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

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:

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:

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:

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:

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:

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.