Lunch & Learn

The BSA Lunch and Learn eSeminars are an exciting series of online presentations covering current topics of interest and clinically relevant research findings in Audiology and related professions, and are free of charge to all BSA members and non-members

Hearing Aids for Music: Exploring the music listening behaviour of people with hearing impairments

Contact Name: Dr Alinka Greasley

Dr Alinka Greasley is Lecturer in Music Psychology at the University of Leeds. Her research centres on people’s everyday musical behaviour and she is an on-going contributor to the Oxford Handbook of Music Psychology on the topics of musical preferences and music listening. Her current project ‘Hearing Aids for Music’ is exploring how music listening behaviour is affected by hearing impairment and the use of HA technology. She is Fellow of the Higher Education Academy and member of the British Psychological Society, and the Society for Education, Music and Psychology Research. She is also a violinist, pianist and DJ

Music listening has significant health and well-being benefits, including for people with all levels of hearing impairment. Digital hearing aids (HA) are optimised for speech amplification and can present difficulties for music perception. The AHRC-funded project ‘Hearing Aids for Music’ is currently exploring how music listening is shaped by hearing impairment and the use of HA technology. Findings from two studies will be discussed. First, a clinical questionnaire investigated the extent of music listening issues and the frequency and success of discussions with audiologists about music. Data from 176 HA users (age range 21-93) highlighted issues listening to live music performances, hearing words in songs, the loss of music from their lives and associated social isolation. Most had never talked about music with their audiologist. A second study explored HA users’ listening experiences in greater depth, with the collection of pure tone audiometry. Accounts from 22 HA users (age range 24-82) showed how listening behaviour is influenced by interactions between the individual nature of hearing loss (e.g. type, level, duration); levels of musical engagement (e.g. daily exposure, training) and contexts (e.g. recorded music at home/travelling,  live performances). The talk will conclude with a discussion of how these findings have informed the design of a national survey which seeks to identify patterns in the listening behaviour of a wider population of HA users

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Issues in diagnosis and management of auditory processing disorders – including spatial processing disorder

Contact Name: Harvey Dillon

Dr Dillon has an undergraduate degree in Electrical Engineering and a Ph.D. for research into psychoacoustics.  In 1979 he joined the National Acoustic Laboratories (NAL) and until 1986, he performed research into speech discrimination testing, audiological testing in sound fields, speech processing for hearing aids, hearing aid fitting methods, and the acoustics of hearing aid coupling systems.  From 1986 to 1990 he held various positions (including Chief Engineer and Development Manager) in the operational area of NAL.  From 1990 he headed the Hearing Aid Research Section of NAL and in 2000 became the Director of Research at NAL.  Dr Dillon was also a Deputy Director of the Co-operative Research Centre for Cochlear Implant and Hearing Aid Innovations from 1991 to 2007.  His current research interests centre on signal processing for hearing aids, procedures for fitting hearing aids, electrophysiological assessment, auditory processing disorders, methods for preventing hearing loss, and methods for evaluating the success of hearing rehabilitation. Dr Dillon has lectured extensively in the areas of acoustics, psychoacoustics, and hearing aids in the audiology program at Macquarie University, at which institution he is an adjunct professor. He is the author or co-author of over 200 scientific articles, eight book chapters, and the author of a text book on hearing aids that is used throughout the world.  He frequently presents invited and keynote addresses in the area of hearing at overseas conferences.

Recorded at the Paediatric Masterclass 30th April 2016 in Greenwich, organised by Jay Jindal; Director of Audiology Planet.

 

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The UK Research Agenda for ENT, Hearing and Balance Care; patients and professionals have decided on the priorities for research in our field

Contact Name: Anne G.M. Schilder

Professor Schilder holds an NIHR Research Professorship and leads the multidisciplinary evidENT team at UCL dedicated to developing the evidence base for ENT, Hearing and Balance.  She is a Paediatric ENT surgeon at the Royal National Throat, Nose and Ear Hospital and holds a chair at the UCL Ear Institute and at the University Medical Center Utrecht (The Netherlands).

Her trials in the field of ear, nose and throat infections in children have been influential in the way global health-care systems think about the management of these conditions and have been translated (inter)national evidence-based guidelines and health policies. Her current work spans the translational research pathway for adult and paediatric ENT and includes developing a national research agenda for ENT, Hearing and Balance.

She is the Joint Co-ordinating Editor of the Cochrane Collaboration ENT Disorders Group and National Specialty Lead for ENT of the NIHR Clinical Research Network

Everyone suffers from ear, nose and throat (ENT) conditions at some stage in their life; all young children have coughs and colds and may suffer from ear infections; when we get older we all lose some of our hearing and balance.

To ensure that patients benefit from the very best treatments in the field, it is important that research is conducted to improve our understanding of ENT conditions and how best to treat them. Doctors and researchers in ENT, Hearing and Balance have therefore worked closely with patients and families to develop an agenda that will guide research in the field for the next 10 years. 

Research priorities include improving the patient’s journey when suffering from ENT problems, such as allergies, and problems of the sinuses and voice. Patients felt it is important that there is research into self-management, in particular for those suffering from dizziness. There is a need to improve the benefit of hearing aids and develop and test new treatments for hearing loss as well as for loss of other senses such as balance and smell.

Patients and professionals agreed that future research in ENT, Hearing and Balance care needs to be patient centered. They have agreed to work together to ensure that future research addresses the issues that matter both to patients and those who care for them.

 

GENERATE’s Research Agenda for ENT, Hearing and Balance Care 

GENERATE, together with doctors and researchers in ENT, Hearing and Balance have worked closely with patients and families to develop an agenda that will guide research in the field for the next 10 years. Research priorities include improving the patient’s journey when suffering from ENT problems, such as allergies, and problems of the sinuses and voice. Patients felt it is important that there is research into self-management, in particular for those suffering from dizziness. There is a need to improve the benefit of hearing aids and develop and test new treatments for hearing loss as well as for loss of other senses such as balance and smell.

For more information click here:

http://www.thebsa.org.uk/the-research-agenda-for-ent-hearing-and-balance-care-patients-and-professionals-have-decided-on-what-needs-to-be-researched/

MomENTum Mapping UK Research Activity in ENT, Hearing & Balance

The BSA is delighted to announce the creation of a database which will showcase current ENT, Hearing and Balance research in the UK.

The database – MomENTum​, will be accessible and located on the ENT UK website. It will be a valuable resource for researchers, both experienced and those new to the field, and for research funders wishing to look for expertise or collaborators. We invite all ENT, Hearing and Balance researchers to be part of this database.

The survey takes a few minutes to complete and asks general questions about your project/s, funder/s and research collaborators.

Please click here to access the survey:

http://www.thebsa.org.uk/momentum-mapping-uk-research-activity-in-ent-hearing-balance/

If you have any questions or comments please contact research@entuk.org

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Hyperacusis – Measurements, Mechanisms and Models

Contact Name: Roland Schaette

“A spider’s web is hidden in one ear, and in the other, a cricket sings throughout the night.” This is how Michelangelo described his experience of hearing loss and tinnitus. The goal of my research is to find the cricket, to understand how tinnitus arises, in order to find new ways of treating it.

I started doing research on tinnitus in 2003, and since November 2008, I have been working in London at the UCL Ear Institute as the British Tinnitus Association Senior Research Associate.

My motivation to work on tinnitus is based on my interest in the auditory system, my fascination with neuronal plasticity, and my own experience of tinnitus (which is fortunately rather benign).

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Dementia and Hearing Loss: the role of Audiology

Contact Name: Sarah Bent

Biography: 

Sarah Bent is a registered Clinical Scientist with the Audiology Department of Betsi Cadwaladr University Health Board in North Wales. She originally studied at the University of Manchester, completing a PhD in Physics before starting her career in Audiology. Sarah’s professional interests include assessment and rehabilitation of adults with dementia or learning disabilities. She is the clinical representative for dementia on the British Society of Audiology Cognition in Hearing Special Interest Group, which has included collaborating as a stakeholder in the NICE update for dementia, and co-running an expert panel workshop (more details to follow in Audacity shortly).

Abstract:

The link between hearing loss and dementia is not a new concept, but recent research has confirmed a strong association (Lin et al., 2011). A recent international survey of Audiology professionals reported a tacit awareness of the needs of those living with dementia, but a belief that they did not have enough information or training (Wright et al., 2014). Added to this, there is evidence to suggest that hearing loss may be under-diagnosed and under-treated in people living with dementia (Bauer et al., 2014).

As a summary of the literature to date, four key reasons are presented to argue why hearing loss should be considered in those living with dementia, and conversely why those living with dementia should be specifically considered in Audiology services.  The impact that Audiology rehabilitation may have is discussed, both on daily living and on cognition. Practicalities of assessment and rehabilitation are also included, drawn from what is known on dementia as applied to clinical experience. And a challenge for action from the Audiology profession as a whole is posed, for all researchers and funding-providers, clinicians and clinical leads, patients and advocates – what role should Audiology have?

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Hidden Hearing Loss – Christmas Special

Contact Name: Chris Plack

Biography: 

Chris Plack studied at the University of Cambridge, where he was awarded a BA in Natural Sciences in 1987, and a PhD in 1990. He held post-doctoral positions at the University of Minnesota and at the University of Sussex, before being awarded a Royal Society University Research Fellowship in 1994, which he held at Sussex and then at the University of Essex. He was Senior Lecturer and then Chair in the Psychology Department at the University of Essex, before moving to Lancaster University in 2005. He moved again to the University of Manchester in 2008, and he currently holds two part-time positions, as Ellis Llwyd Jones Professor of Audiology at the University of Manchester, and as Professor of Auditory Neuroscience at Lancaster University. Chris has over 90 publications in academic journals, and has written an introductory textbook on hearing and edited two other volumes. In 2003 he was elected Fellow of the Acoustical Society of America.

Abstract:

Hearing ability is usually assessed using pure tone audiometry, although it has been known for many years that some individuals with normal audiometric thresholds have hearing difficulties. Recent results from rodent studies suggest that noise exposure and/or ageing can cause loss of the connections, or synapses, between inner hair cells in the cochlea and auditory nerve fibres. This disorder has been termed cochlear synpatopathy and popularly “hidden hearing loss,” because it is not thought to be detectable using pure-tone audiometry. Despite being “hidden,” this disorder may impact on hearing ability in the real world, including functions such as speech perception in noise, and may be a cause of tinnitus. Much research effort is being applied to determine the scale of the problem for human listeners, and to develop a diagnostic test for cochlear synaptopathy

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Expanding CI candidacy beyond the audiogram: using the Speech Intelligibility Index (SII) as a predictor of language outcomes in children

Contact Name: Carolina Leal

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Paediatric Tinnitus: Practice Guidance

Contact Name: Veronica Kennedy

Contact Email: Veronica.kennedy@boltonft.nhs.uk

Biography

Medical Degree from Trinity College Dublin. Qualifications: BA MB BCh BAO MSc FRCS-Ed(Oto)

Previously worked at: Royal National Throat Nose and Ear Hospital; University Hospital of Wales. Joined Bolton in August 2008.

Professional membership: British Association of Audiovestibular Physicians; British Society of Audiology; Professional Advisory Committee for the British Tinnitus Association

Training Programme Director for the Audiovestibular Medicine Training Programme North West / Trent / Wales Regions.

Special Interests and Research: Tinnitus and balance disorders

Abstract

Tinnitus in children is a relatively neglected area, from both a research and clinical perspective. Yet prevalence studies suggest that tinnitus is a surprisingly common experience in children (Sheyte and Kennedy 2010). Whilst the majority are untroubled by it, for some, tinnitus causes distress, and affects their lives both at home and at school. Tinnitus can impact upon sleep, concentration and psychological wellbeing (Kentish et al 2000).

The BSA “Tinnitus in Children: Practice Guidance” is intended for a  range of  professionals including audiologists, medical professionals,, hearing therapists, teachers of the deaf, psychologists and mental health professionals.  It offers a practical and child friendly approach to the assessment and management of tinnitus in children, with the aim of enabling others to develop their clinical skills in Paediatric Tinnitus.

Key recommendations from the Practice Guidance will be presented in this lecture, together with some  suggestions for  child friendly interview techniques, and age-appropriate  ways to explain tinnitus to children.

Kentish, R. Crocker S. McKenna L . Children’s experience of tinnitus: a preliminary survey of children presenting to a Psychology Department.  British Journal of Audiology.2000; 34:335 -40.

Sheyte, A. Kennedy V. Tinnitus in children: an uncommon symptom? 2010 Arch Dis. Child. Aug.95 (8)645-8

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“Keep it simple! The impact of audiologists’ language on clients’ decisions to obtain hearing aids” And “How patient-centred are initial audiological rehabilitation consultations? An investigation of audiologist-patient communication”

Contact Name: Carly Meyer and Caitlin Grenness

Carly Meyer

Carly Meyer (PhD, BSpchPath) is a speech pathologist who currently holds a HEARing CRC Postdoctoral Fellowship. She is also affiliated with the Communication Disability Centre at The University of Queensland. Carly’s research focuses on the holistic management of children and adults with a communication disorder, and is driven by the World Health Organisation’s International Classification of Functioning, Disability and Health. Specifically, Carly’s research interests are associated with: (1) improving outcomes for older adults with hearing impairment through the development of novel treatment approaches, (2) the implementation of patient- and family-centred care in audiology practice, (3) the holistic management of people living in the community with dementia and concomitant hearing loss, and (4) the evaluation of functional outcomes following intervention for communication disorders.

Caitlin Grenness

Caitlin Grenness, PhD is an audiologist, lecturer and research officer at the University of Melbourne and HEARing Cooperative Research Centre in Australia and is affiliated with the Communication Disability Centre at the University of Queensland. Caitlin has taught the adult audiological rehabilitation courses in the Clinical Audiology program since 2010 and serves as a director on the Board of Audiology Australia. Caitlin’s body of research examines patient-centred care in adult audiological rehabilitation; barriers and facilitators to clinician behaviour change, and the impact of service-delivery models on audiologic outcomes. She is passionate about empowering clinicians to provide high quality audiological care.

Keep it simple! The impact of audiologists’ language on clients’ decisions to obtain hearing aids.

Older adults with hearing loss want to be involved in their rehabilitation decisions. To facilitate shared decision making between the client and clinician, it is important that the clinician’s language be easily understood by the client. This is particularly important for older adults with hearing loss, wherein a proportion of clients present with low health literacy. Accordingly, the aims of this study were to: profile the complexity of language spoken by audiologists during hearing assessment appointments; and explore associations between audiologists’ language and clients’ decisions to obtain hearing aids.  Sixty-two initial assessment appointments with adult clients over the age of 55 years were filmed. Each appointment was transcribed, and the diagnosis and management planning phase of appointments was isolated for analysis. Audiologists’ language complexity was profiled using Microsoft Word grammar summary statistics (e.g., Flesch-Kincaid Reading Grade Level) and inspected for the presence of 39 jargon terms (e.g., directional microphone). A binomial, multivariate logistic regression model was applied to the data to determine if the decision to obtain hearing aids was associated with audiologists’ language complexity. Preliminary results indicate that clients were significantly less likely to obtain hearing aids if their audiologist used more complex language.

How patient-centred are initial audiological rehabilitation consultations? An investigation of audiologist-patient communication

Patient-centred communication in health consultations leads to improved patient satisfaction, treatment adherence and self-management. Despite advocacy for patient-centred care within audiology, little research explores the presence of behaviours indicative of such an approach. This study aimed to: 1) observe the nature of patient-centred communication between audiologist and adult patient/companion throughout initial audiology consultations; 2) identify audiologist, patient or consultation-related factors that may influence patient-centred communication dynamics in initial audiology consultations; and, 3) answer the question “do older adults receive patient-centred audiologic rehabilitation?” Sixty-two initial audiological rehabilitation consultations with patients over 55 years were filmed and verbal communication was analysed using the Roter Interaction Analysis System (RIAS). Linear Mixed Modelling was used to examine associations between communication dynamics and audiologist, patient or consultation factors. Results revealed a paucity of patient-centred communication behaviours. For example, audiologist-led unilateral information exchange that focused on hearing aids was observed; patients’/companions’ opinions were rarely elicited; in the presence of a companion, audiologists asked significantly fewer lifestyle-related questions; and, minimal audiologist-patient emotional engagement was observed. Results have implications for at least four areas of clinical practice: 1) attending to psychosocial concerns; 2) shift in focus from biomedical to biopsychosocial; 3) sharing control; 4) involvement of family members.

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Paediatric Vestibular Assessment

Contact Name: Devin McCaslin

Dr. McCaslin currently serves as an associate professor at the Vanderbilt Bill Wilkerson Center in Nashville.  He received a Master’s degree in Audiology from Wayne State University and a PhD in Hearing Science from The Ohio State University.

McCaslin maintains a clinical practice and is an instructor in the both the Doctor of Audiology and Ph.D. programs. Dr. McCaslin’s major academic, clinical and research interests relate to clinical electrophysiology, tinnitus and vestibular assessment.  He also serves as the Deputy Editor-in-Chief of the Journal of the American Academy of Audiology and is president-elect of the American Balance Society

Recently, attention has been focused on dizziness and vertigo in children. The purpose of the present investigation was to develop a metric to measure dizziness disability/handicap outcome for use with patients who are between 4 and 16 years of age. 40 items comprising the alpha version of the DHI-P  (e.g. Does your child’s problem make it difficult for him/her to play) were administered to 86 caregivers.  Their responses to each item were limited to “yes” (scored as 4 points), “sometimes” (scored as 2 points) or “no” (scored as zero points).   Cronbach’s alpha showed that item-total coefficients of this initial data set enabled us to eliminate 15 noncontributing items reducing the scale to 25 items (i.e. beta version). 

We administered the beta version of the DHI-P to 56 primary caregivers of dizzy children (mean patient age 10 years, SD 3 years).  The analysis showed a single factor (eigenvalue of 8.30) explained 33 % of the total item variance.  Item-total correlations showed that 4 items demonstrated item-total correlations less than .40 and they were deleted.  The final version of the DHI-P has 21 items and a maximum score of 84

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The Past, Present and Future: Early Hearing Detection and Intervention

Contact Name: Christine Yoshinaga-Itano

Dr. Christine Yoshinaga-Itano is a professor of Audiology in the Department of Speech, Language and Hearing Sciences, Institute of Cognitive Science, Center for Neurosciences, University of Colorado at Boulder; Department of Otolaryngology and Audiology, University of Colorado at Denver; and the Marion Downs Hearing Center. She isa world leader in research and, for 30 years, has been studying language, speech, and social-emotional development of deaf and hard-of-hearing infants and children. Her ground-breaking research has produced unequivocal evidence that early detection and intervention of hearing loss is successful in having a significant impact on language learning of children with hearing loss.

Dr. Yoshinaga-Itano received her bachelors degree in psychology from the University of Southern California, followed by a masters degree in education of the hearing impaired, and her PhD in audiology and hearing impairment from Northwestern University. She is a teacher of the deaf and hard of hearing and an audiologist. In 1996, she and co-investigator Kathy Arehart received a five-year MCH grant for Universal Newborn Hearing Screening that established the Marion Downs National Center, now the Marion Downs Hearing Center. The present co-director, Sandra Abbot Gabbard, states that Dr. Yoshinaga-Itanos research has had a broad impact: Health and education policies have changed globally; professional standards in audiology, medicine, early childhood and deaf education have been revised; and families worldwide with children who are deaf and hard of hearing have new hope for their childrens futures

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Coding of acoustic information in the auditory pathway

Contact Name: Prof. Alan R Palmer

Alan Palmer received his first degree in Biological Sciences from the University of Birmingham UK in 1972 and his PhD in Communication and Neuroscience from the University of Keele UK in 1977.  After postdoctoral research at Keele he established his own laboratory at the National Institute for Medical Research in London.  Following a Royal Society University Research Fellowship held at the University of Sussex he became a programme leader at the MRC Institute of Hearing Research in 1986.

His is currently Director and Programme Leader at the MRC Institute of Hearing Research, Research Area Lead NIHR Nottingham Hearing Biomedical Research Unit and Honorary Professor of Neuroscience, School of Biomedical Sciences, University of Nottingham. He leads a research team that uses neurophysiological, neuroanatomical and imaging techniques to study the way the brain processes sound.

As a result of the mechanical action of the basilar membrane and transduction in the cochlear hair cells, responses of auditory nerve fibres are tuned like a series of overlapping band pass filters allowing a good representation of the frequency content of any sound, which becomes less clear at high levels as the filters broaden. Activity in the auditory nerve signals the frequency content, the timing and the sound level of the sounds. Pathways from the first brainstem nucleus (the cochlear nucleus) converge in the brainstem to allow combination of information from the two ears for analysis of the location of the sound source, which is then sent to the auditory midbrain. Pathways from the cochlear nucleus also send information about the sound spectrum and its pitch directly to the auditory midbrain where it is integrated with inputs from all lower brainstem nuclei, before sending the information on to the auditory cortex via the thalamus. The auditory cortex has several frequency mapped areas which process sounds in parallel. There is some evidence for processing of different aspects of sounds in different cortical areas, giving rise to suggestions of different anatomical and functional processing streams for different aspects of sound perception. The deeper layers of the cortex send projections back down the auditory pathway enabling the cortex to modulate the ascending flow of auditory information

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Advances in Testing – There is more to the vestibular system than the horizontal semi-circular canal

Contact Name: Jas Sandhu

Contact Email: jas.sandhu@nhs.net

Dr Jas Sandhu (Academic Foundation Doctor) started his career as a physical scientist, gaining MPhys and PhD degrees in Physics from the Universities of Southampton and Cambridge respectively. He returned to Southampton to complete his MSc in Audiology before moving to the RSCH in Brighton where he underwent his clinical training. He has published several seminal papers on ocular VEMPs and is faculty member of several international balance courses. He is currently working for University of Sheffield Teaching Hospitals trust as an Academic Foundation Doctor (General Surgery). He has a specialist interest in vestibular disorders and his research is primarily focused on developing the cervical and ocular versions of the Vestibular Evoked Myogenic Potential (VEMP).

Patients presenting with imbalance and dizziness often undergo a battery of audiovestibular tests that are designed to determine the functional state of the hearing and balance organs. Traditionally the vestibular system has been probed using the bithermal caloric test. Despite the fact that it is often poorly tolerated by patients and only provides low frequency information relating to the lateral semicircular canal, it has retained its position as the cornerstone of vestibular assessment.

Recent advances in basic research and technology have provided clinicians with a number of new methods for determining vestibular function. These include video head-impulse testing (of all three canals), cervical VEMPs and ocular VEMPs. Combining these new techniques with the established repertoire now allows the possibility to more fully establish sites of lesion, which can help in shaping management strategies.

Despite the advent of these new assessment methods, there remains an inertia associated with integrating them into clinical practice. There are many reasons for this including, financial issues, training needs as well as scepticism of their clinical value. In this paper we will discuss these new methods and the latest evidence relating to their scientific underpinning as well as their clinical usefulness.

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Assessing the role of questionnaires in the assessment of auditory processing disorder

Contact Name: Johanna Barry

Contact Email: johanna@ihr.mrc.ac.uk

I trained in Linguistics and Applied Linguistics at the University of Melbourne where I completed a PhD at the Bionic Ear Institute investigating the relationship between speech perception and speech production in pre-linguistically deafened Cantonese-speaking children using a cochlear implant. For my post-doctoral research with Professor Dorothy Bishop, I investigated the causes and correlates of language impairment, specifically focusing on issues to do with heritability of deficits in verbal short-term memory. I was subsequently awarded a Marie Curie Intra-European Fellowship to further investigate the neural bases of these deficits at the Max Planck Institute of Human Cognitive and Brain Sciences. Now at the MRC Institute of Hearing Research, I head the Nottingham Clinical Section. My attention has shifted to questions to do understanding and more effectively assessing auditory and listening deficits in developmental disorders like auditory processing disorder, specific language impairment, hearing impairment, dyslexia.

Research or clinical assessment of children’s listening and cognitive skills provides a snap shot of ability on abstract tasks that putatively tapping into underlying constructs of interest. The tasks provide considerable information about differences in ability to perform tasks, but less insight into how these differences impact on everyday functioning. Parental report-based measures can supplement such information by providing insight into a child’s ability to function in every contexts. However, these measures need to be carefully designed if they are to be useful. This means items should not only be informative about difficulty but should also be easy for respondents to understand as well as minimally susceptible to their individual response biases.

 In this talk, I will describe some work we have done at the MRC Institute of Hearing Research to develop a questionnaire to support the assessment of children referred because of suspected auditory processing disorder. I will begin by reviewing problems with current auditory based assessments of APD. I will explain why we argue that the questionnaire can potentially support clinicians in assessment children. I will then review the approach we took to developing a new questionnaire (the ECLiPS – Evaluation of Children’s Listening and Processing Skills), before presenting working from various studies where we have used the ECLIPS to screen for listening difficulties as part of our endeavour to validate the ECLiPS.

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Effect of cognitive load on speech perception

Contact Name: Sven Mattys

Sven Mattys is a professor of psychology at the University of York. His research focuses on the perceptual and cognitive mechanisms involved in recognising speech, with a special interest in the everyday circumstances under which speech is experienced, such as noise and divided attention. He is a member of the Marie Curie Training Network INSPIRE (Investigating Speech Processing in Realistic Environments) and principal investigator on an ESRC project entitled “Word learning in early, middle and late adulthood”.

Improving the validity of speech-recognition models requires an understanding of how speech is processed in everyday life. Unlike listening conditions leading to a degradation of the signal (e.g., noise), adverse conditions that do not alter the integrity of the signal (e.g., cognitive load, CL) have been under-studied. Drawing upon behavioural and imaging methods, our research indicates that CL reduces sensitivity to phonetic detail and increases reliance on lexical knowledge. Importantly, we show that increased reliance on lexical knowledge under CL is a cascaded effect of impoverished phonetic processing, not a direct consequence of CL. A CL-related deactivation of parts of the auditory cortex associated with early phonetic analysis confirms the early, sensory locus of CL. Ways of integrating CL into the functional architecture of existing speech-recognition models are presented

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Access to hearing health – capitalising on the mobile revolution

Contact Name: Prof. De Wet Swanepoel

De Wet Swanepoel is professor in Audiology at the Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa and senior research fellow at the Ear Science Institute Australia. He has published more than 90 peer-reviewed articles, books and book chapters and has received a number of awards in recognition of his work. His research and clinical interests span the field of early identification and diagnosis of hearing loss, objective measures of auditory functioning, and ear and hearing telehealth.

Hearing loss is a pervasive chronic disability estimated to affect 360 million people globally. Access to ear and hearing health is unavailable to the vast majority of those affected. Novel solutions, capitalizing on advances in technology and connectivity, demonstrate promise as a way to increase access to care. The penetration and ubiquity of mobile phones, even in developing countries, make mHealth a powerful tool for widespread access.  Some of our recent research initiatives have focused on developing mobile phone based solutions to allow for early detection of hearing loss at primary health care levels in underserved populations. I will be sharing initial results from these community-based projects.

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Hearing-assistive devices in single-sided deafness: which device and what benefits?

Contact Name: Padraig Kitterick

Pádraig Kitterick is a senior research fellow in Cochlear Implantation at the National Institute for Health Research Nottingham Hearing Biomedical Research Unit in Nottingham, UK. He is also a visiting scientist at the Medical Research Council Institute of Hearing Research. Pádraig’s research focusses on measuring skills in spatial listening in post-lingually deafened adult users of cochlear implants and on assessing the benefits from preserving residual acoustic hearing in the non-implanted ear of unilaterally-implanted individuals. His work also includes the translation of laboratory research into tools that can be used to monitor outcomes routinely in the clinical environment.

Individuals with a single-sided deafness (SSD) experience difficulties with listening in many everyday situations. These difficulties can arise when sounds are located on the side of the impaired ear. Some hearing-assistive devices aim to address these difficulties by rerouting signals that arrive at the impaired ear to the non-impaired ear. These devices achieve this rerouting either via air conduction (CROS hearing aid) or conduction through the cranial bones (bone-conduction hearing aid). Access to one hearing ear only also severely impairs the ability to determine where sounds are located. Devices such as the cochlear implant have the capacity to improve localisation by restoring useful aspects of hearing in the impaired ear. In this talk I will review the current evidence for the benefits that these devices can provide to individuals with SSD and highlight the current evidence gaps where more research is still needed.

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“It’s not just what you hear, but what you can do with what you hear”

Contact Name: Dr. Kathy Pichora Fuller

Kathy Pichora-Fuller completed a B.A. in Linguistics at the University of Toronto (1977) and a M.Sc. in Audiology and Speech Sciences at the University of British Columbia (1980). She worked as a clinical audiologist and then the Supervisor of Audiology at Mount Sinai Hospital in Toronto and then returned to complete a Ph.D. in Psychology at the University of Toronto (1991). Until 2002, she was a faculty member at UBC in the School of Audiology and Speech Sciences and Director of the Institute for Hearing Accessibility Research.

She is a Professor of Psychology at UTM. She is also an Adjunct Scientist at the Toronto Rehabilitation Institute, and at the Rotman Research Institute at Baycrest, and a Guest Professor in the Linneaus Centre for Hearing and Deafness Research at Linköping University in Sweden.

She was President of the Canadian Association of Speech Language Pathologists and Audiologists (1984-87), served on the executive boards of the Canadian Acoustical Association (1998-2002, 2011-present), International Collegium of Rehabilitative Audiology (1997-2003), Canadian Academy of Audiology (2002-2004) and she was the Canadian representative to the International Society of Audiology (2004-2010). She is the co-chair of the World Congress of Audiology to be held in Vancouver, in 2016. She is presently on the editorial boards of two international journals, Ear and Hearing and the International Journal of Audiology

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Issues in diagnosing and treating auditory processing disorders

Contact Name: Prof Harvey Dillon

Contact Email: Harvey.Dillon@nal.gov.au

Dr Dillon is Director of Research at the National Acoustic Laboratories in Sydney. Dr Dillon has performed research into many aspects of hearing aids. At various times he has also been responsible for the design of hearing aids and for the co-ordination of clinical service provision. Most recently, his research has concerned signal processing schemes for hearing aids, prescription of hearing aids, evaluating the effectiveness of rehabilitation, electrophysiological assessment, diagnosis and remediation of auditory processing disorders, and methods for preventing hearing loss. Dr Dillon is the author of over 200 scientific publications and a widely used text book on hearing aids and is frequently invited to give keynote addresses at international conferences. He has been closely associated with the various NAL prescription rules, COSI outcomes evaluation, the trainable hearing aid, the LiSN-S test of spatial hearing loss, and clinical cortical response testing.

Diagnosing and treating auditory processing disorders (APD) are both critical to assist children with this problem, but both are plagued by difficulties.  Diagnosing is difficult because (a) APD is really a collection of different types of disorders that all affect auditory perception; (b) the real-life symptoms of APD are shared with disorders that are not APD, and (c) deficits that are not APD can cause poor performance on many tests designed to diagnose APD.  Treatment for APD can comprise any or all of Management, Compensation, and Remediation.  Management is relatively straightforward and centres around improving the clarity of speech presented to the child.  Compensation (to assist the child develop skills that compensate for the effects of the deficit) has been little studied.  Remediation backed by evidence of effectiveness exists for very, very few types of APD

 

 

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Fitting Hearing Aids for Different Languages

Contact Name: Dr. Marshall Chasin

Biography

Marshall Chasin, AuD,MSc, Reg. CASLPO, Aud(C) is an Audiologist and the Director of Auditory Research at the Musicians’ Clinics of Canada in Toronto, the Coordinator of Research at the Canadian Hearing Society, and the Director of Research at ListenUp Canada. He received his bachelors in Mathematics and Linguistics at the University of Toronto. He is an Associate Professor in the School of Communication Sciences & Disorders, Faculty of Health Sciences (Audiology) at the University of Western Ontario, and Adjunct Professor at the University of Toronto (in Linguistics) specializing in Acoustic Phonetics. Chasin has been involved with hearing and hearing aid assessment since 1981, having graduated with an M.Sc. from the University of British Columbia, and is the author of over 100 clinically based articles. In 2003, he obtained his AuD from the Arizona School of Health Sciences. Marshall has lectured extensively on implantable hearing aids, hearing aids, music and noise exposure, and is frequently on TV and radio (he’s the good looking balding guy sometimes on Much Music).

Chasin has won several awards over the years including the 2003 Professional Leadership Award for clinical and research work with musicians and performing artists from the Audiology Foundation of America, the Eve Kassirer Award for outstanding professional achievement from CASLPA in 1991, and Honours of the Association from OSLA in 1999.

Chasin is the author of several books, including Musicians and the Prevention of Hearing Loss (1996), CIC Handbook (1997), and Noise Control- A Primer (1999)– all published by Singular Publishing Group, San Diego, CA, as well as Hear the Music, 2001, 2006.

Summary:

This 60 minute session discusses possible considerations for programming hearing instruments  for languages other than English in order to improve speech comprehension

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Speech Recognition and Spatialisation in Complex Listening Environments: Effects of Hearing Aids and Processing

Contact Name: Prof Todd Ricketts

Contact Email: todd.a.ricketts@Vanderbilt.Edu

Todd A. Ricketts, Ph.D, CCC-A, is an associate professor at the Vanderbilt Bill Wilkerson centre for Otolaryngology and Communication Sciences and Director of the Dan Maddox Hearing Aid Research Laboratory. Prior to moving into the Vanderbilt position in 1999, Todd spent three years as an assistant professor at Purdue University. His current research interests are focused in amplification and microphone technology, as well as the relationship between laboratory and everyday benefit. Todd has published more than fifty scholarly articles and book chapters. To date he has presented over 100 scholarly papers/poster presentations, short courses, mini-seminars, and workshops to professional and scholarly conferences both nationally and internationally. He was also named a fellow of the American Speech Language Hearing Association in 2006. He continues to pursue a federally and industry funded research program studying the interaction between amplification technology, listening environment and individual differences as they impact benefit derived from hearing aids and cochlear implants. His current work includes examination of the viability of directional technology for school aged children, the relative benefits and limitations of manual switching, automatic switching and “asymmetric” microphone technology; the impact of extended high frequency bandwidth on user perceived sound quality as a function of hearing loss and the relative benefits and limitations of bilateral cochlear implants. He also serves as the chair of the Vanderbilt University Institutional Review Board: Behavioural Sciences Committee.

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Ototoxicity as a preventable cause of inner ear disease- Is the Audiology profession doing enough to actually achieve this?

Contact Name: Ghada Al-Malky, PhD

Contact Email: g.al-malky@ucl.ac.uk

Dr. Al-Malky specialized in Audio-vestibular medicine in 1996 at the Faculty of Medicine, Alexandria University, Egypt, where she completed her Master’s Degree in 1999. She then moved to the UK in 2000 where she worked in the NHS at Glan Clwyd Hospital, North Wales for several years before taking up an academic role at the Ear Institute, UCL, London, where she is currently a Senior Lecturer. Dr. Al-Malky’s research interests include: * Translational research aiming at bridging the gap between laboratory auditory biophysics and genetics research and clinical applications in human patients. * The verification of the clinical usefulness of the continuous advances in auditory rehabilitation and establishing how they could be best utilized to improve patients’ quality of life. Her current specific research is related to investigating ototoxicity in children from an audiological, genetic susceptibility and clinical impact perspective. One of her major future aims is to establish collaborations to enhance the role of the UK audiology profession in the provision of ototoxicity monitoring and to help establish UK guidelines and standards of care for the management of patients with ototoxicity.

Ototoxicity is damage to the ear following exposure to drugs or chemicals. The inner ear is the commonest site of damage where cochlear and/or vestibular functions are affected. Ototoxic medications can cause irreversible toxicity, with aminoglycosides (AGs) and cisplatin being the most established agents. This side effect and others, such as nephrotoxicity, have limited the use of these treatments to patient groups that have to use them such as oncology and cystic fibrosis (CF) patients. A series of studies are reported in this presentation under three main themes. Theme A focused on audiological assessments and assessment tools; Theme B focused on causation; and Theme C focused on the impact of ototoxicity and current service provision.

Within the Theme A studies, audiological assessment of children with CF exposed to repeated aminoglycosides showed a higher prevalence of ototoxicity (24%) than previously reported in the literature. The studies also showed that the use of a test battery including extended high frequency audiometry (EHF-PTA) and distortion-product otoacoustic emissions (DPOAEs) was better at identifying early signs of ototoxicity than the use of standard audiometry alone and highlighted the importance of using universally accepted criteria for identification of ototoxicity. Theme B studies identified risk factors to ototoxicity such as cumulative exposure, older age, poorer lung function and presence of genetic mutations associated with increased susceptibility to ototoxicity (such as the A1555G mutation in the mitochondrial DNA). A rare case with normal hearing despite having the A1555G mutation and evidence of AG exposure was also discovered. The Theme C studies confirmed that presence of ototoxicity had a significant effect on the quality of life of children surviving cancer and showed that there was wide variation between the understanding and practices of clinicians managing ototoxic patients, such as oncologists and CF clinicians, and audiology professionals regarding ototoxicity monitoring. This identified gaps in the provision of ototoxicity monitoring services in the UK, especially due to the absence of nationally agreed guidelines.

This research has emphasized the significance of ototoxicity as a cause of hearing loss and the importance for audiologists to develop a leading role in establishing effective ototoxicity monitoring services to reduce or even prevent this critical disorder.

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APD: lessons from history

Contact Name: Wayne Wilson

Contact Email: w.wilson@uq.edu.au

Dr Wayne Wilson PhD MAudSA CCP is a Senior Lecturer at the School of Health and Rehabilitation Sciences, The University of Queensland (UQ), Australia. He has served in audiology clinics and universities around the world; has published 65 research papers, book chapters and patents; and has given over 275 presentations at scientific conferences (including 8 key-note addresses) and professional and community meetings. His APD research has been included in white papers and national guidelines in the United Kingdom, Canada and New Zealand and has been listed in the top 10 most read articles in the international scientific literature.

In 2009, Jerger (2009, p. 10) eloquently surmised the controversies surrounding auditory processing disorder (APD) by stating “APD means different things to different people”. He argued this was due (at least in part) to three historical approaches having been taken to APD: 1. the audiological approach, which is based on the concept of brain injury, 2. the psychoeducational approach, which is based on the concept of a set of primary (discrete) auditory abilities and 3. an approach based on the possible impact APD could have on language acquisition and learning. In this presentation I will argue that that a further three approaches can now be added: 4. an approach based on the requirement that APD be modality specific (Cacace & McFarland, 2013), 5. an approach based on the defining feature of APD being a deficit in auditory attention (Moore et al., 2010), and 6. an approach based on abandoning attempts to define APD in favour of managing the presenting listening difficulties (Dillon et al., 2012). While all six approaches to APD contain strengths and weaknesses, attempts to determine which approach would best serve persons with APD are confounded by the high likelihood that these different approaches are identifying different people.

 

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The Complexities of Listening and Understanding in Children with Minimal / Mild Hearing Loss

Contact Name: Dawna Lewis

Dawna Lewis received her M.A. in Audiology from the University of Tennessee and her Ph.D. in Communication Disorders from the University of Nebraska.

She currently works as a Senior Research Associate at Boys Town National Research Hospital in Omaha, Nebraska. Dr. Lewis has presented and published on topics involving pediatric audiology/amplification and assistive listening devices, including FM systems. She received the Editor’s Award from the American Journal of Audiology for two 1994 articles on assistive technology in the classroom. Dr. Lewis also received the 2006 Folsom Distinguished Doctoral Dissertation Award from the University of Nebraska. Dr. Lewis has served on the steering committee for ASHA Special Interest Division 9, Hearing and Hearing Disorders in Childhood, the Joint Committee of ASHA and the Council of Education of the Deaf, and the Research and Creative Endeavors Committee of EAA. She also has served as an Associate Editor for Language, Speech, and Hearing Services in Schools and on the Editorial Board of Seminars in Hearing. Currently, Dr. Lewis is involved in research addressing issues in pediatric amplification and speech perception in children.

 

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Clinical feasibility and acceptability of recording infant obligatory cortical auditory evoked potentials in the sound field: results from the first 55 infants

Contact Name: Prof Kevin Munro

Contact Email: kevin.j.munro@manchester.ac.uk

Dr Kevin Munro has a background in medical sciences and obtained an MSc (Distinction) and PhD in Audiology at the University of Southampton. He also has a Diploma in Management Studies. In August 2002, Kevin took up the position of Clinical Senior Lecturer in Audiology at the University of Manchester and was promoted to Reader in 2005 and then Professor in 2011. Prior to this time, he worked as a clinical scientist in audiology and has been Head of several clinical audiology services including the Regional Audiology Clinic at the Institute of Sound and Vibration Research, University of Southampton. He has extensive clinical experience that includes the assessment and rehabilitation of hearing and balance disorders in adults, and the assessment and habilitation of hearing (including cochlear implants) in children. His research interests include paediatric assessment and habilitation, plasticity of the auditory system, and ‘dead regions’ within the cochlea. in 2001, the British Society of Audiology awarded Kevin the Thomas Simm Littler prize for his contribution to research in audiology. In 2008, the British Society of Audiology then awarded him the Jos Millar shield. He is involved in a variety of professional activities, was a member of the editorial board of the British Journal of Audiology and is a former editor of British Society of Audiology News. He is a former Chief Examiner for the British Association of Audiological Scientists. He will become Chair of the British Society of Audiology in 2012 after serving as Vice Chair from 2010-2012. He has organised many professional and scientific conferences including the 2010 annual conference of the British Society of Audiology.

Munro, Kevin J1,2, Nassar Ruth2, Purdy, Suzanne C3; O’Driscoll, Martin1,2, Booth, Rachel2, Bruce, Iain1,2; Uus Kai1.

1School of Psychological Sciences, University of Manchester, UK; 2Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; 3School of Psychology, University of Auckland, New Zealand

 

There is growing interest in using supra-threshold obligatory cortical auditory evoked potentials (CAEPs) to complement established paediatric clinical test procedures. As part of an on-going study investigating the clinical usefulness of aided CAEPs in infants, we have been obtaining data on feasibility and acceptability of the procedure within the clinical setting. Responses to short duration stimuli (/m/, /g/ and /t/), will ultimately be recorded in 100 normal-hearing and 10 hearing-impaired infants (between 4 and 39 weeks of age) from a loudspeaker at zero degree azimuth and a presentation level of 65 dB SPL. At the time of writing, we have the following data from the first 55 infants (who all passed new-born screening and have no reported hearing difficulties): CAEP test duration, completion and detection rates, and a parental acceptability questionnaire (9 questions with 7-point scale, 1 being best). The mean test duration was 27 minutes (range 17-89 min). A response was obtained to at least one stimuli in 100% of infants. Responses to /g/, /t/ and /m/ were detected in 96%, 88% and 80% of infants, respectively. So far, 29 parents have completed the acceptability questionnaire and the mean score of individual questions range from 1.14-2.62. The poorest score was obtained for the question enquiring about the difficulty of keeping the baby awake and quiet for the duration of the test procedure. In conclusion, the short test duration, high completion and detection rates and good scores on the acceptability questionnaire suggest that the sound field CAEP procedure may be feasible and acceptable for use in infants within the clinical setting.

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Theory of Mind & importance of over hearing

Contact Name: Lyndsey Allen

Contact Email: lyndsey@earfoundation.org.uk

Lyndsey Allen graduated in 2001 with a BSc honours degree in Speech and Language Therapy. From 2005 until 2011, she worked as a Specialist SLT with the children’s cochlear implant programme in Birmingham where she followed the three year certification process to become an Auditory Verbal Therapist. She is founder of the Auditory Verbal Lounge an independent practice offering AVT to children and families in the UK and she also Co-ordinates the professional education programme for a renowned charity The Ear Foundation. Designing and delivering courses for developing listening she presents nationally and internationally on a range of topics. Her special interests are working with children from spoken bilingual families and the use of daily routines to develop spoken language through listening, a topic on which she has published.

Without a well developed Theory of Mind, or mind reading, the world would be a scary unpredictable place. Our insights into the thoughts of other people are the basis of our emotional intelligence, arguably something more important than IQ. Exploring key concepts in Theory Of Mind, this talk will assert the need to consider distance hearing for incidental learning. Overhearing and listening in to other people’s conversations provides an environment that is rich in opportunities for developing Theory of Mind.

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Using a family centred care approach in hearing rehabilitation for older adults & their significant others

Contact Name: Nerina Scarinci

Contact Email: n.scarinci@uq.edu.au

Dr Nerina Scarinci is a Lecturer in Speech Pathology and Audiology at The University of Queensland. Her research primarily focuses on the application of family-centred care principles for adults and children with a communication disability, and their family members. She has a special interest in the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) and it’s application to communication disability, and third-party disability. Nerina completed her doctoral studies in 2009, which focused on the impact of hearing impairment in older adults on significant others.

Research into the barriers and facilitators to hearing rehabilitation in older adults with hearing impairment highlights the critical role of family members in the rehabilitation process. This involvement of family members reflects current trends towards family-centred care in audiology, where services are planned around the entire family, not just the individual client, and where the entire family is recognized as receivers of care. The application of family-centred care to hearing rehabilitation also addresses the potential impact of hearing impairment on the entire family unit, with previous research indicating that family members also experience activity limitations and participation restrictions as a result of a significant other’s hearing loss. This lecture will explore the role of family members in hearing rehabilitation for older adults, including a discussion of the perspective of audiologists, older adults with hearing impairment, and family members. Barriers and facilitators to family member involvement will also be discussed.

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Interventions to improve hearing aid use

Contact Name: Fiona Barker

Contact Email: fiona.barker@windsor-ent.co.uk

Fiona Barker is a registered Clinical Scientist who over an 18 year career has developed a focus on the assessment and management of vestibular problems, dizziness and imbalance. She has a certificate in evidence-based psychological therapy and has a special interest in the consultation process and in the psychological impact of dizziness.

Fiona is also involved in training Clinical Scientists both locally and as a lecturer on balance courses nationally and internationally. As part of Windsor ENT, Fiona organises the Advanced Balance Course in Southampton which has an international reputation for providing high quality training. She has over 10 years experience as a senior examiner and assessor and is actively involved in research and clinical audit.

Fiona also owns and runs a company that develops audio-visual training material for other professionals working in the vestibular field.

People living with a long term health condition have relatively infrequent and brief contacts with health providers. For the majority of the time in order to ‘live well’ they must, by necessity, become effective self-managers. In this seminar Fiona will outline the Chronic Care Model; a framework which has been associated with improved clinical outcomes in other long term conditions. She will discuss how this might be applied in the context of hearing health and explore how the results of her research including a Cochrane systematic review, Delphi review and content analysis of quality standard documents in audiology point towards self-management being an area in need of further exploration within hearing healthcare.

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Health literacy, User Guides & HA Management

Contact Name: Andrea Caposecco

Contact Email: a.caposecco@uq.edu.au

Andrea is currently finishing a PhD on the topic of health literacy, instruction materials, and hearing aid management. In 2010 she was awarded a Master of Philosophy on the topic of cochlear implant outcomes in adults and adolescents with early onset hearing loss. Andrea has seven publications in peer reviewed journals. Prior to embarking on an academic career she gained extensive clinical experience in both rehabilitative and diagnostic audiology in government and private settings.

Speaker: Andrea Caposecco

Authors : Ms Andrea Caposecco 1,2; Prof Louise Hickson1,2; Dr Carly Meyer1,2

Affiliations: 1HEARing Cooperative Research Centre, Melbourne, Australia; 2School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia

 

Health literacy refers to the ability to obtain, process, and comprehend basic health-care information and services.   It is estimated that approximately 30% of older adults have low health literacy. Low health literacy has been consistently associated with poorer health outcomes and poorer use of health-care services. However, there is very limited research on health literacy and how it relates to the field of Audiology. This presentation will discuss research conducted at the University of Queensland, on health literacy, hearing aid user guides, and hearing aid management. The results and implications for Audiologists, heairng aid manufacturers, and other hearing care professionals will be discussed.

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New technology in Audiology: matching patient needs to technology

Contact Name: Josephine Marriage

Contact Email: josephine@chears.co.uk

Josephine is Founder and Director of Chear, an independent centre for second opinion of hearing and hearing aids for infants and children. She is a clinical paediatric audiologist and conducts research around amplification strategies and speech testing in children. Chear has two clinical bases in the UK, the first is based just south of Cambridge, and the second is with Auditory-Verbal UK in London which is a new initiative, supported by Phonak, called Listen and Talk as One. She lectures in Paediatric Audiology and other Master-classes at UCL Ear Institute in London. She is a research associate with Professor Brian Moore at Cambridge University.

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Avenues for improvement in hearing aids

Contact Name: Professor Brian C.J. Moore - Department of Experimental Psychology, University of Cambridge, UK

An Introduction by Shahad Howe : https://connect.sonova.com/p9pia7dw2y2/

To watch the recording: https://connect.sonova.com/p3uliz6vjps/

( 1 hour 17 mins)

Abstract

Despite the advances in signal processing in hearing aids over the past 20-30 years, hearing aids are still far from restoring “normal” hearing. This partly reflects limitations of impaired auditory systems, such as reduced frequency selectivity and reduced sensitivity to temporal fine structure, but also reflects limitations in the hearing aids themselves. Some very basic limitations are:

(1) The gains achieved on real ears are often substantially different from those programmed into the manufacturer’s software, even when averaged over many test ears. In other words, something is systematically wrong in the calibration of the fitting systems. A very common problem is a failure to meet target gains for frequencies above about 3 kHz.

(2) The compression ratios obtained on real ears are often substantially different from (usually below) those programmed into the manufacturer’s software. As a result, soft sounds remain inaudible and strong sounds are too loud.

3) Despite claims of wide bandwidth, most hearing aids are unable to meet the fitting targets of methods like NAL-NL2 or CAM2 for frequencies above about 4 kHz.

4) The output of many hearing aids often falls off markedly for frequencies below a few hundred Hz. This does not create severe problems when listening to speech, but produces severe degradations of sound quality for music.

More subtle problems arise as side effects of the signal processing in hearing aids. Processing such as multi-channel amplitude compression, noise reduction, and adaptive directionality changes the amplitude modulation patterns of the signal and this can have adverse effects on speech intelligibility and sound quality. For listening to music, many hearing-impaired people prefer a linear amplifier with high-quality headphones to their hearing aids. There is increasing evidence that the intelligibility of speech in background sounds is strongly affected by the amplitude fluctuations in the background sounds, even for “steady” noise (Stone et al, 2012). Improved models for predicting the intelligibility of speech in fluctuating background sounds are needed to assess the deleterious effects of the processing in hearing aids, and to select parameters of the processing that minimise these deleterious effects.

Systems for acoustic feedback reduction/cancellation can also have serious deleterious effects when listening to music. The designers of these systems need to evaluate them with music signals, not just speech.

Acknowledgements

Supported by the MRC.

References

Stone, M.A., Füllgrabe, C. & Moore, B.C.J. 2012. Notionally steady background noise acts primarily as a modulation masker of speech. J Acoust Soc Am, 132, 317-326.

Biography

Brian Moore received his B.A. in Natural Sciences in 1968 and his Ph.D. in Psychoacoustics in 1971, both from the University of Cambridge, England.  He is currently Professor of Auditory Perception in the University of Cambridge.  He has also been a Visiting Professor at Brooklyn College, the City University of New York, and the University of California at Berkeley and was a van Houten Fellow at the Institute for Perception Research, Eindhoven, the Netherlands. His research interests are: the perception of sound; mechanisms of normal hearing and hearing impairments; relationship of auditory abilities to speech perception; design of signal processing hearing aids for sensorineural hearing loss; methods for fitting hearing aids to the individual; design and specification of high-fidelity sound-reproducing equipment; perception of music and of musical instruments.  He is a Fellow of the Royal Society of London, a Fellow of the Academy of Medical Sciences, a Fellow of the Acoustical Society of America, a Fellow of the Association for Psychological Science, and an Honorary Fellow of the Belgian Society of Audiology and the British Society of Hearing Aid Audiologists.  He is a member of the Experimental Psychology Society (UK), the British Society of Audiology, The American Speech-Language Hearing Association, The American Auditory Society, the Audio Engineering Society, the Association for Research in Otolaryngology and the American Academy of Audiology.  He is President of the Association of Independent Hearing Healthcare Professionals (UK).  He has written or edited 17 books and over 590 scientific papers and book chapters.  He has twice received the Littler Prize of the British Society of Audiology.  In 2003 he was awarded the Acoustical Society of America Silver Medal in physiological and psychological acoustics.  In 2004 he received the first “International Award in Hearing” from the American Academy of Audiology.  In 2008 he received the “Award of Merit” from the Association for Research in Otolaryngology and the Hugh Knowles Prize for Distinguished Achievement from Northwestern University.  In 2010 he gave the Distinguished Heyser memorial Lecture to the Audio Engineering Society.  He is wine steward of Wolfson College, Cambridge.

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Improvements in hearing aids

Contact Name: Brian Moore

Contact Email: bcjm@cam.ac.uk

Brian Moore received his B.A. in Natural Sciences in 1968 and his Ph.D. in Psychoacoustics in 1971, both from the University of Cambridge, England.  He is currently Professor of Auditory Perception in the University of Cambridge.  He has also been a Visiting Professor at Brooklyn College, the City University of New York, and the University of California at Berkeley and was a van Houten Fellow at the Institute for Perception Research, Eindhoven, the Netherlands. His research interests are: the perception of sound; mechanisms of normal hearing and hearing impairments; relationship of auditory abilities to speech perception; design of signal processing hearing aids for sensorineural hearing loss; methods for fitting hearing aids to the individual; design and specification of high-fidelity sound-reproducing equipment; perception of music and of musical instruments.  He is a Fellow of the Royal Society of London, a Fellow of the Academy of Medical Sciences, a Fellow of the Acoustical Society of America, a Fellow of the Association for Psychological Science, and an Honorary Fellow of the Belgian Society of Audiology and the British Society of Hearing Aid Audiologists.  He is a member of the Experimental Psychology Society (UK), the British Society of Audiology, The American Speech-Language Hearing Association, The American Auditory Society, the Audio Engineering Society, the Association for Research in Otolaryngology and the American Academy of Audiology.  He is President of the Association of Independent Hearing Healthcare Professionals (UK).  He has written or edited 17 books and over 590 scientific papers and book chapters.  He has twice received the Littler Prize of the British Society of Audiology.  In 2003 he was awarded the Acoustical Society of America Silver Medal in physiological and psychological acoustics.  In 2004 he received the first “International Award in Hearing” from the American Academy of Audiology.  In 2008 he received the “Award of Merit” from the Association for Research in Otolaryngology and the Hugh Knowles Prize for Distinguished Achievement from Northwestern University.  In 2010 he gave the Distinguished Heyser memorial Lecture to the Audio Engineering Society.  He is wine steward of Wolfson College, Cambridge.

Despite the advances in signal processing in hearing aids over the past 20-30 years, hearing aids are still far from restoring “normal” hearing. This partly reflects limitations of impaired auditory systems, such as reduced frequency selectivity and reduced sensitivity to temporal fine structure, but also reflects limitations in the hearing aids themselves. Some very basic limitations are:

(1) The gains achieved on real ears are often substantially different from those programmed into the manufacturer’s software, even when averaged over many test ears. In other words, something is systematically wrong in the calibration of the fitting systems. A very common problem is a failure to meet target gains for frequencies above about 3 kHz.

(2) The compression ratios obtained on real ears are often substantially different from (usually below) those programmed into the manufacturer’s software. As a result, soft sounds remain inaudible and strong sounds are too loud.

3) Despite claims of wide bandwidth, most hearing aids are unable to meet the fitting targets of methods like NAL-NL2 or CAM2 for frequencies above about 4 kHz.

4) The output of many hearing aids often falls off markedly for frequencies below a few hundred Hz. This does not create severe problems when listening to speech, but produces severe degradations of sound quality for music.

More subtle problems arise as side effects of the signal processing in hearing aids. Processing such as multi-channel amplitude compression, noise reduction, and adaptive directionality changes the amplitude modulation patterns of the signal and this can have adverse effects on speech intelligibility and sound quality. For listening to music, many hearing-impaired people prefer a linear amplifier with high-quality headphones to their hearing aids. There is increasing evidence that the intelligibility of speech in background sounds is strongly affected by the amplitude fluctuations in the background sounds, even for “steady” noise (Stone et al, 2012). Improved models for predicting the intelligibility of speech in fluctuating background sounds are needed to assess the deleterious effects of the processing in hearing aids, and to select parameters of the processing that minimise these deleterious effects.

Systems for acoustic feedback reduction/cancellation can also have serious deleterious effects when listening to music. The designers of these systems need to evaluate them with music signals, not just speech.

Acknowledgements

Supported by the MRC.

References

Stone, M.A., Füllgrabe, C. & Moore, B.C.J. 2012. Notionally steady background noise acts primarily as a modulation masker of speech. J Acoust Soc Am, 132, 317-326.

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“Music and Cochlear Implants: opening the lid on signal processing strategies”

Contact Name: Prof Colette McKay

Contact Email: colette.mckay@manchester.ac.uk

I obtained a first class honours degree in maths and physics from the University of Melbourne, followed by a PhD in physics from the same university. After completing my clinical qualifications in Audiology, I took up a part time teaching and clinical position in the School of Audiology while my children were small. I moved into full time research in 1990 in the Department of Otolaryngology at Melbourne University in the area of Cochlear Implants. I helped in the development and evaluation of the SPEAK processing strategy, which after 14 years still provides the principles upon which the majority of cochlear implants function today. In 2005 I moved to the UK to take up a chair position at Aston University in Birmingham, where I developed and directed the new BSc (Hons) in Audiology course. In 2007 I moved to Manchester University to lead the research team in the Audiology and Deafness Group.

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“Other things your hearing is good for, especially if your hearing impaired”

Contact Name: Daniel Rowan

Contact Email: dr@isvr.soton.ac.uk

Daniel is a Lecturer in Audiology at the University of Southampton; Admissions Tutor for the BSc Healthcare Science (Audiology) and MSc Audiology programmes in the Faculty of Engineering and the Environment; and is an Audiologist registered with the Registration Council for Clinical Physiologists (RCCP).

Daniel began his training as an Audiologist in the National Health Service in 1995. In 2000, he embarked on the MSc in Audiology at the Institute of Sound and Vibration Research (ISVR), graduating in 2002. On completing the MSc, Daniel conducted his PhD research under the supervision of Prof Mark Lutman and was awarded funding by the Royal National Institute for the Deaf (now Action On Hearing Loss), graduating in 2006. In 2004 he joined the Hearing and Balance Centre as a member of staff. From 2008-2012, Daniel was the Chair of the Professional Practice Committee of the British Society of Audiology.

Daniel is the lead member of a team of scientific advisors from the University of Southampton to the International Committee of Sports for the Deaf, which includes the Deaflympics.

20 million people in the world are blind, most of whom are in developing countries and are over 50 years old — they are therefore also at high risk of hearing impairment. The auditory needs of people who are blind and later develop hearing impairment might differ from sighted people in important ways. For example, some blind report using sound echoes and echolocation for spatial awareness and navigation. This talk describes recent experiments into the auditory aspects of human echolocation and what the implications of these might be for audiology services for blind people. For example, could audiology services have a role in helping blind people without hearing loss enhance their auditory skills, such as to use echoes?

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How adults with hearing impairment perceive the role of aging and cognition in help-seeking and rehabilitation

Contact Name: Ariane Laplante-Levesque

Contact Email: ARL@Eriksholm.com

Ariane Laplante-Lévesque is a research project manager at the Eriksholm Research Centre in Denmark where she leads a research programme investigating hearing aid dispensing processes. She is also an adjunct assistant professor at Linköping University in Sweden where she studies information technology applications in audiology. Ariane completed her PhD at the University of Queensland in Australia. Before, she trained as a clinical and research audiologist in Canada and worked as a clinical audiologist in Australia. Her professional interests include the rehabilitation of adults and older adults with acquired hearing impairment, the client-audiologist relationship, and tele-audiology. She has published extensively on these topics.

Authors and affiliations

Jill Preminger3 & Ariane Laplante-Lévesque1,2

1Eriksholm Research Centre, Denmark

2Linköping University, Sweden

3University of Louisville, USA

Abstract

This qualitative study explored the perspectives of adults with hearing impairment on help-seeking and rehabilitation. In-depth semi-structured interviews were completed in 4 countries with 34 adults with hearing impairment. Participants had different levels of experience in help-seeking and rehabilitation. Participants were asked to “tell the story of their hearing”. This subsequent qualitative analysis focuses on two topics, aging and cognition, that participants spontaneously discussed during the interviews. Adults with hearing impairment see aging and cognition as both barriers and facilitators to their help-seeking and rehabilitation.

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“BSA Showcase”

Contact Name: Kevin Munro

Contact Email: kevin.j.munro@manchester.ac.uk

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“A pilot study of hearing aids and combination devices in the management of tinnitus”

Contact Name: Danny Kearney

Contact Email: Danny.Kearney@cmft.nhs.uk

Danny Kearney is a Senior Audiologist at the Manchester Royal Infirmary. He received his MSc. in Advanced Audiology from the University of Manchester in 2012 and his BSc. (Hons) in Audiology from Aston University in 2007.

In addition to his clinical commitments in Adult Rehabilitation, Paediatrics and Tinnitus Danny is also dedicated to developing services and engaging in research. Danny’s latest research activity has been focused on tinnitus management.

Objective: To determine whether combination devices or hearing aids are more effective in the management of patients with tinnitus and hearing loss.

Design: Participants were issued with either hearing aids or combination devices depending on their random group allocation. Tinnitus Handicap Inventory (THI), Tinnitus Reaction Questionnaire (TRQ) and Visual Analogue Scales (VAS) for tinnitus annoyance and loudness were performed pre and post treatment as outcome measures. Data was also gathered regarding how much the devices were used.

Sample: The sample consisted of 15 participants; seven were allocated to the hearing aid group and eight to the combination device group. On average participants had a symmetrical, high frequency sensorineural hearing loss and all participants were issued with bilateral devices using open fit ear pieces.

Results: An improvement in mean THI, TRQ and VAS scores was measured in both groups. The improvement in THI score did not reach clinical significance in either group and the difference between the groups was not statistically significant. The mean hours of daily device use was higher amongst those in the hearing aid group compared to the combination device group.

Conclusion: A larger scale study should be performed to compare the devices with a larger sample and over a longer period of time.

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Hearing disability and vision impairment in UK adults: prevalence, co-occurrence and correlates

Contact Name: Dr Piers Dawes

Contact Email: piers.dawes@manchester.ac.uk

My research interests involve auditory processing and developmental psychology from childhood to old age, auditory plasticity and developmental disorders. Research methodologies including qualitative and quantitative techniques, including psychometric, psychophysical and electrophysiological (MEG, EEG and ABR) measures. From 2005-2007 I carried out research into auditory processing disorder (APD) for my Phd, supervised by Professor Dorothy Bishop at the University of Oxford. This research involved characterising the auditory and cognitive profile of children and adults diagnosed with APD in comparison to typical participants and those with dyslexia. This research was funded by Deafness Research UK. In 2008, I completed a post-doctoral fellowship at the University of York, where I developed experimental psychometric language tests and psychophysical tests of auditory processing and speech perception for use in a Wellcome Trust-funded 5 year longitudinal study of dyslexia and specific language impairment (Snowling, Hulme and Hayiou-Thomas, chief investigators). I am currently working on a study of auditory plasticity, examining changes in hearing function, listening effort and real-world benefit in relation to hearing aid use in older adults.

Objective

We are the first to describe the prevalence of hearing difficulties in background noise, an ecologically valid measure of hearing disability, in a large and inclusive sample of UK adults aged 40 to 69 years. We also report prevalence of vision impairment and dual sensory problems. Predictive factors of sensory problems were investigated.

Methods

Subsets of the UK Biobank Resource were analysed with respect to self-report of tinnitus, hearing aid and glasses use. Better-eye visual acuity with corrective glasses was assessed with a logMAR chart (n = 116,682). Better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770).

Results

Overall, 10.7% of adults (95%CI 10.5-10.9%) had a significant hearing disability. Prevalence of tinnitus was 16.9% (95%CI 16.6-17.1%) and hearing aid use was 2.0% (95%CI 1.9-2.1%). Prevalence of mild visual impairment and low vision was estimated at 13.1% (95%CI 12.9-13.4%) and 0.8% (95%CI 0.7-0.9%), respectively. Use of glasses was 82.8% (95%CI 82.6-82.9%). The prevalence of dual sensory problems was 2.4% (95%CI 2.2-2.5%). Older adults, those from low socioeconomic and ethnic minority backgrounds were most at risk for sensory problems. Noise exposure was an additional risk for hearing problems.

Conclusion

Similar risk factors for hearing, vision and dual sensory problems and a higher than expected prevalence of dual sensory problems suggest possible shared causes. The use of hearing aids has altered little since the 1980s, and they remain significantly underutilised. Vision impairment is common despite widespread use of corrective visual aids.

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“Bilateral input protects the cortex from unilaterally-driven reorganization in children who are deaf”

Contact Name: Karen Gordon

Contact Email: karen.gordon@utoronto.ca

Karen Gordon is an Associate Professor in the Department of Otolaryngology and a Graduate Faculty Member in the Institute of Medical Science at the University of Toronto. She works at the Hospital for Sick Children in Toronto, Ontario, Canada, as a Scientist in the Research Institute and Director of Research in Archie’s Cochlear Implant Laboratory.

Karen received her Ph.D. (2005) and B.Sc (1991) at the University of Toronto and her M.A. in Audiology (1993) at Northwestern University. She is a registered audiologist (reg. CASLPO, CCC-A), a Fellow of the American Academy of Audiology (AAA), and a member of the Association for Research in Otolaryngology (ARO) and the Society of Ear, Nose and Throat Advances in Children (SENTAC).

Karen’s research focuses on auditory development in children who are deaf and use cochlear implants. Her early work examined the role of a unilateral implant to promote changes in the auditory nerve, brainstem, thalamus and cortex and she is presently interested in the effects of bilateral cochlear implants in these areas. Karen has been awarded grant funding for her work on binaural auditory development in children receiving bilateral cochlear implants from both the Canadian Institutes for Health Research and the SickKids Foundation.

Unilateral hearing in childhood restricts input along the bilateral auditory pathways, possibly causing permanent reorganization.

In this study we asked: (i) do the auditory pathways develop abnormally in children who are bilaterally deaf and hear with a unilateral cochlear implant? and (ii) can such differences be reversed by restoring input to the deprived ear? We measured multichannel electroencephalography in 34 children using cochlear implants and seven normal hearing peers. Dipole moments of activity became abnormally high in the auditory cortex contralateral to the first implant as unilateral cochlear implant use exceeded 1.5 years. This resulted in increased lateralization of activity to the auditory cortex contralateral to the stimulated ear and a decline in normal contralateral activity in response to stimulation from the newly implanted ear, corresponding to poorer speech perception. These results reflect an abnormal strengthening of pathways from the stimulated ear in consequence to the loss of contralateral activity including inhibitory processes normally involved in bilateral hearing. Although this reorganization occurred within a fairly short period (_1.5 years of unilateral hearing), it was not reversed by long-term (3–4 years) bilateral cochlear implant stimulation. In bilateral listeners, effects of side of stimulation were assessed; children with long periods of unilateral cochlear implant use prior to bilateral implantation showed a reduction in normal dominance of contralateral input in the auditory cortex ipsilateral to the stimulated ear, further confirming an abnormal strengthening of pathways from the stimulated ear. By contrast, cortical activity in children using bilateral cochlear implants after limited or no unilateral cochlear implant exposure normally lateralized to the hemisphere contralateral to side of stimulation and retained normal contralateral dominance of auditory input in both hemispheres. Results demonstrate that the immature human auditory cortex reorganizes, potentially permanently, with unilateral stimulation and that bilateral auditory input provided with limited delay can protect the brain from such changes. These results indicate for the first time that there is a sensitive period for bilateral auditory input in human development with implications for functional hearing.

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Recovery from ANSD? A reality, a myth or just getting it all wrong?

Contact Name: Dr Kai Uus

Contact Email: kai.uus@manchester.ac.uk

Research

I am qualified as a paediatrician and thus my research interests are in the area of paediatric audiology

  • Epidemiology or childhood hearing loss
  • Newborn hearing screening
  • ANSD
  • Auditory maturation
  • Auditory function in neurodegenerative conditions
  • Effect of stress on auditory system

Teaching

Undergraduate

  • Lifespan development
  • Paediatric Audiology
  • Advanced Studies

 

Postgraduate

  • Paediatric Audiology

Newborn hearing screening programs are being introduced across the world. Depending on the protocol, these programs usually allow for the identification of neonates and young infants with auditory neuropathy spectrum disorder (ANSD). The talk reviews the issues around auditory brain stem response (ABR) recovery in young infants, putting forward the suggestion that it is not necessarily always associated with normal physiological maturational changes. In some cases, it is related to pathological neuromaturational delay but also other factors. I will argue for conceptualizing ABR recovery as transient ANSD and including it as part of the spectrum.

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“Patient Conversations: What We Say Makes a Difference”

Contact Name: Kris English

Contact Email: ke3@uakron.edu

Kris English, Ph.D. is a professor at the University of Akron/NOAC.  She has authored, co-authored or edited 8 books and 21 chapters, and has presented over 200 workshops and papers in the US, Canada, and Europe, primarily on the topic of audiologic counselling. She recently completed 5 years of service as a Board member for the American Academy of Audiology, including a term as President in 2009-2010.

When patients reject our recommendations, it is our responsibility to understand their concerns and objections. As we listen, we hear expressions of negative emotions such as, ‘I¹d be too embarrassed to be seen at work with hearing aids’, or ‘Everyone says hearing aids are a big hassle’. Patients may never use the word ‘fear’ but we need to realize that it is ‘in the room’ with us and presents itself as resistance, as a ‘no’ to our recommendations. Goulston (2010) observed that the instinctive response to resistance actually creates more resistance: “Most people upshift when they want to get through to other people. They persuade. They encourage. They argue. They push. And in the process, they create [even more] resistance” (p. 4). On the other hand, responses described as ‘patient-centred’ have been strongly correlated with high rates of patient adherence. This session will review the evidence relating patient-centered conversations to adherence rates, and describe two types of responses that can make a positive difference.

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Auditory Steady State Responses in Normal-Hearing and Hearing-Impaired Adults

Contact Name: Dr Tim Wilding

Contact Email: timothy.wilding@manchester.ac.uk

Tim started his training and career in audiology after first working for a number of years as an electronic engineer designing ICs (“computer chips”) for consumer electronic devices. He then went on to obtain a BSc and PhD in Audiology at the University of Manchester where he is now a teaching focused lecturer. His research activities to date have examined: using the ASSR for dead region diagnosis, possible advantage of classroom FM system use, and classroom acoustics measures. He is an RCCP registered audiologist and keeps his clinical skills up to date by working in NHS adult hearing aid clinics whenever possible.

Objectives: The aim of this study was to assess the between-session repeatability of auditory steady state response (ASSR) amplitudes and to examine F ratio response detection parameters.

Design: Supra-threshold ASSRs were recorded from 20 normal-hearing and 10 hearing-impaired subjects. Amplitudes and latencies were recorded in two test sessions conducted on separate days.

Analysis: The repeatability coefficients (limits of expected variation in repeat measurements) for amplitude and latency of ASSRs were calculated. The test time required for the responses to reach significance at 1%, 2%, and 5% F ratios was analysed. The percentage false response detection rate was calculated to determine the suitability of current ASSR threshold estimation protocols for use in audiology clinics.

Results: The repeatability coefficients for the amplitude of ASSRs were 29 nV for the normal-hearing subjects and 57 nV for the hearing-impaired subjects. The repeatability coefficients for the latency of ASSR were 1.10 msec for the normal-hearing subjects and 1.19 msec for the hearing-impaired subjects. High false-positive detection rates were found for detection procedures that used variable test time (“stop when significance reached” methods).

Conclusions: The results of this study showed that ASSR amplitudes are highly variable between test sessions with an average estimated variability in response amplitude of ±40% for normal-hearing participants and ±97% for hearing-impaired participants. This could be a possible cause of test–retest differences in ASSR threshold measurements, as it could potentially lead to thresholds that were above the EEG noise level and significant in one test session subsequently falling below the EEG noise level in the repeat test session leading to insignificant response and thus poorer ASSR threshold.

Reference

Wilding et al. (2012) Ear and Hearing 33:267-278

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The effects of menstrual cycle phase and stress-hormone levels on tinnitus perception

Contact Name: Dr Karolina Kluk

Contact Email: karolina.kluk-de-kort@manchester.ac.uk

I obtained my PhD in 2005 in psychoacoustics at the University of Cambridge and gained my experience in electrophysiology at the University of Toronto in 2006. I started as a lecturer in Audiology at the University of Manchester in September 2006. My research interests lie in development of new electrophysiological techniques to diagnose a wide range of hearing disorders, physiological and perceptual consequences of hearing loss, and brain plasticity induced either by training or deprivation. Recently I became fascinated with the effect of female sex hormones on perception of tinnitus.

Objective: This study aimed to investigate the effects of menstrual cycle phase and stress-hormone levels on tinnitus perception over the menstrual cycle.

Design: After a preliminary session to assess hearing and tinnitus, four sessions were conducted in the four phases of one menstrual cycle for female subjects, and on four consecutive weeks for male subjects. Testing at each session comprised Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI) State Trait Anxiety Inventory (STAI), saliva sample taking for cortisol analysis and tinnitus subjective intensity assessment. A final sixth session comprised a psychosocial stress task.

Sample: Seven female (aged between 19 and 39 years) and three male subjects (aged between 24 and 45 years) who had self-reported tinnitus.

Results: Mean TFI total score in female subjects was significantly higher (over four-fold) in the early luteal phase than in other phases. There was no significant pattern of fluctuation in THI, STAI state or cortisol in female or male subjects, or in TFI total score in male subjects over the four sessions.

Conclusions: Menstrual phase plays a significant part in tinnitus severity fluctuations. The results will aid future tinnitus intervention for women suffering from severe tinnitus.
Acknowledgments: This experiment was conducted in collaboration with Keri Abbot and Dr. Marine Rosa.

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“Respect for a young male with and without a hearing aid: A reversal of the “hearing-aid effect” in medical and non-medical students?”

Contact Name: Dr Claudine Clucas

Contact Email: c.clucas@chester.ac.uk

Claudine obtained her undergraduate degree in Psychology from the University of Connecticut in the USA. She then completed an MSc in Research in Psychology at Oxford University and a PhD on social psychological influences on and consequences of patients’ experiences of feeling respected in doctor-patient relations in the Centre for Hearing and Balance Studies at the University of Bristol. As part of this research, she studied attitudes of respect towards people with hearing aids. Following her PhD, she worked as a researcher in a health and clinical psychology group at University College London and is presently a Psychology lecturer at the University of Chester pursuing research interests in the area of respect in health and non-health contexts.

Objective: To investigate, in line with the “hearing-aid effect”, whether medical students would have less respect for a young male with a hearing aid than without when he was described as either respectworthy (i.e. as deserving respect) or non-respectworthy, and whether their attitudes differed from non-medical students. The interaction between the presence/absence of a hearing aid and respectworthiness on respect level was also explored. Design: Participants were shown a photograph and a written description of a young male. They were pseudo-randomly assigned to one of four core conditions reflecting the presence or absence of a hearing aid and the young man’s respectworthiness, and completed questions regarding their behaviours, beliefs, and feelings of respect towards him.

Study sample: One hundred and eighty-one medical students and a control group of 92 non-medical students.

Results: Results showed more respect for the young male with a hearing aid than without from female participants, and for the young male described as respectworthy compared to non-respectworthy in medical and in non-medical students. However, medical students had more respect for the young male with and without a hearing aid than non-medical students.

Conclusions: Findings were contrary to the “hearing-aid effect”. Possible explanations are given and implications are discussed.

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“Frequency compression hearing aids; benefit, acclimatization, and candidature”

Contact Name: Dr Kathryn Hopkins

Contact Email: kathryn.hopkins-2@manchester.ac.uk

Dr Kathryn Hopkins graduated from the University of Cambridge with a BA in Natural Sciences (specialising in Physiology) in 2005. She stayed in Cambridge to complete her PhD and one-year post-doctoral project  with Prof. Brian Moore on the subject of temporal processing deficits in hearing-impaired listeners. In April 2010 she was appointed as a Lecturer in Audiology at the University of Manchester. Her research focuses on understanding the mechanisms underlying hearing difficulties due to aging and noise exposure.

Frequency compression hearing aids are now commonly fitted in the NHS. However, most previous research studies demonstrating their effectiveness used different fitting procedures to those typically used in the clinic, where clinicians do not usually alter the frequency compression parameters from those recommended by the manufacturer. We examined the possible benefits of frequency compression when used with the manufacturers recommended parameters for adults with mild-severe hearing loss.  We also investigated whether benefit from frequency compression was related to the duration of frequency compression use, as might be expected if a long acclimatization period is necessary to gain full benefit.

Fifty-two adults were tested. All were fitted with Phonak frequency compression  hearing aids as part of their standard clinical care and had been using frequency compression for between two weeks and two years at the time of testing. Speech recognition thresholds in noise and consonant recognition in quiet were measured with and without frequency compression enabled.  Overall, consonant recognition was significantly better with frequency compression enabled, although the effect was small (three percentage points).  There was no significant difference in speech reception thresholds with frequency compression enabled or disabled.

There was no significant correlation between duration of frequency compression experience and benefit from frequency compression for either outcome measure, suggesting that a long period of acclimatisation is not necessary to gain the full benefits from frequency compression.  Frequency compression benefit was correlated with mean audiometric threshold at 2 and 3 kHz, with more benefit for individuals with better thresholds at these frequencies. Analysis of high frequency speech audibility suggested that for participants with a substantial hearing loss at 2 and 3 kHz, high frequency speech information was inaudible irrespective of whether frequency compression was enabled; this might explain the correlation between benefit and audiometric thresholds at these frequencies.

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Science: How not to do it

Contact Name: Bob Carlyon

Contact Email: Bob.Carlyon@mrc-cbu.cam.ac.uk

Dr. Bob Carlyon has been studying the human auditory system since his Ph.D. in Cambridge in the early 1980s. He is currently Programme Leader at the MRC Cognition & Brain Sciences Unit in Cambridge, England. He is also an Official Fellow of Clare Hall Cambridge. He was presented with the Acoustical Society of America’s R. Bruce Lindsay award in 1994, and was elected a Fellow of that Society in 1998. He received the Thomas Simm Littler prize from the British Society of Audiology in 2010. Dr. Carlyon has made important contributions to a wide range of topics in human hearing, a recurring theme being the problem of how we can listen to one voice in the presence of interfering sounds, such as other speakers. Much of his current research addresses how to improve hearing by cochlear implant users.

All of us – whether patients, clinicians, or scientists – rely on the results of scientific experiments. Unfortunately, those experiments are often flawed, or just plain wrong. Fortunately, the problem usually arises from one of a small number of errors. Some of these errors are very obvious, and have even been the subject of some pretty good cartoons. Others are more subtle, and have become of increasing interest to cognitive neuroscientists, but not (yet) to those working in more clinically relevant fields. This talk will help you to spot these common pitfalls when assessing other people’s research, and to avoid falling into the same trap.

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“The challenges of acclimatization to hearing aids”

Contact Name: Dr Piers Dawes

Contact Email: piers.dawes@manchester.ac.uk

My research interests involve auditory processing and developmental psychology from childhood to old age, auditory plasticity and developmental disorders. Research methodologies including qualitative and quantitative techniques, including psychometric, psychophysical and electrophysiological (MEG, EEG and ABR) measures. From 2005-2007 I carried out research into auditory processing disorder (APD) for my Phd, supervised by Professor Dorothy Bishop at the University of Oxford. This research involved characterising the auditory and cognitive profile of children and adults diagnosed with APD in comparison to typical participants and those with dyslexia. This research was funded by Deafness Research UK. In 2008, I completed a post-doctoral fellowship at the University of York, where I developed experimental psychometric language tests and psychophysical tests of auditory processing and speech perception for use in a Wellcome Trust-funded 5 year longitudinal study of dyslexia and specific language impairment (Snowling, Hulme and Hayiou-Thomas, chief investigators). I am currently working on a study of auditory plasticity, examining changes in hearing function, listening effort and real-world benefit in relation to hearing aid use in older adults.

Objectives: To describe the process of becoming accustomed to using hearing aids and factors which facilitate this process from the perspective of adult hearing aid users.

Design: A focus group was carried out in the north of England with adult hearing aid users (n=6). Hearing aid users owned hearing aids for less than two years and had used them at least once in the past three months. A topic guide and discussion exercises were used to elicit participant’s views on becoming accustomed to hearing aid use. Focus group discussion was audio recorded, transcribed verbatim and analysed according to qualitative content.

Results: Participants described becoming accustomed to hearing aids as a multi-factorial process which included adjusting to altered sensory input, managing practical matters such as cleaning and maintenance, discovering benefits and limitations of hearing aid use and managing the psychological impact of hearing aid use, such as on self-image. Factors that support this process included acceptance of hearing loss, persistence and consistent hearing aid use, support from friends, family and clinicians, and provision of information about hearing aids.

Conclusions: Becoming accustomed to hearing aids is a challenging multi-factorial process with both psychological and practical difficulties besides demands of adjusting to hearing aid input. Addressing these diverse challenges may offer novel ways of supporting new hearing aid users.

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“Cell transplantation therapy and age related hearing loss”

Contact Name: Dr David Furness

Contact Email: d.n.furness@gmail.com

My main research interests lie in the field of auditory neuroscience. I am presently investigating the role of fibrocytes in the cochlea. These are cells that are associated with homeostatic mechanisms that regulate the composition of cochlear fluids. These cells appear to go wrong in certain forms of deafness, including age-related deafness (presbyacusis). My group has funding from Deafness Research UK to investigate whether a stem cell/replacement cell strategy might be employed to prevent or ameliorate age-related deafness by replacing defective fibrocytes. The main techniques we employ are electron microscope, post-embedding immunogold electron microscopy, confocal microscopy and cell culturing. We have received funding for our work from the Wellcome Trust, MRC, Deafness Research UK, Midlands Institute of Otology, Royal Society, Physiological Society, British Tinnitus Association and others. Another of my major research interests is cochlear hair cell structure, composition and function. I am focussing on the hair bundle and how the hairs (stereocilia – see picture) function to convert mechanical action from sound stimulation into electrical signals and nerve impulses in nerve fibres going to the brain.

As the causes of age-related hearing loss have become better understood, a number of possible targets for cell replacement or regeneration have been identified. The major effort has generally been expended in replacing the sensory hair cells of the organ of Corti to restore hearing. However, it may well be equally fruitful to target other cells such as the spiral ganglion neurones that transmit the neural signal to the higher auditory pathway, or the spiral ligament fibrocytes that contribute to the homeostatic mechanism that maintains the endocochlear potential and ultimate ensure the survival of the hair cells themselves. I will review these possible targets, focussing particularly on the fibrocytes and their contribution, as well as ways they may be replaced to prevent age-related hearing loss.

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“Snake oil science: using ‘mild deception’ to demonstrate the influence of placebo and patient expectation on hearing aid benefit”

Contact Name: Prof Kevin Munro

Contact Email: kevin.j.munro@manchester.ac.uk

Dr Kevin Munro has a background in medical sciences and obtained an MSc (Distinction) and PhD in Audiology at the University of Southampton. He also has a Diploma in Management Studies. In August 2002, Kevin took up the position of Clinical Senior Lecturer in Audiology at the University of Manchester and was promoted to Reader in 2005 and then Professor in 2011. Prior to this time, he worked as a clinical scientist in audiology and has been Head of several clinical audiology servicess including the Regional Audiology Clinic at the Institute of Sound and Vibration Research, University of Southampton. He has extensive clinical experience that includes the assessment and rehabilitation of hearing and balance disorders in adults, and the assessment and habilitation of hearing (including cochlear implants) in children. His research interests include paediatric assessment and habilitation, plasticity of the auditory system, and ‘dead regions’ within the cochlea. in 2001, the British Society of Audiology awarded Kevin the Thomas Simm Littler prize for his contribution to research in audiology. In 2008, the British Society of Audiology then awarded him the Jos Millar shield. He is involved in a variety of professional activities, was a member of the editorial board of the British Journal of Audiology and is a former editor of British Society of Audiology News. He is a former Chief Examiner for the British Association of Audiological Scientists. He will become Chair of the British Society of Audiology in 2012 after serving as Vice Chair from 2010-2012. He has organised many professional and scientific conferences including the 2010 annual conference of the British Society of Audiology.

Placebo effects— clinical responses associated with the expectations surrounding treatments rather than with any intrinsic property of the treatment—are wide-ranging and are recognized in medical research and clinical practice. Because of their importance, we examined placebo effects in a hearing aid trial using benefit measures typical of those used in clinical trials: speech in noise tests, sound quality ratings and overall personal preference. Our approach was to compare two hearing aids that were acoustically identical. However, we used mild deception and informed the participants that they were comparing a conventional hearing aid with a new hearing aid. On all of our measures, greater benefit was obtained with the ‘new’ hearing aid. Given the potential far reaching impact of these findings, we decided to repeat the study. Once again, greater benefit was obtained with the ‘new’ hearing aid. These findings have important implications for hearing aid researchers. They suggest a need for caution when interpreting hearing aid trials which do not control for placebo effects. This is highly relevant to the UK National Health Service which currently spends around £60m/yr purchasing hearing aids. Our findings also have important implications for audiologists and hearing aid dispensers. It is likely that hearing aid users with positive expectations are more likely to experience benefit; therefore, the manipulation of expectations potentially offers an additional tool to maximize real benefit for audiology patients.

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