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1.
Int J Audiol ; 61(11): 924-931, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34859745

RESUMO

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.


Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial , Percepção da Fala , Criança , Humanos , Desenho de Equipamento , Inteligibilidade da Fala , Perda Auditiva Neurossensorial/reabilitação
2.
Int J Audiol ; 61(7): 531-538, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34255984

RESUMO

This clinical consensus document addresses the assessment, selection, and fitting considerations for non-surgical bone conduction hearing devices (BCHD) for children under the age of 5 years identified as having unilateral or bilateral, permanent conductive or mixed hearing losses. Children with profound unilateral sensorineural hearing losses are not addressed. The document was developed based on evidence review and consensus by The Paediatric Bone Conduction Working Group, which is composed of audiologists from North America who have experience working with BCHDs in children. The document aims to provide clinical direction for an area of paediatric audiology practice that is under development and is therefore lacking in standard protocols or guidelines. This work may serve as a basis for future research and clinical contributions to support prospective paediatric audiology practices.


Assuntos
Auxiliares de Audição , Perda Auditiva Condutiva-Neurossensorial Mista , Perda Auditiva Neurossensorial , Condução Óssea , Criança , Pré-Escolar , Consenso , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/terapia , Humanos , Estudos Prospectivos
3.
Ear Hear ; 42(6): 1447-1461, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33928914

RESUMO

OBJECTIVE: Permanent hearing loss is an important public health issue in children with consequences for language, social, and academic functioning. Early hearing detection, intervention, and monitoring are important in mitigating the impact of permanent childhood hearing loss. Congenital cytomegalovirus (CMV) infection is a leading cause of hearing loss. The purpose of this review was to synthesize the evidence on the association between CMV infection and permanent childhood hearing loss. DESIGN: We performed a systematic review and examined scientific literature from the following databases: MEDLINE, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Embase, and CINAHL. The primary outcome was permanent bilateral or unilateral hearing loss with congenital onset or onset during childhood (birth to 18 years). The secondary outcome was progressive hearing loss. We included studies reporting data on CMV infection. Randomized controlled trials, quasi-experimental studies, nonrandomized comparative and noncomparative studies, and case series were considered. Data were extracted and the quality of individual studies was assessed with the Qualitative Assessment Tool for Quantitative Studies (McMaster University). The quality and strength of the evidence were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A narrative synthesis was completed. RESULTS: Sixty-five articles were included in the review. Prevalence of hearing loss at birth was over 33% among symptomatic CMV-infected newborns and less than 15% in asymptomatic infections. This difference in prevalence was maintained during childhood with more than 40% prevalence reported for symptomatic and less than 30% for asymptomatic CMV. Late-onset and progressive hearing loss appear to be characteristic of congenital CMV infections. Definitions of hearing loss, degree of loss, and reporting of laterality varied across studies. All degrees and both bilateral and unilateral loss were reported, regardless of symptomatic and asymptomatic status at birth, and no conclusions about the characteristics of hearing loss could be drawn. Various patterns of hearing loss were reported including stable, progressive, and fluctuating, and improvement in hearing (sometimes to normal hearing) was documented. These changes were reported in children with symptomatic/asymptomatic congenital CMV infection, presenting with congenital/early onset/late-onset hearing loss and in children treated and untreated with antiviral medication. CONCLUSIONS: Symptomatic and asymptomatic congenital CMV infection should be considered a risk factor for hearing loss at birth and during childhood and for progressive hearing loss. Therefore, CMV should be included as a risk factor in screening and surveillance programs and be taken into account in clinical follow-up of children with hearing loss.


Assuntos
Infecções por Citomegalovirus , Surdez , Perda Auditiva Neurossensorial , Perda Auditiva , Criança , Citomegalovirus , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/epidemiologia , Surdez/complicações , Perda Auditiva/diagnóstico , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Recém-Nascido , Fatores de Risco
4.
Int J Audiol ; 60(5): 385-392, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32930012

RESUMO

OBJECTIVE: Evidence-based protocols for fitting air conduction hearing aids to children offers a vital resource for audiologists. Fitting protocols for providing BCHDs to children are not well-developed, leaving gaps in clinical practice. This work aims to document current practices and challenges of audiologists who fit BCHDs to children. DESIGN: An online survey was distributed to paediatric audiologists in North America to describe their work with patients who use BCHDs. A retrospective file review was also conducted with a sample of clinics in North America to further understand practice patterns. STUDY SAMPLE: A total of 144 audiologists from North America responded to the online survey. Eleven audiologists from seven clinics in North America participated in the retrospective file review. RESULTS: Results of the survey indicated that audiologists are seeking guidance on how to provide optimal amplification to children who use BCHDs. The aided audiogram is widely used to verify BCHD fittings. Audiologists reported uncertainty about providing optimal amplification to children who wear BCHDs. The file review revealed the routine use of the aided audiogram for verification as well as for validation. CONCLUSIONS: For children who use BCHDs, there is a need for clinically feasible electroacoustic verification to accompany appropriate outcome measures.


Assuntos
Audiologia , Auxiliares de Audição , Audiologistas , Condução Óssea , Criança , Humanos , Estudos Retrospectivos
5.
Int J Audiol ; 58(12): 805-815, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31486692

RESUMO

Objective: Provide recommendations to audiologists for the management of children with unilateral hearing loss (UHL) and for needed research that can lend further insight into important unanswered questions.Design: An international panel of experts on children with UHL was convened following a day and a half of presentations on the same. The evidence reviewed for this parameter was gathered through web-based literature searches specifically designed for academic and health care resources, recent systematic reviews of literature, and new research presented at the conference that underwent peer review for publication by the time of this writing.Study sample: Expert opinions and electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Education Resources Information Centre (ERIC), Google Scholar, PsycINFO, PubMed, ScienceDirect, and Turning Research into Practice (TRIP) Database.Results: The resulting practice parameter requires a personalised, family-centred process: (1) routine surveillance of speech-language, psychosocial, auditory, and academic or pre-academic development; (2) medical assessments for determination of aetiology of hearing loss; (3) assessment of hearing technologies; and (4) considerations for family-centred counselling.Conclusions: This practice parameter provides guidance to clinical audiologists on individualising the management of children with UHL. In addition, the paper concludes with recommendations for research priorities.


Assuntos
Perda Auditiva Unilateral/terapia , Criança , Auxiliares de Audição , Perda Auditiva Unilateral/diagnóstico , Testes Auditivos , Humanos
6.
Am J Audiol ; 33(3): 695-704, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-38748932

RESUMO

PURPOSE: Bone conduction hearing devices (BCDs) that deliver sound across the skin (i.e., transcutaneous) are suitable for some individuals who have conductive or mixed hearing losses. Prescriptive targets for percutaneous devices are available, for example, from the Desired Sensation Level-Bone Conduction Hearing Device (DSL-BCD) algorithm. These targets, however, may require modification for use with transcutaneous BCDs. The current study investigated three key variables that may inform target modification: (a) comparison of thresholds measured using an audiometric bone conduction (BC) transducer versus transcutaneous BCDs that offer in situ threshold measurement, (b) transcutaneous BCD default force level outputs versus recommended DSL percutaneous BC targets, and (c) the preferred listening levels (PLLs) of adults wearing transcutaneous BCDs in a laboratory setting. METHOD: Bilateral conductive hearing loss was simulated in 20 normal-hearing adults via earplugs. Thresholds were measured using a B-71 BC transducer and two commercially available BCDs coupled to a soft headband. DSL percutaneous BC targets were generated, and PLLs were obtained for a 60-dB SPL speech stimulus. Force level outputs were measured using a skull simulator on the Audioscan Verifit2 at the hearing aids' default settings and at the participants' PLL for each device. RESULTS: On average, audiometric BC thresholds were significantly better than those measured in situ with each BCD. PLLs were similar to prescribed targets for one device with the smoother response shape and agreed in the high frequencies for both devices. CONCLUSIONS: In situ thresholds are significantly higher than audiometric BC thresholds, suggesting that device-based in situ measurement more accurately accounts for the signal transmission from transcutaneous BCDs. PLLs differed from the percutaneous targets and varied between devices, which may indicate that either target modifications or manipulations of device frequency response shaping are needed to approximate PLL with transcutaneous BCD devices.


Assuntos
Limiar Auditivo , Condução Óssea , Auxiliares de Audição , Perda Auditiva Condutiva , Humanos , Condução Óssea/fisiologia , Perda Auditiva Condutiva/fisiopatologia , Perda Auditiva Condutiva/reabilitação , Adulto , Limiar Auditivo/fisiologia , Feminino , Masculino , Adulto Jovem , Audiometria/métodos
7.
Am J Audiol ; : 1-14, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39259885

RESUMO

PURPOSE: Auditory brainstem response (ABR) thresholds are corrected to estimate behavioral thresholds in infants. Corrections were validated, and a comparison of behavioral threshold estimates between systems was conducted to inform equipment transition and protocols in Ontario, Canada. METHOD: In Study 1, a retrospective file review was conducted. ABR threshold estimates from 84 infants with hearing loss were compared to behavioral thresholds to validate the accuracy of the ABR corrections applied in the Ontario Infant Hearing Program since 2016. Study 2 examined the precision of two different ABR systems to estimate thresholds in 37 adult and 105 infant ears. RESULTS: Corrected ABR thresholds predicted behavioral thresholds in infants to within 1.77 dB (range of mean values across frequency: 1.18-2.26 dB) on average. The average differences decreased across frequency to 0.6 dB (range: 0.14 to -1.23) when ear canal acoustics were accounted for. The average between-system difference in ABR threshold estimates was 2.40 dB (range: 1.18-2.26). CONCLUSIONS: ABR correction factors used in Ontario's Infant Hearing Program provide accurate predictions of behavioral thresholds in infants with hearing loss. When calibration and collection parameters are similar between different ABR systems, threshold estimates are comparable and no further adjustment to correction factors was required.

8.
J Am Acad Audiol ; 24(2): 121-5, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23357805

RESUMO

BACKGROUND: The Parents' Evaluation of Aural/Oral Performance of Children (PEACH) is a caregiver report questionnaire that is suitable for use with children who wear hearing aids. It is available in both a Diary format and a Rating Scale format. Following a critical review of subjective outcome evaluation tools for infants, toddlers, and preschool children (Bagatto, Moodie, Seewald et al, 2011), the Rating Scale version of the PEACH was included in a recently developed guideline for monitoring real-world auditory performance of children who have hearing loss (Bagatto, Moodie, Malandrino et al, 2011). Normative data exist only for the PEACH Diary, not the Rating Scale. PURPOSE: This article evaluates whether published normative data for the PEACH Diary (Ching and Hill, 2007) are replicated on a different sample of children using the PEACH Rating Scale. RESEARCH DESIGN: Fifty-nine children with normal hearing aged 2 mo to 83 mo and their primary caregivers participated in the study. Caregivers completed the PEACH Rating Scale for each child with normal hearing. RESULTS: Results indicated close agreement to existing normative data collected with the PEACH Diary, with no differences in scores between males and females and good internal consistency. Age-related trends published for the Diary version were replicated using the Rating Scale version, as significantly lower scores were observed for children 20 mo of age and younger compared to those older than 20 mo of age. CONCLUSIONS: The currently published norms for the PEACH Diary are valid for use with the PEACH Rating Scale with caregivers of normal hearing children. This validation work adds to the evidence base of the PEACH Rating Scale and supports its use in clinical practice.


Assuntos
Correção de Deficiência Auditiva/normas , Auxiliares de Audição , Transtornos da Audição/terapia , Pais , Inquéritos e Questionários/normas , Adulto , Fatores Etários , Criança , Pré-Escolar , Prática Clínica Baseada em Evidências , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Fatores Sexuais
9.
J Eval Clin Pract ; 29(4): 614-621, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37084185

RESUMO

RATIONALE: There is a growing demand for comprehensive, evidence-based, and accessible clinical practice guidelines (CPGs) to address virtual service delivery. This demand was particularly evident within the field of hearing healthcare during the COVID-19 pandemic, when providers were faced with an immediate need to offer services at a distance. Considering the recent advancement in information and communication technologies, the slow uptake of virtual care, and the lack of knowledge tools to support clinical integration in hearing healthcare, a Knowledge-to-Action Framework was used to address the virtual care delivery research-to-practice gap. AIMS AND OBJECTIVES: This paper outlines the development of a CPG specific to provider-directed virtual hearing aid care. Clinical integration of the guideline took place during the COVID-19 pandemic and in alignment with an umbrella project aimed at implementing and evaluating virtual hearing aid care incorporating many different stakeholders. METHOD: Evidence from two systematic literature reviews guided the CPG development. Collaborative actions around knowledge creation resulted in the development of a draft CPG (v1.9) and the mobilisation of the guideline into participating clinical sites. RESULTS AND CONCLUSION: Literature review findings are discussed along with the co-creation process that included 13 team members, from various research and clinical backgrounds, who participated in the writing, revising, and finalising of the draft version of the guideline.


Assuntos
COVID-19 , Auxiliares de Audição , Humanos , COVID-19/epidemiologia , Atenção à Saúde , Audição , Pandemias
10.
J Eval Clin Pract ; 29(4): 622-631, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37089034

RESUMO

RATIONALE: Following the onset of the COVID-19 pandemic, a clinical practice guideline (CPG) around virtual hearing aid practices was developed to fill a knowledge gap within the field of audiology. Details outlining the development and mobilization of this draft guideline were outlined as Phase 1 (described in a paired paper). AIMS AND OBJECTIVES: This study describes Phase 2 of this project as part of the Knowledge-to-Action Framework, including an evaluation of the methodological quality of the guideline and the resulting tailored version of the document (v2.0). METHOD: The Appraisal of Guidelines for Research and Evaluation II instrument was used to assess methodological quality and to guide revisions. Twenty-two clinicians, from a variety of clinical backgrounds, participated in the evaluation. RESULTS AND CONCLUSION: Findings reported across six domains suggest high mean scores, ranging from 78% to 81%, in order of scope and purpose (highest rated), stakeholder involvement, rigour of development, applicability, clarity of presentation, and editorial independence. Specific recommendations made by in international co-creation team during the evaluation informed the final version of the CPG. Future development and evaluation efforts should aim to include greater representation from nontraditional practice contexts to strengthen global applicability.


Assuntos
COVID-19 , Auxiliares de Audição , Humanos , COVID-19/epidemiologia , Pandemias
11.
J Commun Disord ; 97: 106216, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35526294

RESUMO

PURPOSE: Delays in vocal development are an early predictor of ongoing language difficulty for children who are deaf/hard-of-hearing (CDHH). Despite the importance of monitoring early vocal development in clinical practice, there are few suitable tools. This study aimed to identify the clinical decisions that speech-language pathologists (SLPs) most want to make when assessing vocal development and their current barriers to doing so. METHOD: 58 SLPs who provide services to CDHH younger than 22 months completed a survey. The first section measured potential barriers to vocal development assessment. The second section asked SLPs to rate the importance of 15 clinical decisions they could make about vocal development. RESULTS: SLPs believed assessing vocal development was important for other stakeholders, and reported they had the necessary skills and knowledge to assess vocal development. Barriers primarily related to a lack of commercially available tests. SLPs rated all 15 clinical decisions as somewhat or very important. Their top 5 decisions included a variety of assessment purposes that tests are not typically designed to support, including measuring change, differential diagnosis, and goal setting. CONCLUSIONS: SLPs wish to make a number of clinical decisions when assessing vocal development in CDHH but lack access to appropriate tools to do so. Future work is needed to develop tools that are statistically equipped to fulfill these purposes. Understanding SLPs' assessment purposes will allow future tests to better map onto the clinical decisions that SLPs need to make to support CDHH and their families and facilitate implementation into clinical practice.


Assuntos
Transtornos da Comunicação , Perda Auditiva , Patologia da Fala e Linguagem , Criança , Audição , Humanos , Patologistas , Fala , Inquéritos e Questionários
12.
J Am Acad Audiol ; 22(9): 612-622, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22192606

RESUMO

BACKGROUND: Measurement of the real ear response of a fitted hearing aid allows matching of the frequency response to prescriptive targets, as well as comparison of the response to both threshold and loudness discomfort level (LDL). These processes are recommended procedures for hearing aid fittings. The real ear aided response (REAR) is often predicted based on the coupler response of the device, the real-ear-to-coupler difference (RECD), and the microphone location effect (MLE). Individualized measurement of the RECD tends to increase the accuracy of this prediction. A commercial hearing aid has been developed that measures the individual RECD and incorporates the data into the software-assisted fitting process. PURPOSE: This study evaluated the test-retest reliability and predictive validity of this particular method for measuring the RECD. RESEARCH DESIGN: A repeated measures design was used to evaluate differences between subsequent measures of the RECD in the same ear, and prediction differences associated with using the RECD (and other information) to predict the REAR. STUDY SAMPLE: Fifteen ears, on a convenience sample of ten adults (45-86 yr) and five children (6-15 yr) were tested. All participants were hearing aid users. DATA COLLECTION AND ANALYSIS: Predicted and measured REARs were collected using normal clinical procedures, on an Audioscan Verifit VF-1 for two test signals/levels. Reliability, mean differences between predicted and measured REARs, and 95% confidence intervals of the prediction accuracy are reported. RESULTS: The RECD procedure had test-retest reliability within 2.5 dB for 14 out of 15 ears between 500 and 4000 Hz, and had predictive accuracy within 5 dB between 500 and 4000 Hz for 14 out of 15 ears. However, errors associated with earhook misalignment were discovered. Also, the RECD values measured using this hearing-aid-specific procedure differ somewhat from the normative data available from insert earphone RECDs. CONCLUSIONS: This procedure, when measured according to recommendations, provides a reasonably accurate prediction of the REAR. Functionally, this procedure does not replace the range of measures offered by modern real ear measurement systems. However, given the inaccuracy of software-assisted fittings without a measure of individual ear canal acoustics, use of this procedure may have the potential to improve the accuracy of fittings versus fittings completed without real ear measurement.


Assuntos
Auxiliares de Audição/normas , Adolescente , Idoso , Idoso de 80 Anos ou mais , Criança , Humanos , Pessoa de Meia-Idade , Desenho de Prótese , Ajuste de Prótese , Reprodutibilidade dos Testes
13.
Am J Speech Lang Pathol ; 30(4): 1894-1908, 2021 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-34061568

RESUMO

Purpose Limited evidence-based guidelines for test selection continue to result in inconsistency in test use and interpretation in speech-language pathology. A major barrier is the lack of explicit and consistent adoption of a validity framework by our field. In this viewpoint, we argue that adopting the conceptual validity framework in the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) would support both the development of more meaningful and feasible clinical tests and more appropriate use and interpretation of tests in speech-language pathology. Method We describe and evaluate the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) validity framework and consider its relevance to speech-language pathology. We describe how the validity framework could be integrated into clinical practice and include examples of how it could be applied to support common clinical decisions. We evaluate the costs and benefits of adopting this framework, from the perspectives of speech-language pathologists, clients, and test developers. Results The Standards' validity framework clarifies complex validity issues by shifting the focus of validity from tests to the decisions speech-language pathologists make based on test results. By focusing on decisions, the framework requires critical evaluation of test use, rather than evaluating tests against sets of criteria. Adopting this framework has the potential for appreciable improvement in the way tests are used and valued across our profession. Conclusions Speech-language pathologists, test developers, and clients will benefit from improved evidence-based assessment practices. It is recommended that regulators, test developers, professional associations, universities, and researchers adopt the framework and endorse it as best practice moving forward. This viewpoint proposes a series of first steps toward supporting uptake of the framework into research and practice.


Assuntos
Transtornos da Comunicação , Patologia da Fala e Linguagem , Prática Clínica Baseada em Evidências , Humanos , Testes Psicológicos , Estados Unidos
14.
Int J Audiol ; 49 Suppl 1: S70-9, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20109090

RESUMO

This document describes the protocol for the provision of amplification to infants and preschool children registered with the Ontario infant hearing program (OIHP) in Canada. The provision of amplification includes the prescription and dispensing of hearing instruments to infants and preschool children identified with permanent childhood hearing impairment (PCHI) in the province of Ontario. The first section deals with the structure and processes of the program, while the second section specifies the clinical procedures that are applied in providing hearing instruments to infants and young children with hearing impairment.


Assuntos
Protocolos Clínicos , Auxiliares de Audição , Perda Auditiva/reabilitação , Programas Nacionais de Saúde , Acústica , Audiometria , Limiar Auditivo , Pré-Escolar , Meato Acústico Externo/fisiopatologia , Seguimentos , Perda Auditiva/diagnóstico , Perda Auditiva/fisiopatologia , Humanos , Lactente , Ontário , Seleção de Pacientes , Prescrições , Fatores de Tempo
15.
Lang Speech Hear Serv Sch ; 51(1): 68-73, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31913799

RESUMO

Purpose This clinical focus article describes considerations for recommending assistive hearing technology to infants and young children who have mild bilateral or unilateral hearing loss. These conditions present special challenges compared to bilateral permanent hearing losses that are moderate to profound in their degree in that the recommendation to proceed with technology is not as clear. Conclusion Current clinical practice guidelines and protocols for pediatric hearing aid fitting recommend managing these conditions on a case-by-case basis. Descriptions of key considerations for recommending assistive hearing technology for infants and young children with mild bilateral hearing loss or unilateral hearing loss are offered herein.


Assuntos
Audiologia/métodos , Audiologia/normas , Auxiliares de Audição , Perda Auditiva Bilateral/diagnóstico , Perda Auditiva Bilateral/reabilitação , Perda Auditiva Unilateral/diagnóstico , Perda Auditiva Unilateral/reabilitação , Testes Auditivos , Criança , Pré-Escolar , Implantes Cocleares , Surdez , Feminino , Humanos , Lactente , Masculino
16.
J Am Acad Audiol ; 31(5): 354-362, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31639078

RESUMO

BACKGROUND: Hearing aid prescriptive methods are a commonly recommended component of evidence-based preferred practice guidelines and are often implemented in the hearing aid programming software. Previous studies evaluating hearing aid manufacturers' software-derived fittings to prescriptions have shown significant deviations from targets. However, few such studies examined the accuracy of software-derived fittings for the Desired Sensation Level (DSL) v5.0 prescription. PURPOSE: The purpose of this study was to evaluate the accuracy of software-derived fittings to the DSL v5.0 prescription, across a range of hearing aid brands, audiograms, and test levels. RESEARCH DESIGN: This study is a prospective chart review with simulated cases. DATA COLLECTION AND ANALYSIS: A set of software-derived fittings were created for a six-month-old test case, across audiograms ranging from mild to profound. The aided output from each fitting was verified in the test box at 55-, 65-, 75-, and 90-dB SPL, and compared with DSL v5.0 child targets. The deviations from target across frequencies 250-6000 Hz were calculated, together with the root-mean-square error (RMSE) from target. The aided Speech Intelligibility Index (SII) values generated for the speech passages at 55- and 65-dB SPL were compared with published norms. STUDY SAMPLE: Thirteen behind-the-ear style hearing aids from eight manufacturers were tested. RESULTS: The amount of deviation per frequency was dependent on the test level and degree of hearing loss. Most software-derived fittings for mild-to-moderately severe hearing losses fell within ± 5 dB of the target for most frequencies. RMSE results revealed more than 84% of those hearing aid fittings for the mild-to-moderate hearing losses were within 5 dB at all test levels. Fittings for severe to profound hearing losses had the greatest deviation from target and RMSE. Aided SII values for the mild-to-moderate audiograms fell within the normative range for DSL pediatric fittings, although they fell within the lower portion of the distribution. For more severe losses, SII values for some hearing aids fell below the normative range. CONCLUSIONS: In this study, use of the software-derived manufacturers' fittings based on the DSL v5.0 pediatric targets set most hearing aids within a clinically acceptable range around the prescribed target, particularly for mild-to-moderate hearing losses. However, it is likely that clinician adjustment based on verification of hearing aid output would be required to optimize the fit to target, maximize aided SII, and ensure appropriate audibility across all degrees of hearing loss.


Assuntos
Auxiliares de Audição , Perda Auditiva Neurossensorial , Percepção da Fala , Criança , Humanos , Lactente , Estudos Prospectivos , Software , Inteligibilidade da Fala
17.
J Am Acad Audiol ; 31(7): 496-505, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32119819

RESUMO

BACKGROUND: Pediatric hearing instrument fitting is optimally performed with individually obtained real-ear-to-coupler difference (RECD) measurements. If these measurements cannot be obtained, predicted values based on age are used. Recent evidence obtained from children aged 3-11 years suggests that head circumference (HC) may be a viable alternative or addition to age for use in RECD prediction. PURPOSE: The purpose of the present study was to determine if HC can be used to predict RECDs in infants, children, and adults. RESEARCH DESIGN: A correlational design was used. HC and RECD values were measured in all participants. STUDY SAMPLE: Participants were 278 North American infants and children (136 males and 142 females) aged 1.6 months to 11 years and 109 adults (42 males and 67 females) aged 18 years to 83 years. DATA COLLECTION AND ANALYSIS: After otoscopic inspection and immittance measurements were performed to assess candidacy for inclusion in the study, HC was measured twice for all participants and a single RECD measure was obtained for each participant at twelve frequencies (250 through 12500 Hz). The reliability of HC measurements was assessed with an intraclass correlation analysis. Linear regression analyses were performed with age and HC as predictor variables and RECDs as the dependent variable. RESULTS: Analysis indicated good reliability of the HC measurement. The relationships between RECD and HC were comparable with the relationships between RECD and age. Combining HC and age did not improve predictive accuracy. CONCLUSIONS: HC can be used in children and adults as an alternative metric in the prediction of RECDs when individual RECDs cannot be obtained.


Assuntos
Auxiliares de Audição , Adulto , Cefalometria , Criança , Orelha , Feminino , Audição , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes
18.
Int J Audiol ; 48(9): 632-44, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19504379

RESUMO

This study evaluated prototype multichannel nonlinear frequency compression (NFC) signal processing on listeners with high-frequency hearing loss. This signal processor applies NFC above a cut-off frequency. The participants were hearing-impaired adults (13) and children (11) with sloping, high-frequency hearing loss. Multiple outcome measures were repeated using a modified withdrawal design. These included speech sound detection, speech recognition, and self-reported preference measures. Group level results provide evidence of significant improvement of consonant and plural recognition when NFC was enabled. Vowel recognition did not change significantly. Analysis of individual results allowed for exploration of individual factors contributing to benefit received from NFC processing. Findings suggest that NFC processing can improve high frequency speech detection and speech recognition ability for adult and child listeners. Variability in individual outcomes related to factors such as degree and configuration of hearing loss, age of participant, and type of outcome measure.


Assuntos
Auxiliares de Audição , Perda Auditiva de Alta Frequência/terapia , Dinâmica não Linear , Processamento de Sinais Assistido por Computador/instrumentação , Estimulação Acústica , Adolescente , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Criança , Método Duplo-Cego , Feminino , Humanos , Linguística , Masculino , Pessoa de Meia-Idade , Preferência do Paciente , Reconhecimento Fisiológico de Modelo , Percepção da Fala , Resultado do Tratamento
19.
Am J Speech Lang Pathol ; 28(1): 204-210, 2019 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-31072157

RESUMO

Purpose The misuse of standardized assessments has been a long-standing concern in speech-language pathology and traditionally viewed as an issue of clinician competency and training. The purpose of this article is to consider the contribution of communication breakdowns between test developers and the end users to this issue. Method We considered the misuse of standardized assessments through the lens of the 2-communities theory, in which standardized tests are viewed as a product developed in 1 community (researchers/test developers) to be used by another community (frontline clinicians). Under this view, optimal test development involves a conversation to which both parties bring unique expertise and perspectives. Results Consideration of the interpretations that standardized tests are typically validated to support revealed a mismatch between these and the interpretations and decisions that speech-language pathologists typically need to make. Test development using classical test theory, which underpins many of the tests in our field, contributes to this mismatch. Application of item response theory could better equip clinicians with the psychometric evidence to support the interpretations they desire but is not commonly found in the standardized tests used by speech-language pathologists. Conclusions Advocacy and insistence on the consideration of clinical perspectives and decision making in the test validation process is a necessary part of our role. In improving the nature of the statistical evidence reported in standardized assessments, we can ensure these tools are appropriate to fulfill our professional obligations in a clinically feasible way.


Assuntos
Testes de Linguagem/normas , Medida da Produção da Fala/normas , Patologia da Fala e Linguagem/normas , Competência Clínica , Interpretação Estatística de Dados , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/normas , Humanos , Relações Interprofissionais , Psicometria , Reprodutibilidade dos Testes , Relatório de Pesquisa/normas , Pesquisa Translacional Biomédica/normas
20.
J Speech Lang Hear Res ; 62(10): 3667-3678, 2019 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-31525125

RESUMO

Purpose This study reports validity evidence for an English translation of the LittlEARS Early Speech Production Questionnaire (LEESPQ). The LEESPQ was designed to support early spoken language outcome monitoring in young children who are deaf/hard of hearing. Methods Data from 90 children with normal hearing, ages 0-18 months, are reported. Parents completed the LEESPQ in addition to a concurrent measure of spoken language development, the Receptive-Expressive Emergent Language Test-Third Edition. Normal hearing status and development were confirmed. Results Traditional scale analyses, in addition to item parameters, are reported. The LEESPQ was highly correlated with the Receptive-Expressive Emergent Language Test-Third Edition (r = .92) and age (r = .90) and had high internal consistency (Ω = 0.92). Common factor analysis revealed 2 underlying factors conceptually mapping onto items measuring vocal and symbolic development. A latent traits model was the best fit to the data, and item difficulty broadly conformed to theoretical expectations. Conclusions The present work demonstrates that the LEESPQ accurately captures early spoken language development in a typically developing group of young children. The LEESPQ holds promise as a clinically feasible, spoken language outcome monitoring tool. Future work to identify differences in performance characteristics between typically developing children and clinical populations is warranted.


Assuntos
Linguagem Infantil , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Testes de Linguagem/normas , Medida da Produção da Fala/normas , Inquéritos e Questionários/normas , Canadá , Estudos de Viabilidade , Feminino , Humanos , Lactente , Recém-Nascido , Idioma , Análise de Classes Latentes , Masculino , Reprodutibilidade dos Testes , Traduções
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