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Otoacoustic emissions (OAEs) are generated in the cochlea in response to sound and are used clinically to separate ears with normal hearing from sensorineural hearing loss (SNHL). OAEs were elicited at ambient pressure by clicks (CEOAE) and wideband chirps (TEOAE) sweeping from low-to-high frequency with a sweep rate of either 187.6 Hz/ms (short chirps) or 58.2 Hz/ms (long chirps) and a bandwidth extending to 8 kHz. Chirps were presented at the same sound exposure level (SEL) as clicks, or + 6 dB relative to clicks. A total of 288 OAE waveforms were averaged for short chirps in ~1 minute compared to 120 waveforms for long chirps. Compared to clicks, the chirp has a lower crest factor, which allows it to be presented at an overall higher SEL without distortion. OAEs were elicited in 79 adults with normal hearing and 51 adults with mild-to-moderate SNHL. One-sixth octave OAE signal-to-noise ratios from 0.7 to 8.0 kHz were compared across stimulus types and conditions. The area under the receiver operating curve (AUC) was used to assess the accuracy of detecting SNHL. Average AUCs across 1/6th octave frequencies ranged from 0.90 to 0.89 for TEOAEs and were 0.87 for the CEOAE suggesting excellent test performance.

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Purpose: Listening effort has traditionally been measured using subjective rating scales and behavioral measures. Recent physiological measures of listening effort have utilized pupil dilation. Using a combination of physiological and subjective measures of listening effort, this study aimed to identify differences in listening effort during 2 auditory tasks: sentence recognition and word recognition. Method: Pupil dilation and subjective ratings of listening effort were obtained for auditory tasks utilizing AzBio sentences recognition and Northwestern University Auditory Test No. 6 words recognition, across 3 listening situations: in quiet, at +6 dB signal-to-noise ratio, and at 0 dB signal-to-noise ratio. Task accuracy was recorded for each of the 6 conditions, as well as peak pupil dilation and a subjective rating of listening effort. Results: A significant impact of listening situation (quiet vs. noise) and task type (sentence recognition vs. word recognition) on both physiological and subjective measures was found. There was a significant interaction between listening situation and task type, suggesting that contextual cues may only be beneficial when audibility is uncompromised. The current study found no correlation between the physiological and subjective measures, possibly suggesting that these measures analyze different aspects of cognitive effort in a listening task.

Purpose Our aim was to develop a taxonomy of elements comprising phonological interventions for children with speech sound disorders. Method We conducted a content analysis of 15 empirically supported phonological interventions to identify and describe intervention elements. Measures of element concentration, flexibility, and distinctiveness were used to compare and contrast interventions. Results Seventy-two intervention elements were identified using a content analysis of intervention descriptions then arranged to form the Phonological Intervention Taxonomy: a hierarchical framework comprising 4 domains, 15 categories, and 9 subcategories. Across interventions, mean element concentration (number of required or optional elements) was 45, with a range of 27 to 59 elements. Mean flexibility of interventions (percentage of elements considered optional out of all elements included in the intervention) was 44%, with a range of 29% to 62%. Distinctiveness of interventions (percentage of an intervention's rare elements and omitted common elements out of all elements included in the intervention [both optional and required]) ranged from 0% to 30%. Conclusions An understanding of the elements that comprise interventions and a taxonomy that describes their structural relationships can provide insight into similarities and differences between interventions, help in the identification of elements that drive treatment effects, and facilitate faithful implementation or intervention modification. Research is needed to distil active elements and identify strategies that best facilitate replication and implementation.

The ability to perceive speech is related to the listener's ability to differentiate among frequencies (i.e. spectral resolution). Cochlear implant users exhibit variable speech perception and spectral resolution abilities, which can be attributed at least in part to electrode interactions at the periphery (i.e. spatial resolution). However, electrophysiological measures of peripheral spatial resolution have not been found to correlate with speech perception. The purpose of this study was to systematically evaluate auditory processing from the periphery to the cortex using both simple and spectrally complex stimuli in order to better understanding the underlying processes affecting spatial and spectral resolution and speech perception. Eleven adult cochlear implant users participated in this study. Peripheral spatial resolution was assessed using the electrically evoked compound action potential (ECAP) to measure channel interaction functions for thirteen probe electrodes. We evaluated central processing using the auditory change complex (ACC), a cortical response, elicited with both spatial (electrode pairs) and spectral (rippled noise) stimulus changes. Speech perception included a vowel-discrimination task and the BKB-SIN test of keyword recognition in noise. We varied the likelihood of electrode interactions within each participant by creating three experimental programs, or MAPs, using a subset of seven electrodes and varying the spacing between activated electrodes. Linear mixed model analysis was used to account for repeated measures within an individual, allowing for a within-subject interpretation. We also performed regression analysis to evaluate the relationships across participants. Both peripheral and central processing abilities contributed to the variability in performance observed across CI users. The spectral ACC was the strongest predictor of speech perception abilities across participants. When spatial resolution was varied within a person, all electrophysiological measures were significantly correlated with each other and with speech perception. However, the ECAP measures were the best single predictor of speech perception for the within-subject analysis, followed by the spectral ACC. Our results indicate that electrophysiological measures of spatial and spectral resolution can provide valuable information about perception. All three of the electrophysiological measures used in this study, including the ECAP channel interaction functions, demonstrated potential for clinical utility.

Background When planning evidence‐based intervention services for children with phonology‐based speech sound disorders (SSD), speech and language therapists (SLTs) need to integrate research evidence regarding service delivery and intervention intensity within their clinical practice. However, relatively little is known about the optimal intensity of phonological interventions and whether SLTs’ services align with the research evidence. Aims The aims are twofold. First, to review external evidence (i.e., empirical research evidence external to day‐to‐day clinical practice) regarding service delivery and intervention intensity for phonological interventions. Second, to investigate SLTs’ clinical practice with children with phonology‐based SSD in Australia, focusing on service delivery and intensity. By considering these complementary sources of evidence, SLTs and researchers will be better placed to understand the state of the external evidence regarding the delivery of phonological interventions and appreciate the challenges facing SLTs in providing evidence‐based services. Methods & Procedures Two studies are presented. The first is a review of phonological intervention research published between 1979 and 2016. Details regarding service delivery and intervention intensity were extracted from the 199 papers that met inclusion criteria identified through a systematic search. The second study was an online survey of 288 SLTs working in Australia, focused on the service delivery and intensity of intervention provided in clinical practice. Main Contributions There is a gap between the external evidence regarding service delivery and intervention intensity and the internal evidence from clinical practice. Most published intervention research has reported to provide intervention two to three times per week in individual sessions delivered by an SLT in a university clinic, in sessions lasting 30–60 min comprising 100 production trials. SLTs reported providing services at intensities below that found in the literature. Further, they reported workplace, client and clinician factors that influenced the intensity of intervention they were able to provide to children with phonology‐based SSD. Conclusions & Implications Insufficient detail in the reporting of intervention intensity within published research coupled with service delivery constraints may affect the implementation of empirical evidence into everyday clinical practice. Research investigating innovative solutions to service delivery challenges is needed to provide SLTs with evidence that is relevant and feasible for clinical practice

The primary purpose of this study was to craft and validate a set of core competencies necessary for an e-Helper to possess. A review of the literature guided the creation of the initial competencies. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) SLPs experienced in telepractice within a school setting; (c) current e-Helpers, and (d) scholars experienced in telepractice. Sixty percent (21 out of 35) of the competencies were rated as “important” by 76-100% of respondents. The remaining competencies could be more or less important dependent on workplace requirements.