An introduction to widely-available technologies that enable remote hearing diagnostic testing, simply and cost-effectively.

Step-by-step instruction for a typical Vivosonic Integrity system that uses these technologies to enable real-time (synchronous) non-sedated ABR assessments from a distance.

The technical requirements for successful implementation will be briefly discussed. The session will conclude with a demonstration.

Integrity, non-sedated AEP/OAE Combination System

Integrity’s patented and award winning technologies ™ (Amplitrode™, VivoLink™, and Kalman Filter ), reduce or eliminate many of the frustrations hampering today’s Audiologists performing ABR tests by allowing for superior overall performance in clinical results, patient care and economic efficiency.

For auditory diagnostics in infants through seniors, Integrity™ is available in any combination of DPOAE, TEOAE, ABR. Yet, the system is fully portable, configured in a light carrying computer case, with all starter disposables included (various ear tips, electrodes, etc.) Not only does Integrity™ offer features and benefits that no other competitive OAE or AEP product can match, but it saves $35,000-40,000 of capital, as no shielded room required for Integrity™ ABR. It also saves operating costs – eliminates the need for costly patient relaxation in most cases, and increases revenue opportunities by allowing testing a wider range of patients, who would typically be impossible to test with conventional ABR equipment, and more patients per day, due to faster operation.

Integrity™ benefits include:

• High-Definition ABR Without Sedation
  
  Using Kalman Weighted Filtering, the Integrity is able to generate superior diagnostic, results without sedation. This is particularly suitable to pediatric patients, who can now be awake and feed, speak or play while being tested. It is also an invaluable tool for-hard-to test patients from the general population.


• Flexible Options to Suit Your Situational Needs
  
  With variable options that can include Non-Sedated ABR, OAE and Non-Invasive ECochG, Vivosonic’s innovative Integrity enables clinicians to perform Auditory Electrophysiological or Otoacoustic Emission assessment, on almost any patient, from newborns to seniors.


• Test Wirelessly, In Virtually Any Situation
  
  The first system to possess wireless capabilities, Integrity is a revolution in portable diagnostics, fitting unobtrusively on an alert child’s back who is playing quietly during testing, or into the OR. In addition, the Amplitrode (a miniature electrode-mounted bio-amplifier) protects against electromagnetic noise, delivering clear results in places with electric and magnetic interferences such as Neonatal Intensive Care Units (NICU), hospitals, military medical centers, Operating Rooms (OR) and other clinical settings. Integrity is also valuable in the rare instances where anesthesia is necessary and can be used for intra-operative monitoring.


• Improved Patient Care and Economics
  
  Hospitals will eliminate patient risk associated with anesthesia and shorten the test-to-service timeliness. In addition, they will also be helping to reduce the burden of anesthesia costs on the national healthcare system. Integrity will enable private clinics to lessen patient referrals out and increase their patient population, ensuring quality hearing healthcare within their communities.

Advances in technology necessitate changes in the design of cochlear implants and in the process of fitting and assessing patient outcomes. This workshop offers an opportunity to learn about new assessment tools for implant patients and innovative programming techniques using Soundwave™ , the signature fitting software from Advanced Bionics. Challenging cases will be analyzed by attendees and strategies will be reviewed to optimize patient performance with the Harmony™ HiResolution™ Bionic Ear System.

Course objectives:

• Participants will gain an understanding of the evolution of cochlear implant technology and the impact of advancements in technology on patient outcomes.
• Participants will explore the Minimal Speech Test Battery and current test measures for the assessment of cochlear implant candidates and recipients.
• At the completion of this course, participants will be able to identify three advanced programming techniques applicable to Soundwave™.
• At the completion of this course, participants will be able to identify three resources to support the management of recipients of the Harmony HiResolution Bionic Ear System.

Esther Kelly and Rose Aird Minette--- DARS Office for Deaf and Hard of Hearing Services

In this workshop we will cover a wide variety of programs, resources and assistive technology options which will complement the services you currently provide to your clients. We will cover updates on the latest assistive technology for home and the workplace, the Vocational Rehabilitation program and how it can assist clients with job training or workplace accommodations, the STAP telephone assistance program and the services available statewide by our contractors. Learn about eligibility for the Certificate of Deafness for Tuition Waiver program and how our advocacy services can support clients in need. We will distribute materials which you can bring back to your practice, such as DVDs, applications and brochures, which will surely be appreciated by your customers!

Oticon Intiga is a new hearing device specifically designed to meet the needs of the first time user. The Now Effect refers to the potential for immediate and long-lasting life change for patients who opt to pursue amplification. However, it takes many things to motivate and satisfy the patient who suspects the presence of hearing loss. The patient needs to be encouraged to take action, they need to be in the right mindset in order to commit to a fitting, they need devices that are specifically designed with the expressed needs of first time users in mind and they need long-term support and interaction from their hearing care professional. In this seminar, we will share new insights into each of these four key areas and discuss how the hearing care professional can best serve as many patients as possible.

This three hour course is designed to provide an overview of Phonak's Spice product portfolio, Phonak's Target fitting software and Zoom Technology.

Hour 1 Phonak Spice Product Overview
A review of Phonak's entire Spice product portfolio. All levels of technology will be reviewed including Premium, Advanced and Economy. Features including SoundRecover, StereoZoom and SoundFlow will be reviewed. The client benefit of these features will also be reviewed.

Hour 2 Advanced Phonak Target Fitting
Phonak's Target software represents a unique approach to innovation and patient satisfaction. Features of the Phonak Target software will be discussed in detail including first and follow up fittings.

Hour 3 Zoom Technology: Improved Intelligibility with Directionality
This section will review how directional microphones work and explain the difference between fixed and adaptive directionality. New innovations that take advantage of synchronized directionality will also be reviewed. Recent studies and case studies comparing synchronized directional systems to non synchronized directional systems will also be reviewed.

Participants in this three hour course will gain a better understanding of the Phonak Spice product portfolio, the Phonak Target software and new possibilities in directional microphone systems.

Instructor Biography:

Nate Schau, AuD is the Manager of Audiology for Phonak. He received his AuD from Rush University in Chicago. Prior to working as Manager of Audiology at Phonak he held positions in Technical Support and as a Customer Trainer at Phonak He also worked as a Clinical Audiologist in private practice performing diagnostic testing and dispensing hearing aids. He is a member of the American Academy Audiology and Adjunct Faculty in the Department of Communication Disorders & Sciences at Rush University.

Mild traumatic brain injury (mTBI), also known as concussion, has come to be viewed as the "signature injury" of the current conflicts in Afghanistan and Iraq. The true incidence of military mTBI is unknown, similar in context to the civilian sector which is unable to capture all mild TBI cases due to lack of seeking medical care or undiagnosed cases. A majority of mTBI patients (75-90%) have symptoms that are transient and self-limiting, with apparent full recovery occurring within minutes to several weeks following injury. However, approximately 10% of persons with mTBI do not show the expected rapid and uneventful recovery, with chronic symptoms and/or reported functional deficits. To complicate the recovery of these patients, many will report some form of dizziness/unbalance/vertigo and some degree of hearing loss. Additionally, there is evidence that a portion of these patients will present with central auditory processing deficits. A discussion of mTBI and the co-morbid conditions of hearing loss and central auditory dysfunction will be discussed and an overview of the mechanisms of blast exposure will be presented. Suggestions for evaluation and treatment of these patients will also be discussed.

Learner Outcomes:

The participant will be able to describe the condition of mild traumatic brain injury.
The participant will demonstrate an understanding of the clinical presentation of blast exposure in terms of auditory function, specifically, auditory processing.
The participant will be able to describe a preliminary test battery which can be used for the evaluation of auditory processing in a blast-exposed population


Conflict of Interest: No known conflict of interest regarding the information presented in this material.

Therese C. Walden, Au.D., is a Research Audiologist at the Army Audiology and Speech Center, Walter Reed Army Medical Center, Washington, D.C. Her clinical/research interests are in the areas of adult and geriatric diagnostics, amplification, evidence-based practice and treatment efficacy. Professionally, Dr. Walden serves on multiple editorial boards and has been active on professional boards, committees and task forces and is currently serving as President of the American Academy of Audiology.

Dr. Walden has no known conflict of interest regarding the information presented.

Don Marsh has 39 years of Marketing experience and is the author of one book, and more than 200 articles. In 2009, he completed a series of audio CDs for CareCredit/GE Financial, based on his presentation on “Marketing to the Mature Marketplace”.

As a professional speaker, he has been a featured presenter at more than 100 industry conferences, seminars and workshops, before thousands of hearing healthcare professionals from 50 states and eight foreign countries.

As an independent marketing consultant, he has created customized marketing programs for more than 150 practice owners across the country.

After spending years under contract to leading manufacturers and industry associations, he now works as an independent marketing consultant. As a result, his presentations contain no bias toward any company or product.

The Audiology & Diagnostic Evaluation Outreach Education presentation covers issues
surrounding the audiological diagnostic evaluation processes of infants. With the goal of preventing loss to follow-up in early intervention, the presentation discusses identified gaps in the process and encourages participation in the solutions to reduce loss to follow up care.

Learning outcomes:

As a result of this presentation the participant will be able to:
• Understand the role of the Pediatric Audiologist in the Texas Early Hearing
Detection and Intervention (TEHDI) process.
• Identify the “Just in Time” tools for the Texas audiologist.
• List the steps to enter Audiological data in the TEHDI Management Information
System (MIS).

Karen Ditty, Au.D., coordinates hospital based newborn hearing screening and follow-up
diagnostics for infants and children. She supports early interventionists and hospital staff by
compiling data and statistical information for program accountability, and providing inservice
and trainings to Audiologists.

Currently, Karen has been on staff with the National Center for Hearing Assessment and
Management providing online and on site workshops for Pediatric Audiology. In Texas, she
was the past council member on the Leadership Council for deaf and hard of hearing infants
from birth to three from 1996-1999 and currently manages Universal Newborn Hearing
screening at 8 birthing hospitals in the Houston area.

Dr. Ditty has no known conflict of interest regarding the information presented.

The goal of my presentation is to introduce a physician marketing program that is unique and outside of the traditional methods utilized by our profession and attempting to increase referrals to our practices.

My success with this method has allowed me to establish relationships with family physicians by demonstrating to them how they can utilize some of our sophisticated objective testing equipment within their practices. I talked to them about tympanometry and OAE's being utilized by them in generating at a minimum of $25,000 per practitioner per year. Initially, this captures their attention as I then explain the ease of testing, and the CPT codes utilized. Once patients are identified as potentially having hearing difficulties, my role is to assist them in solving the patient's problem. What they generate in revenue has no effect on what occurs within our practices.

Initially, they may need assistance in reading the objective printouts. This can be done by faxing them for our interpretation. The premise is that when professionals are financially invested in clinical procedures, that generate revenue, they become more conscious of their need to refer appropriately.

The second component of this session I have entitled... "Expanding Our Clinical Expertise in Addition to Audiology". The goal here is to explain, based on my experience, the possibility of expanding our referral network by educating ourselves in other areas such as dermatology, neurology, infectious diseases, and dentistry.

I know this is unique but after spending time with a dermatologist my abilities to identify skin cancers on the head and neck have increased drastically. I have been very successful at referring these patients to that practitioner and/or a dermatologist to confirm that in fact they do have basal cell carcinoma.

Outcomes:
1. How to interact with physicians in the community and generate referrals to your practice.
2. By demonstrating to physicians how they can better evaluate their patients while generating additional revenues for their practice will get their attention and establish a unique referral program to your practice.
3. Being better able to assess patients and identify other areas that will help, not only in your treatment program but also identifying you as a more broad-based expert besides audiology. I will explain how to expand our expertise.

Dr. Ed Aleo received his PhD. from The Ohio State University. He lectures nationally and internationally on topics concerning professional growth, expanding opportunities in audiology outside of the more traditional methods. Ed has been in private practice for 30 years and has owned offices in seven states housed, in traditional clinical settings, hospitals, HMOs, and hearing aid franchises.

His interests revolve around marketing, expanding our expertise outside of audiology while understanding the importance of financial reporting.

Ed has published journal articles, a book on a method of dispensing hearing aids and is an adjunct at St. John's University while lecturing at LSU and Idaho State University.

Dr. Aleo has no known conflict of interest regarding the information presented.

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Erin L. Miller, Au.D. is the Coordinator of the Northeast Ohio Au.D. Consortium (NOAC) and the Coordinator of the Hearing Aid Dispensary at the University of Akron Audiology and Speech Center. She received her Master’s degree from Kent State University in 1986 and her Au.D. from the University of Florida in 2000. Erin was in private practice for over 15 years prior to accepting her position with the NOAC program in 2005.

Her clinical interests include amplification and (central) auditory processing disorders and her professional interests include legislative and regulatory matters.

She is currently a member of the American Academy of Audiology’s Board of Directors and chair’s the Ohio Speech and Hearing Governmental Affairs Coalition. She formerly chaired the Government Relations Committee for the American Academy of Audiology and was a member of the Academy’s Ethical Practices Committee from 2005-2008. Erin has presented numerous ethics sessions across the country, most recently at a continuing education event for the Ohio Academy of Audiology.

There are no affiliations or financial interests with products relative to this presentation.

Auditory and vestibular problems can be challenging to diagnose and often require extensive diagnostic testing to arrive at a narrow differential diagnosis. Otologists and audiologists play a synergistic role in the evaluation of these patients. In particular, preoperative planning requires accurate diagnostic testing that may include testing that is not routine for all patients. Superior canal dehiscence, hearing preservation surgery for acoustic neuroma, and cochlear implantation require specific and thoughtful diagnostic testing. In addition, otologists and audiologists must collaborate to diagnose difficult audiologic and vestibular problems. In this presentation, a case-based approach will be used to discuss the importance of collaboration between the otologist and audiologist. The use of pure-tone audiometry, acoustic reflexes, ABR, VEMP, and ENG will be discussed with a particular attention to the relevance to the otologist.

Learning outcomes:

The participants will be able to:

1. Understand the relevance of audiologic and vestibular testing from the otologist’s point of view.
2. Use techniques to evaluate specific conditions such as superior canal dehiscence, acoustic neuroma, and auditory neuropathy.
3. Collaborate with the otologist to diagnose challenging auditory and vestibular problems.

Angela Shoup, Ph.D. is an Associate Professor in the Department of Otolaryngology – Head and Neck Surgery at the University of Texas Southwestern Medical Center where she also serves as Director of the Division of Communicative and Vestibular Disorders. Dr. Shoup received her Ph.D. in Human Development and Communication Disorders from the University of Texas at Dallas in 1994. As Director of the Division of Communicative & Vestibular Disorders, Dr. Shoup provides administrative oversight for audiologists offering services at the Aston Ambulatory Care Center, Parkland Memorial Hospital Outpatient ENT Clinic, Parkland Memorial Hospital Newborn Nursery Hearing Screening Program, Children’s Medical Center at Dallas and affiliated facilities in Plano and Southlake. Speech-language pathologists and physical therapists from her Division provide services at the Aston Ambulatory Care Center. Dr. Shoup has published articles and textbook chapters on audiologic procedures and implantable hearing aids. She has been an invited speaker and presented research findings at national and international meetings. She served as President of the Texas Academy of Audiology and Chair of the Ethical Practices Committee for the American Academy of Audiology. Her research interests include implementation of universal newborn hearing screening programs, developmental issues in audition, auditory electrophysiology, diagnostic assessment for auditory and vestibular disorders, hearing aids and cochlear implants.

Dr. Shoup has no known conflict of interest regarding the information presented.

J. Walter Kutz Jr., MD is an Assistant Professor in the Department of Otolaryngology at the University of Texas Southwestern Medical Center. After completing Otolaryngology residency training at Baylor College of Medicine in Houston, he completed a two-year fellowship in Otology and Neurotology at the House Ear Clinic in Los Angeles.

Dr. Kutz is active in the education of medical students and residents at the University of Texas Southwestern Medical Center. He was awarded the Chief Resident Appreciation Award for Outstanding Contribution and Leadership. He is also the fellowship director for the UTSW Medical Center Department of Otolaryngology Neurotology Fellowship and the Associate Residency Director for the Department of Otolaryngology at UTSW.

Dr. Kutz is actively involved with research. During residency, Dr. Kutz worked in Dr. William Brownell’s lab investigating lateral diffusion in the plasma membrane of the outer hair cell as it relates to electromotility. He was awarded the J. Charles Dickens Award for Outstanding Basic Science Research at Baylor College of Medicine. His current research interests focus around the management of acoustic neuroma, bone anchored hearing aids, and cochlear implantation. He has published over 20 peer-reviewed manuscripts and has written multiple book chapters.

Dr. Kutz has no known conflict of interest regarding the information presented.

Acceptable Noise Level (ANL) is a unique and robust measure of a listener’s willingness to accept background noise while listening to speech. It has been correlated to listener success with hearing aids and determining the likelihood for a happy hearing aid patient. ANL is based on the premise that listener willingness, rather than ability, to accept background noise will determine if hearing aids are accepted or ultimately rejected. It is a quick and simple procedure that provides significant prognostic information on a hearing impaired listener’s chance for success with hearing aids.

The following are learner outcomes for my proposed ANL presentation: After completion of the presentation, participants will:
1. Understand what Acceptable Noise Level (ANL) is.
2. Be able to complete ANL measurement.
3. Use ANL measurements to determine a patient’s potential success with hearing aids, and if background noise reduction technology is warranted

Dr. Madix is an assistant professor at Louisiana Tech University in Ruston, Louisiana. Dr. Madix received his Ph.D. from the University of Tennessee, and his Master’s degrees in Audiology and Speech Pathology from Louisiana Tech University. Prior to joining the faculty at Louisiana Tech, he dispensed hearing aids both in a medical setting and also in private practice.

With the proliferation of technology and advent of greater access to global connectivity, Audiologists are finding themselves at a crossroads of opportunity to harness a new resource: TeleAudiology. TeleAudiology is one manner to address that continuing shortage of hearing healthcare providers which will not be remedied immediately. Lately, there is a proliferation of research pertaining to the efficacy and validity of TeleAudiology. This presentation will review the status as well as recent research that demonstrates the reality of engaging in TeleHealth and TeleAudiology practices as well as available equipment.

Learning outcomes

Attendees will be able to:
Differentiate between the terms TeleHealth and TeleAudiology
List at least 3 critical components of compliant testing for TeleAudiology
Identify situations in which TeleAudiology can be used most effectively

Jackie L. Clark, PhD/AAA-F; CCC-A; ABA is currently a Clinical Associate Professor UT Dallas’ School of Brain & Behavior Sciences, and has been appointed as a Research Scholar at the University of Witwatersrand in Johannesburg, South Africa. She was the recipient of the American Academy of Audiology Humanitarian Award in 2005. When in Texas, she carries an active clinical caseload with clinical duties involving adult and pediatric diagnosis, hearing aid dispensing, and electrophysiological assessments. Dr. Clark is a long time member of the American Academy of Audiology; board certified with the American Board of Audiology; licensed to practice audiology and dispense hearing aids in the States of Texas and Louisiana. She has authored many peer reviewed research articles, some book chapters, and has been invited to lecture in many parts of the world. Dr. Clark has been able to maintain an international perspective through a number of outlets which include: chair of the humanitarian audiologists in the International Society of Audiology; managing editor of The International Journal of Audiology; co-organizer of the Coalition for Global Hearing Health Conference; and engages in a personal annual philanthropic program in a South African country which she began in 1998.

Dr. Clark has no known conflict of interest regarding the information presented.

Annie Cardella, B.A.; AuD Extern UT Dallas; Callier Center is a graduate of The Ohio State University with Bachelor's degrees in both Linguistics and Italian. She is currently an extern and AuD/PhD student at UT-Dallas and works as a graduate assistant to Dr. Jackie Clark, Ph.D. Her interests include TeleAudiology tinnitus assessment and treatment, auditory rehabilitation, humanitarian audiology, and assessment of speech intelligibility in noise.

Annie Cardella has no known conflict of interest regarding the information presented.

As audiologists, our professional goal for our patients involves much more than simply “hearing louder.” Indeed, the goal is better defined as “listening success.” To be able to listen successfully, multiple cognitive abilities need consideration including overall processing speed, working memory, attention and more. The interaction of cognition and audition is of paramount importance to the patient and the audiologist, because listening is where hearing meets brain. In this presentation, top-down (i.e., cognitive) and bottom-up (i.e., sensory) processes will be explored with specific regard to which technologies facilitate improved “listening success.” Further, we’ll explore and review recently published information which supports the use of these technologies. The application of specific “intelligent automatics” (such as noise reduction, adaptive directionality, and coordinated compression) to working memory, binaural processing, spatial hearing and more will be addressed. A brief question and answer period will be provided.

Brief Outline/Summary of Course Content:

Top-Down (TD) Processing – definition & discussion.

Bottom-up (BU) Processing – definition & discussion.

Human Percepts as combined TD & BU.

Aging population presents increasing age-related maladies.

By age 85 yrs, 50% of population w/Alz Disease.

Multi-tasking as a lack of focus/lack of attention.

Negative Synergy (with specific regard to aging and hearing loss).

Listening is more challenging in specific situations.

Listening is more challenging with reduced cognitive ability.

The importance of Working Memory (definition and discussion).

The importance of attentional processes (def and discussion).

Cognitive ability and hearing loss (literature review).

Cognition and Listening Success (lit. review).

Working Memory Capacity = Processing & Storage components.

Train the brain (AR, LACE, EXERCISE).

Brains change constantly (adaptation, neural plasticity etc).

Exploit neural plasticity.

Technology’s Role?

Brief Discussion of specific technologies, including:

FM, Intelligent Automatics, Noise Reduction, Adaptive Directionality, wireless, advanced feedback management, spatial hearing.

Review elements of Cognition Friendly Amplification.

LEARNING OUTCOMES:

Participants will be able to identify and explain bottom-up (i.e., sensory) and top-down (i.e., cognitive) processes.

Participants will be able to name at least two technologies available in today’s hearing aid technologies which make listening success more likely.

Participants will be able to describe at least two benefits of “knowing where to listen."

Dr. Beck earned his master's degree at the State University of New York at Buffalo (1984) and his doctorate from the University of Florida at Gainesville (2000). His career started at the House Ear Institute (LA) in cochlear implant research and intraoperative cranial nerve monitoring. Five years later he was appointed Assistant Professor of Otolaryngology and Director of Audiology at Saint Louis University. After eight years in that capacity he co-founded a private audiology-based dispensing practice in St Louis. Dr. Beck became Editor-In-Chief of www.audiologyonline.com, www.speechpathology.com and www.healthyhearing.com in 1999. Doug joined Oticon in 2005 as Director of Professional Relations. In 2008, he was appointed Web Content Editor for the American Academy of Audiology (AAA). Dr. Beck is a prolific author and entertaining speaker. He has addressed a wide variety of audiology and professional topics via hundreds of publications and is well known internationally for his entertaining and educational podium presentations.

Dr. Beck has no known conflict of interest regarding the information presented.

Summary: With a perfect storm of continued decreases in codes per the Medicare Physician Fee Schedule, an unstable economy, increased competition from many venues, the bundling of our services, and many hearing aid contracts that are not all beneficial, considerations for practice stability will be discussed for capturing reimbursement to enable quality hearing care.

Objectives:

1. Participants will identify the rules of engagement as a Medicare provider
2. Participants will identify advantages of unbundling hearing aid professional services
3. Participants will identify the procedures that need to be in place for compliance with new federal regulations that impact the practice of audiology.

Debbie Abel, Au.D., is the Director of Reimbursement and Practice Management for the American Academy of Audiology. She also serves as a consultant and has nothing to disclose.