Research Articles (Speech-Language Pathology and Audiology)

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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
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.
Dizziness and imbalance and their association with general and mental health in a community-based cross-sectional study of middle-aged individuals : the Busselton healthy ageing study
(BioMed Central, 2025-04) Smit, Adriana L.; Eikelboom, Robert H.; Bucks, Romola S.; Atlas, Marcus D.; Hunter, Michael; Stegeman, Inge
BACKGROUND : Dizziness and imbalance are common symptoms among patients visiting healthcare providers. Current knowledge about their prevalence, impact on daily life, and associated factors is primarily based on selected samples from individuals seeking medical help, particularly older individuals. This study aimed to estimate the prevalence, symptoms, and impact of dizziness or imbalance symptoms, and to assess the association between these symptoms and their characteristics with demographic, general health, and mental health factors in middle-aged men and women from a representative, general population sample. METHODS : Cross-sectional data were collected from participants aged 45 to 70 years in the Busselton Healthy Ageing Study (BHAS), recruited in the City of Busselton, Western Australia. The data included physical tests and health-related questionnaires covering demographics, medical history, general and mental health, including any dizziness and imbalance symptoms and their impact on daily life. Estimates were made of the prevalence, patterns, and impact of dizziness and imbalance symptoms. Logistic regression was employed to calculate the association between demographic, mental and general health (independent variables) and the presence of dizziness or imbalance symptoms (dependent variable). Adjustments were made for sex and age as confounding factors. RESULTS : Of the 5086 participants, 1216 (23.9%) reported imbalance or dizziness, with light-headedness the most common type (64.3%; 782 of 1216). For nearly half (565; 46.5%) the imbalance or dizziness occasionally effected daily life, while for some, the impact was frequent (n = 50, 4.1%) or constant (n = 15, 1.2%). Being female (adjusted OR 2.05, 95%CI 1.79-2.34) and older in age (in years; adjusted OR 1.02, 95%CI 1.00-1.03), having a history of general health issues, and experiencing mental health problems or mental health symptoms were significantly associated with dizziness or imbalance symptoms. CONCLUSIONS : Dizziness or imbalance are common symptoms among individuals aged 45 to 70 years and are associated with older age, being female, and poorer general and mental health. Given that approximately half of those affected reported occasional effects on daily life, with a few reporting frequent or constant effects, the outcomes of the study could help to raise awareness among healthcare providers about the prevalence, symptoms, and associated conditions.
Gain analysis of self-fitting over-the-counter hearing aids : a comparative and longitudinal analysis
(MDPI, 2025-02) Knoetze, Megan Clarissa; Manchaiah, Vinaya; Cormier, Kayla; Schimmel, Carly; Swanepoel, De Wet; dewet.swanepoel@up.ac.za
OBJECTIVES : To investigate the gain provided by self-fitting over-the-counter (SF-OTC) hearing aids compared to clinical NAL-NL2 targets, the differences between various FDA-approved SF-OTC devices, and potential changes in gain over time. METHODS : Two experiments were conducted: (1) a cross-sectional comparison of six SF-OTC hearing aids (n = 43) and (2) a longitudinal evaluation of gain within five days of self-fitting and four additional time points (n = 15). Real-ear measurements (REMs) were used to measure gain. RESULTS : SF-OTC hearing aid gain corresponded with 10 dB SPL but not 5 dB SPL criteria from NAL-NL2 targets. Differences between NAL-NL2 targets and gain did not differ significantly between devices. There were no significant changes in gain over time for any input level. CONCLUSIONS : SF-OTC hearing aids generally provide user-selected gain levels lower than clinical targets, particularly at higher frequencies. The gain remains stable over time, indicating limited user adjustment after initial fitting. OTC hearing aid manufacturers should consider implementing fitting algorithms that allow for gradual user acclimatization.
Beskrywing van fonologiese patrone by Afrikaanse kinders van 24 tot 72 maande
(LitNet, 2024-02) Du Plessis, Simone; Le Roux, Mia; Geertsema, Salome; Graham, Marien Alet
AFRIKAANS : Alhoewel Afrikaans een van 12 amptelike tale in Suid-Afrika is, is daar slegs beperkte inligting oor fonologiese ontwikkeling. Hierdie ondersoek verskaf ’n waardevolle bydrae tot die ontwikkeling van fonologiese patrone (FP’s) by 24–72 maande oue kinders in die Afrikaanse bevolking. Daarbenewens lewer die navorsing ook kommentaar op die verskille in die voorkoms van FP’s tussen seuns en dogters. Die rasionaal het ingesluit die verskaffing van bewysgebaseerde riglyne en data vir die beskrywing van FP’s aan spraakterapeute. Die navorsingsvraag is: Wat is die kenmerkende beskrywing van ’n fonologiese patroon by ’n Afrikaanse eerstetaalspreker in die ouderdomsgroepe 24–72 maande? Tot op datum het geen ander navorsingsondersoeke die verskynsel van FP’s by Afrikaanssprekende kinders geëvalueer nie. Geen normatiewe data is voorheen ingesamel om die voorkoms van FP’s binne die Afrikaanssprekende groep of die verskille tussen seuns en dogters te bepaal nie. Die doel was om FP’s in die Afrikaans eerstetaalsprekende kind in die ouderdomsgroepe 24–72 maande te bepaal en te beskryf. Die ondersoek het ’n retrospektiewe, beskrywende navorsingsontwerp gebruik en in totaal 147 deelnemers ingesluit. Hierdie retrospektiewe ondersoek het voorheen versamelde elektroniese oudio-opnames van die navorsing deur Pringle, Le Roux, Geertsema e.a. (2022) gebruik. Twaalf deskundige spraakterapeute was deel van die data-ontledingsprosedures om FP’s binne die data te bepaal. Vyf luisteraarspanele is vir die ontledingsprosedures op die been gebring, waarna statistiese ontledings gedoen is om gevorderde resultate te bepaal. Alle patrone het na 72 maande voortgeduur, behalwe die aanvanklike konsonantstemgewing en vokalisasie, wat ten volle uitgeskakel is. Die approksimasie van die trilklank /r/ en die lateraal /l/ het die hoogste voorkoms getoon en daar is beduidende verskille tussen die prestasies van seuns en dogters gevind. Resultate het aan die lig gebring dat eerstetaal-Afrikaanssprekende kinders verskillende voorkomssyfers vir spesifieke FP’s toon as ander kinders van dieselfde ouderdom in ander tale.
The challenging road to sustainable kangaroo mother care practice and service : reflections from a South African health district
(BioMed Central, 2025-03) Bergh, Anne-Marie; Van Rooyen, Elise; Kritzinger, Alta M. (Aletta Margaretha); Skhosana, Maria Rinah; Tshukudu, Mphailele; Feucht, Ute Dagmar; anne-marie.bergh@up.ac.za
BACKGROUND : Kangaroo mother care (KMC) was introduced in the Tshwane Health District in South Africa in 1999. After more than two decades of the expansion of KMC services, we describe the KMC implementation trajectory in the district. METHODS : A group of district clinical specialists, clinicians and academics involved in KMC implementation wrote a reflection on the status of KMC in Tshwane District and lessons for sustaining KMC services and practice. RESULTS : The KMC implementation trajectory is described according to three phases: (1) a slow start (1999–2012); (2) consolidation (2012–2023); and (3) sustaining KMC beyond the COVID-19 pandemic. The Tshwane KMC programme activities are interpreted using a 10-component model for scaling up care for small and/or sick newborns at the district level. Major lessons for the sustainability of KMC practice and service include embedding system-wide supportive supervision in the health system’s budget, encouraging multidisciplinary teamwork, conducting regular KMC refresher activities, and working on improving data to enable meaningful action. CONCLUSION : Despite great strides in KMC implementation and ongoing services in the Tshwane Health District, the road to continued sustainability remains challenging.
Factors influencing person-centred care : speech-language pathologists and audiologists perspective
(AOSIS, 2025-03) Mahomed-Asmail, Faheema; Metcalfe, Louise; Graham, Marien Alet; Eccles, Renata
BACKGROUND : Person-centred care (PCC) is a fundamental aspect of healthcare, and its implementation is primarily based on clinicians’ initiation and sustained efforts and the availability of resources. Recent PCC literature has primarily focused on high-income settings, raising concerns about the feasibility of PCC implementation in low- and middle-income countries. OBJECTIVES : This study examined speech-language pathologists’ (SLPs) and audiologists’ (AUDs) perceptions of barriers and facilitators towards implementing PCC in the diverse South African context, particularly how their demographic factors influence these perceptions. METHODS : A national cross-sectional e-survey pooled 103 clinicians who were providing speech-language pathology and audiological services in South Africa. The e-survey included questions on participants’ demographics, working environment and a seven-point Likert scale rating 10 components that influence PCC. RESULTS : Clinicians scored personal factors (64.7%), followed by their relationships with different professionals (54.9%) as the most facilitating factors for achieving PCC. The most significant perceived barrier was resources, including time and finances (59.8%), followed by the client perspectives (53.9%). Significant associations were found between the components influencing PCC and clinicians’ qualifications, work sectors and populations served. CONCLUSION : The collective findings of this study highlighted the multifaceted nature of PCC implementation within a diverse healthcare context. Client perspectives need to be considered while leveraging clinician attributes and fostering supportive workplace environments for the successful adoption of PCC. CONTRIBUTION : This study contributes to literature of PCC implementation and has captured how the perceptions of speech-language therapists (SLPs) and AUDs call for tailored approaches in diverse healthcare contexts.
Service delivery approaches related to hearing aids in low- and middle-income countries or resource-limited settings
(Public Library of Science, 2024-01-24) Dillard, Lauren K.; Der, Carolina M.; 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
Hearing loss is an important global public health issue which can be alleviated through treatment with hearing aids. However, most people who would benefit from hearing aids do not receive them, in part due to challenges in accessing hearing aids and related services, which are most salient in low- and middle-income countries (LMIC) and other resource-limited settings. Innovative approaches for hearing aid service delivery can overcome many of the challenges related to access, including that of limited human resources trained to provide ear and hearing care. The purpose of this systematic scoping review is to synthesize evidence on service delivery approaches for hearing aid provision in LMIC and resource-limited settings. We searched 3 databases (PubMed, Scopus, Ovid MEDLINE) for peer-reviewed articles from 2000 to 2022 that focused on service delivery approaches related to hearing aids in LMIC or resource-limited settings. Fifteen peer-reviewed articles were included, which described hospital-based (3 studies), large-scale donation program (1 studies), community-based (7 studies), and remote (telehealth; 4 studies) service delivery approaches. Key findings are that hearing aid services can be successfully delivered in hospital- and community-based settings, and remotely, and that both qualified hearing care providers and trained non-specialists can provide quality hearing aid services. Service delivery approaches focused on community-based and remote care, and task sharing among qualified hearing care providers and trained non-specialists can likely improve access to hearing aids worldwide, thereby reducing the burden of untreated hearing loss.
Hearing loss characteristics and cerumen management efficacy in low-income South African communities : a cross-sectional study
(Cambridge University Press, 2025-03) Manganye, Sello Marven; Frisby, Caitlin; Reddy, Tarryn Marisca; De Kock, Tersia; Swanepoel, De Wet; dewet.swanepoel@up.ac.za
AIM : To describe the prevalence and characteristics of hearing loss in a self-referred adult cohort in low-income South African communities and to evaluate the effectiveness of a cerumen management protocol within a community-based service setting. BACKGROUND : Hearing loss affects 1.5 billion people globally, with a disproportionate impact on individuals in low- and middle-income countries (LMICs) and the elderly, often attributed to age-related factors and cerumen impaction. Despite the high prevalence, access to ear and hearing care remains challenging, particularly in LMICs, such as Africa. METHODS : A total of 227 participants aged 43–102 were recruited from two community centres in low-income South African communities for hearing evaluation and cerumen management for those with cerumen impaction. A cross-sectional, predominantly quantitative approach was used. FINDINGS : Video otoscopy of 448 ears revealed normal findings in 57.9%, cerumen impaction in 29.1%, and other abnormalities in 1.3%. The prevalence of confirmed hearing loss was 97.8%, primarily mild (45.8%), and sensorineural hearing loss (SNHL) was the most common (55.3%). Cerumen impaction accompanied hearing loss in 28.4% of cases. Post-treatment, 50.9% of participants with cerumen impaction showed normal otoscopy results, with mean hearing improvements of 16.2 dB (±17.9 SD) in the left ears and 15.8 dB (±17.2 SD) in the right ears, though overall significance was limited. CONCLUSION : The high prevalence of hearing loss and cerumen impaction in low-income communities emphasizes the importance of ear care in primary healthcare (PHC) settings, especially for the elderly. Effective community-based cerumen management highlights the potential of integrating community resources and task-shifting strategies for cost-effective ear care in resource-limited settings.
Automatic development of speech-in-noise hearing tests using machine learning
(Nature Research, 2025-04) Polspoel, Sigrid; Moore, David R.; Swanepoel, De Wet; Kramer, Sophia E.; Smits, Cas
Understanding speech in noisy environments is a primary challenge for individuals with hearing loss, affecting daily communication and quality of life. Traditional speech-in-noise tests are essential for screening and diagnosing hearing loss but are resource-intensive to develop, making them less accessible in low and middle-income countries. This study introduces an artificial intelligence-based approach to automate the development of these tests. By leveraging text-to-speech and automatic speech recognition (ASR) technologies, the cost, time, and resources required for high-quality speech-in-noise testing could be reduced. The procedure, named “Aladdin” (Automatic LAnguage-independent Development of the digits-in-noise test), creates digits-in-noise (DIN) hearing tests through synthetic speech material and uses ASR-based level corrections to perceptually equalize the digits. Traditional DIN tests were compared with newly developed Dutch and English Aladdin tests in listeners with normal hearing and hearing loss. Aladdin tests showed 84% specificity and 100% sensitivity, similar to the reference DIN tests (87% and 100%). Aladdin provides a universal guideline for developing DIN tests across languages, addressing the challenge of comparing test results across variants. Aladdin’s approach represents a significant advancement in test development and offers an efficient enhancement to global screening and treatment for hearing loss.
Auditory emotional prosody perception using pseudo-speech stimuli in native and non-native listeners
(Wiley, 2025-04) Gürses, Emre; Cesur, Sidika; Manchaiah, Vinaya
OBJECTIVE : To assess emotional recognition ability using corpora of emotions conveyed through nonlinguistic pseudo-sentences in native and non-native listeners (Turkish and English). METHODS : A cross-sectional design was employed, including a total of 60 young adults (aged 18–25 years). Of these, 30 were American English-speaking participants with no knowledge of Turkish, while the remaining 30 were age-, sex-, and education-matched Turkish participants. Emotional recognition scores and reaction times were assessed following audiological measurements using a one-interval, five-alternative forced choice method. A hundred stimuli recorded by Turkish speakers were presented, including 5 emotions × 2 speakers × 10 pseudo-sentences. The emotions tested were “neutral,” “happy,” “angry,” “surprised,” and “panicked.” RESULTS : No statistically significant differences exist between the groups' recognition of “neutral” and “angry” emotions. However, significant differences were observed in the recognition of happy, surprised, panicked and the mean scores of the emotions. Reaction times showed that nonmeaningful pseudo-sentences elicited similar listening efforts between native and non-native listeners. CONCLUSION : Overall results suggest that while there may be recognizable vocal cues irrespective of languages for expressing angry and neutral emotions, this does not apply to all emotions. These results point to the fact that the type of test materials may play an important role when measuring emotional recognition among different cultures using auditory stimuli. In terms of reaction time results, pseudo-sentences could be used for cross-language auditory emotion recognition, however with certain emotions.
Building IPECP into community health promotion
(Health and Medical Publishing Group, 2024-07-01) Abdoola, Shabnam Salim; Milton, Carmen; shabnam.abdoola@up.ac.za
Due to its culturally and linguistically diverse society, high prevalence of communication disorders, resource limitations, and fragmented healthcare services, South Africa (SA) needs to integrate interprofessional education and collaborative practice (IPECP) into community health promotion. IPECP in health professions education is necessary in preparing ‘collaborative practice-ready’ health care professionals who are socially accountable and prepared to respond to local health needs. Integrating IPECP strategies into existing curricula and placing interprofessional students at the same clinical sites can promote collaborative education and practice. Providing students with interprofessional clinical practice experience provides real world experience and insight, while enhancing an understanding and respect for other professionals.
The acquisition of constructions : does modality matter?
(AOSIS, 2024-06-12) Wright, Richenda; Geertsema, Salome; Le Roux, Mia; Winckel, Elodie; Dąbrowska, Ewa
BACKGROUND: Language analytic ability is well researched in the context of foreign language acquisition but its role in the acquisition of grammar in the native language is under investigation. OBJECTIVES: Our study explored the influence of language analytic ability and print exposure on receptive grammar and reading comprehension in childhood. Additionally, we investigated whether exposure to specific constructions through the written modality held an advantage over exposure in the audio modality. METHOD: We assessed the language analytic ability, reading comprehension, reading fluency, print exposure, and receptive grammar of 12-year-olds. Subsequently, we exposed them to written or spoken target constructions, followed by an assessment of receptive grammar. Linear regression models were used to analyse the contributions of reading fluency, print exposure, and language analytic ability to reading comprehension and receptive grammar. We also examined the influence of the intervention on receptive grammar. RESULTS: Language analytic ability and print exposure significantly predicted receptive grammar. Print exposure significantly predicted reading comprehension and improvement in receptive grammar. CONCLUSION: Language analytic ability is important for grammar and reading comprehension development. Print exposure enhances reading comprehension by supporting vocabulary development and providing exposure to intricate structures. Both language analytic ability and experience are key factors in construction acquisition. CONTRIBUTION: This study adds to the growing body of evidence emphasising the role of language analytic skills in native language grammar acquisition and advocates for explicit grammar teaching. Furthermore, it underscores the importance of adequate print exposure in grammar acquisition and the development of reading comprehension skills.
Constant dizziness versus episodic vertigo in Ménière's disease : health-related quality of life, cognitive dissonance, and postural problems
(AVES, 2024-09-24) Pyykko, Ilmari; Zou, Jing; Manchaiah, Vinaya
BACKGROUND : The aim was to explore and characterize dizziness and vertigo (constant vs episodic) and associated problems in patients with Ménière’s disease (MD) to allow characterization of the impact of the disease. METHODS : The study used a retrospective survey design. A total of 539 people with MD participated in this study. The online questionnaire included 36 items which had mixture of structured and open-ended questions that were focusing on MD symptoms, impact of their symptoms, vestibular rehabilitation, as well as health-related quality of life (HRQoL). RESULTS : Forty-six percent of the patients had episodic vertigo, 6% had constant dizziness, 15% had both episodic vertigo and constant dizziness, and 31% did not have vertigo or dizziness within the last 2 years. Patients with MD without any vertigo rated their HRQoL as 73.9%, those with episodic vertigo as 71.1%, those with constant dizziness as 56.9%, and those with constant dizziness and episodic vertigo as 57.9% indicating significant reduction in HRQoL in constant dizziness patients. Constant dizziness was associated with cognitive visual problems, fatigue, balance problems, vestibular drop attacks and syncope. The impact of balance problem was more severe among those with constant dizziness. The most common balance problem was tripping-off (34%), followed by swaying (25%) or rocking (8%) sensations. In the self-administered rehabilitative training, there were no differences between any of the vertigo or dizziness groups although disease profile of MD differed significantly. CONCLUSION : We emphasize that constant dizziness in MD constitutes a long-term maladaptation to a vestibular and visual cognitive function causing cognitive dissonance. Different types of vertigo and their associated complaints require different treatment strategies to the manage balance problems and to cope with the disease, but best practices is still under research.
Diverse phenotype of Ménière's disease associated with family history, thyroid disorder, migraine and associated disorders
(Elsevier, 2024-10) Pyykko, Ilmari; Gupta, Vinay; Zou, Jing; Vetkas, Artur; Manchaiah, Vinaya
OBJECTIVE: To better understand the clinical phenotype of Ménière's disease (MD), we examined family history, thyroid disorder, migraine, and associated disorders in complaints of people living with MD. METHOD: We designed the study as a retrospective and examined data gathered from 912 participants with MD. Their data were originally collected by the Finnish Ménière Federation (FMF). The survey data included individual case histories for environmental factors, comorbidities, disease-specific complaints, impact-related questions, cognitive complaints, health-related quality of life (HRQoL), and sense of coherence (SOC). RESULTS: We observed significant differences between those with and without sporadic occurrence, family history, thyroid disorder, and migraine-associated complaints. Family history explained 20% of variability in patient complaints. Patients with a family history of MD whose disease started at younger age experienced balance problems, more severe vertigo spells, more severe vestibular drop attacks (VDA), and less nausea, although they had good SOC. Thyroid disorder explained 14% of variability in patient complaints. MD patients with a thyroid disorder comorbidity suffered more often from constant dizziness, balance problems, greater impact of hearing problems, cognitive complaints, and poor HRQoL. Migraine explained 12% of variability in patients’ complaints and was associated with poor SOC and cognitive balance problems. MD patients with both thyroid disorder and migraine used antidepressants more often than other groups. Logistic regression analysis showed comorbidities of ischemic brain disorder (among 7.1%), kidney insufficiency (among 1.2%), and diabetes (among 7.3%) had statistically significant but restricted association with balance and gait problems, VDA, and reduced HRQoL. CONCLUSIONS: Family history of MD and thyroid disorder or migraine comorbidities in MD influence the complaint pattern and partially explain complex symptom profiles, including symptoms of cognitive problems. Confounders play a minimal role in complaint profile and impact of MD whereas comorbidities influence the complaint structure and partly explain the complex symptom profile in MD.
Hearing aid benefit in daily life : a qualitative ecological momentary assessment study
(Frontiers Media, 2024-10-09) Fourie, Chane; Mahomed-Asmail, Faheema; Oosthuizen, Ilze; Manchaiah, Vinaya; Vercammen, Charlotte; Swanepoel, De Wet; dewet.swanepoel@up.ac.za
INTRODUCTION : Understanding hearing aid wearer experiences in real-world settings is important to provide responsive and individualized hearing care. This study aimed to describe real-life benefits of hearing aids (HAs), as reported by hearing aid wearers through Ecological Momentary Assessment (EMA) in various listening environments. METHOD : Qualitative content analysis of 1,209 open-text responses, provided through self-initiated EMAs, was conducted. The de-identified data was collected retrospectively via a smartphone app compatible with these HAs. Only text responses reflecting positive hearing aid experiences were analyzed.The 1,209 open-text responses were categorized into 18 pre-determined sub- categories, further organized into five overarching categories: Conversational, Leisure, Device-related aspects, Lifestyle, and Other factors. RESULTS : Across these categories, 48 self-generated meaning units highlighted the multifaceted benefits of HAs. In particular, participants reported significant improvements in conversational settings, specifically during phone conversations and meetings, attributed to improved sound quality and speech understanding when wearing their HAs. During leisure activities, particularly TV watching and music listening, clearer sound and ease of Bluetooth streaming contributed to experienced benefits. Lifestyle improvements were reported in occupational and social settings, as hearing aid wearers stated enhanced communication and sound awareness. Device-related factors contributing to positive wearer experiences included extended battery life and the convenience of rechargeable batteries. The most prominent sub-category, other factors, underscored overall satisfaction, comfort with the device, and improved auditory experiences across various environments. CONCLUSION : This study reveals the diverse benefits of HAs in improving communication, listening experiences, and quality of life across various settings, as captured through EMA. By emphasizing features like direct streaming and rechargeability, the findings highlight the importance of personalized hearing care and the potential of real-time listener feedback to inform device enhancements and support strategies, advancing more tailored and effective hearing rehabilitation.
A novel consumer-centric metric for evaluating hearing device audio performance
(Frontiers Media, 2024-05-27) Manchaiah, Vinaya; Taddei, Steve; Bailey, Abram; Swanepoel, De Wet; Rodrigo, Hansapani; Sabin, Andrew
BACKGROUND AND AIM : The emergence of direct-to-consumer hearing devices has introduced confusion in making appropriate choices, highlighting the need for users to be well-informed for optimal device selection. Currently, no established metric offers insights into the sound performance of these devices. This study aimed to introduce and assess a novel consumer-centric metric (i.e., SoundScore) for hearing device audio performance. METHOD : The SoundScore metric was created based on five dimensions of hearing device audio performance (i.e., speech benefit in quiet and moderate, speech benefit in loud, own voice perception, feedback control, streamedmusic sound quality). Tests were conducted under lab conditions with an acoustic manikin using two fitting protocols meant to approximate (1) real-world default device settings for amild-to-moderate sloping hearing loss (“Initial Fit”) and (2) an audiological best-practices approach (“Tuned Fit”). A total of 41 hearing devices comprising 10 prescription hearing aids (Rx-HA), 10 self-fitting over-the-counter hearing aids (OTC-SF), 8 pre-set based over-the-counter hearing aids (OTC-PS), and 13 personal sound amplification systems (PSAPs) were evaluated. RESULTS : SoundScore varied significantly between device classifications with Rx-HA yielding the highest average scores and PSAPs the lowest. SoundScore also varied with fitting method, whereby preset based devices scored lower on average than devices programmable by fitting software. Performance across the five composite sound performance metrics generally improved between “Initial” and “Tuned” fits for Rx-HA. However, this was not observed with OTC-SF. Also, no significant difference in SoundScore was found between devices of different form factors (i.e., BTE vs. ITE). CONCLUSIONS : Initial findings suggest that the SoundScore can effectively distinguish between the audio performance of different hearing aids, offering consumers a valuable decision-making tool. Future studies should examine the relationship between the SoundScore and consumer hearing aid benefit/satisfaction.
Hearing and functioning in Everyday Life Questionnaire : psychometric evaluation and revision
(American Speech-Language-Hearing Association, 2024-06) Karlsson, Elin; Manchaiah, Vinaya; Maki-Torkko, Elina; Granberg, Sarah; Gustafsson, Johanna; Dahlstrom, Orjan; Widen, Stephen
PURPOSE : The aim of the current study was to explore the construct validity and internal consistency reliability of the International Classification of Functioning, Disability and Health (ICF)–based original English version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) and to revise the HFEQ based on the results. METHOD : This study used a cross-sectional survey design. The data were collected using an online survey. Adults with self-reported hearing disability (n = 513) from the United States were included. The ICF components of body functions, activity and participation, and environmental factors were tested as the underlying structure of the HFEQ using confirmatory factor analysis and then adjusted by triangulation with previous content validation. RESULTS : The results of the current study confirmed the ICF components of body functions, activity and participation, and environmental factors as underlying constructs of the HFEQ. However, after triangulation with previous content validation, fine adjustments were made. The revised version of the HFEQ includes two removed items and a fine-tuned factor structure. CONCLUSION : The results confirm that the structure of the HFEQ aligns with the ICF, and the overall results indicate that HFEQ has acceptable construct validity and internal consistency.
Predictors of hearing loss disability : a multinational study using the ICF core set
(Taylor and Francis, 2025) Mahomed-Asmail, Faheema; Graham, Marien Alet; Swanepoel, De Wet; Manchaiah, Vinaya; Yerraguntlag, Krishna; Karlsson, Elin
PURPOSE : Objective audiological assessments provide valuable insights on physiological dimensions of hearing loss (HL), but not on lived experiences and functional limitations perceived by individuals. This study employed the multidimensional ICF framework to explore how demographic and diagnostic variables predict self-reported disability in adults with HL. METHOD : This cross-sectional study included 571 participants from India (94), South Africa (79), Sweden (219), and the USA (179). Responses from structured interviews based on the ICF were measured against demographic and diagnostic variables. RESULTS : 74.6% of the participants were hearing aid (HA) users with moderate-to-severe HL. Five statistically significant predictors were identified; HA usage, degree of HL, level of education, age, and income bracket. The predictors were associated with the ICF components; body functions (b126, b210, b230, b240), activity and participation (d310, d350) and environmental factors (e125, e250, e310, e355, e410, e460). CONCLUSIONS : This study emphasises that an individual’s experience with HL is significantly influenced by various factors beyond the severity of the HL itself. This underscores the ICF’s utility in capturing the complex interplay of biopsychosocial factors on HL. Identifying significant predictors could aid in tailoring interventions to improve health outcomes and quality of life for individuals with HL.

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