Research Articles (Speech-Language Pathology and Audiology)

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Hearing loss configurations in low- and middle-income countries
(Taylor and Francis, 2025-10) Newall, John; Kim, Rebecca; Dawes, Piers; Alnafjan, Fadwa; Vaughan, Glyn; Carkeet, Donna; Ghannoum, Heba; Mcpherson, Bradley; Patel, Nitish Ranjan; Sasidharan, Megha; Damam, Nitin K.; Goswami, S.P.; Chinnaraj, Geetha; Sartika, Dahlia Eka; Alhanbali, Sara; Bartlett, Rebecca A.; Ismail, Afzarini Hasnita; Smith, Mike C.F.; Ghimire, Anup; Shah, Shankar; Martinez, Norberto V.; Ramos, Hubert D.; Alparce, Ultima Angela; Tavartkiladze, George A.; Bakhshinyan, Vigen; Boboshko, Maria; Kasper, Annette; Pifeleti, Sione; Swanepoel, De Wet; Myburgh, Hermanus Carel; Frisby, Caitlin; Pitathawatchai, Pittayapon; Atas, Ahmet; Serbetcioglu, Bulent; Sennaroglu, Gonca; Konukseven, Ozlem; Yilmaz, Suna Tokgoz; Turkyilmaz, Meral Didem; Batuk, Merve; Kara, Eyyup; Senkaya, Duygu Hayir; Babaoglu, Gizem; Oruc, Yesim; Ozkan, Melek Basak; Cetinkaya, Merve Meral; Ceyhan, Aysenur Kucuk; Adali, Inci
OBJECTIVE : The majority of individuals with hearing loss worldwide reside in low- and middle-income countries (LMICs), but there is limited information regarding the characteristics of hearing loss in these regions. This descriptive study aims to address this knowledge gap by analysing audiogram patterns in LMIC populations. Greater knowledge about the properties of hearing loss in LMICs allows for improved planning of interventions. STUDY SAMPLE : Retrospective data from 23 collaborating centres across 16 LMICs were collected. All participants were adults seeking help for hearing problems. A machine learning approach was utilised to classify the hearing threshold data and identify representative profiles. The study comprised 5773 participants. RESULTS : The results revealed mildly sloping audiometric patterns with varying severity. The patterns differed from previous studies conducted in high-income regions which included more steeply sloping losses. The findings also indicated a higher proportion of more severe levels of hearing loss. CONCLUSIONS : These variations could be attributed to population-level differences in the causative mechanisms of hearing loss in LMICs, such as a higher prevalence of infectious disease-related hearing loss. The results may also reflect differences in health seeking behaviours. This study highlights the need for tailored, scalable, hearing interventions for LMICs.
Enhancing audiology students’ understanding of person-centered care : insights from an multi-national virtual student conference
(Taylor and Francis, 2025-04) Mahomed-Asmail, Faheema; Nicholson, Nannette; Metcalfe, Louise; Rutherford, Cherilee; Graham, Marien Alet; Watson, Victoria; Regan, Catherine; Hussain, Saira; faheema.mahomed@up.ac.za
OBJECTIVE : This project sought to investigate the impact of a multi-national peer learning initiative in facilitating a student-led conference on person-centred care (PCC). The primary objective was to assess students’ comprehension of PCC elements before and after engaging in the opportunity, with a concurrent evaluation of the efficacy of the opportunity. DESIGN : A mixed-methods study protocol was followed. Following the conference, participants completed a four-part survey including (a) demographics, (b) retrospective pre-post Likert scale, (c) Likert rating of conference experience and (d) five open-ended questions. STUDY SAMPLE : One hundred and four participants (92.4% female) with a mean age of 21 years (0.07 SD) participated in the study. RESULTS : A significant difference in awareness pre-post conference was demonstrated across all topics (WSR, p < 0.001) with participants satisfied with the conference. Qualitative analysis revealed three main themes: (a) application of PCC; (b) perspectives of PCC; and () barriers to PCC; with nine sub-themes. CONCLUSION : The conference was beneficial in enhancing students’ awareness of topics and principles of PCC. Innovative pedagogical approaches should be considered in order to enhance healthcare education allowing future clinicians to better meet the dynamic needs of their clients.
An overview of World Health Organization guidance aiming to increase global access to critical hearing aid services
(Taylor and Francis, 2025-10) Dillard, Lauren K.; Der, Carolina; Laplante-Levesque, Ariane; Swanepoel, De Wet; Thorne, Peter R.; Mcpherson, Bradley; De Andrade, Victor; Newall, John; Ramos, Hubert D.; Kaspar, Annette; Nieman, Carrie L.; Clark, Jackie L.; Chadha, Shelly
OBJECTIVE : Equitable access to hearing aids and related services remains a global health challenge, particularly in resource-limited settings. A major barrier to access is the lack of diagnostic and rehabilitative services, which is substantially attributable to the persistent shortage of ear and hearing care specialists. This discussion article provides an overview of limitations in the ear and hearing care workforce, the relevance of task sharing to ear and hearing care, and a new, evidence-based World Health Organization (WHO) technical resource aimed at improving access to hearing aids worldwide. DESIGN AND STUDY SAMPLE : A synthesis of current research and expert opinion. RESULTS : First, this article describes the global shortage of qualified ear and hearing care specialists. Next, it describes how community-based care, supported by task sharing among trained non-specialist providers and qualified ear and hearing care providers, could overcome these workforce limitations, and describes the critical role of qualified ear and hearing care providers in task sharing. Finally, this article provides an overview of a WHO resource which provides practical information for hearing aid service provision in resource-limited settings. CONCLUSION : Innovative strategies to expand the ear and hearing care workforce are essential to advance efforts towards equitable access to hearing aids and related services.
Update on the state of audiology in South Africa
(Taylor and Francis, 2025) Mothemela, Bopane; Ramma, Lebogang; Swanepoel, De Wet; u13182006@tuks.co.za
In 2006 the state of audiology in South Africa was reported in the International Journal of Audiology (Swanepoel 2006). Since this time, however, significant changes have occurred within the profession and within the socioeconomic landscape. The country’s population has grown rapidly, from 41.5 million people in 2002 to 60.6 million people in 2022 (Statistics South Africa [Stats SA], 2022) with a predominantly youthful population, with 34% falling between the ages of 15 and 34 (Stats SA, 2022) and only 9.2% 60 years and older. Despite a younger average population age, the country faces many environmental risks for hearing loss including poverty, with approximately 55.5% of the population living below the poverty line, along with a high prevalence of chronic diseases such as diabetes, tuberculosis (TB) and HIV/AIDS (World Bank Group 2020; Stats SA, 2020; Wandai et al. 2017). This letter provides an update on the current state of the audiology profession in South Africa since 2006, with a special focus on training, human resources, and service delivery. Finally, the authors provide a brief commentary on the future of the profession in South Africa.
Using secondary data analysis to compare core vocabulary lists and elicitation duration of two data sets of typically developing preschool Afrikaans-speaking children
(Karger Publishers, 2025) Winter, Petria; Van der Linde, Jeannie; De Wet, Febe; Graham, Marien Alet; Bornman, Juan; jeannie.vanderlinde@up.ac.za
INTRODUCTION : Core vocabulary lists provide an evidence-based method for describing the vocabulary of individuals across various age groups, categorised by different parts of speech. Despite its value, there is a paucity of core vocabulary lists in nonmainstream languages. Resource limitations contribute to this paucity; therefore, more efficient methods for developing core vocabulary lists are needed. This study aimed to compare two sets of previously collected language samples from typically developing 5–6-year-old Afrikaans-speaking children to compare two different elicitation methods for developing a core vocabulary list. We also compared the duration of the language samples to inform the duration required for accurate and representative language samples for the development of core vocabulary lists. METHODS : Using secondary data analysis, we compared the core vocabulary lists from two existing data sets in terms of the number of different words, the frequency of use of each of these words, type-token ratio, and parts of speech used by typically developing 5–6-year-old Afrikaans-speaking children. RESULTS : The average recording time for data set A was 60 min in a single session. The corresponding value for data set B was 250 min, recorded over a period of 1–3 days. A perfect positive Spearman correlation was observed between the results for the two data sets for all parts of speech except interjections and enclitics. Code switching formed part of data set B’s core words but did not appear in data set A’s core word list. CONCLUSION : The findings demonstrate that similar core vocabulary lists can be obtained for 5–6-year-old children using a less invasive and time-effective 60-min elicited method for language samples compared to naturalistic samples collected over 1–3 days. Proposing a more robust and less time- and resource-intensive method of developing vocabulary lists may further support the development of core word lists across ages and in other languages.
Help-seeking among adults with tinnitus : examination of a tinnitus cohort from the Busselton healthy ageing study
(Taylor and Francis, 2025) Carmody, Natalie; Hunter, Michael; Eikelboom, Robert H.
The aim of this study was to examine the help-seeking behaviour of adults with tinnitus and the factors associated with help-seeking. A tinnitus cohort (n = 131) from the Busselton Healthy Ageing Study (BHAS) completed surveys assessing demographic and clinical factors, tinnitus characteristics and distress, health status, and help-seeking behaviour. The study found that of the 131 participants that took part 43.5% sought help for tinnitus. Binomial logistic regression was used to examine the association of health status (Glasgow Health Status Inventory – all purpose (GHSI) total score) and tinnitus distress (Tinnitus Reaction Questionnaire (TRQ) total score) with self-reported hearing loss and self-reported anxiety. The results of the binomial logistic regression found that help-seeking was significantly associated with higher tinnitus distress (odds ratio [OR] 1.04, 95% confidence interval [CI] [1.01, 1.07], p = 0.01) and lower self-reported anxiety levels (OR 0.43, 95% CI [0.18, 1.00], p = 0.05). However, no significant association was found between help-seeking and self-reported hearing loss. Whilst increased tinnitus distress can be expected to be associated with help-seeking, lower anxiety may encourage help-seeking or may be barrier to seeking help. Further work is needed to better understand the relationship with tinnitus, anxiety and help-seeking.
The associations of multimorbidity with fall- and fracture-related hospitalisations : the Busselton Healthy Ageing Study
(Springer, 2025-08) Hoey, Mark A.; Zhu, Kun; Murray, Kevin; Bharat, Chrianna; Eikelboom, Robert H.; Hunter, Michael
SUMMARY : In middle-aged adults, we evaluated the associations between multimorbidity count and patterns with fall- and fracture-related hospitalisations. Falls risk increased linearly with multimorbidity count, and certain multimorbidity patterns were associated with increased risks of falls and fractures. Multimorbidity count and pattern should therefore be considered when risk stratifying patients. PURPOSE : Although multimorbidity is recognised as a risk factor for falls and fractures, most studies are retrospective, and few have explored these relationships through statistically derived multimorbidity patterns. Our prospective cohort study with 4991 participants of the Busselton Healthy Ageing Study aged 45–69 years evaluated the associations of multimorbidity count and classes with incident fall- and fracture-related hospitalisations. METHODS : Twenty-one morbidities were assessed at baseline, and four multimorbidity classes were identified using latent class analysis. Fall- and fracture-related hospitalisations were captured through the Western Australian Data Linkage System over a median follow-up of 7.9 years. Associations were examined using Cox regression models adjusting for sex, baseline age, lifestyle factors, and prior falls/fractures. RESULTS : During follow-up, incident fall- and fracture-related hospitalisations were recorded for 177 (3.5%) and 197 (3.9%) participants, respectively. Each one-unit increase in multimorbidity count was associated with a 16% (95% CI, 7.8–25%) increased risk of fall-related hospitalisations. Multimorbidity scores of 9 and above (HR 2.32 [1.22–4.42]) showed an increased risk of fractures. Compared with the relatively healthy class, the cardiometabolic or mental health and musculoskeletal classes were associated with an increased risk of fall-related hospitalisations (HR 2.84 [1.76–4.59] and 1.78 [1.23–2.59], respectively). The cardiometabolic class was associated with an increased risk of fracture-related hospitalisations (HR 1.79 [1.04–3.07]). CONCLUSION : In middle-aged adults, we showed that multimorbidity count and certain multimorbidity patterns were associated with increased risk for fall- and fracture-related hospitalisations. Multimorbidity should therefore be considered when assessing a patient’s risk of falls and fractures.
Evidence-based strategies to promote hearing help-seeking and hearing aid uptake
(Lippincott Williams and Wilkins, 2025-05) Knoetze, Megan Clarissa; Manchaiah, Vinaya; Swanepoel, De Wet; megan.knoetze@up.ac.za
Hearing loss is a prevalent and often undertreated condition significantly affecting quality of life across social, emotional, and cognitive domains. Despite advancements in hearing health care, many individuals who could benefit from hearing aids either delay seeking help or do not adopt rehabilitation strategies including hearing devices. This may be due to various audiological and non-audiological factors influencing help-seeking behavior and the decision to take up hearing aids.
A perspective on auditory wellness : what it is, why it is important, and how it can be managed
(Sage, 2024) Humes, Larry E.; Dhar, Sumitrajit; Manchaiah, Vinaya; Sharma, Anu; Chisolm, Theresa H.; Arnold, Michelle L.; Sanchez, Victoria A.
During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed.
Is there incremental benefit with incremental hearing device technology for adults with hearing loss?
(MDPI, 2025-06) Manchaiah, Vinaya; Dhar, Sumit; Humes, Larry; Sharma, Anu; Taylor, Brian; Swanepoel, De Wet
OBJECTIVE : This paper reviews the current research on hearing device technology, outlines key challenges, and identifies priorities for future investigation. METHOD : This paper presents an informal narrative review of the current literature on hearing technology, supplemented by expert insights to identify key challenges and future directions. RESULTS : The proliferation of direct-to-consumer (DTC) hearing devices with varied features and prices underscores the need to assess whether advanced technologies offer meaningful improvements. Understanding these incremental benefits is critical for determining the minimum technology required for optimal outcomes. The paper highlights the limitations in current clinical trials, which often suffer from selection bias, and the inadequacies of existing hearing aid outcome measures that may not capture real-life benefits. It emphasizes the need for real-world evidence and the development of assessment tools that better reflect everyday experiences. While existing research provides some insights into the potential benefits of incremental advances in hearing device technology, the evidence remains inconclusive. CONCLUSIONS : Addressing the cost, accessibility, and technological diversity of hearing devices is crucial to advancing hearing healthcare. Future research should prioritize the development of affordable, high-quality devices and establish comprehensive outcome measures that capture real-world benefits. A deeper understanding of these factors can lead to more accessible and effective hearing care, ultimately improving quality of life for individuals with hearing loss.
How much should consumers with mild to moderate hearing loss spend on hearing devices?
(MDPI, 2025-06) Manchaiah, Vinaya; Taddei, Steve; Bailey, Abram; Swanepoel, De Wet; Rodrigo, Hansapani; Sabin, Andrew
BACKGROUND: This study examined the relationship between hearing device price and sound quality. METHOD : A novel consumer-centric metric of sound quality (“SoundScore”) was used to assess hearing devices’ audio performance. Each hearing device is tested with two fittings. The “Initial Fit” is designed to approximate the most likely fitting for an individual with a mild-to-moderate sloping sensorineural hearing loss. The “Tuned Fit” includes adjusting parameters optimized to hit prescriptive fitting targets (NAL NL2) on an acoustic manikin. Each fitting is evaluated across five dimensions. Both fittings are combined using a weighted average to create a single number from 0 to 5 representative of a device’s overall audio performance. Seventy-one hearing devices were tested. RESULTS : A strong positive correlation was found between hearing device price and SoundScore. The average SoundScore increased dramatically as the price approached USD 1000, with marginal improvements beyond this point. SoundScore was consistently poor for devices under USD 500, highly variable between USD 500–1000, and consistently good over USD 1000. CONCLUSIONS : There is a strong but nonlinear relationship between hearing device price and sound quality. This information can aid consumers in making informed decisions while also assisting hearing healthcare professionals in providing comprehensive guidance to their patients.
Hearing aid verification : practices and perceptions of South African audiologists
(AOSIS, 2024-12) Moll, Jared; Burger, Zani; Jacobs, Daneel M.P.; Mothibe, Retshepisitswe P.; Swanepoel, De Wet; Mahomed-Asmail, Faheema; faheema.mahomed@up.ac.za
BACKGROUND : Hearing aid verification is required to objectively measure hearing aid outputs by ensuring that the amplified speech spectrum closely approximates the prescription goals. OBJECTIVES : This study aimed to determine audiologists’ perceptions and practices regarding hearing aid verification and identify facilitators and barriers to its use. METHOD : A cross-sectional national e-survey included questions related to demographics, perceptions of verification, verification practices and two open-ended questions regarding the facilitators and barriers to conducting hearing aid verification in South Africa. RESULTS : Seventy-eight South African audiologists, with experience ranging from less than a year to 34 years, completed the online survey. Of these, 76.3% conduct hearing aid verification, while 23.7% seldom or never perform this verification. Among the audiologists who conducted verification, 81.0% reported performing it on both adults and children. More than three-quarters (86.6%) indicated that they conduct verification only during the initial fitting, while half (53.8%) do so only when a problem arises. Thematic analysis revealed the following barriers to verification: improper equipment, a lack of equipment, non-standard clinical practices and time constraints. CONCLUSION : There are several challenges faced by South African audiologists in performing verification. It may be feasible to address these barriers by raising awareness about the value of verification, offering training, and advocating for the purchase and utilisation of verification equipment. CONTRIBUTION : This study’s findings provide information on the current practices of hearing aid verification in a socioeconomically diverse setting. Furthermore, it highlights important challenges such as a lack of equipment as well as time constraints.
Self-perception and clinical presentation of eating and swallowing difficulties within elderly care
(AOSIS, 2025-03) Bell, Caitlin Shauna; Kruger, Esedra; Vermeulen, Rouxjeanne; Masenge, Andries; Pillay, Bhavani S.; bhavani.pillay@up.ac.za
BACKGROUND : The growing ageing population requires effective management of complex medical diagnoses and healthy ageing support within residential care facilities. However, limited access to guidelines on monitoring residents’ eating and swallowing abilities has been reported. Recent research is critical for future policy development. OBJECTIVES : This study aimed to compare self-perceived and clinical presentation of eating and swallowing abilities among a portion of elderly residents to enhance management of the residential care population within the South African context. METHOD : This comparative, within-subject research study assessed 44 participants using an oropharyngeal dysphagia protocol including a medical history review, the Eating Assessment Tool – 10 (EAT-10), the Mann Assessment of Swallowing Abilities (MASA), and the three-ounce water test of the Yale Swallow Protocol (YSP). A brief cognitive screener was used when cognitive impairment was unknown. RESULTS : Of the participants, 21 out of 44 (48%) self-reported concerns for oropharyngeal dysphagia. Evidence of compensatory eating behaviours, without therapeutic intervention, was found. A negative, low correlation was present between the EAT-10 and the MASA (r = -0.306, p < 0.05) scores. CONCLUSION : Individuals who self-reported eating and swallowing difficulties demonstrated fewer clinical symptoms, potentially due to compensatory techniques. The disparity between patient-reported outcome measures and clinical assessment tools highlights the need for robust screening and assessment policies within this context. CONTRIBUTION : This study highlights the importance of holistic assessment practices by integrating self-perception with clinical findings to address oropharyngeal dysphagia incidence within this complex population.
How I experienced tele-intervention : qualitative insights from persons who stutter
(AOSIS, 2025-01) Hoosain, Raadhiyah; Abdoola, Shabnam Salim; Kruger, Esedra; Pillay, Bhavani S.
BACKFROUND : Tele-intervention gained popularity, during the coronavirus disease 2019 (COVID-19) pandemic, prompting healthcare providers to adapt to remote service delivery. Research about stuttering treatment via tele-intervention in South Africa is limited. Speech-language therapists (SLTs) require further insights to deliver a well-supported approach for treatment of stuttering using tele-intervention, despite limitations such as technological disruptions, including loadshedding, that impact service reliability. OBJECTIVES : The study aims to explore clients’ experiences with tele-intervention for stuttering therapy, and to provide recommendations to improve service delivery. METHOD : Semi-structured interviews were conducted with 11 persons who stutter (PWS) recruited through purposive sampling. Written informed consent was obtained from all participants with experience in both tele-intervention and in-person treatment. Inductive thematic analysis supplemented by descriptive statistics was used to identify patterns and trends. RESULTS : Four main themes emerged: (1) User experiences and factors shaping perceptions of tele-intervention; (2) technical infrastructure: barriers and facilitators; (3) financial and access considerations and (4) in-person treatment experience compared to tele-intervention user experience. Likert scale ratings indicated no considerable difference in preferences between tele-intervention and in-person treatment. CONCLUSION : Participants’ diverse experiences highlighted tele-intervention’s benefits and challenges for stuttering therapy. While limitations exist, findings inform service enhancement in South Africa, emphasising the importance of users’ perspectives in tele-intervention design. CONTRIBUTION : Insights from PWS can be used in informing clinical practice, aiding SLTs in meeting the needs of PWS and guiding best practice. Tele-intervention should be integrated into a hybrid intervention model that PWS prefer.
A qualitative inquiry of speech-language therapists’ views about breastfeeding management
(AOSIS, 2025-01) Schlome, Danica; Kruger, Esedra; Pillay, Bhavani S.; esedra.kruger@up.ac.za
BACKGROUND : Management of oropharyngeal dysphagia within the first few days of an infant’s life results in favourable breastfeeding outcomes, indicating the importance of investigating the breastfeeding management practices of speech-language therapists (SLTs) working within this field. OBJECTIVES : Little has been published about SLTs’ management of breastfeeding in low- and middle-income settings. This study explores the perspectives of a group of experienced South African SLTs on their approach to breastfeeding management. METHOD : Qualitative data were gathered through semi-structured online interviews with 12 experienced SLTs and were subjected to thematic analysis. RESULTS : Three main themes emerged: (1) Approach to breastfeeding management; (2) Exposure, skills and knowledge related to breastfeeding management and (3) Perspectives and attitudes towards breastfeeding management. Participants demonstrated a clear understanding of their roles within the scope of breastfeeding management, which aligns with established literature. Their approaches appeared to be influenced by their perspectives and attitudes towards breastfeeding, as well as their exposure, skills and knowledge in this area. The study underscores the need for breastfeeding training in undergraduate programmes and highlights the demand for continuous professional development opportunities. CONCLUSION : While the findings are drawn from a small sample of experienced clinicians, they offer valuable insights for speech-language pathology clinical educators and professional organisations. CONTRIBUTION : This study suggests a re-evaluation of university curricula to enhance exposure to breastfeeding management.
Swallowing and oral-sensorimotor characteristics in a sample of young hospitalised children with severe acute malnutrition
(Wiley, 2025-05) Eslick, Casey Jane; Kritzinger, Alta M. (Aletta Margaretha; Graham, Marien Al; Kruger, Esedra
AIM : To describe swallowing and oral-sensorimotor characteristics in a sample of young hospitalised children with severe acute malnutrition (SAM). METHODS : The Schedule of Oral-motor Assessment was used to compare oral-sensorimotor skills of 45 hospitalised patients with SAM (M = 15.98 months; SD = 8.03), to pairwise-matched controls (M = 15.96 months; SD = 8.08). Participants were matched for age, gender, TB, HIV-status, socio-economic status including maternal education, paternal employment, housing and transport access. Caregivers reported demographic information, feeding practices and behaviours during feeding. RESULTS : In comparison to controls (n = 6; 13.3%), participants with SAM (n = 25; 55.6%) presented with significantly more oral-sensorimotor difficulties (p < 0.001), across all consistencies except liquids from the trainer cup and bottle. Difficulties included jaw opening and stabilisation, tongue and lip control for chewing, bolus formation and transport, sustained bite and uncoordinated swallowing. Delayed sitting development significantly correlated with uncoordinated swallowing and head extension on puree and cup drinking, and multiple swallows on puree and semi-solids. Force-feeding and slow swallow initiation in semi-solids significantly correlated. Disruptive feeding behaviours and higher levels of food refusal at the beginning of meals were reported. Clinical signs of aspiration were identified. CONCLUSIONS : Oral-sensorimotor dysfunction and possible aspiration were observed in 55.6% of participants with SAM. Safe swallowing function for overall health and nutritional recovery is emphasised. Under-identification of oral-sensorimotor difficulties, lack of referral to speech-language therapists and disruption to continuity of care warrants further research.
International Consortium on Ageing-Related Pathologies (ICCARP) Audiovestibular Group : fostering international consensus to refine International Classification of Diseases (ICD-11) codes for hearing loss across the life course
(Springer, 2025) Tsimpida, Dialechti; Akeroyd, Michael A.; Bentley, Barry L.; Bhattacharjee, Shuvarthi; Bowl, Michael R.; Broome, Emma; Calimport, Stuart R.G.; Calvert, Sian; Christopher, Gary; Dening, Tom; Di Bonaventura, Silvia; Goswami, Ankita; Gougousis, Spyridon; Govaerts, Paul J.; Gupta, Mini; Henshaw, Helen; Huckstepp, Robert T.R.; Iliadou, Vasiliki Maria; Koutsimani, Theano K.; Lewis, Morag A.; Lin, Frank R.; Miotto, Cecilia Luisa; Nolan, Lisa S.; Nuttall, Helen E.; Onyekere, Chukwuebuka Prince; Phanguphangu, Mukovhe; Plack, Christopher J.; Raghavan, Ramasamy S.; Reed, Nicholas S.; Rova, Konstantina; Steel, Karen P.; Stokroos, Robert J.; Swanepoel, De Wet; Szczepek, Agnieszka J.; Whitney, Susan L.
Following the World Health Organization’s (WHO’s) decision to classify age-related aetiologies, and a global call for action to systematically classify the pathologies of ageing, the International Consortium to Classify Ageing-Related Pathologies (ICCARP) was established in 2023 under the leadership of Cardiff Metropolitan University. Within this consortium, the Audiovestibular Group is actively working to refine the classification of hearing and balance disorders, aligning with the WHO’s commitment to enhance diagnostic frameworks. This effort coincided with the release of the 2025 edition of the International Classification of Diseases 11th Revision (ICD-11) on 14th February 2025.
Dysfluencies in a multilingual speaker : a case study
(Universidad de Castilla la Mancha, 2025-02) Nel, Talitha; Geertsema, Salome; Le Roux, Mia; Graham, Marien Alet; Abdoola, Shabnam Salim
Research involving a multilingual person who clutters and stutters in Bantu languages is limited. Our aim was to describe the dysfluencies of a multilingual person with dysfluencies across and within Sepedi, Afrikaans, and South African English (SAE). A single multilingual adult participant with a persistent mild stuttering and moderate cluttering pattern participated. A mixed-method cross-sectional design was implemented. Perceptual analysis was used to study stuttering-like dysfluencies (SLD) and cluttering-like dysfluencies (CLD) across and within the three languages. The results revealed that the most prevalent SLD in all three languages was the repetition of part words. The repetition of whole words was the most prevalent CLD. The plosive /d/ sound represented the highest occurrence and resulted in repetitions of sounds across and within Afrikaans and SAE. There were no repetitions of sounds in Sepedi, but three repetitions of the syllable /se-/ occurred. Future research is recommended to include a bigger sample size, and other Bantu languages should also be considered.
A cross-sectional study of how high-frequency hearing loss impacts cognitive functions in middle-aged-to-older adults
(Frontiers Media, 2025-04) Jayakody, Dona M.P.; Mcilhiney, Paul; Stegeman, Inge; Eikelboom, Robert H.
PURPOSE : Research on the association between hearing loss and cognition has primarily focused on speech-range hearing frequencies (i.e., 0.5–4 kHz), as these frequencies are most relevant to everyday functioning. However, age-related hearing loss (ARHL) tends to impact higher-frequency hearing first, and more severely. Despite this, limited research has investigated the relationship between high-frequency (i.e., >4 kHz) hearing loss and cognitive impairment. In the current study, we aimed to assess whether high-frequency hearing loss predicts non-verbal cognitive functions (i.e., visuospatial executive function, learning, and memory tasks) above and beyond speech-frequency hearing loss. MATERIALS AND METHODS : Participants were 241 English-speaking adults, aged 40–88 years, with hearing loss. Audiometrically assessed better-ear, speech-frequency (0.5, 1, 2 & 4 kHz; BE4PTA) and high-frequency (6 & 8 kHz; BE2PTA) hearing loss were compared to cognitive functions measured using non-verbal tests from the Cambridge Neuropsychological Test Automated Battery; covariates included hearing-loss asymmetry, age, sex, premorbid IQ, and mental health measured with the short-form Depression Anxiety Stress Scales. RESULTS : While correlation analyses demonstrated that all measured cognitive faculties were associated with both BE4PTA and BE2PTA, hierarchical linear regression analyses demonstrated that only BE4PTA predicted cognitive flexibility and working-memory ability after controlling for covariates; age primarily accounted for BE2PTA’s cognitive effects. CONCLUSION : While both speech and higher-frequency hearing loss were associated with poorer cognition, only the former demonstrated effects beyond those of ageing. However, the present study only investigated two frequencies in the higher range, encouraging broader investigation of higher-frequency hearing’s cognitive effects in the future.
Speech-language therapists' views of oral feeding of infants on high-flow oxygen
(AOSIS, 2025-02) Dludla, Andile; Forman, Tarryn B.; Lloyd, Mikaela K.; Moodley, Savannah O.; Pillay, Sarveshvari B.; Kruger, Esedra; esedra.kruger@up.ac.za
BACKGROUND : Introduction of oral feeding for young children receiving high-flow oxygen has recently gained interest. With limited literature, there are varied opinions regarding the safety of oral feeding in this population. AIM : This study describes speech-language therapists’ (SLTs) views on oral feeding for infants receiving high-flow oxygen. SETTING : A South African online survey study. METHODS : A descriptive quantitative survey was distributed electronically via social networking sites. Purposive and snowball sampling were used to recruit expert SLTs. Twenty-one South African SLTs working with paediatric swallowing and feeding, from nine provinces responded. Data were analysed descriptively. RESULTS : Of 21 responses, only nine were fully complete, indicative of how few South African SLTs work with infants on high-flow oxygen. Current oral feeding practices varied with differences between nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC). Strategies for oral feeding included volume and time limitations, monitoring physiological stability and assessing for aspiration. Thin liquids were most commonly used. Varied opinions, with no protocols or guidelines for introduction of oral feeding of young children on high-flow oxygen, are reported. CONCLUSION : SLTs’ practices regarding oral feeding in infants/children receiving high-flow oxygen are variable. Professionals share common approaches to determine feeding readiness and monitor tolerance. Without guidelines and standardised protocols, SLTs are left to make decisions based only on experience. A need exists for further research. CONTRIBUTION : There is variability in initiation of oral feeds, highlighting the need for further data to inform uniform protocol and guideline development to enhance SLTs’ decision-making.

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