Hearing Aids and Auditory Rehabilitation
R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne in Scott-Brown's Essential Otorhinolaryngology, 2022
While some are completely satisfied with the help provided by hearing aids, others have needs which cannot be fully met by them. Support for people with hearing loss may be provided by an aural rehabilitation specialist such as a hearing therapist or specialist clinical psychologist. For many, the experience of losing hearing goes far beyond the frustration of mishearing speech. It can necessitate changes in lifestyle, both at work and at leisure, make conversation effortful and tiring and profoundly alter one's sense of identity. Couples often feel that hearing loss places a strain on their relationship. Those having difficulty adjusting to life with hearing loss may well benefit from an opportunity to discuss their feelings and explore ways of coping with a rehabilitation specialist. A group in particular need of urgent referral to rehabilitation services are those who develop sudden hearing loss; they often report feelings of utter bewilderment and confusion. In a medical emergency, it is easy for emotional needs to be neglected, but timely emotional support is just as important as prompt medical treatment.
Hearing Screening: Teleaudiology and Its Application with Children in Africa and Europe
Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm in Advances in Audiology and Hearing Science, 2020
The rationale for school screening programs is almost obvious. The classroom is an auditory verbal environment where precise transmission and reception of speech is critical for effective learning to occur (Davis et al., 1986). Stated differently, being able to hear all sounds is fundamental when learning to read. The behavioral effects of hearing impairment are frequently subtle and look similar to those of children who experience attention deficit disorders, learning disabilities, language and cognitive delays (Skarżyńki et al., 2013). Common behaviors which occur with hearing loss include: difficulty attending to spoken or other auditory information; frequent requests for repetition; fatigue when listening; inappropriate answers to questions; avoidance of contacts with peers; difficulty with reading skills and written language; and a low tolerance for frustration (Johnson and Seaton, 2011). Children with mild unilateral hearing loss (UHL) exhibit difficulties in sound-source location and problems with speech understanding and these factors can significantly affect in long-term educational outcomes (Lewis et al., 2015). Such negative outcomes can be ameliorated with early identification of hearing loss and intervention via hearing aids, cochlear implants, various assistive listening devices, and aural rehabilitation. These interventions facilitate student speech and language, cognitive and social development, and consequently academic achievement is more likely to remain on target.
Screening Tools for Otological Function in Older Adults
Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm in Advances in Audiology and Hearing Science, 2020
Only about 20% of older hearing impaired subjects referred for aural rehabilitation decided to use HA (Popelka, 1998; Gussekloo, 2003; GBD, 2015). Limited use and low satisfaction with HA have also been cited by the World Health Organization (WHO, 2017). As a consequence, also the results of A screening aimed to quantify the use of HA in the elderly might be debatable. As reported by Weinstein in 1997, the efficacy of a treatment is defined in terms of the extent to which it reduces or deletes the patient’s difficulties in one or more areas of function (Gagne et al., 1995). Therefore, in order to screen the abilities of people wearing HA, again we have to assess the improvements on disability, communication strategies, participation restrictions, and activity limitations, and not limit the investigation to the impairment (Weinstein, 1997; UK Health National Screening Committee, 2014). Many questionnaires and neuro-psychological tests have been used in this field in the past; more recently, many papers have been focused on the effect of aural rehabilitation on central auditory and nonauditory processes (Weinstein, 2016). Based on our clinical experience, this lack of satisfaction with HA is attributable to an inadequate handling of the devices by the elderly and by an insufficient or inappropriate approach of the professionals to the HA provision, that is a comprehensive physical, emotional, psychological rehabilitation process and not a stand-alone tool. This hypothesis has been supported by many papers (McCarthy, 1996; Hickson et al., 2010; Meijerink et al., 2017). In particular, Sweetow et al. (2010) highlighted that auditory training in older adults is rarely proposed, despite being considered effective, and often abandoned by patients to whom it is offered.
Qualitative research methods to investigate communication within a group aural rehabilitation intervention
Published in International Journal of Audiology, 2019
Laura Coco, Maia Ingram, Nicole Marrone
Age-related hearing loss affects one in three Americans aged 60 and older (Goman and Lin 2016), and is characterised by progressive high frequency hearing loss that often leads to communication difficulties, particularly in the presence of background noise (Pichora-Fuller and Singh 2006). Treatment for hearing loss typically centres on the fitting of assistive listening devices such as hearing aids, although the majority of those who could benefit are not using amplification (National Academies of Sciences, Engineering, and Medicine 2016). In addition, hearing health care disparities contribute to low use of amplification among ethnic/racial minorities, including Hispanic/Latino adults (Nieman et al. 2016). Evidence shows the use of hearing aids can improve client outcomes, including speech understanding and quality of life (Bainbridge and Wallhagen 2014; Kitterick and Ferguson 2018). However, even with the assistance of devices, individuals can continue to experience communication difficulties leading to ongoing limitations in their ability to fully participate in daily activities (Gatehouse et al. 2003). Given the complexities of adapting to adult onset hearing loss, there is increased focus on aural rehabilitation (AR) to increase an individual or family’s ability to manage the effects on communication and quality of life (Abrams et al. 2002; Laplante-Lévesque et al. 2012; Hickson et al. 2013; Grenness et al. 2014).
A randomised controlled clinical trial to assess the benefits of a telecare tool delivered prior to the initial hearing assessment
Published in International Journal of Audiology, 2023
D. W. Maidment, E. Heffernan, M. A. Ferguson
Adult aural rehabilitation typically involves an initial hearing assessment followed by the fitting of hearing aids (i.e. sensory management). Hearing aids have been shown to effectively improve listening abilities and quality of life in adults with hearing loss (Ferguson et al. 2017). Nevertheless, hearing aid take-up and adherence is low; it is estimated that two out of three adults who would benefit from hearing aids do not access them (Chia et al. 2007; Davis et al. 2007; Hartley et al. 2010). In addition, up to 24% of individuals with mild to moderate hearing loss who take-up hearing aids do not use them (Ferguson et al. 2017). Reasons for hearing aid non-use and suboptimal-use include poor attitudes towards and acceptance of hearing loss, low self-reported activity limitations and participation restrictions, reduced self-efficacy to manage hearing loss and use hearing aids, as well as a lack of financial and social support (Knudsen et al. 2010; Meyer and Hickson 2012; McCormack and Fortnum 2013; Bennett et al. 2018). Given that the factors influencing hearing aid take-up and adherence are diverse and multifaceted, it has been argued that a holistic, patient-centred approach to hearing healthcare should be adopted, as opposed to one that focuses solely on sensory management (Boothroyd 2007). As such, it is advocated that additional strategies, such as patient education, auditory-cognitive training, and counselling are also necessary to help individuals successfully manage their hearing loss (Boothroyd 2007; Davis et al. 2016; Ferguson et al. 2019).
Perceived improvements and challenges following sequential bilateral cochlear implantation in children and adults
Published in Cochlear Implants International, 2018
Mary Pat Moeller, Lisa J. Stille, Michelle L. Hughes, Rodney P. Lusk
Subjective measures may expand understanding of sequential biCI outcomes by exploring self-perceived benefits in real-world environments. Although individual results vary, several studies reported improved functional outcomes and/or quality of life changes in adults and children following sequential biCIs. Bichey and Miyamoto (2008) reported that 23 adult patients showed significant incremental improvements in self-reported quality of life after receiving both the first and the second CI. Greatest gains were typically reported after the first CI, but some adults reported equal gains following receipt of each implant. Some participants reported functional improvements across multiple domains, including hearing in noise, speech, emotion, and cognition. Subjective reports of the benefits of sequential biCIs in adults were found to correlate with objective measures (Laske et al., 2009), supporting the value of collecting subjective measures to complement what has been learned from objective procedures. Furthermore, biCI users reported better performance across all categories of the Spatial and Qualities of Hearing Scale (SSQ) compared to a group of unilateral CI users, although these differences missed significance (P = .051). Sequential biCI users were most satisfied with improvements in their spatial hearing (Laske et al., 2009). Interviews may yield additional details about the ways that such improvements impact daily communication or functioning in the work setting, which could guide refinement of both objective and subjective tools and support the delineation of goals for aural rehabilitation.