Transcript SHAV Poster Edited

VCU Aural Rehabilitation Support Group:
Connecting Adult Cochlear Implant Patients
Alison King, Jennifer Garbarini, & Haley Athey
VCU Health, Department of Audiology, Richmond, VA
Introduction
Montano and Spitzer (2014) documented that
patients enrolled in auditory rehabilitation
post-cochlear implant activation were able to
optimize their auditory comprehension and
improve their overall satisfaction. Thus, VCU
Audiology initiated a support group for adults
(aged 60-83) who had recently received their
first cochlear implant. Some participants were
long-time hearing aid wearers and continued to
wear an aid on the unimplanted ear. Others had
not worn aids in many years.
Through a grant funded by the MCVH Auxiliary,
recipients had the opportunity to participate in
five group sessions over a five month period.
They received copies of the Listening and
Communication Enhancement (LACE) computer
program for home use and the 5 Keys to
Communication Success (Jessen, 2014) book.
The group allowed new recipients to share
experiences of learning to listen with a cochlear
implant as well as enhance their auditory skills
through the use of provided materials.
Additionally, online resources were cultivated
per participant request.
Theoretical Foundations
Aural rehabilitation significantly improves
listening outcomes for individuals with hearing
loss (Sweetow & Palmer, 2005). Auditory
training programs such as Listening and
Communication Enhancement (LACE) are
supported by research as a helpful tool to
improve listening skills.
The LACE program was selected for the VCU
Audiology Aural Rehabilitation group due to the
statistically significant improvements for
trained subjects on outcome measures
(Sweetow & Palmer, 2005).
The auditory therapist and audiologists
facilitated monthly discussions for participants
regarding home use of LACE, online resources,
and other relevant topics chosen by participants.
LACE is a self-paced adaptive computer
program designed to improve listening and
communication skills.
1) Introduction and overview of LACE
5 Keys to Communication Success (Jessen, 2014)
is a educational guide created to
reduce frustrations with hearing
loss and communication. This book
targets the deconstruction of
communication breakdowns related
to hearing loss. For this reason, the
LACE program and the 5 Keys to
Communication Success were chosen.
3) Listening in noisy environments; 5 Keys to
Communication Success (Jessen, 2014)
The LACE program is available as a CD or
internet-based service and the participants
complete tasks at home. The CD version was
purchased for this grant-funded program.
Participants reported performance and gave
feedback about frustrations to the auditory
therapist through emails, phone calls, and
during support group sessions. Audiology team
support encouraged healthy communication
skills in collaboration with clinical best practice.
Program Characteristics
The MCV Hospitals Auxiliary provides support
to the VCU Medical Center’s patients, visitors
and staff through service, fundraising and other
activities. Grants are awarded yearly through a
competitive grant process within the health
system. VCU Audiology was awarded $625.00
for materials. The group met in a VCUHS facility.
Topics included:
2) Interfacing CI with accessories and listening
to music with your new technology
4) Connectivity: Tips and Tricks
5) Online Resources Review
Meeting Participant Needs
All participants expressed frustration with the
difficulty of the LACE program, regardless of
prior hearing aid use. So additional resources
were located to assist with developing auditory
discrimination and comprehension skills.
Resources were web-based programs as well as
apps commercially available for the iPad or iPod.
These included the apps Angel Sounds, AB Clix,
Continents and Oceans, and Shazam. Web-based
resources included HOPE notes and Cochlear
Adult Communication Skills. Participants also
needed multiple demonstrations re: connecting
their devices to assistive technology for aural
rehabilitation activities.
Participant Outcomes
A significant finding of this program was that the
adult cochlear implant users extolled the value of
connecting with other CI users about struggles
in communication and positive hearing
experiences. Discussions regarding cochlear
implant sound quality and acclimation of daily
life activities were held between the participants.
The following qualitative themes included
benefits of the program as well as common
concerns.
Benefits:
1) Participants valued sharing of experiences with
other CI users
2) Increase in participant satisfaction post-cochlear
implantation with the use of auditory
rehabilitation
3) Improved listening and communication skills
4) Exploration of strategies to assist with difficult
listening situations
5) Extended time with audiological staff to address
connectivity and CI troubleshooting
Concerns:
1) Initial frustration post-activation with auditory
comprehension and discrimination
2) LACE too hard for beginning listeners
3) Preference for the iPad and iPod applications
4) None of the participants were able to find the LACE
useful for the first 5 months post CI activation
5) Common listening concerns: listening in noise,
listening to music, listening to secondary sound
sources, and use of assistive listening devices
6) Connectivity was a concern among all participants
Jessen, D. (2014). Frustrated by Hearing Loss? 5 Keys to Communication
Success. Cut to the Chase Communication.
Montano, J., Spitzer, J. (2014). Adult Audiologic Rehabilitation (2nd ed.).
San Diego, California: Plural Publishing.
Sweetow, R., Henderson-Sabes, J. (2004). The case for LACE,
individualized listening and auditory communication enhancement
training. Hearing Journal, 57 (3), 32-40.
Sweetow, R., & Palmer, C. V. (2005). Efficacy of individual auditory
training in adults: A systematic review of the evidence. J Am Acad
Audiology, 16, 494-504.