The Action Plan for Hearing Loss in Wales

This framework sets out what NHS Wales wants to achieve in an integrated health and social care system for D/deaf/people living with hearing loss.

The Framework is in three parts:

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  • Part 1 introduces the overarching vision and the outcomes the authors want to achieve for people who are D/deaf or living with hearing loss.
  • Part 2 sets out specific actions that will help to improve and deliver sustainable and equitable integrated health and social care services nationally.
  • Part 3 specifies the leadership and monitoring arrangements.

Full document: Integrated Framework of Care and support for people who are D/deaf or living with hearing loss


Improving Deaf people’s access to mental health services

As many as two in three Deaf people in the UK struggle with mental health problems, but most find it too difficult to access psychological therapy.

Guidance for commissioners of primary care mental health services for deaf people from the Joint Commissioning Panel for Mental Health (JCPMH) and Deaf health charity SignHealth, calls for improvement to deaf people’s access to mental health services.

Despite having poorer mental health than the rest of the population, the 60,000 people across the UK who use sign language as their main language often come up against barriers when seeking mental health services.

The guide’s recommendations for commissioners of primary mental health services could make a dramatic change to the mental health of many Deaf people.

Audiometer apps: reliability & potential

Megan Corry, Michael Sanders, and Grant D. Searchfield. The accuracy and reliability of an app-based audiometer using consumer headphones: pure tone audiometry in a normal hearing group.  International Journal Of Audiology.  Published online: 09 May 2017.


Objective: To undertake a preliminary evaluation of the test–retest reliability, and accuracy of an iPad audiometer app using commercial earphones as a low-cost alternative to a clinical audiometer in a restricted sample of normal hearing participants.

Design: Twenty participants self-reporting normal hearing undertook four pure-tone audiometry tests in a single session. Two tests were performed with a 2-channel Type 1 audiometer (GSI-61) using EAR insert earphones and two tests with an iPad based app (Audiogram Mobile) using Apple earbud headphones.

Study sample: Twenty normal hearing participants (13 female and seven male participants, aged 21–26 years) were recruited for the test–retest and accuracy evaluations. Results: The app resulted in different thresholds to the audiometer (F(1, 19) = 16.635, p < 0.001). However test–retest reliability was similar. The app froze or quit unexpectedly over 25% of times used.

Conclusions: Audiometer apps have great potential for clinical settings, especially in resource scarce environments, but reliability should not be assumed. While a low cost-alternative to standard transducers, issues of accuracy and calibration of consumer headphones need to be addressed before such combinations can be used with confidence.

Changes in Psychosocial Measures after a 6-Week Field Trial

Jamie L. Desjardins and Karen A. Doherty. Changes in Psychosocial Measures after a 6-Week Field Trial American Journal of Audiology. Published online 9th May 2017

The purpose of this study was to assess the extent to which intervention with hearing aids, namely, a 6-week hearing aid field trial, can minimize the psychosocial consequences of hearing loss in adults who have previously not sought treatment for their hearing loss.


Twenty-four adults with mild to moderate bilateral sensorineural hearing loss, who had never worn hearing aids or sought help for their hearing loss, participated in this study. Participants were fitted with receiver-in-canal hearing aids, bilaterally, and wore them for 6 weeks. Participants completed subjective measures of hearing handicap and attitudes about hearing loss and hearing aids before, during, and after the hearing aid trial. A control group of age-matched participants followed the same experimental protocol, except they were not fitted with hearing aids.


Using hearing aids for 6 weeks significantly reduced participants’ perceived stigma of hearing aids, personal distress and inadequacy due to hearing difficulties, and hearing handicap.


A hearing aid trial can have a positive effect on a person’s attitudes toward wearing hearing aids and decrease hearing handicap.

Loudness and annoyance of disturbing sounds

Åsa Skagerstrand, Susanne Köbler, and Stefan Stenfelt. Loudness and annoyance of disturbing sounds – perception by normal hearing subjectsInternational Journal Of Audiology. Published online: 09 May 2017.

Objective: Sounds in the daily environment may cause loudness and annoyance. The present study investigated the perception of loudness and annoyance for eight different sounds present in a daily sound environment and at nine different levels varying by ±20 dB around the recorded level. The outcomes were related to tests of participants’ auditory and cognitive abilities.

Design: The participants undertook auditory and working memory (WM) tests prior to ratings of everyday sounds previously shown to be disturbing for persons with hearing impairment (hearing aid users).

Study sample: Twenty-one participants aged between 24 and 71 years, with normal hearing threshold levels.

Results: Both perceived loudness and annoyance were primarily driven by the sound level. Sounds emitted from paper were rated as having greater loudness and being more annoying than the other sound sources at the same sound level. Auditory and cognitive abilities did not influence the perception of loudness and annoyance.

Conclusions: Loudness and annoyance ratings were mainly driven by sound level. Expectations of a sound seemed to influence the assessment of loudness and annoyance while auditory performance and WM capacity showed no influence on the ratings.

Full document available here

Independent prescriber physiotherapist led balance clinic: the Southport and Ormskirk pathway

Burrows, L. et al. The Journal of Laryngology & Otology. 131(5) pp. 417-424


To report the introduction and impact of non-medical prescribing, initiated to improve patient pathways for those presenting with dizziness and balance disorders.

The Southport and Ormskirk physiotherapy-led vestibular clinic sees and treats all patients with dizziness and balance disorders referred to the ENT department. Letters are triaged by an audiologist, who also performs an otological examination and hearing test; this is followed by an assessment with the independent prescriber physiotherapist. An ENT consultant is nearby if joint consultation is needed. Diagnoses, treatments and patient satisfaction were studied, with an analysis of the impact of medication management (stopping or starting medicines) on patients and service.

Having an independent prescriber physiotherapist leading the balance clinic has reduced the number of hospital visits and onward referrals. Nearly half of all patients required medication management as part of their dizziness or balance treatment.

Read the full abstract here

Outcome and cost analysis of bilateral sequential same-day cartilage tympanoplasty

Olusesi, A.D. et al. & Oyeniran, O. (2017) The Journal of Laryngology & Otology. 131(5)  pp. 399-403

Few studies have compared bilateral same-day with staged tympanoplasty using cartilage graft materials.

A prospective randomised observational study was performed of 38 chronic suppurative otitis media patients (76 ears) who were assigned to undergo bilateral sequential same-day tympanoplasty (18 patients, 36 ears) or bilateral sequential tympanoplasty performed 3 months apart (20 patients, 40 ears). Disease duration, intra-operative findings, combined duration of surgery, post-operative graft appearance at 6 weeks, post-operative complications, re-do rate and relative cost of surgery were recorded.

Tympanic membrane perforations were predominantly subtotal (p = 0.36, odds ratio = 0.75). Most grafts were harvested from the conchal cartilage and fewer from the tragus (p = 0.59, odds ratio = 1.016). Types of complication, post-operative hearing gain and revision rates were similar in both patient groups.

Surgical outcomes are not significantly different for same-day and bilateral cartilage tympanoplasty, but same-day surgery has the added benefit of a lower cost.

Read the full abstract here