Research Articles (Speech-Language Pathology and Audiology)

Permanent URI for this collectionhttp://hdl.handle.net/2263/1744

For inquiries regarding this collection or items in the collection, please contact Elsa Coertze
Tel.: +27 12 420 4796

Browse

Now showing 1 - 20 of 689

Assessment accommodations for autistic learners in South African schools : stakeholder perspectives
Nell, Yvonne; Kritzinger, Alta M. (Aletta Margaretha); Graham, Marien A.; Eccles, Renata (AOSIS, 2026-02-28)
BACKGROUND : Autistic learners benefit from demonstrating academic knowledge with the help of assessment accommodations, guided by South African examination policies, such as the National Policy Pertaining to the Conduct, Administration and Management of Examinations and Assessment for the National Senior Certificate Examination. However, stakeholder perspectives on accommodations remain under-explored. OBJECTIVES : This study explored stakeholder perspectives (autistic adults, caregivers, educators, psychologists, speech-language therapists and occupational therapists) on assessment accommodations for autistic learners in South African schools. METHOD : A web-based questionnaire was distributed nationally to professionals and caregivers (n = 92). Quantitative data were analysed descriptively, and qualitative responses were thematically coded. RESULTS : Stakeholders reported a persistent policy-practice disconnect, with educators lacking the knowledge of accommodation policies, as well as the training to implement accommodations, particularly for autistic learners. Similarly, current policies do not adequately accommodate the needs related to sensory regulation and anxiety. Considerable variability emerged in accommodation preferences, reflecting both the heterogeneity of autistic learners and the differences across stakeholder groups. Respondents also prioritised universal design elements such as simplified language, redundancy and clearer assessment layouts, which are not currently considered in South African policy. Overall, findings highlight the need for expanded and individually tailored assessment accommodations informed by diverse stakeholder input. CONCLUSION : The findings highlight a disconnect between policy and practice. Broader autism-specific accommodations are crucial to support equitable assessment conditions in South African schools, especially for learners with sensory and communication challenges. CONTRIBUTION : This study provides insight into stakeholder experiences and suggests that current assessment policies may inadvertently exclude autistic learners. The findings support the need for inclusive, contextually relevant assessment strategies. The contribution aligns with the focus of the journal on disability inclusion by advancing evidence-based recommendations that promote full participation of neurodivergent learners in education systems, particularly within under-resourced and diverse settings.
Hearing loss and hearing aid stigma in low- and middle-income settings : a scoping review
Frisby, Caitlin; Manchaiah, Vinaya; Dawood, Nausheen; Nieman, Carrie; Swanepoel, De Wet (Taylor and Francis, 2026)
PURPOSE : Stigma has been reported as a key barrier to hearing aid uptake. This scoping review explores evidence of reported stigma associated with hearing loss and hearing aids in low- and middle-income (LMI) settings. METHODS : Four databases were searched to identify studies published up to 6 November 2024. Studies mentioning stigma in relation to hearing loss or hearing aids in LMI countries or LMI settings within high-income countries were included. A narrative synthesis was conducted. RESULTS : Twenty-nine studies were included, with 26 conducted in LMI countries and three in LMI settings within high-income countries. Two main domains were identified: (a) stigma experienced by individuals with hearing loss, ear disease, or hearing aids and (b) experiences of stigma reported by direct communication partners. Four themes emerged from affected individuals, including (a) internalized stigma, (b) social stigma, (c) cultural beliefs, and (d) barriers to help-seeking. Communication partners’ themes included (a) perception of individuals with hearing loss, (b) impact on relationships, and (c) cultural beliefs. Unique theme in LMIs is cultural beliefs that hearing loss is associated with witchcraft and curses. CONCLUSIONS : A limited number of studies were identified but emphasized cultural and religious beliefs as important contributing factors to stigma in LMIs. IMPLICATIONS FOR REHABILITATION • Stigma related to hearing loss and hearing aids in low- and middle-income (LMI) settings presents a significant barrier to help-seeking and device adoption. • Community-based education and culturally sensitive interventions are essential to addressing stigma and promoting hearing healthcare uptake. • Targeting both individuals with hearing loss and their communication partners can help reduce negative perceptions. • Rehabilitation strategies should incorporate cultural and religious beliefs to effectively address stigma unique to LMI settings, such as associations with witchcraft and curses.
Usability and performance of self-fitting over-the-counter hearing aids
Knoetze, Megan Clarissa; Manchaiah, Vinaya; Swanepoel, De Wet (American Academy of Audiology, 2025-01)
PURPOSE : Over-the-counter (OTC) hearing aids can potentially improve access to hearing-health care and enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study compared the usability and performance of a range of self-fitting over-the-counter (OTC-SF) hearing aids. RESEARCH DESIGN : This cross-sectional study evaluated six OTC-SF hearing aids. STUDY SAMPLE : Forty-three adults with self-perceived mild-to-moderate hearing difficulties participated in this study. DATA COLLECTION AND ANALYSIS : Participants were randomly assigned to two of six OTC-SF hearing aids and used the manufacturer-provided instructions and smartphone applications. These hearing aids included HP Hearing PRO, Jabra Enhance Plus, Lexie B2 Powered by Bose, Lexie Lumen, Soundwave Sontro, and Sony CRE-C10. Usability was assessed based on the fitting time, hearing aid skills and knowledge (HASK), self-reported ease of the SF process, and Post-Study System Usability Questionnaire (PSSUQ) results. Performance was evaluated using the judgment of sound quality (JSQ) test and speech-in-noise benefit using the digits-in-noise and quick speech-in-noise tests. RESULTS : Fitting time ranged from 14.4 to 27.1 min, with Lexie Lumen requiring the longest time (27.1 min; standard deviation [SD], 5.9 min) and HP Hearing PRO requiring the shortest time (14.4 min; SD = 1.9 min). The HASK scores varied, with Soundwave Sontro achieving the highest score (8.9/10) and HP Hearing PRO achieving the lowest score (6.8/10). Self-reported ease of SF and PSSUQ scores did not differ significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings significantly differed, with Lexie B2 receiving the highest rating (8.1/10 and 7.5/10) and HP Hearing PRO receiving the lowest rating (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantly between devices. A thematic analysis identified seven themes of the participants’ SF experiences and six themes of the researcher’s field notes. Participants generally considered OTC-SF hearing aids user-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality were noted by the researcher as common challenges. CONCLUSIONS : Usability and performance of OTC-SF hearing aids were similar across devices in terms of usability and speech-in-noise benefits. However, the devices exhibited variations in fitting time, HASK, and sound quality, including the overall impression and clarity. These findings can support the decisions of consumers and recommendations of health-care professionals. Further research of the long-term usability and selection processes of OTC-SF hearing aids is necessary.
South African speech-language therapists’ perceived competencies and use of Makaton
Mc Geer, Chriséle; Milton, Carmen; Vorster, Carlien; Graham, Marien Alet (AOSIS, 2026-02)
BACKGROUND : Makaton, an unaided augmentative and alternative communication (AAC) method, is widely used by speech-language therapists (SLTs) in diverse clinical and educational settings. Despite its applicability across populations with complex communication needs, limited research has explored how South African SLTs perceive, use and experience Makaton. This gap is significant given South Africa’s multilingual context, resource disparities and the need for culturally relevant AAC strategies. OBJECTIVES : This study aimed to explore South African SLTs’ perceived competencies and use of Makaton. METHOD : This study employed a mixed-methods design. An online survey comprising closed- and open-ended questions was distributed to SLTs across South Africa. A total of 57 participants were included in the study. Quantitative responses were analysed using descriptive and inferential statistics, while qualitative responses were analysed thematically using Braun and Clarke’s six-phase framework. RESULTS : While 87.7% of participants viewed Makaton as valuable, only 5.5% reported feeling very confident using it. No statistically significant difference between recommending Makaton to parents and team members (Wilcoxon signed-rank [WSR] = −1.386, p = 0.166). Four themes captured Makaton’s perceived value: (1) multimodal communication, (2) accessibility and practicality, (3) support for speech and language development and (4) inclusion and social interaction. Reported challenges included: (1) limited awareness and training, (2) financial and/or resource constraints, (3) poor consistency and carryover, (4) motor and/or cognitive limitations and (5) cultural and regional mismatches. CONCLUSION : While Makaton is positively regarded by SLTs, limited training, confidence and implementation support hinder consistent use. CONTRIBUTION : Expanding access to training and embedding Makaton in professional education may enhance AAC service delivery in the multilingual South African context.
Distinguishing developmental dyslexia from foundational delay : reading proficiency of Afrikaans learners after COVID-19 lockdowns
Stark, Sandra; Geertsema, Salome; Le Roux, Mia; Graham, Marien Alet (Education Association of South Africa, 2026-02)
The COVID-19 lockdowns and related school closures severely disrupted early literacy development worldwide. In this study we examined the long-term impact of these disruptions on Afrikaans-speaking learners in South Africa who were in the Foundation Phase (Grades 1–3) during the lockdowns and were later assessed in Grades 5, 6, and 7. Grounded in the simple view of reading (SVR), which defines reading comprehension as the product of decoding and language comprehension, we explored how delayed acquisition of foundational skills may be misinterpreted as developmental dyslexia (DD). We propose the concept of foundational delay phenomenon (FDP), a novel term describing persistent literacy difficulties stemming from disrupted foundational instruction, which do not align with established classifications such as developmental dyslexia (DD) or general learning delays. The results show that learners in all 3 grades – especially those in Grade 7 – performed well below chronological age expectations in reading and spelling, with some deficits exceeding 30 to 40 months. While a subset met DD criteria, a larger group displayed compounded foundational delays consistent with FDP. These findings highlight the urgent need for refined diagnostic practices to differentiate between reading disorders and entrenched instructional delays caused by the COVID-19 education disruptions.
Efficacy of single-session intervention of tinnitus educational counseling : a systematic review
Pandey, Preeti; Knoetze, Megan Clarissa; Sharma, Anu; Swanepoel, De Wet; Manchaiah, Vinaya (American Speech-Language-Hearing Association, 2026-03)
PURPOSE : This systematic review aims to evaluate the efficacy of single-session interventions of tinnitus educational counseling (SSI-TEDs) in the management of tinnitus. METHOD : A systematic literature search was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five studies met the inclusion criteria: three were two-arm randomized controlled trials (RCTs), and two employed a pretest–posttest design. Two studies compared SSI-TED with other interventions—neuro-music therapy (n = 1) and hypnosis (n = 1). One study included a homework component for 50% of the participants, and another combined SSI-TED with mindfulness and relaxation training. RESULTS : Across five studies, a total of 307 participants received SSI-TED, while 190 were given alternative interventions. At 1–3 months follow-up, one RCT demonstrated a small-to-medium effect of SSI-TED on reducing tinnitus severity and distress. Pretest–posttest studies reported large effects of SSI-TED on these outcomes. Improvements were also observed in negative emotions, frustration, rumination, and social life. The long-term effect of SSI-TED was noted in one study. No significant effects were found for anxiety or depression. CONCLUSIONS : SSI-TED appears to be a promising intervention for reducing tinnitus-related distress and improving emotional well-being in the short term. The evidence suggests moderate benefits in control conditions and larger effects when evaluated in uncontrolled settings. However, its impact on comorbid anxiety and depression remains unclear. Further high-quality studies with long-term follow-up are needed to establish the sustained efficacy, effectiveness, and broader psychological benefits of SSI-TED.
Apple hearing test feature for the AirPods Pro 2 : accuracy, reliability, and time-efficiency
Kruger, Megan; Manchaiah, Vinaya; Swanepoel, De Wet (Wiley, 2026-03)
OBJECTIVE : To evaluate the accuracy, test-retest reliability, and time-efficiency of Apple's Hearing Test Feature (HTF) compared to reference standard pure-tone audiometry (PTA). STUDY DESIGN : Cross-sectional validation study. SETTING : Single-center study at a university clinic. PTA was performed in a sound-treated booth. HTF testing occurred in a quiet room. METHODS : A sample of 25 adults (mean age 50.1 years [SD 14.2]; 68% female) with self-reported mild-to-moderate hearing loss participated. Each contributed 16 thresholds, yielding 400 comparisons. Participants underwent PTA by an audiologist, followed by two independent HTF assessments (start and end of session) using Apple AirPods Pro 2 paired with an iPhone 13. Outcomes included threshold accuracy versus PTA, test-retest reliability, and test duration. RESULTS : Across 400 comparisons, 86.5% of HTF thresholds were within 10 dB HL of PTA. Root mean square deviation (RMSD) values ranged from 3.3 to 7.9 dB HL (left ear) and 5.8 to 9.7 dB HL (right ear), meeting minimally acceptable accuracy (≤10 dB HL). Test-retest was reliable, 84.1% of thresholds within 5 dB HL and 96.6% within 10 dB HL. Desired reliability (≤6 dB HL) was met at all frequencies except 250 Hz (left ear), which met minimum acceptable level. HTF was significantly faster (median 5.5 minutes) than PTA (10.0 minutes; P < .001). CONCLUSION : Apple's HTF demonstrated clinically acceptable accuracy and reliability, with improved time-efficiency compared to PTA. Findings support its potential for consumer-led hearing monitoring and OTC hearing aid self-fitting. Further research should assess inter-device reliability and integration with Apple's Hearing Aid Feature.
Longitudinal analysis of the risk factors for onset and change in tinnitus in the Busselton Healthy Ageing Study
Fuchten, Denise; Stegeman, Inge; Mao, Yinan; Eikelboom, Robert H.; Hunter, Michael L.; Smit, Adriana L. (Public Library of Science, 2026-01)
INTRODUCTION : Effective prevention and intervention strategies for tinnitus rely on identifying risk factors and understanding its progression over time. However, longitudinal data on these aspects are limited. This study therefore aimed to (1) assess the incidence of tinnitus and identify risk factors associated with tinnitus development, and (2) assess the impact of tinnitus and change in impact over time and identify factors associated with this change. METHODS : Data from the Busselton Healthy Ageing Study, a population-based cohort of individuals born between 1946–1964, were used. Information on tinnitus presence and impact, general health, ear-related health and mental health was collected from 3863 participants through questionnaires and physical measurements at two time points with a six-year interval. Logistic regression analysis was used to examine risk factors for tinnitus development. Multinomial logistic regression analysis was used to examine factors associated with changes in impact. RESULTS : The 6-year incidence of tinnitus was 12.1%. Statistically significant risk factors for developing tinnitus included male gender, higher BMI, larger waist circumference, fair subjective health, hearing loss, occupational noise exposure with occasional use of hearing protection, hyperacusis, migraine, and diagnosed anxiety disorder. Among participants with pre-existing tinnitus, 21.4% reported an increase in tinnitus impact over time, while 16.5% experienced a decrease. Changes in impact were influenced by general health and ear-related health factors. CONCLUSION : The high incidence of tinnitus and its notable impact on daily life emphasize the importance of gaining a better understanding of the broad range of identified risk factors for developing tinnitus and change in impact. The multifaceted nature of these factors, comprising hearing-related issues, general health conditions and psychological aspects, underscore the complexity of tinnitus etiology and impact. By gaining more insight into these factors, we can inform future research efforts aimed at developing targeted prevention and intervention strategies tailored to specific demographic groups.
Cochlear implant recipient volunteer partnerships : perceptions of an adult peer community
Diffenthal, Carli; Pottas, Lidia; Soobrayen, Victoria; Le Roux, Talita (Taylor and Francis, 2026)
PURPOSE : To describe adult cochlear implant (CI) recipient volunteer partnerships, as perceived by CI volunteers, in terms of support and informational counselling. By exploring the dynamics of these partnerships, valuable insights are gained into the effectiveness of volunteer support systems, contributing to peer-based interventions and the overall well-being of CI recipients navigating the complexities of cochlear implantation. MATERIALS AND METHODS : Focus group discussions were conducted with eight adult CI volunteers, and qualitative data were thematically analysed. RESULTS : Four overarching themes were identified: (1) Sharing personal experiences, (2) Information broker, (3) Providing support, and (4) Recommendations for CI volunteer partnerships. CONCLUSIONS : Insights from CI volunteers highlight the value of peer support in enhancing person-centred audiological care. The study identifies a need for structured volunteer involvement in CI programs and marks an initial exploration of CI volunteering and mentoring. IMPLICATIONS FOR REHABILITATION • Collaboration between CI volunteers and hearing healthcare professionals highlights the importance of CI programs providing comprehensive informational counselling. • Counselling should integrate technical aspects of CIs with personal experiences shared by CI volunteers, addressing both clinical and human dimensions of the CI journey. • CI volunteers play a critical role in providing emotional support throughout the CI journey, suggesting the need to integrate peer mentoring into rehabilitation programs to sustain CI recipients’ psychological well-being. • CI programs should involve CI volunteers in advocacy efforts to raise awareness and foster supportive CI communities.
Tele-intervention for adults with tinnitus in Ghana, a low- and middle-income country : a feasibility study
Boateng, Joseph Omane; Soer, Maggi E. (Magdalena Elizabeth); Biagio-de Jager, Leigh (Springer, 2026-03-12)
BACKGROUND : Tinnitus may be associated with anxiety and depression which can affect quality of life. In low- and middle-income countries like Ghana, a shortage of specialized clinicians suggests online interventions could alleviate clinician caseloads, but the feasibility of online intervention is yet to be explored. This study assessed the feasibility of providing tele-intervention in the form of online educational counselling (OEC) for adults with tinnitus in Ghana. METHODS : This single-arm trial included 53 Ghanaian adults (female = 21, median age = 34 years) with significant tinnitus severity, internet access, email, and English literacy. Standardized questionnaires were used to assess tinnitus severity, anxiety, and depression levels pre- and post-intervention. Online educational counselling was provided using a free downloadable tinnitus self-help resource over three weeks. Pre- and post-intervention scores were compared and participant perceptions were recorded. RESULTS : Significant reductions in tinnitus severity, anxiety, and depression levels occurred post-intervention. Over half (54.7%) of the participants reported significant reductions in tinnitus severity post-intervention. Bivariate comparisons showed the reduction was associated with baseline tinnitus severity and depression level but not with sex (p = 0.400), hearing status (p = 0.530), or anxiety levels (p = 0.058). Participants demonstrated high adherence (93%) and provided positive feedback on the tele-intervention. CONCLUSION : Online educational counselling for tinnitus is feasible in Ghana based on adherence and feedback. These findings support integrating OEC into tinnitus care in low-resource settings as an initial, scalable option or within a multi-faceted program.
Adaptation of a developmental milestone resource for parents from diverse, low-income communities in South Africa
Eccles, Renata; Du Toit, Maria; Bellini, Ashley; Masule, Kabuba Hendrietta; Molongoana, Palesa N.; Masekela, Mbali M.N.; Bahadoor, Zeneera; Abdoola, Shabnam Salim; Van der Linde, Jeannie (Sage, 2026)
Knowledge of developmental milestones allows parents to support the developmental needs of their children and monitor their behaviour. Many available developmental resources, however, do not apply to culturally, economically, and linguistically diverse communities in low– and middle-income countries. There is a need to adapt established resources to improve contextual relevance. As primary stakeholders, parents should contribute to the adaptations. An existing developmental milestone resource was adapted for parents from low-income communities in South Africa using a mixed-method research design. In phases 1 and 2, a six-member expert panel reviewed and adapted the existing resource for the parents of children aged 2–47 months using a questionnaire and focus group. In phase 3, 18 parents of young children from low-income communities were interviewed to gain their perspectives on the adapted milestone. Most developmental milestones were deemed applicable, but they require adaptation to be relevant for use in low-income communities. The four themes identified were: language use, access to materials indicated in the resource, context and developmental literacy. Parents found the adapted resource relevant to promoting developmental literacy. International developmental milestone resources require contextual adaptation for diverse communities. Parents were included in developing the resource, increasing its relevance. The adapted resource should be trialled to evaluate the effectiveness of promoting parents’ developmental literacy.
Person-centered care in adult auditory rehabilitation : a scoping review
Graham, Marien Alet; Nicholson, Nannette; Glade, Rachel; Delport, Sonja; Mahomed-Asmail, Faheema (Taylor and Francis, 2026)
OBJECTIVE : To scrutinise the efficacy of person-centered care (PCC) in enhancing outcomes for adults navigating hearing loss through a comprehensive examination of literature on PCC in auditory rehabilitation (AR). DESIGN : A scoping review was conducted following Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) reporting standards. A context framework guided the research question. STUDY SAMPLE : Structured searches across multiple databases identified 36 records which were categorised by research design, mapped by the first author's country, and depicted by number of publications per year. Six identified elements of PCC were anaylzed across four components of PCC using deductive qualitative analysis. RESULTS : Most studies were published in the US and Australia; with a gradual increase to four publications per year. From the six PCC elements of person-centered care, family involvement, individualised preferences and treatment uniqueness were most frequently addressed. Notably, active listening and empathy received limited attention. CONCLUSION : Evidence suggests advancement of PCC practices effectively fosters more effective and personalised approaches in adult AR. By pinpointing trends and gaps, we contribute to the advancement of PCC practices, fostering more effective and personalised approaches in AR for improved patient outcomes and experiences.
Image use in aphasia rehabilitation : practices of speech-language pathologists in South Africa and international contexts
Pillay, Bhavani Sarveshvari; Van der Linde, Jeannie; Graham, Marien Alet; Dada, Shakila (Taylor and Francis, 2026)
PURPOSE : The study aimed to explore speech-language pathologists' practices regarding image selection and use in the treatment of people living with aphasia. Images are widely utilised with people living with aphasia, however, supporting their communication optimally remains challenging. METHOD : Ninety-two speech-language pathologists from South Africa, Australia, USA, and the UK completed a custom-designed online survey. Descriptive and inferential statistics, with structured-tabular thematic analysis were used. RESULTS : Sixty-two (82.7%) of the 75 participants who conduct assessments with people living with aphasia mostly use images. Sixty-seven (72.8%) of the total sample include images during treatment. South African respondents reported using black-and-white line drawings (28.1%) less frequently than speech-language pathologists from other countries (9.8%). Coloured images were preferred overall. South African participants significantly reported culture (62.5%) and religious orientation as "always important" (63.3%) compared to their counterparts (34.1%, 12.2%). Respondents use images to support learning and language; and less frequently in discourse with people living with aphasia. The more experienced a respondent was, the more knowledgeable and confident they felt incorporating images. Themes of client considerations and clinical settings for images emerged. Speech-language pathologists' perceived barriers were time, larger caseloads, people living with aphasia's variable responses to images, and lack of resources. CONCLUSION : Speech-language pathologists in this sample have a knowledge base of image types and factors that may contribute to image interpretation in people living with aphasia. However, further research globally is needed. A structured approach to image selection is lacking in both low and middle-income, and high-income countries. Considering people living with aphasia's skills, preferences, and communication partner involvement may optimise image use. Development of a framework for systematically organising image features for people living with aphasia is warranted.
Community-based hearing aid fitting model for adults in low-income communities facilitated by community health workers : a feasibility study
Mothemela, Bopane; Frisby, Caitlin; Mahomed-Asmail, Faheema; De Kock, Tersia; Moore, David R.; Manchaiah, Vinaya; Swanepoel, De Wet (Taylor and Francis, 2025)
BACKGROUND : Hearing loss affects more than 1.5 billion people worldwide, yet fewer than 10% of those who could benefit from hearing aids are able to access them. Barriers such as high costs, limited availability, and a critical shortage of trained professionals in low- and middle-income countries contribute to this gap, while emerging models of care-such as task-shifting to community healthcare workers (CHWs) supported by mHealth technologies-show promise in improving access, affordability, and outcomes in underserved communities. OBJECTIVE : To determine the feasibility and outcomes of a community-based hearing aid fitting model designed for low-income communities facilitated by community health workers (CHWs). METHOD : Using Bowen's framework, feasibility was evaluated according to service delivery and patient outcomes. A total of 25 (six male) participants were fitted with bilateral Go Prime preset, over-the-counter (OTC) hearing aids by CHWs in Khayelitsha, a low-income community in Cape Town, South Africa. Benefit and satisfaction were measured using the International Outcome Inventory for Hearing Aids (IOI-HA). An open-ended survey used to obtain their perceptions on the impact of the hearing aids on communication, the mHealth program, and willingness to purchase the hearing aids was analyzed using inductive thematic analysis. RESULTS : Pure Tone Average across participants was 57.3 dB HL (11.5 SD) in the left ear and 54 dB HL (14.2 SD) int he right ear. The majority of participants self-reported positive outcomes while using hearing aids, including good hearing in background noise. IOI-HA showed above standardized average scores of 3.91 for daily use, 4.46 for benefit, and 4.58 for satisfaction. 92% of the participants reported the hearing aids as extremely helpful, with 87.5% recommending hearing aids for others with hearing loss. Additionally, participants reported positive experiences with them Health support program and described the program as clear and helpful. CONCLUSION : The community-based hearing aid fitting model is feasible and demonstrated positive hearing aid outcomes in a low-income community. This approach, supported by mHealth technologies and CHWs, presents a promising solution to address the hearing care gap in low- and middle-income countries (LMICs).
Self-reported vocal demands, perceptions, and knowledge of occupational voice users in South Africa
Vermeulen, Rouxjeanne; Du Toit, Maria; Van Lierde, K.M. (Kristiane); Graham, Marien Alet; Van der Linde, Jeannie (Elsevier, 2025-07)
OBJECTIVES : The study aimed to describe daily vocal demands, perceptions and knowledge as reported by occupational voice users. STUDY DESIGN : A descriptive, cross-sectional research design was employed. METHODS : A survey on vocal demands, perceptions and knowledge was distributed to 102 occupational voice users via a snowball sampling technique. RESULTS : Slightly more than half of the participants (55%) reported using their voice for work 36.5 hours a week on average (SD = 15.5, range: 33–40). Participants reported that, on average, their daily voice use is 6.3 hours (SD = 2.7) for work and the majority (81%) reported a decrease in voice quality after work; Three-quarters (75%) also reported vocal fatigue at the end of day. Approximately one-third (33%) reported being exposed to environments where they are expected to shout, scream or cheer loudly. More than half of the participants (61%) reported that they have previously received vocal health education but 40% reported that they felt this training was insufficient. High vocal demands are significantly correlated to an increase in perceived vocal handicap rs = 0.242; (P = 0.018), tiredness of voice rs = 0.270; (P = 0.008), physical discomfort rs = 0.217; (P = 0.038) as well as how occupational voice users experience improvement of symptoms with rest rs = −0.356 (P < 0.001). Other risk factors highlighted by occupational voice users are the ingestion of liquid caffeine, alcohol, and carbonated drinks, smoking or the presence of chronic cough, chronic laryngitis, and gastroesophageal reflux disease. CONCLUSIONS : Occupational voice users are subjected to high daily vocal demands that can be seen to be linked to vocal fatigue, changes in voice quality and vocal symptoms experienced. It is essential that occupational voice users as well as treating clinicians are aware of certain significant predictors of both vocal handicap and vocal fatigue. These findings provide insights for developing strategies for training and cultivating vocal health consciousness and preventive voice care initiatives that focus on occupational voice users in South Africa.
Partners’ perceptions of aphasia on communication interaction in their relationship
Van der Riet, Sonika; Kruger, Esedra; Pillay, Bhavani Sarveshvari (University of Toronto Press, 2025-04)
Aphasia impacts relationships by altering communication dynamics, potentially leading to emotional disconnection or, alternatively, bringing partners closer as they support each other through challenges. The study aimed to describe how partners in a relationship perceive the impact of aphasia on their communication interactions. Five couples participated in this qualitative case study design, each comprising a partner with chronic stroke-related aphasia. Initial brief intake surveys were conducted followed by in-depth interviews. Five main themes were constructed through thematic analysis: aphasia alters conversational role dynamics and interactions; couples employ strategies to overcome communication challenges; communication difficulties lead to conflict and hinder resolution; partners of a couple experience diverse emotional reactions to the effects of aphasia; and perceptions of support differ between partners of a couple. Speech-language pathologists play a key role in restoring a more balanced distribution of listener–speaker roles in couples' communication post-aphasia. Understanding both partners' emotional reactions to communication challenges can better equip healthcare professionals to manage these within relationships, ensuring couple-centered care.
Internet-based behavioral cough suppression therapy for refractory chronic cough : a randomized controlled trial
Salois, Jane R.; Heinle, Kassidi L.; Slovarp, Laurie J.; Jette, Marie E.; Manchaiah, Vinaya; Vlaescu, George; Andersson, Gerhard (American Speech-Language-Hearing Association, 2025-09)
Please read abstract in the article.
Marketing practices and information quality for over-the-counter (OTC) hearing aids on Amazon.com
Conway, Kylie; Knoetze, Megan Clarissa; Swanepoel, De Wet; Sharma, Anu; Nassiri, Ashley; Manchaiah, Vinaya (Lippincott, Williams and Wilkins, 2026-02)
INTRODUCTION : Over-the-counter (OTC) hearing aids have become increasingly accessible, yet limited information exists regarding their online listings and marketing practices. This study evaluated cost, satisfaction ratings, review, volume, readability of product descriptions, and Food and Drug Administration (FDA) clearance status of OTC hearing aid listings on Amazon.com. MATERIALS AND METHODS : This cross-sectional, descriptive study analyzed 138 Amazon OTC hearing aid listings. Listing characteristics were extracted, and FDA clearance or registration was verified. Analyses included descriptive data on listing characteristics and nonparametric analysis of key variables: price, FDA-clearance status, device type, and form factor. Readability indices were used to assess the accessibility of product descriptions. RESULTS : Of the 138 listings analyzed, 92 listings (66.7%) identified their product as “OTC hearing aids,” while only 37 (26.8%) were verified as FDA-cleared or registered. FDA-cleared/registered devices cost significantly more than non-FDA-cleared devices. Behind-the-ear (BTE) devices had a significantly higher number of reviews compared with in-the-ear (ITE) devices. The readability of product descriptions was advanced, ranging from 11th-grade to college graduate levels. In addition, 52 listings (37.7%) lacked specific marketing for mild-to-moderate hearing loss, and 13 (9.4%) were marketed to those with hearing loss beyond mild-to-moderate. DISCUSSION : Amazon listings for OTC hearing aids reveal significant inconsistencies in marketing and labeling, including misleading FDA clearance claims and inadequate accessibility of product information. Advanced readability levels and marketing for hearing loss degrees beyond mild-to-moderate further impede consumers’ ability to make informed purchasing decisions. These findings highlight the urgent need for stricter regulatory oversight and improved dissemination of accurate, accessible consumer information.
Establishing linguistic categories for hearing aid experiences in adults : a modified Delphi study
Oosthuizen, Ilze; Manchaiah, Vinaya; Launer, Stefan; Swanepoel, De Wet (American Academy of Audiology, 2025-07)
BACKGROUND : Recent advancements in automated natural language processing (NLP) methods and tools have enhanced the efficacy and accuracy of quantitative analysis of natural language data. NLP offers significant potential for audiology by providing valuable insights from open-text responses about users’ lived hearing aid experiences. PURPOSE : This study aimed to establish linguistic categories pertinent to the experiences of adults using hearing aids, with the ultimate goal of developing a specialized text processing module to facilitate natural language analysis of textual data on hearing aid experiences. RESEARCH DESIGN : A modified electronic Delphi (e-Delphi) design was employed. STUDY SAMPLE : A panel of 16 audiology experts from seven countries. DATA COLLECTION AND ANALYSIS : Two survey rounds were conducted. In round 1, experts rated categories from the Linguistic Inquiry and Word Count (LIWC) software and categories from principal component analysis of open-ended text data on hearing aid experiences. Experts also responded to open-ended prompts regarding categories derived from qualitative studies on hearing aid experiences. Responses were condensed and refined into items for rating during round 2. In round 2, experts reconsidered their ratings in light of the group answers of round 1. All ratings used a four-point Likert scale of importance. Measures of central tendency, levels of dispersion, and Cronbach’s α reliability coefficients were conducted in both rounds for comparative purposes. RESULTS : The open-ended section generated 26 items. Consensus was met on 53 linguistic categories encompassing social (e.g., social situations, social support), emotional (e.g., positive tone, negative tone), cognitive (e.g., cognitive processes, causation), lifestyle (e.g., work, leisure), hearing aid–related (e.g., sound quality, use and handling), and service delivery–related dimensions. CONCLUSIONS : The linguistic categories identified provide a foundation for developing a customized LIWC text processing module tailored to the analysis of hearing aid experiences. Future research is needed to refine and validate the custom text processing module. CLINICAL RELEVANCE STATEMENT : The findings provide a framework to enable the development of a customized hearing aid LIWC dictionary. Such a tool may enhance clinicians’ ability to explore hearing aid outcomes and improve patient-centered care by integrating real-world experiences into clinical practice.
Linguistic and cultural adaptation of internet-based cognitive behavioral therapy for tinnitus to Indian English : methods and readability outcomes
Palaniswamy, Hari Prakash; Vasudevan, Harini; Oak, Aparna; Rajanbabu, Keerthana; Manchaiah, Vinaya; Beukes, Eldre W.; Andersson, Gerhard (Elsevier, 2026-02)
BACKGROUND : Tinnitus often causes distress, irritability, difficulty sleeping, and lack of concentration due to its consistent persistence. Cognitive behavioral therapy (CBT) is a proven psychological treatment that can reduce tinnitus-related distress and can be provided via the Internet (ICBT). Such evidence-based, accessible treatments are not yet available in India. The increasing access to eHealth interventions in India will support and increase access to interventions like ICBT. This study aims to adapt ICBT for tinnitus to Indian English, ensuring it is culturally, linguistically, and contextually appropriate for the Indian population. METHOD : The material was carefully reviewed by an audiologist, a linguist, a psychologist and a psychiatrist. The adaptation procedure primarily followed the ISPOR Principles of Good Practice for the translation and cultural adaptation, with a few adaptations from the Ecological validity model. Conflicts were resolved with consensus among all professionals. Then, the content was validated by the psychologist and psychiatrist. Additionally, readability adjustments ensured comprehensibility of the target population. RESULTS : A total of 76 (54 words and 22 phrases) were recommended for modification for reasons including cultural adaptation, lexicon, linguistic relevance, and concept coverage. Lexicons were the highest reason (52%) for modification. The material was critically validated by the expert committee and finalized based on comprehensibility, cultural appropriateness, and concept coverage, as the average scores were above 8 (benchmark pre-determined) for all modules. The readability scores also fell within the pre-determined criteria to finalize the material. CONCLUSION : This material has been adapted and validated for the Indian population, and it can now be further developed as a treatment program. This represents a significant step towards establishing standard, evidence-based tinnitus treatment protocols in India. Further studies should examine the feasibility, efficacy, and effectiveness of ICBT for the Indian population through clinical trials.

Browse

Recent Submissions