Text messaging to promote responsible personal listening device use in young adults.

OBJECTIVES: The objective of this study is to examine efficacy of text message reminders and to educate and promote safe personal listening device (PLD) use in young adults. METHODS: Three hundred and eighty-seven urban college students from an urban university located in New York City, New York, participated in this pre- and postsurvey 6-month study (September 2016-March 2017). One hundred and ninety-eight students assigned to Group 1 (safe PLD use) received biweekly informative and humorous text reminders to encourage safe PLD use; 189 students assigned to Group 2 (controls) received monthly text messages related to the importance of their participation in the study with no mention of responsible PLD use. The Kruskal-Wallis test was used to analyze the pre- and postquestionnaire data; outcomes were considered significant at P < 0.05. RESULTS: Participants who received text message reminders reported significant (H[1] = 86.7, P < 0.001) change in increasing responsible PLD use; no significant change was reported by controls (H[1] = 0.002, P = 0.96). Females assigned to Group 1 reported modified PLD use more (H[1] = 6.7, P < 0.01) than males, suggesting a gender effect. Participants who received the bi-weekly text reminders rated them as helpful in promoting responsible PLD use; participants assigned to the control group who did not receive biweekly text reminders indicated the reminders could have been helpful in promoting safe PLD use. CONCLUSIONS: Text message reminders were reported and appear effective in motivating responsible PLD use in young adults.

The Effectiveness of Parental Questionnaires in the Assessment of Speech-Language and Auditory Function in Children.

OBJECTIVE: This study investigates the use of a parental questionnaire to determine its effectiveness as a screening tool in identifying speech-language and/or auditory impairments in children. PATIENTS AND METHODS: Parents completed speech-language (n = 36) or audiology (n = 23) questionnaires prior to their child's speech-language and/or auditory evaluations. The speech-language and audiology evaluations were conducted by clinicians at three different universities not familiar with the administration and scoring of the parental questionnaires. A research assistant coded the results of the speech-language and audiology evaluations. Statistical analysis was used to determine if any aspects of the parents' evaluation of their child's speech, language, or hearing correlated with the speech-language pathologists'/audiologists' assessment. The results of the analyses would indicate whether parental reports are a reliable alternative to professionals' assessment. RESULTS: The speech-language questionnaires for children aged 2-5 years revealed the parents' perception of their children speaking 3-word sentences significantly (p < 0.05) corresponded to the children's comprehension and expression skills. The results from the auditory questionnaires revealed that reports of a child's ear pain were (p < 0.05) correlated with auditory dysfunction. CONCLUSIONS: These questionnaires can potentially be used in low-income countries where professional resources are scarce and there are barriers to identifying children with speech-language and/or auditory impairment.

Influence of Hearing Risk Information on the Motivation and Modification of Personal Listening Device Use.

PURPOSE: The purpose of this study was (a) to investigate the behaviors, knowledge, and motivators associated with personal listening device (PLD) use and (b) to determine the influence of different types of hearing health risk education information (text with or without visual images) on motivation to modify PLD listening use behaviors in young adults. METHOD: College-age students (N = 523) completed a paper-and-pencil survey tapping their behaviors, knowledge, and motivation regarding listening to music or media at high volume using PLDs. Participants rated their motivation to listen to PLDs at lower volume levels following each of three information sets: text only, behind-the-ear hearing aid image with text, and inner ear hair cell damage image with text. RESULTS: Acoustically pleasing and emotional motives were the most frequently cited (38%-45%) reasons for listening to music or media using a PLD at high volume levels. The behind-the-ear hearing aid image with text information was significantly (p < .0001) more motivating to participants than text alone or the inner ear hair cell damage image with text. CONCLUSIONS: Evocative imagery using hearing aids may be an effective approach in hearing protective health campaigns for motivating safer listening practices with PLDs in young adults.

Hearing screening in a well-infant nursery: profile of automated ABR-fail/OAE-pass.

OBJECTIVES: The goals were to examine the prevalence of a screening outcome pattern of auditory brainstem response fail/otoacoustic emission pass (ABR-F/OAE-P) in a cohort of infants in well-infant nurseries (WINs), to profile children at risk for auditory neuropathy spectrum disorder, and to compare inpatient costs for 2 screening protocols using automated auditory brainstem response (ABR) and otoacoustic emission (OAE) screening. METHODS: A total of 10.6% (n = 2167) of 20 529 infants admitted to WINs in 2006-2009 were screened for auditory neuropathy spectrum disorder risk by using an experimental protocol (automated ABR testing first, followed by OAE testing if the automated ABR test was not passed). A second WIN cohort (n = 281) was screened by using the standard WIN protocol for the facility (OAE testing first, followed by automated ABR testing if the OAE test was not passed). Comparisons were made regarding preparation and testing times and personnel costs. RESULTS: The ABR-F/OAE-P outcome was found for 0.92% of infants in WINs in inpatient testing and none in outpatient rescreening. The time for test preparation was 4 times longer and that for test administration was 2.6 times longer for the experimental protocol, compared with the standard protocol. Inpatient costs for the experimental protocol included 3 times greater personnel time costs. CONCLUSIONS: Less than 1% of infants in WINs had ABR-F/OAE-P screening outcomes as inpatients and none as outpatients. These results suggest that prevalence is low for infants cared for in WINs and use of OAE testing as a screening tool in WINs is not unreasonable.

High frequency hearing sensitivity in adolescent females of a lower socioeconomic status over a period of 24 years (1985-2008).

PURPOSE: To examine annually over a period of 24 years, the high frequency hearing sensitivity in different groups of urban female adolescents with a low socioeconomic status (SES) and residential foster care. METHODS: Hearing screening (15 decibel [dB] hearing level ranging from 1,000 to 8,000 Hertz [Hz]) and threshold (>15 dB hearing level) records were obtained from 8,710 female adolescents (mean age, 15.8 years [range, 12-20 years]), predominantly Hispanic and African American from households with a low SES. Data related to the use of personal listening devices (PLDs), daily hours of usage, occurrence of tinnitus, and hearing thresholds between 1,000 and 8,000 Hz over an 8-year period (2001-2008) were obtained from the adolescents. RESULTS: High frequency hearing loss (HFHL) doubled over the 24-year period from 10.1% in 1985 to 19.2% in 2008. In comparison with the general adolescent population, this group of female adolescents presented with a higher percentage of bilateral mild or greater degrees of HFHL at two or more frequencies including 3,000, 4,000, and 6,000 Hz. Use of PLDs increased four-fold, from 18.3% (n = 68) in 2001 to 76.4% (n = 227) in 2008. Of the total number reporting tinnitus (n = 286), 99.7% (n = 285) also reported regular PLD use. A significant relationship was found between PLD use and reported tinnitus and HFHL irrespective of time of use of PLD. CONCLUSIONS: Increased incidence of HFHL, reported tinnitus, PLD use, and hours of daily use in at-risk female adolescents of a low SES was found. A frequency interval of 3,000-6,000 Hz should be included in hearing screening protocols to identify potentially disabling hearing loss. Hearing conservation strategies need to be developed and/or modified that target and reach at-risk children and adolescents.

Exposure to disability and hearing loss narratives in undergraduate audiology curriculum.

PURPOSE: To determine whether exposure to disability and hearing loss narratives increased undergraduate communication sciences and disorders (CSD) students' affective responses to scenarios of individuals with hearing impairment. METHOD: Thirty-five CSD undergraduates responded to 8 scenarios (K. English, L. L. Mendel, T. Rojeski, & J. Hornak, 1999). Sixteen students completed a course in audiologic rehabilitation with no exposure to disability and hearing loss narratives; 19 students completed the same course with exposure. Two audiologists, independent and blind to group status, rated the 35 student responses for affective and technical content. RESULTS: Students exposed to the narratives incorporated more affective elements into their technical responses than students not exposed. CONCLUSIONS: Narratives appear to be effective in increasing affective elements in students' technical/informational responses and may have a place and be of value in undergraduate CSD curriculum.

Cochlear implants in young children: informed consent as a process and current practices.

PURPOSE: This study examined the types of information that pediatric cochlear implant (PCI) centers and teams provide to parents of deaf children and the extent to which the informed consent process extends beyond medical issues to include social and cultural aspects. A second purpose was to determine the extent to which centers are applying selected new practices in cochlear implantation: younger age at implantation and bilateral implantation. METHOD: A 23-question survey was sent to 445 cochlear implant centers in the United States. Of the 445 centers contacted, 188 (42%) were excluded as ineligible (nonpediatric), 257 (58%) were determined eligible, and 121 (47%) of these completed the survey. Survey topics included characteristics of PCI centers and teams; the role and importance of professionals/consultants; types of medical, educational, Deaf culture, and identity information and perspectives provided to parents; and current practices regarding age of implantation and bilateral implantation. RESULTS: All of the PCI teams completing the survey presented medical/surgical risks, audiologic information, and variability of communication/educational options; fewer than half (45%) presented Deaf culture and emerging autonomy/identity issues to parents. Most PCI centers felt the optimal age to implant a child was 10-15 months. The majority of PCI centers, regardless of affiliation with a teaching hospital, responded that they rarely or never implanted bilaterally, and few discussed bilateral implants with parents. CONCLUSIONS: Audiologists are the only nonsurgical professionals always represented on the cochlear implant team. In order to best prepare audiologists for this role, graduate audiology programs need to address more extensively the Deaf culture and perspective, as well as genetics of hearing loss. Increased attention to educational audiology and evidence-based research regarding best age to implant and bilateral implantation needs to be included in the discussion with parents. Audiologists play a crucial role in informing parents and coordinating care, and should therefore carefully consider their role in the informed consent process.

Screening methods for childhood hearing impairment in rural Bangladesh.

OBJECTIVE: The purpose of this study was to determine a feasible strategy for screening young children in rural Bangladesh for hearing impairments. METHODS: Trained community health workers (CHWs) screened 4003 children between the ages of 2 and 9 years using conditioned play audiometry (CPA) and a subset of 569 of these children (ages 2-5 years), using physiologic (otoacoustic emissions [OAEs] and tympanometry). Measures of frequency and cross-tabulations are presented to describe results. RESULTS: Hearing screening using CPA was feasible for most children in the 6-9 years age range, but not for the younger children due to shyness and lack of cooperation. More than two thirds of the younger children were untestable on CPA. In response to this limitation, OAEs and tympanometry, requiring less cooperation on the part of the child, was implemented for a sample of younger children. Of the 569 children who received both CPA and OAE/tympanometry, 69% were untestable using CPA and 8.9% were untestable using OAE and tympanometry. CONCLUSIONS: These results suggest that hearing screening using CPA for older (6-9 years) and OAE/tympanometry for younger (2-5 years) children is feasible. Using the physiologic measures of OAE/tympanometry significantly reduced the number of untestable children, resulting in fewer referrals for diagnostic assessments. Thus, if only one methodology could be implemented, physiologic measure would be preferred. This is important because trained audiologists are scarce in Bangladesh. Technology is available and feasible for hearing screening in developing countries. Focus needs now to center on increasing the number of trained audiologists in developing countries to ensure better follow-up and accessibility to audiological services.

Newborn hearing screening in the NICU: profile of failed auditory brainstem response/passed otoacoustic emission.

OBJECTIVE: Incidence of a specific pattern of auditory responses, absent auditory brainstem responses (ABRs) and present otoacoustic emissions (OAEs), in newborn hearing screening in a regional perinatal center neonatal intensive care unit (NICU) is described. This profile, labeled auditory neuropathy or auditory dyssynchrony (AN/AD), is a dysfunction in neural/brainstem transmission that occurs in individuals whose outer hairs cells are functioning normally. Although the AN/AD profile has been associated with various risk factors, incidence and prediction are unknown. METHOD: Analysis of electrophysiologic measures and medical record reviews of the first 22 months of the universal newborn hearing-screening program was conducted. Association of the AN/AD profile was evaluated with the following factors: gender, gestational age, ototoxic drug regimen, low birth weight, hyperbilirubinemia, hydrocephalus, low Apgar score, anoxia, respiratory distress syndrome, pulmonary hypertension, intraventricular hemorrhage, multiple birth, seizure activity, and family history. RESULTS: One hundred fifteen (24.1%) of the 477 infants failed the ABR in 1 or both ears and passed OAEs bilaterally. Comparisons of infants fitting the AN/AD profile with those not fitting the AN/AD profile were negative with 3 exceptions: those with hyperbilirubinemia and those who were administered vancomycin or furosemide. A logistic-regression analysis model failed to predict which infants would be at risk for the AN/AD profile either unilaterally or bilaterally. CONCLUSIONS: Screening of NICU infants should be conducted with ABR first, followed by OAE after failure on ABR. Because the incidence of the AN/AD profile was found to be 24% in this at-risk population, additional study is warranted.

Cerebellar pilocytic astrocytoma with auditory presentation: case study.

An 8-year-old girl complained of decreased hearing and difficulty hearing from her right ear while on the telephone. Pure-tone and speech audiometry, immittance (tympanometry, acoustic reflex thresholds), auditory brainstem response, and transient click-evoked otoacoustic emissions were administered. The results were suggestive of a space-occupying lesion, and the patient was referred to a pediatric neurologist and neurosurgeon. A cerebellar pilocytic astrocytoma was found. The patient's audiologic profile is described, along with implications for pediatric neurologic evaluations.