A validation and normative study of the Parents' Evaluation of Aural/Oral Performance of Children plus (PEACH+) rating scale in Malaysia.

OBJECTIVE: The purpose of the present study was to (1) translate and validate the PEACH + Rating Scale in Malay and (2) establish normative curves as a function of age and examine test-retest reliability for the Malay and English versions of PEACH+. DESIGN: This is a cross-sectional study that used a convenient sampling technique. STUDY SAMPLE: One hundred and fifty-seven parents of typically developing children aged between 4 months and 7 years participated in the study. Forty-nine completed the Malay PEACH + in a pen-to-paper format (Aim 1). One hundred and eight parents completed PEACH + online (69 completed the Malay version and 39 the English version), and 20 of them completed the questionnaire twice (Aim 2). RESULTS: The PEACH + in Malay showed high internal consistency and item-total correlation. The normative data revealed that scores for frequency of auditory behaviour increased rapidly with age until about 20 months and reached an asymptote of around 90% by about 40 months of age. A similar trend was observed for ease of listening scores, which asymptoted around 85%. CONCLUSIONS: The validated Malay PEACH + Rating Scale can be used as a guide to monitor auditory functional performance and listening efforts of Malaysian children in real-world environments.

Impact of the COVID-19 Pandemic on Individuals With Hearing Loss and Audiology Practice in a Developing Country.

OBJECTIVE: This study aimed to determine the challenges faced by individuals with hearing loss at a time when many nations were attempting to move from the COVID-19 pandemic to endemic. DESIGN: A cross-sectional survey was conducted on Malaysian adults with hearing loss to determine the impact of the COVID-19 crisis on hearing aid management, communication difficulties, psychosocial challenges, and access to audiological services. STUDY SAMPLE: One hundred forty-six individuals aged 18 years old and above with hearing loss were recruited from hearing health care centers to participate in the survey. RESULTS: Many of the participants (54.2%) reported significant difficulties communicating with people wearing face masks. For hearing aid management, repairing (36.3%) and fine-tuning devices (30.2%) were considered more challenging than obtaining a battery (21.3%). The COVID-19 pandemic had a serious psychosocial impact on a small portion of the individuals surveyed. Remote services were rarely offered by the audiologists, and most participants preferred in-person treatment. However, the majority perceived that creating awareness and training on telehealth was important. CONCLUSIONS: Effective management for people with hearing loss needs to consider the challenges faced by them, as the world prepares to live with the coronavirus. Clinical protocols should consider providing a service that is helpful for the clients as well as safe and sustainable in future pandemics.

Optimising hearing aid output to paediatric prescriptive targets improves outcomes in children.

OBJECTIVE: This study examined the accuracy of hearing aid output to DSL v5.0 Child targets in a group of children who wear hearing aids, and the impact on their auditory outcomes. DESIGN: For each participant, the output of the initial hearing aid fitting was compared to DSL v5.0 Child prescriptive targets and again after the fitting was adjusted using coupler-based verification and RECD measures. Outcomes for initial and adjusted fittings were examined using the Speech Intelligibility Index (SII), Parent's Evaluation of Aural/Oral Performance of Children (PEACH) rating scale, and speech perception tests in quiet and noise. STUDY SAMPLE: Sixty-eight children aged 3 months to 17 years with moderate to profound hearing loss participated in the study. RESULTS: Fit-to-targets improved significantly after hearing aids were adjusted to match targets to within 5 dB RMSE. Adjusted hearing aids provided increased aided audibility compared to initial fittings and resulted in improved speech perception scores and parent-reported hearing performance. Fifty percent of the children aged 6 to 17 years preferred their adjusted fitting compared to 10% who preferred their initial fitting. CONCLUSIONS: Improvement in fit-to-target to a validated paediatric prescriptive formula using best practice procedures can result in improved auditory outcomes and possible self-reported satisfaction.

Development of the Mandarin Nonsense Word Identification Test.

OBJECTIVE: This study aimed to develop a digitised Mandarin Nonsense Word Speech Perception Test for use in Malaysia, a multilingual country in Southeast Asia. DESIGN: In Phase I, 400 vowel-consonant-vowel (VCV) nonsense word samples containing 20 Mandarin consonants in /a/, /i/, or /u/ contexts were recorded from two speakers of different genders. Acoustic analyses, sound quality ratings, and item validations were used to guide selection of items to form two gender-specific test lists. In Phase II, performance-intensity functions and test-retest reliability for the lists were established. STUDY SAMPLE: Native Mandarin-speaking adults with normal hearing participated in Phase I (n = 10) and Phase II (n = 69). RESULTS: Eighty-four of the 400 VCV words were selected to form two gender-specific test lists. A two-way repeated measure ANOVA revealed a significant interaction effect between speaker-gender and presentation level [F (4.88, 283.20) = 22.79, p < 0.001, ηp2= 0.28]. Intraclass correlation scores of 0.75 and 0.87 were obtained for the female-speaker and male-speaker lists respectively. CONCLUSIONS: The preliminary normative data of the Mandarin nonsense word test have been developed. It is recommended to use separate gender-specific norms when conducting the test. The test has good validity and reliability for testing Mandarin-speaking adults in Malaysia.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions.

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight (N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23-48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Development and evaluation of a hearing aid manual in the Malay language.

OBJECTIVE: This study aimed to (a) translate a hearing aid (HA) manual into Malay language and revise the translated manual based on best practice guidelines; (b) compare the effectiveness of the translated and the revised Malay HA manuals in helping individuals to perform HA management tasks. DESIGN: Cross-sectional, randomised, single-blinded study. STUDY SAMPLE: An Oticon-Dynamo HA manual was translated and revised based on best practice guidelines. Ninety participants aged 55 years and above participated in this study. They were randomly assigned into the control group (received translated manual) and the experimental group (received the revised translated manual). The Hearing Aid Management (HAM) test, which was developed in a previous study, was conducted to evaluate participant's ability to perform HA management tasks using the translated and the revised version of Malay HA manual. RESULTS: The revised Malay HA manual had a lower reading grade level relative to the initial translated Malay HA manual. The ability to perform HA management tasks was better in the experimental group (mean = 12.2, SD = 1.15) versus the control group (mean = 8.7, SD = 2.11). CONCLUSION: Further revision of existing HA manuals based on best practice guidelines is recommended to help individuals better manage their HAs.

A critical review of hearing-aid single-microphone noise-reduction studies in adults and children.

PURPOSE: Single-microphone noise reduction (SMNR) is implemented in hearing aids to suppress background noise. The purpose of this article was to provide a critical review of peer-reviewed studies in adults and children with sensorineural hearing loss who were fitted with hearing aids incorporating SMNR. METHOD: Articles published between 2000 and 2016 were searched in PUBMED and EBSCO databases. RESULTS: Thirty-two articles were included in the final review. Most studies with adult participants showed that SMNR has no effect on speech intelligibility. Positive results were reported for acceptance of background noise, preference, and listening effort. Studies of school-aged children were consistent with the findings of adult studies. No study with infants or young children of under 5 years old was found. Recent studies on noise-reduction systems not yet available in wearable hearing aids have documented benefits of noise reduction on memory for speech processing for older adults. CONCLUSIONS: This evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort. Future research should test SMNR with infants and children who are younger than 5 years of age. Further development, testing, and clinical trials should be carried out on algorithms not yet available in wearable hearing aids. Testing higher cognitive level for speech processing and learning of novel sounds or words could show benefits of advanced signal processing features. These approaches should be expanded to other populations such as children and younger adults. Implications for rehabilitation The review provides a quick reference for students and clinicians regarding the efficacy and effectiveness of SMNR in wearable hearing aids. This information is useful during counseling session to build a realistic expectation among hearing aid users. Most studies in the adult population suggest that SMNR may provide some benefits to adult listeners in terms of listening comfort, acceptance of background noise, and release of cognitive load in a complex listening condition. However, it does not improve speech intelligibility. Studies that examined SMNR in the paediatric population suggest that SMNR may benefit older school-aged children, aged between 10 and 12 years old. The evidence supports the use of SMNR for adults and school-aged children when the aim is to improve listening comfort or reduce listening effort.