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November 2007
The speech understanding difficulties expressed by
older adults likely arise from multiple sources. From the ear to the
brain, numerous structural and chemical changes coincide with advancing
age (for a review, see Willott, 1991; 1999). Not only can these changes
negatively impact the audibility of sound, physiological changes
throughout the auditory system also affect the way frequency and timing
information (in the incoming signal) is encoded and perceived (for a
review see Chisolm, Willott, & Lister, 2003). Some higher-level cognitive
functions, such as attention and memory, also may decline with age.
Because perception depends upon lower-level sensory as well as
higher-level cognitive processes, it is likely that decreased audibility,
slowed neural conduction time, and a struggle to selectively attend to a
voice in the presence of competing noise all occur when an older listener
tries to understand what is being said (for a review see Pichora-Fuller,
Schneider, Benson, Hamstra, & Storzer, 2006). It therefore follows that
rehabilitation of the older patient involves more than improving sound
audibility, because for many people detecting, discriminating, and
attending to the signal of interest might be compromised.
Full Story
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July 2008
Most audiologists agree that fitting hearing aids
is just the initial step in the treatment of acquired hearing loss in
adults, as there is evidence of the effectiveness of aural rehabilitation
to improve long-term benefit from amplification (Sweetow & Palmer, 2005;
Hawkins, 2005; Sweetow & Sabes, 2006). Some such evidence includes
published reports suggesting that return for credit rates for participants
in group aural rehabilitation (AR) classes is p to three times less than
for patients who opt not to participate in group AR (Northern & Beyer,
1999). Few audiologists offer any type of aural rehabilitation or auditory
training in their daily clinical practice, however, despite evidence
supporting its effectiveness. Historically, AR has failed to become
embraced by the wider dispensing community for a number of reasons. First,
it is viewed as time consuming by many practitioners. Even in the face of
solid evidence supporting its effectiveness, AR has not been widely
embraced because it has taken time away from the more lucrative and
perhaps more rewarding task of fitting hearing aids.
Full Story
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November 2008
At one time, when a still-working adult visited an
audiological clinic complaining of listening difficulties, the audiologist
could guess that the patient worked in a factory, on a farm or
construction site, or in the armed services. Working adults who sought
services were often victims of unremitting noise exposure. With the aging
of the work force and the high noise levels in modern society, more
audiologists now treat patients who work in quieter environments. These
workers often have no health-related issues other than hearing loss. As
members of the "baby boom" generation, they tend to be well-educated and
healthy compared with their counterparts of yesteryear. They expect and
deserve to retain the ability to conduct their daily work-related
responsibilities and to advance within their companies. We recently
conducted a series of focus groups to learn who these workers are, how
hearing loss has affected their job performance, and what they would like
from their audiologists (Tye-Murray, Spry, & Mauzé, submitted). Our goal
was to collect information that could guide counseling, aural
rehabilitation intervention, and self-management of this population.
Full Story
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December 2008
Bob MacPherson of bhNEWS discovered this free,
easy-to-use auditory rehabilitation tool from the folks at Med-El. It's
intended for folks who have recently received a cochlear implant (CI), but
looks like a great tool for hearing aid users who want to practice
listening, as well. Plus it's FUN. And as Bob also encouraged folks,
please check out the other available options on rehabilitation in the left
sidebar. Full
Story
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April 2010
As any audiologist can attest, the adult patient's
hearing rehabilitation journey can be long and treacherous. Patients often
find it difficult to reconcile the emerging view of "self" as someone with
diminished hearing with their previous lifelong view of a "self" who is
complete and whole. The resultant lag in this reconciliation process
contributes greatly to the often-noted 7-year delay between when a person
first suspects hearing difficulties and when he or she seeks assistance.
This delay, of course, is documented only for those who have sought
treatment. Most adults with hearing loss are not yet psychologically ready
to take corrective action toward their hearing loss. Prior to 1977
audiologists were told it was unethical to dispense hearing aids to
patients for profit. At that time, many of us argued that we should be
doing precisely that. Proponents cited the audiologist's comprehensive
education and training that encompassed both the pathologies of hearing
loss and the rehabilitative processes necessary to improve diminished
communicative abilities. We touted ourselves as professionals who could
provide the continuity of care needed to guide patients and their families
successfully along the journey toward improved hearing and enhanced
communication. But soon audiology embraced the same hearing aid dispensing
paradigm that traditional dispensers had followed for years.
Full Story
