Purpose: This study examined the relationship between reported listening difficulties and behavioral auditory processing measures in children. Additionally, the role of reported listening difficulty was explored within pediatric auditory processing disorder diagnosis when a true biological gold standard is unavailable. Method: Diagnostic performance and reported listening difficulty were examined across three data sets: (a) 60 children aged 7–14 years referred to the Idaho State University Speech and Hearing Clinic for listening difficulties, (b) 51 children aged 8–9 years who participated in a separate factor analysis study, and (c) 717 children aged 7–14 years who participated in a national normative study. The sensitivity and specificity were calculated using behavioral tests as the index and parent/professional report as the gold standard. In addition, behavioral tests were then used as the gold standard and reported difficulty as the index. Target conditions of the diagnostic systems were speech-in-noise difficulty and more general listening difficulty. Results: Results did not produce both high sensitivity and specificity across measures and data sets. This was true whether the behavioral tests were the index or reported difficulty was the index. Conclusions: Reported difficulty and behavioral tests do not appear to show strong overlap when used in children. Despite this, evidence in the literature does support the utility of reported difficulty as an index test in the diagnostic process when combined with behavioral tests. Furthermore, when it is not possible to identify a good gold standard, it is possible to support diagnostic procedures when there is good standardization by demonstrating (a) good reliability, (b) good validity, (c) that treatment is possible, and (d) that treatment is beneficial.
Purpose: This study aimed to examine how loudspeaker configuration influences the evaluation of personally worn remote microphone (RM) systems under a single signal-to-noise ratio (SNR) condition. Method: This study included 10 school-aged children with hearing loss who used hearing devices and RM systems. Speech recognition was assessed using a Japanese monosyllabic word test at a nominal SNR of −5 dB. Three loudspeaker configurations were tested: unilateral noise at 45°, unilateral noise at 0°, and bilateral uncorrelated noise at ±45°. Each condition was evaluated under microphone only (MIC) and RM input modes. Speech recognition accuracy was analyzed using a generalized linear mixed-effects model, with input condition and loudspeaker configuration as fixed effects and participant and word items as random effects. Results: The use of RM significantly increased the probability of correct speech recognition across all loudspeaker configurations. RM performance was consistent across configurations, with no significant interaction between input condition and loudspeaker configuration. Conclusions: RM systems provided a relatively consistent benefit in speech recognition across different loudspeaker configurations. Meanwhile, speech recognition with MIC input was highly sensitive to noise arrangement. Therefore, the effectiveness of RM systems is best characterized by their ability to stabilize performance under adverse listening conditions rather than by condition-specific enhancement. A unilateral 45° noise configuration appears to provide a practical and feasible setup for clinical RM evaluation. Supplemental Material: https://doi.org/10.23641/asha.34113570
Purpose: As the population of cochlear implant (CI) candidates and recipients grows, there is a need for more audiologists to meet their clinical needs. Little information exists regarding the perception of recent doctorate of audiology (AuD) graduates and the training they received related to CI. Method: We surveyed audiologists who graduated from an accredited AuD program between 2017 and 2023 and asked them several questions about their level of satisfaction regarding their AuD studies. The survey included questions about current work setting, areas of rotation available, and instructor characteristics related to areas in the AuD. Results: Respondents demonstrated high levels of satisfaction with their AuD training overall; 93% reported they were “very” or “somewhat” satisfied. Sixty-three percent reported they were “completely” or “somewhat satisfied” with the training related to CI. Most dissatisfied respondents reported that this was due to limited opportunities for hands-on work with the CI population. Seventy-two percent indicated they were “very” or “somewhat satisfied” with their CI instructor, and many tended to report higher satisfaction when instructors were clinicians with practical experience. CI rotations with adults were more prevalent than pediatric CI placements, and both were rated as less available than pediatric and adult hearing aids and diagnostic testing. A significant number of recent graduates reported gaps in their learning of topics related to insurance, reimbursement, billing, and coding. Conclusions: The results of this study suggest that most recent graduates are satisfied with their AuD training. Areas for improvement that may result in larger numbers of graduates pursuing a career in CI include improved CI-focused clinical rotations and practical opportunities.
Purpose: This study examined audiometric threshold sensitivity and hearing health knowledge, attitudes, and behaviors (KAB) in Spanish-speaking English learner (EL) students and monolingual English-speaking peers across three central Illinois school districts. Method: Participants included 142 children aged 5–17 years (71 non-EL, 71 EL) from elementary, middle, and high schools. Pure-tone air-conduction thresholds were obtained at frequencies from 250 to 8000 Hz following American Speech-Language-Hearing Association–recommended procedures. Middle and high school students completed an adapted KAB survey; all participants completed an open-ended word association task. Linear mixed-effects models examined associations between EL status and thresholds across the frequency range and within the noise-induced hearing loss (NIHL) range. Multiple linear regression examined whether KAB scores predicted low-frequency thresholds after controlling for EL status and age. Results: EL students had significantly elevated thresholds relative to non-EL peers, with differences concentrated in the low frequencies (250–500 Hz) and diminishing across higher frequencies, converging by 6000–8000 Hz. Mean thresholds in both groups fell within clinically normal limits. EL status was not associated with thresholds in the NIHL range (3000–6000 Hz), and KAB scores did not predict thresholds. Conclusions: Spanish-speaking EL students showed systematic low-frequency threshold elevation not attributable to noise exposure or to self-reported hearing health factors. Although differences generally fell within clinically normal limits, even subclinical elevations have been associated with increased listening effort and poorer academic performance, which may be compounded for children simultaneously acquiring English. Findings highlight the need to examine the functional significance of low-frequency threshold differences in linguistically diverse pediatric populations.
