Patricia B. Kricos

Optimal Outcome Measures, Research Priorities, and International Cooperation

&NA; The participants in the Eriksholm Workshop on “Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids” debated three issues that are reported in this article. First, it was agreed that the characteristics of an optimal outcome measure vary as a function of the purpose of the measurement. Potential characteristics of outcome self‐report tools for four common goals of outcome measurement are briefly presented to illustrate this point. Second, 10 important research priorities in outcome measurement were identified and ranked. They are presented with brief discussion of the top five. Third, the concept of generating a brief universally applicable outcome measure was endorsed. This brief data set is intended to supplement existing outcome measures and to promote data combination and comparison across different social, cultural, and health‐care delivery systems. A set of seven core items is proposed for further study.

Audiologic Management of Older Adults With Hearing Loss and Compromised Cognitive/Psychoacoustic Auditory Processing Capabilities

The number and proportion of older adults in the United States population is increasing, and more clinical audiologists will be called upon to deliver hearing care to the approximately 35% to 50% of them who experience hearing difficulties. In recent years, the characteristics and sources of receptive communication difficulties in older individuals have been investigated by hearing scientists, cognitive psychologists, and audiologists. It is becoming increasingly apparent that cognitive compromises and psychoacoustic auditory processing disorders associated with aging may contribute to communication difficulties in this population. This paper presents an overview of best practices, based on our current knowledge base, for clinical management of older individuals with limitations in cognitive or psychoacoustic auditory processing capabilities, or both, that accompany aging.

The influence of nonaudiological variables on audiological rehabilitation outcomes.

&NA; The link between nonaudiological variables and outcomes measurement is explored. Hearing impairment can affect an individuals everyday communication in numerous ways. Both audiological and nonaudiological variables interact with each other to produce a unique predicament for each individual with hearing impairment. The nonaudiological variables that are addressed in this article include race/ethnicity, gender, age, personality, self‐efficacy, and social support, as well as a number of other factors. Some of these variables, such as personality, have been found to exert more influence than audiological factors on audiological rehabilitation outcomes. The potential influence of each variable is discussed and directions for future research are provided.

Differences in Visual Intelligibility Across Talkers

For a number of years, researchers have studied patterns of consonant and vowel confusions in speechreading Visually similar speech sounds are referred to as visemes. Factors affecting viseme groupings include coarticulation effects of accompanying sounds, environmental effects (e g, lighting), and articulatory differences among various talkers. The contribution of the latter, talker differences, is addressed in this paper.

Training influences on visual consonant and sentence recognition

Visual consonant and sentence reception were compared in three groups of 10 normal-hearing young adult subjects including a Training group that received 14 hours of videotaped analytic visual consonant recognition training with 100% feedback concerning the correctness of their responses, a Pseudotraining group that received the same treatment as the Training group with the exception that they were not given any information about whether their responses were correct or not, and a Control group. While all three groups scored significantly higher on the post-treatment visual consonant recognition test, there was no significant difference between the Training group and the Pseudotraining group in terms of improvement scores. Furthermore, none of the groups improved in their ability to recognize visually presented sentence length material. These results are discussed in terms of the development of task-specific performance skills.

Perceived benefits of amplification as a function of central auditory status in the elderly.

A measure of perceived hearing aid benefit was obtained from 24 older hearing-impaired adults who had received their hearing aids a minimum of 6 months prior to this study. Subjects were also administered a battery of tests, including comparisons of maximum scores for phonetically balanced words and the Synthetic Sentence Identification Test to identify central auditory disorder. There appears to be no relationship between perceived hearing aid benefit and central auditory function as measured in this study. Several explanations for these somewhat surprising findings are offered, as well as clinical implications regarding the use of hearing aids by older adults.

Hearing Assistive Technology Considerations for Older Individuals With Dual Sensory Loss

This article focuses on the current state of the science related to audiologic rehabilitation of individuals with dual sensory impairment, with an emphasis on considerations for provision of appropriate hearing assistive technology for this population. A substantial increase in the number of older adults is predicted in the coming years, many of whom will have significant age-related impairments in hearing and vision. Thus, hearing care professionals will be called on increasingly to attend to the special needs of people with dual sensory impairment to ensure maximal quality of life and independence for these individuals. Access to sound is critical for individuals who live with compromises in both vision and hearing. Hearing assistive technology may improve not only their speech perception but also their connection and orientation to the environment, as well as enable greater mobility. Thus, the audiologists provision of appropriate and carefully selected hearing assistive technology may contribute dramatically to the quality of life of the individual with dual sensory loss. Prefitting, fitting, and postfitting considerations in providing hearing aids and other assistive technology to individuals with dual sensory impairment are reviewed.

Play diversity and structural relationships in the play and language of language-impaired and language-normal preschoolers: Preliminary data

The purpose of this study was to compare structural play-language relationships and diversity of symbolic play skills in age matched language-impaired and language-normal children. The language-impaired and language-normal children differed in their play-language correspondences when the structural metrics of mean length of utterance (MLU) and mean length of sequence (MLS) were used. Differences between the groups were also found on specific quantitative and qualitative aspects of symbolic play. Suggestions for play intervention are discussed.

A closed- versus open-set measure of speech discrimination in normally hearing young and elderly adults

This investigation sought to determine whether the pattern of performance differed between young and elderly normally hearing adults on a closed v. open-set discrimination task. The California Consonant Test was administered at 32 dB SL (re:SRT) to 20 young and 20 elderly normally hearing subjects under two conditions: one which required subjects to mark their response on a multiple choice answer form; and a second which required subjects to provide a one-word written response on a blank answer form. The only significant difference occurred within the young group between conditions (closed-set, open-set). The young groups speech discrimination was significantly better in the closed-set condition then in the open-set condition. No other differences were significant. The results question the concept of phonemic regression as a concomitant of ageing.

Gerontological Training for Speech-Language Pathologists:: An Initial Assessment of the Need and Benefits

This study provides an initial, data-based assessment of the need for and benefits of specialized training in gerontology for speech-language pathologists. Respondents were 77 ASHA conferees who completed written questionnaires. The demographic findings suggest that few speech-language pathologists receive gerontological training; nonetheless, the clinicians demonstrated an extensive knowledge of the aging process. Inferential findings indicate that nonprofessional interaction with elders, rather than professional interaction with older clients or gerontological training, is associated with increased knowledge about the aging process. However, both gerontological training and preference for older clients were associated with amount of professional interactions with older clients.