American Journal of Audiology最新文献

Purpose: The aim of this study was to describe psychological inflexibility for hearing difficulty for a sample of adults seeking hearing help and explore associations with demographic and audiological characteristics.

Method: Archival data from 226 clinical electronic medical records at one university clinic were analyzed for this retrospective exploratory study. Audiometric test findings and results from the Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL) were extracted for adult patients seen between June 1, 2022, and February 29, 2024.

Results: The majority had a bilateral hearing loss (64%), 10% had a unilateral hearing loss, and 26% had bilateral pure-tone averages better than 25 dB HL. The AAQ-AHL total scores ranged from 0 to 51, and 8% had a high likelihood of distress from internal struggles related to their difficulty hearing. On individual items, up to one third of the sample expressed internal challenges. The AAQ-AHL total scores were moderately correlated with word recognition in noise, weakly correlated with better ear pure-tone average and word recognition in quiet, and were not correlated with age.

Conclusions: The current study adds to the previous research describing psychosocial challenges that can be experienced by people with hearing difficulties. Our research demonstrates that psychological inflexibility for hearing loss can be experienced by individuals of all ages and hearing status. Based on the present findings, we recommend that audiologists intentionally assess for psychosocial challenges for people seeking hearing help.

Purpose: Audiologists play an essential role in hearing health care. It has been predicted that the supply of audiologists may fail to meet future market demand. One way to improve the number of available audiologists is to improve retention. The purpose of this study was an exploration of audiologist attrition as a first step toward creating strategies to improve retention.

Method: A survey completed by 47 former audiologists included questions about demographics, why participants entered and exited the audiology profession, and job satisfaction.

Results: Participants cited lack of reward as the most common reason for leaving the profession. About a third disliked the for-profit hearing aid dispensing aspect of the profession, and a few would return to the profession for an audiology job that did not involve hearing aid dispensing. About a quarter left audiology to pursue other opportunities (e.g., selling a private practice), and about a quarter reported poor psychosocial work environment.

Conclusion: Findings highlight the need for national efforts focused on (a) improving audiology awareness so students have a greater understanding of audiology as they are exploring career choices, (b) advocating for improved compensation overall and compensation models that de-emphasize sales-based financial incentives, and (c) creating strategies to help improve audiologists' work environment and opportunities for leadership roles.

Supplemental material: https://doi.org/10.23641/asha.28599341.

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and nonmusicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years without any history of hearing loss, vestibular/balance disorder, otologic disorder, or nervous system disorder were included in this study. Participants were divided into musician (n = 19) and nonmusician (n = 18) groups. Vestibular function was assessed and compared via the cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), video head impulse test (vHIT), and modified clinical test of sensory interaction in balance (mCTSIB).

Results: Musicians were found to produce significantly more saccades in the left horizontal semicircular canal during vHIT assessment compared to nonmusicians. Group differences were not found in the cVEMP, oVEMP, or mCTSIB.

Conclusions: This study shows the effects of music exposure on the vestibular system in young adult musicians who show early-onset, subclinical findings on the vHIT that could develop into abnormal results on vestibular assessments if hearing protection use is not increased.

Purpose: The effectiveness of a dedicated bimodal hearing aid and fitting formula was investigated in pediatric cochlear implant recipients who were experienced Desired Sensation Level (DSL) v5.0 users.

Method: In Experiment 1, five children assessed four hearing aid fittings based on combinations of fitting formula (Adaptive Phonak Digital Bimodal [APDB], DSL v5.0, APDB fit to DSL v5.0 targets), hearing aid type (dedicated hearing aid for bimodal listeners, independent hearing aid), and/or prescriptive targets. Speech recognition scores were obtained in a sound booth in quiet and in noise. In Experiment 2, two participants from Experiment 1 were retested with an updated bimodal system.

Results: Bimodal speech recognition in quiet in both experiments was similar across all fitting formulas. In Experiment 1, bimodal speech recognition in noise was similar across fitting formulas; however, both in noise and in quiet, individual differences were observed. In Experiment 2, optimized APDB improved speech recognition in noise performance compared to APDB and similar performance compared to DSL v5.0 in a small set of bimodal listeners.

Conclusion: Preliminary results point to the value of individualized selection of hearing aid fitting formula settings for pediatric bimodal recipients.

Purpose: Diabetes affects the peripheral auditory and vestibular systems. Research suggests that both cervical vestibular evoked myogenic potentials (cVEMP) and ocular VEMP (oVEMP) are affected in individuals with diabetes. Masseter VEMP (mVEMP) is a new tool that assesses the vestibulomasseteric reflex pathways. The study aimed to characterize the cVEMP and mVEMP latency and amplitude parameters in diabetes mellitus type 2.

Method: The study included 21 participants with type 2 diabetes mellitus and 21 age- and gender-matched participants without diabetes aged 48-68 years. mVEMP and cVEMP were recorded using 500 Hz tone burst stimuli, presented at an intensity of 125 dB peSPL for both the groups.

Results: The study suggests significantly prolonged P13 (p = .00) and P11 latencies (p = .00) in participants with diabetes (M for p11 = 15.81, M for p13 = 15.39) compared to participants without diabetes (M for p11 = 13.12, M for p13 = 14.19) for both cVEMP and mVEMP, respectively. No significant differences were observed in N23 (p = .4) and N21 latencies (p = .18) between the diabetes (M for N21 = 22.62, M for N23 = 22.61) and nondiabetes groups (M for N21 = 22.21, M for N23 = 22.40). Additionally, a significant reduction in cVEMP amplitude (P13-N23) was noted in the diabetes group (M for P13-N23 = 0.71, p = .00) than the nondiabetes group (M = 1.44), while mVEMP amplitudes (P11-N21) remained similar across groups (M for P11-N21 for diabetes = 0.72, (M for P11-N21 for nondiabetes = 0.77, p = .44). There were no significant correlations between the duration of diabetes and VEMP parameters, nor between cVEMP and mVEMP responses in either group.

Conclusions: The findings revealed notable differences in cVEMP and mVEMP findings in diabetes individuals. These results suggest that diabetes may lead to neural and labyrinthine impairments. The degree of vestibular impairment varies and affects different reflex pathways. Even though mVEMP has a similar saccular origin as cVEMP, the results between the two do not correlate with each other.

Purpose: The purpose of this study was to evaluate the auditory brainstem response (ABR) of infants with asymmetric intrauterine growth restriction (IUGR) in response to different stimuli and to compare the findings with those of term infants.

Method: A total of 20 infants with asymmetric IUGR who had no risk factors for hearing loss and 20 term healthy infants as a control group participated. Click, chirp, and 4-kHz tone burst at 90 dB nHL stimuli were used, and Waves I, III, and V absolute latencies; Waves I-III, I-V, and III-V interpeak intervals; and wave amplitudes were evaluated.

Results: The Wave V absolute latency and Waves I-V interpeak interval of both click and chirp stimuli in infants with asymmetric IUGR were significantly shorter in both ears (p < .05). In contrast, only Wave III absolute latency was significantly shorter for both ears (p < .05) with a 4-kHz tone burst.

Conclusions: ABR test with click, chirp, and 4-kHz tone-burst stimuli revealed that there are functional differences attributed to IUGR. Contrary to popular belief, these findings are evidence of neurosensory changes caused by IUGR, which is not included as a risk factor in newborn hearing screening programs. The type of stimulus used in the assessment was critical.

Purpose: This scoping review aimed to identify behavioral tests for central auditory processing (CAP) assessment that can be used to investigate early manifestations of pathological cognitive decline in adults and the older adults. Early detection of cognitive decline and dementias is a strategy for delaying the progression of these clinical conditions.

Method: This scoping review was conducted using various online databases and gray literature sources, including the Latin American and Caribbean Literature in Health Sciences, PubMed/Medline, Scopus, Web of Science, Google Scholar, and ProQuest Dissertations & Theses. Studies were included if they assessed individuals who underwent behavioral tests for CAP evaluation and had completed at least one cognitive test.

Results: A total of 1,190 references were retrieved from the databases, with 151 identified as duplicates. After screening 1,039 articles by title and abstract, eight studies were selected for full-text review, and five were included in the final synthesis. The behavioral tests for CAP evaluation used to investigate preclinical manifestations of cognitive decline and dementia were: Synthetic Sentence Identification With Ipsilateral Competing Message, Staggered Spondaic Word test, Dichotic Sentence Identification, and Dichotic Digits Test. Among these, dichotic tests were identified as having the strongest association with cognitive decline, probable Alzheimer's disease, or dementia.

Conclusions: The findings indicate that dichotic tests are the most frequently utilized behavioral tests for CAP evaluation and serve as valuable tools for detecting early manifestations of cognitive decline and dementias. These tests could play a significant role in the early diagnosis and management of cognitive impairments.

With current advances in experimental techniques, there is a renewed interest in studying communication behavior, reflecting a desire to improve our understanding of hearing disability and the effects of treatment interventions at the level of in-the-moment behaviors. Group conversations are among the most challenging situations for people with hearing loss. Experiments on group conversations are increasingly common and disproportionately more demanding than dyad studies to design and execute. Thorough design and planning are critical for successfully capturing valid behavioral data, highlighting the value of sharing behind-the-scenes experiences with the researcher community. We have completed a laboratory study of four-way group conversations involving people with and without hearing loss. This article describes the goals and compromises involved in our design choices and evaluates their effectiveness through participant feedback. Aspects covered include contrasts and covariates, group composition and physical arrangement, participant characteristics, hearing devices, participant experience, physical environment, conversational task, and measurement modalities. Next, we briefly describe the experiment's execution. Finally, we analyze and discuss participants' feedback and reflect on what proved effective, what did not, and what design "worries" proved founded or unfounded. We hope thereby to provide support and inspiration for others who may be faced with similar design challenges. The main message is that such an experiment can be carried out successfully and in such a way that the behavioral and self-report data collected are likely to carry a relatively high degree of ecological validity while still supporting experimental and statistical control.

Purpose: The purpose of this study was to determine the effectiveness of television (TV) streaming on cochlear implant (CI) user performance and satisfaction in quiet and in noise.

Method: Sixteen CI users (15 bilateral) were evaluated in quiet and in noise (5 dB SNR) under three CI conditions: CI only, streaming with CI microphones attenuated by 6 dB, and streaming with CI microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the SSI-ICM served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained.

Results: In quiet, speech understanding and speech clarity ratings were significantly better for the streaming with CI microphones muted condition than the CI only and streaming with CI microphones attenuated conditions; however, sound quality ratings were significantly better for streaming with CI microphones muted than the CI microphones attenuated condition. In noise, speech understanding, speech clarity ratings, and sound quality ratings were significantly different across all conditions with CI only being the poorest, followed by streaming with CI microphones attenuated then by CI microphones muted being the best. In quiet, streaming with CI microphones muted was preferred over CI only. In noise, both streaming options were preferred to CI only. Overall, streaming with CI microphones attenuated was preferred to CI only.

Conclusions: CI users benefited from TV streaming in both quiet and in noise. CI users should be counseled on the benefits of adjusting CI microphone settings when using a TV streamer.

Purpose: Hearing loss is an independent risk factor for falls. Research has demonstrated the importance of a combination of self-report and performance-based tools in predicting falls. Using this approach, the purpose of this study was to examine the association between the degree of hearing loss and fall risk.

Method: Community-dwelling older adults with hearing loss, aged 60 years and above, completed a history form, the Activities-Specific Balance Confidence Scale and the modified Clinical Test of Sensory Interaction in Balance. Average pure-tone audiometry of the better hearing ear was calculated. Fall risk was determined for each participant. Binomial logistic regression and Cohen's kappa were performed.

Results: Fifty-eight participants, with mild (n = 12), moderate (n = 27), moderately severe (n = 14), and severe (n = 5) hearing losses were included in the analysis. Overall fall risk incidence was 46.6%. No significant association was found between the degree of hearing loss and fall risk, while age, gender, and diabetes were revealed to be significant fall risk factors. A key finding was the tendency to overestimate balance confidence using self-report measures.

Conclusions: To our knowledge, this is the first study in Asia employing self-report and performance-based measures to examine hearing loss and fall risk. Our findings provide insight into region-specific factor(s) affecting fall risk and serves to pave the way for future fall risk research. Future studies should include a combination of self-report and performance-based measures, as well as account for protective fall risk factors.