UNIVERSITY OF MARYLAND, COLLEGE PARK Department of Hearing and Speech Sciences HESP 606: BASIC HEARING MEASUREMENT Fall, 2014 Instructor: Sandra Gordon-Salant Office Phone: 405-4225 Office: Room 0119L, Lefrak Hall Dept. Phone: 405-4213 E-mail: sgsalant@umd.edu Course Meets: Thursdays, 3:30-6:00, Rm 0135 Lefrak Hall Internet Course Website: http://www.elms.umd.edu HESP 606 COURSE SYLLABUS September 4, 2014 Introduction; Case History; Cerumen Management, Infection Control September 11, 2014 The Audiometer, Standards and Calibration September 18, 2014 The Audiometer, Standards, and Calibration *September 25, 2014 Pure tone and speech threshold assessment (class re-scheduled to Sept 22: 3:30 – 5:30 in 0135) October 2, 2014 Exam I; Speech Recognition Testing October 9, 2014 Speech Recognition Testing October 16, 2014 Speech Recognition Testing *October 23, 2014 Masking (class re-scheduled to Oct 20: 3:30 – 5:30 in 0135) October 30, 2014 Masking November 6, 2014 Exam II; Classifying Hearing Loss (typed notes handed out) Identification Audiometry (Part I) *November 13, 2014 Identification Audiometry (Part II)/ Intro to Acoustic Immittance (class re-scheduled to Nov 10: 3:30 – 5:30 in 0135) November 20, 2014 Acoustic Immittance Measures November 23, 2013 Thanksgiving Holiday December 4, 2014 Acoustic Immittance Measures December 11, 2014 Special Populations, Case Presentations **December 18, 2014 FINAL EXAMINATION (3:30 – 5:30) 1 Grading System Grades based on: 2 Examinations: Labs: Article critiques: Final: 25%/each 15% (total) 5% (total) 30% Summary of point system: Exams 1 and 2: 100 points/each 2 tests x 100 points = 200 Final: 120 points 1 final x 120 points = 120 Practical labs: 10 points/each 6 labs x 10 points = 60 Article critiques: 5 points/each 4 critiques x 5 pts = 20 Total points 400 ___________________________________________________________________________ University of Maryland grade policy: Course Average 97 - 100 93 – 96 90 – 92 87-89 83-86 80 – 82 Course Grade A+ A AB+ B B- Learner Outcomes Students will acquire knowledge in foundations of audiology practice, identification of hearing loss, and evaluation of hearing. As a result of the knowledge obtained in this course, students will be able to: 1. Identify a range of patient characteristics (age, demographics, medical history and status, cognitive status, physical and sensory abilities) and determine how they relate to clinical services; 2. Understand how pathologies of the auditory system are diagnosed and treated; 3. Apply principles and methods of psychoacoustics and psychometrics to the assessment of hearing in the clinical setting; 4. Use audiologic instrumentation for routine assessment and according to manufacturer’s specifications; 5. Take necessary precautions to prevent the spread of infection/contagious diseases in the clinical setting; 6. Apply principles and methods of acoustics to various environments; measure physical characteristics of acoustic stimuli; 7. Understand aspects of consultation with professionals in related or allied service areas and referral to other professionals, agencies and/or consumer organizations; 8. Identify individuals at risk for hearing impairment; 9. Apply methods of screening individuals for hearing impairment using clinically appropriate screening measures; 10. Obtain a case history; 11. Identify normal and abnormal ear canal conditions during an otoscopic examination and remove cerumen; 2 12. 13. 14. 15. 16. 17. 18. Administer clinically appropriate and culturally sensitive assessment measures; Perform an audiologic assessment using psychophysical measures; Interpret results of an audiologic evaluation to establish type and severity of hearing disorder; Conduct and interpret acoustic immittance measures; Generate appropriate recommendations and referrals resulting from the evaluation process; Conduct an electroacoustic calibration of standard audiometric equipment and determine whether instrumentation is in calibration according to accepted standards; Apply research findings in the provision of patient care and evaluate new techniques based on research evidence; and Administer clinical programs and provide supervision of professionals and support personnel. Formative assessment Each student's knowledge and skills in these areas will be determined by the following assessment procedures: 1. written examinations (two mid-semester examinations and one final examination); 2. practical laboratory exercises, for which students will submit written reports throughout the semester and receive feedback; 3. written critiques of original research articles relevant to the course material, which are part of the required reading. 4. homework assignment Class and University Policies Class Attendance/Lectures Regular class attendance and participation are highly recommended. Students who are unable to attend a class should inform the instructor as soon as possible. It is the student’s responsibility to obtain information from any missed lecture from classmates. In accordance with University of Maryland Policy of Intellectual Property, all course materials including power point presentations, study materials, and tests are copyrighted. Persons who publicly distribute or display or help others publicly distribute or display copies or modified copies of an instructor’s course materials may be considered in violation of the University Code of Student Conduct, Part 9 (k). Canvas Course Website Students should check Canvas accounts regularly at http://elms.umd.edu. The class site will include the syllabus, required articles, assignments, lecture outlines, and grades. For assistance on how to login to Canvas, please visit: http://elms.umd.edu/page/student-support. Computers with internet access are available at open workstation laboratories on campus. For locations and hours of operations, visit: http://www.it.umd.edu/as/cl or contact the Office of Information Technology (OIT) Helpdesk at 301405-1500. Problems/Questions Please contact the instructor as soon as possible about any difficulty with course material, assignments, grades, or other problems/issues related to the course. Email is the best way to reach the instructor outside the class. Academic Integrity The University administers has a nationally recognized Code of Academic Integrity. The Code and 3 Honor Pledge are available on the web at http://www.academicintegrity.umd.edu/AI/Default.aspx . The Code prohibits students from cheating on exams, plagiarizing papers, submitting the same paper for credit in two courses without authorization, buying papers, submitting fraudulent documents, and forging signatures. Students are requested to write the following signed statement on each examination or assignment: “I pledge on my honor that I have not given or received any unauthorized assistance on this examination (or assignment).” Compliance with the code is administered by a Student Honor Council, which strives to promote a “community of trust” on the College Park campus. For additional information, see the Office of Judicial Programs and Student Ethical Development website (http://shc.umd.edu/) Adherence to the University’s Code of Academic Integrity is expected, and there will be a zero tolerance policy for cheating, plagiarism, or other violations. Any suspected violation of University policy will results in Student Honor Council proceedings. Special Accommodations Every effort will be made to accommodate students who are registered with the Disability Support Services (DSS) Office and who provide a University of Maryland DSS Accommodation form which has been updated for the current semester. Accommodations can be provided only after registering with DSS and presenting the instructor with appropriate documentation by the last day to add a class, September 15, 2014. Information on evaluation and accommodations can be obtained from DSS, part of the Counseling Center. For more information, see http://www.counseling.umd.edu/DSS/index.html or call 301-314-7682 for assistance in determining and implementing appropriate academic accommodations. Confidentiality-Posting Grades The University complies with the regulations set forth in the Buckley Amendment. The amendment protects the student from the disclosure of personal and academic information to anyone other than the student, including parents, except under special circumstances. Posting student grades with either student names or social security numbers-in whole or in part-is strictly prohibited. Grades will be available on ELMS (Canvas), UMEG, or directly from the instructor. Religious Observances The University System of Maryland policy on religious observances provides that students should not be penalized because of observances of their religious beliefs; students shall be given an opportunity, whenever feasible, to make up within a reasonable time any academic assignment that is missed due to individual participation in religious observances. I will make every feasible effort to accommodate students' requests based on attendance of religious observances. It is the student's responsibility to inform me of any intended absences for religious observances in advance. Notice should be provided as soon as possible but no later than the end of the schedule adjustment period. Prior notification is especially important in connection with final examinations, since failure to reschedule a final examination before the conclusion of the final examination period may result in loss of credits during the semester. To review the University’s policy or view a variety of other religious holidays, see http://www.faculty.umd.edu/teach/religious.htm Online Course Evaluation, Fall 2014 Your participation in the evaluation of courses through CourseEvalUM is a responsibility you hold as a student member of our academic community. Your feedback is confidential and important to the improvement of teaching and learning at the University. CourseEvalUM will be open for you to complete your evaluations for fall semester courses between Tuesday, December 2 and Sunday December 14. Please go directly to the website (www.courseevalum.umd.edu) to complete your 4 evaluations starting December 2. By completing all of your evaluations each semester, you will have the privilege of accessing online, at Testudo, the evaluation reports for the thousands of courses for which 70% or more students submitted their evaluations. Flu and other illnesses The University of Maryland is concerned for the health of members of the University community. However, we are also concerned about the possibility that widespread illness could disrupt the academic enterprise of the University. If you are even mildly sick with flu-like symptoms, please stay home and seek medical attention. You should return to classes only after your fever and symptoms have abated for 24 hours. I will follow the same policy. To continue the teaching/learning environment of our class even if you or I are absent, and/or classes are canceled, I plan to implement several contingencies this year: 1. I will communicate with all of you via Canvas if class is canceled for any reason; 2. I ask you to communicate with me if you are sick and will miss class; 3. I will post all ppt presentations to Canvas; 4. I will post audio versions of a specific lecture to Canvas if any one of us is sick. Class Cancellations In the event that class is cancelled due to campus closures or other emergencies, the missed class meeting will be rescheduled in its entirety on another day OR already scheduled classes may be extended. This decision will be made by the instructor in conjunction with the students. Every attempt will be made to arrive at a decision that is agreeable to all members of the class. Some course material may be presented online through the Canvas site for the course. Classroom Behavior Students are expected to treat each other with respect. Disruptive behavior of any kind will not be tolerated. Students who are unable to show civility with one another or the instructor will be subject to referral to the Office of Student Conduct or to Campus Police. Students may bring their laptops to class to take notes only. All other technological devices are prohibited during class, including MP3 devices, smart phones, phones, gaming devices, etc. All technological devices are prohibited during exams (except calculators). If these devices, including laptops, are seen and/or used during and exam, the student will not be allowed to continue taking the exam, and the exam score will be noted as zero. 5 LABORATORY ASSIGNMENTS For each lab, type up a summary of the procedures you followed, the results obtained, and conclusions regarding the results. Attach the raw data. Each lab should be a maximum of 2 pages (not including raw data); a cover sheet is unnecessary. The labs are due on the date specified for each. The labs must be typed using a 12-point font. You may turn in the assignments early. 1. Audiometer Calibration. Lab assignment due: September 25, 2014*. (due to the holiday, you may turn this in up until Monday, September 29) You should work with a partner for this lab, and each of you will calibrate one earphone of the Interacoustics pure tone audiometer located in Room 0119M. CHECK THE SCHEDULE FOR THE AVAILABILITY OF THE LAB. I will post hours when I will be available to help you during the calibration if you encounter difficulty. Calibration measures include hearing levels (output levels) across frequency, attenuator linearity, and harmonic distortion. Follow the step-bystep instructions handed out in class. Complete calibration sheet to be submitted with commentary. 2. Pure tone audiometry and speech recognition threshold. Lab assignment due: October 9, 2014. Test one ear of a subject and obtain air conduction thresholds across frequency, bone conduction thresholds, and the speech recognition thresholds. For speech recognition thresholds, please use the ASHA, 1988 method and another method of your choice. 3. ** (DEMO) Speech recognition in noise. Lab assignment due: October 23, 2014*. (can turn this in between 10/20 and 10/27) Select two speech recognition tests that we have talked about in class, one where you present the noise at a fixed signal-to-noise ratio, and the other where you use an adaptive procedure. Be sure to look at normative data for the test before you conduct the lab to select appropriate signal and noise levels. Conduct the testing under earphones. Present one test in noise, at a fixed signal-tonoise ratio to your subject. Present the other test in noise, using the adaptive technique for deriving the signal-to-noise ratio for 50% correct recognition (we have the HINT available, or you can select another test). Present your findings; compare to available normative data; and discuss your preference for one of these two procedures. 4. Masking. Lab assignment due: November 13, 2014*. (can turn this in between 11/10 – 11/17) Have your subject put an EAR plug into one ear (as deeply as possible) to simulate a conductive hearing loss. Test hearing by air conduction and bone conduction; use masking where necessary. Submit audiogram and commentary. 5. Identification Audiometry. Lab assignment due: November 20, 2014 Screen the hearing and middle ear function of both ears of one subject, using ASHA recommended procedures for school-age children (pretend your subject is a child). Submit results and indicate if your subject passes each type of screening measure. Also indicate the recommended follow-up procedures, if any. 6. Acoustic Immittance. Lab assignment due: December 11, 2014. Using the Grason-Stadler/TympStar middle ear analyzer, obtain tympanograms for each ear, acoustic reflex thresholds both ipsilaterally and contralaterally, and acoustic reflex adaptation (10 sec). Submit results and commentary. *note: the earlier you turn in the lab, the earlier I can return them to you, especially before a test. 6 ARTICLE REVIEWS and CRITIQUES One goal of this course is to promote your ability to read and critique original research articles. From the original journal articles on the reading list that have an asterisk (*), you are to select any four articles and do the following: 1. Write a brief summary of the article (purpose, methods, results, discussion). This should be NO LONGER than 1-1.25 pages/article, using double spacing and margins of 1" or more on the left and right side of the page. A cover page is not necessary. 2. Critique the article. You should think about every aspect of the article and indicate where there are faults or limitations with the article. (This should be one paragraph of approximately 1/2 page). Some examples are: a. Is the research question a new and interesting one? b. Does the author provide a rationale for the research they are proposing to do? c. Are the research subjects appropriate in terms of their auditory characteristics, age, education level for the task? Is the number of subjects appropriate? d. Are the stimuli appropriate; are they calibrated? e. Are the procedures such that they foster reliable and valid results? Do the authors use appropriate randomization of procedures? f. Are the procedures confounded in any way? g. Are the statistical analyses correct for answering the research questions posed? h. Is the interpretation of the statistical results accurate? i. Are the conclusions that the authors reach supported by the research that they conducted? Do the results agree with those of other investigators, and if not, have the authors explained why they differ? 3. Suggest ways to improve the research. Describe how you might improve the research, or they next study that should be conducted (1-2 sentences), 4. All summaries and critiques are due by the dates specified below. a. Critique #1 due September 18 – should be one article from either pure tone or speech threshold assessment sections b. Critique #2 due October 16 – should be an article from speech recognition testing section c. Critique #3 due October 30 – should be an article from identification audiometry section d. Critique #4 due December 4 – an article from immittance or evaluating special populations OTHER ASSIGNMENTS 1. Homework Assignment: you will have one homework assignment to view a DVD on cerumen management and write a brief summary of the information presented (1st week of class) 7 2. REQUIRED READINGS Required Texts: Katz, J. (Ed.) (2009). Handbook of Clinical Audiology, 6th Edition. Baltimore: Williams and Wilkins. Review of Basic Principles, Case History, and Cerumen Management Katz, J. "Clinical Audiology," Text, Chapter 1, pp. 3-6. Hannley, M. (1986). Preliminary Procedures - The Case History. Basic Principles of Auditory Assessment, San Diego: College Hill Press. p. 15-26. Beck, D. "Case History,” Text, Chapter 7, pp. 116-122. Vento, B.A., & Durrant, J.D., “Assessing bone conduction thresholds in clinical practice – tuning fork tests,” Text, pp. 55-56. Roeser, R.J., & Roland, P. (1992). What Audiologists Must Know about Cerumen and Cerumen Management. American Journal of Audiology, 1, 27-35. Cohen, M.R., & McCollough, T.D. (1996). Infection control protocols for audiologists. American Journal of Audiology, 5, 20-22. The Audiometer Wilber, L.A. “Calibration: Pure tone, Speech and Noise Signals,” Text, Chapter 2, p. 7-25; 26-27. American Speech-language-Hearing Association (1991). Sound Field Measurement Tutorial. Asha, 33 (Suppl.3), 25-37. Ghent, R.M. (2005). A tutorial on complex sound fields for audiometric testing, Journal of the American Academy of Audiology, 16, 18 – 26. Pure tone thresholds * Carhart, R. & Jerger, J.F. (1959). Preferred method for clinical determination of pure-tone thresholds. Journal of Speech and Hearing Disorders, 24, 330-345. ASHA (2005). Guidelines for Manual Pure-Tone Threshold Audiometry. Available from www.asha.org/policy. Schlauch, R.S., & Nelson, P., "Puretone evaluation," Text, Chapter 3, pp. 30-49. 8 Vento, B.A., & Durrant, J.D., "Assessing bone conduction thresholds in clinical practice, Text, Chapter 4, pp. 50-63. * Mineau, S.M., & Schlauch, R.S. (1997). Threshold measurement for patients with tinnitus: pulsed or continuous tones. American Journal of Audiology, 6, 52-56. * Dean, M.S., & Martin, F.N. (2000). Insert earphone depth and the occlusion effect. American Journal of Audiology, 9, 131-134. * Margolis, R.H., & Saly, G.L. (2008). Distribution of hearing loss characteristics in a clinical population. Ear & Hearing, 29, 524-532. Speech Thresholds McArdle, R., & Hnath-Chisolm, T., "Speech audiometry," Text, Chapter 5, pp. 64-69. Hirsh, I.J., et al. (1952). Development of materials for speech audiometry. Journal of Speech and Hearing Disorders, 17, 321-337. ASHA (1988). Revised guidelines for determining the threshold level for speech. Asha, 30, 8589. * Jahner, J.A., Schlauch, R.A., & Doyle, T. (1994). A comparison of American Speech-LanguageHearing Association Guidelines for obtaining speech-recognition thresholds. Ear and Hearing, 15, 324329. Speech Recognition Testing McArdle, R., & Hnath-Chisolm, T., "Speech audiometry," Text, Chapter 5, pp. 69-79. * Tillman, T.W., & Carhart, R.C. (1966). An expanded test for speech discrimination utilizing CNC monosyllabic words: N.U. Auditory Test No. 6, USAF School of Aerospace Medicine, Report No. SAMTR-66-55. Carhart, R.C. (1965). Problems in the measurement of speech discrimination. Archives of Otolaryngology, 82, 253-260. * Thornton, A.R., & Raffin, M.J.M. (1978). Speech discrimination scores modeled as a binomial variable. Journal of Speech and Hearing Research, 21, 507-518. * Schlauch, R.S., Anderson, E.S., & Micheyl, C. (2014). A demonstration of improved precision of word recognition scores, Journal of Speech, Language, and Hearing Research, 57, 543-555. * Guthrie, L.A., & Mackersie, C.L. (2009). A comparison of presentation levels to maximize word recognition scores, J American Academy of Audiology, 20, 381-390. * Bilger, R., Nuetzel, J., Rabinowitz, W., Rzeczkowski, C. (1984). Standardization of a test of speech perception in noise. Journal of Speech and Hearing Research, 27, 32-48. 9 * Dirks, et al. (1982). A procedure for quantifying the effects of noise on speech recognition. J. Speech and Hearing Disorders, 47, 114-122. * Nilsson, M., Soli, S., & Sullivan, J.A. (1994). Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise. Journal of the Acoustical Society of America, 95, 1085-1099. *. Kirk, K.I., Eisenberg, L.S., Martinez, A.M., & Hay-McCutcheon, M. (1999). Lexical Neighborhood Test: Test-retest reliability and interlist equivalency. Journal of the American Academy of Audiology, 10,113-123. * Killion, M.D., Niquette, P.A., Gudmundsen, T.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. * Wilson, R.H., McArdle, R.A., & Smith, S.L. (2007). An evaluation of the BKB-SIN, HINT, QuickSIN, and WIN materials on listeners with normal hearing and listeners with hearing loss. Journal of Speech, Language, and Hearing Research, 50, 844-856. * McCreery, R., Ito, R., Spratford, M., Lewish, D., Hoover, B., & Stelmachowicz, P.G. (2010). Performance-intensity functions for normal-hearing adults and children using computer-aided speech perception assessment. Ear and Hearing 31, 95-101. * Schafer, E.C., Pogue, J., & Milrany, T. (2012). List equivalency of the AzBio Sentence Test in noise for listeners with normal-hearing sensitivity or cochlear implants. Journal of the American Academy of Audiology, 23, 501-509. Masking Yacullo, W.S. “Clinical masking,” Text, 80-115. Classification of Hearing Loss Clarke, J.B. (1981). Uses and abuses of hearing loss classification. ASHA, 23, 493-500. Martin, F.N., & Champlin, C.A. (2000). Reconsidering the limits of normal hearing. Journal of the American Academy of Audiology, 11, 64-66. Identification Audiometry Johnson, C.D. "Educational Audiology," Text, Chapter 24, pp. 565-567. * Wilson, W.R., & Walton, W.K. (1974). Identification audiometry accuracy: evaluation of a recommended program for school-age children. Language, Speech, Hearing Services in the Schools, 5, 132-142. 10 American Speech-Language-Hearing Association Audiologic Assessment Panel 1996. (1997). Guidelines for audiologic screening. Rockville, MD: Author. * Roush, J., Drake, A., & Sexton, J.E. (1992). Identification of middle ear dysfunction in young children: a comparison of tympanometric screening procedures. Ear and Hearing, 13, 63-69. * Roup, C.M., Wiley, T.L., Safady, S.H., & Stoppenbach, D.T. (1998). Tympanometric screening norms for adults. American Journal of Audiology, 7, 55-60. * Nozza, R.J., Sabo, D.L., & Mandel, E.M. (1997). A role for otoacoustic emissions in screening for hearing impairment and middle ear disorders in school-age children. Ear and Hearing, 18, 227-239. * Taylor, C.L., & Brooks, R.P. (2000). Screening for hearing loss and middle-ear disorders in children using TEOAEs. American Journal of audiology, 9, 1-6. * Lyons, A., Kei, J., & Driscoll, C. (2004). Distortion product otoacoustic emissions in children at school entry: A comparison with pure-tone screening and tympanometry results, " Journal of the American Academy of Audiology, 15, 702-715. * Scudder, S.G., Culbertson, D.S., Waldron, C.M., & Stewart, J. (2003). Predictive validity and reliability of adult hearing screening techniques. Journal of the American Academy of Audiology 14, 9-19. * Shargorodsky, J., Curhan, S.G., Curhan, G.C., & Eavey, R. (2010). Change in prevalence of hearing loss in US adolescents. Journal of the American Medical Association, 304, 772-778. * Paglialonga, A., Grandori, F., & Tognola, G. (2013). Using the speech understanding in noise (SUN) test for adult hearing screening. American Journal of Audiology, 22, 171-174. * Watson, C., Kidd, G.R., Miller, J.D., Smits, C., & Humes, L.E. (2012). Telephone screening tests for functionally impaired hearing: Current use in seven countries and development of a US version. Journal of the American Academy of Audiology, 23, 757-767. * Jansen, S., Luts, H., Dejonckere, P., van Wieringen, A., & Wouters, J. (2013). Efficient hearing screening in noise-exposed listeners using the digit triple test. Ear and Hearing 34, 773-778. Acoustic Immittance Keefe, D.H., & Feeney, M.P. “Principles of acoustic immittance and acoustic transfer functions,” Text, p. 125-156. Shanks, J.E., & Shohet, J. "Tympanometry in clinical practice," Text, Chapter 9, 157-188. * Margolis, R.H., & Goycoolea, H. (1993). Multifrequency tympanometry in normal adults Ear & Hearing, 14, 408-413. * Norrix, L.W., Burgan, B., Ramirez, N., & Velenovsky, D. (2013). Interaural multiple frequency tympanometry measures: Clinical utility for unilateral conductive hearing loss. Journal of the American Academy of Audiology, 24, 231-240. 11 Gelfand, S.A. "The acoustic reflex," Text, Chapter 10, pp. 189-221. * Silman, S., & Gelfand, S. (1981). The relationship between magnitude of hearing loss and acoustic reflex thresholds, J. Speech and Hearing Disorders, 46, 312-316. * Day, J.E., & Feeney, M.P. (2008). The effect of the 226-Hz probe level on contralateral acoustic stapedius reflex thresholds, J. Speech and Hearing Research 51, 1016 – 1025. * Feeney, M.P., Keefe, D.H., & Marryatt, L.P. (2003). Contralateral acoustic reflex thresholds for tonal activators using wideband energy reflectance and admittance. Journal of Speech, Language, and Hearing Research, 46, 128-136. * Shahnaz, N., Bork, K., Polka, L., Longridge, N., Bell, D., & Westerberg, B.D. (2009). Energy reflectance and tympanometry in normal and otosclerotic ears, Ear and Hearing, 30, 219-233. * Prieve, B.A., Vander Werff, K.R., Preston, J.L., & Georgantas, L. (2013). Identification of conductive hearing loss in young infants using tympanometry and wideband reflectance. Ear and Hearing 34,168-178. Evaluating Special Populations * Ramkissoon, I., Proctor, A., Lansing, C., & Bilger, R.C. (2002). Digit speech recognition thresholds (SRT) for non-native speakers of English. American Journal of Audiology, 11, 1-6. * Mayo, L.H., Florentine, M., & Buus, S. (1997). Age of second-language acquisition and perception of speech in noise, Journal of Speech, Language, and Hearing Research, 40, 686-693. * von Hapsburg, D., Champlin, C.A., & Shetty, S.R. (2004). Reception thresholds for sentences in bilingual (Spanish/English) and monolingual (English) listeners. Journal of the American Academy of Audiology, 15, 88-98. * Shi, L-F (2010). Perception of acoustically degraded sentences in bilingual listeners who differ in age of English acquisition. Journal of Speech, Language, and Hearing Research, 53, 821-835. * Calandruccio, L., and Smiljanic, R. (2012). New sentence recognition materials developed using a basic English lexicon. Journal of Speech, Language, and Hearing Research, 55, 1342-1355. * Kirk, K.I., Prusick, L., French, B., Gotch, C., Eisenberg, L.S., & Young, N. (2012). Assessing spoken word recognition in children who are deaf or hard of hearing: A translational approach. Journal of the American Academy of Audiology, 23, 464-475. 12