The association between electrode impedance and short-term outcomes in cochlear implant recipients of slim modiolar and slim straight electrode arrays.

OBJECTIVES: Electrode impedance measurements from cochlear implants (CI) reflect the status of the electrode array as well as the surrounding cochlear environment, and could provide a clinical index of functional changes with the CI. The goals of this study were to examine (1) the impact of electrode array type on electrode impedance, and (2) the relationship between electrode impedance and short-term hearing preservation and speech recognition outcomes. METHODS: Retrospective study of 115 adult hearing preservation CI recipients of a slim modiolar or slim straight array. Common ground electrode impedances, pre- and post-operative hearing thresholds and CNC word recognition scores were retrieved. RESULTS: Electrode impedances were significantly higher for recipients of the straight electrode array. Within individuals, electrode impedances were stable after the first week post-activation. However, increased standard deviation of electrode impedances was associated with greater loss of low frequency hearing at initial activation, and with poorer speech recognition at 6 months post-implantation. CONCLUSIONS: Results demonstrate that electrode impedances depend on the type of implanted array. Findings also suggest that there may be a role for the variability in electrode impedance across electrodes as an indicator of changes in the intracochlear environment that contribute to outcomes with a CI.

Psychosocial Well-Being of Adults Who Are Deaf or Hard of Hearing.

BACKGROUND: Psychosocial well-being can interfere with engagement in activities of daily life. Consideration of psychosocial domains within hearing health care can expand audiologists' ability to understand treatment barriers and provide an opportunity to jointly address challenges. PURPOSE: This study explored psychosocial well-being and predictors among adults who are deaf or hard of hearing (DHH). RESEARCH DESIGN: Cross-sectional survey. STUDY SAMPLE: Two-hundred and sixty-nine surveys were included in the analysis. DATA COLLECTION AND ANALYSIS: Data were collected online. Backward elimination regression analyses were used to identify significant predictors of psychosocial well-being. RESULTS: Findings indicated most (∼70-80%) of the respondents' scores were below clinical cut-off for psychological distress, self-efficacy, quality of life, overall well-being, functioning, and relationship satisfaction, with the remainder falling between mild to severe clinical cut-offs. Psychological distress was predicted by more psychological inflexibility, presence of additional disabilities, and younger age. Increased functional impairment was predicted by psychological inflexibility. CONCLUSION: The majority of adults who are DHH in this study had positive indicators for psychosocial well-being. Screening patients for psychological flexibility could be included in standard hearing health care practices to help clinicians identify individuals who may benefit from additional or different support.

Counseling Competencies in Audiology: A Modified Delphi Study.

Purpose Counseling practices in audiology play a critical role in helping patients and families understand, accept, and adjust to the dynamic impacts ear-related disorders have on their lives. The purpose of this study was to identify what competencies (i.e., knowledge, skills, and attitudes) are important for audiologists to possess to provide effective counseling in practice. Method A modified Delphi study design was used to survey a panel of 33 professionals with expertise in audiologic counseling from 5 different countries. In the 1st survey round, experts were asked to respond to 3 open-ended prompts. Responses were condensed and revised into items experts were asked to rate during the 2nd and 3rd survey rounds, on a 6-point Likert scale of importance. Results A total of 819 items were generated from the open-ended prompts. A total of 72 items were included in the 2nd and 3rd rounds of survey instruments. Consensus was met on 64 audiologic counseling competency items. Conclusions The competency items identified in this study reflect important knowledge, skills, and attitudes that are important to audiologic counseling. Items that met consensus in this study can inform competencies audiology students can acquire during graduate training. Practice guidelines in the field currently lack the necessary clarity and detail needed for implementation of counseling competencies in clinical education. Future research is needed to explore factors important for implementation of evidence-based counseling training in graduate audiology programs.

Counselling users of hearing technology: a comprehensive literature review.

OBJECTIVE: The purpose of this review is to determine the scope of peer-reviewed empirical research related to counselling in audiology with patients using hearing technology and to identify limitations and gaps to guide recommendations for future research. DESIGN: A rapid evidence assessment was used to identify relevant articles for the review. STUDY SAMPLE: Eighteen articles met the inclusion criteria. RESULTS: Three themes were identified: (1) audiologist counselling perspectives, (2) counselling communication trends in practice and (3) audiologist experiences with professional training and reported patient outcomes. Findings revealed audiologists are more confident providing information than counselling that addresses adjustment aspects, and other communication gaps have been observed. CONCLUSIONS: There is limited research related to counselling in audiology. Audiologists continue to report a need for more training in counselling in their graduate programmes. Additional research is needed to determine effective ways to implement counselling in practice and to improve graduate student supervision for the development of counselling competencies and confidence in using skills in practice.

Audiologist Practices: Parent Hearing Aid Education and Support.

BACKGROUND: Early identification of hearing loss has led to routine fitting of hearing aids in infants and young children. Amplification provides opportunities to optimize child development, although it also introduces challenges for parents to navigate. Audiologists have a central role in providing parents with support to achieve effective management strategies and habits. PURPOSE: The purpose of this study was to explore current practices of pediatric audiologists who work with children birth to 5 yr of age, regarding their support of parent learning in achieving effective hearing aid management, identify existing gaps in service delivery, and to determine if audiologists were receptive to receiving training related to effective approaches to provide counseling and support to parents. RESEARCH DESIGN: A cross-sectional, population-based survey was used. STUDY SAMPLE: Three hundred and forty-nine surveys were analyzed from pediatric audiologists who provided services to children birth to 5 yr of age. Responses were received from 22 states in the United States. DATA COLLECTION AND ANALYSIS: Responses were collected through the mail and online. Descriptive statistics were used to analyze the information. RESULTS: More than half (61%) of the audiologists in the study had been providing pediatric hearing aid services to children birth to 5 yr of age for >10 yr. Of the audiologists who reported monitoring hours of hearing aid use, the majority reported that they used data logging (90%). More than half of the audiologists (57%) who shared data logging with parents reported that they encountered defensiveness from parents when addressing hearing aid use. Information and skills that were not routinely provided by one-third to one-half of the audiologists included the following: how to get access to loaner hearing aids (30%), available hearing aid options/accessories (33%), available financial assistance (36%), how to teach hearing aid management to other caregivers (38%), how to do hearing aid maintenance (44%), and how to do a Ling 6 sound check (52%). Many audiologists reported they did not frequently collaborate with speech-language pathologists (48%), early interventionists (47%), or physicians (68%). More than half of the audiologists indicated a desire for more training in counseling skills, for all 14 items queried, to support parents with hearing aid management (53-79%), regardless of their previous training experience. CONCLUSIONS: For young children with hearing loss to achieve optimal benefit from auditory experiences for speech and language development, they need evidence-based, comprehensive, and coordinated hearing aid management. Audiologists have an important role for teaching information and skills related to hearing aids, supporting parent learning, and collaborating with other providers. Pediatric audiologists in this study recognized and desired the need for further training in counseling skills that can better prepare them to meet the emotional needs of parents in the hearing aid management process.