2024-03-28T15:20:11Z
http://ir.lib.uwo.ca/do/oai/
oai:ir.lib.uwo.ca:nursingpub-1035
2012-02-19T08:06:26Z
publication:edupub
publication:nursing
publication:nursingpub
publication:scsdpub
publication:edu
publication:scsd
publication:faculties
A Measure of Community Members’ Perceptions of the Impacts of Research Partnerships in Health and Social Services
King, Gillian
Servais, Michelle
Kertoy, Marilyn
Specht, Jacqueline
Currie, Melissa
Rosenbaum, Peter
Law, Mary
Forchuk, Cheryl
Chalmers, Heather
Willoughby, Teena
Article
2009-08-01T07:00:00Z
Research
Alliance
Partnership
Impact
Evaluation and Program Planning
Evaluation and Program Planning
32
3
289
299
http://dx.doi.org/10.1016/j.evalprogplan.2009.02.002
Nursing
<p>Currently, there are no psychometrically sound outcome measures by which to assess the impacts of research partnerships. This article describes the development of a 33-item, survey questionnaire measuring community members’ perceptions of the impact of research partnerships addressing health or social issues. The Community Impacts of Research Oriented Partnerships (CIROP) was developed using information from the literatures on health promotion, community development, research utilization, and community-based participatory research, and from focus groups involving 29 key informants. Data from 174 community members were used to determine the factor structure, internal consistency, and test–retest reliability of the four CIROP scales, and to provide evidence of construct validity. The CIROP informs research partnerships about the extent of their impact in the areas of Personal Knowledge Development, Personal Research Skill Development, Organizational/Group Access To and Use of Information, and Community and Organizational Development, allowing them to demonstrate accountability to funding bodies. As well, the CIROP can be used as a research tool to assess the effectiveness of knowledge sharing approaches, determine the most influential activities of research partnerships, and determine structural characteristics of partnerships associated with various types of impact. The CIROP provides a better understanding of community members’ perspectives and expectations of research partnerships, with important implications for knowledge transfer and uptake.</p>
https://ir.lib.uwo.ca/nursingpub/31
oai:ir.lib.uwo.ca:nursingpub-1125
2010-01-24T08:16:07Z
publication:nursing
publication:nursingpub
publication:scsdpub
publication:scsd
publication:faculties
A Meeting of Minds: Interdisciplinary Research in the Health Sciences in Canada
Hall, Judith G.
Bainbridge, Lesley
Buchan, Alison
Cribb, Alastair
Drummond, Jane
Gyles, Carlton
Hicks, T. Philip
McWilliam, Carol
Paterson, Barbara
Ratner, Pamela A.
Skarakis-Doyle, Elizabeth
Solomon, Patty
Article
2006-09-26T07:00:00Z
Canada
Government
Health Services Research
Humans
Industry
Interdisciplinary Communication
Organizational Culture
Universities
Canadian Medical Association Journal
Canadian Medical Association Journal
175
7
763
771
10.1503/cmaj.060783
Nursing
Brought together by the newly formed Canadian Academy of Health Sciences (CAHS), recognized national leaders in the 6 health sciences disciplines consider the environment for conducting interdisciplinary health research (IDHR) in Canada. Based on first-hand knowledge and thoughtful reflection, the authors argue that although much progress has been made in support of IDHR in Canada, the practical experience of researchers does not always bear this out. This article examines government, industry and academia to identify the cultural and structural characteristics that demand, promote or prevent IDHR in each sector. At its heart is the question, How can universities best support and enhance IDHR, not only for the benefit of science, but also to meet the growing needs of industry and government for intellectual capital? Focusing on the predominant health sciences disciplines, the authors define IDHR as a team of researchers, solidly grounded in their respective disciplines, who come together around an important and challenging health issue, the research question for which is determined by a shared understanding in an interactive and iterative process. In addition, they suggest that IDHR is directly linked to translational research, which is the application of basic science to clinical practice and the generation of scientific questions through clinical observation. This analysis of academic, industry and government sectors is not intended to offer rigorous data on the current state of IDHR in Canada. Rather, the goal is to stimulate research-policy dialogue by suggesting a number of immediate measures that can help promote IDHR in Canada. Recommended measures to support IDHR are aimed at better resourcing and recognition (by universities and granting agencies), along with novel approaches to training, such as government-and industry-based studentships. In addition, we recommend that professional organizations reconsider their policies on publication and governance. Although intended to maintain professional scopes of practice, these policies also serve to entrench disciplinary boundaries in research. We conclude by suggesting a number of research questions for a more rigorous assessment of the climate for IDHR in Canada. We call for an inventory and comparative analysis of academic centres, institutes and consortiums in Canada that strive to facilitate IDHR; an examination of the impact of professional organizations on health research, and on IDHR in particular; and a systematic review of research training opportunities that promote IDHR, with a view to identifying and replicating proven models.
https://ir.lib.uwo.ca/nursingpub/119
oai:ir.lib.uwo.ca:nursingpub-1149
2010-08-18T18:34:55Z
publication:edupub
publication:nursing
publication:nursingpub
publication:scsdpub
publication:edu
publication:scsd
publication:faculties
Features and Impacts of Five Multidisciplinary Community-university Research Partnerships
King, Gillian
Servais, Michelle
Forchuk, Cheryl
Chalmers, Heather
Currie, Melissa
Law, Mary
Specht, Jacqueline
Rosenbaum, Peter
Willoughby, Teena
Kertoy, Marilyn
Article
2010-01-01T08:00:00Z
Alliance
Impact
Partnership
Research
Health and Social Care in the Community
Health and Social Care in the Community
18
1
59
69
http://dx.doi.org/10.1111/j.1365-2524.2009.00874.x
Nursing
Despite the increasing number of multidisciplinary community–university research partnerships designed to address real-world issues, little is known about their nature. This article describes the features and impacts of five research partnerships addressing health or social service issues, which constituted a convenience sample from the province of Ontario, Canada. The article describes their characteristics, ways of operating, outputs, types of requests received from community members and mid-term impacts. Requests directed to partnerships were tracked over a 10-month period in 2003 to 2004, using a research contact checklist, and 174 community members later completed an impact questionnaire capturing perceptions of the impacts of the partnerships on personal knowledge and research skill development, organisational/group access to and use of information, and community and organisational development. The data indicated that partnerships had similar priorities and magnitudes of mid-term impacts, yet differed in the scope of their partnering, realm of intended influence and the number of mechanisms used to engage and communicate with target audiences. The partnerships produced different types of outputs and received different types of requests from community members. The findings inform researchers about partnership diversity and help to establish more realistic expectations about the magnitude of partnerships' impacts.
https://ir.lib.uwo.ca/nursingpub/111
oai:ir.lib.uwo.ca:ptpub-1020
2010-08-07T21:21:41Z
publication:pt
publication:scsdpub
publication:scsd
publication:pmid
publication:faculties
publication:ptpub
17442653
Measurement Practices in Pediatric Rehabilitation A Survey of Physical Therapists, Occupational Therapists, and Speech-Language Pathologists in Ontario
Hanna, Steven E.
Russell, Dianne J.
Bartlett, Doreen J.
Kertoy, Marilyn
Rosenbaum, Peter L.
Wynn, Kerry
Article
2007-01-01T08:00:00Z
Adult
Analysis of Variance
Attitude of Health Personnel
Child
Disability Evaluation
Disabled Children
Focus Groups
Humans
Occupational Therapy
Ontario
Physical Therapy (Specialty)
Professional Practice
Questionnaires
Speech-Language Pathology
Physical & Occupational Therapy in Pediatrics
Physical & Occupational Therapy in Pediatrics
27
2
25
42
http://dx.doi.org/10.1080/J006v27n02_03
Communication Sciences and Disorders
Physical Therapy
We investigated measurement practices in pediatric rehabilitation. We conducted a survey of 63 physical, 72 occupational, and 74 speech-language therapists working in one of 16 children's rehabilitation programs in Ontario, Canada. Therapists were surveyed about their measurement practices, and their confidence, beliefs, and attitudes about measurement. Results showed that standardized clinical measures were used frequently, but were often modified. Clinicians rated themselves as least comfortable with statistical concepts related to the uncertainty in test scores, and rated factors related to finding appropriate measures as the most important influences on their measurement practices. Some variance in measurement attitudes and practices was associated with treatment centre of practice, suggesting that there may be organizational or peer influences on measurement behaviour. The results have implications for continuing education, measurement development, and interventions designed to facilitate sound measurement practices.
https://ir.lib.uwo.ca/ptpub/21
oai:ir.lib.uwo.ca:scsdpub-1000
2011-02-25T00:53:00Z
publication:psychologypub
publication:psychology
publication:scsdpub
publication:scsd
publication:faculties
Short-term and Working Memory in Children with Specific Language Impairment
Archibald, Lisa M. D.
Dissertation
2006-01-01T08:00:00Z
Short-term memory
Working memory
Children
Specific Language Impairment
SLI
Communication Sciences and Disorders
Investigations of the cognitive processes underlying Specific Language
Impairment (SLI) have implicated deficits in the storage and processing of
phonological or verbal information. This thesis reports five studies that
investigated the role of short-term and working memory in children with SLI.
Study 1 demonstrated SLI deficits on measures of verbal working memory, and
short-term memory for verbal but not visuospatial information. Study 2
provided evidence that children with SLI perform at age-level on visuospatial
working memory measures. Study 3 demonstrated slower processing in the SLI
group across domains, as well as verbal storage decrements, with the greatest
deficits found for tasks tapping both of these. Study 4 found SLI deficits on
measures of nonword repetition in common use, with greater impairments on the
task that relied to a lesser extent on short-term memory. Study 5 established
more accurate recall for multisyllabic nonwords than matched single syllable
lists for all groups, although the SLI group showed different patterns of
phoneme retention. It is suggested that the combination of deficits in
generalized processing speed and verbal storage in SLI may be expected to have
a drastic and detrimental impact on learning, and provides an account of the
disorder that could encompass the range of impairments observed in SLI. The
findings also suggest that factors additional to short-term memory contribute to
poor nonword repetition in SLI.
Dr. Lisa Archibald is currently a faculty member at The University of Western Ontario.
https://ir.lib.uwo.ca/scsdpub/1
oai:ir.lib.uwo.ca:scsdpub-1001
2011-04-09T04:19:19Z
publication:kin
publication:cnspub
publication:rwkex
publication:kinpub
publication:physpharm
publication:rwkex_researcharticles
publication:scsdpub
publication:physpharmpub
publication:scsd
publication:pmid
publication:cns
publication:faculties
21294905
Stuttered Swallowing: Electric Stimulation of the Right Insula Interferes with Water Swallowing. A Case Report
Sörös, Peter
Al-Otaibi, Faisal
Wong, Savio W. H.
Shoemaker, J. Kevin
Mirsattari, Seyed M.
Hachinski, Vladimir
Martin, Ruth E.
Article
2011-02-05T08:00:00Z
Stuttered swallowing
Electric stimulation
Insula
Water swallowing
BMC Neurology
BMC Neurology
11
20
http://dx.doi.org/10.1186/1471-2377-11-20
Communication Sciences and Disorders
Kinesiology
Medical Physiology
Neurology
<p>BACKGROUND: Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear.</p>
<p>CASE PRESENTATION: Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity.</p>
<p>CONCLUSIONS: These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.</p>
https://ir.lib.uwo.ca/scsdpub/2
oai:ir.lib.uwo.ca:scsdpub-1002
2012-03-04T03:21:14Z
publication:healthstudies
publication:scsdpub
publication:scsd
publication:healthstudiespub
publication:pmid
publication:faculties
19854449
The Contribution of Processing Impairments to SLI: Insights from Attention-deficit/Hyperactivity Disorder
Cardy, Janis E. Oram
Tannock, Rosemary
Johnson, Andrew M.
Johnson, Carla J.
Article
2010-03-01T08:00:00Z
Attention Deficit Disorder
Hyperactivity
Child
Language Disorders
Mental Processes
Neuropsychological Tests
Reaction Time
Time Perception
Journal of Communication Disorders
Journal of Communication Disorders
43
2
77
91
http://dx.doi.org/10.1016/j.jcomdis.2009.09.003
Communication Sciences and Disorders
<p>Slowed speed of processing and impaired rapid temporal processing (RTP) have been proposed to underlie specific language impairment (SLI), but it is not clear that these dysfunctions are unique to SLI. We considered the contribution of attention-deficit/hyperactivity disorder (ADHD), which frequently co-occurs with language impairments, to performances on processing tasks. School-aged children who had SLI without concurrent ADHD (n=14), ADHD without concurrent SLI (n=14), and typical development (TD, n=28) performed two nonverbal speeded tasks and one auditory RTP task. RTP impairments were found in many children with SLI and ADHD, and some children with TD. Children with ADHD demonstrated slower processing speed than children with SLI or TD. Overall, findings questioned the uniqueness of these processing dysfunctions to language impairments and the validity of the behavioural paradigms traditionally used to estimate processing dysfunctions. Accounts of SLI should be further scrutinized by considering the influence of other disorders. LEARNING OUTCOMES: Readers will (1) become familiar with areas of overlap between SLI and ADHD, (2) understand some of the confounds associated with behavioural measures of processing speed in children, and (3) recognize the value in testing models of language disorders by including participants with other types of disorders.</p>
https://ir.lib.uwo.ca/scsdpub/3
oai:ir.lib.uwo.ca:hrspub-1001
2012-03-04T03:25:34Z
publication:hrs
publication:rwkex_researcharticles
publication:pmid
publication:cns
publication:faculties
publication:cnspub
publication:rwkex
publication:healthstudies
publication:hrspub
publication:otpub
publication:scsdpub
publication:scsd
publication:healthstudiespub
publication:ot
22225852
The Effects of Word Length, Articulation, Oral-motor Movement, and Lexicality on Gait: A Pilot Study
Davie, K. L.
Cardy, Janis E. Oram
Holmes, J. D.
Gagnon, M.
Hyde, A.
Jenkins, M. E.
Johnson, Andrew M.
Article
2012-01-04T08:00:00Z
Dual task interference
Speech
Cognition
Gait
Gait & Posture
http://dx.doi.org/10.1016/j.gaitpost.2011.12.006
Communication Sciences and Disorders
Occupational Therapy
Rehabilitation and Therapy
<p>Previous research has suggested that articulatory demands are important predictors of the impact of dual-task interference on spatial-temporal parameters of gait. In this study, we evaluated the effects of word length, oral-motor movement, articulation, and lexicality, within a verbal task, on a continuous gait task. Fifteen healthy young women participated in a study in which two word lengths (monosyllabic and bisyllabic) were crossed with four levels of secondary task complexity (no dual-task, non-speech movement, spoken non-word, and spoken word). Spatial and temporal parameters of gait were measured using a 23' instrumented carpet. Results indicated a significant multivariate main effect for task type, F(15, 120)=3.07, that explained 71.1% of the demonstrated variability in gait. Univariate analyses of this main effect revealed statistically significant effects for velocity, step time, swing time, and stance time, but no statistically significant effect for step length. Post hoc analyses suggested that dual-task interference produced significant changes in the parameters of gait, but that this interference was not significantly greater with non-words as compared to the non-speech movement condition, nor was it significantly greater with words as compared to non-words. The results of this systematic deconstruction of a simple verbal task suggest that the motor component of a secondary speech task may produce the largest amount of interference within a dual-task interference paradigm.</p>
https://ir.lib.uwo.ca/hrspub/2
oai:ir.lib.uwo.ca:otpub-1003
2012-03-04T03:40:47Z
publication:pmid
publication:cns
publication:faculties
publication:cnspub
publication:otpub
publication:healthstudies
publication:scsdpub
publication:scsd
publication:healthstudiespub
publication:ot
20976093
Dual-task Interference: The Effects of Verbal Cognitive Tasks on Upright Postural Stability in Parkinson's Disease
Holmes, J. D.
Jenkins, M. E.
Johnson, Andrew M.
Adams, S. G.
Spaulding, S. J.
Article
2010-02-14T08:00:00Z
Dual-Task Interference
Verbal Cognitive Tasks
Upright Postural Stability
Parkinson's Disease
Parkinson's Disease
Parkinson's Disease
2010
696492
http://dx.doi.org/10.4061/2010/696492
Communication Sciences and Disorders
Neurology
Occupational Therapy
<p>Although dual-task interference has previously been demonstrated to have a significant effect on postural control among individuals with Parkinson's disease, the impact of speech complexity on postural control has not been demonstrated using quantitative biomechanical measures. The postural stability of twelve participants with idiopathic Parkinson's disease and twelve healthy age-matched controls was evaluated under three conditions: (1) without a secondary task, (2) performing a rote repetition task and (3) generating a monologue. Results suggested a significant effect of cognitive load on biomechanical parameters of postural stability. Although both groups increased their postural excursion, individuals with Parkinson's disease demonstrated significantly reduced excursion as compared with that of healthy age-matched controls. This suggests that participants with Parkinson's disease may be overconstraining their postural adjustments in order to focus attention on the cognitive tasks without losing their balance. Ironically, this overconstraint may place the participant at greater risk for a fall.</p>
https://ir.lib.uwo.ca/otpub/4
oai:ir.lib.uwo.ca:scsdpub-1008
2021-02-09T23:30:05Z
publication:faculties
publication:scsdpub
publication:scsd
Analysis of the quality of online resources for parents of children who are late to talk
Coughler, Caitlin
M Burke, Shauna
Cardy, Janis Oram
Article
2020-01-01T08:00:00Z
children
language
Late talker
parents
website evaluation
Autism and Developmental Language Impairments
5
10.1177/2396941520917940
© The Author(s) 2020. Background and aims: Internet usage worldwide has become a primary source of health-related information and an important resource for parents to find advice on how to promote their child’s development and well-being. It is important that healthcare professionals understand what information is available to parents online to best support families and children. The current study evaluated the quality of online resources accessible for parents of children who are late to talk. Method: Fifty-four web pages were evaluated for their usability and reliability using the LIDA instrument and Health on the Net Foundation code of conduct certification, and readability using the Flesch Reading Ease Score and Flesch-Kincaid Grade Level. Origin, author(s), target audience, topics discussed, terminology used, and recommendations were also examined. Results: The majority of websites scored within the moderate range (50–90%) for total LIDA scores and usability, but scored in the low range for reliability (<50%). Significantly higher reliability scores (p < 0.001) were found for sites with Health on the Net Foundation code of conduct certification. Readability fell within the standard range. The largest proportion of websites were American, written by speech-language pathologists, with the most common topics being milestones, tips and strategies, and red flags. Discrepancies were mostly seen in terminology and misinformation, and when present, usually related to risk factors and causes. Conclusion: Prior to recommending websites to parents, health professionals should consider readability of the content, check that information is up-to-date, and confirm website sources and reputable authorship. Health professionals should also be aware of the types of unclear or inaccurate information to which parents of children who are late to talk may be exposed online.
https://ir.lib.uwo.ca/scsdpub/8
oai:ir.lib.uwo.ca:scsdpub-1009
2021-02-09T23:30:06Z
publication:faculties
publication:scsdpub
publication:scsd
Lessons learned in practice-based research: Studying language interventions for young children in the real world
Smyth, Rachael E.
Theurer, Julie
Archibald, Lisa M.D.
Oram Cardy, Janis
Article
2020-01-01T08:00:00Z
language intervention
Practice-based research
preschool
Autism and Developmental Language Impairments
5
10.1177/2396941520913482
© The Author(s) 2020. Background and aims: Practice-based research holds potential as a promising solution to closing the research-practice gap, because it addresses research questions based on problems that arise in clinical practice and tests whether systems and interventions are effective and sustainable in a clinical setting. One type of practice-based research involves capturing practice by collecting evidence within clinical settings to evaluate the effectiveness of current practices. Here, we describe our collaboration between researchers and clinicians that sought to answer clinician-driven questions about community-based language interventions for young children (Are our interventions effective? What predicts response to our interventions?) and to address questions about the characteristics, strengths, and challenges of engaging in practice-based research. Methods: We performed a retrospective chart review of 59 young children who had participated in three group language interventions at one publicly funded community clinic between 2012 and 2017. Change on the Focus on the Outcomes of Communication Under Six (FOCUS), a government mandated communicative participation measure, was extracted as the main outcome measure. Potential predictors of growth during intervention were also extracted from the charts, including type of intervention received, attendance, age at the start of intervention, functional communication ability pre-intervention, and time between pre- and post-intervention FOCUS scores. Results: Overall, 49% of children demonstrated meaningful clinical change on the FOCUS after their participation in the language groups. Only 3% of participants showed possibly meaningful clinical change, while the remaining 46% of participants demonstrated not likely meaningful clinical change. There were no significant predictors of communicative participation growth during intervention. Conclusions: Using a practice-based research approach aimed at capturing current practice, we were able to answer questions about the effectiveness of interventions delivered in real-world settings and learn about factors that do not appear to influence growth during these interventions. We also learned about benefits associated with engaging in practice-based research, including high clinical motivation, high external validity, and minimal time/cost investment. Challenges identified were helpful in informing our future efforts to examine other possible predictors through development of a new, clinically feasible checklist, and to pursue methods for improving collection of outcome data in the clinical setting. Implications: Clinicians and researchers can successfully collaborate to answer clinically informed research questions while considering realistic clinical practice and using research-informed methods and principles. Practice-based research partnerships between researchers and clinicians are both valuable and feasible.
https://ir.lib.uwo.ca/scsdpub/9
oai:ir.lib.uwo.ca:scsdpub-1004
2021-03-19T18:44:26Z
publication:faculties
publication:scsdpub
publication:scsd
Investigating the Role of Inattention and/or Hyperactivity/impulsivity in Language and Social Functioning Using a Dimensional Approach
Parks, Kaitlyn M.A.
Cardy, Janis E.Oram
Woynaroski, Tiffany G.
Sehl, Claudia G.
Stevenson, Ryan A.
Article
2021-01-01T08:00:00Z
Attention-deficit/hyperactivity disorder
language
social communication
social competency
social responsivity
Journal of Communication Disorders
89
10.1016/j.jcomdis.2020.106036
Communication Sciences and Disorders
<p>© 2020 Elsevier Inc. The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity did not. Findings suggest that inattention and/or hyperactivity/impulsivity symptoms, inattention in particular, may be especially important for social skills programs geared towards individuals with attention limitations.</p>
https://ir.lib.uwo.ca/scsdpub/4
oai:ir.lib.uwo.ca:scsdpub-1014
2021-03-19T19:47:54Z
publication:pmid
publication:faculties
publication:scsdpub
publication:scsd
30605734
The speech-language pathologist's role in supporting the development of self-regulation: A review and tutorial
Binns, Amanda V.
Hutchinson, Lynda R.
Oram Cardy, Janis
Article
2019-03-01T08:00:00Z
Co-regulation
Executive functions
Language acquisition
Language development
Language therapy
Metacognition
Preschool
School-age
Self-regulation
Speech therapy
Speech-language pathologist
Speech-language therapist
Stress in children
Journal of Communication Disorders
78
1
17
10.1016/j.jcomdis.2018.12.005
Communication Sciences and Disorders
<p>© 2018 Elsevier Inc. Purpose: Children's engagement in self-regulation is a strong and positive predictor of their social and academic success, making self-regulation an important focus for caregivers and clinicians. The aims of this article are to provide a framework for understanding self-regulation and to identify strategies speech-language pathologists can use to integrate self-regulation work into their clinical practice. Method: Empirically supported considerations describing the developmental progression from co-regulation to self-regulation are outlined, and the effects of stress on self-regulation are discussed. A clinical framework is provided to guide speech-language pathologists in considering stress and self-regulation in their clinical work. Strategies are provided to a) support speech-language pathologists’ employment of co-regulation as a method for mitigating the negative effects that stress can have on therapeutic efforts, and to b) support children's development of skills (i.e. executive functions, metacognition) required to actively self-regulate. Conclusion: Given that children's ability to attain a state of regulation is integral to attending, engaging, and learning from their environment, the information provided in this tutorial can be used to inform and enhance current clinical practice.</p>
https://ir.lib.uwo.ca/scsdpub/14
oai:ir.lib.uwo.ca:scsdpub-1021
2021-02-09T23:30:13Z
publication:pmid
publication:faculties
publication:scsdpub
publication:scsd
28369935
Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology
Bishop, Dorothy V.M.
Snowling, Margaret J.
Thompson, Paul A.
Greenhalgh, Trisha
Article
2017-10-01T07:00:00Z
definitions
Developmental language disorder
risk factors
specific language impairment
terminology
Journal of Child Psychology and Psychiatry and Allied Disciplines
58
10
1068
1080
10.1111/jcpp.12721
© 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. Background: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. Methods: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities. Results: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability. Conclusions: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
https://ir.lib.uwo.ca/scsdpub/21
oai:ir.lib.uwo.ca:scsdpub-1025
2021-10-26T16:46:29Z
publication:faculties
publication:scsdpub
publication:scsd
Meta-analysis of receptive and expressive language skills in autism spectrum disorder
Kwok, Elaine Y.L.
Brown, Heather M.
Smyth, Rachael E.
Oram Cardy, Janis
Article
2015-01-01T08:00:00Z
Autism spectrum disorder
Expressive
Language
Receptive
Research in Autism Spectrum Disorders
9
202
222
10.1016/j.rasd.2014.10.008
Communication Sciences and Disorders
<p>© 2014 Elsevier Ltd. All rights reserved. Clinical anecdotes suggest that children with autism spectrum disorder (ASD) often show an atypical language profile in which expressive language exceeds receptive language competency. However, the few studies to directly explore this language profile have yielded inconsistent findings. This meta-analysis examined 74 studies that reported the receptive and expressive language performances of children and youth with ASD. Four potential predictors (age, language domain, source of language data, method of ASD diagnosis) were separately analyzed for their contribution to the relative receptive and expressive language impairment in ASD. Contrary to popular belief, the current meta-analyses found no evidence that an expressive advantage is common in ASD. Overall, children and youth with ASD showed equally impaired receptive and expressive language skills, both falling roughly 1.5 SD below peers with typical development. No discrepancies were found in receptive and expressive language across developmental stages, cognitive abilities, vocabulary, global language skills, caregiver report measures, clinician-administered measures, mixed method measures, or method of ASD diagnosis. Although some individual children with ASD may have an expressive-better-than-receptive language profile, this profile is not common enough to be a useful marker of ASD.</p>
https://ir.lib.uwo.ca/scsdpub/25
oai:ir.lib.uwo.ca:scsdpub-1024
2021-10-26T18:24:59Z
publication:faculties
publication:scsdpub
publication:scsd
Nonverbal learning disabilities and asperger syndrome in young adults: Vocabulary, gestalts, and social perception
Stothers, M. E.
Oram Cardy, J.
Article
2015-09-04T07:00:00Z
Medical and Educational Perspectives on Nonverbal Learning Disability in Children and Young Adults
264
315
10.4018/978-1-4666-9539-9.ch009
Communication Sciences and Disorders
<p>© 2016, IGI Global. All rights reserved. The purpose of this chapter is to explore data-driven hypotheses concerning linguistic similarities and differences in adults with nonverbal learning disabilities (NLD) and autism spectrum disorder (ASD). The focus of the chapter is on profiling linguistic, cognitive, and neuropsychological strengths and weaknesses seen in both clinical groups. A research sample of adults from 19 to 44 years of age is described. Findings include strengths in the breadth of vocabulary and weaknesses in semantic precision and integration. A secondary finding, in which responses to adult autism screening surveys distinguish both clinical groups from controls, and the clinical groups from one another, is presented. Patterns and trends in this data point to difficulties with verbal and nonverbal gestalt formation that are amenable to intervention. Clinical examples of interventions suggested by the data are provided, as they apply to post-secondary students of the same age as the sample.</p>
https://ir.lib.uwo.ca/scsdpub/24
oai:ir.lib.uwo.ca:scsdpub-1042
2021-03-20T19:25:35Z
publication:pmid
publication:faculties
publication:scsdpub
publication:scsd
24892229
Nonlinear frequency compression in hearing aids: impact on speech and language development.
Bentler, Ruth
Walker, Elizabeth
McCreery, Ryan
Arenas, Richard M
Roush, Patricia
Article
2014-07-01T07:00:00Z
Child
Preschool
Female
Hearing Aids
Hearing Loss
Humans
Language Development
Male
Nonlinear Dynamics
Speech
Speech Intelligibility
Speech Perception
Treatment Outcome
Ear and hearing
35
4
143
152
Communication Sciences and Disorders
<p>OBJECTIVES: The research questions of this study were: (1) Are children using nonlinear frequency compression (NLFC) in their hearing aids getting better access to the speech signal than children using conventional processing schemes? The authors hypothesized that children whose hearing aids provided wider input bandwidth would have more access to the speech signal, as measured by an adaptation of the Speech Intelligibility Index, and (2) are speech and language skills different for children who have been fit with the two different technologies; if so, in what areas? The authors hypothesized that if the children were getting increased access to the speech signal as a result of their NLFC hearing aids (question 1), it would be possible to see improved performance in areas of speech production, morphosyntax, and speech perception compared with the group with conventional processing.</p>
<p>DESIGN: Participants included 66 children with hearing loss recruited as part of a larger multisite National Institutes of Health-funded study, Outcomes for Children with Hearing Loss, designed to explore the developmental outcomes of children with mild to severe hearing loss. For the larger study, data on communication, academic and psychosocial skills were gathered in an accelerated longitudinal design, with entry into the study between 6 months and 7 years of age. Subjects in this report consisted of 3-, 4-, and 5-year-old children recruited at the North Carolina test site. All had at least at least 6 months of current hearing aid usage with their NLFC or conventional amplification. Demographic characteristics were compared at the three age levels as well as audibility and speech/language outcomes; speech-perception scores were compared for the 5-year-old groups.</p>
<p>RESULTS: Results indicate that the audibility provided did not differ between the technology options. As a result, there was no difference between groups on speech or language outcome measures at 4 or 5 years of age, and no impact on speech perception (measured at 5 years of age). The difference in Comprehensive Assessment of Spoken Language and mean length of utterance scores for the 3-year-old group favoring the group with conventional amplification may be a consequence of confounding factors such as increased incidence of prematurity in the group using NLFC.</p>
<p>CONCLUSIONS: Children fit with NLFC had similar audibility, as measured by a modified Speech Intelligibility Index, compared with a matched group of children using conventional technology. In turn, there were no differences in their speech and language abilities.</p>
https://ir.lib.uwo.ca/scsdpub/42
oai:ir.lib.uwo.ca:scsdpub-1052
2021-10-26T14:47:26Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
28590893
Acoustic reflexes in normal-hearing adults, typically developing children, and children with suspected auditory processing disorder: Thresholds, real-ear corrections, and the role of static compliance on estimates
Saxena, Udit
Allan, Chris
Allen, Prudence
Article
2017-06-01T07:00:00Z
Acoustic reflex thresholds
Acoustic reflexes
Auditory processing disorders
Children
Ear canal volume
Real-ear-to-coupler difference
Static compliance
Journal of the American Academy of Audiology
28
6
480
490
10.3766/jaaa.15136
Communication Sciences and Disorders
<p>Background: Previous studies have suggested elevated reflex thresholds in children with auditory processing disorders (APDs). However, some aspects of the child's ear such as ear canal volume and static compliance of the middle ear could possibly affect the measurements of reflex thresholds and thus impact its interpretation. Sound levels used to elicit reflexes in a child's ear may be higher than predicted by calibration in a standard 2-cc coupler, and lower static compliance could make visualization of very small changes in impedance at threshold difficult. For this purpose, it is important to evaluate threshold data with consideration of differences between children and adults. Purpose: A set of studies were conducted. The first compared reflex thresholds obtained using standard clinical procedures in children with suspected APD to that of typically developing children and adults to test the replicability of previous studies. The second study examined the impact of ear canal volume on estimates of reflex thresholds by applying real-ear corrections. Lastly, the relationship between static compliance and reflex threshold estimates was explored. Research Design: The research is a set of case-control studies with a repeated measures design. Study Sample: The first study included data from 20 normal-hearing adults, 28 typically developing children, and 66 children suspected of having an APD. The second study included 28 normal-hearing adults and 30 typically developing children. Data Collection and Analysis: In the first study, crossed and uncrossed reflex thresholds were measured in 5-dB step size. Reflex thresholds were analyzed using repeated measures analysis of variance (RM-ANOVA). In the second study, uncrossed reflex thresholds, real-ear correction, ear canal volume, and static compliance were measured. Reflex thresholds were measured using a 1-dB step size. The effect of real-ear correction and static compliance on reflex threshold was examined using RM-ANOVA and Pearson correlation coefficient, respectively. Results: Study 1 replicated previous studies showing elevated reflex thresholds in many children with suspected APD when compared to data from adults using standard clinical procedures, especially in the crossed condition. The thresholds measured in children with suspected APD tended to be higher than those measured in the typically developing children. There were no significant differences between the typically developing children and adults. However, when real-ear calibrated stimulus levels were used, it was found that children's thresholds were elicited at higher levels than in the adults. A significant relationship between reflex thresholds and static compliance was found in the adult data, showing a trend for higher thresholds in ears with lower static compliance, but no such relationship was found in the data from the children. Conclusions: This study suggests that reflex measures in children should be adjusted for real-ear-tocoupler differences before interpretation. The data in children with suspected APD support previous studies suggesting abnormalities in reflex thresholds. The lack of correlation between threshold and static compliance estimates in children as was observed in the adults may suggest a nonmechanical explanation for age and clinically related effects.</p>
https://ir.lib.uwo.ca/scsdpub/52
oai:ir.lib.uwo.ca:scsdpub-1048
2021-08-17T20:04:37Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31241448
Auditory brainstem responses in children with auditory processing disorder
Ankmnal-Veeranna, Sangamanatha
Allan, Chris
Allen, Prudence
Article
2019-01-01T08:00:00Z
Auditory processing disorder
Axonal conduction time
Click-evoked ABR
Synaptic transmission time
Journal of the American Academy of Audiology
30
10
904
917
10.3766/jaaa.18046
Communication Sciences and Disorders
<p>Background: The ASHA recommends including electrophysiological measures in an auditory processing disorder (APD) assessment battery, but few audiologists do so, potentially because of limited published evidence for its utility. Purpose: This study compared the auditory brainstem responses (ABRs) of children with APD with age-matched children and adults. Study Sample: This study retrospectively examined the records of 108 children suspected of APD (sAPD) who had click-evoked ABRs recorded as part of their clinical assessment. Twenty adults and 22 typically developing (TD) children were recruited as controls. Data collection and Analysis: Click-evoked ABRs were recorded at slow (13.3 clicks/sec) and faster (57.7 clicks/sec) stimulation rates. ABRs were analyzed using typical clinical measures (latencies and interpeak intervals for waves I, III, and V) and using a model proposed by Ponton et al that offered a more detailed analysis of axonal conduction time and synaptic transmission delay. Results: Both clinical measures and the Ponton model analysis showed no significant differences between TD children and adults. Children sAPD showed absolute latencies that were significantly prolonged when compared with adults but not when compared with TD children. But individual children sAPD showed clinically significant delays (.2 standard deviations of TD children’s data). Examination of responses delineating axonal versus synaptic transmission showed significant delays in synaptic transmission in the group of children sAPD in comparison to TD children and adults. These results suggest that a significant portion of children with listening difficulties showed evidence of reduced or atypical brainstem functioning. Examining the responses for axonal and synaptic delays revealed evidence of a synaptic pattern of abnormalities in a significant portion (37.03%) of children sAPD. Such observations could provide objective evidence of factors potentially contributing to listening difficulties that are frequently reported in children identified with APD. Conclusions: Children sAPD often showed abnormalities in the ABR, suggesting a neurophysiologic origin of their reported difficulties, frequently originating at or before the first synapse. This study provides supportive evidence for the value of click-evoked ABRs in comprehensive auditory processing assessment batteries.</p>
https://ir.lib.uwo.ca/scsdpub/48
oai:ir.lib.uwo.ca:scsdpub-1054
2021-10-26T16:51:56Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26107426
Crossed and uncrossed acoustic reflex growth functions in normal-hearing adults, typically developing children, and children with suspected auditory processing disorder
Saxena, Udit
Allan, Chris
Allen, Prudence
Article
2015-09-02T07:00:00Z
acoustic refl exes
Auditory processing disorders
children
International Journal of Audiology
54
9
620
626
10.3109/14992027.2015.1043147
Communication Sciences and Disorders
<p>Previous data suggested that children with suspected auditory processing disorders (APD) often show elevated or absent acoustic reflex thresholds, especially in crossed conditions (e.g. Allen & Allan, 2014). This study further explored these effects by measuring acoustic reflex growth functions (ARGF). Design: Crossed and uncrossed ARGF slopes were obtained by linear fits between reflex amplitudes and increases in activator level from threshold to 15 dB above it. Study sample: Normal-hearing adults, typically developing children and children with reported listening difficulties and suspected of having an APD, participated. Results: The ARGF slopes were shallower in crossed than in uncrossed conditions for all groups but the magnitude of the effect was significantly greater in the children with suspected APD. There were no differences between the typically developing children and the adults. Conclusions: The results suggest shallower ARGFs in children with suspected APD. Given the role of the acoustic reflex in facilitating hearing speech in noise these findings may begin to shed light on physiologic explanations for some of the difficulties that are reported by children with suspected APD.</p>
https://ir.lib.uwo.ca/scsdpub/54
oai:ir.lib.uwo.ca:scsdpub-1057
2021-08-17T17:38:16Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31913799
Audiological considerations for managing mild bilateral or unilateral hearing loss in infants and young children
Bagatto, Marlene
Article
2020-01-01T08:00:00Z
Language, Speech, and Hearing Services in Schools
51
1
68
73
10.1044/2019_LSHSS-OCHL-19-0025
Communication Sciences and Disorders
<p>Purpose: This clinical focus article describes considerations for recommending assistive hearing technology to infants and young children who have mild bilateral or unilateral hearing loss. These conditions present special challenges compared to bilateral permanent hearing losses that are moderate to profound in their degree in that the recommendation to proceed with technology is not as clear. Conclusion: Current clinical practice guidelines and protocols for pediatric hearing aid fitting recommend managing these conditions on a case-by-case basis. Descriptions of key considerations for recommending assistive hearing technology for infants and young children with mild bilateral hearing loss or unilateral hearing loss are offered herein.</p>
https://ir.lib.uwo.ca/scsdpub/57
oai:ir.lib.uwo.ca:scsdpub-1058
2021-08-17T17:51:34Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Fitting bone conduction hearing devices to children: audiological practices and challenges
Gordey, Dave
Bagatto, Marlene
Article
2020-01-01T08:00:00Z
Bone conduction hearing devices
children
conductive hearing loss
guidelines
mixed hearing loss
protocols
International Journal of Audiology
None
None
10.1080/14992027.2020.1814970
Communication Sciences and Disorders
<p>Objective: Evidence-based protocols for fitting air conduction hearing aids to children offers a vital resource for audiologists. Fitting protocols for providing BCHDs to children are not well-developed, leaving gaps in clinical practice. This work aims to document current practices and challenges of audiologists who fit BCHDs to children. Design: An online survey was distributed to paediatric audiologists in North America to describe their work with patients who use BCHDs. A retrospective file review was also conducted with a sample of clinics in North America to further understand practice patterns. Study sample: A total of 144 audiologists from North America responded to the online survey. Eleven audiologists from seven clinics in North America participated in the retrospective file review. Results: Results of the survey indicated that audiologists are seeking guidance on how to provide optimal amplification to children who use BCHDs. The aided audiogram is widely used to verify BCHD fittings. Audiologists reported uncertainty about providing optimal amplification to children who wear BCHDs. The file review revealed the routine use of the aided audiogram for verification as well as for validation. Conclusions: For children who use BCHDs, there is a need for clinically feasible electroacoustic verification to accompany appropriate outcome measures.</p>
https://ir.lib.uwo.ca/scsdpub/58
oai:ir.lib.uwo.ca:scsdpub-1061
2021-05-05T01:00:03Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31486692
Consensus practice parameter: audiological assessment and management of unilateral hearing loss in children
Bagatto, Marlene
DesGeorges, Janet
King, Alison
Kitterick, Padraig
Laurnagaray, Diana
Lewis, Dawna
Roush, Patricia
Sladen, Douglas P.
Tharpe, Anne Marie
Article
2019-12-02T08:00:00Z
children with hearing loss
CROS hearing aids
remote microphone systems
single-sided deafness
Unilateral hearing loss
International Journal of Audiology
58
12
805
815
10.1080/14992027.2019.1654620
Objective: Provide recommendations to audiologists for the management of children with unilateral hearing loss (UHL) and for needed research that can lend further insight into important unanswered questions. Design: An international panel of experts on children with UHL was convened following a day and a half of presentations on the same. The evidence reviewed for this parameter was gathered through web-based literature searches specifically designed for academic and health care resources, recent systematic reviews of literature, and new research presented at the conference that underwent peer review for publication by the time of this writing. Study sample: Expert opinions and electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Education Resources Information Centre (ERIC), Google Scholar, PsycINFO, PubMed, ScienceDirect, and Turning Research into Practice (TRIP) Database. Results: The resulting practice parameter requires a personalised, family-centred process: (1) routine surveillance of speech-language, psychosocial, auditory, and academic or pre-academic development; (2) medical assessments for determination of aetiology of hearing loss; (3) assessment of hearing technologies; and (4) considerations for family-centred counselling. Conclusions: This practice parameter provides guidance to clinical audiologists on individualising the management of children with UHL. In addition, the paper concludes with recommendations for research priorities.
https://ir.lib.uwo.ca/scsdpub/61
oai:ir.lib.uwo.ca:scsdpub-1065
2021-10-26T14:52:39Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26967359
Editorial: Providing hearing AIDS to infants and young children
Bagatto, Marlene
Editorial
2016-03-01T08:00:00Z
Journal of the American Academy of Audiology
27
3
164
165
10.3766/jaaa.27.3.1
Communication Sciences and Disorders
https://ir.lib.uwo.ca/scsdpub/65
oai:ir.lib.uwo.ca:scsdpub-1069
2021-05-26T13:35:08Z
publication:brain
publication:pmid
publication:brainpub
publication:faculties
publication:scsdpub
publication:scsd
publication:institutes
33933598
Speech-evoked brain activity is more robust to competing speech when it is spoken by someone familiar
Holmes, Emma
Johnsrude, Ingrid S.
Article
2021-08-15T07:00:00Z
Attention
Auditory cortex
Familiarity
fMRI
Speech
Voice
NeuroImage
237
10.1016/j.neuroimage.2021.118107
Communication Sciences and Disorders
<p>When speech is masked by competing sound, people are better at understanding what is said if the talker is familiar compared to unfamiliar. The benefit is robust, but how does processing of familiar voices facilitate intelligibility? We combined high-resolution fMRI with representational similarity analysis to quantify the difference in distributed activity between clear and masked speech. We demonstrate that brain representations of spoken sentences are less affected by a competing sentence when they are spoken by a friend or partner than by someone unfamiliar—effectively, showing a cortical signal-to-noise ratio (SNR) enhancement for familiar voices. This effect correlated with the familiar-voice intelligibility benefit. We functionally parcellated auditory cortex, and found that the most prominent familiar-voice advantage was manifest along the posterior superior and middle temporal gyri. Overall, our results demonstrate that experience-driven improvements in intelligibility are associated with enhanced multivariate pattern activity in posterior temporal cortex.</p>
http://creativecommons.org/licenses/by-nc-nd/4.0/
https://ir.lib.uwo.ca/scsdpub/69
oai:ir.lib.uwo.ca:scsdpub-1070
2021-05-26T13:24:02Z
publication:faculties
publication:scsdpub
publication:scsd
How Long Does It Take for a Voice to Become Familiar? Speech Intelligibility and Voice Recognition Are Differentially Sensitive to Voice Training
Holmes, Emma
To, Grace
Johnsrude, Ingrid S.
Article
2021-01-01T08:00:00Z
attention
auditory perception
learning
memory
open data
speech perception
Psychological Science
10.1177/0956797621991137
When people listen to speech in noisy places, they can understand more words spoken by someone familiar, such as a friend or partner, than someone unfamiliar. Yet we know little about how voice familiarity develops over time. We exposed participants (N = 50) to three voices for different lengths of time (speaking 88, 166, or 478 sentences during familiarization and training). These previously heard voices were recognizable and more intelligible when presented with a competing talker than novel voices—even the voice previously heard for the shortest duration. However, recognition and intelligibility improved at different rates with longer exposures. Whereas recognition was similar for all previously heard voices, intelligibility was best for the voice that had been heard most extensively. The speech-intelligibility benefit for the most extensively heard voice (10%–15%) is as large as that reported for voices that are naturally very familiar (friends and spouses)—demonstrating that the intelligibility of a voice can be improved substantially after only an hour of training.
https://ir.lib.uwo.ca/scsdpub/70
oai:ir.lib.uwo.ca:scsdpub-1072
2021-10-26T17:06:14Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
X-Linked Hearing Loss: Two Gene Mutation Examples Provide Generalizable Implications for Clinical Care
Stanton, Susan G.
Article
2014-06-01T07:00:00Z
American Journal of Audiology
190
200
https://doi.org/10.1044/2014_AJA-13-0040
Communication Sciences and Disorders
<p>To describe the inheritance patterns and auditory phenotype features of 3 Canadian families with mutations in 2 X-linked “deafness” genes (DFNX). Audiological, medical, and family histories were collected and family members interviewed to compare hearing thresholds and case histories between cases with mutations in SMPX versus POU3F4. The family pedigrees reveal characteristic X-linked inheritance patterns. Phenotypic features associated with the SMPX (DFNX4) mutation include early onset in males with rapid progression from mild and flat to sloping sensorineural loss, with highly variable onset and hearing loss severity in females. In contrast, phenotypic features associated with the POU3F4 (DFNX2) mutation are characterized by an early onset, mixed hearing loss with fluctuation in males, and a normal hearing phenotype reported for females. The study shows how this unique inheritance pattern and both gender and mutation-specific phenotype variations can alert audiologists to the presence of X-linked genetic etiologies in their clinical practice. By incorporating this knowledge into clinical decision making, audiologists can facilitate the early identification of X-linked hearing loss and contribute to the effective team management of affected families.</p>
https://ir.lib.uwo.ca/scsdpub/72
oai:ir.lib.uwo.ca:scsdpub-1071
2021-08-13T16:12:03Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
27838790
A common variant in CLDN14 causes precipitous, prelingual sensorineural hearing loss in multiple families due to founder effect
Pater, Justin A.
Benteau, Tammy
Griffin, Anne
Penney, Cindy
Stanton, Susan G.
Predham, Sarah
Kielley, Bernadine
Squires, Jessica
Zhou, Jiayi
Li, Quan
Abdelfatah, Nelly
O’Rielly, Darren D.
Young, Terry Lynn
Article
2017-01-01T08:00:00Z
Human Genetics
136
1
107
118
10.1007/s00439-016-1746-7
Genetic isolates provide unprecedented opportunities to identify pathogenic mutations and explore the full natural history of clinically heterogeneous phenotypes such as hearing loss. We noticed a unique audioprofile, characterized by prelingual and rapid deterioration of hearing thresholds at frequencies >0.5 kHz in several adults from unrelated families from the island population of Newfoundland. Targeted serial Sanger sequencing of probands for deafness alleles (n = 23) that we previously identified in this founder population was negative. Whole exome sequencing in four members of the largest family (R2010) identified a CLDN14 (DFNB29) variant [c.488C>T; p. (Ala163Val)], likely pathogenic, sensorineural hearing loss, autosomal recessive. Although not associated with deafness or disease, CLDN14 p.(Ala163Val) has been previously reported as a variant of uncertain significance (VUS). Targeted sequencing of 169 deafness probands identified one homozygote and one heterozygous carrier. Genealogical studies, cascade sequencing and haplotype analysis across four unrelated families showed all subjects with the unique audioprofile (n = 12) were also homozygous for p.(Ala163Val) and shared a 1.4 Mb DFNB29-associated haplotype on chromosome 21. Most significantly, sequencing 175 population controls revealed 1% of the population are heterozygous for CLDN14 p.(Ala163Val), consistent with a major founder effect in Newfoundland. The youngest CLDN14 [c.488C>T; p.(Ala163Val)] homozygote passed newborn screening and had normal hearing thresholds up to 3 years of age, which then deteriorated to a precipitous loss >1 kHz during the first decade. Our study suggests that genetic testing may be necessary to identify at-risk children in time to prevent speech, language and developmental delay.
https://ir.lib.uwo.ca/scsdpub/71
oai:ir.lib.uwo.ca:scsdpub-1089
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
28346016
DSL prescriptive targets for bone conduction devices: adaptation and comparison to clinical fittings
Hodgetts, William E.
Scollie, Susan D.
Article
2017-07-03T07:00:00Z
bone-anchored hearing aids
force
Hearing aids
levels
prescription
validation
verification
International Journal of Audiology
56
7
521
530
10.1080/14992027.2017.1302605
Objective: To develop an algorithm that prescribes targets for bone conduction frequency response shape, compression, and output limiting, along with a clinical method that ensures accurate transforms between assessment and verification stages of the clinical workflow. Design: Technical report of target generation and validation. Study sample: We recruited 39 adult users of unilateral percutaneous bone conduction hearing aids with a range of unilateral, bilateral, mixed and conductive hearing losses across the sample. Results: The initial algorithm over-prescribed output compared to the user’s own settings in the low frequencies, but provided a good match to user settings in the high frequencies. Corrections to the targets were derived and implemented as a low-frequency cut aimed at improving acceptance of the wearer’s own voice during device use. Conclusions: The DSL-BCD prescriptive algorithm is compatible with verification of devices and fine-tuning to target for percutaneous bone conduction hearing devices that can be coupled to a skull simulator. Further study is needed to investigate the appropriateness of this prescriptive algorithm for other input levels, and for other clinical populations including those with single-sided deafness, bilateral devices, children and users of transcutaneous bone conduction hearing aids.
https://ir.lib.uwo.ca/scsdpub/89
oai:ir.lib.uwo.ca:scsdpub-1092
2021-08-13T16:54:02Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Objective quality and intelligibility prediction for users of assistive listening devices: Advantages and limitations of existing tools
Falk, Tiago H.
Parsa, Vijay
Santos, Joao F.
Arehart, Kathryn
Hazrati, Oldooz
Huber, Rainer
Kates, James M.
Scollie, Susan
Article
2015-03-01T08:00:00Z
IEEE Signal Processing Magazine
32
2
114
124
10.1109/MSP.2014.2358871
This article presents an overview of 12 existing objective speech quality and intelligibility prediction tools. Two classes of algorithms are presented?intrusive and nonintrusive?with the former requiring the use of a reference signal, while the latter does not. Investigated metrics include both those developed for normal hearing (NH) listeners, as well as those tailored particularly for hearing impaired (HI) listeners who are users of assistive listening devices [i.e., hearing aids (HAs) and cochlear implants (CIs)]. Representative examples of those optimized for HI listeners include the speech-to-reverberation modulation energy ratio (SRMR), tailored to HAs (SRMR-HA) and to CIs (SRMR-CI); the modulation spectrum area (ModA); the HA speech quality (HASQI) and perception indices (HASPI); and the perception-model-based quality prediction method for hearing impairments (PEMO-Q-HI). The objective metrics are tested on three subjectively rated speech data sets covering reverberation-alone, noise-alone, and reverberation-plus-noise degradation conditions, as well as degradations resultant from nonlinear frequency compression and different speech enhancement strategies. The advantages and limitations of each measure are highlighted and recommendations are given for suggested uses of the different tools under specific environmental and processing conditions.
https://ir.lib.uwo.ca/scsdpub/92
oai:ir.lib.uwo.ca:scsdpub-1094
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
25500177
Sensitivity of envelope following responses to vowel polarity
Easwar, Vijayalakshmi
Beamish, Laura
Aiken, Steven
Choi, Jong Min
Scollie, Susan
Purcell, David
Article
2015-02-01T08:00:00Z
Hearing Research
320
38
50
10.1016/j.heares.2014.11.008
Envelope following responses (EFRs) elicited by stimuli of opposite polarities are often averaged due to their insensitivity to polarity when elicited by amplitude modulated tones. A recent report illustrates that individuals exhibit varying degrees of polarity-sensitive differences in EFR amplitude when elicited by vowel stimuli (Aiken and Purcell, 2013). The aims of the current study were to evaluate the incidence and degree of polarity-sensitive differences in EFRs recorded in a large group of individuals, and to examine potential factors influencing the polarity-sensitive nature of EFRs. In Experiment I of the present study, we evaluated the incidence and degree of polarity-sensitive differences in EFR amplitude in a group of 39 participants. EFRs were elicited by opposite polarities of the vowel /ε/ in a natural /hVd/ context presented at 80dB SPL. Nearly 30% of the participants with detectable responses (n=24) showed a difference of greater than ~39nV in EFR response amplitude between the two polarities, that was unexplained by variations in noise estimates. In Experiment II, we evaluated the effect of vowel, frequency of harmonics and presence of the first harmonic (h1) on the polarity sensitivity of EFRs in 20 participants with normal hearing. For vowels /u/, /a/ and /i/, EFRs were elicited by two simultaneously presented carriers representing the first formant (resolved harmonics), and the second and higher formants (unresolved harmonics). Individual but simultaneous EFRs were elicited by the formant carriers by separating the fundamental frequency in the two carriers by 8Hz. Vowels were presented as part of a naturally produced, but modified sequence /susash{phonetic}i/, at an overall level of 65dB SPL. To evaluate the effect of h1 on polarity sensitivity of EFRs, EFRs were elicited by the same vowels without h1 in an identical sequence. A repeated measures analysis of variance indicated a significant effect of polarity on EFR amplitudes for the vowel /u/ and a near-significant effect for /i/, when h1 was present. EFRs elicited by unresolved harmonics and resolved harmonics without h1 demonstrated no significant differences in amplitude due to polarity. The results suggest that h1 contributes to the polarity sensitivity of EFRs elicited by low frequency F1 carriers. However, it is unlikely that this is only due to the influence of a polarity-sensitive frequency-following response to the fine structure at h1. Removing h1 by filtering also decreased the asymmetry of the vowel envelope, especially for those with low first formant frequencies. A measure called the envelope asymmetry index was computed to evaluate the relationship between stimulus envelope asymmetry above and below the baseline, and polarity-sensitive differences in EFR amplitude. A significant positive correlation between envelope asymmetry index and absolute amplitude differences in EFR due to polarity suggests that one of the causes contributing to the polarity sensitivity of EFRs could be the asymmetry in stimulus envelope. This stimulus characteristic, however, explains only a fraction of the variability observed and there may be other factors that contribute to individual differences in polarity sensitivity of the EFR to naturally produced vowel stimuli.
https://ir.lib.uwo.ca/scsdpub/94
oai:ir.lib.uwo.ca:scsdpub-1086
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
29415585
Semantic context improves speech intelligibility and reduces listening effort for listeners with hearing impairment
Holmes, Emma
Folkeard, Paula
Johnsrude, Ingrid S.
Scollie, Susan
Article
2018-07-03T07:00:00Z
behavioural measures
hearing aids
Psychoacoustics/hearing science
speech perception
International Journal of Audiology
57
7
483
492
10.1080/14992027.2018.1432901
Objective: We investigated whether speech intelligibility and listening effort for hearing-aid users is affected by semantic context and hearing-aid setting. Design: Participants heard target sentences spoken in a reverberant background of cafeteria noise and competing speech. Participants reported each sentence verbally. Eight participants also rated listening effort after each sentence. Sentence topic was either the same as, or different from, the previous target sentence. Study sample: Twenty participants with sensorineural hearing loss were fit binaurally with Signia receiver-in-the-canal hearing aids. Participants performed the task twice: once using the hearing aid’s omnidirectional setting and once using the “Reverberant Room” setting, designed to aid listening in reverberant environments. Results: Participants achieved better speech intelligibility for same-topic than different-topic sentences, and when they used the “Reverberant Room” than the omnidirectional hearing-aid setting. Participants who rated effort showed a reliable reduction in listening effort for same-topic sentences and for the “Reverberant Room” hearing-aid setting. The improvement in speech intelligibility from semantic context (i.e. same-topic compared to different-topic sentences) was greater than the improvement gained from changing hearing-aid setting. Conclusions: These findings highlight the enormous potential of cognitive (specifically, semantic) factors for improving speech intelligibility and reducing perceived listening effort in noise for hearing-aid users.
https://ir.lib.uwo.ca/scsdpub/86
oai:ir.lib.uwo.ca:scsdpub-1095
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26226606
Evaluation of Speech-Evoked Envelope Following Responses as an Objective Aided Outcome Measure: Effect of Stimulus Level, Bandwidth, and Amplification in Adults with Hearing Loss
Easwar, Vijayalakshmi
Purcell, David W.
Aiken, Steven J.
Parsa, Vijay
Scollie, Susan D.
Article
2015-01-01T08:00:00Z
Aided outcome measure
Amplitude modulation
Envelope following responses
Fourier analyzer
Fricatives
Hearing AIDS
Hearing loss
Ling 6 sounds
Low-pass filtering
Objective outcome measure
Sound quality rating
Speech discrimination
Speech stimulus
Stimulus bandwidth
Stimulus level
Vowel
Ear and Hearing
36
6
635
652
10.1097/AUD.0000000000000199
Objectives: The present study evaluated a novel test paradigm based on speech-evoked envelope following responses (EFRs) as an objective aided outcome measure for individuals fitted with hearing aids. Although intended for use in infants with hearing loss, this study evaluated the paradigm in adults with hearing loss, as a precursor to further evaluation in infants. The test stimulus was a naturally male-spoken token/susa∫i/, modified to enable recording of eight individual EFRs, two from each vowel for different formants and one from each fricative. In experiment I, sensitivity of the paradigm to changes in audibility due to varying stimulus level and use of hearing aids was tested. In experiment II, sensitivity of the paradigm to changes in aided audible bandwidth was evaluated. As well, experiment II aimed to test convergent validity of the EFR paradigm by comparing the effect of bandwidth on EFRs and behavioral outcome measures of hearing aid fitting. Design: Twenty-one adult hearing aid users with mild to moderately severe sensorineural hearing loss participated in the study. To evaluate the effects of level and amplification in experiment I, the stimulus was presented at 50 and 65 dB SPL through an ER-2 insert earphone in unaided conditions and through individually verified hearing aids in aided conditions. Behavioral thresholds of EFR carriers were obtained using an ER-2 insert earphone to estimate sensation level of EFR carriers. To evaluate the effect of aided audible bandwidth in experiment II, EFRs were elicited by/susa∫i/low-pass filtered at 1, 2, and 4 kHz and presented through the programmed hearing aid. EFRs recorded in the 65 dB SPL aided condition in experiment I represented the full bandwidth condition. EEG was recorded from the vertex to the nape of the neck over 300 sweeps. Speech discrimination using the University of Western Ontario Distinctive Feature Differences test and sound quality rating using the Multiple-Stimulus Hidden Reference and Anchor paradigm were measured in the same bandwidth conditions. Results: In experiment I, an increase in stimulus level above threshold and the use of amplification resulted in a significant increase in the number of EFRs detected per condition. At positive sensation levels, an increase in level demonstrated a significant increase in response amplitude in unaided and aided conditions. At 50 and 65 dB SPL, the use of amplification led to a significant increase in response amplitude for the majority of carriers. In experiment II, the number of EFR detections and the combined response amplitude of all eight EFRs improved with an increase in bandwidth up to 4 kHz. In contrast, behavioral measures continued to improve at wider bandwidths. Further change in EFR parameters was possibly limited by the hearing aid bandwidth. Significant positive correlations were found between EFR parameters and behavioral test scores in experiment II. Conclusions: The EFR paradigm demonstrates sensitivity to changes in audibility due to a change in stimulus level, bandwidth, and use of amplification in clinically feasible test times. The paradigm may thus have potential applications as an objective aided outcome measure. Further investigations exploring stimulus-response relationships in aided conditions and validation studies in children are warranted.
https://ir.lib.uwo.ca/scsdpub/95
oai:ir.lib.uwo.ca:scsdpub-1093
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
25731582
Evaluation of wideband frequency responses and non-linear frequency compression for children with mild to moderate high-frequency hearing loss
Wolfe, Jace
John, Andrew
Schafer, Erin
Hudson, Mary
Boretzki, Michael
Scollie, Susan
Woods, Whitney
Wheeler, Julie
Hudgens, Krystal
Neumann, Sara
Article
2015-03-01T08:00:00Z
Hearing aids
Moderate hearing loss
Nonlinear frequency compression
International Journal of Audiology
54
3
170
181
10.3109/14992027.2014.943845
Objective: To evaluate wideband amplification and non-linear frequency compression (NLFC) as a means to improve speech recognition for children with mild/moderate hearing loss. Design: Randomized within-subject design with repeated measures across test conditions. Study sample: Eleven children with mild to moderate hearing loss were evaluated with: (1) Phonak BTE without NLFC, (2) Phonak BTE with NLFC, and (3) Oticon BTE with wideband response extending to 8000 Hz. Results: Use of NLFC provided better detection and recognition of high-frequency stimuli (e.g. /sh/ and /s/). No difference in performance between conditions was observed for speech recognition when measured with the University of Western Ontario (UWO) plurals test and the UWO distinctive features difference test. Finally, there were no differences between conditions on the BKB-SIN test. Conclusions: Children with mild to moderate hearing loss have good access to high-frequency phonemes presented at fixed levels (e.g. 50 to 60 dBA) with both wideband and NLFC technology. Similarly, sentence recognition in noise was similar with wideband and NLFC. Adaptive test procedures that probe performance at lower input levels showed small but significant improvements in the detection and recognition of the phonemes /s/ and /sh/ with NLFC condition when compared to the NLFC Off and wideband conditions.
https://ir.lib.uwo.ca/scsdpub/93
oai:ir.lib.uwo.ca:scsdpub-1081
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33136646
The accuracy of envelope following responses in predicting speech audibility
Easwar, Vijayalakshmi
Birstler, Jen
Harrison, Adrienne
Scollie, Susan
Purcell, David
Article
2020-01-01T08:00:00Z
Formant
Frequency following response
Fricative
Hotelling's T 2
Negative predictive value
Phase coherence
Positive predictive value
Receiver operating characteristics curve
Sensitivity
Specificity
Vowel
Ear and Hearing
1732
1746
10.1097/AUD.0000000000000892
Objectives: The present study aimed to (1) evaluate the accuracy of envelope following responses (EFRs) in predicting speech audibility as a function of the statistical indicator used for objective response detection, stimulus phoneme, frequency, and level, and (2) quantify the minimum sensation level (SL; stimulus level above behavioral threshold) needed for detecting EFRs. Design: In 21 participants with normal hearing, EFRs were elicited by 8 band-limited phonemes in the male-spoken token /susa∫i/ (2.05 sec) presented between 20 and 65 dB SPL in 15 dB increments. Vowels in /susa∫i/ were modified to elicit two EFRs simultaneously by selectively lowering the fundamental frequency (f0) in the first formant (F1) region. The modified vowels elicited one EFR from the low-frequency F1 and another from the mid-frequency second and higher formants (F2+). Fricatives were amplitude-modulated at the average f0. EFRs were extracted from single-channel EEG recorded between the vertex (Cz) and the nape of the neck when /susa∫i/ was presented monaurally for 450 sweeps. The performance of the three statistical indicators, F-test, Hotelling's T2, and phase coherence, was compared against behaviorally determined audibility (estimated SL, SL ≥0 dB = audible) using area under the receiver operating characteristics (AUROC) curve, sensitivity (the proportion of audible speech with a detectable EFR [true positive rate]), and specificity (the proportion of inaudible speech with an undetectable EFR [true negative rate]). The influence of stimulus phoneme, frequency, and level on the accuracy of EFRs in predicting speech audibility was assessed by comparing sensitivity, specificity, positive predictive value (PPV; the proportion of detected EFRs elicited by audible stimuli) and negative predictive value (NPV; the proportion of undetected EFRs elicited by inaudible stimuli). The minimum SL needed for detection was evaluated using a linear mixed-effects model with the predictor variables stimulus and EFR detection p value. Results: of the 3 statistical indicators were similar; however, at the type I error rate of 5%, the sensitivities of Hotelling's T2(68.4%) and phase coherence (68.8%) were significantly higher than the F-test (59.5%). In contrast, the specificity of the F-test (97.3%) was significantly higher than the Hotelling's T2(88.4%). When analyzed using Hotelling's T2as a function of stimulus, fricatives offered higher sensitivity (88.6 to 90.6%) and NPV (57.9 to 76.0%) compared with most vowel stimuli (51.9 to 71.4% and 11.6 to 51.3%, respectively). When analyzed as a function of frequency band (F1, F2+, and fricatives aggregated as low-, mid- and high-frequencies, respectively), high-frequency stimuli offered the highest sensitivity (96.9%) and NPV (88.9%). When analyzed as a function of test level, sensitivity improved with increases in stimulus level (99.4% at 65 dB SPL). The minimum SL for EFR detection ranged between 13.4 and 21.7 dB for F1 stimuli, 7.8 to 12.2 dB for F2+ stimuli, and 2.3 to 3.9 dB for fricative stimuli. Conclusions: EFR-based inference of speech audibility requires consideration of the statistical indicator used, phoneme, stimulus frequency, and stimulus level.
https://ir.lib.uwo.ca/scsdpub/81
oai:ir.lib.uwo.ca:scsdpub-1083
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31176869
Investigating potential interactions between envelope following responses elicited simultaneously by different vowel formants
Easwar, Vijayalakshmi
Scollie, Susan
Purcell, David
Article
2019-09-01T07:00:00Z
Frequency following response
Frequency specificity
Fundamental frequency
Neural phase-locking
Periodicity
Place specificity
Hearing Research
380
35
45
10.1016/j.heares.2019.05.005
Envelope following responses (EFRs) evoked by the periodicity of voicing in vowels are elicited at the fundamental frequency of voice (f0), irrespective of the harmonics that initiate it. One approach of improving the frequency specificity of vowel stimuli without increasing test-time is by altering the f0 selectively in one or more formants. The harmonics contributing to an EFR can then be differentiated by the unique f0 at which the EFRs are elicited. The advantages of using such an approach would be increased frequency specificity and efficiency, given that multiple EFRs can be evaluated in a certain test-time. However, multiple EFRs elicited simultaneously could interact and lead to altered amplitudes and outcomes. To this end, the present study aimed to evaluate: (i) if simultaneous recording of two EFRs, one elicited by harmonics in the first formant (F1) and one elicited by harmonics in the second and higher formants (F2+), leads to attenuation or enhancement of EFR amplitude, and (ii) if simultaneous measurement of two EFRs affects its accuracy and anticipated efficiency. In a group of 22 young adults with normal hearing, EFRs were elicited by F1 and F2+ bands of /u/, /a/ and /i/ when F1 and F2+ were presented independently (individual), when F1 and F2+ were presented simultaneously (dual), and when F1 or F2+ was presented with spectrally matched Gaussian noise of the other (noise). Repeated-measures analysis of variance indicated no significant group differences in EFR amplitudes between any of the conditions, suggesting minimal between-EFR interactions. Between-participant variability was evident, however, significant changes were evident only in a third of the participants for the stimulus /u/ F1. For the majority of stimuli, the change between individual and dual conditions was positively correlated with the change between individual and noise conditions, suggesting that interaction-based changes in EFR amplitude, when present, were likely due to the restriction of cochlear regions of excitation in the presence of a competing stimulus. The amplitude of residual noise was significantly higher in the dual or noise relative to the individual conditions, although the mean differences were very small (<3 nV). F-test-based detection of EFRs, commonly used to determine the presence of an EFR, did not vary across conditions. Further, neither the mean reduction in EFR amplitude nor the mean increase in noise amplitude in dual relative to individual conditions was large enough to alter the anticipated gain in efficiency of simultaneous EFR recordings. Together, results suggest that the approach of simultaneously recording two vowel-evoked EFRs from different formants for improved frequency-specificity does not alter test accuracy and is more time-efficient than evaluating EFRs to each formant individually.
https://ir.lib.uwo.ca/scsdpub/83
oai:ir.lib.uwo.ca:scsdpub-1096
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26226607
Effect of Stimulus Level and Bandwidth on Speech-Evoked Envelope Following Responses in Adults with Normal Hearing
Easwar, Vijayalakshmi
Purcell, David W.
Aiken, Steven J.
Parsa, Vijay
Scollie, Susan D.
Article
2015-01-01T08:00:00Z
Aided outcome measure
Envelope following responses
Fricatives
Ling-6 sounds
Low-pass filtering
Objective outcome measure
Sound quality rating
Speech discrimination
Speech stimulus
Stimulus bandwidth
Stimulus level
Vowel
Ear and Hearing
36
6
619
634
10.1097/AUD.0000000000000188
Objective: The use of auditory evoked potentials as an objective outcome measure in infants fitted with hearing aids has gained interest in recent years. This article proposes a test paradigm using speech-evoked envelope following responses (EFRs) for use as an objective-aided outcome measure. The method uses a running speech-like, naturally spoken stimulus token/susa∫i/(fundamental frequency [f0] = 98 Hz; duration 2.05 sec), to elicit EFRs by eight carriers representing low, mid, and high frequencies. Each vowel elicited two EFRs simultaneously, one from the region of formant one (F1) and one from the higher formants region (F2+). The simultaneous recording of two EFRs was enabled by lowering f0 in the region of F1 alone. Fricatives were amplitude modulated to enable recording of EFRs from high-frequency spectral regions. The present study aimed to evaluate the effect of level and bandwidth on speech-evoked EFRs in adults with normal hearing. As well, the study aimed to test convergent validity of the EFR paradigm by comparing it with changes in behavioral tasks due to bandwidth. Design: Single-channel electroencephalogram was recorded from the vertex to the nape of the neck over 300 sweeps in two polarities from 20 young adults with normal hearing. To evaluate the effects of level in experiment I, EFRs were recorded at test levels of 50 and 65 dB SPL. To evaluate the effects of bandwidth in experiment II, EFRs were elicited by/susa∫i/low-pass filtered at 1, 2, and 4 kHz, presented at 65 dB SPL. The 65 dB SPL condition from experiment I represented the full bandwidth condition. EFRs were averaged across the two polarities and estimated using a Fourier analyzer. An F test was used to determine whether an EFR was detected. Speech discrimination using the University of Western Ontario Distinctive Feature Differences test and sound quality rating using the Multiple Stimulus Hidden Reference and Anchors paradigm were measured in identical bandwidth conditions. Results: In experiment I, the increase in level resulted in a significant increase in response amplitudes for all eight carriers (mean increase of 14 to 50 nV) and the number of detections (mean increase of 1.4 detections). In experiment II, an increase in bandwidth resulted in a significant increase in the number of EFRs detected until the low-pass filtered 4 kHz condition and carrier-specific changes in response amplitude until the full bandwidth condition. Scores in both behavioral tasks increased with bandwidth up to the full bandwidth condition. The number of detections and composite amplitude (sum of all eight EFR amplitudes) significantly correlated with changes in behavioral test scores. Conclusions: Results suggest that the EFR paradigm is sensitive to changes in level and audible bandwidth. This may be a useful tool as an objective-aided outcome measure considering its running speech-like stimulus, representation of spectral regions important for speech understanding, level and bandwidth sensitivity, and clinically feasible test times. This paradigm requires further validation in individuals with hearing loss, with and without hearing aids.
https://ir.lib.uwo.ca/scsdpub/96
oai:ir.lib.uwo.ca:scsdpub-1097
2023-04-27T20:51:16Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Virtual Hearing Aid Care: Clinical Practice Guideline v2.0
Glista, Danielle
O'Hagan, Robin
DiFabio, Danielle Leah
Moodie, Sheila Theresa Frances
Munoz, Karen
Richert, Frances
Curca, Ioan
Meston, Christine
Pfingstgraef, David
Joseph, Keiran
Brown, Christine L
Report
2022-11-08T08:00:00Z
Virtual care
hearing
https://doi.org/10.5206/0820211097
Communication Sciences and Disorders
<p>This clinical practice guideline (CPG) provides guidance around the delivery of virtual hearing aid care according to hearing healthcare professional practices and responsibilities, informed implementation strategies, clinical decision frameworks, and technology and infrastructure requirements. Guidance aligns with person-centred care approaches across four virtual care types: hearing aid management, programming, verification, and validation. CPG recommendations are based on evidence resulting from systematic literature review and co-creation efforts from an international team of hearing healthcare providers and clinician/scientist leaders in the field.</p>
http://creativecommons.org/licenses/by-nc/4.0/
https://ir.lib.uwo.ca/scsdpub/97
oai:ir.lib.uwo.ca:nca-1001
2021-11-26T19:37:33Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Language Development Services Guidelines Ontario Infant Hearing Program
Bagatto, Marlene
Clinical Protocols
2018-04-02T07:00:00Z
<p>The IHP Language Development Pathway (LDP) is comprised of the nine steps summarized in the table below (Coutu et al., 2015).While the pathway intends to capture the process for providing language development services, the sequence of steps may not occur exactly as outlined below(e.g.,some steps may be initiated or occur at the same time).The steps may not be sequential and are not intended to describe separate and/or different appointments.The table provides an overview of the service providers who may be supporting a child who is D/HH and their family,during each step in the process. It is not intended to be exhaustive of all professionals who may be working with a child and/or their family.</p>
https://ir.lib.uwo.ca/nca/2
oai:ir.lib.uwo.ca:nca-1006
2021-11-26T18:50:33Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Modified Physiological Hearing Screening: Interim Protocol For Ontario Infants During the COVID-19 Pandemic
Bagatto, Marlene
Clinical Protocols
2020-10-21T07:00:00Z
<p>This protocol describes interim procedures for a modified physiological hearing screen for Ontario infants who are over 8 weeks corrected age and who were not offered a newborn hearing screen through the Infant Hearing Program (IHP) due to service interruptions as a result of the COVID-19 pandemic. The scope of this document includes details of the modified hearing screen as funded by the Ministry of Children, Community and Social Services (MCCSS) for the Ontario IHP. It will remain in effect as an interim service during the global pandemic and will be recalled at the discretion of the MCCSS.</p>
https://ir.lib.uwo.ca/nca/7
oai:ir.lib.uwo.ca:scsdpub-1108
2022-01-20T20:33:25Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Assessment of cochlear electrophysiology in typically developing children and children with auditory processing disorder
Allen, P
Ankmnal Veeranna, Sangamanatha
Allan, Chris
Article
2021-10-28T07:00:00Z
Electrocochleography
Auditory brainstem response
Auditory processing disorder
International Journal of Pediatric Otorhinolaryngology
151
December
https://doi.org/10.1016/j.ijporl.2021.110962
Communication Sciences and Disorders
<h3 id="x-sectitle0015">Objective</h3>
<p id="x-abspara0010">Children with <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/auditory-processing-disorder" title="Learn more about auditory processing disorder from ScienceDirect's AI-generated Topic Pages">auditory processing disorder</a> (APD) are reported to have abnormal auditory <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/brain-stem-response" title="Learn more about brainstem responses from ScienceDirect's AI-generated Topic Pages">brainstem responses</a> (ABR) but little is understood about their cochlear integrity. Poor cochlear integrity can affect neural responses. In this study, cochlear and auditory <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/brainstem" title="Learn more about brainstem from ScienceDirect's AI-generated Topic Pages">brainstem</a> integrity was investigated in children with APD.</p>
<h3 id="x-sectitle0020">Method</h3>
<p id="x-abspara0015">Twenty children with APD, sixteen typically developing children and twenty adults participated in this study. Click evoked <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/electrocochleography" title="Learn more about electrocochleography from ScienceDirect's AI-generated Topic Pages">electrocochleography</a> (ECochG) and ABRs were recorded from all the participants. Cochlear responses were analyzed using a) latency and amplitude of summating potential; action potential, b) transmission time between summating potential and action potential, c) summating potential/action potential amplitude ratio and d) action potential latency difference to condensation and rarefaction polarity. Amplitude in the ABR components was examined.</p>
<h3 id="x-sectitle0025">Results</h3>
<p id="x-abspara0020">Children with APD showed similar cochlear function to the typically developing children. There were no significant differences in wave I amplitude between children with APD and typically developing children. However, wave V amplitude was significantly reduced in children with APD compared to typically developing children.</p>
<h3 id="x-sectitle0030">Conclusion</h3>
<p id="x-abspara0025">In the absence of any functional differences in the cochlea, children with APD can show poor amplitude in the later components of the ABR. The ABR anomalies observed in children with APD arise due to poor neural processing, possibly after the first auditory synapse.</p>
https://ir.lib.uwo.ca/scsdpub/108
oai:ir.lib.uwo.ca:scsdpub-1112
2022-06-09T21:32:54Z
publication:faculties
publication:scsdpub
publication:scsd
Working Memory and Language Learning: A Review
Archibald, Lisa
Archibald, Lisa
Article
2017-01-01T08:00:00Z
developmental language disorder
DLD
working memory
Child Language Teaching and Therapy
33
1
5
17
https://doi.org/10.1177/0265659016654206
Communication Sciences and Disorders
<p>Children with speech, language, and communication needs (SLCN) form a highly heterogeneous group including those with an unexplained delay in language development known as specific language impairment (SLI). There is growing recognition that multiple mechanisms underlie the range of profiles observed in these children. Broadly speaking, both the domain-general executive attentional system known as working memory and domain-specific linguistic processing have been implicated in children with SLI. It has been challenging to tease apart these influences, however, due to the symbiotic relationship between working memory and language learning. For example, working memory limits might constrain the linguistic detail encoded whereas poor language knowledge would place greater demands on working memory for retaining unfamiliar phonological information. There is growing evidence for separable impairments in these processing resources leading to relative deficits in linguistic or working memory processes in different children. Such findings have important clinical implications for both the assessment and treatment of children with SLCN.</p>
https://ir.lib.uwo.ca/scsdpub/112
oai:ir.lib.uwo.ca:scsdpub-1113
2022-11-23T19:46:24Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
35580238
A Scoping Review of Technology and Infrastructure Needs in the Delivery of Virtual Hearing Aid Services
DiFabio, Danielle
O'Hagan, Robin
Glista, Danielle
Article
2022-06-02T07:00:00Z
https://doi.org/10.1044/2022_AJA-21-00247
Communication Sciences and Disorders
<p>Purpose: The digital health revolution has brought forward integral technological advancements enabling virtual care as a readily accessible delivery model. Despite this forward momentum, the field of audiology still faces barriers that impede the uptake of virtual services into routine clinical practice. The aim of this study was to gather, synthesize, and summarize the literature around virtual hearing aid intervention studies and the related technology and infrastructure requirements. </p>
<p id="x-d1e230">Method: A scoping review was conducted using MEDLINE, CINAHL, Scopus, Nursing and Allied Health, and Web of Science databases. Objectives, inclusion criteria, and scoping review methods were specified in advance and documented in a protocol.</p>
<p id="x-d1e237">Results: The 11 studies identified through this review related to virtual hearing aid services delivered by a licensed health care provider and/or facilitator(s) specific to hearing aid management, programming, verification, and validation services. Service delivery models varied according to patient population, technology experience, type(s) and time course of care, type of remote location, and technology/support requirements. Barriers and facilitators to implementation-related themes including technology access and function, client sociotechnical, convenience, education and training, interaction quality, service delivery, and technology innovation.</p>
<p id="x-d1e244">Conclusions: This scoping review provides evidence around the technology and infrastructure required for full integration of virtual hearing aid services into practice and according to care type. Low-tech versus high-tech requirements may be used to guide virtual service delivery triaging efforts. Research and development efforts in the areas of pediatrics, clinical support tools, and hearing aid/app-based solutions will support further uptake of virtual service delivery in audiology.</p>
https://ir.lib.uwo.ca/scsdpub/113
oai:ir.lib.uwo.ca:scsdpub-1115
2023-05-08T17:29:10Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Validity and reliability of integrated pressure level real-ear-to-coupler difference measurements
Urichuk, Matthew J. B.
Purcell, David
Scollie, Susan
Article
2023-05-02T07:00:00Z
Real-ear measurements; RECD; assistive technology; hearing aids; instrumentation; middle ear; tele-audiology/tele-health
International Journal of Audiology
10.1080/14992027.2023.22050009
Communication Sciences and Disorders
<p>Objectives: (1) To validate the measurement of foam-tip real-ear-to-coupler differences (wRECD) using an integrated pressure level (IPL) method and (2) to compare the reliability of this method to SPL-based measurement of the wRECD. Design SPL-based wRECD and the proposed IPL wRECD measurement were completed bilaterally. Test-retest reliability of IPL wRECD was determined with full re-insertion into the ear canal and compared to published SPL wRECD test-retest data. Study sample 22 adults with normal hearing and middle ear status were recruited. Results Differences between SPL-based wRECD and IPL wRECD measurements were within 1.51 dB on average below 5000 Hz. At and above 5000 Hz, IPL wRECD exceeded SPL wRECDs by 6.11 dB on average. The average test-retest difference for IPL wRECD across all assessed frequencies was 0.75 dB with the greatest improvements in reliability found below 750 Hz and above 3000 Hz. Conclusions IPL wRECD yielded improved estimates compared to SPL wRECD in high frequencies, where standing-wave interference is present. Independence from standing wave interference resulted in increased wRECD values above 4000 Hz using the IPL measurement paradigm. IPL wRECD is more reliable than SPL wRECD, does not require precise probe-microphone placement, and provides a wider valid wRECD bandwidth than SPL-based measurement.</p>
https://ir.lib.uwo.ca/scsdpub/114
oai:ir.lib.uwo.ca:nca-1009
2023-08-15T19:40:13Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Auditory, Visual, and Audiovisual Speech Intelligibility for Sentence-Length Stimuli: An Investigation of Conversational and Clear Speech
Gagne, Jean-Pierre
Querengesser, Carol
Folkeard, Paula
Munhall, Kevin G
Masterson, Valerie M
Article
1995-01-01T08:00:00Z
audiology
speech intelligibility
The Volta Review
97
1
33
51
<p>Previous investigators have shown that the use of clear speech improves the auditory speech intelligibility of talkers. In the present study, the differences in speech intelligibility for sentences spoken conversationally and in a clear manner were investigated under three different experimental conditions: Auditory-only, visual-only, and audiovisually. Six talkers were videotaped while saying a list of 17 sentences twice: first while using conversational speech and then while using clear speech. The recorded stimuli were randomized and presented to subjects under one of the three experimental conditions, A broadband noise was mixed with the audio signal for the auditory-only and the audiovisual conditions. An auditory, visual, and audiovisual speech intelligibility score was obtained for the tokens of conversational and clear speech spoken by individual talkers. Overall, in each experimental condition, speech intelligibility improved significantly for the tokens of clear speech. However, for the auditory-only and the visual-only conditions there was a significant interaction between <em>talker</em> and <em>manner</em> of speech. In those sensory modalities, the speech intelligibility of some talkers improved when they used clear speech. The results suggest that for an individual talker there is not a direct association in the amount of improvement provided by the use of clear speech across sensory modalities.</p>
http://creativecommons.org/licenses/by-nc/4.0/
https://ir.lib.uwo.ca/nca/10
oai:ir.lib.uwo.ca:scsdpub-1073
2023-08-15T19:42:19Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33284647
Evaluating the accuracy of step tracking and fall detection in the starkey livio artificial intelligence hearing aids: A pilot study
Rahme, Mohamed
Folkeard, Paula
Scollie, Susan
Article
2021-03-01T08:00:00Z
American Journal of Audiology
30
1
182
189
10.1044/2020_AJA-20-00105
Communication Sciences and Disorders
<p>Purpose: The primary purpose of this study was to examine the efficacy and the effectiveness of Starkey Livio Artificial Intelligence hearing aids in tracking step count. A secondary purpose was to investigate the accuracy of the fall detection and alert system of Livio hearing aids in detecting fall maneuvers. Method: A participant wore Binaural Starkey Livio receiver-in-the-canal style hearing aids, a Sportline pedometer, and a Fitbit Charge 3 concurrently during both real-world and treadmill walking conditions. The real-world condition was conducted over a 5-day period. Step count for the treadmill protocol was assessed at six different treadmill speeds (2 mph, 2.5 mph, 3 mph, 3.5 mph, 4 mph, 4.5 mph, and 5 mph). The fall detection and alert system were assessed through falling maneuvers of activities of daily living. Results: In the real-world condition, Livio, Sportline, and Fitbit recorded steps within 1 SD of each other. In addition, Livio recorded the most accurate steps compared to actual physical steps taken. In the treadmill condition, Livio recorded the least number of steps across all walking paces compared to the rest of the devices. Also, Livio hearing aids detected majority of the engaged falling maneuvers. Conclusions: The Livio was found to be feasible, consistent, and sensitive in detecting steps and falls. Further research of higher sample size and recruitment of individuals with hearing loss are suggested.</p>
https://ir.lib.uwo.ca/scsdpub/73
oai:ir.lib.uwo.ca:scsdpub-1078
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33874803
Detection, Speech Recognition, Loudness, and Preference Outcomes With a Direct Drive Hearing Aid: Effects of Bandwidth
Folkeard, Paula
Eeckhoutte, Maaike Van
Levy, Suzanne
Dundas, Drew
Abbasalipour, Parvaneh
Glista, Danielle
Agrawal, Sumit
Scollie, Susan
Article
2021-01-01T08:00:00Z
direct drive
extended bandwidth
hearing aids
loudness perception
speech perception
Trends in Hearing
25
10.1177/2331216521999139
Direct drive hearing devices, which deliver a signal directly to the middle ear by vibrating the tympanic membrane via a lens placed in contact with the umbo, are designed to provide an extension of audible bandwidth, but there are few studies of the effects of these devices on preference, speech intelligibility, and loudness. The current study is the first to compare aided speech understanding between narrow and extended bandwidth conditions for listeners with hearing loss while fitted with a direct drive hearing aid system. The study also explored the effect of bandwidth on loudness perception and investigated subjective preference for bandwidth. Fifteen adult hearing aid users with symmetrical sensorineural hearing loss participated in a prospective, within-subjects, randomized single-blind repeated-measures study. Participants wore the direct drive hearing aids for 4 to 15 weeks (average 6 weeks) prior to outcome measurement. Outcome measures were completed in various bandwidth conditions achieved by reducing the gain of the device above 5000 Hz or by filtering the stimuli. Aided detection thresholds provided evidence of amplification to 10000 Hz. A significant improvement was found in high-frequency consonant detection and recognition, as well as for speech in noise performance in the full versus narrow bandwidth conditions. Subjective loudness ratings increased with provision of the full bandwidth available; however, real-world trials showed most participants were able to wear the full bandwidth hearing aids with only small adjustments to the prescription method. The majority of participants had either no preference or a preference for the full bandwidth setting.
https://ir.lib.uwo.ca/scsdpub/78
oai:ir.lib.uwo.ca:scsdpub-1109
2022-03-15T16:27:17Z
publication:faculties
publication:scsdpub
publication:scsd
Closing the species gap: Translational approaches to studying sensory processing differences relevant for autism spectrum disorder
Scott, Kaela E.
Schulz, Samantha E.
Moehrle, Dorit
Allman, Brian L.
Oram Cardy, Janis
Stevenson, Ryan A.
Schmid, Susanne
Article
2021-05-18T07:00:00Z
sensory phenotypes
preclinical animal studies and human testing
rodent models for ASD
autism spectrum disorder
Autism Research
14
7
1322
1331
https://doi.org/10.1002/aur.2533
Communication Sciences and Disorders
<p>Lay Summary: It has always been difficult to relate results from animal research to humans. We try to close this gap by studying changes in sensory processing using careful protocol design and collaboration between clinicians and researchers. Sensory pathways are comparable between animals and humans, and are affected in the same way as the rest of the brain in ASD. Using changes in hearing as a template, we point the field in an innovative direction by providing a framework for collecting cohesive data in rodents and humans.</p>
<p>_______________________________________</p>
<p>study of sensory phenotypes has great potential for increasing research translation between species, a necessity to decipher the neural mechanisms that contribute to higher-order differences in neurological conditions such as autism spectrum disorder (ASD). Over the past decade, despite separate advances in our understanding of the structural and functional differences within the brain of autistic and non-autistic individuals and in rodent models for ASD, researchers have had difficulty translating the findings in murine species to humans, mostly due to incompatibility in experimental methodologies used to screen for ASD phenotypes. Focusing on sensory phenotypes offers an avenue to close the species gap because sensory pathways are highly conserved across species and are affected by the same risk-factors as the higher-order brain areas mostly responsible for the diagnostic criteria for ASD. By first reviewing how sensory processing has been studied to date, we direct our focus to electrophysiological and behavioral techniques that can be used to study sensory phenotypes consistently across species. Using auditory sensory phenotypes as a template, we seek to improve the accessibility of translational methods by providing a framework for collecting cohesive data in both rodents and humans. Specifically, evoked-potentials, acoustic startle paradigms, and psychophysical detection/discrimination paradigms can be created and implemented in a coordinated and systematic fashion across species. Through careful protocol design and collaboration, sensory processing phenotypes can be harnessed to bridge the gap that exists between preclinical animal studies and human testing, so that mutually held questions in autism research can be answered.</p>
<p>Funding information: BrainsCAN, Grant/Award Number: Accelerator grant; Canada Foundation for Innovation, Grant/Award Number: John R. Evans Leaders Fund; Canadian Institutes of Health Research, Grant/Award Number: Project scheme grant; Natural Sciences and Engineering Research Council of Canada, Grant/Award Number: Discovery grant; Simons Foundation Autism Research Initiative, Grant/Award Number: Explorer grant; Social Sciences and Humanities Research Council of Canada, Grant/Award Number: Insight grant</p>
https://ir.lib.uwo.ca/scsdpub/109
oai:ir.lib.uwo.ca:scsdpub-1111
2022-03-15T17:11:27Z
publication:faculties
publication:scsdpub
publication:scsd
Reliability of Speech-Language Pathologists' Categorizations of Preschoolers' Communication Impairments in Practice
Cunningham, Barbara J.
Oram Cardy, Janis
Article
2021-03-01T08:00:00Z
American Journal of Speech-Language Pathology
30
2
734
739
https://doi.org/10.1044/2020_AJSLP-20-00239
Communication Sciences and Disorders
<h3 id="x-d1e215">Purpose</h3>
<p>An efficient and reliable way to categorize children's communication impairments based on routine clinical assessments is needed to inform research and clinical decisions. This preliminary study assessed interrater reliability of speech-language pathologists' categorization of preschoolers' speech, language, and communication impairments using a clinical consensus document.</p>
<h3 id="x-d1e222">Method</h3>
<p>Six speech-language pathologists at three community sites worked in pairs to assess 38 children aged 1–5 years, then used the clinical consensus document to categorize children's communication impairments broadly. Identified language and speech sound impairments were further subcategorized.</p>
<h3 id="x-d1e229">Results</h3>
<p>Speech-language pathologists had substantial to almost perfect agreement for three broadly focused impairment categories. Agreement for whether language difficulties/disorders were developmental or associated with a biomedical condition was almost perfect, but moderate for whether difficulties impacted receptive or expressive language, or social communication skills. Agreement was fair for rule-based speech delays/disorders, but low for motor-based and mixed speech impairments.</p>
https://ir.lib.uwo.ca/scsdpub/111
oai:ir.lib.uwo.ca:scsdpub-1006
2021-02-10T16:37:02Z
publication:faculties
publication:scsdpub
publication:scsd
Using implementation science to engage stakeholders and improve outcome measurement in a preschool speech-language service system
Cunningham, Barbara Jane
Oram Cardy, Janis
Article
2020-01-02T08:00:00Z
Focus on the Outcomes of Communication Under Six (FOCUS)
implementation science
preschool
service systems
Speech-language pathology
stakeholder engagement
webinars
Speech, Language and Hearing
23
1
17
24
10.1080/2050571X.2019.1711307
Communication Sciences and Disorders
<p>© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group. Background: This tutorial presents one example of collaborative implementation research in a preschool speech-language service system–Ontario Canada's Preschool Speech and Language Program. Working collaboratively with stakeholders including policy makers, managers, and speech-language pathologists (SLPs), four webinar modules were developed to support implementation of the Focus on the Outcomes of Communication Under Six (FOCUS), a new participation-focused outcome measurement tool in pediatric speech-language pathology. The webinar modules were pilot tested at two community sites to determine whether they were effective at increasing SLPs’ knowledge, perceptions, and intentions for practice. The Knowledge-to-Action framework was used to inform all phases of this work. Methods: Forty-six SLPs completed an initial 15-item survey online, consecutively viewed the four webinar modules (67 minutes), and then completed a final 15-item survey online. Results: After viewing the webinar modules, SLPs reported significantly higher perceptions about the value of participation-based outcome measures and outcome monitoring; perceptions of reliability, validity and clinical utility of the FOCUS; intentions to use data from the FOCUS to support clinical discussions and decision making; and intentions to submit data as part of a provincial outcome monitoring program. Conclusions: Barriers to this type of implementation research included a variety of challenges related to methodology. Facilitators included research products that were highly relevant to the practice context, high rates of participation in our pilot study, and external validity for pilot study results. Collaborating with stakeholders is an important part of implementation work and is critical for ensuring research is relevant to and applicable in clinical practice.</p>
https://ir.lib.uwo.ca/scsdpub/6
oai:ir.lib.uwo.ca:scsdpub-1015
2021-02-09T23:30:08Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
31072157
A comment on test validation: The importance of the clinical perspective
Daub, Olivia
Skarakis-Doyle, Elizabeth
Bagatto, Marlene P.
Johnson, Andrew M.
Cardy, Janis Oram
Article
2019-02-01T08:00:00Z
American Journal of Speech-Language Pathology
28
1
10.1044/2018_AJSLP-18-0048
© 2019 American Speech-Language-Hearing Association. Purpose: The misuse of standardized assessments has been a long-standing concern in speech-language pathology and traditionally viewed as an issue of clinician competency and training. The purpose of this article is to consider the contribution of communication breakdowns between test developers and the end users to this issue. Method: We considered the misuse of standardized assessments through the lens of the 2-communities theory, in which standardized tests are viewed as a product developed in 1 community (researchers/test developers) to be used by another community (frontline clinicians). Under this view, optimal test development involves a conversation to which both parties bring unique expertise and perspectives. Results: Consideration of the interpretations that standardized tests are typically validated to support revealed a mismatch between these and the interpretations and decisions that speech-language pathologists typically need to make. Test development using classical test theory, which underpins many of the tests in our field, contributes to this mismatch. Application of item response theory could better equip clinicians with the psychometric evidence to support the interpretations they desire but is not commonly found in the standardized tests used by speech-language pathologists. Conclusions: Advocacy and insistence on the consideration of clinical perspectives and decision making in the test validation process is a necessary part of our role. In improving the nature of the statistical evidence reported in standardized assessments, we can ensure these tools are appropriate to fulfill our professional obligations in a clinically feasible way.
https://ir.lib.uwo.ca/scsdpub/15
oai:ir.lib.uwo.ca:scsdpub-1011
2022-09-01T14:25:30Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31525125
Validity evidence for the littlEARS early speech production questionnaire: An english-speaking, canadian sample
Daub, Olivia
Cardy, Janis Oram
Johnson, Andrew M.
Bagatto, Marlene P.
Article
2019-10-01T07:00:00Z
Journal of Speech, Language, and Hearing Research
62
10
3667
3678
10.1044/2019_JSLHR-L-18-0411
Communication Sciences and Disorders
<p>© 2019 American Speech-Language-Hearing Association. Purpose: This study reports validity evidence for an English translation of the LittlEARS Early Speech Production Questionnaire (LEESPQ). The LEESPQ was designed to support early spoken language outcome monitoring in young children who are deaf/hard of hearing. Methods: Data from 90 children with normal hearing, ages 0–18 months, are reported. Parents completed the LEESPQ in addition to a concurrent measure of spoken language development, the Receptive-Expressive Emergent Language Test–Third Edition. Normal hearing status and development were confirmed. Results: Traditional scale analyses, in addition to item parameters, are reported. The LEESPQ was highly correlated with the Receptive-Expressive Emergent Language Test–Third Edition (r = .92) and age (r = .90) and had high internal consistency (Ω = 0.92). Common factor analysis revealed 2 underlying factors conceptually mapping onto items measuring vocal and symbolic development. A latent traits model was the best fit to the data, and item difficulty broadly conformed to theoretical expectations. Conclusions: The present work demonstrates that the LEESPQ accurately captures early spoken language development in a typically developing group of young children. The LEESPQ holds promise as a clinically feasible, spoken language outcome monitoring tool. Future work to identify differences in performance characteristics between typically developing children and clinical populations is warranted.</p>
https://ir.lib.uwo.ca/scsdpub/11
oai:ir.lib.uwo.ca:scsdpub-1012
2021-03-19T19:50:43Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
31085404
Barriers to implementing evidence-based assessment procedures: Perspectives from the front lines in pediatric speech-language pathology
Cunningham, Barbara Jane
Daub, Olivia May
Oram Cardy, Janis
Article
2019-07-01T07:00:00Z
Children who are deaf or hard of hearing
Evidenced-based assessment
Implementation
Outcome monitoring
Practice-based research
Speech-language pathology
Journal of Communication Disorders
80
66
80
10.1016/j.jcomdis.2019.05.001
Communication Sciences and Disorders
<p>© 2019 Elsevier Inc. Purpose: This practice-based research study was a collaborative effort between researchers and speech-language pathologists (SLPs). The purpose of the study was to assess SLPs’ perceptions of barriers for two new evidence-based assessment procedures to be implemented in practice. Procedures were for (1) program-level outcome monitoring and (2) individual vulnerability testing for children who are deaf or hard of hearing. These procedures were summarized for clinicians in an online learning module. Method: After finishing the online learning module, SLPs completed electronic surveys to identify perceived barriers to implementation. Fifty-four SLPs completed an online survey specific to the program-level outcome monitoring procedures. Twenty-five also completed an online survey specific to individual vulnerability testing. Surveys were structured using the Ottawa Model of Research Use, which assesses barriers within three components: (1) the practice environment; (2) clinicians’ knowledge, skills, and beliefs; and (3) the evidence-based innovation (development and content of the online learning module). Results: Most items specific to program-level outcome monitoring were rated positively. Some barriers were identified within the practice environment and evidence-based innovation, but clinicians’ skills, knowledge, and beliefs were not barriers to implementation. For individual vulnerability testing, barriers were noted across all components of the Ottawa Model of Research Use. Conclusions: This work demonstrates the value of including front-line clinicians in the development of evidence-based assessment procedures. Through practice-based research, we identified SLPs’ perceived barriers to implementation, allowing for modifications to be made to the online learning module prior to wider-scale implementation. The barriers identified and methods used in our work may be useful to other researchers and programs involved in developing materials and methods for the implementation of evidence-based assessment procedures.</p>
https://ir.lib.uwo.ca/scsdpub/12
oai:ir.lib.uwo.ca:scsdpub-1020
2022-09-01T14:26:55Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
29086796
Language outcomes in children who are deaf and hard of hearing: The role of language ability before hearing aid intervention
Daub, Olivia
Bagatto, Marlene P.
Johnson, Andrew M.
Cardy, Janis Oram
Article
2017-11-01T07:00:00Z
Journal of Speech, Language, and Hearing Research
60
11
3310
3320
10.1044/2017_JSLHR-L-16-0222
Communication Sciences and Disorders
<p>© 2017 American Speech-Language-Hearing Association. Purpose: Early auditory experiences are fundamental in infant language acquisition. Research consistently demonstrates the benefits of early intervention (i.e., hearing aids) to language outcomes in children who are deaf and hard of hearing. The nature of these benefits and their relation with prefitting development are, however, not well understood. Method: This study examined Ontario Infant Hearing Program birth cohorts to explore predictors of performance on the Preschool Language Scale–Fourth Edition at the time of (N = 47) and after (N = 19) initial hearing aid intervention. Results: Regression analyses revealed that, before the hearing aid fitting, severity of hearing loss negatively predicted 19% and 10% of the variance in auditory comprehension and expressive communication, respectively. After hearing aid fitting, children’s standard scores on language measures remained stable, but they made significant improvement in their progress values, which represent individual skills acquired on the test, rather than standing relative to same-age peers. Magnitude of change in progress values was predicted by a negative interaction of prefitting language ability and severity of hearing loss for the Auditory Comprehension scale. Conclusions: These findings highlight the importance of considering a child’s prefitting language ability in interpreting eventual language outcomes. Possible mechanisms of hearing aid benefit are discussed.</p>
https://ir.lib.uwo.ca/scsdpub/20
oai:ir.lib.uwo.ca:scsdpub-1084
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
30957582
An evaluation of the Sennheiser HDA 280-CL circumaural headphone for use in audiometric testing
Folkeard, Paula
Hawkins, Marianne
Scollie, Susan
Sheikh, Bilal
Parsa, Vijay
Article
2019-07-03T07:00:00Z
Circumaural headphone
ETSPL
extended high frequencies
REAT
International Journal of Audiology
58
7
427
433
10.1080/14992027.2019.1594415
Objective: Evaluation of the Sennheiser HDA 280-CL circumaural headphone for the determination of (1) equivalent threshold sound pressure levels (ETSPL) for 125–18,000 Hz.; (2) real ear attenuation (250–8000 Hz); (3) insertion loss (63–18,000 Hz); (4) frequency response (125–18,000 Hz); (5) total harmonic distortion (THD) (125–10,000 Hz); and, (6) linearity (11,200–18,000 Hz).Study Sample: Twenty-five normal hearing adults aged 18–25 participated in (1) and (2).Design: (1) Hearing thresholds were measured using the Sennheiser HDA 280-CL. Frequency specific ETSPL values were calculated in an artificial ear. (2) Sound field thresholds were measured with the ears open and covered with the headphone to obtain the real ear attenuation thresholds (REAT). These values were used to determine the maximum permissible ambient noise levels (MPANL). (3) A B&K HATS mannequin recorded the output levels of a broadband pink noise with the ears open and covered with the headphones. (4, 5) The frequency response, THD and linearity were measured in an artificial ear.Results: Values for ETSPL, REAT, MPANL, insertion loss, as well as measures of frequency response, THD and linearity are presented.Conclusions: The Sennheiser HDA 280-CL meets the requirements for audiometric testing and the values presented can be used for calibration.
https://ir.lib.uwo.ca/scsdpub/84
oai:ir.lib.uwo.ca:scsdpub-1098
2022-09-01T14:23:41Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
34061568
Adopting a Conceptual Validity Framework for Testing in Speech-Language Pathology
Daub, Olivia
Cunningham, Barbara Jane
Bagatto, Marlene P
Johnson, Andrew M
Kwok, Elaine Y
Smyth, Rachael E
Cardy, Janis Oram
Article
2021-06-02T07:00:00Z
American journal of speech-language pathology
30
4
1894
1908
10.1044/2021_AJSLP-20-00032
Communication Sciences and Disorders
<p>Purpose Limited evidence-based guidelines for test selection continue to result in inconsistency in test use and interpretation in speech-language pathology. A major barrier is the lack of explicit and consistent adoption of a validity framework by our field. In this viewpoint, we argue that adopting the conceptual validity framework in the Standards for Educational and Psychological Testing (American Educational Research Association et al., 2014) would support both the development of more meaningful and feasible clinical tests and more appropriate use and interpretation of tests in speech-language pathology. Method We describe and evaluate the (American Educational Research Association et al., 2014) validity framework and consider its relevance to speech-language pathology. We describe how the validity framework could be integrated into clinical practice and include examples of how it could be applied to support common clinical decisions. We evaluate the costs and benefits of adopting this framework, from the perspectives of speech-language pathologists, clients, and test developers. Results The validity framework clarifies complex validity issues by shifting the focus of validity from tests to the decisions speech-language pathologists make based on test results. By focusing on decisions, the framework requires critical evaluation of test use, rather than evaluating tests against sets of criteria. Adopting this framework has the potential for appreciable improvement in the way tests are used and valued across our profession. Conclusions Speech-language pathologists, test developers, and clients will benefit from improved evidence-based assessment practices. It is recommended that regulators, test developers, professional associations, universities, and researchers adopt the framework and endorse it as best practice moving forward. This viewpoint proposes a series of first steps toward supporting uptake of the framework into research and practice.</p>
https://ir.lib.uwo.ca/scsdpub/98
oai:ir.lib.uwo.ca:scsdpub-1010
2021-03-20T19:36:57Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
31434024
Establishing consensus among community clinicians on how to categorize and define preschoolers’ speech and language impairments at assessment
Cunningham, Barbara Jane
Kwok, Elaine
Turkstra, Lyn
Oram Cardy, Janis
Article
2019-11-01T07:00:00Z
Delphi
Practice-based research
Preschoolers
Speech and language impairments
Terminology
Journal of Communication Disorders
82
10.1016/j.jcomdis.2019.105925
Communication Sciences and Disorders
<p>© 2019 Elsevier Inc. Purpose: To achieve consensus amongst speech-language pathologists (SLPs) on the categories and definitions of preschoolers’ communication impairments. Methods: In Phase 1, impairments were identified, categorized, and defined based on an evidence review. In Phase 2, a four-round Modified Delphi study was completed with SLPs (N = 38). SLPs reviewed three documents that categorized and defined preschoolers’: (1) broadly focused impairments, (2) language disorder sub-categories, and (3) speech sound disorder sub-categories; rated whether categories captured all preschoolers with communication impairments and definitions were clear (consensus = 90% agreement across all documents); and made suggestions for improvement. Documents were revised between rounds based on SLPs’ responses, literature review, and consultation with experts. Results: In Round 1, 90% agreement was reached only for the language disorder sub-categories document. In Round 2, no consensus was reached for the Speech Sound Disorder sub-categories document. In Round 3, consensus was reached for all three documents, but a fourth round was run to incorporate newly updated terminology. In Round 4, consensus was reached for updated terminology presented in the language disorders document. Conclusions: Clinical and research expertise are integrated throughout the final documents, resulting in consensus terminology for preschoolers’ communication impairments. Findings can support consistent terminology for preschoolers with communication impairments amongst SLPs. In research, documents will be used in a developing data collection tool that will undergo reliability testing prior to use in large scale studies related to children's communication. This study demonstrates the value of engaging in practice-based research.</p>
https://ir.lib.uwo.ca/scsdpub/10
oai:ir.lib.uwo.ca:scsdpub-1017
2021-05-05T00:19:47Z
publication:pmid
publication:faculties
publication:scsdpub
publication:scsd
30352251
Dynamics of spontaneous alpha activity correlate with language ability in young children
Kwok, Elaine Y.L.
Cardy, Janis Oram
Allman, Brian L.
Allen, Prudence
Herrmann, Björn
Article
2019-02-01T08:00:00Z
Detrended fluctuation analysis
EEG
Frequency flexibility
Neural oscillations
Resting-state
Self-organization criticality
Behavioural Brain Research
359
56
65
10.1016/j.bbr.2018.10.024
Communication Sciences and Disorders
<p>© 2018 Elsevier B.V. Early childhood is a period of tremendous growth in both language ability and brain maturation. To understand the dynamic interplay between neural activity and spoken language development, we used resting-state EEG recordings to explore the relation between alpha oscillations (7–10 Hz) and oral language ability in 4- to 6-year-old children with typical development (N = 41). Three properties of alpha oscillations were investigated: a) alpha power using spectral analysis, b) flexibility of the alpha frequency quantified via the oscillation's moment-to-moment fluctuations, and c) scaling behavior of the alpha oscillator investigated via the long-range temporal correlation in the alpha-amplitude time course. All three properties of the alpha oscillator correlated with children's oral language abilities. Higher language scores were correlated with lower alpha power, greater flexibility of the alpha frequency, and longer temporal correlations in the alpha-amplitude time course. Our findings demonstrate a cognitive role of several properties of the alpha oscillator that has largely been overlooked in the literature.</p>
https://ir.lib.uwo.ca/scsdpub/17
oai:ir.lib.uwo.ca:scsdpub-1007
2021-02-10T16:39:56Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
30897967
Effectiveness of a parent-implemented language intervention for late-to-talk children: a real-world retrospective clinical chart review
Kwok, Elaine Y.L.
Jane Cunningham, Barbara
Oram Cardy, Janis
Article
2020-01-02T08:00:00Z
functional communication
outcome
preschool
International Journal of Speech-Language Pathology
22
1
48
58
10.1080/17549507.2019.1584643
Communication Sciences and Disorders
<p>© 2019, © 2019 The Speech Pathology Association of Australia Limited Published by Taylor & Francis. Purpose: This study aimed to: (1) evaluate the effectiveness of Target WordTM–The Hanen Program® for Parents of Children Who are Late Talkers for improving the real-world communicative participation skills of children who are late-to-talk, and (2) explore predictors of change in children’s communicative participation skills. Method: We conducted a retrospective clinical chart review for 76 families who participated in the Target Word programme at a publicly-funded clinic. Families completed the Focus on the Outcomes of Communication Under Six (FOCUS) at pre-intervention, post-intervention, and after a 3-month consolidation period and scores were compared across the three assessment points. Regression analysis was then used to explore the relation between changes in children’s communicative participation skills and potential predictors of change identified by 25 Target Word certified speech-language pathologists. Result: At the end of intervention, 75% of children had made a clinically significant change in communicative participation skills. Clinicians proposed verbal imitation, language development stagnation and parent interaction style as the top predictors of change in communicative participation skills. Of these, only verbal imitation at pre-intervention predicted change in communicative participation following the intervention. Conclusion: The Target Word programme can facilitate the development of communicative participation skills in late-to-talk children. Modifications to the intervention may be needed in order to maximise outcomes for children with limited verbal imitation.</p>
https://ir.lib.uwo.ca/scsdpub/7
oai:ir.lib.uwo.ca:scsdpub-1013
2021-03-19T19:52:41Z
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
Exploring participation and impairment-based outcomes for Target Word™: A parent-implemented intervention for preschoolers identified as late-to-talk
Cunningham, Barbara Jane
Kwok, Elaine
Earle, Cindy
Oram Cardy, Janis
Article
2019-06-01T07:00:00Z
communicative participation
intervention
late talkers
outcomes
parent-implemented
Child Language Teaching and Therapy
35
2
145
164
10.1177/0265659019846931
Communication Sciences and Disorders
<p>© The Author(s) 2019. This study explored participation- and impairment-based outcomes for 24 late-to-talk toddlers (M age = 20.46 months, SD = 3.09, 62.5% male) whose parents participated in Target Word™, The Hanen Program® for Parents of Children who are Late Talkers in community clinics across Ontario. Parents completed the MacArthur–Bates Communicative Development Inventories (MBCDI), The Focus on the Outcomes of Communication Under Six (FOCUS-34), and a speech sound checklist: (1) prior to starting the program, (2) at the end of direct intervention, and (3) after a consolidation period. Speech-language pathologists classified children’s communicative function using the Communication Function Classification System (CFCS) at all assessment points and provided FOCUS scores from an initial assessment. No change was recorded in CFCS levels between initial assessment and start of the program, but many children moved to a more advanced level by the end of the program (n = 12) or consolidation period (n = 19). Significant changes in children’s communicative participation skills (FOCUS) were found between initial assessment and the start of the program, and during the 12-week direct intervention (75% made clinically meaningful change). Significant growth in expressive vocabulary and consonant inventory occurred during direct intervention. Correlations between change on impairment- and participation-based measures were not significant. The Target Word program appears to improve communicative function for late-to-talk preschoolers. Children also made gains in communicative participation skills, expressive vocabulary, and consonant inventory during the program, but further research is needed to determine the effectiveness of Target Word in these areas.</p>
https://ir.lib.uwo.ca/scsdpub/13
oai:ir.lib.uwo.ca:scsdpub-1082
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31274072
Skill transference of a probe-tube placement training simulator
Koch, Robert W.
Saleh, Hasan
Folkeard, Paula
Moodie, Sheila
Janeteas, Conner
Agrawal, Sumit K.
Ladak, Hanif M.
Scollie, Susan
Article
2020-01-01T08:00:00Z
Education
Hearing aids
Probe-tube placement
Real ear
Simulation
Skill transference
Training
Journal of the American Academy of Audiology
31
1
40
49
10.3766/jaaa.18054
Background: Probe-tube placement is a necessary step in hearing aid verification which needs ample hands-on experience and confidence before performing in clinic. To improve the methods of training in probe-tube placement, a manikin-based training simulator was developed consisting of a 3D-printed head, a flexible silicone ear, and a mounted optical tracking system. The system is designed to provide feedback to the user on the depth and orientation of the probe tube, and the time required to finish the task. Although a previous validation study was performed to determine its realism and teachability with experts, further validation is required before implementation into educational settings. Purpose: This study aimed to examine the skill transference of a newly updated probe-tube placement training simulator to determine if skills learned on this simulator successfully translate to clinical scenarios. Research Design: All participants underwent a pretest in which they were evaluated while performing a probe-tube placement and real-ear-to-coupler difference (RECD) measurement on a volunteer. Participants were randomized into one of two groups: the simulator group or the control group. During a two-week training period, all participants practiced their probe-tube placement according to their randomly assigned group. After two weeks, each participant completed a probe-tube placement on the same volunteer as a posttest scenario. Study Sample: Twenty-five novice graduate-level student clinicians. Data Collection and Analysis: Participants completed a self-efficacy questionnaire and an expert observer completed a questionnaire evaluating each participant’s performance during the pre- and posttest sessions. RECD measurements were taken after placing the probe tube and foam tip in the volunteer’s ear. Questionnaire results were analyzed through nonparametric t-tests and analysis of variance, whereas RECD results were analyzed using a nonlinear mixed model method. Results: Results suggested students in the simulator group were less likely to contact the tympanic membrane when placing a probe tube, appeared more confident, and had better use of the occluding foam tip, resulting in more improved RECD measurements. Conclusions: The improved outcomes for trainees in the simulator group suggest that supplementing traditional training with the simulator provides useful benefits for the trainees, thereby encouraging its usage and implementation in educational settings.
https://ir.lib.uwo.ca/scsdpub/82
oai:ir.lib.uwo.ca:scsdpub-1043
2021-08-13T17:41:13Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33515845
Comparison of machine learning models to classify Auditory Brainstem Responses recorded from children with Auditory Processing Disorder
Wimalarathna, Hasitha
Ankmnal-Veeranna, Sangamanatha
Allan, Chris
Agrawal, Sumit K.
Allen, Prudence
Samarabandu, Jagath
Ladak, Hanif M.
Article
2021-03-01T08:00:00Z
Auditory Brainstem Responses
Auditory Processing Disorder
Machine Learning
Signal feature extraction
Computer Methods and Programs in Biomedicine
200
None
10.1016/j.cmpb.2021.105942
Communication Sciences and Disorders
<p>Introduction: Auditory brainstem responses (ABRs) offer a unique opportunity to assess the neural integrity of the peripheral auditory nervous system in individuals presenting with listening difficulties. ABRs are typically recorded and analyzed by an audiologist who manually measures the timing and quality of the waveforms. The interpretation of ABRs requires considerable experience and training, and inappropriate interpretation can lead to incorrect judgments about the integrity of the system. Machine learning (ML) techniques may be a suitable approach to automate ABR interpretation and reduce human error. Objectives: The main objective of this paper was to identify a suitable ML technique to automate the analysis of ABR responses recorded as a part of the electrophysiological testing in the Auditory Processing Disorder clinical test battery. Methods: ABR responses recorded during routine clinical assessment from 136 children being evaluated for auditory processing difficulties were analyzed using several common ML algorithms: Support Vector Machines (SVM), Random Forests (RF), Decision Trees (DT), Gradient Boosting (GB), Extreme Gradient Boosting (Xgboost), and Neural Networks (NN). A variety of signal feature extraction techniques were used to extract features from the ABR waveforms as inputs to the ML algorithms. Statistical significance testing and confusion matrices were used to identify the most robust model capable of accurately identifying neurological abnormalities present in ABRs. Results: Clinically significant features in the time-frequency representation of the signal were identified. The ML model trained using the Xgboost algorithm was identified as the most robust model with an accuracy of 92% compared to other models. Conclusion: The findings of the present study demonstrate that it is possible to develop accurate ML models to automate the process of analyzing ABR waveforms recorded at suprathreshold levels. There is currently no ML-based application to screen children with listening difficulties. Therefore, it is expected that this work will be translated into an evaluation tool that can be used by audiologists in the clinic. Furthermore, this work may aid future researchers in exploring ML paradigms to improve clinical test batteries used by audiologists in achieving accurate diagnoses.</p>
https://ir.lib.uwo.ca/scsdpub/43
oai:ir.lib.uwo.ca:scsdpub-1085
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
30461412
Face and content validity of a probe tube placement training simulator
Koch, Robert W.
Moodie, Sheila
Folkeard, Paula
Scollie, Susan
Janeteas, Conner
Agrawal, Sumit K.
Ladak, Hanif M.
Article
2019-03-01T08:00:00Z
Content validity
Education
Face validity
Hearing AIDS
Probe tube placement
Real-ear
Simulation
Training
Journal of the American Academy of Audiology
30
3
227
234
10.3766/jaaa.17114
Background: Probe tube placement is an important skill audiologists must learn to make real-ear measurements in an audiology clinic. With current evidence-based guidelines recommending insertion of the probe tube within 5 mm of the tympanic membrane (TM) for proper acoustical measurements, students must be well trained to ensure they are capable to perform this placement in clinical practice. This is not always the case as it has been found that real-ear measurements are not performed in a clinic as often as required. To address this, a simulator consisting of a 3D-printed ear model and an optical tracking system was developed to provide a training system for students to practice probe tube placement and to provide a method to evaluate competency before starting clinical practicum placements. Two simulators were developed, an adult model and a pediatric model. Purpose: To assess the face and content validity of the two probe tube placement simulators (adult and pediatric) and define barriers and facilitators to implementing this system into an educational setting. Research Design: Participants followed the setup and operating instructions designed to guide them through each functionality of the simulator. A questionnaire was used to assess face and content validity, applicability to an educational setting, and to determine perceived barriers and facilitators to using the probe tube simulators for training purposes. Five additional probe tube placements with each simulator were performed in which distance-to-TM was recorded. Study Sample: Twelve participants with significant probe tube placement experience. Data Collection and Analysis: Participants rated each question in the questionnaire from 0% to 100% depending on their level of agreement. Averages and standard deviations (SDs) were compiled and presented for each section (face validity, content validity, and applicability to an educational setting). Final facilitators and barriers for the simulator were compiled and the top answers of each are presented. The five quantitative probe tube placement measurements for each participant were averaged, SDs were calculated, and contacts with the TM while placing the probe tube were recorded. Results: The average face validity score over all questions for the adultmodel was 65% (SD518.2)whereas the pediatricmodel received a score of 64%(16.4). The overall content validity average score was 78.7% (17) and applicability to an educational setting had an average score of 80% (5.33). The average distance-to-TM across all trials and participants was 3.74 mm (1.82) for the adult model and 2.77 mm (0.94) for the pediatric model with only one participant exceeding the recommended maximum of 5 mm. Listed shortcomings of the current simulator included realismof the 3D-printed ear, ease of insertion of an otoscope tip into the ear, ability to visualize the ear canal "landmarks" and the TM, and foam tip insertion experience. Conclusions: Results were generally very positive for the simulator, and future iterations will look to improve the flexibility and texture of the ear, as well as the otoscopic view of the ear canal and TM.
https://ir.lib.uwo.ca/scsdpub/85
oai:ir.lib.uwo.ca:scsdpub-1114
2023-03-02T15:37:16Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
36122495
Machine learning approaches used to analyze auditory evoked responses from the human auditory brainstem: A systematic review.
Wimalarathna, Hasitha
Ankmnal-Veeranna, Sangamanatha
Allan, Chris
Agrawal, Sumit K
Samarabandu, Jagath
Ladak, Hanif M
Allen, Prudence
Review
2022-11-01T07:00:00Z
Humans
Algorithms
Brain Stem
Databases
Factual
Evoked Potentials
Auditory
Brain Stem
Machine Learning
Computer methods and programs in biomedicine
226
107118
107118
Biomedical
Communication Sciences and Disorders
Signal Processing
<p>BACKGROUND: The application of machine learning algorithms for assessing the auditory brainstem response has gained interest over recent years with a considerable number of publications in the literature. In this systematic review, we explore how machine learning has been used to develop algorithms to assess auditory brainstem responses. A clear and comprehensive overview is provided to allow clinicians and researchers to explore the domain and the potential translation to clinical care.</p>
<p>METHODS: The systematic review was performed based on PRISMA guidelines. A search was conducted of PubMed, IEEE-Xplore, and Scopus databases focusing on human studies that have used machine learning to assess auditory brainstem responses. The duration of the search was from January 1, 1990, to April 3, 2021. The Covidence systematic review platform (www.covidence.org) was used throughout the process.</p>
<p>RESULTS: A total of 5812 studies were found through the database search and 451 duplicates were removed. The title and abstract screening process further reduced the article count to 89 and in the proceeding full-text screening, 34 articles met our full inclusion criteria.</p>
<p>CONCLUSION: Three categories of applications were found, namely neurologic diagnosis, hearing threshold estimation, and other (does not relate to neurologic or hearing threshold estimation). Neural networks and support vector machines were the most commonly used machine learning algorithms in all three categories. Only one study had conducted a clinical trial to evaluate the algorithm after development. Challenges remain in the amount of data required to train machine learning models. Suggestions for future research avenues are mentioned with recommended reporting methods for researchers.</p>
https://ir.lib.uwo.ca/scsdpub/115
oai:ir.lib.uwo.ca:scsdpub-1046
2021-08-17T20:06:03Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31195854
Spectral ripple discrimination in children with auditory processing disorder
Ankmnal Veeranna, Sangamanatha
Allan, Chris
Macpherson, Ewan
Allen, Prudence
Article
2019-11-02T07:00:00Z
auditory processing disorder
spectral processing
Spectral ripple discrimination
spectral shape
International Journal of Audiology
58
11
733
737
10.1080/14992027.2019.1627007
Communication Sciences and Disorders
<p>Objective: The purpose of this study was to examine developmental trends in spectral ripple discrimination (SRD) and to compare the performance of typically developing children to children with auditory processing disorder (APD). Study design: Cross-sectional study. Study sample: Fifteen children with APD, as well as 17 typically developing children and 14 adults reporting no listening or academic difficulties participated. Results: Typically developing children showed poor SRD thresholds compared to adults, indicating prolonged maturation of spectral shape recognition. Both typically developing children and APD children showed a maturational trend in SRD, but a General Linear Model fit to their thresholds showed that children with APD displayed SRD thresholds that were significantly poorer than those of typically developing children when controlling for age. This suggests that in APD children, SRD maturation lags behind typically developing children. Conclusion: Poor spectral ripple discrimination may explain some of the listening difficulties experienced by children with APD.</p>
https://ir.lib.uwo.ca/scsdpub/46
oai:ir.lib.uwo.ca:nca-1002
2021-11-26T19:04:32Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Protocol for Audiological Surveillance of Children at Risk for Permanent Hearing Loss
Bagatto, Marlene
P, Marie
Martin, Vanessa
Tanaka, Louise
Hyde, Martyn
Witte, Jill
Malandrino, April
Clinical Protocols
2019-07-17T07:00:00Z
<p>This document addresses procedures for the audiological surveillance of hearing of infants and young children at risk for late onset or progressive permanent hearing loss (PHL). It is closely linked with the Ontario Infant Hearing Program (IHP) Protocol for Universal Newborn Hearing Screening Auditory Brainstem Response Assessment (ABRA) Protocol, and the IHP protocol for Audiometric Assessment for Children Aged 6 to 60 Months with respect to risk indicators, hearing screening technology applied, screening bypass, and audiological assessment procedures. </p>
https://ir.lib.uwo.ca/nca/3
oai:ir.lib.uwo.ca:scsdpub-1060
2021-08-17T17:43:38Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Status of early hearing detection and intervention programs in Canada: Results from a country-wide survey
Bagatto, Marlene
Moodie, Sheila
Fitzpatrick, Elizabeth
Kealey, Chantal
Campbell, Bill
Aiken, Steve
Article
2020-01-01T08:00:00Z
EARLY HEARING DETECTION AND INTERVENTION
INFANT HEARING LOSS
LANGUAGE DEVELOPMENT
POPULATION HEALTH
UNIVERSAL NEWBORN HEARING SCREENING
Canadian Journal of Speech-Language Pathology and Audiology
44
3
107
124
Communication Sciences and Disorders
<p>In Canada, early hearing detection and intervention programs go beyond population screening of newborn hearing and offer services to confirm the presence or absence of hearing loss and provide services should permanent hearing loss be detected. Early hearing loss identification and intervention is critical to promote language, literacy, and social skills in developing children. However, a report card issued in 2014 from the Canadian Infant Hearing Task Force indicated that comprehensive early hearing detection and intervention programs were not uniformly available across Canada. The current work aimed to update the status of early hearing detection and intervention programs in Canada through a 24-item survey completed by 19 representatives in all 13 provinces and territories. Since 2014, there have been some improvements in early hearing detection and intervention programs in some areas of Canada. In others, comprehensive infant hearing services are not available province-or territory-wide or have not been provided with the necessary resources to sustain a suitable early hearing detection and intervention program. Results revealed that Canada is insufficient in offering comprehensive, accessible, and sustainable early hearing detection and intervention programs. Babies born in Canada deserve access to all components of an early hearing detection and intervention program, regardless of where they live. Continued action from Canada’s provincial and territorial governments in addition to federal policy leadership is needed to achieve sufficient and sustainable early hearing detection and intervention programs across the country.</p>
<p><a href="https://cjslpa.ca/files/2020_CJSLPA_Vol_44/No_3/CJSLPA_Vol_44_No_3_2020_MS_1198.pdf" target="_blank">https://cjslpa.ca/files/2020_CJSLPA_Vol_44/No_3/CJSLPA_Vol_44_No_3_2020_MS_1198.pdf</a></p>
https://ir.lib.uwo.ca/scsdpub/60
oai:ir.lib.uwo.ca:scsdpub-1005
2021-02-09T23:30:04Z
publication:pmid
publication:preciseresearchgroup
publication:faculties
publication:precisepreschoolpubs
publication:scsdpub
publication:scsd
publication:institutes
32375752
Selecting and tailoring implementation interventions: A concept mapping approach
Kwok, Elaine Yuen Ling
Moodie, Sheila T.F.
Cunningham, Barbara Jane
Oram Cardy, Janis E.
Article
2020-05-06T07:00:00Z
Concept mapping
Implementation intervention
Implementation planning
Outcome measurement
Population outcomes; health outcomes; stakeholder engagement
Practice-based research
Speech-language pathologist
BMC Health Services Research
20
1
10.1186/s12913-020-05270-x
© 2020 The Author(s). Background: To improve the uptake of research into practice, knowledge translation frameworks recommend tailoring implementation strategies to address practice barriers. This study reports our experience pairing the Theoretical Domains Framework with information from multiple stakeholder groups to co-develop practice-informed strategies for improving the implementation of an evidence-based outcome measurement tool across a large community health system for preschoolers with communication impairments. Methods: Concept mapping was used to identify strategies for improving implementation of the Focus on the Outcomes of Communication Under Six (FOCUS) in Ontario Canada's Preschool Speech and Language Program. This work was done in five stages. First, we interviewed 37 speech-language pathologists (clinicians) who identified 90 unique strategies to resolve practice barriers to FOCUS implementation. Second, clinicians (n = 34), policy-makers (n = 3), and members of the FOCUS research team (n = 6) sorted and rated the strategies by importance and feasibility. Third, stakeholders' sorting data were analyzed to generate a two-dimensional concept map. Based on the rating data from stakeholders, we prioritized a list of strategies that were rated as highly important and highly feasible, and summarized the practice barriers addressed by each of the prioritized strategies. Fourth, we validated these findings with stakeholders via an online survey. Fifth, the mechanisms of action of the prioritized list of strategies were considered based on available evidence from the Theoretical Domains Framework and associated behavior change literature. Results: Stakeholders categorized the 90 unique implementation strategies into a six-cluster concept map. Based on stakeholders' ratings, a list of 14 implementation strategies were prioritized. These implementation strategies were reported to resolve barriers within the environmental context and resources and beliefs about consequences domains of the Theoretical Domains Framework. All but one of the prioritized strategies have a demonstrated link in resolving existing barriers according to the behavioral change literature. Conclusions: Our study contributes to a growing literature that demonstrates the process of tailoring implementation strategies to specific barriers. Practical drawbacks and benefits of using concept mapping as a way to engage stakeholders in implementation research are discussed.
https://ir.lib.uwo.ca/scsdpub/5
oai:ir.lib.uwo.ca:scsdpub-1064
2021-10-26T15:06:22Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Relevance of the International Classification of Functioning, Health and Disability: Children & Youth Version in Early Hearing Detection and Intervention Programs
Bagatto, Marlene P.
Moodie, Sheila T.
Article
2016-08-01T07:00:00Z
childhood hearing loss
Early hearing detection and intervention program
family-centered early intervention
ICF-CY
Joint Committee on Infant Hearing
Seminars in Hearing
37
3
257
271
10.1055/s-0036-1584406
Communication Sciences and Disorders
<p>Early hearing detection and intervention (EHDI) programs have been guided by principles from the Joint Committee on Infant Hearing and an international consensus of best practice principles for family-centered early intervention. Both resources provide a solid foundation from which to design, implement, and sustain a high-quality, family-centered EHDI program. As a result, infants born with permanent hearing loss and their families will have the support they need to develop communication skills. These families also will benefit from programs that align with the framework offered by the World Health Organization's International Classification of Functioning, Disability and Health: Children & Youth Version (ICF-CY). Within this framework, health and functioning is defined and measured by describing the consequences of the health condition (i.e., hearing loss) in terms of body function, structures, activity, and participation as well as social aspects of the child. This article describes the relevance of the ICF-CY for EHDI programs and offers a modified approach by including aspects of quality of life and human development across time.</p>
https://ir.lib.uwo.ca/scsdpub/64
oai:ir.lib.uwo.ca:nca-1004
2021-11-26T19:52:17Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Protocol for the Provision of Amplification
Bagatto, Marlene
Scollie, Susan
Moodie, Sheila T.
Seewald, Richard
Hyde, Martyn
Glista, Danielle
Hawkins, Marianne
Easwar, Viji
Tharpe, Anne Marie
Crukley, Jeff
Levy, Charla
Zimmo, Sahar
Moodie, Shane
Richert, Frances
Parsa, Vijay
Clinical Protocols
2019-03-15T07:00:00Z
<p>This Protocol addresses the provision of amplification (hereafter: 'Amplification') to infants and pre-school children who are receiving services from the Ontario Infant Hearing Program (IHP). Providing amplification includes the process of prescribing a hearing aid based on appropriate assessment information, verification that the specified acoustical performance targets have been achieved, fitting the device on the child, and evaluation of device effectiveness in daily life.</p>
https://ir.lib.uwo.ca/nca/5
oai:ir.lib.uwo.ca:nca-1003
2021-11-26T19:54:23Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Protocol for Universal Newborn Hearing Screening in Ontario
Bagatto, Marlene
Boehm, Susan
El-Naji, Rana
Martin, Vanessa
Pigeon, Marie
Tanaka, Louise
Hyde, Martyn
Clinical Protocols
2019-07-15T07:00:00Z
<p>This document describes the Ontario Infant Hearing Program’s (IHP) protocol for universal newborn hearing screening (UNHS) of newborns and infants. It overrides all previous protocols on this subject provided by the IHP. The primary audience for this protocol is those who conduct newborn hearing screening within the IHP. All newborn and infant hearing screening funded by the Ontario Ministry of Children, Community and Social Services (MCCSS) must be carried out in full accordance with this protocol. It is based on continuous review of the best available scientific and clinical evidence and expert consultation complemented by consultation and collaboration with other major Early Hearing Detection and Intervention (EHDI) programs in Canada and worldwide.</p>
https://ir.lib.uwo.ca/nca/4
oai:ir.lib.uwo.ca:scsdpub-1062
2021-05-05T01:00:03Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31315672
Risk factors for hearing loss in children: A systematic literature review and meta-analysis protocol
Vos, Bénédicte
Noll, Dorie
Pigeon, Marie
Bagatto, Marlene
Fitzpatrick, Elizabeth M.
Article
2019-07-17T07:00:00Z
Acquired hearing loss
Children
Congenital hearing loss
Hearing loss
Late onset hearing loss
Newborn
Progressive hearing loss
Risk factor
Surveillance
Systematic Reviews
8
1
10.1186/s13643-019-1073-x
Background: Hearing loss in newborns and children is a public health concern, due to high prevalence and negative effects on their development. Early detection and intervention of childhood hearing loss may mitigate these negative effects. Population-based newborn hearing screening programs have been established worldwide to identify children at risk for congenital hearing loss and to follow children at risk for late onset or progressive hearing loss. This article presents the protocol for a systematic review that aims to review the risk factors associated with permanent hearing loss in children, including congenital, early, or late onset. Risk factors associated with progressive hearing loss will be investigated as a secondary aim. Methods: Scientific literature from the following databases will be investigated: MEDLINE, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Embase, and CINAHL. The primary outcome is a permanent bilateral or unilateral hearing loss with congenital onset or onset during childhood (birth to 18 years). The secondary outcome is progressive hearing loss. Studies must report data on risk factors associated with permanent hearing loss; risk factors may be present at birth or later and result in immediate or delayed hearing loss. Randomized controlled trials, quasi-experimental studies, nonrandomized comparative and non-comparative studies, and case series will be included. The risk of bias will be assessed using the Qualitative Assessment Tool for Quantitative Studies (McMaster University). If aggregation of data is possible for a subsection of studies, we will pool data using meta-analysis techniques. If aggregation of data is not possible, a qualitative synthesis will be presented. We will assess the quality and strength of the overall body of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Discussion: The resulting information will inform the update of a provincial audiological surveillance protocol for the Ontario Infant Hearing Program and will be applicable to early hearing detection and intervention (EHDI) programs worldwide. Systematic review registration: We have registered the protocol in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42018104121.
https://ir.lib.uwo.ca/scsdpub/62
oai:ir.lib.uwo.ca:nca-1005
2021-11-26T19:50:15Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Audiometric Assessment for Children aged 6 to 60 months
Scollie, Susan
Pigeon, Marie
Bagatto, Marlene
Witte, Jill
Malandrino, April
Clinical Protocols
2019-03-01T08:00:00Z
<p>This protocol addresses procedures for audiometric assessment of hearing thresholds in infants and young children using behavioural measures of threshold and associated measures in a test battery. The scope of this document includes these assessments as funded by MCCSS for the Ontario Infant Hearing Program (IHP).</p>
<p>In infants and young children, modified operant conditioning is used to obtain systematic behavioural responses to sound from older infants and young children. These conditioned responses are used as the basis of behavioural audiometry until the child is developmentally able to complete standard audiometry, at about 3 to 5 years of age in typically developing children (Sabo et al., 2003).</p>
<p>The evidence-based clinical protocol statements in this document are the responsibility of the Child Amplification Laboratory at the University of Western Ontario and detailed endorsement of any specific product or by any other person is not implied. The programmatic, process and outcome review, and contractual statements in this document are the responsibility of the Ontario Ministry of Children, Community and Social Services. We acknowledge the contributions of Martyn Hyde, Nina Picton, and Judy Widen to earlier versions of this protocol.</p>
https://ir.lib.uwo.ca/nca/6
oai:ir.lib.uwo.ca:scsdpub-1091
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26967364
Fitting noise management signal processing applying the American Academy of audiology pediatric amplification guideline: Verification protocols
Scollie, Susan
Levy, Charla
Pourmand, Nazanin
Abbasalipour, Parvaneh
Bagatto, Marlene
Richert, Frances
Moodie, Shane
Crukley, Jeff
Parsa, Vijay
Article
2016-03-01T08:00:00Z
Children
Guidelines
Hearing AIDS
Hearing loss
Noise
Protocols
Journal of the American Academy of Audiology
27
3
237
251
10.3766/jaaa.15060
Background: Although guidelines for fitting hearing AIDS for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying some technologies are not always available. One such technology is noise management in children's hearing AIDS. Children are frequently in highlevel and/or noisy environments, and many options for noise management exist in modern hearing AIDS. Verification protocols are needed to define specific test signals and levels for use in clinical practice. Purpose: This work aims to (1) describe the variation in different brands of noise reduction processors in hearing AIDS and the verification of these processors and (2) determine whether these differences are perceived by 13 children who have hearing loss. Finally, we aimed to develop a verification protocol for use in pediatric clinical practice. Study Sample: A set of hearing AIDS was tested using both clinically available test systems and a reference system, so that the impacts of noise reduction signal processing in hearing AIDS could be characterized for speech in a variety of background noises. A second set of hearing AIDS was tested across a range of audiograms and across two clinical verification systems to characterize the variance in clinical verification measurements. Finally, a set of hearing aid recordings that varied by type of noise reduction was rated for sound quality by children with hearing loss. Results: Significant variation across makes and models of hearing AIDS was observed in both the speed of noise reduction activation and the magnitude of noise reduction. Reference measures indicate that noise-only testing may overestimate noise reduction magnitude compared to speech-in-noise testing. Variation across clinical test signals was also observed, indicating that some test signals may be more successful than others for characterization of hearing aid noise reduction. Children provided different sound quality ratings across hearing AIDS, and for one hearing aid rated the sound quality as higher with the noise reduction system activated. Conclusions: Implications for clinical verification systems may be that greater standardization and the use of speech-in-noise test signals may improve the quality and consistency of noise reduction verification cross clinics. A suggested clinical protocol for verification of noise management in children's hearing AIDS is suggested.
https://ir.lib.uwo.ca/scsdpub/91
oai:ir.lib.uwo.ca:scsdpub-1075
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33296929
Fit-to-Targets and Aided Speech Intelligibility Index Values for Hearing Aids Fitted to the DSL v5-Adult Prescription
Dao, Andre
Folkeard, Paula
Baker, Sandra
Pumford, John
Scollie, Susan
Article
2021-02-01T08:00:00Z
adult
fit-to-target
hearing aid
hearing loss
RMSE
SII
verification
Journal of the American Academy of Audiology
32
2
90
98
10.1055/s-0040-1718707
Background Matching hearing aid output levels to prescribed targets is a component of preferred practice, yet recent normative data on appropriateness of fittings are lacking. Verification measures that assess closeness of fit-to-target include raw deviations from target, root-mean-squared-error (RMSE) deviations from target, and aided Speech Intelligibility Index (SII) values. Establishing normative ranges for these measures may help hearing professionals determine whether a patient's fit-to-targets and/or aided speech audibility is typical for his or her degree of hearing loss. Purpose This article aims to characterize the range of fit-to-target and the range of aided SII associated with hearing aid fittings using the Desired Sensation Level version 5.0 (DSL v5-adult) prescription with adults, considering also hearing aid style, venting, and audiometric characteristics. Research Design A descriptive and correlational study of data collected from a retrospective chart review. Results Hearing aid fittings to 281 ears were compiled. The four-frequency average deviation from target (RMSE) was within ± 5 dB of target in 77% of fittings for mid-level speech. Deviation from targets increased with hearing loss, particularly when the loss is greater than 85 dB hearing level or if the loss was steeply sloping. Venting increased the deviation from targets in the low frequencies. Aided SII values strongly correlated with the participants' hearing thresholds. Clinical ranges for RMSE and aided SII were developed for characterization of fitting outcomes. Conclusion Fitting to DSL v5-adult targets was observed within ± 5 dB absolute deviation, or within 5 dB RMSE, on average for typical adult hearing aid fittings. Confidence intervals for deviation from target and aided SII are proposed.
https://ir.lib.uwo.ca/scsdpub/75
oai:ir.lib.uwo.ca:scsdpub-1053
2021-10-26T15:22:14Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26827021
Localization-in-noise and binaural medial olivocochlear functioning in children and young adults
Boothalingam, Sriram
Macpherson, Ewan
Allan, Chris
Allen, Prudence
Purcell, David
Article
2016-01-01T08:00:00Z
Journal of the Acoustical Society of America
139
1
247
262
10.1121/1.4939708
Communication Sciences and Disorders
<p>Children as young as 5 yr old localize sounds as accurately as adults in quiet in the frontal hemifield. However, children's ability to localize in noise and in the front/back (F/B) dimension are scantily studied. To address this, the first part of this study investigated localization-in-noise ability of children vs young adults in two maskers: broadband noise (BBN) and speech-babble (SB) at three signal-to-noise ratios: -12, -6, and 0 dB. In the second part, relationship between binaural medial olivocochlear system (MOC) function and localization-in-noise was investigated. In both studies, 21 children and 21 young adults participated. Results indicate, while children are able to differentiate sounds arriving in the F/B dimension on par with adults in quiet and in BBN, larger differences were found for SB. Accuracy of children's localization in noise (for both maskers) in the lateral plane was also poorer than adults'. Significant differences in binaural MOC interaction (mBIC; the difference between the sum of two monaural- and binaural-MOC strength) between adults and children were also found. For reasons which are not clear, adult F/B localization in BBN correlates better with mBIC while children's F/B localization in SB correlated better with binaural MOC strength.</p>
https://ir.lib.uwo.ca/scsdpub/53
oai:ir.lib.uwo.ca:scsdpub-1088
2021-08-13T16:54:02Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31136317
Test-Retest Variability in the Characteristics of Envelope following Responses Evoked by Speech Stimuli
Easwar, Vijayalakshmi
Scollie, Susan
Aiken, Steven
Purcell, David
Article
2018-01-01T08:00:00Z
Amplitude
Auditory steady-state response
Coefficient of variation
Detection
Fourier analyzer
Fricatives
Phase coherence
Repeatability coefficient
Vowels
Ear and Hearing
41
1
150
164
10.1097/AUD.0000000000000739
Objectives: The objective of the present study was to evaluate the between-session test-retest variability in the characteristics of envelope following responses (EFRs) evoked by modified natural speech stimuli in young normal hearing adults. Design: EFRs from 22 adults were recorded in two sessions, 1 to 12 days apart. EFRs were evoked by the token /susa∫ i/ (2.05 sec) presented at 65 dB SPL and recorded from the vertex referenced to the neck. The token /susa∫ i/, spoken by a male with an average fundamental frequency [f0] of 98.53 Hz, was of interest because of its potential utility as an objective hearing aid outcome measure. Each vowel was modified to elicit two EFRs simultaneously by lowering the f0 in the first formant while maintaining the original f0 in the higher formants. Fricatives were amplitude-modulated at 93.02 Hz and elicited one EFR each. EFRs evoked by vowels and fricatives were estimated using Fourier analyzer and discrete Fourier transform, respectively. Detection of EFRs was determined by an F-test. Test-retest variability in EFR amplitude and phase coherence were quantified using correlation, repeated-measures analysis of variance, and the repeatability coefficient. The repeatability coefficient, computed as twice the standard deviation (SD) of test-retest differences, represents the ±95% limits of test-retest variation around the mean difference. Test-retest variability of EFR amplitude and phase coherence were compared using the coefficient of variation, a normalized metric, which represents the ratio of the SD of repeat measurements to its mean. Consistency in EFR detection outcomes was assessed using the test of proportions. Results: EFR amplitude and phase coherence did not vary significantly between sessions, and were significantly correlated across repeat measurements. The repeatability coefficient for EFR amplitude ranged from 38.5 nV to 45.6 nV for all stimuli, except for /∫/ (71.6 nV). For any given stimulus, the test-retest differences in EFR amplitude of individual participants were not correlated with their test-retest differences in noise amplitude. However, across stimuli, higher repeatability coefficients of EFR amplitude tended to occur when the group mean noise amplitude and the repeatability coefficient of noise amplitude were higher. The test-retest variability of phase coherence was comparable to that of EFR amplitude in terms of the coefficient of variation, and the repeatability coefficient varied from 0.1 to 0.2, with the highest value of 0.2 for /∫/. Mismatches in EFR detection outcomes occurred in 11 of 176 measurements. For each stimulus, the tests of proportions revealed a significantly higher proportion of matched detection outcomes compared to mismatches. Conclusions: Speech-evoked EFRs demonstrated reasonable repeatability across sessions. Of the eight stimuli, the shortest stimulus /∫/ demonstrated the largest variability in EFR amplitude and phase coherence. The test-retest variability in EFR amplitude could not be explained by test-retest differences in noise amplitude for any of the stimuli. This lack of explanation argues for other sources of variability, one possibility being the modulation of cortical contributions imposed on brainstem-generated EFRs.
https://ir.lib.uwo.ca/scsdpub/88
oai:ir.lib.uwo.ca:scsdpub-1022
2021-02-09T23:30:15Z
publication:pmid
publication:faculties
publication:scsdpub
publication:scsd
27325168
Testing the accuracy of timing reports in visual timing tasks with a consumer-grade digital camera
Smyth, Rachael E.
Oram Cardy, Janis
Purcell, David
Article
2017-06-01T07:00:00Z
Consumer grade hardware
Visual timing accuracy
Visual timing errors
Visual timing test
Behavior Research Methods
49
3
967
971
10.3758/s13428-016-0757-6
© 2016, Psychonomic Society, Inc. This study tested the accuracy of a visual timing task using a readily available and relatively inexpensive consumer grade digital camera. A visual inspection time task was recorded using short high-speed video clips and the timing as reported by the task’s program was compared to the timing as recorded in the video clips. Discrepancies in these two timing reports were investigated further and based on display refresh rate, a decision was made whether the discrepancy was large enough to affect the results as reported by the task. In this particular study, the errors in timing were not large enough to impact the results of the study. The procedure presented in this article offers an alternative method for performing a timing test, which uses readily available hardware and can be used to test the timing in any software program on any operating system and display.
https://ir.lib.uwo.ca/scsdpub/22
oai:ir.lib.uwo.ca:scsdpub-1110
2022-03-15T16:58:35Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
33769836
Compensation to Altered Auditory Feedback in Children With Developmental Language Disorder and Typical Development
Coughler, Caitlin
Hamel, Emily Michaela
Oram Cardy, Janis
Archibald, Lisa M.D.
Purcell, David W.
Article
2021-03-06T08:00:00Z
ASHAWire
64
6S
2363
2376
https://doi.org/10.1044/2020_JSLHR-20-00374
Communication Sciences and Disorders
<h3 id="x-d1e261">Purpose</h3>
<p>Developmental language disorder (DLD), an unexplained problem using and understanding spoken language, has been hypothesized to have an underlying auditory processing component. Auditory feedback plays a key role in speech motor control. The current study examined whether auditory feedback is used to regulate speech production in a similar way by children with DLD and their typically developing (TD) peers.</p>
<h3 id="x-d1e268">Method</h3>
<p>Participants aged 6–11 years completed tasks measuring hearing, language, first formant (F1) discrimination thresholds, partial vowel space, and responses to altered auditory feedback with F1 perturbation.</p>
<h3 id="x-d1e275">Results</h3>
<p>Children with DLD tended to compensate more than TD children for the positive F1 manipulation and compensated less than TD children in the negative shift condition.</p>
<h3 id="x-d1e282">Conclusion</h3>
<p>Our findings suggest that children with DLD make atypical use of auditory feedback.</p>
https://ir.lib.uwo.ca/scsdpub/110
oai:ir.lib.uwo.ca:scsdpub-1055
2021-10-26T16:42:27Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26317850
Cochlear delay and medial olivocochlear functioning in children with suspected auditory processing disorder
Boothalingam, Sriram
Allan, Chris
Allen, Prudence
Purcell, David
Article
2015-08-28T07:00:00Z
PLoS ONE
10
8
10.1371/journal.pone.0136906
Communication Sciences and Disorders
<p>Behavioral manifestations of processing deficits associated with auditory processing disorder (APD) have been well documented. However, little is known about their anatomical underpinnings, especially cochlear processing. Cochlear delays, a proxy for cochlear tuning, measured using stimulus frequency otoacoustic emission (SFOAE) group delay, and the influence of the medial olivocochlear (MOC) system activation at the auditory periphery was studied in 23 children suspected with APD (sAPD) and 22 typically developing (TD) children. Results suggest that children suspected with APD have longer SFOAE group delays (possibly due to sharper cochlear tuning) and reduced MOC function compared to TD children. Other differences between the groups include correlation between MOC function and SFOAE delay in quiet in the TD group, and lack thereof in the sAPD group. MOCmediated changes in SFOAE delay were in opposite directions between groups: increase in delay in TD vs. reduction in delay in the sAPD group. Longer SFOAE group delays in the sAPD group may lead to longer cochlear filter ringing, and potential increase in forward masking. These results indicate differences in cochlear and MOC function between sAPD and TD groups. Further studies are warranted to explore the possibility of cochlea as a potential site for processing deficits in APD.</p>
https://ir.lib.uwo.ca/scsdpub/55
oai:ir.lib.uwo.ca:scsdpub-1049
2021-10-25T18:37:29Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
31558110
The Medial Olivocochlear Reflex Is Unlikely to Play a Role in Listening Difficulties in Children
Boothalingam, Sriram
Allan, Chris
Allen, Prudence
Purcell, David W.
Article
2019-01-01T08:00:00Z
auditory processing disorder
listening difficulty
medial olivocochlear reflex
otoacoustic emissions
Trends in Hearing
23
None
10.1177/2331216519870942
Communication Sciences and Disorders
<p>The medial olivocochlear reflex (MOCR) has been implicated in several auditory processes. The putative role of the MOCR in improving speech perception in noise is particularly relevant for children who complain of listening difficulties (LiD). The hypothesis that the MOCR may be impaired in individuals with LiD or auditory processing disorder has led to several investigations but without consensus. In two related studies, we compared the MOCR functioning of children with LiD and typically developing (TD) children in the same age range (7–17 years). In Study 1, we investigated ipsilateral, contralateral, and bilateral MOCR using forward-masked click-evoked otoacoustic emissions (CEOAEs; n = 17 TD, 17 LiD). In Study 2, we employed three OAE types: CEOAEs (n = 16 TD, 21 LiD), stimulus frequency OAEs (n = 21 TD, 30 LiD), and distortion product OAEs (n = 17 TD, 22 LiD) in a contralateral noise paradigm. Results from both studies suggest that the MOCR functioning is not significantly different between the two groups. Some likely reasons for differences in findings among published studies could stem from the lack of strict data quality measures (e.g., high signal-to-noise ratio, control for the middle ear muscle reflex) that were enforced in the present study. The inherent variability of the MOCR, the subpar reliability of current MOCR methods, and the heterogeneity in auditory processing deficits that underlie auditory processing disorder make detecting clinically relevant differences in MOCR function impractical using current methods.</p>
https://ir.lib.uwo.ca/scsdpub/49
oai:ir.lib.uwo.ca:scsdpub-1047
2021-10-26T14:20:48Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
30870241
Auditory Localization and Spatial Release From Masking in Children With Suspected Auditory Processing Disorder
Boothalingam, Sriram
Purcell, David W.
Allan, Chris
Allen, Prudence
Macpherson, Ewan
Article
2019-09-01T07:00:00Z
Ear and hearing
40
5
1187
1196
10.1097/AUD.0000000000000703
Communication Sciences and Disorders
<p>OBJECTIVES: We sought to investigate whether children referred to our audiology clinic with a complaint of listening difficulty, that is, suspected of auditory processing disorder (APD), have difficulties localizing sounds in noise and whether they have reduced benefit from spatial release from masking. DESIGN: Forty-seven typically hearing children in the age range of 7 to 17 years took part in the study. Twenty-one typically developing (TD) children served as controls, and the other 26 children, referred to our audiology clinic with listening problems, were the study group: suspected APD (sAPD). The ability to localize a speech target (the word "baseball") was measured in quiet, broadband noise, and speech-babble in a hemi-anechoic chamber. Participants stood at the center of a loudspeaker array that delivered the target in a diffused noise-field created by presenting independent noise from four loudspeakers spaced 90° apart starting at 45°. In the noise conditions, the signal-to-noise ratio was varied between -12 and 0 dB in 6-dB steps by keeping the noise level constant at 66 dB SPL and varying the target level. Localization ability was indexed by two metrics, one assessing variability in lateral plane [lateral scatter (Lscat)] and the other accuracy in the front/back dimension [front/back percent correct (FBpc)]. Spatial release from masking (SRM) was measured using a modified version of the Hearing in Noise Test (HINT). In this HINT paradigm, speech targets were always presented from the loudspeaker at 0°, and a single noise source was presented either at 0°, 90°, or 270° at 65 dB A. The SRM was calculated as the difference between the 50% correct HINT speech reception threshold obtained when both speech and noise were collocated at 0° and when the noise was presented at either 90° or 270°. RESULTS: As expected, in both groups, localization in noise improved as a function of signal-to-noise ratio. Broadband noise caused significantly larger disruption in FBpc than in Lscat when compared with speech babble. There were, however, no group effects or group interactions, suggesting that the children in the sAPD group did not differ significantly from TD children in either localization metric (Lscat and FBpc). While a significant SRM was observed in both groups, there were no group effects or group interactions. Collectively, the data suggest that children in the sAPD group did not differ significantly from the TD group for either binaural measure investigated in the study. CONCLUSIONS: As is evident from a few poor performers, some children with listening difficulties may have difficulty in localizing sounds and may not benefit from spatial separation of speech and noise. However, the heterogeneity in APD and the variability in our data do not support the notion that localization is a global APD problem. Future studies that employ a case study design might provide more insights.</p>
https://ir.lib.uwo.ca/scsdpub/47
oai:ir.lib.uwo.ca:scsdpub-1103
2021-09-29T14:59:35Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
21873343
A critical review of audiological outcome measures for infants and children
Bagatto, Marlene P
Moodie, Sheila T
Seewald, Richard C
Bartlett, Doreen J
Scollie, Susan D
Article
2011-08-30T07:00:00Z
Trends in amplification
15
1
23
33
10.1177/1084713811412056
Communication Sciences and Disorders
<p>Outcome evaluation is an important stage in the pediatric hearing aid fitting process, however a systematic way of evaluating outcome in the pediatric audiology population is lacking. This is in part due to the need for an evidence-based outcome evaluation guideline for infants and children with hearing loss who wear hearing aids. As part of the development of a guideline, a critical review of the existing pediatric audiology outcome evaluation tools was conducted. Subjective outcome evaluation tools that measure auditory-related behaviors in children from birth to 6 years of age were critically appraised using a published grading system (Andresen, 2000). Of the tools that exist, 12 were appraised because they met initial criteria outlined by the Network of Pediatric Audiologists of Canada as being appropriate for children birth to 6 years of age who wear hearing aids. Tools that were considered for the guideline scored high in both statistical and feasibility criteria. The subjective outcome evaluation tools that were ultimately chosen to be included in the guideline were the LittlEARS Auditory Questionnaire (Tsiakpini et al., 2004) and the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Rating Scale (Ching & Hill, 2005b) due to the high grades they received in the critical review and their target age ranges. Following this critical review of pediatric outcome evaluation tools, the next step was for the Network Clinicians to evaluate the guideline (Moodie et al., 2011b).</p>
https://ir.lib.uwo.ca/scsdpub/103
oai:ir.lib.uwo.ca:scsdpub-1037
2021-10-26T18:33:04Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
22615475
Perceptual acclimatization post nonlinear frequency compression hearing aid fitting in older children
Glista, Danielle
Scollie, Susan
Sulkers, Jacob
Article
2012-12-01T08:00:00Z
Children
Hearing aids
Hearing device evaluation
Single-subject design
Journal of Speech, Language, and Hearing Research
55
6
1765
1787
10.1044/1092-4388(2012/11-0163)
Communication Sciences and Disorders
<p>Purpose: In this study, the authors evaluated the effect of frequency compression hearing aids on speech perception ability and the time course and magnitude of acclimatization-related changes. Method: Participants included children ages 11-18 years. Speech perception ability was evaluated over well-controlled baseline, treatment, and withdrawal study phases. Study-worn hearing aids were individually fitted to all participants. The authors evaluated speech perception ability using outcomes of speech detection (/s/ and /S/ sounds), /s-S/ discrimination, and plural and consonant recognition. Results: Indices of change were discussed on a case-by-case basis across all study phases. Significant treatment effects were measured for all cases, on at least one measure, with some listeners displaying significant acclimatization trends following a trial of frequency compression. Conclusion: Findings suggest that frequency compression provided varying outcomes, both in benefit and acclimatization, across listeners. For some, a period of acclimatization was necessary before change could be measured. For others, performance remained stable over the time course under evaluation, suggesting that some but not all children will experience improved speech recognition ability after a period of frequency compression hearing aid use. © American Speech-Language-Hearing Association.</p>
https://ir.lib.uwo.ca/scsdpub/37
oai:ir.lib.uwo.ca:scsdpub-1067
2021-10-26T16:40:38Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26967360
Pediatric audiology in North America: Current clinical practice and how it relates to the American Academy of Audiology pediatric amplification guideline
Moodie, Sheila
Rall, Eileen
Eiten, Leisha
Lindley, George
Gordey, Dave
Davidson, Lisa
Bagatto, Marlene
Scollie, Susan
Article
2016-03-01T08:00:00Z
Children
Guidelines
Hearing AIDS
Hearing loss
Protocols
Survey
Journal of the American Academy of Audiology
27
3
166
187
10.3766/jaaa.15064
Communication Sciences and Disorders
<p>Background: There is broad consensus that screening and diagnosis of permanent hearing loss in children must beembedded within a comprehensive, evidence-based, family-centered intervention program. Clinical practice guidelines (CPGs) for pediatric hearing assessment and hearing aid verification aim to reduce variability in practice and increase the use of effective evidence-based diagnostic and treatment options so that optimal outcomes may be achieved. To be of value, guidelines must be translated and implemented into practice and ongoing monitoring of their use in practice should occur. Purpose: This paper provides the results of two studies that aim to examine current pediatric audiology and amplification practice in North America. Research Design: A concurrent embedded mixed methods design was used. Study Sample: An electronic survey was distributed to North American audiologists who delivered pediatric audiology services with 350 audiologists participating in study 1 and 63 audiologists participating in study 2. Data Collection and Analysis: A quantitative approach was the predominant method of data collection. Respondents were prompted to provide additional qualitative text and detail regarding their quantitative response choice. This qualitative text was used during the analysis phase and combined with quantitative results to assist understanding of respondents' knowledge, skills, and barriers/facilitators to implement best practice in pediatric amplification. Results: Approximately 70% of audiologists reported using best-practice protocols for pediatric hearing aid fitting. Despite widespread knowledge and increased use of CPGs over the last 18 yrs, results of these studies show that variation in practice patterns continue to exist. Several examples of implementation challenges are discussed with recommendations provided. Conclusions: In order for audiologists working with children who are deaf or hard of hearing and their families to achieve the principles of family-centered early intervention, practice guidelines must continue to be developed, disseminated, and translated as they have a positive impact on the services provided. Researchers and clinical audiologists who deliver services must continue to collaborate to understand the "how" and "why" of implementing guidelines into practice and to identify the barriers/facilitators encountered in trying to do so.</p>
https://ir.lib.uwo.ca/scsdpub/67
oai:ir.lib.uwo.ca:scsdpub-1029
2021-03-19T18:36:45Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
An examination of clinical uptake factors for remote hearing aid support: a concept mapping study with audiologists
Glista, Danielle
O’Hagan, Robin
Moodie, Sheila
Scollie, Susan
Article
2020-01-01T08:00:00Z
Audiologists
clinical uptake
concept mapping
connected hearing healthcare
follow-up appointment
hearing aids
remote fitting
tele-audiology
International Journal of Audiology
10.1080/14992027.2020.1795281
Communication Sciences and Disorders
<p>© 2020 The Authors. Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of British Society of Audiology, International Society of Audiology, and Nordic Audiological Society. Objective: To develop a conceptual framework around the factors that influence audiologists in the clinical uptake of remote follow-up hearing aid support services. Design: A purposive sample of 42 audiologists, stratified according to client-focus of either paediatric or adult, were recruited from professional associations in Ontario, Canada, as members of the six-step, participatory-based concept mapping process. Analyses included multidimensional scaling and hierarchical cluster analysis. Results: Six main themes emerged from this research according to overall level of importance: (1) technology and infrastructure; (2) audiologist-centred considerations; (3) hearing healthcare regulations; (4) client-centred considerations; (5) clinical implementation considerations; and (6) financial considerations. Subthemes were identified at the group-level and by subgroup. These highlight the importance of TECH factors (accessible Technology, Easy to use, robust Connection, and Help available), as well as the multi-faceted nature of the perceived attitudes/aptitudes across stakeholders. Conclusion: Findings can be utilised in tailored planning and development efforts to support future research, knowledge dissemination, best-practice protocol/guideline development, and related training to assist in the clinical uptake of remote follow-up hearing aid support services, across variable practice contexts.</p>
<p>https://www.tandfonline.com/doi/full/10.1080/14992027.2020.1795281</p>
http://creativecommons.org/licenses/by-nc-nd/4.0/
https://ir.lib.uwo.ca/scsdpub/29
oai:ir.lib.uwo.ca:scsdpub-1034
2021-10-26T17:01:58Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
25514453
The ling 6(HL) test: Typical pediatric performance data and clinical use evaluation
Glista, Danielle
Scollie, Susan
Moodie, Sheila
Easwar, Vijayalakshmi
Article
2014-01-01T08:00:00Z
Aided thresholds
Children
Hearing aids
Ling 6(HL) test
Outcome measurement
Journal of the American Academy of Audiology
25
10
1008
1021
10.3766/jaaa.25.10.9
Communication Sciences and Disorders
<p>Background: The Ling 6(HL) test offers a calibrated version of naturally produced speech sounds in dB HL for evaluation of detection thresholds. Aided performance has been previously characterized in adults.Purpose: The purpose of this work was to evaluate and refine the Ling 6(HL) test for use in pediatric hearing aid outcome measurement.Research Design: This work is presented across two studies incorporating an integrated knowledge translation approach in the characterization of normative and typical performance, and in the evaluation of clinical feasibility, utility, acceptability, and implementation.Study Sample: A total of 57 children, 28 normally hearing and 29 with binaural sensorineural hearing loss, were included in Study 1. Children wore their own hearing aids fitted using Desired Sensation Level v5.0. Nine clinicians from The Network of Pediatric Audiologists participated in Study 2.Data Collection and Analysis: A CD-based test format was used in the collection of unaided and aided detection thresholds in laboratory and clinical settings; thresholds were measured clinically as part of routine clinical care. Confidence intervals were derived to characterize normal performance and typical aided performance according to hearing loss severity. Unaided-aided performance was analyzed using a repeated-measures analysis of variance. The audiologists completed an online questionnaire evaluating the quality, feasibility/executability, utility/comparative value/relative advantage, acceptability/applicability, and interpretability, in addition to recommendation and general comments sections.Results: Ling 6(HL) thresholds were reliably measured with children 3-18 yr old. Normative and typical performance ranges were translated into a scoring tool for use in pediatric outcome measurement. In general, questionnaire respondents generally agreed that the Ling 6(HL) test was a high-quality outcome evaluation tool that can be implemented successfully in clinical settings.Conclusions: By actively collaborating with pediatric audiologists and using an integrated knowledge translation framework, this work supported the creation of an evidence-based clinical tool that has the potential to be implemented in, and useful to, clinical practice. More research is needed to characterize performance in alternative listening conditions to facilitate use with infants, for example. Future efforts focused on monitoring the use of the Ling 6(HL) test in daily clinical practice may help describe whether clinical use has been maintained across time and if any additional adaptations are necessary to facilitate clinical uptake.</p>
https://ir.lib.uwo.ca/scsdpub/34
oai:ir.lib.uwo.ca:scsdpub-1036
2021-10-26T18:34:19Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
22846636
Stimuli and normative data for detection of Ling-6 sounds in hearing level
Scollie, Susan
Glista, Danielle
Tenhaaf, Julianne
Dunn, Andrea
Malandrino, April
Keene, Kelley
Folkeard, Paula
Article
2012-12-28T08:00:00Z
Adults
Amplification or hearing aids
Children
Efficacy
Outcomes
American Journal of Audiology
21
2
232
241
10.1044/1059-0889(2012/12-0020)
Communication Sciences and Disorders
<p>Purpose: The purpose of this work was to develop and evaluate a calibrated version of the Ling-6 sounds for evaluation of aided detection thresholds. Stimuli were recorded, and data from calibration values in dB HL were developed. Aided performance was characterized in adults and children. Method: Stimuli were recorded, prepared, and transferred to a CD for testing. Initial testing was completed on 29 normally hearing young adults to determine typical responses in dB SPL and reliability. Corrections to dB HL were determined for each stimulus. Twenty-seven adults and 5 children with hearing losses were tested. Results: Average normal sound field thresholds were 1 dB HL. Aided thresholds for adults varied with unaided hearing level and were better for low-frequency sounds. Adults and children performed differently, possibly because of greater hearing aid gain for children. Conclusions: Stimulus preparation and shaping resulted in a recorded, calibrated set of Ling-6 stimuli that provide flat normal thresholds in hearing level for normally hearing listeners. Typical performance ranges may vary with hearing level and prescription. More data are required to fully characterize this trend in the pediatric population. © American Speech-Language-Hearing Association.</p>
https://ir.lib.uwo.ca/scsdpub/36
oai:ir.lib.uwo.ca:scsdpub-1107
2021-10-28T18:30:05Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
12371658
Real-ear-to-coupler difference predictions as a function of age for two coupling procedures
Bagatto, Marlene P
Scollie, Susan D
Seewald, Richard C
Moodie, K Shane
Hoover, Brenda M
Article
2002-10-10T07:00:00Z
Journal of the American Academy of Audiology
13
8
407
15
10.1055/s-0040-1716004
Communication Sciences and Disorders
<p>The predicted real-ear-to-coupler difference (RECD) values currently used in pediatric hearing instrument prescription methods are based on 12-month age range categories and were derived from measures using standard acoustic immittance probe tips. Consequently, the purpose of this study was to develop normative RECD predicted values for foam/acoustic immittance tips and custom earmolds across the age continuum. To this end, RECD data were collected on 392 infants and children (141 with acoustic immittance tips, 251 with earmolds) to develop normative regression equations for use in deriving continuous age predictions of RECDs for foam/acoustic immittance tips and earmolds. Owing to the substantial between-subject variability observed in the data, the predictive equations of RECDs by age (in months) resulted in only gross estimates of RECD values (i.e., within +/- 4.4 dB for 95% of acoustic immittance tip measures; within +/- 5.4 dB in 95% of measures with custom earmolds) across frequency. Thus, it is concluded that the estimates derived from this study should not be used to replace the more precise individual RECD measurements. Relative to previously available normative RECD values for infants and young children, however, the estimates derived through this study provide somewhat more accurate predicted values for use under those circumstances for which individual RECD measurements cannot be made.</p>
https://ir.lib.uwo.ca/scsdpub/107
oai:ir.lib.uwo.ca:scsdpub-1044
2021-08-17T17:47:34Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
32069128
Audiological outcome measures with the BONEBRIDGE transcutaneous bone conduction hearing implant: impact of noise, reverberation and signal processing features
Curca, Ioan A.
Parsa, Vijay
Macpherson, Ewan A.
Scollie, Susan
Vansevenant, Katherine
Zimmerman, Kim
Lewis-Teeter, Jamie
Allen, Prudence
Parnes, Lorne
Agrawal, Sumit
Article
2020-07-02T07:00:00Z
APHAB
Bone-anchored hearing aid
BONEBRIDGE
directional microphone
noise reduction
reverberation
sound quality
speech intelligibility
International Journal of Audiology
59
7
556
565
10.1080/14992027.2020.1728400
Communication Sciences and Disorders
<p>Objective: To assess the performance of an active transcutaneous implantable-bone conduction device (TI-BCD), and to evaluate the benefit of device digital signal processing (DSP) features in challenging listening environments. Design: Participants were tested at 1- and 3-month post-activation of the TI-BCD. At each session, aided and unaided phoneme perception was assessed using the Ling-6 test. Speech reception thresholds (SRTs) and quality ratings of speech and music samples were collected in noisy and reverberant environments, with and without the DSP features. Self-assessment of the device performance was obtained using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Study sample: Six adults with conductive or mixed hearing loss. Results: Average SRTs were 2.9 and 12.3 dB in low and high reverberation environments, respectively, which improved to −1.7 and 8.7 dB, respectively with the DSP features. In addition, speech quality ratings improved by 23 points with the DSP features when averaged across all environmental conditions. Improvement scores on APHAB scales revealed a statistically significant aided benefit. Conclusions: Noise and reverberation significantly impacted speech recognition performance and perceived sound quality. DSP features (directional microphone processing and adaptive noise reduction) significantly enhanced subjects’ performance in these challenging listening environments.</p>
https://ir.lib.uwo.ca/scsdpub/44
oai:ir.lib.uwo.ca:scsdpub-1105
2021-10-28T18:26:20Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
17982367
Evaluation of the desired sensation level [input/output] algorithm for adults with hearing loss: the acceptable range for amplified conversational speech
Jenstad, Lorienne M
Bagatto, Marlene P
Seewald, Richard C
Scollie, Susan D
Cornelisse, Leonard E
Scicluna, Ron
Article
2007-11-06T08:00:00Z
Ear and hearing
28
6
793
811
10.1097/AUD.0b013e318157670a
Communication Sciences and Disorders
<p>OBJECTIVES: This study had two related purposes: first, to define the range of optimal ear canal levels of aided speech in both high frequency and low frequency regions for adults, using both subjective and objective definitions of optimal; and second, to determine whether a prescribed frequency response, such as that given by Desired Sensation Level [Input/Output], falls within the adult listener's optimal range. DESIGN: Twenty-three adult listeners with mild to moderately severe sensorineural hearing loss were selected from a pool of research volunteers. They were fitted in the laboratory with the Siemens Signia hearing instrument and tested with 20 nominally different frequency responses. All advanced processing options of the hearing instrument were disabled. Subjective ratings of loudness and quality and objective measures of consonant identification were obtained for every frequency response. RESULTS: These adult listeners had, on average, a 10 dB range of measured responses in both the low and the high frequencies that resulted in optimal performance on all the measurements. The range did not vary with degree or configuration of hearing loss, or previous hearing aid experience. Desired-Sensation-Level Input/Output targets were within the optimal range for the low frequencies, and 3 dB above the optimal range for the high frequencies. CONCLUSIONS: A range of aided ear canal frequency responses was determined within which adults with mild to moderately severe hearing loss performed optimally on both objective and subjective outcomes. Clinical implications of this finding include the following: prescriptive methods providing different targets may all result in optimal fittings; and a range of targets may be more appropriate than a single target when setting the frequency-gain characteristics of the hearing instrument.</p>
https://ir.lib.uwo.ca/scsdpub/105
oai:ir.lib.uwo.ca:nca-1000
2021-11-26T19:56:04Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
Protocol for Auditory Brainstem Response-Based Audiological Assessment (ABRA)
Bagatto, Marlene
Easwar, Viji
El-Naji, Rana
Hyde, Martyn
Malandrino, April
Martin, Vanessa
Pigeon, Marie
Purcell, David
Scollie, Susan
Witte, Jill
Clinical Protocols
2020-10-06T07:00:00Z
<p>This protocol document includes a tabular synopsis of all key protocol elements, followed by expanded sections that may include additional details, rationale, challenges,and solutions for each topic area,plus appendices with selected references and further technical or procedural specifications.There are numerous changes from the 2016 Infant Hearing Program Audiologic Assessment document; the most important areas of change or emphasis are indicated by shading of the topic section number.The following synopsis can stand alone as a summary of the current ABRA protocol including all changes from previous versions.Areas within the 2008 IHP Assessment Protocol that relate to the protocol for Visual Reinforcement Audiometry (VRA) and Conditioned Play Audiometry(CPA) are included in the Protocol for Audiometric Assessment for Children Aged 6 to 60 months.</p>
https://ir.lib.uwo.ca/nca/1
oai:ir.lib.uwo.ca:scsdpub-1033
2021-03-20T19:34:22Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26967363
Fitting frequency-lowering signal processing applying the American Academy of audiology pediatric amplification guideline: Updates and protocols
Scollie, Susan
Glista, Danielle
Seto, Julie
Dunn, Andrea
Schuett, Brittany
Hawkins, Marianne
Pourmand, Nazanin
Parsa, Vijay
Article
2016-03-01T08:00:00Z
Children
Digital signal processing
Frequency-lowering
Guidelines
Hearing AIDS
Hearing loss
Protocols
Speech acoustics
Journal of the American Academy of Audiology
27
3
219
236
10.3766/jaaa.15059
Communication Sciences and Disorders
<p>Background: Although guidelines for fitting hearing AIDS for children are well developed and have strong basis in evidence, specific protocols for fitting and verifying technologies can supplement such guidelines. One such technologyisfrequency-lowering signal processing. Children require accesstoabroad bandwidth of speech to detect and use all phonemes including female/s/. When access through conventional amplification is not possible, the use of frequency-lowering signal processing may be considered as a means to overcome limitations. Fitting and verification protocols are needed to better define candidacy determination and options for assessing and fine tuning frequency-lowering signal processing for individuals. Purpose: This work aims to (1) describe a set of calibrated phonemes that can be used to characterize the variation in different brands of frequency-lowering processors in hearing AIDS and the verification with these signals and (2) determine whether verification with these signal are predictive of perceptual changes associated with changes in the strength of frequency-lowering signal processing. Finally, we aimed to develop a fitting protocol for use in pediatric clinical practice. Study Sample: Study 1 used a sample of six hearing AIDS spanning four types of frequency lowering algorithms for an electroacoustic evaluation. Study 2 included 21 adults who had hearing loss (mean age 66 yr). Data Collection and Analysis: Simulated fricatives were designed to mimic the level and frequency shape of female fricatives extracted from two sources of speech. These signals were used to verify the frequency-lowering effects of four distinct types of frequency-lowering signal processors available in commercial hearing AIDS, and verification measures were compared to extracted fricatives made in a reference system. In a second study, the simulated fricatives were used within a probe microphone measurement system to verify a wide range of frequency compression settings in a commercial hearing aid, and 27 adult listeners were tested at each setting. The relation between the hearing aid verification measures and the listener's ability to detect and discriminate between fricatives was examined. Results: Verification measures made with the simulated fricatives agreed to within 4 dB, on average, and tended to mimic the frequency response shape of fricatives presented in a running speech context. Some processors showed a greater aided response level for fricatives in running speech than fricatives presented in isolation. Results with listeners indicated that verified settings that provided a positive sensation level of /s/ and that maximized the frequency difference between /s/ and /f/ tended to have the best performance. Conclusions: Frequency-lowering signal processors have measureable effects on the high-frequency fricative content of speech, particularly female/s/. It is possible to measure these effects either with a simple strategy that presents an isolated simulated fricative and measures the aided frequency response or withamore complex system that extracts fricatives from running speech. For some processors, a more accurate result may be achieved with a running speech system. In listeners, the aided frequency location and sensation level of fricatives may be helpful in predicting whether a specific hearing aid fitting, with or without frequency-lowering, will support access to the fricatives of speech.</p>
https://ir.lib.uwo.ca/scsdpub/33
oai:ir.lib.uwo.ca:scsdpub-1100
2021-10-26T18:47:55Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
22194316
The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP)
Bagatto, Marlene P
Moodie, Sheila T
Malandrino, April C
Richert, Frances M
Clench, Debbie A
Scollie, Susan D
Article
2011-12-24T08:00:00Z
Trends in amplification
15
1
57
76
10.1177/1084713811420304
Communication Sciences and Disorders
<p>This study proposed and evaluated a guideline for outcome evaluation for infants and children with hearing loss who wear hearing aids. The University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP) was developed following a critical review of pediatric outcome evaluation tools and was systematically examined by the Network of Pediatric Audiologists of Canada. It consists of tools to gather clinical process outcomes as well as functional caregiver reports. The UWO PedAMP was administered to a clinical population of infants and children with hearing aids. Sixty-eight children were administered the functional outcome evaluation tools (i.e., caregiver reports) a total of 133 times. Clinical process outcomes of hearing aid verification (e.g., real-ear-to-coupler difference) revealed typical aided audibility (e.g., Speech Intelligibility Index). Results for the LittlEARS(®) questionnaire revealed that typically developing children with hearing loss who wear hearing aids are meeting auditory development milestones. Children with mild to moderate comorbidities displayed typical auditory development during the 1st year of life after which development began to decline. Children with complex factors related to hearing aid use had lower scores on the LittlEARS, but auditory development was in parallel to norms. Parents' Evaluation of Aural/Oral Performance (PEACH) results indicated no age effect on scoring for children above 2 years of age; however, the effect of degree of hearing loss was significant. This work provides clinicians with a systematic, evidence-based outcome evaluation protocol to implement as part of a complete pediatric hearing aid fitting.</p>
https://ir.lib.uwo.ca/scsdpub/100
oai:ir.lib.uwo.ca:scsdpub-1102
2021-10-28T18:22:17Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
22194314
Knowledge translation in audiology: promoting the clinical application of best evidence
Moodie, Sheila T
Kothari, Anita
Bagatto, Marlene P
Seewald, Richard
Miller, Linda T
Scollie, Susan D
Article
2011-12-24T08:00:00Z
Trends in amplification
15
1
5
22
10.1177/1084713811420740
Communication Sciences and Disorders
<p>The impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitate the development and dissemination of evidence for clinical audiology practice. Finally, a project that uses the knowledge-to-action (KTA) framework for the development of outcome measures in pediatric audiology is introduced.</p>
https://ir.lib.uwo.ca/scsdpub/102
oai:ir.lib.uwo.ca:scsdpub-1066
2021-10-26T14:55:24Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
26967361
Prescribing and verifying hearing AIDS applying the American Academy of Audiology pediatric Amplification guideline: Protocols and outcomes from the Ontario Infant hearing program
Bagatto, Marlene
Moodie, Sheila
Brown, Christine
Malandrino, April
Richert, Frances
Clench, Debbie
Scollie, Susan
Article
2016-03-01T08:00:00Z
Childhood hearing loss
Clinical protocols
Early Hearing Detection and Intervention
Hearing aid fitting
Hearing AIDS
Patient outcomes
Journal of the American Academy of Audiology
27
3
188
203
10.3766/jaaa.15051
Communication Sciences and Disorders
<p>Background: Guidelines and protocols for pediatric hearing aid fitting are necessary to meet the goals of Early Hearing Detection and Intervention (EHDI) programs. The American Academy of Audiology published an update to their Pediatric Amplification Guideline in 2013. Ontario's Infant Hearing Program (IHP) offers specific protocols that aim to fulfill recommended guidelines. It has recently been updated to align with the American Academy of Audiology Guideline and other evidence. Purpose: A summary of the updates to the Ontario IHP's Amplification Protocol is described. In addition, data illustrating hearing-related outcomes of the program are offered. Research Design: The updated Ontario protocol is based on evidence, wherever possible. Where research is not yet available, clinical decision support has been described in a systematic way. Outcomes of the Ontario IHP were obtained through a longitudinal clinical observation study. Study Sample: One hundred and fifteen children with hearing loss, who wore hearing AIDS, were included in the outcome analyses (mean = 28.6 mo; range = 1.3-115.3 mo). Hearing losses ranged from mild to profound, unilateral or bilateral sensorineural (pure-tone average = 52.3 dB HL). They were recruited from four IHP clinics within Ontario. Children with complexities in addition to hearing loss were included. Intervention: The children were fitted with hearing AIDS following Ontario's Amplification Protocol. Data Collection and Analyses: During routine clinical appointments, IHP Audiologists administered questionnaires to the parents of their pediatric patients using a systematic outcome measurement protocol (University of Western Ontario Pediatric Audiological Monitoring Protocol). Hearing aid fitting details (e.g., speech intelligibility index) were also gathered to describe the quality of the hearing aid fittings in relation to the functional outcomes. Regression analyses were conducted to characterize scores on the questionnaires and the impact of important variables. Children with complexities were analyzed separately from those who were typically developing. Results: Important updates to Ontario's Amplification Protocol offer new details about candidacy considerations as well as technical updates. Outcomes from the IHP reveal protocol elements can be executed clinically and when they are, typically developing children who wear hearing AIDS are meeting auditory development and performance milestones. Conclusions: Updates to Ontario's Amplification Protocol are necessary to support the evolution of EHDI programs and the evidence which sustains them. With advances in technology and additional research, pediatric hearing aid fitting will continue to progress and support systematic measurement of outcomes for children who wear hearing AIDS. The application of state-of-the-art hearing aid fitting practices to the pediatric population within EHDI programs supports good outcomes for infants and children with hearing loss.</p>
https://ir.lib.uwo.ca/scsdpub/66
oai:ir.lib.uwo.ca:scsdpub-1104
2021-10-26T18:39:15Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
21492945
External validation of the LittlEARS® Auditory Questionnaire with English-speaking families of Canadian children with normal hearing
Bagatto, Marlene P
Brown, Christine L
Moodie, Sheila T
Scollie, Susan D
Article
2011-04-16T07:00:00Z
International journal of pediatric otorhinolaryngology
75
6
815
7
10.1016/j.ijporl.2011.03.014
Communication Sciences and Disorders
<p>OBJECTIVE: To examine the external validity of the United Kingdom English version of the LittlEARS(®) Auditory Questionnaire with English-speaking families of Canadian children with normal hearing. METHODS: The United Kingdom English version of the LittlEARS was administered to English-speaking families of 130 children with normal hearing in Ontario, Canada. Total scores for these children were compared to German-derived normative values. RESULTS: There was no significant difference between Canadian and German norms when using the United Kingdom English version of the LittlEARS Auditory Questionnaire. CONCLUSIONS: The United Kingdom English version of the LittlEARS Auditory Questionnaire is appropriate for use with English-speaking families of normal hearing Canadian children.</p>
https://ir.lib.uwo.ca/scsdpub/104
oai:ir.lib.uwo.ca:scsdpub-1101
2021-10-28T18:20:37Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
22194315
An integrated knowledge translation experience: use of the Network of Pediatric Audiologists of Canada to facilitate the development of the University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP v1.0)
Moodie, Sheila T
Bagatto, Marlene P
Miller, Linda T
Kothari, Anita
Seewald, Richard
Scollie, Susan D
Article
2011-12-24T08:00:00Z
Trends in amplification
15
1
34
56
10.1177/1084713811417634
Communication Sciences and Disorders
<p>Pediatric audiologists lack evidence-based, age-appropriate outcome evaluation tools with well-developed normative data that could be used to evaluate the auditory development and performance of children aged birth to 6 years with permanent childhood hearing impairment. Bagatto and colleagues recommend a battery of outcome tools that may be used with this population. This article provides results of an evaluation of the individual components of the University of Western Ontario Pediatric Audiological Monitoring Protocol (UWO PedAMP) version 1.0 by the audiologists associated with the Network of Pediatric Audiologists of Canada. It also provides information regarding barriers and facilitators to implementing outcome measures in clinical practice. Results indicate that when compared to the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Diary, audiologists found the PEACH Rating Scale to be a more clinically feasible evaluation tool to implement in practice from a time, task, and consistency of use perspective. Results also indicate that the LittlEARS(®) Auditory Questionnaire could be used to evaluate the auditory development and performance of children aged birth to 6 years with permanent childhood hearing impairment (PCHI). The most cited barrier to implementation is time. The result of this social collaboration was the creation of a knowledge product, the UWO PedAMP v1.0, which has the potential to be useful to audiologists and the children and families they serve.</p>
https://ir.lib.uwo.ca/scsdpub/101
oai:ir.lib.uwo.ca:scsdpub-1031
2021-03-19T18:34:06Z
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
The Use of Frequency Lowering Technology in the Treatment of Severe-to-Profound Hearing Loss: A Review of the Literature and Candidacy Considerations for Clinical Application
Glista, Danielle
Scollie, Susan
Article
2018-01-01T08:00:00Z
frequency lowering
hearing aids
high frequency
severe-to-profound hearing impairment
Seminars in Hearing
39
4
377
389
10.1055/s-0038-1670700
Communication Sciences and Disorders
<p>© 2018 Thieme Medical Publishers Inc. All rights reserved. This article provides a review of the current literature on the topic of frequency lowering hearing aid technology specific to the treatment of severe and profound levels of hearing impairment in child and adult listeners. Factors to consider when assessing listener candidacy for frequency lowering technology are discussed. These include factors related to audiometric assessment, the listener, the type of hearing aid technology, and the verification and validation procedures that can assist in determining candidacy for frequency lowering technology. An individualized candidacy assessment including the use of real-ear verification measures and carefully chosen validation tools are recommended for listeners requiring greater audibility of high-frequency sounds, when compared with amplification via conventional hearing aid technology.</p>
https://ir.lib.uwo.ca/scsdpub/31
oai:ir.lib.uwo.ca:scsdpub-1106
2021-09-28T22:24:03Z
publication:pmid
publication:faculties
publication:nca
publication:scsdpub
publication:scsd
publication:institutes
16999252
Evaluation of a probe-tube insertion technique for measuring the real-ear-to-coupler difference (RECD) in young infants
Bagatto, Marlene P
Seewald, Richard C
Scollie, Susan D
Tharpe, Anne Marie
Article
2006-09-27T07:00:00Z
Journal of the American Academy of Audiology
17
8
573
81
10.3766/jaaa.17.8.4
A common strategy for measuring the real-ear response of the real-ear-to-coupler difference (RECD) in the pediatric population is to insert a probe-tube separately from the eartip. This strategy is at times difficult to implement while attempting to obtain the measurement from a young infant. An RECD probe-tube insertion technique that involves connecting the probe-tube to an eartip with plastic film for simultaneous insertion was examined on 30 infants. Repeated measurements were completed on each infant to obtain within-session test-retest reliability data. Probe-tube insertion depth was also examined across participants to provide a guideline for the infant population. Findings indicate that reliable RECD values can be obtained in infants when the probe-tube is extended approximately two to four millimeters (mm) beyond the eartip or 11 mm from the entrance to the ear canal. Clinical implications of this work are discussed.
https://ir.lib.uwo.ca/scsdpub/106
970859/simple-dublin-core/100//