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Wednesday, May 16, 2018

Having the ability to confidently communicate with patients and their families is critical in any health care setting. But do audiologists suffer from a collective self-doubt? At the 2018 American Academy of Audiology annual conference in Nashville, TN, The Hearing Journal spoke with D’Anne Rudden, AuD, who led a conference session on the science behind confidence issues and explored potential fixes (spoiler alert: there’s no quick fix!) that may help boost one's self-esteem. Read on—with confidence!
Hearing Journal: Dr. Rudden, can you give us some context of the perceived confidence gap in audiology?
rudden.jpgD’Anne Rudden, AuD: We're a profession primarily of women, and because women tend to have underconfidence in themselves, as shown by statistics, it would be a great opportunity to speak to the vast majority in our profession—without leaving men out. Men tend to have the opposite issue, so you can kind of speak to the gap, not only between having and not having confidence but the gap that sometimes exists between male and female audiologists in general. We often lack confidence in general as a profession, so we need to talk about how we can change our mindset and the direction we want to take audiology in the future. 
One of the interesting statistics that I think about a lot is that success correlates more highly with confidence than competence—and it kind of blows your mind. 
Hearing Journal: In what specific area(s) have you seen this confidence gap manifest in audiology?
One thing that comes to mind is when mentoring audiology students. They come in with skills that they try to put into practice. But I've been noticing that many of these students miss some of the basics—how they can use their knowledge in a meaningful way. They sometimes put themselves in a place of not showing up as the expert. They lack confidence in presenting test results and recommendations, and I see that patients are not exhibiting any trust. If we're going to show up in the world, especially in light of people being able to buy things over the counter, we need to have an even stronger belief in ourselves and in what we bring to the table.
Hearing Journal: Do you think the advent of over-the-counter hearing aids is affecting/has affected this issue with self-confidence among audiologists?
Anytime change happens, there’s always this potential for one to feel like he or she is being attacked or to create stories to stabilize what one’ thinks will happen in the future. Audiology is always in this really interesting place in health care where we certainly have the expertise but we don't always have a seat in the health care table as we would want. There is an inherent gap between where we are and where we want to be. So it’s important to realize that we don't have to stay in this gap; that we can overcome that gap.
Hearing Journal: What are some practical strategies to address this confidence gap?
There's no way to go around it but through practice. There are some things that can be done to work on it—things that I've worked on myself. In this alchemy of confidence—how to create transformation in your confidence—the first step is simple awareness: being aware, without judgment, of what's going on and how it plays into how you show up to the world; being willing to dig a little deeper into some of your fears; and then being able to flip the script and practice putting yourself out there.
For example, do the power pose, wonder woman pose, or CEO pose. Putting yourself in that physical shape and breathing deeply can change your limbic system's response. Your fight, flight, or freeze response can shift in relationship to your physical shape and how you breathe into that particular shape.
We have all of the skills. It's just a matter of creating the condition for confidence to show. As hearing care professionals, we're here for each other. So let's have each other's backs and work together to move the profession forward in a confident manner. 

Dr. Rudden is the owner of Longmont Hearing and Tinnitus Center in Longmont, CO. 

Monday, May 7, 2018

By Raymond H. Hull, PhD

midnfullness.JPGThe fast- paced lives that we live in our profession can result in a loss of the focus and concentration that is essential for a successful day at work serving our patients. We desire to serve our patients well, but sometimes we arrive at our office with a clear plan for the day, and then in what seems to be only a few moments, we are on our way back home wondering where the day went! Did I treat my patients well? Were they satisfied with the services that I provided? Is everything logged into their files properly? When we are on auto-pilot for much of the day, we often wonder if everything was done correctly and we treated our patients well. But maybe we need to slow down and practice an art that is becoming quite popular in the worlds of business, health care, and others. It's called "mindfulness." 

Recently, I have been hearing a great deal about the art of mindfulness. I was skeptical at first, thinking that it that it was perhaps something that only the 1960s hippies engaged in. However, I am finding that the topic of mindfulness has made it into many current publications including the news, and it is something that professionals are living by with greater frequency.   

 According to Carolyn Gregoire in the article "13 Things Mindful People Do Differently Each Day," the reason that the subject of mindfulness is becoming so popular is that the public is looking for something to combat stress and burnout, technology addition and the constant non-constructive "busyness" that they find themselves caught up in each day (Huffingtonpost, 2017). So, what is involved in living mindfully in our everyday work lives?

 Here are a few:

 1. For example, Hougaard and Carter wrote about "an affliction that touches nearly all of us: email addiction" (HBR, 2016). They state that emails have a way of seducing our attention and redirecting it to lower priority tasks. The reason? Because completing small, quickly accomplished tasks releases dopamine, a pleasurable hormone in our brains. This release can addict us to email, compromising our concentration. If we are "mindful" when we open our mailbox, we can focus on contents that are important, and avoid those that are trash. In fact, they suggest that a better way to start the day is to not check our emails at all first thing in the morning. Avoiding our emails will help us sidestep an onslaught of distractions and short-term problems during a period of time that could be used for focus and creativity.

 2. Work to become a more creative professional. In order to tap into our creativity, our wisdom, our ability to connect with what we really value, we should strive to become a more mindful person. How do we do that? Go for a walk. Mindful people know that simply going for a walk can be an excellent way of calming the mind, gaining a new perspective regarding the tasks that we must complete in our chosen profession, while allowing us to reflect on problems and gain new solutions for solving them.

3. Mindfulness and creativity go hand-in-hand, Gregoire continues. Mindfulness practice boosts creative thinking. A quiet state of mindfulness, according to David Lynch (2007) in Catching the Big Fish helps to gain access to our most creative state of mind. If you want to become more mindful, but are struggling to do so, try engaging in a few moments of quiet distraction. It could be a moment of silent relaxation while sitting at your desk—eyes closed.  When I am working at my computer and have a mental block, I leave my computer on and walk down our long hallway to the window at the far end. There, I spend a few moments looking at the trees, the sky and the clouds. When I return to my computer, I am amazed at the change in my ability to concentrate on the task at hand and my level of creativity.

4. I hear people bragging about their ability to multitask. According to Gregoire, multitasking is an enemy to productivity (Huffingtonpost, 2017). It keeps us from fully concentrating on tasks that are the most important ones. Research has shown that when our attention is divided between several tasks that we are trying to complete, it takes 50 percent longer to complete the original task, and we are 40 percent more likely to make errors. Rather than dividing our attention, it is more productive to take frequent breaks between periods of work on a single task, thus my walk down our long hallway. By attending to one single task until its completion, we stand a better chance of completing it correctly.

5. Lastly, mindful people have a healthy relationship with their mobile devices. They know when to look at it, and when to put it away so as to not be distracted. They stow their device away when they are attending to important tasks, and particularly when they are communicating with their patients or colleagues!

Finally, one more thing from Hougaard and Carter: When you get to work in the morning, take 10 minutes at your desk or in your car before you begin your day's activities (HBR, 2016). Close your eyes, relax, sit upright and place your focus on your breathing. During this time your attention is all your own, not on the tasks that are facing you. It will help to increase your focus. According to those authors, focus and awareness are key since focus is the ability to concentrate on tasks at hand, and awareness is the ability to recognize and release distractions.

Try the art of mindfulness in your professional life, and you will be amazed at what it can do for you.

Author information: Dr. Hull is a professor of communication sciences and disorders, and the coordinator of the Doctor of Audiology Program at Wichita State University in Wichita, KS. He has published books on rehabilitative audiology and interpersonal communication.

Wednesday, March 7, 2018

By Chun-Yi Lin, and Kuei-Ju Lin
Anyone with no experience with hearing loss may not know exactly how a child’s hearing is affected, what makes hearing easier, or how to get along with the hearing-impaired individuals. However, as long as we are willing to understand the facts about hearing loss, each of us can assist in improving the lives of people with hearing loss.  

Hearing loss ≠ myopia: Patients with these conditions need to wear assistive technology, but the aided performances are quite different!
"You cannot hear me even when I am next to you?" The teacher asked Huang (an 8-year-old boy who wears bilateral hearing aids) with sarcastic voices in front of all the classmates. The teacher apparently believes that Huang has been wearing hearing aids, and he should be able to hear well like a normal-hearing person. Therefore, the teacher refused to wear FM system in class. Huang was frightened by the scenes of chaos and he refused to go to school again.
Hearing loss is often compared to myopia (shortsightedness), in that hearing aids (HAs) and cochlear implants (CIs), like glasses, can correct sensory function. However, this comparison often leads to misunderstanding of hearing impairment; corrected hearing is not always the same as corrected vision. Particularly, hearing-impaired people sometimes have difficulty achieving fluent communication because of environmental sounds, reverberation, and sounds coming from varying distances, to cite a few (Fleming, Giordano, Caldara & Belin, 2014).
Even if the HA or CI is adjusted appropriately, these devices are still not the same as the normal-functioning ears. The individual differences and learning demands of hearing-impaired listeners are not simply measured or predicted in decibels.
“Hearing” ≠ “listening clearly” ≠ “comprehending” or “communicating”
“My child had already worn his hearing aids, why he cannot understand my words?” a mother asked, and she thought her child should understand everything she said.
“When my student wears hearing aids, he seems aware I am talking to him, but he still cannot give me the correct answer for what I am asking. Are the hearing aids useful?” A teacher wonders.
HAs or CIs adjustments mainly depend on the individual's detection of sounds. However, the ability to hear is not the same as hearing clearly. For example, when a person with hearing impairment can hear the words “white” and “wine” at 50 dB HL, he or she cannot necessarily distinguish these two words correctly at 50 dB HL. That’s why, we can observe some children to be able to detect sounds but unable to identify the right word/s spoken.
Comprehension is the reception of information, meaning, and intent, and communication is the two-way transfer of meaningful information (Kiessling et al., 2003). Although daily communication seems straightforward, people with hearing loss need to grapple with many factors like the effectiveness of HAs or CIs, their hearing and speech abilities, a speaker's accent, intelligibility, rate of speech, and noise and distance, which can make communication more challenging (Howell, 2008; Kilman, Zekveld, Hällgren & Rönnberg, 2014).
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Hearing voices and listening to the messages they convey clearly are the basic elements of comprehension and communication (as shown in Fig. 1). For instance, in school, if a student says "fidget spinner" to a hearing-impaired child, words that the latter may have never heard before, the hearing-impaired child may have trouble communicating because he or she does not comprehend the meaning of the words.
Language develops quickly and many new vocabularies emerge in our daily lives. Listening clearly is never enough for hearing-impaired people. The essential step is to comprehend the meaning of the content. Building up a two-way communication requires that the speaker and the listener both understand their conversation content. Thus, it’s vital to make sure that people with hearing loss could communicate with others by expressing thoughts and feelings that they deem important.  

Hearing level cannot fully represent hearing performance
“You are severe hearing loss, and your senior has the same hearing level as you do. If he can pass the English listening exam, so do you.” An undergraduate student encountered the difficulties of listening to the electrical signals of listening exam. He wishes he could apply for the exemption for examination. However, the school teacher believed that if the senior student who has the same hearing level could participate and pass the exam, this undergraduate is no exception without questioning.
Even two people with the same hearing level might have different learning and hearing needs. For example, student A and B both have average hearing threshold at 60 dB HL. Their teacher may expect for them to hear at same levels. However, student A has hearing threshold at 60 dB HL in three different frequencies (500 Hz, 1k Hz, and 2k Hz). On the other hand, student B has hearing threshold at 30 dB HL for 500 Hz, 60 dB HL for 1k Hz, and 90 dB HL for 2k Hz. To compare with student A, the student B’s high frequency is apparently poorer, but the low frequency is better. Consequently, we should be aware the student B may have more difficulties in perceive high frequency sounds (e.g., /s, sh, f, t/ etc.), and hearing level cannot fully represent hearing performance. So, it is recommended to always consider the hearing thresholds at different frequencies when providing hearing rehabilitation goals.
Every individual is unique, but there is one thing we all have in common: we all want to be treated with respect. We can show our respect for people with hearing loss by breaking down the myths and preconceived ideas to better understand their unique challenges.

Author information: Chun-Yi Lin is an audiologist at the Children’s Hearing Foundation in Taiwan, where Kuei-Ju Lin is assistant research fellow while working as a primary school teacher. Both are completing their PhD in Special Education.   
Edwards, A. (2016). The difference between “normal” hearing vs hearing with hearing aids. Retrieved from: normal-hearing-or-hearing-loss.
Fleming, D., Giordano, B. L., Caldara, R., & Belin, P. (2014). A language-familiarity effect for speaker discrimination without comprehension. Proceedings of the National Academy of Sciences of the United States of America, 111(38), 13795-13798. doi: 10.1073/pnas.1401383111
Howell, P. (2008). Effect of speaking environment on speech production and perception. Journal of the Human-Environment System, 11(1), 51–57.
Kaland, M., & Salvatore, K. (2002). The psychology of hearing loss. The ASHA Leader, 7(5), 4–15.
Kiessling. J., Pichora-Fuller, M. K., Gatehouse, S., Stephens, D., Arlinger. S., Chisholm, T. H., Davis, A. C., Erber, N. P., Hickson, L., Holmes, A. E., Rosenhall, U., von Wedel, H. (2003). Candidature for and delivery of audiological services: special needs of older people. International Journal of Audiology, 42(2), 92–101.
Kilman, L., Zekveld, A., Hällgren, M., & Rönnberg, J. (2014). The influence of non-native language proficiency on speech perception performance. Frontiers in Psychology, 5, 651. doi:  10.3389/fpsyg.2014.00651
Lederberg, A. R., & Golbach, T. (2002). Parenting stress and social support in hearing mothers of deaf and hearing children: A longitudinal study. The journal of Deaf Studies and Deaf Education, 7(4), 330-345. doi:
Tye-Murray, N. (2015). Foundations of aural rehabilitation: children, adults, and their family members: 4th Edition. Clifton Park, NY: Delmar Cengage Learning.

Wednesday, March 7, 2018

​Missed our #HearingChat on World Hearing Day 2018? We've got you covered! Check out this recap of our lively conversation with ​Barbara Kelley, Executive Director of  the Hearing Loss Association of America (HLAA), and Clifford Olson, AuD, of  Applied Hearing Solutions​ and host of The Hearing Journal’s upcoming podcast. Click here

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Thursday, February 22, 2018

Enjoyed our February cover story about athletes with hearing loss? You might want to check out these inspiring books as well.


Longshot: The Adventures of a Deaf Fundamentalist Mormon kid 
and his Journey to the NBA
by Lance Allred (basketball )


Catch a Star: Shining Through Adversity to Become a Champion 
by Tamika Catchings (basketball) with Ken Petersen


No Excuses: Growing Up Deaf and Achieving Super Bowl Dreams 
by Derrick Coleman (football)


Kicking Up Dirt: A True Story of Determination, Deafness, and Daring 
by Ashley Fiolek (motocross) with Caroline Ryder


In Quest of Gold: The Jim Ryun Story 
by Jim Ryun (track) with Mike Phillips


A Reason to Believe: The Blaise Winter Story 
by Blaise Winter (football)