American Journal of Audiology最新文献

Purpose: The purpose of this study was to evaluate the auditory brainstem response (ABR) of infants with asymmetric intrauterine growth restriction (IUGR) in response to different stimuli and to compare the findings with those of term infants.

Method: A total of 20 infants with asymmetric IUGR who had no risk factors for hearing loss and 20 term healthy infants as a control group participated. Click, chirp, and 4-kHz tone burst at 90 dB nHL stimuli were used, and Waves I, III, and V absolute latencies; Waves I-III, I-V, and III-V interpeak intervals; and wave amplitudes were evaluated.

Results: The Wave V absolute latency and Waves I-V interpeak interval of both click and chirp stimuli in infants with asymmetric IUGR were significantly shorter in both ears (p < .05). In contrast, only Wave III absolute latency was significantly shorter for both ears (p < .05) with a 4-kHz tone burst.

Conclusions: ABR test with click, chirp, and 4-kHz tone-burst stimuli revealed that there are functional differences attributed to IUGR. Contrary to popular belief, these findings are evidence of neurosensory changes caused by IUGR, which is not included as a risk factor in newborn hearing screening programs. The type of stimulus used in the assessment was critical.

With current advances in experimental techniques, there is a renewed interest in studying communication behavior, reflecting a desire to improve our understanding of hearing disability and the effects of treatment interventions at the level of in-the-moment behaviors. Group conversations are among the most challenging situations for people with hearing loss. Experiments on group conversations are increasingly common and disproportionately more demanding than dyad studies to design and execute. Thorough design and planning are critical for successfully capturing valid behavioral data, highlighting the value of sharing behind-the-scenes experiences with the researcher community. We have completed a laboratory study of four-way group conversations involving people with and without hearing loss. This article describes the goals and compromises involved in our design choices and evaluates their effectiveness through participant feedback. Aspects covered include contrasts and covariates, group composition and physical arrangement, participant characteristics, hearing devices, participant experience, physical environment, conversational task, and measurement modalities. Next, we briefly describe the experiment's execution. Finally, we analyze and discuss participants' feedback and reflect on what proved effective, what did not, and what design "worries" proved founded or unfounded. We hope thereby to provide support and inspiration for others who may be faced with similar design challenges. The main message is that such an experiment can be carried out successfully and in such a way that the behavioral and self-report data collected are likely to carry a relatively high degree of ecological validity while still supporting experimental and statistical control.

Purpose: The aim of this study was to describe psychological inflexibility for hearing difficulty for a sample of adults seeking hearing help and explore associations with demographic and audiological characteristics.

Method: Archival data from 226 clinical electronic medical records at one university clinic were analyzed for this retrospective exploratory study. Audiometric test findings and results from the Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL) were extracted for adult patients seen between June 1, 2022, and February 29, 2024.

Results: The majority had a bilateral hearing loss (64%), 10% had a unilateral hearing loss, and 26% had bilateral pure-tone averages better than 25 dB HL. The AAQ-AHL total scores ranged from 0 to 51, and 8% had a high likelihood of distress from internal struggles related to their difficulty hearing. On individual items, up to one third of the sample expressed internal challenges. The AAQ-AHL total scores were moderately correlated with word recognition in noise, weakly correlated with better ear pure-tone average and word recognition in quiet, and were not correlated with age.

Conclusions: The current study adds to the previous research describing psychosocial challenges that can be experienced by people with hearing difficulties. Our research demonstrates that psychological inflexibility for hearing loss can be experienced by individuals of all ages and hearing status. Based on the present findings, we recommend that audiologists intentionally assess for psychosocial challenges for people seeking hearing help.

Purpose: The goal was to gain insight into the effects of hearing loss and hearing aids (HAs) on the perception of "natural sounds" and their importance in daily life by documenting the opinions of hearing care professionals (HCPs).

Method: A questionnaire was designed where HCPs were asked to rate their patients' perception of natural sounds before and after receiving an HA. The online survey was conducted with 301 HCPs in France.

Results: According to respondents, the incidence of hearing natural sounds increased substantially at the end of the trial period relative to the start, especially for patients living in remote rural areas. Respondents also indicated an increase in listening accuracy, pleasantness, and importance of natural sounds at the end of the trial period. The majority of respondents indicated (a) that their patients find it important to listen to natural sounds and (b) that they are satisfied with their HAs in that respect.

Conclusions: This study demonstrates the importance of natural sounds for most people with hearing loss. It highlights the effects of HA on patients' awareness of natural sounds and suggests that future research should consider the patients' place of residence.

Purpose: Audiologists play an essential role in hearing health care. It has been predicted that the supply of audiologists may fail to meet future market demand. One way to improve the number of available audiologists is to improve retention. The purpose of this study was an exploration of audiologist attrition as a first step toward creating strategies to improve retention.

Method: A survey completed by 47 former audiologists included questions about demographics, why participants entered and exited the audiology profession, and job satisfaction.

Results: Participants cited lack of reward as the most common reason for leaving the profession. About a third disliked the for-profit hearing aid dispensing aspect of the profession, and a few would return to the profession for an audiology job that did not involve hearing aid dispensing. About a quarter left audiology to pursue other opportunities (e.g., selling a private practice), and about a quarter reported poor psychosocial work environment.

Conclusion: Findings highlight the need for national efforts focused on (a) improving audiology awareness so students have a greater understanding of audiology as they are exploring career choices, (b) advocating for improved compensation overall and compensation models that de-emphasize sales-based financial incentives, and (c) creating strategies to help improve audiologists' work environment and opportunities for leadership roles.

Supplemental material: https://doi.org/10.23641/asha.28599341.

Purpose: Hearing loss is an independent risk factor for falls. Research has demonstrated the importance of a combination of self-report and performance-based tools in predicting falls. Using this approach, the purpose of this study was to examine the association between the degree of hearing loss and fall risk.

Method: Community-dwelling older adults with hearing loss, aged 60 years and above, completed a history form, the Activities-Specific Balance Confidence Scale and the modified Clinical Test of Sensory Interaction in Balance. Average pure-tone audiometry of the better hearing ear was calculated. Fall risk was determined for each participant. Binomial logistic regression and Cohen's kappa were performed.

Results: Fifty-eight participants, with mild (n = 12), moderate (n = 27), moderately severe (n = 14), and severe (n = 5) hearing losses were included in the analysis. Overall fall risk incidence was 46.6%. No significant association was found between the degree of hearing loss and fall risk, while age, gender, and diabetes were revealed to be significant fall risk factors. A key finding was the tendency to overestimate balance confidence using self-report measures.

Conclusions: To our knowledge, this is the first study in Asia employing self-report and performance-based measures to examine hearing loss and fall risk. Our findings provide insight into region-specific factor(s) affecting fall risk and serves to pave the way for future fall risk research. Future studies should include a combination of self-report and performance-based measures, as well as account for protective fall risk factors.

Purpose: The purpose of this study was to determine the effectiveness of television (TV) streaming on cochlear implant (CI) user performance and satisfaction in quiet and in noise.

Method: Sixteen CI users (15 bilateral) were evaluated in quiet and in noise (5 dB SNR) under three CI conditions: CI only, streaming with CI microphones attenuated by 6 dB, and streaming with CI microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the SSI-ICM served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained.

Results: In quiet, speech understanding and speech clarity ratings were significantly better for the streaming with CI microphones muted condition than the CI only and streaming with CI microphones attenuated conditions; however, sound quality ratings were significantly better for streaming with CI microphones muted than the CI microphones attenuated condition. In noise, speech understanding, speech clarity ratings, and sound quality ratings were significantly different across all conditions with CI only being the poorest, followed by streaming with CI microphones attenuated then by CI microphones muted being the best. In quiet, streaming with CI microphones muted was preferred over CI only. In noise, both streaming options were preferred to CI only. Overall, streaming with CI microphones attenuated was preferred to CI only.

Conclusions: CI users benefited from TV streaming in both quiet and in noise. CI users should be counseled on the benefits of adjusting CI microphone settings when using a TV streamer.

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: 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 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.