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Low-gain Hearing Aids As a Treatment Option for Patients with Normal Hearing Thresholds Who Exhibit Auditory Processing Deficits (0.1 CEUs)

Recorded On: 04/28/2017

Low-gain Hearing Aids As a Treatment Option for Patients with Normal Hearing Thresholds Who Exhibit Auditory Processing Deficits (0.1 CEUs)

Record Date: Friday, April 28, 2017; 1:00 - 2:00 p.m. EDT

Presenters: Melissa Kokx-Ryan, AuD, CCC-A, FAAA

CEUs: 0.1

Duration: 1 hour

Instructional Level: Intermediate

Program Focus:
Knowledge

Learner Outcomes: Upon completion, each participant in the eAudiology Web seminar will be able to:

  1. Discuss available literature regarding the use of low-gain hearing aids for individuals with normal to near-normal hearing thresholds and APD concerns.
  2. Analyze the different applications of low-gain hearing aids in an adult population with APD.
  3. Subjectively and objectively verify low-gain hearing aid fittings in an adult population.

Description: It is not uncommon for a patient to be referred for an audiometric evaluation due to perceived difficulty understanding speech in noise, despite having normal or near-normal hearing thresholds (NHT). In recent years, many DoD and VA audiologists have reported seeing increasing numbers of these patients among service members and veterans who have a history of noise- or blast-exposure. Patients who have NHT but report subjective hearing difficulties and/or score poorly on clinical tests are generally diagnosed with auditory processing deficits (APD). When these patients are diagnosed with APD, audiologists within the DoD and VA, as well as those in the private sector who see similar, non-military patients, are increasingly offering low-gain hearing aids (LGHAs) as a treatment option despite the presence of NHT. Providers who use this treatment method anecdotally report that patients receive substantial benefits from LGHAs; however, there is little evidence in peer reviewed literature to support the use of LGHAs in adult patients with NHT. Consequently, the American Academy of Audiology and the American Speech-Language Hearing Association caution that use of LGHAs should be evaluated on a case-by-case basis, and the British Special Interest Group dedicated to APD explicitly rejects fitting LGHAs in the absence of peripheral hearing loss for this patient population.

At Walter Reed National Military Medical Center (WRNMMC), we can identify two patient populations who are currently fit with LGHAs: those who have NHT but have been diagnosed with APD, and those with a predominantly mild degree of sensorineural hearing loss. The goal of this quality improvement study was to compare subjective measures of hearing-aid benefit across these two patient populations fit with LGHAs in the Audiology Departments of WRNMMC to improvement patient management strategies at WRNMMC. A review of currently available literature and presentations, as well as basic and advanced audiometric findings from the patients at WRNMMC will be presented with follow-up outcome measures of hearing aid use and benefit. These results suggest a surprisingly high level of patient benefit, providing support for continued use of LGHAs as a viable treatment option for some patients with NHT and APD at WRNMMC.

The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or the U.S. Government.

Melissa Kokx-Ryan, AuD, CCC-A, FAAA

Audiologist, Walter Reed National Military Medical Center

Walter Reed National Military Medical Center (WRNMMC) and a PhD student at Gallaudet University. She completed her fourth-year clinical externship at the Children's Hospital of Philadelphia and earned her AuD from Gallaudet University in 2014. She is supported by an appointment to the Student Research Participation Program at the U.S. Army Public Health Center administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and the USAPHC. Her research interests include the study of auditory processing deficits, hearing aid applications, and hidden hearing loss. She is currently involved in several ongoing research protocols at Walter Reed, some of which include investigating the prevalence of communication problems in Service Members with blast-exposure, exploring the natural history of traumatic brain injury within a military cohort focusing on the auditory and sensorimotor impacts, and her dissertation investigating low-gain hearing aids as treatment for patients with normal hearing thresholds who exhibit auditory processing deficits.

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