Improving Patients' Quality of Life
An interview with Carl Crandell
It's been a busy year for professors in the Department of Communication Sciences and Disorders. As part of their new doctoral degree in audoilogy, the Department teaches on-campus candidates, as well as over 235 students and audiologists from all over the country via distance learning, cementing the program's reputation as a national trend-setter. In addition, CSD faculty are unique in CLAS, as they not only teach, conduct research and publish, but also treat patients int he UF Speech and Hearing Clinic (fourth floor Dauer Hall).
Cn: How do you and other CSC professors manage combining so many elements?
CC: I think to some extent we have gotten ourselves in the not so unusual position of being overworked (laughs). Actually, in many ways combining all these elements has practical advantages. For example, cases I treat in the clinic give me ideas for new research projects, teaching ideas come from the lab and the clinic, while my research results often change my approach in the clinic.
Cn: Tell us about your current research.
CC: The most exciting thing I'm doing right now is conducting studies that look at the relationship between hearing loss and overall quality of life. We are finding a very strong relationship between one's degree of hearing loss and his/her quality of life and physical health. This makes sense because hearing loss reduces communication which can increase isolation, eventually leading to withdrawal from society, aggravation, frustration and even depression. Psychosocial problems like these can, in turn, contribute to serious functional/physical health problems.
Our work shows that improving communication via hearing aids positively impacts these problems. Within only three months of wearing a hearing aid, an individual's psychosocial status (and therefore quality of life) improves drastically.
I'm not saying that by improving communication we're directly improving physical problems, but improving communication certainly seems to decrease the impact of those physical problems on an individual. If hearing loss has diminished your contact with people and you're sitting at home isolated, not doing the things you like to do, suffering from arthritis, heart problems or other illnesses, you'd probably tune into those problems more than you would if you were out actively enjoying the world.
No one has studied hearing aids and health explicitly, but the literature shows that active, upbeat people are healthier—they beat cancers more easily, for example, than those with psychosocial problems. Hearing aids can help overcome the psychosocial problems which can minimize the quality of life concerns, which in turn overcome a lot of the functional health problems. We're hoping to take these findings into the health care field to show that insurance companies should be purchasing high technology hearing aids for appropriate patients—if for no other reason than because it could be an effective tool in reducing patient visits for other complaints.
Twenty-nine million people in this country suffer from hearing loss, and only around 20 percent are currently using hearing aids. So there are a lot of people out there that could stand to benefit.
Cn: You're currently working on a book with UF architecture professor Gary Seabine which examines how classroom acoustics affect school children.
CC: Yes, we've just started on that. I've been working in this area for about a decade now.
We've done numerous studies that show that noise and reverberations in normal classroom environments can very significantly influence the academic performance of many populations of children, including children with even mild degrees of hearing loss, those under 15 years old (because their auditory abilities haven't fully developed yet), and those with attention deficit, ESL, language, reading or speech problems. In a typical classroom, the noise and reverberation will not allow these children to understand the teacher and learn the way they should.
Cn: Can this be addressed?
CC: Definitely. By improving the environment through technology, we find, for example, that many ADD kids no longer need Ritalin. If you're sitting in a room and can only hear 50% of what is being said, how long is your attention going to be there? It's hard enough for school kids to pay attention as it is.
We've been looking at one technology in particular, called Sound Field FM Amplification [Crandell has a book out on the subject], where the teacher wears a microphone and his/her voice is transmitted through the room on loud speakers. There have been over 40 studies done that have shown very positive effects using this technology in classrooms. Not only can it improve the acoustical environment and help academic performance, but it's also extremely cost-effective. Over a ten-year period it costs just a few dollars per child. Reading scores go up, academic scores go up, and failure rates go way down.
It's an area that until now, educators haven't really considered. We're working right now on the Federal level to establish appropriate acoustics standards for classrooms (there are currently no standards). My mentor Fred Bess at Vanderbilt just did a study that shows that children with very slight hearing loss have a 37% failure rate—as compared to a 3% failure rate in the general population. One of the major differences he found between kids with hearing loss and those with normal hearing was self esteem, which was much poorer in kids with even very slight hearing loss. So this work has great implications. We hope to have the federal standards in place in next couple of years. All new classrooms will have to meet these standards, and the Sound Field technology can help with older classrooms. In some cases, just fixing the AC or the lighting system in an older classroom can effectively reduce noise.
Cn: It must be rewarding to see your work improve people's lives.
CC: I really enjoy what I do because it has immediate applications. I like to see kids passing who were once failing. I like to work with patients here in the clinic and see them reentering the world and enjoying life because now they can hear. That's what makes this field so exciting.
