The SCAN-A in testing for auditory processing disorder in a sample of British adults

Objective: The SCAN-A (Keith, 1994) is a test for auditory processing disorders in adolescents aged 11+ and adults developed in the USA. It was previously found that the children's version (the SCAN-C) over diagnoses auditory processing disorder in UK children. This study was conducted to assess the use of the SCAN-A with UK adults. Design: Comparison of UK adult's SCAN-A performance to US-based normative data. Study Sample: 31 UK adults aged 19 to 64 years (M 24, sd 10). Results: The UK sample scored significantly worse on three subtests: the Filtered Words (FW), Competing Words (CW) and Competing Sentences (CS) sections as well as on the Total Score. Conclusions: Applying US norms to UK adult's performance results in a high rate of over-identification of listening difficulties. Alternative UK norms are provided and implications for use of the SCAN-A with UK adolescents and adults are discussed. © 2011 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society

Improving hearing and vision in dementia : Protocol for a field trial of a new intervention

IntroductionQuality of life and other key outcomes may be improved by optimising hearing and vision function in people living with dementia. To date, there is limited research assessing the efficacy of interventions aimed at improving hearing and vision in people with dementia. Here, we outline a protocol to field test a newly developed home-based intervention, designed to optimise sensory functioning in people with dementia in three European sites. The results of this study will inform the design and conduct of a full-scale randomised controlled trial (RCT) in five European sites.Methods and analysisIn this multisite, single arm, open label, feasibility study, participants with dementia (n=24) will be assessed for hearing and vision impairments and be prescribed a hearing aid and/or glasses. Each participant will have a study partner (‘dyads’). A subset of dyads will receive ‘sensory support’ from a ‘sensory support therapist’, comprising home visits over 12 weeks. The therapist will offer the following intervention: adherence support for corrective devices; adaptations to the home environment to facilitate sensory function; communication training; and referral to community-based support services. The primary outcomes will be process measures assessing the feasibility, tolerability and acceptability of: (1) the intervention components; (2) the method of implementation of the intervention and (3) the study procedures, including outcome assessment measures. Quantitative data will be collected at baseline and follow-up. Qualitative data using semistructured interviews will be collected postintervention and weekly, using participant diaries. Finally, we will explore a model of cost-effectiveness to apply in the subsequent full-scale trial. This feasibility study is a necessary step in the development of a complex, individualised, psychosocial intervention. The data gathered will allow logistical and theoretical processes to be refined in preparation for a full-scale RCT.Ethics and disseminationEthical approval was obtained in all three participating countries. Results of the field trial will be submitted for publication in a peer-reviewed journal.</jats:sec

Unilateral and bilateral hearing aids, spatial release from masking and auditory acclimatization

Spatial release from masking (SRM) was tested within the first week of fitting and after 12 weeks hearing aid use for unilateral and bilateral adult hearing aid users. A control group of experienced hearing aid users completed testing over a similar time frame. The main research aims were (1) to examine auditory acclimatization effects on SRM performance for unilateral and bilateral hearing aid users, (2) to examine whether hearing aid use, level of hearing loss, age or cognitive ability mediate acclimatization, and (3) to compare and contrast the outcome of unilateral versus bilateral aiding on SRM. Hearing aid users were tested with and without hearing aids, with SRM calculated as the 50% speech recognition threshold advantage when maskers and target are spatially separated at ±90° azimuth to the listener compared to a co-located condition. The conclusions were (1) on average there was no improvement over time in familiar aided listening conditions, (2) there was large test-retest variability which may overshadow small average acclimatization effects; greater improvement was associated with better cognitive ability and younger age, but not associated with hearing aid use, and (3) overall, bilateral aids facilitated better SRM performance than unilateral aids

Interventions for hearing and vision impairment to improve outcomes for people with dementia: a scoping review

Background:Age-related hearing and vision problems are common among people with dementia and are associated with poorer function, reduced quality of life and increased caregiver burden. Addressing sensory impairments may offer an opportunity to improve various aspects of life for people with dementia.Methods:Electronic databases were searched using key terms dementia, hearing impairment, vision impairment, intervention, and management. Database searches were supplemented by hand searching bibliographies of papers and via consultation with a network of health professional experts. Studies were eligible for inclusion if they included adults aged over 50 with dementia with adult-onset hearing or vision impairment who had received a hearing or vision intervention in relation to cognitive function, rate of decline, psychiatric symptoms, hearing/vision-related disability, quality of life, and/or caregiver burden outcomes. A range of study designs were included. Results were summarized descriptively according to level of evidence and effect sizes calculated where possible. Risk of bias was assessed using Downs and Black's (1998) checklist. The development of the intervention was summarized according to the CReDECI2 scheme. PROSPERO review registration number 2016:CRD42016039737.Results:Twelve papers describing hearing interventions and five papers describing vision interventions were included. Most were of low to moderate quality. One high quality randomized controlled trial of a hearing aid intervention was identified. Hearing interventions included provision of hearing aids, assistive listening devices, communication strategies, hearing aid trouble shooting, and cochlear implantation. Vision interventions included prism lenses, rehabilitation training, and cataract surgery. There was no consistent evidence for the positive impact of hearing/vision interventions on cognitive function, rate of cognitive decline, quality of life, or caregiver burden.Conclusion:Sensory interventions may promote better outcomes, but there is a need for properly powered, controlled trials of hearing and vision interventions on outcomes relevant to people living with dementia

What do hearing healthcare professionals do to promote hearing aid use and benefit among adults? A systematic review

Objective: To conduct a systematic review of the evidence in relation to what hearing healthcare professionals do during hearing aid consultations and identifying which behaviours promote hearing aid use and benefit among adult patients. Design: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMed and Google Scholar. The Crowe Critical Appraisal Tool and Melnyk Levels of Evidence were used to assess quality and level of evidence of eligible studies. Behaviours of hearing healthcare professionals were summarised descriptively. Study Sample: 17 studies met the inclusion criteria. Results: Twelve studies described behaviours of audiologists and five studies were intervention studies. Audiologists were typically task- or technically-oriented and/or dominated the interaction during hearing aid consultations. Two intervention studies suggested that use of motivational interviewing techniques by audiologists may increase hearing aid use in patients. Conclusions: Most studies of clinicians’ behaviours were descriptive, with very little research linking clinician behaviour to patient outcomes. The present review sets the research agenda for better-controlled intervention studies to identify which clinician behaviours better promote patient hearing aid outcomes and develop an evidence base for best clinical practice

Improving the provision of hearing care to long-term care home residents with dementia: developing a behaviour change intervention for care staff

Context: Hearing loss disproportionately affects long-term care home (LTCH) residents with dementia, impacting their quality of life. Most residents with dementia rely on LTCH staff to provide hearing care. However, previous research shows provision is inconsistent. The Behaviour Change Wheel (BCW) can be used for developing behaviour-change interventions. Objective: To describe the structured, multistage development of an intervention to help LTCH staff provide hearing care to residents with dementia. Method: Using results from qualitative and quantitative studies and patient and public involvement sessions, we outlined problems associated with hearing care and determined the changes that should be made using the Capabilities, Opportunities, and Motivation-Behaviour Change Model. We then selected and specified five target behaviours for intervention, and identified relevant intervention functions, behaviour change techniques (BCTs), and modes of delivery. Findings: The multi-component intervention is designed to boost the psychological capability, reflective motivation, and physical opportunity of care assistants. The intervention functions deemed most appropriate were education, modelling, incentivisation, and environmental restructuring, alongside several specific BCTs. Limitations: Some of the larger-scale issues relating to hearing care, such as collaborations between LTCHs and audiology services and the costs of hearing devices, were not able to be addressed in this intervention. Conclusions: This study is the first to use the BCW to develop an intervention targeting the staff’s provision of hearing care to LTCH residents with dementia. This intervention addresses the wide-ranging barriers that staff experience when providing hearing care. Trialling this intervention will provide insight into its effectiveness and acceptability for residents and staff

Erratum:Association of dietary factors with presence and severity of tinnitus in a middle-aged UK population (PLoS ONE (2015) 9:12 (e114711) DOI: 10.1371/journal.pone.0114711)

[This corrects the article DOI: 10.1371/journal.pone.0114711.]

What are the correlates of hearing aid use for people living with dementia?

Objectives: To identify correlates of hearing aid use in people with dementia and age-related hearing loss. Methods: Bivariate and multivariate logistic regression analyses of predictor variables from 239 participants with dementia and hearing loss in the European SENSE-Cog Randomized Controlled Trial (Cyprus, England, France, Greece, and Ireland). Results: In multivariate analysis, four variables were significantly associated with hearing aid use: greater self-perceived hearing difficulties (OR 2.61 [CI 1.04−6.55]), lower hearing acuity (OR .39 [CI .2−.56]), higher cognitive ability (OR 1.19 [CI 1.08−1.31]), and country of residence. Participants in England had significantly increased odds of use compared to Cyprus (OR .36 [CI .14−.96]), France (OR .12 [CI .04−.34]) or Ireland (OR .05 [CI .01−.56]) but not Greece (OR 1.13 [CI .42–3.00]). Conclusions: Adapting interventions to account for cognitive ability, country of residence, self-perceived hearing difficulties, and hearing acuity may support hearing aid use in people with dementia