The latest medical research on Audiology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about audiology gathered by our medical AI research bot.

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Access to Speech and Language Services and Service Providers for Children With Speech and Language Disorders.

Speech Language Path

The purposes of this study were to (a) examine children's access to services for their speech and language disorders during their lifetimes; (b) identify any child, disorder, and family characteristics associated with access to services; and (c) describe the speech and language service providers among children who received care.

Data from the 2012 National Health Interview Survey were used for this retrospective cohort study. Our sample included 491 children (ages 3;0-17;11 [years;months]) with speech disorders and 333 children with language disorders. We measured the receipt of services for speech or language difficulties (main outcome) and the type of professional providing services (secondary outcome). We examined associations between services and child, disorder, and family characteristics.

Approximately 75% of children with speech and language disorders had ever received services for their difficulties. Privately insured children and children with co-occurring conditions were more likely to receive services than their peers who were uninsured (speech: 6.1 [1.7,21.3]; language: 6.6 [1.3,32.9]) and had no co-occurring conditions (speech: 2.1 [1.2,3.9]; language: 2.9 [1.5,5.5]). Speech-language pathologists (SLPs) were the most commonly reported provider of services (speech: 68%, language: 60%) followed by early interventionists.

Most children with speech and language disorders received services. However, disparities existed by race/ethnicity, health insurance type, co-occurring diagnoses, and disorder duration (speech only). Most children who received services were being provided with care by the experts of speech and language: SLPs. Updated population-based data and implementation studies are needed to document speech and language screening, referral, and access to services.

https://doi.org/10.23641/asha.19799389.

Allied Health Professionals' Views on the Use of Three-Dimensional Food Printing to Improve the Mealtime Quality of Life for People With Dysphagia: Impact, Cost, Practicality, and Potential.

Speech Language Path

Much is promised in relation to the use of three-dimensional (3D) food printing to create visually appealing texture-modified foods for people with dysphagia, but little is known of its feasibility. This study aimed to explore the perspective of allied health professionals on the feasibility of using 3D food printing to improve quality of life for people with dysphagia.

Fifteen allied health professionals engaged in one of four 2-hr online focus groups to discuss 3D food printing for people with dysphagia. They discussed the need to address the visual appeal of texture-modified foods and watched a video of 3D food printing to inform their discussions on its feasibility. Focus group data were transcribed verbatim, de-identified, and analyzed using thematic content analysis. Participants verified summaries of the researchers' interpretation of the themes in the data.

Participants suggested that 3D food printing could improve the mealtime experience for people with dysphagia but noted several barriers to its feasibility, including the time and effort involved in printing the food and in cleaning the printer. They were not convinced that 3D-printed food held higher visual appeal or looked enough like the "real food" it represented.

Allied health professionals considered that 3D food printing could benefit people with dysphagia by reducing the negative impacts of poorly presented texture-modified foods. However, they also considered that feasibility barriers could impede uptake and use of 3D food printers. Further research should consider the views of people with dysphagia and address barriers reported in this study.

The Interrelationship of Tinnitus and Hearing Loss Secondary to Age, Noise Exposure, and Traumatic Brain Injury.

Ear and Hearing

Tinnitus has been the No. 1 disability at the Veteran Administration for the last 15 years, yet its interaction with hearing loss secondary to etiologies such as age, noise trauma, and traumatic brain injuries remains poorly characterized. Our objective was to analyze hearing loss and tinnitus, including audiogram data, of the Million Veteran Program within the context of military exposures in an aging population.

Health records, questionnaires, audiograms, and military data were aggregated for 758,005 Veteran participants in the Million Veteran Program 2011 to 2020, with relative risks (RR) calculated for ancestries, sex, hearing loss and military exposures such as combat, blast, and military era served. A multivariate model with significant demographic measures and exposures was then analyzed. Next, audiogram data stratified by sex were compared for those with and without tinnitus by two methods: first, mean thresholds at standard frequencies were compared to thresholds adjusted per ISO 7029:2000E age and sex formulae. Second, levels for those ≤40 years of age were compared with those 41 and older. Finally, a proportional hazards model was examined to ascertain the timing between the onset of tinnitus and hearing loss, calculated separately for electronic health record diagnoses (ICD) and self-report.

Tinnitus was either self-reported, diagnosed, or both in 37.5% (95% CI, 37.4 to 37.6), mean age 61.5 (95% CI, 61.4 to 61.5), range 18 to 112 years. Those with hearing loss were 4.15 times (95% CI, 4.12 to 4.15) as likely to have tinnitus. Americans of African descent were less likely to manifest tinnitus (RR 0.61, 95% CI, 0.60 to 0.61), as were women (RR 0.65, 95% CI, 0.64 to 0.65). A multivariate model indicated a higher RR of 1.73 for traumatic brain injury (95% CI, 1.71 to 1.73) and daily combat noise exposure (1.17, 95% CI, 1.14 to 1.17) than age (0.998, 95% CI, 0.997 to 0.998). Subjects ≤40 years of age had small but significantly elevated hearing thresholds through all standard frequencies compared to Veterans without tinnitus, and the effect of tinnitus on hearing thresholds diminished with age. In the hazard model, those >40 with new onset of tinnitus were at risk for hearing loss sooner and with greater incidence than those who were younger. The rate of hearing loss following tinnitus approached 100%. In contrast, only approximately 50% of those who self-reported hearing loss initially were at risk for later hearing loss, in contrast to ICD comparison, where those with ICD of hearing loss were more likely to sustain an ICD of tinnitus subsequently.

Evidence suggests that the occurrence of tinnitus in the military is more closely related to environmental exposures than to aging. The finding that tinnitus affects hearing frequencies across the audiogram spectrum suggests an acoustic injury independent of tonotopicity. Particularly for males >40, tinnitus may be a harbinger of audiologic damage predictive of later hearing loss.

A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram.

Ear and Hearing

Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers.

A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss."

From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz (p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies (p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test (p ≥ 0.211) also exhibited no publication bias in the meta-analyses.

Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.

Analysis of Health Disparities in the Screening and Diagnosis of Hearing Loss: Early Hearing Detection and Intervention Hearing Screening Follow-Up Survey.

Am J Audiology

The purpose of this study was to (a) provide introductory literature regarding cultural constructs, health disparities, and social determinants of health (SDoH); (b) summarize the literature regarding the Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) Hearing Screening Follow-Up Survey (HSFS) data; (c) explore the CDC EHDI HSFS data regarding the contribution of maternal demographics to loss-to-follow-up/loss-to-documentation (LTF/D) between hearing screening and audiologic diagnosis for 2016, 2017, and 2018; and (d) examine these health disparities within the context of potential ethnoracial biases.

This is a comprehensive narrative literature review of cultural constructs, hearing health disparities, and SDoH as they relate to the CDC EHDI HSFS data. We explore the maternal demographic data reported on the CDC EHDI website and report disparities for maternal age, education, ethnicity, and race for 2016, 2017, and 2018. We focus on LTF/D for screening and diagnosis within the context of racial and cultural bias.

A literature review demonstrates the increase in quality of the CDC EHDI HSFS data over the past 2 decades. LTF/D rates for hearing screening and audiologic diagnostic testing have improved from higher than 60% to current rates of less than 30%. Comparisons of diagnostic completion rates reported on the CDC website for the EHDI HSFS 2016, 2017, and 2018 data show trends for maternal age, education, and race, but not for ethnicity. Trends were defined as changes more than 10% for variables averaged over a 3-year period (2016-2018).

Although there have been significant improvements in LTF/D over the past 2 decades, there continue to be opportunities for further improvement. Beyond neonatal screening, delays continue to be reported in the diagnosis of young children with hearing loss. Notwithstanding the extraordinarily diverse families within the United States, the imperative is to minimize such delays so that all children with hearing loss can, at the very least, have auditory accessibility to spoken language by 3 months of age. Conscious awareness is essential before developing a potentially effective plan of action that might remediate the problem.

Are items actively removed from working memory during free time in children with developmental language disorder?

Int J Lang

Children with developmental language disorder (DLD) have deficits in verbal and non-verbal processing relative to typically developing (TD) peers, potentially reflecting difficulties in working memory, processing speed and inhibition of interference. We examined working memory in children with DLD using the serial-order-in-a-box-complex span (SOB-CS) interference-based model, which posits a time-based mechanism, free time, that governs how interference affects processing performance.

(1) To determine the degree to which children with DLD and TD children differ in the amount of free time available during working memory tasks, and whether potential group differences in free time differ depending on the domain of task demands? (2) To determine the relationship between free time and interference effects on working memory accuracy in children with DLD relative to TD peers.

We examined the relationship between free time and working memory in children aged 9-13 years with DLD relative to age-matched TD peers. Working memory tasks involved five conditions that varied verbal versus non-verbal task demands in an interference processing phase relative to a recall test phase. Free time was the time between response on the interference processing task and onset of the recall test phase.

DLD and TD groups did not differ in total free time in any condition. Results indicated group differences in the relationship between free time and accuracy in the conditions involving verbal recall, but not non-verbal recall. In the verbal-only condition, relatively more free time was associated with worse accuracy for the DLD group, but with better accuracy for the TD group. In the condition with verbal recall paired with non-verbal interference processing, relatively more free time was associated with better accuracy for the DLD group, but not for the TD group.

What is already known on the subject DLD is characterized by core deficits in verbal processing, but also deficits in non-verbal processing. Processing-based hypotheses of DLD-limited verbal working memory, slowed processing speed and inefficient inhibition-do not fully account for behavioural profiles in DLD when considered separately, yet there is evidence suggesting interrelationships among these factors. What this paper adds to existing knowledge The current study tests the key mechanism posited by a theoretical framework that has the potential to integrate these processing-based hypotheses. Our findings indicate that the effect of this mechanism differed in DLD relative to TD peers in the presence of high verbal task demands. Our findings also demonstrate the importance of considering the interrelationships among cognitive processes in children with DLD. What are the potential or actual clinical implications of this work? In practice, results from the current study suggest that children with DLD may benefit from supplementing verbal information with non-verbal information and from pauses between successive presentations of verbal information. These strategies may support their ability to maintain and act on information during verbal processing.

Is sentence ambiguity comprehension affected after mild traumatic brain injury? Results suggest cognitive control is more important than diagnosis.

Int J Lang

Individuals with mild traumatic brain injury (mTBI) may experience chronic cognitive-linguistic impairments that are difficult to evaluate with existing measures. Garden path sentences are linguistically complex sentences that lead readers down a path to an incorrect interpretation. Previous research indicates many individuals, with or without mTBI, may have difficulty fully resolving the ambiguity of garden path sentences, a skill which may require cognitive control. Evidence suggests cognitive control can be impacted by mTBI. Thus, impairments in cognitive control are expected to correlate with interpreting ambiguous sentences.

To examine the relationship between cognitive control and the processing of ambiguous garden path sentences in adults with mTBI. We predict individuals with mTBI will perform more poorly on ambiguous sentence tasks compared with a control group. Further, we predict that performance on this task will correlate with measures of cognitive control and working memory.

A total of 20 adults with mTBI history and 44 adults with no significant neurological history were recruited from the community. Participants completed a computerized, ambiguous sentence measure with carefully designed comprehension questions and an abbreviated neuropsychological battery of cognitive-linguistic tasks.

Participants performed similarly on sentence ambiguity resolution measures across groups with a wide range in performance. A comprehension measure aimed at identifying full ambiguity resolution correlated with cognitive control across groups.

What is already known on the subject Cognitive control and ambiguous sentence processing are known to be linked, but the circumstances and individual variability associated with when cognitive control is recruited to support sentence processing are not fully understood. Very little is known about sentence processing following TBI history, despite cognitive control commonly being impaired following mild TBI. Thus, our study was necessary to explore the theoretical and clinical relationships between cognitive control and ambiguous sentence processing in individuals with mild TBI history. What this paper adds to existing knowledge This study adds to our understanding of how cognitive control and ambiguous sentence processing are linked in those with mild TBI history, and similar to the few previous studies, there were no group differences in cognitive or sentence measures. The positive correlation between cognitive control on Stroop and a particular ambiguous sentence comprehension question targeting inhibitory control highlights that any relationship between abilities or assessment tasks must be very specific to tasks with overlapping requirements, such as inhibition. What are the potential or actual clinical implications of this work? The relationship between cognitive and ambiguous sentence measures highlights the need to assess all areas of cognition and communication in those with mild TBI history without assuming that impairments in cognitive performance will relate to communication. The overlap between abilities is highly specific and must be explored on a case-by-case basis in those with mild TBI. Evaluation and treatment should still be individualized based on the functional communication profile of the client.

Trajectories of receptive and expressive vocabulary in Mandarin speaking children under 4 years of age fitted with cochlear implants: a 12-month longitudinal study.

International Journal of Epidemiology

To explore trajectories of receptive and expressive vocabulary in Mandarin-speaking children under the age of 4 years, fitted with cochlear implants (CIs).

Vocabulary trajectories were measured at baseline, 3, 6, and 12 months after implantation using the Chinese version of the MacArthur-Bates Communicative Development Inventory.

There were 216 children with CIs in West China Hospital who took part and were divided into three groups based on age at first CI.

Receptive and expressive vocabulary scores of the younger implantation group were significantly different from the older groups at baseline. After 12 months of implant use, there were no significant differences between all groups. Furthermore receptive vocabulary trajectories for all children with CIs were not significantly different from those of children with normal hearing. However, expressive vocabulary trajectories were poorer when compared to children with normal hearing. Significant differences were seen between receptive and expressive vocabulary in all age groups.

This study suggests no differences in vocabulary trajectories in Mandarin-speaking children whether they received their first CI at 1, 2, or 3 years of age. It is important that clinicians convey realistic expectations about potential differences in receptive vs. expressive trajectories for Mandarin-speaking children fitted with CIs.

MicroRNA Profiling in the Perilymph of Cochlear Implant Patients: Identifying Markers that Correlate to Audiological Outcomes.

Am Academy Audiology

 MicroRNA (miRNA) expression profiles from human perilymph correlate to post cochlear implantation (CI) hearing outcomes.

 The high inter-individual variability in speech perception among cochlear implant recipients is still poorly understood. MiRNA expression in perilymph can be used to characterize the molecular processes underlying inner ear disease and to predict performance with a cochlear implant.

 Perilymph collected during CI from 17 patients was analyzed using microarrays. MiRNAs were identified and multivariable analysis using consonant-nucleus-consonant testing at 6 and 18 months post implant activation was performed. Variables analyzed included age, gender, preoperative pure tone average (PTA), and preoperative speech discrimination (word recognition [WR]). Gene ontology analysis was performed to identify potential functional implications of changes in the identified miRNAs.

 Distinct miRNA profiles correlated to preoperative PTA and WR. Patients classified as poor performers showed downregulation of six miRNAs that potentially regulate pathways related to neuronal function and cell survival.

 Individual miRNA profiles can be identified in microvolumes of perilymph. Distinct non-coding RNA expression profiles correlate to preoperative hearing and postoperative cochlear implant outcomes.

From Bench to Booth: Examining Hair-Cell Regeneration Through an Audiologist's Scope.

Am Academy Audiology

Damage to auditory hair cells is a key feature of sensorineural hearing loss due to aging, noise exposure, or ototoxic drugs. Though hair-cell loss...

Approaches to Treat Sensorineural Hearing Loss by Hair-Cell Regeneration: The Current State of Therapeutic Developments and Their Potential Impact on Audiological Clinical Practice.

Am Academy Audiology

Sensorineural hearing loss (SNHL) is typically a permanent and often progressive condition that is commonly attributed to sensory cell loss. All ve...

Investigational Medicinal Products for the Inner Ear: Review of Clinical Trial Characteristics in ClinicalTrials.gov.

Am Academy Audiology

 The previous 30 years have provided information on the mechanisms of cell death in the inner ear after noise exposure, ototoxic drug injury, and during aging, and clinical trials have emerged for all of these acquired forms of hearing loss. Sudden hearing loss is less well understood, but restoration of hearing after sudden hearing loss is also a long-standing drug target, typically using steroids as an intervention but with other agents of interest as well.

 The purpose of this review was to describe the state of the science regarding clinical testing of investigational medicinal products for the inner ear with respect to treatment or prevention of acquired hearing loss.

 Comprehensive search and summary of clinical trials listed in the National Library of Medicine (www.

 Study phase, status, intervention, and primary, secondary, and other outcomes are summarized for studies assessing prevention of noise-induced hearing loss, prevention of drug-induced hearing loss, treatment of stable sensorineural hearing loss, and treatment of sudden sensorineural hearing loss.

 This review provides a comprehensive summary of the state of the science with respect to investigational medicinal products for the inner ear evaluated in human clinical trials, and the current challenges for the field.