(PP1601) Cochlear Implant Evaluations of Spanish Speaking Adults: A Survey

With the Hispanic population rising in the U.S., audiologists need reliable evaluation protocols in Spanish. An online questionnaire was created and distributed nationwide with the purpose of investigating current clinical trends in Spanish cochlear implant evaluations. 32 cochlear implant audiologists accessed the survey, 23 of whom worked with Hispanic candidates. Spanish HINT (32%) and Spanish AzBio (64%) were the most common sentence tests used. Audiologists described the S-AzBio as equivalent to the English AzBio. Scoring and accent of recording was seen as a limitation. Results confirm the need for evidence-based, culturally diverse audiological care for the Hispanic community.

Summary: 

Introduction. The AzBio sentence test serves as the standard for speech perception cochlear implant (CI) evaluations of English speaking candidates. With the increase of the Hispanic population in the U.S. and the lack of information in the literature about CI evaluation protocols for Spanish speaking candidates, audiologists need valid and reliable speech perception materials in Spanish. The purpose of this study was to investigate current trends in CI evaluations of Spanish speaking adults around the country.

Methods. A questionnaire was created and distributed nationwide using the QualtricsXM® online survey platform. The questions explored: 1) participant demographics, 2) demographics of population served and 3) materials used for Spanish CI evaluations. Results of the survey were analyzed using QualtricXM® reports and Excel.

Results. A total of 40 audiologists accessed the survey, 32 of whom worked with CIs. Of the population served, 60% were white and 25% were Hispanic or Latino. 23 audiologists worked with Spanish speaking candidates in states which included New York, California, Illinois, New Mexico, Florida and Louisiana. 7 audiologists spoke another language and Spanish was the most common (43%). The materials used for sentence perception testing included: Spanish HINT (32%), Spanish AzBio (64%) and Spanish Synthetic Sentences (4%). Online translation tools were used while testing in 70% of the cases. S-HINT were rated less difficult when compared to the English AzBio, and S-AzBio were rated similar to the English AzBio. Audiologists reported, however, that the S-AzBio was too difficult to score for them and they needed help from the interpreters. Additionally, they expressed concern regarding differences in accents between the speakers in the recording and the population served.

Discussion. Results of the survey bring to light the lack of audiological research and protocols available in Spanish, which makes it difficult for audiologists to provide evidence-based care to Hispanic patients. The S-AzBio, developed in 2021, is perceived as reasonably equivalent to the English AzBio, with the S-HINT being less similar to the protocols that are used in English evaluations today. As a result, the S-AzBio has quickly become popular among clinicians. Research conducted with the English HINT has recognized its limitations when compared to the AzBio to show long-term benefit of cochlear implantation as patients reach top scores soon after implantation. In clinical practice, HINT sentences continue to be used to test patients with processing difficulties or cognitive decline. Limitations to the S-AzBio arise regarding scoring and the Spanish accent of the speakers in the recorded materials.

Conclusion. The results of the survey reveal a need for culturally and linguistically diverse audiologists who can provide optimal care to the Hispanic / Latino community. Additionally, there is significant need for research conducted in Spanish to equate the evidence-based practices used with the English speaking population. The S-HINT and S-AzBio are the most commonly used tests for CI evaluations in Spanish, with the S-AzBio quickly becoming popular since its development in January of 2021. Information regarding these two tests will allow for efficient and successful CI evaluations of Spanish speaking candidates.