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BACKGROUND: Outbreaks, such as the COVID-19 pandemic in 2020, exacerbate barriers to accessing early childhood developmental care. Tele-assessment may serve as an innovative approach to developmental monitoring to overcome service delivery amidst challenging circumstances. It is vital to collect caregivers' perspectives of this potential service delivery method to inform clinical decision making. OBJECTIVES: This study aimed to determine caregivers' perspectives of interview-based early developmental tele-assessment in a South African context. METHOD: Thirty caregivers of children (aged birth - 36 months) completed a caregiver-report developmental assessment via a telecommunications platform, as well as an online questionnaire probing their perspectives on the tele-assessment. RESULTS: Most participants (96.7%, n = 29 out of 30) rated their overall experience of the tele-assessment as positive; however, 53.8% (n = 14 out of 26 that answered the question) indicated that they would additionally still prefer in-person assessment. CONCLUSION: Tele-assessment appears to be a viable approach for caregivers to access developmental care during circumstances such as COVID-19.Contribution: This study provided valuable insight into a novel approach using interview-based early developmental tele-assessment and the perspectives of caregivers thereof.
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COVID-19 , Cuidadores , Telemedicina , Humanos , Cuidadores/psicologia , Lactente , Feminino , Masculino , Pré-Escolar , África do Sul , Recém-Nascido , SARS-CoV-2 , Adulto , Desenvolvimento Infantil , Inquéritos e Questionários , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/psicologiaRESUMO
Importance: With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy. Objective: To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists. Design, Setting, and Participants: Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023. Interventions: In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices. Main Outcomes and Measures: The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA). Results: Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better. Conclusion: This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.
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OBJECTIVE: This project sought to investigate the impact of a multi-national peer learning initiative in facilitating a student-led conference on person-centred care (PCC). The primary objective was to assess students' comprehension of PCC elements before and after engaging in the opportunity, with a concurrent evaluation of the efficacy of the opportunity. DESIGN: A mixed-methods study protocol was followed. Following the conference, participants completed a four-part survey including (a) demographics, (b) retrospective pre-post Likert scale, (c) Likert rating of conference experience and (d) five open-ended questions. STUDY SAMPLE: One hundred and four participants (92.4% female) with a mean age of 21 years (0.07 SD) participated in the study. RESULTS: A significant difference in awareness pre-post conference was demonstrated across all topics (WSR, p < 0.001) with participants satisfied with the conference. Qualitative analysis revealed three main themes: (a) application of PCC; (b) perspectives of PCC; and () barriers to PCC; with nine sub-themes. CONCLUSION: The conference was beneficial in enhancing students' awareness of topics and principles of PCC. Innovative pedagogical approaches should be considered in order to enhance healthcare education allowing future clinicians to better meet the dynamic needs of their clients.
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BACKGROUND: Oral feeding practices of young patients on high-flow oxygen (HFO2) have been controversial. Limited literature exists on this topic, but new studies suggest introducing oral feeds. OBJECTIVE: This study aims to describe the changes in swallowing and feeding of a group of young children on HFO2. METHOD: Twelve participants (mean age 34.17 months [s.d. = 3.97]) on HFO2 were assessed clinically at the bedside using the Schedule of Oral Motor Assessment. Assessments were conducted twice to determine the change in characteristics: upon approval from the managing doctor when respiratory stability on HFO2 was achieved and for a second time on the last day of receiving HFO2 (mean 2.6 days apart). Patients received standard in-patient care and speech therapy intervention. RESULTS: Most participants displayed typical oral motor function at initial and final assessments for liquid, puree and semi-solid consistencies. Purees and soft solid consistencies were introduced to most participants (n = 11, 91.7%). Solids and chewables were challenging for all participants during both assessments. Half of the participants displayed gagging and a wet vocal quality with thin liquids at the initial assessment only. CONCLUSION: This small-scale study found that HFO2 should not preclude oral diets, but in this sample, small amounts of oral feeding could be introduced with caution, in an individualised manner, and with a collaborative multidisciplinary approach. Further research is essential.Contribution: Partial oral feeding of specific consistencies was possible during the assessment of young paediatric in-patients on HFO2. Monitoring of individual patient characteristics and risk factors by a specialist feeding team is essential.
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Transtornos de Deglutição , Deglutição , Humanos , Criança , Pré-Escolar , Transtornos de Deglutição/etiologia , Oxigênio , Fatores de RiscoRESUMO
OBJECTIVE: The study aimed to explore facilitators and barriers in delivering person-centered care from the perspective of speech-language pathologists and audiologists in a socio- economically diverse workplace across micro, meso, and macro levels. METHOD: A national cross-sectional e-survey was conducted among pooled speech-language pathologists and/or audiologists from South Africa. The e-survey included quantitative components to describe participant demographics which was analysed using descriptive and inferential statistics. The qualitative data was analyzed using metaphor and thematic analysis approaches to describe respondents' perspectives of barriers and facilitators in delivering person-centered care. RESULTS: The e-survey was completed by 63 clinicians (36.5% Audiologists; 36.5% Speech-Language Therapists; 27.0% dually qualified Speech-Language Therapists and Audiologists) mostly between the ages of 26 to 35 years old (33.3%). Respondents were working in various settings including the public sector (41.3%), private sector (44.4%) and in academia (14.3%). Facilitators and barriers were identified within all three systems (macro, meso and micro). The metaphor analysis resulted in six categories: uncertainty of Person centered care; its essential nature; associated challenges; relational aspect; analogies referring to animals; and food-related analogies. Thematic analysis of open-ended questions revealed five barriers, with three relating to micro systems; i) clinician factors, ii) client factors, iii) clinician and client interaction, and two related to factors within the meso system; iv) resources, and v) workplace. Only two themes were identified as facilitators towards PCC, clinician factors (mirco) and workplace factors (meso).' CONCLUSIONS: Insights gained from exploring Speech-Language Pathologists' and Audiologists' perceptions of implementing PCC in a socio-economically diverse setting highlight the need to address contextual (meso and macro systems) and personal (micro system) factors to promote and deliver PCC effectively. Notably, for the public sector, resources emerged as a major concern and barrier on the macro system level. Despite these challenges, the investigation revealed two noteworthy facilitators: clinician factors, at the micro level, and workplace factors, at the meso level. This nuanced understanding emphasizes the necessity of tailored interventions targeting both individual and systemic aspects to enhance the successful implementation of person-centered care. PRACTICAL IMPLICATIONS: Strategies should focus on enhancing clinicians' communication skills, collaboration, and teamwork, as well as addressing resource limitations through the adaptation of tools and implementation of PCC ISO standards.
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Audiologistas , Assistência Centrada no Paciente , Patologia da Fala e Linguagem , Humanos , Adulto , Feminino , Estudos Transversais , Masculino , África do Sul , Inquéritos e Questionários , Atitude do Pessoal de Saúde , Pesquisa Qualitativa , Pessoa de Meia-Idade , Local de Trabalho/psicologiaRESUMO
INTRODUCTION: Bilinguals constitute a significant portion of speech-language pathologists' (SLPs) caseloads. Insight into the cross-linguistic effect on voice is needed to guide SLPs to make linguistically appropriate observations when working with heterogenous populations. METHOD: Nineteen female English-Northern Sotho bilinguals performed three speech tasks (reading, picture description, and monologue) in each language. Acoustic analysis of mean fundamental frequency (f0), intensity, and articulation rate was conducted with Praat. A panel of blinded listeners reached consensus after independently reviewing the recordings during perceptual analysis of voice quality, resonance, and glottal attack. RESULTS: The following statistically significant differences were found across and within the languages: The mean f0 was 204.61 Hz in the Northern Sotho picture description yet 196.50 Hz in the English picture description. The mean intensity of reading in Northern Sotho was 66.38 dB whereas the mean intensity of reading in English was 65.09 dB. Articulation rate was 3.78 syllables/s in English passage reading and 3.41 syllables/s in Northern Sotho passage reading. Within English, passage reading elicited a significantly quicker articulation rate than the picture description (3.34 syllables/s) and monologue (3.46 syllables/s). Within Northern Sotho, mean f0 was 203.83 Hz in passage reading yet 191.11 Hz in the monologue. Perceptual voice quality, glottal attack, and resonance were comparable across languages. CONCLUSION: Relationships between languages spoken, task performance, and vocal characteristics were observed in English-Northern Sotho bilingual females. SLPs must consider the interaction of language, task performance, and vocal characteristics when working with bilingual clients.
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Multilinguismo , Voz , Humanos , Feminino , Idioma , Fala , Linguística , Qualidade da VozRESUMO
INTRODUCTION: The stigma associated with wearing hearing aids, known as the "hearing aid effect," remains a significant issue in hearing healthcare. Despite notable changes in the look and feel of hearing aids over the last decade, little is known about the influence of socioeconomic factors on the perception of different hearing devices in a socioeconomically diverse setting. OBJECTIVE: To determine the hearing aid effect across a range of hearing devices and its association with socioeconomic factors, namely area of residence and level of education across African communities. METHOD: The study used a cross-sectional design with 322 participants (161 rural, 161 urban); mean age 31.9 years (14.7 SD). Participants rated photographs of seven different styles of devices [standard behind-the-ear hearing aid (BTE HA) with an earmould, mini BTE HA with a slim tube (ST), in-the-canal (ITC) HA, Airpod, receiver-in-canal (RIC), completely-in-canal (CIC) HA, and Personal Sound Amplification Product (PSAP)] worn by a peer model using a validated scale of eight attributes (attractiveness , age, success, hardworking, trustworthiness, intelligence, friendliness, education). The ratings of the BTE HA with earmould were used as a benchmark for comparison. RESULTS: No hearing aid effect was observed across all participants (n=322) with device ratings ranging between neutral and positive. Significant differences between device ratings were evident for attractiveness for ST and PSAP and trustworthiness for ITC. In terms of residence, urban participants provided more favorable ratings compared to rural participants, with significant differences across three attribute ratings: hardworking for ST; attractiveness, hardworking for ITC; age for RIC and Airpod and hardworking for PSAP. For level of education, significant differences were found for attributes of attractiveness (H = 13.5; p = 0.001) for ITC; attractiveness (H = 14.7, p = 0.001) for PSAP; age (H = 9.5; p = 0.009) for RIC; age (H = 14.3; p<0.001) and intelligence (H = 15.1; p< 0.001) for Airpod and; hardworking (H =11.9, p = 0.003) for ST. CONCLUSION: Overall, participants had a neutral to positive view of hearing devices with preferences for less visible, conventionally styled devices. Socioeconomic variables such as educational attainment and geographical location influence perceptions of hearing devices emphasizing the importance of taking these aspects into account when prescribing hearing devices.
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Introduction: Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods: Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results: This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion: The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
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PURPOSE: This study aims to identify and describe factors that influence hearing aid outcomes including social networks, self-reported mental health, and service delivery models. METHOD: A prospective cross-sectional online survey was sent to hearing aid users recruited through an online platform (http://www.hearingtracker.com) between October and November 2021. The survey contained questions on patient demographics, audiological variables, general health and social factors, and self-reported hearing aid outcomes using the International Outcome Inventory for Hearing Aids (IOI-HA). Regression models evaluated potential contributing factors of hearing aid outcomes on the IOI-HA. RESULTS: Three hundred ninety-eight hearing aid users completed the survey with an average age of 66.6 (SD = 13.0) years, of which 59.3% were male. Positive contributing factors of hearing aid outcomes (IOI-HA total score) were social network of people with hearing loss with hearing aids (p < .010; Exp[B] = 0.03, 95% CI [0.01, 0.1]), self-reported mental health (p < .05; Exp[B] = 0.6, 95% CI [0.01, 1.2]), work situation (p < .001; Exp[B] = 1.9, 95% CI [0.7, 2.8]), quality of life (p < .005; Exp[B] = 1.2, 95% CI [0.3, 1.1]), and self-reported hearing difficulty (p < .02; Exp[B] = 0.8, 95% CI [0.2, 1.5]). Negative contributing factors of hearing aid outcomes included social networks of people with hearing loss without hearing aids (p < .001; Exp[B] = -0.1, 95% CI [-0.2, -0.2]) and service delivery model of private or university clinic compared to big-box retailers (p < .001; Exp[B] = -1.6, 95% CI [-2.7, -0.7]). CONCLUSIONS: Novel factors including social network of persons with hearing loss who use hearing aids, self-reported mental health, service delivery model, and work situation are significant contributors to hearing aid outcomes. These newly identified factors can inform public hearing health promotion and individualized audiological care to optimize hearing aid outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24060486.
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Surdez , Auxiliares de Audição , Perda Auditiva , Humanos , Masculino , Idoso , Feminino , Autorrelato , Qualidade de Vida , Estudos Transversais , Saúde Mental , Estudos Prospectivos , Perda Auditiva/reabilitação , Rede SocialRESUMO
The purpose of the study was to describe the evolution of outcomes among full-term infants with moderate hypoxic-ischemic encephalopathy (HIE); from their early swallowing and feeding abilities during hospitalization, to their later developmental outcomes at 6 and 12 months. Four participants with moderate HIE were recruited. Early feeding and swallowing were assessed using the Neonatal Feeding Assessment Scale and video fluoroscopic swallow studies. Developmental assessments were conducted at 6 and 12 months using the Rossetti Infant-Toddler Language Scale and Vineland-3 Scale. All participants displayed atypical outcomes throughout the study, including oropharyngeal dysphagia initially during hospitalization. All participants were discharged on oral feeds but some breastfeeding difficulties persisted. Variable but pervasive developmental delays were found among all participants at 6 and 12 months. This study emphasizes the need for consistent early intervention from the neonatal period onward, for all infants with moderate HIE. Future studies should use larger cohorts, longer follow-up, and correlational designs.
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Introduction: Increasingly person-centered care (PCC) is being recognized as an important aspect of speech-language pathology and audiology (SLP/A) service delivery. This study aimed to (i) identify preferences toward PCC; (ii) determine predictors of these preferences; and (iii) describe the understanding and views of PCC among SLP/A in South Africa. Methods: A mixed-method design was followed utilizing an online survey and four focus group discussions. The survey included demographic questions, the modified Patient-Practitioner Orientation Scale (mPPOS), the Ten-Item-Personality-Inventory (TIPI) and an open-ended question. The focus group discussions included prompting questions which facilitated an open-ended discussion. Results: A total of 91 practitioners (39.6% speech-language pathologists) completed the online survey, with nine (44.4% audiologists) participating in the focus group discussions. A high preference toward PCC was noted, with a total mean mPPOS score of 4.6 (0.6 SD). Quantile regression analysis revealed four predictors (age, home language, sector, and personality trait openness) associated with PCC preferences. Three main categories emerged from the open-ended question and focus group discussions: (i) Positive experiences with PCC; (ii) restrictions toward PCC, and (iii) PCC exposure. Discussion: Positive (age and personality trait openness) and negative (home language and sector of employment) predictors toward PCC exist among speech-language pathologists and audiologists, with an overall general preference toward PCC. Practitioners experience facilitators and barriers toward implementing PCC including the extent of personal experiences, available resources and tools as well as workplace culture. These aspects require further investigation.
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Adequate early childhood development is critical for later-life success. Developmental profiles of specific populations are required to support implementation of early intervention services. Three hundred fifty-three caregivers of children with mean age 17.9 months (SD = 10.5) were selected from a primary healthcare clinic. Overall positive identification of signs of a developmental delay, with the Bayley Scales of Infant and Toddler Development III, was 51.8% (n = 183). Logistic regression analysis determined the effect of age and gender on results. Prevalence of developmental delay increased with age from 33.1% for children under 12 months to 61.7% and 66.3% for children between 13-24 months and 25-36 months, respectively. Females were 1.82 times (95% CI [1.16, 2.85]) more likely to have had no signs of developmental delay; 2.30 times (95% CI [1.14, 4.65]) in motor and 2.06 times (95% CI [1.23, 3.45]) in adaptive behaviour domains. One-third of children presented with low levels of adaptive behaviour functioning. One hundred and one (28.6%) participants across age groups displayed superior social-emotional ability, possibly due to familial structures and relationships. One-third of children presented with poor adaptive behaviour function, attributed to cultural differences. This study contributes to information on developmental characteristics of children in South Africa.
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Importance: Hearing loss is a highly prevalent condition, with numerous debilitating consequences when left untreated. However, less than 20% of US adults with hearing loss use hearing aids. Over-the-counter (OTC) hearing aids became available in October 2022 to improve access and affordability. However, clinical effectiveness studies of available OTC hearing aids using the existing devices in the market are limited. Objective: To compare the clinical effectiveness of a self-fitting OTC hearing aid with remote support and a hearing aid fitted using audiologist-fitted best practices. Design, Setting, and Participants: This randomized clinical effectiveness trial was conducted between April 14 and August 29, 2022. Sixty-eight adults with self-perceived mild to moderate hearing loss were recruited and randomly assigned to either the self-fitting or the audiologist-fitted group. Following bilateral hearing aid fitting, participants first completed a 2-week, take-home field trial without any support. Access to fine-tuning for both groups was only available after the 2-week trial. Support and adjustment were provided remotely for the self-fitting group per request and by the audiologist for the audiologist-fitted group. Participants were then reassessed after an additional 4-week take-home trial. Interventions: A commercially available self-fitting OTC hearing aid was provided to participants in the self-fitting group who were expected to set up the hearing aids using the commercially supplied instructional material and accompanying smartphone application. In the audiologist-fitted group, audiologists fitted the same hearing aid according to the National Acoustics Laboratories nonlinear version 2 algorithm for prescriptive gain target using real-ear verification with hearing aid use instruction. Main Outcomes and Measures: The primary outcome measure was self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB). Secondary measures included the International Outcome Inventory for Hearing Aids (IOI-HA) and speech recognition in noise measured using an abbreviated speech-in-noise test and a digits-in-noise test. All measures were completed at baseline and at 2 intervals following hearing aid fitting (2 and 6 weeks). Results: Sixty-four participants were included in the analytic sample (33 men [51.6%]; mean [SD] age, 63.6 [14.1] years), with equal numbers of participants (n = 32) randomized into each group. The groups did not differ significantly in age (effect size r = -0.2 [95% CI, -0.3 to 0.2]) or 4-frequency pure-tone average (effect size r = 0.2 [95% CI, -0.1 to 0.4]). After the 2-week field trial, the self-fitting group had an initial advantage compared with the audiologist-fitted group on the self-reported APHAB (Cohen d = -0.5 [95% CI, -1.0 to 0]) and IOI-HA (effect size r = 0.3 [95% CI, 0.0-0.5]) but not speech recognition in noise. At the end of the 6-week trial, no meaningful differences were evident between the groups on any outcome measures. Conclusion and relevance: In this randomized clinical effectiveness trial, self-fitting OTC hearing aids with remote support yielded outcomes at 6 weeks post fitting comparable to those of hearing aids fitted using audiologist best practices. These findings suggest that self-fitting OTC hearing aids may provide an effective intervention for mild to moderate hearing loss. Trial Registration: ClinicalTrials.gov Identifier: NCT05337748.
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Surdez , Auxiliares de Audição , Perda Auditiva Neurossensorial , Perda Auditiva , Percepção da Fala , Masculino , Adulto , Humanos , Pessoa de Meia-Idade , Audiologistas , Perda Auditiva/reabilitação , Resultado do Tratamento , Autorrelato , Perda Auditiva Neurossensorial/reabilitaçãoRESUMO
PURPOSE: More affordable hearing aids are now available due to over-the-counter (OTC) hearing aid regulations. Although laboratory studies have validated many OTC hearing technologies, there are limited real-world benefit studies. This study compared hearing aid outcomes reported by clients from OTC and conventional hearing care professional (HCP) service delivery models. METHOD: An ecological, cross-sectional survey design was employed. An online survey was sent to the Hearing Tracker user and OTC Lexie hearing aid user databases. Moreover, 656 hearing aid users completed the survey-406 through conventional HCP services (M age = 66.7 ± 13.0 years) and 250 through the OTC model (M age = 63.7 ± 12.2 years). Self-reported hearing aid benefit and satisfaction were measured with the International Outcome Inventory for Hearing Aids outcome tool. RESULTS: No significant difference for overall hearing aid outcomes between HCP and OTC users was evident using regression analyses, controlling for age, gender, duration of hearing loss, duration before hearing aid purchase, self-reported hearing difficulty, and unilateral versus bilateral fitting. For the "daily use" domain, HCP clients reported significantly longer hours of daily use. For the "residual activity limitations" domain, OTC hearing aid users reported significantly less difficulty hearing in situations where they most wanted to hear better. CONCLUSIONS: OTC hearing aid outcomes could complement and provide similar satisfaction and benefit to HCP models for adults. Service delivery aspects such as self-fitting, acclimatization programs, remote support, behavioral incentivization, and payment options should be investigated for their potential role in OTC hearing aid outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22134788.
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Auxiliares de Audição , Perda Auditiva , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Perda Auditiva/reabilitação , Testes Auditivos , AudiçãoRESUMO
PURPOSE: Language sample analysis is widely regarded as the gold standard of language assessment. However, the uncertainty regarding the optimal length of sample and the limited availability of developmental language data for nonmainstream languages such as Afrikaans complicate reliable use of the method. The study aimed to provide guidelines on representative length of sample and concurrently provide a preliminary description of the spoken language skills of Afrikaans-speaking children. METHOD: The study involved 30 typically developing Afrikaans-speaking children aged between 3;6 and 9;6 (years;months). A descriptive research design was used to transcribe and analyze 1-hr interactions collected in natural environments of participants who were recruited using referral sampling. Video and audio recordings of the samples were transcribed using adapted Sampling Utterances and Grammatical Analysis Revised analysis procedures. RESULTS: Results indicated that mean length of utterance in words per minute, number of different words per minute, and total number of words per minute stabilized at 30 min and no significant differences were found between 30 min and longer time segments. Morphology results concur with existing developmental findings in Afrikaans. Lexical diversity results correlated with the findings of the lexical specificity and accuracy in the Prutting and Kirchner Pragmatic Protocol (Prutting & Kirchner, 1987). The developmental trajectories for pragmatic and phonological development were consistent with existing guidelines. CONCLUSIONS: The study concluded that a 30-min interaction segment provides a representative language sample for Afrikaans-speaking children who are between 3;6 and 9;6. It provides promising preliminary developmental data and clinical guidelines, confirming the potential of language sample analysis (LSA) as a reliable component of language assessment in Afrikaans.
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Transtornos do Desenvolvimento da Linguagem , Idioma , Criança , Humanos , Lactente , Projetos Piloto , Linguística , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Linguagem Infantil , Testes de LinguagemRESUMO
OBJECTIVES: The study aimed to describe daily vocal demands, perceptions and knowledge as reported by occupational voice users. STUDY DESIGN: A descriptive, cross-sectional research design was employed. METHODS: A survey on vocal demands, perceptions and knowledge was distributed to 102 occupational voice users via a snowball sampling technique. RESULTS: Slightly more than half of the participants (55%) reported using their voice for work 36.5 hours a week on average (SD = 15.5, range: 33-40). Participants reported that, on average, their daily voice use is 6.3 hours (SD = 2.7) for work and the majority (81%) reported a decrease in voice quality after work; Three-quarters (75%) also reported vocal fatigue at the end of day. Approximately one-third (33%) reported being exposed to environments where they are expected to shout, scream or cheer loudly. More than half of the participants (61%) reported that they have previously received vocal health education but 40% reported that they felt this training was insufficient. High vocal demands are significantly correlated to an increase in perceived vocal handicap rs = 0.242; (P = 0.018), tiredness of voice rs = 0.270; (P = 0.008), physical discomfort rs = 0.217; (P = 0.038) as well as how occupational voice users experience improvement of symptoms with rest rs = -0.356 (P < 0.001). Other risk factors highlighted by occupational voice users are the ingestion of liquid caffeine, alcohol, and carbonated drinks, smoking or the presence of chronic cough, chronic laryngitis, and gastroesophageal reflux disease. CONCLUSIONS: Occupational voice users are subjected to high daily vocal demands that can be seen to be linked to vocal fatigue, changes in voice quality and vocal symptoms experienced. It is essential that occupational voice users as well as treating clinicians are aware of certain significant predictors of both vocal handicap and vocal fatigue. These findings provide insights for developing strategies for training and cultivating vocal health consciousness and preventive voice care initiatives that focus on occupational voice users in South Africa.
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OBJECTIVE: Development of the Feather Squadron (FS) has created a cost-effective, accessible form of assessment through tele-audiology. As accessibility to reliable, cost-effective assessment of auditory processing (AP) skills is limited in South Africa (SA), this study aims to establish whether there is correlation between the FS and traditional tests of AP viz. Frequency Pattern and Dichotic Digits Test, and to establish its relevance to the SA population. DESIGN: Retrospective, within-subject, comparative design used to compare performance on the FS and the traditional tests. Data were considered in two ways: Firstly, using the traditional -2SD cut-off on some subtests of the FS compared to the same traditional tests, and secondly, by comparing the Z-scores obtained on the FS compared to Z-scores on the same traditional tests obtained by applying a double arcsine transformation. STUDY SAMPLE: Sixty-six subjects (35 males, 31 females) aged between 8.08 and 9.75 years (mean = 8.73; SD = 0.51) seen for AP assessments between 2016 and 2019. RESULTS: -2SD criteria yielded no significant association (p > 0.05). Z-score comparison suggested a statistically significant correlation (p < 0.05). CONCLUSION: A statistically significant correlation between certain subtests of FS with traditional tests of AP to merit its use in the SA population is suggested.
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Transtornos da Percepção Auditiva , Masculino , Feminino , Animais , Humanos , Criança , Transtornos da Percepção Auditiva/diagnóstico , África do Sul , Plumas , Estudos Retrospectivos , Percepção Auditiva , Testes com Listas de DissílabosRESUMO
OBJECTIVE: To determine the perceived satisfaction and understanding of hearing assessment feedback, using the Ida My Hearing Explained Tool (IMHET), compared to the standard audiogram reported by adult clients and audiologists. DESIGN: This study is a mixed-method design comparing clients and audiologists' perceptions through a single-blinded, randomised control trial and focus group discussions. After using either the audiogram or IMHET for feedback, clients and audiologists completed the adapted Patient Satisfaction Questionnaire (PSQ). STUDY SAMPLE: During client's initial audiological consultations, audiologists provided hearing assessment feedback (Total = 51) using the IMHET or audiogram. Twenty-seven clients and seven audiologists participated in focus groups, and/or open-ended questions. RESULTS: Satisfaction was not significantly different (p > 0.05) between the IMHET (76.18; SD: 2.66) or audiogram (75.63; SD: 4.73) for the overall PSQ scores reported by clients and audiologists. Two shared main themes, understanding and satisfaction, were identified for both tools from the focus groups and open-ended questions. A third main theme, recommendations, was identified only for the IMHET. CONCLUSIONS: The IMHET is a valuable resource for clients during hearing assessment feedback. Audiologists recommend that the audiogram be used as a supplement when using the IMHET to provide feedback.
Assuntos
Audiologistas , Audiologia , Adulto , Humanos , Retroalimentação , Audição , Audiologia/métodos , Testes AuditivosRESUMO
PURPOSE: The aim of this study was to describe extended high-frequency (EHF) pure-tone audiometry monitoring of ototoxicity in a longitudinal treatment program for drug-resistant tuberculosis (DRTB). METHOD: This was a retrospective record review of longitudinal conventional (0.25-8 kHz) and EHF (9-16 kHz) audiometry for ototoxicity monitoring of DRTB patients undergoing treatment at community-based clinics between 2013 and 2017. Data from 69 patients with an average age of 37.9 years (SD = 11.2, range: 16.0-63.8 years) were included. Patients were assessed by primary health care audiologists (87%) or community health workers (13%) using portable audiological equipment. The average length of time between initial and exit assessments was 84.6 days (SD = 74.2, range: 2-335 days). RESULTS: EHF ototoxicity of a mild or greater degree of hearing loss (> 25 dB HL in one or both ears across frequencies) was evident in 85.5% of patients' posttreatment, compared with 47.8% of patients across conventional frequencies. EHF audiometry demonstrated an ototoxic shift (American Speech-Language-Hearing Association criteria) in 56.5% of cases compared with 31.9% when only conventional audiometry was considered. Mean hearing deterioration for patients was significant across EHFs (9-16 kHz) bilaterally (p < .05). Absent EHF thresholds at the initial assessment, owing to maximum output limits, was a limitation that occurred most frequently at 16 kHz (17.4%, 24/138). CONCLUSIONS: EHF audiometry is most sensitive for the early detection of ototoxicity and should be included in monitoring programs. Clinical ototoxicity monitoring protocols should consider shortened assessment approaches that target frequencies most sensitive to ototoxicity, including EHFs. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21651242.