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  1. Audiologic Intervention for Adults with Hearing Loss and Compromised Cognitive/Psychoacoustic Auditory Processing CapabilitiesBethany Ringrose B.A., Sangeetha Gopalakrishn Dr. Kathleen Hutchinson, Ph.D., Dr. Laura Kelly, Ph.D.Department of Speech Pathology and Audiology Miami University, Oxford, OH • Method • Participants: • 2 males: 10 females • Ranged from ages 54 to 93 years old (mean=81.8 years) • 1 to 45 years of hearing aid experience (mean= • Inclusion criteria included: • At least 18 years of age • Have a mild to moderate sensorineural, conductive, or mixed HL • Wear binaural or monaural hearing aids on a daily basis • Able to attend weekly one hour sessions at Miami University Speech and Hearing Clinic for six weeks • If in the experimental group, have access to a personal computer • Groups were randomly assigned • Design: • Pre- and Post-Testing • The Mini-Mental State Examination (MMSE) and Locus of Control test were administered during pre-testing only (Folstein & McHugh, 1975; Reid & Ziegler, 1981) • Duration Pattern Sequence Test, (Musiek, 1990) • Dichotic Digits, (Musiek, 1983) • Hearing in Noise Test (HINT), (Nisson, Soli, & Sullivan, 1994) • Client Oriented Scale of Improvement (COSI), (Dillon, James, & Ginis, 1997) • Control Group: One hour traditional AR, once weekly for 6 weeks • Experimental Group: One hour AR sessions and LACE 4 hours weekly for 6 weeks • Materials: • Listening and Comprehension Enhancement (LACE) was developed by Dr. Robert Sweetow from the Department of Otolaryngology at the University of California San Francisco. LACE is an interactive, home-based program developed for adults with hearing impairments. The program was designed to engage individuals in the hearing-aid adjustment process by presenting listening strategies and building confidence; adults also attend to cognitive strategies to improve memory and word recall (Sweetow & Henderson-Sabes, 2006). • Coursework from the program “Learning to Hear Again: An Audiological Rehabilitation Curriculum Guide” as well as supplemental handouts were used during weekly individual rehabilitation sessions (Wayner & Abrahamson, 1996). The program addressed compensatory strategies, environmental modifications, assertiveness, training speechreading, and building confidence Results Data supports the use of LACE program in conjunction with a traditional aural rehabilitation program. However, further investigation of the data revealed variability related to the interaction of the post-test scores and left-ear effect within each group. For the Duration Pattern Sequence test and Dichotic Digit test, pre- to post-test was significant (p < 0.01), suggesting a difference in one’s perceptual abilities by participation groups. The results of this study are consistent with other research investigating LACE as well as traditional audiological rehabilitation methods (Kricos & Holmes, 1996; Sweetow & Henderson-Sabes, 2006). Discussion The results of this study demonstrated positive benefits supporting the use of aural rehabilitation. Positive effects were seen in both the experimental and control groups, demonstrating that aural rehabilitation improves temporal processing, dichotic listening, and hearing in the presence in noise. Subjective changes in a variety of listening situations were reported by patients demonstrating positive psychosocial benefits. The participants reported an improvement in their comprehension and listening abilities by attending weekly sessions and/or practicing hearing skill sets on a computer. Additionally, significant improvements in auditory memory and sequencing skills were shown in the Duration Pattern Sequence (DPS) test for the experimental group, demonstrating greater change in sequence perception as a result of the use of LACE software. Introduction: Significant biological and psychological changes occur as a part of aging, which unquestionably alter the overall quality of life for older adults (Reid & Zeigler, 1981). One of these changes, presbycusis or an age-related hearing loss, is the most common sensory impairment and the third most prevalent chronic condition among aging adults (Tye-Murray, 1998; Van Eyken, Van Camp, &VanLaer, 2007). Purpose: The purpose of this study was to investigate the clinical management of adults with limitations in cognitive or psychoacoustic auditory processing capabilities, or both, that accompany hearing loss Traditional methods of audiological rehabilitation (AR) and home software program, Listening and Communication Enhancement (LACE), were investigated to determine efficacy in cognitive and psychosocial improvements in adults with hearing impairments. • Traditional AR Methodologies: • Active Listening Training • Conversation Repair Strategies • Pragmatic and Visual Cues • Analytic Auditory Training • Consonant Recognition Training • Auditory Memory Exercises • Environmental Modifications • Preferential Seating and Reducing Background Noise • LACE Exercises: • Speech in Noise • Rapid Speech • Competing Speaker • Auditory Memory References Dillon, H., James, A., & Ginis, J. (1997). Client Oriented scale of improvement (COSI) and its relationship to several other measures of benefit _____and satisfaction provided by hearing aids. Journal of American Academy of Audiology, 8, 2743. Folstein, M.F., & McHugh, P.R., (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal _____Psychiatric Resources, 12, 189-98. Kricos, B. P. & Holmes, A. E. (1996). Efficacy of audiologic rehabilitation for older adults. Journal of American Academy of Audiology, 7, 219-_____229. Musiek, F.E. (1983). Assessment of auditory dysfunction: the Dichotic Digits Test revisited. Ear & Hear. 4: 79-83. Musiek, F.E. (1990). Duration pattern test. AUDITEC: St. Louis, MI. NeuroTone (2007). Listening and Auditory Comprehension Enhancement, v2.1. NeuroTone, Inc.: Redwood City, CA. Nilsson, M., Soli, S.D., & Sullivan, J.A. (1994). Development of Hearing in Noise Test for the measurement of speech recognition thresholds in _____quiet and in noise. Journal of the Acoustical Society of America, 95, 1085-1099. Sweetow, R.W. & Henderson-Sabes, J. (2006). The need for and development of an adaptive listening and communication enhancement _____ (LACE) program. Journal of American Academic Audiology, 17, 538-558. Wayner, D.S. & Abrahamson, J.E. (1996). Learning to hear again: An audiological rehabilitation curriculum guide. Hear Again: Austin. Van Eyken, E., Van Camp, G., & Van Laer, L. (2007). The complexity of age-related hearing impairment: Contributing environmental and _____genetic factors. Audiology and Neurotology, 12 (6), 345-358. Wingfield, A. & Tun, P. A. (2001). Spoken language comprehension in older adults: Interactions between sensory and cognitive change in _____normal aging. Seminars in Hearing, 22(3), 287-301. Zekveld, A. A., Deijen, J. B., Goverst, T. S., & Kramer S. E. (2007). The relationship between nonverbal cognitive functions and hearing loss. _____Journal of speech, Language, Hearing Research, 50, 74-82. www.lacecentral.com

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