SIG 8 Perspectives Vol. 16, No. 1, November 2015

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Vocal Performance Teachers and Hearing Loss

Hearing thresholds and distortion product otoacoustic emissions were measured for teachers of vocal performance who were gathered for a national conference. Results showed mean audiometric thresholds to be consistent with noise induced hearing loss, more than what would be expected with normal aging. Years of instruction and age were considered as factors in the hearing loss observed. It was concluded that hearing conservation should be initiated with this group to help raise awareness and protect them from hearing loss due to occupational noise exposure.

Standardized Patients: Potential to Improve Student Training in Aural Rehabilitation

Hearing loss is a growing public health concern. The multifaceted consequences of hearing loss are far reaching and include reduced audibility, well-being, and quality-of-life. Audiologists require specific training to address the wide range of hearing loss (re)habilitation needs, including some of the psychosocial needs of patients. One instructional method that might provide valuable training for the next generation of clinicians is the use of simulated or standardized patients (SPs). Standardized patients (SPs) are actors who are recruited, trained, and typically paid to portray patients, family members, or healthcare team members in a standardized manner for purposes of training healthcare professionals. Advantages to using SPs as an instructional technique were identified through a review of the literature and through discussion with two focus groups of experienced educators in the field of audiology. Advantages included those inherent to SP scenarios (e.g., standardization, authenticity, and safety), as well as those inherent to the experience (e.g., student reflection, comprehensive feedback, etc.). Benefits to students can include increased student confidence and improved interpersonal skills. Although time and resource investments necessary for SP case implementation can be prohibitive for some programs, creative instructors can harness many of the benefits using alternative implementations of SP cases.

Principles of Solution Focused Therapy and Their Application to Audiology

The concept of client-centered therapy (Rogers, 1951) has influenced many professions to refocus their treatment of clients from assessment outcomes to the person who uses the information from this assessment. The term adopted for use in the professions of Communication Sciences and Disorders and encouraged by The American Speech-Language-Hearing Association (ASHA) is patient-centered care, with the goal of helping professions, like audiology, focus more centrally on the patient. The purpose of this paper is to examine some of the principles used in a patient-centered therapy approach first described by de Shazer (1985) named Solution-Focused Therapy and how these principles might apply to the practice of audiology. The basic assumption behind this model is that people are the agents of change and the professional is there to help guide and enable clients to make the change the client wants to make. This model then is focused on solutions, not on the problems. It is postulated that by using the assumptions in this model audiologists will be more effective in a shorter time than current practice may allow.

Building Blocks of Gene Expression: DNA to RNA to Protein

Understanding the genetics of hearing loss can improve the quantity and quality of the information that those who work with individuals with hearing loss can share with their patients and clients. This understanding must start with a basic understanding of genetics in general. The general concepts of genetics can then be applied to the specific genes and proteins that are part of the hearing process, disruption of which can cause hearing loss. This article starts with a description of the central principal or mantra of genetics: “DNA to RNA to Protein.” Double-stranded deoxyribonucleic acid (DNA) in the nucleus of a cell is used as a template from which ribonucleic acid (RNA) is transcribed, or expressed. RNA transcribed from DNA instructions moves from inside the cellular nucleus out into the cytoplasm where it can then translated into a protein. Proteins are the main functional components in cells. In general, they are what implement and control cellular processes. Each step in this process from DNA to RNA to protein is carefully regulated, and a small mistake or change in any component or step can make a big difference. This article finishes by describing how small changes can cause hearing loss.

The Impact of the Affordable Care Act on Insurance Coverage of Hearing Healthcare

Implementation of the Affordable Care Act (ACA) impacts the profession of audiology beyond individual audiology practice patterns in the clinic. The legislation and further required implementation of the ACA may dictate coverage of audiologic services and devices now and into the future. Audiologic (re)habilitative services and devices have not historically been covered and are unlikely included in benchmark plans. Under the current language of the ACA, states without mandated coverage of hearing healthcare prior to 2011 will face significant challenges in creating mandates. Arguments for including audiologic services and devices as an Essential Health Benefit (EHB) include quality care, improved patient outcomes, and improved consistency in coverage patterns across the United States. Due to the limited definition of EHB from the Department of Health and Human Services (HHS) and loopholes in plans required to follow ACA guidelines, it is very possible that the inconsistencies across plans and states may increase and that financial repercussions at the state level may hinder passage of state-level mandated coverage of hearing healthcare.

Interdisciplinary Approach to Dizziness: Roles of Audiology and Physical Therapy

Dizziness is one of the most common reasons patients seek medical care, and because there are many causes of dizziness, management of these patients requires an interdisciplinary approach. Peripheral vestibular dysfunction is the most common cause of dizziness/vertigo diagnosed in specialty clinics. The purpose of this article is to present an interdisciplinary approach to the management of patients with vestibular dysfunction with a focus on the unique and overlapping contributions of audiology and physical therapy to vestibular assessment and rehabilitation.