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The purpose of this study was to analyze and compare the linguistic content of the Spanish HINT and the Spanish AzBio sentence tests. The results revealed that the Spanish AzBio is linguistically more complex as compared with the Spanish HINT in terms of sentence length, complexity, and grammatical structure.

Purpose: Self-reported listening-related fatigue in adolescents with hearing loss (HL) was investigated. Specifically, the extent to which listening-related fatigue is associated with school accommodations, audiologic characteristics, and listening breaks was examined. Method: Participants were 144 adolescents with HL ages 12-19 years. Data were collected online via Qualtrics. The Vanderbilt Fatigue Scale-Child was used to measure listening-related fatigue. Participants also reported on their use of listening breaks and school accommodations, including an Individualized Education Program (IEP) or 504 plan, remote microphone systems, closed captioning, preferential seating, sign language interpreters, live transcriptions, and notetakers. Results: After controlling for age, HL laterality, and self-perceived listening difficulty, adolescents with an IEP or a 504 plan reported lower listening-related fatigue compared to adolescents without an IEP or a 504 plan. Adolescents who more frequently used remote microphone systems or notetakers reported higher listening-related fatigue compared to adolescents who used these accommodations less frequently, whereas increased use of a sign language interpreter was associated with decreased listening-related fatigue. Among adolescents with unilateral HL, higher age was associated with lower listening-related fatigue; no effect of age was found among adolescents with bilateral HL. Listening-related fatigue did not differ based on hearing device configuration. Conclusions: Adolescents with HL should be considered at risk for listening-related fatigue regardless of the type of hearing devices used or the degree of HL. The individualized support provided by an IEP or 504 plan may help alleviate listening-related fatigue, especially by empowering adolescents with HL to be self-advocates in terms of their listening needs and accommodations in school. Additional research is needed to better understand the role of specific school accommodations and listening breaks in addressing listening-related fatigue.

McKinney (2018) has argued that for the scholarship of teaching and learning (SoTL) to advance within a discipline, the integration of SoTL must be closely examined and opportunities for growth in SoTL must be recognized and discussed. To that end, this paper reflects on the degree to which SoTL is integrated into communication sciences and disorders (CSD) by examining a variety of topics: perspectives and theories historically valued by our discipline, existing supports for SoTL at various levels (i.e., individual teacher-scholars, departments, institutions, and the CSD discipline as a whole), the application of SoTL findings in teaching and learning. Four specific recommendations are made because of this examination and reflection.

Although pedagogy focused on social justice, power, and privilege have been included in teacher preparatory programs for a number of years, such topics are much newer and relatively unexplored within the context of Communication Sciences and Disorders (CSD) preprofessional programs. This reflection provides information on use of a living document assignment to encourage undergraduate CSD students to grapple with these difficult topics (e.g., privilege, oppression, social justice, allyship) early in their professional careers resulting in benefits for the students, their future clients, and the field of CSD.

Research shows that prerequisite courses prepare students for participation in more challenging coursework and more advanced future learning. Despite being a field that heavily relies on research evidence to inform clinical decisions as part of evidence-based practice, many undergraduate Communication Sciences and Disorder (CSD) programs do not include prerequisite undergraduate coursework dedicated to research methods. The purpose of the present study was to explore speech-language pathology and audiology graduate students' experiences with and opinions about critical appraisal of research articles. A total of 201 graduate students from institutions nationwide completed an online survey with questions related to exposure to research appraisal, use of an appraisal tool, and perspectives on the importance of research appraisal and confidence in appraisal skills. Results indicated that nearly one-third of the respondents did not learn or could not remember learning about article appraisal in their undergraduate CSD programs, though almost all survey respondents reported that they had learned about article appraisal in their graduate classes. Over half of the students used an article appraisal tool to bolster their learning of article critiques, almost all of whom found it helpful. Most of the respondents recognized the importance of article appraisal knowledge prior to graduate school but suggested that many of their undergraduate instructors did not place importance on the skill. Respondents' confidence in their article appraisal skills ranged from "least confident" to "most confident". This study supports early and ongoing practice with article appraisal, which will provide these future clinicians with the confidence to communicate their knowledge and understanding when making evidence-informed clinical decisions. Additionally, instructors who teach article appraisal may consider using a hands-on appraisal tool since almost all students with experience using them believe they are helpful.

The purpose of this study was to determine if emotional resilience can be effectively increased through targeted instruction. To examine this question, five novel curricular elements were designed to target the social-emotional competencies known to undergird the development of emotional resilience. These five curricular elements were incorporated into an 8-week course on Counseling in Speech-Language Pathology and Audiology. Students completed a self-assessment pre- and post-course to assess for change in level of resilience. Results indicated overall increased levels of resilience after the 8-week course. While further research is needed, this study is the first to show that increasing emotional resilience can be achieved through targeted curricular intervention in CSD.

Audacity is a multi-platform free, open-source audio recorder and editor software. The advantage of Audacity software is as follows: easy installation and simple visual interface, no registrations or hardware requirements, and availability at no cost might make it a preferred software to carry out class demonstrations and lab activities for an undergraduate course in the Communication Sciences and Disorders discipline. The tutorial aims to illustrate how Audacity software can be used to demonstrate various psychoacoustic phenomena commonly taught in undergraduate Hearing Science courses. This tutorial is divided into fundamental and advanced concepts from the pedagogy and student learning standpoint. The fundamental concepts involve using sine waves to demonstrate frequency, amplitude, and phase related to auditory perception. The advanced concepts include the generation of complex periodic non-speech signals, wave superposition, beats, missing fundamental frequency, demonstration of different filters, and amplitude and frequency modulation. Future research is needed to evaluate the benefits of using Audacity software for psychoacoustical demonstrations in an undergraduate Hearing Science course.

Human anatomy and physiology?is?considered one of the most difficult courses a student can take in a pre-health professional major in the US (Slominski, et. al., 2017). Research has revealed benefits of the use of art and anatomy within medical education, including improved clinical observational skills, greater understanding of disease and patient perspectives, and greater ability to empathize (Bell & Evans, 2014). Bell and Evans (2014) argue that observational skills are often overlooked in medical education. Use of art assignments in a graduate anatomy and physiology course will be discussed with reference to design and learning outcomes.?The purpose of this study?was to?evaluate?the relationship between art and medical education for audiology students. This study aimed to incorporate STEAM education (art assignments, the teaching effect, and community outreach) into audiology curriculum. Auburn University's Au.D. class of 2022 participated in this study, consisting of 10 students. The Student Assessment of Learning Gains (SALG) questionnaire was conducted and provided qualitative and quantitative evidence supporting the integration of art in the Doctor of Audiology curriculum. BASE (pre) and SALG (post) outcomes assessed that the use of STEAM assignments can help improve the retention of the anatomy and physiology within of the auditory system. Cross-tabulations of pre and post course responses show a positive increase in student understanding of course material. A positive perception that art assignments enhanced student confidence and clinical observation skills related to the course was observed. Many students felt they had a great gain in understanding covered topics. The effects of utilizing the teaching effect and community outreach were also positively seen by student participants. Students' opinions following coursework and cross-tabulations support a place for art in health education and healthcare.

Purpose: There is an increasing concern regarding hazardous recreational noise exposure among adolescents and young adults. Daily exposure to loud sound levels over a long period of time can increase the risk of noise-induced hearing loss. The full extent of the impact of recreational noise on hearing is not yet fully understood. The purpose of this review was to synthesize research that investigated hearing function in relation to recreational noise exposure in adolescents and young adults. Method: A systematic literature search of five databases covering the years 2000-2023 was performed. The articles included investigated audiological measurements of hearing function in relation to recreational noise exposure. Results: Four hundred sixty records were identified, of which 20 met the inclusion criteria and were included in the results. This review showed that although some recreational noise activities can be potentially harmful, there is an unclear relationship between exposure and outcome. Some findings indicated hearing threshold shifts or reduced otoacoustic emission amplitudes after recreational noise exposure, but most changes were short term and in the extended high-frequency range. Conclusions: There seemed to be inconsistencies regarding the utilization of methods of measuring exposure and outcome between studies. This might be one reason for the differing results in studies on the reported impact on hearing function from recreational noise exposure. To draw more certain conclusions about long-term effects, there is a need for longitudinal research that utilizes sound level measurements to assess low and high degrees of recreational noise exposure in relation to hearing function.

The purpose of this study was to investigate which of the available Spanish sentence tests U.S. audiologists currently utilize to evaluate Spanish-speaking cochlear implant candidates. An online questionnaire was created and distributed nationwide. A total of 25 audiologists reported using the Spanish HINT and Spanish AzBio. Limitations regarding scoring and variability of accents were described.

A growing understanding of twice-exceptional (2e) students has caused many to consider the possibility of misdiagnosis and missed diagnoses in the gifted student. Despite this, auditory processing disorders (APD) and vision processing disorders (VPD) are seldom examined in the 2e research literature, yet are not uncommon in the 2e population. Because both auditory and vision processing are foundational to the human experience, challenges in these areas may significantly impact higher-order skills such as attention and executive function, as well as academic performance. This article explores what is currently known about these processing disorders, examines potential co-occurring conditions, such as dyslexia and Attention Deficit/Hyperactivity Disorder (ADHD), and presents clinical case file data suggesting how these sensory disorders may appear in the 2e population. Proper identification, management, and support of APD and VPD in 2e students could improve our ability to address student needs at the foundational level.

Purpose: Understanding the wide-ranging effects of traumatic brain injury (TBI), including posttraumatic auditory and vestibular disturbances, is an essential part of shaping audiology students' readiness for clinical practice. Several recent audiology studies revealed discrepancies in knowledge and application among practicing audiologists in Australia concerning TBI. These studies emphasize the need of exploring the existing TBI-related curriculum within Australian graduate audiology programs. Method: A qualitative research design employing semistructured interviews was conducted. A total of six leading academic educators from all six Australian graduate audiology programs participated in the study. Interview transcripts were analyzed using thematic analysis. Results: Implementation of TBI content into audiological curricula was found to be influenced by three interrelated themes: professional culture, contextual barriers, and practice of teaching and learning. Conclusions: The findings provide an insight into the perceived barriers associated with incorporating TBI-related content into existing audiology curricula. The findings highlight the importance of enhancing audiology curricula in relation to TBI, ensuring that graduate audiologists can provide high-quality care and management for patients with posttraumatic audiovestibular disturbances.

Purpose: The contributions from the central auditory and cognitive systems play a major role in communication. Understanding the relationship between auditory and cognitive abilities has implications for auditory rehabilitation for clinical patients. The purpose of this systematic review is to address the question, "In adults, what is the relationship between central auditory processing abilities and cognitive abilities?" Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to identify, screen, and determine eligibility for articles that addressed the research question of interest. Medical librarians and subject matter experts assisted in search strategy, keyword review, and structuring the systematic review process. To be included, articles needed to have an auditory measure (either behavioral or electrophysiologic), a cognitive measure that assessed individual ability, and the measures needed to be compared to one another. Results: Following two rounds of identification and screening, 126 articles were included for full analysis. Central auditory processing (CAP) measures were grouped into categories (behavioral: speech in noise, altered speech, temporal processing, binaural processing; electrophysiologic: mismatch negativity, P50, N200, P200, and P300). The most common CAP measures were sentence recognition in speech-shaped noise and the P300. Cognitive abilities were grouped into constructs, and the most common construct was working memory. The findings were mixed, encompassing both significant and nonsignificant relationships; therefore, the results do not conclusively establish a direct link between CAP and cognitive abilities. Nonetheless, several consistent relationships emerged across different domains. Distorted or noisy speech was related to working memory or processing speed. Auditory temporal order tasks showed significant relationships with working memory, fluid intelligence, or multidomain cognitive measures. For electrophysiology, relationships were observed between some cortical evoked potentials and working memory or executive/inhibitory processes. Significant results were consistent with the hypothesis that assessments of CAP and cognitive processing would be positively correlated. Conclusions: Results from this systematic review summarize relationships between CAP and cognitive processing, but also underscore the complexity of these constructs, the importance of study design, and the need to select an appropriate measure. The relationship between auditory and cognitive abilities is complex but can provide informative context when creating clinical management plans. This review supports a need to develop guidelines and training for audiologists who wish to consider individual central auditory and cognitive abilities in patient care.

Purpose: The significance of extended high-frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). Method: Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40-ms /da/ stimuli. Results: Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < 0.01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p [less than or equal to] 0.01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < 0.01). Conclusions: Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).

The goal of the University of Southern California (USC) WonderKids Program is to expose students to numerous Science, Technology, Engineering, and Math (STEM) careers in an after-school setting. Elementary school students explore STEM fields with hands-on curricula and guest speakers from those fields. In partnership with the USC/Norris Comprehensive Cancer Center, a medical- and cancer-themed curriculum was developed for elementary students in the Los Angeles area. The curricula described in this article introduces first- and third-grade students to the main concepts of audiology, gastroenterology, and osteology/orthopedics fields and the way cancer can affect parts of the body that are covered in these fields. Pretests and posttests were designed to assess the impact of the educational intervention. Students demonstrated statistically significant improvements in their understanding of key objectives of all topics.

Intercultural competence (ICC) is increasingly important for healthcare professionals, and study abroad (SA) programs have been one mechanism to increase students' ICC. With SA programs being cancelled due to the pandemic, and qualitative literature supporting virtual intercultural learning (ICL), the purpose of this paper is to describe a novel approach towards "study abroad" without traveling abroad and evaluate participant gains in ICC with a virtual international ICL experience embedded into a graduate level pediatric audiology course. Nine U.S students and ten students at a partner institution in India were enrolled in the course. Comparison of pre- and post-IDI® scores showed a significant increase in ICC in both groups of participants. The increase in the group mean score for the U.S. students was substantially higher than the group mean score increases in SA students from the same institution. Qualitative reflections support the quantitative data. Overall, results indicate that embedding virtual international ICL activities in a course can be an effective mechanism to enhance ICC, both for U.S. students without traveling abroad, and for the overseas partner students, indicating that the program was mutually beneficial.

Students in undergraduate Communication Sciences and Disorders (CSD) programs with an interest in audiology often report feeling unprepared to make career and graduate school decisions due to a lack of exposure to the field. The present study examines the impact of near-peer mentoring and hands-on lab experiences on undergraduate student perceptions of career preparedness and of the profession of audiology by examining pre- and post-course survey responses and lab wrapper responses of 41 undergraduate speech and hearing science majors enrolled in an introductory audiology course. Students were paired in groups with a first-year audiology graduate mentor to walk through a series of three clinical lab exercises. Results showed a positive influence on perceptions of career readiness resulting from both mentoring and clinical lab exposure, and more confidence in career decisions following the course.

The critical lack of racially and ethnically diverse healthcare professionals in the field of Communication Sciences & Disorders (CSD) in contrast to the increasing diversity of the U.S. population may contribute to healthcare disparities and negatively impact healthcare outcomes. It is therefore imperative for transformational programs and practices to be enacted to substantially increase the number of CSD professionals representing Black, Indigenous, and People of Color (BIPOC). As training institutions that graduate and contribute to the certification of CSD professionals, universities are fundamental for contributing to this change. Numerous barriers have been identified that limit the number of underrepresented minority students who matriculate in and graduate from speech-language pathology and audiology graduate programs. At Syracuse University, a group of academic and clinical CSD faculty developed a program to specifically address these barriers: the Academic Skill Building and Networking (ALIGN) program. ALIGN implements a multifaceted approach toward facilitating the success of CSD BIPOC graduate students through the integration of academic and professional skill building, peer mentoring and networking, and professional mentoring and networking into the program curriculum. This study described the rationale and development of the ALIGN program, and reported quantitative and qualitative survey results to determine the preliminary effects of this program on an inaugural cohort of ALIGN participants. Overall, quantitative and qualitative data indicated that ALIGN had a substantial, positive impact on academic skills relative to study habits, understanding difficult course concepts, and general learning, and provided crucial support and connection opportunities with fellow BIPOC students.

Traditional forms of clinical pedagogy include post-observation feedback and side-by-side coaching. The purpose of this pilot study was to evaluate a newer strategy, bug-in-ear technology (BIET), in which clinical supervisors provide live feedback through a discrete earpiece. BIET has the potential to overcome limitations associated with traditional clinical pedagogy. This pilot study compared side-by-side coaching to BIET coaching, using standardized patients in an on-campus audiology clinic. In this study, first-year Au.D. students conducted a case history assessment for two standardized patients. Likert-response ratings and qualitative data from open-set questions indicated BIET coaching was well received by supervisors because it provided a discrete way to deliver quick, live feedback to students. Although supervisor ratings of BIET were slightly more positive than student ratings, comments from both students and supervisors indicated they could see BIET coaching working well in the future, with modifications. Likert-response items indicated student preference for BIET was associated with feelings of confidence and desire to use BIET. More research is needed to examine ways in which BIET coaching can be operationalized to support audiology clinical education.

Jordan has been one of the leading Arab countries in establishing academic programs in the field of speech-language pathology (SLP) in the Arab region. The first master's program was established at the University of Jordan in 1992 in Amman. The first bachelor's program in SLP was established in 1992 at the private Applied Sciences University in Amman, Jordan. Currently, there are two master's and four bachelor's programs in Jordan. The total number of graduates holding bachelor's degrees from the four programs is 2472, and the total number of graduates with master's degrees is 500. According to the records of the Licensing Unit at the Ministry of Health, there are 142 licensed speech-language pathologists, 754 technician speech-language pathologists, 27 licensed audiologists, 244 technician-audiologists, and seven assistant technician audiologists. The total number of ASHA-certified Jordanian SLPs is around 15. The profession of SLP in Jordan has progressed remarkably in the past twenty years; however, it requires more attention at different levels to continue to advance. More financial support is needed for scholars to conduct more rigorous research. A code of ethics should be developed to promote the service delivery models and SLP services. Additionally, more centers are needed all over the country to service the vast numbers of individuals with communication disorders. A professional association should be established immediately to regulate and promote the profession at all levels.

The study's first objective is to present an overview of the demographic information of speech therapists and the current service delivery process provided by government entities in the Kingdom of Bahrain. The second objective is to analyze the caseload and workload of the Speech Unit clinics at Salmaniya Medical Complex. The study takes a descriptive, analytical approach to analyze data collected via a web-based online survey (17 questions) to determine demographic information about speech therapists in the Kingdom of Bahrain. A survey was completed by 59 participants: 45 Bahraini therapists and 45 female therapists. The significant findings show that only 24 therapists were based in medical settings, while the rest were school-based. Most speech therapists have bachelor's degrees, while there are currently seven master's degree holders. Most therapists have less than ten years of experience. Despite the Ministry of Health and the NHRA's support for allied professions, there is a severe shortage of speech therapists in all healthcare facilities and other ministries that offer rehabilitation programs to those with disabilities or in need of services. A cross-national study involving all professionals in the public and private sectors is now required to promote a broader perspective and comprehensive analysis, particularly as the Bahrain health system transitions toward autonomy and health insurance.

The aim of the study is to examine the different effects of the COVID-19 pandemic on Audiology students in Turkey in terms of e-learning, tele-Audiology education, psychological-social situations and personal development. The study was carried out using an online survey created on Google Forms. The survey included 4 demographic questions, and 29 questions about the effects of COVID-19 on Audiology students. Study sample: A total of 518 undergraduate and graduate Audiology students participated in the study. The majority of the participants indicated that the pandemic had a negative effect on the practical knowledge and professional competence acquired through the online education system implemented due to the restrictions. A great majority of the participants indicated that their theoretical and practical knowledge about teleaudiology was "too insufficient". During this period, the level of anxiety in students and damage to their social relationships were obtained as "too much". In addition, a negative effect was observed in the personal development of the students. The study concluded that strategies and approaches should be developed for the current pandemic period and similar situations that may occur in the future.

Purpose: The purpose of this study was to investigate engagement in collaborative research (team science) and perceptions of related knowledge and skills to inform personnel preparation and workforce development efforts. Method: A questionnaire was used to solicit information about the team science-related experiences of 220 doctoral students, faculty, and research scientists in speech-pathology and audiology. Additionally, the questionnaire surveyed participants' perceptions of readiness, benefits, and challenges to team science. Results: Results demonstrated low percentages of respondents had received training in collaborative research (17%), and those with training were more likely to engage in cross-disciplinary collaborative research. Group differences were found with female researchers reporting lower psychological safety than male researchers. The most frequently cited advantages of team science included diverse perspectives, collective expertise, innovative ideas, and productivity. Conversely, common challenges included time constraints, finding collaborators, and differing expectations. Implications: Because this study yielded group difference in psychological safety between groups that differed in gender and position, results suggest additional efforts may be necessary to ensure that imbalances in the power structure of members are not allowed to dissuade members from actively contributing to team activities. Additional training opportunities in team science could support the degree to which professionals in communication science and disorders engage in collaborative research.

This article is a genuine contribution between an undergraduate student (Jennifer Zicka) and her mentor (Dr. Roger Reeb). Jennifer made unique contributions to an ongoing project that empowers and supports guests at homeless shelters as they strive to overcome personal challenges and obstacles related to homelessness. After a brief description of the Project, we celebrate Jennifer's unique contributions, which sets the stage for the centerpiece of the article -- Jennifer's heartfelt reflection on how this experiential learning contributed to her civic-related development, personal growth, and the pursuit of her dream career.

Cultural humility represents a set of concepts that extend the core notion of cultural competence required for licensed professionals in audiology and speech-language pathology (ASHA, n.d.). A cultural humility mindset includes self-evaluation, addressing power imbalances, and fostering productive partnerships (Tervalon & Murray-Garcia, 1998). This paper examines each of these aspects of cultural humility and discusses possible ways to apply them in communicative sciences and disorders education.

This article introduces this timely special issue on "Beyond Cultural Competence: Addressing racism, equity and inclusion," and provides information on how this issue was conceptualized. The editors reflect on the critical importance of equity and inclusion work in speech-language pathology and audiology in order to address structural racism and inequities for diverse students and professionals. It concludes by offering insights about the emerging levels of evidence as well as a call to action for continued engagement and expanded scholarship of teaching and learning research on these topics.

Participation in intensive, immersive, service-learning study abroad programs with intentional intercultural activities embedded in the course curriculum has been shown to enhance cultural competence as measured via the Intercultural Development Inventory (IDI®) (Krishnan, Masters, Holgate, Wang & Calahan, 2017; Krishnan, Lin & Benson, 2020). The purpose of this study was to evaluate the relative impact of embedding intercultural learning activities on students' intercultural competence when included in an on-campus course compared to a study abroad program. The intervention group consisted of 34 students enrolled in the on-campus course which incorporated intentional intercultural activities. Forty-one students who did not take the course comprised the control group. Comparison of the pre- and post-IDI® scores showed a significant increase in intercultural competence in the intervention group and no change in score in the control group participants. Qualitative data supported these findings. The increase in group mean score is slightly lower than group mean score increases in study-abroad students. Results indicate that incorporating intentional intercultural learning activities in an on-campus course can be an effective mechanism for students to enhance intercultural competence without travelling abroad.

This study investigated the effects of the application of instructor-made videos (IMVs) on a population of first-year master's in audiology students. The investigation sampled 10 students and investigated both their perception of IMVs as a tool and the empirical effects of the tool. This study examined how IMVs can be applied specifically in conjunction with traditional lecturing techniques. The methodology included surveys and interviews before and after exams. The findings demonstrated that the effect of IMVs is largely positive, particularly as indicated by students and, to a lesser degree, by the increase in grades. Wider research from external sources is consistent with this conclusion. Suggestions for further research, including expansion to subjects outside the field of audiology and an investigation into continued and refreshed post-education learning are made.

Purpose: Untreated hearing loss is a significant public health issue affecting the quality of life of millions of Americans. Barriers to treatment invite novel and innovation solutions, but as these solutions create new treatment delivery models, they also may--purposefully or accidentally--challenge the values of the field. Method: Value-sensitive design methodology is used in this study to identify the values in current hearing health care service delivery. We performed qualitative content analysis of questionnaires, clinical practice guidelines, and professional ethics documents that represent the intended and enacted values in audiology. Results: The result is a comprehensive list of values that can be used as a structured codebook for systematic textual analysis of materials representing current best practices in the provision of hearing health care services. A secondary result is an analysis of the relative importance of values in audiology, inferred from the frequency of references to each value. Conclusions: Subjective benefit, professional duties, and self-efficacy were the core values identified in the current provision of audiologic care, and these values should be central to considerations for new hearing health care models and technologies.

Background: Speech-language therapists and audiologists (SLT&As) may encounter difficulties when confronted with patient death and dying, which may conflict with their moral beliefs and result in moral injury. Furthermore, South African SLT&As practice in a country with a high mortality rate, which may add to the complexity of their experience. Moreover, they may be influenced by African philosophies promoting care, which might conflict with their experiences of patient death and dying. Aims: To explore the moral injury experienced by South African SLT&As in patient death and dying, and how they overcame the injury. Methods & Procedures: This article forms part of a larger qualitative study that explored SLT&As' experiences of patient death and dying in South Africa. Thematic analysis was conducted on the transcripts of 25 episodic narrative interviews conducted with South African SLT&As on their experiences of patient death and dying. Outcomes & Results: Findings suggest that South African SLT&As experienced helplessness, guilt and anger in patient death and dying. However, with support from the allied team, engaging in self-reflection and religious practices, they reported alleviation of moral injury. Conclusions & Implications: In order to mitigate moral injury in South African SLT&As, they require professional education, self-care strategies, guidelines and support from the teams in which they work and their supervisors. Research is needed that explores how SLT&As' biographical characteristics and interactions with significant others of dying and deceased patients, may result in moral injury.

Standardized patients (SPs) are increasingly being used with students in the field of communication sciences and disorders (CSD). The purpose of this paper is to describe the use of SPs with CSD students. Challenges to the clinical education of students are described, and a call is made to expand the use of SPs to facilitate student learning of clinical skills and to assess students' clinical competency.

Assessment is an ongoing process that is necessary at every stage of designing, implementing, and evaluating simulation-based learning experiences (SBLEs). Designing and aligning a high-quality assessment process provides instructors and researchers with valuable data to understand if students have met the desired simulation learning objectives, where students are in their learning, and opportunities to enhance the SBLE. This reflection discusses the importance of assessing student learning outcomes as well as the effectiveness of all simulation-based learning experiences (SBLEs) in communication sciences and disorders (CSD). While the benefits and effectiveness of simulation have been demonstrated in other health professions, simulation research is in its beginning in CSD. Building the evidence to inform systematic integration of simulation into CSD curricula and to further best practices in our field is essential. Further, to advance the Scholarship of Teaching and Learning (SoTL) in simulation, researchers and instructors must disseminate their findings, measures and tools, assessment processes, and even simulation scenarios. Dissemination serves to enhance evidence-based education practices and further validate the assessment processes we are using to ensure quality simulation.

Purpose: Down syndrome occurs in one of 700 births, and high rates of hearing loss are reported in this population. This puts children with Down syndrome at risk for communication, learning, and social development difficulties, compounding known language and cognitive vulnerabilities in this population. The purpose of this study was to comprehensively characterize audiological profiles in children with Down syndrome, including the use of extended high-frequency sensitivity and speech intelligibility index assessment. Method: Participants were 18 children with Down syndrome between 5 and 17 years of age. Audiological profiles were characterized using behavioral audiometry, tympanometry, and wideband acoustic immittance (WAI). Audibility was characterized using the speech intelligibility index. Results: Of the participants successfully completing behavioral audiometry, hearing loss of a moderate or greater degree was observed in one or both ears for 46% of the participants at conventional audiometric test frequencies and 85% of the participants at frequencies above 8 kHz. Seven children met criteria for amplification based on the speech intelligibility index, but only two wore hearing aids. Abnormal middle ear function was found in approximately 50% of the participants for whom WAI or tympanometry were successfully measured. Conclusions: Consistent with prior research, high rates of hearing loss and middle ear dysfunction were observed. The high prevalence of hearing loss above 8 kHz suggests the importance of including extended high-frequency assessment in audiologic characterization of children with Down syndrome. Few children meeting audibility-based guidelines for amplification wore hearing aids, putting them at additional risk for speech/language and educational difficulties.

Purpose: Twenty years ago, von Hapsburg and Peña (2002) wrote a tutorial that reviewed the literature on speech audiometry and bilingualism and outlined valuable recommendations to increase the rigor of the evidence base. This review article returns to that seminal tutorial to reflect on how that advice was applied over the last 20 years and to provide updated recommendations for future inquiry. Method: We conducted a focused review of the literature on masked-speech recognition for bilingual children and adults. First, we evaluated how studies published since 2002 described bilingual participants. Second, we reviewed the literature on native language masked-speech recognition. Third, we discussed theoretically motivated experimental work. Fourth, we outlined how recent research in bilingual speech recognition can be used to improve clinical practice. Results: Research conducted since 2002 commonly describes bilingual samples in terms of their language status, competency, and history. Bilingualism was not consistently associated with poor masked-speech recognition. For example, bilinguals who were exposed to English prior to age 7 years and who were dominant in English performed comparably to monolinguals for masked-sentence recognition tasks. To the best of our knowledge, there are no data to document the masked-speech recognition ability of these bilinguals in their other language compared to a second monolingual group, which is an important next step. Nonetheless, individual factors that commonly vary within bilingual populations were associated with masked-speech recognition and included language dominance, competency, and age of acquisition. We identified methodological issues in sampling strategies that could, in part, be responsible for inconsistent findings between studies. For instance, disparities in socioeconomic status (SES) between recruited bilingual and monolingual groups could cause confounding bias within the research design. Conclusions: Dimensions of the bilingual linguistic profile should be considered in clinical practice to inform counseling and (re)habilitation strategies since susceptibility to masking is elevated in at least one language for most bilinguals. Future research should continue to report language status, competency, and history but should also report language stability and demand for use data. In addition, potential confounds (e.g., SES, educational attainment) when making group comparisons between monolinguals and bilinguals must be considered.

Purpose: This study aimed to gather the views and experiences of clinicians and managers on early intervention audiology and speech-language pathology services for culturally and linguistically diverse (CALD) families of children with hearing loss. Method: This qualitative descriptive study involved 27 semistructured interviews with audiologists, speech-language pathologists, and managers working with CALD families of young children with hearing loss. Purposeful sampling was used to recruit participants from three hearing centers working with these families. Interviews were analyzed using thematic analysis. Results: Analysis of the data resulted in five themes--(a) There were perceived added complexities for CALD families in accessing and being involved in services and receiving information; (b) there were perceived family-provider relationship complexities, cultural differences, and service delivery challenges in working with CALD families; (c) clinicians and managers used various strategies for service provision of CALD families; (d) involving interpreters benefited service provision but was challenging at times; and (e) looking to the future and recommendations for clinical practice. Conclusions: Current practices reflect some principles of family-centered care for CALD families of young children with hearing loss. Families and services may benefit from more support regarding family-provider partnerships, information materials and child assessments, working with interpreters, and center support for time and resources.

Purpose: This review article provides a theoretical overview of the development of spectral resolution in children with normal hearing (cNH) and in those who use cochlear implants (CIs), with an emphasis on methodological considerations. The aim was to identify key directions for future research on spectral resolution development in children with CIs. Method: A comprehensive literature review was conducted to summarize and synthesize previously published behavioral research on spectral resolution development in normal and impaired auditory systems. Conclusions: In cNH, performance on spectral resolution tasks continues to improve through the teenage years and is likely driven by gradual maturation of across-channel intensity resolution. A small but growing body of evidence from children with CIs suggests a more complex relationship between spectral resolution development, patient demographics, and the quality of the CI electrode--neuron interface. Future research should aim to distinguish between the effects of patient-specific variables and the underlying physiology on spectral resolution abilities in children of all ages who are hard of hearing and use auditory prostheses.

Speech-related professionals such as speech language pathologists (SLPs) and audiologists make use of neuro-advancements including neurotechnologies such as cochlear implants (CIs), brain-computer interfaces, and deep brain stimulation. Speech-related professionals could occupy many roles in relation to their interaction with neuro-advancements reflecting the roles expected of them by their professional organizations. These roles include: service provider, promoter of neuro-products such as CIs, educator of others, neuro-related knowledge producer and researcher, advocates for their fields and their clients in relation to neuro-advancements, and influencers of neuro-policy, neuroethics and neuro-governance discussions. Lifelong learning, also known as professional development, is used as a mechanism to keep professionals up to date on knowledge needed to perform their work and could be used to support the fulfillment of all the roles in relation to neuro-advancements. Using 300 English language Canadian newspapers and academic articles from SCOPUS and the 70 databases of EBSCO-Host as sources, we found that the neuro-advancement content linked to speech-related professionals centered around CIs and brain computer interfaces, with other neuro-technologies being mentioned much less. Speech-related professionals were mostly mentioned in roles linked to clinical service provision, but rarely to not at all in other roles such as advocate, researcher or influencer of neuroethics and neuro-governance discussions. Furthermore, lifelong learning was not engaged with as a topic. The findings suggest that the mentioning of and engagement with roles of speech-related professionals linked to neuro-advancements falls short given the expectations of roles of speech-related professionals for example. We submit that these findings have implications for the education of speech-related professionals, how others perceive the role and identity of speech-related professionals, and how speech-related professionals perceive their own role.

Background: Annual health checks in primary care include hearing assessment, though current guidance recommends subjective assessment only. Previous studies suggest this is inadequate and recommend objective alternatives such as hearing screening. This study aimed to assess the feasibility of hearing screening and examine the last recorded annual health check outcome for hearing, for those diagnosed with hearing loss as a result of the screening process. Method: Hearing screening took place in four locations and 75 people with learning disabilities participated. Contact was made with each individual's GP to share results and to request onward referral where indicated. Findings: Wax occlusion prevented screening for 23%. Fifty-seven people completed the screen, and 25 had suspected hearing loss. Of these, 22 people required referral to Audiology to verify their hearing thresholds. Only 13 were actually referred, and 11 individuals underwent assessment in Audiology, resulting in 10 being diagnosed with hearing loss. The most recent annual health check outcomes for hearing were examined for those diagnosed with hearing loss. Of the records we accessed, hearing loss had not been identified or actioned in every case. Conclusions: Hearing screening is shown here to be a suitable method for detecting hearing loss. We recommend changing current annual health check practice to incorporate objective screening. Only 12% of those with suspected hearing loss were known to Audiology services, suggesting a substantial proportion of undetected hearing loss in the community. We found evidence of apparent reluctance around referral and hearing aid fitting and make suggestions for improvement.

Purpose: This tutorial reviews the complexity of issues and definitions around topics of diversity. The impact of diversity and cultural responsiveness are presented in the context of ethics in the practice of speech-language pathology, audiology, and speech-language-hearing-swallowing sciences. Method: Concepts discussed include culture, cultural sensitivity and responsiveness, and perceptions of the terms minority and majority, among others. Available resources on ethics, changing paradigms, and clinical practice are shared. Guiding professional documents are also cited and practical examples included. Conclusions: The road to cultural responsiveness or sensitivity is one of engaging in active learning and exploring. This tutorial provides some thoughts and tools for connecting ethical practices with the provision of culturally sensitive/responsive services, be they clinical, academic, or research oriented. It us up to the professional, or the reader, to initiate an exchange or practice that is devoid of cultural bias or stereotyping. Awareness of the many factors that impact the connection between the professional and the patient/client/student is of great relevance when striving to provide culturally sensitive services. The reader will gain an expanded notion of culture and diversity in the personal and professional contexts.

Purpose: The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. Method: A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information. Results: A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest. Conclusions: Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.

Purpose: This study investigates a blended learning model which incorporates online learning for a competency-focused, work-based learning (WBL) programme within allied healthcare. The case-study is centred on hearing aid audiology. Design/methodology/approach: The study evaluated the feedback received through a tripartite group of stakeholders (learners, academic staff and employers). Findings: Results showed that although there was universal support for blended learning, incorporating online learning, each stakeholder contributed different perspectives. The authors identified that in terms of curriculum design, a comprehensive analysis of the holistic perspective across all stakeholders is essential to ascertain the suitability of this learning mode for WBL. The study may provide the basis of a preparatory framework for the development of a generic, competency-focused model that can be applied across allied healthcare WBL programmes. Originality/value: Although previous studies of WBL have been reported, to the knowledge of the authors, there is no current reference in the literature to studies that examine thematic areas relevant to all three stakeholders across a programme of this nature in hearing aid audiology.

Purpose: This tutorial introduces communication sciences and disorders (CSD) educators to contemplative pedagogy (sometimes called mindfulness in the classroom). While contemplative pedagogy has considerable overlap with evidence-based teaching and learning, and aligns with values in the CSD discipline, there are few published reports investigating the role of contemplative pedagogy in CSD education. This tutorial outlines the potential benefits of contemplative pedagogy to CSD education and offers suggestions on how to create mindful educators and classrooms. Specific contemplative practices are described. Basic instructions, along with ideas and examples of how practices can be modified and contextualized in CSD classrooms, are provided. Conclusions: Educators can bring contemplative practices into CSD classrooms in many ways. Educators can cultivate a contemplative disposition through a personal practice that can enhance the development of self-awareness. Self-awareness can then inform critical reflection of teaching. Educators can select and design contemplative practices that integrate students' first-, second-, and third-person ways of knowing. As an addition to the pedagogical toolbox, contemplative pedagogy offers opportunities for educators and students to connect their own values and experiences with the process of teaching and learning.

Purpose: Service-learning has the potential to improve student outcomes by providing students opportunities to apply their knowledge and skills in real-world contexts and is well suited to graduate education in communication sciences and disorders. However, relatively few service-learning studies in the literature focus on audiology, and the range of outcomes specific to audiology service-learning has not yet been characterized in a systematic way. The purpose of this critical review was to characterize the impact of service-learning on audiology students and clients/patients as evidenced by reflection activities and outcome measures, as well as to describe the common challenges and best practices in the available literature that may inform future research on service-learning in the field. Method: A systematic search of the literature using multiple databases was completed according to standard guidelines. The impact of each study was evaluated using a standard scale of training efficacy. Study methods, including reflection activities and outcome measures, were recorded. Results: Nine peer-reviewed studies on service-learning in audiology were selected. Six of the nine studies reported changes in student attitudes or awareness related to issues of clinical practice; five of the nine studies reported improvements in student knowledge/skills. Conclusions: Overall, results of the review indicated benefits of service-learning to student clinicians. However, evidence for transference of service-learning benefits to organizational or departmental practice and benefit to patients/clients was lacking. Methodological limitations in the measurement of outcomes in prior works complicated evaluation of their impact; best practices were identified and synthesized for use in future research on audiology service-learning experiences.

Purpose: The purposes of this meta-review are to (a) articulate the importance of transparency and reproducibility in meta-analysis, (b) assess the transparency and reproducibility of meta-analyses published in journals of the American Speech-Language-Hearing Association (ASHA), and (c) discuss the implications of our findings and recommendations for future research. Method: We conducted a meta-review of all meta-analyses published in ASHA journals through December 31, 2020. Our systematic review yielded 47 meta-analyses for inclusion in this review. We coded all eligible reports on the core elements of transparency and reproducibility in meta-analysis. Results: Our findings suggest that though reporting tendencies have improved over time, much work is needed to promote transparency and reproducibility in meta-analytic work. Key areas for future accountability include preregistering study protocol, using Preferred Reporting in Systematic Reviews and Meta-Analysis checklists, providing full data sets, and publishing analytic codes. Conclusions: The state of reporting in meta-analysis is improving over time. We conclude with a discussion of specific areas that need further attention, and recommendations for researchers to consider when conducting future meta-analyses.

This survey study describes rates of utilization of evidence-informed auditory-verbal strategies among 132 professionals (teachers of the deaf, speech-language pathologists, audiologists, early interventionists, and others) working with children who are deaf or hard of hearing who use listening and spoken language. Relationships between provider characteristics (e.g., years of experience, possession of advanced credentials) and rates of strategy utilization were explored. Providers certified as a Listening and Spoken Language Specialist (LSLS) were found to use all 19 strategies most frequently, followed by those who were in the certification process. Non-LSLS certified professionals were least likely to use the strategies. Statistically significant differences in utilization rates based on certification status were found for asking, "What did you hear?"; motherese; and whispering. Results of the study may inform advocacy for highly qualified professionals to serve children with hearing loss whose parents desire a listening and spoken language outcome.

Purpose: Audiology clinics have a need for a nonlinguistic test for assessing speech scores for patients using hearing aids or cochlear implants. One such test, the Spectral-Temporally Modulated Ripple Test Lite for computeRless Measurement (SLRM), has been developed for use in clinics, but it, as well as the related Spectral-Temporally Modulated Ripple Test, has primarily been assessed with cochlear implant users. The main goal of this study was to examine the relationship between SLRM and the Arizona Biomedical Institute Sentence Test (AzBio) for a mixed group of hearing aid and cochlear implant users. Method: Adult hearing aid users and cochlear implant users were tested with SLRM, AzBio in quiet, and AzBio in multitalker babble with a +8 dB signal-to-noise ratio. Results: SLRM scores correlated with both AzBio recognition scores in quiet and in noise. Conclusions: The results indicated that there is a significant relationship between SLRM and AzBio scores when testing a mixed group of cochlear implant and hearing aid users. This suggests that SLRM may be a useful nonlinguistic test for use with individuals with a variety of hearing devices.

Background: As part of their professional responsibilities, speech-language therapists and audiologists are required to deliver bad news. Aims: The aim of this qualitative study is to describe and characterize the subjective experience of speech-language therapists and audiologists when delivering bad news to clients or their family members. Methods & Procedures: A group of 156 speech-language therapists and audiologists replied in writing to an open question asking them to describe a clinical encounter in which they delivered bad news. The texts that were generated in response to this question served as a data base. Qualitative content analysis was used to analyse data and generate themes. Outcomes & Results: Thematic analysis of participants' texts revealed the challenges inherent to the delivery of bad news. Four main themes emerged from text analysis: difficulty in phrasing the news; the deliverer's emotional experience; the receiver's reaction; and being alone or in companion with another healthcare provider during the delivery of the bad news. Conclusions & Implications: Speech-language therapists and audiologists experience difficulties similar to those experienced by other healthcare professionals when delivering bad news. Nevertheless, speech-language therapists and audiologists seem to perceive the delivery of bad news situation in a broader sense than the conventional definition given to this term in the medical arena.

Purpose: We aimed to develop and validate the Musicians' Hearing Handicap Index (MHHI), a new self-evaluation tool for quantifying occupation-related auditory difficulties in music professionals. Although pure-tone audiometry is often considered the "gold standard" and is usually employed as the main instrument for hearing assessment, it cannot fully describe the impact of hearing dysfunction. The MHHI is an attempt to complement the hearing impairment assessment toolbox and is based on a unique approach to quantify the effects of hearing-related symptoms or hearing loss on the performance of musicians and other music industry professionals. Method: An initial set of 143 questionnaire items was successively refined through a series of critical appraisals, modifications, and suggestions. This yielded an intermediate questionnaire consisting of 43 items, which was administered to 204 musicians and sound engineers. After exploratory factor analysis, the final form of the MHHI questionnaire was obtained, consisting of 29 items. The questionnaire's test-retest reliability, internal consistency, discriminating power, content validity, criterion validity, and aspects of construct validity and inherent conceptual structure were assessed. Results: Exploratory factor analysis revealed a combination of four common factors for the 29 validated questionnaire items. They were named "impact on social and working lives," "difficulties in performance and sound perception," "communication difficulties," and "emotional distress." The MHHI was shown to be a valid and reliable instrument to assess musicians' and sound engineers' occupational difficulties due to hearing impairment and related symptoms. Conclusion: The ability of the MHHI to discriminate between groups of music professionals with different auditory symptoms or pure-tone audiometry thresholds suggests that auditory symptoms might influence a professional's performance to an extent that cannot be assessed by a pure-tone audiogram.