Contents List

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via ola Kala on Inoreader http://ift.tt/1V2lVUf
via IFTTT

Editorial Board

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via ola Kala on Inoreader http://ift.tt/1QUJ5H5
via IFTTT

Contents List

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via xlomafota13 on Inoreader http://ift.tt/1V2lVUf
via IFTTT

Editorial Board

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via xlomafota13 on Inoreader http://ift.tt/1QUJ5H5
via IFTTT

Contents List

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via ola Kala on Inoreader http://ift.tt/1V2lVUf
via IFTTT

Editorial Board

Publication date: March 2016
Source:Gait & Posture, Volume 45





from #Audiology via ola Kala on Inoreader http://ift.tt/1QUJ5H5
via IFTTT

Time-frequency decomposition of click evoked otoacoustic emissions in children

Publication date: Available online 11 March 2016
Source:Hearing Research
Author(s): Srikanta K. Mishra, Milan Biswal
Determining the time-frequency distributions of click-evoked otoacoustic emissions (CEOAEs) are scientifically and clinically relevant because of their relationship with cochlear mechanisms. This study investigated the time-frequency properties of CEOAEs in 5 to 10 year old children. In the first part, we examined the feasibility of the S transform to characterize the time-frequency features of CEOAEs. A synthetic signal with known gammatones was analyzed using the S transform, as well as a wavelet transform with the basis function used traditionally for CEOAE analysis. The S and wavelet transforms provided similar representations of the gammatones of the synthetic signal in the mid and high frequencies. However, the S transform yielded a slightly more precise time-frequency representation at low frequencies (500 and 707 Hz). In the second part, we applied the S transform to compare the time-frequency distribution of CEOAEs between adults and children. The time-frequency representation of the CEOAEs in adults and children were computed using the S transform. Several confounding variables, such as spontaneous emissions and potential efferent effects from the use of higher click rates, were considered for obtaining reliable CEOAE recordings. The results revealed that the emission level, level versus frequency plot, latency, and latency versus frequency plot in 5 to 10 year old children are adult-like. The time-frequency characteristics of CEOAEs in 5 to 10 year old children are consistent with the maturation of various aspects of cochlear mechanics, including the basal to apical transition. In sum, the description of the time-frequency features in children and the use of the S transform to decompose CEOAEs, are novel aspects of this study. The S transform can be used as an alternative approach to characterize the time-frequency distribution of CEOAEs.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1TCII9P
via IFTTT

Time-frequency decomposition of click evoked otoacoustic emissions in children

Publication date: Available online 11 March 2016
Source:Hearing Research
Author(s): Srikanta K. Mishra, Milan Biswal
Determining the time-frequency distributions of click-evoked otoacoustic emissions (CEOAEs) are scientifically and clinically relevant because of their relationship with cochlear mechanisms. This study investigated the time-frequency properties of CEOAEs in 5 to 10 year old children. In the first part, we examined the feasibility of the S transform to characterize the time-frequency features of CEOAEs. A synthetic signal with known gammatones was analyzed using the S transform, as well as a wavelet transform with the basis function used traditionally for CEOAE analysis. The S and wavelet transforms provided similar representations of the gammatones of the synthetic signal in the mid and high frequencies. However, the S transform yielded a slightly more precise time-frequency representation at low frequencies (500 and 707 Hz). In the second part, we applied the S transform to compare the time-frequency distribution of CEOAEs between adults and children. The time-frequency representation of the CEOAEs in adults and children were computed using the S transform. Several confounding variables, such as spontaneous emissions and potential efferent effects from the use of higher click rates, were considered for obtaining reliable CEOAE recordings. The results revealed that the emission level, level versus frequency plot, latency, and latency versus frequency plot in 5 to 10 year old children are adult-like. The time-frequency characteristics of CEOAEs in 5 to 10 year old children are consistent with the maturation of various aspects of cochlear mechanics, including the basal to apical transition. In sum, the description of the time-frequency features in children and the use of the S transform to decompose CEOAEs, are novel aspects of this study. The S transform can be used as an alternative approach to characterize the time-frequency distribution of CEOAEs.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TCII9P
via IFTTT

Time-frequency decomposition of click evoked otoacoustic emissions in children

Publication date: Available online 11 March 2016
Source:Hearing Research
Author(s): Srikanta K. Mishra, Milan Biswal
Determining the time-frequency distributions of click-evoked otoacoustic emissions (CEOAEs) are scientifically and clinically relevant because of their relationship with cochlear mechanisms. This study investigated the time-frequency properties of CEOAEs in 5 to 10 year old children. In the first part, we examined the feasibility of the S transform to characterize the time-frequency features of CEOAEs. A synthetic signal with known gammatones was analyzed using the S transform, as well as a wavelet transform with the basis function used traditionally for CEOAE analysis. The S and wavelet transforms provided similar representations of the gammatones of the synthetic signal in the mid and high frequencies. However, the S transform yielded a slightly more precise time-frequency representation at low frequencies (500 and 707 Hz). In the second part, we applied the S transform to compare the time-frequency distribution of CEOAEs between adults and children. The time-frequency representation of the CEOAEs in adults and children were computed using the S transform. Several confounding variables, such as spontaneous emissions and potential efferent effects from the use of higher click rates, were considered for obtaining reliable CEOAE recordings. The results revealed that the emission level, level versus frequency plot, latency, and latency versus frequency plot in 5 to 10 year old children are adult-like. The time-frequency characteristics of CEOAEs in 5 to 10 year old children are consistent with the maturation of various aspects of cochlear mechanics, including the basal to apical transition. In sum, the description of the time-frequency features in children and the use of the S transform to decompose CEOAEs, are novel aspects of this study. The S transform can be used as an alternative approach to characterize the time-frequency distribution of CEOAEs.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TCII9P
via IFTTT

Time-frequency decomposition of click evoked otoacoustic emissions in children

Publication date: Available online 11 March 2016
Source:Hearing Research
Author(s): Srikanta K. Mishra, Milan Biswal
Determining the time-frequency distributions of click-evoked otoacoustic emissions (CEOAEs) are scientifically and clinically relevant because of their relationship with cochlear mechanisms. This study investigated the time-frequency properties of CEOAEs in 5 to 10 year old children. In the first part, we examined the feasibility of the S transform to characterize the time-frequency features of CEOAEs. A synthetic signal with known gammatones was analyzed using the S transform, as well as a wavelet transform with the basis function used traditionally for CEOAE analysis. The S and wavelet transforms provided similar representations of the gammatones of the synthetic signal in the mid and high frequencies. However, the S transform yielded a slightly more precise time-frequency representation at low frequencies (500 and 707 Hz). In the second part, we applied the S transform to compare the time-frequency distribution of CEOAEs between adults and children. The time-frequency representation of the CEOAEs in adults and children were computed using the S transform. Several confounding variables, such as spontaneous emissions and potential efferent effects from the use of higher click rates, were considered for obtaining reliable CEOAE recordings. The results revealed that the emission level, level versus frequency plot, latency, and latency versus frequency plot in 5 to 10 year old children are adult-like. The time-frequency characteristics of CEOAEs in 5 to 10 year old children are consistent with the maturation of various aspects of cochlear mechanics, including the basal to apical transition. In sum, the description of the time-frequency features in children and the use of the S transform to decompose CEOAEs, are novel aspects of this study. The S transform can be used as an alternative approach to characterize the time-frequency distribution of CEOAEs.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TCII9P
via IFTTT

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

J Am Acad Audiol. 2016 Mar;27(3):166-187

Authors: Moodie S, Rall E, Eiten L, Lindley G, Gordey D, Davidson L, Bagatto M, Scollie S

Abstract
BACKGROUND: There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur.
PURPOSE: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America.
RESEARCH DESIGN: A concurrent embedded mixed methods design was used.
STUDY SAMPLE: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2.
DATA COLLECTION AND ANALYSIS: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents' knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification.
RESULTS: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided.
CONCLUSIONS: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the "how" and "why" of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.

PMID: 26967360 [PubMed - as supplied by publisher]

from #Audiology via xlomafota13 on Inoreader http://ift.tt/228hM6N
via IFTTT

Cochlear Implantation in Neurobrucellosis.

Cochlear Implantation in Neurobrucellosis.

Balkan Med J. 2016 Jan;33(1):108-11

Authors: Bajin MD, Savaş Ö, Aslan F, Sennaroğlu L

Abstract
BACKGROUND: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation.
CASE REPORT: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members' statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving.
CONCLUSION: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results.

PMID: 26966626 [PubMed]

from #Audiology via xlomafota13 on Inoreader http://ift.tt/1MdOZ3T
via IFTTT

Time-frequency decomposition of click evoked otoacoustic emissions in children

Publication date: Available online 11 March 2016
Source:Hearing Research
Author(s): Srikanta K. Mishra, Milan Biswal
Determining the time-frequency distributions of click-evoked otoacoustic emissions (CEOAEs) are scientifically and clinically relevant because of their relationship with cochlear mechanisms. This study investigated the time-frequency properties of CEOAEs in 5 to 10 year old children. In the first part, we examined the feasibility of the S transform to characterize the time-frequency features of CEOAEs. A synthetic signal with known gammatones was analyzed using the S transform, as well as a wavelet transform with the basis function used traditionally for CEOAE analysis. The S and wavelet transforms provided similar representations of the gammatones of the synthetic signal in the mid and high frequencies. However, the S transform yielded a slightly more precise time-frequency representation at low frequencies (500 and 707 Hz). In the second part, we applied the S transform to compare the time-frequency distribution of CEOAEs between adults and children. The time-frequency representation of the CEOAEs in adults and children were computed using the S transform. Several confounding variables, such as spontaneous emissions and potential efferent effects from the use of higher click rates, were considered for obtaining reliable CEOAE recordings. The results revealed that the emission level, level versus frequency plot, latency, and latency versus frequency plot in 5 to 10 year old children are adult-like. The time-frequency characteristics of CEOAEs in 5 to 10 year old children are consistent with the maturation of various aspects of cochlear mechanics, including the basal to apical transition. In sum, the description of the time-frequency features in children and the use of the S transform to decompose CEOAEs, are novel aspects of this study. The S transform can be used as an alternative approach to characterize the time-frequency distribution of CEOAEs.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TCII9P
via IFTTT

Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs.

Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs.

J Am Acad Audiol. 2016 Mar;27(3):264-275

Authors: Moodie S, Pietrobon J, Rall E, Lindley G, Eiten L, Gordey D, Davidson L, Moodie KS, Bagatto M, Haluschak MM, Folkeard P, Scollie S

Abstract
BACKGROUND: Real-ear-to-coupler difference (RECD) measurements are used for the purposes of estimating degree and configuration of hearing loss (in dB SPL ear canal) and predicting hearing aid output from coupler-based measures. Accurate measurements of hearing threshold, derivation of hearing aid fitting targets, and predictions of hearing aid output in the ear canal assume consistent matching of RECD coupling procedure (i.e., foam tip or earmold) with that used during assessment and in verification of the hearing aid fitting. When there is a mismatch between these coupling procedures, errors are introduced.
PURPOSE: The goal of this study was to quantify the systematic difference in measured RECD values obtained when using a foam tip versus an earmold with various tube lengths. Assuming that systematic errors exist, the second goal was to investigate the use of a foam tip to earmold correction for the purposes of improving fitting accuracy when mismatched RECD coupling conditions occur (e.g., foam tip at assessment, earmold at verification).
STUDY SAMPLE: Eighteen adults and 17 children (age range: 3-127 mo) participated in this study.
DATA COLLECTION AND ANALYSIS: Data were obtained using simulated ears of various volumes and earmold tubing lengths and from patients using their own earmolds. Derived RECD values based on simulated ear measurements were compared with RECD values obtained for adult and pediatric ears for foam tip and earmold coupling.
RESULTS: Results indicate that differences between foam tip and earmold RECDs are consistent across test ears for adults and children which support the development of a correction between foam tip and earmold couplings for RECDs that can be applied across individuals.
CONCLUSIONS: The foam tip to earmold correction values developed in this study can be used to provide improved estimations of earmold RECDs. This may support better accuracy in acoustic transforms related to transforming thresholds and/or hearing aid coupler responses to ear canal sound pressure level for the purposes of fitting behind-the-ear hearing aids.

PMID: 26967366 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hMUi
via IFTTT

Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety.

Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety.

J Am Acad Audiol. 2016 Mar;27(3):252-263

Authors: McCreery R, Walker E, Spratford M, Kirby B, Oleson J, Brennan M

Abstract
BACKGROUND: Children who wear hearing aids may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing aids in children has not been empirically verified.
PURPOSE: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing aids to determine the likelihood of amplification-induced hearing loss.
RESEARCH DESIGN: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively.
STUDY SAMPLE: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing aids were included in the analysis.
DATA COLLECTION AND ANALYSIS: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequency-specific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits.
RESULTS: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference.
CONCLUSIONS: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing aids.

PMID: 26967365 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC86J
via IFTTT

Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols.

Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols.

J Am Acad Audiol. 2016 Mar;27(3):237-251

Authors: Scollie S, Levy C, Pourmand N, Abbasalipour P, Bagatto M, Richert F, Moodie S, Crukley J, Parsa V

Abstract
BACKGROUND: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children's hearing aids. Children are frequently in high-level and/or noisy environments, and many options for noise management exist in modern hearing aids. Verification protocols are needed to define specific test signals and levels for use in clinical practice.
PURPOSE: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing aids and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice.
STUDY SAMPLE: A set of hearing aids was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing aids could be characterized for speech in a variety of background noises. A second set of hearing aids was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss.
RESULTS: Significant variation across makes and models of hearing aids was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing aids, and for one hearing aid rated the sound quality as higher with the noise reduction system activated.
CONCLUSIONS: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children's hearing aids is suggested.

PMID: 26967364 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hJaW
via IFTTT

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols.

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols.

J Am Acad Audiol. 2016 Mar;27(3):219-236

Authors: Scollie S, Glista D, Seto J, Dunn A, Schuett B, Hawkins M, Pourmand N, Parsa V

Abstract
BACKGROUND: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying technologies can supplement such guidelines. One such technology is frequency-lowering signal processing. Children require access to a broad bandwidth of speech to detect and use all phonemes including female /s/. When access through conventional amplification is not possible, the use of frequency-lowering signal processing may be considered as a means to overcome limitations. Fitting and verification protocols are needed to better define candidacy determination and options for assessing and fine tuning frequency-lowering signal processing for individuals.
PURPOSE: This work aims to (1) describe a set of calibrated phonemes that can be used to characterize the variation in different brands of frequency-lowering processors in hearing aids and the verification with these signals and (2) determine whether verification with these signal are predictive of perceptual changes associated with changes in the strength of frequency-lowering signal processing. Finally, we aimed to develop a fitting protocol for use in pediatric clinical practice.
STUDY SAMPLE: Study 1 used a sample of six hearing aids spanning four types of frequency lowering algorithms for an electroacoustic evaluation. Study 2 included 21 adults who had hearing loss (mean age 66 yr).
DATA COLLECTION AND ANALYSIS: Simulated fricatives were designed to mimic the level and frequency shape of female fricatives extracted from two sources of speech. These signals were used to verify the frequency-lowering effects of four distinct types of frequency-lowering signal processors available in commercial hearing aids, and verification measures were compared to extracted fricatives made in a reference system. In a second study, the simulated fricatives were used within a probe microphone measurement system to verify a wide range of frequency compression settings in a commercial hearing aid, and 27 adult listeners were tested at each setting. The relation between the hearing aid verification measures and the listener's ability to detect and discriminate between fricatives was examined.
RESULTS: Verification measures made with the simulated fricatives agreed to within 4 dB, on average, and tended to mimic the frequency response shape of fricatives presented in a running speech context. Some processors showed a greater aided response level for fricatives in running speech than fricatives presented in isolation. Results with listeners indicated that verified settings that provided a positive sensation level of /s/ and that maximized the frequency difference between /s/ and /∫/ tended to have the best performance.
CONCLUSIONS: Frequency-lowering signal processors have measureable effects on the high-frequency fricative content of speech, particularly female /s/. It is possible to measure these effects either with a simple strategy that presents an isolated simulated fricative and measures the aided frequency response or with a more complex system that extracts fricatives from running speech. For some processors, a more accurate result may be achieved with a running speech system. In listeners, the aided frequency location and sensation level of fricatives may be helpful in predicting whether a specific hearing aid fitting, with or without frequency-lowering, will support access to the fricatives of speech.

PMID: 26967363 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC6vK
via IFTTT

Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

J Am Acad Audiol. 2016 Mar;27(3):204-218

Authors: Walker E, McCreery R, Spratford M, Roush P

Abstract
BACKGROUND: Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population.
PURPOSE: This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines.
RESEARCH DESIGN: Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa.
STUDY SAMPLE: The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer).
DATA COLLECTION AND ANALYSIS: Children and their families participated in an initial baseline visit, followed by visits twice a year for children <2 yr of age and once a yr for children >2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL.
RESULTS: Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in background noise with HAs, compared to the SNHL group.
CONCLUSIONS: The American Academy of Audiology Pediatric Amplification Guidelines recommend that children with ANSD receive an HA trial if their behavioral thresholds are sufficiently high enough to impede speech perception at conversational levels. For children with ANSD in the mild-to-severe HL range, the current results support this recommendation, as children with ANSD can achieve functional outcomes similar to peers with SNHL.

PMID: 26967362 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hIUx
via IFTTT

Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.

Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.

J Am Acad Audiol. 2016 Mar;27(3):188-203

Authors: Bagatto M, Moodie S, Brown C, Malandrino A, Richert F, Clench D, Scollie S

Abstract
BACKGROUND: Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence.
PURPOSE: A summary of the updates to the Ontario IHP's Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered.
RESEARCH DESIGN: The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study.
STUDY SAMPLE: One hundred and fifteen children with hearing loss, who wore hearing aids, were included in the outcome analyses (mean = 28.6 mo; range = 1.3-115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included.
INTERVENTION: The children were fitted with hearing aids following Ontario's Amplification Protocol.
DATA COLLECTION AND ANALYSES: During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those who were typically developing.
RESULTS: Important updates to Ontario's Amplification Protocol offer new details about candidacy considerations as well as technical updates. Outcomes from the IHP reveal protocol elements can be executed clinically and when they are, typically developing children who wear hearing aids are meeting auditory development and performance milestones.
CONCLUSIONS: Updates to Ontario's Amplification Protocol are necessary to support the evolution of EHDI programs and the evidence which sustains them. With advances in technology and additional research, pediatric hearing aid fitting will continue to progress and support systematic measurement of outcomes for children who wear hearing aids. The application of state-of-the-art hearing aid fitting practices to the pediatric population within EHDI programs supports good outcomes for infants and children with hearing loss.

PMID: 26967361 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC6vE
via IFTTT

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

J Am Acad Audiol. 2016 Mar;27(3):166-187

Authors: Moodie S, Rall E, Eiten L, Lindley G, Gordey D, Davidson L, Bagatto M, Scollie S

Abstract
BACKGROUND: There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur.
PURPOSE: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America.
RESEARCH DESIGN: A concurrent embedded mixed methods design was used.
STUDY SAMPLE: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2.
DATA COLLECTION AND ANALYSIS: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents' knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification.
RESULTS: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided.
CONCLUSIONS: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the "how" and "why" of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.

PMID: 26967360 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hM6N
via IFTTT

Providing Hearing Aids to Infants and Young Children.

Providing Hearing Aids to Infants and Young Children.

J Am Acad Audiol. 2016 Mar;27(3):164-165

Authors: Bagatto M

PMID: 26967359 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC7zT
via IFTTT

Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs.

Using the Real-Ear-to-Coupler Difference within the American Academy of Audiology Pediatric Amplification Guideline: Protocols for Applying and Predicting Earmold RECDs.

J Am Acad Audiol. 2016 Mar;27(3):264-275

Authors: Moodie S, Pietrobon J, Rall E, Lindley G, Eiten L, Gordey D, Davidson L, Moodie KS, Bagatto M, Haluschak MM, Folkeard P, Scollie S

Abstract
BACKGROUND: Real-ear-to-coupler difference (RECD) measurements are used for the purposes of estimating degree and configuration of hearing loss (in dB SPL ear canal) and predicting hearing aid output from coupler-based measures. Accurate measurements of hearing threshold, derivation of hearing aid fitting targets, and predictions of hearing aid output in the ear canal assume consistent matching of RECD coupling procedure (i.e., foam tip or earmold) with that used during assessment and in verification of the hearing aid fitting. When there is a mismatch between these coupling procedures, errors are introduced.
PURPOSE: The goal of this study was to quantify the systematic difference in measured RECD values obtained when using a foam tip versus an earmold with various tube lengths. Assuming that systematic errors exist, the second goal was to investigate the use of a foam tip to earmold correction for the purposes of improving fitting accuracy when mismatched RECD coupling conditions occur (e.g., foam tip at assessment, earmold at verification).
STUDY SAMPLE: Eighteen adults and 17 children (age range: 3-127 mo) participated in this study.
DATA COLLECTION AND ANALYSIS: Data were obtained using simulated ears of various volumes and earmold tubing lengths and from patients using their own earmolds. Derived RECD values based on simulated ear measurements were compared with RECD values obtained for adult and pediatric ears for foam tip and earmold coupling.
RESULTS: Results indicate that differences between foam tip and earmold RECDs are consistent across test ears for adults and children which support the development of a correction between foam tip and earmold couplings for RECDs that can be applied across individuals.
CONCLUSIONS: The foam tip to earmold correction values developed in this study can be used to provide improved estimations of earmold RECDs. This may support better accuracy in acoustic transforms related to transforming thresholds and/or hearing aid coupler responses to ear canal sound pressure level for the purposes of fitting behind-the-ear hearing aids.

PMID: 26967366 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hMUi
via IFTTT

Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety.

Stability of Audiometric Thresholds for Children with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Implications for Safety.

J Am Acad Audiol. 2016 Mar;27(3):252-263

Authors: McCreery R, Walker E, Spratford M, Kirby B, Oleson J, Brennan M

Abstract
BACKGROUND: Children who wear hearing aids may be at risk for further damage to their hearing from overamplification. Previous research on amplification-induced hearing loss has included children using linear amplification or simulations of predicted threshold shifts based on nonlinear amplification formulae. A relationship between threshold shifts and the use of nonlinear hearing aids in children has not been empirically verified.
PURPOSE: The purpose of the study was to compare predicted threshold shifts from amplification to longitudinal behavioral thresholds in a large group of children who wear hearing aids to determine the likelihood of amplification-induced hearing loss.
RESEARCH DESIGN: An accelerated longitudinal design was used to collect behavioral threshold and amplification data prospectively.
STUDY SAMPLE: Two-hundred and thirteen children with mild-to-profound hearing loss who wore hearing aids were included in the analysis.
DATA COLLECTION AND ANALYSIS: Behavioral audiometric thresholds, hearing aid outputs, and hearing aid use data were collected for each participant across four study visits. Individual ear- and frequency-specific safety limits were derived based on the Modified Power Law to determine the level at which increased amplification could result in permanent threshold shifts. Behavioral thresholds were used to estimate which children would be above the safety limit at 500, 1000, 2000, and 4000 Hz using thresholds in dB HL and then in dB SPL in the ear canal. Changes in thresholds across visits were compared for children who were above and below the safety limits.
RESULTS: Behavioral thresholds decreased across study visits for all children, regardless of whether their amplification was above the safety limits. The magnitude of threshold change across time corresponded with changes in ear canal acoustics as measured by the real-ear-to-coupler difference.
CONCLUSIONS: Predictions of threshold changes due to amplification for children with hearing loss did not correspond with observed changes in threshold over across 2-4 yr of monitoring amplification. Use of dB HL thresholds and predictions of hearing aid output to set the safety limit resulted in a larger number of children being classified as above the safety limit than when safety limits were based on dB SPL thresholds and measured hearing aid output. Children above the safety limit for the dB SPL criteria tended to be fit above prescriptive targets. Additional research should seek to explain how the Modified Power Law predictions of threshold shift overestimated risk for children who wear hearing aids.

PMID: 26967365 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC86J
via IFTTT

Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols.

Fitting Noise Management Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Verification Protocols.

J Am Acad Audiol. 2016 Mar;27(3):237-251

Authors: Scollie S, Levy C, Pourmand N, Abbasalipour P, Bagatto M, Richert F, Moodie S, Crukley J, Parsa V

Abstract
BACKGROUND: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children's hearing aids. Children are frequently in high-level and/or noisy environments, and many options for noise management exist in modern hearing aids. Verification protocols are needed to define specific test signals and levels for use in clinical practice.
PURPOSE: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing aids and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice.
STUDY SAMPLE: A set of hearing aids was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing aids could be characterized for speech in a variety of background noises. A second set of hearing aids was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss.
RESULTS: Significant variation across makes and models of hearing aids was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing aids, and for one hearing aid rated the sound quality as higher with the noise reduction system activated.
CONCLUSIONS: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children's hearing aids is suggested.

PMID: 26967364 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hJaW
via IFTTT

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols.

Fitting Frequency-Lowering Signal Processing Applying the American Academy of Audiology Pediatric Amplification Guideline: Updates and Protocols.

J Am Acad Audiol. 2016 Mar;27(3):219-236

Authors: Scollie S, Glista D, Seto J, Dunn A, Schuett B, Hawkins M, Pourmand N, Parsa V

Abstract
BACKGROUND: Although guidelines for fitting hearing aids for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying technologies can supplement such guidelines. One such technology is frequency-lowering signal processing. Children require access to a broad bandwidth of speech to detect and use all phonemes including female /s/. When access through conventional amplification is not possible, the use of frequency-lowering signal processing may be considered as a means to overcome limitations. Fitting and verification protocols are needed to better define candidacy determination and options for assessing and fine tuning frequency-lowering signal processing for individuals.
PURPOSE: This work aims to (1) describe a set of calibrated phonemes that can be used to characterize the variation in different brands of frequency-lowering processors in hearing aids and the verification with these signals and (2) determine whether verification with these signal are predictive of perceptual changes associated with changes in the strength of frequency-lowering signal processing. Finally, we aimed to develop a fitting protocol for use in pediatric clinical practice.
STUDY SAMPLE: Study 1 used a sample of six hearing aids spanning four types of frequency lowering algorithms for an electroacoustic evaluation. Study 2 included 21 adults who had hearing loss (mean age 66 yr).
DATA COLLECTION AND ANALYSIS: Simulated fricatives were designed to mimic the level and frequency shape of female fricatives extracted from two sources of speech. These signals were used to verify the frequency-lowering effects of four distinct types of frequency-lowering signal processors available in commercial hearing aids, and verification measures were compared to extracted fricatives made in a reference system. In a second study, the simulated fricatives were used within a probe microphone measurement system to verify a wide range of frequency compression settings in a commercial hearing aid, and 27 adult listeners were tested at each setting. The relation between the hearing aid verification measures and the listener's ability to detect and discriminate between fricatives was examined.
RESULTS: Verification measures made with the simulated fricatives agreed to within 4 dB, on average, and tended to mimic the frequency response shape of fricatives presented in a running speech context. Some processors showed a greater aided response level for fricatives in running speech than fricatives presented in isolation. Results with listeners indicated that verified settings that provided a positive sensation level of /s/ and that maximized the frequency difference between /s/ and /∫/ tended to have the best performance.
CONCLUSIONS: Frequency-lowering signal processors have measureable effects on the high-frequency fricative content of speech, particularly female /s/. It is possible to measure these effects either with a simple strategy that presents an isolated simulated fricative and measures the aided frequency response or with a more complex system that extracts fricatives from running speech. For some processors, a more accurate result may be achieved with a running speech system. In listeners, the aided frequency location and sensation level of fricatives may be helpful in predicting whether a specific hearing aid fitting, with or without frequency-lowering, will support access to the fricatives of speech.

PMID: 26967363 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC6vK
via IFTTT

Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

Children with Auditory Neuropathy Spectrum Disorder Fitted with Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Current Practice and Outcomes.

J Am Acad Audiol. 2016 Mar;27(3):204-218

Authors: Walker E, McCreery R, Spratford M, Roush P

Abstract
BACKGROUND: Up to 15% of children with permanent hearing loss (HL) have auditory neuropathy spectrum disorder (ANSD), which involves normal outer hair cell function and disordered afferent neural activity in the auditory nerve or brainstem. Given the varying presentations of ANSD in children, there is a need for more evidence-based research on appropriate clinical interventions for this population.
PURPOSE: This study compared the speech production, speech perception, and language outcomes of children with ANSD, who are hard of hearing, to children with similar degrees of mild-to-moderately severe sensorineural hearing loss (SNHL), all of whom were fitted with bilateral hearing aids (HAs) based on the American Academy of Audiology pediatric amplification guidelines.
RESEARCH DESIGN: Speech perception and communication outcomes data were gathered in a prospective accelerated longitudinal design, with entry into the study between six mo and seven yr of age. Three sites were involved in participant recruitment: Boys Town National Research Hospital, the University of North Carolina at Chapel Hill, and the University of Iowa.
STUDY SAMPLE: The sample consisted of 12 children with ANSD and 22 children with SNHL. The groups were matched based on better-ear pure-tone average, better-ear aided speech intelligibility index, gender, maternal education level, and newborn hearing screening result (i.e., pass or refer).
DATA COLLECTION AND ANALYSIS: Children and their families participated in an initial baseline visit, followed by visits twice a year for children <2 yr of age and once a yr for children >2 yr of age. Paired-sample t-tests were used to compare children with ANSD to children with SNHL.
RESULTS: Paired t-tests indicated no significant differences between the ANSD and SNHL groups on language and articulation measures. Children with ANSD displayed functional speech perception skills in quiet. Although the number of participants was too small to conduct statistical analyses for speech perception testing, there appeared to be a trend in which the ANSD group performed more poorly in background noise with HAs, compared to the SNHL group.
CONCLUSIONS: The American Academy of Audiology Pediatric Amplification Guidelines recommend that children with ANSD receive an HA trial if their behavioral thresholds are sufficiently high enough to impede speech perception at conversational levels. For children with ANSD in the mild-to-severe HL range, the current results support this recommendation, as children with ANSD can achieve functional outcomes similar to peers with SNHL.

PMID: 26967362 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hIUx
via IFTTT

Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.

Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.

J Am Acad Audiol. 2016 Mar;27(3):188-203

Authors: Bagatto M, Moodie S, Brown C, Malandrino A, Richert F, Clench D, Scollie S

Abstract
BACKGROUND: Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence.
PURPOSE: A summary of the updates to the Ontario IHP's Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered.
RESEARCH DESIGN: The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study.
STUDY SAMPLE: One hundred and fifteen children with hearing loss, who wore hearing aids, were included in the outcome analyses (mean = 28.6 mo; range = 1.3-115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included.
INTERVENTION: The children were fitted with hearing aids following Ontario's Amplification Protocol.
DATA COLLECTION AND ANALYSES: During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those who were typically developing.
RESULTS: Important updates to Ontario's Amplification Protocol offer new details about candidacy considerations as well as technical updates. Outcomes from the IHP reveal protocol elements can be executed clinically and when they are, typically developing children who wear hearing aids are meeting auditory development and performance milestones.
CONCLUSIONS: Updates to Ontario's Amplification Protocol are necessary to support the evolution of EHDI programs and the evidence which sustains them. With advances in technology and additional research, pediatric hearing aid fitting will continue to progress and support systematic measurement of outcomes for children who wear hearing aids. The application of state-of-the-art hearing aid fitting practices to the pediatric population within EHDI programs supports good outcomes for infants and children with hearing loss.

PMID: 26967361 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC6vE
via IFTTT

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

Pediatric Audiology in North America: Current Clinical Practice and How It Relates to the American Academy of Audiology Pediatric Amplification Guideline.

J Am Acad Audiol. 2016 Mar;27(3):166-187

Authors: Moodie S, Rall E, Eiten L, Lindley G, Gordey D, Davidson L, Bagatto M, Scollie S

Abstract
BACKGROUND: There is broad consensus that screening and diagnosis of permanent hearing loss in children must be embedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur.
PURPOSE: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America.
RESEARCH DESIGN: A concurrent embedded mixed methods design was used.
STUDY SAMPLE: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2.
DATA COLLECTION AND ANALYSIS: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents' knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification.
RESULTS: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided.
CONCLUSIONS: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the "how" and "why" of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.

PMID: 26967360 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/228hM6N
via IFTTT

Providing Hearing Aids to Infants and Young Children.

Providing Hearing Aids to Infants and Young Children.

J Am Acad Audiol. 2016 Mar;27(3):164-165

Authors: Bagatto M

PMID: 26967359 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1WgC7zT
via IFTTT

Word Recognition Variability With Cochlear Implants: The Degradation of Phonemic Sensitivity.

Objective: Cochlear implants (CIs) do not automatically restore speech recognition for postlingually deafened adults. Average word recognition remains at 60%, and enormous variability exists. Understanding speech requires knowledge of phonemic codes, the basic sound units of language. Hearing loss may result in degeneration of these long-term mental representations (i.e., "phonemic sensitivity"), and CI use may not adequately restore those representations. This investigation examined whether phonemic sensitivity is degraded for CI users, and whether this degradation results in poorer word recognition. Study Design: Thirty adults with CIs and 20 normal-hearing controls underwent testing. Methods: Participants were assessed for word recognition in quiet, along with tasks of phonemic sensitivity using an audiovisual format to maximize recognition: initial consonant choice (ICC), in which they selected the word with the same starting sound as a target word, final consonant choice (FCC), in which they selected the word with the same ending sound, and backwards words, in which they repeated phonemes comprising words in backwards order. Results: Phonemic sensitivity was poorer for CI users than for normal-hearing controls for ICC and FCC. For CI users, ICC and FCC predicted 25% and 40% of variance in word recognition, respectively. Longer duration of CI use did not lead to greater restoration in phonemic sensitivity. Conclusion: Even for adults who presumably had developed refined phonemic representations, hearing loss can degrade those representations, which results in poorer word recognition. Cochlear implants do not adequately restore those representations. Findings suggest the need for rehabilitative efforts to improve CI users' phonemic sensitivity. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

from #Audiology via xlomafota13 on Inoreader http://ift.tt/1pCSjRD
via IFTTT