WIDEXAUDIOLOGICAL PROFESSIONALISM, EVIDENCE AND SOLUTIONS

LISE HENNINGSENAUDIOLOGICAL RESEARCH & COMMUNICATION, WIDEX

ISHAA, IRELAND, APRIL 2010

AGENDA

/ Introduction / WHAT IS IMPORTANT

/ A good starting point / THE IMPORTANCE OF A GOOD DIALOGUE

/ Knowing where to start/ EVIDENCE BASED PRACTICE

/ Significant challenges/ WIDEX SOLUTIONS

IMPORTANTTHE IMPORTANT PERSPECTIVE

/ Hearing loss occurs slowly, and day to day changes are minimal./ Many people associate hearing loss with ageing and stigma.

“THE AVERAGE HEARING IMPAIRED ADULT WAITS 7 YEARS BEYOND FIRST RECOGNITIONBEFORE SEEKING CORRECTIVE MEASURES”

www.hear-it.org

IF ONE IS TRULY TO SUCCEED IN LEADING A PERSON TO A SPECIFIC PLACE, ONE MUST FIRST AND FOREMOST TAKE CARE TO FIND HIM WHERE HE IS AND BEGIN THERE

SØREN KIERKEGAARD, 1859

A GOOD DIALOGUEA GOOD START TO FIND THE RIGHT SOLUTION

COUNSELLING - SATISFACTION

Professional counselling

Increasing understanding

Increased trust

Increased acceptance

Increased customer

satisfaction

COMMUNICATION

DESCRIPTION PHASE

/ INVESTIGATION/ OPEN QUESTIONS/ CREATING

PERSPECTIVE

EVALUATION PHASE

/ DOUBLE CHECKING ISSUES

/ ARE THE ISSUES REALLY UNDERSTOOD?

REHABILITATION PHASE

/ PROVIDING GUIDANCE

/ RECOMMENDING SOLUTION

EVIDENCE BASED PRACTICE

knowing why you make your choice

EVIDENCE BASED PRACTICE

EVIDENCE-BASED PRACTICE COMBINES THE BEST AVAILABLE EVIDENCE FROM RESEARCH WITH PATIENT CHOICES AND INDIVIDUAL CLINICAL JUDGEMENT (COX, 2005)

Best available evidence

Practitioner expertise

Client values & choices

Decision - Making

EVIDENCE BASED PRACTICE/ Evidence-based practice gives a sound foundation for decision making in

the audiological practice/ The approach is:

/ ONE HEARING PROBLEM AND ONE PATIENT AT A TIME.

/ 5 STEP PROCESS TO TACKLE ONE PROBLEM AT A TIME.

EVIDENCE BASED PRACTICE

FORMULATE A FOCUSED AND ANSWERABLE QUESTION

SEARCH FOR THE BEST AVAILABLE EVIDENCE

EVALUATE EVIDENCE FOR VALIDITY AND RELEVANCE

MAKE RECOMMENDATIONS BASED ON EVIDENCE, CLINICAL EXPERTISE, USER NEEDS

EVALUATE THE RESULTS AND DETERMINE WAYS TO IMPROVE FURTHER

EVIDENCE BASED PRACTICE

FORMULATE A FOCUSED AND ANSWERABLE QUESTION

SEARCH FOR THE BEST AVAILABLE EVIDENCE

EVALUATE EVIDENCE FOR VALIDITY AND RELEVANCE

MAKE RECOMMENDATIONS BASED ON EVIDENCE, CLINICAL EXPERTISE, USER NEEDS

EVALUATE THE RESULTS AND DETERMINE WAYS TO IMPROVE FURTHER

EVIDENCE BASED PRACTICE

EFFICACY

EVIDENCE MEASURED UNDER IDEAL CONDITIONS ASK:”HOW WELL CAN IT WORK?”

EFFECTIVENESS

EVIDENCE MEASURED IN THE REAL WORLDASK:”HOW WELL DOES IT WORK?”

WIDEX SOLUTIONSTHE MOST WELL KNOWN CHALLENGES AND EMPIRICAL EVIDENCE

AUDIOLOGICAL CORNERSTONES

/ Maintaining the dynamics of everyday sound/ SOFT, NORMAL AND LOUD SOUNDS

AUDIOLOGICAL CORNERSTONES

/ Precision in fitting/ THE SOUND PRESSURE LEVEL MUST BE AS

INTENDED

AUDIOLOGICAL CORNERSTONES

/ Comfort and clarity of speech in noise/ NOISE REDUCTION AND SPEECH

ENHANCEMENT MUST BE RELATIVE TO DEGREE OF HEARING LOSS

CHALLENGES WE FACE

LISTENING IN BACKGROUND NOISE

RELAXATION AND MUSIC

HEARING FROM A DISTANCE

SOUNDS OF NATURE

TELEPHONE USE

OUR PROVEN CHOICE

SIGNATURE FEATURES

AUDIBILITY EXTENDER ZEN TONES SPEECH

ENHANCER

KEY FINDINGS

/ The Audibility Extender improves the perception and production of important speech sounds – especially high-frequency consonants

/ Zen tones can help a large portion of the hearing-impaired population relax and concentrate; tinnitus sufferers have also rated Zen as helping reduce the effects of tinnitus

/ The Speech Enhancer improves speech intelligibility in noise

THE AUDIBILITY EXTENDERFINDING THE SOUND AND MOVING IT

FREQUENCY LOWERING TECHNIQUES/ AVAILABLE TECHNIQUES

EITHER TRANSPOSE OR COMPRESS SOUND IN THE FREQUENCY DOMAIN

/ AIM IS TO MAKE HIGH FREQUENCY SOUNDS AUDIBLE

FREQUENCY LOWERING TECHNIQUES

GOOD HEARING, GOOD RESOLUTION

Low to high frequencies

Poorer hearing, poorer resolutionWhy use transposition?

Goodresolution

Moderateresolution

Poorresolution

Dead region

MAIN POINTS FROM STUDIES

/ The Audibility Extender improves speech perception and production for children and adults with severe-to-profound high frequency hearing loss

/ Acclimatisation and training are essential for improvements in speech perception/production

/ Initial low preference for speech sounds

/ Progress in language scores and acceptance occur fast after targeted use of the Audibility Extender

/ Counselling is necessary to facilitate acceptance

/ Increase in confidence and self-esteem in school-aged children

LANGUAGE PERFORMANCE

/ Improvement of perception and production of speech sounds is documented in a wide range of studies

KUK ET AL, 2009

EFFECTS OF TRAINING ACCLIMATISATION AND COUNSELLING

/ Training and acclimatisation are necessary to fully realise the potential of the Audibility Extender

KORHONEN ET AL, 2008

EFFECTS OF COUNSELLING/ Counselling on expectations facilitates

acceptance

KUK ET AL, 2007B

SUCCESSFUL USE WITH CHILDREN/ Beneficial for language development/ Especially high frequency consonant production/ Increased confidence and self-esteem

AURIEMMO ET AL, 2009

THE SPEECH ENHANCERTAILOR-MADE NOISE REDUCTION AND SPEECH ENHANCEMENT

SPEECH ENHANCER

/ Speech enhancement and noise reduction system

/ Based on Speech Intelligibility Index (SII) optimisation

/ Ensures optimum SII in all listening environments

/ Speech is heard clearly under noisy conditions

ADAPTS TO SITUATIONS AND CLIENTS

KAROLINA SMEDS ET AL., 2009

MAIN FINDINGS FROM STUDIES

/ The Speech Enhancer can improve speech intelligibility in noise

/ The Speech Enhancer does not compromise listener comfort in noisy environments

/ Measurements of long-term average gain changes with the Speech Enhancer activated/deactivated confirm that the Speech Enhancer varies with SNR and hearing loss

EFFECT ON SPEECH INTELLIGIBILITY/ The Speech Enhancer can improve speech intelligibility

in noise

PEETERS, ET AL., 2009

LISTENING COMFORT IN NOISE/ The speech enhancer does not compromise listener

comfort in noisy environments

PEETERS, ET AL., 2009

ZENWHEN AUDIBILITY IS NOT THE ONLY FOCUS

ZEN/ Harmonic sound program

/ Based on fractal technology

/ Adjustable tempo and pitch

/ Six different zen styles for relaxation and concentration purposes

MAIN FINDINGS FROM STUDIES/ On average, 70% rated the Zen styles as relaxing

/ By adjusting the Zen tones to the preferences of the subjects, 86% found the fine tuned Zen style to be relaxing. The Zen tones can provide a relaxing listening background.

/ Helps a large portion of the hearing impaired population relax and concentrate.

/ Tinnitus sufferers, who are under double strain, rate the effects of tinnitus significantly milder after six months of daily Zen use

A ZEN STUDY – RELAXATION/ On average, 70% chose “somewhat relaxing” or “very

relaxing”

KUK & PEETERS, 2008

A ZEN STUDY – CONCENTRATION / Concentration improved significantly when using

Zen compared to usingthe master program

KUK AND PEETERS, ORCA (2008)

A ZEN STUDY – TINNITUS/ 10 out of 14 subjects reported that the effects of their

tinnitus were milder after 6 months of daily Zen use/ The change in THI score was significant for five of the

subjects

SWEETOW, 2009

AGENDA

/ IMPORTANT

/ A GOOD DIALOGUE

/ EVIDENCE

/ SOLUTIONS

IN ORDER TRULY TO HELP SOMEONE, I MUST UNDERSTAND MORE THAN HE DOES;

BUT FIRST AND FOREMOST I MUST UNDERSTAND WHAT HE UNDERSTANDS.

IF I DO NOT DO THAT, MY GREATER UNDERSTANDING WILL BE OF NO HELP TO HIM

SØREN KIERKEGAARD, 1859