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.ConclusionsApplication 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 ANSDo How low can you go? Cochlear implantation in a teenager with ANSD and near normal pure-

tone 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 P2X2 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 P2X2 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: 7494-74992 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 QuickSIN 5, 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.References1. 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/glr1153. 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: 10.1059/0003-4819-154-5-201103010-000094. 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: 10.1059/0003-4819-154-5-201103010-000095. 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 hearing-impaired listeners. Journal of the Acoustical Society of America, 116, 2395-2405. doi: 10.1121/1.17844406. 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 CochlearImplants ~ 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.ConclusionsNew 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, 20132. 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 self-rated 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.

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.

This research is financially supported by the HEARing CRC, established and supported under the Australian Government’s Cooperative Research Centres Program.

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.References1) IFHOH Human Rights Toolkit

http://ifhoh.org/papers/ifhoh_un_crpd_toolkit.pdf2) 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 deaf-blindness, and particularly on communication in an audiology/clinical setting, rather than on particular causes of vision and/or hearing impairments.