American Journal of Audiology最新文献

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.

Purpose: The masseter acoustic/vestibular evoked myogenic potential (mVEMP) is a recently developed electrophysiological tool used to assess otolithic function. The mVEMP assesses brainstem integrity and is sensitive in detecting brainstem lesions. The masseter muscles are supplied by the mandibular branch of the fifth cranial nerve and help stabilize the jaw in response to high-intensity sound. The temporalis and masseter muscles function together to stabilize the mandible. Both muscles are supplied by the trigeminal nerve. Hence, the study hypothesized that mVEMP could also be recorded from the temporalis muscle.

Method: Twenty healthy adults (13 males and seven females; age range: 18-28 years) were recruited for the study. mVEMPs were recorded using a 500-Hz tone burst with 125 dB peSPL for all individuals. Vestibular evoked myogenic potentials (VEMPs) were then recorded in the temporalis muscle of the same individuals. VEMPs from the masseter and temporalis muscles were recorded ipsilaterally, contralaterally, and bilaterally, respectively. A within-subject design was adopted, and purposive sampling was used to assign the subjects.

Results: Both VEMPs from the masseter and temporalis muscles elicited a 100% response rate. A paired t test revealed no significant difference (p > .05) in the p11 and n21 latencies for unilateral and bilateral stimulation between masseter and temporalis VEMPs. In addition, a paired t test revealed a significant difference (p < .05) in the p11-n21 rectified amplitude between the masseter and temporalis VEMPs. The rectified amplitude for the temporalis muscle was reduced than masseter muscle.

Conclusions: The study found that VEMPs recorded from the temporalis muscle are similar to mVEMPs. This preliminary finding supports that the temporalis serves as an alternate muscle to record mVEMP.

Purpose: Speech audibility refers to how much access a listener has to the acoustic cues that comprise spoken communication. The Speech Intelligibility Index (SII) is a measure of speech audibility that has had increasing use in pediatric audiology to quantify auditory access with and without hearing aids. This tutorial focuses on clinical applications of the SII in children who are deaf and hard of hearing (DHH).

Method: We discuss the calculation of the SII and the current clinical tools that calculate aided and unaided SII. We describe practical uses of the SII throughout the steps of audiologic care, including at diagnosis of hearing loss, hearing technology candidacy, hearing aid verification, and long-term management of children who are DHH. Common questions about clinical applications of the SII are addressed throughout the tutorial. Finally, we present three case studies that illustrate the application of SII to clinical decision making and counseling with children and their families.

Conclusions: The SII has multiple applications in pediatric audiology. Speech audibility can support device candidacy and management decisions for children who are DHH.

Purpose: Individuals with hearing loss typically experience greater listening effort, which is the additional recruitment of cognitive/mental resources such as attention and memory to understand speech and can be aversive and tiring. Reducing effort is an important goal of the hearing health care industry. Pupillometry is an objective and increasingly popular measure of listening effort, but gold standard measures of pupil size are expensive and unwieldy. The purpose of this study was to compare a low-cost and portable pupillometry device (Gazepoint GP3 HD) to a more traditional gold standard pupillometry tool (EyeLink 1000) for indexing listening effort via pupil size.

Method: Twenty normal-hearing young adults (age range: 18-23 years) were recruited in this study. Participants' pupil size was measured using the Gazepoint and EyeLink pupillometry devices while listening to Hearing in Noise Test sentences in stationary speech-shaped noise at signal-to-noise ratios (SNRs) ranging from -8 to +8 dB.

Results: Participants' word report accuracy increased from approximately 12% to 100% when the SNRs increased from -8 to +8 dB. Peak pupil diameter decreased for both devices and was smaller with the Gazepoint device. Data quality was comparable for the two devices.

Conclusion: Gazepoint appeared to be an effective pupillometry device that records pupil dilation across a wide range of SNRs, without interfering with the auditory task.

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.