Impact of Hearing Loss on Social Participation in Children: A Scoping Review.

Social participation can be defined as involvement in activities that provide a platform to interact with society and others. Untreated hearing loss effects communication skills, academic achievements, and peer-group interaction. Since a typical body structure and body functioning are essential to demonstrate day to day activities. Altogether these factors can influence the social participation in children with HL. The aim of this study is to systematically review the impact of hearing loss on social participation in children.A literature search was carried out to obtain studies exploring social participation among children with HL. Two authors independently searched four electronic databases, PubMed, Scopus, Embase, and Web of Science. The search strategy was designed by using six main terms 'social participation', 'social engagement', 'social interaction', 'hearing loss', 'hearing impairment', 'hearing disorder', and Boolean operators 'AND', 'OR' were used to make the search strings. The current review included four studies after meeting the eligibility criteria. Findings showed that social participation is affected in children with HL. Reduced hearing ability is one of the factors of reduced social participation in children. Children using hearing aids or cochlear implants, participate more frequently in social activities. The findings of this review suggest that HL is associated with reduced social participation. However, using hearing aids and cochlear implants followed by auditory verbal therapy has significant improvement in social participation. Future studies need to investigate whether early rehabilitation can increase social participation in children.

Self-esteem among Individuals with Hearing Loss: A Systematic Review.

Purpose: Self-esteem is important for decision making, emotional health, and overall well-being. In individuals with hearing loss (HL), self-esteem may vary due to degree of HL, hearing devices, academic set-ups and communication strategies used by family members. This study aimed to systematically review the impact of hearing loss on self-esteem. Method: A systematic search was conducted to identify the studies focusing on self-esteem of the individuals with HL. Four electronic databases, PubMed, Scopus, Embase, and CINAHL, were used. Title screening and abstract reading were performed by two independent authors. Appropriate studies were considered for full-length reading. The references of the obtained articles were manually searched to identify eligible studies. A mixed-methods appraisal tool was used to critically appraise the included studies. Results: Out of 1219, twelve studies met the inclusion criteria. Individuals with HL exposed to total communication had a positive impact on self-esteem. Interestingly, hearing competence of parents and siblings was linked with their self-esteem. Children with HL have higher self-esteem than normal-hearing children. Children with HL attending mainstream schooling and using cochlear implants had positive and higher self-esteem. Further, higher education level, employment, and marital status were effectively associated with self-esteem. Conclusion: Positive self-esteem intensely improves mental and emotional well-being. Appropriate and timely provided rehabilitation accompanied by family support can induce healthier and more fulfilling social life. Additionally, healthy self-esteem can empower individuals with HL to engage in social activities diligently. To sum up, early intervention and family participation are required to improve overall quality of life.

Knowledge, Beliefs, and Practices Towards Cochlear Implantations Among Otorhinolaryngologists in India.

The outcome of the cochlear implant is dependent highly on the knowledge, belief and practice of cochlear implant in otolaryngologists who are among the important team members. The study explored the knowledge, beliefs, and practices towards cochlear implantations among otorhinolaryngologists in India. An online cross-sectional survey study was carried out using convenient sampling among otorhinolaryngologists in India. Phase-I involved developing and validating of a questionnaire to study the knowledge, beliefs, and practices towards cochlear implants among otorhinolaryngologists in India while phase II involved administration of the questionnaire and analysis. Data collection was conducted using Google Forms. A total of 106 otorhinolaryngologists participated across 24-65 years of age and with experience ranging from 1 to 42 years. The participating otorhinolaryngologists reported having good knowledge about the candidacy for a cochlear implant but having limited knowledge of the recent developments and governmental schemes. The otorhinolaryngologists displayed positive beliefs regarding cochlear implantation. Most recommended a battery of tests to determine the candidacy and gave a lot of importance to rehabilitation (96.2%) and surgery for implantation (83%). The respondents also practiced giving importance to a team approach involving multiple team members. High costs and financial burden emerged to be the major challenges for cochlear implantation in India. The findings of the survey indicate an overall positive belief and practices towards cochlear implantation by otorhinolaryngologists in India. However, there is a need to spread more awareness among them about the recent advances and schemes that would further improve their service delivery.

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review

Abstract Introduction Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

Stress among Parents of Children with Hearing Loss and How They Deal with It: A Systematic Review.

Introduction Parenting a child with hearing loss may be accompanied by high stress levels and several challenges. Objectives The present systematic review was performed to compile the existing literature pertaining to parental stress in parents of children with hearing loss and coping strategies. Data synthesis The databases searched include PubMed/Medline, Scopus, Cochrane Library and Cumulative Index to Nursing, and Allied Health Literature. The systematic review was designed and performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines. The screening for studies was performed independently by two researchers. Methodological quality appraisal was done using the Mixed methods appraisal tool. Twenty-eight studies were identified and included in the present review, which discussed the stress factors and coping mechanism associated with having child with hearing loss reported by parents. The factors leading to stress were thematically classified into parent/family-related factors, child-related factors, and professionals/service-related factors. The coping strategies were thematically classified into improved support systems and better professional resources. Conclusion The present systematic review was an attempt at exploring the various stress causing factors among parents of children with hearing loss. The various coping strategies would help in better planning services for these parents and helping to lessen the stress.

Effect of Preeclampsia and Gestational diabetes mellitus on Neonatal Distortion Product Otoacoustic Emissions: A Tertiary Care Center Study.

PURPOSE: To determine whether preeclampsia and gestational diabetes mellitus is a risk factor for cochlear damage and sensorineural hearing impairment in infants. MATERIALS AND METHODS: Longitudinal study was conducted in 2 tertiary referral centers. 1068 neonates were included, who were born to preeclampsia, gestational diabetes mellitus, and healthy mothers. The hearing evaluation was done using DPOAE on day 2 and for those who failed the initial DPOAE on day 2, underwent repeat DPOAE on day 15, ABR was done on day 30 if repeat DPOAE was Refer. The results were compared between the groups and analyzed. RESULTS: On initial DPOAE, bilateral ear absent DPOAE rates were 19.5%, 15.8%, and 3.5% among preeclampsia, Gestational Diabetes Mellitus (GDM), control groups respectively. The difference was statistically significant (P < .001). Also it was noted that absent DPOAE was significantly high at low and mid frequencies (1000, 2000, 3000, and 4000 Hz) in bilateral ear. However the difference in repeat DPOAE among the groups were not significant (Right ear P = .17, Left ear P = .31). Infants who failed repeat DPOAE test underwent ABR test in which 3 of GDM group, 2 infants of preeclampsia group and 1 infant of control group had absent ABR test. CONCLUSION: This study reveals that GDM and preeclampsia showed remarkable association of hearing loss at lower and mid frequencies which was transient. The prevalence of absent DPOAE was corresponding to the severity of the maternal conditions under the study.

Universal Newborn Hearing Screening: An Indian Experience of Conceptualizing and Testing a Comprehensive Model.

There have been isolated attempts to implement newborn hearing screening at various setups across India. However, none of these attempts has followed a holistic model comprising of multiple components. Therefore, a need was felt to design and implement a comprehensive universal newborn hearing-screening model to, improve follow-up, and provide practically implementable solutions for developing economies. The model was conceptualized after a detailed preliminary planning level. Separate protocols for newborns from well-baby nursery and neonatal intensive care unit were implemented. Measures were implemented to improve follow-up. Knowledge, attitude, and practices survey followed by a sensitization program was carried out to highlight the importance of newborn hearing screening among the healthcare providers. A knowledge and attitude survey was also carried out among mothers. The estimated prevalence rate was 8.78 per 1000. Measures enabled an improved follow-up rate that lead to a reduced age of identification to 6 months. The surveys among mothers and healthcare providers helped to identify the lacunae in knowledge levels, which need to be filled in order to improve their attitudes. Thus, this was a successful model for universal newborn hearing screening comprising of two-stage screening, separate protocols, steps to improve follow-up, improving awareness among parents, sensitization programs, and surveys among mothers as well as healthcare providers.

Vocal Health Care amongst Hindustani Classical Singers- A Mixed Methods, Cross-Sectional Survey.

OBJECTIVES: The objective of the present survey was to profile the knowledge, attitude, and practices towards vocal health care amongst Hindustani classical singers. STUDY DESIGN: Mixed-methods, cross-sectional questionnaire-based study. METHODS: A self-reported questionnaire was developed and used to gather data on the knowledge, attitude, and practices of Hindustani classical singers towards vocal health care. An online survey link was generated, and responses were collected from self-identified trained Hindustani classical singers. Descriptive statistics was carried out for the closed-ended questions and inductive approach was used to analyse the responses of open-ended questions. RESULTS: Ninety-four self-identified trained Hindustani classical singers participated in the study. The responses indicate good knowledge towards vocal health measures and positive attitudes towards vocal health care. The open-ended responses were analysed using an inductive approach. Although, 70% were aware about role of a speech language pathologist, only 9.7% reported of consulting one in the event of voice problem. Further, 70% singers reported of following precautions to avoid voice problems while 85.1% considered voice rest as necessary before a performance. The singers reported of using home remedies, vocal and non-vocal measures as a part of vocal health measures. CONCLUSIONS: The present study helps to profile the knowledge, attitude, and practices towards vocal health care amongst Hindustani classical singers. It also helps to provide a basis for further studies to establish an empirical basis for the reported practices towards vocal health care.

Impact of COVID-19 pandemic on audiology practice: A scoping review.

BACKGROUND: COVID-19 has significantly impacted the professional practice of health care professionals including audiological practice. Audiologists had to adopt to changes and modify their practice to deal with the pandemic. Reasonable published work has been seen since the onset of the pandemic, depicting impact on the audiology practice across the globe in different practice settings and contexts. The present scoping review was carried out to explore the impact of COVID-19 pandemic on audiology practice and the challenges faced. MATERIAL & METHODS: A literature search was carried out to identify the studies exploring the impact of COVID-19 pandemic on audiology practice. Three electronic databases namely Scopus, PubMed/Medline, and Cochrane Library were searched using keywords. After title and abstract screening, suitable studies were identified. RESULTS: Of the total 172, nine studies focusing on impact of COVID-19 pandemic on audiology practice COVID-19, published between January 2020 to June 2021 were included. Overall, the COVID-19 pandemic and the subsequent restrictions, caused changes in routine clinical practices in audiology. These changes were with respect to stringent infection control measures, mode of service delivery, changes in routines with reduced services or prioritizing services. Challenges included issues with remote services, experience, and support. CONCLUSION: The present review reveals the changes in audiology practice during COVID -19 and challenges encountered by audiologists. These findings would help in better planning of audiology practice in the post pandemic world.

Spectral and Temporal Characteristics of Vowels in Konkani.

The present study was undertaken to study the acoustic characteristics of vowels using spectrographic analysis in Mangalorean Catholic Konkani dialect of Konkani spoken in Mangalore, Karnataka, India. Recordings were done using CVC words in 11 males and 19 females between the age range of 18-55 years. The CVC words consisted of combinations of vowels such as (/i, i:, e, ɵ, ə, u, o, ɐ, ӓ, ɔ/) and consonants such as (/m, k, w, s, ʅ, h, l, r, p, ʤ, g, n, Ɵ, t, l, b, dh/). Recordings were done in a sound-treated room using PRAAT software and spectrographic analysis was done and spectral and temporal characteristics such as fundamental frequency (F0), formants (F1, F2, F3) and vowel duration. The results showed that higher fundamental frequency values were observed for short, high and back vowels. Higher F1 values were noted for open vowels and F2 was higher for front vowels. Long vowels had longer duration compared to short vowels and females had longer vowel duration compared to males. The acoustic information in terms of spectral and temporal cues helps in better understanding the production and perception of languages and dialects.

Psychosocial Adjustments after Advanced Laryngeal Cancer Treatment - A Systematic Review.

Psychosocial adjustments are alterations needed by a person after a life-altering event. The present review explored the psychosocial adjustments after advanced laryngeal cancer treatment. Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PubMed and Scopus were searched. Two hundred and three hits, after the three-stage screening, 13 articles were included. Mixed methods appraisal tool was used to perform the quality appraisal. The findings from 1109 laryngeal cancer survivors and 154 spouses of total laryngectomy patients helped to identify the barriers and coping mechanism toward psychosocial adjustments. The barriers included reactions of spouse or family members, effect of voice, communication and speech intelligibility and work and family relationships. The coping was enhanced with a better awareness, motivation and support system. These findings would help in improving the training programs and enhance the pre- and post-treatment counselling based on the priorities and demands of the patient.

Association between Spontaneous Otoacoustic Emission and Psychoacoustic measures.

AIM: The aim of the present study was to evaluate the association of presence and absence of spontaneous otoacoustic emissions (SOAEs) on different psycho-acoustic measures such as intensity discrimination, gap detection test, duration discrimination test, modulation detection for sinusoidal amplitude modulated noise at 8, 20, 60, and 100 Hz. METHOD: Sixty adults with hearing sensitivity within normal limits were divided into two groups; group 1 consisted of participants with SOAEs present and group 2 consisted of participants with SOAEs absent. All the participants were tested for presence of SOAEs and different psycho-acoustic measures. RESULTS: The present study results showed no significant difference on intensity discrimination, gap detection test, duration discrimination test, modulation detection for sinusoidal amplitude modulated noise at 8, 20, 60, and 100 Hz in presence and absent of SOAE. CONCLUSION: The findings reveals that the presence or absence of SOAE did not influence or enhance the psychophysical performance at most comfortable level in individuals having normal hearing.

Impact of coronavirus disease 2019 on professional practices of audiologists and speech-language pathologists in India: A knowledge, attitude and practices survey.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread throughout the world and become a global pandemic. This has hampered and led to drastic changes in the functioning of healthcare services, forcing the professionals to adapt and work efficiently. The present study aimed to explore the impact of COVID-19 on the professional practices of audiologists and speech-language pathologists in India using a cross-sectional knowledge, attitude and practices survey. MATERIAL AND METHODS: The study was conducted in two phases; phase one involved development and validation of the questionnaire, while phase II involved data collection. A cross-sectional self-reported internet-based study using convenience sampling was carried out. RESULTS: Two hundred and eleven audiologists and speech-language pathologists responded to the survey. Overall, the professionals exhibited good knowledge levels regarding the COVID-19 outbreak. However, there were differences in their attitudes towards service delivery in the midst of the pandemic. Further, poor practices towards infection control measures especially in terms of hand washing was noted. CONCLUSION: The findings of the present study are useful in highlighting the need to create better awareness among these professionals about appropriate and standard infection control measures. There is a need to have in place standard operating protocols for hand wash and infection control as well as inclusion in curriculum.

Voice-related complaints and vocal and nonvocal habits of Hindustani classical singers: a questionnaire-based study.

OBJECTIVE: This study aimed to profile voice-related complaints, as well as vocal and nonvocal habits among Hindustani classical singers. METHOD: Cross-sectional study design was used to profile voice-related complaints and vocal and nonvocal habits among Hindustani classical singers. Phase I involved developing a questionnaire for exploring vocal and nonvocal habits. Phase II involved the administration of the survey to 61 Hindustani classical singers. RESULTS: Based on the overall findings, 41% of singers reported of at least three vocal symptoms. The most common vocal symptoms included out of breath while singing, felling tired after singing and experiencing tension or tightness in neck/shoulder. The commonly reported vocal habits included excessive phone use, loud coughing/sneezing, throat clearing and excessive speaking. A high consumption of caffeinated beverages and spicy food were also reported. CONCLUSION: This study helps to highlight the voice-related complaints and vocal and nonvocal habits of Hindustani classical singers. Further studies, need to explore the prevalence of voice problems incorporating other dimensions of voice evaluation such as acoustic, auditory perceptual, self-reported and laryngeal examination.

Parent reported barriers and facilitators towards cochlear implantation - A systematic review.

CONTEXT: Early identification and intervention of hearing loss at a young age leads to long term benefits from language, communication, social, educational and financial aspects. Cochlear implantation is a widely recommended rehabilitation option for hearing loss. The process of cochlear implantation is a long one and the role played by parents is crucial. OBJECTIVE: The present systematic review was carried out with the aim of identifying the different parent reported barriers towards cochlear implantation. DATA SOURCES: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and Cochrane Library. STUDY SELECTION: Studies in parent reported barriers towards cochlear implantation screened and identified using 3 stages by 2 reviewers. Mixed Methods Appraisal Tool was used to carry out the quality appraisal of included studies. DATA EXTRACTION: Outcome measures related to barriers and facilitators. RESULTS: Nineteen studies were identified and included in the present review which discussed the parent reported barriers based on themes such as service delivery, social issues, time related, device/surgery, financial, child related and others. The different factors that facilitated the process included availability of resources, finances, child related and parental. CONCLUSION: The present review was a novel attempt at exploring the different parent reported barriers towards cochlear implantation. The facilitators, which can be used to overcome these barriers, will be useful for making the process smoother.

Reliability and Validity of the Kannada Version of the Consensus Auditory-Perceptual Evaluation of Voice.

Purpose The purpose of this study was to evaluate the reliability and validity of the Kannada version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). Method The Kannada version of CAPE-V comprises six phrases that are phonetically designed as per the CAPE-V requirements. Sixty-five (21 individuals with dysphonia and 44 asymptomatic) participants were enrolled for the instrument psychometric validation. The interrater and intrarater reliability as well as validity were assessed. Results High level of agreement was noted between the three raters across all the CAPE-V parameters, highest for pitch (intraclass correlation coefficient value = .98) and lowest for loudness (intraclass correlation coefficient value = .96). High intrarater reliability agreement (intraclass correlation coefficient value > .97) was also noted for all the parameters. Among the correlation for parameters that are comparable between CAPE-V and the Grade, Roughness, Breathiness, Asthenia, and Strain scale, the highest correlation was noted for overall severity. There was a significant difference noted between the study and control groups for all parameters except loudness. The discriminant function analysis and classification revealed that 98% were correctly identified. Conclusion The Kannada version of CAPE-V has been proven to be a psychometrically reliable and valid tool to use for auditory-perceptual evaluation of voice.

Knowledge and attitudes toward transgender community among speech-language pathologists in India: A questionnaire-based exploration.

Background: During the transition process, transgender individuals may require voice and communication services. Speech-language pathologists are increasingly involved in rendering clinical services and assisting transgender clients in voice and communication therapy. Previous studies in different countries have highlighted the lack of competence expressed by the speech-language pathologists toward serving the members of the lesbian, gay, bisexual, transgender, and queer communities. Presently, no such findings are available in the Indian context. Thus, a need was felt for identifying the concerns toward treatment for transgender individuals in speech-language pathology settings in India. Aim: The aim of the present study was to assess the knowledge, comfort levels and attitudes of speech-language pathologists practicing in India regarding the transgender community. Method: An online survey method was used to assess the knowledge and attitudes among speech-language pathologists working in India toward the transgender community. Results: The findings of the study revealed higher comfort levels as compared to self-rated knowledge levels in addressing issues related to transgender healthcare. Evidence-based practices toward transgender healthcare emerged as the topic needing more information. The study also helped to identify several moral beliefs and practices for voice therapy for the transgender population. Conclusion: There is a strong need to educate the speech language pathologists toward transgender healthcare in order to promote better cultural competence. The findings of the present study help to identify the lacunae in knowledge as well as to highlight the need to have continuing education programs in this area.

A Preliminary Attempt to Profile Tympanometric Measures in Infants Using High Frequency Probe Tones.

There is dearth of published data on high frequency tympanometric measures for infants in Indian context. Aim of present study was to profile Peak compensated static acoustic admittance (Ytm), Tympanometric peak pressure (TPP), Tympanometric width (TW) and Equivalent ear canal volume (Vea) in infants. Cross-sectional study on 50 infants with present TEOAEs and with risk indicators for hearing loss. Tympanometry was performed using GSI-Tympstar for 678 and 1000 Hz probe tones. Descriptive statistics were used to determine mean, SD and minimum and maximum for both genders. Using 678 Hz, Ytm ranged from 0.09 to 1. 48 mmho (males) and 0.11 to 1.14 mmho (females), while with 1000 Hz ranged from 0.15 to 1.49 (males) and 0.13-1.61 mmho (females). Using 678 Hz, TPP ranged from -95 to 70 daPa (males) and -155 to 80 daPa (females), while with 1000 Hz ranged from -75 to 95 daPa (males) and -145 to 50 daPa (females). Using 678 Hz, TW ranged from 30 to 190 daPa (males) and 40-23 daPa (females), while with 1000 Hz ranged from 60 to 210 daPa (males) and 40-183 daPa (females). Using 678 Hz, Vea ranged from 0.11 to 1.7 mmho (males) and 0.14-2.5 mmho (females), while with 1000 Hz ranged from 0.14 to 2.0 mmho (males) and 0.14-3.6 mmho (males). This study was a preliminary attempt to profile the tympanic measures. Ytm values were lesser or similar to other studies, TPP and Vea values had lower and narrow range, while TW were more than previous studies.

Knowledge and Perceptions of Teleaudiology Among Audiologists: A Systematic Review.

BACKGROUND AND OBJECTIVES: The knowledge and perception of teleaudiology among audiologists will determine the acceptance and success of teleaudiology practice. This systematic review was conducted to review the published literature on knowledge and perceptions of teleaudiology application among audiologists. MATERIALS AND METHODS: Five studies exploring knowledge and perceptions of teleaudiology application among audiologists published in the English language up to May 2017 were included. RESULTS: Positive attitudes was observed across the studies regarding acceptance towards application of teleaudiology. The most common sources of knowledge were on the job, graduate studies, and continuing education programs. The major barriers to the uptake of application of teleaudiology were in terms of limitations in infrastructure, reimbursement, and licensure. CONCLUSIONS: The study sheds light on the existing knowledge and perceptions of teleaudiology applications among audiologists. This will help in improving the existing teleaudiology services as well as overcome the challenges faced.

Acoustic Analysis of Voice in Singers: A Systematic Review.

Purpose: Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers. Method: A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population-investigation-outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction. Results: Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth. Conclusion: Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.