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Seminars in Hearing Feb 2023A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named "common sounds audiogram" (CSA). Typically, a child's... (Review)
Review
A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named "common sounds audiogram" (CSA). Typically, a child's hearing detection thresholds are plotted on the CSA to indicate that child's audibility of speech and environmental sounds. Importantly, the CSA may be the first item that parents see when their child's hearing loss is explained. Thus, the accuracy of the CSA and its associated counseling information are integral to the parents' understanding of what their child can hear and to the parents' role in the child's future hearing care and interventions. Currently available CSAs were collected from professional societies, early intervention providers, device manufacturers, etc., and analyzed ( = 36). Analysis included quantification of sound elements, presence of counseling information, attribution of acoustic measurements, and errors. The analyses show that currently-available CSAs are wildly inconsistent as a group, not scientifically justified, and omit important information for counseling and interpretation. Variations found among currently available CSAs can lead to very different parental interpretations of the impact of a child's hearing loss on his/her access to sounds, especially spoken language. Such variations, presumably, could also lead to different recommendations regarding intervention and hearing devices. Recommendations are outlined for the development of a new, standard CSA.
PubMed: 36970646
DOI: 10.1055/s-0043-1764128 -
Revista Brasileira de Medicina Do... Dec 2020Speech pathologists and audiologists work with the provision of health care, and as such, are susceptible to burnout syndrome. The objective of this study was to discuss... (Review)
Review
Speech pathologists and audiologists work with the provision of health care, and as such, are susceptible to burnout syndrome. The objective of this study was to discuss scientific studies of burnout syndrome in speech pathologists and audiologists. A search was conducted across electronic databases using the following keywords: "burnout syndrome" and "speech pathologists/ audiologists." The search retrieved 11 articles addressing burnout in this occupational category. Prevalence estimates of burnout syndrome in speech pathologists varied widely across studies. The scarcity of the literature and high methodological variability prevented a deeper analysis of the topic. Future studies are encouraged to pay closer attention to occupational stress and mental health in speech pathologists and audiologists in order to provide these professionals with specialized care.
PubMed: 33324464
DOI: 10.47626/1679-4435-2020-480 -
Seminars in Hearing Feb 2018Counseling in audiology is an important aspect of service delivery. How audiologists interact with patients and foster counseling relationships to help patients and... (Review)
Review
Counseling in audiology is an important aspect of service delivery. How audiologists interact with patients and foster counseling relationships to help patients and families understand and live with hearing loss can impact outcomes of audiological interventions. Currently, variability exists in how graduate training programs are teaching counseling skills, and the extent to which counseling skills development is supported in clinical experiences is unclear. This article seeks to explore the perspectives related to the importance of counseling and counseling training experiences received through clinical instruction of Au.D. students beginning their final year of study, to identify where counseling training might be limited, and to examine how counseling skills might be better supported. Findings revealed that students generally appreciate the importance of counseling in audiology. Data suggest that how students are supported in developing counseling skills appears to be variable and unstructured.
PubMed: 29422714
DOI: 10.1055/s-0037-1613706 -
International Journal of Audiology Sep 2018Define clinical trials and adverse event (AE) monitoring from the perspective of the audiologist. Rationalise the importance of audiology's involvement before, during...
OBJECTIVES
Define clinical trials and adverse event (AE) monitoring from the perspective of the audiologist. Rationalise the importance of audiology's involvement before, during and after monitoring. Identify strengths and weaknesses in toxicity grading scales, and discuss factors that may influence these.
DESIGN
Literature involving commonly cited grading scales used to capture ototoxicity is reviewed. Current regulations and language associated with clinical trial implementation and AE monitoring are described. Personal observations based on a variety of clinical populations are drawn from years of experience developing and employing ototoxicity monitoring protocols in a complex medical setting.
RESULTS
Six commonly used grading scales for ototoxicity are systematically reviewed for strengths and weaknesses. Necessary considerations that inform selection of grading scales are presented. A review of and historical context for clinical trial development and AE monitoring is provided.
CONCLUSIONS
The audiologist's role in therapeutic decision making goes beyond collection of the audiogram. Clear communication to stakeholders in ototoxicity monitoring is paramount, and toxicity grading scales are one tool to facilitate this exchange. Various factors should be considered in advance of selecting the most appropriate scale to capture hearing loss, and no scale is without limitation.
Topics: Adverse Drug Reaction Reporting Systems; Age Factors; Attitude of Health Personnel; Audiologists; Clinical Decision-Making; Clinical Trials as Topic; Dose-Response Relationship, Drug; Drug Monitoring; Health Knowledge, Attitudes, Practice; Hearing; Hearing Loss; Hearing Tests; Humans; Predictive Value of Tests; Professional Role; Prognosis; Reproducibility of Results; Research Design; Risk Factors; Severity of Illness Index
PubMed: 29276851
DOI: 10.1080/14992027.2017.1417644 -
Seminars in Hearing May 2021Difficulty hearing in the presence of background noise is a common complaint heard by audiologists. This can be accompanied by additional difficulty in classrooms and... (Review)
Review
Difficulty hearing in the presence of background noise is a common complaint heard by audiologists. This can be accompanied by additional difficulty in classrooms and other difficult listening situations. This was recently exacerbated by the coronavirus disease 2019 (COVID-19) shutdowns and the accompanying mask usage and virtual meetings. This article describes one such patient seen during the recent shutdown. This patient reported difficulty hearing during her college coursework for her music performance major. She was an established otology patient with an extensive middle ear history including multiple surgeries. During the shutdown, she virtually consulted with the auditory processing disorders clinic at the recommendation of her otologist to discuss her college-related difficulty and pursue educational accommodations. Challenges and solutions for seeing this patient and other, similar patients virtually are discussed as well as a review of how this patient proceeded and how the knowledge gained from this patient could apply to others with similar concerns.
PubMed: 34381293
DOI: 10.1055/s-0041-1731690 -
International Journal of Audiology Sep 2020Two studies explored hearing-aid user and audiologist experiences of hearing-aid use and fitting for music in the UK. One-hundred-seventy-six hearing-aid users (age...
Two studies explored hearing-aid user and audiologist experiences of hearing-aid use and fitting for music in the UK. One-hundred-seventy-six hearing-aid users (age range: 21-93 years; mean: 60.56 years) answered a 4-item questionnaire on music listening difficulties and discussions about music in clinic. 99 audiologists (age range: 22-71 years; mean: 39.18 years) answered a 36-item questionnaire on the frequency and type of discussions, training received, and strategies for optimizing hearing aids for music. Closed and open-ended questions were included. Sixty seven percent of hearing-aid users reported some degree of difficulty listening to music with hearing aids, and 58% had never discussed music in clinic. 50% of audiologists surveyed asked 1 in 5 (or fewer) patients about music and 67% had never received music-specific training. Audiologist training on music was significantly associated with confidence in providing advice, confidence in programming hearing aids for music, and programming hearing aids for music for a greater number of patients. Hearing-aid users' and audiologists' experiences of music remain mixed. In the absence of formalised training in optimizing hearing aids for music, there is a need for systematic research relating fitting strategies to clinical outcomes and the development of guidelines for audiologist training.
Topics: Adult; Aged; Aged, 80 and over; Audiologists; Auditory Perception; Hearing Aids; Humans; Middle Aged; Music; Surveys and Questionnaires; Young Adult
PubMed: 32615052
DOI: 10.1080/14992027.2020.1762126 -
The Application of Clinical Genetics 2016Mucopolysaccharidosis type IVA (MPS IVA or Morquio A) is an autosomal recessive lysosomal storage disease which results in a striking skeletal phenotype, but does not... (Review)
Review
Mucopolysaccharidosis type IVA (MPS IVA or Morquio A) is an autosomal recessive lysosomal storage disease which results in a striking skeletal phenotype, but does not negatively impact the intellect of the patient. MPS IVA has a phenotypic continuum that ranges from a severe and rapidly progressing form to a slowly progressive form. The clinical diagnosis is often made in the preschool years based on abnormal bone findings on physical examination and dysplasia on radiographic imaging. Supportive care has been the mainstay in caring for patients. Orthopedic physicians often form the core of the care team due to the early and severe skeletal abnormalities; however, systemic disease is common and requires aggressive monitoring and management. Interdisciplinary care teams often consist of medical geneticists, cardiologists, pulmonary specialists, gastroenterologists, otolaryngologists, audiologists, and ophthalmologists. With the US Food and Drug Administration's approval of elosulfase alfa, patients >5 years of age now have access to this medication from the time of diagnosis. The clinical trial with once weekly intravenous dosing (2.0 mg/kg per week) showed improvement in the 6-minute walk test. The composite end point analysis to evaluate the combining changes from baseline in 6-minute walk test, 3-minute stair climb test, and respiratory function showed that at a dose of 2.0 mg/kg per week, subjects performed better when compared to placebo. This indication was clinically meaningful in the treatment group. The treatment was generally well tolerated, and the uncommon infusion reactions responded well to traditional enzyme replacement therapy infusion reaction management algorithms. Currently, clinical trials are underway to determine the efficacy and safety in MPS IVA patients <5 years of age.
PubMed: 27366102
DOI: 10.2147/TACG.S69080 -
Seminars in Hearing May 2017Impaired hearing is related to poor health outcomes, including compromised cognitive function, in aging individuals. Hearing loss is the third most common chronic health... (Review)
Review
Impaired hearing is related to poor health outcomes, including compromised cognitive function, in aging individuals. Hearing loss is the third most common chronic health condition after arthritis and heart disease in older adults and the fourth most detrimental condition related to quality of life in older adults. Only 18% of aging adults who have impactful hearing loss actually use custom-fit amplification. Therefore, the majority of aging individuals entering senior living facilities will have untreated hearing loss. Older adults move to senior communities to maintain or increase their social engagement, to receive care from qualified staff, and to ultimately enhance their quality of life. We know that the majority of individuals over 65 years of age have significant hearing loss, which leaves them with complex listening needs due to low incidence of hearing aid use, group communication situations that are common for social activities, interactive dining environments, and the need for telephone use to connect with loved ones. Busy staff and family members may not be aware of the impact of decreased hearing on quality of life, as well as caregiver burden. HearCARE (Hearing and Communication Assistance for Resident Engagement) is an initiative to provide communication assistance on a day-to-day basis in senior living facilities in a cost-effective manner. This innovative model for delivering audiology services and communication assistance in senior living communities employing communication facilitators who are trained and supervised by an audiologist will be described. Data related to the communication facilitator training, daily activities, interactions with the audiologist, use of devices, and impact on residents, staff, and families will be described.
PubMed: 28522893
DOI: 10.1055/s-0037-1601574 -
Drug Design, Development and Therapy 2022Mucopolysaccharidosis type IVA (MPS IVA or Morquio A) is an autosomal recessive disorder and is one of the lysosomal storage diseases. Patients with MPS IVA have a... (Review)
Review
Mucopolysaccharidosis type IVA (MPS IVA or Morquio A) is an autosomal recessive disorder and is one of the lysosomal storage diseases. Patients with MPS IVA have a striking skeletal phenotype but normal intellect. The phenotypic continuum of MPS IVA ranges from severe and rapid progress to mild and slow progress. The diagnosis of MPS IVA is usually suspected based on abnormal bone findings and dysplasia on physical examination and radiographic investigation in the preschool years. In the past, only supportive care was available. Due to the early and severe skeletal abnormalities, the orthopedic specialist was usually the main care provider. However, patients need aggressive monitoring and management of their systemic disease. Therefore, they need an interdisciplinary team for their care, comprising medical geneticists, cardiologists, pulmonary specialists, gastroenterologists, otolaryngologists, audiologists, and ophthalmologists. After the US Food and Drug Administration approved elosulfase alfa in 2014, patients older than 5 years could benefit from this treatment. Clinical trials showed clinically meaningful improvements with once-a-week intravenous dosing (2.0 mg/kg per week), significantly improving the 6min walk test, the 3min stair climb test, and respiratory function when compared with placebo. Elosulfase alfa is well-tolerated, and there is a good response indicated by decreasing urine glycosaminoglycans.
Topics: Chondroitinsulfatases; Enzyme Replacement Therapy; Humans; Mucopolysaccharidosis IV; Phenotype
PubMed: 35046639
DOI: 10.2147/DDDT.S219433 -
Journal of Medical Internet Research Feb 2022Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States.
OBJECTIVE
The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention.
METHODS
A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life.
RESULTS
Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3.
CONCLUSIONS
This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04004260; https://clinicaltrials.gov/ct2/show/NCT04004260.
Topics: Adult; Audiologists; Cognitive Behavioral Therapy; Humans; Internet; Quality of Life; Tinnitus; Treatment Outcome
PubMed: 35156936
DOI: 10.2196/27584