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This issue<br />

<strong>BAA</strong> Conference <strong>2017</strong> 16 <strong>2017</strong> Conference Programme 18 Regional News 25<br />

Summer <strong>2017</strong><br />

ISSUE 43<br />

<strong>BAA</strong><br />

<strong>MAGAZINE</strong><br />

British Academy of Audiology<br />

• Single Sided Deafness: CROS Aid<br />

or BAHA?<br />

• Promoting Uptake of Rehabilitation<br />

Support for Hearing Loss<br />

• Development of the Spatial Speech<br />

Assessment<br />

• Deafness in Low and Middle Income<br />

Countries: Massive Open Online<br />

Course<br />

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patients, even allowing for fine tuning to the Sprint<br />

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• Instant access to educational reference materials**<br />

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Contents:<br />

General:<br />

3 Editorial<br />

4 President’s Word<br />

16 <strong>BAA</strong> Conference <strong>2017</strong><br />

18 <strong>2017</strong> Conference Programme<br />

29 Industry Updates<br />

Contributions:<br />

Please send to:<br />

baamagazine@gmail.com<br />

Advertising:<br />

Contact <strong>BAA</strong> for a media<br />

pack at: advertising@baaudiology.org<br />

Autumn issue<br />

Contributions to be received by:<br />

20th September <strong>2017</strong><br />

Edition: Autumn <strong>2017</strong><br />

Publication date: 27th October <strong>2017</strong><br />

Contact Us<br />

British Academy of Audiology<br />

Fitwise Management Ltd<br />

Blackburn House<br />

Redhouse Road<br />

Seafield<br />

Bathgate<br />

EH47 7AQ<br />

Telephone: +44 (0) 1625 290046<br />

email: admin@baaudiology.org<br />

Social Media:<br />

Search for British Academy<br />

of Audiology in the “groups”<br />

section and become a<br />

member for regular updates!<br />

We’re on Twitter! Follow us:<br />

@<strong>BAA</strong>udiology<br />

Find us on Linkedin.com:<br />

Look for <strong>BAA</strong> in the<br />

groups section.<br />

Features:<br />

7 To Assess the Effect of Chemo<br />

Radiotherapy with Cisplatin on<br />

the Hearing and Balance System<br />

in Patients with Cancer of the<br />

Nasopharynx and Oropharynx within<br />

a Regional Oncology Service<br />

10 Single Sided Deafness: CROS Aid or<br />

BAHA?<br />

Trainees:<br />

27 Deafness in Low and Middle<br />

Income Countries: Massive Open<br />

Online Course<br />

12 ‘Being Heard’ - Lived Experience<br />

of Adults with Mild Hearing Loss:<br />

Qualitative Research into the<br />

Diversity of Experience and Impact of<br />

Mild Hearing Loss<br />

14 Promoting Uptake of Rehabilitation<br />

Support for Hearing Loss<br />

23 Development of the Spatial Speech<br />

Assessment<br />

25 Regional News<br />

28 Breaking News… A New Oticon<br />

Student Award is Coming to the<br />

<strong>BAA</strong> Conference<br />

Welcome to the summer edition of the <strong>BAA</strong> magazine.<br />

I hope you are all looking forward to some holidays over the<br />

coming months.<br />

Conference <strong>2017</strong> has launched and the programme looks very<br />

exciting – keep checking the <strong>BAA</strong> website and Horizon for updates. If you<br />

haven’t already done so, please consider registering to attend – the Board and<br />

Conference team have worked hard to ensure the event represents excellent<br />

value for money.<br />

We have recently been receiving less submissions for the magazine. We<br />

understand everyone is very busy, but please do consider submitting articles,<br />

course reviews, audit, research – anything you think would be of interest to our<br />

readership. Please also email the Editor if there is a topic you would like to see in<br />

a future edition.<br />

Finally, this will be the last edition for me as Editor of the <strong>BAA</strong> Magazine as I take<br />

on a new adventure outside the world of Audiology. It has been a pleasure and I<br />

wish the <strong>BAA</strong> every success in the future.<br />

Kathryn Whitfield<br />

Clinical Scientist (Audiology) and Team Leader of the Newborn Hearing<br />

Screening Programme, Crewe<br />

Disclaimer: The views expressed in any <strong>BAA</strong> publication or mailing are not necessarily those of the Academy. The Academy does not necessarily endorse the content of<br />

advertisements or inserts in any publication or mailing. The Academy reserves the right to decline advertisements without having to justify editorial decisions. The editing<br />

team may edit and reformat the content of articles that are submitted. Whilst every care has been taken to ensure that data is accurate, the editors cannot accept liability to<br />

any party for loss or damage caused by errors or omissions resulting from any party. The Academy’s decision on all matters relating to content is final.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 3


PRESIDENT<br />

MICHELLE BOOTH<br />

President, British Academy of Audiology<br />

President’s Word<br />

Dear Member,<br />

Welcome to the summer edition of<br />

the <strong>BAA</strong> Magazine. Over the past<br />

few weeks, we have enjoyed some<br />

lovely weather – long may it continue,<br />

as I’m sure many of you will be<br />

looking to well-deserved breaks over<br />

the next few months.<br />

This is my 3rd President’s words,<br />

which means there is only one more<br />

to go before I hand over the baton to<br />

Sue Falkingham at our Conference<br />

in Bournemouth in November. The<br />

time has flown by and despite the<br />

role being far busier than I imagined,<br />

I have enjoyed every minute of it so<br />

far. It is a difficult role to do whilst<br />

trying to maintain the focus on<br />

the ‘day job’ and try to keep some<br />

element of work/life balance. As an<br />

Audiologist working in the NHS, there<br />

are constant pressures and as I write<br />

this, in the back of my mind I am<br />

thinking about our IQIPS accreditation<br />

review which takes place in June.<br />

I wholeheartedly support the<br />

accreditation process and can see<br />

the many benefits it has made to our<br />

service at Sherwood Forest Hospitals<br />

NHS Foundation Trust, but my advice<br />

would be don’t underestimate the<br />

amount of work involved in, not only<br />

achieving accreditation, but also<br />

maintaining it!<br />

Over the past few months I have<br />

been very grateful of the decision<br />

by the <strong>BAA</strong> Board to take on Wendy<br />

Farrington-Chadd as a Consultant<br />

CEO. Wendy has been a great source<br />

of support and advice and is busy<br />

devoting her time to key areas where<br />

<strong>BAA</strong> want to make a difference.<br />

Wendy is currently collating the<br />

data collected from the workforce<br />

survey done in the autumn of 2016<br />

and is also working on the recently<br />

collected data from the membership<br />

survey sent out to all members last<br />

month. She will present the data to<br />

the <strong>BAA</strong> Board meeting in July and<br />

we can then create an action plan to<br />

take forward, which we will of course<br />

share with you, our membership.<br />

Speaking of the membership survey,<br />

some of the results were a little<br />

disappointing as members expressed<br />

criticism of some of the work that<br />

the <strong>BAA</strong> Board and its committee<br />

members do. Please try to remember<br />

that we are all volunteers and do<br />

much of this work in our own time.<br />

We have, over the past few years,<br />

seen the number of people putting<br />

themselves forward for committees<br />

and especially for board roles<br />

diminish. So for those of you who<br />

think <strong>BAA</strong> need to do more, perhaps<br />

you could help us by joining one of<br />

our many committees or putting<br />

yourselves forward for a board<br />

role when nominations are invited<br />

towards the end of the summer.<br />

However, despite some negative<br />

feedback and criticism, there was<br />

also constructive feedback from the<br />

survey and we thank those of you<br />

who took the time to complete the<br />

survey and offer your suggestions.<br />

As you will see in this edition of<br />

the magazine, Claire Benton and<br />

the Conference planning team<br />

have been working hard to pull<br />

together an amazing programme<br />

for the <strong>BAA</strong> Conference this year.<br />

This year’s programme continues<br />

in its streamlined format, with<br />

early morning discussion groups<br />

and workshops. A new edition to<br />

this year’s programme is the back<br />

to basics tutorials designed for all<br />

delegates, whether you want to<br />

update your knowledge or gain new<br />

skills. Our keynote speakers promise<br />

to deliver interesting presentations<br />

on current ‘hot topics’ within our<br />

profession. I hope there is something<br />

there that whets your appetite and I<br />

look forward to seeing many of you in<br />

Bournemouth in November. Keep an<br />

eye out for further updates on what<br />

conference has to offer on our social<br />

media and in the Horizon newsletter<br />

which drops into your inbox every<br />

fortnight. I will also continue to keep<br />

you informed via my Presidential Blog<br />

which you can find on our Facebook<br />

page and on the <strong>BAA</strong> website.<br />

I do hope you enjoy the interesting<br />

articles in this edition of the magazine<br />

and look forward to keeping you<br />

updated on my activity over the<br />

coming months.<br />

Kindest Regards<br />

Michelle Booth<br />

<strong>BAA</strong> President<br />

Claire Benton and the Conference planning<br />

team have been working hard to pull<br />

together an amazing programme for the<br />

<strong>BAA</strong> Conference this year.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 4


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<strong>BAA</strong> <strong>MAGAZINE</strong> / AUTUMN 2016 / 5


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<strong>BAA</strong> <strong>MAGAZINE</strong> / SPRING <strong>2017</strong> / 6


FEATURE<br />

To Assess the Effect of Chemo<br />

Radiotherapy with Cisplatin on<br />

the Hearing and Balance System<br />

in Patients with Cancer of the<br />

Nasopharynx and Oropharynx within<br />

a Regional Oncology Service<br />

GAYNOR CHITTICK<br />

Chief Audiologist<br />

Chemo Radiotherapy (CRT) is<br />

used in the treatment of advanced<br />

head and neck cancers. Cisplatin<br />

is a chemotherapeutic drug widely<br />

used in the treatment of solid<br />

tumours of the head and neck.<br />

Cisplatin is known to be ototoxic<br />

and can damage hearing and/or<br />

balance functions. Cisplatin induced<br />

hearing loss is usually bilateral and<br />

irreversible (Chen et al 2006). The<br />

basal turn of the cochlea is affected<br />

first causing a high frequency<br />

hearing loss, however hearing<br />

loss may progress to the middle<br />

frequencies when doses in excess<br />

of 100mg/m² are used and with each<br />

cisplatin dose (Rybak et al 2009).<br />

The reported incidence of<br />

Sensorineural Hearing Loss<br />

(SNHL) following treatment with<br />

CRT appears to be variable. It<br />

may be related to the age of the<br />

patient, dose of cisplatin, noise<br />

exposure, exposure to other ototoxic<br />

medications, depleted nutritional<br />

state, and cranial irradiation<br />

(Bokemeyer et al 1998).<br />

Studies have shown a wide<br />

range of incidence of hearing loss<br />

following CRT, varying from 58% to<br />

81% at frequencies from 250Hz to<br />

8000Hz (Zuur et al 2007), to 100%<br />

when testing higher frequencies up<br />

to 12500Hz (Kopelman et al 1988).<br />

2% - 36% of patients complain<br />

of tinnitus following treatment with<br />

CRT (Reddel et al 1982).<br />

There is little evidence suggesting<br />

that cisplatin affects the vestibular<br />

system (Schacht et al 2012).<br />

Aintree University Hospital NHS<br />

Foundation Trust (AUH) has a<br />

regional centre for head and neck<br />

cancer. We decided to establish<br />

the incidence of SNHL, tinnitus and<br />

dizziness following treatment with<br />

CRT for cancer of the nasopharynx<br />

and oropharynx within our local<br />

population so that we could give<br />

our patients advice regarding the<br />

effects of their treatment and also<br />

offer early intervention, should the<br />

individual suffer any hearing loss,<br />

balance disturbance, or troublesome<br />

tinnitus.<br />

Method<br />

This was a prospective study to<br />

examine the effects of cisplatin<br />

on the hearing system in adults<br />

treated with CRT for cancer of the<br />

nasopharynx and/or oropharynx<br />

at AUH. 31 patients have been<br />

recruited to this study to date.<br />

Patients were referred when the<br />

decision to treat with CRT was<br />

made.<br />

All patients were given an<br />

information leaflet about the study<br />

and consented to take part.<br />

A baseline assessment was<br />

completed prior to treatment with<br />

CRT at 3 months and 12 months<br />

post treatment. This included<br />

pure tone audiometry at 250Hz,<br />

500Hz, 1000Hz, 2000Hz, 3000Hz,<br />

4000Hz, 6000Hz, 8000Hz, 9000Hz,<br />

10000Hz, 11200Hz, and 12500Hz<br />

via air conduction and at 500Hz,<br />

1000Hz, 2000Hz, 3000Hz and<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 7


FEATURE<br />

4000Hz via bone conduction.<br />

Tympanometry was performed<br />

when indicated i.e. if there was an<br />

abnormal tympanic membrane and/<br />

or air bone gap of 25dB or more at 2<br />

or more of the following frequencies:<br />

500Hz, 1000Hz, 2000Hz, and<br />

4000Hz on the audiogram, or a<br />

subjective complaint of aural fullness<br />

by the patient.<br />

Patients were asked about preexisting<br />

hearing loss, ear disease,<br />

ear surgery, noise exposure,<br />

balance complaints and tinnitus.<br />

Romberg and Unterberger tests<br />

were completed on all patients. The<br />

effect of any tinnitus was determined<br />

using the Newman Tinnitus Handicap<br />

Inventory.<br />

A significant hearing loss was<br />

classed as being greater than 15 dB<br />

change in thresholds at 2 or more<br />

frequencies. All patients with a<br />

conductive loss due to otitis media<br />

were excluded from the study.<br />

Results<br />

31 patients completed the study<br />

(62 ears); however 5 patients had a<br />

conductive loss due to otitis media,<br />

possibly due to the radiotherapy<br />

element of their treatment so these<br />

results were excluded from the<br />

study. The age range was from 38 –<br />

75 years with an average age of 62<br />

years. There were 5 females and 26<br />

males recruited to the study.<br />

Over 75% of patients had less<br />

than 15dB change in their hearing<br />

levels in the range 250Hz to 4000Hz,<br />

however, in the higher frequencies of<br />

6000Hz to 12500Hz, 50% or more<br />

patients had a greater than 15dB<br />

change in their hearing thresholds.<br />

This change in hearing thresholds<br />

increased at higher frequencies with<br />

over a third of patients developing<br />

a greater than 30dB drop in their<br />

hearing thresholds at 9000Hz,<br />

10000Hz, 11200Hz and 12500Hz.<br />

The incidence of increased hearing<br />

loss increases at higher frequencies<br />

(figure 1).<br />

There was no correlation between<br />

increasing age of the patient and<br />

increased hearing loss.<br />

Sex was not found to be a risk<br />

factor in developing SNHL following<br />

CRT.<br />

Tinnitus<br />

20% of patients were found to<br />

have pre-existing tinnitus and this<br />

was graded as mild on completion<br />

of the Newman Tinnitus Handicap<br />

Inventory.<br />

Following treatment, 25%<br />

of patients developed tinnitus.<br />

Newman Tinnitus Handicap<br />

Inventory scores ranged from 6%<br />

(mild) to 78% (catastrophic), with an<br />

average score of 51%.<br />

1 patient with existing tinnitus<br />

reported that the tinnitus level<br />

increased during treatment with<br />

CRT which resulted in a reduction of<br />

the dose of cisplatin. Subjectively,<br />

the tinnitus then returned to its pretreatment<br />

level.<br />

Balance<br />

No patients had any self-reported<br />

complaints of balance problems prior<br />

to treatment with CRT. Romberg and<br />

Untenbergers tests did not show any<br />

abnormalities.<br />

Following treatment, no patients<br />

reported any self-perceived change<br />

to their balance and Romberg and<br />

Untenberger tests did not show<br />

abnormalities.<br />

Discussion<br />

High frequency hearing is a common<br />

finding following treatment with<br />

cisplatin. Most patients with a high<br />

frequency hearing loss notice that<br />

Patients were asked about pre-existing hearing loss, ear disease,<br />

ear surgery, noise exposure, balance complaints and tinnitus. The<br />

effect of any tinnitus was determined using the Newman Tinnitus<br />

Handicap Inventory.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 8


understanding conversation in a<br />

noisy place becomes more difficult,<br />

they may start to mishear and their<br />

family notice that the TV at home is<br />

getting turned up. With increased<br />

and more frequent cisplatin doses,<br />

the mid frequencies can also be<br />

affected causing additional problems<br />

hearing speech even in small groups<br />

with family and friends. We found<br />

that within our patient population,<br />

frequencies >6000Hz were most<br />

affected.<br />

11% of patients who developed<br />

a SNHL went on to have hearing<br />

aids fitted, and at the review stage,<br />

were obtaining good benefit from<br />

them. All patients who developed a<br />

conductive loss but were excluded<br />

from this study, had hearing aids<br />

fitted.<br />

25% of patients developed<br />

persistent tinnitus following<br />

treatment and all patients were<br />

given general advice and information<br />

on tinnitus, written support and<br />

information, signposted to the British<br />

Tinnitus Association and had access<br />

to the Aintree Tinnitus Support<br />

Group. 8% of patients also opted<br />

to be enrolled onto our full tinnitus<br />

management programme.<br />

1 patient with existing tinnitus<br />

reported that the tinnitus level<br />

increased during treatment with<br />

CRT which resulted in a reduction of<br />

the dose of cisplatin. Subjectively,<br />

the tinnitus then returned to its pretreatment<br />

level.<br />

This may not have happened if the<br />

patient had not been alerted to the<br />

possible side effects of treatment<br />

and what options were available if<br />

any new or worsening symptoms<br />

developed.<br />

No patients reported any change<br />

in their balance. There is little in<br />

the literature regarding cisplatin<br />

treatment on balance or vertigo,<br />

so it would appear that cisplatin is<br />

not sufficiently toxic to the balance<br />

system in these doses.<br />

4% of patients were referred onto<br />

clinical psychology due to underlying<br />

anxiety and difficulty coping<br />

following treatment.<br />

Since starting this study, we have<br />

found that there is an increased<br />

awareness about the effects of<br />

CRT with cisplatin on hearing<br />

amongst the multi-disciplinary team<br />

and more information is available<br />

to patients and their families<br />

when at clinic. Patients are more<br />

informed regarding the effects of<br />

the treatment and there is a point<br />

of contact within the Audiology<br />

department for these patients to<br />

contact with any hearing, tinnitus or<br />

balance related queries.<br />

We feel that by assessing hearing<br />

function before, during and after<br />

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<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 9


FEATURE<br />

Single Sided<br />

Deafness: CROS<br />

Aid or BAHA?<br />

KERRY DOWNES<br />

Advanced Audiologist,<br />

St George’s Hospital<br />

Single Sided Deafness (SSD) affects around 9,000 new people<br />

each year in the UK. For many individuals, the condition can<br />

have a profound and debilitating effect on their lives. Sufferers<br />

experience difficulty picking up sounds from their deaf side,<br />

struggle in crowds and background noise and are unable to<br />

localise sounds. Whilst some losses are congenital or acquired<br />

in early childhood, most occur in adulthood and are of sudden<br />

onset. Adjusting to SSD can cause stress and anxiety, and<br />

impact hugely on a person’s well-being. In particular, individuals<br />

report withdrawal from group activities and feelings of isolation<br />

(Wie et al, 2010).<br />

There is some evidence to support the use of intratympanic<br />

steroids for idiopathic sudden SSD (Ferri et al, 2012), but results<br />

have varied widely and research on success rates are limited.<br />

Consequently, SSD remains a predominantly permanent and<br />

untreatable condition. Rehabilitation options include support<br />

groups and counselling, and provision of either Contralateral<br />

Routing of Sound (CROS) or Bone-Anchored Hearing Aids<br />

(BAHA).<br />

CROS/ BiCROS aids and BAHA can help to alleviate the<br />

difficulties caused by the head-shadow effect and provide relief<br />

to some of the difficulties SSD sufferers face (Faber et al, 2013).<br />

Most of the available research comparing the two amplification<br />

options is in regard to older, more cumbersome and cosmetically<br />

unappealing CROS aids with a wire around the back of the neck,<br />

and percutaneous connected abutments for BAHAs which are<br />

also less cosmetically appealing and can be prone to infection.<br />

With the improved technology and cosmetics of CROS aids, and<br />

the release of subcutaneous Cochlear BAHA attracts, this study<br />

aimed to provide an up to date and relevant insight into patient<br />

choice between the two amplification options.<br />

The research also intended to challenge some common<br />

assumptions; such as congenital SSD sufferers not opting for<br />

amplification and elderly patients avoiding BAHA due to the<br />

surgery involved. Factors which may influence the choice were<br />

also investigated; age, cause of deafness, acoustic neuroma<br />

surgery and high frequency thresholds in the hearing ear.<br />

Methods:<br />

30 individuals with SSD were referred to the BAHA service over<br />

the course of 16 months. All were offered back-to-back trials<br />

of wireless Phonak CROS/BiCROS aids (open-fit BTEs) and<br />

Cochlear BAHAs on soft-bands, for at least 2 weeks each. 27<br />

completed trials with both devices, 3 declined trials with BAHAs<br />

as they had no interest in pursuing this option.<br />

Following the trials, the patients attended follow-up<br />

appointments to give their feedback on the devices. Based on<br />

their experiences, the patients then made the decision whether<br />

to:<br />

- Proceed with BAHA and be added to the surgery<br />

waiting list (Group A)<br />

- Continue with the CROS aids (discharged from BAHA<br />

Service) (Group B)<br />

- Decline both options and return to being unaided<br />

(Group C)<br />

Data was collected retrospectively from patient records and<br />

mean averages were calculated. With the “age of patient”<br />

being the age at the time of data collection rather than at the<br />

time of the trials. The 3 patients who refused BAHA trials were<br />

included in Group B.<br />

Findings:<br />

90% of patients reported some level of benefit from either a<br />

CROS system or BAHA on soft-band, and only 3 people (10%)<br />

chose option C - to pursue neither device and return to being<br />

unaided. Of the 27 patients who reported benefit; 37% opted<br />

to be implanted with a BAHA (Group A), and 63% declined<br />

BAHA and chose to stick with their CROS aids (Group B).<br />

High frequency hearing in patients’ better ears were worse<br />

in Group B; with average thresholds at 4kHz and 8kHz: 14.4dB<br />

and 28.1dB compared with Group A; 12.5dB and 20.5dB.<br />

The age of patients varied in both groups. The mean average<br />

was lower in Group A: 45.5 years compared to 50.8 years<br />

in Group B. However the oldest patient assessed (81 years),<br />

chose to proceed with implantation – indicating that age is not<br />

an overriding factor in the decision-making process.<br />

27% of patients involved had long-standing SSD – reporting<br />

that the hearing loss occurred either in childhood or >20 years<br />

ago, and the majority of these did report benefit from either<br />

BAHA or CROS aids; with only one person declining both<br />

options. The main cause of deafness in all groups was the<br />

removal of acoustic neuromas: 50% in Group A, 44% in Group<br />

B and 33% (one person) in Group C.<br />

Conclusions:<br />

Both BAHA and CROS aids were found to alleviate some of<br />

the difficulties associated with SSD for the majority of patients<br />

- with both long-standing and recently acquired hearing losses.<br />

Those with a high-frequency loss in their hearing ear may<br />

experience more benefit from a BiCROS system, due to the<br />

added amplification offered on this side.<br />

All individuals with SSD should be referred to Audiology and<br />

offered trials with both devices as part of their rehabilitation.<br />

Clinicians should be mindful not to influence patient choice<br />

based on out-dated assumptions of which device is more<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 10


suitable, but instead, guide patients to make an informed<br />

decision themselves. Clinicians also noted that the outcome<br />

of the trials could not be predicted from the first appointment,<br />

as many who seemed wholly pessimistic about the devices<br />

returned triumphant, whilst others who seemed certain to<br />

benefit from one would report the opposite!<br />

The vast majority of patients included in this study lost their<br />

hearing suddenly; whether in childhood or as an adult. Suddenonset<br />

SSD clearly has huge psychological effects: many were<br />

suffering with anxiety and still carrying a sense of loss and grief<br />

about their hearing.<br />

A greater awareness of CROS aids and BAHAs is required<br />

in the medical community as many individuals are not referred<br />

for amplification until years after the onset of hearing loss.<br />

Research into the psychological aspects may present a case<br />

for an improved and well known pathway for these individuals;<br />

including counselling and support groups with other sufferers.<br />

With many people losing their hearing through planned acoustic<br />

neuroma surgery, there is the opportunity to provide support<br />

even before the surgery to help the patient prepare for what is<br />

to come and to know what services are available to them.<br />

References:<br />

Faber, H.T., de Wolf, M.J.F., Cremers, C.W.R.J. et al.. (2013).<br />

Benefit of Baha in the elderly with single-sided deafness. Eur<br />

Arch Otorhinolaryngol. 270, (4) 1285–1291<br />

Ferri, E., Frisian, A., Fasson, A.C., Armato, E., Spinato,<br />

G., Amadori, M. (2012). Intratympanic steroid treatment for<br />

idiopathic sudden sensorineural hearing loss after failure of<br />

intravenous therapy. ISRN Otolaryngol. 2012: 647271.<br />

Wie, O. B., Pripp, A. H., Tvete, O. (2010). Unilateral Deafness<br />

in Adults: Effects on Communication and Social Interaction.<br />

Annals of Otology. 119(11):772-781.<br />

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FEATURE<br />

‘Being Heard’ - Lived Experience of Adults<br />

with Mild Hearing Loss: Qualitative Research<br />

into the Diversity of Experience and Impact<br />

of Mild Hearing Loss<br />

SARA COULSON<br />

Senior Lecturer Audiology<br />

DeMontfort University<br />

KATE CHAPMAN<br />

Lecturer Drama Studies<br />

DeMontfort University<br />

BACKGROUND<br />

According to the World Health<br />

Organisation (2002), by 2030, hearing loss<br />

will be in the top 10 disease burdens in the<br />

UK, above cataracts and diabetes. In 2015,<br />

the Department of Health published its<br />

Action Plan on Hearing Loss which made<br />

a number of proposals. One of these was<br />

to encourage early awareness, diagnosis<br />

and management of hearing loss.<br />

With most health problems, you are<br />

strongly encouraged to be assessed as<br />

soon as you feel any symptoms. This is<br />

because it is widely accepted that early<br />

interventions tend to result in better<br />

outcomes (Claire et al, 2007; Moniz-Cook<br />

et al, 2010; National Institute on Aging,<br />

2013; Bowel Cancer UK, <strong>2017</strong>).<br />

Early interventions in mental health can<br />

prevent its escalation (Claire et al, 2007).<br />

Early interventions in dementia can delay<br />

its progression, and has also shown a<br />

beneficial effect for carers (Moniz-Cook<br />

et al, 2010). The combined economic<br />

costs to the UK for these conditions both<br />

directly from care, and indirectly from<br />

lost productivity and reduced quality of<br />

life, have been estimated at £131 billion<br />

per year (Centre for Mental Health, 2014;<br />

Alzheimer’s Society, 2014).<br />

Studies have shown links between<br />

unaddressed hearing loss and social<br />

isolation and depression (Tambs, 2004;<br />

WHO, <strong>2017</strong>). Other studies have shown<br />

links with the incidence of hearing<br />

loss and cognitive decline (Wayne and<br />

Johnsrude, 2015). One could, therefore,<br />

conclude that early intervention in hearing<br />

loss would have resulting positive impacts<br />

on the outcomes or prognosis for people<br />

with dementia or mental health problems.<br />

The majority of hearing loss is<br />

progressive and due to aging or exposure<br />

to noise. According to Sheild, (2006)<br />

developed countries consistently report<br />

that approximately 22% of their population<br />

has some form of hearing loss, and for<br />

16% of the population the hearing loss<br />

is categorised as mild (average pure tone<br />

thresholds of the best ear at 0.5, 1, 2 & 4<br />

kHz between 20 and 40 dB (BSA, 2015)).<br />

In a national US survey between 1999<br />

and 2004, Agrawal et al (2008) found that<br />

over 8% of adults between the ages of<br />

20 – 29 reported hearing loss, and that<br />

the prevalence increased in this time.<br />

The World Health Organisation has linked<br />

increasing hearing loss in young people<br />

with the ubiquitous use of phones as<br />

personal audio systems (WHO, <strong>2017</strong>).<br />

A different study by Honeycutt et al<br />

(2003) looked at the economic costs of<br />

disability including both medical treatment<br />

and lost productivity due to illness or<br />

inability to access education and work. For<br />

hearing loss, the lifetime cost in US dollars<br />

was $330 000 per person, of which 4/5 of<br />

that was lost productivity.<br />

Given the high projected disease<br />

burden of hearing loss, increasing<br />

prevalence of hearing loss among younger<br />

adults, and the financial implications<br />

of supporting people with dementia,<br />

mental health problems and difficulties<br />

accessing education and work, it seems<br />

prudent to provide early assessment and<br />

rehabilitation for hearing loss. This means<br />

providing reasonable adjustments in work<br />

and education, counselling and support,<br />

and hearing aids and assistive listening<br />

devices for people with mild hearing loss.<br />

Hearing aids are free to patients on the<br />

NHS and provide huge benefits to people<br />

with hearing loss at a small cost to the<br />

NHS of less than £100 each (AoHL, 2015).<br />

THE ‘BEING HEARD’ PROJECT<br />

Research and statistics are important<br />

tools providing evidence for best practice.<br />

It is also important to understand the<br />

implications of best practice on individuals.<br />

‘Being Heard’ began as a collaborative<br />

project seeking to explore and reveal the<br />

experiences of people with mild hearing<br />

loss. This category has become the focus<br />

of debate since North Staffordshire Clinical<br />

Commissioning Group withdrew the<br />

provision of hearing aids to people with<br />

mild hearing loss in order to save money<br />

(AoHL, <strong>2017</strong>).<br />

AIM: to capture and disseminate the<br />

experiences of people diagnosed as<br />

having mild hearing loss in order to define<br />

the parameters of this categorisation and<br />

to understand the diversity of experience<br />

within it.<br />

OBJECTIVES:<br />

1. To pilot an interdisciplinary<br />

research relationship which uses<br />

the methodologies of theatre and<br />

performance to disseminate research,<br />

engage stakeholders and create impact.<br />

2. To build a wider partnership (beyond HE)<br />

to facilitate advocacy and dissemination<br />

of research.<br />

3. To undertake 15 interviews with<br />

contributors with the aim of gaining<br />

a picture of their experiences and the<br />

ways in which mild hearing loss impacts<br />

on their lives, the strategies they use<br />

and the ways in which their hearing is<br />

changing.<br />

4. To curate material from the interviews to<br />

use in a verbatim theatre performance<br />

which will reflect the diversity and detail<br />

of the experience of mild hearing loss<br />

and its treatment.<br />

5. To present the performance to<br />

audiences of health professionals,<br />

commissioners of hearing rehabilitation<br />

services, and those with hearing loss as<br />

a stimulus for debate and discussion.<br />

6. To disseminate research by sharing the<br />

performance as a film and to evaluate its<br />

impact as an advocacy and awareness<br />

raising tool.<br />

RESEARCH QUESTION<br />

How does mild hearing loss impact on the<br />

lived experience of adults in the UK?<br />

STUDY DESIGN<br />

Recruitment<br />

Participants were self-selected volunteers<br />

recruited through Action on Hearing Loss,<br />

Leicester Aging Together and De Montfort<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 12


University using posters and email<br />

requests.<br />

Data Collection Method and Tools<br />

Volunteers to the study had their hearing<br />

tested using pure tone audiometry to<br />

confirm a mild hearing loss before being<br />

included in the study. They were then<br />

interviewed using a list of structured<br />

questions. Topics of relationships<br />

and social interactions, employment,<br />

education, community engagement, and<br />

mental health were explored. As we are<br />

looking to understand the individual’s<br />

lived experience, the questions were<br />

open-ended to allow a wide variety of<br />

responses. The interviews were audio<br />

recorded and then reviewed for themes<br />

and key messages.<br />

Analysis<br />

The volunteers’ words formed the basis of<br />

the script of a verbatim performance in the<br />

style of Augusto Boul. Verbatim theatre<br />

is a documentary style of performance,<br />

in which actors perform only using<br />

words that were uttered by ‘real’ people.<br />

However, the identities of the hard of<br />

hearing contributors were not used in<br />

the performance. The collected data was<br />

curated for themes, and a script created.<br />

Themes identified included:<br />

- first signs of hearing loss<br />

- family<br />

- work<br />

- social life<br />

- hearing aids<br />

- strategies<br />

Dissemination<br />

Actors have performed the verbatim<br />

script and a film, ‘Being Heard’, has<br />

been produced. The film was shown to<br />

the research contributors on May 19th<br />

<strong>2017</strong> for comment, in which it was well<br />

received. ‘Being Heard’ is now available to<br />

use as tool for advocacy and awarenessraising<br />

around mild hearing loss. The<br />

outcomes of the research will also be<br />

shared in a live performance for health<br />

professionals, commissioners, and other<br />

stakeholders. For further information,<br />

please contact Sara Coulson at<br />

sara.coulson@dmu.ac.uk.<br />

REFERENCES<br />

Action on Hearing Loss (2015). Hearing<br />

Matters. [Online] Available at: https://<br />

www.actiononhearingloss.org.uk/~/media/<br />

Documents/Policy%20research%20<br />

and%20influencing/Research/Hearing_<br />

Matters_2015/Hearing%20Matters%20<br />

Report.ashx (Accessed 2.6.17)<br />

Action on Hearing Loss (<strong>2017</strong>). North<br />

Staffordshire Hearing Aid proposals.<br />

[Online] Available at: https://www.<br />

actiononhearingloss.org.uk/get-involved/<br />

campaign/hearing-aid-cuts/northstaffordshire.aspx<br />

(Accessed 2.6.17)<br />

Agrawal, Y, Platz, E A, Niparko, J K<br />

(2008). Prevalence of Hearing Loss<br />

and Differences by Demographic<br />

Characteristics Among US Adults. Data<br />

From the National Health and Nutrition<br />

Examination Survey, 1999-2004. Arch<br />

Intern Med. 2008;168(14):1522-1530<br />

Alzheimer’s Society (2014). Dementia<br />

UK: update. [Online] Available at https://<br />

www.alzheimers.org.uk/download/<br />

downloads/id/2323/dementia_uk_update.<br />

pdf (Accessed 2.6.17)<br />

Bowel Cancer UK (<strong>2017</strong>)<br />

#STOPBOWELCANCER [Online]<br />

Available at https://www.bowelcanceruk.<br />

org.uk/campaigning/early-diagnosis/<br />

(Accessed 19.05.17)<br />

British Society of Audiology (2015).<br />

Recommended Procedure Pure-tone<br />

air-conduction and bone conduction<br />

threshold audiometry with and without<br />

masking. [Online] Available at: http://<br />

www.thebsa.org.uk/wp-content/<br />

uploads/2011/04/Pure-Tone-<br />

Audiometry-1.pdf (Accessed 2.6.17)<br />

Centre for Mental Health (2014).<br />

Economic and social costs of mental<br />

health problems. [Online] Available at<br />

https://www.centreformentalhealth.org.<br />

uk/economic-and-social-costs. (Accessed<br />

2.6.17)<br />

Claire M Kelly, CM, Jorm, AF and<br />

Wright, A (2007). Improving mental health<br />

literacy as a strategy to facilitate early<br />

intervention for mental disorders. Med J<br />

Aust; 187 (7): 26.<br />

NHS England and Department of<br />

Health (2015). Action Plan on Hearing<br />

Loss. 23 March 2015, Department of<br />

Health.<br />

Honeycutt, A A, Grosse, S, Dunlap, L<br />

J, Schendel, D E, Chen, H, Brann, E, al<br />

Homsi, G (2003), ECONOMIC COSTS OF<br />

MENTAL RETARDATION, CEREBRAL<br />

PALSY, HEARING LOSS, AND VISION<br />

IMPAIRMENT, in Barbara M. Altman,<br />

Sharon N. Barnartt, Gerry E. Hendershot,<br />

Sheryl A. Larson (ed.) Using Survey<br />

Data to Study Disability: Results from<br />

the National Health Survey on Disability<br />

(Research in Social Science and Disability,<br />

Volume 3) Emerald Group Publishing<br />

Limited, pp.207 – 228<br />

Moniz-Cook, E, Agar, S, Gibson, G, Win,<br />

T & Wang, M (2010). A preliminary study<br />

of the effects of early intervention with<br />

people with dementia and their families<br />

in a memory clinic. Aging and Mental<br />

Health, p199 – 211.<br />

National Institute on Aging (2013).<br />

2012 – 2013 Alzheimer’s Disease<br />

Progress Report: Seeking the Earliest<br />

Interventions. [Online] Available at:<br />

https://www.nia.nih.gov/alzheimers/<br />

publication/2012-2013-alzheimersdisease-progress-report.<br />

(Accessed<br />

18.05.<strong>2017</strong>)<br />

Sheild, B (2006). Evaluation of the<br />

social and economic costs of hearing<br />

impairment: A report for Hear-It. [Online]<br />

Available at: http://www.hear-it.org/sites/<br />

default/files/multimedia/documents/<br />

Hear_It_Report_October_2006.pdf<br />

(Accessed 2.6.<strong>2017</strong>)<br />

Tambs, K (2004). Moderate Effects<br />

of Hearing Loss on Mental Health and<br />

Subjective Well-Being: Results From<br />

the Nord-Trøndelag Hearing Loss Study.<br />

Psychosomatic Medicine: September/<br />

October 2004 - Volume 66 - Issue 5 - pp<br />

776-782<br />

Wayne, R V, Johnsrude, I S (2015). A<br />

review of causal mechanisms underlying<br />

the link between age-related hearing loss<br />

and cognitive decline. Ageing research<br />

reviews, 23: 154 – 166.<br />

Wingfield, A, Tun, P A, McCoy, S L<br />

(2005). Hearing loss in older adulthood.<br />

What it is and how it interacts with<br />

cognitive performance. Current directions<br />

in psychological science: a journal of the<br />

American Psychological Society 14(3);<br />

144 – 148.<br />

World Health Organisation. (2002)<br />

Prevention of deafness and hearing<br />

impairment. [Online] Available at: www.<br />

who.org<br />

World Health Organisation (<strong>2017</strong>)<br />

Prevention of deafness and hearing loss.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 13


FEATURE<br />

Promoting Uptake of Rehabilitation<br />

Support for Hearing Loss<br />

CRYSTAL ROLFE<br />

Head of Local Engagement England- South<br />

East, Action on Hearing Loss<br />

Introduction<br />

One in six people in the UK has Hearing<br />

Loss (HL), a condition becoming more<br />

prevalent due to the ageing population<br />

(Davis et al., 2007). Untreated HL<br />

negatively affects physical and mental<br />

health, yet people with HL take on<br />

average 10–15 years to seek help, with<br />

only one in three acquiring a Hearing<br />

Aid (HA).<br />

There is evidence that this delay is<br />

due to: 1) people postponing seeking<br />

help; 2) barriers to accessing existing<br />

rehabilitation support, such as delays<br />

in referrals (Meyer and Hickson, 2012;<br />

Knudsen et al., 2010).<br />

While the role that hearing screening<br />

can play in increasing HA uptake has<br />

been documented (Davis et al., 2007),<br />

there has been no study comparing<br />

different methods of increasing<br />

uptake or identifying the barriers that<br />

intervention developers should focus<br />

on.<br />

As part of Action on Hearing<br />

Loss’s programme of work, we aim<br />

to encourage people to accept and<br />

address hearing loss. We carried out<br />

research with UCL as part of an MSc<br />

in Health Psychology. This study aimed<br />

to describe personal experiences of<br />

HL among UK adults and their views<br />

on possible intervention strategies to<br />

promote the uptake of rehabilitation<br />

support.<br />

Method<br />

Preliminary work:<br />

The Behaviour Change Wheel (Michie<br />

et al., 2011) was used to design eight<br />

hypothetical interventions across<br />

four workshops, involving a Patient<br />

Participation Group and an Expert<br />

Steering Group.<br />

Qualitative research:<br />

• Semi-structured, face-to-face<br />

qualitative interview design<br />

• 22 participants with HL, aged 66–88<br />

• Interviews focused on participants’<br />

experiences of seeking and gaining<br />

access to help, and their views on<br />

eight hypothetical interventions<br />

• Inductive thematic analysis to analyse<br />

verbatim transcripts<br />

Results<br />

Three themes were identified:<br />

From realisation to readiness<br />

Realisation: Most participants initially<br />

misattributed symptoms of HL to<br />

external factors, assessing their hearing<br />

capacity by using everyday sounds as<br />

objective indicators or by comparing<br />

their hearing to other people’s hearing.<br />

Encouraging people to monitor their<br />

hearing capacity against objective<br />

criteria, eg TV volume, a ticking clock,<br />

could raise awareness of HL and help<br />

people realise more quickly that they<br />

have symptoms.<br />

Readiness: The decision to seek<br />

support ultimately has to come from<br />

people themselves. Participants<br />

modified their environments and were<br />

only ready to seek help when they<br />

realised their HL could not be mitigated<br />

and would not remedy itself.<br />

Competing demands: Once a state<br />

of ‘readiness’ has been achieved, action<br />

was often delayed further because HL<br />

did not take priority over competing dayto-day<br />

demands.<br />

Family: An intervention based<br />

on encouraging family members to<br />

support people with HL to seek and<br />

prioritise support was mostly deemed<br />

acceptable. Yet, the way in which some<br />

participants’ families communicated<br />

concerns often led to resistance.<br />

Others thought family members<br />

reluctant to raise the topic of HL for fear<br />

of causing offence. Generally, however,<br />

participants were more offended by<br />

family members not raising the subject<br />

of suspected HL. Many felt that<br />

discussions initiated sensitively might<br />

have encouraged them to seek help.<br />

Others felt that speaking to people with<br />

HL could stimulate action.<br />

Healthcare professionals and<br />

screening: For many, offers of support<br />

from qualified healthcare professionals<br />

were important in making the journey<br />

to self-realisation. GPs were particularly<br />

trusted due to their expertise.<br />

Screening: Most participants said<br />

they would have attended a screening<br />

invitation. Screening was acceptable to<br />

most, with screening as a part of other<br />

health checks being deemed the most<br />

acceptable method. Self-screening,<br />

using tests available online or by phone,<br />

was less popular, as participants felt<br />

that professional involvement was<br />

important to validate and encourage<br />

acceptance of test results, and prompt<br />

further action.<br />

Combating social stigma<br />

identity: Some participants were<br />

reluctant to identify as a person with<br />

HL, associating HL with ageing,<br />

disability, and prosthetics. Many sought<br />

to hide HL from others for fear of<br />

disapproval or being treated differently.<br />

Visibility: There was a strong<br />

preference for hidden HAs. Some<br />

people felt pressure from others to<br />

conceal HAs. Half of participants<br />

identified interventions based on<br />

improving HA design as being most<br />

likely to have encouraged them to seek<br />

support for HL. Some however, felt<br />

that HA marketing aimed at increasing<br />

uptake by emphasising that the devices<br />

can be hidden, actually perpetuated<br />

stigma. Others felt that enhancing HA<br />

visibility could destigmatise HAs and<br />

HL.<br />

Creating norms: Some people<br />

delayed seeking help because they did<br />

not want to feel part of a minority group.<br />

They felt that raising awareness of the<br />

prevalence of HL and HAs would be<br />

beneficial. Making comparisons with<br />

celebrities and HAs were encouraging<br />

and boosted self-esteem by reducing<br />

stigma. Increasing the visibility of HL<br />

among everyday public figures with<br />

whom they could more easily identify,<br />

was also seen as helpful.<br />

Accessing appropriate<br />

rehabilitation support<br />

GPs: Did not raise the subject of HL<br />

but did refer onwards on request.<br />

Cost barrier: Many participants<br />

delayed seeking help because they had<br />

not realised that HAs on the NHS were<br />

free.<br />

Assess and fit: Although this<br />

service was welcomed, it did not make<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 14


participants more likely to go ahead with<br />

getting HAs.<br />

Alternative rehabilitation: Some<br />

were more willing to use HAs if found<br />

in places not associated with disability,<br />

and available from everyday locations<br />

eg. high street shops. Therefore,<br />

promotion of alternative devices as a<br />

substitute for HAs was not beneficial,<br />

as it was seen as less effective and<br />

time consuming.<br />

Knowledge of benefits: Allowing<br />

people to experiment with HAs to<br />

appreciate the benefits may encourage<br />

people to get and use them.<br />

Limitations<br />

Limitations of this study are fully<br />

discussed in the paper but include<br />

that the study focused on those who<br />

had sought help; ideally, it would<br />

have recruited people experiencing<br />

early signs of HL, but it is difficult to<br />

recruit those who have not identified<br />

themselves as experiencing HL, so the<br />

data may not represent the views of<br />

those less willing to seek help.<br />

Next steps<br />

Action on Hearing Loss are working in a<br />

number of ways to address this issue:<br />

• Working on the task and finish groups<br />

for the Action Plan on Hearing Loss<br />

who are working towards filling the<br />

evidence gaps on hearing screening<br />

as a step towards securing a national<br />

hearing screening programme and<br />

promoting opportunistic screening.<br />

• Creating materials to encourage and<br />

support friends and families to initiate<br />

proactive discussions with people<br />

who may have unaddressed hearing<br />

loss.<br />

• Holding hearing screening events<br />

and promoting our hearing check.<br />

• We will be holding a webinar to<br />

bring together international experts<br />

from different disciplines to discuss<br />

methods to increase uptake of<br />

support for hearing loss, share<br />

evidence and create solutions.<br />

Conclusion<br />

There are several interventions which<br />

can be piloted, focusing on realisation.<br />

Awareness of the benefits of taking<br />

action and creating social norms are<br />

also important. If you would like to be<br />

involved in the webinar, please contact<br />

Crystal Rolfe for more information.<br />

References<br />

Davis, A., Smith, P., Ferguson, M.,<br />

Stephens, D. and Gianopoulos, I.<br />

(2007). Acceptability, benefit and costs<br />

of early screening for hearing disability:<br />

a study of potential screening tests and<br />

models. National Coordinating Centre<br />

for Health Technology Assessment,<br />

University of Southampton.<br />

Knudsen, L.V., Öberg, M., Nielsen,<br />

C., Naylor, G. and Kramer, S.E. (2010).<br />

Factors influencing help seeking,<br />

hearing aid uptake, hearing aid use and<br />

satisfaction with hearing aids: A review<br />

of the literature. Trends in Amplification,<br />

14(3), 127–154.<br />

Meyer, C. and Hickson, L. (2012).<br />

What factors influence help-seeking<br />

for hearing impairment and hearing aid<br />

adoption in older adults? International<br />

journal of audiology, 51(2), 66–74.<br />

Michie, S., van Stralen, M.M. and<br />

West, R. (2011). The behaviour change<br />

wheel: a new method for characterising<br />

and designing behaviour change<br />

interventions. Implementation Science,<br />

6(1), 42.<br />

Contact: Crystal Rolfe: crystal.rolfe@<br />

hearingloss.org.uk<br />

Publication: Rolfe, C. and Gardner, B.<br />

(2016). Experiences of hearing loss and<br />

views towards interventions to promote<br />

uptake of rehabilitation support among<br />

UK adults. International Journal of<br />

Audiology, 55(11), 666673.<br />

Early Bird Allocation<br />

Almost Gone!<br />

On the Programme<br />

Sharing decisions in Tinnitus: Preference, Information and<br />

Approaches | Helen Pryce<br />

Audiologist Guided Internet-Based CBT for Tinnitus:<br />

Feasible, Acceptable and Effective | Eldre Beukes<br />

ANNUAL CONFERENCE 07.09.17<br />

Thursday 7 September <strong>2017</strong><br />

Sheffield Hallam University | City Campus<br />

Tickets from £75<br />

Full details available at<br />

www.tinnitus.org.uk/btaconf<strong>2017</strong><br />

#BTAConf<strong>2017</strong><br />

NEW! Workshops<br />

‘Practice guidance for tinnitus in adults’<br />

‘How we manage hyperacusis in children’<br />

‘Getting a support group from good to great’<br />

‘Eye movement desensitisation and reprocessing therapy &<br />

tinnitus’<br />

‘The relationship between tinnitus, hyperacusis & anxiety in<br />

children’<br />

‘Dealing with challenging support group members’<br />

Round Table Q&A<br />

Tinnitus Toolkit: Person-Centered Care in Tinnitus<br />

Management | Cherilee Rutherford<br />

Evaluation of a Cognitive Model of Tinnitus Distress: Is it<br />

Accurate and is it Useful? | Lucy Handscomb<br />

Mobile Applications for Management of Tinnitus |<br />

Magda Sereda<br />

Shapiro Prize & Poster Competition<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 15


CONFERENCE<br />

<strong>BAA</strong> Conference<br />

<strong>2017</strong><br />

CLAIRE BENTON<br />

Conference Lead<br />

It is becoming clear that conference organising is fairly<br />

similar to painting the Forth Bridge, no sooner had I<br />

unpacked from Glasgow that the planning for <strong>2017</strong> began,<br />

or so it felt. The <strong>BAA</strong> Board is committed to bringing you<br />

the best value, most informative and enjoyable conference<br />

we can. This year we have been keen to ensure the<br />

conference is value for money for all, we have reviewed our<br />

costings and predicted outgoings and I can assure you that<br />

the choices made are the best value for money. We have<br />

kept delegate fees for members fixed this year and have<br />

worked together with our sponsors to ensure all delegates<br />

have a great experience.<br />

Venue:<br />

This November, we return to the Bournemouth International<br />

Centre (BIC) on the 16th and 17th. I have a great fondness<br />

for this lovely coastal town having spent a lot of my<br />

formative years in the area and indeed Bournemouth<br />

Audiology department was one of my first placements<br />

when studying at ISVR. The conference centre is right on<br />

the sea front with views out over the pier and beach. Each<br />

morning you’ll be able to have a bracing walk along the<br />

front or through the lower gardens (beware the enormous<br />

squirrels) to lectures.<br />

Getting to Bournemouth is straightforward, with good<br />

road links, airports at both Bournemouth and Southampton<br />

and the train station is only 1.5 miles from the conference<br />

centre. Please check the conference website for details on<br />

travel, for local information and the Bournemouth app which<br />

will help guide you around the town and gives discounts in<br />

a large number of restaurants.<br />

The BIC itself offers great accommodation for all our<br />

lectures, workshops and, of course, the exhibition. The<br />

rooms are a little more spread out than last year and<br />

we have taken this into account with the design of the<br />

programme. One of the best reasons to pick Bournemouth<br />

is the wide range of accommodation available within an<br />

easy walk of the conference centre; there is something for<br />

every budget, even a boutique chocolate hotel around the<br />

corner. Once again our conference HQ hotel will be the<br />

Marriott Highcliff Hotel.<br />

After the success last year in Glasgow, we will be<br />

repeating our public engagement event on the Tuesday<br />

before conference. A small team of us will be taking to<br />

the streets of Bournemouth with the generous support of<br />

Starkey and their hearing van, to talk to the public about all<br />

things Audiology and offering to screen their hearing.<br />

We are also bringing back our own <strong>BAA</strong> Conference<br />

app, after trialling it last year, some improvements are<br />

being made to improve its functionality to help you get the<br />

most from both the lectures and exhibition. Delegates will<br />

be sent details of how to download it once it is launched<br />

nearer to November.<br />

Conference Planning Team:<br />

I am delighted that the whole team from last year have<br />

agreed to continue for another year. John Fitzgerald,<br />

Charlotte Murray-Smith, Leah Cooper and Sue Falkingham<br />

are developing the scientific programme. Kathryn Whitfield,<br />

Louise Lister, Alex Griffiths-Brown and Sonam Sehemby<br />

make up the organising committee who will be arranging<br />

the gala dinner and working on the marketing. Once again<br />

Phyllis Tait and Laura Graham from Fitwise lead the support<br />

for <strong>BAA</strong>, together they manage the speakers, marketing<br />

and all the background negotiations and planning that<br />

makes the conference run smoothly.<br />

As well as the <strong>BAA</strong> website and Horizons email, details<br />

about the conference will be on our Facebook page and<br />

Twitter, so keep your eyes on those for the most up-to-date<br />

details. We will also be running our conference blog for<br />

behind-the-scenes details, previews of keynote lectures<br />

and details about Bournemouth.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 16


Programme:<br />

We felt that the slightly pared back programme with fewer<br />

streams worked well last year, so this year will follow a<br />

similar pattern. After listening to the delegate feedback<br />

from last year, we are aiming to balance the content to<br />

include basic science, research and clinical presentations.<br />

We feel it is important to include presentations on wider<br />

topics such as leadership and career development. As you<br />

will see over the next four pages, the programme is filling<br />

up nicely. We are excited to have Dave Fabry giving the<br />

Adrian Davis lecture to start the conference; Dave will be<br />

discussing the deregulation of hearing aid care in America<br />

and its implications for us here in the UK. The issue of<br />

over-the-counter hearing aids/PSAPs/Hearables is not going<br />

away, so we return to it later on in the day with a review<br />

of what is currently available and future implications for<br />

our patients by David Maidment. This year the Bamford<br />

lecture will be delivered by Gwen Carr, discussing engaging<br />

teenagers with telehealth. Friday keynote lectures continue in<br />

the theme modernising our services by discussing self-fitting<br />

hearing aids with Elizabeth Convery from NAL in Sydney.<br />

For our main round table discussion forum at the end of<br />

Thursday, we will be covering the development of the future<br />

workforce with a focus on apprenticeships in Audiology.<br />

The All You Need to Know series of talks return, this<br />

year being opened up to include topics submitted by<br />

delegates. These talks aim to be practically based with<br />

online resources available immediately to delegates. As well<br />

as free papers to discuss projects, new developments and<br />

research, we are inviting delegates to submit clinical case<br />

studies for discussion.<br />

The sponsor track takes a little longer to come together<br />

as we work with our platinum sponsors. This year, our<br />

main sponsors will be adding to the educational content<br />

of the conference again with a variety of speakers from all<br />

over the world. We will let you know once we have more<br />

information on the content of this track and the programme<br />

on the conference website will always be the most upto-date<br />

version.<br />

You will notice that the associate Audiologist and student<br />

tracks have disappeared. This is not to suggest these<br />

groups are not welcome, quite the opposite. Feedback from<br />

departments and delegates last year suggest that rather<br />

than having their own workshops and presentations, both<br />

students and associate/assistant Audiologists would prefer<br />

to access the main conference programme. So we have<br />

altered the delegate rates to allow this. On the Thursday,<br />

we are running a series of more informal workshops aimed<br />

at those possibly at the early stages of their careers or for<br />

those starting a new clinical area in Audiology. These will<br />

cover topics such as understanding hearing aid features,<br />

counselling skills and tinnitus, and will give you practical<br />

tips. We will be limiting numbers to these, so do check<br />

whether you need to book in if you like the look of one or<br />

more, if you have exams coming up, these could be for you.<br />

Exhibition:<br />

Already, the exhibition for Bournemouth is a sell-out. With<br />

a fantastic space full of the complete range of companies,<br />

sponsors, charities and societies, there is something for<br />

everyone and the opportunities for updates and networking<br />

are endless. We couldn’t run the conference without the<br />

support of our sponsors and exhibitors, so come and make<br />

the most of everyone being under one roof. Having had<br />

a glimpse of what’s planned by some companies, I can<br />

assure you <strong>BAA</strong> will be bringing you the largest and most<br />

exciting Audiology exhibition this year.<br />

Awards:<br />

Last year, reading through all the nominations for the<br />

different awards was an unexpected highlight of organising<br />

the conference. I would encourage you to have a look<br />

through the different award categories and consider<br />

nominating your colleague, team, or department and<br />

celebrate the work that is going on around the country.<br />

Once again, we will feature a review of all nominations<br />

received in the conference handbook. This year, the award<br />

ceremony is split over the two days and awards will be<br />

given out at the end of the keynote sessions in the main<br />

auditorium.<br />

We have a new award this year, the Paediatric Audiologist<br />

of the Year sponsored by Phonak, who are looking for the<br />

Audiologist who has made a significant contribution to the<br />

field. To reflect the changing education routes in Audiology,<br />

the Oticon Student of the Year award has also changed, for<br />

details please do check the website.<br />

New last year was the Supervisor of the Year award, this<br />

was a popular inclusion and we were not expecting the<br />

number of nominations that flooded in. This year, the <strong>BAA</strong><br />

Training and Education committee have requested a slight<br />

alteration to the award. From <strong>2017</strong>, it will be known as the<br />

Paul Doody Supervisor of the Year award. The committee<br />

felt they wanted to acknowledge the work carried out by<br />

Paul. Paul was an Audiologist in Scotland who worked for<br />

many years training Audiologists, last year he coordinated<br />

the Associate track but sadly passed away shortly before<br />

the conference took place. The committee feel that Paul<br />

exemplified many of the qualities they look for in the winner<br />

of the award so, with his family’s permission, felt it was<br />

fitting to name the award after him.<br />

Gala Dinner:<br />

In 1985, I held my birthday party at the Bournemouth<br />

International Centre, this seems as good a reason as any<br />

to have the 1980’s as our theme for this year. We are<br />

delighted to have The Guv’nors as our house band for the<br />

night, featuring Audiology’s very own Daniel Rowan. So<br />

start looking for those leg warmers, back combing your<br />

hair and charging your Sinclair C5, as we will bring you<br />

an unforgettable evening of music, food and memories<br />

of the 80’s. The gala dinner is always a sell out, so book<br />

your ticket early and join us on the 16th November in the<br />

Purbeck Hall.<br />

So there we have it, conference <strong>2017</strong> is only just around<br />

the corner. Check your Horizon email and the website for<br />

updates. I hope you can join us in November, remember<br />

Audiology moves pretty fast, if you don’t stop and look<br />

around once in a while you could miss it…<br />

To find out more and to book your place visit the website<br />

at: www.baaudiology.org/conference<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 17


CONFERENCE<br />

<strong>2017</strong> Conference Programme<br />

Thursday 16th November<br />

Main Auditorium<br />

Solent Hall<br />

08:00 –<br />

09:00<br />

08:00–<br />

08:50<br />

09:00 –<br />

09:15<br />

09:15 –<br />

09:45<br />

Exhibition Opens – Windsor Hall<br />

Solent Hall<br />

SQC Committee<br />

Welcome to Conference<br />

Michelle Booth, President, British Academy of Audiology<br />

Adrian Davis Lecture<br />

Deregulation of Hearing Aids, Dave Fabry<br />

Tregonwell Hall<br />

HTS Relaunch<br />

09:45 –<br />

10:15<br />

10:15 –<br />

10:30<br />

10:30 –<br />

11:15<br />

Keynote Lecture, Topic and Speaker TBC<br />

For the most up to date programme information please visit the <strong>BAA</strong> website<br />

Award Presentations Part 1<br />

Refreshment break and exhibition viewing<br />

Main Auditorium<br />

Solent Hall<br />

Tregonwell Hall<br />

Bay View Suite 2<br />

Sponsors Track<br />

Tregonwell Seminar Suites<br />

Back to Basics<br />

11:20 – 11:40<br />

Listening Fatigue<br />

Kevin Munro<br />

11:20 – 11:40<br />

Visual Dependency<br />

Diego Kaski<br />

11:20 – 12:00<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

11:40 – 12:00<br />

Hidden Hearing Loss<br />

Chris Plack<br />

11:40 – 12:00<br />

MRI scanning and BPPV<br />

Harry Akran and Elhaam<br />

Hashim<br />

Sponsored by Sivantos<br />

Day 1<br />

12:00 – 12:05<br />

Comfort Break<br />

12:00 – 12:05<br />

Comfort Break<br />

12:00 – 12:05<br />

Comfort Break<br />

12:00 – 12:05<br />

Comfort Break<br />

11:20 –<br />

12:45<br />

12:05 – 12:25<br />

Wearables<br />

David Maidment<br />

12:25 – 12:35<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

12:05 – 12:25<br />

Differences in aetiologies<br />

between adults and<br />

children with balance<br />

difficulties<br />

Dr Sudhira Ratnayake<br />

12:25 – 12:35<br />

Predictors of clinical<br />

recovery in vestibular<br />

neuritis<br />

Diego Kaski<br />

12:05 – 12:30<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Sponsored by Oticon<br />

12:05 – 12:45<br />

Push the button:<br />

understanding hearing aid<br />

features<br />

Jack Bennett<br />

12:35-12:45<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

12:45–<br />

14:00<br />

Lunch, Poster and Exhibition Viewing – Windsor Hall<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 18


Thursday 16th November<br />

Solent Hall<br />

14:00–<br />

14:30<br />

British Academy of Audiology Annual General Meeting<br />

Awards<br />

<strong>BAA</strong> members only<br />

Main Auditorium<br />

Solent Hall<br />

Tregonwell Hall<br />

Bay View Suite 2<br />

Sponsors Track<br />

Tregonwell Seminar Suite<br />

Back to Basics<br />

14:35– 15:05<br />

AYNTK – Hearing and<br />

Learning Disabilities<br />

JB Martin and Colin Beard<br />

14:35– 15:05<br />

AYNTK – Leadership<br />

Ruth Thompsen<br />

14:35 – 15:05<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

14:35 – 15:05<br />

Come feel the noise:<br />

starting the tinnitus talk<br />

David Bagguley<br />

Sponsored by Phonak<br />

14:35 –<br />

16:00<br />

15:05 – 15:35<br />

AYNTK<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong><br />

website<br />

15:05 – 15:35<br />

AYNTK – Research –<br />

Planning to Completion<br />

Kevin Munro<br />

15:05 – 15:35<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Sponsored by Oticon<br />

15:05 – 15:35<br />

Listen, do you want to<br />

know a secret: how to<br />

improve your counselling<br />

skills Sue Falkingham<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

15:35 – 16:00<br />

Real Wild Child: top tips<br />

for testing children<br />

Claire Benton<br />

Day 1<br />

15:35-<br />

15:40<br />

Comfort Break<br />

15:40 – 16:00<br />

cCMV<br />

Paul Griffiths<br />

15:40 – 16:00<br />

Strategic Direction of the<br />

NHS and Audiology<br />

Wendy Farrington-Chad<br />

15:40- 16:00<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

15:40-<br />

16:00<br />

Sponsored by Starkey<br />

16:00 –<br />

16:25<br />

Refreshment Break, Poster and Exhibition Viewing - Windsor Hall<br />

Main Auditorium<br />

Solent Hall<br />

16:30 –<br />

17:30<br />

Apprenticeships<br />

Amanda Casey, Daniel Rowan, Lizanne Steekamp, Cheryl Bott, Teresa Locksley<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 19


CONFERENCE<br />

Friday 17th November<br />

Windsor Hall<br />

08:00 –<br />

09:00<br />

Exhibition Open – Windsor Hall<br />

Tregonwell Hall<br />

08:00–<br />

08:50<br />

Breakfast Workshop<br />

Tregonwell Seminar Suite<br />

08:00–<br />

08:50<br />

Breakfast Workshop<br />

Tregonwell Seminar Suite<br />

09:00 –<br />

09:15<br />

09:15 –<br />

09:45<br />

09:45 –<br />

10:15<br />

10:15-<br />

10:30<br />

10:30–<br />

11:15<br />

Welcome to Day 2 of Conference<br />

Sue Falkingham, Incoming President<br />

Bamford Lecture Teenagers and Telehealth<br />

Gwen Carr<br />

Keynote Lecture, Self Fitting Hearing Aids<br />

Elizabeth Convery<br />

Award Presentations Part 2<br />

Refreshment Break, Poster and Exhibition Viewing Windsor Hall<br />

Main Auditorium<br />

Solent Hall<br />

Moderator:<br />

Tregonwell Hall<br />

Moderator:<br />

Sponsors Track<br />

Moderator:<br />

Tregonwell Seminar Suites<br />

11:20 – 11:40<br />

Developing Confidence and<br />

Resilience – Empowering<br />

Deaf Children and Young<br />

People to be Safe, Social<br />

and Successful<br />

Louise Cole<br />

11:40 – 12:00<br />

An Update on the Position<br />

Statement and an Overview<br />

of the Interdisciplinary<br />

Service and Management of<br />

APD Children<br />

Nicci Campbell<br />

12:00-12:05<br />

Comfort Break<br />

11:20 – 11:40<br />

Cochlear Implants and<br />

Single Sided Deafness<br />

Richard Irving<br />

11:40 – 12:00<br />

Carina Middle Ear Implant<br />

Jane Humphries<br />

12:00-12:05<br />

Comfort Break<br />

11:20 – 11:40<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Sponsored by Phonak<br />

11:40 – 12:00<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Day 2<br />

Sponsored by Oticon<br />

11:20 –<br />

12:45<br />

12:05 -12:15<br />

Free Papers<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:15 – 12:25<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:05 – 12:15<br />

Free Papers<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:15 – 12:25<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:00 -12:-05<br />

Comfort Break<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

12:25-12:35<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:35-12.45<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:25 – 12:35<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:35-12:45<br />

Free Paper<br />

For information on how to<br />

apply to present a free paper<br />

visit the <strong>BAA</strong> website<br />

12:05-12:45<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Sponsored by ReSound GN<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 20


Friday 17th November<br />

12:45 -<br />

14:15<br />

Lunch, Poster and Exhibition Viewing Exhibition – Windsor Hall<br />

Main Auditorium<br />

Solent Hall<br />

Moderator:<br />

Tregonwell Hall<br />

Moderator:<br />

Sponsors Track<br />

Moderator:<br />

Tregonwell Seminar Suite<br />

14:20 – 14:40<br />

FM in pre-school children<br />

Sarah Allens<br />

14:20 – 14:40<br />

Tinnitus and ototoxicity<br />

Professor David Bagguley<br />

14:20 – 14:40<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

14:20–<br />

15:55<br />

14:40 – 15:00<br />

3D tune in<br />

Lorenzo Picinali and<br />

Harsahda Patel<br />

14:40 – 14:50<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

14:50-15:00<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

Sponsored by Sivantos<br />

14:40 – 14:50<br />

Topic and Speaker TBC<br />

For the most up to date<br />

programme information<br />

please visit the <strong>BAA</strong> website<br />

Sponsored by ReSound GN<br />

15:00 –<br />

15:05<br />

Comfort Break<br />

15:05 – 15:15<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:15 – 15:25<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:05 – 15:15<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:15 – 15:25<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:05 – 15.45<br />

Topic and Speaker TBC<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

Topic and Speaker TBCe<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

Day 2<br />

14:20–<br />

15:55<br />

15:25 – 15:35<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:25 – 15:35<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:35-15:45<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

15:35-15:45<br />

Free Paper<br />

For information on how<br />

to apply to present a<br />

free paper visit the <strong>BAA</strong><br />

website<br />

Comfort Break Comfort Break Comfort Break Comfort Break<br />

15.45-<br />

15.55<br />

Main Auditorium<br />

Solent Hall<br />

16:00 –<br />

16:30<br />

Summary of Conference<br />

Will Brassington<br />

Closing Remarks<br />

lSue Falkingham, Incoming President, British Academy of Audiology<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 21


<strong>BAA</strong> <strong>MAGAZINE</strong> / SPRING <strong>2017</strong> / 22


FEATURE<br />

Development of the Spatial<br />

Speech Assessment<br />

This study was submitted in partial fulfilment of the requirements for the MSc degree in Advanced<br />

Audiology (UCL Ear Institute)<br />

BHAVISHA PARMAR<br />

Senior Audiologist<br />

RESEARCH SUPERVISORS<br />

DR J BIZLEY<br />

UCL Ear Institute<br />

DR D V VICKERS<br />

UCL Speech, Hearing and Phonetic Sciences<br />

Can we test a hearing aid user’s<br />

spatial hearing and speech<br />

discrimination at the same time?<br />

Introduction<br />

Current clinical tests of localisation and<br />

speech understanding do not reflect<br />

the difficulties faced when listening<br />

in the real world with competing<br />

speakers and other distractions.<br />

There are currently no gold standard<br />

tests of localisation for clinical practice<br />

(Volck et al 2015) and assessments<br />

of both localisation and speech<br />

discrimination tests are not routinely<br />

carried out for adult hearing aid users.<br />

However, there is a need to be able to<br />

assess hearing abilities, including the<br />

ability to identify and locate speech, in<br />

a way that reflects listening in the real<br />

world.<br />

With this requirement in mind,<br />

a simultaneous assessment of<br />

localisation and speech discrimination<br />

was developed by Bizley et al (2015)<br />

and used to test normal hearing<br />

participants. During this assessment,<br />

the participant was seated in the<br />

centre of the anechoic chamber and<br />

surrounded by eighteen speakers<br />

arranged at 150 intervals. The<br />

following sixteen monosyllabic words<br />

from the Chear Auditory Perception<br />

Test (CAPT) (Marriage et al. 2011)<br />

were spoken, in pairs, by a single<br />

female in the presence of multi-talker<br />

babble:<br />

A target word was presented<br />

Table 1: Monosyllabic words from the Chear Auditory Perception test<br />

(CAPT) (Marriage et al.2001) used in the simultaneous assessment of<br />

relative localisation and speech discrimination developed by Bizley et al<br />

(2015).<br />

followed by a reference word from<br />

an adjacent speaker. A touch-screen<br />

tablet was used to allow participants<br />

to report both words and the location<br />

of the target word in relation to the<br />

reference word. Word identification<br />

and word localisation percentage<br />

scores were recorded across speaker<br />

location. Bizley et al (2015) found that<br />

normal hearing listeners had the best<br />

relative localisation scores were for<br />

words coming from the front of space<br />

when compared to those presented<br />

in the periphery. This pattern reflects<br />

the superior availability of binaural<br />

localisation cues in frontal space. The<br />

inverse result was found for word<br />

identification with higher recognition<br />

scores being obtained in laterally<br />

rather than in frontal space. This effect<br />

is likely due to the effects of the head<br />

shadow effect enhancing the signalto-noise<br />

ratio at the near-ear giving a<br />

mono-aural advantage.<br />

Method<br />

The current study focussed on using<br />

the spatial speech assessment<br />

technique to test the performance<br />

of hearing aids in a group of five<br />

adults with bilateral moderate to<br />

severe sensorineural hearing loss. All<br />

five participants were experienced<br />

hearing aid users, but for the<br />

purposes of this study they were<br />

fitted with Phonak Sky Q hearing aids<br />

and given a period of six weeks to<br />

allow for acclimatisation before the<br />

assessments took place.<br />

The hearing aids were programmed<br />

with three different microphone<br />

programs – omnidirectional, directional<br />

and the binaural beamformer. All<br />

participants were given a hearing<br />

aid microphone diary, adapted from<br />

Cord et al (2002) to assess the<br />

subjective benefit of each microphone<br />

programme in different situations and<br />

asked to spend roughly equivalent<br />

amounts of time listening with each.<br />

After the six week trial, each<br />

participant returned to perform the<br />

spatial speech assessment. Before<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 23


FEATURE<br />

Figure 1. Touchscreen display with ‘Final Consonant’ words from the<br />

CAPT test (Marriage et al 2001).<br />

testing, a pre-test was performed<br />

which allowed us to measure speech<br />

identification thresholds and to set the<br />

signal-to-noise ratio to an equivalent<br />

level of difficulty across listeners. We<br />

also tested listeners using standard<br />

localisation and speech discrimination<br />

in noise tests carried out in the<br />

crescent of sound, a clinical test set up<br />

for assessing spatial hearing (Kitterick<br />

et al. 2011). Each task was carried out<br />

for each microphone setting and the<br />

order was counter balanced between<br />

subjects.<br />

Results:<br />

There were no statistically significant<br />

differences between the three<br />

hearing aid microphone settings in<br />

terms of relative localisation and word<br />

identification scores in the spatial<br />

speech assessment. However, it was<br />

clear that in its current form, the relative<br />

localisation task was too difficult for<br />

the hearing aid users with performance<br />

rarely exceeding that expected by<br />

chance. While word identification<br />

scores were better than chance,<br />

they were still below those of normal<br />

hearing listeners tested at a difficultymatched<br />

signal-to-noise ratio.<br />

During standard localisation and<br />

speech discrimination tasks, the<br />

hearing aid user’s performance was far<br />

better than in the simultaneous test.<br />

Results fell within the expected range<br />

for the test performance of person<br />

with normal hearing, as suggested by<br />

the reference data (Kitterick et al 2011).<br />

However, this does not imply that their<br />

localisation and speech discrimination<br />

abilities have been restored to<br />

near-normal levels as the testing<br />

environment is unrealistic of everyday<br />

life situations. There was no significant<br />

difference between microphone<br />

settings. It is important to note that<br />

the standard test of localisation<br />

measured absolute localisation rather<br />

than relative localisation, far fewer<br />

speakers were utilised and the test<br />

was in silence rather than in the<br />

presence of the multiple sources of<br />

background noise in Bizley et al (2015).<br />

A hearing aid microphone<br />

performance diary, adapted from<br />

that of Cord et al (2002), was used to<br />

investigate the subjective experience<br />

of each of the three microphone<br />

settings. There was a vast variation in<br />

results (recorded on visual analogue<br />

scales for particular situations) and<br />

all participants struggled significantly<br />

in the presence of background noise<br />

and high reverberation levels. The<br />

only situation in which one setting<br />

out-performed the others was for<br />

situations where the target signal<br />

was directly in front of the participant,<br />

when the binaural beamformer<br />

was rated as providing a significant<br />

advantage.<br />

Conclusion<br />

The discrepancy between<br />

performance estimated using current<br />

clinical tests and the spatial speech<br />

assessment suggests that standard<br />

clinical tests may be over estimating<br />

the abilities of hearing impaired<br />

listeners to identify or localise sounds<br />

in noisy environments.<br />

Results from the hearing aid<br />

microphone diary show no significant<br />

difference between the performances<br />

of the three microphone settings<br />

as experienced by the participant.<br />

This highlights the need for further<br />

counselling to hearing aid users on<br />

the limitations on certain hearing<br />

aid settings to avoid unrealistic<br />

expectations.<br />

We were unable to determine<br />

whether the microphone settings<br />

influenced localisation in noise as<br />

the hearing aid users were unable<br />

to perform this task. While the<br />

difference in outcomes with this test<br />

and standard tests emphasises the<br />

need for a more sensitive clinical<br />

assessment tool, further adaptation<br />

of the simultaneous task is required<br />

for it be suitable for measuring<br />

performance with hearing impaired<br />

listeners. Further adaptations of the<br />

test are being explored as part of an<br />

on-going programme of work and are<br />

yielding promising outcomes.<br />

References<br />

Bizey, J., Elliott, N., Wood, K. &<br />

Vickers, D., 2015. Simultaneous<br />

Assessment of Speech Identification<br />

and Spatial Discrimination: A Potential<br />

Testing Approach for Bilateral Cochlear<br />

Implant Users?. Trends in Hearing ,<br />

Volume 19, pp. 1-11.<br />

Cord, M. S. R., Walden, B. &<br />

Dyrlund, O., 2002. Relationship<br />

between laboratory measures of<br />

directional advantage and everyday<br />

success with directional microphone<br />

hearing aids. Journal of the American<br />

Academy of Audiology, Volume 15,<br />

pp. 353-364.<br />

Kitterick, P., Lovett, R., Goman, A..,<br />

2011. The AB-York crescent of sound:<br />

An apparatus for assessing spatial<br />

listening skills in children and adults.<br />

Cochlear Implants International , 12(3),<br />

pp. 164-169.<br />

Marriage, J., Vickers, D., Baer, T.<br />

& Moore, B., 2011. Using speech<br />

perception measures to guide<br />

the choice of amplification. In: A<br />

Sound Foundation through Early<br />

Amplification. Staefa, Switzerland:<br />

Phonak, pp. 273-279.<br />

Volck, A. et al., 2015. Sound<br />

Localisation measured by eye tracking.<br />

International Journal of Audiology,<br />

54(12), pp. 976-983.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 24


INFORMATION<br />

<strong>BAA</strong> Members – Education and<br />

Information Days<br />

We are asking you to have<br />

your say…<br />

To keep you informed, up to date, current in<br />

clinical best practice and future trends, <strong>BAA</strong><br />

is keen to understand the best and most<br />

efficient ways to do that. So keep watching<br />

your inboxes as a survey is on its way to you.<br />

Please spare 5 minutes to respond when it<br />

arrives to you – your responses to this short<br />

survey really will help us to shape these<br />

events in the right way for you.<br />

In the meantime, please feel<br />

free to send any comments or<br />

feedback to <strong>BAA</strong>@fitwise.co.uk<br />

CPD<br />

Just a reminder that<br />

there are templates and<br />

examples of CPD activity<br />

available on the website.<br />

We would love to hear<br />

from any of you who can<br />

share any great advice or<br />

examples on reflective<br />

CPD writing.<br />

How would you split up the country?<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 25


MORE TIME.<br />

BETTER<br />

CARE.<br />

BY CHARLOTTE BUFTON, AUDIOLOGIST<br />

“Leightons was highly recommended to me by a<br />

friend and, having only been an NHS audiologist,<br />

I was sceptical about the ‘dark side’ of Audiology<br />

- sales. However, moving to Leightons has been<br />

one of my best decisions. It combines the<br />

highlights of my NHS job: focus on patient care<br />

and working within a great team, with all the<br />

time I need to really get to know my patients.<br />

The focus is always on what’s best for a patient,<br />

so it doesn’t feel like a sales role. Working with<br />

private technology is amazing and the clarity you<br />

get from the latest hearing aids is far beyond<br />

what I’d ever imagined.”<br />

“Each store has its own personality and set up<br />

but they are all linked by the same enthusiasm<br />

and full of people who love what they do. As a<br />

company, Leightons supports new ideas and<br />

drives them forward. This means you feel you’re<br />

constantly moving forward and developing as a<br />

clinician. Knowing that you’re progressing your<br />

career is one of the most important factors in<br />

job satisfaction.”<br />

WE’RE ON THE LOOKOUT<br />

AMBITIOUS AUDIOLOGIST?<br />

Do you share our ambition to deliver best in<br />

market audiology and help your patients live life<br />

to the full?<br />

Do you share our passion to deliver the highest<br />

possible clinical standards and fit the very latest<br />

hearing aids?<br />

Would you like to receive an industry leading<br />

salary, uncapped commission and a generous<br />

benefits package?<br />

WHO WE ARE<br />

LEIGHTONS was founded in 1928 and is still<br />

proudly family-owned and family-run. We're<br />

expanding across the South and are looking for<br />

forward-thinking, experienced, qualified and<br />

registered audiologists and hearing aid<br />

dispensers to join our team.<br />

INDUSTRY-LEADING SALARY<br />

BONUS & UNCAPPED COMMISSION<br />

COMPANY CAR<br />

BENEFITS PACKAGE<br />

PRIVATE HEALTHCARE<br />

GYM MEMBERSHIP<br />

PENSION<br />

JOIN US<br />

To watch our latest videos and find out more<br />

about audiology and hearing care careers at<br />

Leightons, visit leightons.co.uk/careers, call<br />

Louisa Edward on 0808 208 00 88 or email<br />

louisaedward@leightons.co.uk.


TRAINEES<br />

Deafness in Low and Middle<br />

Income Countries: Massive Open<br />

Online Course<br />

NEIL <strong>SUMMER</strong>FIELD<br />

Trainee/Student Liaison<br />

If you are interested in digital<br />

innovation in education, you may have<br />

heard of MOOCs (Massive Online<br />

Open Courses). You may even have<br />

tried studying Chemistry, Population<br />

Health or one of the other wide<br />

ranging topics on offer. For those<br />

who are unfamiliar with the term,<br />

the aim of a MOOC is to enable the<br />

international community to take an<br />

active part in learning on a topic of<br />

their choice. The only pre-requisite is<br />

an internet connection and an interest<br />

in the subject. In February 2016, we<br />

launched six weeks of free learning<br />

in UoM’s MOOC on Deafness in<br />

Low and Middle Income Countries<br />

(LMIC). With a re-launch imminent,<br />

we thought it timely to update <strong>BAA</strong><br />

readers on the progress.<br />

UoM’s MOOC seeks to address<br />

the needs of the 360 million<br />

individuals worldwide that have<br />

a disabling hearing loss (WHO,<br />

<strong>2017</strong>). This equates to over 5%<br />

of the world’s population with an<br />

estimated 85% of deafness in LMIC.<br />

For these deaf children and adults,<br />

the opportunities and expectations<br />

differ significantly from what is<br />

available in the UK. In many LMIC,<br />

there is little access to audiological<br />

services, no Teachers of the Deaf and,<br />

perhaps most importantly, significant<br />

stigma attached to deafness. Many<br />

healthcare professionals, teachers<br />

and members of the public have<br />

very little understanding of the<br />

impact of deafness. Many people<br />

misunderstand the condition meaning<br />

that deafness is not positively<br />

approached. Meanwhile it is estimated<br />

that 60% of childhood hearing loss<br />

in LMIC could be prevented (WHO,<br />

<strong>2017</strong>). As the immediate impact<br />

of deafness is on the ability of the<br />

individual to communicate, a lack<br />

of awareness of others can have a<br />

significant impact leading to feelings<br />

of isolation and exclusion.<br />

Six weeks of learning were created<br />

enabling students to understand<br />

the way the ear works and causes<br />

of deafness. We considered how<br />

language, signed or spoken, may<br />

be acquired and showed footage<br />

of deaf role models from around<br />

the world, evidencing what may be<br />

achievable. The inspiring footage<br />

from existing and emerging projects<br />

in LMIC offered opportunities for<br />

global change and gave real food for<br />

thought (particularly footage of the<br />

first recipients of cochlear implants in<br />

Malawi).<br />

We were fortunate enough to have<br />

individuals and organisations from all<br />

around the world working together to<br />

create the MOOC – demonstrating<br />

what can be achieved when a global<br />

community pulls together. This<br />

included Soundseekers UK, Deaf Child<br />

World Wide, Royal Dutch Kentalis,<br />

The Manchester Deaf Centre, The<br />

World Health Organization, The<br />

University of Texas, CBM, and deaf<br />

individuals and academics from a<br />

range of countries and backgrounds.<br />

The first run of the course attracted<br />

1670 students, 97% of which rated<br />

the course as good (39%) or excellent<br />

(58%). 42% of the students were<br />

from emerging countries. We were<br />

delighted to learn that this was the<br />

highest rating UoM MOOC to date.<br />

We asked the students whether<br />

anything had surprised them about the<br />

experiences of deaf people in LMIC<br />

and received a variety of responses,<br />

for example:<br />

“I am so surprised of how many<br />

people consider and think of persons<br />

with deafness or hard of hearing,<br />

most deaf people face stigmatisation,<br />

communication barrier, seen<br />

unproductive and are victimised.<br />

Again, I never knew that treatment for<br />

malaria can cause deafness. I have<br />

really learnt a lot from this course”.<br />

We also asked how they would<br />

use their learning to support positive<br />

change:<br />

“I plan to educate the people I work<br />

with and the patients I see.”<br />

“As a result of this MOOC, I will be<br />

able to provide clear information to<br />

the community during my counselling<br />

programs. I will raise awareness in<br />

the community about hearing loss and<br />

possible course of hearing loss.”<br />

We are now preparing for a course<br />

re-launch over the next few months.<br />

To register for the course please visit:<br />

www.coursera.org/course/deafness<br />

WHO (<strong>2017</strong>) Deafness and Hearing<br />

Loss. Accessed at: www.who.int/<br />

mediacentre/factsheets/fs300/en/<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 27


TRAINEES<br />

Breaking News… A New Oticon Student<br />

Award is Coming to the <strong>BAA</strong> Conference<br />

NEIL <strong>SUMMER</strong>FIELD<br />

Trainee/Student Liaison<br />

You may or may not have already<br />

heard, but in addition to the normal<br />

awards being presented at this<br />

year’s conference, we would like to<br />

announce that Oticon have teamed<br />

up with the Academy in order<br />

to present the first ‘<strong>BAA</strong>/Oticon<br />

Student of the Year Award’. This<br />

award is aimed at recognising a<br />

student who has achieved academic<br />

success in their course, particularly in<br />

their final dissertation.<br />

In addition to holding the title of<br />

“<strong>BAA</strong>/Oticon Student of the Year”,<br />

the winner will receive a trophy which<br />

they can use to show off to all their<br />

friends as well as a cash prize, and<br />

if that was not enough, Oticon will<br />

sponsor an all expenses trip to the<br />

renowned Eriksholm International<br />

Summer Camp.<br />

This new award is open to all<br />

students who are members of the<br />

<strong>BAA</strong> on Audiology courses leading<br />

to qualification or registration, and<br />

nominees will be identified by the<br />

higher education institutes. The<br />

identified nominees will be asked<br />

to provide an abstract of their work<br />

which will then be assessed by the<br />

judging panel. The winner will then<br />

be announced at the Conference in<br />

Bournemouth in November.<br />

To make sure you do not miss out,<br />

sign up for your free <strong>BAA</strong> student<br />

membership today and remind your<br />

lectures and course leads how good<br />

you are.<br />

Launch of Hearing Therapy CPD<br />

modules at Aston University<br />

We are excited to announce a new tiered<br />

programme of professional development modules<br />

in Hearing Therapy with our established School of<br />

Life and Health Sciences Audiology Department.<br />

These can be taken independently or combined<br />

to achieve the following qualifications:<br />

PG Certificate Modules:<br />

- Hearing Therapy (5-day<br />

face to face training +<br />

online support)<br />

- Tinnitus Management<br />

(online delivery)<br />

- Aural Rehabilitation (online<br />

delivery)<br />

MSc Modules:<br />

- Research Methods<br />

(online delivery + face<br />

to face supervision and<br />

introduction)<br />

- Research Project (online<br />

delivery + face to face<br />

supervision)<br />

Why Hearing Therapy CPD at Aston?<br />

- Suitable for audiologists, hearing therapists, and<br />

graduates from science and social science disciplines<br />

- Flexible delivery to suit those in employment: all<br />

modules can be taken independently as continuing<br />

professional development<br />

- Advanced skills in research and rehabilitation<br />

management obtained<br />

- Aston University is the first in the UK to offer a<br />

Professional Doctorate in Hearing Therapy.<br />

For further information or to apply visit<br />

www.aston.ac.uk/doctorofhearingtherapy<br />

PG Diploma Modules:<br />

- Evidence-based Practice<br />

(online delivery)<br />

- Health Behaviours (online<br />

delivery)<br />

- Vestibular Rehabilitation<br />

(online delivery)<br />

Doctorate Modules:<br />

- Qualitative Research<br />

Methodology (online<br />

delivery) OR Quantitative<br />

Methods & Advanced<br />

Statistics (online delivery)<br />

- Research Thesis<br />

(individual support)<br />

Hearing Therapy CPD advert 174x131mm.indd 2 23/03/<strong>2017</strong> 09:57<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 28


INDUSTRY<br />

UPDATES<br />

The future is now: with<br />

Sprint and TeleCare<br />

Sprint, a new innovation for NHS audiology services with an evidence* based workflow, has<br />

just raised the innovation bar even higher. The highly sophisticated Sprint hearing aids can<br />

not only be fitted in an instant, but using the new myHearing App can now transform how<br />

patients manage and maintain their hearing aids, with patients being right at the centre of<br />

the fitting process.<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 29


INDUSTRY<br />

UPDATES<br />

Following a Sprint fitting, patients<br />

can download the myHearing<br />

App to their smartphone and<br />

immediately connect directly with<br />

their audiologist using text, voice<br />

or video CareChat. A brief tap of<br />

their smartphone and patients<br />

have instant access to educational<br />

reference materials** along with<br />

a daily satisfaction rating that<br />

allows patients to indicate to their<br />

audiologist how they are progressing<br />

on their hearing journey with the<br />

personalised learning modules that<br />

have been set up for them.<br />

What does this mean for the<br />

patient? Better communication with<br />

their audiologist, greater satisfaction<br />

with their hearing aids and reduced<br />

numbers of return visits to the clinic.<br />

What does this mean for the<br />

audiologist? Improved patient<br />

outcomes and satisfaction, instant<br />

patient feedback and greater<br />

efficiency with reduced follow ups in<br />

the clinic.<br />

For more information, please<br />

contact your Sivantos NHS<br />

Audiologist or contact Sarah Banks<br />

at Sivantos on 01293 423703 to<br />

discuss booking a meeting on how<br />

Sprint & TelecCare can work for you.<br />

For further information, also visit<br />

www.bestsound-technology.co.uk<br />

*Please email sarah.banks@<br />

sivantos.com to receive a summary<br />

of the evidence<br />

**Booklet versions are also<br />

available for patients without<br />

smartphones.<br />

Photos Courtesy Sivantos:<br />

A brief tap of their smartphone and patients have instant access<br />

to educational reference materials along with a daily satisfaction<br />

rating that allows patients to indicate to their audiologist how<br />

they are progressing on their hearing journey.<br />

Experience the<br />

sound<br />

of quality<br />

With an integrated sound room solution from Otometrics<br />

Otometrics – the market leader in audiology equipment and software – makes choosing<br />

and installing a sound room easier. Here are 4 ways we help you to a quality sound room<br />

without the hassle:<br />

probes and<br />

mized<br />

tegrated<br />

• Audiology equipment integration, expert consultancy and turnkey design service<br />

• Custom-designed to suit your clinic<br />

• Easy to construct and move – with no special floor preparation needed<br />

• Short on space? Corner booths available to maximise available space.<br />

Get started today! Contact your Otometrics representative for a free consultation.<br />

Learn more: otometrics.co.uk/soundrooms<br />

Otometrics, UK. +44 (0) 870 9000 675. info-uk@otometrics.com<br />

Otometrics A/S, Denmark. +45 45 75 55 55. info-dk@otometrics.com<br />

www.otometrics.co.uk<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / <strong>SUMMER</strong> <strong>2017</strong> / 30


British Academy of Audiology<br />

14th Annual Conference<br />

16-17 NOVEMBER <strong>2017</strong> Bournemouth International Centre<br />

Abstract submissions until:<br />

24th July <strong>2017</strong><br />

Early bird price valid until:<br />

2nd October <strong>2017</strong><br />

@<strong>BAA</strong>udiology | #<strong>BAA</strong>Conf<br />

British Academy of Audiology<br />

More information is available on<br />

www.baaudiology.org<br />

<strong>BAA</strong> <strong>MAGAZINE</strong> / WINTER <strong>2017</strong> / 31


TargetMatch<br />

Saving you time without compromise<br />

NEW<br />

Breakthrough<br />

Technology<br />

TargetMatch is a new automated guidance system for real ear and test box measurements developed by Phonak in collaboration<br />

with Otometrics. It provides you with the benefits of a seamless, step by step workflow, using the Aurical hardware and software<br />

enabling you to fit and verify directly in Phonak Target.<br />

TargetMatch guides you through the process of probe tube placement, obtaining Real Ear and 2cc/test box measurements and<br />

automatic or manual target matching. This creates an easy and effective way of incorporating verification into the fitting process.<br />

This unique functionality will save you time but without compromising your service, allowing you to truly focus on your patient’s<br />

needs.<br />

If you want to be one of the first to experience TargetMatch,<br />

please contact your Phonak Regional Sales Manager<br />

phonak.com<br />

Follow us on social media:<br />

@PhonakGB @PhonakUK @PhonakUK

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