        

       S.N. Loss            - 1 case

 

5.  Functional loss

 

     Entire test battery for unilateral and/or bilateral functional hearing loss - 1 case

     Stenger administration & interpretation   - 1 Unilateral total loss (organic)

                                                                       - 1 Unilateral functional hearing loss

 

6.  A holistic diagnostic formulation based on the entire test battery- 5 cases

 

7.  Hearing aid selection ( subjective & objective methods):  Adult  - 2 cases;  Children - 2 cases.

 

8.  Management of Hearing Impaired

 

      Children below 3 yrs.               -  1 case

      Children above 3 yrs.               -  1 case

      Adult (Postlingual)                   -  1 case

      Geriatric                                   -  1 case

 

9.  Preparation of a home program for young hearing impaired child - 1 case

 

III. Break-up of Marks Allotted for Clinical Work Internal Assessment 

 

        Internal  Practical/oral examination         20

        Completion of Minimum Requirements  10

        Journal                                                      05

        Case Presentation                                     05                           

        Clinical Intervention & Management      10

               (during the academic year)           

           -------                                                            

                            Total  Marks:                       50                                                                              

                                                                       -------

 

IV. Scheme of Conduct of Practical Examination for  the 3rd year students:

 

                 Practical/oral Exam.            70

                 Viva Voce                           30

                                                          -------

                 Total Marks:                      100

 

Following is the weightage of marks allotted to different topics covered in the clinical practicum:

 

Sr.No.             Topics                                                                             Marks

 

 1.   Knowledge of calibration equipment & procedure                            10

 2.    Immittance                                                                                         10

 3.    ABR/SAL                                                                                          10

 4.    Test battery interpretation                                                                 20

         (inclusive of correlation of PTA, Speech audiometry,

           impedance, special tests, etc.)

 5.    Hearing aids  & management of hearing impaired                           20

     ----

                                                                                                                  35

 

The  Practical Examination can be conducted using the OSPE/OSCE  method.  It will contain procedure stations, response station and/or combination of the two.

 

Procedure Station examples:

 

1.  Reading/Interpreting an ABR report

2. Given the test battery results, interpreting the site of lesion

3. Carrying out immittance on a subject.

4. Identifying the equipment needed for calibration

5. Troubleshooting a hearing aid

6. Carrying out SISI/Tone Decay test at a given frequency

7. Writing an integrated report/summary based on the audiometric data provided

8. Carrying out hearing aid analysis

9. Identifying different types of hearing aids, their parts, various presets, couplers.

 

Response Station/Combined Procedure-Response Station Examples

 

1. Answering questions based on procedure stations.

2. Interpreting/Reading REIG report.

3. Suggesting ways of modifying hearing aid response for a given hearing impairment.

4.  Given a test battery  report, explaining what is wrong?

5. Given a case history, suggesting management for the case.

6. Carrying out parental counselling/adult counselling regarding a given point.

 

Internship

 

A student after passing the Final (Third) Year B. Sc. (HLS) Examination, but before being eligible for admission to the B. Sc. (HLS) degree, shall undergo six months of compulsory Internship in the institution in which he/she has studied and/or other government/non-government organisations at the discretion of the Head of the College/Institute.

 

At the end of  U.G. program (of 3½ years including 6-months' internship) the students must fulfil the following mini mum requirements (in contact hours):

 

Speech Pathology

 

The clinician shall have a total minimum of 1,000 hours of clinical work at the end of the B. Sc. (HLS) program. The break up under each head is as follows:

 

 

Child Assessment & Therapy (Total: Min.  500 Hours)

 

                                 Language Disorder       Articulation     Fluency    Voice     Total (Min.)

 

Assessment                             25                            25                  25           25        200 Hrs.

 

Therapy                                 100                            25                 100          25        300 Hrs.

 

Adult Assessment & Therapy  (Total: Min. 400 Hours)

 

                                  Language Disorder      Articulation     Fluency    Voice      Total

 

Assessment                             30                            20                30          20         150 Hrs.

 

Therapy                                   50                            50                50          50         250 Hrs.

 

 

                                                                   Child                             Adult                         Total

 

Assessment                                     200    Hrs.                      150 Hrs.                    350  Hrs.

 

Therapy                                           300    Hrs.                      250 Hrs.                   550  Hrs.

 

                      Total                          500    Hrs.                      400 Hrs.                1,000 Hrs.        

 

 

 

Audiology

 

The clinician shall have a total minimum of 1,000 hours of clinical work at the end of the B. Sc. (HLS) program. The break up under each head is as follows:

 

  Child                  Adult                Total  

Evaluation / Diagnostics:                                            150  Hrs.            150 Hrs.            400 Hrs.    

Rehabilitative (Inclusive of

   hearing aid selection):                                              100 Hrs.             100 Hrs.            300  Hrs.

 

                                                                Total            275  Hrs.            275  Hrs.          1000   Hrs.     

 

Note:-  If the student clinician , despite genuine efforts, is unable to meet the stipulated minimum requirements in any given category, he or she may be allowed to compensate by putting in extra hours in any of the other categories thus meeting the stipulated grand total.  The hours can also be compensated by suitable posting during 6 months' internship.

 

 

OFFICIAL TRANSCRIPTS

 

The official transcripts shall be issued to the students on demand by the College/Institution concerned, on payment of prescribed fees, if any. Format of the transcript based on American Speech-Language and Hearing Association (ASHA) guidelines being issued by TNMC is appended (Appendix E).

 

There are two parts to the transcripts: Academic Course Work and Clinical Practicum.

 

1. Academic Course Work: Calculation of GPA (Grade Point Average)

 

         GPA is the average of the product of semester credit hours and grade point `earned ' in a subject. For example, if in Paper I with 3 semester credit hours, a candidate gets A grade, his/her Grade Points for Paper I will be 3 x 4 = 12. (See notes below).   Thus, if a course consists of 6 papers, the grade points for all the 6 papers is calculated, summed  and divided by the sum of the credit hours of all the 6 papers.  The resulting value is the GPA. This can be given for each year of the course separately and a combined score for all the three years taken together can also be given.                                                                                                     

 

Notes:

 1. Semester credit hours is based on American system of one semester credit hour is equivalent to 16 clock hours.  Thus, if a subject is taught for 50 clock hours, it will correspond to 3 semester credit hours.

2. Grade points are as follows:  A: 4 points;  B - 3 pts.; C - 2 pts.; D - 1; pt.; F  - 0 pt.

3. Where marks are given for a paper, the marks will be converted to grades as under:

    75% and above:  A grade;  66 to 74% - B;  50 to  65% -  C; 40 - 49% - D; <40% - F

 

 (This apparently more liberalised conversion of marks to grades is because of the fact that our examination system is entirely different from the American system: The weightage for MCQs is only 20%;  the comprehensive  examination  is at the end of the academic year along with all the subjects prescribed for the course all which are compulsory for all the students; person who has taught the course, person who sets the paper and finally the person who evaluates them can all, be and usually are, different individuals.  Our students here, therefore, are at considerable disadvantage.)   

 

2. Supervised Clinical Practicum

 

This shows the actual contact hours a student has earned classified under various subheadings for each of the two disciplines of Audiology and Speech-Language Pathology.  This can be calculated and records updated monthly, term-wise and for each academic year on a progressive basis for each student so that it will be possible to achieve more uniform distribution of clinical work assignment.  For example, if a student has many more hours in Audiology and lacking hours in Speech -Language Pathology in one term or year, it can be compensated in the next term or year.  Within a given discipline, disparities among subheadings can be minimised.  This will also help later in posting students during internship.

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