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The purpose of this study was to compare three intervention conditions in virtual rapid word learning instruction for young children who are deaf and hard of hearing (DHH): traditional, general physical activity, and semantic richness physical activity. We focused on an initial step in learning a new word: mapping a word form to a referent. Fourteen children who were DHH and 14 children with typical hearing (TH) participated in a pseudoword-learning virtual session in each condition, and receptive and expressive knowledge of targeted pseudowords was assessed. Of interest was the impact of different types of physical activity on rapid learning of word-like forms. There was an interaction of group and condition for expressive production of pseudowords. Children who were DHH learned to produce more pseudowords in the general physical activity condition, whereas children with TH learned to produce more pseudowords in the semantic richness physical activity condition. There were no effects of group or condition on receptive learning of pseudowords. Children who are DHH can rapidly map word-like forms to referents via teleintervention, and physical activity may interact with word learning differently for children who are DHH and children with TH. [ABSTRACT FROM AUTHOR]

Purpose: For over 15 years, Mental Health First Aid™ (MHFA) has successfully been delivered in Wales, United Kingdom, with growing interest in the MHFA programme and increasing course attendees. Trainers, aware of the need for support, know the importance of MHFA being accessible for different communities and learner groups. MHFA has always focused on increasing mental health literacy. One marginalised group, with lower mental health literacy than the general population, is Deaf people, a group with increased risk of mental health problems. This paper aims to provide insights about why Deaf people are twice as likely as hearing people to experience mental health problems. Design/methodology/approach: During this paper, the authors have used four focal points i) exploring situational contexts for Deaf people; ii) reasons why Deaf individuals are at greater risk of mental health problems; iii) the authors explore a project, "Hear Deaf", and implementation of MHFA Wales by Deaf MHFA trainers; and iv) initiatives to influence and impact on policymakers. Findings: During the project, nine MHFA courses were delivered to Deaf communities across different locations in Wales, often with information and advertisements circulated directly to Deaf communities through Deaf clubs, resulting in 120 Deaf people trained. The authors conclude with their own reflections as a researcher and an MHFA who work predominantly with Deaf communities. Originality/value: This paper provides a discussion on the specific risks for Deaf people around mental health and the importance of mental health promotion programmes for Deaf communities. Further research is needed regarding the impact of MHFA on Deaf populations. [ABSTRACT FROM AUTHOR]

To inform and optimise a cochlear implant (CI) fitting software design through an analysis of big data to define array-specific comfort (C) level profiles, frequently-used MAP parameters, and the minimum number of Neural Response Telemetry thresholds (tNRT) needed to create an accurate profile. To evaluate the software's ease of use and completion time for AutoNRT®s. MAPs analysis. Clinical study evaluating software use in creating MAPs, addressing sound-quality issues and setting patient goals. MAPs (N = 39,885); CI recipients (N = 47) and clinicians (N = 19). Distinct C-level profiles were observed for lateral-wall, contour, and slim-modiolar electrode arrays. Default settings were used for most MAP parameters (13/16) except for Pulse Width, Rate, and Maxima. Nine tNRT measurements were required for an accurate C-level profile. Measurement-time of nine tNRTs via the new algorithm was comparable to five tNRTs using the previous algorithm. Nearly all (99%) clinical tasks were completed by clinicians with the first use of the software. Most CI recipients (79.5%) rated goal-setting as valuable. Custom Sound Pro fitting software developed based on big data analysis incorporates a guided fitting workflow and expected fitting ranges. It helps to improve clinical efficiency, is easy to use and supports patient-centred care. [ABSTRACT FROM AUTHOR]

This article is the seventh in a series of eight articles that comprise a special issue on family-centered early intervention for children who are deaf or hard of hearing and their families, or FCEI-DHH. This article, Structure Principles , is the third of three articles (preceded by Foundation Principles and Support Principles) that describe the 10 FCEI-DHH Principles. The Structure Principles include 4 Principles (Principle 7 , Principle 8 , Principle 9 , and Principle 10) that highlight (a) the importance of trained and effective Early Intervention (EI) Providers, (b) the need for FCEI-DHH teams to work collaboratively to support families, (c) the considerations for tracking children's progress through developmental assessment, and (d) the essential role of progress monitoring to continuously improve systems. [ABSTRACT FROM AUTHOR]

This is the fourth article in a series of eight that comprise a special issue on family-centered early intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, FCEI-DHH. This article describes the co-production team and the consensus review method used to direct the creation of the 10 Principles described in this special issue. Co-production is increasingly being used to produce evidence that is useful, usable, and used. A draft set of 10 Principles for FCEI-DHH and associated Tables of recommended behaviors were developed using the knowledge creation process. Principles were refined through two rounds of eDelphi review. Results for each round were analyzed using measures of overall group agreement and measures that indicated the extent to which the group members agreed with each other. After Round 2, with strong agreement and low to moderate variation in extent of agreement, consensus was obtained for the 10 Principles for FCEI-DHH presented in this special issue. This work can be used to enhance evolution of FCEI-DHH program/services and systems world-wide and adds to knowledge in improvement science. [ABSTRACT FROM AUTHOR]

This article is the second of eight articles in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Five foundational values that guide FCEI-DHH are described, providing an evidence-informed, conceptual context for the 10 FCEI-DHH Principles and other articles presented in this issue. These values are applicable for Early Intervention (EI) Providers and other professionals on FCEI teams, as well as for FCEI-DHH programs/services and systems. The five key values include (1) being family-centered, (2) responding to diversity, (3) involving invested parties, especially families and individuals who are DHH, (4) supporting holistic child development, and (5) ensuring fundamental human rights. These evidence-informed values are considered essential to the effective provision of FCEI-DHH supports. [ABSTRACT FROM AUTHOR]

This Call to Action is the eighth and final article in this special issue on Family-Centered Early Intervention (FCEI) for children who are deaf or hard of hearing (DHH) and their families, or FCEI-DHH. Collectively, these articles highlight evidence-informed actions to enhance family well-being and to optimize developmental outcomes among children who are DHH. This Call to Action outlines actionable steps to advance FCEI-DHH supports provided to children who are DHH and their families. It also urges specific actions to strengthen FCEI-DHH programs/services and systems across the globe, whether newly emerging or long-established. Internationally, supports for children who are DHH are often siloed, provided within various independent sectors such as health/medicine, education, early childhood, and social and disability services. With this Call to Action, we urge invested parties from across relevant sectors to join together to implement and improve FCEI-DHH programs/services and systems, build the capacity of early intervention (EI) Providers and other professionals, extend research regarding FCEI-DHH, and fund EI supports, systems, and research, all with the aim of advancing outcomes for families and their children who are DHH. [ABSTRACT FROM AUTHOR]

The present study aims to examine the Executive Function (EF) skills of preschool-aged children who are deaf and hard of hearing (DHH), and explore the variables related to their EF skills. Thirty preschoolers who were DHH and an additional 35 preschoolers with typical hearing were recruited. All DHH use spoken language as their communication mode, and wore hearing devices. Results revealed that preschoolers who are DHH are delayed in some EF skills, particularly inhibitory control and cognitive flexibility. Interestingly, in working memory, they exhibit age-appropriate verbal working memory, whereas they do not have an advantage over their hearing peers in visual-spatial working memory. Correlational results showed that working memory is related to language skills, while inhibitory control is related to the age of auditory exposure and early intervention. Thus, the results highlight the importance of early auditory exposure and early intervention, as well as language, in EF development in preschoolers who are DHH. [ABSTRACT FROM AUTHOR]

To investigate Mandarin Tone 2 production of disyllabic words of prelingually deafened children with a cochlear implant (CI) and a contralateral hearing aid (HA) and to evaluate the relationship between their demographic variables and tone-production ability. Thirty prelingually Mandarin-speaking preschoolers with CI+HA and 30 age-matched normal-hearing (NH) children participated in the study. Fourteen disyllabic words were recorded from each child. A total of 840 tokens (14 × 60) were then used in tone-perception tests in which four speech therapists participated. The production of T2-related disyllabic words of the bimodal group was significantly worse than that of the NH group, as reflected in the overall accuracy (88.57% ± 16.31% vs 99.29% ± 21.79%, p < 0.05), the accuracy of T1+T2 (93.33% vs 100%), the accuracy of T2+T1 (66.67 ± 37.91% vs 98.33 ± 9.13%), and the accuracy of T2+T4 (78.33 ± 33.95% vs 100%). In addition, the bimodal group showed significantly inferior production accuracy of T2+T1 than T2+T2 and T3+T2, p < 0.05. Both bimodal age and implantation age were significantly negatively correlated with the overall production accuracy, p < 0.05. For the error patterns, bimodal participants experienced more errors when T2 was in the first position of the tone combination, and T2 was most likely to be mispronounced as T1 and T3. Bimodal patients aged 3–5 have T2-related disyllabic lexical tone production defects, and their performances are related to tone combination, implantation age, and bimodal age. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess central auditory processing (CAP) tests in patients with single sided deafness (SSD)and to study the effect of central auditory processing disorders(CAPD) on the contralateral routing of signal (CROS) hearing aid performance in these subjects. This case-control study was performed in Audiovestibular unit, ENT Department. The study included 20 children with SSD and 20 healthy control children. All participants were subjected to CAP tests including pitch pattern sequence (PPS), gap in noise (GIN) and speech intelligibility in noise (SPIN) tests. The child was fitted with CROS and evaluated by SPIN test and bern benefit in single - sided deafness (BBSS) questionnaire. There were lower SPIN, PPS, and GIN total correct scores in children with SSD than the control group. The group with normal central test battery has higher SPIN score and significant performance with questionnaire when fitted with CROS. Children with normal central auditory processing test battery performed better when fitted with CROS than those with abnormal test battery. [ABSTRACT FROM AUTHOR]

The SKI-HI Deaf Mentor Program is an early intervention model that supports families in creating an effective bilingual environment (American Sign Language [ASL]/English) with their deaf or hard of hearing child. The program can be adopted and implemented in any state. A Deaf Mentor is a deaf or hard of hearing adult specifically trained to engage with and teach families ASL using the Deaf Mentor Curriculum Manual. The program and materials were created for face-to-face delivery to families in home settings. When COVID-19 lockdowns and stay-at-home orders went into place in March 2020, Deaf Mentors had to think creatively to provide services to families virtually. This created a variety of challenges as well as new learning opportunities. The authors discuss both the challenges and positive experiences shared by Deaf Mentors about shifting family services to a virtual platform. [ABSTRACT FROM AUTHOR]

This study investigated if the language profiles of prelingually deaf children with bilateral cochlear implants (CIs) and children with typical hearing (TH) matched on their quantitative score on clinical spoken expressive language tasks differed in terms of sentence complexity, sentence length, and severity of grammatical errors. No significant differences were found between the groups in terms of (1) proportion of simple, conjoined, and complex sentences; (2) mean length of utterance based on words and syllables; and (3) proportion of local and global grammatical errors. The results indicate that the quantitative scores on the clinical spoken expressive language tasks are related to similar spoken language profiles in children with CIs and children with TH. These findings suggest that these tests can be used for meaningful comparisons of expressive spoken language skills. However, more studies are needed on the real-life expressive language skills of children with CIs, as clinical tests often rely on one specific modality (in this study: spoken language) and might therefore not accurately represent the language skills of the children. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic significantly disrupted the lives of the deaf community, and the implementation of restrictions on face-to-face meetings resulted in the trial introduction of video remote interpreting (VRI) in a secure psychiatric setting. This study aims to use a qualitative research paradigm to explore user experiences to inform potential future technological developments in this area. Design/methodology/approach: Twelve deaf patients and three interpreters took part in structured face-to-face interviews and discussed their experiences of the use of VRI, with the results being assessed using thematic analysis. Findings: Seven main themes were identified: resource availability, ease of use, technical issues, misunderstandings, medium secure-specific issues, preferences and human factors. All participants agreed that they did not like the VRI technology in the health-care environment in its current format, and their main concern was the difficulty in understanding the information being communicated. It was considered that this had the potential to incur potentially serious medico-legal and safety implications for both staff and patients alike. Practical implications: This study has provided detailed users' feedback about the potential future use in this communication tool and can help guide service developers to review the technology design to tailor it towards the users' needs. While the existing technology is not currently suitable for this deaf population, particularly because of the potential for error, there is potential scope for further research in this area. Originality/value: The COVID-19 pandemic provided a unique opportunity to explore the potential use of VRI for a deaf patient population within a secure psychiatric setting, where such technology is unlikely to have otherwise been used. [ABSTRACT FROM AUTHOR]

The purpose of this case study was to explore the communication needs of a child with deafness and cerebral palsy (DCP) and how these needs can be supported by interventions targeting the use of communication approaches and strategies. One semi-structured interview with the child's parents and five observations of the child in different contexts before and after the interventions took place. A rating scale "Checklist of Identified Needs", deriving from the observation data, the "Early Years Foundation Stage (EYFS) Development Matters" assessment and a British Sign Language (BSL) receptive and expressive skills assessment were used to explore the child's communication strategies before and after the intervention. The child completed two parallel school-based interventions lasting seven weeks, (i) one delivered daily which focused on BSL usage and Augmentative Alternative Communication (AAC) and (ii) one targeting communication strategies such as initiating and maintaining eye contact using a weekly "social story" and play-based sessions. Our results indicated that the combined use of sign and AAC technology to target key areas of communication use and a targeted approach using social stories to support communication strategies can be effective in enhancing communication skills of children with DCP. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to describe the factors affecting early and late cochlear implantation. Materials and Methods: A total of 159 patients from the Hospital Canselor Tuanku Muhriz (HCTM) Cochlear Implant Programme were recruited in this retrospective cross-sectional study. All paediatric Cochlear Implant (CI) recipients with pre-lingual deafness were included in this retrospective study. The study was conducted from January 2019 until December 2020. The pre-lingual cochlear implant recipients' data were analysed based on demographics and interval from diagnosis to hearing aid fitting and implantation. The association between the dependent variables with early and late cochlear implantation was compared. Results: A total of 83 (52%) patients were female. Chinese race constituted most of the patients, which was 90/159 (57%). The majority were from middle -income families (M40); 89 (56%). The most common aetiology of Hearing Loss (HL) was idiopathic; 139 (87%), followed by intrauterine infections, which comprised of congenital CMV; 8 (5%) and congenital Rubella; 1 (1%) and nonspecific intrauterine infection 2 (1%). The relationship between the universal neonatal hearing screening and the interval between diagnosis to implantation was significant (p=0.033). Other variables were not significant. Conclusion: UNHS was a significant factor contributing to early and late implantation. The median age of diagnosis of hearing loss was 18 months (interquartile range; 15); the age of CI was 34 months (interquartile range; 24); the interval from diagnosis to hearing aid was 2 months (interquartile range; 5), and the interval from diagnosis to CI was 16 months (interquartile range; 14). [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to share the old and new process of early intervention services in Maine for children who are D/deaf or hard of hearing (DHH), the Exploring Language and Communication Opportunities (ELCO) process and resources available to families of children who are DHH living in Maine. Conclusions: Prior to 2016, families in Maine with children who are DHH were referred to multiple agencies for services, causing confusion and increased stress. In addition, when gathering information to better support their child, families were receiving conflicting information across their service providers. With a new referral process and ELCO, a unified message related to communication and language opportunities is shared, as well as the resources available in the community. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the acoustic changes in vowel production with different forms of auditory feedback via cochlear implant (CI), hearing aid (HA), and bimodal hearing (CI + HA). Method: Ten post–lingually deaf adult bimodal CI users (aged 50–78 years) produced English vowels /i/, /ɛ/, /æ/, /ɑ/, /ʊ/, and /u/ in the context of /hVd/ during short-term use of no device (ND), HA, CI, and CI + HA. Segmental features (first formant frequency [F1], second formant frequency [F2], and vowel space area) and suprasegmental features (duration, intensity, and fundamental frequency [fo]) of vowel production were analyzed. Participants also categorized a vowel continuum synthesized from their own productions of /ɛ/ and /æ/ using HA, CI, and CI + HA. Results: F1s of all vowels decreased; F2s of front vowels but not back vowels increased; vowel space areas increased; and vowel durations, intensities, and fos decreased with statistical significance in the HA, CI, and CI + HA conditions relative to the ND condition. Only fos were lower, and vowel space areas were larger with CI and CI + HA than with HA. Average changes in fo, intensity, and F1 from the ND condition to the HA, CI, and CI + HA conditions were positively correlated. Most participants did not show a typical psychometric function for vowel categorization, and thus, the relationship between vowel categorization and production was not tested. Conclusions: The results suggest that acoustic, electric, and bimodal hearing have a measurable impact on vowel acoustics of post–lingually deaf adults when their hearing devices are turned on and off temporarily. Also, changes in fo and F1 with the use of hearing devices may be largely driven by changes in intensity. [ABSTRACT FROM AUTHOR]

Nurse Chelsea Sharp describes her experience managing a medically complicated case of a patient seeking Botox treatment [ABSTRACT FROM AUTHOR]

Few studies exist on the early care and education (ECE) of children who are deaf in low-to-middle-income countries, and none examine the roles of deaf adults in such provision. A research base is needed to inform contextually sensitive "deaf-infused" models of ECE in such contexts that build on indigenous deaf community experience, knowledge, and local expertise. This paper discusses the development of ECE in Ghana in sub-Saharan Africa focusing specifically on the perspectives of deaf adults on their roles in ECE support and leadership. Seventeen deaf adults with different leadership and advocacy roles in Ghana were interviewed about their perceptions of ECE priorities in this context, and the role of deaf adults in the development and delivery of early support. The participants expressed diverse views on ECE for the children and their families and suggested ways of building capacity and leadership among deaf adults to support ECE for the children and their families. [ABSTRACT FROM AUTHOR]

Permanent childhood hearing impairment (PCHI) represents the most frequent sensory pathology at birth. PCHI has a relevant psychological impact on the life of both the affected children and their families. Thus, the aim of this work is to explore the degree of parental distress felt by mothers of a deaf or hard-of-hearing child, to determine if this stress is associated with variables related to the children's health (e.g., the severity of hearing loss, presence of other conditions, difficulty with treatment options, difficulty with rehabilitation) or family characteristics such as socio-economic and educational status. The study used the Parenting Stress Index–Short Form (PSI-SF) questionnaire administered to mothers. The results were analyzed in relation to variables such as parents' education level, number of children, severity of hearing loss, presence of other chronic conditions, presence of cognitive delay, familiarity with hearing loss, time of diagnosis, use of prosthetics, and start in a rehabilitation program. The data indicate a correlation between maternal stress levels and low-educational levels, as well as the presence of congenital infections and cognitive delay. These results highlight the need for a comprehensive physical and psychological approach for hearing-impaired children, as stress factors can affect the adherence to effective rehabilitation. [ABSTRACT FROM AUTHOR]

Bilingual bimodalism is a great benefit to deaf children at home and in schooling. Deaf signing children perform better overall than non-signing deaf children, regardless of whether they use a cochlear implant. Raising a deaf child in a speech-only environment can carry cognitive and psycho-social risks that may have lifelong adverse effects. For children born deaf, or who become deaf in early childhood, we recommend comprehensible multimodal language exposure and engagement in joint activity with parents and friends to assure age-appropriate first-language acquisition. Accessible visual language input should begin as close to birth as possible. Hearing parents will need timely and extensive support; thus, we propose that, upon the birth of a deaf child and through the preschool years, among other things, the family needs an adult deaf presence in the home for several hours every day to be a linguistic model, to guide the family in taking sign language lessons, to show the family how to make spoken language accessible to their deaf child, and to be an encouraging liaison to deaf communities. While such a support program will be complicated and challenging to implement, it is far less costly than the harm of linguistic deprivation. [ABSTRACT FROM AUTHOR]

Increasing cultural and linguistic diversity among children and families brings new challenges for early intervention professionals. The purpose of this study was to identify the specific roles and needs of speech-language pathologists (SLPs) who practice in early intervention settings with culturally and linguistically diverse families of d/Deaf multilingual learners (DMLs). Thirteen SLPs completed an online survey about their practices and needs. Interviews were conducted with five parents of DMLs. Results showed that SLPs have lower self-satisfaction with families of DMLs compared to mainstream families. Parents were highly satisfied with the support they received. Both groups of participants reported a need for specific tools or adaptations, especially if there was no shared language. Thematic analysis identified three themes: communication and partnership, professional resources for responding to diversity, and diversity of parental profiles. This article provides an insight into the perspectives of both professionals and culturally and linguistically diverse parents, and identifies specific aspects of early intervention services with parents of DMLs: developing partnership in the context of cultural and/or linguistic differences, discussing topics related to multilingualism, and providing highly adaptable family-centered services. [ABSTRACT FROM AUTHOR]

To explore the lived experiences of culturally Deaf British Sign Language (BSL) users who access adult hearing aid services. Semi-structured qualitative interviews were conducted in BSL by the Deaf researcher and analysed using an Interpretative Phenomenological Analysis (IPA) approach. Eight Deaf BSL expert informants who were experienced users of NHS adult hearing aid clinics. Participants expressed dissatisfaction about audiology staff's lack of Deaf awareness and did not feel valued as Deaf signers. Participants' motivations for hearing aid use primarily concerned audibility rather than speech. Mismatch of perspectives on 'hearing' between audiologists and Deaf patients are discussed in the context of culturally sensitive services. Inadequate or uncertain linguistic access during appointments is considered in light of patient agency. This is the first study to explore culturally Deaf signers' specific experiences of adult hearing aid services in the UK and their experiences of hearing aids. There are numerous reasons why Deaf signers wear hearing aids, but access to spoken language is not a priority. Limited Deaf awareness and cultural competence in adult hearing aid services can result in patient frustration and disempowerment. Suggestions for improvement in the Deaf signing patient experience are offered. [ABSTRACT FROM AUTHOR]

Purpose: The U.S. Food and Drug Administration indications for cochlear implantation in children is currently 9 months of age and older for children with bilateral profound sensorineural hearing loss (SNHL). Studies have shown that earlier activation of a cochlear implant (CI) can lead to better spoken language outcomes. As auditory skills are a precursor to the development of spoken language, this study was developed to investigate the influence of age at CI activation on auditory skill acquisition in young children. A secondary aim was to describe the auditory skills of children implanted prior to 9 months of age as compared to children with older ages of activation. Method: Functional Listening Index (FLI) scores obtained during routine clinical visits were reviewed for 78 pediatric CI recipients with congenital bilateral profound hearing loss who were activated before 2 years of age. A linear mixedeffects model assessed the effect of age at CI activation on cumulative FLI scores over time. Results: There was a significant interaction between age at activation and chronological age at the time of evaluation, indicating that children with earlier access to sound achieved a greater number of auditory skills than those with later CI activations when measured at the same chronological age. Children activated before the age of 9 months approximated scores expected of children with typical hearing, whereas children activated between 9 and 24 months of age did not. Conclusions: Younger age at CI activation is associated with increased auditory skills over time. Children who undergo cochlear implantation and CI activation before 9 months achieve more auditory skills by 4 years of age than children who are activated at later ages. These data suggest that reducing the approved age at cochlear implantation for children with congenital bilateral profound SNHL may support optimal auditory skill acquisition. [ABSTRACT FROM AUTHOR]

Objectives: This paper aims to determine the factors that affect the position of deaf children within the professional treatment procedure and family environment. Methods: The sample consisted of 217 respondents, of which 94 were parents of deaf and hard-of-hearing children and 123 respondents were professionals. Qualitative and quantitative analyses were applied for processing the results. Testing was performed with Wilks lambda, and the tested significance in the discriminant analysis was done via the F test at the statistical significance of 0.01. Results: The results demonstrated a relationship between the influence of the communication system and the attitude of the environment toward deaf children where the communication discriminatory factor was isolated. Insufficient information from the experts and decision-making factors in the education and rehabilitation processes are also isolated. Discussion: The obtained results indicated that it is necessary to carry out a series of systematic activities to improve and enhance the cooperation between parents and professionals to increase the level of information of professionals and to develop better models of counseling, education, and working with parents. [ABSTRACT FROM AUTHOR]

Single-sided deafness presents communication challenges for adults. There are a range of care options, including CROS hearing aids, available but little is known about patient preferences for these interventions. The objective of this study was to understand the viewpoints of patients making decisions about audiological interventions they use. A constructivist worldview using thematic analysis to undertake a constant comparative analysis of 8 semi-structured interviews. Participants were recruited from Portsmouth Hospitals University NHS Trust audiology service in England. The results of the study describe ongoing iterative judgements being made by participants, informed by their access to information, effectiveness of audiological interventions, stigma, barriers to accessing care, and constant cost-benefit analyses being made. The key factors involved in decision-making by individuals with Single-sided deafness (SSD) are discussed. This study represents the first in-depth exploration of the individual's lifeworld related to which factors influence use of different audiological interventions by individuals with SSD. It highlights the complex and ongoing nature of how decisions are made by these individuals and identifies the need for greater information provision by clinicians, such as through use of a decision aid tool. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the negative auditory and non-auditory effects developed immediately after using ultrasonic scalers and their potential role in the development of permanent hearing loss.Materials and Methods: The auditory functions of 60 dental clinicians were evaluated with the pure tone audiometry test (PTA), tympanogram and the otoacoustic emission test (OAE) before and immediately after using ultrasonic scalers. The paired t-test was used to evaluate the difference in the pre- and post-exposure recordings for all three tests.Results: There was a significant increase in the PTA and tympanogram test results, along with reduced OAE values immediately after using ultrasonic scalers. Hearing ability dropped by 63% to 66% immediately after using ultrasonic scalers. The maximum hearing disability was noted for low-frequency thresholds. The reduction was greater in the left than in the right ear.Conclusions: Noise-emitting devices such as ultrasonic scalers produce significant immediate auditory and non-auditory changes. It is important that dentists recognise the initial signs of hearing damage and adopt appropriate measures while working to prevent the development of permanent hearing impairment in future. [ABSTRACT FROM AUTHOR]

Aim: Although there are many treatment options for the treatment sudden idiopathic sensorineural hearing loss (SSHL), the most effective treatment method is still unclear. The purpose of this study was to determine the optimal treatment option for SSHL by examining the 5-years patient data of our clinic. Methods: The patients who were diagnosed as SSHL in our clinic between January 1, 2016 and July 31, 2021 were included in the present study. The treatment in groups were only oral steroid (OS) (group 1, n=30), OS and hyperbaric oxygen therapy (HBOT) (group 2, n=30), OS and intratympanic steroid therapy (ITS) (group 3, n=30) and OS+ITS+HBOT (group 4, n=30). The baseline pure tone audiometry (PTA), 3rd month PTA averages, audiological hearing gains and treatment success (a gain more than 15 Db in PTA) were determined and compared statistically. Results: The initial PTA averages (dB) in groups were 46.07±14.20, 45±12.49, 45.83±10.92, and 45.93±10.29, respectively. There were significant differences between the groups according to the PTA after treatment (p<0.05). In the after-treatment PTA threshold evaluation, the mean of group 4 was statistically significantly lowest (p<0.05). There were significant differences between the groups according to the PTA gain (p<0.05). In the paired comparisons of the groups according to PTA gain, the value of group 4 was significantly highest in all groups (p<0.05). No significant difference was found between the groups according to the other parameters (p>0.05). Conclusion: In this study, the combined (oral+IT+HBOT) therapy was superior to other treatment modalities. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this prospective randomized clinical trial was to compare the therapeutic efficacy of steroid treatment (systemic and intratympanic) versus combined administration of steroids and hyperbaric oxygen therapy (HBOT) as initial treatment in cases of idiopathic sudden sensorineural hearing loss (ISSNHL). Material and methods: 102 patients with up to a 10-day history of ISSNHL were randomized into two groups and followed prospectively. Group A (52 patients) received prednisolone intravenously followed by methylprednisolone orally and 3 courses of intratympanic injections with dexamethasone, whereas Group B (50 patients) were administered a combination of the aforementioned treatment together with 10 sessions of HBOT. The patients were followed-up with audiograms and pure-tone averages (PTAs) were measured. Hearing change was evaluated by comparing pre- and posttreatment PTAs. Results: The final mean hearing gain was 21.0 for Group A and 31.1 dB HL for Group B. The 10.1 dB HL difference in favor of Group B was statistically significant (p=0.004). However, when recovery was assessed in terms of Siegel's criteria, no statistically significant difference could be demonstrated. Patients younger than 45 years old achieved better hearing outcomes, and treatment was more effective at low frequencies (0.25 and 0.5 kHz). Combined HBOT and steroid treatment seems to provide greater hearing benefit for patients with severe hearing loss (initial PTA >70 dB HL). Conclusions: Early application of HBOT combined with systemic and intratympanic steroid administration significantly improved hearing outcomes with an absolute gain in PTA audiometric threshold of 10.1 dB (95% CI 1.5--29.8, p=0.004). Therefore, adding HBOT along with steroids as initial treatment in ISSNHL is recommended. Younger patients with severe hearing loss can be expected to derive most benefit. [ABSTRACT FROM AUTHOR]

Background: The role of prosody in language acquisition and effective communication is documented in research. Nevertheless, rehabilitation of prosodic skills in children with hearing impairment using hearing aids or cochlear implants is relatively neglected compared to other speech and language areas. Objective: To detect the effect of prosodic rehabilitation using the adapted translated version of the "Prosody Treatment Program" on expression of prosodic features in Egyptian Arabic-speaking hearing-impaired school-age children fitted with hearing aids or cochlear implant devices in comparison to conventional auditory and language rehabilitation. Methods: This study was conducted on 34 children with sensorineural hearing loss in a randomized controlled trial design. Children were randomly divided into 2 groups, group A (cases) and group B (control), by block randomization. Both groups were initially evaluated for their prosodic skills using objective measures. Group A received rehabilitation for prosody using the Prosody Treatment Program for 1 h, once per week for 3 months, while group B received conventional auditory and language training and served as their control. Both groups were re-evaluated using the same protocol after 3 months of therapy. Results: A statistically significant improvement of most of the assessed prosodic parameters in group A was shown when comparing the pretherapy and posttherapy scores, as well as comparing between both studied groups after therapy. Conclusions: Prosody is amenable to motor learning. The Prosody Treatment Program seems to be an effective rehabilitation tool in improving some prosodic skills of hearing-impaired children. Prosodic rehabilitation showed superiority to conventional auditory and language training in improving the expression of some prosodic features and pragmatic language skills. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the test--retest reliability and the minimum detectable change (MDC) scores of the Listening Self-Efficacy Questionnaire (LSEQ). Method: A total of 77 older adults who were experienced hearing aid users were administered the LSEQ in pen--paper format on two separate occasions. They were provided the first copy of the LSEQ in the clinic to take home to complete. Those participants who completed and returned the first copy of the questionnaire were then mailed a second copy of the LSEQ to complete and return approximately 2 weeks later. The mean subscale and total scale scores from the two administrations were compared using intraclass correlation coefficients (ICCs) to determine test--retest reliability of the measure. The MDC scores, or the minimum difference between scores to demonstrate a real change in self-efficacy levels, were also calculated for each subscale and the total scale. Results: The ICCs ranged from 0.786 to 0.920 for the subscale and total scale scores. The MDC scores for the subscale and total scale ranged from 14.3% to 19.1%. Conclusions: The results of this study indicate that the LSEQ has moderate to excellent test--retest reliability. The MDC scores demonstrate that the LSEQ has the potential to detect true changes in listening self-efficacy in older patients with hearing loss who use hearing aids. The LSEQ may aid clinicians in understanding listening self-efficacy in their patients and how their self-efficacy levels change with amplification. [ABSTRACT FROM AUTHOR]

Acupuncture has long been used to relieve some inner ear diseases such as deafness and tinnitus. The present study examined the effect of electroacupuncture (EA) on noise-induced hearing loss (NIHL) in animals. A NIHL rat model was established. Electroacupuncture pretreatment at 2 Hz or posttreatment at the right Zhongzhu (TE3) acupoint was applied for 1 hour. Auditory thresholds were measured using auditory brainstem responses (ABRs), and histopathology of the cochlea was examined. The results indicated that the baseline auditory threshold of ABR was not significantly different between the control (no noise), EA-only (only EA without noise), noise (noise exposure only), pre-EA (pretreating EA then noise), and post-EA (noise exposure then posttreating with EA) groups. Significant auditory threshold shifts were found in the noise, pre-EA, and post-EA groups in the immediate period after noise exposure, whereas auditory recovery was better in the pre-EA and post-EA groups than that in the noise group at the three days, one week (W1), two weeks (W2), three weeks (W3), and four weeks(W4) after noise stimulation. Histopathological examination revealed greater loss of the density of spiral ganglion neurons in the noise group than in the control group at W1 and W2. Although significant loss of spiral ganglion loss happened in pre-EA and post-EA groups, such loss was less than the loss of the noise group, especially W1. These results indicate that either pretreatment or posttreatment with EA may facilitate auditory recovery after NIHL. The detailed mechanism through which EA alleviates NIHL requires further study. [ABSTRACT FROM AUTHOR]

Poor binaural hearing in children was hypothesized to contribute to related cognitive and academic deficits. Children with unilateral hearing have normal hearing in one ear but no access to binaural cues. Their cognitive and academic deficits could be unique from children receiving bilateral cochlear implants (CIs) at young ages who have poor access to spectral cues and impaired binaural sensitivity. Both groups are at risk for vestibular/balance deficits which could further contribute to memory and learning challenges. Eighty-eight children (43 male:45 female, aged 9.89 ± 3.40 years), grouped by unilateral hearing loss (n = 20), bilateral CI (n = 32), and typically developing (n = 36), completed a battery of sensory, cognitive, and academic tests. Analyses revealed that children in both hearing loss groups had significantly poorer skills (accounting for age) on most tests than their normal hearing peers. Children with unilateral hearing loss had more asymmetric speech perception than children with bilateral CIs (p <.0001) but balance and language deficits (p =.0004, p <.0001, respectively) were similar in the two hearing loss groups (p >.05). Visuospatial memory deficits occurred in both hearing loss groups (p =.02) but more consistently across tests in children with unilateral hearing loss. Verbal memory was not significantly different than normal (p >.05). Principal component analyses revealed deficits in a main cluster of visuospatial memory, oral language, mathematics, and reading measures (explaining 46.8% data variability). The remaining components revealed clusters of self-reported hearing, balance and vestibular function, and speech perception deficits. The findings indicate significant developmental impacts of poor binaural hearing in children. [ABSTRACT FROM AUTHOR]

Objectives: Recurrent idiopathic sudden sensorineural hearing loss (ISSNHL) is a rare disease. In this study, we evaluated the correlations between hearing recovery after the first and recurrent episodes of ISSNHL and characterized the clinical features of different episodes of ISSNHL.Methods: This retrospective study was conducted by reviewing medical records pertaining to the period 2008-2018. A total of 30 patients (16 male, 14 female) who had experienced at least two episodes of ISSNHL were included. All patients were had received steroid therapy (including systemic and IT) and/or hyperbaric oxygen therapy within 2 weeks after the onset of disease. The SDRG's criteria was used for the grading of hearing recovery.Results: The median age at the first and second episode of ISSNHL was 48 and 53.5 years, respectively; a total of 30% of patients presented with vertigo in the first episode and 40% presented with vertigo in the second episode. The hearing outcomes of both episodes showed significant improvement after treatment. The rate of complete recovery after the first and second episodes was 46.67% and 33.33%, respectively. A significant positive correlation was observed between the treatment outcomes of the first and second episodes (r = 0.721, p < 0.001).Conclusion: In ISSNHL, hearing recovery after a recurrent episode is significantly correlated with the hearing outcome after the initial episode (p = 0.042). The treatment outcome of the first episode is a prognostic factor for the outcomes of recurrent episodes. [ABSTRACT FROM AUTHOR]

Objective: The association between sudden sensorineural hearing loss (SSNHL) and radiological findings of the vertebrobasilar artery is not well-known and little research has been done. We hypothesized that the radiological features of the vertebrobasilar artery contribute to the incidence and prognosis of SSNHL.Methods: We retrospectively enrolled patients diagnosed with unilateral SSNHL (SSNHL group) and those with acute vestibular neuritis (AVN; control group) in our hospital. All patients underwent magnetic resonance imaging and computed tomography. We measured the following parameters on the radiological images: basilar artery diameter, direction and distance of basilar artery deviation, direction and distance of vertebral artery deviation, and incidence of vertebral artery obstruction. Pure tone audiometry (PTA) was performed in all patients. Follow up PTA between 1 week and 1 month after treatment was performed in the SSNHL group.Results: A total of 244 SSNHL patients and 62 AVN patients were included in the analysis. Age, body mass index, and basilar artery diameter were found to be significantly associated with SSNHL. In the SSNHL group, patients were divided into three subgroups based on the consistency between the basilar artery deviation site and disease site. No significant difference was noted in initial PTA, final PTA, PTA recovery, and symptom improvement among the three groups. In case of the basilar artery, when the deviation and disease sites were in the opposite direction and the basilar artery diameter was >3.5 mm, diameter of basilar artery was positively correlated with PTA recovery.Conclusions: The strength of this study is that radiological evaluation of the vertebrobasilar artery was performed. Further research on the association between SSNHL and radiological features of the vertebrobasilar artery should be conducted to emphasize the importance of vascular assessment in SSNHL. [ABSTRACT FROM AUTHOR]

As a consequence of long-lasting experiences of communicative and social deprivation and exclusion, adults who are deaf and have intellectual disabilities must be considered a high-risk group for the development of mental health problems. A therapeutic living community model with special emphasis on social communication development that has been implemented at three different sites in Austria is described. Through the development of the therapeutic living communities and subsequent observations, an approach is suggested to understand the mediating role of signed language and social communication skills in mental health outcomes for those with such mental health risk factors. The model requires further empirical verification. [ABSTRACT FROM AUTHOR]

While the majority of cochlear implant recipients benefit from the device, it remains difficult to estimate the degree of benefit for a specific patient prior to implantation. Using data from 2,735 cochlear-implant recipients from across three clinics, the largest retrospective study of cochlear-implant outcomes to date, we investigate the association between 21 preoperative factors and speech recognition approximately one year after implantation and explore the consistency of their effects across the three constituent datasets. We provide evidence of 17 statistically significant associations, in either univariate or multivariate analysis, including confirmation of associations for several predictive factors, which have only been examined in prior smaller studies. Despite the large sample size, a multivariate analysis shows that the variance explained by our models remains modest across the datasets (R 2 = 0.12 –0.21). Finally, we report a novel statistical interaction indicating that the duration of deafness in the implanted ear has a stronger impact on hearing outcome when considered relative to a candidate's age. Our multicenter study highlights several real-world complexities that impact the clinical translation of predictive factors for cochlear implantation outcome. We suggest several directions to overcome these challenges and further improve our ability to model patient outcomes with increased accuracy. [ABSTRACT FROM AUTHOR]

Background: Attaining socio-emotional competence is challenging for children with hearing impairment. There is wide recognition of children with cochlear implant (CI) indicating significant improvement in their speech and language abilities, however many factors may restrict their chance of having reciprocal social interactions. A significant improvement in speech and language does not automatically affirm the quality of social interactions. This present observation on social-emotional development addressed a more current representative population of children with hearing loss who have benefitted from cochlear implantation. Methods: The research conducted a systematic review of selected articles from Scopus and PubMed databases, retrieved through three search-process keywords, namely socio-emotional, children and CI. The inclusion criteria only included journal articles published in English with empirical data from the year 2010--2019. The initial search had identified 189 potential abstracts and after removal of duplicates, only 38 eligible studies met the inclusion criteria. Results: Among 38 studies reviewed, 19 studies showed comparable socio-emotional skills with peers in social interaction, empathy, emotion theory of mind and comprehension skills. Conversely, the other 19 studies presented underprivileged results in socio-emotional functioning mainly in identifying facial expression, regulating emotion and emotional cues in the auditory domain. Conclusion: This review concluded that the socio-emotional development among children with CI, both at preschool-age and school-age, was not justified due to the heterogeneity in studies across measurement and small sample size. Also, the conclusion recommended extensive crossreferencing, mixed-mode research design, detailed distinguishing of socio-emotional functioning and identification of diverse groups of the population with impaired hearing as an approach to provide empirical evidence on socio-emotional functioning among children with CI in the future. [ABSTRACT FROM AUTHOR]

This cross-sectional quantitative study investigated parents' perceptions of the quality of family-centered practice in an early intervention service for young children who are deaf or hard of hearing through the use of the Measures of Processes of Care (MPOC-56). The results indicated that the majority of families accessing the service were satisfied with the family-centered practices they were receiving. Consistent with previous studies in different disability settings, families were least satisfied with the provision of general information regarding the child's disability, identifying further access to unbiased information and resources is needed. This highlighted a tension in the role of organizations operating within individualized funding models in regard to who is responsible for the dissemination of reliable and evidence-based general information. As the MPOC-56 has not been used in deaf or hard of hearing populations previously, this study found it was an appropriate measure for caregiver perceptions of family-centered practice within this population. [ABSTRACT FROM AUTHOR]

The author discusses the Sudden Sensorineural Hearing Loss (SSNHL) condition in singers. Topics covered include its causes, treatment, problems resulting from SSNHL onset, and coping strategies during and after treatment, and the author's personal experience with SSNHL as a performer and teacher of music. Also noted is the value of prior information in coping with the physical and emotional issues linked to SSNHL.

Objective: Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients. Method: A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented. Results: A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1–11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction. Conclusion: The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment. [ABSTRACT FROM AUTHOR]

This study qualitatively explored the factors that influence how parents of children who are Deaf or hard-of-hearing with Down syndrome prioritise hearing care and management and developed an associated theory to explain that priority. Grounded theory was used for the purposes of this qualitative study. Data were collected using in-depth interviews which were analysed using a three-tiered qualitative coding process. Eighteen mothers of children who are Deaf or hard-of-hearing with Down syndrome participated in this study. The higher the extent of engaged professional support, perception of benefit for child, parent activation, and family engagement, the higher the priority for hearing care and management will likely be among parents of children who are Deaf or hard-of-hearing with Down syndrome. Understanding how parents of children who are Deaf or hard-of-hearing with Down syndrome decide to prioritise hearing care and management has implications for how hearing health providers and others provide care to parents to enhance priority for hearing-related needs. [ABSTRACT FROM AUTHOR]

Background Best practice guidelines for verifying fittings of bone-anchored hearing devices (BAHD) recommend using aided sound-field thresholds (ASFT), but express caution regarding the variables impacting obtaining valid and reliable ASFTs. 1 Recently, a skull simulator was introduced to facilitate programming BAHD devices in force level (FL) to desired sensation level-bone conduction devices (skull simulator/DSL-BCD) 2,3 targets in a hearing aid analyzer. Currently, no evidence is available reporting if differences in measured FL using the manufacturer first-fit (FF) and word recognition in quiet, sentence reception threshold in noise, and subjective outcomes are present for a BAHD programmed using ASFT versus programmed using skull simulator/DSL-BCD targets. Purpose The aim of this study was to examine if significant differences were present in FL using the FF and word recognition in quiet at 50 and 65 decibel of sound pressure level (dB SPL), sentence reception threshold in noise and subjective outcomes using the abbreviated profile of hearing aid benefit (APHAB), and speech, spatial, and qualities of hearing (SSQ) between a BAHD fit using ASFT or skull simulator/DSL-BCD targets. Research Design A double-blind randomized crossover design with 15 adults having unilateral sensorineural hearing loss. All participants were successful users of the Cochlear America Baha 5. Data Collection and Analysis Baha Power 5 devices were fitusing FF, ASFT, and skull simulator/DSL-BCD targets. Order of the three fitting strategies was randomly assigned and counter-balanced. Results No significant differences were found for a BAHD device programmed using ASFT versus skull simulator/DSL-BCD targets for consonant-nucleus-consonant words in quiet at 50 or 65 dB SPL, sentence reception threshold in noise, the APHAB or SSQ. There were, however, significant differences, at primarily 500 to 2,000Hz in measured FLs between the FF, ASFT, and skull simulator/DSL-BCD targets at 50 and 65 dB SPL. Conclusions There were no significant differences in subject performance with two speech measures and subjective responses to two questionnaires for BAHD fittings using ASFT versus using skull simulator/DSL-BCD targets. Differences in FL between the three fitting strategies were present primarily at 500 to 2,000Hz. Limitations of the study are highlighted along with situations where the skull simulator can play a significantly beneficial role when fitting BAHD devices. [ABSTRACT FROM AUTHOR]

The current study examined the effects of an 11-week exercise intervention on brain activity during a working memory (WM) task and resting-state functional network connectivity in deaf children. Twenty-six deaf children were randomly assigned to either an 11-week exercise intervention or control conditions. Before and after the exercise intervention, all participants were scanned with functional magnetic resonance imaging (fMRI) during N-back task performance and a resting state. The behavioural results showed that the exercise intervention improved WM performance. Task activation analyses showed an increase in the parietal, occipital, and temporal gyri and hippocampus and hippocampus (HIP). In addition, WM performance improvements were associated with greater activation in the left HIP region. Resting-state functional connectivity (Rs-FC) between HIP and certain other brain areas shown a significant interaction of group (exercise versus no exercise) and time (pre- and postintervention). Moreover, connectivity between the left HIP and left middle frontal gyrus was related to improved WM performance. These data extend current knowledge by indicating that an exercise intervention can improve WM in deaf children, and these enhancements may be related to the WM network plasticity changes induced by exercise. [ABSTRACT FROM AUTHOR]

Objectives: Acupuncture, widely used in Chinese society, has been studied as an adjunct treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). The purpose of this study is to investigate the effectiveness of combined acupuncture and hyperbaric oxygen therapy (HBOT) with conventional steroid therapy for ISSNHL. Methods: This retrospective chart review enrolled 154 patients who met the ISSNHL criteria and were categorized into three groups according to the different treatment regimens. Among these patients, 43 underwent steroid therapy only (S) group, 74 received steroid and HBOT (S-H) group, and the remaining 37 were treated with combined acupuncture-HBOT in addition to steroid therapy (S-H-A) group. The outcome was determined by comparing the differences in pure-tone thresholds and absolute hearing gains after treatment calculated at each audiometric octave frequency or grouped frequencies of audiograms. Hearing recoveries classified into three grades: complete, partial, and poor were also analyzed and compared among different treatment groups. Results: All subjects presented with initial severe hearing loss with averaged hearing thresholds >70 dB. The S-H-A group exhibited good hearing improvement outcomes at each audiometric octave frequency and grouped frequencies of audiograms, with greater hearing gain and had more favorable outcomes in hearing recovery grades compared with the S group and the S-H group. Conclusions: The results obtained in this study revealed a preliminary finding of ISSNHL patients benefiting from combined acupuncture, HBOT, and conventional steroid therapy. Acupuncture is a safe and nonpharmacologic treatment option and can be considered as an initial treatment strategy in such a clinical scenario. [ABSTRACT FROM AUTHOR]