Educating teenagers about hearing health by training them to educate children

Welch, D. et al. International Journal of Audiology. Published online 19th May 2016.

Image source: four moons –

Objective: We investigated the change in hearing-health behaviour amongst teenagers trained to deliver the Dangerous Decibels programme to younger children.

Design: The Dangerous Decibels programme uses a two-stage process to train 8–12 year-old children to protect their hearing from noise: (1) a team of experts train ‘Educators’ who (2) give classroom training to children in schools. Training teenagers as Educators may add a second level of benefit if teenagers internalize the hearing-health messages that they present and thus protect their own hearing better. They were assessed before training, immediately after, and three months later (after all had presented the classroom training) using a questionnaire. In addition, a focus group was conducted with a subgroup of the Educators to assess their subjective experience.

Study sample: We trained 44 Educators aged 14–17 years.

Results: Results were generally positive: there were significant and sustained improvements in knowledge, self-reported behaviour, and perceived supports towards protecting hearing, and trends but not significant changes in attitudes or perceived barriers to hearing protection.

Conclusions: Providing training to teenagers had benefits beyond the delivery of training to younger children, but improvements in the delivery model may increase the uptake and impact on the teenagers.

Read the abstract here



Personalised long-term follow-up of cochlear implant patients using remote care, compared with those on the standard care pathway: study protocol for a feasibility randomised controlled trial

Cullington, H. et al. BMJ Open. 2016. 6:e011342
Image source: Duane Storey // CC BY-NC-ND 2.0

Introduction: Many resources are required to provide postoperative care to patients who receive a cochlear implant. The implant service commits to lifetime follow-up. The patient commits to regular adjustment and rehabilitation appointments in the first year and annual follow-up appointments thereafter. Offering remote follow-up may result in more stable hearing, reduced patient travel expense, time and disruption, more empowered patients, greater equality in service delivery and more freedom to optimise the allocation of clinic resources.

Methods and analysis: This will be a two-arm feasibility randomised controlled trial (RCT) involving 60 adults using cochlear implants with at least 6 months device experience in a 6-month clinical trial of remote care. This project will design, implement and evaluate a person-centred long-term follow-up pathway for people using cochlear implants offering a triple approach of remote and self-monitoring, self-adjustment of device and a personalised online support tool for home speech recognition testing, information, self-rehabilitation, advice, equipment training and troubleshooting. The main outcome measure is patient activation. Secondary outcomes are stability and quality of hearing, stability of quality of life, clinic resources, patient and clinician experience, and any adverse events associated with remote care. We will examine the acceptability of remote care to service users and clinicians, the willingness of participants to be randomised, and attrition rates. We will estimate numbers required to plan a fully powered RCT.

Ethics and dissemination: Ethical approval was received from North West—Greater Manchester South Research Ethics Committee (15/NW/0860) and the University of Southampton Research Governance Office (ERGO 15329).

Results: Results will be disseminated in the clinical and scientific communities and also to the patient population via peer-reviewed research publications both online and in print, conference and meeting presentations, posters, newsletter articles, website reports and social media.

Read the full article here



A systematic review of techniques and effects of self-help interventions for tinnitus: Application of taxonomies from health psychology

Greenwell, K. et al. International Journal of Audiology. Published online: 5 May 2016
Image source: Paul Griggs – Wellcome Images // CC-BY-NC-ND 4.0

Objective: Self-help interventions are followed by people independently with minimal or no therapist contact. This review aims to assess the effectiveness of self-help interventions for adults with chronic tinnitus and systematically identify the self-help techniques used.

Design: Systematic review and application of health psychology taxonomies. Electronic database searches were conducted, supplemented by citation searching and hand-searching of key journals. Prospective controlled trials, which used measures of tinnitus distress, functional management, anxiety, depression, and quality of life, were included. Michie et al’s behaviour change techniques (BCTs) taxonomy and Taylor et al’s PRISMS taxonomy of self-management components were applied to describe interventions.

Study sample: Five studies were included, providing low-to-moderate levels of evidence.

Results: Randomized controlled trial studies were too few and heterogeneous for meta-analysis to be performed. Studies comparing self-help interventions to therapist-guided interventions and assessing non tinnitus-specific psychosocial outcomes and functional management were lacking. Fifteen BCTs and eight self-management components were identified across interventions.

Conclusions: A lack of high-quality and homogeneous studies meant that confident conclusions could not be drawn regarding the efficacy of self-help interventions for tinnitus. Better reporting and categorization of intervention techniques is needed for replication in research and practice and to facilitate understanding of intervention mechanisms.

Read the abstract here

Evidence-based guidelines for recommending cochlear implantation for young children: Audiological criteria and optimizing age at implantation

Leigh, J.R. et al. International Journal of Audiology. Published online: 4 May 2016

Objective: Establish up-to-date evidence-based guidelines for recommending cochlear implantation for young children.

Design: Speech perception results for early-implanted children were compared to children using traditional amplification. Equivalent pure-tone average (PTA) hearing loss for cochlear implant (CI) users was established. Language of early-implanted children was assessed over six years and compared to hearing peers.

Study sample: Seventy-eight children using CIs and 62 children using traditional amplification with hearing losses ranging 25–120 dB HL PTA (speech perception study). Thirty-two children who received a CI before 2.5 years of age (language study).

Results: Speech perception outcomes suggested that children with a PTA greater than 60 dB HL have a 75% chance of benefit over traditional amplification. More conservative criteria applied to the data suggested that children with PTA greater than 82 dB HL have a 95% chance of benefit. Children implanted under 2.5 years with no significant cognitive deficits made normal language progress but retained a delay approximately equal to their age at implantation.

Conclusions: Hearing-impaired children under three years of age may benefit from cochlear implantation if their PTA exceeds 60 dB HL bilaterally. Implantation as young as possible should minimize any language delay resulting from an initial period of auditory deprivation.

Read the abstract here

Deaf awareness week

Deaf Awareness Week runs from 2 to 8 May 2016. During the week, organisations come together to raise awareness and promote social inclusion. Promoted by the UK Council on Deafness, Deaf Awareness Week is an opportunity to raise awareness that 1 in 6 people in the UK are deaf or have a hearing loss.

image source:


Common purpose is this year’s theme. A range of posters are available to download here.


More information about the common purpose initiative is available here

Development and validation of a smartphone-based digits-in-noise hearing test in South African English

Potgieter, J-M. et al. International Journal of Audiology.Published online: 28 April 2016
Image source: Esther Vargas // CC BY-SA 2.0

Objective: The objective of this study was to develop and validate a smartphone-based digits-in-noise hearing test for South African English.

Design: Single digits (0–9) were recorded and spoken by a first language English female speaker. Level corrections were applied to create a set of homogeneous digits with steep speech recognition functions. A smartphone application was created to utilize 120 digit-triplets in noise as test material. An adaptive test procedure determined the speech reception threshold (SRT). Experiments were performed to determine headphones effects on the SRT and to establish normative data.

Study sample: Participants consisted of 40 normal-hearing subjects with thresholds ≤15 dB across the frequency spectrum (250–8000 Hz) and 186 subjects with normal-hearing in both ears, or normal-hearing in the better ear.

Results: The results show steep speech recognition functions with a slope of 20%/dB for digit-triplets presented in noise using the smartphone application. The results of five headphone types indicate that the smartphone-based hearing test is reliable and can be conducted using standard Android smartphone headphones or clinical headphones.

Conclusion: A digits-in-noise hearing test was developed and validated for South Africa. The mean SRT and speech recognition functions correspond to previous developed telephone-based digits-in-noise tests.

Read the abstract here

Hearing Aid Use is Associated with Better Mini-Mental State Exam Performance

Qian, Z.J. et al. The American Journal of Geriatric Psychiatry. Published online: 12 April 2016

Image source: Jonas Bergsten // Public Domain

Objectives: Hearing loss is associated with cognitive decline in the elderly. However, it is unknown if the use of hearing aids (HAs) is associated with enhanced cognitive function.

Design: Cross-sectional study.

Setting: Academic medical center.

Measurements: Participants underwent audiometric evaluation, the Mini-Mental State Examination (MMSE), and the Trail Making Test, Part B (TMT-B). The impact of use versus disuse of HAs was assessed. Performance on cognitive tests was then compared to unaided hearing levels.

Results: HA users performed better on the MMSE (1.9 points; rank-sum, p=0.008) despite having worse hearing at both high frequencies (15.3 dB hearing level; t-test, p<0.001) and low frequencies (15.7 dB hearing level; t-test p<0.001). HA use had no effect TMT-B performance. Better performance on the MMSE was correlated with both low frequency (ρ=-0.28, p=0.021) and high frequency (ρ=-0.21, p=0.038) hearing level, but there was no correlation between performance on the TMT-B and hearing at any frequency.

Conclusions: Despite having poorer hearing, hearing aid users performed better on the MMSE. Better performance on cognitive tests with auditory stimuli (MMSE) but not visual stimuli (TMT-B) suggests that hearing loss is associated with sensory-specific cognitive decline rather than global cognitive impairment. As hearing loss is nearly universal in those >80 years, hearing aids should be strongly recommended to minimize the cognitive impairment in the elderly.

Read the abstract here

Occupational stress among Swedish audiologists in clinical practice: Reasons for being stressed

Brännström, K.J et al. International Journal of Audiology. Published online: 22 Apr 2016
Image source: Nanette Hoogslag, Wellcome Images // CC BY-NC-ND 4.0

Objective: The present study reports on the application of a Swedish translation of the audiologist occupational stress questionnaire (AOSQ) on audiologists working in Sweden. The relations between AOSQ scores and perceived effort, perceived rewards, coping strategies at work, demographic variables such as salary, education length, practise length, and practice type were tested.

Design: A cross-sectional e-mail survey using the AOSQ, effort-reward imbalance questionnaire, and demographic questions.

Study sample: Four-hundred and four Swedish licensed audiologists working with clients.

Results: The Swedish AOSQ translation demonstrated high inter-item correlations and high internal consistency. Several stress factors were identified: time spent at work, accountability, leadership at the workplace, paperwork and practice demands, equipment and clinical protocols, own health concerns, and job control. The outcome on the complete AOSQ questionnaire was related to perceived effort, perceived rewards, coping strategies at work, and age.

Conclusions: The Swedish AOSQ translation seems to provide a valid measure of occupational stress among audiologists.

Read the abstract here

Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss

Stikaa, C.J. & Haysb, R.D. International Journal of Audiology. Published online: 22 Apr 2016

Objective: Self-reports of ‘hearing handicap’ are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL.

Design: The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews. Study sample: The 73-item field-test instrument was completed by 409 adults (22–91 years old) with varying degrees of AOHL and from different areas of the USA.

Results: Multitrait scaling analysis supported four multi-item scales and five individual items. Internal consistency reliabilities ranged from 0.93 to 0.96 for the scales. Construct validity was supported by correlations between the IHEAR-IT scales and scores on the 36-item Short Form Health Survey, version 2.0 (SF-36v2) mental composite summary (r = 0.32–0.64) and the Hearing Handicap Inventory for the Elderly/Adults (HHIE/HHIA) (r ≥ −0.70).

Conclusions: The field test provides initial support for the reliability and construct validity of the IHEAR-IT for evaluating HRQOL of individuals with AOHL. Further research is needed to evaluate the responsiveness to change of the IHEAR-IT scales and identify items for a short-form.

Read the abstract here

Application of the transtheoretical model of behaviour change for identifying older clients’ readiness for hearing rehabilitation during history-taking in audiology appointments

Ekberg, K. et al. International Journal of Audiology. Published online: 13 Apr 2016

Objectives: The transtheoretical model (TTM) of behaviour change focuses on clients’ readiness for adopting new health behaviours. This study explores how clients’ readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients’ readiness has consequences for the rehabilitation decisions they make within the initial appointment.

Design: Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment.

Study sample: The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments.

Results: Clients’ readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined).

Conclusions: The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients’ needs, attitudes, desires, and psychological readiness for action in order to optimize clients’ hearing outcomes.

Read the abstract here