Purpose
This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States.
Method
Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population.
Findings/Conclusions
There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.
The prevalence of missing responses coupled with large intersubject variability and intrasubject test-retest variability are a detriment to the clinical utility of DPOAEs evoked with low-level stimuli.
The purpose of this study was to evaluate and compare the efficacy of hearing screening tools to identify hearing loss in the older adult population. The test-retest reliability of both the AuDX DPOAE hand-held screener and subjective otoscopic ratings of percent earwax accumulation were evaluated. Additionally, the predictive validity was investigated for five hearing screening tools: the DPOAE hand-held screener, pure-tone screening, screening otoscopy, self-assessment of communication, and case history screening. The research was conducted through typical community hearing screenings on normal-hearing and hearing-impaired volunteer subjects. The screening subjects included 67 adults aged 49 to 89 years. Of those, 44 returned for a full audiologic evaluation. Key findings include: (1) Pure-tone screening had predictive validity for actual hearing loss in the older adult population when a 25 dB HL fence is used; (2) Screening otoscopy ratings were highly reliable across time and raters; (3) Self-assessment scores did not predict compliance with referral recommendations; (4)The AuDX DPOAE hand-held screener proved to be reliable in the overall pass/refer outcome, but lacked predictive validity for actual hearing loss in older adults.
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