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OBJECTIVE: Related to the hearing health journey, this study aimed to: (i) explore how empowerment manifests itself from individuals' first awareness of hearing loss through to hearing aid fitting and then to becoming an active hearing aid user, (ii) identify points when the different dimensions of empowerment are most relevant, and (iii) conceptualise empowerment. DESIGN: A semi-structured interview study was conducted, followed by a template analysis of the data. STUDY SAMPLE: Adult hearing aid users from Sweden (n = 8) and Australia (n = 10) who had worn hearing aids for between 6 and 36 months. RESULTS: The themes that emerged from the transcripts were knowledge, skills and strategies, participation, self-efficacy, and control. CONCLUSIONS: This study conceptualises empowerment along the hearing health journey as the process through which individuals with hearing-related challenges acquire and use knowledge, skills, and strategies, and increase self-efficacy, participation, and the feeling of control of their hearing health care, hearing solutions, and everyday lives. There are not specific points along the hearing health journey where any dimension is uniquely relevant, instead, each dimension is a dynamic component at all stages.

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Objective: To investigate the effect of varying cross-over frequency (CF) settings for electric-acoustic (EA) stimulation in one ear combined with acoustic (A) hearing in the opposite ear on binaural speech perception, localization and functional performance in real life. Methods: Performance with three different CF settings set according to audiometric-based criterion were compared, following a four week familiarisation period with each, in ten adult cochlear implant recipients with residual hearing in both ears. On completion of all trials participants selected their preferred CF setting. Results: On average, CF settings did not have a significant effect on performance scores. However, higher ratings on device usage were associated with the preferred CF settings. Conclusion: Individuals who use EA + A stimulation may benefit from access to different CF settings to achieve maximal device usage.

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OBJECTIVE: We investigated effects of aetiology and age at implantation on changes in threshold (T) levels, comfortable (C) levels and dynamic range (DR) for cochlear implants (CIs) in children over the first five years of life. DESIGN: Information was collected at 6 months post-activation of CIs, and at 3 and 5 years of age. STUDY SAMPLE: One hundred and sixty-one children participating in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. RESULTS: Children with neural and structural cochlear lesions had higher T-levels and C-levels as compared to those without these conditions. Parameter settings varied from manufacturer's defaults more often in the former than in the latter group. Investigation of the effect of age at implantation for children without neural and structural cochlear lesions showed that those implanted at ≤12 months of age had higher T-levels and narrower DR at 6 months post-activation, as compared to the later-implanted group. For both early- and later-implanted groups, the C-levels at 6 months post-activation were lower than those at age 3 and 5 years. There were no significant differences in T-levels, C-levels, or DR between age 3 and 5 years. CONCLUSIONS: Aetiology and age at implantation had significant effects on T-levels and C-levels.

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This paper reports findings from a study that was aimed at investigating how best to prescribe devices that provide electric-acoustic stimulation. The localization and speech perception of adults who use electric-acoustic stimulation in one ear and acoustic amplification in the opposite ear were evaluated. Results indicated localization benefits when acoustic amplification was used in both ears. Systematic adjustments of the relative output and cross-over frequencies were implemented to determine the settings that optimized outcomes. Results from a case study indicated benefits for localization and speech perception when electric-acoustic stimulation in one ear was combined with a hearing aid in the opposite ear, after acoustic-to-electric levels and cross-over frequencies were optimized.

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Cochlear implant systems that combine electric and acoustic stimulation in the same ear are now commercially available and the number of patients using these devices is steadily increasing. In particular, electric-acoustic stimulation is an option for patients with severe, high frequency sensorineural hearing impairment. There have been a range of approaches to combining electric stimulation and acoustic hearing in the same ear. To develop a better understanding of fitting practices for devices that combine electric and acoustic stimulation, we conducted a systematic review addressing three clinical questions: what is the range of acoustic hearing in the implanted ear that can be effectively preserved for an electric-acoustic fitting?; what benefits are provided by combining acoustic stimulation with electric stimulation?; and what clinical fitting practices have been developed for devices that combine electric and acoustic stimulation? A search of the literature was conducted and 27 articles that met the strict evaluation criteria adopted for the review were identified for detailed analysis. The range of auditory thresholds in the implanted ear that can be successfully used for an electric-acoustic application is quite broad. The effectiveness of combined electric and acoustic stimulation as compared with electric stimulation alone was consistently demonstrated, highlighting the potential value of preservation and utilization of low frequency hearing in the implanted ear. However, clinical procedures for best fitting of electric-acoustic devices were varied. This clearly identified a need for further investigation of fitting procedures aimed at maximizing outcomes for recipients of electric-acoustic devices.

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