Misophonia is a condition characterized by hypersensitivity and strong emotional reactivity to specific auditory stimuli. Misophonia clinical presentations are relatively complex and reflect individualized experiences across clinical populations. Like some overlapping neurodevelopmental and neuropsychiatric disorders, misophonia is potentially syndromic where symptom patterns rather than any one symptom contribute to diagnosis. The current study conducted an exploratory k-means cluster analysis to evaluate symptom presentation in a non-clinical sample of young adult undergraduate students (N = 343). Individuals participated in a self-report spectrum characteristics survey indexing misophonia, tinnitus severity, sensory hypersensitivity, and social and psychiatric symptoms. Results supported a three-cluster solution that split participants on symptom presentation: cluster 1 presented with more severe misophonia symptoms but few overlapping formally diagnosed psychiatric co-occurring conditions; cluster 3 was characterized by a more nuanced clinical presentation of misophonia with broad-band sensory hypersensitivities, tinnitus, and increased incidence of social processing and psychiatric symptoms, and cluster 2 was relatively unaffected by misophonia or other sensitivities. Clustering results illustrate the spectrum characteristics of misophonia where symptom patterns range from more “pure” form misophonia to presentations that involve more broad-range sensory-related and psychiatric symptoms. Subgroups of individuals with misophonia may characterize differential neuropsychiatric risk patterns and stem from potentially different causative factors, highlighting the importance of exploring misophonia as a multidimensional condition of complex etiology.

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A longitudinal study reported positive speech and language outcomes for 29 children with hearing loss in an auditory-verbal therapy program (AVT group) (aged 2 to 6 years at start; mean PTA 79.39 dB HL) compared with a matched control group with typical hearing (TH group) at 9, 21, and 38 months after the start of the study. The current study investigates outcomes over 50 months for 19 of the original pairs of children matched for language age, receptive vocabulary, gender, and socioeconomic status. An assessment battery was used to measure speech and language over 50 months, and reading, mathematics, and self-esteem over the final 12 months of the study. Results showed no significant differences between the groups for speech, language, and self-esteem (p > 0.05). Reading and mathematics scores were comparable between the groups, although too few for statistical analysis. Auditory-verbal therapy has proved to be effective for this population of children with hearing loss.Is Auditory-Verbal Therapy Effective 365 for total language, receptive vocabulary, gender, and socioeconomic level (as measured by the education level of the head of the household). Participants Auditory-Verbal Therapy Group (AVT Group)Selection criteria for the participants were: Pure-Tone Average (PTA) at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz of ≥ 40dB hearing threshold levels in the better ear; prelingually deafened (at ≤ 18 months old); attended the educational program weekly for intensive one-on-one, parent-based AVT for a minimum of 6 months; wore hearing devices consistently (hearing aids and/or cochlear implants) and aided hearing was within the speech range or had received a cochlear implant; no other significant cognitive or physical disabilities reported by parents or educators; 2 to 6 years of age at the first test session; and both parents spoke only English to the child .The children attended one of the five regional centers of an AVT program in Queensland, Australia, which offers a range of services including audiology, early intervention, and a cochlear implant program. This program adheres to the Principles of Auditory-Verbal Therapy (adapted from Pollack, 1970; endorsed by the AG Bell Academy for Listening and Spoken Language, 2007). Even though a particular AVT program may adhere to all of these principals, programs may vary in the operational details. A description of the AVT program in this study can be found at http://www.hearandsaycenter.com.au/ mission-delivery.html.Of the 10 children who left the study between the 38-month and 50-month posttests, 2 had left the program because of diagnosis of additional disabilities, 6 had moved away or were unavailable for testing, and the departure of 2 TH group children from the study necessitated omitting their matched AVT group pair. The remaining AVT group participants had bilateral sensorineural hearing loss ranging from moderate to profound (mean PTA 79.39 dB HL; range = 45 dB to >110 dB). All children were fitted with hearing aids, commencing intervention within 3 months of diagn...

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Last year the first author published two articles in The Hearing Journal reporting on studies she conducted on (1) the effectiveness of an online hearing test and (2) the quality of earmolds made from impressions taken by the purchaser as part of the online acquisition process. 1,2 Both studies demonstrated reasons for serious concern about online hearing aid dispensing, especially when done without benefit of professional services.One reason for concern is that the online hearing tests often failed to determine hearing thresholds accurately. Secondly, the ability of an untrained consumer to make his or her own earmold impressions in order to buy a hearing aid via the Internet is questionable at best. Together, these two studies indicated that dispensing over the Internet can result in ill-fitting hearing aids or even potentially dangerous fittings. ASSESSING THE PURCHASE PROCESSFor the third and concluding article in our series, we had two hearing-impaired subjects purchase hearing aids of their choice via the Internet so we could assess the process and its results.One subject has a medically complicated hearing loss, and we wanted to determine if the online company considered any medical factors before dispensing to a consumer. The second subject was a male with presumed presbycusis.Both subjects were asked to follow the online purchasing process as detailed on the company's web site. We gave them no professional advice in ordering, but members of our team were present for each Internet interaction and for a phone conversation to the online company. SUBJECT ONEThe first subject (JW) is a 71-year-old woman who was diagnosed with a sudden sensorineural hearing loss (SSNHL) over 10 years ago. Her latest and most severe attack occurred in 2005 after she took a plane flight when she had a virus. She was fitted with binaural BTE aids soon after her diagnosis and has worn hearing aids ever since. Her audiogram can be seen in Figure 1. Of particular note are her word-recognition scores, which on average are poor in quiet and more so in noise. She complains of difficulty understanding speakers with lowpitched voices and in group settings such as restaurants. She finds many communication situations very frustrating.JW was recruited for our study after she and her husband came to our university clinic in search of a fitting that would improve her speech recognition. She was wearing a pair of BTE aids from a major manufacturer that were originally fitted at an ENT practice where she was being treated for her SSNHL and which is located outside her home state. Since the fitting, JW reported that her local audiologist has adjusted the instruments "probably more than 50 times." She brought to our clinic a bag full of the earmolds that have been made for her over the years. She said she used most of them from time to time, as she can hear better some days with one and other days with another.