Ewan Macpherson hails from St. John's, Newfoundland. He completed a B.Sc. in Engineering Physics (Queen's) and an M.Sc. in Physics (Waterloo), during which he developed both a computational model of sound localization and a desire to study spatial hearing in real human listeners. His doctoral (Psychology, Wisconsin-Madison) and postdoctoral work (Kresge Hearing Research Institute, University of Michigan) involved studies of spatial hearing in undergraduates, cats, and cochlear implant users. He joined the faculty of the School of Communication Sciences and Disorders and the National Centre for Audiology at the University of Western Ontario in January 2009.

The role of interaural difference cues in horizontal, vertical, and dynamic sound localization by normally hearing and hearing impaired listeners. Sound localization provides a listener with awareness of events outside the visual field and the ability to isolate one source among many in a noisy environment. A listener's representation of auditory space must be assembled by combining multiple acoustical cues. This presentation will describe a series of studies that have quantified the integration of individual cues for sound location under various stimulus conditions. Information about the left/right location of a sound source is provided by interaural time and level differences (ITD and ILD); listeners weight ITD highly in stimuli containing low frequencies and weight ILD highly only in stimuli lacking low frequencies. Information about the vertical and front/back location of a source is provided by spectral cues generated by the directionally dependent acoustics of the pinnate; ITD and ILD influence listeners' weighting of the left- and right-ear monaural cues similarly to their contribution to lateral localization. Information about front/back location is also provided by dynamic interaural cues generated by head movements; the salience of those cues depends upon stimulus frequency and on head velocity. The significance of these results in informing attempts to improve sound localization in hearing aid and cochlear implant users will be discussed.

Marshall Chasin, AuD, is an Audiologist and the Director of Research at the Musicians' Clinics of Canada, an Associate Professor in Audiology at the University of Western Ontario, and adjunct professor in Linguistics at the University of Toronto. He is the author or editor of "Musicians and the Prevention of Hearing Loss", "CIC Handbook", "Noise Control - a primer", "Hear the Music", "Hearing Loss in Musicians", and in 2010, Consumer Handbook of Hearing Loss and Noise. Dr. Chasin is the editor in chief of the Canadian Hearing Report and has been the recipient of several awards including the 2009 Presidents award from the Canadian Academy of Audiology for meritorious bravery in fighting evil witches and other neat stuff.

Setting hearing aids differently for different languages
Clinically one may see a bilingual client and wonder whether there should be a different set of electro-acoustic parameters for the two languages of interest. The Speech Intelligibility Index (or SII) tells most of the story but is far from the entire picture. The SII can provide information on the various speech sounds or phonemes, but it does not provide information on word level and sentence level cues that may be very important. An example of a word level issue is Japanese where a typical word may consist of a CVCV structure. In order for the intervening consonant to be audible, a clinical suggestion is to implement a quicker release time for speakers of Japanese versus a fitting for someone with a similar audiometric loss who is a speaker of English. We can return to Japanese for an example of a sentence level difference. Japanese, like most languages that have a Subject-Object-Verb (SOV) word order has "post"-positions rather than prepositions. Postpositions in Japanese may be sentence final and as such, may not be as audible as it should be. A clinical solution would be setting the WDRC circuitry to generate more gain for quieter sounds than for an "English program".

M. Samantha Lewis, Ph.D., CCC-A, FAAA received a MA from the University of Connecticut and a PhD from the University of Florida, both in audiology. Currently, Dr. Lewis is a Research Investigator at the Veteran Affairs (VA) Rehabilitation Research and Development (RR&D) National Center for Rehabilitative Auditory Research located at the Portland VA Medical Center and an Assistant Professor in the Department of Otolaryngology/Head & Neck Surgery at the Oregon Health & Science University. She receives funding from a VA RR&D Career Development Award-2 (#C7067W) and serves as a Co-Investigator on two other grants funded by the Department of VA.

Why Are Not All Users of Advanced Hearing-Aid Technology Satisfied Hearing-Aid Users?
Have you ever wondered why some of your patients, even those that you fit with the most advanced hearing-aid technology, are not satisfied hearing-aid users? Are you frustrated when you discover that your patient is not even wearing the hearing aids? Sometimes hearing-aid benefit and use has little to nothing to do with the hearing-aid technology (or the audiogram) and more to do with the individual person. In fact, the World Health Organization's revised and expanded view of health (e.g., hearing) and disability includes the contextual and environmental factors that pertain to a given patient. With these thoughts in mind, this presentation will review the scientific evidence related to the extra-audiologic factors that have been shown to be associated with hearing-aid use and satisfaction. Counseling techniques, including those used in motivational interviewing (Miller and Rollnick, 2002), will be offered as a potential means for you to address some of these issues with your patients, with the ultimate aim of improving their satisfaction with, and use of, hearing aids. Examples of, and practice with, these techniques will be provided during this presentation so that they can be implemented easily into your clinical practice as soon as you return to the office.

Audiology Services Manager

Canadian Forces Health Services Group Head Quarters/Forces Health Protection

Pierre Lamontagne has been working for the Department of National Defence since 1975, with 20 of those years as a uniformed member of the Canadian Forces. His military audiology training was complemented with a brief training period at Sunnybrook Hospital. With 20+ years of clinical audiology behind him, his current role with Health Services Headquarters is to oversee the provision of audiology services for all Canadian Forces members and to champion initiatives to effectively protect soldiers from the danger of excessive noise. One of his major tasks is the development and implementation of an improved Hearing Loss Prevention Program, which is intended to reduce the burden of Noise Induced Hearing Loss in the Canadian Forces.

HEARING LOSS PREVENTION PROGRAM

The Hearing Loss Prevention Program (HLPP) is designed to identify signs of Noise Induced Hearing Loss (NIHL) at a very early stage, thus giving us the opportunity to intervene, before hearing loss actually occurs. To do so, we are going to look at "Standard Threshold Shifts" (STS), as defined by the Occupational Safety and Health Administration (OSHA). Every time a STS is identified, some level of intervention will be required to try and find the cause of the hearing decline and hopefully prevent further deterioration. It is actually possible for an individual to sustain 2 or 3 STS and still have normal hearing. The Canadian Forces has acquired, top of the line, fully automated, micro-processor screening audiometers that are in the process of being installed on every military base and in all recruiting centers. This will bring consistency and more accuracy in our audiometry screening process. These audiometers will not only perform the audiogram for us but their software will give us an analysis of the results, do a comparison with the baseline audiogram and identify STSs for us. This equipment will also enable us to capture data that can be used for statistics and analysis which could be helpful in identifying trends or problem areas.

Dr. Debra Busacco holds a Ph.D., M.S., M.Phil. in audiology from Columbia University. Dr. Busacco earned an A.B. degree in special education from Marywood University. She also holds a post master's degree in gerontology from the Brookdale Institute of Hunter College, City University of New York. Dr. Busacco has 29 years of experience as an audiologist in a variety of setting. She has conducted 60 national and international presentations. Her textbook entitled "Audiologic Interpretation across the Lifespan" was recently published by Allyn & Bacon. She also has 18 peer-reviewed publications on a variety of topics in audiology. Her area of expertise is auditory rehabilitation for older adults

Making Your Practice Accessible for Patients with Dual Sensory Loss

This presentation will focus on the growing population of older adults, those with hearing and vision loss acquired later in life. Dual sensory loss, affects 9% - 21% of adults 65 years of age and older. This estimate is expected to increase significantly over the next several decades as older adults will constitute a larger proportion of the world population. In this presentation age-related changes in the auditory and visual mechanisms as well as common causes of low vision loss in older adults will be addressed. Components of auditory rehabilitation programs using a bio psychosocial model will be highlighted. Guidelines for improving accessibility to audiology services using auditory and visual assistive devices will be shared. Case studies will be presented for the audience's review and discussion. Resources on dual sensory loss will be provided.

Dr. Brian Taylor, Au.D. is the Director of Professional Development for Unitron US. He is responsible for all Unitron US initiatives related to practice management, clinical fitting protocols and value-added services. He holds an Au.D degree from the Central Michigan University. Prior to his affiliation with Unitron, he held the position of Director of Professional Development and Global Training Manager for Amplifon, Milan, Italy. Brian has also managed several clinics in his 20 years within the profession. Dr. Taylor has written dozens of articles on a wide range of topics related to practice management and hearing aids. He has lectured in both North America and Canada. He is the co-author (with Gus Mueller) of the upcoming text from Plural Publishing entitled: Understanding Modern Hearing Aids. When he's not lecturing, writing or managing the Unitron customer loyalty program, Brian likes to spend time with his wife and three sons in Plymouth, Minnesota.

Measuring Quality in Your Practice (Alternative Title: Evidence-Based Practice Management)

Most audiologists realize that patient satisfaction and hearing aid benefits are determined by several factors, including the communication skills of the professional and support personnel, product quality and use time of the devices. Beyond the important dimensions of hearing aid benefit culled from the pertinent research, this course will reach beyond traditional measures of hearing aid outcome and provide a global approach to why and how quality must be measured. Seven independent and unique dimensions of quality will be covered in this course.

Using scientifically derived surveys from outside and within the hearing aid industry, this course will provide an evidence-based method for identifying quality gaps in your practice as well as how to narrow this gaps through information analysis, problem-solving strategies and goal setting

Debunking Common Hearing Aid Selection and Fitting Myths

The purpose of this seminar is to review common hearing aid fitting and selection practices, and to identify those not supported by clinical evidence. This seminar will highlight common statements heard in a typical hearing aid dispensing clinic as well as popular fitting and selection practices. Attendees will be encouraged to identify gaps in their own practice and take information from this course to narrow those fitting gaps, using an evidence-based practice paradigm. The television series, the Myth Busters will be used as an entertaining frame of reference throughout the presentation. Participants will learn how to debunk common hearing aid selection and fitting myths, and raise the bar for clinical H.A. fittings. These modifications will help increase their patients' satisfaction.

Don Marsh has 38 years of marketing experience and is the author of one book, and more than 200 articles, along with a series of CDs and DVDs based on his presentation on "Marketing to the Mature Marketplace". He has been a featured presenter at more than 60 industry conferences and has also created customized marketing programs for hundreds of practice owners in Canada and the United States. After spending years under contract to leading manufacturers and national organizations, he now works as an Independent Marketing Consultant. As a result, his presentations contain no bias toward any company or product.

"Marketing to the Mature Marketplace"

We are approaching a unique moment in our history, when one in three Canadians will be over the age of 50 with the expectation of living longer than any previous generation.
For audiologists and their staff, the ability to meet the demands of this moment will be the pathway to increased patient satisfaction and long-term practice growth. "Marketing to the Mature Marketplace" is divided into four sections: Section 1: Inside the Mature Marketplace; Section 2: Positioning for Success; Section 3: The Relationship Imperative; and Section 4: 10 Pathways to Success in Challenging Times. After completion of this session, participants will be able to:
Learn the "5 Key Concepts" that motivate the 50+ Mature Marketplace;

Understand how the unique physical and cognitive changes that occur with aging impact the decision-making process;
Develop enhanced relationship-building skills for all staff levels that lead to increased patient satisfaction and long-term practice growth;
Create non-traditional Marketing programs proven to be effective, especially in times of economic challenge and limited budgets;
Develop external (patient acquisition) and internal (patient retention) communication programs that lead to increased market penetration and decreased marketing costs.

Chantal Laroche, Ph.D. is a Full professor in the Audiology/Speech-Language Pathology Program at University of Ottawa. She obtained a Ph.D. in biomedical sciences (Audiology) from the University of Montreal in 1989. Her research projects are oriented towards the perception of warning sounds (e.g. fire alarms, reverse alarms) in noisy backgrounds; the effects of noise on hearing and health; the impact of hearing protection and hearing aids on communication; and the development of functional evaluation tools for hearing-critical jobs.

Hearing aids and hearing protectors in the workplace - A few things to consider

Collaborators: Christian Giguère and Véronique Vaillancourt, University of Ottawa

Functional hearing involves activities such as sound detection, recognition, localization and speech perception, which typically occur in background noise and can be influenced by hearing loss, hearing aids and hearing protection. In many workplaces, the audiogram is currently used to classify the hearing of employees, despite its limited relationship to functional hearing ability. By relying on functional assessment tools, audiologists can assist employers in making more informed decisions regarding fitness to work in employees. Preliminary data suggest that, in general, hearing aids yield greater benefits for speech recognition in quiet than in noise and can, in some cases, hinder sound localization of front/back sources without significantly affecting localization in the left/right horizontal plane. Data further emphasize the need for individual testing in light of the limited predictive power of the audiogram and other unaided measures.

The use of hearing protection in noisy workplaces is even more widespread. However, hearing protectors can compromise the perception of crucial sounds such as alarms and sirens, especially in workers with hearing loss. Data from recent studies emphasize the need to consider factors such as audibility and distortion in the prediction of sound perception under hearing protectors.

Dr. Robert Sweetow is the Director of Audiology and Clinical Professor in the Dept. of Otolaryngology at the University of California, San Francisco. He received his Ph.D. from Northwestern University in 1977. Master of Arts from the University of Southern California and Bachelor of Science from the University of Iowa. Dr. Sweetow has written 25 textbook chapters and over 100 scientific articles on counseling, tinnitus, and amplification. He is a reviewer for several scientific journals, and the author of Counseling for Hearing Aid Fittings. He is a former member of the Board of Directors of AAA. Dr. Sweetow has lectured worldwide and is a highly sought after speaker known for his informative and entertaining style. His research interests include amplification, counseling and rehabilitation, neuroscience, and tinnitus. His was the co-developer of the interactive, adaptive computerized auditory training program called LACE (Listening and Communication Enhancement). Dr. Sweetow received the 2008 Distinguished Achievement Award from the American Academy of Audiology.

AUDITORY TRAINING AND CHALLENGES ASSOCIATED WITH PARTICIPATION AND COMPLIANCE

When individuals have hearing loss, physiological changes in their brain interact with relearning of sound patterns. Some individuals utilize compensatory strategies that may result in successful hearing aid use. Others, however, are not so fortunate. Modern hearing aids can provide audibility, but may not rectify spectral and temporal resolution, susceptibility to noise interference, or degradation of cognitive skills, such as declining auditory memory and slower speed of processing associated with aging. Frequently, these deficits are not identified during a typical "hearing aid evaluation". Aural rehabilitation has long been advocated to enhance communication but has not been considered time or cost-effective. Home-based, interactive adaptive computer therapy programs are available which are designed to engage the adult hearing impaired listener in the hearing aid fitting process, provide listening strategies, build confidence, and address cognitive changes. Despite the availability of these programs, many patients and professionals are reluctant to engage in and complete therapy. In this presentation a proposal for identifying auditory and non-auditory factors that may adversely affect the overall audiologic rehabilitation process will be described in addition to features that should be incorporated into training. This will be followed by an exploration of reasons for the lack of compliance with therapeutic options and possible solutions to maximizing participation and adherence.

Ruth Bentler obtained her PhD in Speech & Hearing Sciences from the University of Iowa in 1987, where she is now a Professor of Audiology and Director of AuD studies. She teaches graduate students in courses related to hearing aids and adult auditory rehabilitation. As the Director of the Hearing Aid Laboratory for Basic and Applied Research within the Department of Communication Sciences and Disorders, Dr. Bentler has been involved in numerous research endeavors involving directional microphones, digital noise reduction, and, most currently, frequency lowering algorithms.

Technological innovation continues to abound, from talking hearing aids to trainable processors and more. In this presentation the focus will be on the evidence related to the design, as well as the evidence related to marketed effectiveness.

Frequency lowering is the generic term used to refer to any of the current technologies that take high-frequency input signals—typically considered to be speech sounds—and deliver these sounds to a lower frequency region for improved speech understanding. The concept is not new—but the potential for success is. In this session, an overview of these processing schemes and recent data relative to the appropriateness for different populations will be presented.

New Technologies: Evidence-Based Design
A. New product options/styles
  1. Disposable
  2. Implantable
  3. "Open" fitting overview
B. New processing schemes/features
  1. Trainable hearing aids
  2. Features (DIR, DNR)
C. Open fittings considerations
  1. Where should the receiver be?
  2. How much occlusion?
  3. What prescription?
  4. What MPO?

Update on Frequency-Lowering Techniques
 Distinguishing Frequency Compression from Frequency Transposition
 Data to support?
 Fitting Considerations & Issues

Kathleen Campbell, Ph.D., Professor and Director of Audiology Research at Southern Illinois University School of Medicine has directed and provided audiology services and research for over 25 years. She is the author of "Essential Audiology for Physicians" and editor/author of "Pharmacology and Ototoxicity for Audiologists" and has published numerous articles on basic and clinical auditory science. She has received a wide variety of NIH grants for her ototoxicity research and holds the patents on D-methionine as a protective agent against noise, chemotherapy and aminoglycoside induced hearing loss (These patents are in clinical trials). Dr. Campbell is an ASHA Fellow, served on the AAA board of directors, received a Special Presidential Citation from AAA and received the national 2004 Copper Black Award in Creative Achievement from American Mensa for her inventions on otoprotective agents and received a 2009 Medical Innovators Award.

Otoprotective Agents: On the Horizon

In the future, we may be able to prevent or reduce permanent noise and drug-induced hearing loss by administering protective agents. Current research suggests that a variety of pharmacologic agents may be given before or in some cases even after a toxic cochlear exposure and prevent permanent hearing loss. Some of these protective agents may be given orally while others need to be injected or administered to the round window. Some agents have only been tested in animals while others are in or are approaching clinical trials. Therefore in the not too distant future, audiologists may be involved in determining when otoprotective agents should be used in their patient populations. Consequently they should be aware of the various agents being developed. Further many of the protective agents are derived from or contained in foodstuffs. Therefore this research suggests a role of nutrition in preventing hearing loss. This presentation will review current research in otoprotective agents for drug- and noise- induced ototoxicity including Dr. Campbell's own research with D-methionine as an otoprotective agent. However an overview of the various types of otoprotective agents currently being developed will be provided. Dr. Campbell owns several patents for protective agents which are now in clinical trials.

Frank Russo is Associate Professor of Psychology and Director of Psychological Science Training at Ryerson University. After earning his Ph.D. from Queen's University at Kingston (2002), he was awarded the Shaw Post-Doctoral Prize in Acoustics (Canadian Acoustical Association) and completed Post-Doctoral Fellowships at the University of Toronto in Music Cognition and Hearing Science. His research is situated at the intersection of music, mind and technology with current projects investigating multisensory integration, assistive technology, emotional response/regulation, and the role of mimicry in communication of spoken and sung emotion (see lab website for more info, http://www.ryerson.ca/smart). He has published widely in diverse fields including audiology, engineering, music, psychology and semiotics. Other notable work includes consultation with U.S. and Canadian Departments of Transportation on Locomotive Horn Effectiveness, and co-invention of a sensory substitution technology supporting perception of music by deaf and hard of hearing individuals (Emoti-Chair). He currently serves on the editorial board of Psychomusicology: Music, Mind and Brain and the board of directors of the Canadian Acoustical Association and the Society for Music Perception and Cognition

Perception of Music: Problems and Prospects

Music can be found in all human cultures and participation in music is not limited to young adults or those with healthy hearing. Indeed, older adults are among the greatest consumers of music. Nonetheless, many older listeners show mild impairment in perception of melody and tonality even in the absence of peripheral hearing loss. At least some of these difficulties appear to be based in the brain and may thus be seen as somewhat impervious to audiologic interventions. I will review the evidence for this claim and consider the prospect of assistive approaches that incorporate visual and vibro-tactile input. I will also consider the prospect of these same approaches to support auditory development of deaf children with cochlear implants.

Dr. Anu Sharma is Professor in the Dept. of Speech Language and Hearing, Center for Neuroscience and the Institute for Cognitive Science at University of Colorado at Boulder and in Dept. of Otolaryngology at University of Colorado Health Sciences Center. She is adjunct professor at the University of Texas at Dallas, Callier Center for Communication Disorders. Dr. Sharma has won awards for her research at international scientific meetings. Dr. Sharma's research has been funded since 2001 by the National Institutes of Health and other agencies. Her NIH funded work on cochlear implants was highlighted in a report presented to the United States Congress in 2003.

Clinical biomarkers of central auditory development in hearing impaired children.

We are investigating the deterioration, development, plasticity and re-organization of the human central auditory pathways in normal hearing children, in deaf children who regain hearing after being fitted with hearing aids and/or cochlear implants and in children with auditory neuropathy. Our measures of central auditory maturation include cortical auditory evoked potentials (CAEP), high density electroencephalography (EEG), Magnetoencephalography (MEG) and behavioral measures. We will discuss results using these and other brain imaging measures in humans and in animal models of deafness.
Based on our basic research findings, we have developed clinical biomarkers of central auditory development using the P1 CAEP. We will present case studies and population studies which will illustrate the use of the P1 biomarker. Overall, we find that CAEPs are powerful objective biomarkers of central auditory maturation and plasticity. They may serve as clinical indicators of central auditory development in children who have hearing impairment and/or auditory neuropathy and who receive intervention via conventional hearing aids and/or cochlear implants.
Supported by NIH DC 06257

Sharon A. Sandridge, Ph.D. is currently Director, Audiology Clinical Services and Co-Director, Tinnitus Management Clinic, and Audiology Research Lab (ARL) at the Cleveland Clinic, in Cleveland, OH. Dr. Sandridge received her BA and MA from the University of Akron and her Ph.D. from the University of Florida. Her primary clinical and research interests include the management of tinnitus as well as amplification and electrophysiology. She and her colleague, Dr. Craig Newman, have completed a number of funded-research projects and have authored a number of articles in these areas.

Management of Tinnitus: A Multidisciplinary Team Approach

The Tinnitus Management Clinic (TMC) at the Cleveland Clinic offers a unique multidisciplinary approach to the assessment and treatment of patients with varying levels of tinnitus distress. This session will provide an overview of the clinical pathway we follow in the management of our patients with tinnitus.
Discussion will focus on:
interactions among audiology and other disciplines including psychology, neurology, physical therapy, and dentistry in the assessment and treatment of tinnitus;
benefits of a group education format that incorporates informational counseling through a PowerPoint presentation;
benefits of utilizing brief screening techniques employed by the members of the team to determine the best treatment option/s;
and strategies and management options provided by members of the TMC team with an emphasis on audiologic options including sound therapy and counseling.

Dr. Kerry Bowman has a Ph.D. in Bioethics, a fellowship in Cultural Psychiatry and a Masters degree in Social Work. Dr. Bowman is the Clinical Ethicist at Mount Sinai Hospital and teaches at the University of Toronto.
Dr. Bowman lectures and publishes widely on ethics in health care, reproductive ethics, emerging medical technology, end-of-life care and cultural diversity. He has consulted extensively on these topics in Germany, Iran, South Africa and The People's Republic of China.
Dr. Bowman is also a conservationist and founder of The Canadian Ape Alliance, is on the board of directors of The Jane Goodall Institute and is a consultant to The United Nations Environment Program. He is actively involved in conservation projects in North Korea, Central Africa and Brazil.

Innovation, Ethics and Audiology

Innovation and medical progress in recent years have brought improved and even restored hearing to many people. However, these innovations have led to a decline in people with hearing impairment, raising deep social and ethical questions related to diversity, inclusion, tolerance and identity. What is fundamentally at issue is whether hearing loss is a component of human diversity or a medical problem to be eliminated.
Furthermore, innovations in stem cell technology show highly promising potential in the domain of audiology. Yet the use of stem cells continues to be divisive in our society. This presentation will explore questions of diversity, identity and medical interventions as well as the current ethical arguments for and against both genetic screening and stem cells.

Dr. Gans received his Ph.D. from The Ohio State University. He is a past President of the American Academy of Audiology (2004-05) and has been actively involved in scientific, professional, and governmental issues for over 20 years. He is an adjunct Professor for Nova Southeastern University and the University of South Florida in vestibular and equilibrium sciences. Dr. Gans has published or presented over 200 papers internationally and has developed numerous tests and treatment for vestibular disorders. He has authored a vestibular rehabilitation textbook and several chapters in leading textbooks. He is the Founding Director of The American Institute of Balance.

New Trends in the Evaluation and Treatment of the Dizzy Patient
The program will highlight the latest evidenced-based diagnostic and treatment strategies for a variety of equilibrium disorders for both children and adults. The use of both clinical and electrophysiological tests as well as an overview of vestibular rehabilitation diagnosis-based strategies and BPPV repositioning maneuvers will be presented.

Sheila Moodie is a Research Audiologist at The National Centre for Audiology and a PhD Candidate in Health & Rehabilitation Sciences at The University of Western Ontario. She has been actively involved in the development of the Desired Sensation Level (DSL) Method with a special focus on translating the research from the laboratory to clinical practice. More recently as part of her PhD work she has been interested in engaging and collaborating with clinical audiologists in research projects that facilitate evidence-building for the benefit of patients and also assists in identifying barriers and facilitators for implementing change in clinical practice.

Engaging Audiologists in Research: The Network of Pediatric Audiologists in Canada

The knowledge-to-action process [KTA] (Graham et al, 2006; Graham & Tetroe, 2007; Harrison et al, 2010; Straus, 2009) has been suggested as a framework to enhance the development and clinical use of best evidence and increase the implementation of the use of evidence in practice to positively affect patient outcomes. This presentation will focus on describing the development of The Network of Pediatric Audiologists in Canada and present the results of a collaborative research project aimed at comparing the results of clinical measures of pediatric hearing aid performance by pediatric audiologists in Canada with the DSL v5.0a target criteria. This presentation will also highlight the barriers and facilitators to implementing evidence-based protocols into clinical practice.

Todd A. Ricketts, Ph.D, is an associate professor and the Director of AuD Education at the Vanderbilt Bill Wilkerson Center and Director of the Dan Maddox Hearing Aid Research Laboratory. Todd has published more than sixty scholarly articles and book chapters and provided over 200 presentations nationally and internationally. He continues to pursue a federally and industry funded program studying various aspects of hearing, hearing aids and cochlear implants. He was named a Fellow of ASHA in 2006 and received the Editors award from the American Journal of Audiology at the 2008 AHSA convention. He also is the current chair of the Vanderbilt University Institutional Review Board: Behavioral Sciences Committee.

Hearing Aid Features: What really works and clinical implications for selection, adjustment and counseling

In this session current and future hearing aid technologies such as digital noise reduction, digital impulse reduction, wireless signal routing, reverberation tail suppression, directional microphones and speech enhancement will be discussed. Both the effectiveness of the technology in the laboratory and what we know about the impact of the technology on user benefit and satisfaction in the real world will be discussed. Challenges and limitations in relating laboratory data to real world benefit and defining "real world benefit" will also be presented from the standpoint of adopting an evidence based approach to appropriate selection hearing aid technology and counseling. Implications for selection, adjustment and counseling related to specific features will be discussed. Specific techniques for verification of various technologies will be provided.

Open Canal Hearing Aids: Tips and Tricks for the Clinic

In this presentation the application of modern feedback suppression in order to achieve open canal hearing aid fittings and the benefits, limitations and clinical pitfalls related to these fittings will be discussed. Recent data examining how the open fitting interacts with the prescriptive method and the expected benefit from directional microphones, digital noise reduction and other digital features will be explored.

Workshop Leader:
Kathy Pichora-Fuller, PhD
Workshop Co-presenters:
Ulrike Lemke, PhD, Advanced Concepts & Technologies, Phonak, Switzerland
Kelly Murphy, PhD, Clinical Psychology, Baycrest Geriatric Health Care System, Toronto
Marilyn Reed, MSc, Audiology, Baycrest Geriatric Health Care System, Toronto
Alex Shaw, PhD, Research, CNIB, Toronto
Pat Spadafora, MSW, Sheridan Elder Research Centre, Oakville

Aging Forum: Keeping older adults communicating when they have multiple impairments: From clinic to home care services and back – an inter-professional challenge

The prevalence of hearing loss increases markedly with age and it is one of the three most prevalent chronic health conditions in older adults. About 75% of people who have a hearing loss are over 75 years of age, and some estimates indicate that 50% of those 75 years old have a hearing loss, although the average age of first-time hearing aid use is about 70. Around the same time when audiologists are beginning to work with older adults, they may also be experiencing a number of other health issues, including declines in vision and cognition. Hearing loss no doubt combines with vision and cognitive declines in ways that affect assessment and management in audiology and in the practices of other health care professionals. These combinations may be critical in later decisions regarding ability to live independently. Hearing loss may magnify the functional impact of declines in vision and cognition and conversely, declines in vision and cognition may increase the importance of hearing as individuals try to maintain healthy lifestyles and social interaction. In the workshop, experts in vision and cognition will engage audiologists in considering how our practices could evolve to better serve the needs of older adults.

Kathy Pichora-Fuller is a Full Professor in Department of Psychology at the University of Toronto, and an Adjunct Scientist at the Toronto Rehabilitation Institute. She worked as a clinical audiologist and then the Supervisor of Audiology at Mount Sinai Hospital in Toronto before completing her PhD in 1991. Until 2002, she was on faculty in the School of Audiology and Speech Sciences and Director of the Institute for Hearing Accessibility Research at UBC. She combines clinical experience in rehabilitative audiology with experimental research on auditory and cognitive aging.

Effects of auditory and cognitive aging on health and social participation

Some of the most long-standing puzzles in audiology concern why two people who have similar audiograms have such different experiences as listeners in everyday life. There are different sub-types of presbycusis (sensory, metabolic, and neural) that may account for some of these individual differences and how easily the associated perceptual problems of these listeners are solved by amplification. With ‘normal' aging, there are also sub-clinical declines in some aspects of cognitive processing; however, other aspects of cognition (e.g., vocabulary) are well preserved. Because listeners use both bottom-up (from the ear) information about the signal and top-down (from the brain) knowledge to construct meaning during listening, the interactions between age-related changes in auditory and cognitive processing also seem to explain some individual differences. It seems that there is a gradual shift to relatively less use of bottom-up and more use of top-down information processing. Neuroscientists have suggested that brain plasticity results in less lateralized and a posterior-anterior shift in patterns of brain activity. Somewhat paradoxically, poor hearing may undermine cognitive performance, but expert use of context and knowledge may enable listeners to compensate for poor hearing. Auditory and cognitive functioning are intertwined in the everyday lives of older communicators.

Marilyn Reed is the Professional Practice Leader for Audiology at Baycrest, a geriatric care and research centre in Toronto, where she has worked since 1997. She graduated with a Masters degree in Audiology from the University of Southampton in England in 1976, and has since worked in clinical audiology in a variety of settings, always with a geriatric interest. She was vice president of the College of Audiologists and Speech-Language Pathologists in 2008-9, a Councilor of the College for 6 years, and is currently a non-council member of the Audiology Practice Advisory Committee. She is a volunteer with Canadian International Hearing Services and on the Board of New Leaf Living and Learning, a residential program for dual-diagnosed developmentally disabled adults.

Dr. Ulrike Lemke is a senior researcher at Phonak's headquarters in Switzerland since 2006. She conducts and coordinates research in the fields of psycho-acoustics and successful aging. In her work she combines her experience as a clinical and experimental psychologist with her expertise in cognitive aging and neuroscience. Besides working for Phonak, she sees senior clients in a private practice. There she conducts neuropsychological assessments as well as cognitive-behavioral therapy. She completed her Ph.D. in Psychology at the University of Jena, Germany (2004) and is licensed as a psychotherapist. Previously she worked at the Department of Gerontopsychology, University of Zurich (2003-2005), at the Division of Psychiatry Research, University Hospital of Psychiatry Zurich (2000-2002), and at the Department of Biological and Clinical Psychology, University of Jena (1997-2000).

Alexander Shaw completed his doctorate in Experimental Psychology at Simon Fraser University in 2002, with a focus on health and cultural issues. Since 2003, Dr. Shaw has worked at CNIB where he has conducted social rehabilitation research on a broad range of topics related to persons who are blind or visually impaired. These topics include employment, physical activity, quality of life, needs of persons with vision loss including seniors, and access to vision rehabilitation services by members of diverse language groups.

Dr. Kelly Murphy is a Clinical Neuropsychologist in the Cognitive and Behavioural Health Program at Baycrest, an assistant professor of Psychology at the University of Toronto, and an adjunct faculty member in graduate studies (Psychology) at York University. Dr. Murphy runs a clinical service specializing in the early detection and treatment of memory decline in older adults with mild cognitive impairment (MCI) who are at risk of developing future dementia. The service includes Memory Intervention for MCI, which is a program providing education about lifestyle factors for optimizing memory function, training on practical memory strategies, and psychosocial support for clients with MCI and their family members. Her research focuses primarily on cognitive aging, memory intervention, and mild cognitive impairment (MCI).

Pat Spadafora is the Director of the Sheridan Elder Research Centre (SERC). Ms. Spadafora has over thirty-five years of experience in the social work and education fields and, in recent years, has focused on applied research. Ms. Spadafora has a proven track record of bringing innovative projects to fruition. Ms. Spadafora's expertise and interests include, among others, global population aging, aging in place, enabling technologies, the health impact of participating in the performing arts and building community capacity. Ms. Spadafora is a member of a number of committees, including her role as a Director with the International Federation on Ageing.

Josée Lagacé has been an assistant professor at the University of Ottawa since July 2009. She has worked as an audiologist in various settings for 17 years and recently completed her PhD in Biomedical Sciences. Her research interests include speech perception problems in noisy environments, particularly in children identified with auditory processing disorder. The goal of her research program is to develop a better understanding of the etiology of the speech listening difficulties in noisy backgrounds which would allow interventions to be better targeted and, thus, more effective. As an assistant professor, lecturer, internship supervisor, research co-supervisor and mentor, she has helped train a number of audiologists. She is interested in all aspects of training audiologists and the future of the profession in Canada.

L'évaluation du trouble de traitement auditif en communautés francophones: par où commencer?

Although a large number of assessment tools for auditory processing disorder (APD) exist for English speaking patients, the situation is quite different for francophone clientele. As such, batteries of tests that have been used over the years to assess APD in Francophone children have been somewhat limited. This pre-conference workshop will address audiological assessment of APD in francophone communities using the available tools. The goal is to help clinicians tailor a battery of tests that could be used within specific settings, while complying with the published guidelines. Specifically, categories of available francophone behavioural tests, as well as electrophysiological measures for the assessment of APD will be described. The types of auditory processes assessed by each will be reviewed. Furthermore, interpretation of central auditory test results will be discussed with an eye toward determining the presence and nature of the disorder, and making follow-up recommendations for rehabilitation. Audiologists working with francophone clientele will share their tricks of the trade and their experience. In addition, the current definition and conceptualizations of APD will be reviewed.

Laudia LeBlanc completed her Master's Degree in audiology in 1996 at l'Université de Montréal. She has been working at the Georges-L.-Dumont Hospital in Moncton New Brunswick since graduation. Her work setting being in a regional hospital, she has been exposed to a varied clientele ranging from pediatrics to the elderly. She was actively involved with the implementation of the New Brunswick Universal Newborn and Infant Hearing Screening Program in 2002. Since 2008, she has been participating as co-author of a manual for the evaluation and intervention of APD in children (Manuel d'évaluation et d'intervention pour les troubles de traitement auditif chez les enfants). She was co-presenter on APD training for school personnel (psychologists, resource teachers and speech-language pathologists) and also involved in training other audiologists in the province on APD assessment and intervention. She is also a resource person for APD in Regional Health Authority A in New Brunswick. She is currently working on a research project to collect French normative data for speech in noise in collaboration with Josée Lagacé, Ph.D.

Marianne Paquet a terminé en 2002 son baccalauréat en ergothérapie à l'Université de Montréal. Depuis, elle travaille auprès des enfants ayant un trouble du language, un bégaiement ou un trouble de traitement auditif à l'Institut Raymond-Dewar. Elle co-anime plusieurs groupes d'intervention interdisciplinaires auprès des TTA en plus d'intervenir en individuel auprès d'eux. Elle participe par ailleurs à un groupe de discussion sur cette clientèle. Intéressée par l'enseignement et la recherche, elle a donné diverses formations sur le TTA au fil des ans et est membre du comité de la recherche de l'IRD.

En 1996, Mojgan Owliaey a obtenu son baccalauréat en audiologie en Iran. Par la suite, elle a terminé sa maîtrise en 2003 à l'Université de Montréal. Ses champs d'intérêt portent sur l'évaluation et la réadaptation auprès des enfants ayant un trouble de traitement auditif (TTA). Elle donne plusieurs conférences et formations aux différents professionnels sur la réadaptation auprès de la clientèle présentant un TTA. Elle a obtenu une bourse de recherche de l'Association Canadienne des Orthophonistes et des Audiologistes en 2009. Elle supervise des stages et dirige un projet de recherche sur l'évaluation de l'efficacité de l'entraînement à l'écoute dans le bruit chez les enfants ayant un TTA.

Amineh Koravand a obtenu son baccalauréat en audiologie en Téhéran et sa maîtrise en audiologie à l'Université de Montréal. Elle complète présentement ses études doctorales en Sciences biomédicales (option audiologie) à l'Université de Montréal. Ses intérêts de recherche portent sur la relation existant entre le système auditif périphérique et le système auditif central chez les enfants malentendants. Elle souhaite développer des mesures neurophysiologiques évaluant des fonctions auditives centrales d'enfants malentendants dès les premières années de leur vie. Elle contribue à la formation en audiologie, en tant que chargée de cours, superviseure de stage et co-directrice d'étudiants à la maîtrise.