American Journal of Audiology最新文献

Background: Hearing aid verification ensures that appropriate audibility and access to the speech signal are provided to the hearing aid user. Best practice guidelines recommend evidence-based verification measures (on-ear real-ear aided response [REAR] and simulated REAR) to match the hearing aid output with prescribed targets. Skill development for measuring and interpreting REAR involves six stages: novice, advanced, beginner, competent, proficient, and expert. At the competent stage, trainees can perform entrustable professional activities independently, demonstrating sufficient competence for unsupervised practice.

Purpose: The purpose of this study was to obtain consensus on key competency criteria expected for audiologists performing hearing aid verification across the lifespan to ensure effective real-ear performance evaluation.

Method: A modified e-Delphi technique was used. In the preparatory stage, 54 preselected competency items were categorized into seven domains. In the first round of the survey, expert audiologists rated their level of agreement on a 7-point Likert scale ranging from strongly disagree to strongly agree for each competency. An a priori threshold of 70% was required for consensus.

Results: Twenty-nine expert audiologists completed the first survey round. Consensus was achieved for 52 out of the 54 competency items. Competencies related to calibration, equipment setup, and interpretation of REAR had over 90% agreement. Items not reaching initial consensus were revised for Round 2 based on expert feedback.

Conclusions: Results from Round 1 and the new consolidated items will be shared in Round 2. This study identifies key competencies for audiologists to perform on-ear and simulated REAR, forming the basis for knowledge, training, and improved clinical outcomes.

Purpose: This study examined the impact of music tempo and mode on hearing performance, hypothesizing that listening to happy music (fast tempo, major mode) would improve hearing performance in noise.

Method: Sixty-three normal-hearing subjects aged 18-35 years were included. Participants were randomly assigned to one of three groups: happy music, sad music, or control (no music). The happy music group listened to fast-tempo music (> 120 beats per minute [bpm]) in the major mode, whereas the sad music group listened to slow-tempo music (< 80 bpm) in the minor mode. The control group did not listen to music. The Hearing in Noise Test (HINT) and the Audible Contrast Threshold (ACT) test were administered before and immediately after the music tracks. Speech reception thresholds under different HINT conditions (noise front, noise right, and noise left) and audible contrast thresholds from the ACT test were determined and compared.

Results: Both HINT and ACT test results differed significantly across groups depending on music tempo and mode. Post hoc analyses revealed a significant improvement in performance on the HINT noise front, HINT noise right, and ACT after listening to happy music. In contrast, a significant decline in the HINT noise-left performance was observed after listening to sad music.

Conclusions: The findings indicate that listening to fast-tempo music in the major mode can positively affect hearing performance in noise. Furthermore, the results highlight the potential importance of incorporating music and music-based programs into auditory-cognitive development and rehabilitation.

Purpose: The association between working memory and the self-perception of hearing difficulties in older adults is not well understood. Therefore, the purpose of the study was to investigate the relation between auditory working memory and self-reported hearing difficulties in older adults with varying degrees of pure-tone hearing loss.

Method: Twenty-four older adults with varying degrees of sensorineural hearing loss participated. Self-reported hearing difficulties were assessed using the Adult Auditory Performance Scale (AAPS). Auditory working memory was measured using the Word Auditory Recognition and Recall Measure (WARRM).

Results: Results revealed significant negative correlations between the WARRM recall score and the AAPS global, easy listening, noise, and complex listening scores. Pure-tone hearing was significantly correlated with self-reported hearing difficulty in easy listening environments (e.g., quiet and ideal listening) but was not for noise or complex listening. Regression analyses revealed that pure-tone hearing accounted for a significant amount of variability associated with the AAPS easy listening, whereas WARRM recall scores accounted for a significant amount of variability associated with AAPS noise and complex listening scores.

Conclusions: Findings suggest that cognitive factors, such as auditory working memory, contribute to the self-perception of hearing difficulty among older adults. Routine clinical measurement of self-reported hearing difficulties and auditory working memory may provide a more global assessment of the hearing challenges faced by older adults with pure-tone hearing loss.

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.