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AUDIOLOGY - DISTINGUISHED BY VALUE THURSDAY 10/15/2015 7:15 Registration 7:30 Early Bird Session -Widex Solutions for Single Sided Deafness Widex CROS/BICROS 8:30 Breakfast with the Vendors (30 minutes) Sponsored by Widex 9:00 2 hr KEYNOTE: Robert Sweetow, Ph.D. An Overview of Tinnitus Theory and Management 11:00 Break 11:15 Robert Sweetow, Ph.D. Cognitive Behavioral Therapy for Tinnitus 12:15 Exhibits (15 min) 12:30 Lunch 1:30 Exhibits (15 min) 1:45 Alicia Spoor, Au.D. AQC, PQRS, VBM, and other acronyms that you NEED to know Julie Cohen, Au.D. Mark the Word Meat and Pass the Mustard Please - Assessing the Impact of Hearing Impairment on Listening in Real-World Environments 2:45 Exhibits (15 min) 3:00 Gail Linn, Au.D. Verification - Is it Important? Natalie Feleppelle, Au.D. Audiologist s Role in Early Identification of Autism 4:00 Break (15 min) 4:15 Gus Mueller, Ph.D. Hearing Aid Verification: Can you afford NOT to do it? 5:30 Trivia Bowl

FRIDAY 10/16/2015 7:00 Registration 7:15 Early Bird Session: Starkey 8:15 Breakfast with the Vendors (30 minutes) Sponsored by Starkey 8:45 2 hrs KEYNOTE: Gus Mueller, Ph.D. Day to day hearing aid fittings: Clinical tips gleaned from research 10:45 Exhibits (15 min) 11:00 Speed Dating with the Manufacturers 12:00 Lunch Business Meeting Silent Auction End 1:30 Robin Pinto, Au.D. and Ashley Zaleski-King, Au.D. Assessment of vestibular compensation, visual dependence and symptoms of visual motion hypersensitivity Larry Medwetsky, Ph.D. The Spoken-Language Processing Approach: Broadening our Conceptualization of Central Auditory Processing 2:30 Break 2:45 Samira Anderson, Ph.D. What can evoked potentials tell you about the hearing aid fitting? Larry Medwetsky, Ph.D. (continued) 3:45 Break 4:00 Matt Goupell, Ph.D. Considerations for mapping of cochlear implants for users with substantial residual hearing Larry Medwetsky, Ph.D. Interpreting Central Auditory Processing Test findings: Not as Straightforward as One Might Think 5:00 FINAL CHECKOUT 1

Samira Anderson, Au.D., Ph.D. Dr. Samira Anderson practiced as a clinical audiologist in Minnesota for 26 years before she entered the Ph.D. program in Communication Sciences and Disorders at Northwestern University in 2007. While a student, she received a New Century Scholars Doctoral Scholarship from the American Speech-Language-Hearing Association and a Doctoral Scholarship Research award from the Illinois Academy of Audiology. After finishing her Ph.D., she joined the faculty of the Department of Hearing and Speech Sciences at the University of Maryland in January of 2013. She now directs the Hearing Brain Lab, using electrophysiological methods to investigate central auditory processing across the lifespan, from infants to older adults. In 2014 she was awarded a grant from the Hearing Health Foundation to study neural adaptation in new hearing aid users. Dr. Anderson has been highly productive in the last seven years with more than 20 publications and more than 50 presentations and posters. Although hearing aid technology has improved dramatically in the last few decades, less than 20% of senior citizens with hearing loss use hearing aids. One possibility for this lack of acceptance of hearing aids is that deficits in auditory processing associated with aging and hearing loss may limit amplification benefits. Real-ear measurement ensures that appropriate amplification is delivered to the tympanic membrane, but how does amplification affect central auditory processing? This presentation will discuss how evoked potential measurements may be used to inform us of the effects of amplification on central auditory processing. Following this presentation, the learner will be able to: a. Describe ways in which evoked potentials can be used to verify hearing in an infant b. Describe the effects of aging and hearing loss on brainstem and cortical evoked potentials c. List the effects of amplification on brainstem and cortical evoked potentials in older adults d. Discuss how amplification effects on evoked potentials change over time Julie Cohen, Au.D. Julie Cohen, Au.D., is a research audiologist at the Walter Reed National Military Medical Center in Bethesda, MD and a Hearing and Speech Sciences Ph.D. student at University of Maryland (UMCP). Dr. Cohen received her B.A. (2008) and Au.D degrees (2012) from UMCP. Her areas of research include auditory fitness for duty in the military population, sound localization, hearing aids, and long term auditory and vestibular changes following traumatic brain injury. In addition to the time she spends in research, she provides clinical services to military retirees and their dependents. For the past 6 years she has taught several courses as a lecturer and adjunct faculty member at UMCP. Clinical audiologists are tasked with assessing the impact of a patient s hearing loss on their ability to communicate in the real-world. Current methods implemented in the clinic, such as speech perception in noise testing or qualitative surveys, are not entirely representative of factors 2

that the patient may face in a challenging communication environment. Laboratory studies have attempted to create these real-world environments in the sound booth by assessing speech perception in degraded environments (noise level, reverberation time, speed, etc.) or with the additional of visual cues, but these studies also fall short of maintaining ecological validity. Two methods have been developed to separately approach the issue of assessing a listener s listening performance in naturalistic environments: 1) complex auditory scene localization and 2) realworld speech perception. Method 1 assessed how listeners maintained spatial awareness in realistic environments by measuring their ability to identify changes in complex auditory scenes containing multiple competing sound sources. Up to six sound sources were presented simultaneous through a speaker array, and listeners were instructed identify when they detected a change in the scene and what speaker the change occurred. Method 2 measured how well groups of four participants were able to communicate in noisy public spaces, like cafeterias and restaurants. Tablet computers were used to prompt the talker with a target phrase in each trial, and speed and accuracy of the response was measured for the other three listeners. Results from several studies that implemented these methods with normal and hearing impaired listeners will be discussed. Learning Outcomes: 1) Learner will be able to discuss importance of real-world speech perception experiments. 2) Learner will be able to list differences in standard hearing aid directional microphone settings. 3) Learner will be able to describe how hearing aids may impact a listener s spatial hearing ability. Natalie Feleppelle, Au.D. Natalie Feleppelle, Au.D. is the clinical subject matter expert in pediatric audiology at the Audiology and Speech Pathology Center at Walter Reed National Military Medical Center in Bethesda. In addition, she serves as the manager of the ABR and EHDI programs and on the Cochlear Implant, Craniofacial, and NICU High Risk Clinic multidisciplinary teams. Prior to her current position, Dr. Feleppelle held staff appointments at Children's National Medical Center in Washington DC, The Children's Hospital of Philadelphia, and John Tracy Clinic in Los Angeles. She completed her residency at Nationwide Children's Hospital in Columbus. Dr. Feleppelle earned her Au.D. at The Ohio State University. She is Board Certified by the American Board of Audiology and is a Fellow of the American Academy of Audiology. Dr. Feleppelle s clinical and research interests include autism, early hearing loss detection and intervention, and unilateral hearing loss. Children with autism can have better long-term outcomes when they are diagnosed and treated at a young age. Research shows early intervention can significantly improve a child s development. 3

A reliable diagnosis of autism can often be made by an experienced professional at 2 years of age and in some cases earlier. However, the average age that children are typically diagnosed is much older. As a result, these children miss out on early intervention during critical years when it is most effective. Healthcare providers have an opportunity to change the status quo. This course will discuss the barriers to early identification and ways in which the audiologist can identify children that may have undiagnosed autism and would benefit from a developmental evaluation. Learning Outcomes 1. List the most common developmental concerns reported by parents of young children with undiagnosed autism. 2. Discuss the barriers that prevent the early identification of autism: 3. Describe the major characteristics of autism: 4. Name one parent report screening tool that can be used by healthcare providers to assess the need for referral for developmental evaluation. Matthew J. Goupell, Ph.D. Matthew Goupell is an assistant professor in the Department of Hearing and Speech Sciences at the University of Maryland. He received a B.S. in physics and mathematics at Hope College in Holland, MI (2001) and a Ph.D. in physics at Michigan State University (2005). He spent three years as a post-doc at the Austrian Academy of Sciences in Vienna, Austria and two years as a post-doc at the University of Wisconsin Madison researching auditory perception in bilateral cochlear-implant users. As cochlear-implant (CI) candidacy requirements relax, surgical techniques improve, and new devices are introduced, a growing number of CI users have substantial and usable residual hearing. However, approaches to mapping in these CI users likely need to be altered from the traditional methods to maximize user performance. In this talk, we will discuss traditional mapping approaches, and how those approaches change when mapping the newest CIs and CI populations: electro-acousticstimulation (EAS), hybrid (short array) CIs, and CIs used in individuals with single-sided deafness. Learning outcomes: 1) Be able to discuss the basics of cochlear implant mapping, such as frequency-to-electrode allocation. 2) Be able to describe new cochlear implant device functionality. 4

3) To apply knowledge of the new devices to develop new approaches to cochlear implant mapping. Gail Linn, Au.D. Gail Linn has been working with hearing aids since 1984. She received a Master s Degree in Audiology from the University of Northern Iowa and her Doctorate from Salus University. During that time she owned Iowa Hearing Clinics in Waterloo Iowa, worked as Director of Private Practice and Industry at the American Speech Language Hearing Association. Currently she is the owner of Potomac Audiology. We will look at how Real Ear Measures or Probe Microphone Measures are used for the initial fitting. How changing the dome sizes and venting affects the frequency response. We will discuss how Probe Microphone Measures is an important counseling tool for patients who are first time uses and even experienced users. We will look at how real ear measures can be used to differentiate ourselves from Hearing Aid Dealers and Over the Counter Hearing aids. And we will see how Verification can be used in promoting our practices. 1. Learn how First Fits when programming hearing aids rarely match the persons recommended target 2. Learn how venting and domes affect the frequency response 3. Understand how measuring can help solve patient complaints that are difficult to solve if probe microphone measures are not performed. 4. Understand that measuring is going to be more important as more Over-the-Counter Hearing aids and PSAPS are sold. Larry Medwetsky, Ph.D. Dr. Larry Medwetsky graduated with a M. Sc. in Audiology from McGill University and a Ph.D. in Speech and Hearing Sciences in 1994 from the Graduate Center, City University of New York. He has served as an educational audiologist, research associate, VP of Clinical Services in a large speech and hearing clinic, and is presently an associate professor at Gallaudet University in the Department of Hearing, Speech and Language Sciences. Dr. Medwetsky has published and presented on many different topics with a special focus on the underlying speech processes and deficits in both individuals with normal hearing and hearing loss. The Spoken-Language Processing Approach: Broadening our Conceptualization of Central Auditory Processing (1st talk) 5

Recent research reveals that the processing of speech involves the intertwining of auditory processes, cognition, language, as well as other mechanisms, as early as the cochlea and brainstem levels. Comprehensive approaches to addressing central auditory processing disorders must be cognizant of these mechanisms. This presentation will (a) highlight the research; (b) provide the presenter s conceptualization of how these mechanisms are systematically engaged when processing speech, and (c) discuss how different underlying deficits can lead to different processing related deficits. By ascertaining where deficits are present, one can derive individualized interventions that can successfully address the specific issue(s) at hand. 1. articulate the various processes engaged in effective auditory spoken language processing. 2. discuss the specific impact of deficits in any of these processes and how they can be manifested in everyday life. 3. describe an approach to developing a comprehensive test battery that, in turn, can be used to determine the specific processing deficits present. Interpreting Central Auditory Processing Test findings: Not as Straightforward as One Might Think (2nd talk) Audiologists have access to a variety of tests when examining central auditory processing. Test administration and scoring are relatively easy tasks, however, interpretation of findings is not as straightforward. Analysis and interpretation of results from different CAP tests will be shared, as well as their implications for intervention. 1. Critically describe the importance of interpreting a specific CAP test score in light of other test findings as derived through a test battery approach. 2. Be cognizant of possible different interpretations of CAP test findings that have been typically reported in the literature. 3. Utilize the knowledge gained from this presentation to influence future interpretation of the CAP tests reviewed in this presentation, and, in turn, guide appropriate recommendations. H. Gustav Mueller, Ph.D. Dr. H. Gustav Mueller is Professor of Audiology, Vanderbilt University, and has a private consulting practice nestled between the tundra and reality on a western North Dakota island. He also holds faculty positions with the University of Northern Colorado and Rush University. He is the Senior Audiology consultant for Sivantos Group and Contributing Editor for AudiologyOnline. Dr. Mueller is a Founder of the American Academy of Audiology and a Fellow of the ASHA. He is the Hearing Aids Series Editor for Plural Publishing and has authored seven books. 6

Research has shown the value of fitting patients to validated prescriptive algorithms. Other research has shown that this only can be accomplished by using probe-microphone measures (speechmapping). There is no Plan B. This seminar reviews the rationale for using validated prescriptive methods, and the serious mistakes that can be made when real-ear verification is not conducted. Through illustrative case studies, we ll walk through some protocols to show how these measures can be used effectively (and efficiently). Learning Outcomes Describe the rationale behind the use of prescriptive fitting procedures. Discuss the limitations of using fitting approaches designed by Describe how probe-mic measures can be used to verify the fitting, and assess the function of special hearing aid features. Friday: Day to day hearing aid fittings: Clinical tips gleaned from recent research There are nearly 200 research articles published each year regarding the design, selection and fitting of hearing aids. So much to read, so little time. In this seminar, we ll pull out many of these articles from recent years that have particular clinical applications, and review how some of these research findings can be used in day-to-day practice. In fact, there just might be a few things that you can apply on Monday morning. Learning Outcomes Describe how research evidence can be used to critically assess hearing aid features. Discuss how recent research evidence can be used to add efficiency to hearing aid selection procedures Describe how recent research adds to the understanding of true patient benefit of different hearing aid features. Robin Pinto and Ashley Zaleski-King Robin Pinto is a staff audiologist and the Army Audiology Externship Program Director at the Walter Reed National Military Medical Center in Bethesda, MD. She received her master s degree in audiology from Indiana University and an AuD from Salus University. Dr. Pinto has been practicing audiology with an emphasis in balance assessment and treatment for 14 years. She has participated in and helped develop several multi-disciplinary teams at Walter Reed to accurately evaluate and diagnose patients with dizziness and balance disorders. Her activities over the past 10 years have heavily focused on the assessment and rehabilitation of vestibular problems in the blast and TBI populations and clinical research endeavors related to assessment. She has also co-developed several seminars which provide physicians, audiologists, and other 7

allied health professionals with didactic as well as experiential exposure to the evaluation and treatment of vestibular disorders. Ashley Zaleski-King is an audiology research fellow at Walter Reed National Military Medical Center in Bethesda, MD and a Communication Sciences Ph.D. student at Gallaudet University. She received a B.A. from Vanderbilt University before attending Gallaudet for completion of the Au.D. Clinical research experience at the Mayo School of Health Sciences in Arizona focused on vestibulo-ocular reflex (VOR) electrophysiological patterns in patients clinically identified with vestibular migraine. Current clinical research interests include visual/vestibular sensory systems, compensation processes following vestibular insult, and the multi-sensory effects of traumatic brain injury (TBI). Typically, patients with acute vestibular dysfunction have symptoms of dizziness, imbalance and oscillopsia. After acute vestibular dysfunction, these symptoms are known to decrease or persist depending on variety of factors affecting the compensation process. Persistent symptoms of visual motion hypersensitivity, also known as visual vertigo, are less understood. The presentation will highlight the assorted patterns of vestibular compensation with an emphasis on increased visual dependence. Symptoms of visual motion hypersensitivity will be reviewed, and a Quality Improvement (QI) study conducted at the Walter Reed National Military Medical Center Audiology Clinic will be discussed. The goal of the QI study was to improve vestibular assessment and recommendations for referred dizzy patients. The outcomes of the following objectives will be presented: 1) improve interview and assessment processes of dizzy patients with quantification of visual dependence and measurement of visual motion hypersensitivity 2) improve identification of co-morbid symptoms in dizzy patients that may be related to severity of dizziness (i.e. anxiety and depression) and 3) identify changes in dizziness symptoms following treatment (i.e. vestibular rehabilitation therapy, behavioral health, etc.) as they relate to visual dependency, 1 month post audiology assessment. Learner Outcomes: 1. Participants will be able to explain the vestibular central compensation process affecting gaze stability and balance. 2. Participants will be able to identify symptoms of visual motion hypersensitivity and measure visual dependence 3. Participants will be able to explain multi-disciplinary roles in vestibular assessment and rehabilitation. Alicia Spoor Alicia D.D. Spoor, Au.D. is President of and Audiologist at Designer Audiology, LLC in Highland, Maryland. Prior to opening her own practice, Dr. Spoor worked at the Mayo Clinic 8

Arizona on the hearing aid team and the cochlear implant team and in two Maryland private practices. She is involved professionally at both the national and state levels. Dr. Spoor is currently the Secretary for the Academy of Doctors of Audiology (ADA), Chair of the Audiology Quality Consortium (AQC), and Legislative Chair for the Maryland Academy of Audiology (MAA). She previously chaired ADA s Advocacy Committee and was President of MAA in 2010. Dr. Spoor is also a member of the American Academy of Audiology s (AAA) Strategic Document Committee on Adult Hearing Screening and is a contributing author to the third edition of Audiology Practice Management. She has presented at local and national conferences on a variety of advocacy-related topics in the past three years. Recently, Dr. Spoor was named a VIP- Very Important Professional, Successful by 40 by The Daily Record (Baltimore, MD). Outside of work, Alicia enjoys traveling with her husband and playing soccer. Since 2009, the Audiology Quality Consortium (AQC) has collaborated on the development, testing, and reviewing of measures for the Centers of Medicare and Medicaid Services (CMS) Physician Quality Reporting System (PQRS). In 2015, Audiologists must report on 50% of eligible measures to avoid the payment penalty on claims submitted in 2017. This presentation will review the mission and members of the AQC, explain the current measures Audiologists can report on, and highlight some of the possible measures to be included in the next few years. Additionally, the Value Based Modifier (VBM) system will be explained, as known to date. This session will focus on private-practice Audiology clinics and Ear, Nose, and Throat (ENT)/Audiology clinics, not hospital-audiology clinics or the specific billing and coding of PQRS measures. Objectives/Outcomes: 1. Participants will be able to describe the current PQRS measures for Audiology and what measures may be applicable in 2016 to the profession. 2. Attendees will be able to identify organizations involved in the AQC and websites to find resources about PQRS and VBM. 3. Participants will be able to identify their practice setting and report how Value Based Modifiers will affect their reporting and payment. Robert Sweetow, Ph.D. Dr. Robert Sweetow is Professor in the Department of Otolaryngology at the University of California, San Francisco and the former Director of Audiology at UCSF. He received his Ph.D. from Northwestern University in 1977, M.A. from the University of Southern California and B.S. from the University of Iowa. Dr. Sweetow has written more than 25 textbook chapters and over 120 scientific articles on counseling, tinnitus, auditory training, and amplification. He is a reviewer for several scientific journals, the author of Counseling for Hearing Aid Fittings and a former member of the Board of Directors of the American Academy of Audiology. 9

Dr. Sweetow has lectured worldwide and was the developer of the interactive, adaptive computerized auditory training program called LACE (Listening and Communication Enhancement). He was the recipient of the prestigious 2008 Distinguished Achievement Award from the American Academy of Audiology. Most current therapies for tinnitus patients incorporate counseling along with some form of acoustic stimulation. Because of the strong correlations between tinnitus, hearing loss, noise exposure, and stress, it is logical that therapeutic intervention address the main contributing factors to tinnitus distress, that is, the phantom auditory perception, the hyper-vigilance paid to the tinnitus, and the negative emotional reaction. Advances in neuroscience and neuro-imaging have provided a greater understanding of the effects of various acoustical stimuli, for example, noise and music, on the brain and human behavior. Knowledge about site of stimulation, neural interactions, and transfer of neurotransmitters help explain the behavioral consequences, both positive and negative, of exposure to sound at both high and low intensities. Studies have shown that listening to certain types of stimuli induces relaxation in most individuals, and that specific parameters of the sound may be important. In this presentation, a critical analysis of new and existing theories about tinnitus will be provided. In addition, an integrated approach to tinnitus patient management that incorporates instructional and adjustment-based counseling (in the form of cognitive-behavioral intervention), amplification, relaxation exercises, and sleep management will be detailed.the first two hours of this session will be in a lecture format, while the final hour will be a detailed tutorial of cognitive-behavioral intervention. The course is designed to provide audience members with practical solutions and functional skills that can be immediately utilized in their clinical practice. Learning Objectives: At the culmination of this session, participants will be able to: 1. discuss various psychological and physical theories of tinnitus 2. demonstrate a working knowledge of how current management strategies can be applied to specific patients 3. apply cognitive behavioral intervention to tinnitus patients 10