American Journal of Audiology最新文献

Purpose: This study examined the lived experiences of former audiologists to examine career journeys within and after audiology. The long-term goal of this research is to help academic audiologists create optimal ways to recruit future audiologists who will thrive in the profession and help the profession improve the lived experience of audiologists in the workplace, to improve retention.

Method: A qualitative (grounded theory) approach was used. Virtual interviews were completed by 28 participants (25 former audiologists, three in the departure planning stage).

Results: The theoretical model developed from audiologists' career stories includes Origin Story, Audiology Career Story, and Post-Audiology Story. Three main themes are described as part of the Audiology Career Story: Link Between Family & Career, Confluence of Experiences, and Self-Evolution & Pondering Change. The Confluence of Experiences subthemes were as follows: Wanting More, Bad Management, Compensation, Lack of Desirable Jobs, Burnout & Workload, Desire for Flexibility, and Sales Emphasis. This model suggests there are complex and interconnected reasons why audiologists change jobs within audiology and leave the profession. The most common post-audiology position was that of full-time, at-home caregiver (n = 5). For those employed in the workforce, most stayed in health care-related professions and 73% reported post-audiology compensation was equal to or greater than compensation as an audiologist.

Conclusions: Personal and professional factors, and connections among these factors, influence the lived experiences of former audiologists. Awareness of former audiologists' career stories provide insights that may help the profession improve recruitment and retention.

Supplemental material: https://doi.org/10.23641/asha.29089475.

Purpose: Individuals with health loss may refrain from using medical products due to concerns about their appearance. This study aimed to examine the impact of hearing loss (HL) or the use of a hearing device (HD) on social appearance anxiety and self-esteem.

Method: The study included 236 adults over the age of 18 years: 74 with normal hearing (NH), 44 with HL (not using HD), 62 with unilateral use of hearing aids (HAs), and 56 with unilateral use of cochlear implants (CIs). Each participant completed the self-esteem subscale of the Rosenberg Self-Esteem Scale (RSES) and the Social Appearance Anxiety Scale (SAAS).

Results: While the SAAS scores of individuals with HL were significantly different from individuals with NH, there was no significant difference for the RSES scores. CI users had higher average SAAS scores compared to HA users. Furthermore, there was a significant negative correlation between SAAS and RSES scores for each group.

Conclusions: HL and the use of a visible HD increase social appearance anxiety. Developing intervention programs for those with HL who have social appearance anxiety can improve their participation in social interaction and increase their self-esteem.

Purpose: This study aims to examine the effect of age and several methodological alterations such as position (parent lap vs. car seat), calibration strategy (standard vs. default), and illuminance on sinusoidal harmonic acceleration (SHA) outcomes in children aged 6 months to 5 years.

Method: Fifty-two healthy children, aged 6 months to 5 years, and 23 healthy adults, aged 22 to 39 years, participated. To assess the effect of light illuminance on the corneoretinal potential, adults completed SHA at 0.16 Hz immediately, 5 and 10 min after the rotary chair door was closed, and then again after 10 s of light illumination. To assess the effect of position and calibration strategy, adults completed SHA using default and standard calibration in a standard seat and in a forward seat position. In children, SHA was completed at 0.01, 0.04., and 0.16 Hz in a car seat or booster seat and in a parent's lap, if tolerated.

Results: Gain decreased with darkness adaptation and significantly increased in response to using a light wand. In the adults, gain was higher regardless of test position using default calibration and significantly lower in forward seat position using standard calibration; however, in the pediatric group, there were no significant differences in outcomes relative to age or position. Overall, children had significantly higher gain, phase, and symmetry when compared to the adults.

Conclusions: SHA testing is feasible using a combination of conditions without significantly affecting interpretation. Pediatric SHA test outcomes were higher compared to those of adults, supporting the need for pediatric normative data.

Purpose: Auditory processing (AP) disorder is underdiagnosed in Australian children due to reduced access to assessments. Mobile health technology (mHealth) tools such as the AP assessment application Feather Squadron (FS) may be a way to overcome barriers of clinical assessments. This study aimed to consider the validity of FS as a remote assessment tool when compared to current Australian clinical assessments of speech recognition in noise, dichotic listening, temporal processing, and auditory short-term memory.

Method: This study employed a within-subject, comparative design. Thirty-five normal-hearing children aged between 6.8 and 13.1 years (M = 9.1, SD = 1.8) were tested on the following AP skills: dichotic listening, temporal sequencing, speech recognition in noise, and auditory short-term memory. Participants were tested using traditional clinical tests administered by a qualified audiologist and then completed an mHealth delivered counterpart via the FS application. Results of both clinical and FS tests were converted into age-related z scores or scaled scores for comparison.

Results: Significant, positive interclass correlations were found on assessments of dichotic listening in the worse ear and temporal sequencing. However, poor agreement was noted between these assessments using Bland-Altman analysis, which found substantial bias and wide limits of agreement. A moderate significant Pearson correlation was noted when comparing performance on the clinical and FS auditory short-term memory task.

Conclusions: mHealth tools like FS may be useful for identifying children at risk of AP disorder and increasing referrals for assessment. The poor limits of agreement and bias recognize that FS assessments cannot directly replace clinical tests of AP skills and that despite significant relations between tasks, clinical assessments of AP skills delivered by specialists in a controlled environment remains preferable.

Purpose: For many people with bothersome tinnitus, accessing in-person intervention is difficult. We developed a remote counseling program, Tinnitus Activities Treatment-Online (TAT-Online), to provide for patients' tinnitus education and coping strategies. We aimed to test the effectiveness and acceptability of the remote counseling program in adults with tinnitus.

Method: We included adults with chronic tinnitus who had access to a smartphone, tablet, or computer. In total, 59 adult participants completed all study procedures out of 243 adults who were initially enrolled. Participants completed weekly modules that included viewing narrated videos, practicing strategies using homework, and completing quizzes at the end of each session to assess learning. Participants completed the sessions in a self-paced manner over 6 weeks: Week 1: Questionnaires and Introduction; Week 2: Thoughts and Emotions; Week 3: Sleep; Week 4: Hearing; Week 5: Concentration; and Week 6: Relaxation Techniques and Sound Therapy. Participants completed four outcome measures before the remote counseling began in Week 1 and after the remote counseling concluded in Week 6. Statistical analysis was conducted using a doubly multivariate analysis of variance approach. Acceptability of TAT-Online was determined based on an exit survey and compliance in completing the activities.

Results: Comparing pre- to posttest scores, there was a significant improvement on all tinnitus measures and significantly lower ratings of tinnitus loudness and annoyance. There was no significant change in Meaning of Life ratings. Mean ratings of effectiveness for the TAT-Online videos were rated at 9 out of 10. The self-paced format of TAT-Online was acceptable and easy to follow and effective for patients' learning to cope with tinnitus.

Conclusions: Self-paced remote tinnitus counseling, which included asynchronous educational videos, reflection exercises, and helpful strategies, was effective for learning how to cope with tinnitus. In future studies, we plan to conduct a randomized control trial to further investigate the effectiveness of TAT-Online in combination with hearing or tinnitus devices.

Purpose: Sentences are encoded with sematic context, which facilitates audiologic ability to navigate background noise, or speech-in-noise (SIN), conditions. To examine how semantic context contributes to performance on one commonly used SIN test, the Quick Speech-in-Noise Test (QuickSIN) by Etymotic Research, Inc. (henceforth "QuickSIN"), we use a novel experimental paradigm that isolates semantic information.

Method: Ten college-aged monolingual participants with typical hearing listened to 72 sentences delivered in 0, 5, 10, 15, 20, or 25 dB SNR followed by a choice between two visual words. One word was related to the overall sentence meaning, and the other word was unrelated. The reaction time (RT) to correctly select related targets was measured to index usage of semantic information.

Results: Participant's RTs to select a correct response were compared across different signal-to-noise ratios (SNRs). We found that less favorable noise conditions (0, +5 dB SNR) elicited a greater usage of semantic information than more favorable noise conditions (20, 25 dB SNR). Transformed RT data were analyzed with nonparametric tests that assessed the homogeneity of variance within responses to each SNR condition. Results indicated that participants' RTs were consistently varied within each SNR condition, except to sentences in +20 dB SNR, indicating an imbalance in the degree of semantic context used in the sentences in that SNR level.

Conclusions: Respondents to the QuickSIN use semantic context to facilitate processing especially at less favorable SNR levels, which is consistent with research supporting a greater role of semantic information during suboptimal listening conditions. Differences in context use across noise conditions means test performance also reflects language processing and should be considered for updated tests of speech-in-noise performance. Critically, responses to sentences at the +20 dB SNR used in the QuickSIN are so inconsistently varied in their degree of semantic usage as to prohibit a clinical interpretation alongside the other conditions. These findings warrant the development of a quick-to-administer SIN test with stimuli that are balanced for semantic expectancy to avoid language effects.

Purpose: This study aimed to identify individual factors associated with older adults' ability to manage commercially available over-the-counter (OTC) hearing aids (HAs).

Method: Participants completed an OTC HA skills assessment, scored on a 4-point Likert scale (3 = independent with no difficulty, 0 = unable to complete). Steps included downloading the application (app), inserting the HAs, and cleaning them with a brush. Scores were averaged to calculate an overall mean; higher scores indicated better OTC HA skills. Each independent variable was analyzed in separate linear regression models, and geometric mean ratios (GMRs) were calculated for significant factors. OTC HA skills were also examined dichotomously, with unsuccessful performance defined as any unresolved error.

Results: Eighty-two adults participated in the study, 66% (n = 54) of whom were new HA users. After adjusting for covariates, education remained a strong predictor of OTC HA skills: Individuals with less than a college degree demonstrated 45% lower performance compared to those with a master's degree or higher (GMR = 0.55, 95% confidence interval [0.34, 0.89]). Overall, 68% (n = 56) of participants were unsuccessful in completing the OTC HA assessment. The most challenging tasks across all participants were manually adjusting the volume, pairing the HAs with a smartphone, and replacing the wax guard. New HA users performed significantly worse than experienced users on the task of putting the HAs on, t(52) = -2.58, p = .013, with a moderate effect size (Cohen's d = -0.44).

Conclusions: Education emerged as a strong predictor of OTC HA skills, underscoring the need to address disparities in device usability. These findings highlight the importance of developing tailored devices and educational materials to support users with lower educational attainment. Such efforts may help promote more equitable access and prevent the exacerbation of existing hearing health disparities in the era of OTC HAs.

Supplemental material: https://doi.org/10.23641/asha.29847827.

Purpose: Numerous individuals in the United States are bothered enough by tinnitus that it affects normal daily activities, including sleep and concentration. There is a high prevalence of self-reported bothersome tinnitus in the U.S. military, and therefore, it is important to assess the impact of tinnitus on functional performance. The primary aim of this study was to examine the effects of tinnitus on a range of subjective, objective, auditory, and cognitive measures. A secondary aim was to determine which factors best predict whether individuals ever self-reported tinnitus. A prospective study was conducted to address the primary aim, and an exploratory machine learning approach was used to address the second.

Method: The study included 463 active duty U.S. Service members being seen for annual hearing surveillance. Participants completed several auditory and cognitive tests, along with questionnaires regarding tinnitus, depression, anxiety, and sleep difficulty.

Results: The primary aim found no significant performance differences on tasks of selective attention, short-term memory, or speech in noise between the tinnitus groups. However, there were significant group differences in extended high-frequency hearing. A machine learning algorithm was used to predict whether an individual self-reported experiencing tinnitus. The model had approximately 80% accuracy, excellent sensitivity, and modest specificity.

Conclusions: Study findings corroborated other evidence that extended high-frequency thresholds are poorer in those who reported ever experiencing tinnitus, regardless of tinnitus bother. Our results suggest that combining results from audiometric testing, high-frequency hearing, and subjective assessment of sleep achieved 80% accuracy in predicting tinnitus presence.

Purpose: The Minimum Speech Test Battery-Version 3 for adults (MSTB-3) was released in 2024 as an evidence-based, streamlined test battery for pre-operative determination of candidacy and postoperative assessment of adult cochlear implant (CI) performance. A survey was dispersed to examine clinicians' understanding and adoption of the new protocol and gain clinical insights on its implementation.

Method: A link to a 32-question survey was distributed to audiologists via e-mail and social media platforms, collecting responses from 307 participants practicing in various settings. The survey assessed respondents' understanding of MSTB-3 materials, participation in training sessions, and integration of MSTB-3 recommendations into clinical care. Descriptive statistics were used to analyze data and identify trends.

Results: Results indicated that 89% of audiologists were familiar with the MSTB-3, with 60% having participated in one or more training sessions. Of the respondents, 85% reported incorporating parts or all of the MSTB-3 recommendations into their practices and 75% believed it improved standardization of CI evaluations. Clinicians reported using Consonant-Nucleus-Consonant (CNC) word scores for CI candidacy decisions, consistent with MSTB-3 recommendations, but varied in the score criteria used to determine candidacy. Results show a trend toward more streamlined and efficient patient care delivery recommendations.

Conclusions: The MSTB-3 has facilitated greater consistency in CI evaluation and follow-up care, addressing historical variability in clinical practices. Its evidence-based approach, including streamlined test protocols and user-friendly tools, offers a framework for improved CI access and standardization. Further training and dissemination efforts are recommended to enhance clinicians' understanding and to address implementation challenges, ultimately advancing the quality of CI services and reducing disparities in care.

Purpose: This study aimed to explore the integrated digit-in-noise test (iDIN) as a tool for assessing speech recognition in noise among older hearing aid (HA) users, including those who cannot be tested using conventional sentence-in-noise tests.

Method: The study involved 81 older HA users with moderate-to-severe hearing loss. Participants underwent the iDIN, along with two sentence-in-noise tests (Mandarin Hearing in Noise Test [MHINT] and Mandarin Chinese Matrix Sentence Test [CMNmatrix]) and two working memory (WM) tests (reading span test and digit span test). Correlation analysis and hierarchical multiple regression were employed to relate iDIN outcomes to conventional sentence-in-noise test results.

Results: Among 56 participants who completed all tests, high correlations (ranging from .66 to .73) were observed between speech recognition thresholds (SRTs) measured using sentence-in-noise tests and SRTs measured with two-, three-, four-, and five-digit sequences on the iDIN. Reading span and two-digit SRT were significant predictors for SRTs measured using the CMNmatrix test. The two-digit SRT and the difference between five-digit and two-digit SRTs accounted for 57.9% and 61.3% of the variance in MHINT and CMNmatrix SRTs, respectively. When using 0.5 as the cutoffs for the two-digit SRT, among the 81 participants, the two-digit SRT (sensitivity: 0.818; specificity: 0.895) effectively differentiated those who could successfully complete sentence-in-noise tests.

Conclusions: The findings highlight the potential of the iDIN as a simple, quick, and reliable tool for measuring speech recognition that correlates well with performance on conventional sentence-in-noise tests and for those who could not be tested using these conventional measures. While results on short digit sequences primarily reflect auditory function, longer digit sequences involve the contribution of WM function, providing additional information regarding an individual's ability to understand speech in noise.