American Journal of Audiology最新文献

Objectives: Sensory augmentation or "neurofeedback" devices have been used in balance rehabilitation to provide additional sensory information to complement natural sensory inputs and enhance sensory reweighting. The VertiGuard RT vibrotactile neurofeedback balance training system records body sway (direction, amplitude, and acceleration) via a wearable sensor and provides feedback to the wearer in real time via vibrotactile sensory feedback. This study aimed to explore the feasibility and usability of VertiGuard RT vibrotactile neurofeedback balance training in older adults with hearing loss and describe the participants' overall perspectives of the device and training.

Design: A mixed-methods design was used, including qualitative semistructured interviews analyzed using thematic analysis and the System Usability Scale for quantitative analysis.

Study sample: A subset of participants from a larger trial of the VertiGuard RT device (N = 14) of older adults with mild-to-profound hearing loss was recruited.

Results: Participants found the VertiGuard RT training feasible; however, usability varied, with a number of challenges, including technical issues, challenge level of the exercises, and degree of feedback.

Conclusion: This study provides suggestions for improving future iterations of the VertiGuard RT system and the design of technology-enhanced balance training systems for older adults.

Supplemental material: https://doi.org/10.23641/asha.29289926.

Purpose: This study aims to explore the presence of contralateral suppression of otoacoustic emissions (CS-OAEs) in unilateral cochlear implant (CI) users with auditory neuropathy spectrum disorder (ANSD).

Method: We enrolled three unilateral CI users with bilateral ANSD and stable otoacoustic emissions in the nonimplanted ear, exhibiting diverse postsynaptic ANSD backgrounds including cerebellar ataxia, areflexia, pes cavus, optic atrophy, sensorineural hearing loss syndrome, Optic Atrophy Plus Syndrome, and Spinocerebellar Ataxia. Measurements of transient-evoked otoacoustic emissions (TEOAEs) were conducted both with and without contralateral electrical stimulation (CES) across five frequency bands. CES was delivered via a CI using a direct audio input cable connected to a computer. In order to elicit a response, broad-band noise is applied and presented at a comfortable level.

Results: Minor amplitude reductions (between 0.2 and 0.6 dB SPL) were observed in TEOAEs with CES across different frequencies for each subject. Despite these changes, there was no prominent suppression effect observed, which emphasizes the differences in CS-OAE responses among individuals with postsynaptic ANSD.

Conclusions: The absence of significant CS-OAE suppression suggests that direct electrical stimulation through CES may not consistently engage the efferent auditory system in patients with postsynaptic ANSD characteristics. It is essential to broaden the study population to encompass a more diverse range of ANSD presentations in order to confirm the effectiveness of CES in stimulating efferent pathways.

Purpose: This study developed and translated the Chinese version of the Listening Self-Efficacy Questionnaire (C-LSEQ), tested its reliability and validity, and explored listening self-efficacy characteristics among older adults with age-related hearing loss (ARHL).

Method: One hundred seventy-two patients with ARHL aged ≥ 60 years completed the C-LSEQ by the direct interview method, as well as the pure-tone hearing threshold test, the speech recognition threshold test in noise, and the Hearing Handicap Inventory for Elderly-Screening. Using the random number table method, the C-LSEQ was resurveyed to 20 of the 172 study participants 2 weeks after the initial evaluation. The validity of C-LSEQ was further determined by comparing the scores of three groups: the young adults with normal-hearing group (n = 50), the older adults with normal-hearing group (n = 20), and the older adults with ARHL with no hearing aid use history. Analysis of variance and post hoc tests analyzed sex, education, and hearing loss's impact on listening self-efficacy in ARHL.

Results: (a) Reliability: The Cronbach's α coefficients were > .8, and the retest reliability was > 0.9 (p < .001). (b) Validity test: The composite reliability of the two subscales and the summary questionnaire were all > 0.7, and the average variance extracted was all > 0.5. The level of efficacy was higher with two normal-hearing groups compared to ARHL (p < .001). At a cutoff > 80, C-LSEQ distinguished ARHL from normal hearing with 100% sensitivity and 92.85% specificity.

Conclusion: The structure of the C-LSEQ was stable, with good reliability and validity, and it could be used to assess the listening self-efficacy of older adults.

Supplemental material: https://doi.org/10.23641/asha.29954486.

Purpose: Understanding speech in challenging environments can be fatiguing for individuals with and without hearing loss. Empirical research examining interventions to reduce such fatigue, however, is limited. Our study investigated the effects of imperfect captions, such as those created using automated speech recognition systems, on listening-related fatigue during a challenging speech task.

Method: Twenty-two adults (aged 18-63 years) with essentially normal hearing completed a sustained dual task designed to induce listening-related fatigue. The primary task was audiovisual sentence recognition in quiet, with speech levels individually adjusted for ~70% correct performance (without captions). The secondary task was response time (RT) to topic words presented during the speech task. Participants completed the dual task with or without captions. Subjective fatigue ratings were obtained before, during, and after the dual task. Vigilant attention was measured via the secondary task and before and after the dual task using visual stimuli (RTs to a visual marker presented at random intervals).

Results: Subjective fatigue ratings increased significantly over the course of the dual task. However, this increase was larger for the group who had captions, even though they had better sentence recognition overall. Evidence of behavioral fatigue (slowed RTs over time) was also present but only for those in the Caption group. Anecdotal reports from study participants suggest that the increased fatigue for the Caption group was related to the cognitive challenge of combining information from the time-locked audiovisual cues and the time-delayed, and imperfect, text captions.

Conclusions: Even though they were time-delayed and contained inaccuracies, captions improved speech recognition. However, this benefit was accompanied by greater increases in subjective and behavioral fatigue. Therefore, in some conditions imperfect captions can have negative consequences for listening-related fatigue. Further research is needed to determine whether this pattern holds in different circumstances, such as with audio-only stimuli.

Supplemental material: https://doi.org/10.23641/asha.29646482.

Purpose: Given emerging evidence suggesting a correlation between hearing and cognitive performance, hearing loss may be a modifiable risk factor for future cognitive decline or dementia in older adults. However, more evidence is needed to determine how hearing loss and hearing aid (HA) treatment affect cognition and self-perceived listening abilities in this population.

Method: The current study used a repeated-measures design to explore changes in cognitive performance, self-reported hearing difficulties, and noise acceptance in older adults at baseline and at 2 and 4 months after receiving their first pair of bilateral HAs.

Results: The results of this study suggest a significant average improvement for all three test measures after 2 and 4 months of HA use. Results on the individual cognition measures indicated that the significant average improvement on working memory tasks in a low-cognition group drove the overall significant improvement in fluid cognition. The principal components analysis found associations between test measures and patient variables, including better ear pure-tone average (PTA) and hours of HA use. Most notable were associations among baseline listening difficulty ratings, noise acceptance, and PTA as well as associations between cognitive performance and average hours of HA use.

Conclusions: Significant average improvements in cognitive performance, self-reported hearing difficulties, and noise acceptance were found after 2 and 4 months of HA use in older adults. Participants with lower baseline fluid cognition showed greater gains on working memory measures. Average performance on test measures was associated with hearing thresholds and hours of HA use.

Background: An increase in gun violence over the last few years has resulted in gunshot injuries soaring as a top public health issue in the United States. The increase in gun violence has also led to an increase in gunshot wounds on the temporal bone. The most common major complaint in conscious patients with temporal bone trauma is hearing loss.

Purpose: The purpose of this study is to explain the need for successful management of penetrating head injuries, demonstrate the role of the audiologist in determining cochlear function after gunshot injury to the temporal bone, and discuss the importance of interdisciplinary approach involving audiologists and physicians. We hypothesized that early and accurate audiological assessment is critical for effective surgical intervention and patient outcomes.

Research design: We present three unique cases of temporal bone trauma due to gunshot injuries, with quite different audiological results, in this exploratory case report.

Conclusions: The variability in assessment protocols used and audiological outcomes demonstrate the need for successful management of penetrating head injuries, the role of the audiologist in determining cochlear function after gunshot injury to the temporal bone, and the importance of interdisciplinary approach. Collaboration between the surgeon and audiologist, coupled with prompt and accurate audiologic results, can lead to the most successful outcome for the patient, thus improving the quality of health care.

Purpose: This study aimed to explore the informed consent practices used by audiologists in South African newborn hearing screening (NHS) programs and to gather perspectives from professionals involved in these programs both locally and internationally.

Method: A sequential, explanatory mixed-methods design was employed. Phase 1 comprised a survey with audiologists who were recruited via professional associations and social media platforms. Phase 2 comprised two focus group interviews with NHS program experts who provided further insights into the reported informed consent practices.

Results: Although practices varied between private and public health care sectors, there was general agreement among participants on the best timing and format for delivering information, the timing of the consent process, and the consistency of consent procedures for both high-risk and well babies. However, the information provided to these two groups of babies varied. The focus group interviews highlighted subtle details of obtaining true informed consent, distinguishing it from implied consent and informed choice, emphasizing its complexity and significance for clinical practice. The importance of providing accessible, culturally sensitive information to ensure parental autonomy and informed decision making was also highlighted by the findings.

Conclusions: Findings highlight the critical role of informed consent in NHS. Effective informed consent in NHS programs requires timely, clear, and culturally appropriate communication. This study underscores the need for standardized practices in informed consent to enhance parental understanding and support for NHS programs in South Africa, and proposes strategies to improve informed consent processes, particularly in contexts where universal NHS is not mandated.

Purpose: This study aims to characterize patient characteristics of children undergoing sedated auditory brainstem response (ABR) at a tertiary-level medical center.

Method: A retrospective chart review analyzed children, under 18 years of age, who underwent sedated ABR evaluation in an operating room at a single tertiary academic center from January 1, 2013, to January 1, 2023. The following information was collected: sex, age, family history of hearing loss, newborn hearing screen status, and presence or absence of known risk factors for childhood hearing loss (neurodegenerative disorders, syndromes, congenital cytomegalovirus infection, other congenital infections, craniofacial anomalies, Apgar score at 5 min, neonatal intensive care unit stay of > 5 days, ototoxic medication treatment, low birth weight, assisted ventilation, and history of outer or middle ear pathology). Data were collected and stored using Research Electronic Data Capture software.

Results: The mean age of children undergoing sedated hearing assessment was 23.12 months. Roughly half the children who underwent sedated testing passed newborn hearing screening, while the other half referred. Findings show statistically significant difference in age of children undergoing sedated assessment that passed (30.57 months) versus referred (16.10 months) newborn hearing screening. While majority of children who passed newborn hearing screening were found to have normal hearing with sedated evaluation, 24% had sensorineural or mixed hearing loss and 18% conductive hearing loss. Findings showed a higher proportion of children subsequently identified with conductive hearing loss had sedated assessment completed in conjunction with another procedure. Overall, nearly 60% of children undergoing sedated ABR had another procedure in conjunction.

Conclusions: This study highlights the need for continued vigilance in hearing assessments to prevent delays in diagnosis. Both children who passed and referred newborn hearing screening subsequently underwent sedated ABR testing. We recommend whenever possible, children needing sedated hearing assessment do so in conjunction with another procedure to limit the need for multiple sedation events.

Purpose: Hearing loss (HL) has been associated with declines for cognitive, physical, and other facets of health. Accordingly, hearing care practitioners (HCPs) may have a responsibility to address health domains beyond hearing. The current study compared client and HCP attitudes toward the role of HCPs in addressing such domains.

Method: One thousand four hundred one clients and 94 HCPs were recruited from Connect Hearing, a network of audiology clinics across North America. Clients and HCPs completed questionnaires focused on five health domains associated with HL (cognitive health, socioemotional health, physical health, mobility and balance, and overall wellness). Prior to their hearing care appointment, clients indicated their expectations of HCPs to address such domains. Concurrently, HCPs indicated their perceived ability to address the domains.

Results: HCP ability was significantly greater than client expectations within the domains of cognitive and socioemotional health, while client expectations were greater than HCP ability within the domains of physical health and mobility and balance.

Conclusions: HCPs report that they are generally capable of fulfilling their role and meeting their clients' expectations across health domains beyond hearing. Potential strategies to enhance alignment between client expectations and HCP ability are discussed. Such strategies include holistic and integrated care.

Supplemental material: https://doi.org/10.23641/asha.29525603.

Purpose: Patients with vestibular-related dysfunction are commonly referred to a physical therapist for vestibular rehabilitation (VR) or possibly to an audiologist for objective vestibular test battery (VTB). As a conservative first step, patients are often referred to VR for evaluation and management and from there patients may be referred for VTB when patients are not meeting therapy goals or VR evaluation is unclear of the diagnosis. This research aimed to investigate the referral patterns from VR to VTB and VTB to VR.

Method: Retrospective chart review was completed at a large Midwestern tertiary hospital. This study included 149 patients aged 18 years and older with history of dizziness, vertigo, or imbalance concerns who received VR and VTB. Patients were divided into two groups: (a) VR-first group and (b) VTB-first group. Descriptive statistics were used to quantify the total number of VR sessions for total cohort and common vestibular diagnoses and determine differences in sessions between VR-first and VTB-first groups.

Results: Statistically significant differences in number of VR sessions were observed between the VR-first and VTB-first groups, with less sessions overall in the VTB- first group (p < .05), except for the BPPV group (p = .12).

Conclusion: Early and accurate objective vestibular testing can significantly impact the treatment trajectory for patients with unilateral, bilateral, and central vestibular findings.