Cultural competence in NHS hearing aid clinics: a mixed-methods case study of services for Deaf British sign language users in the UK.

BACKGROUND: This study identified and explored how National Health Service (NHS) hearing aid clinics address cultural competence concerning Deaf British Sign Language (BSL) users. This was approached by (i) investigating how organisational processes meet the needs of Deaf signers from a hospital and hearing aid clinic perspective, (ii) analysing policies and guidelines to investigate if they equip practitioners to meet the needs of Deaf signers and (iii) exploring with practitioners who work in hearing aid clinics about their experiences of working with Deaf signers. METHODS: This study utilised a mixed-methods multiple case study design, incorporating documentary analysis and semi-structured interviews. Interview analysis was conducted using Reflexive Thematic Analysis (RTA). The research encompassed two hearing aid clinics in separate hospitals, producing 19 documents and eight interviews (four at each site) with audiologists ensuring a representative mix of professional experience levels. RESULTS: Four themes emerged from the integrated analysis: (1) Understanding Deaf signers; (2) Communicating with Deaf signers; (3) Barriers and Facilitators and (4) Service improvement. A noticeable gap in understanding BSL as both a language and a cultural system was apparent across various policies, strategies, training programmes and staff expertise. Over-reliance on interpreters provided a false sense of accessibility and most participants felt tentative to engage directly with Deaf signers. Positive practices observed at Sites A and B encompassed accurate identification of patients as Deaf signers, improved interpreter availability, communication methods, enhanced training and the encouragement of professional self-awareness. CONCLUSION: This is the first study that explores cultural competence of hearing aid clinics and its staff concerning Deaf signers in the UK. The results show both clinics require development to become an effective provider for culturally Deaf signers. Examples of how to design culturally competent practices have been provided to assist hearing aid clinics. The findings may be applicable to other underrepresented groups who are not typical users of conventional, acoustic hearing aids provided by the NHS.

'I don't really know where I stand because I don't know if I took something away from her': Moral injury in South African speech-language therapists and audiologists due to patient death and dying.

BACKGROUND: Speech-language therapists and audiologists (SLT&As) may encounter difficulties when confronted with patient death and dying, which may conflict with their moral beliefs and result in moral injury. Furthermore, South African SLT&As practice in a country with a high mortality rate, which may add to the complexity of their experience. Moreover, they may be influenced by African philosophies promoting care, which might conflict with their experiences of patient death and dying. AIMS: To explore the moral injury experienced by South African SLT&As in patient death and dying, and how they overcame the injury. METHODS & PROCEDURES: This article forms part of a larger qualitative study that explored SLT&As' experiences of patient death and dying in South Africa. Thematic analysis was conducted on the transcripts of 25 episodic narrative interviews conducted with South African SLT&As on their experiences of patient death and dying. OUTCOMES & RESULTS: Findings suggest that South African SLT&As experienced helplessness, guilt and anger in patient death and dying. However, with support from the allied team, engaging in self-reflection and religious practices, they reported alleviation of moral injury. CONCLUSIONS & IMPLICATIONS: In order to mitigate moral injury in South African SLT&As, they require professional education, self-care strategies, guidelines and support from the teams in which they work and their supervisors. Research is needed that explores how SLT&As' biographical characteristics and interactions with significant others of dying and deceased patients, may result in moral injury. WHAT THIS PAPER ADDS?: What is already known on this subject? Moral injury and measures used to overcome the injury have been explored in military personnel, doctors and nurses, but not in SLT&As. However, studies that explored the perceptions of SLTs and/or audiologists regarding providing palliative care and of death and dying, particularly that by Rivers et al. in 2009, suggested that these professionals may be at risk of experiencing emotional trauma due to patient death, particularly when not receiving undergraduate education on this subject. However, the extent of this trauma and the support needed to overcome it is unknown because the participants in these studies may have not experienced patient death, and were only students or just SLTs. What this article adds? This article highlights the complexity of speech-language therapy and audiology practice when confronted with patient death and dying. South African SLT&As may have to make decisions that conflict with their morals and professional practice standards, especially as the helping nature of their profession is characterized by African philosophies that promote care, which may result in moral injury. Clinical implications of this article This article indicates that in addition to undergraduate education on patient death and dying, SLTs and audiologists require continuous professional education on this topic, self-care strategies, support from the teams in which they work, and their supervisors and guidelines for when they encounter patient death and dying.

Audiologists' perspectives on management of mild bilateral hearing loss in infants and young children.

OBJECTIVE: Universal newborn hearing screening programs have led to early identification of infants with congenital mild bilateral hearing loss (MBHL). The current lack of evidence-based protocols to guide audiological management of infants with MBHL has led to clinical equipoise about fitting of hearing aids. The purpose of this study was to increase understanding about the perspectives of paediatric audiologists on factors influencing their management of MBHLin infants and young children. DESIGN: A qualitative descriptive research methodology involving semi-structured interviews with audiologists. STUDY SAMPLE: Twenty-three paediatric audiologists in diagnostic and rehabilitation settings in Victoria, Australia. RESULTS: Three main themes that influenced management were identified. These include: (1) evidence, or the lack of it, influences audiologists' practice; (2) audiologists recognise the need to be fluid; and (3) family characteristics and parents' perspectives. "Audiologists delivering family-centred practice" was identified as an overarching theme across these factors. CONCLUSIONS: Audiologists recognised the importance of adopting a family-centred approach in their management of MBHL in infants and young children. Embodied in their practice was the acknowledgement of limited evidence, the consideration of multiple child and family factors, and the incorporation of perspectives of parents and families in adopting a fluid approach to provide individualised services.

An examination of clinical uptake factors for remote hearing aid support: a concept mapping study with audiologists.

OBJECTIVE: To develop a conceptual framework around the factors that influence audiologists in the clinical uptake of remote follow-up hearing aid support services. DESIGN: A purposive sample of 42 audiologists, stratified according to client-focus of either paediatric or adult, were recruited from professional associations in Ontario, Canada, as members of the six-step, participatory-based concept mapping process. Analyses included multidimensional scaling and hierarchical cluster analysis. RESULTS: Six main themes emerged from this research according to overall level of importance: (1) technology and infrastructure; (2) audiologist-centred considerations; (3) hearing healthcare regulations; (4) client-centred considerations; (5) clinical implementation considerations; and (6) financial considerations. Subthemes were identified at the group-level and by subgroup. These highlight the importance of TECH factors (accessible Technology, Easy to use, robust Connection, and Help available), as well as the multi-faceted nature of the perceived attitudes/aptitudes across stakeholders. CONCLUSION: Findings can be utilised in tailored planning and development efforts to support future research, knowledge dissemination, best-practice protocol/guideline development, and related training to assist in the clinical uptake of remote follow-up hearing aid support services, across variable practice contexts.

Adults' cochlear implant journeys through care: a qualitative study.

BACKGROUND: Cochlear implants (CIs) can provide a sound sensation for those with severe sensorineural hearing loss (SNHL), benefitting speech understanding and quality of life. Nevertheless, rates of implantation remain low, and limited research investigates journeys from traditional hearing aids to implantable devices. METHOD: Fifty-five adults (≥ 50 years), hearing aid users and/or CI users, General Practitioners, and Australian and United Kingdom audiologists took part in a multi-methods study. Focus groups, interviews, and surveys were thematically analysed. RESULTS: One hundred forty-three data-capture events disclosed 2 themes: 1) "The burden of hearing loss and the impact of Cochlear Implants", and 2) "Professional Support and Practice, and HCPs Roles and Responsibilities". CONCLUSIONS: Care experience can include convoluted, complex journeys towards cochlear implantation. The significant impact of this, as hearing loss progresses, motivates people to consider implants, but they and healthcare professionals need clear supported with defined referral pathways, and less system complexity.

Practice patterns of South African audiologists in cerumen management: a pilot study.

OBJECTIVE: To determine the training, self-reported competence and practice patterns of South African audiologists (SAAs) regarding cerumen management (CM). DESIGN: Prospective cross-sectional survey. An online questionnaire was completed by SAA between July and September 2016. The questionnaire addressed sections on educational training, experience and practice patterns of SAAs regarding CM. STUDY SAMPLE: Three hundred and fifty-six SAAs responded to an email invitation sent to 382 actively-practicing audiologists. RESULTS: Majority of the participants (85%) were employed for less than 10 years. Forty-nine percent received less than 10 hours of theoretical training while 57% received less than 10 hours of clinical education. A total of 96% of the participants indicated they felt competent to perform CM, with 96% preferring manual, ear syringing, or a combination of the two. Handwashing pre- and post-procedure was the preferred method of infection prevention and control by 87% of the participants with 66% of these indicating they only wore gloves. Majority (85%) of the participants indicated that they always explained the possible complications of CM to their patients. CONCLUSION: Findings from this study indicate that South African audiologists feel that they are adequately trained and competent to perform CM.

Current practice of ototoxicity management across the United Kingdom (UK).

OBJECTIVE: Effective management of patients diagnosed with ototoxicity is needed to reduce hearing and balance damage which affects communication and life quality. Despite widespread recommendations to monitor and manage ototoxicity in an early and effective manner, there is limited evidence to support the actual implementation of these recommendations for affected patient groups in healthcare services across the UK with limited publications available. In this study, an online questionnaire analysed the current practice of ototoxicity management and patient pathways across the UK once the diagnosis of ototoxicity was confirmed, targeting Audiologists, ENTs/AVPs and GPs. DESIGN: Qualitative Survey Study. STUDY SAMPLE: A randomised sample of hearing services in the UK, including audiology departments; GP practices and local health settings were targeted with a total of 134 completed surveys. RESULTS: About 72% reported the absence of ototoxicity management protocols within their centre. Results depicted great inconsistency and variation across the UK in ototoxicity management services provided, treatment modification, monitoring and referral pathways. CONCLUSION: Developing and advocating national guidelines are intended not only to inform clinical decision making but to provide minimum standards of care in ototoxicity management and offer greater awareness and education to improve patients' quality of life.

[Hearing aid provision in children]. / Hörgeräteversorgung im Kindesalter.

Achieving high-quality hearing aid fitting in children is an interdisciplinary task and a challenge for all involved specialist disciplines. According to quality agreements (standards), comparative hearing aid fitting is mandatory prior to prescription. Furthermore, RECD measurements and, in older children, in-situ measurements should be applied on a regular basis for finetuning and adjustment of the hearing aid fitting. ENT physicians, phoniatricians and pediatric audiologists, pediatric acousticians, teachers of the hearing impaired, and special educational needs teachers should work together in an interdisciplinary approach.

Audiology occupational stress experienced by audiologists practicing in India.

OBJECTIVE: The aim of the present study is to identify the levels of occupational stress across different types of setting, years of experience, and age. DESIGN: A questionnaire-based observational research design using the audiology occupational stress questionnaire (AOSQ) was used. STUDY SAMPLE: The sample comprised of audiologists registered under the Indian Speech and Hearing Association. The questionnaire was sent via personal email to 400 audiologists, of which 100 responded. RESULTS: Descriptive statistics and chi-square analysis were carried out. Participants in both the groups experienced stress to some extent, with more stress reported in private practitioners. CONCLUSION: This study helps to identify certain factors that contribute towards work-related stress. These in turn have an impact on the overall professional output of a professional.

Knowledge and Practice in Cochlear Re-Implantation in the UK: A Survey for Audiologists.

BACKGROUND: Cochlear implantation (CI) has proven to be a highly effective method for rehabilitating individuals with severe to profound hearing loss. However, challenges persist, particularly in cases where CI failure necessitates re-implantation. This study aims to address the gap in understanding the knowledge and practices of audiologists in the UK regarding cochlear re-implantation through a comprehensive questionnaire survey. METHODS: A bespoke questionnaire was distributed to audiologists working with CI across the UK. The survey, which included multiple-choice items, open-text responses, and visual analogue scales, was made accessible via an online link shared through professional bodies, email groups, and social media platforms. RESULTS: The survey received 27 responses, predominantly from female audiologists (71.4%), with significant representation from London (28.6%) and the East of England (21.4%). A majority of respondents had over 16 years of CI experience (35.7%) and held a master's degree (60.7%). Key reasons for CI re-implantation included electrode failure (82.1%) and hermetic seal failure (60.7%). While respondents showed strong confidence in counselling (88.8%) and managing re-implanted devices (84.6%), there was a noted variation in opinions regarding the need for additional training in intraoperative measures. CONCLUSION: This survey highlights the current practices and training needs of UK audiologists in CI re-implantation. This underscores the importance of targeted training to fill knowledge gaps and improve clinical care during CI re-implantation, ultimately enhancing outcomes for both audiologists and CI recipients.

Understanding, experience and attitudes towards artificial intelligence technologies for clinical decision support in hearing health: a mixed-methods survey of healthcare professionals in the UK.

OBJECTIVES: Clinician acceptance influences technology adoption, but UK health professionals' attitudes towards artificial intelligence (AI) in hearing healthcare are unclear. This study aimed to address this knowledge gap. METHODS: An online survey, based on the Checklist for Reporting Results of Internet E-Surveys, was distributed to audiologists, ENT specialists and general practitioners. The survey collected quantitative and qualitative data on demographics and attitudes to AI in hearing healthcare. RESULTS: Ninety-three participants (mean age 39 years, 56 per cent female) from three professional groups (21 audiologists, 24 ENT specialists and 48 general practitioners) responded. They acknowledged AI's benefits, emphasised the importance of the clinician-patient relationship, and stressed the need for proper training and ethical considerations to ensure successful AI integration in hearing healthcare. CONCLUSION: This study provides valuable insights into UK healthcare professionals' attitudes towards AI in hearing health and highlights the need for further research to address specific concerns and uncertainties surrounding AI integration in hearing healthcare.

Impact of COVID-19 on continuing professional development: Perspectives of audiologists.

BACKGROUND:  The coronavirus disease 2019 (COVID-19) pandemic triggered unprecedented disruptions to continuing professional development (CPD) activities, which are essential for healthcare professionals (HCPs) to stay abreast on best practices, current knowledge and emerging technologies, ultimately enhancing patient care. Audiologists encountered multiple challenges during the pandemic, necessitating adaptations and innovations in their CPD practices. While literature was published during the pandemic on shifting education systems to online platforms, little is known about its impact on the CPD of young audiologists working in the private sector. METHODS:  A descriptive, qualitative research design was adopted to collect rich data from 11 audiologists using online semi-structured interviews which were thematically analysed using Braun and Clark's steps. RESULTS:  COVID-19 brought about both positive adaptations and negative disruptions to the CPD activities of young audiologists. Eight major themes were identified in this study. These include (1) the adoption of online learning, (2) improved flexibility, (3) cost-effectiveness, (4) diverse learning opportunities, (5) keeping current, (6) isolation and networking, (7) limited interactivity and (8) uncertain quality assurance. CONCLUSION:  The COVID-19 pandemic had a considerable influence on the CPD activities of young audiologists in the private sector. While presenting significant challenges, including disruptions to traditional learning modalities, the pandemic also catalysed innovation and adaptation within the profession.Contribution: This study highlights the resilience exhibited by young audiologists towards their CPD and also provides actionable insights for informing professional development initiatives, tailored to the evolving needs of audiologists in the post-COVID-19 era.

Continuing professional development barriers and recommendations: Perspectives of audiologists.

BACKGROUND:  Continuing professional development (CPD), a compulsory requirement of the Health Professions Council of South Africa (HPCSA), is undertaken by healthcare professionals (HCPs), including audiologists, to remain up-to-date with the latest developments, technology and best practices within their discipline. However, the low compliance rates of audiologists engaging in CPD need to be investigated to establish the barriers that audiologists encounter as well as possible interventions to improve their participation. OBJECTIVES:  This study aimed to explore the barriers that audiologists encounter when participating in CPD activities and to highlight their suggestions for improving its uptake. METHOD:  The descriptive qualitative research design entailed the use of semi-structured online interviews with 11 audiologists practising within the private sector in the province of KwaZulu-Natal, South Africa, their responses being thematically analysed. RESULTS:  Three barriers were identified, namely: (1) personal, (2) financial and (3) structural barriers, with eight subthemes and nine recommendations provided by participants. CONCLUSION:  It is anticipated that implementing the proposed strategies will address the barriers and allow active engagement of audiologists in their continued education.Contribution: Limited literature has been documented on the barriers that young, private sector audiologists encounter within the South African context while also providing suggestions to address these barriers.

Evaluation of professional satisfaction of audiologists working in Türkiye based on their personality characteristics and sector of work.

Purpose: This study investigates the relationship between audiologists' personality traits and professional satisfaction. Design: Big Five-50 Personality Traits and Professional Satisfaction Scale was used to examine the relationship between audiologists' personality traits and professional satisfaction. Statistical analyzes were performed with SPSS and AMOS programs. Study example: This study examines 167 audiologists who completed a minimum of an undergraduate program in audiology before the professional field. Results: The results of confirmatory factor analysis indicate that both scales are reliable and valid. There is a significant relationship between extraversion, agreeableness, conscientiousness, and emotional stability and occupational satisfaction. However, there is no significant relationship between intelligence/imagination and professional satisfaction. Conclusions: Extraversion, agreeableness, conscientiousness, emotional stability/neuroticism affect job satisfaction. Understanding these dynamics can inform strategies that will increase the professional wellbeing and productivity of audiologists.

South African speech-language therapists' and audiologists' professional quality of life.

BACKGROUND:  Limited research is available regarding the professional quality of life experiences of South African speech-language therapists and audiologists, despite the implications this has for wellbeing, quality of patient care, productivity and attrition from the professions. OBJECTIVES:  This study explored levels of compassion satisfaction, burnout, and secondary traumatic stress, the relationships between these, differences on the basis of registration and years of experience and participants' perceptions of their professional quality of life. METHOD:  A sample of 92 South African speech-language therapists and audiologists completed an online survey that included the Professional Quality of Life (ProQOL) scale. The data were analysed using descriptive statistics, analysis of variation (ANOVA), correlations and thematic analysis. RESULTS:  The findings indicated that participants experienced slightly higher levels of secondary traumatic stress and burnout and slightly lower levels of compassion satisfaction than international samples. There were significant inter-relationships between the three elements of professional quality of life, and no significant differences for these on the basis of registration or years of experience. Participants identified a range of factors that contributed to their experiences of compassion satisfaction and fatigue, as well as suggestions for improvement. CONCLUSION:  Professional quality of life plays an important role in South African speech-language therapists and audiologists' professionalism, job performance and satisfaction and retention.Contribution: The data collected provide valuable insights into the professional quality of life experiences of South African speech-language therapists and audiologists, as well as those working in similar contexts. It also offers suggestions that may contribute to future research and interventions.

Awareness and perspectives of audiologists on assessment and management of misophonia in India.

Background: The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia. Purpose: The main aim of our study is to document the present level of awareness and knowledge about misophonia assessment and management among audiologists in India. Methods: A descriptive cross-sectional study was carried out among audiologists from all over India. Descriptive statistical procedures were measured based on the type of questions being addressed, and a non-parametric chi-square test was done to see the association among variables. Results: The results show a lack of knowledge about misophonia even among audiologists, as only 15.3% of the audiologist reported being confident in handling cases with misophonia. Conclusion: Although the exact assessment and management of misophonia is still the topic of debate, it is clear that audiologists are the team's key members. However, the results clearly show a lack of confidence in handling cases of misophonia among audiologists in India. This result shows the future need for Research in misophonia from an audiological perspective.

Impact of COVID-19 Pandemic on Older Adults Using Hearing aid/s: Indian Scenario.

The present study explored the impact of COVID-19 on hearing health and problems faced by older adults using hearing aid/s. Fifty older adults in the age range of 55-95 years were selected for the study based on the inclusion and exclusion criteria. Therefore, the developed questionnaire was administered to them. Statistical analysis was performed for all the responses achieved. Closure of hearing aid companies and audiological centers was found to have a negative impact on availing audiological services. Likewise, a huge hike in the price of these services made it impossible for people to afford them. Despite the availability of tele-audiology, older adults were not able to make the best use of it due to numerous reasons. We sought to explore patients' perceptions to break down these barriers by enhancing the quality of tele-audiology, home visits, and remote services. Therefore, the present report may facilitate in planning and implementation of policies related to audiological services, especially during times of crisis, which may help strengthen our hearing health care system. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03209-8.

Hearing Healthcare Professionals' Views about Over-The-Counter (OTC) Hearing Aids: Analysis of Retrospective Survey Data.

Over-the-counter hearing aids have been available to consumers in the US since 17 October 2022 following a ruling by the Food and Drug Administration. However, their reception by hearing healthcare professionals (HHP) has been mixed, and concerns have been expressed by many HHPs. The aim of this study was to examine the concerns that HHPs have towards over-the-counter (OTC) hearing aids. The study used a retrospective survey design. The survey data of HHPs (n = 730) was obtained from Hearing Tracker. A 22-item structured questionnaire was administered using a Question Scout platform. Descriptive analyses examined reported areas of concern and a Fisher's exact test examined the relationship between demographics and responses. A cluster analysis with partitioning around medoids (PAM) was used to identify a sub-group of participants based on responses. Nearly half of HHPs who participated reported that they will support patients with OTC hearing aids purchased elsewhere, whereas a quarter reported that they will sell OTC hearing aids in their clinic or website. HHPs expressed over 70% agreement in 'concern' statements in 14 of the 17 items. Issues about safety, counseling, and audiological care were the key concerns expressed by HHPs about OTC hearing aids. Some demographics (i.e., profession, primary position) were associated with responses to some statements. Two groups were identified based on the responses to concern statements. The HHPs in the first cluster 'OTC averse' (51%) agreed on all the 17 concern statements, whereas the second cluster 'OTC apprehensive' (49%) had some items rated as disagree (i.e., consumers will give up on amplification) and neither agree nor disagree (i.e., do not provide good value, warranties and return periods will be worse), and remaining items were rated as agree. OTC hearing aids were initiated to improve affordability, accessibility, and hearing aid uptake and are currently a rapidly emerging category of hearing devices. Overall, the results of the current study indicate that HHPs have serious concerns about OTC hearing aids. HHP concerns cited in this study provide useful feedback to stakeholders (e.g., HHP professional agencies, FDA, industry, and insurance payers) involved in improving OTC hearing aid implementation.

Tele-Audiology in India: Current and Future Trends in Knowledge, Attitude, and Practice Among Audiologists.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has led to widespread use of telepractice in hearing health care services. In this study, we investigated the knowledge, attitude, and practice (KAP) of tele-audiology among Indian audiologists. The current study is based on tele-practice guidelines recommended by the Indian Speech and Hearing Association for tele-audiology services in India. SUBJECTS AND METHODS: An internet-based KAP questionnaire survey was performed among 108 audiologists. The questionnaire included 33 items categorized under the following domains: demographic information and KAP of tele-audiology. Of the 108 audiologists included in the study, 38 admitted to the practice of tele-audiology previously and during the COVID-19 pandemic (tele-practitioners), and 70 respondents had no experience of tele-audiology (non-telepractitioners). RESULTS: Overall higher scores were observed with regard to the knowledge domain, and a mixed attitude regarding tele-practice was observed among audiologists. Most respondents acknowledged the advantages of tele-audiology in clinical practice. However, audiologists were hesitant to utilize this technology owing to the challenges associated with tele-practice. CONCLUSIONS: Despite adequate awareness and a positive attitude, a gap is observed between available knowledge and its actual application/utilization in tele-audiology. Tele-audiology practice was limited to counseling, hearing impairment treatment, and troubleshooting tips for hearing aids. Evidence-based practices to perform diagnostic test battery in tele-mode, hands-on training to run diagnostic test battery/rehabilitation using a tele-mode approach, and greater understanding of the technical requirements for tele-practice may result in a positive perception and encourage tele-audiology practice among audiologists. Specialized training and regular continuing education programmes are important to promote tele-audiology services in clinical practice.

Profiles and predictors of onset based differences in vocal characteristics of adults with auditory neuropathy spectrum disorder (ANSD).

Purpose: Onset-based differences are understudied in Auditory Neuropathy Spectrum Disorder (ANSD) in dimensions such as voice, which is addressed in the study. The study aimed to profile and predict the best metrics of onset-related differences in acoustic vocal characteristics of early and late-onset ANSD patients. Methods: 31 participants (15 early and 16 late-onset) aged 15-30 years diagnosed with ANSD were included in the study. The sustained phonation of vowel /i/ recorded by the participants using android based smartphones of selected configuration was sent over email to the experimenter. Acoustic parameters (fundamental frequency, harmonic frequencies, jitter, shimmer, harmonic-to-noise ratio, cepstral peak prominence -CPP, and pitch sigma) were analysed using Praat software. Results: Results revealed significantly increased (p < 0.05) fundamental frequency along with decreased F2 and F3 of /i/ in the early-onset ANSD compared to the late-onset group, which can be explained based on differences in the pathophysiology of the disorder. Although not statistically significant, mean perturbations (jitter and shimmer), harmonic-to-noise ratio, cepstral peak prominence, and pitch sigma were more affected in the early-onset group, reflective of lowered auditory feedback and periodicity in their voice samples. Results of discriminant analysis marked the emergence of F2, F3, and CPP as the most sensitive metrics for onset-based group differences in voice characteristics. Conclusions: The findings from the study highlight the role of acoustical voice evaluation (especially CPP, F2 & F3) in verifying the onset of ANSD disorder. The insights from the onset-based differences seen in vocal characteristics can indirectly help audiologists in deciding the management options for ANSD.