Excerpt: As expressed in published guidelines, there are several components to the overall hearing aid fitting process. The primary focus usually surrounds the selection of the hearing aids and their special features, verification of the fitting, and then some type of real-world validation. Another component recommended in all published hearing aid fitting guidelines but often overlooked, is pre-testing.

Question: I've been fitting a lot of receiver-in-canal (RIC) products, and when I have a patient with good low-frequency hearing, I like to use the smaller gain receiver option because I worry about the larger gain receiver being noisier. Sometimes though, use of the smaller gain receiver makes it difficult to fit prescriptive targets for moderately-severe to severe high frequency hearing loss thresholds. Should I be concerned about larger receivers being noisier?

Background: Case reports are presented on four Veterans, aged 29–46 years, who complained of chronic dizziness and/or postural instability following blast exposures. Two of the four individuals were diagnosed with mild traumatic brain injury and three of the four were exposed to multiple blasts. Comprehensive vestibular, balance, gait, audiometry and neuroimaging procedures were used to characterize their injuries.Case report: Vestibular assessment included videonystagmography, rotary chair and cervical and ocular vestibular evoked myogenic potentials. Balance and gait testing included the sensory organization test, preferred gait speed and the dynamic gait index. Audiometric studies included pure tone audiometry and middle-ear measurements. Neuroimaging procedures included high resolution structural magnetic resonance imaging, susceptibility-weighted imaging and diffusion-tensor imaging.Findings: Based on the neuroimaging and vestibular and balance test results, it was found that all individuals had diffuse axonal injuries and all had one or more micro-hemorrhages or vascular anomalies. Three of the four individuals had abnormal vestibular function, all had abnormally slow walking speeds and two had abnormal gait and balance dysfunction.Conclusion: The use of contemporary neuroimaging studies in conjunction with comprehensive vestibular and balance assessment provided a better understanding of the pathophysiology and pathoanatomy of dizziness following blast exposures than standard vestibular and balance testing alone.

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This session is developed by, and presenters invited by, Cultural and Linguistic Considerations Across the Discipline. This session was developed by the Convention Program Committee to increase SLPs’ awareness regarding research and clinical applications of the International Classification of Functioning, Disability and Health (ICF) across pediatric and adult populations around the world. Discussants provide perspectives from Australia, Brazil, Canada, Jamaica, and the United States.

Background: The past decade has yielded changes in the education and training of audiologists and technological advancements that have become widely available for clinical balance function testing. It is unclear if recent advancements in vestibular instrumentation or the transition to an AuD degree have affected audiologists’ vestibular clinical practice or opinions.Purpose: The purpose of this study was to examine predominant opinions and practices for vestibular assessment (VA) and vestibular rehabilitation (VR) over the past decade and between master’s- and AuD-level audiologists.Method: A 31-question survey was administered to audiologists via U.S. mail in 2003 (N = 7,500) and electronically in 2014 (N = 9,984) with a response rate of 12% and 10%, respectively.Results: There was an increase in the number of audiologists providing vestibular services in the past decade. Most respondents agreed that audiologists were the most qualified professionals to conduct VA. Less than half of the surveyed audiologists felt that graduate training was adequate for VA. AuD-level audiologists were more satisfied with graduate training and felt more comfortable performing VA compared to master’s-level audiologists. Few respondents agreed that audiologists were the most qualified professionals to conduct VR or that graduate training prepared them to conduct VR. The basic vestibular test battery was unchanged across surveys and included: calorics, smooth pursuit, saccades, search for spontaneous, positional, gaze and optokinetic nystagmus, Dix‐Hallpike, case history, and hearing evaluation. There was a trend toward greater use of air (versus water) calorics, videonystagmography (versus electronystagmography), and additional tests of vestibular and balance function.Conclusions: VA is a growing specialty area in the field of audiology. Better training opportunities are needed to increase audiologists’ knowledge and skills for providing vestibular services. The basic tests performed during VA have remained relatively unchanged over the past 10 yr.

The purpose of this session is to examine the vestibular consequences of mild traumatic brain injury (TBI) and blast exposure. Preliminary data will be presented showing characteristics of vestibular dysfunction and postural instability related to mild TBI and blast exposure. Also reviewed will be the latest findings including recent data collected at the War Related Illness & injury Center showing vestibular impairments in those with mTBI. The target audience is audiologists, physical therapists, neurologists, otolaryngologists. This session will cover intermediate level of content.

This session was developed by Special Interest Division #6: Hearing & Hearing Disorders. Cervical vestibular evoked myogenic potentials (cVEMP) supplement the current vestibular test battery by providing diagnostic information about saccular and/ or inferior vestibular nerve function. The session will provide background, recording method, and clinical application of the cVEMP