Audiology Services Research Articles

Factors Affecting the Use of Speech Testing in Adult Audiology.

ObjectiveTo evaluate hearing healthcare professionals’ (HHPs) speech testing practices in routine adult audiology services, and better understand the facilitators and barriers to speech testing provision.DesignA cross-sectional questionnaire studyStudy SampleA sample (n=306) of HHPs from the public (64%) and private sector (36%), in the United Kingdom (UK), completed the surveyResultsIn the UK, speech testing practice varied significantly between health sectors. Speech testing was carried out during the audiology assessment by 73.4% of private sector HHPs and 20.4% of those from the public sector. During the hearing aid intervention stage speech testing was carried out by 56.5% and 26.5% of HHPs from the private and public sector, respectively. Recognised benefits of speech testing included: 1) providing patients with relatable assessment information, 2) guiding hearing aid fitting, 3) supporting a diagnostic test battery. A lack of clinical time was a key barrier to uptake.ConclusionUse of speech testing varies in adult audiology. Results from the present study found the percentage of UK HHPs making use of speech tests was low compared to other countries. HHPs recognised different benefits of speech testing in audiology practice but the barriers limiting uptake were often driven by factors derived from decision makers rather than clinical rationale. Privately funded HHPs used speech tests more frequently than those working in the public sector where time and resources are under greater pressure and governed by guidance that does not include a recommendation for speech testing. Therefore, the inclusion of speech testing in national clinical guidelines could increase the consistency of use and facilitate the comparison of practice trends across centres.

‘I had nothing. It’s just life experience that helped me through that situation’: Australian audiologists’ perspectives on audiological clinical practice for traumatic brain injury and rehabilitation

ABSTRACT Objective Australian Audiologists’ perspectives on standard non-specialized clinical practice in the context of Traumatic Brain Injury (TBI) were examined, including the perceived barriers to optimal service provision. Design A qualitative research design utilizing semi-structured interviews was conducted using purposive sampling. Nine participants were interviewed about their understanding of the impact of TBI on hearing and balance; identification, diagnosis and management of auditory and vestibular dysfunction following TBI; barriers to service delivery; training relating to complex clients (i.e., TBI); and awareness of referral pathways. Results Three major themes, each with subthemes, were evident in the data. The major themes reflected general considerations of audiological professional culture and specific issues related to knowledge of TBI and clinical practice with patients. Analysis revealed that professional culture seemed to act as a contextual barrier and interacted with the perceived lack of TBI related knowledge to hinder optimal clinical practice in this patient population. Conclusion Application of the biopsychosocial model, including interdisciplinary care in the management of patients with TBI, is needed. An improvement in theoretical and practical knowledge encompassing the wide-ranging effects of TBI is critical for the optimal audiological service delivery.

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Online Assessment of Speech Perception and Auditory Spectrotemporal Processing in Spanish-English Bilinguals.

There is limited access to audiology services for the growing population of Spanish-English bilinguals in the United States. Online auditory testing can potentially provide a cost-effective alternative to in-person visits. However, even for bilinguals with high English proficiency, age of English acquisition may affect speech perception accuracy. This study used a comprehensive test battery to assess speech perception and spectrotemporal processing abilities in Spanish-English bilinguals and to evaluate susceptibility of different tests to effects of native language. The online battery comprised three tests of speech in quiet (vowel and consonant identification and words in sentences), four tests of speech perception in noise (two for intelligibility and two for comprehension), and three tests of spectrotemporal processing (two tests of stochastically modulated pattern discrimination and one test of spectral resolution). Participants were 28 adult Spanish-English bilinguals whose English acquisition began either early (≤ 6 years old) or late (≥ 7 years old) and 18 English monolingual speakers. Significant differences were found in six of the 10 tests. The differences were most pronounced for vowel perception in quiet, speech-in-noise test, and two tests of speech comprehension in noise. Late bilinguals consistently scored lower than native English speakers or early bilinguals. In contrast, no differences between groups were observed for digits-in-noise or three tests of spectrotemporal processing abilities. The findings suggest initial feasibility of online assessment in this population and can inform selection of tests for auditory assessment of Spanish-English bilinguals.

Feasibility and Assessment of a Hybrid Audiology Service Delivery Model for Older Adult Hearing Aid Users: A Pilot Study.

The aim of this study was to provide insight for the feasibility and outcomes of hybrid (combination of in-person office and Internet-based appointments) audiology services. This pilot included two phases. First, we surveyed audiologists regarding what elements of a best-practice, in-person delivery of a hearing intervention could be delivered via Internet-based appointments. Next, we piloted the feasibility and assessed outcomes of the procedures identified. Ten first-time hearing aid users aged 70 years and older were fit with Phonak Audeo M90-312T hearing aids. Two Internet-based follow-up appointments were completed using the myPhonak app. We administered the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S), the Client Oriented Scale of Improvement (COSI), the Quick Speech-in-Noise Test (QuickSIN), and real-ear aided responses (REARs) to determine whether participants experienced improvements on hearing-related outcomes. The Telehealth Acceptance Questionnaire (TAQ) and the Visit-Specific Satisfaction Questionnaire (VSQ-9) were administered to gauge comfort with telehealth and satisfaction with Internet-based appointments. Survey results revealed that after an initial in-person appointment, nearly all follow-up hearing intervention components could be delivered remotely. We performed Wilcoxon signed-ranks tests to determine if the baseline and outcome results differed for outcomes. Baseline scores improved after 6 weeks (ps = .02 and. 005 for QuickSIN and HHIE-S) for speech-in-noise performance and self-perceived hearing difficulties. REARs from 500 to 4000 Hz measured after 6 weeks did not differ from baseline (ps = .612 and .398 for the right and left ears), suggesting no significant deviation from prescriptive targets because of remote fitting adjustments. All participants reported improvement in COSI goals after the intervention. TAQ results suggested that comfort with telehealth improved after attending Internet-based appointments (p = .005). VSQ-9 results revealed no differences in reported patient satisfaction between in-person and Internet-based appointments. We were able to develop a feasible hybrid audiology service delivery model for older adults. Our results enhance the evidence base for the implementation of telehealth audiology services.

A randomised controlled clinical trial to assess the benefits of a telecare tool delivered prior to the initial hearing assessment

Objective To assess the benefits of the Ida Institute’s Why improve my hearing? Telecare Tool used before the initial hearing assessment appointment. Design A prospective, single-blind randomised clinical trial with two arms: (i) Why improve my hearing? Telecare Tool intervention, and (ii) standard care control. Study sample Adults with hearing loss were recruited from two Audiology Services within the United Kingdom’s publicly-funded National Health Service. Of 461 individuals assessed for eligibility, 57 were eligible to participate. Results Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (primary outcome) scores did not differ between groups from baseline to post-assessment (Mean change [Δ]= −2.28; 95% confidence interval [CI]= −6.70, 2.15, p= .307) and 10-weeks follow-up (Mean Δ= −2.69; 95% CI= −9.52, 4.15, p = .434). However, Short Form Patient Activation Measure scores significantly improved in the intervention group compared to the control group from baseline to post-assessment (Mean Δ= −6.06, 95% CI= −11.31, −0.82, p = .024, ES= .61) and 10-weeks follow-up (Mean Δ= −9.87, 95% CI= −15.34, −4.40, p = .001, ES= −.97). Conclusions This study demonstrates that while a patient-centred telecare intervention completed before management decisions may not improve an individual’s self-efficacy to manage their hearing loss, it can lead to improvements in readiness.

Coupling Hearing Health With Community-Based Group Therapy for Cognitive Health in Low-Income African American Elders

Purpose: To address disparities in the domains of hearing health and cognitive health experienced by African American elders in early stages of cognitive-communicative decline, a cognitive stimulation therapy (CST) group was established. The group intervention was coupled with comprehensive audiology services. This clinical focus article describes the features of the program, its implementation, and outcomes from its first cohort of participants. Method: CST is an evidence-based group intervention for elderly individuals living with mild-to-moderate dementia. The program was designed to (a) adapt and then apply CST to a target group of low-income African American elders and (b) integrate audiology services and education about hearing health and hearing loss in the context of CST therapy. In partnership with two community health centers in North St. Louis, a CST group was established for 12 elderly African American clients with cognitive-communicative impairments as measured by standardized assessments. During weekly group sessions, culturally informed activities and discussions were conducted with input from staff and participants to stimulate social interaction and cognition. Health topics relevant to age-related sensory and cognitive decline were introduced, with emphasis on management of common chronic diseases such as diabetes that are known to be associated with increased risk of hearing loss. Free hearing health services were provided, including screenings and, as needed, full audiological evaluations, cerumen management, otolaryngology referrals, hearing aids, and aural rehabilitation. Results: Participants' self-administered ratings and self-generated comments indicated meaningful increases in actionable knowledge about both hearing and cognitive health that led to enhanced utilization of available health services. They also suggested that audiology services were paramount to their enthusiastic adherence to the combined CST–audiology program. Conclusion: Interlinking of interventions for hearing and cognition reduced common barriers to care for this target group of low-income African American elders with cognitive-communicative impairments.

801 EFFECTIVENESS OF HEARING REHABILITATION FOR CARE HOME RESIDENTS WITH DEMENTIA: A SYSTEMATIC REVIEW

Abstract Introduction Hearing loss is common among people with dementia living in long-term care homes, leading to poorer quality of life, communication difficulties and exacerbated dementia-related symptoms. Hearing rehabilitation may improve outcomes; however, evidence suggests hearing is poorly managed in care homes. Methods A systematic review reporting on the effectiveness of, and barriers and facilitators to, hearing rehabilitation for residents with dementia was conducted. No restrictions on publication date or language were set and grey literature was considered. Eligible studies were critically appraised and presented via a narrative review. Results Sixteen studies, most of low-to-moderate quality, were identified. Hearing rehabilitation, including hearing devices, communication techniques and visual aids (e.g. flashcards), were reported to improve residents’ communication, quality of life and reduce agitation, with improvements in staff knowledge of hearing loss and job satisfaction. Residents’ symptoms of dementia presented barriers, e.g. losing or not tolerating hearing aids. Low staff prioritization of hearing loss due to time-pressures and lack of hearing-related training for staff were further barriers, particularly for residents who required assistance with hearing devices. Adopting a person-centered approach based on residents’ capabilities and preferences and involving family members facilitated hearing device use. Conclusions Residents with dementia can benefit from hearing rehabilitation. Identifying and implementing efficient, individualized hearing rehabilitation is necessary for those with complex cognitive needs. Increased funding and support for the social care sector is required to address systemic issues that pose barriers to hearing rehabilitation, including time-pressures, lack of training for staff and access to audiology services for residents.

Effectiveness of Hearing Rehabilitation for Care Home Residents With Dementia: A Systematic Review

To report the effectiveness of, and barriers and facilitators to, hearing rehabilitation for care home residents with dementia. Systematic review. Care home residents with dementia and hearing loss. No restrictions on publication date or language were set and gray literature was considered. Eligible studies were critically appraised and presented via a narrative review. Sixteen studies, most of low to moderate quality, were identified. Hearing rehabilitation, including hearing devices, communication techniques, and visual aids (eg, flashcards), was reported to improve residents' communication and quality of life and reduce agitation, with improvements in staff knowledge of hearing loss and job satisfaction. Residents' symptoms of dementia presented barriers, for example, losing or not tolerating hearing aids. Low staff prioritization of hearing loss due to time pressures and lack of hearing-related training for staff were further barriers, particularly for residents who required assistance with hearing devices. Adopting a person-centered approach based on residents' capabilities and preferences and involving family members facilitated hearing device use. Residents with dementia can benefit from hearing rehabilitation. Identifying and implementing efficient, individualized hearing rehabilitation is necessary for those with complex cognitive needs. Increased funding and support for the social care sector is required to address systemic issues that pose barriers to hearing rehabilitation, including time pressures, lack of training for staff and access to audiology services for residents.

A qualitative study showing that a telecare tool can have benefits before and during the initial hearing assessment appointment

Objective To examine patient and audiologist experiences and perspectives of using a patient-centred telecare tool, the Ida Institute’s Why Improve My Hearing? (WIMH) Tool, before and during the initial hearing assessment appointment. Design A qualitative study comprising individual semi-structured interviews using a maximum variation sampling strategy. The data were analysed using an established thematic analysis technique. Study sample Fifteen participants, including ten patients (i.e. adults with hearing loss) and five audiologists, were recruited from Adult Audiology Services within the United Kingdom’s publicly-funded National Health Service (NHS). Results Three themes described the impact of using the WIMH Tool. Theme 1 (i.e. enhanced preparation before the appointment): the Tool helps patients to better understand and accept their hearing difficulties in advance of their first appointment. Theme 2 (i.e. enriched discussion during the appointment): the tool can enhance patient-centred communication, as well as the efficiency of the appointment. Theme 3 (i.e. varied impact on outcomes following the appointment): the Tool can improve patient motivation, readiness, and involvement in decision-making, though it may have limited impact on additional outcomes, such as adherence. Conclusion The WIMH Tool can be successfully implemented in audiological practice, resulting in benefits before and during the initial hearing assessment appointment.

Health Status of Minority Francophone Seniors in Manitoba and Access to Services in French: Potential for Social Isolation

Francophone seniors in Manitoba represent a growing and vulnerable population, with poorer health outcomes and limited access to health and social services in the official minority language. To avoid isolation, support services are required, as chronic diseases and reduced mobility have a direct impact on both physical and social needs. The purpose of this study is to examine the current health status of seniors in the Francophone minority population of Manitoba and their access to health and social services in French. Demographic, social and health profiles were obtained for Francophone and non-Francophone Home Care clients in Winnipeg. Although diagnosed with similar health conditions as non-Francophones, Francophone seniors are less likely to be assessed with reduced cognitive performance and conditions making mood and behaviour unstable, such as dementia other than Alzheimer’s. Gaps in bilingual health services were identified for pharmacy, audiology and occupational therapy services, meal and transportation systems as well as support services for informal caregivers. Housing options with in-house support services provided in French are available and additionally provide opportunities for seniors to socialize with other Francophones. For the elderly living in singlehome units and their caregivers, support services provided in the official minority language are needed.

Delivery of Speech-Language Therapy and Audiology Services Across the World at the Start of the COVID-19 Pandemic: A Survey

Purpose:Speech-language pathologists (SLPs) and audiologists from around the world were forced to enter the world of telepractice at the start of the COVID-19 pandemic. This study investigated which types of applications SLPs and audiologists used most frequently at that time. It also examined what the main obstacles then were to provide speech, language, and hearing services through telepractice.Method:A short electronic survey with 13 questions was distributed around the world. In total, 1,466 surveys from SLPs and audiologists from 40 countries were used for the analysis. Most of them (77.4%) delivered care through online real-time communication. A minority (40.1%) also delivered care through videos or exercises that they sent to their clients, 37.8% delivered through face-to-face intervention in the same room, 30.0% delivered through telephone without video, and 21.5% provided distant computer-based treatment.Results:The most frequently used applications were those that establish synchronous video communication with the client (60.5%). SLPs and audiologists reported using applications to create exercises more frequently than applications that contain exercises or training (15.0% vs. 12.0%). The most reported obstacle (31.2%) referred to technical problems (poor Internet connection, poor quality, or poor access to resources). Other frequently reported obstacles included the difficulty to perform assessment or treatment procedures (13.8%), concentration issues during sessions (12.4%), and lack of interaction between professional and client or patient (10.9%).Conclusions:Many SLPs and audiologists reported using telepractice technology, mainly in the form of real-time videoconferencing. However, existing barriers included technical problems such as poor Internet connection.

Defining Audiology through Occupational and Health Policy Action.

Many barriers to accessibility exist for Medicare beneficiaries seeking hearing and balance care such as availability of providers, coverage for services, and ability to pay. Other statutory and administrative barriers exist including the need for physician orders to have audiology services covered, the classification of audiologists as suppliers of "other diagnostic tests" under Medicare payer policy, and non-coverage of certain audiologic management and treatment services. Nearly two decades of legislative efforts have not resulted in any substantial changes to U.S. health policy, while the need for audiology services has increased due to a growing demographic of older adults. The Medicare Audiologist Access and Services Act (MAASA) has been introduced in the 116th and 117th Congress and proposes amendments to the Social Security Act that would address statutory barriers to accessing hearing and balance care among Medicare beneficiaries and would recognize audiologists for their scope of practice within the Medicare program. Objectives of the present review are to provide a summary of statutes in the Social Security Act and Standard Occupational Classification system which affect audiologists, audiology services, and Medicare beneficiaries and to discuss previous and current legislative health policy efforts to address these statutory barriers to hearing and balance care access.

Psychometric Evaluation of a Patient Experience Questionnaire (PEQ) for Outpatient Appointments: Analysis Using Data from a U.K. National Health Service Audiology Department.

The Audiology Department at the Royal Surrey NHS Foundation Trust (RSFT), United Kingdom, developed a patient experience questionnaire (PEQ) to assess and compare patients' experiences of attending a wide range of appointments (e.g., hearing assessment, hearing aid fitting, hearing aid review, tinnitus therapy, balance assessment, and balance rehabilitation). The aim of this study was to assess the psychometric properties of the PEQ. The PEQ is a unidimensional instrument with four items that assess a patient's experience of an outpatient appointment. Retrospective cross-sectional study. Patients attending appointments for audiology services at RSFT between January and March 2020. All patients (n = 656) attending appointments for audiology services at RSFT during randomly selected days between January and March 2020 were given the questionnaire to complete themselves (PEQ-self) or to complete on their child's behalf (PEQ-parent). The factor structures for the PEQ-self and PEQ-parent were assessed separately, using confirmatory factor analysis. A multiple-causes, multiple-indicators (MIMIC) model was fitted to explore potential bias due to gender and age. Internal consistency was assessed using Cronbach's α. The bivariate correlations between PEQ scores and other variables were evaluated using the nonparametric Spearman correlation coefficient. Floor and ceiling effects were assessed using the distribution of total scores. Confirmatory factor analysis revealed that a one-factor model gave a close fit to the data for both the self and parent versions. Cronbach's α for the total score was 0.77 for the PEQ-self and 0.86 for the PEQ-parent. The MIMIC model showed no significant direct effects of age or gender for either version. Both the PEQ-self and PEQ-parent questionnaire can be reliably used to measure patients' experiences of outpatient audiology appointments. Future studies should aim to assess the psychometric properties of the PEQ-self and PEQ-parent for a range of outpatient appointments other than audiology.

EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study.

BackgroundHearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology.AimThis study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project.MethodsWe applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training.Key FindingsOlder users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user.ConclusionOlder and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes.

The use of tele-audiology in ototoxicity monitoring: A scoping review

Introduction Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. Methods The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. Results and discussion While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

A script for the telepractice of speech-language therapy and audiology services - what was learnt from the COVID-19 pandemic

RESUMO Apresenta-se um roteiro de atuação em telessaúde para atendimento fonoaudiológico de pacientes adultos em domicílio que foi aplicado em um projeto comunitário durante a Pandemia da COVID-19. O roteiro foi desenvolvido em três etapas distintas. A partir de uma revisão de literatura para a identificação de facilitadores e barreiras para o atendimento de pacientes via telessaúde, foi feita a implementação de um serviço de telefonoaudiologia em uma Unidade Básica de Saúde, possibilitando a experiência para a discussão mediante a prática de facilitadores para a atuação clínica e maneiras de qualificar a teleconsulta fonoaudiológica. Por fim, deu-se a elaboração do roteiro, organizado em 20 itens, divididos em três seções. A sua elaboração incluiu, além da escrita, a discussão detalhada de cada item elencado, considerando a efetividade das ações propostas, qualificação das teleconsultas e integralidade do atendimento do paciente. O roteiro apresentado se propõe a ser suporte para a atuação em telefonoaudiologia. Entretanto, deve ser adaptado à realidade cultural e social dos profissionais e pacientes que a esta forma de atuação forem expostos. Visto que não se trata de um conjunto de práticas e procedimentos fechados em si, deverá ser atualizado conforme novos procedimentos e tecnologias estejam acessíveis para a atuação em telefonoaudiologia.

Audiologists' Perceptions of Hearing Healthcare Resources and Services in South Africa's Public Healthcare System.

Hearing loss poses a significant burden globally. Its prevalence is exceptionally high in countries across the African region, where healthcare resources and services remain inaccessible. This study aimed to describe audiologists' perceptions regarding hearing healthcare resources and services within South Africa's public healthcare system. A national self-developed telephonic survey was conducted with audiologists in public healthcare system hospitals across South Africa, with the final sample comprising 100 audiologists. Most (82%) audiologists indicated that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care for all hearing devices post-warranty expiration were limited. Efforts should be made to upsurge hearing healthcare resources, including increasing the financial budgets allocated to audiology resources so that increased diagnostic and screening audiology equipment and hearing devices can be procured where required, and additional audiologists can be employed within the South African public sector hospitals where needed.

Roteiro pré, durante e pós teleconsulta fonoaudiológica - o que aprendemos com a pandemia da COVID-19

ABSTRACT In this study, a script for the telepractice of speech language pathology and audiology services for adult patients at home, is presented. This tool was developed in three stages and used for a community project during the COVID-19 pandemic. A literature search was performed to identify the facilitators and barriers to remote patient care before implementing telepractice at a primary health care unit. This practical experience led to further discussions about the facilitators of clinical performance and different ways to remotely offer quality assessments and rehabilitation. Divided into three sections, the final script was organized into twenty items. To provide comprehensive patient care, detailed discussions were held about each item to verify the effectiveness and quality of the teleconsultations, for the script to be written. This guide is intended to be used as a tool for speech language pathology and audiology telepractice. However, it must be adapted to the cultural and social realities of the professionals and patients who use it. Additionally, it does not constitute a closed set of practices and procedures and should be updated as new procedures and technologies become available.

Impact of Auditory–Oral Education on Device Use in Children With Hearing Loss

This study examined changes in datalogging for children attending an auditory-oral educational program with integrated audiology services versus children attending a mainstream or nonspecialized program. Eighty children participated in this study, half of which were enrolled in an auditory-oral educational program versus the nonspecialized or mainstream setting. Datalogging for cochlear implant and hearing aid users was obtained via retrospective medical and educational chart review from 2016 to 2019. Results demonstrated that at post-enrollment, children attending the auditory-oral educational program significantly increased device wear time (as measured by average hours/day) when compared to the control group. Children using hearing aids enrolled in the specialized educational program obtained the largest improvement in overall wear time, averaging an increase of 5 hr/day of device use from pre- to post-enrollment. This is the first study to document the association of specialized educational programs on device use. Clinical and educational programs should collaborate to provide integrated services to lessen family burden and increase a child's device use and retention.