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ARA Institute 2023 in Boston, MA
Leveraging Technology for AR

When: November 14-15, 2023 (immediately prior to the ASHA Convention)

Where: Boston Convention and Exhibition Center (Westin in the Faneuil room) Boston, MA


Hotel: Institute attendees can take advantage of ASHA housing discounts! ASHA membership/Convention attendance is not required for reduced pricing. Click here for more information

Welcome to our conference on Aural Rehabilitation. This event aims to provide a platform for researchers, clinicians, and professionals to share their knowledge and experience on the latest developments in AR. The conference offers a unique opportunity to engage in discussions on real-life case studies, cutting-edge research, and clinical practices related to AR. Attendees will have the chance to network with like-minded professionals, exchange ideas, and build collaborations to improve outcomes for people with hearing difficulties. In addition, we will also recognize the contributions of individuals who have made significant contributions to the field. To cap off the event, we invite you to enjoy a wine and cheese poster session, where you can view and discuss the latest research while enjoying some refreshments.

  • Discussions of case studies, cutting-edge research, and clinical practices related to AR.

  • Networking with like-minded professionals focused on improving outcomes for people with hearing difficulties.

  • Recognition of contributors to the field.

  • A wine and cheese poster session!


Tuesday, November 14, 2023

8:00 – 9:00 AM - Registration and Continental Breakfast

9:00 – 9:10 AM - Welcome from Dr. Carole E. Johnson, 2023 President of the Academy of Rehabilitative Audiology

9:10 – 9:20 AM - Introduction to the 2023 Academy of Rehabilitative Audiology Honors of the Academy Winner – Joseph Montano, PhD

9:20 – 9:50 AM - Keynote Speaker: Dr. Patti McCarthy

  • Academy of Rehabilitative Audiology 2023 Honors of the Academy Winner Rush University; Chicago, IL. “A Career in Aural Rehabilitation: Perceptions of the Past, Present, and Future”

Herbert Oyer Award Presentations

9:50 – 10:00 AM - Herbert Oyer Award Presentations: Dr. Carole Johnson

10:00 – 10:30 AM - Exploring the Influence of Patient Attributes on the Association between Hearing Handicap and Readiness to Pursue Hearing Aids

  • Lipika Sarangi, AuD/PhD Student; 2023 Herbert Oyer Award Winner
  • University of Arkansas Medical Sciences; Litte Rock, AR

  • Faculty Advisor: Jani Johnson, PhD, AuD University of Memphis; Memphis, TN

  • Abstract: This study explored whether select patient attributes were significant predictors of readiness to pursue hearing aids (HAs) and estimated the impacts of hearing aid self-efficacy (HASE) and emotional states, on the relationship between perceived hearing handicap and readiness to pursue HAs. Sixty-two adults with self-reported hearing difficulties and no previous experience with HAs self-reported their hearing handicap, HASE, personality, emotional states in varying contexts, and readiness to pursue HAs. Individuals with greater hearing handicap and who had experienced hearing loss for a shorter duration were more ready to pursue HAs. Having higher HASE, more positive emotional states in social situations, higher scores for the Agreeableness, and having lower Conscientiousness personality trait scores also independently predicted readiness. Neither HASE nor reported emotional states had a significant impact on the relationship between perceived hearing handicap and readiness to pursue HAs. Certain patient characteristics independently motivate people towards or away from pursing HAs. However, it remains unclear whether targeted modification of these patient attributes would directly facilitate behavior change. Future research should further explore these questions to facilitate a more individualized audiologic rehabilitation.

10:30 – 11:00 AM - Cognitive Communication & Speech-in-Noise Deficits Following Mild Traumatic Brain Injury

  • Devan Lander, AuD/PhD Student; 2023 Herbert Oyer Award Winner

  • Faculty Advisor: Christina Roup, PhD The Ohio State University; Columbus, OH

  • Abstract: Mild traumatic brain injury has a high rate of occurrence across the lifespan in the United States. Following mild traumatic brain injury (mTBI), patients may report persistent difficulty with communication, especially in noisy environments. A sample of adults aged 19 to 77 years old with and without (control) a history of mTBI were recruited. Perceived cognitive communication difficulty, subjective hearing difficulty (HD), and speech-in-noise performance were measured. Results indicate that following mTBI, adults perceived significantly greater difficulty with cognitive communication than the control group. However, differences on the speech-in-noise task did not differ significantly between groups. When HD was considered, adults with HD and a history of mTBI had significantly more perceived cognitive communication difficulty and significantly poorer speech-in-noise performance in the most difficult condition compared to the control group and adults with a history of mTBI and minimal HD. Results demonstrate that following mTBI adults perceive more cognitive communication difficulty. Further, adults who reported HD and mTBI history have significantly more speech-in-noise deficits compared to the control group and adults with mTBI and no HD. These results may inform audiologic recommendations for aural rehabilitation and cognitive communication therapy following mTBI.


11:00 – 11:15 AM - Break

Research Presentations

11:15 – 11:30 AM - Efficacy of Group Aural Rehabilitation Classes for Older Adults with Hearing Loss: A Scoping Review

  • Laura Gaeta, PhD; Rachel Keiko Stark, MS; & Noemi Celio, AuD Student Sacramento State University; Sacramento, CA

  • Abstract: Group aural rehabilitation (AR) has been presented in the published literature as a way for older adults with hearing loss to learn about living with hearing loss, psychosocial exercises and counseling, and receive training in areas like communication strategies (Hawkins, 2005). However, the published literature examining the effectiveness of this intervention is dated, does not reflect current technology use and service delivery methods, and is very heterogeneous in its variables and outcomes, which poses a challenge for comparisons and summaries for understanding its benefit. This scoping review poster presentation will consider all peer-reviewed materials published on group AR since the last published evidence synthesis in 2005 (Hawkins, 2005). Primary, original research that includes adults over the age of 55 with hearing loss that participated in group AR in either a clinical, healthcare, or educational (e.g., university) setting was included.  Case studies and other primary research that do not include a group-based program were excluded. Biomedical databases PubMed, PsycINFO and CINAHL will be searched, as well as education databases ERIC and Education Full Text. The search was developed by a health sciences librarian, combining the search from the 2005 systematic review on the topic with updated, subject expert-supplied, key terms, and controlled vocabulary. Analysis of the research focused on the reported demographic information of the participants, the measurements used by the researchers during AR to examine effectiveness, and the evaluation of the group AR intervention in this population. The poster will present these findings, as well as recommendations for designing and strengthening future group AR studies.

11:30 – 11:45 AM - Comparison of Auditory-Visual and Visual-Only Speech Perception in Adults with Normal Hearing

  • Laura Gaeta, PhD Sacramento State University; Sacramento, CA

  • Abstract:

    • Background: Auditory-visual and visual-only speech perception methods include speechreading and lipreading, respectively. Speechreading is a communication strategy aimed at helping utilize visual and auditory cues to recognize a spoken message, whereas lipreading relies on visual cues. In noise, the addition of visual information has been shown to increase speech understanding (Erber, 1969; Sumby & Pollack, 1954).

    • Purpose: To compare the benefit of lipreading (i.e., visual-only) and speechreading (i.e., auditory-visual) in individuals with normal hearing with a simulated hearing loss.

    • Methods: Twelve adults (age range: 23-46 years) participated in the study. All participants underwent a pure-tone hearing screening and completed a questionnaire about their otologic history. Hearing loss was simulated using earplugs (NRR of 32 dB). Sentence recordings were presented via the NTID Speechreading CID Everyday Sentences List DVD. Participants listened to four sentence lists in four conditions (visual-only with no earplugs; audio-only with no earplugs; visual-only with earplugs; audio-only with earplugs). The presentation order was counterbalanced.

    • Results: Accuracy scores were 99.3% for the visual-only condition, 80.1% for the visual-only with earplugs condition, 98.9% for the audio-only condition, and 33.5% for the audio-only with earplugs condition. Comparison between conditions will be reported at the time of presentation.

    • Conclusion: These results demonstrate benefits for the addition of visual information for speech perception.


11:45 – 1:00 PM - Lunch and Silent Auction

1:00 – 1:30 PM - Auditory Rehabilitation for Experienced Adult CI User: Can Late Intervention Make a Difference?        

  • Naama Tsach, PhD Affiliate Researcher in the Auditory-Cognition Lab in University of Haifa-Israel, American Cochlear Implant Alliance, Private Practice

  • Abstract: Adult cochlear implant (CI) recipients who lost their hearing at a later age often report difficulty coping complex communication situations, and limited participation in social activities. These difficulties highlight the need to expand rehabilitation beyond CI mapping alone.

    This study presents a case of a woman referred to Auditory Rehabilitation (AR) 3 years and ten months after receiving a CI. She reported minimal benefit to communication and quality of life, supported by low scores in speech perception tests, including comprehension of sentences in background noise (OLSA, Hebrew-BIO) and monosyllabic word recognition (Hebrew AB).

    The AR intervention consisted of 16 one-hour sessions, 14 conducted remotely and two in-person. Primary goals of AR were : 1) Developing listening skills to be applied in daily situations. 2) Understanding factors affecting auditory and communication function and improving management of challenging situations. 3) Increasing enjoyment and engagement in activities involving hearing. 4) Reducing the effort and pressure associated with communication.

    AR goals, dilemmas, challenges, and results will be discussed, as well as Intervention methods in terms of contents, tasks, and the matter in which they were conducted.

    Key results of the intervention include: 1) Growing confidence and independence in participating in conversations and social activities .2). Enjoyment of hearing-based activities. 3) Improved understanding of individuals with reduced speech intelligibility, 5)Enhanced attentiveness to speech, and occasional experiences of incidental hearing.6)Noticeable improvement in understanding speech in background noises and perceiving speech phonemes in monosyllabic words.

    These outcomes suggest that late intervention through auditory rehabilitation can make a significant difference for experienced adult CI users, improving their auditory and communication abilities, and overall quality of life.


1:30 – 2:00 PM - Benefits and Challenges of Assistive Listening Devices (ALDs) for Older Hospital Patients          

  • Marissa Merrifield, AuD, PhD Student & Karen Doherty, PhD Syracuse University; Syracuse, NY

  • Abstract: Good communication is important for hospital patients. However, hospitals are noisy environments, often leading to communication difficulties, even for normal hearing listeners. Older individuals, which make up roughly 40 percent of hospital inpatients (DeFrances et al., 2008), have more difficulty hearing in background noise than younger listeners (Doherty and Desjardins, 2008), making communication breakdowns likely. The primary objective of this study was to investigate the benefits and challenges of using assistive listening devices (ALDs) to improve communication for older hospital inpatients. Participants were recruited using daily hospital admission sheets and were at least 60 years of age, cognitively able to provide consent, and medically stable. Forty-eight patients provided consent. Participants had, on average, a moderate sloping sensorineural hearing loss. Patients were provided with a Pocketalker manufactured by Williams Sound and instructed on how to use it. A survey was administered to the participants asking them to report with whom they used the ALD with each day (i.e. family members, hospital staff, and doctors). Sixty-five percent of participants used the ALD to communicate with their family members and 62% used the device to communicate with other hospital staff. However, only 38% of participants used the device when communicating with their doctor. Additionally, participants were asked if the device was helpful and easy to use. Results showed that 96% of participants found the ALD was easy to use, and 88% reported that overall, the ALD was helpful. Thus, the ALDs were helpful to patients and an easy way for them to improve communication with family members and hospital staff.  However, patients found it difficult to get the ALDS on in enough time to use them with physicians during early morning rounds or quick physician visits.

2:00 – 2:30 PM - Effectiveness of Using Wearable Sensors as a Measure of Listening-Related Stress          

  • Lipika Sarangi, PhD, AuD University of Arkansas Medical Sciences; Little Rock, AR

  • Abstract: Psychophysiological measures in the laboratory such as changes in pupil dilation, heart rate, respiration, and skin sweat have been used to evaluate listening effort-related stress/arousal. However, these assessments in controlled laboratory conditions do not always reflect effects of listening-related stress in daily life. Recent advances in wearable sensor technology might allow for similar assessments in daily listening. This research sought to evaluate whether commercially available, wearable sensors can provide valid information about psychophysiological effects associated with difficult listening in a controlled setting. A within-subject repeated measures study was conducted on 16 young adults with typical hearing ability. Participants wore 3 commercially available sensors to record heart rate (HR), respiration rate (RR), and skin conductance. Sentences in noise were presented at -4, 0, +4, and +8 dB SNR and participants were asked to repeat the keyword in each sentence. Half of the keywords were highly predictable from sentence context and the other half were with low predictability. Additionally, to simulate stress, participants were informed that incorrect responses will result in a flash of light and a reduction in compensation. Participants also reported their emotional states using the Self-assessment Manikin (SAM) and NASA-Task Load Index (TLX). Results demonstrated that individuals reported higher arousal and task load with decreasing SNR, for low-predictability, and with simulated stress condition. Participants had significantly higher HR (p = .04) and RR (p < .001) in difficult listening conditions, when measured with sensors. However, no significant differences were observed for skin conductance. HR and RR measured using wearable sensors could successfully be used to assess reflect physiological responses related to listening difficulties in daily life and could potentially be used in research to demonstrate post-amplification benefits.


2:30 – 3:00 PM - Expanded Definition of Health-related Quality of Life in Considering Benefits of Advanced Digital Technology Hearing Aids

  • Carole E. Johnson, PhD, AuD HERO Lab, University of Oklahoma Health Sciences Center; Oklahoma City, OK

  • Abstract: Over the past twenty years, the American Academy of Audiology has assembled groups to assess the health-related quality of life benefits of hearing aids. The first 2004 Task Force on the Health-related Quality of Life Benefits of Amplification conducted a systematic review included studies involving analog hearing aids. The 2022 Writing Group is updating the systematic review and included studies assess the HRQoL benefits of advanced digital technology (ADT) hearing aids. We will present an expanded framework of HRQoL in addition to the progress made in assessing the nonacoustic benefits of ADT hearing aids. We will discuss the impact of technological advances in amplification on the HRQoL benefits of amplification and their implications for aural rehabilitation.


3:00 – 3:15 PM - Break

3:15-3:45 PM- The Impact of Wearing Hearing Aids on Emotion            

  • Jani Johnson, PhD University of Memphis; Memphis, TN

  • Abstract: Although acquired hearing loss can negatively impact emotional processing, limited research explores how amplification through hearing aids (HAs) might compensate for these deficits. Available evidence on emotional processing is mostly restricted to measures obtained under controlled laboratory conditions; however, social-emotional factors that modulate this outcome are difficult to replicate in contrived environments. The current study aimed to clarify the real-world effects of premium-feature HAs on inter- and intra-individual emotion processing in older adults.

    Thirty individuals aged 50-78 years with bilateral, uncomplicated, mild-to-moderate hearing loss, and no experience with HAs participated in this ABA repeated reversal trial. Participants completed an unaided baseline trial, an aided trial, and an unaided withdrawal trial. Speech communication outcomes and self-reported and physiologic measures of intra-individual emotion perception were assessed for each arm of the study. Repeated measures with corrections for pairwise comparisons and multilevel linear mixed model analyses were performed to explore differences with and without HAs.

    In addition to improved speech communication outcomes, participants reported greater arousal with hearing aids especially in quieter environments both in daily listening and in the lab. Increased heart rate and respiration activity supported self-report measures when assessed in daily listening. However, physiologic changes were not reflected in laboratory conditions. Participants reported feeling more pleasantness when wearing hearing aids in daily listening environments when speech was present, but less pleasantness when listening to nonspeech sounds or in background noise. The impact of amplification on this dimension of emotion processing was not clearly observed in the lab. Finally, and possibly most importantly, peripheral physiologic measures indicated a healthier autonomic nervous system in daily listening when wearing hearing aids, suggesting better physical recovery from stress.

Wednesday, November 15, 2023

9:00 – 9:30 AM - Continental Breakfast

9:30 – 10:15 AM - Business Meeting


10:15 – 11:15 AM - Swap Shop”: Tips and Strategies to Assist Older Patients Embrace Technology       

  • Coordinator:  Carole E Johnson, AuD, PhD University of Oklahoma Health Sciences Center; Oklahoma City, OK

  • Abstract: Older adults’ limitations with technology may impact the benefit they may leverage with advanced digital technology hearing aids. Data and case studies will begin the session that will culminate with participants sharing tips and strategies to assist older adults with hearing loss embrace technology for the successful use of amplification. Participants should bring one-page handouts demonstrating tips and strategies to “swap” with other audiologists!

11:15 – 11:45 AM - Embracing Technology in Teaching Aural Rehabilitation – Participant Round Table

  • Coordinator:  Carole E Johnson, AuD, PhD University of Oklahoma Health Sciences Center; Oklahoma City, OK

  • Abstract: The session will begin with a presentation and discussion of the use of artificial intelligence in aural rehabilitation. Participants will then discuss tips and suggestions for how to use technology in the classroom when teaching aural rehabilitation to speech-language pathology and audiology students.  


11:45 AM - Adjourn



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