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Purpose: This study aimed to (a) identify participant factors associated with hearing aid review (HAR) appointment attendance, (b) investigate whether the completion of self-report survey identifying hearing aid--related problems affects HAR appointment attendance, and (c) investigate whether hearing aid problems and hearing aid management deficiencies are adequately addressed during HAR appointments. Method: A prospective cohort study of adult hearing aid owners recruited from a single hearing clinic in Western Australia. Potential participants were invited to an annual HAR appointment via postal letter. The invitation included a paper-based self-report survey evaluating either (a) hearing aid problems, (b) hearing aid management skills, or (c) hearing aid outcomes, depending on which intervention/control group the potential participants were assigned to, and a reply paid addressed envelope. Two months later, potential participants were sent all three paper-based self-report surveys, irrespective of whether they had attended or not attended an HAR appointment. Results: (a) There was no significant difference in gender or source of funding for hearing services between HAR appointment attendees and nonattendees. HAR nonattendees lived a greater distance from their clinic and were younger than attendees. (b) Survey completion did not influence HAR appointment attendance rates. (c) A significant reduction in individuals' self-reported hearing aid problems was recorded following the attendance at the HAR appointment. No significant changes in hearing aid management skills or overall hearing aid outcomes were detected. Conclusions: Long travel distances may be a barrier to attendance at review appointments. HAR appointments appear to be effective in improving hearing aid problems. [ABSTRACT FROM AUTHOR]

Purpose: This research assessed the feasibility and construct validity of ecological momentary assessment in capturing the hearing experiences of adults with mild hearing impairment in natural environments. Method: Twenty-nine adults between the ages of 55 and 79 years (M = 69 years) answered multiple surveys on a smartphone app over a 2-week trial. Participants also wore 1 environmental classifier and a streamer allowing bidirectional communication between smartphone and classifier. Surveys were triggered based on defined criteria, or by the participants. A paper-based self-report questionnaire was administered before and after the trial. Results: Feasibility was indicated by high compliance rates, with a total of 1,128 surveys completed. Of these, 72% were completed during a listening event, 26% within 1 hr, and only 2% of the surveys more than 1 hr after the listening event. The mean survey completion time was 1 min 40 s. Mean pre- and post-trial self-report scores were not significantly different, indicating no reactivity. Construct validity was indicated by the close agreement between subjective ratings of listening situations and objective data from the hearing aid classifier. Conclusions: Ecological momentary assessment is a feasible and valid research methodology for older adults with mild hearing impairment. The methodology has potential as a clinical counseling and outcome tool. [ABSTRACT FROM AUTHOR]

Purpose: Periodic reports of audiology clinical practice patterns, including acoustic reflex threshold (ART) protocols, provide insights into trends and assist in clinical decision making. Therefore, the purpose of this study was to examine audiologists' ART protocols, factors influencing audiologists' decision to test, and considerations for mentoring Doctor of Audiology (AuD) students in ART testing. Method: This study used a paper survey distributed by mail to a random sample of audiologists. Participants were 102 audiologists, representing diversity across age, clinical experience, and work setting. The survey asked participants to provide (a) demographics, (b) ART protocols, (c) rationale for ART testing, and (d) perspectives on mentoring of ART testing. Results: When ART testing is conducted, 100%of respondents conduct ipsilateral ART testing, compared to 75% for contralateral testing. Most use 500-, 1000-, and 2000-Hz stimulus frequencies, and 56% report 4000 Hz. Patient-related factors are the primary reason participants cite for conducting, or not conducting, ART tests. Most supervisor-participants encourage AuD students to conduct ART tests, based on patient-centered and student learning--centered reasons, and use a variety of strategies to guide students when ART findings are unusual. Conclusions: Fewer than half (43%) of participants conduct ART testing for all new patients, suggesting it is ancillary to the standard test battery for most participants. When ART testing is conducted, ipsilateral testing only or a combination of ipsilateral and contralateral testing is used. Ongoing trends in ART testing include continued popularity of 500--2000 Hz and ipsilateral-only or ipsilateral plus contralateral testing. [ABSTRACT FROM AUTHOR]

Purpose: Hearing aid management describes the skills and knowledge required for the handling, use, care, and maintenance of the hearing aid. The importance of hearing aid management skills and knowledge is evidenced by their association with hearing aid outcomes. However, the nature of this association and the influence of participant factors on this association are unknown. Accordingly, the aims of the current study were to (a) investigate participant factors that influence hearing aid management skills and knowledge and (b) investigate the impact of hearing aid management skills and knowledge on hearing aid outcomes. Method: Factors associated with hearing aid management skills and knowledge were investigated through an e-mail-- and paper-based self-report survey, including the Hearing Aid Skills and Knowledge Inventory (Bennett, Meyer, Eikelboom, & Atlas, 2018b) and the International Outcomes Inventory for Hearing Aids (Cox & Alexander, 2002). The study sample included 518 adult hearing aid owners, ranging in age from 18 to 97 years (M = 71 years, SD = 14 years), 61% male and 39% female, recruited from seven hearing clinics across Australia. Results: Participant factors found to be associated with hearing aid skills and knowledge included participants' age, gender, style of hearing aid, age of current hearing aid, and total years of hearing aid ownership. Higher levels of hearing aid management skills and knowledge were found to be associated with better hearing aid outcomes, specifically higher self-reported satisfaction with hearing aids, perceived benefit from hearing aids, and overall outcome of the hearing aid fitting as evaluated by the International Outcomes Inventory for Hearing Aids. Conclusions: Hearing aid management difficulties were greatest for older people, women, and owners of behind-the-ear style of hearing aids, suggesting that clinicians need to be cognizant of the additional needs for these three groups. The positive association between hearing aid outcomes and hearing aid skills and knowledge emphasizes the importance of education and training on hearing aid management for successful aural rehabilitation. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the reliability and validity of the Turkish version of the 40-item Vanderbilt Fatigue Scale for Adults (TR-VFS-A-40). Method: This study included 317 adults with no hearing loss and 260 adults with hearing loss in the study group, totaling 577 adults aged 18--75 years. While 31 adults in the study group did not use any hearing technology, there were 96 hearing aid users and 123 cochlear implant (CI) users. A subset of 80 CI users completed the TR-VFS-A-40 a second time, 2 weeks later, to assess test--retest reliability. Intraclass correlation coefficients were used to assess test--retest reliability. Cronbach's alpha was used to evaluate internal consistency. To examine construct validity, a confirmatory factor analysis (CFA) was performed. For concurrent validity analysis, the Checklist Individual Strength (CIS) and TR-VFS-A-40 scores were analyzed using the Spearman correlation test. Results: Cronbach's alpha values were excellent for the total scale of .987 and the cognitive, emotional, physical, and social subscales (.953, .954, .955, and .946, respectively). Analyses of concurrent validity revealed strong and significant correlations between CIS and TR-VFS-A-40 scores, indicating a good concurrent validity. The CFA determined that the construct validity of the TR-VFSA- 40 was satisfactory. Conclusion: The TR-VFS-A-40 is a valid and reliable measure of LRF. [ABSTRACT FROM AUTHOR]

Purpose: This study examined children's ability to perceive speech from multiple locations on the horizontal plane. Children with hearing loss were compared to normal-hearing peers while using amplification with and without advanced noise management. Method: Participants were 21 children with normal hearing (9-15 years) and 12 children with moderate symmetrical hearing loss (11-15 years). Word recognition, nonword detection, and word recall were assessed. Stimuli were presented randomly from multiple discrete locations in multitalker noise. Children with hearing loss were fit with devices having separate omnidirectional and noise management programs. The noise management feature is designed to preserve audibility in noise by rapidly analyzing input from all locations and reducing the noise management when speech is detected from locations around the hearing aid user. Results: Significant effects of left/right and front/back lateralization occurred as well as effects of hearing loss and hearing aid noise management. Children with normal hearing experienced a left-side advantage for word recognition and a right-side advantage for nonword detection. Children with hearing loss demonstrated poorer performance overall on all tasks with better word recognition from the back, and word recall from the right, in the omnidirectional condition. With noise management, performance improved from the front compared to the back for all three tasks and from the right for word recognition and word recall. Conclusions: The shape of children's local speech intelligibility on the horizontal plane is not omnidirectional. It is task dependent and shaped further by hearing loss and hearing aid signal processing. Front/back shifts in children with hearing loss are consistent with the behavior of hearing aid noise management, while the right-side biases observed in both groups are consistent with the effects of specialized speech processing in the left hemisphere of the brain. [ABSTRACT FROM AUTHOR]

Purpose: Tinnitus is highly prevalent among U.S. military Veterans, yet referral to, and use of, tinnitus rehabilitation services to improve quality of life and functional status with tinnitus is low. Veterans with tinnitus often have other health issues that overlap or exacerbate the impact of tinnitus, potentially complicating referral and rehabilitative pathways. This qualitative study explores views on the daily impacts of tinnitus and experiences with tinnitus-related health care among Veterans. The goal of this research is to amplify the voices of Veterans regarding their experiences with tinnitus to illuminate the physiological and socioemotional sequelae associated with the condition and to increase clinician awareness of the complex, interdisciplinary rehabilitative needs among Veterans with bothersome tinnitus. Method: This qualitative study was part of a larger study about tinnitus and traumatic brain injury (TBI). Veterans were sampled to represent national Department of Veterans Affairs (VA) users with and without comorbid TBI, and who were or were not interested in tinnitus rehabilitation services. Forty Veterans with tinnitus were interviewed (32 men, eight women). Data were analyzed using a modified grounded theory approach. Results: Major themes across the Veteran interviews included (a) functional effects of tinnitus on daily life, (b) tinnitus and other health conditions, (c) reactions to the lack of a cure for tinnitus, (d) strategies to improve quality of life and function, and (e) use of VA services for tinnitus. Conclusions: Our findings highlight that bothersome tinnitus negatively impacted various aspects of daily functioning, including communication, sleep, concentration, and mood, suggesting a need for audiologists to work closely with mental health services to improve quality of life and functional status for those negatively impacted by the condition. Future work is needed to obtain the viewpoints of clinicians and other health care partners to better understand the barriers and facilitators to providing evidence-based tinnitus treatment in VA and non-VA settings. [ABSTRACT FROM AUTHOR]

Purpose: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a randomized clinical trial designed to determine the effects of a bestpractice hearing intervention versus a successful aging health education control intervention on cognitive decline among community-dwelling older adults with untreated mild-to-moderate hearing loss. We describe the baseline audiologic characteristics of the ACHIEVE participants. Method: Participants aged 70-84 years (N = 977; Mage = 76.8) were enrolled at four U.S. sites through two recruitment routes: (a) an ongoing longitudinal study and (b) de novo through the community. Participants underwent diagnostic evaluation including otoscopy, tympanometry, pure-tone and speech audiometry, speech-in-noise testing, and provided self-reported hearing abilities. Baseline characteristics are reported as frequencies (percentages) for categorical variables or medians (interquartiles, Q1-Q3) for continuous variables. Between-groups comparisons were conducted using chi-square tests for categorical variables or Kruskal--Wallis test for continuous variables. Spearman correlations assessed relationships between measured hearing function and self-reported hearing handicap. Results: The median four-frequency pure-tone average of the better ear was 39 dB HL, and the median speech-in-noise performance was a 6-dB SNR loss, indicating mild speech-in-noise difficulty. No clinically meaningful differences were found across sites. Significant differences in subjective measures were found for recruitment route. Expected correlations between hearing measurements and self-reported handicap were found. Conclusions: The extensive baseline audiologic characteristics reported here will inform future analyses examining associations between hearing loss and cognitive decline. The final ACHIEVE data set will be publicly available for use among the scientific community. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to reveal occupational effects on the hearing of hot air balloon (HAB) pilots and examine the relationship between the duration of experience and these effects. Method: This study included 31 male HAB pilots and a control group of 32 male participants. Tympanometry, eustachian tube function (ETF) test, pure-tone audiometry, and transient evoked otoacoustic emission (TEOAE) tests were performed. Results: Pure-tone audiometry results were significantly worse at 125, 500, and 6000 Hz in the right ear and 125, 500, 4000, and 6000 Hz in the left ear in the HAB group than the control group. Although tympanometry evaluation parameters did not differ between the HAB and control groups, ETF test was significantly worse in the HAB group than the controls bilaterally. TEOAE results were significantly worse at 1000, 2000, and 4000 Hz in the right ear and 4000 Hz in the left ear in the HAB group than the controls. There was a significant positive correlation for 125, 4000, 6000, and 8000 Hz between the duration of experience and right ear hearing thresholds. For the left ear, the duration of experience showed a significant positive correlation at 3000, 4000, 6000, and 8000 Hz. When the relationship between the duration of experience and TEOAE results was evaluated, a significant negative correlation was found at 4000 Hz in the left ear. Conclusion: In HAB pilots, in whom eustachian tube dysfunction is quite common, noise and high altitude affected hearing, especially low and high frequencies, and the duration of experience was found to be associated with hearing thresholds. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the effectiveness of television (TV) streaming on hearing aid user performance and satisfaction in quiet and in noise. Method: Twenty experienced hearing aid users were evaluated in quiet and in noise (5 dB SNR) under three hearing aid conditions: hearing aids, streaming with hearing aid microphones attenuated by 6 dB, and streaming with hearing aid microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the Synthetic Sentence Identification--Ipsilateral Competing Message (SSI-ICM) served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained. Results: Speech understanding was significantly better in quiet than in noise, and streaming improved performance in noise when the hearing aid microphones were muted. Sound quality satisfaction was significantly better in quiet than in noise but was not impacted significantly by the hearing aid settings. Speech clarity satisfaction was significantly better in quiet than in noise, and streaming improved satisfaction in noise when the hearing aid microphones were muted. More participants preferred streaming with the microphones muted in quiet, in noise, and overall; however, results did not reach statistical significance. Conclusions: Hearing aid users did not benefit from TV streaming with the microphones attenuated or muted when listening in quiet. TV streaming was more beneficial to hearing aid users when listening in noise with the microphones muted. Hearing aid users should be counseled on the impact of the hearing aid microphone settings when using a TV streamer, particularly in noise. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate students' academic and civic learning, with particular interest in cultural competence, gained through participation in the Speech, Language, and Hearing Sciences in Zambia study-abroad program. Method: Twelve female students participated in the program. Quantitative data collected included pre- and postprogram administration of the Public Affairs Scale (Levesque-Bristol & Cornelius-White, 2012) to measure changes in participants' civic learning. Qualitative data included journals, end-of-program reflection papers, videos, and researcher field notes. Feedback was also obtained from community-partner organizations via a questionnaire and rating scale. Results: Comparison of the pre- and postprogram Public Affairs Scale data showed a significant increase in cultural competence and a marginal increase in community engagement at the conclusion of the program. Qualitative data showed that participants' cultural awareness was increased, they benefited from hands-on learning, and they experienced a variety of emotions and emotional and personal growth. Conclusions: Results show that a short-term study-abroad program with a service-learning component can be a mechanism for students to enhance academic and civic learning, specifically cultural competence and clinical skills. Sustainability of programs is a challenge that needs to be addressed. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this study was to examine the factors associated with long-term outcomes of postconcussive disruptive dizziness in Veterans of the post-9/11 wars. Method: For this observational cohort study, the Neurobehavioral Symptom Inventory--Vestibular subscale (NSI-V) score was used as an outcome measure for dizziness in 987 post-9/11 Veterans who indicated disruptive dizziness at an initial Veterans Health Administration Comprehensive Traumatic Brain Injury Evaluation (CTBIE). An NSI-V change score was calculated as the difference in the scores obtained at the initial CTBIE and on a subsequent survey. Differences in the NSI-V change scores were examined for demographics, injury characteristics, comorbidities, and vestibular and balance function variables, and multiple linear regression analyses were used to explore associations among the variables and the NSI-V change score. Results: The majority of Veterans (61%) demonstrated a decrease in the NSI-V score, suggesting less dizziness on the survey compared with the CTBIE; 16% showed no change; and 22% had a higher score. Significant differences in the NSI-V change score were observed for traumatic brain injury (TBI) status, diagnoses of post-traumatic stress disorder (PTSD), headache and insomnia, and vestibular function. Multivariate regressions revealed significant associations between the NSI-V change score and the initial CTBIE NSI-V score, education level, race/ ethnicity, TBI status, diagnoses of PTSD or hearing loss, and vestibular function. Conclusions: Postconcussive dizziness can continue for years following an injury. Factors associated with poor prognosis include TBI, diagnoses of PTSD or hearing loss, abnormal vestibular function, increased age, identification as a Black Veteran, and high school education level. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were to (a) describe normative ranges-- expressed as reference intervals (RIs)--for vestibular and balance function tests in a cohort of Service Members and Veterans (SMVs) and (b) to describe the interrater reliability of these tests. Method: As part of the Defense and Veterans Brain Injury Center (DVBIC)/Traumatic Brain Injury Center of Excellence 15-year Longitudinal Traumatic Brain Injury (TBI) Study, participants completed the following: vestibulo-ocular reflex suppression, visual-vestibular enhancement, subjective visual vertical, subjective visual horizontal, sinusoidal harmonic acceleration, the computerized rotational head impulse test (crHIT), and the sensory organization test. RIs were calculated using nonparametric methods and interrater reliability was assessed using intraclass correlation coefficients between three audiologists who independently reviewed and cleaned the data. Results: Reference populations for each outcome measure comprised 40 to 72 individuals, 19 to 61 years of age, who served either as noninjured controls (NIC) or injured controls (IC) in the 15-year study; none had a history of TBI or blast exposure. A subset of 15 SMVs from the NIC, IC, and TBI groups were included in the interrater reliability calculations. RIs are reported for 27 outcome measures from the seven rotational vestibular and balance tests. Interrater reliability was considered excellent for all tests except the crHIT, which was found to have good interrater reliability. Conclusion: This study provides clinicians and scientists with important information regarding normative ranges and interrater reliability for rotational vestibular and balance tests in SMVs. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive behavioral therapy (CBT) is a gold standard yet underutilized treatment for tinnitus, and tinnitus is especially highly prevalent among veterans. The aims of this study were twofold: to determine (a) if CBT for tinnitus is underutilized because participants find it less acceptable than other behavioral treatments for tinnitus and (b) if veterans and nonveterans rate behavioral treatments for tinnitus differently. Method: This cross-sectional study was conducted online with a sample of 277 adults in the United States who self-reported at least some level of bothersome tinnitus in the past week. The sample for this study consisted of 129 veterans and 148 nonveterans. Participants read descriptions of CBT, tinnitus retraining therapy (TRT), and mindfulness-based stress reduction (MBSR). For each treatment, presented to them in random order, they provided credibility, expectancy, and acceptability ratings. Results: Among 277 participants, 147 (53.07%) reporting gender were women, 216 (77.98%) reporting race/ethnicity were White, and 129 (46.57%) were veterans of any branch of the U.S. Armed Forces. Veteran ratings of credibility, expectancy, and acceptability were significantly lower than nonveteran ratings across treatments. There were differences in credibility, expectancy, and acceptability ratings across treatments, and post hoc testing revealed that TRT was consistently rated higher than CBT or MBSR. Conclusions: Despite strong research support, CBT was rated as less acceptable than a different, less widely empirically supported treatment. Veterans' ratings of acceptability were lower than those of nonveterans across all treatments. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the effectiveness of an Internet delivered Mindfulness Based Tinnitus Stress Reduction (i-MBTSR) program during the COVID-19 pandemic. Tinnitus, often a chronic condition, is experienced by 15% of the population. For those with severe, bothersome tinnitus, quality of life is reduced and the treatment options are limited. We evaluated an approach intended to decrease tinnitus-related distress. Method: This study examined the data collected for an online i-MBTSR course using a retrospective design. The intervention included an 8-week self-paced i-MBTSR course, including didactic information about mindfulness and tinnitus, as well as meditation practices. Outcome measures included the Tinnitus Functional Index (TFI) and Perceived Stress Scale (PSS), which were measured at four time periods. These time points included pretreatment, midtreatment at 3 weeks, immediately posttreatment, and at 6-month follow-up. Results: Forty-three participants completed the intervention. The mean preintervention tinnitus severity rating was 59.96 ("severe tinnitus") as measured by the TFI. Mean TFI scores dropped to 44.16 (p < .001) at midtreatment and to 34.23 (p = .001) at posttreatment. Repeated-measures analysis of variance and multivariate analysis of variance tests were conducted to determine changes in the two scales at the four time periods. There were significant differences in perceived stress and tinnitus self-function found in all measures and submeasures between the pre-, mid-, and posttreatment time points with the exception of the TFI Auditory subtest. These gains remained significant for those who completed the 6-month follow-up. Conclusions: The i-MBTSR course appears to be a viable and effective treatment modality. A shorter 3-week course may be effective. Case-control studies to more systematically investigate the effectiveness of i-MBTSR for tinnitus are required. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to generate a conceptual framework describing which aspects of children and adolescents’ lives are affected by chronic tinnitus. Design: Views and experiences of 32 participants from two participant groups informed this study: (a) a tinnitus group, consisting of adults who had experienced tinnitus during childhood and/or adolescence and primary carers of children/ adolescents with tinnitus, and (b) a clinicians’ group, consisting of clinicians who provided care for children/adolescents with tinnitus. Participants produced statements describing aspects of children/adolescents’ lives that may be affected by chronic tinnitus. Key concepts were identified through the processes of sorting the statements and rating them for degree of associated impact. Result: Participants identified 118 unique aspects of the lives of children/adolescents who may be affected by chronic tinnitus. These were clustered into four concepts: (a) emotional well-being, (b) academic performances, (c) social/relations, and (d) auditory/cognitive processing. At a group level, participants rated the impact of tinnitus as above a slight degree but below a moderate degree of impact. However, individual participant’s ratings indicated a range of perceived impact for each statement. Conclusions: The experience of chronic tinnitus during childhood and adolescence extends beyond the mere perception of sound. The perception of tinnitus may impact a child’s emotional well-being, academic performances, social/relational, and auditory/cognitive processing. The impact of tinnitus in one aspect of a child’s life may influence other aspects of their life. While at a group level, participants regarded the impact of tinnitus as “somewhat more than mild” to “less than moderate”; individual participant’s ratings indicate that the impact from chronic tinnitus may be highly individual and highlighted the importance of individual assessment and management. Clinically, tinnitus management during childhood and adolescence may be improved if clinicians consider the impact and manifestation of tinnitus within each child’s daily life and tailor tinnitus education and management strategies accordingly. [ABSTRACT FROM AUTHOR]

Purpose: No gold standard criteria exist for diagnosing developmental auditory processing disorder (APD). This study aimed to identify APD criteria, which are consistent with that used for comorbidities, and how comorbidities predicted APD. Method: A retrospective study of 167 participants (males = 105, females = 62; age: 6--16 years; nonverbal IQ > 80) with suspected APD is presented. Five SCAN-3 tests evaluated auditory processing (AP). Comorbidities included attentiondeficit/ hyperactivity disorder, language impairment, and impaired manual dexterity, which were identified using percentile ≤ 5 in the Swanson, Nolan and Pelham parental rating scale; Children's Communication Checklist-2; and Movement Assessment Battery for Children-2, respectively. Results: Percentiles ≤ 9, ≤ 5, and < 2 in two or more AP tests had sensitivities (specificities) of 76% (70.6%), 59.3% (76.5%), and 26% (82.4%), respectively, in predicting comorbidities, which were present in 150 of the 167 participants. The criterion of "≤ 9 percentile in two or more AP tests" (Approach I) diagnosed APD in 119 participants, and criterion "≤ 5 percentile in two or more AP tests or ≤ 5 percentile in one AP plus one or more measures of comorbidities" (Approach II) diagnosed 123. The combination of approaches diagnosed 128 participants (76.6%) with APD, of which 114 were diagnosed by each approach (89%). Language impairment and impaired manual dexterity, but not attention-deficit/ hyperactivity disorder, predicted APD. Conclusions: "Percentile ≤ 9 in two or more AP tests" or "percentile ≤ 5 in one AP plus one or more measures of comorbidities" are evidence-based APD diagnostic criteria. Holistic and interprofessional practice evaluating comorbidities including motor skills is important for APD. [ABSTRACT FROM AUTHOR]

Purpose: This exploratory study assessed the perceptual, cognitive, and academic learning effects of an adaptive, integrated, directionality, and noise reduction hearing aid program in pediatric users. Method: Fifteen pediatric hearing aid users (6--12 years old) received new bilateral, individually fitted Oticon Opn hearing aids programmed with OpenSound Navigator (OSN) processing. Word recognition in noise, sentence repetition in quiet, nonword repetition, vocabulary learning, selective attention, executive function, memory, and reading and mathematical abilities were measured within 1 week of the initial hearing aid fitting and 2 months post fit. Caregivers completed questionnaires assessing their child's listening and communication abilities prior to study enrollment and after 2 months of using the study hearing aids. Results: Caregiver reporting indicated significant improvements in speech and sound perception, spatial sound awareness, and the ability to participate in conversations. However, there was no positive change in performance in any of the measured skills. Mathematical scores significantly declined after 2 months. Conclusions: OSN provided a perceived improvement in functional benefit, compared to their previous hearing aids, as reported by caregivers. However, there was no positive change in listening skills, cognition, and academic success after 2 months of using OSN. Findings may have been impacted by reporter bias, limited sample size, and a relatively short trial period. This study took place during the summer when participants were out of school, which may have influenced the decline in mathematical scores. The results support further exploration with age- and audiogrammatched controls, larger sample sizes, and longer test-- retest intervals that correspond to the academic school year. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate reallife benefit from directional microphone and noise reduction ("noise management" [NM]) processing using retrospective self-reports and smartphone-based ecological momentary assessments (EMAs) combined with logging of the acoustic environments. Method: A single-blinded, counterbalanced crossover design was used. Eleven hearing-impaired adults were bilaterally fitted with behind-the-ear devices with NM either activated (NMON) or deactivated. For the retrospective self-reports, the short scale of the Speech, Spatial, and Qualities Hearing Scale questionnaire (SSQ12) was applied. For the EMAs, smartphone-based self-reports combined with hearing aid (HA)--based classifications of the listening environments ("soundscapes") experienced by the participants was used. To explore potential associations with the real-life data, two laboratory measures of aided speech recognition in noise were administered. Results: The soundscapes in which the participants submitted their EMAs were representative of the soundscapes they experienced during normal HA use and of the soundscapes reported in the literature for older HA users. The SSQ12 and EMA scores both showed an overall benefit from NMON. The EMA scores, together with the logged acoustic data, revealed that this benefit was driven by NMON being preferred particularly in listening environments classified as "speech" or "speech in noise." The laboratory measures of aided speech recognition in noise were unable to predict the real-life data. Conclusions: EMA combined with acoustic data-logging is suited for more targeted evaluations of real-life HA benefit. Advanced NM settings can provide subjective user benefits in specific listening situations. [ABSTRACT FROM AUTHOR]

Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitusrelated services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients' selfefficacy, engagement, and motivation to complete the intervention. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare questionnaire-based and performance-based screening tools as predictors of an auditory processing disorder (APD) diagnosis. The questionnaire-based screening tools used were the Children's Auditory Performance Scale, Fisher's Auditory Problems Checklist, and Buffalo Model Questionnaire--Revised. The performance-based screening tools were from the SCAN-3 screening tests, that is, Auditory Figure Ground, Competing Words Free Recall (CW-FR), and Gap Detection Test. Predictability was ascertained by comparing the scores from screening tools with those from diagnostic APD tests and with the final diagnosis of APD. Research Design: This study is a retrospective singleobservation study. Method: The screening and diagnostic test results were retrospectively analyzed from the medical records of 85 individuals (female = 39) aged 7-23 years who were seen for APD assessment at Bloomsburg University's Clinic for Hearing and Balance. Each participant was assessed with at least two questionnaire-based and at least two performance-based screening tools. Results: Spearman correlation coefficient analysis showed a moderate relationship within questionnaire-based screening tools, whereas there was no relationship between questionnaire- and performance-based tools. Notably, the performance-based CW-FR screening tool showed a significant relationship with five diagnostic tests. The questionnaire-based screening tools did not predict APD diagnosis. The performance-based tool CW-FR (φ = 0.33) and the SCAN-3 screening battery (φ = 0.44) predicted the diagnosis of APD. Conclusion: A performance-based screening tool or battery can be used to determine whether additional diagnostic APD evaluation is warranted. Referral for diagnostic assessment should not be based solely on questionnairebased screening tools. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to preliminarily investigate the sentiments associated with consumer opinions of personal sound amplification products (PSAPs). Method: Online reviews of 21 popular PSAPs were collected from the Amazon.com website. The reviews for each product were exported to compile individual product-specific text files. A sentiment mining analysis was completed to aggregate the number of positive and negative comments for each product. In addition, the effect of value for money, available features, perceived benefit, and overall perception of PSAPs was evaluated. A correlational analysis was completed to examine the relationship between different PSAP features and the number of positive and negative comments. Results: Mixed-model analysis of variance showed a significantly higher number of positive comments for high-and mid-cost products in terms of overall perception and perceived benefit compared to low-cost products. For feature attribute, high-cost products had significantly higher positive comments compared to mid- and low-cost products. There was a strong correlation between price and positive comments and a moderate correlation between price and negative comments. Also, there was a significant moderate correlation between presence of compression and feedback suppression PSAP features and positive comments. Conclusions: Positive sentiments expressed toward PSAPs were found to favor high- and mid-level products. However, there was a considerably high number of negative sentiments reported across all the PSAPs investigated. The noticeable thing is that the negative comments do not change significantly across price ranges. However, the positive comments significantly increase with an increase in product price range. This indicates a possible increase in benefit with high-cost products. However, this claim requires further empirical evidence through controlled studies. [ABSTRACT FROM AUTHOR]

Purpose: Previous research suggests the existence of gap detection impairments because of tinnitus. The current study aimed to determine whether there was objective evidence of gap impairment in individuals with tinnitus by recording silent gap in white noise cortical auditory evoked potentials (CAEPs) in a chronic tinnitus group and a no- tinnitus group. The results were compared to previous gap- evoked potential and behavioral gap detection studies. Method: Chronic tinnitus and no-tinnitus groups were formed by matching pairs of subjects (n = 26) based on age, gender, and hearing thresholds. Behaviorally determined gap detection thresholds were used to define the electrophysiological gap duration conditions of subthreshold, threshold, and suprathreshold gaps in white noise. Amplitude, latency, and area of the CAEP were analyzed by group and condition using mixed-model analyses of variance. Results: Across all participants, as the duration of the gap increased, amplitude and area of the CAEP increased. There were no significant differences by tinnitus status between groups for any outcome measures, except for a significant interaction between group and gap duration for P1 latency. Conclusions: Silent gap-evoked CAEPs can be recorded in adults with and without tinnitus. Amplitude and area were sensitive to gap duration across groups; latency was not. Contrary to hypotheses, there was little evidence supporting differences in gap-evoked CAEPs between the tinnitus and control groups. Stimulus and other factors that may have contributed to the lack of a group difference in the current study are discussed, as well as implications for future studies of objective measures of tinnitus perception. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to determine whether short-term experience (i.e., 4 weeks) with a smartphone-based hearing aid application (SHAA) might positively improve attitudes toward amplification uptake and hearing impairment. Method: We recruited 15 experienced hearing aid wearers who had ceased wearing their devices for > 1 year (i.e., "In-the-Drawer" group) and 15 individuals with self-reported hearing difficulties who had yet to adopt hearing aids (i.e., "First-Time" group). We obtained participant attitudes preand post-SHAA using 3 surveys and analyzed perceptible changes in attitude for each survey. Comparative findings were then generalized to the health belief model in the context of perceived benefits (i.e., efficacy of an action to reduce risk) and reduced perceived barriers (i.e., tangible and psychological costs that inhibit compliance and adoption). Results: A short trial period with an SHAA appears to modify the psychological perception toward amplification and reduce listener perception with respect to hearing difficulties in both groups. Conclusion: A short trial period with an SHAA improved the perceived benefits and reduced the perceived barriers in the average First-Time listener, who often delays adoption of traditional amplification. The same trial period was also found to improve perceived benefits and reduce perceived barriers for the average In-the-Drawer listener, but to a lesser degree than their First-Time counterparts. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the benefit of self-adjusted personal sound amplification products (PSAPs) to audiologist-fitted hearing aids based on speech recognition, listening effort, and sound quality in ecologically relevant test conditions to estimate real-world effectiveness. Method: Twenty-five older adults with bilateral mild-tomoderate hearing loss completed the single-blinded, crossover study. Participants underwent aided testing using 3 PSAPs and a traditional hearing aid, as well as unaided testing. PSAPs were adjusted based on participant preference, whereas the hearing aid was configured using best-practice verification protocols. Audibility provided by the devices was quantified using the Speech Intelligibility Index (American National Standards Institute, 2012). Outcome measures assessing speech recognition, listening effort, and sound quality were administered in ecologically relevant laboratory conditions designed to represent real-world speech listening situations. Results: All devices significantly improved Speech Intelligibility Index compared to unaided listening, with the hearing aid providing more audibility than all PSAPs. Results further revealed that, in general, the hearing aid improved speech recognition performance and reduced listening effort significantly more than all PSAPs. Few differences in sound quality were observed between devices. All PSAPs improved speech recognition and listening effort compared to unaided testing. Conclusions: Hearing aids fitted using best-practice verification protocols were capable of providing more aided audibility, better speech recognition performance, and lower listening effort compared to the PSAPs tested in the current study. Differences in sound quality between the devices were minimal. However, because all PSAPs tested in the study significantly improved participants' speech recognition performance and reduced listening effort compared to unaided listening, PSAPs could serve as a budget-friendly option for those who cannot afford traditional amplification. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Method: Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. Results: More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-Ha total score and average hearing threshold level (pure-tone average [PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. Conclusions: When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in pTa for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers. [ABSTRACT FROM AUTHOR]

Purpose: The primary purposes of this study were to examine the effects of hearing loss and respondent type (self- vs. parent-proxy report) on subjective fatigue in children. We also examined associations between child-specific factors and fatigue ratings. Method: Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS; Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). We compared self- and parent-proxy ratings from 60 children with hearing loss (CHL) and 43 children with normal hearing (CNH). The children ranged in age from 6 to 12 years. Results: School-age CHL experienced more overall and cognitive fatigue than CNH, although the differences were smaller than previously reported. Parent-proxy report was not strongly associated with child self-report, and parents tended to underestimate their child's fatigue, particularly sleep/rest fatigue. Language ability was also associated with subjective fatigue. For CHL and CNH, as language abilities increased, cognitive fatigue decreased. Conclusions: School-age CHL experience more subjective fatigue than CNH. The poor association between parent-proxy and child reports suggests that the parent-proxy version of the PedsQL-MFS should not be used in isolation when assessing fatigue in school-age children. Future research should examine how language abilities may modulate fatigue and its potential academic consequences in CHL. [ABSTRACT FROM AUTHOR]