Episode Transcript
Hello, and welcome to The Future is Sound, a partnership in hearing podcast. Brought to you by Oticon Canada. I'm your host, Becca Angel, and thanks for joining me on my first podcast journey where we will chat broadly about all things hearing. We will launch fun new episodes every month, and if you have any suggestions or comments, be sure to get in touch. Okay, let's get started.
Rebecca: Hi everyone. We have another guest on the show today. It's Ryan McCreery. Ryan is the vice president of research at Boys Town National Research Hospital. Ryan, I found this online, so I'm assuming this is still the case?
Ryan: Yeah. That's still as of today, my job title. Thanks for the invitation and I'm excited to talk to you today.
Rebecca: Cool. Yeah, we're going to talk a little bit about what you do at your own research laboratory, which I know sort of focuses on various aspects of hearing and hearing aids, amplification, language development, and in particular, outcomes for children who wear hearing aids. I know that some of your findings from the lab have sort of I guess helped with clinical protocols for fitting hearing aids in kids with hearing loss as well. We’ll chat a little bit about that too.
Ryan: Yeah, it's one of the areas that I'm most passionate about in our work. My background is as the pediatric audiologist. I worked for about 10 years in the clinic. Seeing kids and working with families before I decided to go back and get a PhD. I'm really glad that I did, because I feel like it helped my research questions to be more clinically oriented and more in line with what the needs of children and families are. I feel like that's always sort of influenced my work and still something that I think about even though I don't see patients anymore.
Rebecca: Yeah. My first question is, where did you begin? In a nutshell, how did you came up with some of those initial research goals?
Ryan: I fell into audiology indirectly. I feel a lot of people don't start out like, most people want to be an astronaut or something.
Rebecca: It’s my next question, why are you an audiologist? I don't know. My brother is an ENT and I didn't know what I was going to do with my life.
Ryan: I didn't know what I wanted to do when I went to college and I had the opportunity to work in a laboratory school at the University of Northern Colorado in Greeley. The classroom that I got assigned to was a classroom for children who are deaf and hard of hearing. In Colorado at the time, they were rolling out their universal newborn hearing screening program.
Some of the kids in the classroom had been identified through universal newborn hearing screening, and some of them had not, and it was a really stark contrast. The kids who had been identified through newborn hearing screening were talking and looked a lot like kids that you would see in a normal preschool classroom.
It was exciting to me to see that change happening. I feel like it was really good timing, and so I decided that I was going to become an audiologist and I did my master's degree at the University of Nebraska. Then I got a job as an audiologist at Boys Town National Research Hospital in Omaha.
During that period of time, Pat Stelmachowicz was the director of audiology and had a research lab where she studied amplification and helping to optimize amplification for kids. I was a clinician, but Pat's laboratory was in the clinic. She would come in and ask us questions and it really, really got me interested in research. But it took quite a bit of time before I was ready to jump back into school and to get in the PhD program. But when I did, Pat was my primary mentor for my research and I really continued to work with her until she retired in 2012.
Rebecca: Okay, cool. For 10 years, you were sort of working clinically with kids?
Ryan: Yeah and adults. That's the other dirty little secret about Boys Town is that we're really widely known about the pediatric work that we do. But right now, about 70% of our patients are adults. I fitted a lot of hearing aids on adults, but my passion was always in pediatrics. I always enjoyed working with kids and families. It felt like a really challenging situation.
A lot of those unanswered questions that I had as a clinician were things that really pushed me to pursue a PhD, because I would ask Pat questions like, well, why don't we do this? She’s like, well, why don't you get a PhD and do some research? I'm getting really tired of having to answer all of your questions and I can't answer all of them.
Rebecca: I guess that was a little while ago. You've been working in research at Boys Town for how long now? Because you were the director and now you're the vice president, right?
Ryan: Yeah, so I finished my PhD in 2011 and moved into a research scientist role in Pat's lab. Then I started my own lab later that same year in 2011. Then I became director of audiology when Pat retired in 2012, and then 2017 assumed an administrative role over the entire research program. Boys Town is known in our field for their audiology and communication research, but Boys Town also has really amazing research programs in neuroscience and behavioral health, all focused on helping kids and families, but just different elements of that.
Instead of just being over the audiology component of it, I'm now over the whole research enterprise. We have 42 laboratories across those areas in neuroscience, behavioral health, and communication disorders. It's cool because not only do I get to do my own research in the lab, but I also get to work with really, really smart people who are all trying to do research to improve the lives of children and families in different areas. I would say I just learned so much all the time at work. It's awesome.
Rebecca: Yeah. I didn't realize how many labs there were there.
Ryan: Yeah. I think in audiology, we know about some of the labs that are hearing related, but there's all kinds of cool work going on there and I'm still learning about it myself. I've been in the role now for six years and there's still cool areas of research that I am learning about. It's a great place to be.
Rebecca: Are you finding any overlap there where there's like oh, there's this hearing aid study, but then there's this communication study in neuroscience?
Ryan: Yeah. One of the awesome things about Boys Town is that we're not a university. There’s no teaching requirements associated with it. All of us in the research program just do research. There’s a big incentive for us to collaborate across areas. Obviously, you mentioned a lot of the work that I do is an overlap between audiology, and language, and academic, and reading development. Looking specifically at how kid’s hearing aids are fitted, obviously, a very interesting audiology question, but then that has branched out into, how we fit the hearing aids, does that help with language and academic outcomes? We've found out through those collaborations with our colleagues in language that it does help.
More recently, we have started collaborations with our colleagues in neuroscience. Trying to get neural evidence to support a lot of the things that we're seeing behaviorally in the lab. Beth Heinrichs-Graham is a scientist at Boys Town who we've collaborated with now for four or five years.
We're starting to publish papers that show not only do kids that wear their hearing aids more and who have better audibility through their hearing aids have better outcomes behaviorally, but we're actually seeing differences in the brain where kids who wear their hearing aids more consistently have responses during working memory tasks or language tasks that look more like kids with normal hearing than kids who don't wear their hearing aids as much or who can't hear as much through their hearing aids.
It's exciting to see those collaborations occur and they couldn't happen probably if we didn't have such a robust research program with experts in all of these different areas. It's just been a great place to be.
Rebecca: That's cool. On that note of just hearing aids, do you see changes in research goals and ideas as the technology sort of changed? I feel like we've suddenly gone on this crazy trajectory of all these digital developments in hearing aids and how that changed the questions that you ask.
Ryan: Yeah, for sure. I think one of the big challenges that we face as a field in hearing aid research is that the technology changes so rapidly. We have to be creative in how we think about our research questions, because I don't know that it's that interesting to test whether the new noise reduction that came out this year is better than the old noise reduction that was in the year previous, because the scientific process takes so much time that Pat and I published a study about noise reduction in hearing aids for kids with hearing loss in 2010.
By the time we went through the process, collected the data, and got it published, the noise reduction that we were talking about wasn't available in hearing aids anymore because it had been several years and several iterations of technology.
I think we have to be creative and think about, how can we ask questions that are helpful to audiologists where they can use that information to benefit their patients? That noise reduction study is a great example because it showed that kids can use this modulation based noise reduction and it doesn't negatively impact their speech recognition.
That's Important because there are a lot of other modulation based noise reduction systems out there, and I think it's useful information for us to have. It's not so much about this particular manufacturer signal processing is heads and tails above everyone else's. But can we ask the question in a general way that's more applicable. I think that's just something we have to think about if we're going to evaluate signal processing features, which we often do in our work.
Rebecca: In terms of like test setup and stuff, has that changed a lot too? When you started, was it really kind of basic and now you have all these other moving parts, like additional speakers?
Ryan: I'm kind of old I feel these days. When I started as an audiologist, I was programming hearing aids with a screwdriver and not a computer. I'm glad I had that experience because I feel like it helped me to think about, how to understand how amplification works in a really fundamental way that now that we have a computer that can make really good changes across a whole range of frequencies, that's a totally different problem now.
But what's interesting is it's gotten so complicated that we are designing a study where we're testing kids with their hearing aids and measuring their speech recognition using some realistic kinds of listening situations. If you recruit a bunch of kids who wear hearing aids into this study, they might be fitted with different manufacturer’s devices and the signal processing might be different.
It's a really fun and interesting problem to try to figure out how do we design an experiment that is going to work across all these different manufacturer's devices and that you know that the features are implemented in a similar way, or if they're not, how do we analyze that? It's exciting and fun to work through. There's times when it's frustrating when you don't know what a hearing aid is doing, because as much as we get a lot of support from hearing aid manufacturers, they can't share all of their proprietary information with us about their signal processing.
It's a an interesting, collaboration with them so that we maintain our independence and our objectivity, but also that we're assessing these things in a way that isn't counterintuitive or isn't how kids would use them when they're wearing their hearing aids in the real world.
Rebecca: Yeah. It can come up for Oticon, sometimes just people wanting specific studies that look at like one hearing aid versus another hearing aid and we can't put these types of studies out, but it's really hard to make those studies happen without all of these other moving parts and everything too and the climate period too like, if you switch from one manufacturer to another, there's these other factors that you got to consider.
It's not easy to be like, this is the study I want to do seems easy in theory and I've chatted with Dave Gordey lots about this, but it's always a roadblock there to try and actually make that come to life.
Ryan: Yeah. There's always difficulty in making those comparisons between devices and we try not to focus too much on those types of granular comparisons in our work because I'm not sure that a lot of the manufacturer’s technologies that are out there are fundamentally that different. There's obviously differences, but at the end of the day, everyone has a hearing aid with the directional microphone. You hope that they all kind of work in the same way and provide a similar amount of benefit.
I'm more interested in can we get a similar answer using a bunch of different technologies? That's where we've tried to focus our energy is not so much it's manufacturer A different than manufacturer B. It's like if we have a bunch of kids who are fitted with all kinds of devices, do we see consistent patterns, because I think that's going to be more useful for audiologists.
Rebecca: Yeah, in like a more broad sense. One of a more kind of recent study that I was just looking at, I think it might have been 2023. You guys just had one come out this year or last year, I think that sounded kind of interesting. I thought we could chat a little bit about that one, but it was titled Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children with Hearing Aids? Can we chat a little bit about what that was looking at?
Ryan: Yeah. I'm glad you asked about this study because it's one of my favorites. We've been working on this paper for several years. We started a study in 2009, even before I was done with my PhD, that was called the Outcomes of Children with Hearing Loss study, and we call it OCHL, and the people at Iowa who were involved call it OCHL. We followed 300 kids with hearing aids across 17 US states for 10 years. We gathered a lot of data from that study that we've published lots and lots of papers about. But this is probably one of my favorite papers because it combines a bunch of different aspects of things that I've been interested in by using all of that data that we collected over 10 years.
We published the paper in 2020 where we were encouraging audiologists to think about using audibility as a way to look at hearing aid candidacy rather than the audiogram. The main reason is that when you test a child's hearing, most often you're using either insert earphones or an ear mold.
As audiologists, we are programmed to think a lot about what happens when we put a hearing aid on a child's ear and how the sound levels are a lot louder in the ear. But we don't necessarily think about the impact that that has when we're doing a hearing test. When you measure hearing in DBHL, in audiogram, that sound level that's calibrated on your audiometer is a lot different than the sound level in that baby's ear canal, which is a lot higher.
What happens is your thresholds look better. we looked at transmitting the audiogram into unaided audibility in that 2020 paper, and it showed that kids that had unaided audibility that was less than 80 were at risk for delays in their speech and language across a number of domains. That was cool.
But then we started to get questions from audiologists about, what about those kids who show up with moderate to severe hearing loss? We fit them with hearing aids, but they don't appear to be doing very well. It's the same problem that you run into with whether to fit a child with mild hearing loss when you think that their thresholds are better because of their tiny little ear canals.
The same issue comes up with kids who are sort of on that gray area between hearing aid candidacy and cochlear implant candidacy. There's no question that kids with severe to profound hearing loss are probably going to be good candidates for a cochlear implant. But these kids who appear as infants to have moderate or moderately severe loss, and then as they get older and their ear canal gets bigger, drift into cochlear implant candidacy.
The question that we had was, would it be better to use the aided audibility through the hearing aid as an indicator about when maybe we need to either increase access through the hearing aid or transition that child to a cochlear implant or a different intervention.
Catherine Weissman was a postdoc in my laboratory and now she's a scientist at Boys Town who I'm collaborating with. Catherine went through all of those data and looked to see what level of aided audibility through the hearing aid put kids at risk for delays in language. She compared Aided audibility with other measures like the audiogram and things like that and other audiological measures that we use like speech recognition.
What she found was that kids who have less than half of the access to long term average speech spectrum through their hearing aids are going to be at risk for delays in language, even if their hearing aids are well fitted. What's interesting about that is that corresponds really closely to what our current cochlear implant candidacy criteria are in the US. It puts you at about a 65 to 70 DBHL threshold. The nice thing about that is it gives audiologists a way to think about hearing aid candidacy that's not totally based on the audiogram and takes into account how much can we give children to their hearing aids.
If you have a child that you're seeing who has audibility less than 50% or an SAI of 0.5 or less, then we don't want to wait and see what's going to happen. We either want to increase the child's audibility by reprogramming the hearing aids. We want to consider that the child may be a candidate for a cochlear implant, or if neither of those two things are an option, then we might think about other interventions like supporting the child with visual communication, because we know that they're going to be at risk for not being able to develop spoken language.
It's exciting because we took a really clinical question and we used all of these data that we had collected for the last 10 years to try to answer it. Catherine just did an amazing job of making it a very nuanced sort of discussion and audiologists like it to be very black and white. That's how we are. But she did a really nice job of talking about the issues that surround that and I think it's a really important contribution to the literature that she wrote and did. I'm always excited to see when people who work in my lab take an idea like that and put it out in the world, because I think it's going to be really helpful for audiologists.
Rebecca: Yeah. We talked recently a lot about aided speech and noise testing, other things that we can sort of do in the clinic. We just had a guest speaker at one of our pediatric seminars recently, and it was a lot about testing in the clinic after the fact with speech and noise and stuff like that. I know that there is a little bit about looking at aided speech recognition and noise too, and how we can implement that into clinical practice. From the study that was just kind of published, it sounds like there could be a number of other studies that branch off from that one too.
Ryan: Absolutely. I think one of the things we have to do is validate Catherine's finding. In a new group of kids, we always try to do that to add support to that approach. To your point, we do a lot of work looking at speech recognition and background noise, and we think it's a really critical outcome measure. What we're trying to do is help audiologists figure out what are the types of speech and noise testing that are going to give you the most information. The issue is that we have so many different types of speech recognition tests.
I think a lot of times as audiologists, we're sort of trained to think about which one is better and which one's the right one to use. What we're finding in our studies is that you get a very similar answer across a lot of the different tests. The kids who do well on a pediatric AzBio Sentence Test in noise are also going to do well on the BKB speech and noise test and they might have higher or lower scores on one, but I just think it's so important for audiologists to pick a tool and use it and to start by testing with words in quiet, and when a child reaches a good level of performance in quiet, then moving on to words in noise, and then once they get words in noise, then moving to sentences in noise can be a really useful thing, because if you have a child who you fit with a hearing aid and they're not progressing through those stages where they can do it in quiet and it gets better and then they can do it in noise and it starts to get better, that's a normal developmental process. Audiologists are the only professionals who are in a great position to do that kind of testing.
I encourage my colleagues to try to use that as a tool, because it can provide a lot of useful information and if a child's not progressing through those stages of speech recognition, then we need to look at their intervention. Can we do something different with the hearing aid? Do we need to provide more support in other areas? It’s cool because it leads us to do something about it. There's nothing worse than a clinical outcome measure where you look at the results and you're like, I have no idea what I'm supposed to do here.
It's like, if we're just checking a box, then we're never going to keep doing that outcome measure. But if it leads us to do something different or to change the intervention, I think that's very useful.
Rebecca: Yeah, we looked at the pediatric minimum speech test battery, and I think at first it felt quite daunting, it was like, trying to follow this protocol, but I think to your point, just choosing a couple of tests or one test and just implementing that is a really good place to start.
Ryan: I love the pediatric minimum speech test battery. I think they did a fantastic job. But you can tell that it was developed by consensus, by a large group of pediatric audiologists because everybody's favorite speech recognition test is included and it does make the protocol really big. But I think it's also really good because it shows all of the different options that are available.
In our clinic, we don't do each step in that process. We pick a closed set task to start with and we use the open and closed set task. It’s our closed set word recognition test, and then we'll move on to PBK, monosyllabic words open set in quiet, or CNC in quiet, and then we'll add some background noise. As kids progress and their performance improves, then we'll get into sentences and background noise, and that can be really useful information for audiologists. It follows the same Process as the minimum speech test battery without all of the little steps that they have built into the protocol.
Rebecca: Yeah, and I think that was kind of their point too. If somebody has already progressed past the first four tests, don't start at the first test. You can kind of be a bit liberal with how you use it.
Ryan: Yeah, and I think it's always good to remember that a lot of the speech recognition measures that we developed were developed on a group of kids that hadn't had the benefits of universal newborn hearing screening, even though they're very recent tests. Karen Kirk developed the Lexical Neighborhood Test when she was in the cochlear implant program at Indiana in the late 1990s, which was not that long ago.
In her cohort of kids that she tested in their original study of the Lexical Neighborhood Test, the average performance for the kids was about 50%. Now, we use that test in our study and the kids with hearing aids are at 90%, because we've got intervention, there's just things that improved, and that's awesome.
That means that the lexical neighborhood test may not be the best tool anymore, or it may be really good, but it’s been hard to keep up because the kids have progressed so well. It's a great problem to have.
Rebecca: Yeah, true. You mentioned just before we were recording about protocols and just your involvement in some of the early hearing programs and any sort of like recent changes to that.
Ryan: Yeah, so I have been so lucky that as a scientist, I get asked to be involved in sort of protocol development in Canada provincial programs providing amplification for kids, but then also just a lot of educational guidelines in the US as well. I think it's a great way to bring research to practice, but then also to get feedback from clinicians and educators about whether it works or not, because you can have a great idea that seems like a really great thing in the laboratory, and then when you go to actually implement it, the audiologists are like, yeah, that's very clever, but it's never going to work. It keeps me grounded because I've had audiologists involved in those processes tell me, that's really bad. That's not going to work. I'm sure you thought you were super smart when you came up with that, but you're not.
It's great because you get that feedback from the people who really matter because if other researchers like what we're doing, that's great, but to me, the ultimate positive outcome is when a clinician comes up and says, I read this paper and it really helped me with this patient or whatever, because that's why we're doing the work that we're doing and why we spend so much time trying to figure out how to communicate the results that we get to clinicians or parents even, because if we can help them, then I think that's great.
Rebecca: Yeah, the SII for mild hearing loss and whether or not we should fit, were you a part of implementing that into the early hearing program? It was kind of nice to hear the explanation.
Ryan: Yeah. We started looking at unaided hearing and how to characterize unaided hearing because we noticed that kids in the OCHL study who had mild hearing loss were not getting consistent access to hearing aids, even though there have been decades of research to show that mild bilateral hearing loss is a risk for language development.
We started looking at our data and if you had a threshold between 20 and 30 DBHL on the audiogram, it was a coin flip as to whether or not you were going to be prescribed a hearing aid. We started trying to think about ways to get audiologists to consider not waiting until kids with mild hearing loss develop problems with communication before we provide intervention.
We started thinking about using unaided audibility because it incorporates those ear canal acoustics effects that we talked about. It also, unlike the audiogram, reflects access to speech and language, which is really what we care about when we fit kids with hearing aids. It also gives you a really nice comparison to figure out when you fit a child with a hearing aid, how much better are you making their access?
There's a lot of positive qualities to it, but we didn't have any evidence to support that. The challenge with that is, you could do a study where you took a bunch of kids with mild hearing loss, and you fit some of them with hearing aids, and you don't fit some of them, and see what happens. But it would be unethical to do that because we know that there's long term risks to speech and language development.
What happened was in the OCHL study, there were kids who didn't get hearing aids or who didn't use the hearing aids that were provided. It gave us a way to take a natural sample of kids who either didn't get hearing aids or didn't wear them and say, let's look at what level of audibility is a risk for speech and language development because some of those kids who weren't fitted with hearing aids have language scores that were very similar to their peers with normal hearing, and some of them didn't.
That opportunity, having that big group of kids with hearing loss who didn't wear hearing aids allowed us to do an analysis that otherwise we wouldn't have been able to do ethically. It was a great opportunity. Now that we've implemented it in British Columbia and in the clinic at Boys Town, we're able to see, does this work? What are the problems with it? Are there situations where we would have fitted it before where we're not now or vice versa? We're getting a lot of great input. It's helping us to hone in on what level of hearing presents a risk for communication problems.
That's really what we should be focusing on, not, you have a certain threshold on the audiogram because the audiogram isn't necessarily weighted for speech. The frequencies on the audiogram are all important for speech, but it's not always the case that we capture things like configuration the way we can with the speech intelligibility index.
We like the tool, but we also understand it's a big change for audiologists to start thinking about audibility instead of thinking about mild, moderate, and severe. But we think it's useful and we're getting a lot of positive feedback.
Rebecca: I've heard lots of positive feedbacks in BC. I work with the pediatric clinics here. I think at first it was like, what's this new thing? But now it's definitely—it was quick to become a really useful tool for sure.
Ryan: Yeah. We've refined our approach based on feedback that we received from audiologists. It's a great collaboration that we have. Like I said, we learned so much through those partnerships that we can make it better and think about how we're implementing it. An example of that was, we didn't have any kids with unilateral hearing loss in that study, but the audiologists were like, we want to know what this is for unilateral hearing loss too.
We've started a whole line of research on audibility for kids with unilateral hearing loss. It's very interesting, because of feedbacks from audiologists in BC who were like, no, we're not going to use the audiogram for kids with unilateral hearing loss and audibility for kids with bilateral hearing loss. That doesn't make sense.
We were just trying to be honest about the data that we have, but it's forced us to go out now and get the data so that we can support that recommendation for kids with unilateral hearing loss as well. It keeps our work going and they keep me on my toes for sure.
Rebecca: I was chatting recently with Erica Zaia who does a lot of vestibular stuff in BC. And we were chatting about vestibular stuff in kids with hearing loss. She actually mentioned Boys Town. I was trying to figure out where some of this research is coming or whatever. Just because it's kind of top of mind. Do you know of any sort of vestibular stuff happening with kids down there?
Ryan: Yeah, so I am probably the least knowledgeable audiologist that you're ever going to encounter when it comes to vestibular.
Rebecca: It might be me.
Ryan: I am a dummy when it comes to vestibular. But fortunately, Boys Town is lucky enough to have Dr. Kristen Janky as our director of our vestibular program, and she runs the clinical arm of the vestibular program and has a research lab where she's actively looking at pediatric outcomes for kids with hearing loss on vestibular tests.
She's got a very interesting line of work looking at what tests we need to include in our vestibular test battery for kids with hearing loss. She's looking at kids before and after cochlear implantation to see if the vestibular problems that are very common in kids who get cochlear implants, were those a problem before they got the implant? Are they worse after the implant or better after the implant?
It's exciting work. One of the challenges that kids with hearing loss face is reading development. We've always assumed that the problems with reading development for kids with hearing loss are related to language and their hearing. Well, that's probably a contributing factor. But what's interesting is Kristen's work is showing that part of it may be their ability to stabilize their gaze while they're reading. If you have a vestibular problem, your ability to stabilize your gaze and make the saccadic movements that we make when we're reading can be impaired, but we're not currently looking at that as a contributing factor to reading problems and kids with hearing loss.
Kristen is embarking on a 5-year research project right now where she's measuring not only the auditory outcomes and vestibular outcomes, but looking at how does that impact reading development. I think it's a really exciting area, because we assume sometimes if kids have vestibular problems that they're just going to compensate, whatever that means, and that they'll just develop out of it.
Some kids probably do, but I don't know that that's a safe assumption. Some of these kids who have persistent vestibular problems might need physical therapy or other interventions that would help them to have even better outcomes. A lot of these stuff has great evidence to support it. This is another example where I'm just so lucky to work with people who have these varied expertise because as someone who knows nothing about vestibular, I can tell you about this great vestibular research that's happening.
Rebecca: Yeah. It feels like the tip of the iceberg in a way.
Ryan: Yeah. There's all kinds of exciting stuff happening and I'm just giddy to be a part of it.
Rebecca: Yeah. On that note, what's up next for you? Are you , working on anything coming? Are you talking at any events coming up recently or anything like that?
Ryan: Yeah. There's two projects that I'm excited to mention. One is called the FAST TRAK. It's an acronym that Derek Stiles at Boston Children's Hospital, who's a collaborator on the project, came up with, and it stands for Finding Appropriate Solutions To Treat Reduced Audibility in Kids. It's really a culmination of that mild hearing loss research that we talked about where we're trying to develop new clinical tools for assessment of kids with mild hearing loss.
The 1st part of it is doing. Audiometry that calibrates to the ear canal. When you do otoacoustic emissions, we calibrate the signal to your ear canal, but that's the only hearing test that we use that's calibrated to your ear canal, even though we know that ear canal acoustics can affect other tests like ABR and audiometry.
First part of FAST TRAK is just figuring out, can we calibrate in kids ear canals and does it matter? The answers are yes, we can, and yes, it does matter. We're finishing the laboratory phase of that project, and we've implemented FAST TRAK at six clinical audiology sites that will collect data for the next three years to test whether that approach is feasible in a clinical environment.
The second part of FAST TRAK is developing speech recognition tasks in noise that are actually sensitive to the difficulties that kids with mild hearing loss have. If you take a child with mild hearing loss and measure their speech recognition, oftentimes they are at 100%. The assumption is that they're not going to have problems, even though we know they do. We've developed some more challenging speech recognition tasks that really provide an insight into listening difficulties that kids with mild hearing loss have. We've also implemented that in those clinical audiology centers and so we're excited over the next few years to be able to gather evidence on that to help. It's a really exciting project and being able to partner with the pediatric audiologist at those sites to get their input is just so important for the for the research. It'll be exciting to share those results coming soon.
I'm presenting at the American Academy of Audiology meeting in Seattle in April.
Rebecca: Okay, cool. I definitely think there's a few that’s so close to BC. I would imagine there'll be some Canadians at the Triple A (AAA) this year.
Ryan: Well, if you see me at the Triple A (AAA) meeting in April, if this doesn't come out after that, then come and say hi, because I'll be there for the meeting.
Rebecca: Cool. Any final thoughts to share or we covered lots of it?
Ryan: No, I appreciate the opportunity to come on and talk about the work that we're doing and hopefully the listeners find it really interesting. But if not, you can contact me.
Rebecca: Yeah, sure.
Ryan: Via email or we have a really awesome Instagram page for the lab that's ran by my research assistants. I have nothing to do with it, which is why it's so phenomenal.
Rebecca: What's it?
Ryan: APC lab is the acronym and I can send it to you to, to put in the show notes, but it's cool. We highlight research articles that we put out and try to put it in a context that is beneficial for clinicians and for parents and kids with hearing loss and try to engage with those communities as part of that. It’s a great resource about the work that we're doing.
Rebecca: Yeah. Great. I'll include it in the description. Sweet. Okay. Well, thanks so much, Ryan.
Ryan: Thank you. I appreciate it.
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