Virtual Vestibular Screening Compared to On-Site Assessment

Student (AuD) Investigators: Emily Parks, Emily Nusbickel, Brandie Mack, Morgan Zupkus

The purpose of this study was to determine if a Virtual Dynamic Visual Acuity (DVA) test is effective in identifying the need for further in-person vestibular evaluation. A complete vestibular examination typically requires specialized equipment (e.g., videonystagmography, video head-impulse test, rotary chair, vestibular-evoked myogenic potentials), and necessitates patients to travel to a clinic for testing. However, some bedside exam techniques, such as the DVA, might adapt well to a remote administration, and have the potential for an effective tool to identify potential patients with vestibular dysfunction who will need further diagnostic work. Efficient online identification could lead to more patients receiving the appropriate diagnosis and/or treatment when they visit their audiologist for a full evaluation in person. The results of this study provided information regarding the feasibility of telehealth for vestibular diagnostics.

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Spatial cognitive functions in deaf/Deaf older adults with and without vestibular impairment

PI: Chizuko Tamaki 

Co-PI: Kristen Maul

This project was supported by Gallaudet University's Priority Research Fund.

Evidence on the effects of vestibular dysfunction on cognitive functions, including in the area of spatial memory and navigation have been reported in the recent literature.  With the premise that:

(1) There is an increased risk of vestibular dysfunction in people who are deaf;

(2) Many deaf individuals utilize an established sign language (e.g., American Sign Language, or ASL), which is visual-spatial in nature; 

(3) Use of such langauge appears to have positive influence on some aspects of spatial cognitive development; and

(4) Aging often amplifies the effects of cognitive deficiencies

This long-term work aims to understand the role of visual-spatial language (i.e., ASL) use in the development and more importantly rentention of spatical cognitive functions in older adults who suffer vestibular dysfunction. 

 

Deaf and Hard of Hearing Audiology Students: Student and Preceptor Perspectives 

Lead Investigator: Sarah Sparks, Au.D.

This project had two purposes. The first was to explore audiologist attitudes and possible biases regarding deaf and hard of hearing (DHH) audiology students. The second was to explore DHH audiology students’ self-perceptions and perceptions of audiology preceptor bias. Audiology preceptors are licensed audiologists who supervise students in clinical settings. According to the 2020 Audiology Student Census, students with some level of hearing loss make up ~14% of future audiologists. Although a minority in comparison to students with typical hearing ability, DHH students are entering Au.D. and undergraduate communication sciences and disorders programs and receiving the clinical education required for these programs. Although acceptance of DHH students within the audiology profession has not been documented among Au.D. programs, this topic has been explored in other healthcare professions such as medicine. DHH Au.D. students have life experience that audiologists with typical hearing ability cannot offer patients. At present, there are no empirical data to support recommendations for audiology preceptors about how to support these students during clinical rotations. This project was a first step at addressing this problem. 

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Can Absent Saccular Function Mitigate Virtual Reality Sickness? (2018-2020)

Lead investigator: L. Noelle Allemang

This project compared cybersickness symptoms of three groups of individuals: those with absent saccular function and are deaf, those with normal saccular function and are deaf, and those with normal saccular function and are hearing. We measured saccular function using cVEMP testing and assessed cybersickness via participant self-report after completing a virtual reality maze using the Oculus Rift (Oculus VR, Irvine, CA). 

 

Virtual Reality Assessment of Visual Dependence (2016-2020)

Lead investigator: Ashley Zaleski King

This project focused on identification of individuals who may rely more on visual information relative to other sensory inputs for spatial orientation, and to investigate how heightened sensitivity to visual inputs might relate to visual vertigo symptoms. Using the Oculus Rift we assessed visual and somatosensory parameters that may influence the perception of verticality differently in patients with vestibular weakness relative to normally-functioning individuals.

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Effect of Preference for Handedness on Direction of Tilt of Subjective Visual Vertical (2018-2020)

Lead investigator: Emalee Danner

This project focused on subjective visual vertical (SVV) clinical test responses. Using the Oculus Rift headset SVV responses were measured while visual input was changed. We studied effects of direction of tilt, head tilt, direction of background motion, and preference for handedness on SVV tilt.  

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The Effect of Hearing Protection on Postural Stability (2017-2019)

Lead investigator: Alexandra Howell

This project explored the impact of auditory cues on balance. Specifically, we studied the effect of double hearing protection on postural stability by measuring postural sway in the presence of noise with and without hearing protection devices. 

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Characteristics of Random Saccades in Deaf Signers and Non-signers (2017-2019)

Lead investigator: Sarah Sparks

This project explored characteristics of random saccades clinical assessment results (accuracy, velocity, and onset latency) in young deaf and hearing adults with 10+ years of signing experience and less than 2 years of signing experience.

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Vestibular Function in Deaf Young Adults Who Received Cochlear Implants as Children (2017-2018)

Lead investigator: Sarah Sparks

This project involved assessment of vestibular function and functional balance ability in deaf young adults. vHIT, cVEMP, and oVEMP were used to assess function of the vestibular end organs in subjects who received cochlear implants as children and subjects who do not have cochlear implants. Functional balance ability was measured using mCTSIB.

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Virtual Visual Environment Stability with Oculus Rift (2014-2016)

Lead investigator: Sean Smith

This project explored the stability of the visual environment during subjects' head motion. Specifically, we tested to whether subjects were able to maintain as stable and quiet standing stance within a virtual reality scenery as they would with true reality vision.  

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Caloric Irrigator Tip Insertion Depth (2013-2015)

Lead investigator: Jonathan Suen

This project explored the effects of varied insertion depth during caloric irrigations on the vestibulo-ocular reflex nystagmus outputs, in young adult participants with typical vestibular functions.

 

Caffeine Withdrawal Effects on Oculomotor Testing (2013-2015)

Lead investigator: Krystyna Graham

Patients, in preparation for a vestibular assessment appointment, are frequently asked to refrain from taking caffeine prior to the appointment. This project explored whether abstinence from caffeine has an impact on the oculomotor components of the videlonystagmography test battery. In particular, participants who are regular coffee drinkers were studied. 

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Effects of Gaze Direction During Ocular VEMP (2013-2015)

Lead investigator: Ashley Espinosa

Oculor VEMP (oVEMP) can be measured only when the inferior oblique muscle of the eye contralateral to the stimulated ear is contracted. This project compared the amplitude and latencies of the oVEMP responses during the upward gaze, up/medial gaze, and up/lateral gaze. 

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Stimulus Rate and VEMP Thresholds (2004-2006)

Lead investigator: Chiz Tamaki

This project investigated the effects of stimulus rate, from 5.1 Hz up to 19.1 Hz, on the cervical VEMP thresholds. 

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