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Purpose: The purpose of this study was to investigate how the amount of home language use between the primary caregiver and bilingual Spanish- and English-speaking children with hearing loss who use cochlear implants (CIs) versus their bilingual age-matched peers with normal hearing (NH) can impact speech outcomes in the home language., Method: Thirty-four bilingual Spanish- and English-speaking children (17 CI users and 17 with NH) between the ages of 5;3 and 7;9 (years;months) participated in this study. Independent variables were the amount of home language use with the primary caregiver and hearing status, and dependent variables were vowels and consonants correctly produced and occurrence of selected phonological processes. The amount of home language use was ascertained from surveys, and the dependent measures were based on a single-word picture elicitation task., Results: Bilingual children with CIs who are exposed to Spanish for more than 80% of the time via their primary caregiver performed better on Spanish segmental accuracy measures than those who are exposed to Spanish from only 20% to 50% of the time, specifically on vowels (partial η 2 = .31) and consonants (partial η 2 = .025). Children with NH outperformed children with CIs on all accuracy measures in Spanish., Conclusions: Preliminary results suggest the importance of language exposure through interactions with the primary caregiver for speech development in bilingual children. Future studies should investigate strategies to facilitate home language development in bilingual children with CIs, enabling them to reach their full potential.

Aim: Aging is related to deterioration of bodily and neural functions, leading to various disorders and symptoms, including the development of dementia, hearing loss, or tinnitus. Understanding how these phenomena are intertwined and how aging affects those is crucial for prevention and the future development of interventions., Methods: We utilized the UK Biobank which includes a total of 502,382 participants between 40 and 70 years old. We used logistic regression models and cox proportional hazard models and compared hazard ratios., Results: The odds of reporting tinnitus in the older age group (i.e., older than 58 years) were increased by 53.6 % and a one decibel increase in the speech-reception thresholds enhanced the odds for tinnitus by 13.0 %. For our second analysis regarding hearing loss, the risk of dementia increased by 14.0 % with an increase by one decibel in the speech-reception threshold score. In terms of aging, each additional year increased the risk by 17.3 %. Tinnitus alone showed a significant influence with a hazard ratio of 52.1 %, however, when adding hearing loss, age and various covariates, the effect vanished., Conclusion: Findings confirm that tinnitus is indeed related to aging, but presumably independent of the aging processes accompanying the development of dementia. This highlights the urge to further investigate the impact of aging on neural processes that are relevant for alterations in the auditory systems (e.g., leading to the development of tinnitus or hearing loss) as well as for increased vulnerability in terms of neurodegenerative diseases., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objectives: The aim of the present study was to investigate the knowledge and attitudes of first-time pregnant women regarding hearing loss in infants, and to identify the key factors that influence their perceptions., Methods: After validating and ensuring the reliability of a well-structured questionnaire consisting of 15 items, it was distributed to a total of 400 pregnant women who were experiencing their first pregnancies. Utilizing a cluster sampling method, participants were selected from both public hospitals and private gynecologist offices across diverse geographic regions in Tehran, Iran. Participants were asked to respond on a three-point scale (No, Not Sure, Yes). The results were analyzed using both descriptive and analytic statistics., Results: The translated questionnaire exhibited suitable face validity, test-retest reliability, and internal consistency. Findings revealed the highest maternal knowledge for "newborns can be born with hearing loss "(77.5%) and the lowest knowledge score was observed for "delayed birth cry can lead to hearing loss" (23.8%). Regarding attitudes, 72.5% of mothers scored above the mean of 5.65 out of 6, indicating a preference for early diagnosis and intervention. Several factors, such as education level and the mother's city of residence, showed a significant correlation with certain knowledge and attitude-related questions. Notably, individuals receiving care at public hospitals showed greater knowledge compared to those visiting private clinics., Conclusions for Practice: Mothers play a crucial role in child health and need to have a thorough understanding of pediatric diseases in order to make informed decisions. One particular condition that mothers should be well-informed about is hearing loss, as it has a significant impact on language development. However, this study reveals that there are gaps in maternal knowledge when it comes to the specific causes of hearing loss., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: The speech intelligibility index (SII) is used to quantify the audibility of the speech. This study examined the relationship between self-reported hearing aid (HA) outcomes and the difference in aided SII (SII A ) calculated from the initial fit (IF) gain and that prescribed as per the second generation of National Acoustic Laboratory Non-Linear (NAL-NL2)., Design: A prospective observational study., Study Sample: The study included 718 first-time and 253 experienced HA users. All users had a valid real-ear measurement (REM) at three input levels (55, 65 and 80 dB SPL)., Results: The gain provided by IF was lower than NAL-NL2 at 55 and 65 dB SPL. IF gain exhibited reduced compression than NAL-NL2 as input levels increased from 55 to 80 dB SPL. On average, the SII A provided by IF was significantly lower than that for NAL-NL2 at all input levels. The difference in SII A between IF and NAL-NL2 at 80 dB SPL input level with 0 dB signal-to-noise ratio (SNR) turned out to be a predictor for self-reported outcome for first-time HA users., Conclusion: The study suggests that an SIIA close to that provided by NAL-NL2 at high input levels would be preferred to obtain a better self-reported outcome. .

Objectives: Musicians who wear hearing aids are a unique subset of hearing-impaired individuals. There are a number of issues musicians experience with hearing aids, making effective hearing rehabilitation a challenge. Research suggests hearing aid satisfaction in musicians is lower partly due to their advanced listening skills, however, qualitative research addressing musicians who wear hearing aids for music is scarce. The current study aimed to record the barriers encountered by musicians who wear hearing aids when playing their instrument/singing, listening to recorded music and listening to live music., Design: Professional musicians who wear hearing aids were interviewed. Participants were questioned about their experiences with hearing loss and hearing aids, with particular emphasis on experiences listening to recorded and live music, and playing or performing music with the hearing aids., Study Sample: Eight professional musicians were interviewed, using a semi-structured interview style, with a question and prompt guide., Results: Thematic analysis revealed three main themes in the data: the musicians' journey, communication, and flexibility/adjustability., Conclusions: The results have implications for future research into specific fitting parameters for hearing aids for musicians (particularly for music performance), the need for evidence-based rehabilitation programs for musicians with hearing loss, and the need for a glossary of terms to assist communication between Audiologists and musicians.

Objective: The aim of this project was to investigate the provision of counselling in adult audiological rehabilitation and to highlight training barriers and needs., Design: A service evaluation in which respondents completed a survey in which they rated their knowledge, confidence and competence in addressing the hearing, social and emotional needs of their patients. They were also asked to define counselling., Sample: 64 UK practising audiologists in adult audiological rehabilitation, aged 20->60 years (84% females, 16% males), with a range of years in clinical practice., Results: Counselling definitions fell into three main categories: the audiologist as the doer, the audiologist as the facilitator, and the audiologist and patient as partners. Respondents reported feeling more able to counsel the hearing related needs of their patients, than emotional or social needs. There were significant positive statistical associations between counselling training completed and self-rated counselling abilities for managing emotional needs. Clinical experience was not associated with self-rated counselling. Lack of supervision and training were identified as some of the main barriers to providing emotional support. Almost all respondents reported a desire for further training in delivering emotional support, with the belief that this would improve services and patient outcomes., Conclusions: UK audiologists demonstrated person-centred thinking through their definitions of counselling. However, they reported significant barriers in being able to support the needs of adults with hearing loss. Training needs around emotional support in audiology counselling are not currently being met. It is important for clinical training programmes to address this gap by incorporating more counselling courses into their curricula.

Background: Hearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL., Methods: A randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made., Results: Compared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up., Conclusions: The ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health., Trial Registration: ISRCTN54021189 (retrospectively registered on 18/07/2023)., (© 2024. The Author(s).)

Purpose: The aim of the study was to analyze how face masks influence speech perception and time spent looking at the speaker's mouth and eyes by adults with and without hearing loss., Method: Twenty participants with hearing loss and 20 without were asked to repeat Spanish words presented in various conditions, including different types of face masks (no mask, transparent window mask, and opaque mask FFP2) and presentation modes (audiovisual, video only, and audio only). Recognition accuracy and the percentage of time looking at the speaker's eyes and mouth (dwell time) were measured., Results: In the audiovisual condition, participants with hearing loss had significantly better word recognition scores when the speaker wore no mask compared to when they wore an opaque face mask. However, there were no differences between the transparent mask and no mask conditions. For those with typical hearing, the type of face mask did not affect speech recognition. Audiovisual presentation consistently improved speech recognition for participants with hearing loss across all face mask conditions, but for those with typical hearing, it only improved compared to video-only mode. These participants demonstrated a ceiling effect in audiovisual and audio-only modes. Regarding eye movement patterns, participants spent less time looking at the speaker's mouth and more time at the eyes when the speaker wore an opaque mask compared to no mask or a transparent mask., Conclusion: The use of transparent face masks (ClearMask-type model) is recommended in contexts where face masks are still used (hospitals) to prevent the hindering effect of opaque masks (FFP2-type model) in speech perception among people with hearing loss, provided that any fogging of the window of the transparent mask is controlled by wiping it off as needed and the light is in front of the speaker to minimize shadows.

Objective: People with hearing loss often encounter difficulties in hearing under adverse conditions, such as listening in the presence of noise. Listening effort is an indicator used to assess listening difficulties in daily life. Although many studies on listening effort have been conducted in recent years, there is a notable gap in the exploration of how task load influences listening effort in young adults. This study compared the effects of background noise and memory load on task performance and subjective listening effort in young adults with and without hearing loss., Methods: The study included a group of 8 adults with hearing loss (mean age: 24.1 ± 6.0 years) and a group of 16 individuals with normal hearing (mean age: 27.9 ± 4.9 years). A number memorizing task was conducted, involving two types of auditory digits (either three or seven digits) presented under multi-talker babble noise conditions of signal-to-noise ratio of -5 dB [SN -5 dB] or SN +5 dB. Participants determined whether the number presented in the encoding interval matched the one presented in the retrieval interval. Subsequently, they were asked to complete a questionnaire using a Visual Analog Scale (VAS) to assess their subjective listening effort. Percentage of correct responses, reaction times, and VAS ratings were compared between adults with and without hearing loss., Results: Our results showed significant differences between the two groups in the percentage of correct responses and the reaction time under the SN -5 dB conditions, regardless of the memory load. Under the SN +5 dB conditions, a significant difference was found only in the percentage of correct responses for seven digits. In the normal hearing group, the percentage of correct responses and VAS ratings tended to decrease as the memory load increased, even under the same noise condition. Conversely, in the hearing loss group, a consistent trend could not be identified in the effects of noise and memory load on the percentage of correct responses and VAS ratings., Conclusion: These results suggest that in conditions of high noise load, young adults with hearing loss show a higher tendency for listening effort to be affected by other loads. We confirmed that for some participants with hearing loss, the task exceeded a certain level of difficulty in the SN -5 dB and seven digits condition, leading to a change in their motivation and strategy used. Future research should examine ways to control for participants' motivations., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024. Published by Elsevier B.V.)

Objective: Hearing loss in the older adult population is a significant global health issue. Hearing aids can provide an effective means to address hearing loss and improve quality of life. Despite this, the uptake and continued use of hearing aids is low, with non-use of hearing aids representing a significant problem for effective audiological rehabilitation. The aim of this study was to investigate the reasons for the non-use of hearing aids., Design and Study Sample: A cross-sectional survey was used to investigate the reasons given for the non-use of hearing aids by people with hearing loss ( n  = 332) and family members ( n  = 313) of people with hearing loss in Australia, the UK, and USA., Results: Survey results showed that hearing aid non-users generally cited external factors as reasons for non-use, whereas family members reported non-use due to attitudinal barriers. Past users of hearing aids and family members of past users both identified devices factors as barriers to use., Conclusions: Differences in reasons for non-use may provide further insight for researchers and clinicians and help inform future clinical practice in addressing the low uptake and use of hearing aids by people with hearing loss and the role of family members in audiological rehabilitation.

Background: Cognitive screening tools enable the detection of cognitive impairment, facilitate timely intervention, inform clinical care, and allow long-term planning. The Montreal Cognitive Assessment for people with hearing impairment (MoCA-H) was developed as a reliable cognitive screening tool for people with hearing loss. Using the same methodology across four languages, this study examined whether cultural or linguistic factors affect the performance of the MoCA-H., Methods: The current study investigated the performance of the MoCA-H across English, German, French, and Greek language groups (n = 385) controlling for demographic factors known to affect the performance of the MoCA-H., Results: In a multiple regression model accounting for age, sex, and education, cultural-linguistic group accounted for 6.89% of variance in the total MoCA-H score. Differences between languages in mean score of up to 2.6 points were observed., Conclusions: Cultural or linguistic factors have a clinically significant impact on the performance of the MoCA-H such that optimal performance cut points for identification of cognitive impairment derived in English-speaking populations are likely inappropriate for use in non-English speaking populations. To ensure reliable identification of cognitive impairment, it is essential that locally appropriate performance cut points are established for each translation of the MoCA-H., (© 2024 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)

Purpose: The purpose of this study was to assess the combined effects of type 2 diabetes (T2D) and hearing loss on the level of distress in individuals with diabetes., Methods: The 2021 National Health Interview Survey included 2633 adults (ages 18+) with T2D who reported perceived hearing loss, level of diabetes-related distress, household composition, and demographic characteristics. Logistic regressions evaluated these association between hearing loss and diabetes distress controlling for age, income, region of residence, marital status, rurality, educational attainment, insurance coverage, time since diabetes diagnosis, and household composition. Interaction effects examined differential associations between demographic groups., Results: About 3.5% of adults with T2D in the sample reported hearing loss, and 70% reported diabetes-related distress. Results indicated that diabetes distress was significantly more likely among individuals with hearing loss (OR = 2.08) relative to their hearing counterparts. Additionally, females (OR = 1.50), low-income earners (OR = 1.84), middle-income earners (OR = 1.41), non-Hispanic Blacks (OR = 1.58), and Hispanics (OR = 1.75) with diabetes had higher odds of reporting diabetes distress. Interaction analyses indicated that non-Hispanic Blacks and Hispanics with hearing loss had a 37% and 19%, respectively, higher likelihood of diabetes distress relative to non-Hispanic Whites with hearing loss., Conclusion: Diabetes distress was more likely among individuals with hearing loss. These findings suggest the communication challenges of individuals with hearing loss may explain the observed differences in distress., Competing Interests: Conflict of InterestThe authors have no conflicts of interest.

Objective: To evaluate the Québec Audiological Assessment Protocol for Younger and Older Adults (QAAP-YOA) and its accompanying clinical tool efficacy to assess the needs of individuals with hearing loss in a simulated context. This study is the Phase 2 in the development of the QAAP-YOA., Design: Participants completed two needs assessments with simulated clients and wrote audiological reports, while applying the QAAP-YOA with and without the use of its clinical tool. Interviews were filmed, and reports collected. Both were scored by two independent evaluators. A qualitative analysis of reports was also conducted., Study Sample: Eleven audiology students and four early-career audiologists ( n  = 15)., Results: The clinical tool did not influence the interview process since both experimental conditions had similar compliance rates to the protocol ( p  = 0.114). Compliance rates for assessment reports were higher with the clinical tool ( p  < 0.001). Participants' conclusions after applying the QAAP-YOA were consistent across participants. The information provided in the reports was more comprehensive and coherent with the client's needs when participants used the clinical tool., Conclusions: The QAAP-YOA can lead to a greater standardisation of needs assessments and to more comprehensive reports, which may lead to intervention programs more closely aligned with clients' needs.

Objective: To develop a prototype of a decision aid to be used on a website for adults with hearing loss. Design: Development was guided by the International Patient Decision Aid Standards (IPDAS) and included a survey and think-aloud process., Study Sample: A total of 153 participants completed a survey about what to include in the decision aid (111 adults with hearing loss, 21 family members of adults with hearing loss, and 21 professionals). Six adults with hearing loss and six family members participated in a think-aloud process to provide feedback as they used an initial version of the decision aid., Results: In the survey, 26 of the 38 potential items were identified as being highest priority and were included in the initial version of the decision aid. This initial version was then tested in the think-aloud sessions and a prototype of a web-based version was developed based on participant responses related to: 1) information on the decision aid, 2) ease of use, 3) layout and orders of the items, 4) satisfaction, 5) areas for improvement (e.g., need for graphics)., Conclusions: The methodologies used in this study are recommended for developing decision aids for adults with acquired hearing loss.

Purpose: Cochlear implantation is a well-established option for early intervention. Children with hearing impairment and their parents are users of intervention services, with parents being more suited to provide insight into their experiences. The purpose of the current study was to describe the experiences of parents of children with cochlear implants (CIs) in the South African context., Methods: A qualitative research design was employed. Non-probability, purposive sampling was used. Seven, online semi-structured interviews were conducted with parents of children with CIs. Data were analysed using inductive thematic analysis., Results: Participants expressed feelings of certainty and assurance in the CI journey. Participants extended gratitude to the healthcare professionals involved in their children's CI journey. Feelings of doubt and stress were noted when coming to terms with the decision of cochlear implantation and financial stressors were noted as a challenge. Many participants found it challenging transitioning their children into school., Conclusions: Parents conveyed having no regrets with their decision of cochlear implantation for their child and were grateful for the support provided by healthcare professionals. However, financial, and educational challenges remain. Findings suggest the need for more financial support for cochlear implantation in South Africa, and for adequate inclusive educational settings.

Objectives: Tinnitus is a phantom sound sensation without an external sound source. Due to its subjective and multifaceted nature it is measured using multi-item self-reported instruments. Many well-validated tinnitus-related questionnaires are available for clinical practice and scientific research, but so far no attention has been paid to their measurement invariance. The study aimed to examine measurement invariance of the Tinnitus Handicap Inventory with regard to gender and hearing impairment, and to identify the items that show differential item functioning (DIF) across the groups., Design: This is a retrospective study using medical data from patients with tinnitus. They completed the Tinnitus Handicap Inventory (THI) and underwent pure-tone audiometry., Study Sample: 1106 adult patients with tinnitus (554 women and 552 men; 320 with normal hearing and 786 with hearing loss), aged 19-84 years., Results: In the analysis, multi-group confirmatory factor analysis, hybrid ordinal logistic regression, Kernel smoothing in Item Response Theory, and lasso regression were applied. Measurement invariance was demonstrated across gender, but across hearing status the measurement was non-invariant. Five items were found to have DIF., Conclusions: Researchers and clinicians should be aware of the potential risk of response bias when tinnitus severity is evaluated.

Objective: With our aging population, an increasing number of older adults with hearing loss have cognitive decline. Hearing care practitioners have an important role in supporting healthy aging and should be knowledgeable about cognitive decline and associated management strategies to maximize successful hearing intervention., Methods: A review of current research and expert opinion., Results: This article outlines the association between hearing loss and cognitive decline/dementia, hypothesized mechanisms underlying this, and considers current research into the effects of hearing intervention on cognitive decline. Cognition into old age, cognitive impairment, dementia, and how to recognize cognitive decline that is not part of normal aging are described. Screening of older asymptomatic adults for cognitive decline and practical suggestions for the delivery of person-centered hearing care are discussed. Holistic management goals, personhood, and person-centered care in hearing care management are considered for older adults with normal cognitive aging through to dementia. A case study illustrates important skills and potential management methods. Prevention strategies for managing hearing and cognitive health and function through to older age, and strategies to maximize successful hearing aid use are provided., Conclusion: This article provides evidence-based recommendations for hearing care professionals supporting older clients to maximize well-being through the cognitive trajectory.

Technological and therapeutic advances have allowed many children who are born hard-of-hearing (HoH) to start school with age-appropriate spoken language skills, yet many of these children continue to find everyday conversations challenging. This scoping review maps the evidence related to development of conversation and pragmatic skills in children who are HoH and learning spoken language. The review followed Arksey and O'Malley's methodological framework and the PRISMA Extension for Scoping Reviews guidelines. Quality appraisal, data extraction, and thematic analysis were used to describe the data. Systematic searches identified 36 articles for inclusion. Sample sizes were small and heterogenous. Most studies focused on school-aged children with severe hearing loss or greater. Methodological rigor varied. Thematic analysis revealed two global themes. First, children who are HoH continue to find conversation and pragmatics difficult to master, and second, there are a set of audiological, communication, environmental, and demographic characteristics that are associated with better conversation and pragmatic outcomes, some of which are fixed, whereas others are malleable. Focused attention on designing valid and reliable assessments for conversation and pragmatic skills, and on developing therapeutic approaches targeting early conversation and pragmatic skill development, is needed to reduce the impact conversation and pragmatic differences across the lifespan., (© The Author(s) 2024. Published by Oxford University Press.)

Collaboration between teachers of students who are deaf and hard of hearing (TSDHH) and educational audiologists is essential when developing successful, comprehensive service delivery plans for students who are deaf and hard of hearing. Despite the importance, little is known about how these two professions work together. This study sought to describe the current state of collaboration between educational audiologists and TSDHH and to explore the barriers and facilitators to this collaboration. Anonymous survey responses from 752 educational audiologists and TSDHH showed that collaboration is considered valuable and is occurring frequently, via a variety of formats and despite significant barriers. More research is needed to understand how efforts to minimize barriers to collaboration might improve the quality of collaboration and ultimately impact the success of student support., (© The Author(s) 2024. Published by Oxford University Press.)

Objective: Childhood hearing impairment has potential repercussions on the mental well-being of both children and their parents. As a vulnerable population in accessing health care services, they may face specific challenges, especially during the COVID-19 pandemic. This cross-sectional study aims to investigate the association between childhood hearing impairment and the mental health of children and their parents, and to assess health care utilization of hearing-impaired children and its impact on mental outcomes for both during the COVID-19 pandemic., Methods: Using the National Health Interview Survey (NHIS) database, we analyzed data for 15,989 children aged 5-17 and their corresponding parents. The correlations between childhood hearing impairment and mental outcomes were examined using logistic regression models. The 2020 (quarter 3 and quarter 4)-2021 NHIS data was singled out and re-analyzed, focusing on the utilization of medical care during the COVID-19 pandemic., Results: After accounting for covariates, hearing-impaired children exhibited a higher frequency of anxiety (OR 2.33, 95% CI 1.79-3.02) or depression (OR 2.14, 95% CI 1.59-2.88). Parents of hearing-impaired children had significantly higher odds of a higher frequency of anxiety (OR 1.55, 95% CI 1.20-2.01) or depression (OR 1.73, 95% CI 1.30-2.29). Interaction effect of hearing impairment with survey year on parents' mental health outcomes was observed ( p for interaction <0.1). Children with hearing loss had higher odds of reporting delayed medical care (OR 2.00, 95% CI 1.11-3.59) or canceled medical care (OR 1.96, 95% CI 0.98-3.96, p  = 0.059) due to the pandemic. Delayed medical care (OR 12.41, 95% CI 2.78-55.46) or canceled medical care (OR 6.26, 95% CI 1.28-30.75) due to the COVID-19 pandemic significantly contributed to the increase of anxiety frequency in hearing-impaired children., Conclusion: Childhood hearing impairment exhibits a substantial impact on children's and parental mental health, which is further exacerbated by the COVID-19 pandemic. Families of hearing-impaired children appear to be in a vulnerable position during public health emergencies such as the COVID-19 pandemic, which can further exacerbate their mental outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Li, Lin, Cen, Fan, Hong, Wu, Chen and Zhong.)

Background: Older adults with hearing impairments are vulnerable to cognitive impairment. Although previous reports suggest a correlation between widowhood and cognitive impairment, further investigation is needed to elucidate the effect of widowhood on cognitive function and the moderating effects of social support and participation on widowhood-related cognitive impairment in this vulnerable demographic., Methods: The study's data were sourced from the nationally representative Chinese Longitudinal Healthy Longevity Survey (CLHLS) for the years 2011, 2014, and 2018. Multiple linear regression was used to analyze the association between widowhood and cognitive function among older adults. Multivariate logistic regression examined the effect of widowhood on the likelihood of experiencing various levels of cognitive impairment in older adults with hearing impairments. A moderating effect model explored the roles of social support and participation in mitigating widowhood-related cognitive impairment., Results: The cognitive function of older adults with hearing impairment was found to be lower than that of those without hearing impairment. Widowhood was significantly negatively correlated with Mini-Mental State Examination (MMSE) scores in older adults, both with (Coef. = -0.898) and without (Coef.: = -0.680) hearing impairments. A stronger association was observed between widowhood and declining cognitive function among older adults with hearing impairment. Specifically, widowhood may be more likely to significantly increase the likelihood of moderate and severe cognitive impairment (RRR = 1.326, 1.538) among older adults with hearing impairments. Social support and social participation significantly moderated the cognitive impairment associated with widowhood among hearing-impaired older adults. These forms of support and engagement are buffers against the risk of widowhood-related cognitive impairment among this demographic., Conclusions: Our findings indicate that widowhood is significantly associated with cognitive impairment in older adults with hearing impairment. Social support and participation help mitigate this risk. Strategies should prioritize early screening, specialized cognitive rehabilitation, comprehensive care, and enhancing social support and participation to maintain cognitive health in this vulnerable population following widowhood., (© 2024. The Author(s).)

Purpose: This study aimed to investigate family resilience-defined as the capacity of a family to harness its collective strengths and resources to recover from and adapt to significant adversities or crises effectively-in primary caregivers of children who are deaf and hard of hearing (cDHH) and its association with quality of life, life satisfaction, perceived social support, and loneliness., Method: The study involved 108 primary caregivers of cDHH and 139 primary caregivers of children with normal hearing. Participants underwent psychometric evaluations including the Family Resilience Scale, World Health Organization Quality of Life Assessment-Brief Form, Satisfaction with Life Scale, UCLA Loneliness Scale, and Multidimensional Scale of Perceived Social Support., Results: Significant differences were found in almost every scale and its subdimension between the two groups ( p < .05). Correlation analysis revealed significant correlations between all scale total scores for both groups ( p < .05, .153 < | r | < .737). Quality of life was found to be a significant predictor of family resilience, F (1, 139) = 41.824, R 2 = .279, B = 0.495, t = 6.467, p < .001., Conclusions: Our study highlights the significant impact of having cDHH on caregivers' family resilience, quality of life, life satisfaction, feelings of loneliness, and perceived social support. The results underscore the importance of enhancing caregivers' quality of life as a potential strategy to improve their family resilience. Further research is needed to understand the complex interplay of factors influencing these outcomes.

Purpose: To verify the association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people., Methods: This is a cross-sectional, observational, and descriptive study with a quantitative data approach. A database with information collected in a medium-sized Brazilian municipality was used. The study was conducted with 235 elderly people registered in five Family Health Strategy Units. Sociodemographic and health information and the results of the following questionnaires were used: Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S), Medical Outcomes Study (MOS) Social Support Survey, Subjective Health Assessment, and Short-Form 6-Dimension (SF-6D) Health and Quality of Life Index. Groups with and without participation restriction were compared according to sociodemographic, health, social support, and quality of life variables. A multivariate binary logistic regression method was employed to evaluate the associations between the independent variables and participation restriction., Results: The group with participation restriction is composed of older individuals with lower quality of life and poorer self-perception of health. Poorer self-perception of health was the only predictor of participation restriction related to hearing loss., Conclusion: Participation restriction is associated with poorer self-perception of health. The study highlights the importance of assessing individuals' self-perception regarding biopsychosocial issues, in addition to considering the environmental context to understand the social and emotional impacts caused by hearing loss.

Objectives: A great deal of literature documents the significant demands, both physical and psychosocial, that care partners experience when providing care to persons with a range of health conditions. There is, however, far less research available on care partners of adult persons who are d/Deaf or hard of hearing (d/DHH). In response to this gap, the authors developed measures of d/DHH stigma among care partners as part of the work of the Lancet Commission on Hearing Loss' Measures, Models, and Stigma Reduction Subgroup. The measures examined in this article are part of a larger set of parallel measures to enable comparison of stigma measurement across groups., Design: The present study describes the preliminary validation of five stigma scales specifically tailored for use to assess the prevalence and effect of stigma on the care partners of adult people who are d/DHH in the United States. Care partners in this context are defined broadly and can include spouses, partners, adult children, siblings, and friends of persons who are d/DHH. The scales describe the care partner's own assessment of how the person who is d/DHH experiences and perceives stigma as well as the care partner's own internalized, experienced, and perceived stigma as a result of their association with a person who is d/DHH. This latter set of three scales describes secondary stigma, or the stigma a person experiences related to their association with a member of a stigmatized group. Measures were developed through a process that included a literature review, Delphi groups with people who became d/DHH after they developed spoken language, cognitive interviews, and a pretest. An online, self-administered preliminary validation survey was conducted with 151 care partners., Results: Results support the internal reliability of each of the five stigma scales (ordinal α's all greater than 0.9) and that each scale is assessing a single factor., Conclusions: Additional testing is needed to confirm the validity of these measures. After further validation, they can be used to assess the prevalence and effect of stigma on care partners of persons who are d/DHH and to evaluate the success of interventions developed to address stigma and its effects both on the care partner and the person who is d/DHH and receiving the care., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Although hearing devices such as cochlear implants and hearing aids often improve communication, many people who are d/Deaf or hard of hearing (d/DHH) choose not to use them. Hearing device-related stigma, or negative societal beliefs about people who use hearing devices, often drives this decision. Although much research has documented the negative effects of hearing device-related stigma, no widely accepted, validated measure to quantify such stigma across populations currently exists. In this article, we describe the preliminary validation of four distinct but related scales measuring hearing device-related stigma in different populations, including people who use hearing devices and those close to them., Design: We preliminarily validated four measures for quantifying hearing device-related stigma in different populations that were previously developed and refined through a literature review, Delphi interviews, cognitive interviews, and a pretest. We preliminarily validated these measures through self-administered online surveys in a convenience sample in the United States. Among participants who use a hearing device and who either (a) self-identified as being d/DHH before they developed language (lifelong; n = 78) or (b) those who self-identified as having acquired a d/DHH identity after they developed language (acquired n = 71), we validated an anticipated hearing device-related stigma scale (d/DHHS-LE-HDA). We validated three scales that measure perceived hearing device-related stigma observed by parents of children who are d/DHH and who use a hearing device (n = 79) (d/DHHS-P-HDPO), care partners of adults who are d/DHH and use a hearing device (n = 108) (d/DHHS-CP-HDPO), and health care providers (n = 203) (d/DHHS-HCP-HDSH). Exploratory factor analysis assessed the reliability of each measure., Results: Each of the four scales loaded onto one factor. Factor loadings for the eight-item scale measuring anticipated hearing device-related stigma among the two populations with lived experience ranged from 0.635 to 0.910, with an ordinal α of 0.93 in the lifelong d/DHH participants and 0.94 among the acquired d/DHH participants. The six-item scale of perceived stigma observed by parents had item loadings from 0.630 to 0.920 (α = 0.91). The nine-item scale of hearing device-related stigma observed by care partners had item loadings from 0.554 to 0.922 (α = 0.95). The eight-item scale of hearing device-related stigma reported by health care providers had item loadings from 0.647 to 0.941 (α = 0.89)., Conclusions: Preliminary validation results show that the four stigma measures perform well in their respective populations. The anticipated stigma scale performed similarly well for both lifelong d/DHH and acquired d/DHH, which suggests that it could perform well in different contexts. Future research should further validate the scales described here as well as measure hearing device-related stigma in different populations-including people who live in different geographic regions and people using different kinds of hearing devices-and evaluate the success of interventions developed to reduce hearing device-related stigma., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

People who are d/Deaf or hard of hearing (d/DHH) often experience stigma and discrimination in their daily lives. Qualitative research describing their lived experiences has provided useful, in-depth insights into the pervasiveness of stigma. Quantitative measures could facilitate further investigation of the scope of this phenomenon. Thus, under the auspices of the Lancet Commission on Hearing Loss, we developed and preliminarily validated survey measures of different types of stigma related to d/Deafness and hearing loss in the United States (a high-income country) and Ghana (a lower-middle income country). In this introductory article, we first present working definitions of the different types of stigma; an overview of what is known about stigma in the context of hearing loss; and the motivation underlying the development of measures that capture different types of stigma from the perspectives of different key groups. We then describe the mixed-methods exploratory sequential approach used to develop the stigma measures for several key groups: people who are d/DHH, parents of children who are d/DHH, care partners of people who are d/DHH, healthcare providers, and the general population. The subsequent manuscripts in this special supplement of Ear and Hearing describe the psychometric validation of the various stigma scales developed using these methods., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

In this special supplement of Ear and Hearing, we have presented preliminarily validated measures for stigma related to being d/Deaf or hard of hearing (d/DHH) in the United States and Ghana. In this concluding article, we suggest avenues for the future refinement and use of these measures. First, the measures should be further validated. Second, they should be used to assess the current state of d/DHH stigma and the importance of different kinds of stigma in different populations, which should in turn drive the development of interventions to reduce d/DHH stigma. Third, these measures can assist in evaluating the effectiveness and cost-effectiveness of those interventions. The evidence from this work can then inform investment cases and cost-of-condition studies, which will support advocacy efforts and policy development for reducing stigma and improving the lives of people who are d/DHH., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Parents are integral to the development and overall well-being of their child. Previous research has studied the emotional effects parenting experiences have on parents. However, parents caring for children with disabilities have unique parenting experiences, filled with both victories and challenges. Parenting a child with disabilities can bring additional responsibilities as parents respond to their child's special needs. Specifically, parents of children who are d/Deaf or hard of hearing (d/DHH) are required to make ongoing life-changing decisions about their child's life, including mode of communication, medical care, and education. Across the world, many adults who are d/DHH experience stigma. However, less is known about the stigma faced by children who are d/DHH and their parents. Measuring the nature and magnitude of stigma-affecting parents of children who are d/DHH could offer insights into how to additionally support these parents. Nonetheless, there is a gap in validated scales to measure stigma among parents of children who are d/DHH. In response, we developed and preliminarily validated five measures of stigma among parents of children who are d/DHH., Design: Measures were developed through a mixed-method process: (1) a scoping literature review, (2) a modified Delphi process consisting of two group discussions (n = 3, n = 4) and two individual discussions with parents of children who are d/DHH from high-income countries (HICs) and low- and middle-income countries (LMICs), (3) cognitive interviews with parents of children who are d/DHH in the United States (U.S.) (n = 5) and Ghana (n = 5), and (4) a pretest of the survey in the U.S. (n = 28) and Ghana (n = 30). Modifications to the measures were made after each stage. This article focuses on evaluating the psychometric performance of the developed measures. Parents were recruited in the U.S. (n = 100) and Ghana (n = 173). Convenience sampling was used in both countries. In Ghana, survey administration was in-person with trained interviewers collecting data on tablets. In the U.S. data were collected online through self-administered surveys., Results: The final five scales measured: (1) parental observation of stigma their child experiences (seven items), (2) parental perceptions of stigma toward their child (eight items), (3) parental secondary experienced stigma (eight items), (4) perceived parental secondary stigma (five items), and (5) parental internalized stigma (seven items). All scales performed strongly and similarly across both country samples. The scales had ordinal αs ranging from 0.864 to 0.960, indicating strong reliability., Conclusions: This study provides a set of preliminarily validated stigma measures to capture the experience of parents of children who are d/DHH. Measuring stigma among parents is critical to understanding parental mental health, as parental well-being affects the health and development of their child. Furthermore, measuring observed stigma by parents can allow the researcher to gain an understanding of the stigma experienced by children who are d/DHH that they may not be able to communicate. Further studies testing these measures across other countries and with more diverse samples are needed., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Qualitative evidence suggests that stigma experienced by people who are d/Deaf and hard of hearing (d/DHH) can reduce willingness to engage with health services. Quantitative evidence remains lacking, however, about how health care providers (HCPs) perceive societal stigma toward people who are d/DHH, how HCPs might enact d/DHH stigma within provider-patient encounters, and what patients who are d/DHH share with providers about those patients' perceptions and experiences of stigma. Such quantitative evidence would allow HCPs to understand if and how stigma influences hearing health decisions made by people who are d/DHH. It could also shape practices to reduce d/DHH stigma within clinical encounters and guide providers in considering stigma as a driving force in their patients' hearing health care decisions. Building that evidence base requires validated quantitative measures. In response, the present study initiated an iterative process toward developing and preliminarily validating HCP self-report measures for different forms of d/DHH stigma. These measures draw upon HCPs' own perspectives, as well as their reports of secondhand information about stigma shared during clinical conversations. We developed and preliminary validated four measures: (1) provider-perceived stigma (HCPs' perceptions of the existence of negative attitudes and stereotypes toward d/DHH individuals in society), (2) provider-enacted stigma (self-reported subtle or indirect acts of stigma HCPs might commit during clinical encounters), (3) secondhand patient-experienced stigma (external acts of stigma reported to HCPs by patients who are d/DHH during clinical encounters), and (4) secondhand patient-perceived stigma (perceptions of negative attitudes and stereotypes reported to HCPs by patients who are d/DHH during clinical encounters)., Design: Scale items were extracted from a comprehensive literature review of stigma measures. Question stems and individual items were adapted for HCPs, cognitively tested on 5 HCPs, and pretested with 30 HCPs. The 4 scales were then validated on a sample of primary care providers and hearing care specialists (N = 204) recruited through an online survey. All data were collected in the United States., Results: We conducted an exploratory factor analysis of the four proposed d/DHH stigma HCP stigma scales. Scale items loaded satisfactorily with ordinal alphas ranging between 0.854 and 0.944., Conclusions: The four measures developed and preliminarily validated in this study can provide opportunities for HCPs to develop a more nuanced understanding of stigma experienced and perceived by their patients who are d/DHH and how that stigma manifests across social contexts, including health care settings. Further, the ability to assess forms of d/DHH stigma in clinical encounters, as well as their association with patient disengagement and resistance to advanced hearing care, could lead to innovative stigma-reduction interventions. Such interventions could then be evaluated using the measures from this article and then applied to clinical practice. We envision these measures being further refined, adapted, and tested for a variety of health care contexts, including primary care settings where hearing difficulties may first be identified and in hearing health care settings where audiologic rehabilitation is initiated., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Ageism appears widely across the globe and poses an important threat to older people's well-being and health. With respect to hearing health, experiences, perceptions, and fear of ageism can delay the diagnosis of hearing loss, reduce pursuit of hearing care, and fuel reluctance to wear a hearing device. Ageism intertwines with hearing loss stigma, which potentially deepens the negative effects of both; however, little evidence exists to quantify the effects of the intersection of ageism and hearing loss stigma. This lack of data on both hearing loss stigma and ageism, and their intersection, may stem from the lack of validated measures for both. Therefore, as part of a parent study to develop and preliminarily validate d/Deaf and hard of hearing stigma measures, we also adapted and preliminarily validated measures of both experienced and observed ageism., Design: We adapted four ageism measures through a literature review, expert discussions, and cognitive interviews and validated them in the United States through self-administered online surveys with convenience samples of (1) people aged 60 and older who became d/Deaf or hard of hearing (d/DHH) after developing language or in adulthood ("acquired" d/DHH), (2) care partners of people aged 60 or older who are d/DHH (acquired), (3) health care providers, and (4) the general population. For each of the scales, we applied exploratory factor analysis and estimated scale reliability with ordinal α., Results: For the population of persons over age 60 who are d/DHH (acquired) (N = 146), nine social stigma items and four employment discrimination items loaded well onto two separate factors, one which measures social stigma and one which measures employment discrimination. All loadings were >0.7. The two factors were moderately correlated at 0.428. For care partners of people aged 60 or older who are d/DHH (N = 72), nine items loaded well onto a single factor, with loadings between 0.650 and 0.936 and an ordinal α of 0.95. Among the general population (N = 312), 10 items loaded cleanly onto a single factor, with loadings between 0.702 and 0.919 and an ordinal α of 0.96. For the health care providers (N = 203), 11 items loaded well onto a single factor, with loadings between 0.541 and 0.874. For these three populations, each of the single factors measure social stigma., Conclusions: Ageism threatens the health and wellbeing of older people in both high- and low-income countries. Validated measures of ageism are necessary to understand the relationship between ageism, d/DHH stigma and the well-being of older adults and to design effective ageism-reduction and mitigation interventions. This preliminary validated set of experienced ageism measures offers a starting point for more studies that not only further validate these measures but are larger in scale, occur in more diverse settings, and provide insights into the experience of ageism and its effects on the health and well-being of older adults., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: In this article, we examine the psychometric performance of 3 scales measuring experienced, perceived, and internalized d/Deaf or hard of hearing (d/DHH) stigma among adult (18 and older) populations of individuals who are d/DHH, including those who have been d/DHH since before they developed language (lifelong) and those who became d/DHH after they developed language (acquired) in the United States and Ghana., Design: The preliminary validation study took place in the Greater Accra and Eastern regions of Ghana and across the United States. In the United States, all data were collected online via self-administered surveys in English. In Ghana, trained interviewers who are d/DHH and fluent in Ghanaian Sign Language conducted interviews with participants who are lifelong d/DHH using a video survey. Ghanaian participants with acquired d/DHH status were surveyed by trained hearing interviewers. We calculated polychoric correlation matrices between the measures to remove redundant and unrelated items and used exploratory factor analysis to create the final scales. We also tested the association between the factor scores and a simple summing method for calculating the scale., Results: The study sample included people who have been d/DHH since before they developed language (Ghana: n = 171, United States n = 100) and people who became d/DHH after they developed language (Ghana: n = 174, United States: n = 219). The final experienced, perceived, and internalized scales included six, seven, and five items, respectively. All three scales performed well as unidimensional measures across all four samples. Across the four samples, the experienced, perceived, and internalized stigma scales yielded ordinal αs ranging from 0.725 to 0.947, 0.856 to 0.935, and 0.856 to 0.935, respectively. It would be acceptable to operationalize all stigma scales as sum-of-item scores., Conclusions: The scales performed well and appear to provide a valid means of measuring different types of stigma among diverse groups of people who are d/DHH. Future work should refine and validate these scales in additional contexts., Competing Interests: The authors have no conflicts of interest to disclose. This work was supported in part from a central fund for the Lancet Commission on Hearing Loss whose contributors included RTI International in the Research Triangle Park, NC, USA, and the Provost’s Office, the School of Medicine, the Chancellor for Health Affairs, the Pratt School of Engineering, the Duke Global Health Institute, and the Department of Head and Neck Surgery and Communication Sciences at Duke University in Durham, NC, USA. In addition, further support for the present work was kindly and generously provided by RTI International and by the Department of Head and Neck Surgery and Communication Sciences at Duke. And finally, other aspects of the Lancet Commission were supported financially or with in-kind contributions by the National Institute on Deafness and Other Communication Disorders in Bethesda, MD, USA, the National Institute on Aging in Bethesda, MD, USA, the Fondation Pour L’Audition in Paris, France, the Duke Clinical & Translational Science Institute, and the World Health Organization in Geneva, Switzerland. There are no conflicts of interest, financial, or otherwise., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Hearing and vision impairments are associated with cognitive decline and dementia risk. Explanations for this include age-related processes impacting on sensory and cognitive function (common cause), or sensory impairments having a direct or indirect impact on cognition via social engagement, depression and physical activity (cascade). We tested whether associations between hearing, vision and episodic memory were mediated by allostatic load, social engagement, depression and physical activity., Methods: We used structural equation modelling with cross-sectional data from the USA (n = 4746, aged 50-101), England (n = 4907, aged 50-89) and Ireland (4292, aged 50-80) to model factors related to the common cause (indexed by allostatic load) and the cascade hypothesis with respect to cognitive ability (episodic memory)., Results: Poorer hearing/vision was associated with lower social engagement, depression and sedentary lifestyle. Poor vision was not related to allostatic load, and poor hearing was associated with allostatic load in only one data set, contributing to a common-cause hypothesis. Lower social engagement, depression and a sedentary lifestyle were associated with poorer episodic memory, contributing to the cascade hypothesis. Using effect estimates to calculate the proportion of the total effects mediated by the combined mediator variables, up to two fifths of the relationship between hearing and vision with episodic memory can be explained by the mediators., Conclusions: The association between hearing, vision and episodic memory is mediated by allostatic load, social engagement, depression, and physical activity. The finding that social engagement, depression, and physical activity mediate the association between sensory abilities and cognitive function supported the cascade hypotheses. Interventions to improve healthy lifestyle, reduce depression and foster social engagement of older people with sensory impairments are likely to be beneficial in preventing cognitive decline and dementia., (© 2024 The Author(s). International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)

In speech-language therapy, the evaluation of children with atypical speech embodies the practical expertise of the therapist and the therapeutic goal of facilitating rehabilitation by guiding these children toward more typical speech behaviors. This study aims to provide an interactional explanation of how positive evaluations given by speech therapists are sequentially formatted, constructed, and oriented in therapy practice and what interactional consequences they have on the interpretation and learning of children with hearing impairment. Adopting conversation analysis as a methodology, this empirical study delves into naturally occurring conversations between speech therapists and children with hearing impairment within the context of Chinese speech-language therapy, focusing specifically on instances of positive evaluations in the third-turn position. The analysis reveals a prevalent occurrence of positive evaluations during therapeutic interactions, showcasing a diverse range of formats employed, spanning from explicit to implicit expressions. A fine-grained conversation analysis demonstrates the delicate and intricate nature of therapists' positive evaluations, in terms of their indexicality (the function of being referential), and sensitivity to local contingencies. Furthermore, these positive evaluations serve as a critical site for displaying the epistemic asymmetry and its negotiation in and through therapist-client interactions. By providing an empirical demonstration of the interactional skill involved in speech-language therapy and advocating for evaluations characterized by clear indexicality and recipient-orientedness, this study contributes to enhancing the efficiency and effectiveness of rehabilitation practices while shedding new light on the atypical interactions involving people with communicative impairments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This systematic review examined the audiological and non-audiological factors that influence hearing aid use, benefit and satisfaction in adults based on studies published during the last decade (2010 and 2023)., Design: Studies were identified by using PRISMA guidelines for systematic searches on five platforms (Web of Science, Scopus, PubMed, EBSCOhost including CINAHL and Academic Search Complete). The National Institute of Health Quality assessment tool and the Oxford Centre for Evidence Based Medicine tool were used for quality assessment and grading of level of evidence., Results: Forty-six articles were included in the review. A total of 101 significant factors influencing hearing aid use ( n  = 47), benefit ( n  = 17) and satisfaction ( n  = 37) were identified. Clear determinants of hearing aid use, benefit and satisfaction included hearing sensitivity, self-reported hearing difficulty, speech perception, attitude and beliefs. 34 cross-sectional studies in this review were graded level 4, 9 cohort studies rated level 3, and 3 randomised control trials rated level 2., Conclusion: Factors associated with hearing aid outcomes identified in the past decade support previous evidence. New factors like social networks and service-delivery models, have also been identified. These factors require further investigations through high quality studies to further strengthen existing evidence.

Background: This study evaluates the Quality of Life (QoL) in children with moderate to profound hearing impairments using cochlear implants (CIs), compared to those with normal hearing. It explores the impacts of hearing loss and the effectiveness of CIs in pediatric populations., Methods: Conducted at a tertiary care academic center, this cross-sectional study included children aged 13-18. Participants were divided into three groups: normal hearing, yet to be treated moderate or worse hearing loss (uHL), and CI users. Demographic data were collected, and the QoL was assessed using the Hearing Environments and Reflection of Quality of Life (HEAR-QL) questionnaire, with scores across various subdomains compared., Results: Of the 79 children meeting the inclusion criteria, 38 % had normal hearing, 29 % had at least moderate HL, and 33 % were CI users. Statistically significant differences in HEAR-QL scores were found among the groups. The normal hearing group reported the highest scores. In the subdomain of hearing circumstances and academic performance, CI users showed no significant difference from the normal hearing group, unlike those with untreated uHL who scored lower. However, in social interaction and emotional well-being subdomains, CI users' scores were lower than those of the normal hearing group but similar to the uHL group., Conclusion: Children with CIs show comparable QoL in auditory capabilities to their normal hearing peers but experience significant challenges in psychosocial and emotional areas. This indicates that while CIs can improve hearing-related quality of life, they do not fully address the psychosocial impacts of hearing loss., Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: To identify geographic, sociodemographic, and clinical factors associated with parental self-efficacy in a diverse cohort of deaf or hard-of-hearing (DHH) children., Study Design: Cross-sectional study., Setting: Tertiary children's hospital., Methods: Four hundred forty parents of DHH children aged 0 to 17 completed the 25-item Scale of Parental Involvement and Self-Efficacy (SPISE) survey from 2014 to 2022. Residential addresses were geocoded and assigned Area Deprivation Index and Social Vulnerability Index rankings, and univariable and multivariable analyses were conducted using sociodemographic and clinical variables, including sex, race/ethnicity, insurance type, survey language, age at the survey, comorbidities, newborn hearing screening results, and hearing loss laterality and severity., Results: Compared to English and Spanish-speaking parents, Chinese-speaking parents were associated with overall lower parental self-efficacy and involvement (regression coefficient = -0.518, [-0.929, -0.106]), Cohen's d = 0.606) and lower scores on items related to their ability to affect multiple aspects of their child's development and expression of thoughts as well as competency in checking and putting on their child's sensory device. Across univariable and multivariable analyses, besides Chinese language, all other sociodemographic, clinical, and geographic variables were not associated with SPISE score., Conclusion: To achieve the best patient outcomes, care teams can use the SPISE to evaluate parental self-efficacy and provide targeted support to parents at risk for having lower knowledge and confidence scores about critical skills necessary to facilitate their child's auditory access and language development. Notably, this study found similar reports of parental efficacy across various sociodemographic, clinical, and geographic variables but significantly lower SPISE scores in Chinese-speaking families., (© 2024 The Authors. Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Auditory scene analysis (ASA) is the process through which the auditory system makes sense of complex acoustic environments by organising sound mixtures into meaningful events and streams. Although music psychology has acknowledged the fundamental role of ASA in shaping music perception, no efficient test to quantify listeners' ASA abilities in realistic musical scenarios has yet been published. This study presents a new tool for testing ASA abilities in the context of music, suitable for both normal-hearing (NH) and hearing-impaired (HI) individuals: the adaptive Musical Scene Analysis (MSA) test. The test uses a simple 'yes-no' task paradigm to determine whether the sound from a single target instrument is heard in a mixture of popular music. During the online calibration phase, 525 NH and 131 HI listeners were recruited. The level ratio between the target instrument and the mixture, choice of target instrument, and number of instruments in the mixture were found to be important factors affecting item difficulty, whereas the influence of the stereo width (induced by inter-aural level differences) only had a minor effect. Based on a Bayesian logistic mixed-effects model, an adaptive version of the MSA test was developed. In a subsequent validation experiment with 74 listeners (20 HI), MSA scores showed acceptable test-retest reliability and moderate correlations with other music-related tests, pure-tone-average audiograms, age, musical sophistication, and working memory capacities. The MSA test is a user-friendly and efficient open-source tool for evaluating musical ASA abilities and is suitable for profiling the effects of hearing impairment on music perception., (© 2023. The Author(s).)

Research investigating the complex interplay of cognitive mechanisms involved in speech listening for people with hearing loss has been gaining prominence. In particular, linguistic context allows the use of several cognitive mechanisms that are not well distinguished in hearing science, namely those relating to "postdiction", "integration", and "prediction". We offer the perspective that an unacknowledged impact of hearing loss is the differential use of predictive mechanisms relative to age-matched individuals with normal hearing. As evidence, we first review how degraded auditory input leads to reduced prediction in people with normal hearing, then consider the literature exploring context use in people with acquired postlingual hearing loss. We argue that no research on hearing loss has directly assessed prediction. Because current interventions for hearing do not fully alleviate difficulty in conversation, and avoidance of spoken social interaction may be a mediator between hearing loss and cognitive decline, this perspective could lead to greater understanding of cognitive effects of hearing loss and provide insight regarding new targets for intervention., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 The Authors. Ear & Hearing is published on behalf of the American Auditory Society, by Wolters Kluwer Health, Inc.)

Background: Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults., Methods: We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function., Results: We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01)., Conclusions: Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults., (© 2024 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)

Objectives: Hearing loss (HL) (receptive communication impairment) is a known risk factor for depression. However, dysphonia (expressive communication impairment), has received little study. We study HL, self-reported voice disorder, and combined impairment as risk factors for depression in a large national cohort., Methods: This was a cross-sectional epidemiologic study. Data were analyzed from the Korean National Health and Nutrition Examination Survey (KNHANES) cycles 2008-2012 and 2019-2020. KNHANES uniquely contains both audiometry and voice disorder data. HL (yes/no) was defined as ≥25 dB pure tone average. Voice disorder (yes/no) was defined by self-report. Depression (yes/no) was defined by physician diagnosis. Odds ratios for depression were calculated using multivariable logistic regressions with HL and voice disorder., Results: 8,524 individuals aged 19 to 80 years old had complete data. The mean age was 57.3 years (SD = 13.4) and 64% were women. All regressions were controlled for age and sex. Those with HL, versus those without, had 1.27 times the odds (95% CI = 1.07-1.52, p = 0.007) of depression. Those with self-reported voice disorder, versus those without, had 1.48 times the odds (1.22-1.78, p < 0.001) of depression. Those with HL and self-reported voice disorder, versus those with neither, had 1.79 times the odds (1.27-2.48, p < 0.001) of depression., Conclusions: This study demonstrates independent relationships between HL and depression and self-reported voice disorder and depression. Combined HL and self-reported voice disorder had nearly 1.8 times the odds of depression. This is likely due to the grossly additive effect of difficulty with incoming and outgoing communication streams., Level of Evidence: II Laryngoscope, 134:4060-4065, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: The age of identification of hearing loss in children is highly influenced by the hearing help seeking behaviour of their parents, particularly in countries without universal newborn hearing screening programs. In this study, an attempt was made to identify the factors associated with help seeking behaviour in parents of children with hearing loss, and the relationship of such factors with the age of identification of hearing loss., Design: Focus group discussions based on the framework of health belief model were carried out. The discussions were transcribed and the transcripts were thematically analysed., Study Sample: Participants were 35 parents of children with hearing loss from the state of Karnataka in India., Results: The findings revealed 30 factors related to their awareness about hearing loss, geographical location, socio-economic status, family, and society. The factors differed between early and late help seekers., Conclusions: Awareness, accessibility, and affordability are the key factors that influenced the hearing help seeking behaviour of the participants. Effective public awareness programs, newborn hearing screening programs, and provisions to make hearing healthcare affordable to all can reduce the age of identification of paediatric hearing loss in India.

Objective: Approximately 20% to 40% of children with hearing loss encounter psychosocial difficulties. This prevalence may be outdated, given the advancements in hearing technology and rehabilitation efforts to enhance the psychosocial well-being of these children. A systematic review of up-to-date literature can help to identify factors that may contribute to the children's psychosocial well-being., Design/study Sample: A systematic review was conducted. Original articles were identified through systematic searches in Embase, Medline, PsychINFO, and Web of Science Core Collection. The quality of the papers was assessed using the Newcastle-Ottawa Quality Assessment Scale and custom Reviewers' Criteria., Results: A search was performed on 20 October 2022. A total of 1561 articles were identified, and 36 were included for review. Critical appraisal led to 24 good to fair quality articles, and 12 poor quality articles., Conclusion: Children with hearing loss have a twofold risk of experiencing psychosocial difficulties compared to normal hearing peers. Estimates for functioning in social interactions, like speech perception (in noise) or language proficiency, have proven to be more adequate predictors for psychosocial difficulties than the degree of hearing loss. Our findings can be useful for identifying children at risk for difficulties and offering them earlier and more elaborate psychological interventions.

Objectives: To develop and validate a novel questionnaire aimed at providing a structured, evidence-based methodology for hearing aid recommendation and selection using self-reported importance ratings for different modern hearing aid features., Design: The initial questionnaire items were created through a concept mapping approach that involved input from hearing aid users. Hearing care professional focus groups ( n  = 10) were conducted to assess questionnaire content and design, and to guide modifications. Validation of this initial 34-item version of the questionnaire was conducted using an anonymous online survey tool (Qualtrics). Exploratory factor analysis was used to assess the factor structure of the dataset, using principal axis factoring. Questionnaire reliability and inter-item correlation were assessed. Items with low factor loading and high cross-loading were removed., Study Sample: Two hundred and eighteen adult participants with a self-reported hearing loss (median age = 48 years, range = 18-95 years) completed the questionnaire., Results: Analysis and item removal resulted in a 28-item questionnaire. Three factors were identified, dividing the hearing aid features into the subscales: "Advanced connectivity & streaming", "Physical attributes & usability", and "Sound quality & intelligibility"., Conclusion: This study has resulted in a patient-oriented questionnaire that allows clinicians to gather patient input in a structured manner.

Context: Patient-reported experience measures (PREMs) provide important insights into the challenges experienced when living with a chronic condition. Although patient-reported outcome measures (PROMs) exist in audiology, there are no validated PREMs to help clinicians understand patient perspectives and identify areas where patients may need additional support or interventions., Objective: The aim of this study was to develop and evaluate content for the new 'My Hearing PREM', which captures lived experiences of hearing loss from patients' perspectives., Design: My Hearing PREM was developed and tested in two key phases. Phase 1 involved generating the PREM prototype in accordance with our conceptual model of the lived experience of hearing loss. In Phase 2, cognitive interviews were conducted with adults with hearing loss to appraise the content of the PREM (relevance, clarity, acceptability and comprehensiveness) and assess its respondent burden. Key stakeholders (e.g., adults with hearing loss, patient and public representatives, clinicians and researchers) were consulted throughout Phases 1 and 2 to review and refine the PREM. Interview data were analysed using thematic analysis., Setting and Participants: Sixteen participants (aged 16 years and over) with hearing loss took part in cognitive interviews, recruited from UK audiology departments and non-clinical settings (e.g., lip-reading classes, national charity links and social media)., Results: Most PREM items were found to be relevant, clear, acceptable and comprehensive. Several problems were identified, including items not working well with the response scale options, irrelevant questions and a lack of clarity about terms (e.g., healthcare professionals) and whether questions should be answered based on the use of hearing aids (or not). The PREM was amended accordingly., Conclusions: Currently, no hearing loss-specific PREMs exist in audiology. Involving multiple stakeholders in the development of the PREM helped to ensure that the items were relevant, clear, acceptable and comprehensive. The PREM is undergoing further evaluation and refinement in preparation for investigating the feasibility of implementing it into clinical practice., Patient or Public Contribution: Ongoing Patient and Public Involvement and Engagement (PPIE) with key groups (South Asian Women's groups, young people's groups, learning disability networks and student populations) was integral to the study. PPIE members reviewed patient information sheets and consent forms, advised on recruitment, reviewed the interview schedule and checked coding and analysis procedures. PPIE members provided feedback on the PREM's comprehensibility. Members of the public, including adults attending lip-reading classes and hearing aid users from the South Asian community, provided feedback on iterative PREM drafts., (© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)

Objective: Examine the association between military blast exposure and functional status among veterans with a focus on functional disability as a proxy for quality of life and explore the potential modifying effect of hearing loss on this association., Study Design: Prospective cohort., Setting: Multi-institutional tertiary referral centers., Patients: 540 veterans., Exposure: Self-reported military blast exposure with and without tinnitus; high-frequency hearing loss (yes/no)., Main Outcome Measure: WHO Disability Assessment Schedule 2.0 questionnaires at baseline and annually over 5 years. The odds of membership into three functional disability trajectory groups: low functional disability, moderate functional disability, and high functional disability., Results: Of 540 veterans, 197 (36.5%) self-reported a blast exposure history, and 106 of 197 (53.8%) reported tinnitus as a direct result of the blast. Blast exposure without tinnitus increased the odds of moderate functional disability compared with low functional disability (odds ratio [OR] = 1.5; 95% confidence interval [CI], 0.92-2.51), which strengthened among those with blast with tinnitus (OR, 3.6; 95% CI, 2.1-6.1). Blast exposure without tinnitus also increased the odds of membership to high functional disability versus low functional disability (OR, 2.2; 95% CI, 1.1-4.8). Hearing loss further increased the odds of reporting functional disability. The probability of low functional disability was approximately 60% if there was no history of blast or hearing loss, dropping to 20% if there was blast, tinnitus, and hearing loss history., Conclusions: Blast exposure negatively affects the quality of life of veterans, especially when compounded with tinnitus and hearing loss., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2024, Otology & Neurotology, Inc.)

Music is an important part of life for many people. It can evoke a wide range of emotions, including sadness, happiness, anger, tension, relief and excitement. People with hearing loss and people with cochlear implants have reduced abilities to discriminate some of the features of musical sounds that may be involved in evoking emotions. This paper reviews these changes in perceptual abilities and describes how they affect the perception of emotion in music. For people with acquired partial hearing loss, it appears that the perception of emotion in music is almost normal, whereas congenital partial hearing loss is associated with impaired perception of music emotion. For people with cochlear implants, the ability to discriminate changes in fundamental frequency (associated with perceived pitch) is much worse than normal and musical harmony is hardly perceived. As a result, people with cochlear implants appear to judge emotion in music primarily using tempo and rhythm cues, and this limits the range of emotions that can be judged. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

Background: Mobile health (mHealth) solutions can improve the quality, accessibility, and equity of health services, fostering early rehabilitation. For individuals with hearing loss, mHealth apps might be designed to support the decision-making processes in auditory diagnostics and provide treatment recommendations to the user (eg, hearing aid need). For some individuals, such an mHealth app might be the first contact with a hearing diagnostic service and should motivate users with hearing loss to seek professional help in a targeted manner. However, personalizing treatment recommendations is only possible by knowing the individual's profile regarding the outcome of interest., Objective: This study aims to characterize individuals who are more or less prone to seeking professional help after the repeated use of an app-based hearing test. The goal was to derive relevant hearing-related traits and personality characteristics for personalized treatment recommendations for users of mHealth hearing solutions., Methods: In total, 185 (n=106, 57.3% female) nonaided older individuals (mean age 63.8, SD 6.6 y) with subjective hearing loss participated in a mobile study. We collected cross-sectional and longitudinal data on a comprehensive set of 83 hearing-related and psychological measures among those previously found to predict hearing help seeking. Readiness to seek help was assessed as the outcome variable at study end and after 2 months. Participants were classified into help seekers and nonseekers using several supervised machine learning algorithms (random forest, naïve Bayes, and support vector machine). The most relevant features for prediction were identified using feature importance analysis., Results: The algorithms correctly predicted action to seek help at study end in 65.9% (122/185) to 70.3% (130/185) of cases, reaching 74.8% (98/131) classification accuracy at follow-up. Among the most important features for classification beyond hearing performance were the perceived consequences of hearing loss in daily life, attitude toward hearing aids, motivation to seek help, physical health, sensory sensitivity personality trait, neuroticism, and income., Conclusions: This study contributes to the identification of individual characteristics that predict help seeking in older individuals with self-reported hearing loss. Suggestions are made for their implementation in an individual-profiling algorithm and for deriving targeted recommendations in mHealth hearing apps., (©Giulia Angonese, Mareike Buhl, Inka Kuhlmann, Birger Kollmeier, Andrea Hildebrandt. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 12.08.2024.)