American Journal of Audiology最新文献

Purpose: This clinical focus article describes the development of a novel, remotely delivered counseling program for patients with hyperacusis. For many patients, seeking management of hyperacusis is limited by accessibility and affordability issues of care. By reducing these barriers, remote counseling has the potential to advance hyperacusis care and improve outcomes for many people suffering from hyperacusis.

Method: We created a 4-week remote counseling program that included asynchronous videos, hands-on activities and quizzes, handouts and resources for teaching coping skills and keeping patients engaged, and synchronous discussions for coaching. Weekly content was derived from in-person therapy using hyperacusis activities treatment (HAT) and focused on five relevant topics that included (a) an overview of hyperacusis, tinnitus, hearing, and hearing loss; (b) reactions to hyperacusis and strategies to reduce negative reactions to sounds; (c) thought analysis and restructuring; (d) relaxation techniques and mindfulness; and (e) gradual sound exposure and proper use of hearing protection.

Results: Our remote counseling program, HAT-Online, provides holistic education about hyperacusis, coping strategies to lessen reactions to everyday sounds and challenge thoughts and fears, and management options including customized sound therapy and relaxation exercises.

Conclusion: With implementation of this remote counseling program, our team anticipates gathering early clinical evidence needed to support larger, multisite, future randomized clinical trials that will be designed to more fully evaluate the effectiveness of the remote delivery of HAT's counseling and customized sound therapy components to reduce reactions to hyperacusis.

Purpose: The goal of this study was to provide evidence of the inherent variability associated with monitored live voice (MLV) presentation methods and encourage audiologists to more closely follow best practice of using recorded stimuli. To accomplish the goal, administration times for word recognition testing were compared between MLV and MP3 recorded stimuli presented directly from an audiometer (computer assisted, CA). Furthermore, the variability of administration time across testers was evaluated.

Method: Fifty-word NU-6 lists were presented via MLV and CA to listeners with typical hearing (TH; defined as a four-frequency [500, 1000, 2000, and 4000 Hz] pure-tone average [PTA] of 20 dB HL or better) and hearing loss (HL; defined as a four-frequency PTA poorer than 20 dB HL). Audiologists and doctor of audiology students administered the word lists. Administration times were compared between the two presentation methods (MLV and CA).

Results: MLV administration time was significantly shorter than CA presentation time for both the TH and HL groups. There was also a significant difference in word recognition scores (WRS) between the TH and HL groups only when using the CA method. Most notably, there was significantly more variability in the administration time for MLV presentation across testers compared to the CA method. Data were compared to Mendel and Owen (2011), and MLV administration time was found to be significantly shorter than CA and compact disk (CD) administration time.

Conclusions: Despite the shorter average administration time for MLV presentation compared to CA or CD, the significant variability in administration time among individual testers limits the clinical value of the test results. In addition, WRS for those with hearing loss were significantly poorer than those with TH when using CA but not for MLV, indicating that MLV is not sensitive to the presence of sensorineural hearing loss. Thus, using recorded word recognition is strongly recommended.

Purpose: We aim to determine the prevalence and characteristics of developmental disabilities among the clinical population of children who receive hearing health care in the United States.

Method: Using electronic health records of 131,709 children (0-18 years), we identified those with a diagnosis of attention deficit/hyperactivity disorder, autism spectrum disorder, vision differences, cerebral palsy, chromosomal abnormalities, delayed milestones, Down syndrome, or intellectual disability. We determined prevalence, age of first audiology encounter, age of diagnosis for the developmental disability, and hearing status based on the specific disability and the number of diagnoses. Binomial and multinomial logistic regressions were performed.

Results: One in four children had a diagnosed developmental disability. The most common disabilities were delayed milestones (11.3%), vision differences (7.4%), attention-deficit/hyperactivity disorder (6.6%), and autism spectrum disorder (6.2%). Half of the children with developmental disabilities had at least one diagnosis before their first audiology encounter. Children with developmental disabilities were more likely to have a reduced hearing or an unknown hearing status than children without developmental diagnoses. For children with reduced hearing, those with developmental disabilities had higher rates of bilateral configurations and poorer hearing severity levels.

Conclusions: Developmental disabilities are common among children who seek hearing health care. Moreover, developmental disabilities often co-occur with reduced hearing. Further research and advocacy efforts are critical for creating clinical practices that are inclusive of, and equitable for, children with complex and diverse developmental profiles.

Supplemental material: https://doi.org/10.23641/asha.27857847.

Purpose: Our study used preoperative neuroanatomical features to predict auditory development in Chinese-learning children with cochlear implants (CIs).

Method: T1-weighted whole-brain magnetic resonance imaging (MRI) scans were obtained from 17 Chinese-learning pediatric CI candidates (12 females and five males, age at MRI = 23.0 ± 15.0 months). Voxel-based morphometry was applied to examine the children's whole-brain structure. Machine learning was employed using neuroanatomical features to predict children's auditory skills up to 24 months after CI. The whole-brain neural model and auditory/visual cortex neural model were compared with a nonneural model using gender, age at CI activation, and preoperative residual hearing as predictors. Model performance was quantified using the mean square error (MSE) between predicted values and observations.

Results: The model with preoperative neuroanatomical features showed a significantly smaller MSE than the nonneural model in predicting auditory skills in children with CIs. Specifically, the auditory-related area played an important role in predicting post-CI outcomes.

Conclusions: The preoperative neuroanatomical features outperformed the nonneural features in predicting auditory skills in children with CIs. These results indicate that neural structure holds the potential to serve as an objective and effective feature for predicting post-CI outcomes.

Supplemental material: https://doi.org/10.23641/asha.28012046.

Purpose: The present study examined masseteric vestibular evoked myogenic potential (mVEMP) responses in children and compared these results with those of adults, using both air- and bone-conduction modes of stimulation.

Method: Fifteen children and fifteen adults with hearing thresholds below 15 dB HL were considered for the study. Ipsilateral 500-Hz narrow-band chirp (NB CE-chirp) evoked mVEMP responses were elicited via a zygomatic montage through both air- and bone-conduction modes of stimulation. Therefore, the recorded responses were analyzed for various mVEMP parameters, namely, absolute P11 and N21 peak latencies, the peak-to-peak amplitude of the P11-N21 complex, and the interaural asymmetry ratio.

Results: NB CE-chirp-evoked mVEMPs were 100% present at 500 Hz using both air- and bone-conduction modes of stimulation. No significant differences were found in mVEMP parameters between ears, genders, or modes of stimulation in both children and adults. However, a significant P11-N21 amplitude difference was observed between the two groups.

Conclusion: The findings of the study highlighted the need to incorporate age-appropriate reference values for interpreting mVEMP responses for children and adults across air- and bone-conduction modes.

Purpose: Experiencing difficulty with activities of daily living (ADLs) and instrumental ADLs (IADLs) and/or the consequences of unmet ADL/IADL-related needs is associated with adverse health-related outcomes. The association of hearing loss (HL) with experiencing the consequences of unmet ADL/IADL-related needs is not well understood. We investigated the associations of HL with experiencing ADL/IADL difficulties and the consequences of unmet ADL/IADL-related needs in older adults.

Method: We investigated cross-sectional associations between audiometric HL, the number of ADL and IADL difficulties, and the number of consequences of unmet ADL/IADL-related needs among adults aged 65 years and older in the National Health and Aging Trends Study.

Results: In 4,724 older adults, 30.5% (n = 1,736) and 30.9% (n = 1,727) had self-reported difficulty with ADLs and IADLs, respectively. Of the 2,289 participants who reported difficulty with at least one ADL/IADL, 14.0% (n = 741) reported experience of at least one consequence of an unmet ADL/IADL-related need. In multivariable ordinal regression analyses, mild (OR = 1.38, 95% CI [1.1, 1.73]) and moderate or greater (OR = 1.57, 95% CI [1.17, 2.1]) HL were associated with higher odds of difficulties with additional ADLs. Moderate or greater HL was associated with higher odds of reporting difficulties with additional IADLs (OR = 1.59, 95% CI [1.19, 2.12]). There was no significant association between HL and higher odds of having additional consequences of unmet needs.

Conclusions: Our results show an association between HL and a higher number of ADL and IADL difficulties. Adults with HL may require increased support to address difficulties with daily activities and prevent experiencing related consequences.

Supplemental material: https://doi.org/10.23641/asha.28300049.

Purpose: Although burnout among audiologists has been studied in various countries, there is no research yet that examines this issue in Türkiye, where working conditions and sociodemographic factors may differ from those in other countries. Considering the unique working conditions and sociodemographic factors, this study aimed to investigate the burnout levels of Turkish audiologists. Additionally, this study will explore the impact of various sociodemographic variables on burnout, work-related quality of life, and depression to gain a deeper understanding of the specific challenges faced by audiologists in Türkiye.

Method: A total of 193 audiologists, with a median age of 27 (interquartile range: 25-29) years, working in different working areas, such as clinical practice, academic institutions, rehabilitation centers, and amplification services in Türkiye, were included. Audiologists were invited to participate in this study via several online forums and hospital notice boards. All participants completed the sociodemographic data form and then the Maslach Burnout Inventory (MBI), Work-Related Quality of Life Scale (WRQoL), and Beck Depression Inventory (BDI).

Results: Differences between MBI, WRQoL, and BDI scores were analyzed according to gender, level of education, area of work, and title of audiologist. There are significant differences in the subscale scores of the MBI and WRQoL scales and in the BDI scores between groups according to gender, education, and area of work. There are also significant differences in BDI scores according to title. There is a significant correlation between the MBI, WRQoL, and BDI scores of audiologists.

Conclusions: This study represents the initial exploration of burnout, quality of work life, and depression levels among audiologists employed in Türkiye. A low quality of work life can increase the risk of burnout and depression. Enhancements in the work environment can lessen burnout and depression while also improving employees' general quality of life.

Objective: This report documents the effects of hearing treatment in an adult with a history of mild traumatic brain injury (mTBI) and normal peripheral hearing acuity.

Design: This report details a case study of a 26-year-old female with a history of mTBI.

Study sample: A 26-year-old female with a history of mTBI presented with auditory symptoms including tinnitus, hyperacusis, listening fatigue, and speech-in-noise (SIN) difficulties despite diagnostic audiological findings showing normal peripheral auditory function and suprathreshold SIN performance within the normal range. The patient was fit with premium-level receiver-in-the-canal (RIC) hearing aids (HAs) using several different mild-gain fitting approaches involving wide dynamic range compression (WDRC) or linearized gain. A combination of objective and subjective methods was utilized to guide clinical decision making on the fitting approach and to verify/validate treatment outcomes.

Results: Despite no difference in acutely aided SIN performance between the WDRC or linearized fitting approaches, the patient expressed a clear preference for the HA fitting approach involving application of 2-10 dB of shaped linearized gain > 1.5 kHz for soft, medium, and loud input levels (with greatest gain applied at 3-4 kHz). These settings were preferred in terms of loudness and sound quality even compared to the WDRC fitting approaches previously reported in literature. This fitting approach was verified and validated by SIN testing showing improved performance in the aided condition, as well as high levels of self-reported benefit and satisfaction, reduction in self-reported hearing handicap, reduction in sound sensitivity, and enhanced quality of life with HAs.

Conclusions: Results add to the growing body of evidence supporting the benefits of mild-gain HAs for adults with mTBI and self-reported SIN deficits despite normal hearing acuity. Results also support the importance of using a combination of measures (e.g., SIN testing, patient report, outcome questionnaires) to guide the HA fitting process and to verify/validate treatment outcomes. Although findings were derived from a single case study and should be interpreted with caution, the patient's preference for a shaped linearized mild-gain approach is noteworthy. There exists a lack of clinical guidelines and prescriptive fitting methodology for fitting HAs in mTBI adults with SIN difficulty despite normal peripheral hearing acuity. Future research should systematically compare WDRC versus linearized gain approaches of fitting in this population to develop a clinical methodology for HA fitting and optimize outcomes in this special subpopulation.

Purpose: This mixed-methods design (a) quantitatively describes the symptom cluster assignments of patients with chronic dizziness who completed a dizziness triage questionnaire and (b) qualitatively explains patient-reported themes associated with the most frequently assigned symptom cluster.

Method: A retrospective hybrid explanatory mixed-methods design was implemented to examine an artificial intelligence dizziness triage questionnaire posted online in a vestibular disorders support group from June 2021 to November 2022. Symptom cluster assignments are described in 791 participants. In the qualitative analysis, emerging codes were identified in the dominant symptom cluster in 50 participants.

Results: Quantitative analysis identified a total of 301 symptom cluster combinations. The analysis from 791 participants revealed that females exhibited more symptom clusters than males, age impacted symptoms inversely, and longer duration of symptom history exhibited more symptom clusters. "Positional" was the most common symptom cluster among 50 participants. Of those 50, six major themes emerged from the data: (a) physical symptoms, (b) cognitive symptoms, (c) triggers, (d) temporal information, (e) management, and (f) emotions.

Conclusions: The results from this study emphasize the complexity and variability of chronic dizziness. Comprehensive patient assessments that combine questionnaires with clinical expertise and patient dialogue are needed to improve diagnosis and management.

Purpose: Prior work estimating sound exposure dose from earphone use has typically measured earphone use time with retrospective questionnaires or device-based tracking, both of which have limitations. This research note presents an exploratory analysis of sound exposure dose from earphone use among college-aged adults using real-ear measures to estimate exposure level and ecological momentary assessment (EMA) to estimate use time.

Method: Earphone levels were measured at the ear drum of 53 college students using their own devices, earphones, and preferred music and speech stimuli at their normal listening volume. Participants completed 1 week of EMA, where they reported on their minutes of earphone use every 2 hr. Based on the EMAs and their measured earphone levels, sound exposure doses from earphone use were calculated.

Results: Compliance on EMA was 73%, comparable to most studies using this method in audiology research. Earphone levels were lower than those reported by most prior literature. The average listening level across music and speech, with A-weighting and diffuse-field corrections, was 60 dBA. Earphone use time was also lower than most prior work. Most participants had doses under 1%.

Conclusions: Using EMA to track earphone use is a potentially simple way to facilitate measurements of sound exposure from earphone use without relying on retrospective questionnaires or limiting the sample to specific devices, earphones, or apps. Evidence was also found for potentially lower sound levels and sound exposure doses from earphone use among college-aged adults than previously reported.

Supplemental material: https://doi.org/10.23641/asha.28205072.