The Official Publication of the Canadian Academy of Audiology, Marc Fagelson writes about how awareness and consideration of the special needs of patients with PTSD – the increased need to monitor the acoustical environment

Excerpt: Tinnitus: Clinical and Research Perspectives summarizes contemporary findings from basic and clinical research regarding tinnitus mechanisms, effects, and interventions. The text features a collection of international authors, active researchers, and clinicians who provide an expansive scope of material that ensures relevance for patients and professionals. Reviews and reports of contemporary research findings underscore the text s value for classroom use in audiology and otolaryngology programs. Patients and students of audiology will benefit from the text s coverage of tinnitus mechanisms, emerging practice considerations, and expectations for outcomes--for example, recent successes of cognitive behavioral therapy, neuromodulation, and hearing aid use. These and other topics, such as the effects of noise and drugs on tinnitus, are reported in a way that enhances clinicians ability to weave such strategies into their own work. The influence of tinnitus on all aspects of life is explored, from art to medicine and communication to isolation, thereby providing clinicians and patients a deeper understanding of and greater facility managing a tinnitus experience. Finally, this text includes case studies that provide a practical view of tinnitus effects and management approaches. The editors hope that the consideration of mechanisms, interventions, and outcomes resonates with patients, clinicians, and students of audiology.

Tinnitus has the potential to influence a wide range of routine and important activities in a person's life. It can impair sleep, communication, concentration, and in severe cases can be affected by depression, anxiety, and other mental health issues. Perhaps more important, tinnitus may influence the patient's psychological state; its bidirectional effects, although well established, often challenge patients and providers across a variety of clinical settings. Management of tinnitus requires audiologists to be adept at communicating and supporting coping strategies that may include, but should not be limited to, patient-centered counseling and delivery of sound therapy or hearing aids. In the short term, patient care may benefit from interprofessional collaborations and effective referral networks. In the long term, the inclusion of tinnitus clinic rotations, classes, and interprofessional opportunities for students in Audiology programs should provide AuD students the experiences and competencies to provide for patients with tinnitus.

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Objective: This study examined the influence of prescription on hearing aid (HA) fitting characteristics and 5-year developmental outcomes of children. Design: A randomised controlled trial implemented as part of a population-based study on Longitudinal Outcomes of Children with Hearing Impairment (LOCHI). Study sample: Two-hundred and thirty-two children that were fit according to either the National Acoustic Laboratories (NAL) or Desired Sensation Level (DSL) prescription. Results: Deviation from targets and root-mean-square error in HA fitting revealed no significant difference between fitting prescriptions. Aided audibility quantified by using the Speech Intelligibility Index (SII) model showed that DSL provided higher audibility than NAL at low and medium input levels but not at high input level. After allowing for hearing loss desensitisation, differences in audibility between prescription groups were significant only at low input level. The randomised trial of prescription that was implemented for 163 children revealed no significant between-group differences in speech production, perception, and language; but parent-rated functional performance was higher for the DSL than for the NAL group. Conclusions: Proximity to prescriptive targets was similar between fitting prescriptions. The randomised trial revealed differences in aided audibility at low input level between prescription groups, but no significant differences in speech and language abilities.

Summary Objective The purpose of this study was to describe the early vocalization skills in children with cleft lip and palate (CLP) at 6 and 12 months of age and compare these early vocalization measures to later speech and vocabulary development at 30 months of age. Methods The participants in the study included 13 children without cleft lip or palate (NCLP) who were typically developing and 13 children with CLP matched for age, gender and socioeconomic status. Standardized measures of cognition, language, hearing, and prelinguistic vocalization measures were administered at 6 and 12 months and speech production, and vocabulary measures were collected at 30 months of age. Results Group differences were observed in both receptive and expressive language development at 12 and 30 months of age. Group differences were observed in the frequency of babbling and Mean Babbling Level at 12 months and speech sound accuracy and vocabulary production at 30 months of age. Significant correlation coefficients were observed between babbling frequency at 6 months and consonant inventory size, vocabulary at 30 months for the children with clefts and PCC-R for noncleft children. Conclusions This study documented that young children with clefts have persistent vocalization and vocabulary deficits well beyond palate closure. Measures of babbling frequency, Mean Babbling Level and consonant inventories provide clinically effective means of identifying these early deficits. Additionally, these measures may provide a tool for monitoring the effects of early intervention programs that promote facilitation of sound and vocabulary development.

Trauma-provoked tinnitus challenges patients and clinicians. Effects of trauma may exacerbate tinnitus, and patients with both tinnitus and posttraumatic stress disorder rate distress levels as higher than patients who experience only one or the other. This presentation will highlight links between tinnitus and trauma histories relevant to clinical audiologists.

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