CAA 2026 Agenda

Description:

The Pre-Conference program will provide audiology professionals with an in-depth exploration of contemporary approaches to cochlear implant management, emphasizing programming optimization, individualized patient care, and outcomes-focused clinical practices. Through expert-led presentations and multidisciplinary perspectives, participants will examine strategies to enhance cochlear implant performance, address the unique needs of implant recipients across the continuum of care, and integrate patient and professional perspectives into clinical decision-making. Designed for practicing audiologists and hearing healthcare professionals, this continuing education session offers practical insights and evidence-based approaches to support excellence in cochlear implant care.

Level of Instruction: Intermediate to Advanced 

Description:

As audiologists, we increasingly recognize that age-related hearing loss is not solely a peripheral phenomenon. Presbycusis reflects complex interactions among cochlear pathology, central auditory processing, cognitive resources, and lived linguistic experience. A holistic understanding of aging and hearing is essential to improve assessment and rehabilitation outcomes in older adults.

My research examines speech perception in aging using both behavioral and electrophysiological approaches to better characterize these interacting systems. We recorded sensory obligatory cortical responses (P1–N1–P2 complex) and the speech-specific mismatch negativity (MMN), an objective marker of automatic speech discrimination, in younger and older adults. Older adults demonstrated reduced P1–N1–P2 amplitudes, suggesting age-related changes in early cortical encoding. However, MMN amplitudes were relatively preserved compared to younger adults, though waveform morphology was poorer, particularly over frontal regions. This pattern suggests that while basic cortical responsiveness declines with age, some automatic speech discrimination mechanisms may be maintained, albeit with reduced neural efficiency. These findings reinforce that age-related decline extends beyond audibility and involves cortical and auditory–cognitive integration processes.

Behaviorally, older adults exhibited greater difficulty with fine-grained vowel discrimination and speech recognition in noise, even when controlling for hearing thresholds. These results indicate that suprathreshold processing deficits contribute substantially to communication difficulties. Importantly, speech-in-noise performance did not consistently align with peripheral hearing status alone, underscoring the need to evaluate central auditory and cognitive factors in clinical settings.

Additionally, my work has explored how bilingual experience interacts with auditory aging. Although language background influenced speech sound discrimination patterns, bilingual older adults did not consistently show poorer speech-in-noise outcomes than monolingual peers. Electrophysiological findings further suggested relatively preserved neural sensitivity to speech contrasts in some bilingual listeners. While linguistic experience shapes auditory processing, aging-related neural and perceptual changes remain central to speech perception outcomes. Collectively, this work supports a comprehensive framework that integrates peripheral sensitivity, cortical encoding, cognition, and linguistic experience. Moving beyond the audiogram to include speechin-noise measures and objective cortical assessments will allow audiologists to better address real-world communication challenges faced by our aging population.

Level of Instruction: Intermediate

Learning Objectives:

Upon completion, participants will be able to:

• Describe age-related changes in both peripheral and central auditory processing and explain how these changes impact speech perception in older adults.
• Interpret behavioral and electrophysiological findings (e.g., P1–N1–P2 complex and mismatch negativity) as markers of cortical auditory processing in aging populations.
• Apply a holistic assessment framework that integrates audiometric, speech-in-noise, and central auditory measures to improve clinical decision-making and rehabilitation planning for older adults.

Description:

Over 95% of patients with NF2-related schwannomatosis (NF2-SWN) develop bilateral vestibular schwannomas, causing progressive hearing loss unresponsive to many interventions (e.g., ~35% durable response to bevacizumab or brigatinib). This leads to speech intelligibility deficits, social isolation, loneliness, and reduced quality of life. Auto-captioning glasses offer hands-free, real-time speech-to-text via AI and AR displays, but lack real-world evaluation in NF2-SWN. We present a prospective pilot study protocol (N=35 English-speaking adults over 18 years with NF2-SWN, PTA over 25 dB HL or WRS less than 90%) to test feasibility, acceptability, and preliminary efficacy of Captify Pro glasses over 12 weeks, paired with SocialBit smartwatch for socialization metrics.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to:

• Describe challenges of hearing loss in NF2-SWN and rationale for autocaptioning glasses as a visual assistive technology.
• Explain potential integration of captioning glasses into audiology practice for NF2-SWN patients underserved by amplification/implants.
• Identify the specific aims and study design of this protocol evaluating captioning glasses and the biomarkers used.

Description:

Hearing aids and cochlear implants improve access to sound, yet many patients continue to struggle with speech understanding, particularly in noise, rapid conversation, and complex listening environments. These difficulties contribute to social withdrawal, reduced device satisfaction, and elevated return and abandonment rates. Growing evidence demonstrates that amplification alone does not address central auditory processing deficits that develop with untreated hearing loss and prolonged auditory deprivation. As a result, leading hearing care organizations — including the Academy of Doctors of Audiology, the American Academy of Audiology, and the American Speech-LanguageHearing Association — recognize aural rehabilitation as a critical component of standard hearing care.

This session examines aural rehabilitation as a core component of comprehensive hearing care and reviews clinical evidence supporting its role in improving speech comprehension, patient confidence, and long-term outcomes. Drawing from peer-reviewed research and multi-clinic outcome data, the presentation highlights how structured, adaptive auditory training leverages neuroplasticity to strengthen speech-in-noise processing, auditory working memory, processing speed, and auditory closure.

Participants will review outcome measures commonly used to assess benefit, including improvements in speech-in-noise performance and patient-reported communication confidence. The session will also explore patient adherence data, comparing engagement rates for aural rehabilitation with those reported for traditional physical therapy, and will discuss clinical practices associated with higher compliance and better outcomes.

Clinical case examples will illustrate how aural rehabilitation can be integrated across patient populations, including new hearing aid users, patients dissatisfied with amplification, individuals who initially decline hearing aids, and special populations such as those with mild hearing loss, hidden hearing loss, or auditory processing disorders. By reframing aural rehabilitation as “physical therapy for the brain,” this session provides clinicians with an evidence-based framework for delivering more complete care — addressing both the brain and the ears to improve real-world communication outcomes.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to:

• Explain the role of auditory processing and Neuroplasticity in persistent speech-in-noise difficulties among adults with hearing loss.
• Identify key outcome measures used to evaluate the effectiveness of aural rehabilitation in clinical practice.
• Describe evidence-based strategies for integrating aural rehabilitation into treatment plans for patients across the hearing care spectrum.

Description:

Stay informed on the latest legislative and regulatory developments impacting audiology practice in California. This session will feature updates from CAA’s legislative advocacy team on current policy initiatives and pending legislation, along with a discussion of recent regulatory changes, licensure updates, and professional practice guidelines relevant to audiologists.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to:

• Name initiatives in the Board’s 2025 – 2028 Strategic Plan that may impact them or their practice.
• Explain legislative changes that the Board’s Sunset Review process created for Board licensees.
• Describe recent legislative or regulatory changes impacting speech-language pathologists, audiologists, or hearing aid dispensers in California.
• Describe political and policy efforts this year in California as well as the specific activities that CAA was involved in that directly impact audiologists.
• Discuss how certain laws and regulations governing audiologists may impact their practices.

Description:

Relative to typically hearing peers, children with hearing loss (HL) may exert higher effort when listening to speech in challenging environments. This can result in higher listening-related fatigue, which has been linked to lower reading outcomes and well-being. Because there is substantial variability in the listening-related fatigue experienced by children with HL, the goal of this research was to identify predictors of listeningrelated fatigue among children and adolescents with HL.

The first study included 144 adolescents with HL, ages 12-19. They completed an online survey about experiences with listening-related fatigue and school accommodations, including use of an Individualized Education Program (IEP) or a 504 plan. The second study is ongoing; currently, 38 children and adolescents with HL, ages 6-18, have participated. In the second study, listening-related fatigue is assessed through child- and self-report, and information regarding sociodemographic characteristics, audiologic factors, everyday auditory skills, speech recognition, and language skills is collected.

In the first study, use of an IEP or 504 plan was associated with lower listening-related fatigue, after accounting for age, HL laterality (i.e., bilateral or unilateral HL), and self-perceived listening difficulty (p = .006). There was a significant interaction between age and HL laterality: listening-related fatigue decreased with age among adolescents with unilateral HL, but not bilateral HL (p ( .001). Higher use of school accommodations, such as a remote microphone or notetaker, was associated with increased listening-related fatigue (p’s ( .05). Listeningrelated fatigue did not differ between adolescents who used hearing aids vs. cochlear implants (p = .69). Analyses in the second study will focus on the contributions of sociodemographic characteristics, like bilingualism, and audiologic factors, like amount of hearing device use, on listening-related fatigue.

Adolescents with HL should be considered at-risk for listening-related fatigue regardless of the type of hearing devices used, especially adolescents with bilateral HL. The individualized attention provided by an IEP or 504 plan may help to reduce listening-related fatigue. Additional research is needed to better understand the role that specific school accommodations play in addressing listening-related fatigue, as well as the extent to which fatigue can be predicted by family- and childrelated factors.

Level of Instruction: Intermediate

Learning Objectives:

Upon completion, participants will be able to:

• Discuss the impacts of listening-related fatigue on academic and social outcomes among children with hearing loss.
• Describe the associations between listening-related fatigue and school accommodation use among children and adolescents with hearing loss.
• Identify the audiologic and sociodemographic factors that predict listening-related fatigue among children and adolescents with hearing loss.

Description:

In clinical audiology, success is about making sure that life is heard – that conversations can be joined, words understood, music enjoyed, and environments recognized. It is a common clinical experience that for some hearing aid wearers, one type of sound processing does not feel quite right, while another feels much better. This session expands on those observations by exploring how sound preference forms and the domains that shape it—ranging from individual listening histories and perceptual tendencies to psychological, cognitive, and contextual factors that influence what “sounds right” to each person.

Building on this theoretical foundation, the session also examines why a structured clinical approach to identifying personal sound preference may be effective in improving outcomes. We review new, novel research that compare distinct sound designs and demonstrate that enabling patients to hear and contrast these options can support clearer decision making, smoother acclimatization, and more satisfying fittings for both first time and experienced wearers. Importantly, the evidence shows that sound preference cannot be predicted by simple demographic or lifestyle profiles; it is a nuanced and personal phenomenon that ideally requires listeners to experience sounds in different environments.

To translate this into real world impact, the session highlights an ongoing field study in which hearing care providers are implementing a sound preference identification tool in daily practice. Beyond clinical insights, this study explores whether preference guided fittings influence business efficiency measures such as return rates and conversion, while also capturing the experiences of HCPs—and potentially patients—as they incorporate preference discussions and real world listening into routine care. Together, these perspectives deepen our understanding of how sound preference can shape both clinical outcomes and clinic operations.

Level of Instruction: Intermediate

Learning Objectives: 

Upon completion, participants will be able to:

• Differentiate between distinct sound designs and summarize research findings on how listeners respond to these designs in controlled and real world listening conditions
• Interpret early findings from real?world clinical studies, including experiences from hearing care providers who are implementing a sound?preference tool in everyday practice.
• Discuss the limits of using demographic or lifestyle factors alone to predict preference and appreciate why direct listening experiences in multiple environments are essential.

Description:

Audiograms are essential clinical tools; however, they represent only one dimension of an individual’s hearing experience. Across the lifespan—from infancy through older adulthood—person-centered audiology care requires looking beyond hearing thresholds to understand how hearing differences affect communication, participation, identity, and quality of life. This educational case study explores person-centered care as a unifying framework applicable to audiologists serving patients of all ages.

Using composite cases drawn from pediatric, school-age, adult, and aging populations, this session illustrates how person-centered principles can be applied across diverse clinical contexts. Particular attention is given to pediatric pathways, including EHDI, Early Start, and school-age transitions, while also drawing parallels to adult and older adult care, such as new diagnosis adjustment, life transitions, and changes in communication needs over time.

The session examines common challenges encountered across the lifespan, including emotional responses to diagnosis, system navigation, cultural and linguistic considerations, access barriers, and shifting priorities as individuals age. Emphasis is placed on recognizing individuals and families as experts in their own lived experience and supporting informed, shared decision-making that aligns care with personal goals rather than solely audiometric outcomes.

Participants will explore practical, evidence-informed strategies that operationalize person-centered care, including reflective counseling, collaborative goal setting, functional needs assessment, intentional follow-up, and interdisciplinary collaboration. Case examples demonstrate how these approaches enhance engagement, continuity of care, and outcomes that matter most to individuals and families—such as communication access, autonomy, participation, and overall well-being.

This session equips audiology professionals with actionable tools applicable across pediatric, adult, educational, and medical settings. By centering care on the person rather than the audiogram, audiologists can deliver compassionate, equitable, and effective care throughout the lifespan, advancing excellence in hearing healthcare across California.

Level of Instruction: Intermediate

Learning Objectives:

Upon completion, participants will be able to:

• Describe key principles of person-centered care applicable across the audiology lifespan. 
• Identify individual, family, and system factors influencing engagement and outcomes beyond audiometric data.
• Apply counseling and care coordination strategies that align audiologic services with personal goals and functional needs.

Description:

Aural rehabilitation (AR) is widely recognized as an essential component of comprehensive hearing healthcare, yet it is often underutilized in clinical practice due to time constraints, limited reimbursement, and workflow challenges. As hearing technology continues to advance, patient success increasingly depends on education, communication strategies, and structured listening rehabilitation that extend beyond device fitting.

This presentation will explore how integrating scalable aural rehabilitation strategies into a private practice setting can improve clinical efficiency, reduce repetitive counseling time, and enhance both patient and clinician satisfaction. Drawing from real-world implementation in an independent audiology practice, teaching experience in adult aural rehabilitation at Rush University, and the development of Tonotop — a software platform designed to support patient education and listening rehabilitation — attendees will learn practical approaches to embedding AR into routine care without increasing clinician workload.

The session will demonstrate how structured educational pathways, guided listening exercises, and outcome tracking can improve patient engagement, reduce follow-up troubleshooting visits, and create a more consistent care experience across providers. Attendees will leave with actionable strategies for incorporating aural rehabilitation into their clinics in a sustainable and time-efficient way.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to: 

• Describe the role of structured aural rehabilitation in improving patient outcomes and clinic workflow efficiency.
• Identify at least three strategies for integrating patient education and listening rehabilitation into routine clinical care without increasing appointment time.
• Explain how scalable tools and guided AR programs can improve patient satisfaction, clinician satisfaction, and continuity of care.

Description:

Diabetes is widely recognized for its systemic complications; however, its impact on hearing health remains underrecognized. Emerging evidence suggests a significant association between diabetes, particularly Type 1 diabetes, and sensorineural hearing loss, tinnitus, and other auditory deficits. Despite this growing body of literature, the relationship between diabetes and auditory dysfunction is insufficiently addressed in clinical practice, patient education, and public health initiatives.

This study explores awareness, attitudes, and practices related to hearing health among individuals with Type 1 diabetes. Using a cross-sectional survey design, data were collected on the self-reported prevalence of hearing difficulties and tinnitus, awareness of the association between diabetes and hearing loss, experiences with hearing healthcare, and perceived barriers to accessing audiological services.

Preliminary findings from 15 participants indicate strong participant interest in integrating routine hearing screenings into standard diabetes care. Most respondents reported that they would welcome regular audiological evaluations if offered in conjunction with routine medical appointments, reflecting high receptiveness to preventive hearing care. Despite this willingness, a substantial gap in awareness was identified. The majority of participants were unaware that individuals with Type 1 diabetes may be at increased risk for hearing loss or tinnitus. This knowledge deficit highlights a gap in patient education regarding diabetes-related complications beyond commonly emphasized conditions such as neuropathy, retinopathy, and nephropathy. Furthermore, most respondents reported that hearing health had never been discussed by their healthcare providers within the context of diabetes management, nor had they been referred for hearing evaluation unless they independently raised concerns. These findings suggest that hearing health is largely overlooked in current diabetes care models.

Overall, the results underscore the need for enhanced provider education, improved patient counseling, and the incorporation of routine hearing screenings into comprehensive diabetes management to better support the long-term health outcomes of individuals with Type 1 diabetes.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to:

• Describe the association between Type 1 diabetes and auditory complications, including sensorineural hearing loss and tinnitus, based on current evidence.
• Identify gaps in patient awareness and provider counseling regarding hearing health within standard diabetes management practices.
• Discuss the rationale and potential benefits of incorporating routine audiological screening into comprehensive care models for individuals with Type 1 diabetes.

Description:

Central Auditory Processing Disorder (CAPD) assessment continues to present clinical challenges due to the absence of an established gold-standard test battery. As a result, assessment practices may vary across clinicians, practice settings, and geographic regions, potentially impacting diagnostic consistency and clinical decision-making. The purpose of this capstone project was to identify and characterize the test batteries and clinical practices currently utilized by licensed audiologists in the assessment of CAPD, with an emphasis on documenting variability in assessment approaches on an international scale. Given the lack of standardized guidelines, it was hypothesized that significant variability would exist in the assessment tools and protocols employed among practicing audiologists.

This study employed a cross-sectional, anonymous survey design distributed via Qualtrics. Recruitment was conducted using publicly available information through national and state professional organizations, professional social media platforms and postings, and networking within the audiology community. Following Institutional Review Board (IRB) approval, survey distribution and data collection were initiated. The survey collected information regarding CAPD test batteries, assessment approaches, and clinical decision-making strategies used by practicing, licensed audiologists. Billing and treatment practices related to CAPD were included as exploratory variables to inform future research. Planned analyses include basic summaries, charts, and correlation tests to examine how assessment practices relate to provider characteristics, such as years of clinical experience, work setting, and geographic location. 

At this time, data collection and statistical analysis are ongoing; therefore, final results and conclusions are not available yet. Complete results and conclusions will be presented at the conference and are expected to provide clinically relevant insight into current CAPD assessment practices, identify areas of variability, and inform future efforts toward improved standardization within audiology.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion, participants will be able to:

• Describe the current challenges in CAPD assessment, including how the lack of a gold-standard test battery can lead to differences in diagnosis and clinical decisions across clinicians and settings.
• Identify and compare the CAPD test batteries and clinical approaches currently used by licensed audiologists worldwide, with a focus on where and how practices vary by setting and region.
• Interpret survey findings using summaries, charts, and correlation results to examine how assessment practices relate to provider characteristics (e.g., years of experience, work setting, and geographic location) and consider what that may suggest about a standard.

Description:

High-speed surgical drilling used in otologic and skull-base procedures produces extremely intense sound levels, raising concerns about noise-induced hearing loss (NIHL) in the non-operative ear. Prior studies have documented drill intensities exceeding 110-160 dB SPL and have suggested the potential for contralateral hearing changes, particularly in the mid-to-high frequencies, which tend to be the most vulnerable to NIHL (Perez et al., 2024; Solmaz et al., 2024).

The purpose of this study was to evaluate changes in hearing thresholds of the non-operative ear following various surgeries of the temporal bone. Medical records of adults aged 21 years and older who underwent canalplasty (n=31), tympanomastoidectomy (n=251) and acoustic neuroma (n=461) surgeries at UC San Diego between 2014 and 2024 were retrospectively reviewed. Medical records were reviewed for age, sex, surgical approach, and pre- and post-operative audiologic test results. Post-operative audiograms were typically obtained 1-2 months following surgery, and included air conduction thresholds (250-8000 Hz), bone conduction thresholds (250-4000 Hz), and word recognition scores (WRS) in percent correct. For the purpose of this study, only bone conduction thresholds were used to focus only on the sensorineural hearing component.

It was hypothesized that acoustic neuroma surgeries had greater decrement in bone conduction thresholds compared to tympanomastoidectomies due to differences in drill time between those surgeries. Results are described according to the type of surgery and analyzed for statistical differences. This study aimed to provide a more complete understanding of the potential long-term risks to hearing associated with ear and skull-base surgeries involving a high-speed drill, and may help surgeons better inform patients about these risks.

Level of Instruction: Intermediate 

Learning Objectives:

Upon completion, participants will be able to:

• Describe the intensity levels of high-speed surgical drills used in otologic and skull-based procedures and its relevance to noise-induced hearing loss in the non-operative ear. 
• Compare changes in non-operative ear bone conduction thresholds across tympanomastoidectomy and acoustic neuroma surgeries.
• Explain how the presence or absence of contralateral hearing threshold changes following temporal bone surgery can inform future research directions, patient counseling, and surgical decision-making.

Description:

Improperly fitted hearing protection devices (HPDs) reduce real-world attenuation compared to manufacturer-labeled Noise Reduction Ratings (NRRs), which are derived under controlled laboratory conditions. In actual workplace environments, variability in insertion technique, ear canal anatomy, device selection, and user compliance can significantly compromise protection. Nearly 30% of employees enrolled in an OSHA-compliant hearing conservation program were found to be receiving inadequate attenuation relative to their documented noise exposures, placing them at continued risk for noise-induced hearing loss despite program participation. These findings underscore that simply providing HPDs and relying solely on NRR is not sufficient/effective protection depends on proper fit, consistent use, and user competency. Fit-testing systems such as the 3M E-A-Rfit Dual-Ear Validation System allow objective measurement of individual Personal Attenuation Ratings (PARs).

This study evaluated the impact of a structured fit training session on attenuation outcomes for earplugs and earmuffs. Twenty adult participants with normal otoscopic findings were recruited. Each subject completed dual-ear PAR measurements using foam earplugs and over-the-ear earmuffs. Baseline fit-testing was conducted following manufacturer instructions without additional coaching. Participants then received a standardized 15-minute hands-on fit training session covering correct insertion techniques for foam earplugs (roll-down, pull-back, hold) and proper positioning and seal checks for earmuffs. Immediately following training, PAR measurements were repeated for both HPD types. Mean PAR values pre- and post-training were compared using paired t-tests. Baseline results demonstrated wide inter-subject variability, particularly for foam earplugs. Mean baseline PAR for earplugs increased significantly post-training (p < 0.001). Earmuffs showed less variability at baseline and also increased significantly following training (p = 0.02). The proportion of subjects achieving 20 dB attenuation increased from 35% to 85% for earplugs and from 55% to 80% for earmuffs after training. Fit training significantly improved attenuation outcomes for both HPD types, with the greatest gains observed for foam earplugs. Results highlight the importance of individualized fit verification and hands-on training in hearing conservation programs. Incorporating objective fit-testing systems may substantially enhance worker protection and reduce risk of occupational noise-induced hearing loss.

Level of Instruction: Intermediate 

Learning Objectives:

Upon completion, participants will be able to:

• Describe the principles and clinical application of a real ear fit validation system for measuring Personal Attenuation Ratings (PARs) in hearing protection devices.
• Describe the pre- and post-fit training attenuation outcomes, measured by the PARs.
• Explain the role of individual fit verification and hands-on training in improving hearing protection effectiveness.

Description:

When investigating the physiological mechanisms of dizziness and falls, research often treats sensory loss and cerebrovascular health as separate entities, leaving a gap in our understanding of their relationship. Furthermore, few studies have incorporated transcranial Doppler (TCD) ultrasound alongside objective and subjective audiological assessments. This study evaluates the feasibility of combining these tools to examine cerebrovascular contributions to auditory and vestibular function, as well as fear of falling, providing a foundation for future larger-scale research.

This study included 16 participants (mean age 28.56 years; SD = 13.74; range 18?75), consisting of 8 healthy controls and 8 symptomatic individuals with self-reported dizziness or hearing loss. Participants underwent a multidisciplinary protocol including standard hearing screening (pure-tone average: PTA), cervical vestibular evoked myogenic potentials (cVEMPs: asymmetry ratio), and TCD ultrasound to measure mean blood flow velocity (MFV), pulsatility index (PI), and resistive index (RI) in the middle (MCA) and posterior (PCA) cerebral arteries. Subjective outcomes were assessed via the Dizziness Handicap Inventory (DHI) and the Falls Efficacy Scale-International (FES-I). 

Analysis revealed territory-specific associations between cerebrovascular hemodynamics and neurotologic function. Increased vascular resistance and pulsatility within the posterior circulation (PCA) were significantly correlated with higher hearing thresholds. Specifically, PTA demonstrated a robust positive correlation with both PCA PI (r = 0.63, p = 0.01) and PCA RI (r = 0.59, p = 0.02). While saccular integrity (cVEMP) showed a consistent negative trend with blood flow across both territories, it did not reach statistical significance. However, a significant negative correlation was identified between MCA MFV and fear of falling (FES-I) (r = -0.57,  p= 0.02), suggesting that anterior perfusion may play a direct role in balance-related self-efficacy.

These preliminary findings suggest that TCD may serve as a valuable, non-invasive tool to identify subclinical vascular changes that parallel auditory and vestibular decline. The data provide a promising signal that increased PCA resistance may be an early marker for auditory degradation, while compromised MCA perfusion may contribute to the psychological burden of fall risk. This study successfully demonstrates the feasibility of an integrated methodology, establishing a foundation for larger, longitudinal investigations to validate these vascular-sensory relationships.

Level of Instruction: Advanced

Learning Objectives:

Upon completion, participants will be able to:

• Describe the application of transcranial Doppler (TCD) ultrasound for monitoring blood flow velocity and vascular resistance indices within the middle and posterior cerebral arteries.
• Analyze the relationship between increased vascular resistance in the posterior circulation and elevated pure-tone auditory thresholds.
• Differentiate between the territory-specific roles of the anterior and posterior cerebral circulation as they relate to fear of falling and sensory-level decline.

Description:

Rotational chair testing provides an objective assessment of the vestibuloocular reflex (VOR), offering insight into vestibular function. However, despite its value, VOR data in early infancy have been notably limited. This study addressed this gap by capturing vestibular responses in infants via a new pediatric rotational chair. Fifty-five infants, ages 1–12 months, were evaluated longitudinally to track changes in vestibular function, with demographic data including weight, height, BMI, inter pupillary distance, and head circumference collected at each visit. Each infant completed standardized rotational chair assessments (0.04, 0.08, 0.16, 0.32 Hz). Caregiver-reported developmental status was collected at each visit using the Ages and Stages Questionnaire (ASQ), while motor development was assessed with the Peabody Developmental Motor Scales (PDMS). Analyses focused on identifying age-related trends in VOR gain, phase, and symmetry, and determining whether vestibular measures correlated with physical growth or developmental scores. Preliminary findings suggest measurable changes in rotational chair responses across the first year of life, consistent with ongoing maturation of the vestibular system. Associations between vestibular function and motor development were also explored. These results provide insight into typical vestibular development in infancy and may support earlier identification of atypical vestibular maturation.

Level of Instruction: Intermediate

Learning Objectives:

Upon completion, participants will be able to:

• Analyze age-related trends in VOR gain, phase, and symmetry in infants from 1–12 months using rotational chair data.
• Evaluate the relationship between infant vestibular function and physical growth parameters, including BMI, head circumference, and inter-pupillary distance.
• Interpret correlations between vestibular measures and motor development outcomes as assessed by the Peabody Developmental Motor Scales (PDMS) and caregiver-reported Ages and Stages Questionnaire (ASQ).

Description:

Despite the dramatic improvements in hearing aid technology during the past several deacdes, speech recognition in noise and spatial awareness remain as significant barriers to patient benefits. More recently, deep neural networks (DNNs) are transforming hearing aid signal processing by enabling real-time data-driven optimization of both spectral-temporal enhancement and spatial filtering. In this study, we present an integrated edge-AI framework combining (1) DNN-based speech enhancement for signal-to-noise ratio (SNR) improvement, (2) DNN-based adaptive directionality that dynamically optimizes beampatterns using acoustic scene analysis and spatial features, and (3) DNN-based speech-presence detection and spatial awareness enhancement. The system operates entirely onboard, without cloud dependency, while preserving 50+ hours of operation on a single charge with an energy-efficient system-on-a-chip (SOC) architecture that is fully integrated within the hearing aid’s processor.

Objective evaluations included Hagerman-based SNR measurements, adaptive Speech Reception Threshold (SRT50) testing using HINT, and an artificial intelligence–based speech-to-text intelligibility metric applied across multiple real-world noise scenarios. Behavioral testing in hearing-impaired listeners assessed CNC, QuickSIN, and WIN performance, while ecological momentary assessment (EMA) captured real-world subjective benefit and preference.

Results demonstrate significant improvements in multi-talker babble conditions, while DNN-based directionality yielded substantial SRT50 improvements, particularly for non-frontal target speech and competing rear interferers. AI-based objective intelligibility metrics corroborated behavioral findings. Importantly, spatial adaptation preserved awareness of environmental sounds and improved detection of off-axis speech onsets, addressing a key limitation of conventional directional systems. Benefits varied across noise types, highlighting the importance of training data diversity and context-aware adaptation. The integrated system resolves the traditional trade-off between speech intelligibility and spatial awareness, illustrating the potential of unified deep learning architectures in modern hearing aids. These findings support a paradigm shift from heuristic signal processing toward holistic, AI-driven acoustic optimization for real-world listening performance of advanced hearing aids.

Discussion will focus on clinical applications for this technology, as well emerging areas of opportunity for DNN processing for both laboratory and “real world” benefits.

Level of Instruction: Intermediate

Learning Objectives: 

Upon completion, participants will be able to:

• Identify four priorities for hearing aid benefit by prospective first-time hearing aid users
• Discuss the ways that ecological momentary assessment (EMA) measures may be used to augment laboratory measurements with real-world subjective benefit and preference.
• Describe two ways that deep neural networks (DNNs) are transforming hearing aid signal processing in current and emerging devices

Description:

Bimodal hearing, pairing a cochlear implant (CI) in one ear with a hearing aid in the other, can be the next step for patients who have “maxed out” traditional amplification yet still struggle in noise, fatigue quickly, or miss key speech cues. Even with strong outcomes, many candidates are never referred, and some practices lose continuity when the conversation shifts from hearing aids to implantation. Co-presented by an audiologist and an otologist, this session delivers a practical, clinicready approach that improves outcomes while keeping audiology central to long-term care. Attendees will learn to spot the tipping point when the poorer ear is no longer providing meaningful benefit with conventional amplification. We will review adult CI referral indicators including speech recognition patterns, asymmetry, listening effort, and real-world communication impact. Participants will leave with an efficient screening and documentation workflow, including recommended speech testing conditions, practical referral thresholds, and “don’t wait” red flags, plus counseling language that reduces fear, sets realistic expectations, and frames CI evaluation as an informed choice. The session also covers post-activation success: optimizing the acoustic ear to achieve the “best of both worlds.” Topics include hearing aid fitting priorities for the better ear, loudness balancing, managing tinnitus and asymmetry, streaming/accessory counseling, and verification using standardized outcome measures. Through case examples, we’ll address common barriers like “my good ear is fine,” insurance uncertainty, and appointment fatigue. Attendees will receive ready-to-use tools: a CI screening checklist, a co-management timeline, and an outcomes plan that demonstrates bimodal benefit over time for patients and referral partners—designed for immediate use in private practice and multidisciplinary settings.

Level of Instruction: Introductory/Basic

Learning Objectives:

Upon completion,participants will be able to:

• Identify at least 3 CI referral indicators for adult bimodal candidates and apply them to 3 case vignettes to determine whether CI evaluation is recommended.
• Implement a 5-step bimodal co-management workflow (screen, counsel, refer, coordinate, verify) by drafting a one-page clinic protocol that can be deployed within 30 days of the course.
• Demonstrate an outcomes-based bimodal follow-up plan by selecting 2 validated measures and defining a verification schedule at baseline, 3 months, and 6 months, including at least 2 loudness balancing/optimization steps for the acoustic ear.