A proof-of-concept study of the benefits of a single-session of tinnitus instruction and counselling with homework on tinnitus.

Objective: The objective of this study was to provide proof-of-concept of a single session of tinnitus instruction and counselling with and without homework.Design: A mixed-method design using questionnaires and thematic evaluation of qualitative data was implemented.Study sample: Sixteen participants received instruction in a single, one-to-one counselling session; eight participants additionally undertook homework consisting of either positive visualisation augmented by sound or a workbook of written and drawing activities supporting the instruction provided in the counselling session. All participants completed questionnaires just before and 3 weeks after the intervention, half were interviewed 3 weeks following the intervention.Results: Average tinnitus functional index (TFI) scores were 45 (SD 25) before and 29 (SD 23) following counselling, with a change of 4.8 or greater recorded in 75% and change of 13 points or greater in 50% of participants. Both counselling and counselling with homework showed similar changes in the TFI. This finding was supported by the qualitative analysis from which a model consisting of the themes of counselling benefit, content, application and homework benefit was derived.Conclusions: This study provides proof-of-concept of a single tinnitus instruction and counselling session, based on an ecological model of tinnitus.

A crossover trial comparing wide dynamic range compression and frequency compression in hearing aids for tinnitus therapy.

PURPOSE: It has been suggested that frequency lowering may be a superior tinnitus reducing digital signal processing (DSP) strategy in hearing aids than conventional amplification. A crossover trial was undertaken to determine if frequency compression (FC) was superior to wide dynamic range compression (WDRC) in reducing tinnitus. METHOD: A 6-8-week crossover trial of two digital signal-processing techniques (WDRC and 2 WDRC with FC) was undertaken in 16 persons with high-frequency sensorineural hearing loss and chronic tinnitus. RESULTS: WDRC resulted in larger improvements in Tinnitus Functional Index and rating scale scores than WDRC with FC. The tinnitus improvements obtained with both processing types appear to be due to reduced hearing handicap and possibly decreased tinnitus audibility. CONCLUSIONS: Hearing aids are useful assistive devices in the rehabilitation of tinnitus. FC was very successful in a few individuals but was not superior to WDRC across the sample. It is recommended that WDRC remain as the default first choice tinnitus hearing aid processing strategy for tinnitus. FC should be considered as one of the many other options for selection based on individual hearing needs. Implications of Rehabilitation Hearing aids can significantly reduce the effects of tinnitus after 6-8 weeks of use. Addition of frequency compression digital signal processing does not appear superior to standard amplitude compression alone. Improvements in tinnitus were correlated with reductions in hearing handicap.

Spatial masking: Development and testing of a new tinnitus assistive technology.

Masking is widely used in the management of tinnitus, however, masking at the perceived spatial location of tinnitus has not been investigated. This article examines the development of a method for the spatial masking of tinnitus. This report consists of three studies: Study I is a proof of concept study comparing customized spatial masking to conventional bilateral masking; Study II is a prototype evaluation in which the spatial masking paradigm was compared to a bilaterally equal masker using iPods connected to hearing aids in a 4-week cross-over trial; and Study III is a 4-month crossover pilot study-using prototype hearing aid-based maskers, and in which three-dimensional (3D) masking (2 months) was compared to a Tinnitus Retraining Therapy (2 months). There was a preference for the 3D masking stimulus across all three studies. Individual changes in the Tinnitus Handicap Inventory (THI) after 2 weeks of trial (Study II) and Tinnitus Functional Index (TFI) after 2 months of trial (Study III) were observed without large group differences. The spatial masking concept was piloted successfully. The qualitative and quantitative results obtained indicate directions for future clinical trials and therapy development. This study indicates that spatial masking of tinnitus is feasible, of benefit to many participants, and warrants further trials.

A parental questionnaire to evaluate children's Auditory Behavior in Everyday Life (ABEL).

The Auditory Behavior in Everyday Life (ABEL) questionnaire was developed to assess parental perceptions of their children's auditory behavior. The original 49-item questionnaire was intended to assess auditory communication, environmental awareness, functional independence, and social/ communication skills. Our goal was to capture some of the changes in children's everyday auditory behavior in a reliable and easily quantifiable manner. Parents of 28 children aged 4 to 14 years with varying degrees of hearing loss (mild-profound) completed the questionnaire. The results were used to examine the reliability and factor structure of the questionnaire. Eleven items had poor item-total correlations. After these items were removed, the questionnaire had an overall reliability of 0.94 (Cronbach's alpha), and three factors accounted for 20.5% of the variance in the data. In a pilot investigation of the ABEL to determine its appropriateness for children with cochlear implants, questionnaires were also given to a separate group of parents of seven children aged 3 to 12 years who were about to receive a cochlear implant. Questionnaire and speech perception results were obtained preimplant and at 6, 12, 18, 24, and 36 months. Complete (6 visits) or near-complete (4 visits) results were obtained for four children. There were significant improvements over time for both speech perception and questionnaire ratings and there was significant agreement between the two measures. Overall the results indicate excellent reliability and validity of the ABEL questionnaire. Our intent was to develop a simple, quick tool for parents to rate children's auditory skills in everyday life. A shorter questionnaire can be achieved by eliminating items with the poorest reliability and factor loadings. The resultant 24-item ABEL questionnaire has an excellent overall reliability of 0.95. The items fall within three factors, "Aural-oral," "Auditory Awareness," and "Social/Conversational Skills." Children's auditory behavior can be assessed using an overall rating or separately for the three factors. Further research is needed to evaluate this short version of the questionnaire in children wearing hearing aids and cochlear implants.