Audiology Research

Purpose: Decentralized hearing care models facilitated by community health workers (CHWs) can improve access to care in low-income settings. Preset hearing aids, which offer user-selectable pre-developed amplification programs, may support such models, but little is known about their real-world use and alignment with clinical recommendations. Method: This longitudinal study formed part of a feasibility project implementing the World Health Organization’s (WHO’s) hearing aid service delivery approach in three low-income South African communities. Adults (≥18 years) with confirmed moderate-to-severe bilateral hearing loss were fitted with preset hearing aids by trained CHWs. Devices offered four preset amplification programs. Participant-driven selections were recorded at four distinct time points: fitting and follow-ups at 2 weeks, 2 months, and 6 months post-fitting. Results: In total, 36 participants (mean age = 76 years, SD = 8.9, range 50–96) were fitted with devices. Although over half (right: 52.8%, left: 58.3%) presented with high-frequency loss, only 34% initially selected the corresponding program. Most participants (80.6%, n = 29) changed their selections at least once over the six months. Significant associations between hearing loss configuration and selection occurred at some time points only in the left ear, but agreement with clinically recommended programs declined from 42% at baseline to 28% at six months. Conclusions: CHW-facilitated hearing aid delivery supports user autonomy in low-resource settings. However, frequent changes and divergence from clinically recommended programs suggest reliance on user-driven trial-and-error adjustments rather than audiometric fit, which may limit long-term benefit. Ongoing, person-centred guidance is needed for the effective use of preset hearing aids. Full article

Objectives: Hearing aids (HAs) are the most common intervention recommended for hearing loss (HL). Many adults with HL do not seek HA rehabilitation. Several studies have attempted to identify barriers and facilitators to using HAs. Different bureaucratic processes for acquiring HAs may lead to different barriers and facilitators. In addition, studies have not yet explored the factors influencing compliance with a recommendation for an HA consultation. This study focuses on the stage prior to consultation in a context where HAs are heavily subsidized. Methods: 148 patients who had undergone a hearing test during 2022 at Hadassah University Medical Center and received a recommendation to undergo a hearing aid consultation were contacted for a telephone survey. Seventy-two adults, 48 male and 24 female, aged 25–85 years, with HL ranging from slight to profound, responded to a telephone questionnaire. The questionnaire, based on two previously published English questionnaires and translated and adapted into Hebrew, was used to assess the main reasons a person did or did not comply with the recommendation to pursue an HA consultation. Results: HL was more severe in those who sought hearing rehabilitation. The main reasons for seeking hearing rehabilitation are the need and desire to hear better and pressure from others. The foremost reasons for not pursuing hearing rehabilitation are feeling that there is currently no need, esthetics, lack of time, and self-consciousness. No significant gender- or age-based differences were found. Conclusions: There are additional barriers to seeking HAs aside from cost and accessibility. Understanding the reasons for avoidance of hearing rehabilitation may help in developing strategies that encourage people to seek hearing rehabilitation and use HAs when the need exists. Full article

Background: hearing loss represents, today, one of the most significant health problems affecting the world’s population. This clinical condition, particularly manifest in adulthood, can arise or be aggravated by both the presence of specific pathologies and by taking multiple classes of drugs at the same time. Methods: to understand this relationship, the present non-interventional observational study aimed to investigate the relationship between worsening hearing abilities in 1651 patients aged between 18 and 99 years. In particular, the thorough history of patients allowed us to evaluate the pathological profiles, pharmacological profiles, and therapeutic regimens adopted. This allowed us to evaluate its association with self-reported hearing loss, assessed through the administration of the HHIE-S-It questionnaire. Furthermore, given the presence of multimorbidity, the possible correlation between self-reported hearing loss and the specific classes of drugs, categorized using the Anatomical Therapeutic Classification (ATC) system, was evaluated. Results: the results highlighted how patients taking drugs, both in mono- and polytherapy regimens, had higher hearing deficits than patients not taking drugs. Furthermore, an apparent dose–response effect, in which the risk of moderate to severe impairment progressively increased with the number of drugs taken, was also observed. Different classes of drugs, particularly those used for the treatment of diseases of the cardiovascular system, as well as drugs for acid-related disorders, were significantly linked to an increased risk of perceived hearing impairment. On the contrary, agents belonging to the antidiabetic category have proven to be drugs capable of offering a potential protective effect. Conclusion: this study highlighted how both the number of drugs taken and some specific categories of drugs can contribute to perceived hearing impairment. While this evidence highlights the importance of integrating audiological evaluation into the management of patients in polypharmacy, the cross-sectional nature of the design precludes the inference of causality. This evidence still favors safer and more personalized therapeutic strategies. Full article

Background/Objectives: This study aimed to linguistically and culturally adapt the Social Participation Restrictions Questionnaire (SPaRQ) and the Hearing Handicap Inventory (HHI) for the Elderly/Adults to Danish and to investigate the reliability and validity of the questionnaires and their subscales in a clinical population. These questionnaires are quantifiable self-assessment tools that are used internationally to evaluate the social–emotional impacts of hearing impairment. Methods: The translation and cross-cultural adaptation procedures followed recommendations to adapt hearing-related questionnaires for different languages and cultures. In total, 64 participants (43 hearing aid users and 21 hearing aid candidates) completed both questionnaires using a test–retest paradigm. Results: Reliability analysis showed good internal consistency (Cronbach’s alpha between 0.82 and 0.94) and good agreement between the test and retest rounds (intraclass correlation values between 0.79 and 0.88) with both questionnaires. Neither SPaRQ nor HHI were correlated with better-ear PTA. However, SPaRQ and HHI, as well as their subscales, were significantly correlated with each other. Significant differences were observed at baseline between the HA users and candidates in terms of the better-ear PTA, but the distributions of subscale scores were broad and overlapping. Conclusions: The Danish version of SPaRQ is a reliable instrument for measuring the subjective impacts of hearing impairment. It can be used to capture the experiential aspects of hearing impairment that are not necessarily captured with objective measures of hearing. Full article

Purpose: This study aimed to evaluate retrospectively self-reported changes in tinnitus severity and distress associated with the COVID-19 pandemic and vaccination using validated self-report instruments. It further explored patient-reported onset of tinnitus following vaccination, gender differences in symptom severity, and associations with psychological distress. Method: A cross-sectional online survey was completed by 189 adults between December 2023 and April 2024. Participants retrospectively self-reported tinnitus onset and severity before, during, and after the COVID-19 pandemic using the Tinnitus Handicap Inventory (THI) and the Tinnitus Reaction Questionnaire (TRQ). Additional items assessed COVID-19 vaccination history, infection status, and adverse vaccine reactions. Repeated measures ANOVAs and chi-square tests were used to examine retrospectively reported longitudinal changes and group differences. Results: Mean THI scores increased significantly over time—before (M = 9.57, SD = 16.00), during (M = 29.97, SD = 32.30), and currently (M = 36.92, SD = 28.04)—with large effect sizes across functional, emotional, and catastrophic subscales (p < 0.001). TRQ scores also were reported to rise from before (M = 7.86, SD = 15.29) to during (M = 26.38, SD = 29.58) and remained elevated at the current time (M = 29.79, SD = 24.00), p < 0.001. Approximately 25.9% and 27.0% of respondents reported new or worsened tinnitus after the first and second vaccine doses, respectively. No significant gender differences in symptom severity were observed. TRQ severity classification revealed a marked shift, with moderate or greater distress increasing from 5.8% (before) to 35.6% (current). Conclusions: Retrospective self-reports indicated that tinnitus burden significantly increased during the COVID-19 pandemic and remained elevated at the time of survey completion. A notable proportion of individuals reported new-onset tinnitus following vaccination, though causality cannot be inferred. These findings highlight the need for continued monitoring and comprehensive care addressing both audiological and psychological components of tinnitus. Full article

Background: Spinal Muscular Atrophy type 1 (SMA type 1) is a genetic neuromuscular disease that typically presents before 6 months of age and is characterized by profound hypotonia, progressive muscle weakness, and early involvement of respiratory and bulbar musculature. Swallowing impairment (dysphagia) is a hallmark of SMA type 1 and significantly contributes to morbidity. Despite the documented benefits of disease-modifying therapies (DMTs) in terms of enhanced survival and motor outcomes, their impact on swallowing remains understudied. Aim: This study aims to longitudinally characterize swallowing function in children with SMA type 1 treated with DMTs, while contextualizing these findings in relation to the patients’ current motor abilities and cognitive performance. Materials and Methods: A single-center, longitudinal, observational study was conducted at IRCCS Besta, Milan, Italy, from 2021 to 2025. Swallowing function was evaluated using four validated scales (MAS, OrSAT, FILS, and p-FOIS), while motor and cognitive functions were assessed using CHOP-INTEND and age-appropriate cognitive tests (DQ/IQ). Patients were stratified by baseline swallowing status, pharmacological therapy, and age at DMT administration. Non-parametric statistical tests were applied. Results: No statistically significant changes in swallowing function were observed over one year in the overall cohort or its subgroups, despite significant improvements in motor function. MAS/e, FILS, and p-FOIS showed moderate associations with CHOP-INTEND and DQ/IQ scores. Conclusions: Swallowing function in children with SMA type 1 remained largely stable, while motor function significantly improved over one year, regardless of baseline swallowing status, DMT type, and age at administration. These findings underscore the need for standardized, longitudinal assessments of swallowing, motor, and cognitive functions in the management of SMA type 1. Full article

Introduction: Noggin encoding (NOG) gene plays a critical role in early embryogenesis and development of bones, joints, cartilage, eyes, and neural tissue. The NOG gene encodes the noggin protein. Noggin is the only secreted inhibitor of bone morphogenetic protein (BMP) that is associated with abnormal phenotypes in humans. The most commonly observed manifestations of NOG gene mutations include bilateral conductive hearing loss, proximal symphalangism, broad thumbs, hyperopia, and a distinct facial appearance. This genetic disorder was first reported in 1990 by Teunissen and Cremers. Since then, various phenotypic presentations of NOG mutation have been reported, leading to the introduction of the term NOG-related symphalangism spectrum disorder (NOG-SSD). Case report: In this report, we describe a family (mother and daughter) with bilateral mixed hearing loss. Both patients had hyperopia, distinct facial appearance with hemicylindrical nose, broad thumbs, and syndactyly of the second and third toes. Genetic testing confirmed a NOG gene mutation. Bilateral stapedotomy was successfully performed, resulting in significant hearing improvement. However, due to sensorineural component of hearing loss, complete hearing recovery was only achieved with the use of hearing aids. Discussion: The etiology of the sensorineural component of hearing loss in NOG-SSD remains unclear. In animal models, the NOG gene is essential for inner ear development, while in humans, only middle ear malformations have been reported. The phenotypic variability observed in individuals with NOG mutations is very wide, suggesting that the sensorineural component of hearing loss could represent one of the possible manifestations. Conclusions: Conductive hearing loss is the primary manifestation of the NOG-SSD, and all previously reported cases of NOG gene mutations have presented exclusively with conductive hearing loss. It is possible that additional genetic factors, not necessarily directly related to the NOG gene but present in this family, contribute to the development of the sensorineural component of hearing loss, although thorough genetic testing did not reveal any additional mutation. This is, to our knowledge, the first report of mixed hearing loss associated with a NOG mutation confirmed preoperatively. Further studies are needed to determine whether the sensorineural component represents a primary manifestation or arises from secondary mechanisms. Full article

Background/Objectives: Spanish-speaking patients face persistent barriers in accessing equitable audiological care, particularly when standardized language-appropriate tools are lacking. Two Spanish-language sentence recognition tests, the Spanish AzBio Sentence (SAzB) and the Latin American Hearing in Noise Test (LAH), are commonly used to evaluate speech perception in adults with hearing loss. However, performance differences between these measures may influence referral decisions for hearing intervention, such as cochlear implantation. This study compared test performance under varying noise and spatial conditions to guide appropriate test selection and reduce the risk of misclassification that may contribute to healthcare disparities. Methods: Twenty-one bilingual Spanish/English speaking adults with normal bilateral hearing completed speech perception testing using both the SAzB and LAH. Testing was conducted under two spatial configurations: (1) speech and noise presented from the front (0° azimuth) and (2) speech to the simulated poorer ear and noise to the better ear (90°/270° azimuth). Conditions included quiet and three signal-to-noise ratios (+10, +5, and 0 dB). Analyses included paired t-tests and one-way ANOVAs. Results: Participants scored significantly higher on the LAH than on the SAzB across all SNR conditions and configurations, with ceiling effects observed for the LAH. SAzB scores varied by language dominance, while LAH scores did not. No other differences were observed based on any further demographic information. Conclusions: The SAzB provides a more challenging and informative assessment of speech perception in noise. Relying on easier tests like the LAH may obscure real-world difficulties and delay appropriate referrals for hearing loss intervention, including cochlear implant evaluation. Selecting the most appropriate test is critical to avoiding under-referral and ensuring Spanish-speaking patients receive equitable and accurate care. Full article

Background/Objectives: Previous research has demonstrated that the perception of self-motion, as signaled by cervical proprioception, is significantly altered during neck muscle fatigue, while no similar effects are observed when self-motion is signaled by the vestibular system. Given that in typical natural movements, both proprioceptive and vestibular signals are activated simultaneously, this study sought to investigate whether the misperception of motion persists during neck muscle fatigue when both proprioceptive and vestibular stimulation are present. Methods: The study evaluated the gain of the perceptual responses to symmetric yaw sinusoidal head rotations on a stationary trunk during visual target localization tasks across different rotational frequencies. In addition, the final localization error of the visual target was assessed following asymmetric sinusoidal head rotations with differing half-cycle velocities. Results: The findings indicated that even with combined proprioceptive and vestibular stimulation, self-motion perceptual responses under neck muscle fatigue showed a pronounced reduction in the gain at low-frequency stimuli and a notable increase in localization error following asymmetric rotations. Notably, spatial localization error was observed to persist after asymmetric stimulation conditioning in the light. Additionally, even moderate levels of muscle fatigue were found to result in increased self-motion misperception. Conclusions: This study suggests that neck muscle fatigue can disrupt spatial orientation, even when the vestibular system is activated, so that slow movements are inaccurately perceived. This highlights the potential risks associated with neck muscle fatigue in daily activities that demand precise spatial perception. Full article

Purpose: The present study aimed to describe the adaptation and validation process of the MuRQoL (Music Related Quality of Life questionnaire) from English to Hebrew and to describe normative data from a cohort of adults with normal hearing versus those with hearing aids or cochlear implants. Methods: After thoroughly translating and adapting to Hebrew, the participants completed the questionnaire online. We calculated the Cronbach’s alpha and McDonald’s omega scores for all scales and subscales. The construct validity of the questionnaire was evaluated using Confirmatory Factor Analysis (CFA) and the “known group” method. A total of 310 adults participated in this study. Fifty-four participants were deaf or hard of hearing, and 256 had normal hearing. Results: Internal consistency of the MuRQoL-He scales and subscales demonstrated good-to-excellent reliability. The goodness-of-fit indices for the frequency and importance scales were within acceptable standards. We found a significant difference in the frequency scale, where the normal-hearing group scores were significantly higher than those of the deaf and hard-of-hearing groups. Conclusions: The validity and reliability of the MuRQoL-He have been confirmed, indicating that it is suitable for guiding music rehabilitation for Hebrew-speaking deaf and hard-of-hearing adults. Full article

Background and Clinical Significance: Benign paroxysmal positional vertigo (BPPV) most commonly involves the posterior semicircular canal (PSC), whereas anterior semicircular canal BPPV (ASC-BPPV) is rare, accounting for only 1–3% of cases. Most ASC-BPPV cases respond well to particle repositioning maneuvers (PRMs), with refractory presentations being exceptional and diagnostically challenging, particularly when differential diagnoses such as apogeotropic posterior semicircular canal BPPV (PSC-BPPV) or central causes must be excluded. Case Presentation: A 43-year-old woman presented with vertigo triggered by head extension and rolling in bed. Initial neurological and otoneurological examinations were unremarkable. During the left Dix–Hallpike maneuver, a vertical down-beating nystagmus with subtle leftward torsion appeared after a 5 s latency and lasted 15 s. The supine head-hanging maneuver provoked a stronger and longer 30 s response, while the right Dix–Hallpike was negative. Despite repeated PRMs, including Yacovino (Deep Head-hanging), reverse Epley, Epley, and modified Semont maneuvers, the patient remained symptomatic over three years. Intermittently, conversion to PSC-BPPV was suspected, and temporary resolution was achieved after left-sided Epley and Semont maneuvers, but recurrence followed. Treatment with a mechanical rotational chair (TRV) initially resolved symptoms, but vertigo recurred several months later following two syncopal episodes with minor trauma. Extensive neurological evaluation, including MRI, CT, EEG, and vascular ultrasound, excluded central causes. Conclusions: This case illustrates the diagnostic and therapeutic difficulties posed by refractory ASC-BPPV, particularly in differentiating it from apogeotropic PSC-BPPV and central etiologies. It underscores the importance of latency, torsional characteristics, and supine head-hanging testing in diagnosis and demonstrates the potential role of mechanical rotational chairs in management. Personalized approaches incorporating anatomical imaging and maneuver adaptation are essential in such complex cases. Full article

Background/Objectives: Skull vibration-induced nystagmus (SVIN) is a rapid bedside test that reveals vestibular asymmetry. Its clinical utility in Ménière’s disease (MD) remains controversial, particularly regarding its association with radiological endolymphatic hydrops (EH). This study aimed to evaluate the relationship between SVIN, audiovestibular parameters, and EH severity in patients with unilateral definite MD. Methods: This prospective observational study was conducted at a tertiary academic referral center and included patients with unilateral MD who underwent SVIN testing (SVT), audiovestibular evaluation (PTA, cVEMP, oVEMP, vHIT, and caloric testing), and 3T MRI with gadolinium-enhanced 3D-FLAIR sequences to quantify EH. Results: In total, 84 patients were included in the study. SVIN was present in 57.14% of patients (n = 48), with ipsilesional nystagmus being the most frequent subtype (64.58%). Patients with SVIN had significantly higher vestibular EH (p = 0.017) and vestibular endolymphatic ratio (REL) in the affected ear (p = 0.019). Disease duration (p = 0.026) and shorter time since last vertigo spell (p = 0.018) were also associated with SVIN presence. REL correlated moderately with disease duration (r = 0.390, p < 0.001), PTA (r = 0.576, p < 0.001), and number of vertigo spells (r = 0.236, p = 0.031), but not with time since last crisis (r = −0.127, p = 0.252). ROC analysis yielded an AUC of 0.735 for REL in predicting SVIN. Conclusions: SVIN correlates with the severity of vestibular EH. This finding indicates a stimulus-locked response of a vestibular asymmetry rather than a purely structural alteration. Full article

Background: Hearing and cognition decline with age. Hearing is now considered an independent risk factor for later cognitive impairment. Computerized cognitive auditory training is being discussed as a possible adjunctive therapy approach. Objectives: The aim of this exploratory study is to investigate how the success of a computer-based cognitive auditory training (CCAT) can be measured. For this purpose, the influence of a CCAT on different dimensions of hearing and cognition was determined. Materials and Methods: 23 subjects between 52 and 77 years old were recruited with normacusis to moderate hearing loss. They underwent 40 digital training lessons at home. Before, during, and after completion, concentration ability with the d2-R, memory (VLMT), subjective hearing impairment (HHI), hearing quality (SSQ12), listening effort in noise (ACALES), and speech understanding in noise (GÖSA) were measured. Results and Discussion: In this uncontrolled, non-randomized study, one of the main findings was that cognitive dimensions, namely processing speed, improved by 12.11 ± 16.40 points (p = 0.006), and concentration performance improved by 12.56 ± 13.50 points (p = 0.001), which were not directly trained in CCAT. Learning performance also improved slightly by 4.00 ± 7.00 (p = 0.019). Subjective hearing handicap significantly reduced by 10.70 ± 12.38 (p = 0.001). There were no significant changes in the SSQ-12 (p = 0.979). Hearing effort improved by 1.79 ± 2.13 dB SPL (p = 0.001), 1.75 ± 2.09 (p = 0.001), and 3.32 ± 3.27 dB (p < 0.001), respectively. Speech understanding in noise did not improve significantly. CCAT is likely to improve several dimensions of hearing and cognition. Controlled future studies are needed to investigate its efficacy. Full article

Background/Objectives: A.BA.CO. is a speech-to-text captioning system developed for school classrooms. The system uses remote microphones to capture the teacher’s speech without background noise. Under this setup, an issue of signal latency arises for students wearing hearing aids (HAs) or cochlear implants (CIs), whose latency is different from that of the remote microphones and may require the development of a temporal coupling solution. This study establishes the foundation for such a solution by determining the latency of two RMs (Remote Microphones) compatible with both HA and CI systems. The frequency response of the systems is analyzed independently and combined. Methods: The RMs combined with two Behind-The-Ear HAs, for which transparency was verified, were tested with two different compression ratios in a laboratory specializing in electroacoustic measurements using the comparison method to assess performance. Results: The time measurements revealed that the RMs differ by 10–12 ms (23–24 ms and 33–35 ms) and that the two HAs have time delays that differ by 1–2 ms (6–7 ms and 5–7 ms). The frequency responses showed that when HA and RM have similar gains, they exhibit comb-filter distortions. This effect could alter the acoustic output of devices in the ear canal and vary according to the mix ratio and mutual positions of HA and RM, potentially necessitating greater commitment from the wearer. Conclusions: The communication system will have to foresee different delays based on the model and brand of RM because similar transmission systems do not have the same time delays. RMs were originally designed for HA and are most effective if they represent the only or major acoustic stimulation that reaches the eardrum. These limits must be considered when estimating the effectiveness of A.BA.CO. with RM. Full article

Background/Objectives: Although research has demonstrated the positive impacts of hearing aid (HA) digital noise reduction (DNR), limited research is available on the impacts of the strength of DNR on listening effort. This study evaluated the effects of changes in the strength of HA DNR on listening effort, measured, behaviorally, using a self-report rating scale, and, physiologically, using pupillometry. The agreement between both measures was also examined. Methods: Eleven young adults with normal hearing completed a sentence-in-noise recognition task. Stimuli were processed through four noise reduction conditions (off, minimum, medium, maximum) using DNR algorithms found in conventional digital HAs. After sentence presentation, participants subjectively rated their perceived listening effort. Pupillometry was recorded during the task to assess changes in pupil size (a proxy of listening effort) during sentence recognition. Results: Participants’ perceived listening effort reduced as the noise reduction strength increased from off to medium DNR and then plateaued for the maximum DNR condition. Pupil dilation increased from off to medium DNR and then reduced for the maximum condition. Correlation analyses suggested no agreement between self-report and pupillometry measures of listening effort. Conclusions: Both self-report and pupillometry measures demonstrated changes in listening effort, with changes in the DNR strength indicating that noise reduction systems do provide benefit in reducing listening effort to a certain extent. Lack of agreement between the measures suggests that both methods might be assessing different constructs of listening effort and care should be taken while making methodological decisions to assess listening effort in individuals wearing HAs. Full article

Background/Objectives: The primary objective of the present study was to investigate early global development in children after one year of cochlear implant (CI) use. The secondary objective was to investigate the role of variables such as age at CI activation, gender, and parental schooling in early global development in children with a CI. Methods: The study sample included 24 subjects. All children were affected by severe-to-profound congenital bilateral sensorineural hearing loss (HL). The HL was diagnosed between 1 and 23 months of age (median 3 months) and participants underwent cochlear implant activation at 9–25 months (median 14 months). Participants were evaluated before CI surgery and after one year of CI use using the Italian version of the Griffiths III scales. Results: The general developmental quotient remained stable, as did the developmental quotients on scales A, C, D, and E. However, the development quotients on scale B, corresponding to the domain of “language and communication,” underwent a significant increase (p value < 0.05). There was a statistically significant negative effect of “age at CI activation” on both DQ at scale B (t − 3.457) and GDQ (t − 42.069). Maternal schooling had a significant positive effect on GDQ and DQ for scales A to D (p. value < 0.05). Conclusions: After one year of CI use, a significant improvement in the early global development of children was found in the language and communication domain. The age at CI activation and the level of the mother’s education were found to be related to early global development. Full article

Parenting stress significantly affects caregivers of deaf and hard-of-hearing (DHH) children, influenced by unique challenges and stressors. Background/Objectives: This study aims to develop the Chinese Family Stress Scale (CFSS) and to identify the stressors and contributing factors to elevated stress levels. Methods: The study involved 257 caregivers of DHH children aged 0–12 years old. The CFSS was used to assess parenting stress in caregivers of DHH children, with its reliability and validity evaluated. Factors such as speech intelligibility, oral language use, self-compassion, and social support were examined for their impact on parenting stress. Results: Key stressors included financial issues, discipline, education concerns, medical care, and safety. Elevated parenting stress was significantly associated with poor speech intelligibility of the child, inadequate oral language use, negative aspects of self-compassion, and insufficient social support. The CFSS showed good reliability and validity in measuring parenting stress among caregivers of DHH children. Conclusions: The CFSS is an effective tool for assessing parenting stress in caregivers of DHH children. Interventions to reduce parenting stress can focus on improving children’s communication skills, enhancing caregiver self-compassion, and bolstering social support networks. Full article

Background: Children diagnosed with Speech Sound Disorders (SSDs) encounter difficulties in speech perception, especially when listening in the presence of background noise. Recommended protocols for auditory processing evaluation include behavioral linguistic and speech processing tests, as well as objective electrophysiological measures. The present study compared the auditory processing profiles of children with SSD and typically developing (TD) children using a battery of behavioral language and auditory tests combined with auditory evoked responses. Methods: Forty (40) parents of 7–10 years old Greek Cypriot children completed parent questionnaires related to their children’s listening; their children completed an assessment comprising language, phonology, auditory processing, and auditory evoked responses. The experimental group included 24 children with a history of SSDs; the control group consisted of 16 TD children. Results: Three factors significantly differentiated SSD from TD children: Factor 1 (auditory processing screening), Factor 5 (phonological awareness), and Factor 13 (Auditory Brainstem Response—ABR wave V latency). Among these, Factor 1 consistently predicted SSD classification both independently and in combined models, indicating strong ecological and diagnostic relevance. This predictive power suggests real-world listening behaviors are central to SSD differentiation. The significant correlation between Factor 5 and Factor 13 may suggest an interaction between auditory processing at the brainstem level and higher-order phonological manipulation. Conclusions: This research underscores the diagnostic significance of integrating behavioral and physiological metrics through dimensional and predictive methodologies. Factor 1, which focuses on authentic listening environments, was identified as the strongest predictor. These results advocate for the inclusion of ecologically valid listening items in the screening for APD. Poor discrimination of speech in noise imposes discrepancies between incoming auditory information and retained phonological representations, which disrupts the implicit processing mechanisms that align auditory input with phonological representations stored in memory. Speech and language pathologists can incorporate pertinent auditory processing assessment findings to identify potential language-processing challenges and formulate more effective therapeutic intervention strategies. Full article