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Objectives: Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision., Design: A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male., Results: Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision., Conclusions: Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.

This is an abridged translation of a recent Dutch consensus on diagnosis and treatment of hearing impairment in children and adults with intellectual disability. Available diagnostic methods are discussed. The use of Oto-Acoustic Emissions as a rapid and low-cost objective screening method is particularly encouraged. Risk groups, protocols for early identification and diagnostic screening in older children and adults, recommendations for treatment and support, and priorities for research have been formulated.

Successful rehabilitation of the profoundly hearing impaired by means of a speech-processing hearing aid requires integration of auditory and visual speech information. In two studies we investigated (1) which perceptual dimensions play a role in processing various auditory patterns by profoundly hearing-impaired subjects, and (2) which Dutch consonants and vowels can be identified by the average lipreader. One of the important cues in auditory pattern discrimination seems to be the presence of temporal fluctuations (beats) in the signal, resulting from two closely placed frequency components. However, this feature is confounded with the perception of loudness. A second cue used by some subjects is the presence of high-frequency peaks. In lipreading, at least three groups of consonants and three vowel groups may be distinguished; phonemes within a group cannot be discriminated from each other. Important features for both consonants and vowels are degree of lip opening and lip activity (movement or rounding). These results suggest how the auditory speech signal might be coded so as to provide supplementary information to speechreading.