American Journal of Audiology最新文献

{"title":"Clinical Prevalence and Impact of False Air-Bone Gaps in Clinical Audiometry: A Study of 1,000 Ears.","authors":"Shai Chordekar, Liron Kariv, Nir Fink","doi":"10.1044/2026_AJA-26-00029","DOIUrl":"10.1044/2026_AJA-26-00029","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate hearing loss classification depends on air-bone relationships; however, \"false\" air-bone gaps (ABGs) in sensorineural hearing loss (SNHL) frequently compromise diagnostic clarity. By shifting the focus from ABG magnitude to clinical prevalence, this study uses the prevalence of clinical ABGs (≥ 15 dB) as a primary metric to quantify diagnostic ambiguity in routine practice and to evaluate the efficacy of bone-conduction (BC) testing at frequencies where frequent false ABGs occur.</p><p><strong>Method: </strong>We retrospectively analyzed audiometric data from 1,000 ears (500 adults). The analysis focused on the prevalence of clinical ABGs and ABG magnitudes across the tested frequencies, including a secondary analysis of their relationship with hearing loss severity. The clinical utility of the 250-Hz BC threshold was evaluated by examining whether audiologists relied on an isolated 250-Hz ABG when classifying hearing loss as conductive or mixed.</p><p><strong>Results: </strong>False ABGs in SNHL were most common at 250 Hz (43.5%) and 4000 Hz (13.9%), with an increasing severity of hearing loss. Audiologists did not rely on isolated ABG at 250 Hz to classify hearing loss as conductive, as all confirmed conductive/mixed cases were detected by ABGs at other frequencies. At 4000 Hz, false ABGs were intensity-dependent artifacts, mainly appearing when the air-conduction thresholds were 50 dB HL.</p><p><strong>Conclusions: </strong>False ABGs often occur at 250 and 4000 Hz. Routine 250-Hz BC testing is unnecessary for most adults and lacks diagnostic value. Focusing on the 500- to 4000-Hz range and using the cross-check principle for 4000-Hz high-intensity thresholds will improve accuracy and efficiency.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"893-902"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrotemporal Features in Identifying Environmental Sounds: A Scoping Review.","authors":"Megha Sasidharan, Rashmi J Bhat, Kishan Madikeri Mohan","doi":"10.1044/2026_AJA-25-00327","DOIUrl":"10.1044/2026_AJA-25-00327","url":null,"abstract":"<p><strong>Objective: </strong>Environmental sounds are important in our day-to-day auditory experiences. Acoustic properties of sounds help listeners identify and interpret them. Understanding the spectrotemporal features of the environmental sounds is valuable for designing auditory devices and interventions, especially for individuals with hearing impairments. This article aimed to understand the role of spectrotemporal information in the perception of environmental sounds.</p><p><strong>Design: </strong>A literature search was carried out using five electronic databases, including Cochrane Library, Scopus, Web of Science, PubMed, and CINAHL. Key words broadly representing environmental sounds and spectrotemporal features were used. A quality assessment tool for systematic reviews and meta-analyses (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), developed by the National Institutes of Health (Study Quality Assessment Tools), was used for this process.</p><p><strong>Results: </strong>A total of 14 studies that explored the role of either temporal or spectral features or both in environmental sound perception were identified. The combination of spectral measures (such as harmonicity, spectral centroid, spectral velocity, and resolution) and temporal measures (such as duration, envelope, rhythm, and onset time) provides the auditory system with the necessary information to infer the physical properties and actions of sound-producing sources. The most informative frequency range for environmental sound identification was found to be 1200-2400 Hz, comparable to the critical frequency regions of speech.</p><p><strong>Conclusions: </strong>This scoping review indicates that spectrotemporal features of environmental sounds play a significant role in auditory perception. The review also reveals substantial heterogeneity in study methodologies, thereby making it difficult to generalize. However, the specific features identified in this review may be useful for aural rehabilitation in individuals with hearing disorders.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1178-1195"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative Ranges for Auditory Brainstem Response Wave I Amplitude: A Potential Diagnostic Indicator of Cochlear Deafferentation.","authors":"Sean D Kampel, Garnett P McMillan, Anne E Heassler, Nicole K Whittle, Haley A Szabo, Naomi F Bramhall","doi":"10.1044/2026_AJA-25-00296","DOIUrl":"10.1044/2026_AJA-25-00296","url":null,"abstract":"<p><strong>Purpose: </strong>While cochlear synaptopathy has limited impact on auditory thresholds, there is increasing evidence that cochlear deafferentation is associated with auditory perceptual deficits. However, there is currently no means for diagnosing synaptopathy or deafferentation in individual patients. The objectives of this study were to establish normative ranges for auditory brainstem response (ABR) Wave I amplitude, a measure sensitive to synaptopathy in animals, in a population at low risk for cochlear deafferentation and then compare a population at high risk for deafferentation to the normative ranges.</p><p><strong>Method: </strong>The low-risk sample consisted of 169 non-Veteran young adults with normal audiograms, minimal self-reported noise exposure history, and no auditory complaints (tinnitus, decreased sound tolerance, or speech perception in noise difficulty). ABR Wave I amplitude normative ranges were generated for 2, 4, and 8 kHz tonebursts and were statistically adjusted for sex and average distortion product otoacoustic emission (DPOAE) levels. Ninety-one military Veterans with normal audiograms and at least one auditory complaint were included in the high-risk comparison sample.</p><p><strong>Results: </strong>While the DPOAE-adjusted ABR normative ranges were effective at distinguishing between the low- and high-risk samples, the results also indicated that adjusting the ABR normative ranges for outer hair cell dysfunction may not be necessary and could be problematic. ABR normative ranges that were adjusted only for sex were able to differentiate between the low- and high-risk samples, with 51% of the high-risk sample falling below the normative ranges for a 105 dB peak equivalent sound pressure level 8-kHz toneburst.</p><p><strong>Conclusion: </strong>In patients with normal audiograms, sex-specific ABR Wave I amplitude normative ranges can be used by clinicians to identify patients with high degrees of cochlear deafferentation.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1088-1101"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of the Hearing Aid Step-Counting Feature in Active Older Adults.","authors":"Mohamed Rahme, Paula Folkeard, Abigail Naus, Susan Scollie","doi":"10.1044/2026_AJA-25-00290","DOIUrl":"10.1044/2026_AJA-25-00290","url":null,"abstract":"<p><strong>Purpose: </strong>The use of hearing aid-based step counting may offer objective measurement of activity, but there is little published literature on the perspectives of older adult users in using this feature. The purpose of this study was to qualitatively describe the experiences and motivation for using a hearing aid step-counting feature in a sample of active older adults.</p><p><strong>Method: </strong>A prospective qualitative research design was employed with the use of focus groups with active older adult participants who were fitted with hearing aids with a step-counting feature. Twelve older adults with hearing loss (age range: 64-88 years) were recruited in this study. Half of the participants were experienced hearing aid users. Participants were recruited from two physical activity groups with varying intensity levels.</p><p><strong>Results: </strong>The majority of participants were physically active and had prior experience using step-counting features on alternative devices. Major themes were Goal Setting and Health Monitoring, Device Use, and Movement and Motivation Factors. Background experiences and individual perspectives related to the reasons and motivations for using hearing aids for monitoring daily step count were the major subthemes.</p><p><strong>Conclusions: </strong>Participants who engaged in light-intensity physical activity were more likely to be motivated to monitor daily step count using the hearing aids. Participants' perspectives on the reason for motivation varied between cursory monitoring to stay consistently active and striving to meet a daily step objective.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32159181.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"857-867"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Envelope Following Response Normative Ranges for Diagnosing Cochlear Deafferentation.","authors":"Anne E Heassler, Garnett P McMillan, Sean D Kampel, Nicole K Whittle, Haley A Szabo, Sarah Verhulst, Brad N Buran, Naomi F Bramhall","doi":"10.1044/2026_AJA-25-00277","DOIUrl":"10.1044/2026_AJA-25-00277","url":null,"abstract":"<p><strong>Purpose: </strong>The lack of a means to diagnose cochlear synaptopathy, a type of cochlear deafferentation, prevents clinicians from identifying patients with this auditory deficit and providing them with appropriate treatments. The envelope following response (EFR) has potential as a diagnostic indicator of deafferentation. However, it is not clear what constitutes an abnormal EFR. The objectives of this study were to establish normative ranges for EFR magnitude in a population at low risk for cochlear synaptopathy and then compare EFRs from a population at high risk for synaptopathy to those normative ranges.</p><p><strong>Method: </strong>The low-risk sample consisted of young adults with normal audiograms, minimal reported lifetime noise exposure, and no auditory complaints. Normative ranges were generated using rectangular amplitude-modulated (RAM) or sinusoidal amplitude-modulated EFR stimuli and were adjusted for sex and distortion product otoacoustic emission (DPOAE) levels. The high-risk sample consisted of military Veterans with normal audiograms who reported at least one auditory complaint (tinnitus, decreased sound tolerance, or speech-in-noise difficulty).</p><p><strong>Results: </strong>The RAM EFR normative ranges for a 4-kHz carrier resulted in the biggest separation of the low- and high-risk samples, with 31%-34% of Veterans falling below the lower bound of the normative range. There were no consistent effects of DPOAE adjustment on the normative ranges across sex and stimulus condition, and computational modeling suggests that adjusting for DPOAEs may not be necessary in individuals with normal audiograms.</p><p><strong>Conclusion: </strong>EFR normative ranges for the 4-kHz RAM EFR will allow for the clinical identification of patients with normal audiograms who may have significant degrees of cochlear deafferentation.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32347524.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"903-918"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss Perceptions in Patients With Subjective Asymmetry: Analysis and Implications.","authors":"Aaron Tucker, Andrew Belilos, Pavan S Krishnan, Arman Saeedi, Mihai A Bentan, Sarah Gills, Daniel H Coelho","doi":"10.1044/2026_AJA-25-00291","DOIUrl":"10.1044/2026_AJA-25-00291","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the accuracy of self-reported hearing asymmetry in predicting objectively defined asymmetric hearing loss (AHL) and identify patient factors associated with over- or underestimation of individual ear hearing loss severity.</p><p><strong>Method: </strong>A cross-sectional survey analysis of consecutive adult patients undergoing audiometric evaluation was conducted at the audiology and otology/neurotology clinics of a single tertiary referral center from 2020 to 2025. Fifty patients reporting hearing asymmetry who had not undergone prior audiometric testing within 5 years were included. A survey was administered to quantify subjective individual ear hearing loss severity before audiometric evaluation to determine the accuracy of self-reported AHL (≥ 15 dB interaural difference) and subjective severity estimation for each ear.</p><p><strong>Results: </strong>Seventy percent of patients incorrectly identified AHL based on audiometric testing. Misclassification did not differ significantly according to age, sex, or race. Patients with lower (< 25 dB) or moderate (25-50 dB) binaural pure-tone averages were more likely to misclassify AHL than those with higher thresholds (> 50 dB). Sixty-two percent of patients misclassified the worse hearing ear, with a strong bias toward overestimation (94%). In contrast, 48% misclassified the better hearing ear, with a modest skew toward underestimation (58%). Across subgroups, worse hearing ears were significantly overestimated compared with better hearing ears. Patients with better binaural hearing and narrower interaural differences were more prone to worse hearing ear overestimation.</p><p><strong>Conclusions: </strong>It is likely that patients do not reliably estimate AHL corresponding to a 15-dB interaural difference. Better binaural hearing and lower interaural asymmetry were associated with poorer estimation of the worse hearing ear, underscoring the importance of audiometric confirmation in patients with preserved hearing.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1078-1087"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality-of-Life Profiles in Adults With Tinnitus.","authors":"Preeti Pandey, Hansapani Rodrigo, Megan Kruger, Eldre Beukes, De Wet Swanepoel, Anu Sharma, Gerhard Andersson, Vinaya Manchaiah","doi":"10.1044/2026_AJA-26-00095","DOIUrl":"https://doi.org/10.1044/2026_AJA-26-00095","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to characterize the multidimensional burden of tinnitus on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) moving beyond symptom severity alone.</p><p><strong>Method: </strong>A cross-sectional analysis was conducted using baseline data (<i>N</i> = 428, <i>M</i>_age = 54.9 years, 51.9% female) from several clinical trials examining the efficacy of internet-based cognitive behavioral therapy for tinnitus. Data were collected using a series of online questionnaires including demographic, audiological, and clinical variables. HRQoL was assessed using the EQ-5D-5L profile dimensions.</p><p><strong>Results: </strong>Participants primarily reported no problems with mobility (76.6%), self-care (92.5%), and usual activities (65.2%); however, pain/discomfort (33.4%) and anxiety/depression (40.2%) were the most affected EQ-5D-5L dimensions at baseline. Higher tinnitus severity was consistently associated with worse outcomes across all dimensions (<i>p</i> < .05). A 10-point increase in Tinnitus Functional Index (TFI) scores was associated with 53% and 51% higher odds of worse usual activities and anxiety/depression, respectively. Participants reporting a fully healthy EQ-5D-5L profile had substantially lower tinnitus severity compared with those with any reported problems (mean TFI: 39.0 vs. 55.3, <i>d</i> = 0.78). Cluster analyses identified a smaller subgroup with markedly poorer multidimensional health, characterized by higher tinnitus severity and greater psychological and sleep-related distress, with no significant differences in demographic or audiological characteristics between profiles.</p><p><strong>Conclusions: </strong>Tinnitus severity is associated with multidimensional reductions in HRQoL, particularly in functional activity and emotional health. The identification of a high-burden profile characterized by anxiety, depression, sleep disturbance, and activity limitation highlights the need for integrated, biopsychosocial approaches to tinnitus management.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33307416.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Self-Reported Workload and Measures of Speech Recognition in Adults Across the Lifespan.","authors":"Donghyeon Yun, Lauren K Dillard, Lois J Matthews, Judy R Dubno","doi":"10.1044/2026_AJA-25-00298","DOIUrl":"10.1044/2026_AJA-25-00298","url":null,"abstract":"<p><strong>Purpose: </strong>Listening workload may partially explain variations in speech recognition that speech audibility alone cannot capture, as increased workload can interfere with speech processing. This study aimed to investigate the association between listening workload and speech recognition in a large sample of the general population with varying ages and hearing thresholds.</p><p><strong>Method: </strong>Data from 635 participants, from a longitudinal cohort study, who completed a modified version of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) following the Northwestern University Auditory Test No. 6 (NU-6; <i>n</i> = 635), Speech Perception in Noise test (SPIN; <i>n</i> = 440), and Staggered Spondaic Word test (SSW; <i>n</i> = 455) were included. Adjusted for age, sex, and race, linear regressions models were used to examine associations between self-reported workload, defined by NASA-TLX domains of performance, effort, and frustration, with five outcomes of speech recognition, measured by the NU-6 (both adjusted and unadjusted for audibility), SPIN low-context (both adjusted and unadjusted for audibility), and SSW total percent scores.</p><p><strong>Results: </strong>In general, lower levels of self-reported workload were associated with better speech recognition scores, including for audibility-adjusted and non-audibility-adjusted speech recognition tasks and after adjustment for demographic factors.</p><p><strong>Conclusions: </strong>Findings suggest that self-reported performance, effort, and frustration ratings were associated with speech recognition in various listening conditions, with influences from reduced speech audibility and demographic factors including age, sex, and race. Thus, self-reported workload may serve as a complementary tool to provide better understanding of listening abilities of individuals with hearing loss.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32690985.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"983-993"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Anxiety Levels Affect Postural Stability?","authors":"Aysegul Zeytin Cinpolat, Oznur Yigit, Songul Aksoy","doi":"10.1044/2026_AJA-25-00226","DOIUrl":"10.1044/2026_AJA-25-00226","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the impact of individuals with different levels of anxiety on postural stability.</p><p><strong>Method: </strong>A total of 133 individuals over 18 years old participated: 44 with mild anxiety (Group I), 47 with high anxiety (Group II), and 42 in the control group. None had dizziness complaints. Anxiety levels were determined using the State Anxiety Inventory. Balance was assessed using the Modified Clinical Test of Sensory Interaction on Balance, Limits of Stability (LOS) Test, Walk Across Test, Tandem Walking Test, and Dizziness Handicap Inventory.</p><p><strong>Results: </strong>The study identified significant differences in LOS parameters across anxiety levels. The mild anxiety group demonstrated a reduced right lateral maximum excursion compared to the control group (99.50% ± 5.64% vs. 95.02% ± 8.21%), corresponding to a mean difference of 4.48% (<i>p</i> = .010). Posterior maximum excursion was also significantly lower in both the mild and high anxiety groups relative to controls. The mild anxiety group showed a mean value of 53.97% ± 15.41% versus 64.00% ± 16.05% in controls, yielding a mean difference of 10.03% (<i>p</i> = .006). Similarly, the high anxiety group exhibited a posterior excursion of 53.12% ± 15.82%, with a mean difference of 10.88% from controls (<i>p</i> = .004). These findings indicate that participants with higher anxiety levels demonstrated lower stability limits, particularly in the lateral and posterior directions.</p><p><strong>Conclusion: </strong>Anxiety appears to negatively affect maximum excursion values in the LOS Test, suggesting an association between anxiety level and postural control.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"936-944"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of Audiologists' Clinical Practice Patterns and Perceptions of Electrophysiological Assessments.","authors":"Kelsey Mankel, Caitlin N Price, Allie Austin, Mira Milman","doi":"10.1044/2026_AJA-25-00334","DOIUrl":"10.1044/2026_AJA-25-00334","url":null,"abstract":"<p><strong>Purpose: </strong>Electrophysiological assessments in audiology are used for neurodiagnostic evaluations, newborn hearing screenings, and estimating auditory thresholds when behavioral responses are unobtainable or unreliable. Nonetheless, evidence suggests that many electrophysiological tools remain underutilized. This study examined current practice patterns, perceptions, and barriers related to electrophysiological testing among audiologists in the United States.</p><p><strong>Method: </strong>An online survey distributed between January and April 2025 yielded 220 eligible responses. Participants answered questions specific to their patient population (i.e., <i>n</i> = 178 regarding adult patients, <i>n</i> = 174 for pediatric patients) to examine potential differences in utilization and perspectives.</p><p><strong>Results: </strong>Nearly 60% of audiologists working with pediatric populations reported using electrophysiological techniques at least monthly compared to approximately 40% of those working with adults. Across specific tests, auditory brainstem response testing was the most frequently used for both populations, followed by electrocochleography and vestibular evoked myogenic potentials. Most respondents rated electrophysiological assessments as very or quite useful and beneficial for at least some or most patient cases. Key barriers included lack of time, financial limitations related to equipment and reimbursement, and population-specific challenges (pediatric populations: setup or recording difficulties including patient cooperation, noise, etc.; adult populations: limited perceived clinical relevance of electrophysiological techniques).</p><p><strong>Conclusions: </strong>These findings underscore both the recognized value of electrophysiological assessments as well as the practical, perceptual, and financial barriers restricting broader implementation. Addressing these challenges at individual, institutional, and national levels may support fuller scope-of-practice adoption and enhance patient care across the field.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.33043112.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"1060-1077"},"PeriodicalIF":1.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}