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Purpose: This study assesses the impact of patient clinical history on audiologists' performance when interpreting auditory brainstem response (ABR) results. Method: Fourteen audiologists' accuracy in estimating hearing threshold for 16 infants through interpretation of ABR traces was compared on 2 occasions at least 5 months apart. On the 1st occasion, ABR traces were presented to the audiologists with no clinical information except for the age of the child. On the 2nd occasion, audiologists were given a full clinical history for the ABR cases. Results: The addition of clinical history information had no statistically significant impact on sensitivity, specificity, or accuracy of diagnosis. Although the mean numbers of true-negative and true-positive diagnoses were higher when audiologists were given clinical information, the difference was again not statistically significant. Conclusion: This study suggests that if there are circumstances in which case material is incomplete or unavailable, audiologists have no cause for concern regarding the accuracy of their interpretation of ABR traces. In a clinical manner, this may help audiologists with large caseloads or audiologists who need to provide a diagnosis of hearing loss in a short time by allowing them to focus on conducting ABR without the need for case history information.

Background: Conversational breakdowns are a persistent concern for older adults with hearing impairment (HI). Previous studies in experimental settings have investigated potential causes of breakdowns in conversations with a person with HI, and effective strategies for repairing these breakdowns. However, little research has explored the causes of hearing-related communication breakdowns, and their repairs, in extended, naturally occurring conversations in a healthcare setting. Aims: To analyse systematically instances of clients' initiations of repair within video-recorded initial audiology appointments, and to examine the interactional environment in which they occurred. Methods & Procedures: Participants included 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 of the 63 appointments. Conversation analysis (CA) was used to examine the video-recorded audiology appointments with older adults with HI. The corpus was systematically analysed for all instances of "other-initiated repair" by clients (initiation of repair targeting the prior speakers' turn). A collection of 51 instances of other-initiated repair were identified. These instances were analysed in detail for: (1) the interactional environment in which they occurred; (2) the strategy by which the client initiated repair; and (3) the strategies used by the audiologist to repair the communication breakdown. Outcomes & Results: In 76% (n = 39) of the 51 cases of other-initiated repair from the client, there was a lack of mutual gaze between participants (i.e., either the audiologist or the client were looking away or facing in another direction during the prior turn). More specifically, many of these instances occurred when the audiologist was speaking to the client while multitasking. Audiologists used multiple-repair strategies in their responsive turn in an attempt to repair the communication breakdown efficiently. Conclusions & Implications: These findings, from extended, naturally occurring conversations with older adults with HI in clinic settings, highlight the importance of face-to-face communication even in quiet one-to-one settings. Clinicians should remain aware of their movements and gaze when speaking to clients during appointments. The findings also provide further support for the importance of communication programs in hearing rehabilitation.

Purpose: The purpose of this study was to clarify the prevalence, type, severity, and age-dependency of hearing loss in 22q11.2 deletion syndrome. Method: Extensive audiological measurements were conducted in 40 persons with proven 22q11.2 deletion (aged 6-36 years). Besides air and bone conduction thresholds in the frequency range between 0.125 and 8.000 kHz, high-frequency thresholds up to 16.000 kHz were determined and tympanometry, acoustic reflex (AR) measurement, and distortion product otoacoustic emission (DPOAE) testing were performed. Results: Hearing loss was identified in 59% of the tested ears and was mainly conductive in nature. In addition, a high-frequency sensorineural hearing loss with down-sloping curve was found in the majority of patients. Aberrant tympanometric results were recorded in 39% of the ears. In 85% of ears with a Type A or C tympanometric peak, ARs were absent. A DPOAE response in at least 6 frequencies was present in only 23% of the ears with a hearing threshold =30 dB HL. In patients above 14 years of age, there was a significantly lower percentage of measurable DPOAEs. Conclusion: Hearing loss in 22q11.2 deletion syndrome is highly prevalent and both conductive and high-frequency sensorineural in nature. The age-dependent absence of DPOAEs in 22q11.2 deletion syndrome suggests cochlear damage underlying the high-frequency hearing loss.

This investigation assessed the factors affecting career choice among 474 current undergraduate and graduate speech-language pathology and audiology students (from four universities). A 14-item questionnaire was developed that included questions related to general influence of career choice and whether or not the participants had previously been, or are currently, diagnosed with a communication disorder. Results indicated that both indirect and direct personal exposure to either field can be a significant factor in career choice for students. The majority of participants (70%; n = 331) indicated that the desire to work in a helping profession most directly affected their decision to become a speech-language pathologist or audiologist. Findings highlight those variables that affected a student's decision to enter these fields and will assist human resource managers with the recruitment of professionals to our workforce.

We undertook this project because we believed that hearing loss experienced by the target population was greater than the referral figures suggested. Therefore, we set up a trial service initiative designed to examine the efficacy of different referral routes into audiology services for adults with learning disability. This retrospective analysis focuses on the generation of data on hearing loss on a small population sample (n = 136) gathered over a 6-month period in 2012. We suggest remedial action now to prevent more problems in the future.

The field of communication disorders encompasses the health science disciplines of both speech-­language pathology and audiology. Pertinent literature for communication disorders can be found in a number of databases. Librarians providing information literacy instruction may not have the time to cover more than a few resources. This study develops a list of commonly recommended databases and a list of core journals in communication disorders and then looks at indexing of the journals to discover which databases should be prioritized in library sessions.

Hearing is at the heart of language development and school readiness; increasing numbers of Early Head Start programs have come to rely on otoacoustic emissions (OAE) technology to screen all infants and toddlers for hearing loss. Successful identification of hearing health needs is dependent not only on an appropriate screening method, but also on adherence to an evidence-based follow-up protocol that includes referral to health care providers and specialists. Tools and resources are available to help programs make the most of their OAE hearing screening process and these can further inform other heath and developmental screening efforts.

This article reflects on the author's experience supervising a public school program for students who are deaf or hard-of-hearing, specifically addressing national, regional, and local trends affecting it. These trends included teacher efficacy, changes in educational service delivery, advances in technology, the selection of the listening and spoken language model, the needs of university teacher education programs, and telepractice. Furthermore, the author describes how the program responded to these trends, which ultimately resulted in positive educational outcomes for the students being served.

Schools located near to airports are exposed to high levels of noise which can cause cognitive, health, and hearing problems. Therefore, this study sought to explore whether this noise may cause auditory language processing (ALP) problems in primary school learners. Sixty-one children attending schools exposed to high levels of noise were matched to 68 children in quieter schools. Audiological screening and ALP assessments were undertaken and revealed that the children from the noise-exposed schools scored below average in all the ALP subtests. This study suggests that airport noise may impact on children's ALP abilities.

Purpose: The purpose of this study was to demonstrate improved precision of word recognition scores (WRSs) by increasing list length and analyzing phonemic errors. Method: Pure-tone thresholds (frequencies between 0.25 and 8.0 kHz) and WRSs were measured in 3 levels of speech-shaped noise (50, 52, and 54 dB HL) for 24 listeners with normal hearing. WRSs were obtained for half-lists and full lists of Northwestern University Test No. 6 (Tillman & Carhart, 1966) words presented at 48 dB HL. A resampling procedure was used to derive dimensionless effect sizes for identifying a change in hearing using the data. This allowed the direct comparison of the magnitude of shifts in WRS (%) and in the average pure-tone threshold (dB), which provided a context for interpreting the WRS. Results: WRSs based on a 50-word list analyzed by the percentage of correct phonemes were significantly more sensitive for identifying a change in hearing than the WRSs based on 25-word lists analyzed by percentage of correct words. Conclusion: Increasing the number of items that contribute to a WRS significantly increased the test's ability to identify a change in hearing. Clinical and research applications could potentially benefit from a more precise word recognition test, the only basic audiologic measure that estimates directly the distortion component of hearing loss and its effect on communication.

Background: Pitch perception is enhanced among persons with autism. We extended this finding to memory for pitch and melody among school-aged children. Objective: The purpose of this study was to investigate pitch memory in musically untrained children with autism spectrum disorders, aged 7-13 years, and to compare it to that of age- and IQ-matched typically developing children. Methods: The children were required to discriminate isolated tones in two differing contexts as well to remember melodies after a period of 1 week. The tasks were designed to employ both short- and long-term memory for music. For the pitch discrimination task, the children first had to indicate whether two isolated tones were the same or different when the second was the same or had been altered to be 25, 35, or 45 cents sharp or flat. Second, the children discriminated the tones within the context of melody. They were asked whether two melodies were the same or different when the leading tone of the second melody was the same or had been altered to be 25, 35, or 45 cents sharp or flat. Long-term memory for melody was also investigated, as the children attempted to recall four different two-bar melodies after 1 week. Results: The children with autism spectrum disorders demonstrated elevated pitch discrimination ability in the single-tone and melodic context as well as superior long-term memory for melody. Pitch memory correlated positively with scores on measures of nonverbal fluid reasoning ability. Conclusion: Superior short- and long-term pitch memory was found among children with autism spectrum disorders. The results indicate an aspect to cognitive functioning that may predict both enhanced nonverbal reasoning ability and atypical language development.

Background: Although many children with Down syndrome experience hearing loss, there has been little research to investigate its impact on speech and language development. Studies that have investigated the association give inconsistent results. These have often been based on samples where children with the most severe hearing impairments have been excluded and so results do not generalize to the wider population with Down syndrome. Also, measuring children's hearing at the time of a language assessment does not take into account the fluctuating nature of hearing loss in children with Down syndrome or possible effects of losses in their early years. Aims: To investigate the impact of early hearing loss on language outcomes for children with Down syndrome. Methods & Procedures: Retrospective audiology clinic records and parent report for 41 children were used to categorize them as either having had hearing difficulties from 2 to 4 years or more normal hearing. Differences between the groups on measures of language expression and comprehension, receptive vocabulary, a narrative task and speech accuracy were investigated. Outcomes & Results: After accounting for the contributions of chronological age and nonverbal mental age to children's scores, there were significant differences between the groups on all measures. Conclusions & Implications: Early hearing loss has a significant impact on the speech and language development of children with Down syndrome. Results suggest that speech and language therapy should be provided when children are found to have ongoing hearing difficulties and that joint audiology and speech and language therapy clinics could be considered for preschool children.

A 36-item survey was used to determine whether special educators have access to the services of an audiologist and whether they obtained benefit from the audiologist's services. Additional goals included gathering information about special educators' understanding of basic audiological concepts related to a school setting, added job responsibilities brought about by lack of access to an audiologist, and collaboration between these teachers and audiologists. The survey was emailed to special educators identified through online school district directories. A total of 39% of the surveyed special educators had access to an educational/contractual audiologist, with 71% of them believing they received benefit from these services. These benefits included provision of hearing screenings, in-services, and aural (re)habilitation. In all, 73% of the special educators judged their own background understanding of basic audiological information within the "low" range, and most of the special education teachers surveyed did not feel prepared to assist students with hearing aids, FM systems, or cochlear implants. Less than half of the special educators (47%) reported that collaboration between these professionals was strong where available. Special educators consider themselves unprepared to handle the audiological maintenance needs of their students' equipment and are often unaware of the audiologist's role, including their availability in schools. (Contains 2 tables and 4 figures.)

This paper discusses the experiences of parents of deaf children with additional complex needs (ACN) in accessing cochlear implant (CI) services and achieving ongoing support. Of a total study group of fifty-one children with ACN, twelve had been fitted with a CI. The parental accounts provide a rich and varied picture of service access. For some families accessing audiological assessment for CI was problematic, for others expectations, access to a qualified teacher of the deaf to FM amplification were problematic. Where services were similar in quality and quantity to typically developing deaf children who had received a CI there were high levels of satisfaction. For all the children implantation was delayed, the level of communication skills prior to implantation was very low, and expectations were uncertain and unclear. Deaf children with ACN require at least the same access to services as typically developing children. It can be argued that this group requires a higher level of input from qualified specialists, yet findings from this study suggest some children are likely to be receiving substantially less input, and in some cases no specialist input. Recommendations for audiological and educational management are also made. (Contains 3 tables.)

Presently, there is a world-wide shortage of professionals qualified to serve children who are deaf and hard of hearing and their families who are seeking a listening and spoken language outcome. To address the crisis of capacity, it is anticipated that an increasing number of professionals not currently serving as mentors will need to engage in mentoring partnerships. These professionals must acquire unique and specific skills and be able to implement them throughout the mentoring cycle. Use of advanced technology can serve to eliminate barriers associated with traditional models. Multiple options and programs using diverse technology make it possible for increased numbers of mentors and mentees to work effectively together, thereby reducing the global deficit of qualified professionals.

Children who are deaf and hard of hearing and their families need access to appropriate early intervention services that are delivered by professionals who are well trained and experienced using their chosen communication approach. Unfortunately, a lack of qualified practitioners, especially in remote and rural communities, and limited funding can affect the quality of services that are provided to some children. Advances in telecommunication and distance technology have led to models of telepractice that can provide access to appropriate services and reduce overall costs. While more efficacy research is needed, preliminary findings support the delivery of early intervention services through these distant service delivery models. Professionals who embrace models of telepractice can help to ensure that more children with hearing loss and their families receive the intervention to which they are entitled.

This manuscript describes a pilot project in which infants in Guam who refer on newborn hearing screening receive diagnostic audiological evaluation conducted by audiologists in Colorado over the Internet (telepractice). The evaluation is completed in real time using commercially-available software and personal computers to control the diagnostic audiological equipment remotely, and videoconferencing with support personnel and the family. Test results for 9 infants, all of whom received complete diagnostic assessment by auditory-evoked potentials and otoacoustic emissions, are described. Further elaboration is provided on steps to establishing the project and how regulatory, privacy and confidentiality, and professional practice issues in telepractice are addressed.

Recent advances in videoconferencing technology have resulted in a substantial increase in the use of live videoconferencing--referred to here as telepractice--to diagnose and treat speech, language, and hearing disorders. There is growing support from professional organizations for use of this service delivery model, as videoconferencing technology can alleviate the effects of distance on access to care. As telepractice becomes a standard mode of conducting diagnostic and treatment services in speech, language, and hearing disorders, it is essential to assure that research supports its application in the field. Search criteria were established to identify publications, primarily in peer-reviewed journals, from 1995 to 2011. These studies generally validate the delivery of diagnostic and therapeutic services through telepractice when compared to traditional services delivered in a face-to-face clinical setting. Most studies examined adults and school-age children. The search was then expanded to identify diagnostic and treatment services for infants, toddlers, and young children. The existing literature compels professionals to conduct more research related specifically to the effectiveness and efficacy of telepractice.

Purpose: The main goals of this study were to determine if school-based speech-language pathologists (SLPs) have access to the services of an audiologist and if those SLPs felt they obtained benefit from the audiologist's services. Additional goals included gathering information about SLPs' (a) understanding of basic audiological concepts typical for a school setting, (b) added job responsibilities brought about by lack of access to an audiologist, and (c) collaboration with audiologists. Method: A 36-item survey was e-mailed to 1,000 SLPs listed with the American Speech-Language-Hearing Association as being employed in schools. Two-hundred and nine respondents from 42 states returned the survey. Results: Seventy-six percent of the responding SLPs had access at some time to an audiologist, with 88% of them believing they received benefit from the services provided by that audiologist, primarily in the areas of hearing screenings and in-services. Thirty-eight SLPs (58%) who did not have access to an audiologist reported having additional job responsibilities. Conclusion: Many school-based SLPs believed they received benefit from an audiologist when they had access to one. Collaboration between these professionals was strong, yet findings indicate that audiologists could improve their collaborative efforts with SLPs and assist them in working within their scope of practice and maintaining their ethical standards.

The present review summarizes historic and recent research which has investigated the role of the corpus callosum in dichotic processing within the context of audiology. Examination of performance by certain clinical groups, including split brain patients, multiple sclerosis cases, and other types of neurological lesions is included. Maturational, age related, and genetic factors are also discussed. Finally, some attention is given to recent trends in audiology research to develop improved diagnostic and rehabilitation tools for individuals with dichotic deficits potentially related to callosal dysfunction. (Contains 5 figures.)

Purpose: The purpose of this preliminary investigation was to examine potential barriers to seeking services for communication impairments perceived by lesbian, gay, bisexual, and transgender (LGBT) people. Specifically, this clinical survey investigated (a) the rate and importance of disclosure of membership in the LGBT community by people with communication impairments to their clinicians and (b) the perception of bias of audiologists and speech-language pathologists against LGBT individuals with communication impairments. Method: A total of 192 people identifying as LGBT with a communication impairment responded to a web-based survey. The survey contained questions about the respondents' demographic information, living situation, and experiences with clinical services for communication impairments. In addition, the survey contained open-ended comment sections. Results: There were differences in the responses of LGBT people with speech-language impairments and those with hearing impairments. The majority of respondents did not disclose their membership in the LGBT community, although they felt it was important. Most respondents reported perceiving bias toward a heterosexual orientation from their clinicians. Conclusions: Exploration of issues important to the LGBT community contributes to the growing emphasis on diversity and cultural competency in communication sciences and disorders. Specific clinical recommendations and directions for future research are discussed. (Contains 4 tables.)

Despite receiving increased professional and public awareness since the initial American Speech Language Hearing Association (ASHA) statement defining Auditory Processing Disorders (APDs) in 1993 and the subsequent ASHA statement (2005), many misconceptions remain regarding APDs in school-age children among health and academic professionals. While many disorders account for why a child has difficulty understanding auditory content, this article will provide an overview of the history of APDs, current clinical presentations, distinguish between the common and often coexisting disorders seen in school-age children, and discuss how an audiological evaluation is used to detect the presence of APDs. Using a case method approach, a clinical case scenario describing the elusive nature of APDs, the importance of comprehensive audiological testing, and the interdisciplinary role of health professionals, with emphasis on the distinct role of the school nurse will be highlighted. (Contains 4 tables and 2 figures.)