Background: The projected increase in the aging population raises concerns about how to manage the healthcare needs in a cost effective way. Within hearing healthcare, there are currently too few audiologists to meet the expected demand, and training more professionals may not be a feasible way of addressing this problem. For this reason, there is a need to develop different ways of assessing hearing sensitivity that can be conducted accurately and inexpensively when a certified audiologist and/or sound-attenuated booth is unavailable. More specifically, there is a need to determine if the HHT can yield accurate and reliable data from older adults with varying degrees of hearing loss. Purpose: To compare audiometric thresholds obtained using the Etymotic ‘Home Hearing Test’ (HHT), an automated pure-tone air-conduction test, to those obtained using manual audiometry, among older adults with varying degrees of hearing loss. Study Sample: Participants were 112 English-speaking adults (58% Female), aged 60 years and older. Participants were excluded from this study if otoscopy revealed cerumen impaction and/or suspected ear pathology. Intervention: All participants completed the HHT on tablet computers in a carpeted classroom and MA in a double-walled sound attenuated booth using insert earphones for both measures. Both measures were completed in the same test session and the order of testing (MA vs. HHT) was counterbalanced. Data Collection and Analysis: Absolute differences in thresholds measurements (in dBHL) were calculated across all ears (n = 224 ears) and for all frequencies (octave frequencies from 0.5 – 8 kHz). Correlation and multiple linear regression analyses were conducted to determine if thresholds obtained using the HHT significantly correlated with thresholds using MA. Mean thresholds for each method (HHT and MA) were compared using correlation analyses for each test frequency. Multiple linear regression analysis was used to examine the relationship between the four-frequency PTA (average threshold at 0.5, 1, 2, and 4 kHz) in the better-hearing ear measured using the HHT and a set of seven independent factors: four-frequency PTA in the better-hearing ear measured via MA, treatment group (HHT vs. MA), age, gender, and degree of hearing loss (mild, moderate, > moderate). Results: Correlation analyses revealed frequency-specific correlations, ranging from 0.91 – 0.97, for air-conduction thresholds obtained using the HHT and MA. Mean HHT thresholds were significantly correlated with mean MA thresholds in both ears across the frequency range. This relationship held true across different degrees of hearing loss. The regression model accounted for a significant amount of variance in the HHT better ear PTA, with MA better-ear PTA being the only significant predictor in our final model, with no effect of degree of loss, age or gender. Conclusions: The HHT is an accurate and cost effective method of establishing pure-tone air conduction thresholds, when compared to manual audiometry. Therefore, the...
Recent and significant changes in policy and service delivery approaches, using over-the-counter models, have been developed to specifically address cost and accessibility of hearing healthcare (HHC) services • This qualitative study demonstrates that, although cost remains a key challenge, long-standing issues of stigma and trust in the HHC system -originally identified about 30 years ago -remain despite significant technological advances and generational change • Such barriers may remain an impediment to HHC uptake among older adults
Purpose A comprehensive aural rehabilitation (AR) program incorporates sensory management, perceptual training, counseling, and instruction. However, the process of designing and implementing such a program is inconsistent across clinical sites, and additional information regarding the use of teleaudiology to implement AR services is needed. The purpose of this clinical focus article is to describe the process of creating and implementing a comprehensive teleaudiology AR program for older adults who use cochlear implants (CIs) at the University of South Alabama (USA) Speech & Hearing Center. Conclusions A comprehensive teleaudiology AR program may be successfully designed and implemented for older adult populations. Information provided in this clinical focus article may serve as a guide or example for other trained health care professionals looking to create an in-person or telehealth AR program for older adults who use CIs. Supplemental Material https://doi.org/10.23641/asha.16755289
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