We are thrilled to announce the winners of the 2014 Plural Publishing Research Awards given in honor of the late Dr. Sadanand Singh. These two scholarships are awarded by the Council of Academic Programs in Communication Sciences and Disorders and honorees and their faculty sponsors are acknowledged at the annual CAPCSD meeting, taking place this year in Orlando, FL, April 10-12. Congratulations to Doreen Hansmann, the master’s level winner and to Meg Simione, the doctoral level winner.
Hello Plural Community-
This week we are re-posting an article from the Hearing Health & Technology Matters blog regarding Plural author James Jerger. We hope you enjoy.
Section from Jerger’s “Audiology in the USA” makes its online debut – By David H. Kirkwood, the editor of Hearing News Watch and editor-in-chief of Hearing Health & Technology Matters
No one has done more to advance the field of audiology over the past half century than James Jerger. As a researcher, writer/editor, teacher, and founding president of the American Academy of Audiology, Dr. Jerger has played an out-sized role in shaping the history of audiology and in preparing the profession to meet the needs of the 21st century.
That’s why when our blog, Hearing Health & Technology Matters (HHTM), had the unprecedented opportunity to publish an extensive passage from Dr. Jerger’s book, Audiology in the USA, online we seized it. With the permission of the book’s publisher, Plural Publishing, Wayne Staab has posted a 10-page section on rehabilitation from the book on Wayne’s World, his blog at HHMT.
Here, Dr. Jerger presents a fascinating and fast-moving chronicle of hearing aids from the carbon granule devices of 1902 through today’s advanced digital instruments. The Distinguished Scholar-in-Residence at the School of Behavioral and Brain Sciences, University of Texas at Dallas, also recounts the development of real-ear measurements, the discovery of the phenomenon of auditory deprivation, and the invention of outcome measures to determine patient benefit. Especially interesting are the portraits Dr. Jerger paints of some of the men and women who made important contributions to audiology.
As Wayne Staab states on his blog, HHTM is honored to have the privilege of being the first to publish a chapter from Audiology in the USA on the Internet. To read it, visit Wayne’s World.
We are offering 30% off list price PLUS free ground shipping now through December 24th on any title published before 2012- including Dr. Jerger’s Audiology in the USA. Just enter promotion code HOL1330 at checkout and select DEFAULT SHIPPING METHOD to apply your discount.
The Nature of Aural Rehabilitation by Raymond Hull, PhD, FASHA, FAAA
When my book, “Introduction to Aural Rehabilitation” was first published by Plural Publishing in 2010, I wanted everyone to read the first sentence. To me, it said it all. Those words are, “The aim of aural habilitative/rehabilitative services on behalf of those with impaired hearing is to overcome the handicap”. I felt that it was an all-encompassing statement that covered many aspects of the services that we offer on behalf of those with impaired hearing. However, it was a very general statement that left specifics unanswered. In the current second edition of “Introduction to Aural Rehabilitation”, I continue by saying, “The audiologist works with the patient to assist in remediating the handicapping effects of the hearing loss…to overcome the communicative, educational, social and psychological effects…that may result from impaired hearing”.
Now, the question that has plagued me and many of us during our careers as audiologists is, what do the specific elements of “remediation” actually involve? It is a subject that has been debated extensively over the years, and I have witnessed and been a part of those discussions. During my graduate studies, I was taught that what was in the book, “What People Say” by Ordman and Ralli contained many of the necessary ingredients for a successful program of aural rehabilitation. That approach, of course, has thankfully long passed into history. It seems that for nearly every person who provides services on behalf of individuals who possess impaired hearing, approach their habilitation/rehabilitation in ways in which they feel most comfortable. And, of course, that is appropriate since every audiologist deserves the opportunity to develop their own approaches to serving their patients, whether children or adults.
However, although audiologists generally have differing philosophies regarding the most effective and efficient avenues for serving their patients and assisting them to regain their place in their hearing/communicating worlds, it seems that there are common elements in the process that we all consider to be important in serving our patients. And, from those elements, variations on that theme provide fertile ground for individual approaches that generally take on many different characteristics, including those that I utilize and advocate in the second edition of “Introduction to Aural Rehabilitation” that I edited and share the authorship with other very talented authors.
First of all, the “list” of components that I feel are the most important in aural rehabilitation treatment continues to become shorter. But, even though the list has become shorter, I feel what is contained in that list has become more meaningful both for the patient and in relation to my own feelings that I am addressing the specific needs of the patient. Therefore, it is not a process that I feel somehow compelled to provide because it was “what I was taught in graduate school”.
The following is a description of the process that I advocate for working with adult who possess impaired hearing.
1. First of all, I ask the question that my primary care physician or my dentist or my dermatologist always asks me when I am seen by her. That is, “How are you doing? What can I do for you today?” Those are probably the most important questions that a doctor can ask their patient. And, if I have issues of concern, I tell her about those—a tooth that doesn’t feel well, and I point to its location. If I am seeing my dermatologist, I might say that I noticed a spot on my face and I want you to take a look at it, or for my primary care physician, my left knee has been giving me fits! In the situation involving audiologist and patient, the same questions are also appropriate. If the patient responds with, “Oh, nothing really. I can’t think of anything”. The patient’s spouse may fill in the gaps with, “Oh yes, there ARE problems!” And, we move on from there.
2. Most importantly, I listen to my patients as they tell me about difficulties they have in their own listening environments, and I take notes. I don’t want to hear replies in response to a pre-designed “communication profile”. I want them to tell me about their own listening environments and any difficulties they have in various situations where communication is intended to take place. I may give them prompts that involve typical places of hearing difficulty that I would like to hear about.
3.After my patient has given me a synopsis of why she or he has made the appointment to see me, and we have completed a case history, a thorough hearing evaluation is completed, particularly in regard to speech recognition since that is an important element in the patient’s real world of communication.
4. If warranted, depending upon the specific difficulties the patient is experiencing, appropriate amplification devices may be selected and fit as per the specific difficulties the patient is experiencing in her or his communicative life.
5. My patients and I talk about ways to improve upon their most difficult communicative environments. These usually center on home, job, social environments, church, and meetings. An environment in which the majority of my patients experience difficulty is that of their home, and may be specific to hearing and understanding their spouse or significant other. We talk about the acoustic environment that typical homes offer, since homes can be essentially anechoic chambers in which sound, particularly that of the sounds of speech, do not carry well.
So, above and beyond a hearing impairment, there are other reasons why it can be difficult to carry on a conversation in a home or other environment, particularly when one or both of those who are talking may not speak with the precision or clarity that enhances speech recognition. Hearing aids can certainly help, but they do not improve poor speakers!
6. If warranted and possible, I work with those who communicate most frequently with the patient on their speaking habits, including precision in articulation, voice production, and the use of appropriate suprasegmental aspects of speech. This is critically important on behalf of both adults and children with impaired hearing. My background in public speaking and interpersonal communication assist me in that aspect.
What I have written here is certainly not what I was taught in my graduate course in aural rehabilitation when I was a graduate student, and it is far from the prescribed course found in “What People Say”. But, I feel that what I am doing, and what I am advocating in my book, “Introduction to Aural Rehabilitation” is something that can truly help people, both children and adults, who possess impaired hearing in their personal, educational, occupational and social lives.
*Information on this topic can be found in Hull (2013) “Breaking News: Going Beyond the Basics in Aural Rehabilitation”. Hearing Journal, 66, 14-15.
Raymond H. Hull, PhD, CCCA & SP, Professor of Communication Sciences and Disorders, Audiology/Neurosciences
Department of Communication Sciences and Disorders
School of Health Sciences
College of Health Professions,
Wichita State University
Wichita, Kansas 67260—0075
Our guest post this week comes from HEARING Life Australia and explains the benefits and uses of different types of hearing tests. The intention is to share this with your patients to help simplify the complexities in such a way that anyone can understand.
4 Types of Hearing Tests You Should Consider
If you often find yourself asking your loved ones to repeat themselves, find it difficult to follow conversations, or receive frequent complaints that you talk too loudly, it may be time to book a hearing test at your local hearing clinic.
Hearing tests employ a range of technologies that can determine your level of hearing impairment and whether you need to invest in a hearing aid. But with so many hearing tests available, it’s important to know which one is right for you.
Consider the following types of hearing tests:
1. Pure-Tone Testing
This hearing test will reveal the faintest tones a person can hear at various frequencies, from low to high. This test involves an audiometer machine emitting a range of beeps and whistles, called pure tones, with the participant responding to each sound.
When taking the pure-tone test, the participant may be asked to respond to the sounds through raising a finger or hand, pressing a button, or vocally affirming to indicate that a sound was heard.
The results of the test are plotted on an audiogram, a graph that charts the degree and type of hearing loss.
Pure-tone testing is a behavioral measurement that relies on patient reaction, and therefore is best performed on adults and children mature enough to cooperate with the test procedure.
2. Speech Discrimination Tests
These tests involve an audiologist assessing the participants’ ability to hear speech, with the results also recorded on an audiogram. These tests may involve the participant having to repeat words that are said to them.
Hearing loss that comes with aging generally begins with individuals losing the ability to hear higher frequencies, so that certain speech sounds begin to sound confusingly similar. A speech test can measure the amount of experienced speech distortion.
In order to assess the participants ability to understand speech with background noise, speech testing may be conducted in a quiet or noisy environment. This test is typically used on older children and adults, and may be used to confirm the results of the pure-tone test.
3. Auditory Brain Stem Response (ABR)
The ABR test provides information about the inner ear (cochlea) and the brain pathways required for hearing. For this test, electrodes are connected to the head in order to monitor the brain’s response to sounds. The participant lays still or even sleeps during the test.
This test can be performed on children, or those that might have difficulty with more typical behavioural methods of hearing loss tests.
4. Online Hearing Tests
For an initial assessment at home, taking an online hearing test is a great way find out whether someone should seek further professional assistance. While an online hearing test is not intended to replace a hearing assessment with an experienced hearing care professional, it may assist in identifying whether hearing loss is an issue.
In order to undertake an online hearing test at home, it is necessary to have Internet access with the ability to stream sounds, as well as a pair of headphones. Before starting, it is important to check that the computer volume is on and that the surrounding environment is quiet.
Online hearing tests may consist of different components, such as an audio screening which will test the respondents’ ability to hear sounds. An online test may also include questions that require honest answers regarding the person’s hearing ability. These tests will typically generate a score or recommendation that can be used as the starting point to assessing hearing health.
About the Author:
This post was written by HEARINGLife Australia, one of the world’s leading networks of hearing care professionals. HEARINGLife has provided hearing services to Australians for over 70 years.
HEARINGLife aims to provide sufficient information about hearing loss, hearing aids and hearing tests by providing independent advice and to provide customers with options in a way that is easily understandable. More information can be obtained from HEARINGLife’s website and social media profiles: Google Plus | Facebook | Twitter
Recently a few of our authors have been on television! They are experts in the field of audiology and we are happy to share their wisdom and success.
Ruth Bentler, PhD was on Charlie Rose’s Brain Series speaking about the brain and hearing. Specifically she detailed some of the history of the hearing aid and the future of hearing loss awareness and acceptance. Just want to see Ruth? Skip to the 20 minute mark.
Brian Taylor, AUD was interviewed on hearing health by Morgan Fairchild for the new show Baby Boomers in America on the LifeTime Network. He discusses the importance of early detection and maintained audiologic care.
Dr. Graeme Clark explains of the bionic ear that the challenge was to put the wire around the inner ear which is only about 2-3 cm in diameter. Dr. Graeme got the idea to curl the wire from shells’ spirals and found that in this way a wire could go around the inner ear if it was bendable and flexible enough. This led them to designing the first prototype from the University of Melbourne; along with the electronics, which had to be reduced to match the size of the silicone tubes.
The bionic ear cochlear implant works by having an outside speech processor with a microphone and an imbedded receiver stimulator which stimulates the hearing. When one speaks the microphone picks up the sound waves, sends them through the speech processor which converts this into patterns of electrical signals which are then sent by radio waves through the skin to the implant. Then the implant stimulates the wires around the inner ear. This is the process by which a deaf person is able to hear. Listen to Dr. Graeme Clark explain this process.
“There were many times during the early stages of my involvement with the bionic ear that I could have given up, but didn’t. In spite of problems, criticisms and difficulties I felt that I just had to go on to explore the possibilities to the very end. Someone had to do it, because it was the only chance that profoundly deaf people could have of being able to hear.” – Professor Graeme Clark AC (http://www.graemeclarkoration.org.au/about-graeme-clark.php)
The cochlear implant has evolved significantly due to the persistent innovative work and dedication from various teams and researchers. They have been successfully used since the 1980s.
Just last year, researches at the Tel Aviv University discovered that under certain conditions, bilateral cochlear implants (implants placed in both ears) have the ability to salvage binaural sound processing for the deaf. Learn more about Dr. Henkin’s work.
Do you have difficulty hearing and following conversations in noisy restaurants and crowded rooms? Are male voices easier to understand than female voices? Do you experience ringing or buzzing sounds in your ears? If you answered “Yes” to any of these questions, you may have a hearing loss and need to visit an audiologist. Audiologists are healthcare professionals that specialize in evaluating, diagnosing, treating and managing hearing loss and balance disorders in adults and children.
Untreated hearing loss affects your ability to understand speech, negatively impacting you socially and emotionally. Hearing loss can affect people of all ages; not just seniors. Over 36 million American adults have some degree of hearing loss. The statistics are shocking, especially knowing that over half of those 36 million Americans are younger than age 65.
12 million Americans have hearing loss as a result of noise exposures. Over 5 million of those people are under the age of 18. Noise induced hearing loss is a permanent and preventable disability that can affect your quality of life. Follow these easy steps to protect your hearing:
- Walk away from the noise
- Turn down the volume
- Wear proper ear protection
Hearing loss is an increasing preventable health concern in this nation. Taking time to see an audiologist for regular hearing screenings and knowing the signs of hearing loss can protect your hearing. This October is both Audiology Awareness Month and Protect Your Hearing Month! Follow the guide below to avoid extended exposure to loud noises and celebrate by preventing hearing damage; or go to the American Academy of Audiology’s website to see what you can do to spread awareness this month.
On September 9th of this year, Plural author Dr. Blake Wilson was awarded the Lasker-DeBakey Clinical Medicine Research Award for his pioneering efforts in cochlear implantation, along with Graeme Clark and Ingeborg Hochmair. Dr. Wilson was chosen to receive the award because he, “oversaw a giant leap forward in speech encoding for implants that ingeniously manipulated the timing and place of stimulation so as to minimize distortion and channel interaction.” 1
He is the Co-Director for the Duke Hearing Center and an adjunct professor for the university. He also is Chief Strategy Advisor for MED-EL Medical Electronics GmbH of Innsbruck, Austria and a Senior Fellow Emeritus of the Research Triangle Institute (RTI) in the Research Triangle Park, NC. He has been involved in the development of the cochlear implant (CI) for the past three decades and is the inventor of many of the signal processing strategies used with the present-day devices. His book Better Hearing with Cochlear Implants: Studies at Research Triangle Institute describes his and Dr. Michael Dorman’s research in more depth.
Current cochlear implants still have limitations in delivering speech signals but are able to distinguish speech in loud noise areas, as well as identify a speaker’s gender. Dr. Wilson and the other awardees contributions to the field have given 300,000 implant recipients the gift of hearing.
1. O’Donoghue, G. Cochlear Implants — Science, Serendipity, and Success. The New England Journal of Medicine, Sept. 9, 2013, doi: 10.1056/NEJMp1310111
Graduation can be an exciting and yet terrifying time. What do you do now that you’ve graduated and completed all your hard studies? Many turn to advice from those who are more experienced to aid them in making a decision.
We were fortunate to sit down with several of our authors in the field of audiology at the AudiologyNOW! meeting this past April. We asked these seasoned experts what advice they would give to students or anyone starting out in the communication disorders professions. Their responses were heartfelt, candid, a little irreverent, but definitely reveal a deep love for their profession.
Some of their advice-
- Consider going into private practice
- Get an MBA/other higher degree
- Be true to yourself; do what you want to do and do it well
- Continue learning about the industry/technology
- Communicate with patients better than your peers
We hope you enjoy!
Our guest post this week, by Melaine Lewis with Hearing Direct, explains the details of hearing loss and recommended courses of action.
Hearing loss can occur due to a number of reasons, these can be due to changes that the body undergoes (age-related) or more man-made reasons such as exposure to harmful noise. According to Kochkin’s 2008 survey (*MarkeTrak VIII) 35 million Americans are thought to present the symptoms of impaired hearing and the number is projected to increase to 40 million by 2025.
The biggest group and the subject of this post are the age-related (Presbycusis) hearing loss suffers whose condition is often misunderstood. Many sufferers chose to ‘accept’ diminished hearing as a given fact, though modern healthcare offers means to mange the condition so its influence on daily lives is minimized.
What Is Age-Related Hearing Loss?
Let’s start by explaining what it isn’t. It isn’t a condition that an individual can control like noise induced hearing loss nor does it normally lead to complete hearing loss.
It is a gradual demise in hearing ability known as sensorineural hearing loss. As the body matures, two processes lead to reduced hearing of certain frequencies. The first is degeneration of a part of the inner ear that contains micropscopic blood vessels, while the second process is the decline in sensitive hair cells inside the cochlea (a snail-shell like structure in the inner ear) that gradually become damaged or die due to increases in free radicals that damage certain cells in the body. The body is unable to regrow these hair cells (these are really nerve endings that detect sound) which leads to the categorization of agerelated hearing loss as a permanent one.
What Are The Typical Symptoms Of Age-Related Hearing Loss?
The level of hearing loss will vary between individuals. Some will be able to make simple adjustments in their lifestyle to counteract its affects, while in the case of other individuals the deterioration in hearing ability will require the intervention of modern healthcare.
Symptoms and signs can include:
- Certain sounds seem too loud
- Difficulty following a group conversation
- Difficulty hearing in noisy areas
- Hard to tell high-pitched sounds (such as “s” or “th”) from one another
- Increased difficulty in understanding women and children
- Problems hearing when there is background noise
- Voices that sound mumbled or slurred
What Is The Recommended Course of Action?
If you suspect that you or someone you care for might be experiencing the telltale signs of hearing loss, it should be investigated by your family doctor, local ENT unit or hearing center. Although the most common causes are linked to aging, other causes should also be investigated to be ruled out.
These may include:
- Acoustic neuroma
- Certain infections such as meningitis, mumps, scarlet fever and measles
- Use of certain medicines
- Genetic conditions
- Skull fractures
- Traumatic noisy events
To eliminate and diagnose the precise cause(s), a hearing test will need to be performed. A basic test can be conducted at your family doctor’s practice, though it is likely that you may also need to book a physical audiometry test at your local ENT or hearing center.
Equipped with the result, your healthcare advisor will be able to recommend the most suitable solution from using ALDs (Assistive Listening Devices such as Hearing Aids) or adapting certain communication techniques. In the case of severe hearing loss, learning sign language and even cochlear implants may form part of the recommended options.
Hearing loss does not have to undermine your quality of life. It can and should be managed.
About the Author:
Melanie Lewis is a trained hearing aid audiologist. She works for Hearing Direct, the UK’s biggest supplier of deaf and hard of hearing aids from hearing aid accessories such as batteries to ALDs (Assistive Listening Devices).
* The MarkeTrak VIII survey included 80,000 members of the National Family Opinion (NFO) panel. Of these, 14,623 hearing impaired individuals were identified.