Validity and Reliability of the Korean version of the Communication Scale for Older Adults

Purpose: Aural rehabilitation has been used to reduce communication difficulties related to hearing loss and minimize their consequence in everyday life. Aural rehabilitation includes diagnosis and identification of hearing loss, provision of appropriate assistive listening devices such as hearing aids and cochlear implants, auditory training, speechreading, and communication strategies training. Communication strategies refer to a course of action taken to facilitate conversation interaction or to correct communication problems. Compared to other components of aural rehabilitation, communication strategies have not been focused on as a significant evaluation tool in spite of their importance in daily life. This study aimed to develop a Korean version of the Communication Scale for Older Adults (K-CSOA) originally designed by Kaplan et al. (1997) to evaluate the changes in communication strategies and attitudes.Methods: The K-CSOA was composed of communication strategies and communication attitudes. The Communication strategies have three subcategories of Facilitative (10 items), Repair (15 items), and Preparatory strategies (16 items). The communication attitudes have also three subcategories of Own Attitude (19 items), Family’s Attitude (7 items), and Others Attitude (5 items). The validity and reliability of K-CSOA were obtained with total sixty subjects consisting of thirty subjects with normal hearing and thirty subjects with different degrees of hearing loss with mean age of 72 years old ranging from 60 years old to 85 years old.Results: The validity and reliability of the K-CSOA were measured using Pearson`s correlation coefficient, Cronbach Alpha coefficient, and independent t-tests. The correlation coefficients were high (.502-.984) between total means of K-CSOA and subcategories of K-CSOA. The internal consistency ranged from .802 to .930 for Communication Strategies and from .620 to .962 for Communication Attitudes. The test-retest correlation of the K-CSOA was .986 and .988 for Communication Strategies and Attitudes, respectively. The correlation coefficient was .784 between the K-CSOA and Korean Hearing Handicap for the Elderly (KHHIE). In addition, there were significant differences in Communication Strategies and Communication Attitudes between the normal hearing and hearing loss groups.Conclusion: These results indicate that K-CSOA can be used as a useful clinical tool providing in-depth information regarding communication strategies and attitudes in Korean elderly people.

Development of Assessment of Music Perception for the Hearing-impaired

Purpose: Enhancement of musical perception has a positive impact on the emotional stability, quality of life, and aural rehabilitation in individuals with hearing loss. In Korea, however, there are a few test batteries available for properly assessing their abilities to perceive music. The purpose of this study was to develop a evaluation material for the music perception ability, Assessment of Music Perception (AMP) considering the Korean culture and emotion.Methods: A total of 15 normal hearing adults (33.1 ± 11.4 years) were recruited. They performed the AMP which includes eight sub-tests: pitch, melody, rhythm, timbre, and harmony perception test, emotional reaction test, Music listening Attitudes and Satisfaction Questionnaire (MASQ), and Mismatch negativity (MMN).Results: The average percentage of correct answer was 94.0% ± 6.1% in pitch perception test, 94.0% ± 7.1% in melody perception test, 99.3% ± 1.8% in rhythm perception test, 78.9% ± 41.8% in timbre perception test, 96.7% ± 10.4% in emotional reaction test, 85.7% ± 14.1% in harmony perception test. The area of the negative waveform for MMN was 275.27 ± 225.65 μV·ms with the intensity of 70 dBnHL.Conclusion: Considering high scores of a instrument, a developed AMP could be applied for evaluating the music perception ability. However, a little bit of correction for each factor of materials is recommended for comprehensive AMP material. In the future, the music perception ability of the hearing impaired should be evaluated utilizing AMP.

Designing and Implementing a Comprehensive Telehealth Aural Rehabilitation Program for Adult Cochlear Implant Recipients

Purpose A comprehensive aural rehabilitation (AR) program incorporates sensory management, perceptual training, counseling, and instruction. However, the process of designing and implementing such a program is inconsistent across clinical sites, and additional information regarding the use of teleaudiology to implement AR services is needed. The purpose of this clinical focus article is to describe the process of creating and implementing a comprehensive teleaudiology AR program for older adults who use cochlear implants (CIs) at the University of South Alabama (USA) Speech & Hearing Center. Conclusions A comprehensive teleaudiology AR program may be successfully designed and implemented for older adult populations. Information provided in this clinical focus article may serve as a guide or example for other trained health care professionals looking to create an in-person or telehealth AR program for older adults who use CIs. Supplemental Material https://doi.org/10.23641/asha.16755289

Incorporating Patient Narratives to Enhance Audiological Care and Clinical Research Outcomes

Purpose The engagement of patients as key stakeholders in their experience of care processes is a critical component of quality improvement efforts for both clinical care and translational research. Increasingly, health care systems are soliciting input from patients on care processes and experiences through surveys, patient interviews, and patient video narratives. The purpose of this viewpoint article is twofold: (a) to describe the increasing role of patient narratives about their experiences with adverse health conditions to inform patient-centered research and quality improvement efforts and (b) to present three patient narratives that highlight the real-world impacts of hearing loss and tinnitus, the life enhancing impacts of aural rehabilitation, and the importance of prospective ototoxicity monitoring in individuals with complex health conditions. Conclusion Patient narratives provide individual patient perspectives that can be used to build awareness of the range of experiences and impact of hearing disorders, and to explore patient preferences for when and how to implement hearing-related clinical services.

A Randomized Controlled Trial Using Automated Technology for Improving Ototoxicity Monitoring in VA Oncology Patients

Purpose Determine the efficacy of ototoxicity monitoring (OM) administered as automated protocols with the Oto-ID mobile audiometer (automated ototoxicity monitoring [A-OM]), compared with usual care (UC) OM in cancer patients receiving cisplatin. Method Participants were patients ( n = 46, mean age 64.7 years; range: 30–78 years) receiving cisplatin-based chemotherapy at the Department of Veterans Affairs Portland Health Care System. A randomized controlled trial contrasted A-OM and UC at up to three program evaluations (PEs) conducted by the study audiologist who was blinded to arm through PE1. PE1 occurred before randomization or oncology treatment; PE2 and PE3 occurred during and/or after treatment at 35 and 365 days postrandomization. The A-OM group ( n = 24) used Oto-ID to screen their hearing before each cisplatin dose. Oto-ID results were sent to the study audiologist for interpretation, follow-up, and care coordination. The UC group ( n = 22) received a consult for OM services through the audiology clinic. Outcomes included hearing shift near each patient's high-frequency hearing limit, revised hearing-handicap inventory score, and survival time from the start of treatment. Adherence to OM protocols, patients' use of aural rehabilitation services, and oncologists' treatment decisions were also examined. Results Ototoxicity was identified at a high overall rate (46% and 76% at 35 and 365 days, respectively, postrandomization). Adherence to monitoring prior to each cisplatin dose was 83.3% for those randomized to A-OM compared with 4.5% for UC. Randomization to A-OM was not associated with reduced ototoxic hearing shifts or self-reported hearing handicap relative to UC; neither did it compromise participants' survival. Half of participants in each arm accessed aural rehabilitation services. One in each arm had a documented ototoxicity-related cisplatin dose reduction. Conclusions Auditory impairment was an actionable concern for the participants and their oncology providers. A dedicated surveillance program using the Oto-ID's automated protocols improved adherence to OM recommendations over a traditional UC service delivery model. Supplemental Material https://doi.org/10.23641/asha.16649602

A Study for Composition and Comparison of the Music Perception Tests for Normal Hearing and Cochlear Implant Users

Purpose: The aim of this study was to compose the test for music perception and analyze the characteristic of cochlear implant users’ music perception.Methods: The test was made up with the pitch, melody, and timbre factors, using three low and high frequencies, six music genres, and four types of musical instruments correspondingly. The tests were conducted to 10 normal-hearing (NH) young adults and 10 young cochlear-implant (CI) users.Results: All the music perception tests showed significant differences between NH and CI group [F(1, 4) = 0.018, p = 0.019]. In the pitch test, CI group showed significantly lower correction rate(51.3%) than NH group (82.7%) did with higher correction rates in low frequencies. In the melody test, CI group showed significantly lower correction rate (29.7%) than NH group (95.8%) did with the highest performance in folk songs (51.7%). In the timbre test, CI group showed significantly reduced performance (22.5%) than NH group (65.8%) did. For both CI and NH groups, the pitched percussion showed the highest scores (45% and 100%) while the woodwind showed the lowest scores (13.3% and 48.3%).Conclusion: Out of three tests, CI group showed better performance in pitch perception than melody and timber perception. CI group showed better performances in low pitch sounds, melodies of familiar genre, and sound of pitched percussion instruments’ timber showing complicated music perception ability. To enhance the music perception ability for CI users by aural rehabilitation, more specified and systematic music perception test material should be developed.

Parental views on informational counselling provided by audiologists for children with permanent childhood hearing loss

Background: The absence of best practice guidelines on informational counselling, has caused lack of clarity regarding the information audiologists should provide to parents and caregivers following the diagnosis of a hearing loss. Research shows that informational counselling provided by audiologists is limited and often biased, with little evidence of how parents experience this service.Objectives: To explore the nature and practice of informational counselling by audiologists.Method: This study was descriptive in nature and adopted a survey design to obtain information on the current practices of informational counselling from the perspective of parents and primary caregivers. Ninety-seven face-to-face semi-structured interviews were conducted across KwaZulu-Natal province of South Africa. Descriptive statistics and thematic analysis using Nvivo software were conducted.Results: The majority of the parents reported receiving some form of informational counselling. However, the information provided by audiologists was considered to be biased as it included a favoured communication option, school and rehabilitative technology. There was a lack of information related to aural rehabilitation and family-centred intervention. The provision of all communication options, school options and rehabilitative technology were identified as gaps that contribute to an unfavourable decision-making process.Conclusion: There are inefficiencies experienced by families of deaf and hard of hearing children during informational counselling. However, this understanding, together with the identified gaps by parents, can help address the professional response to caring for families with deaf and hard of hearing children.

Aural Rehabilitation via Telepractice During COVID-19: A Global Perspective on Evolving Early Intervention Practices

Introduction: Pre-pandemic, telepractice was not globally implemented despite its effectiveness. Clinicians reported challenges related to technology, confidence, and inadequate resources. Objectives: To document global telepractice, identify current obstacles and measure the impact of a possible solution. The timing of this research facilitated tracking telepractice changes during the pandemic. Methods: Two surveys measured practitioners’ experience and attitude towards telepractice. Survey 1 was completed in February-March 2020. Participants then received two specialized lesson kits to trial if desired. Survey 2 was a follow-up after 4-6 weeks. Results: Between surveys, the proportion of participants providing telepractice increased from 47.6% to 91.7%. The lesson kits were trialled by 74.3%. Their use had a positive impact on three of the top five factors affecting the delivery of telepractice: parent coaching, clinician experience and accessing resources. Conclusion: Telepractice was rapidly adopted globally during the pandemic. The specialized resources were helpful in overcoming some of the barriers to delivery.

Auditory and speech development in a 3-year-old boy with auditory neuropathy spectrum disorder

Background: Auditory neuropathy spectrum disorder (ANSD) in the auditory neural pathway can affect the auditory and speech development of children. Since the symptoms and complications of this disorder are similar in different children, hearing management and rehabilitation can help with better development of speech/ language and hearing perception in children with ANSD. The Case: In this study, the case was a one-yearold boy with ANSD and mild to moderate highfrequency sensorineural hearing loss. He first underwent various audiological examinations. Then, an aural rehabilitation program containing different auditory information and games was provided to him, his family, and caregiver at their home and in the rehabilitation center. Conclusion: Although auditory neuropathy/ dissynchrony in the auditory neural pathway has negative effect on the auditory and speech development, but the children with ANSD can use different inputs for language comprehension and acquisition if they receive effective education, especially auditory training at an earlier age. Keywords: Auditory neuropathy spectrum disorder; speech perception; auditory training