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The link between nonaudiological variables and outcomes measurement is explored. Hearing impairment can affect an individual's everyday communication in numerous ways. Both audiological and nonaudiological variables interact with each other to produce a unique predicament for each individual with hearing impairment. The nonaudiological variables that are addressed in this article include race/ethnicity, gender, age, personality, self-efficacy, and social support, as well as a number of other factors. Some of these variables, such as personality, have been found to exert more influence than audiological factors on audiological rehabilitation outcomes. The potential influence of each variable is discussed and directions for future research are provided.

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The participants in the Eriksholm Workshop on "Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids" debated three issues that are reported in this article. First, it was agreed that the characteristics of an optimal outcome measure vary as a function of the purpose of the measurement. Potential characteristics of outcome self-report tools for four common goals of outcome measurement are briefly presented to illustrate this point. Second, 10 important research priorities in outcome measurement were identified and ranked. They are presented with brief discussion of the top five. Third, the concept of generating a brief universally applicable outcome measure was endorsed. This brief data set is intended to supplement existing outcome measures and to promote data combination and comparison across different social, cultural, and health-care delivery systems. A set of seven core items is proposed for further study.

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Two intervention procedures for the rehabilitation of elderly adults with hearing impairment were evaluated: analytic auditory training and active listening training. Seventy-eight older adults with hearing loss served as subjects. Twenty-six subjects received no training, 26 received analytic training, and 26 received active listening training. The effectiveness of the audiologic rehabilitation programs was determined via measures of speech recognition, hearing handicap perception, and psychosocial function. Active listening was found to be an effective treatment for helping individuals with hearing impairment improve their auditory-visual recognition of speech in noise and improve certain aspects of their psychosocial functioning. Support for analytic speech recognition drills alone was not demonstrated.

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A 48-item questionnaire was administered to 100 older adults to determine their expectations regarding hearing aid use. The sample consisted of volunteers from a variety of senior citizen organizations and ranged in age from 55 to 92 years. Only individuals who reported no prior hearing aid usage were included in the sample. Expectations for the following factors were considered: cosmetics, acoustics, communication benefits, comfort, ease of use, cost and upkeep, and attitudes toward hearing aid use. In general, the older adults in this sample appeared to have very positive expectations regarding the use of hearing aids. Eighty-seven percent apparently have medium to high expectations for hearing aid use. Since the older adult's satisfaction with amplification may be influenced by original expectations and attitudes, the information provided in this study may be useful in improving the pre-fitting counseling of older hearing-impaired adults.

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This investigation sought to determine whether the pattern of performance differed between young and elderly normally hearing adults on a closed v. open-set discrimination task. The California Consonant Test was administered at 32 dB SL (re:SRT) to 20 young and 20 elderly normally hearing subjects under two conditions: one which required subjects to mark their response on a multiple choice answer form; and a second which required subjects to provide a one-word written response on a blank answer form. The only significant difference occurred within the young group between conditions (closed-set, open-set). The young group's speech discrimination was significantly better in the closed-set condition then in the open-set condition. No other differences were significant. The results question the concept of phonemic regression as a concomitant of ageing.

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A measure of perceived hearing aid benefit was obtained from 24 older hearing-impaired adults who had received their hearing aids a minimum of 6 months prior to this study. Subjects were also administered a battery of tests, including comparisons of maximum scores for phonetically balanced words and the Synthetic Sentence Identification Test to identify central auditory disorder. There appears to be no relationship between perceived hearing aid benefit and central auditory function as measured in this study. Several explanations for these somewhat surprising findings are offered, as well as clinical implications regarding the use of hearing aids by older adults.

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Visual consonant and sentence reception were compared in three groups of 10 normal-hearing young adult subjects including a Training group that received 14 hours of videotaped analytic visual consonant recognition training with 100% feedback concerning the correctness of their responses, a Pseudotraining group that received the same treatment as the Training group with the exception that they were not given any information about whether their responses were correct or not, and a Control group. While all three groups scored significantly higher on the post-treatment visual consonant recognition test, there was no significant difference between the Training group and the Pseudotraining group in terms of improvement scores. Furthermore, none of the groups improved in their ability to recognize visually presented sentence length material. These results are discussed in terms of the development of task-specific performance skills.

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The purpose of this study was to compare structural play-language relationships and diversity of symbolic play skills in age matched language-impaired and language-normal children. The language-impaired and language-normal children differed in their play-language correspondences when the structural metrics of mean length of utterance (MLU) and mean length of sequence (MLS) were used. Differences between the groups were also found on specific quantitative and qualitative aspects of symbolic play. Suggestions for play intervention are discussed.

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Comprehension of semantic concepts considered basic to academic performance in the early grades was evaluated with the Boehm Test of Basic Concepts (BTBC) for 15 orally trained, severely and profoundly hearing-imparied children, ages 13--14 years. The children also were required to construct written sentences using these same concepts. Teachers of the hearing-impaired children completed a questionnaire of their expectation levels of the vocabulary competence, comprehension, and production for each child on the 50 items of the BTBC. Classroom texts used by the children were examined for the presence of these specific concepts. The measure of comprehension showed that four-fifths of the children scored lower than the 10th percentile for second-grade hearing children, and two-thirds scored at or below the 1st percentile. Evaluating production, 68% of the sentences produced by the children contained semantic, syntactic, or semantic-syntactic errors. The individual's level of vocabulary comprehension was higher than each child's level of production. Classroom teachers were able to predict accurately each child's comprehension and production scores. Finally, the survey of the classroom textbooks used by the children revealed that approximately 80% of the BTBC test items appeared within the texts. Implications are discussed.

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Topics of research in the field of speech and hearing were identified and compared over a 21-yr period (1954--1974). These topics were identidied by a key-word analysis of approximately 8200 titles consisting of articles in national and international journals, and of theses and dissertations presented in the state of Ohio. Results of this analysis have pinpointed certain research trends in the field of speech and hearing. Attention to certain topics has either declined, increased, or reached a peak during the 21-yr period, while interest in some topics has been consistently maintained throughout the years. The information reported provides a perspective from which to view contributions made by researchers in the field of speech and during the last two decades.

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The titles of a substantial sample of articles related to speech pathology and audiology over a period of 21 years were catalogued under one or more of 10 categories, e.g., normal audition, defective phonation, and the like. The titles of theses and dissertations in this field of six universities of Ohio over the same period were also catalogued. The articles appeared in 17 journals. The journals were treated as seven groups of "related" journals. The total output of journals was stable over the period studied; a "group" of journals tended to be consistent with itself over successive 3-year periods; the seven groups of journals tended to be unique, and not to replicate each other. The topics treated in the journals were accepted as a criterion for contemporaneousness. The student output of the universities varied in contemporaneousness from one school to another, ranging upward to r = 0.98 (10 categories). The overall correlation between the student and the journal outputs was r = 0.79.

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