Access Type

Open Access Dissertation

Date of Award

January 2022

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Communication Sciences and Disorders

First Advisor

Margaret Greenwald

Abstract

With the revitalization of aural rehabilitation (AR) and increased use of telepractice services, there is a paucity of research examining factors that have the potential to affect remote assessment. An assessment of memory is commonly included in a comprehensive AR assessment because recently developed auditory-cognitive training programs include auditory-based cognitive activities, such as auditory memory tasks. This investigation explored the effect of presentation modality on speech discrimination performance and whether self-reported hearing ability correlated with remote memory assessment in older adults.Older adults self-reported their hearing abilities and completed speech discrimination and memory tasks. Data were collected remotely via a telephone session and an optional videoconferencing session. Measures were taken to control the acoustic environment as well as the timing and clarity of stimulus presentation as closely as possible using telepractice. These measures included the use of a sound-level meter app, a speech audibility and intelligibility check, and voice onset cues to ensure consistent presentation timing. A quantitative design was used to explore the associations between the primary outcome measures and a paired samples t-test was used to examine the effect of presentation modality on speech discrimination. Self-reported hearing ability and remote speech discrimination were not significantly associated with memory performance. Additionally, measures of self-reported hearing ability and speech discrimination were not significantly correlated. Participant age, gender, and education level were not significantly correlated with any of the primary outcome measures. Speech discrimination did not differ significantly for live voice versus recorded voice. The findings from this study support the use of audio-recorded stimuli for remote assessment, which increases the reliability of administration as well as the variety of tasks appropriate for telepractice. The lack of a significant association between self-reported hearing ability and memory performance conflicts with findings from research conducted face-to-face. Therefore, future investigations should explore potential reasons for this finding, as it could impact remote assessment strategies. Additional work is also needed to better understand factors that facilitate and serve as barriers to successful implementation of telepractice.

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