Utah program helps deaf babies to hear

SALT LAKE CITY — When Genevieve “Evie” Shawcroft came into the world just over a year ago, she likely didn’t hear much of what was going on.

The sandy-haired, blue-eyed baby girl was born with mild-to-moderate hearing loss, giving her what doctors said was little chance of normal development without the help of hearing aids.

But the estimated $ 3,000 to $ 5,000 cost for the unexpected equipment and additional doctor visits was almost more to bear than the diagnosis itself, said Evie’s mom, Ashley Shawcroft.

The Tooele family had already endured mounting medical bills and was making payments on a high insurance deductible resulting from an accidental injury earlier that same year. And, as with many insurance plans, hearing aids aren’t a covered benefit.

“All of a sudden you have a brand new baby and then this diagnosis, and I was worried about that, but the financial costs, too, it was a lot to worry about,” Shawcroft, a registered nurse, said.

She began scrambling for available resources and possible charity programs to help their cause, and came across a Deseret News article about a relatively new Children’s Hearing Aid Pilot Program, which was approved by Utah lawmakers in 2013 and is enrolling children up to age 3 for free hearing aids.

Evie had failed the newborn hearing screening and two follow-up tests after that. It remains unknown what caused her hearing loss, but she fit the bill for the state program and was approved with a set of hearing aids at about 8 months old.

Up to that point, she had been fortunate enough to use a pair on loan from her audiologist.

“You need to hear sounds to be able to acquire speech and language and speech and language are the basis for communication for many people,” said Dr. Stephanie McVicar, a certified audiologist and director of early hearing detection and intervention for the Utah Department of Health, which oversees the program. “Without speech and language, it isolates the children and really limits them socially and in their learning abilities.”

She said the sooner the auditory system gets stimulation — by hearing sounds — the better and more ready the system is for speech and language.

“If you miss this window, you are always playing catch-up and the child may never have clear speech,” McVicar said. “Children need to hear words thousands of times before they can process those sounds, before they can say them and put them into words and then recognize them in written form.”

The Children’s Hearing Aid Pilot Program is nearly halfway through its two-year trial period and has placed 29 hearing aids on 19 Utah children, including little Evie.

The help came at the right time. “It was such a relief,” Shawcroft said.

Without the program, she said, the family would have had to pay with a credit card, because they couldn’t stand in the way of their daughter’s development.

“It’s very hard when you get that diagnosis, it’s just a shock and it kind of rocks your world,” Shawcroft said. “I remember a phase where we were banging pots and pans and waiting for her to blink to tell us she heard something.”

The now-toddler is walking and communicating at her level, saying her dog’s name, “Mom” and “Dad,” and “cracker.” She’s learning a bit of American Sign Language and her two older sisters are picking it up as well.

“The whole family is learning,” Shawcroft said, adding that she’s seeking support from other parents with deaf infants and participating in other interventional programs the state offers through the Utah Schools for the Deaf and Blind, which conducts home visits and periodic assessments with deaf children in the state.

“In the back of my mind, there’s always this worry that she’s not developing normally. I just wonder if we are on par with other kids,” she said.

But Evie, she said, is “doing very well. She seems like a very happy little girl.”

Eligibility for the program is based on a family’s gross income, up to 300 percent of the federal poverty level, and children on Medicaid are not eligible, as Medicaid covers the cost of hearing aids for kids.

The program targets babies and children up to age 3, as that is the most critical time period for language development.

McVicar said there are about 100 babies born with hearing loss each year in Utah and others develop late-onset hearing loss later in life from underlying conditions or illnesses that occur.

Worldwide, deaf babies are often termed “million-dollar babies,” as anticipated lifetime care costs could reach that high, McVicar said.

Rep. Rhonda Menlove, R-Payson, said it is “an expensive process for families, at a time when their earning power is at its least.”

Menlove successfully sponsored another hearing-related bill, dealing with cytomegalovirus, which can cause hearing loss in children and did in her own granddaughter, who now wears cochlear implants and is working hard to keep pace with her peers.

A portion of the $ 100,000 allocated for the program has already helped kids from 22 cities within the state at seven participating clinics, but it is well within its budget, as the devices are less expensive than initially anticipated. The result is an increased opportunity to help more children in need, McVicar told the state’s Health and Human Services Interim Committee on Wednesday.

She is ramping up outreach and promotion of the program, including information in packets mailed to families of infants who fail the newborn hearing screening, as health worker would like to help the children who can benefit the most and at the youngest age.

“Early auditory stimulation is important or they won’t be able to catch up,” McVicar said.

Rep. Becky Edwards, R-North Salt Lake, sponsored the original bill, HB157, that created the program and is aiming to file for an extension of the mandate to keep the program going. She said she is encouraged and optimistic about its progress so far. It is slated to end in 2015 without further legislative action.

“I would hate to see it end,” Menlove said. Her colleagues on the committee agree, but some would like to see more data before making the program a permanent fixture of the Utah health landscape.

Previous charitable programs have left physicians footing their own bill for overhead costs, but this one is designed to compensate them for their time and expertise, allowing for more respect and support of the program across the industry, she said.

The state’s Hearing Aid Recycling Program is still up and running, soliciting used or broken hearing aids from residents that are then recycled and used in Utahns who need them but cannot afford the devices. The downside to it, however, McVicar said, is that patients miss out on leading technology.

So, while Evie may have been able to hear most sounds without hearing aids, they are now helping her hear small sounds like “s” and “t,” “and other sounds we take for granted,” Shawcroft said.

For more information about the program, visit health.utah.gov/CHAPP or call 801-584-8215.

“There isn’t a better time for their brains to grow and develop,” McVicar said. “It literally changes their lives to have a program like this.”

Shawcroft agrees, calling it a “tender mercy” in her child’s life, and she hopes more children and families can benefit from the program in the future.

Email: [email protected]

Twitter: wendyleonards

Article source: http://www.deseretnews.com/article/865606417/Utah-program-helps-deaf-babies-to-hear.html?pg=all

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Chronic tinnitus and pain behind Porthleven man’s suicide

Chronic tinnitus and pain behind Porthleven man’s suicide

Chronic tinnitus and pain behind Porthleven man’s suicide

Extreme pain and loss of hearing caused by chronic tinnitus led to a man taking his own life in Porthleven.

Christopher Slowikowski hanged himself in Peverell Terrace, where he was found by partner of ten years Felicity Paton, on June 26, 2011.

Mr Slowikowski, 60, lost his hearing as a child, after he contracted an ear infection.

It had deteriorated further until at the time of his death he had lost 80 per cent of his hearing and suffered from constant noise and pain from the tinnitus.

Despite that he had perfect speech, with Ms Paton saying a person “wouldn’t have known”, although it made communication “very difficult.”

He also had problems with his hand, after previously attempting to take his own life in May 2011 by cutting himself while on the street near Porthleven’s clock tower, but he was seen by a member of the public who called an ambulance.

After this attempt he tried to electrocute himself and was then seen to walk into the sea fully clothed, “wild with anger” that his attempts had failed, according to Ms Paton.

Mr Slowikowski had been under the care of Cornwall’s mental health services, but a lack of communication had led to him being discharged without being informed.

He had been referred by psychiatric liaison nurse Martin Bray, following his first suicide attempt.

Mr Bray said in a statement: “Mr Slowikowski said his intent was to die, triggered by ongoing tinnitus and separation from partner Felicity.”

Previously Ms Paton had told Mr Slowikowski that she no longer wanted to live with him, although they still remained in close contact.

Mr Slowikowksi was seen by the home treatment team and community mental health team, who had differing views.

The eventual agreement was there was no mental health problem, and it was instead a reaction to social stresses and physical health.

However, Mr Slowikowski was not informed of this decision or given advice about different organisations he could turn to.

Colin Quick, who has since become associate director of community services for Cornwall Foundation Trust, said he had carried out a serious incident review, after joining the trust, with two independent members of staff interviewing those involved.

As a result there had been a “number of action points” but he added: “They felt there was nothing from our services’ side that would have affected the outcome.”

However, he acknowledged there had been “some communication issues” between the two teams and the way referrals were dealt with had now “significantly changed.”

Ms Paton said after he attempted to slit his wrist the situation deteriorated further, as he then had problems showering and dressing.

He broke his last analogue hearing aid so could not really hear, and had broken his glasses so could not really see, plus he was in increasing pain.

“We were talking about it getting to a point that was unbearable,” she said.

However, in the days immediately preceding his death Ms Paton said there was a “new level of calmness” to Mr Slowikowski and she believed, in retrospect, this was because he had “worked out his exit from the pain.”

After finding Mr Slowikowski hanged she immediately called 999, but acknowledged: “I just knew he had chosen what he had chosen, and I had to let this be.”

He was airlifted to the Royal Cornwall Hospital and put on a ventilator, which was subsequently switched off following a short bedside visit by the hospital chaplain.

The cause of death was given as asphyxia due to hanging, with coroner Dr Barrie van den Berg recording a verdict of suicide.

He said: “It is tragic someone feels their physical condition is so bad there’s only one way out.”

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Article source: http://www.falmouthpacket.co.uk/news/11314244.Chronic_tinnitus_and_pain_behind_Porthleven_man_s_suicide/

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ACC doubles support over hearing aids

ACC doubles support over hearing aids

Updated at 4:11 pm today


The Accident Compensation Corporation is doubling its support for hearing aid clients.

Judith Collins.

Judith Collins.

Photo: RNZ

From Monday, ACC will significantly increase its contributions to the cost and repair of hearing loss devices and introduce new funding for ear moulds.

ACC Minister Judith Collins said it should encourage greater competition in the hearing aid market.

“ACC will now pay separately for the hearing consultation which means that clients will be able to shop around for the best price in hearing aids, rather than having to buy where they had the initial test. It’s important that clients have the option to look for the best price and service.”

Ms Collins said ACC and the Ministry of Health have worked closely with the hearing sector on the funding changes.

Next story in National: Rotavirus vaccine added to schedule

Article source: http://www.radionz.co.nz/news/national/248669/acc-doubles-support-over-hearing-aids

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‘Ringing in the Ears’ Alters Processing of Emotion

'Ringing in the Ears' Alters Processing of Emotion

More than 50 million Americans suffer from tinnitus, a condition that causes individuals to hear noises that are not really there.

Sounds like whooshing, train whistles, cricket noises, or whines may be heard with the severity often varying on a day to day basis.

Research has shown that tinnitus is associated with increased stress, anxiety, irritability, and depression, all of which are affiliated with the brain’s emotional processing systems.

In a new study, University of Illinois speech and hearing science professor Fatima Husain, Ph.D., investigated how the uncontrolled noises affected emotional processing with the research findings reported in the journal Brain Research.

“Obviously, when you hear annoying noises constantly that you can’t control, it may affect your emotional processing systems,” Husain said.

“But when I looked at experimental work done on tinnitus and emotional processing, especially brain imaging work, there hadn’t been much research published.”

She decided to use functional magnetic resonance imaging (fMRI) brain scans to better understand how tinnitus affects the brain’s ability to process emotions. These scans show the areas of the brain that are active in response to stimulation, based upon blood flow to those areas.

Three groups of participants were used in the study: people with mild-to-moderate hearing loss and mild tinnitus; people with mild-to-moderate hearing loss without tinnitus; and a control group of age-matched people without hearing loss or tinnitus.

Each person was put in an fMRI machine and listened to a standardized set of 30 pleasant, 30 unpleasant, and 30 emotionally neutral sounds (for example, a baby laughing, a woman screaming, and a water bottle opening).

The participants pressed a button to categorize each sound as pleasant, unpleasant, or neutral.

The tinnitus and normal-hearing groups responded more quickly to emotion-inducing sounds than to neutral sounds, while patients with hearing loss had a similar response time to each category of sound.

Over all, the tinnitus group’s reaction times were slower than the reaction times of those with normal hearing.

Activity in the amygdala, a brain region associated with emotional processing, was lower in the tinnitus and hearing-loss patients than in people with normal hearing.

Tinnitus patients also showed more activity than normal-hearing people in two other brain regions associated with emotion, the parahippocampus and the insula. The findings surprised Husain.

“We thought that because people with tinnitus constantly hear a bothersome, unpleasant stimulus, they would have an even higher amount of activity in the amygdala when hearing these sounds, but it was lesser,” she said.

“Because they’ve had to adjust to the sound, some plasticity in the brain has occurred. They have had to reduce this amygdala activity and reroute it to other parts of the brain because the amygdala cannot be active all the time due to this annoying sound.”

Because of the sheer number of people who suffer from tinnitus in the United States, a group that includes many combat veterans, Husain hopes her group’s future research will be able to increase tinnitus patients’ quality of life.

“It’s a communication issue and a quality-of-life issue,” she said.

“We want to know how we can get better in the clinical realm. Audiologists and clinicians are aware that tinnitus affects emotional aspects, too, and we want to make them aware that these effects are occurring so they can better help their patients.”

Source: University of Illinois

 
Woman with hands over her ears photo by shutterstock.

 

 

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Article source: http://psychcentral.com/news/2014/06/27/ringing-in-the-ears-alters-processing-of-emotion/71781.html

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Neuromonics Signs Reselling Agreement with AuDConnex

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Westminster, CO (PRWEB) June 25, 2014

Neuromonics, Inc., manufacturer and distributor of clinically proven tinnitus treatment devices, has signed a reseller agreement with AuDConnex.

AuDConnex will obtain special pricing, marketing and other support on all Neuromonics products for its members, according to Eula Adams, CEO of Neuromonics. The AudConnex buying group provides competitive pricing on audiology products to members, as well as training and education on practice management and advances in technology that impact the audiology industry.

“Agreements such as the one with AuDConnex allow more audiologists and hearing aid providers – and more consumers – to hear the good news about tinnitus relief,” says Adams. “AudConnex will serve as an essential partner to Neuromonics, delivering the miracle of tinnitus relief to more tinnitus sufferers.”

Neuromonics manufactures and distributes clinically proven, FDA-cleared medical devices to treat tinnitus, the condition often described as buzzing, ringing, hissing, humming, roaring, whistling or “ringing in the ears” that someone hears in the absence of any external sound. Globally, tinnitus affects an estimated 10-15 percent of the population. In the United States alone, more than 50 million people suffer from the condition, according to the American Tinnitus Association. Usually brought on by exposure to loud noise, tinnitus is especially significant in the military, with more than 34 percent of returning veterans from Iraq and Afghanistan suffering from the condition.

Neuromonics products use calming, relaxing music embedded with a neural stimulus that interacts with the tinnitus perception, explains Adams. The music engages the auditory pathways to promote neural plastic changes. Over time, these changes help the brain to filter out the tinnitus perception, reducing tinnitus disturbance and providing long-term relief from symptoms. The compact devices are simple to use, function much like familiar consumer music players, and fit easily into patients’ lifestyles.

Neuromonics, Inc. (http://www.neuromonics.com)

Based in Westminster, Colo., Neuromonics, Inc., manufactures and distributes clinically proven, FDA-cleared medical devices to treat tinnitus. The patented and clinically proven Oasis, working the Neuromonics Tinnitus Treatment, provides long-term treatment and significant relief for those with severe tinnitus. The Haven, with the ability to program and individualize hearing profiles, is a management tool offering situational relief for tinnitus symptoms. The Sanctuary, also a management tool, works with pre-programmed profiles for on-demand relief.

With research and development beginning in the early 1990s, Neuromonics has helped thousands of tinnitus sufferers improve their quality of life and overcome the daily life challenges associated with tinnitus. Today, Neuromonics provides its devices to nearly 2,000 hearing professionals on four continents, through direct relationships and reseller partners. Neuromonics news includes segments on national media including “The Doctors” and CNN.

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Article source: http://www.prweb.com/releases/2014/06/prweb11971786.htm

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Expanding services: Speech and hearing center adds audiologist

June 21, 2014

Expanding services: Speech and hearing center adds audiologist


By Phyllis Zorn, Staff Writer



Enid News and Eagle
The Enid News and Eagle


Sat Jun 21, 2014, 10:08 PM CDT

ENID, Okla. —
A local nonprofit speech and hearing center is expanding services after hiring a new audiologist with skills not previously available in the region.

Audiologist Kim Tinius joined Hedges Regional Speech and Hearing in early April, said Carmen Ball, executive director at Hedges.

Tinius comes to Enid from a privately operated audiology and speech pathology clinic in Tulsa.

“In our clinic, I’m planning to bring in cochlear implants for patients when hearing aids are not enough,” Tinius said.

According to the National Institutes of Health website, a cochlear implant is a small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing. The implant consists of an external portion that sits behind the ear, and a second portion that is surgically placed under the skin.

An implant has a microphone to pick up sound, a speech processor to select and arrange the sounds, a transmitter and receiver/simulator to convert the sounds to electric impulses, and an electrode array to send the impulses to different areas of the auditory nerve.

Implants don’t restore normal hearing, but give a representation of sounds that can help a deaf person understand speech, the NIH website reads. They can be helpful to people who lost their hearing late in life and to young children who need to acquire speech, language and social skills. For young children, intensive therapy after the implantation is required, the NIH website reads.

An ear surgeon who can do the implant, called an otologist, is in Oklahoma City, but the extensive process of mapping the auditory nerve now can be done in Enid, Tinius said.

Another new service Tinius will bring to Hedges is work with bone-anchored hearing aids.

“It’s a device in the skull that permits the transmission of sound without an ear canal,” Tinius said.

According to a study posted on the NIH National Library of Medicine website, bone-anchored hearing aids are the most reliable hearing rehabilitation available for patients born without ear canals and unable to benefit from other hearing aids.

“I had three people who came in this week that I referred on to surgeons for that,” Tinius said.

Iola Canning, team leader at the office of ENTs Dr. Jerome Dilling, Jr. and Dr. Edward Barns, said Dilling can perform cochlear implants and bone-anchored hearing aid implants locally.

Tinius also is adept at vestibular and balance testing.

“Vestibular loss is commonly associated with meningitis, cytomegalovirus, inner ear anomalies and connexin 26 mutations, among other conditions,” reads the American Speech-Language-Hearing Association website.

Tinius was drawn to the field of audiology after her son, Nate, was born. Nate, 14, has a cochlear implant.

“I come from a background of that,” Tinius said. “I am able to counsel parents on making decisions for their family’s situation.”







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Article source: http://www.enidnews.com/localnews/x1669977133/Expanding-services-Speech-and-hearing-center-adds-audiologist

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Final Word: “Best Practices” ≠ “Good-enough Practices”

Hearing Review July 2014

By Dennis Van Vliet, AuD

Best Practices. What does the term mean, and who decides what are the best practices, or the standard of care? With respect to hearing aids, there are published standards offered by professional organizations and other stakeholders. My experience with these efforts is that a group of experienced clinicians, researchers, and educators meet and develop a series of recommendations. These are offered to the professional community for peer review, and eventually published. The published standards typically are not too specific so that the document can outlive new technology and protocols that may emerge in the time following the release of the document.

The standards typically include language that the practitioner should act ethically, not harm anyone, and use the best available evidence for guidance in the approach we take clinically. The lack of specificity gives us some freedom to develop our own unique approach to patients.

What we see and hear in clinics and offices is that clinicians are typically following guidelines and what they learned in their training, with a number of common elements. Practitioners typically follow a similar path when attempting best practices, and include most of the following:

  • Evaluation. A basic need for understanding the type and extent of a patient’s hearing loss is an evaluation performed within the scope of practice of the clinician. The evaluation typically includes procedures to identify and need for medical referral, along with measures to help with any subsequent hearing aid fitting.
  • Rehabilitation-specific history with respect to the needs and concerns of the patient. Treatment plans are designed using the unique needs of the patient as a guide to develop specific recommendations to address those needs. A careful interview with the patient and any significant others helps uncover those needs.
  • Form factor and technology selection. When the treatment plan includes hearing aids or similar devices, the selection of the technology and the form factor of the hearing aids are a key part of the rehabilitation plan. The fact that form factor and technology choice have matured well beyond the small, medium, and large choices of a decade or more ago suggests that there is room for careful best practice guidelines when approaching these clinical decisions.
  • Fitting using appropriate methodology to achieve audibility, comfort, and performance goals. As technology has improved, giving us the capability to make more extensive adjustments compared to the 1970s—when earmold drilling and lamb’s wool in the tubing were the go-to methods—we have had to adapt our skill sets and approach to fitting. Then, as now, audibility and comfort are important, but today there are other important factors to consider that affect performance.
  • Verification and validation. There’s a good deal of angst about verification and validation. Most of us report relying on a subjective response rather than following the commonly discussed best practices of objective verification of the fitting, and using a standardized validation method. That is a discussion subject for another time. I will only say that the fitting screen of your programming computer is only an estimate of what is happening in our patients’ ears. Accuracy is dependent upon acoustic parameters, which are affected by the earmold depth, residual cavity size, venting, as well as the information we enter into the computer, such as receiver gain or, in the case of a behind-the-ear (BTE) product, whether it is a thin tube or #13 tube fitting. The data on the fitting screen should be viewed as only an estimate of the signal delivered to the ear and not true verification. Similarly, payment in full for hearing aids and assurance that everything is “fine” is not validation.
  • Rehabilitation plan including coaching on behavioral changes to optimize communication, auditory skills training, and global lifestyle changes to encourage wellness and cognitive capacity. Currently, we may talk about this, but I see little evidence that we are successful in getting patients to actively engage in these efforts.
  • Ongoing follow-up and support. I think we all offer long-term support, but what are our goals, and how do we direct the follow-up to ensure optimal outcomes for our patients?

I may have asked enough questions in the list above to stimulate some introspection. If you take the time to do that, let me offer some more questions for consideration. When I ask myself what has changed in the past few years in hearing aid offerings that may change how we approach hearing aid fittings, I can think of two critical areas: 1) Wireless connectivity, and 2) The refinement of noise reduction capabilities in hearing aids.

Wireless has a high tech appeal, and brings easy-to-demonstrate benefits to specific life activities, such as telephone communication and television or video enjoyment. Do we have a protocol for selection and setup of wireless systems? Are we following up to see that patients are using them? If they are not, why not? Do we ask if the patient has a pacemaker device? We should ask that question, to ensure that we select a system that will not interfere with a pacemaker.

van vliet author box

I discussed noise reduction in last month’s Final Word. We should be developing and implementing protocols for deployment of noise reduction to ensure comfort and performance—not simply allowing defaults to dictate our fittings.

The Final Word? Best practices are in place to help guide us to provide excellent care for our patients. As we look at our daily practice, we need to remember that they are called “Best Practices” not “Good-enough Practices.”

Original citation for this article: Van Vliet D. “Best practices” ≠ “good-enough practices”. Hearing Review. 2014;21(7):50.

Article source: http://www.hearingreview.com/2014/06/final-word-best-practices-%E2%89%A0-good-enough-practices/

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