As the number of states passing legislation to ban smartphone use in schools increases, problems have arisen for students with hearing assistive technology that involves connectivity with an app that allows control of features such as volume level and/or program changes. Some states allow exceptions for medical reasons documented by a physician, but others allow no exceptions and may offer students bulkier options to use, such as tablets that may not be optimized for the hearing assistive technology. Research regarding the negative impact of allowing possession of smartphones during the school day is often countered with the need for students to have access to a communication device for emergencies and access to accommodations such as live captioning. Possible solutions are proposed, including links to manufacturer-compatible remote controls for hearing aids and cochlear implants. The options to allow the use of a smartphone for students who control their technology or access accommodation features may be included in the Individualized Educational Plan. Audiologists are encouraged to review the possible restrictions experienced by the adolescents they serve to allow sharing of appropriate solutions with the school districts and provision of information that may facilitate purchases of new equipment, such as remote controls.
Participation in extracurricular activities positively affects quality of life, including social satisfaction, but disabilities may influence the extent of involvement in adolescents. For example, a diagnosis such as Deaf or hard of hearing may coincide with communication deficits or accessibility challenges that could alter participation patterns. This study investigates the effect of auditory status on activity involvement in adolescents relative to the number and type of activities and the relationship between extracurricular engagement and quality of life. Participants included 113 adolescents (13-17 years) who either used a cochlear implant ( n = 68) or had typical hearing ( n = 45). Adolescents completed an online survey querying demographic characteristics (e.g., auditory history, self-rated communication skills, extracurricular activity involvement), temperament, and social satisfaction. Adolescents with typical hearing engaged in significantly more extracurricular activities than adolescents with cochlear implants, with significantly higher participation in performing arts, community service, and academic-based clubs than the cochlear implant group. Higher levels of activity engagement co-occur with social satisfaction. Clinicians should encourage participation in extracurricular activities to foster social interactions and positive quality of life in adolescents who are Deaf or hard of hearing.
Transition planning is essential to support all students, and especially those with challenges because of their disabilities. This review addresses the legal requirements and guidance for transition planning with a focus on the health care considerations for students who are deaf or hard of hearing as they move from supervised technology use and medical care to greater independence as adults. By recognizing that the necessary training starts in the preschool years with simple tasks such as notifying others when a hearing aid is not working, audiologists can take a lead role in developing a more comprehensive plan, including health care considerations. Useful assessments of self-advocacy skills are provided that can be used to guide service providers to develop annual goals for a comprehensive transition plan with emphasis on three main areas: Health/Medical Skills, Hearing Technology and Use Skills, and Educational Services/Communication Access. Multiple resources are cited to assist hearing health care professionals in ensuring the students have access to an appropriate transition plan.
Poor emotion recognition has been linked to social and emotional problems in everyday life. This may particularly affect teenagers navigating social scenes in adolescence, when peers become more important than family, and those with disabilities like hearing loss that may affect emotion recognition. This study investigates the effect of auditory status (deaf or hard of hearing using cochlear implant, CI, versus typical hearing, TH) on visual emotion recognition in adolescents, and its association with social relationships. Participants included 24 adolescents with TH ( M = 13.7 years) and 34 adolescent long-term CI users ( M = 13.3 years). Adolescents completed an emotion recognition task viewing video clips of faces morphing from a neutral expression to six facial expressions at 60, 80, or 100% emotion intensities via a gating task, and questionnaires about social relationships. Adolescents with TH significantly outperformed the CI group in the 80% emotion intensity condition ( p = 0.02), but not the other conditions ( p > 0.05). Better visual emotion recognition in CI users coincided with older age, better speech in noise ability, and more positive friendship quality. Significant performance differences with 80% emotion intensity suggest the CI group processes facial expressions qualitatively differently from TH peers, which has implications for therapeutic intervention for social skills in CI users.
Mobile devices have evolved from simple communication tools into powerful platforms for accessibility and inclusion. Based on personal experience as a late-deafened adult with extensive technical knowledge and lived experiences, the current mobile accessibility landscape for adolescents who are deaf or hard of hearing is reviewed. There is an emphasis on iOS and Android ecosystems, third-party apps, and emerging technologies. Practical applications for audiologists, educators, and rehabilitation professionals are discussed, alongside strategies to integrate mobile accessibility into clinical and educational practice, fostering independence, safety, and self-advocacy.
Adolescents who are Deaf or hard of hearing (DHH) face challenges beyond those typically encountered by teenagers. DHH teens have higher rates of social isolation and peer victimization compared with peers with typical hearing. Additionally, they need to develop self-advocacy skills to enhance accessibility across educational, employment, and social environments. Research studies often do not fully capture the full experience of adolescents who are DHH, or how living with hearing loss as a teenager has changed over time. This qualitative study explores the academic and social experiences during high school from the perspective of adults with hearing loss as they reflect on the past and current high school students as they reflect on their present situations. Participants included four adults ( M = 48.8 years) and nine adolescents ( M = 16.0 years) with congenital hearing loss, all of whom used hearing technology (i.e., hearing aid, cochlear implant) in high school. Participants responded in writing to prompts about challenges they encountered while in high school. Qualitative analysis was conducted to identify themes across essays. Peer interactions emerged as the most common struggle, regardless of generation, with self-advocacy relative to school technology and communication strategies as the second most common theme. Personal perspectives of having a hearing loss as an adolescent highlight the need for parents, clinical and educational professionals, and community programs to look beyond the medical and technology needs of those with hearing loss to understand the impact that a childhood diagnosis of DHH has on the whole person.
Social capital-the benefits, such as access to information, support, and resources, that flow from personal relationships and social networks-can play a significant role in the transition from school to postschool life and can be particularly helpful for young people who are Deaf or hard of hearing (DHH). This article provides an overview of a two-stage qualitative study that, in the first stage, retrospectively investigated the earlier social capital experiences of DHH university students and how these had assisted their transition from high school to postsecondary education. The second stage explored these students' views on ways in which professionals and parents can support adolescents' development and use of social capital that most benefits their postschool transition. Ten DHH university students whose primary communication mode was spoken language participated in semi-structured interviews. Thematic analysis of the study's findings specific to the role of audiologists generated four major themes: deaf connections, encouragement, specialized assistive technology, and holistic support. Clinical implications of these findings and recommendations for audiologists working with adolescents and young adults are outlined.
Objective:The purpose of the current study is to characterize hearing aid streaming in a group of adolescent hearing aid users. Background:Streaming via Bluetooth technology has been broadly adopted in devices such as hearing aids, for both children and adults; however, most research on the applications and benefits of streaming has only been conducted with adults who are deaf or hard of hearing (DHH). We have a limited knowledge base on how streaming impacts hearing aid use during adolescence or how adolescents who are DHH use streaming with their hearing aids. Conclusion:The results of this prospective research study indicate that adolescents with streaming used their hearing aids more often than peers without streaming, averaging over two additional hours of daily use. Streaming music and videos were the most common situations in which adolescents reported using connectivity, while tracking hearing aid use and using a phone app to troubleshoot hearing aid problems were the least common. While adolescents experienced some technical challenges with streaming, such as connectivity issues, reduced battery life, and compatibility with a limited number of devices, their overall perception of streaming through their hearing aids was extremely positive.
Implementation of over-the-counter (OTC) hearing aid sales can take many forms. The OTC Hearing Aid and Self-Care Symposium included one panel of speakers who addressed considerations for implementation from the perspectives of pharmacists, audiologists, and consumers. This article, written by the panel moderator, offers an overview of implementation options and issues addressed by the speakers and a pharmacist's perspective on the need for interprofessional collaboration.
Over-the-counter (OTC) hearing aids became available for purchase online, in retail stores, and in pharmacies in October 2022. As trusted sources of healthcare information, audiologists and pharmacists are likely among the first to field questions about these devices. Therefore, it is essential for them to understand their proper use, identify reliable devices, and know when to refer patients for further evaluation. Understanding the regulatory criteria for OTC hearing aids is especially important. These devices must meet specific conditions for sale, which ensure their safety and effectiveness for the public. Familiarity with these regulations will ensure that audiologists and pharmacists can help patients choose devices that meet established standards, avoiding misrepresented products. Given the visibility and accessibility of OTC hearing aids in pharmacies, pharmacists can offer initial guidance, answer questions, and help patients navigate the available options on their shelves. Audiologists, experts in hearing health, can assess a patient's hearing needs and determine whether an OTC hearing aid is a suitable option, guiding the patient's device selection. This article will summarize a presentation given to audiologists and pharmacists by Julie Cohen, AuD, PhD, an audiologist and scientific reviewer at the Food and Drug Administration (FDA), on the FDA's OTC Hearing Aid Regulations. Audience questions were answered by Dr. Cohen and by FDA lead scientific reviewer, Lindsay Devries, AuD, PhD.
Standardized outcome measures are essential for evidence-based pediatric audiology practice, yet Malaysia lacks unified national guidelines, risking inconsistent care quality and inequitable service delivery for children with hearing loss. This conceptual review presents a national perspective on pediatric audiology outcome measures, synthesizing findings from expert panel discussions, literature integration, and practice assessment through triangulation. Key insights were gathered through the Seventh Malaysian Audiology Scientific Conference forum, involving structured panels with government, private sector, and international representatives, plus insights from 180 forum participants. Current landscape analysis reveals public sector services follow established protocols with government investment in equipment upgrades, while private sector practices demonstrate significant variability. Critical gaps include sector variability, absence of unified standards, inadequate inter-facility comparison capabilities, and the need for tiered implementation approaches. Implementation challenges include fragmented service delivery, limited access to advanced tools outside specialized centers, workforce and infrastructure gaps, and private sector constraints. International examples, particularly the Welsh Primary Care Audiology Pathway, demonstrate successful integration models enhancing service consistency and equity. Strategic recommendations propose a three-phase framework: foundation (stakeholder coordination), development (culturally-adapted standards), and sustainability (monitoring and evaluation). A national task force comprising key stakeholders is recommended to lead standardization efforts, ensuring consistent, evidence-based care for children with hearing loss across Malaysia's diverse healthcare settings.
This editorial summarizes the 7th Malaysian Audiology Scientific Conference (MASCO) 2025, held in Penang, Malaysia, under the theme "Building Strong Foundations: The Evolution of Evidence-Based Practice in Audiology." The conference gathered 111 audiologists and 26 students, featuring six plenary sessions by international and local experts on translational practice, auditory processing disorder, tinnitus management, and pediatric hearing loss. Participants presented 14 oral papers, 15 three-minute pitches, and 23 e-posters showcasing innovative diagnostic tools and clinical applications. MASCO 2025 emphasized bridging research and practice through interdisciplinary collaboration and localized strategies to advance audiology service delivery in Malaysia.
The device-oriented subjective outcome (DOSO) was originally designed to evaluate hearing aid performance in terms of communication ease, satisfaction, and listening effort. It underwent review by a panel of eight experts from audiology and related disciplines. The Malay version of the DOSO scale was assessed for content validity, face validity, and reliability to confirm its cultural appropriateness and precision in evaluating hearing aid outcomes among Malaysian users. Fifteen items were revised to improve clarity based on the expert's feedback. Face validity testing was conducted with 33 experienced hearing aid users, and test-retest reliability was evaluated using seven participants. The content validity analysis revealed a high item-level Content Validity Index (CVI) ranging from 0.62 to 1.00, alongside a robust overall Scale-Level Content Validity Index/Average (S-CVI/Ave) of 0.90. Face validity scores (I-FVI: 0.67-1.00; S-FVI/Ave: 0.88) and a comprehension clarity score of 0.86 suggest that the tool was effectively understood. Cronbach's α values varied between 0.77 and 1.00, indicating good to excellent internal consistency. The validated Malay DOSO serves as a reliable tool for assessing hearing aid outcomes, thereby endorsing its use in both clinical and community contexts in Malaysia. Additional research involving a more diverse population is recommended to improve generalizability.
This preliminary study benchmarks audiovestibular practices among audiologists in Asia-Pacific (APAC) countries with established professional training programs, forming the first phase of a broader initiative covering 17 nations. A structured questionnaire was adapted and updated to include contemporary clinical domains such as vestibular rehabilitation, cochlear implant services, and tele-audiology. The tool underwent expert review and pilot testing, demonstrating strong psychometric properties (Cronbach's α, α = 0.91; KMO = 0.743; Bartlett's p < 0.001). Responses were obtained from 40 audiologists across India, Malaysia, Singapore, Nepal, and New Zealand. Most participants provided services across screening, diagnostic, therapeutic, and rehabilitative domains. Core procedures such as immittance testing, otoacoustic emissions, and auditory brainstem response were widely implemented, while vestibular and rehabilitative services showed increasing integration. Respondents represented diverse professional contexts, including universities, private hospitals, and government healthcare systems. Notably, there was strong professional consensus in support of regional standardization of guidelines, training, and governance mechanisms. These findings validate the adapted tool, establish a foundational dataset, and highlight readiness for regional collaboration. As the broader 17-country study advances, this work provides a baseline for benchmarking, policy development, and capacity building toward harmonized audiovestibular care across the APAC region.
Inner ear malformations (IEMs) represent unique challenges in cochlear implantation, potentially influencing electrode placement during surgery and neural responsiveness. Thus, electrically evoked cortical auditory potentials (eCAEPs) were suggested to be performed as objective measures of higher-level auditory perception at the cortical level in assessing cochlear implant (CI) outcomes in this complex population. This study aims to evaluate preliminary findings of P1 latency in eCAEPs among CI recipients with several types of IEMs at different positions of electrodes, that is, apical, medial, and basal regions. A cohort of five CI recipients with IEMs was evaluated using postoperative eCAEPs recordings, and P1 latency was analyzed at different positions of electrodes. The mean age of the subjects was 14.01 ± 5.51 years, with common cavity malformations, incomplete partition type I (IP-I), incomplete partition type II (IP-II), and enlarged vestibular aqueduct. Early data suggest P1 responses were generally present in all IEM cases in this cohort, with the mean of P1 latency for the electrode at apical, medial, and basal regions of 108.2 ± 13.4, 124.0 ± 23.6, and 140.0 ± 41.5 ms, respectively. These findings may reflect differential cortical response across IEM types at multiple CI electrode locations.
The study aimed to evaluate the level of awareness, knowledge, and current clinical practices related to auditory processing disorder (APD) among audiologists within Malaysia's Ministry of Health (MOH), and to identify barriers to effective diagnosis and management. A cross-sectional online survey was conducted among MOH audiologists using a questionnaire adapted from validated APD surveys. The survey assessed professional demographics, self-rated APD knowledge, training exposure, and clinical practices related to APD screening, diagnosis, and management. A total of 117 audiologists completed the survey, yielding a response rate of 57%. Most respondents rated their knowledge and skills in APD diagnosis and management as poor. Only 15% conducted APD screening, and fewer than 5% offered diagnostic services. Key barriers included a lack of formal training, insufficient assessment tools, the absence of clinical guidelines, and limited inter-professional collaboration. While audiologists acknowledged the importance of diagnosing APD, the findings suggest limited confidence and capacity in handling APD cases in clinical practice. These findings highlight significant gaps in APD-related competency among Malaysian audiologists, underscoring the need for structured training, standardized diagnostic protocols, and interdisciplinary engagement to enhance APD service provision across the public healthcare system.
