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Purpose: The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. Method: A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information. Results: A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest. Conclusions: Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.

Purpose: The purpose was to examine author-level impact metrics for faculty in the communication sciences and disorder research field across a variety of databases. Method: Author-level impact metrics were collected for faculty from 257 accredited universities in the United States and Canada. Three databases (i.e., Google Scholar, ResearchGate, and Scopus) were utilized. Results: Faculty expertise was in audiology (24.4%; n = 490) and speech-language pathology (75.6%; n = 1,520). Women comprised 68.1% of faculty, and men comprised 31.9% of faculty. The percentage of faculty in the field of communication sciences and disorders identified in each database was 10.5% (n = 212), 44.0% (n = 885), and 84.4% (n = 1,696) for Google Scholar, ResearchGate, and Scopus, respectively. In general, author-level impact metrics were positively skewed. Metric values increased significantly with increasing academic rank (p < 0.05), were greater for men versus women (p < 0.05), and were greater for those in audiology versus speech-language pathology (p < 0.05). There were statistically significant positive correlations between all author-level metrics (p < 0.01). Conclusions: These author-level metrics may serve as a benchmark for scholarly production of those in the field of communication sciences and disorders and may assist with professional identity management, tenure and promotion review, grant applications, and employment.

State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the newborn hearing screening area, a total of 293 items were listed by 49 EHDI coordinators, and themes were identified within each SWOT category. A threats, opportunities, weaknesses, and strengths, or TOWS, analysis yielded 12 recommendations that focused on similar themes. Out of these 12 recommendations, 3 distinct strategies emerged. States are encouraged to: 1) enhance existing screening practices by requiring systematic data collection, reporting, and automation as well as integration of universal newborn hearing screening database systems with other public health initiatives; 2) leverage existing state legislative support to update and expand current universal newborn hearing screening policies and garner increased resources (i.e., personnel and funding); and 3) reduce loss to follow-up by integrating and centralizing data collection and tracking among various agencies and addressing the screening needs of special populations (e.g., home births, non-native English speaking families, religious and cultural minorities). Addressed appropriately, these recommendations can substantially strengthen newborn hearing screening efforts in state EHDI programs. (Contains 6 tables.)

Pediatric audiologists play a vital role in detection, diagnosis, and intervention for young children with hearing loss and their families. Preparing the next generation of pediatric audiologists necessitates a creative approach that balances the requirements of a broad curriculum with the special skills needed to serve a unique and varied population of children who are deaf or hard of hearing and their families. Fortunately, many university programs across the United States have developed specialty tracks, and a growing number are working in partnership with government and other agencies to improve and expand personnel preparation in pediatric audiology. They are joined in this effort by a cadre of talented students who are genuinely committed to working with this population. Still, many challenges remain, among them the sustained financial resources needed to support graduate training programs and students. There is also a need to substantially increase the diversity of our work force in pediatric audiology. (Contains 3 tables.)

This directory lists programs in the United States and Canada for training teachers of the deaf, professional specialists, and interpreters for the deaf. Specialists include rehabilitation counselors, psychologists, audiologists, and media personnel. Programs are listed by state, and data usually include contact information, type of degree or certificate offered, and number of graduates. (DB)

Purpose: The purpose of this viewpoint is to outline and describe the Asian Pacific Islander (API) Speech-Language-Hearing Caucus's initiatives to promote diversity, equity, and inclusion for Asian Americans and Pacific Islanders (AAPIs) in speech-language pathology and audiology. Specifically, we discuss the caucus's efforts through research and community advocacy. Through research, the Counter Story Project, led by Breslin et al. (2022), was a qualitative study that documented and analyzed systemic racism experienced by AAPI professionals. Thematic findings revealed microaggressions in professional settings and racial overgeneralizations on AAPIs' communication and cultural upbringing. Through community advocacy, the caucus provides a wide array of programs and events, including Anti-Racism Learning Community, API Speaker Series, Bilingual Assessment and Treatment Resources, Career Panel, API Caucus Research and Clinical Symposium, Graduate School Panel, API Scholarship, and API Mentor-ship Program. Conclusion: Through these initiatives, the caucus strives for recruitment and retention of AAPI audiologists and speech-language pathologists to achieve its long-term mission of providing accessible and quality speech, language, and hearing services to AAPI communities in the United States. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine the hearing health care experience of satisfied and dissatisfied consumers as reported on Google reviews. Method: Using qualitative thematic analysis, open-text responses from Google regarding hearing health care clinics across 40 U.S. cities were examined. During the original search, 13,168 reviews were identified. Purposive sampling led to a total of 8,420 five-star reviews and 321 one-star reviews. The sample consisted of 500 five-star (satisfied) and 234 one-star (dissatisfied) reviews, describing experiences with audiology clinics, excluding reviews related to ear, nose, and throat services; other medical specialties; and those not relevant to hearing health care. Results: Satisfied and dissatisfied consumer reviews yielded nuanced dimensions of the hearing health care consumer experience, which were grouped into distinct domains, themes, and subthemes. Six and seven domains were identified from the satisfied and dissatisfied reviews, encompassing 23 and 26 themes, respectively. The overall experience domain revealed emotions ranging from contentment and gratitude to dissatisfaction and waning loyalty. The clinical outcomes domain highlights the pivotal contribution of well-being and hearing outcomes to the consumer experience, while the standard of care domain underscores shared expectations for punctuality, person-centered care, and efficient communication. Facility quality, professional competence, and inclusive care were also highlighted across positive and negative reviews. Conclusions: Findings indicate dimensions of satisfied and dissatisfied hearing health care consumer experiences, identifying areas for potential service refinement. These consumer experiences inform person-centric service delivery in hearing health care. [ABSTRACT FROM AUTHOR]

Purpose: The Joint Committee on Infant Hearing recommends hearing screening before 1 month of age, audiologic diagnosis before 3 months of age, and enrollment in early intervention before 6 months of age (1-3-6 benchmarks of Early Hearing Detection and Intervention [EHDI] programs). Nearly 98% of newborns have their hearing screened, but many, who do not pass or do not complete their newborn hearing screening, fail to complete the EHDI process. Historically, lower socioeconomic level, more complex infant health status, and farther geographical location reduce rates of EHDI follow-up, but levels vary widely across states. This study examined barriers to the EHDI process by comparing census-based variables at the state and regional levels to national and Texas EHDI outcomes, respectively. Method: We used correlational analysis to assess relationships between U.S. Census data (state- and region-specific population and geographic characteristics, sociodemographic and geographic factors, and health and health insurance) and EHDI data (newborn screening, audiologic diagnosis, and early intervention) at the national level and in Texas. Results: Nationally, higher labor force participation, lower unemployment rates, and presence of health insurance significantly correlated with higher rates of completing EHDI benchmarks. Larger population size and density and higher socioeconomic factors coincided with higher rates of completing the EHDI process and lower rates of loss to follow-up (LTF) or loss to documentation in Texas. Conclusions: Population, socioeconomic, and demographic factors significantly correlate with following through with the EHDI process, with weak correlations at the national level and strong correlations at the state level. These findings underscore the need to increase our attention to underserved, economically challenged, and/or geographically distanced families who have children with a higher risk of becoming LTF in the EHDI process. [ABSTRACT FROM AUTHOR]

Purpose: Regulatory changes in the United States introduced over-the-counter (OTC) hearing aids with the goal of increasing the accessibility and affordability of hearing health care. It is critical to understand the values inherent to hearing health care systems to evaluate their effectiveness in serving people with hearing difficulty. In this study, we evaluated the relative importance of values across service delivery models and the extent to which the introduction of OTC hearing aids represents a values shift relative to traditional audiology. Method: We performed a qualitative content analysis of two document categories: critique documents that motivated the creation of OTC hearing aids and regulatory documents that defined OTC hearing aids. Team members coded portions of text for the values they expressed. In total, 29,235 words were coded across 72 pages in four documents. Rank-order analyses were performed to determine the prioritization of values within each category of documents and subsequently compare values between OTC and traditional audiology documents analyzed in a previous study. Results: Critique and regulatory documents both prioritized values related to reducing barriers to hearing aid access and use, but the lack of a significant correlation in the rank order of values in these documents was evidence of inconsistency between the motivation and implementation of OTC hearing aids. Differences in the rank order of values in the OTC documents compared to traditional audiology were consistent with a values shift. Conclusions: The introduction of OTC as a solution to low hearing aid use represents a values shift, challenging the values of traditional audiology. This research demonstrates a need to establish the values of hearing health care service delivery through a consensus of stakeholders, including individuals from diverse backgrounds underserved by the traditional model. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is associated with a range of poor psychosocial outcomes. Cochlear implants (CI) are an available treatment option for significant hearing loss and have been linked to improved quality of life in patients. Evidence suggests that audiologists lack the skills to appropriately detect, address, and refer for psychosocial needs among patients with hearing loss. The objective of this study is to examine the attitudes and practice patterns related to psychosocial care among audiologists who work with CI users. Methods: A cross-sectional survey was administered to clinical audiologists who work with CI recipients in the United States. The survey evaluated participants’ attitudes toward psychosocial services and factors that contribute to their abilities to address the psychosocial needs of their patients. Additionally, participants were surveyed about their practice patterns including the use of psychosocial screeners, clinical protocols regarding psychosocial care, and referral patterns for coordinated psychosocial services. Descriptive statistics were used to summarize survey responses. Results: Sixty-eight audiologists completed the survey. Of these audiologists, a majority (73.6%) held the attitude that most or all CI patients would benefit from psychosocial intervention. Despite clinicians’ recognition of psychosocial needs in this population, over 90% of participants reported never screening for psychosocial symptoms. Additionally, a majority of respondents indicated that they seldom refer their patients for psychosocial services, with referrals occurring less than half the time (58%) or never (27%). Additionally, few audiologists reported utilizing protocols or resources for guiding psychosocial practices. Audiologists indicated that the primary factors that influence their psychosocial practices include time available to spend with the patient and their comfort level in counseling. Conclusion: Audiologists working with CI patients recognize the potential benefit of psychosocial intervention in this population. Nevertheless, audiologists encounter barriers in clinical practice which limit their ability to identify and address the psychosocial needs of their patients. Strategies designed to enhance audiologists’ capacity to recognize the psychosocial needs of CI users, in addition to improved interprofessional practice on CI teams, implies significant opportunities to improve the provision of patient-centered hearing care. [ABSTRACT FROM AUTHOR]

Purpose: Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis. Method: An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis. Results: Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy). Conclusions: Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis. Supplemental Material: https://doi.org/10.23641/asha.24431188 [ABSTRACT FROM AUTHOR]

The article discusses research which aimed to determine the impact of the audiology and geriatrics partnership on veterans' access to appropriate audiology care by reviewing 50 charts randomly selected via convenience samples from 2017 to 2018. Cited are the prevalence of hearing loss among a sample of veterans in a Geriatrics Consult clinic, barriers to receiving audiology care among older veterans, and lessons learned from the initiative to increase the access of hearing care services.

Purpose: The purpose of this study was to investigate if peer-reviewed randomized controlled trials (RCTs) for the management/treatment of tinnitus conducted in the United States include diverse participants in terms of gender, race/ethnicity, education, occupation, and income. Method: We performed a comprehensive and systematic literature search via PubMed, Web of Science, Clinical-Trials.gov, and the Cochrane Central Register of Controlled Trials. Our goal was to identify prospective RCTs of tinnitus intervention conducted in the United States from January 1994 to September 2021 and published in peer-reviewed journals. Results: A total of 2,584 studies were retrieved. Thirty-two peer-reviewed articles met all inclusion criteria. Of the included studies, approximately 96% reported participants' gender. Approximately 15% studies reported race/ethnicity information in alignment with the U.S. Census Bureau. However, an underrepresentation of both females and people of color was evident across studies. Reporting of socioeconomic status information of participants was also scarce, with only 25% studies reporting education and/or occupation of participants and 0% reporting income levels. Conclusions: This study indicates underrepresentation and underreporting of diverse participant pools in tinnitus research. Reasons for such underrepresentation are explored. Additionally, this systematic review indicates that recent research in tinnitus portrays an optimistic trend in terms of reporting and recruitment of diverse participant groups. Sustainable strategies for including diverse research participants are essential for hearing health care equity. Research and strategies to promote this goal are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this pilot study is to begin exploring the diversity, equity, and inclusion (DEI) initiatives being implemented by communication sciences and disorders (CSD) programs at various universities across the United States with the intent to guide and support future research studies. Method: Publicly available data of DEI initiatives used by CSD programs across the United States were utilized for this study. A three-step procedure was used to explore reported initiatives. First, responses were reviewed to determine whether the reported initiatives were focusing on diversity, equity, and/or inclusion. Second, each independent initiative was reviewed, and common themes were identified. Third, the reported impact of DEI initiatives on CSD programs was explored. Results: This study produced four major findings related to DEI initiatives in CSD programs: (a) The majority of CSD programs included in this study reported use of DEI initiatives focusing on inclusion; (b) CSD programs included in this study reported implementation of DEI initiatives that fall into seven themes; (c) CSD programs included in this study reported DEI initiative impact on students and a reduced number of programs reported impact on faculty, staff, and the community; and (d) the DEI initiatives of CSD programs included in this study appeared to vary according to university-level factors. Conclusions: There is a dearth of information relating to the use of DEI initiatives being implemented by CSD programs. The results of this pilot study can be used to implement future studies and programs with the ultimate goal of improving DEI in the fields of speech-language pathology and audiology. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between herpes simplex virus (HSV) and hearing loss using comprehensive population-based research., Design: This cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between HSV (types 1 and 2) and hearing loss. The final sample comprised 4608 participants aged 20-49 years. Weighted multivariate regression, subgroup and sensitivity analyses were employed for statistical evaluations., Setting: Utilising the NHANES data, this cross-sectional study provides insights into the American population aged 20-49 years., Participants: The study includes 4608 participants from the NHANES 2011-2012 and 2015-2016 cycles, focusing on those with complete data on HSV infection and hearing assessment., Interventions Exposure: The study analyses the association between HSV (types 1 and 2) infection and hearing loss, using weighted multivariate regression for statistical evaluations., Results: We observed an association between HSV-1 infection and an increased likelihood of hearing impairment (OR, 1.4 (95% CI 1.1 to 1.9)). A similar association was noted for those coinfected with HSV-1 and HSV-2 (OR, 1.6 (95% CI 1.1 to 2.3)). Similarly, higher grades of hearing loss and elevated pure-tone averages were more prevalent in these groups. Notably, the association between HSV-1 and hearing impairment was more pronounced in individuals aged 20-34 (OR, 2.1 (95% CI 1.4 to 3.3); P for interaction=0.020) and those with a body mass index (BMI) below 30 (OR, 1.8 (95% CI 1.1 to 2.8); P for interaction=0.028)., Conclusions: Our findings suggest an association between HSV-1 infection or coinfections with HSV-1 and HSV-2 and the presence of hearing impairment. The association appears particularly pronounced among younger individuals and those with a lower BMI. Further prospective research is needed to explore the causal impact of HSV on auditory function., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: Audiological services are underused, possibly because patients need to drive long distances to see a provider. In this study, we measured the association of drive times to the nearest audiologist with population density, income, ethnicity, race, and distance to the nearest audiology graduate program., Method: Drive times for each census block group to the nearest audiologist were measured using census data, the National Provider Identifier Registry, and a geographic analyzing tool called ArcGIS for all block groups within the United States. The association between drive times and population density, income, ethnicity, race, and audiology program distance was evaluated with a population density-matched case-control study and multiple linear regression analyses., Results: Approximately 5.29 million Americans need to drive at least 1 hr to visit their closest audiologist. The 10% most rural-dwelling Americans drive an average of 33.8 min. The population density-matched case-control study demonstrated that percent below poverty, percent identifying as Hispanic, and travel times to the nearest audiology program were all significantly higher in census block groups with high drive times to the nearest audiologist. An average of 7.96% of individuals in census block groups with low drive times identified as Hispanic, but 18.8% identified as Hispanic in high drive time groups. The multiple linear regression showed that the effect of demographics and distance to the nearest audiology program was highest in rural areas. In both analyses, adjusting for poverty did not drastically change the effect of percent identifying as Hispanic on drive times., Conclusions: Long drive times restrict access to audiological care for those who live in rural areas. This restriction disproportionately affects those in rural areas who identify as Hispanic or have low income.

Objective: The objective of this study was to obtain an understanding of audiologists' knowledge of Spanish speech perception materials for the paediatric hearing loss population., Design: An electronic survey, the Knowledge of Spanish Audiology & Speech Tools (KSAST) was distributed via Qualtrics to audiologists who worked with Spanish-speaking children., Study Sample: One hundred and fifty-three audiologists practicing in the United States completed the electronic survey over a period of six months., Results: Audiologists lacked knowledge of current Spanish measures and there was no consensus on what providers were administering for the paediatric population. The largest gaps in knowledge existed for the infancy through early childhood age groups. Notably, even when Spanish measures exist, audiologists reported feeling uncomfortable using them in clinic due to a variety of reasons (e.g., did not know how to access measure, did not know how to administer)., Conclusions: This study highlights the lack of consensus in managing Spanish-speaking patients with hearing loss. There is a lack of validated age-appropriate measures to accurately assess speech perception for Spanish-speaking children. Future research should focus on improving training on management of Spanish-speaking patients, as well as development of speech measures and best practice guidelines for this population.

Background Audiology is experiencing pressure from market forces that may change the profession's nature. Research suggests that understanding resistance needs to change and organizational culture may provide insights that can facilitate change. Purpose This study was designed to examine audiologists' resistance to change, organizational culture, and clinical practices related to hearing aid pricing and audiology assistants. Research Design This study utilized a cross-sectional and nonexperimental survey design. Study Sample Participants were 205 U.S. audiologists, representing diversity across experience, work setting, and location. Data Collection This survey examined demographics and clinical practice strategies. Resistance to change (RTC) scale examined disposition toward change. Organizational culture profile (OCP) examined organizational culture perspectives. Results The majority (52%) of respondents use bundled pricing but 42% of these repondents anticipate transitioning to unbundling. Use of hybrid pricing is increasing. Service-extender personnel were reported by 41%. Although the majority (66%) do not work with audiology assistants currently, 32% of these participants anticipate they will do so in the future. Results indicated lower RTC and greater years of experience were associated with more positive perceptions about organizational culture. Pricing structure was related to experience. Conclusion Trends indicate use of bundled pricing is decreasing, use of hybrid pricing is increasing, and employment of audiology assistants is increasing. Experienced audiologists are more likely to report unbundled and hybrid pricing compared with less experienced audiologists. [ABSTRACT FROM AUTHOR]

This study surveyed the effects of the COVID-19 pandemic on the audiology workplace. The study used a cross-sectional survey design for audiologists across the globe (n = 337) using an online survey (June–August 2020) focussing on changes to the workplace during the pandemic. Participants represented varied work settings and audiology services. Only a third (31.5%) provided psychosocial support, which may be important during the pandemic, as part of their services. Almost all (97%) audiologists reported changes to their workplace, with 76.4% reporting reduced caseloads during the COVID-19 pandemic. When rating their current and anticipated work conditions, 38.7% reported reduced working hours although only 13.8% anticipated reduced working hours in 6-months' time. Audiologists ranked services such as access to hearing assessment, hearing device adjustment and maintenance, and general audiological support as being more important during the pandemic than services such as psychosocial, emotional and tinnitus support. The COVID-19 pandemic has resulted in significant disruptions to audiological practice that highlights the need to adapt and incorporate new audiological practices including telehealth, to ensure patients have continued access to care and clinics remain sustainable during the ongoing COVID-19 pandemic and recovery phase. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to examine students' ability to use effective clinical collaboration online in a designed scaffolded environment. Three groups were formed to achieve this goal: two control groups (one using no collaboration and one using live, face-to-face collaboration) and one treatment group using virtual collaboration. Method: A quasi-experimental design was conducted at two U.S. universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computerbased audiology case simulations were developed, and participants were randomly placed into the three groups. The clinical reasoning data were analyzed using one-way analysis of variance and Tukey's post hoc analyses. Results: The results indicated that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no-collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Conclusions: The results imply that lower scores were associated with students receiving more instructor-designed content and higher scores with students receiving less instructor-designed content. Students who received more scaffolds with the collaborations may have demonstrated better decision-making outside the training exercise than those who did not receive scaffolds. However, lower scores on the exercise did not necessarily imply lower skill. Lower scores simply implied a different path toward mastery. [ABSTRACT FROM AUTHOR]

Healthcare policy decisions that affect the day-to-day work of an audiologist and his/her ability to best serve our patients occur every day. It is imperative that every professional participate in advocacy efforts; however, many audiologists are unfamiliar with current advocacy initiatives, how to participate, or how critical one phone call, email, or meeting could be in the legislative process. [ABSTRACT FROM AUTHOR]

Purpose: The study examined psychologically meaningful language dimensions (i.e., social and emotional dimensions, health dimensions, and personal concerns) within online consumer reviews on hearing health care services using an automated textual analysis approach. Method: Nine thousand six hundred twenty-two consumer reviews of hearing health care services, including an open- ended question (i.e., free text response to the prompt "share details of your own experience at this place") and an overall rating (on a 5-point scale ranging from "very good" to "very poor") were extracted from Google.com from 40 different cities across the United States.Inaddition,somemetadata about the cities (i.e., region, population size, median age, percentage of older adults) were also recorded. Text responses were analyzed using the automated Linguistic Inquiry and Word Count software for selected language dimensions. The language dimensions of online hearing health care reviews were descriptively compared with language dimensions observed in the natural language of typical bloggers. Language dimensions from free text responses were correlated with quantitative overall experience ratings. Results: Automated linguistic analysis showed that consumer reviews on hearing health care services had higher social processes, positive emotions, hearing, health, money, and work, and lower negative emotions and time-awareness when compared to typical bloggers. Examining the association between overall experience rating and the language dimensions revealed two broad findings. First, higher engagement of consumers in terms of social processes, positive emotions, hearing, and work dimensions was related to higher experience ratings. Second, higher engagement of consumers in terms of negative emotions, time awareness, and money was related to lower experience ratings. Conclusions: Online reviews contain information about various dimensions (i.e., social and emotional dimensions as well as personal concerns) that have bearing toward the way in that they rate their health care experiences. Automated linguistic analysis of consumer reviews appears helpful in identifying gaps in service delivery that may influence consumer experience. [ABSTRACT FROM AUTHOR]

Background Historically, the Deaf community and audiologists have had differing views concerning hearing loss intervention. Even so, members of the Deaf community may see an audiologist for a variety of reasons and it is important that audiologists understand how to best work with these individuals. Professional audiological organizations encourage cultural competence when working with different cultures, including the Deaf community. Purpose This study investigates audiologists' current cultural competency and exposure to, knowledge of, and attitudes towards Deaf individuals. Research Design A survey was sent out to 600 audiologists and descriptive analyses was completed. Data Collection and Analysis Study data were managed using REDCap electronic data capture tools and subsequently tabulated for each of the various survey questions. Results Findings indicate that audiologists have relatively limited exposure to this population in a clinical setting, most use interpreters, and most would like to take more ASL courses. Audiologists' attitudes were positive in serving members from the Deaf community. Conclusion Findings suggest that more education on the use of interpreters would be beneficial. Future research may include examining the Deaf community's experience with audiologists, and the impact of exposure and other variables on the knowledge of and interactions with this population. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the experiences and opinions of clinical educators from various allied health care fields, including audiology, related to the use of simulation as a teaching technique and determine the status of clinical simulation techniques in training audiology graduate students nationwide. Method: An interview was conducted with nine faculty members in the College of Health Professions at Towson University to discuss advantages and challenges of incorporating clinical simulation techniques into student learning. A thematic analysis was used to analyze the interview responses. Additionally, a web-based questionnaire was sent to all audiology graduate program directors nationwide, yielding a response rate of 63%. These data were analyzed using descriptive statistics. Results: Interview responses revealed a number of benefits and barriers related to simulation use at the graduate level. Benefits included its use as a learning tool, a quality control measure, and an aid in professional development. It also increases students' confidence levels in clinical procedures and counseling skills and exposes them to a variety of clinical pathologies not routinely seen. Barriers included lack of training with simulators, lack of funding to purchase simulator technology, and lack of resources, such as time and space. At present, only 50% of audiology program directors reported using clinical simulation to train their students. Conclusions: The field of audiology is embracing simulation techniques in training its preprofessional work force. To date, there has been limited guidance from professional organizations regarding the role of simulation in audiology. Additional assistance focusing on best practices for these techniques is warranted. [ABSTRACT FROM AUTHOR]

The demand for telehealth services will continue to grow alongside an increased need for audiology services among both children and adults. Insurance coverage policies for audiologic services are specific to each payer and vary widely in the level of coverage provided for both in-person and telehealth-based audiology services. While benefits for children are fairly comprehensive, coverage for audiology services for adults is generally poor. Traditional Medicare does not cover hearing aids or other rehabilitative audiologic services, and other payer policies vary widely. Lack of benefits for hearing and balance services is inconsistent with the evidence base and leaves many beneficiaries without access to meaningful care for hearing and balance disorders, which are highly prevalent among and disproportionately affect Medicare beneficiaries. The purpose of this article is to discuss regulatory and reimbursement considerations for telehealth provision in audiology and elucidate opportunities to influence related health policy at both state and federal levels. [ABSTRACT FROM AUTHOR]

Clinic closures across the United States in response to the coronavirus disease 2019 (COVID-19) pandemic meant that many audiology services were reduced to phone calls, video visits, and modified services (e.g., curbside, mail-ins, drop offs). Audiologists and other providers needed a way to manage hearing- and ear-related complaints via telehealth. A simple pure tone air conduction threshold test performed at home was used to determine which patients needed to come into the clinic for an in-person appointment. This case will review a 56-year-old male who was being treated for an idiopathic sudden sensorineural hearing loss prior to clinic closure. He had on file a comprehensive audiogram at first onset of symptoms and was treated with oral steroids. Virtual hearing testing was then utilized for a variety of other patients from teenagers to adults to triage hearing- and ear-related complaints while clinics were closed for in-person visits. [ABSTRACT FROM AUTHOR]

Most information on geographic variations in the employment of U.S. adults who are deaf or hard of hearing comes from the American Community Survey (ACS), which includes few people who are DHH in sparsely populated states. Using nationally representative Behavioral Risk Factor Surveillance System surveys from 2016–2018, the authors examined national-, regional-, and state-level employment rates of U.S. adults who were DHH and compared these rates with ACS estimates for this population. It was found that the national employment rate for people who were DHH was 51.3%; regional rates ranged from 47.9% to 56.9%, state rates from 36.9% to 68.0%. These figures were comparable to ACS estimates at all geographic levels. These findings indicate that employment disparities are not uniform across the United States for people who are DHH and underscore the need for additional policies in areas where this population experiences low employment. [ABSTRACT FROM AUTHOR]

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in healthrelated outcomes that currently exists. [ABSTRACT FROM AUTHOR]

Purpose: Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes.Methods: A multiple baseline design was implemented to assess a screening paradigm for identifying and referring patients aged ≥55 years with hearing loss at 10 family medicine clinics in 2 health systems. Patients completed a consent form and the Hearing Handicap Inventory for the Elderly (HHI). An electronic alert prompted clinicians to screen for hearing loss during visits.Results: The 14,877 eligible patients during the study period had 36,701 encounters. Referral rates in the family medicine clinics increased from a baseline rate of 3.2% to 14.4% in 1 health system and from a baseline rate of 0.7% to 4.7% in the other. A general medicine comparison group showed referral rate increase from the 3.0% baseline rate to 3.3%. Of the 5,883 study patients who completed the HHI 25.2% (n=1,484) had HHI scores suggestive of hearing loss; those patients had higher referral rates, 28% vs 9.2% (P <.001). Of 1,660 patients referred for hearing testing, 717 had audiology data available for analysis: 669 (93.3%) were rated appropriately referred and 421 (58.7%) were considered hearing aid candidates. Overall, 71.5% of patients contacted felt their referral was appropriate.Conclusion: An electronic alert used to remind clinicians to ask patients aged ≥55 years about hearing loss significantly increased audiology referrals for at-risk patients. Audiologic and audiogram data support the effectiveness of the prompt. Clinicians should consider adopting this method to identify patients with hearing loss to reduce its known and adverse sequelae. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older adults is understudied., Methods: Cross-sectional analysis of National Health and Aging Trends Study (2021) participants. The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (10-dB increments) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were wrist accelerometry-derived (Actigraph) total activity counts, daily active minutes, activity fragmentation (using active-to-sedentary transition probability), and self-reported participation in vigorous activities and walking for exercise in the last month. We used multivariable regression adjusted for sociodemographic and health covariates., Results: Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss including hearing aid users, nonusers (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users., Conclusions: Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: This report focuses on audiology productivity measures and targets, impacting variables, and implementation of productivity in pediatric settings and "life span facilities" with a significant population of pediatric patients. Research Design: A questionnaire was sent to 116 facilities in geographically diverse locations. Results: Of the 116 surveys sent, 25 surveys were returned (response rate of 21.5%) and 22 had sufficient data to be included for analyses. The majority of the sites measure productivity at the individual and/or department level. No predominant productivity measurement method was reported. Measurement methods included the following: appointment length (n = 6), weighting Current Procedural Terminology codes (n = 6), relative value units (n = 5), a combination of methods (n = 1), and other specific parameters (n = 1). Thirteen sites measured productivity as a percentage of scheduled worked time with a target of 69% (ranged from 40% to 85%). Many variables thought to impact productivity were evaluated: age of the patient, scheduling, use of a 2nd tester, no-show rate, hearing aid status, components of auditory brainstem response evaluation, documentation time, and monaural or binaural services. Schedule review and adjustment, efficiency, and communication with staff were methods reported to increase productivity. Conclusion: Most surveyed facilities measure productivity at the individual and/or department levels. However, there is no standard method. Current productivity measures include time-based measures based on appointment length, time-based measures assigned to Current Procedural Terminology codes, relative value units, combined approaches, and individual site developed programs. Many variables impact productivity measurements. Further study and discussion are needed to develop an optimal method for productivity measurement in audiology. [ABSTRACT FROM AUTHOR]

Abstract This study employs statistical modeling and mapping techniques to analyze the availability and accessibility of audiologists (practitioners who diagnose and treat hearing loss) in the United States at the county scale. The goal is to assess the relationships between socio-demographic and structural factors (such as health policy and clinical programs which train audiologists) and audiologist availability. These associations are analyzed at the county level, via a mixed effects hurdle model. At the county level, the proportion of older adults reporting difficulty hearing is negatively associated with audiologist supply. The findings show that audiologists tend to locate in metropolitan counties with higher median household incomes, younger populations, and lower proportions of older adults reporting hearing difficulty, suggesting an inverse care-type relationship between audiologist availability and need for hearing health services. Notably, neither state legislation requiring insurance plan coverage of hearing services for adults or Medicaid coverage of audiology services were significant predictors of audiologist supply at the county level. Highlights • As hearing loss prevalence rises, the shortage of audiologists in the US is worsening. • Counties with a greater share of older adults reporting hearing difficulty have fewer audiologists. • Clinical audiology programs were a strong predictor of audiologist supply at the county level. [ABSTRACT FROM AUTHOR]

Background: Pediatric audiologists are an important source of support for parents when a child is identified with hearing loss. As parents learn how to manage their child's hearing loss they often need help navigating challenges that arise; however, audiologists may experience a variety of barriers implementing effective counseling strategies. Many internal and external barriers experienced by parents can be appropriately supported and navigated within audiology services. Purpose: To investigate audiologists' perceptions, training, and confidence related to counseling and to explore the influence of years practicing audiology and taking a counseling course on perceptions and confidence. Research Design: A cross-sectional, population-based survey. Study Sample: Three hundred and fifty surveys were analyzed from pediatric audiologists across the U.S. Responses were received from 26 states and one U.S. territory. Data Collection and Analysis: Data were collected through the mail and online. Descriptive and comparative statistics were used to analyze the information. Content analysis was performed to identify emergent themes from the responses to open-ended questions. Results: Pediatric audiologists reported their perceptions about importance of counseling skills, challenges they encounter, their confidence in counseling, and how often they use the skills when needed in practice. Most audiologists (≥75%) felt it was very or extremely important to talk with parents about nine of the ten items (e.g., their [parents'] expectations). Three-fourth of the audiologists reported experiencing a moderate challenge or greater in knowing how to assess the presence of psychosocial challenges and in having enough time to address emotional needs. Many of the audiologists felt very or extremely confident in guiding parents in the development of an action plan (62%) and determining if parents have external barriers (60%). Approximately one-third or less of the participants reported performing any of the skills (e.g., determining if parent has external or internal barriers) ≥75% of the time, and a statistically significant difference was found with participants practicing ≤10 yr using the skills more frequently than participants practicing for ≥11 yr. In addition, there was a statistically significant difference between participants who had taken an audiology-specific counseling course and those who had not; those who had reported being more confident and using counseling skills more often than audiologists did not have a counseling course. Conclusions: This study found strong support for audiologist perceived importance of counseling; however, fewer audiologists reported confidence in their counseling skills and in using counseling skills. Counseling training was variable; audiologists would benefit from a more systematic approach to counseling instruction within graduate training. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to test the viability of a novel method for automated characterization of mobile health apps. Method: In this exploratory study, we developed the basic modules of an automated method, based on text analytics, able to characterize the apps' medical specialties by extracting information from the web. We analyzed apps in the Medical and Health & Fitness categories on the U.S. iTunes store. Results: We automatically crawled 42,007 Medical and 79,557 Health & Fitness apps' webpages. After removing duplicates and non-English apps, the database included 80,490 apps. We tested the accuracy of the automated method on a subset of 400 apps. We observed 91% accuracy for the identification of apps related to health or medicine, 95% accuracy for sensory systems apps, and an average of 82% accuracy for classification into medical specialties. Conclusions: These preliminary results suggested the viability of automated characterization of apps based on text analytics and highlighted directions for improvement in terms of classification rules and vocabularies, analysis of semantic types, and extraction of key features (promoters, services, and users). The availability of automated tools for app characterization is important as it may support health care professionals in informed, aware selection of health apps to recommend to their patients. [ABSTRACT FROM AUTHOR]

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Similarly to hearing loss and dizziness, tinnitus is a frequently reported complication of COVID-19 and remains the subject of numerous scientific reports. However, the exact impact of SARS-CoV-2 on the pathophysiology of tinnitus observed in post-COVID syndrome remains unclear. One suspected cause behind the development of vestibulocochlear symptoms is the inflammation of neural tissue triggered by SARS-CoV-2 infection.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to analyze the results of Brainstem Auditory Evoked Potentials (BAEP) in the context of tinnitus development among patients diagnosed with post-COVID syndrome.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; This retrospective study involved the analysis of BAEP test results of patients admitted to the Audiology Clinic of the Military Institute of Medicine at the National Research Institute and diagnosed with the post-COVID syndrome. The study compared the average latency values of waves I, II, III, IV, V, and intervals I-III, III-V, I-V. The statistical analysis of the obtained data was performed.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; Out of 18 patients (9 female, 9 male) with an average age of 54.22 years (9.65) diagnosed with post-COVID syndrome, tinnitus was identified in 5 individuals (27.78%). A statistically significant increase in wave V latency (5.98 vs. 5.63 [ms]; P &lt; 0.05) and interval III-V (1.99 vs. 1.71 [ms]; P&lt;0.05) was observed between the groups of patients with and without tinnitus.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Discussion:&lt;/b&gt; Study results analyzing BAEP changes in patients with post-COVID syndrome in the context of tinnitus are insufficient in current literature. The only available report linking post-COVID syndrome with sensorineural hearing loss demonstrated a statistically significant increase in latency values of waves III, V, and an increase in intervals I-III, III-V.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Tinnitus in patients suffering from post-COVID syndrome may be related to prolonged conduction of nerve impulses within the brainstem auditory pathway. Detailed pathophysiology of these changes requires further research.&lt;/br&gt.