Academic journal article The Volta Review

A Qualitative Analysis of Auditory Rehabilitation for Adults with Cochlear Implants

Academic journal article The Volta Review

A Qualitative Analysis of Auditory Rehabilitation for Adults with Cochlear Implants

Article excerpt

INTRODUCTION

In 2001, the International Classification of Functioning, Disability, and Health (ICF) was developed by the World Health Organization (WHO; 2001). A unique facet of the ICF was the goal of looking at a variety of factors influencing the quality of life for individuals with hearing loss, rather than mainly focusing on fitting individuals with hearing technology. A conceptual framework was developed by the ICF to include the following: health condition, body function and body structure, activity, participation, environmental factors, and personal factors. In 2007, Hickson, Worrall, and Scarinci noted "it is generally conceded that hearing aid fitting alone does not meet the needs of all older people with hearing impairment [sic]" (p. 212). Research supporting this notion has also identified a shortcoming of the ICF's conceptual framework to be its minimal focus on the inclusion of the family members and communication partners of people with hearing loss (Laplante-Lévesque, Hickson, & Worrall, 2010; Scarinci, Worrall, & Hickson, 2009).

In 2018, the WHO reported that hearing loss costs $750 billion dollars globally each year and recommended interventions to assess, identify, and treat hearing loss through cost-effective means without compromising quality of service (WHO, 2018). The American Speech-Language-Hearing Association (2017) reports the number of Americans with hearing loss has doubled in the last 30 years. The National Institute on Deafness and Other Communication Disorders (NIDCD; 2016) reports "about 2 percent of adults aged 45 to 54 have disabling hearing loss. The rate increases to 8.5 percent for adults aged 55 to 64. Nearly 25 percent of those age 65 to 74 and 50 percent of those who are 75 and older have disabling hearing loss." Adults with hearing loss who are no longer able to benefit from hearing aids may consider cochlear implants as a viable hearing technology. Lin, Thorpe, Gordon-Salant, and Ferrucci (2011) determined that around 150,000 older adults would potentially benefit from cochlear implants in the United States given their identified hearing loss. As of 2012, only 58,000 cochlear implants devices had been registered as being provided to adults (NIDCD, 2017). It is reasonable to postulate that the number of cochlear implants for adults in the United States has increased significantly in recent years. Research has suggested that older adults can improve speech perception and auditory skills through the use of a cochlear implant despite having an aging brain (Dillon et al., 2013; Lenarz, Sönmez, Joseph, Büchner, & Lenarz, 2012). Additionally, improved access to sound through cochlear implants has been shown to improve the quality of life for older adults (Vermeire, Brokx, Wuyts, Cochet, Hofkens, & Van de Heyning, 2005).

Auditory (Aural) rehabilitation is defined as an "intervention aimed at minimizing and alleviating the communication difficulties associated with hearing loss" (Tye-Murray, 2015, p. 3). It is a well-established intervention to improve listening and spoken language skills in individuals who utilize hearing aids (Boothroyd, 2007; Hickson et al., 2007); however, there is little qualitative evidence to support its use with adults who utilize cochlear implants. The use of options for service provision within this intervention (e.g., face-to-face intervention, individual practice, group practice) when working with adult recipients of cochlear implants has been quantitatively studied with varying degrees of success documented (Bernstein et al., 2012; Boothroyd, 2010; Oba, Galvin, & Fu, 2013; Plant, Bernstein, & Levitt, 2015). One of the many goals of auditory rehabilitation is to teach the individual with hearing loss communication repair strategies to help them better navigate conversations when there is a communication breakdown. Since a spouse is often a primary support person, it is not a stretch to postulate that many communication breakdowns often happen within the context of this relationship and therefore a need to teach the spouse communication repair strategies would be advantageous. …

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