2014 NZAS Conference - Abstracts
Thursday 3 July 2014
09.00
Chuck Berlin
Auditory Neuropathy/unusual forms of loss
11.00
Robert Cowan , The HEARing CRC
New Approaches to Preserve Residual Hearing and Improve Performance for Cochlear Implant
Recipients
Improvements in technology for cochlear implant patients over the past two decades have largely
centred on the external speech processor and approaches to speech processing. Although some
changes in materials and/or structure of the implanted receiver-stimulator have been
implemented, relatively few changes have been made to the electrode array for cochlear implants
or to the electroneural interface. Application of new technologies and materials could result in an
improved capacity and function of the electroneural interface for cochlear implant electrode
arrays, including enhancing the preservation and use of acoustic residual hearing.
A range of new designs in electrode array have focused initially on improving the position of the
electrode array closer to neural elements. Psychophysical tests have shown a narrowing of
current spread, however, this has not yet been translated to improved speech perception. A
range of materials and processes for surface modification of silicone rubber, and for incorporation
of molecules such as corticosteroids into the surface of the electrode array have been evaluated
to address this problem. In particular, studies investigated means of controlling the timing of
release of therapeutics into the cochlear environment. In addition, studies have investigated the
potential benefits of application of electroporation techniques.
Results showed that surface modifications using polymer technology can provide for significantly
varied release times and profiles for therapeutics into the cochlear environment using both
passive and active dissolution methods. Direct application of these materials into the cochlear
environment may be an important element for preservation of residual hearing, or in the future,
for improving the capacity and functionality of the electro-neural transmission.
A second group of studies have investigated designs of electrode array specifically aimed at
preservation of residual hearing, and the use of this in an electroacoustic speech processing
scheme. Results show that residual hearing can be preserved, and that benefit from
electroacoustic hearing is evident in both speech perception in noise and localization. This result
has implications for extending candidature to individuals with greater degrees of residual hearing
than previously considered.
Conclusions
Application of new technologies and processes may improve transmission of electrical signals, and
thereby, significantly improve the performance of future designs of cochlear implant electrode
arrays.
This research is financially supported by the HEARing CRC, established and supported
under the Australian Government’s Cooperative Research Centres Program.
11.45
Kirsty Gardner-Berry
Cochlear implantation in patients with ANSD
o Clinical presentation of infants, children & adults with ANSD referred for cochlear implant
candidacy
o Imaging findings in children with ANSD (MRI and CT-scan) and outcomes with cochlear
implants in children with abnormal auditory nerves
o Electrical ABR findings in patients with ANSD
o How low can you go? Cochlear implantation in a teenager with ANSD and near normal puretone thresholds.
14.00
Peter Thorne, Audiology, Physiology and Centre for Brain Research, University
of Auckland
Cochlear Adaptation and its Influence on Understanding Noise-Induced Hearing Loss
Noise-induced hearing loss stems from over-exposure of cochlear tissues to loud sound. There is
evidence that the cochlea also adapts to background noise, most likely so it sustains sensitivity to
important incoming sounds. Here evidence is presented that these adaptive mechanisms may
confer protection on cochlear tissues to noise exposure. For example, a decline in the number of
glutamate receptors in auditory nerves reduces their excitability with background noise. Recently
a molecular mechanism involving adenosine tri-phosphate (ATP) receptors (P2X2) in cells lining the
cochlear endolymphatic space has been shown to induce long-term (hours) cochlear adaptation to
chronic noise exposure(1). This may explain some Temporary Threshold Shift (TTS) and sensitivity
of people to Permanent Threshold Shift (PTS)(1). Normal mice develop a TTS with noise exposure
that has a similar time course to that in humans, but mice lacking P2X2 receptors do not.
Interestingly, mice without these receptors have greater susceptibility to PTS. This is interpreted
as the normal cochlea adapting to noise (measured as a TTS) and indicating that this adaptation
confers some protection to noise exposure(1). Reinforcing this, a mutation in the P2X 2 gene leads
to the dominantly inherited, progressive sensorineural hearing loss in humans, DFNA41, which is
exacerbated by noise(2). These studies imply that some TTS may reflect P2X 2 receptor-dependent
adaptation rather than cochlear injury and that loss of this adaptation increases sensitivity to
noise damage. Cochlear adaptation needs to be taken into account when considering damaging
effects of noise and may explain individual differences in susceptibility to NIHL.
1
Housley et al., PNAS, 110: 7494-7499
2
Yan et al., PNAS, 110: 2228–2233
14.30
Anne Greville
Changes to the ACC Hearing Loss Regulations
A summary of the amendments to the hearing loss regulations coming into force on 1 July 2014
will be given, including discussion of hearing aid payments for children covered by ACC. Updated
information on implementation issues will also be presented.
14.50
Anna McMillan, Bay Audiology Ltd; Rebecca Kelly-Campbell; University of
Canterbury; Karen Thomas; University of Canterbury, Bay Audiology Ltd
Mild Hearing Loss: Characteristics of Hearing Aid Adopters and Non-Adopters
Mild hearing loss (MHL: PTA500Hz-4kHz < 40dB in the better ear) is increasingly being recognised as a
significant impairment, which can have a deleterious impact on communication and cognitive
capacity1,2, however hearing aid uptake in this group is low3,4. This study aimed to identify
differences between adults with MHL who adopt hearing aids and those who do not. In addition,
this study aimed to investigate clinical outcomes for the hearing aid adopters, to help identify
factors that could improve hearing aid uptake in this group. Measures used were the QuickSIN5,
HHI6,7 and SADL8 questionnaires. 38 adults participated in this study, of whom 12 adopted hearing
aids and 26 did not. Between-group variables included: age, gender, subjective hearing loss
severity, importance of improving hearing, pre- and post-hearing aid fitting HHI scores,
qualification level, living status, work status, length of hearing loss, prior hearing aid use, and
ethnicity. Results of the analysis showed that hearing aid adopters were older, rated their own
hearing as significantly worse, rated the importance for change significantly higher and scored
higher on the HHI social scale than non-adopters. Analysis of the adopters showed a clinically
significant improvement in HHI scores post-hearing aid fitting and the majority of hearing aid
adopters were within or above the normative range on each of the SADL subscales. These findings
highlight that hearing aid adopters with MHL experienced greater social impact of hearing
impairment than the non-adopters and the majority who chose to adopt hearing aids experienced
positive outcomes.
References
1. Holstrum, W., Biernath, K., McKay, S., & Ross, D. (2009). Mild and Unilateral Hearing Loss:
Implications for Early Intervention. Infants & Young Children, 22(3), 177-187.
2. Lin, F. R. (2011). Hearing loss and cognition among older adults in the United States. J Gerontol
A Biol Sci Med Sci, 66(10), 1131-1136. doi: 10.1093/gerona/glr115
3. Chou, R., Dana, T., Bougatsos, C., Fleming, C., & Beil, T. (2011). Screening adults aged 50 years
or older for hearing loss: a review of the evidence for the U.S. preventive services task force. Ann
Intern Med, 154(5), 347-355. doi: 10.1059/0003-4819-154-5-201103010-00009
4. Chou, R., Dana, T., Bougatsos, C., Fleming, C., & Beil, T. (2011). Screening adults aged 50 years
or older for hearing loss: a review of the evidence for the U.S. preventive services task force. Ann
Intern Med, 154(5), 347-355. doi: 10.1059/0003-4819-154-5-201103010-00009
5. Killion, M., Niquette, P.A., Gudmundsen, G.I., Revit, L.J., & Banerjee, S. (2004). Development of a
quick speech-in-noise test for measuring signal-to-noise ratio loss in normal-hearing and hearingimpaired listeners. Journal of the Acoustical Society of America, 116, 2395-2405. doi:
10.1121/1.1784440
6. Ventry, I.M. & Weinstein, B.E. (1982). The hearing handicap inventory for the elderly: A new
tool. Ear and Hearing, 3 (3), 128-134.
7. Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The hearing handicap
inventory for adults: Psychometric adequacy and audiometric correlates. Ear and Hearing, 11 (6),
430-433.
8. Cox, R.M., & Alexander, G.C. (1999). Measuring satisfaction with amplification in daily life: the
SADL scale. Ear and Hearing, 20 (4), 306-320.
15.40
Angela Deken, (CDHB Universal Newborn Hearing Screening and Early Intervention
Programme Co-ordinator,Christchurch Women's Hospital), Jan Pollard (Chief Audiologist , Sonic)
Infant Hearing Screening in NZ: The Christchurch Experience
The Infant Hearing Screening program was implemented in NZ in January 2009 and since then has
seen a rapid development in both systems and data collection. Christchurch DHB is a large
program with 9 dedicated newborn hearing screeners and 4 part time NICU nurses and is
presently using an AABR protocol. The presentation reviews the evolution of the screening
program, screening methods and staff training required for an effective program. Identification of
the challenges in funding and resource allocation and innovations in the way in which the program
is run will also be highlighted as well as future directions in the Christchurch Infant Screening
program.
16.00
Sarah De Heer, Parent of a hearing impaired child, Christchurch.
A Parent's Perspective, Navigating Life with a Deaf Child
The importance of the parent/child relationship and how this is underpinned by a complex set of
thoughts, feelings and experiences for parents. Parents have to absorb and respond to
information and opinions from a variety of sources, and this can lead to considerable
responsibility. There is quite an emotional toll for parents which can lead to a variety of outcomes.
How can we best help parents to bear this responsibility, support their child and take part in
family life?
16.20
Kirsty Gardner Berry
LOCHI study (Longitudinal Outcomes of Children with Hearing Impairment)
o 3 and 5 year Speech and language outcomes of children diagnosed with ANSD
following newborn hearing screening
o Other LOCHI-specific results to expand this into a 45 minute presentation.
o Population characteristics, speech-in-noise testing, and other measures that have been
included in the LOCHI study
Friday 4 July 2014
08.30
Chuck Berlin
Hearing loss after brain injury and temporal lobe surgery
09.30
Robert Cowan, The HEARing CRC
Use of Cortical Auditory Evoked Potentials for Assessment and Fitting of Hearing Aids and Cochlear
Implants ~ New Approaches
The advent and adoption of universal newborn screening programs world-wide has been clearly
shown to be of benefit to longer-terms speech and language outcomes, provided that early
detection leads to early device fitting. This has created a need for a low cost, highly effective
means of objectively establishing thresholds, both unaided and aided, to enable accurate fitting of
hearing aids and cochlear implants. In addition, with the predicted increase in prevalence of
hearing impairment in the elderly population, coupled with potential increased prevalence of
cognitive decline, it is imperative that audiologists have an objective means of device fitting in
adult/elderly patients who cannot subjectively cooperate with assessment and fitting procedures.
To date, standard electrophysiological methods for objectively measuring thresholds in infants,
such as ABR or ASSR, have been recognized as being clinically effective. However, these tests are
subject to several drawbacks. For example, the need to sedate infants introduces the potential for
adverse events, and the use of broad tonal stimuli does not necessarily give information on
perception of speech elements across the frequency range. In addition, the requirement for
subjective evaluation of traces, can require the use of highly-skilled electrophysiological expertise,
limiting the potential sites in which this technology can be used.
To address these issues, HEARing CRC has been developing HEARLab™, and a range of software
test modules that can be implemented in this technology platform to assess hearing thresholds
and to more accurately fit hearing aids to infants identified at an early age through universal
newborn screening. Use of speech specific stimuli, automated stimulus/response recognition, the
lack of any need for sedation, and rapid assessment times are specific advantages of this
technology. More recently, the technology has been adapted to enable its use with cochlear
implant patients. This has incorporated engineering solutions to limit artefact effects and enable
use of auditory evoked cortical potentials for fitting of cochlear implants.
Conclusions
New approaches to threshold testing and fitting of hearing aids and cochlear implants has been
established as feasible and effective through use of HEARLab and associated software test
modules.
This research is financially supported by the HEARing CRC, established and supported
under the Australian Government’s Cooperative Research Centres Program.
10.45
Abin Kuruvilla Mathew, Suzanne C. Purdy, David Welch, Niels H. Pontoppidan, Filip
M. Rønne, Auckland University
Cortical Encoding of Complex Acoustic cues
Recently the contribution of complex acoustic cues to speech perception, especially in background
noise has been recognised. Event related potentials (ERPs) are sensitive to the acoustic
characteristics of natural speech stimuli. Hence they may be useful for better understanding
listeners’ difficulties encoding discriminable acoustic cues in the presence of noise and for
objectively determining optimal hearing aid settings. To determine whether ERPs show stimulus
dependent morphological changes which reflect discrimination of complex acoustic cues Cortical
auditory evoked potentials were recorded from adults with normal hearing and adults with
sensorineural hearing loss in response to speech and non-speech sounds across various conditions
(background noise, aiding). ERPs were recorded with the participants engaged in a passive
listening task, watching subtitled videos. At least 150 artifact-free trials for each participant were
required to measure individual latencies and peak amplitudes of ERPs. ERP components show
significant effects of complex acoustic stimulus cues. Amplification introduces spectral and
temporal changes to the stimuli which are reflected in cortical responses. These data contribute to
our understanding of encoding of complex acoustic cues in the auditory cortex and the possible
use of ERPs to objectively assess benefit from hearing instrument digital signal processing
strategies.
11.05
Rose Thomas Kalathottukare, Auckland University
Prosody perception, reading accuracy, nonliteral language comprehension, and music and tonal
pitch discrimination in school aged children
Speech processing in natural contexts involves the perception and integration of both segmental
(i.e., phonological) and supra segmental (prosodic) information. Prosody has a role in indexical,
grammatical, emotional, and pragmatic levels of communication and it conveys a speaker’s
emotional state (e.g., happy vs. sad), gender and identity, information on sentence type (question
vs. statement), and word boundaries within phrases (Wells & Peppe, 2003; Cleary et al, 2005).
Accurate perception and production of prosodic patterns of speech are important for successful
communication, particularly in social settings. Twenty-five school aged children with normal
hearing (NH) were tested on their perception of prosody using the receptive prosody subtests of
the Profiling Elements of Prosody in Speech-Communication (PEPS-C; Peppé & McCann, 2003) and
Child Paralanguage (CP) subtest of Diagnostic Analysis of Non Verbal Accuracy 2 (DANVA 2;
Nowicki & Duke, 1994). Performance of children with hearing loss on the two prosody measures
was compared with age matched NH children. Children were also tested on their reading
accuracy, comprehension of nonliteral language, and music and tonal pitch discrimination. Overall
results showed that the NH children aged 7;1 to 9;11 year olds had poorer scores than the 10;1 to
12;11 year olds on Chunking Reception and Contrastive Stress Reception subtests of PEPS-C and
CP subtest of DANVA 2, indicating a developmental effect on speech prosody perception. Children
with hearing loss had poorer scores greater variability on the PEPS-C and DANVA 2 assessments
compared to NH controls. Statistically significant correlations were observed between prosody
perception scores and musical and tonal pitch perception and reading measures for the NH group.
The clinical implications of these results for children with hearing loss will be discussed.
References
1. Cleary, M., Pisoni, D. B. & Kirk, K. I. (2005). Influence of voice similarity on talker
discrimination in children with normal hearing and children with cochlear implants. Journal
of Speech Language and Hearing Research, 48, 204–223.
2. Nowicki, S. & Duke, M. P. (1994). Individual differences in the nonverbal communication of
affect: the diagnostic analysis of nonverbal accuracy scale. Journal of Nonverbal Behavior,
18, 9-35.
3. Peppé, S. & McCann, J. (2003). Assessing intonation and prosody in children with atypical
language development: The PEPS-C test and the revised version. Clinical Linguistics &
Phonetics, 17, 345-354.
4. Wells, B. & Peppé, S. 2003. Intonational abilities of children with speech and language
impairments. Journal of Speech Language and Hearing Research, 46, 5-20.
11.25
Richard Bishop
Reduced Auditory Redundancy: Clinical Presentations & Management
Auditory redundancy refers to auditory information that is in excess of that needed for
comprehension in an ideal listening setting. It is inversely related to listening effort and is the basis
of listening difficulties experienced by persons with different degree of peripheral deafness
(“hearing loss”). However, reduced auditory redundancy can also be present when there is no
peripheral deafness. It may be related to a level-dependent asynchrony of spiral ganglion activity
(Frazer, 2013), resulting in a reduction of neural synchrony in the auditory brain (Kraus et al,
2000). This presentation will present a brief theoretical model, discuss presenting symptoms,
clinical findings and audiological management for these clients.
References:
1. Frazer G, personal communication, 2013
2. Kraus N, Bradlow A R, Cheatham M A, Cunningham J, King DC D, Koch D V, Nicol T G,
McGee T J,
3. Stein L K &Wright B A. Consequences of Neural Asynchrony: A Case of Auditory
Neuropathy. Journal of the Association for Research in Otolaryngology, 2000, 1, 33 – 45.
11.45
Oscar Cañete, Suzanne Purdy, Colin Brown, Michel Neeff, Peter Thorne
Impact of unilateral hearing loss on behavioural and evoked potential measures of auditory
function
There is currently no consensus regarding treatment for unilateral hearing loss (UHL), despite
evidence for negative consequences (learning, speech and language, sound localisation, speech
perception) in children and adults. We are investigating how auditory skills and cortical auditory
evoked potentials (CAEPs) are affected by untreated and treated unilateral hearing loss (UHL) in
order to advance our knowledge of auditory plasticity in people with UHL and to determine the
impact of UHL on a range of auditory functions. Results for adults with UHL and normal hearing
controls will be presented for tests of sound localisation, spatial speech perception in noise,
acoustic reflexes, CAEPs in noise (+5 signal to noise ratio) and self-ratings of spatial listening
(Speech, Spatial and Qualities of Hearing, SSQ12 questionnaire). The results show that difficulties
with spatial speech recognition test are more pronounced when the signal is directed to the
affected ear and there may be right-left ear differences in the impact of UHL that should be
considered when deciding upon management for this population. The pattern of CAEP responses
across electrodes is altered in people with UHL compared to controls. CAEPs may provide a useful
tool for mapping auditory changes after treatment of UHL using bone anchored hearing aids or
other devices. Acoustic reflex thresholds and perception of loudness are also affected by UHL and
unilateral amplification. The SSQ12 is a useful, brief self-report index of auditory difficulties in
people with UHL with and without amplification devices. Preliminary results show UHL has
significant effects on auditory skills (sound localisation and speech perception), CAEPs and selfrated quality of hearing. Better evidence-based management guidelines are needed for this
population.
13.40
Peter Thorne, Section of Audiology, Department of Physiology and Centre for
Brain Research, University of Auckland, Auckland
Kaye Coddington Memorial Lecture: The University of Auckland Audiology Programme:
Kaye’s Enduring Influence.
The Master of Audiology programme was established at the University of Auckland in 1990. After
years of planning and discussion around host departments and the appropriate format of a
training programme for Audiology, the first cohort of students started in late February 1990; and
we’ve never looked back. The programme now in its 25th year has produced around 220
Audiology graduates who occupy clinical and industry positions around the world. It is a highly
respected Audiology degree programme and has a focus on clinical and academic excellence.
Kaye was extremely influential in the design and implementation of the programme and provided
the essential clinical input at the really formative period of the programme. Although she was
working full-time as the Director of the National Audiology Centre at the time, she helped
enormously to deliver this part of the programme and was very vocal and firm about what should
happen and espoused values of clinical excellence and evidence–based practice as the core of the
training. She felt that students needed a high level of “hands-on” clinical experience and very
strong supervision during their clinical experiences. Her real passion was paediatrics and she was
the most wonderful role model and teacher in this area especially; her approach to paediatric
audiology is so valued that 25 years on we still use a DVD that she developed which shows her
conducting different paediatric tests and sharing her wisdom on the do’s and don’ts of testing 3
year olds. Kaye’s values, principles and views on clinical excellence still resonate and continue as
key elements and themes throughout the MAud programme as it enters its 25th year.
14.00
Greg O’Beirne, University of Canterbury
An update on the University of Canterbury Master of Audiology programme
The Master of Audiology programme at the University of Canterbury was established in 2005 to
address the shortage of Audiologists in New Zealand, and has so far graduated 72 Audiologists.
Our core teaching staff consists of Dr Rebecca Kelly-Campbell, Associate Professor Greg O’Beirne,
Dr Donal Sinex, and our clinical educators Dr Bekah Gathercole and Ms Fiona Yip. In addition, 20
distinguished international scholars have taught courses to our students as part of the Erskine
fellowship programme. Following our successful NZAS Endorsement in 2013, this year sees the
introduction of a reorganised and updated curriculum and a streamlined course structure. While
the second year thesis component remains unchanged, the 16 postgraduate and two
undergraduate courses of our old curriculum have been replaced by eight team-taught courses
that are entirely at the postgraduate level. In addition to placements at our own Speech and
Hearing Clinic, our close working relationships with NZAS members allow us to arrange supervised
clinical practica for our students in a variety of settings (both public and private) within the greater
Christchurch area and throughout New Zealand. Despite the challenges faced by academic
programmes in New Zealand, the UC Master of Audiology is a thriving programme that continues
to produce graduate Audiologists of high quality.
14.20
Melissa Baily, Accessable
Statistics over the past three years of the Hearing Aid Subsidy & Funding Schemes
14.40
Sue Primrose, Ministry of Health
Update from Ministry of Health
15.30
Mellissa Babbage, GA O’Beirne, M Bergin, E Macassey, P Bird4
Patterns of extended high-frequency hearing loss following stapedectomy
Stapedectomy procedures are typically associated with a high rate of hearing improvement and a
low rate of sensorineural deterioration in the conventionally measured frequency range.
However, it has been documented that a hearing loss in the extended high-frequencies (8 – 20
kHz) may occur relatively frequently following otherwise successful procedures. The information
regarding the relative magnitude and rates of transient and permanent loss of high-frequency
hearing acuity remains limited. We aimed to document the prevalence, patterns, and degree of
hearing deterioration at 0.25 – 16 kHz, following stapedectomy. In particular, we aimed to
determine the rates of transient and permanent extended high-frequency hearing loss. Hearing
thresholds were measured preoperatively, and at approximately 1 week, 1, 3, 6, and 12 months
following stapes surgery in 25 patients. Despite mean improvements in hearing thresholds from
0.25 to 8 kHz, there was a decrease in the highest frequency at which a hearing threshold was
measureable in 82% of patients at the first postoperative assessment. There was a trend towards
improvement over time, however in 55% of patients a change in the highest frequency heard
remained evident 12 months postoperatively. Whether this hearing loss is of clinical importance is
unclear, however the results do suggest that hearing thresholds in the extended high-frequency
range may be used as a more sensitive measure of operative trauma. Investigations of methods to
protect the ear from surgical trauma may utilise extended high-frequency threshold measurement
as a more efficient method to determine their efficacy.
15.50
Anna McMillan, Bay Audiology Ltd; Grant Searchfield, University of Auckland
The Use and Utility of Hearing Aid Data logging in New Zealand
Over the past 10 years, datalogging has become a very useful tool which reveals specific details
about a hearing aid wearer’s use of their aids and the sound environments they have been in.
This study aims to investigate New Zealand Audiologists’ use and opinion of datalogging. MNZAS
Audiologists will be surveyed with questions ranging from which aspects of datalogging they find
most useful to whether they share datalogging information with other health professionals to
assist in the management of cases. Hearing aid manufacturers have been consulted during the
design of the survey and the results will help them to improve the utility of datalogging and to
better advise Audiologists on how to utilise it best. Preliminary findings on such things as how
often Audiologists look at datalogging information, how reliable they find it and whether they
apply its recommendations will be presented.
References:
1.
Banerjee S. Hearing aids in the real world: use of multimemory and volume controls.
Journal of the American Academy of Audiology 2011;22(6):359-74.
2.
Humes LE. Dimensions of hearing aid outcome. Journal of the American Academy of
Audiology 1999;10(1):26-39.
3.
Hartley D, Rochtchina E, Newall P, Golding M, Mitchell P. Use of hearing AIDS and assistive
listening devices in an older Australian population. Journal of the American Academy of
Audiology;21(10):642-53.
4.
Gopinath B, Schneider J, Hartley D, Teber E, McMahon CM, Leeder SR, Mitchell P.
Incidence and predictors of hearing aid use and ownership among older adults with
hearing loss. Annals of Epidemiology;21(7):497-506.
16.10
Jenny Stygall, MAud Student, Auckland University
Occupational Stress in Newborn Hearing Screeners in New Zealand
The purpose of this research was to identify the potential stressors for newborn hearing screeners
and gain an understanding of how they perceive and experience stress. A qualitative method was
applied. Interviews were conducted with volunteer participants to investigate sources of stress in
the screener role. Interview questions were formulated from a model of occupational stress based
on similar conceptualisations by different researchers (Cooper & Marshall, 1976; Fletcher, 1988;
French, Caplan, & Van Harrison, 1982; Schuler, 1982). The authors claim six main factors (factors
intrinsic to the job, role-based stress, relationships at work, career development, organisational
structure and climate, and the home/work interface) are stressors common to all jobs. An online
questionnaire-based survey was sent by the National Screening Unit to all newborn hearing
screeners in New Zealand. Five questions were relevant to this thesis: stressors in the job,
satisfying aspects of the job, dissatisfying aspects of the job, recommendations for improvements,
and ‘other’ comments/suggestions.
The results of the interviews (n = 7) revealed all six factors as stressors in the screener role. The
results of the online survey (n = 65 (a proportion of the screener workforce)) revealed that five of
the six factors were sources of stress. The home/work interface was not found to be a stressor.
The findings showed screeners experience: poor physical working conditions, excessive workloads,
role conflict and ambiguity, risks and dangers, poor training, and a lack of career development.
Poor working relationships between parents, colleagues, lead screeners, screening co-ordinators,
and other District Health Board staff were also evident; screeners experienced verbal abuse,
bullying, mistrust, favouritism, a lack of support, and unrealistically high expectations.
Furthermore, stress at work affected screeners’ home life and vice versa. In addition, screeners
reported physical, psychological, behavioural and organisational symptoms of stress.
These results: (1) identify potential stressors and consequences of stress in the screener role, (2)
provide an understanding of how newborn hearing screeners perceive and experience stress, and
(3) contribute new information that will assist in changes to the screener role.
Saturday 5 July 2014
08.30
Robert Cowan, The HEARing CRC
The HEARing Cooperative Research Centre – Translating Innovation in Hearing Loss Prevention and
Improved Remediation to Improved Patient Outcomes
In 1991, the Commonwealth of Australia established a Cooperative Research Cenre Program,
aimed at bringing together university researchers and industry engineers at the outset of projects.
The primary aim of this program was to improve innovation through ensuring that research was
translated into commercial application.
The CRC for Cochlear Implant, Speech and Hearing Research was established in 1992, and since
that time, three iterations of the HEARing CRC have operated. In 2014, the HEARing CRC was
awarded an additional $A28million to continue its research and innovation program. This grant is
matched by some $A98million in in-kind and cash contributions from its 26 Member
organisations.
The rationale for the HEARing CRC was contained in the “Listen Hear Australia! The Economic Cost
and Impact of Hearing Loss in Australia”, commissioned in 2007 by the HEARing CRC and The
Victorian Deaf Society. This report identified that lost productivity was a major cost for hearing
impaired adults, and was addressable through improved methods for preventing hearing loss, and
improved remeditation.
HEARing CRC has had several successes in addressing these challenges, and in ensuring that the
outcomes of its research are translated into clinical practice. The HEARing CRC’s new program of
research and innovation seeks to change the character of hearing loss prevention and audiological
clinical services in Australia, in particular to develop more patient-centric outcomes, and
enhanced delivery methods that ensure equal access to services regardless of geographic locale.
This research is financially supported by the HEARing CRC, established and supported
under the Australian Government’s Cooperative Research Centres Program.
09.15 Trish Carraher and Jenny Southee, LIFE Unlimited Hearing Therapy Services
Independence through innovative application of Technology - a Hearing Therapy perspective
‘Aural rehabilitation is any device, procedure, information, interaction or therapy which lessens
the communicative and psychosocial consequences of a hearing loss’ (Ross, 1997). The World
Health Organization (WHO) defined health in its broader sense in 1948 as "a state of complete
physical, mental, and social well-being and not merely the absence of disease or infirmity”. An
inability to hear loved ones, friends, colleagues and service providers can cause devastation. An
inability to hear on the phone, hear the doorbell, smoke alarms or a baby crying can put a person
in unsafe situations. Being on constant alert for indications that someone is talking to them or
wanting their attention can cause irritability, anxiety, stress and tiredness. Continued levels of
stress can result in lack of confidence, withdrawal, isolation and frustration and may spiral into
depression. Effective use of technology can address many of these issues enhancing the physical,
mental and social well-being and thus the overall health of the user. Positive outcomes can
benefit both the person with hearing loss and everyone they interact with. The variety and
adeptness of technology is growing rapidly resulting in simple and complex equipment becoming
more readily available. Hearing Therapists are constantly challenged to think ‘outside the square’
and be innovative when integrating technology to meet specific and often complex needs of
clients.
LIFE Unlimited Hearing Therapy Services has also been involved in the design and implementation
of a joint process with the New Zealand Fire Service to assess the need for specialized smoke
alerting equipment. This presentation will share several case studies that illustrate enhancement
of communication through innovative application of technology.
References:
1. Ross, M. (1997). A Retrospective Look at the Future of Aural Rehabilitation. Journal of the
Academy of Rehabilitative Audiology
2. Robertson, M. (2003) Hearing Loss and Grieving. Retrieved from www.shhhaust.org (April
2011) Websites: www.who.int/classifications
09.45
Louise Carroll NFD
Why is the Convention on the Rights of Persons with Disabilities important?
Human rights are human needs or requirements which are essential for all human beings to live a
life with dignity. The Universal Declaration of Human Rights (Bill of Rights), adopted by the United
Nations (UN) in 1948, was the first international document to state the human rights that all
people have. In 2006, the UN General Assembly adopted the Convention on the Rights of Persons
with Disabilities (CRPD) and its Optional Protocol on 13 December 2006, spelling out in more
detail the accessibility needs and human rights of people with all types of disabilities.
This Convention is important because it reflects a change in thinking about disability as it requires
governments to respect the rights of disabled people and to ensure they can participate fully in all
areas of life. Here I argue that the CRPD does apply to the human right to communicate and that it
is the States responsibility to enable access to rehabilitation including fully funded hearing aids as
such equipment is required to “enable persons with disabilities to live independently and
participate fully in all aspects of life…” This is further supported by the State being required to
take “appropriate measures to ensure to persons with disabilities access, on an equal basis with
others, to the physical environment, to transportation, to information and communications,
including information and communications technologies and systems…””
With this in mind we need to see Governments worldwide being held accountable by non
government organisations, using the UN submission processes to the UN Committee on the CRPD
and the UN Universal Periodic Reviews of member states as vehicles to ensure the right to
communicate as it applies to people who are hard of hearing, is upheld.
References
1)
IFHOH Human Rights Toolkit
http://ifhoh.org/papers/ifhoh_un_crpd_toolkit.pdf
2)
United Nations Convention on the Rights of Persons with Disabilities
http://www.un.org/disabilities/default.asp?id=150
10.45
Virginia Good
Special Olympics New Zealand, the Healthy Hearing programme and regional screening initiatives
WHO (2013) reports that 1 – 3% of the world population has an intellectual disability (ID) i.e. 70 –
213 million. The 66th World Health Assembly (2013) reported that people with disabilities do not
receive the health care they need; have poorer health; are more than twice as likely to find
healthcare providers’ skills and facilities inadequate; nearly three times more likely to be denied
health care; and are four times more likely to be treated badly.
At the 2013 Special Olympics NZ National Summer Games, a significant disparity was seen
between NZ and worldwide rates of sensorineural hearing loss of a unilateral or bilateral nature at
any level. The rate for NZ was four times greater than the world average (28.1% versus 7.8%).
Blocked ears due to wax occlusion were also higher than worldwide rates (38.6%), where despite
pre-event checks and Ear Nurses on-site was 40%. In 2013, Accessable reported an incremental
increase in funding applications for adults with complex needs with a dual disability. In the past,
many with ID were not eligible and could not afford aiding even if hearing loss was diagnosed.
These data suggest that at least for hearing concerns, NZ is sadly following the worldwide trend,
i.e. people with ID are not receiving the hearing care they need.
Opportunities for training and education about the special needs population, assessment and
successful communication is critical. Special Olympics (SO) provides opportunities via the Healthy
Hearing programme which began at Christchurch National Summer Games in 2005 run by Dr Kim
Wise, MNZAS. Through SO, audiologists can facilitate professional development and support
hearing needs of people with ID. MNZAS membership’s kind donations are well used by SO.
11.15
Chuck Berlin
Major truths in audiology which are myths
Concurrent Sessions
08.30 – 11.00
PTAG UP SKILLING SESSION
Session will include paper by Kirsty Gardner Berry
Managing infants with ANSD during the first 12 months of life
 To fit or not to fit: issues surrounding the choice of whether or not to fit amplification to young
infants with ANSD
 BOA and VROA findings in a group of 12 infants with ANSD
 The role of parent observations in early management of infants with ANSD
 The use of cortical auditory evoked potentials (CAEPs) to manage infants with ANSD.
09.45 – 11.15
Catherine Winfrey and Geraldine Boley
DEAFBLIND AWARENESS WORKSHOP: Affiliation: Blind Foundation
Deafblindness, or dual sensory loss, is the condition of having both significant hearing impairment
and significant vision impairment. The combined impact of vision and hearing loss yields a unique
disability that profoundly impacts a person’s life. Deafblindness affects a growing number of
people, due to the growing proportion of seniors in the population and the increasing survival
rates of very premature babies.
This interactive workshop introducing the definition of deaf-blindness used by the Ministry of
Health and the Blind Foundation in determining eligibility for services. Through experiential
activities, participants gain an understanding of the most significant functional challenges
associated with dual sensory loss, and explore ways to improve communication with deaf-blind
clients in an audiology setting. Additional sources of information and support for audiologists and
clients will be identified, and current information on funding entitlements for hearing aids for
people with low vision will be presented. This workshop focuses on the functional impact of deafblindness, and particularly on communication in an audiology/clinical setting, rather than on
particular causes of vision and/or hearing impairments.