American Journal of Audiology最新文献

Purpose: Accrediting bodies for Doctor of Audiology (AuD) programs require students to develop competencies related to pharmacological agents and their effects on hearing and balance. This study was designed to assess education on pharmacology in AuD programs.

Method: The scope of pharmacology education within AuD curricula was surveyed in 2021-2022 using a survey distributed online to program directors across the United States.

Results: About one third of the AuD programs in the United States and Puerto Rico offered a dedicated pharmacology course. Other AuD programs reported that they embedded pharmacology education within the rest of the curriculum. Among colleges/universities offering a pharmacology course, the content included was variable. Review of the content in pharmacology showed little consistency in how pharmacological topics are addressed across programs.

Conclusions: The current accreditation standards for AuD programs require knowledge of the effects of pharmaceutical compounds on hearing and balance but provide little specific guidance. More consistency in the education of future audiologists with respect to pharmacological foundations has the potential to benefit patients.

Purpose: Hearing aid self-efficacy (HASE) refers to an individual's belief in their ability to effectively use hearing aids (HA). Researchers have demonstrated the positive impacts of HASE on success with HAs and auditory rehabilitation (AR). They have suggested structured protocols to incorporate HASE in AR. However, a few clinicians are implementing it in their practice. This study identified barriers and facilitators to implementing a structured self-efficacy-based AR (SEBAR) protocol in clinical practice.

Method: An interpretive phenomenological qualitative approach was used. Five audiologists aged 26-36 years completed semistructured interviews designed around the Capability Opportunity Motivation-Behavior (COM-B) model.

Results: Six shared themes emerged, aligning with four of the six COM-B components. Barriers identified included lack of knowledge and training among audiologists, time constraints in clinical setup, and lack of flexibility to adopt new protocols. Facilitators included intrinsic motivation to improve care, supporting patient testimonials, and integration of the protocol into billable services.

Conclusion: A collaborative effort among audiologists and other stakeholders such as researchers, educators, and policy makers could enhance implementation of the SEBAR protocol in clinical practice.

Supplemental material: https://doi.org/10.23641/asha.31378597.

Purpose: Our study aimed to compare the new M&RIE (Microphone & Receiver-In-Ear) hearing aid directionality technology with the traditional omnidirectional mode in terms of speech intelligibility (SI) skills in noise.

Method: Twenty-four participants (12 women and 12 men) with bilateral symmetrical sensorineural hearing loss and no hearing aid experience, aged 28-65 years, were included in our study. Audiologic evaluations were performed, and eligible participants were fitted with hearing aids set to M&RIE and omnidirectional modes. Free-field hearing assessments and Turkish Matrix Tests under different signal/noise conditions were conducted.

Results: Significant differences were found between M&RIE and omnidirectional mode for both speech reception threshold and SI in noise when the signal was from the front and noise from the back (p < .01), as well as for SI when both signal and noise were presented from the front (p < .01).

Conclusions: In our study, M&RIE outperformed the omnidirectional mode in speech understanding tests under quiet and different noise conditions. Since placing the microphone in the ear canal is the most natural place for sound collection, M&RIE could potentially benefit any hearing aid user within the gain range of the device.

Purpose: This study examined how cognitive skills (nonverbal intelligence, verbal working memory, and attention) influence academic performance in children with minimal to mild conductive hearing loss (mCHL) and whether this relationship is moderated by subjective fatigue and listening effort. We also compared these effects with age- and sex-matched children with normal hearing sensitivity (NHS).

Method: A cross-sectional correlational study was conducted on 130 children with mCHL and 130 children with NHS (aged 10-12 years). Audiological testing, cognitive assessments (Seguin form board test, digit span, operation span, and dichotic digit tests), and subjective fatigue ratings (visual analog scale) were collected. Listening effort was measured using a dual-task paradigm that involved speech-in-noise and digit-reversal tasks. Teachers rated academic performance using the Academic Performance Rating Scale and supported by recent academic marks. Multiple linear regression and moderation analyses were performed.

Results: Children with mCHL exhibited significantly higher listening effort, greater subjective fatigue, lower cognitive scores, and poorer academic performance than their peers with NHS did. Moderation analysis revealed that subjective fatigue significantly weakened the positive relationship between cognition and academic performance in children with mCHL but not in children with NHS. A z test confirmed that the moderating effect was significantly stronger in the mCHL group.

Conclusions: These findings suggest that subjective fatigue plays a critical role in modulating the effects of cognition on academic success in children with mCHL. Interventions addressing listening efforts and fatigue management are suggested for improving educational outcomes in this population.

Supplemental material: https://doi.org/10.23641/asha.31057807.

Purpose: Narrowband (NB) chirps have recently been of great interest in audiology for the electrophysiological assessment of hearing in infants, but clinicians have little information about these new stimuli and how they compare to more standard stimuli, such as 2-1-2-cycle tones. The current study examined the frequency specificity of NB chirps by comparing the spectral characteristics of 500-, 1000-, 2000-, and 4000-Hz NB CE-Chirp LS ("level-specific" version) stimuli with those of the 2-1-2 tones.

Method: Spectral characteristics, including center frequency (CF), bandwidth, and stimulus energy changes after stopband filtering, were compared. Bandwidth was computed as the difference between the upper and lower frequencies at the -20 and -3 dB cutoff points of the main lobe; CF was determined as the geometric mean of the upper and lower frequencies at the -20 and -3 dB cutoff points.

Results: At 100 dB peSPL, the bandwidths of the 500-, 1000-, and 2000-Hz NB CE-Chirp LS acoustic spectra were 1.8-1.9 times wider than those of the acoustic spectra for the 2-1-2 tones; the 4000-Hz NB CE-Chirp LS bandwidths were 1.4-1.5 times wider than those of the 2-1-2 tones. The energy of the NB CE-Chirp LS stimuli was concentrated within ±0.75 octave of the CF, compared to ±0.5 octave for 2-1-2 tones. These spectral characteristics did not change with stimulus intensity.

Conclusions: The NB CE-Chirp LS stimuli demonstrated poorer frequency specificity compared with that of the 2-1-2 tones. NB-chirp thresholds may therefore underestimate true thresholds, especially in steeply sloping hearing loss. Further studies are needed to investigate the cochlear place specificity of auditory brainstem responses to the NB CE-Chirp LS stimuli before recommending them for clinical use.

Purpose: Reduced spectral resolution limits speech recognition in cochlear implant (CI) listeners. Although many studies have examined this association, uncertainties remain regarding its strength and contributing methodological and clinical factors. This narrative review synthesizes findings from studies of postlingually deafened adult CI listeners, focusing on psychophysical measures of spectral resolution and their strengths and limitations.

Method: We reviewed studies published through January 2025 that examined the relationship between psychophysical measures of spectral resolution and speech perception outcomes in postlingually deafened adult CI listeners. Twenty-four studies met inclusion criteria and tested this association statistically. Where available, the coefficient of determination (R²) and effect size measures were extracted to quantify the strength of this association.

Results: Several studies found a statistically significant association between psychophysical measures of spectral resolution and speech recognition performance. The predictive power of spectral resolution measures for speech perception outcomes varied substantially (R² = .21-.69), depending on the specific measure used and the type of speech material. Spectral ripple discrimination/detection threshold tasks and their modified versions, on average, show higher predictive capacity for investigating this link. These measures are especially predictive when using speech materials such as consonant-nucleus-consonant words and AzBio or Institute of Electrical and Electronics Engineering sentences presented in quiet or multitalker babble at moderate signal-to-noise ratios. In contrast, measures based on forward-masking paradigms and pitch ranking tend to yield weaker or nonsignificant associations.

Conclusions: The review underscores spectral resolution as a key leverage point in efforts to improve speech recognition outcomes. Variability in observed associations highlights the need for further mechanistic research into the pathways linking spectral resolution to speech recognition outcomes. Future studies are warranted to improve both the predictive accuracy and clinical feasibility of spectral resolution assessment tools.

Purpose: The current study explored audiologists' experiences and related insights when communicating the audiological findings to parents of children diagnosed with permanent hearing loss.

Method: Purposive and snowball sampling approaches were used. The sample comprised 11 qualified audiologists with experience in pediatric audiology. Participants were recruited via professional associations and social media platforms. Semistructured interviews were conducted online and audio-recorded. Inductive thematic analysis was used to analyze the data and generate themes.

Results: The results of this study revealed the need to tailor feedback to parental needs and the need to share information over multiple sessions. The main challenges that audiologists were faced with during this process were managing the emotional responses of parents and the linguistic barriers. Family-centered approaches, transparency, a team approach, continuity of care, and reflection facilitated the navigation of these challenges.

Conclusions: The results of this study emphasize the importance of information provision, as well as emotional support and tailored communication, ensuring alignment with family-centered care practices in pediatric audiology. Experience and reflection provide opportunity for growth and development of effective communication practices when having to deliver bad news.

Purpose: Audiologic assessment is crucial for managing hearing loss across the lifespan. Routine evaluations typically include pure-tone audiometry and word recognition in quiet (WRQ), the clinical standard for over 60 years. More recently, speech-in-noise tests such as the Quick Speech-in-Noise Test (QuickSIN) have been adopted. This study investigated the effects of age, sex, and hearing sensitivity on WRQ and QuickSIN performance in a large clinical cohort.

Method: Data from 9,042 patients (17,414 ears; aged 18-90 years) who underwent audiometric assessment at the Stanford Ear Institute were analyzed. All completed pure-tone audiometry, WRQ, and monaural QuickSIN. Analyses focused on individuals with hearing loss (9,373 ears) and those with normal hearing (4,277 ears), using stepwise linear regression. In a subset of normal-hearing individuals (1,095 ears), perceived auditory disability was also assessed using the 12-item Speech, Spatial, and Qualities of Hearing Scale (SSQ12).

Results: In the hearing-loss cohort, high-frequency pure-tone average (HFPTA) predicted both WRQ and QuickSIN performance. Sex also contributed, with females performing better on QuickSIN but worse on WRQ. After adjusting for HFPTA and sex, age affected QuickSIN but not WRQ. In the normal-hearing group, hearing sensitivity had no effect on WRQ, but thresholds at 2000 and 4000 Hz influenced QuickSIN. Sex predicted QuickSIN performance, with males performing better. After accounting for thresholds, age was associated with both WRQ and QuickSIN. QuickSIN, but not WRQ, predicted perceived auditory disability on the SSQ12.

Conclusions: After accounting for hearing sensitivity, age showed minimal effects on speech performance in normal-hearing and hearing-loss groups, explaining less than 1% of WRQ variance and < 0.5 dB on QuickSIN. These findings suggest age has limited impact on speech recognition once hearing thresholds are considered. Small but consistent sex effects aligned with prior work. For WRQ, ceiling effects may mask age-related changes, while for QuickSIN, the small effect may be driven by additional peripheral or central auditory factors.

Purpose: This systematic review aims to evaluate the efficacy of single-session interventions of tinnitus educational counseling (SSI-TEDs) in the management of tinnitus.

Method: A systematic literature search was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five studies met the inclusion criteria: three were two-arm randomized controlled trials (RCTs), and two employed a pretest-posttest design. Two studies compared SSI-TED with other interventions-neuro-music therapy (n = 1) and hypnosis (n = 1). One study included a homework component for 50% of the participants, and another combined SSI-TED with mindfulness and relaxation training.

Results: Across five studies, a total of 307 participants received SSI-TED, while 190 were given alternative interventions. At 1-3 months follow-up, one RCT demonstrated a small-to-medium effect of SSI-TED on reducing tinnitus severity and distress. Pretest-posttest studies reported large effects of SSI-TED on these outcomes. Improvements were also observed in negative emotions, frustration, rumination, and social life. The long-term effect of SSI-TED was noted in one study. No significant effects were found for anxiety or depression.

Conclusions: SSI-TED appears to be a promising intervention for reducing tinnitus-related distress and improving emotional well-being in the short term. The evidence suggests moderate benefits in control conditions and larger effects when evaluated in uncontrolled settings. However, its impact on comorbid anxiety and depression remains unclear. Further high-quality studies with long-term follow-up are needed to establish the sustained efficacy, effectiveness, and broader psychological benefits of SSI-TED.

Supplemental material: https://doi.org/10.23641/asha.31215364.

Background: Currently, there is an absence of standardized vestibular guidelines governing cochlear implant candidacy criteria and postoperative evaluations. In response to this gap, a scoping review was completed to help identify trends among the literature regarding preoperative and postoperative testing.

Purpose: The primary goal of this study was to improve understanding of vestibular outcomes within the cochlear implant population, particularly the adult population, and to support referrals for preoperative and postoperative vestibular testing.

Method—eligibility criteria: To be included in this review, articles were composed of adult cochlear implant recipients and analyze preoperative and/or postoperative vestibular test measures such as video head impulse test, vestibular evoked myogenic potentials (VEMPs), caloric irrigations, videonystagmography, posturography, or functional vestibular tests. Articles were published through PubMed from 2017 to 2024 and were available in English.

Results: There were 35 articles selected for a final review. The studies revealed recurring themes that highlight considerations such as age-related factors, postoperative subjective symptoms, and the composition of the vestibular assessment. The most common vestibular test measures, notably abnormal postoperatively, were caloric irrigations and cervical VEMPs. The current literature is lacking in data regarding the late-life population, particularly those over the age of 80 years. However, of the population tested, it is noted that impact from cochlear implantation may be greater for the aging group. Additionally, the overall quality of the articles included were at a higher risk of bias and typically consisted of small sample sizes.

Conclusions: Cochlear implantation leads to a risk for vestibular impairment, primarily of the horizontal semicircular canal and/or saccule. This risk could increase with age; however, literature is lacking objective data on the older adult population, particularly over the age of 80 years. As a future direction for this work, research could focus on vestibular outcomes and appropriate protocols for older cochlear implant recipients.