American Journal of Audiology最新文献

Purpose: Many factors create barriers for early hearing detection and intervention (EHDI), especially those related to unfavorable social determinants of health (SDOH). The primary aim of this study was to evaluate diagnostic timing of infants at risk for congenital hearing loss in consideration of known barriers. Understanding the specific barriers to early diagnosis can inform interventions to improve timeliness of diagnosis and subsequent habilitation.

Method: A retrospective chart review was completed for infants referred for diagnostic audiologic testing at a tertiary urban-setting Children's Hospital from 2018 to 2021. After exclusion criteria were applied, 1,488 infants were included in the analysis. Various factors were recorded from electronic medical records including those specific to SDOH. Time to diagnosis was derived and compared across five factors of interest that have previously been shown to impact diagnostic timeline, including (a) insurance type, (b) race/ethnicity, (c) presence of middle ear dysfunction at first auditory brainstem response (ABR), (d) proximity to diagnostic center, and (e) diagnostic timing before and during/after the COVID-19 pandemic.

Results: Across the study time period, 77% of infants referred for diagnostic testing had confirmed diagnosis by the EHDI benchmark of 3 months. Analysis of time to diagnosis across factors of interest revealed no clinically significant differences for insurance type, race/ethnicity, proximity to diagnostic center, or timing in reference to the COVID-19 pandemic. Presence of middle ear dysfunction on first ABR was found to significantly protract final diagnostic timing.

Conclusions: Although some known barriers for EHDI can be universal, other factors may have a differential impact on an infant's timeline to diagnosis based on their specific location, which can interact differently with additional known barriers. Understanding local challenges will serve to better guide programs in implementing facilitators that will address their specific needs for improved outcomes.

Purpose: The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)-based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results.

Method: This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation.

Results: The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure.

Conclusion: The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.

Purpose: This study aimed to investigate barriers and facilitators experienced by clinical educators and graduate students when talking with patients about difficult emotions and thoughts related to their hearing.

Method: A longitudinal observational design was used and an Implementation Research Logic Model guided the process. Five clinical educators and five graduate students participated in the study. Participants completed pre- and postmeasures and attended individual debriefing sessions during the 8-month study period.

Results: Four themes emerged from the debriefing sessions: (a) learning process, (b) confidence, (c) barriers, and (d) supervision. Participants described that the Acceptance and Action Questionnaire-Managing Child Hearing Loss and Acceptance and Action Questionnaire-Adult Hearing Loss served as a reminder to ask about patients' internal barriers and increased awareness of their discomfort in talking about patient emotions. Participants also described barriers and struggles related to supporting students in gaining counseling skills.

Conclusions: Screening for internal challenges helped clinicians remember to talk with patients about their difficult thoughts and emotions. Clinician hesitancy to engage in conversations with patients about their emotions can interfere with opportunities for patients to share their struggles and with training student in these skills.

Purpose: This study examined children's ability to perceive speech from multiple locations on the horizontal plane. Children with hearing loss were compared to normal-hearing peers while using amplification with and without advanced noise management.

Method: Participants were 21 children with normal hearing (9-15 years) and 12 children with moderate symmetrical hearing loss (11-15 years). Word recognition, nonword detection, and word recall were assessed. Stimuli were presented randomly from multiple discrete locations in multitalker noise. Children with hearing loss were fit with devices having separate omnidirectional and noise management programs. The noise management feature is designed to preserve audibility in noise by rapidly analyzing input from all locations and reducing the noise management when speech is detected from locations around the hearing aid user.

Results: Significant effects of left/right and front/back lateralization occurred as well as effects of hearing loss and hearing aid noise management. Children with normal hearing experienced a left-side advantage for word recognition and a right-side advantage for nonword detection. Children with hearing loss demonstrated poorer performance overall on all tasks with better word recognition from the back, and word recall from the right, in the omnidirectional condition. With noise management, performance improved from the front compared to the back for all three tasks and from the right for word recognition and word recall.

Conclusions: The shape of children's local speech intelligibility on the horizontal plane is not omnidirectional. It is task dependent and shaped further by hearing loss and hearing aid signal processing. Front/back shifts in children with hearing loss are consistent with the behavior of hearing aid noise management, while the right-side biases observed in both groups are consistent with the effects of specialized speech processing in the left hemisphere of the brain.

Purpose: The purpose of this study was to evaluate the potential contribution of limited English proficiency on daily hearing aid wear time for children with hearing loss.

Method: A retrospective chart review was completed to evaluate hearing aid wear time based on data logging information available at the time of a follow-up visit following an initial hearing aid fitting. Children were included in the study if they had permanent bilateral hearing loss and were less than 60 months of age at the time of their first follow-up visit. Wear time was compared between children who attended an interpreter-mediated appointment and those who did not have an interpreter present. The presence of an interpreter at the appointment was the study indicator that the family had limited English proficiency.

Results: Children from families with limited English proficiency exhibited significantly shorter daily wear time (M = 1.3 hr) than their peers whose families were English-proficient speakers, thus, having a shared language with their audiologists (M = 5.2 hr).

Conclusions: Results of this study suggest that family-clinician language discordance might put children at greater risk of shorter hearing aid wear time than children whose caregivers share a common language with their child's audiologist. There can be many linguistic, cultural, and educational factors that contribute to hearing aid wear time in children whose families have limited English proficiency as well as different approaches to improving that wear time. Efforts should ensure that hearing and hearing aid-related information is accessible to all families, especially those with clinician-family language discordance. Such efforts can include, among others, training that improves clinicians' cultural and linguistic responsiveness to the diverse families they serve.