Ecological momentary assessment is a feasible and valid research methodology for older adults with mild hearing impairment. The methodology has potential as a clinical counseling and outcome tool.

The development of appropriate audiological assessment in the clinic, and further evaluation of the real-world listening needs and performance of people with mild hearing impairment is required to provide a more effective pathway for this clinical population.

Current approaches to the measurement of hearing aid benefit typically use clinical or laboratory-based speech perception tests or retrospective self-report surveys. However, when assessing hearing aid outcomes in adults with mild hearing impairment, the traditional outcome measures may not be sufficiently sensitive. An alternative to these techniques are approaches that capture data about real-world experiences as they are experienced, such as ecological momentary assessment. This single-subject experimental design pilot study investigated the feasibility of using ecological momentary assessment in assessing whether hearing aids make a difference to the real-world listening experiences of adults with mild hearing impairment. Ten participants with an average age of 70 years and no previous amplification experience answered survey questions on their listening experiences over a 4-week period (1 week without hearing aids, 2 weeks with hearing aids, and 1 week without hearing aids). A total of 860 surveys were collected. Participants reported significantly better speech understanding and less listening effort during the 2-week trial with hearing aids compared to baseline conditions. In addition, they reported that they were significantly less hampered by their hearing difficulties and had greater enjoyment of listening events with wearing hearing aids. Individual variation in hearing aid benefit was evident. This pilot study showed that ecological momentary assessment has potential to quantify self-reported aided benefit for individuals with mild hearing impairment fitted with hearing aids. This research also highlighted that a real-world approach is needed to explore individualized outcomes and provide different insights to standardized questionnaires.

Clinical populations with mild HI use HAs as frequently as those with a moderate HI. These findings support the recommendation of HAs for adults with milder degrees of HI.

To obtain real-world insights into the hearing difficulties of individuals, the field of hearing research has recently started to adopt ecological momentary assessment. Using this approach, study participants describe their experiences in real time, in their own natural environment. This paper describes the use of ecological momentary assessment in hearing research to date. Several studies have shown the approach is feasible and has good construct validity for use with adults with hearing impairment and/or tinnitus. Two recent studies conducted by the authors are described. The first study investigated the listening experiences of older adults with mild hearing impairment and concluded that ecological momentary assessment provided group and individual data which highlighted the between-subject variability in this clinical population. The second study investigated the difference that the provision of hearing aids could make for older adults with mild hearing impairment. The pilot study indicated that ecological momentary assessment could be successfully used in intervention studies to measure, for example, individual hearing aid benefit, which may extend beyond improved speech understanding. The study also revealed the potential for ecological momentary assessment as a tool for clinical practice and decision-making. Ecological momentary assessment can result in a rich array of research data if specific study design guidelines, presented in this paper, are followed. The development of a clinical ecological momentary assessment tool would provide clinicians an individualized outcome measure and facilitate the adoption of a greater degree of client- and family-centeredness, thereby improving rehabilitation outcomes.

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