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Doctor of Audiology Program

Department of Audiology & Speech Pathology

Audiologic Rehabilitation Laboratory

The Audiologic Rehabilitation Laboratory is located on the James H. Quillen VAMC Campus.  The laboratory is composed of one investigator, one research audiologist, and 3 current audiology doctoral students. 

The Audiologic Rehabilitation Laboratory research is supported by the Rehabilitation Research and Development (RR&D) Service, Department of Veterans Affairs via the Auditory and Vestibular Dysfunction Research Enhancement Award Program grant and previously, by RR&D supported Career Development Awards.


Sherri Smith, PhD, Director of the Audiologic Rehabilitation Laboratory

Dr. Smith is the Director of the Audiologic Rehabilitation Laboratory and founded the laboratory in 2003.  Her overarching research interest falls under the umbrella of audiologic rehabilitation (AR) for older adults.  In general, Dr. Smith studies factors that may influence the AR process--from assessment to interventions (hearing aids and beyond) to outcome assessment.  In particular, her research examines self-efficacy, auditory working memory, dual-sensory impairment (concurrent hearing and vision loss), questionnaire development, and clinical utility of outcome measures in the AR process. The end goal of her research is to develop clinical tools and service delivery processes to tailor a given patient's AR plan such that his/her individualized goals are optimized, resulting in an improved quality of life.

Research Projects and Current Funding

Several projects conducted in the Audiologic Rehabilitation Laboratory were funded by the VA Rehabilitation Research and Development Service.  

Role of Self-Efficacy in Audiologic Rehabilitation for Older Adults (RR&D Career Development Award, C3529V; PI: Smith)

The goal of this project was two-fold. The first goal was to develop a hearing-aid self-efficacy questionnaire, which we called the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA; West & Smith, 2007).  The MARS-HA quantifies self-efficacy levels for skills associated with successful hearing-aid use (See the Other Section on this page to download MARS-HA materials).  The second goal of this project was to determine if outcomes from an enhanced hearing-aid orientation based on self-efficacy principles were better than outcomes from a standard hearing-aid orientation in new hearing-aid users.   (Smith & West, in preparation).

Speech-in-Noise Measures as a Predictor of Hearing Aid Outcomes (RR&D Merit Review, C4352R; PI: Richard Wilson; Co-Is: Anna Nblek and Sherri L. Smith)

The focus of this study was to examine the relation between the Acceptable Noise Level (ANL), a subjective speech-in-noise measure, and performance on the Words-In-Noise (WIN) test, an objective speech-in-noise measure, in both aided and unaided conditions.  A second purpose of this study was to show well unaided ANL and WIN scores predict hearing-aid success. For this purpose, we sought to include multiple indicators of success as measured via a battery of questionnaires, in addition to patterns of hearing-aid use (e.g., full-time, part-time, or non-use) used by Nblek and colleagues (2006). A total of 120 Veterans completed this project. The mean ANLs were 15.5 dB (unaided) and 13.5 dB (aided); the mean WIN 50% points were 14.4 dB S/N (unaided) and 12.6 dB S/N (aided).  Both differences were significant.   Pearson r correlations showed no significant relation between ANLs and WIN thresholds in unaided or aided conditions.  Unaided ANL was not significantly correlated with any (sub)scale score on the self-report measures used in the study but unaided WIN thresholds were significantly correlated with at least one (sub)scale score on each self-report measure.  In conclusion, the study found that ANL and WIN results provide different clinical information.  Both ANLs and WIN thresholds significantly improved with amplification.  Unaided ANL and WIN scores were not highly accurate predictors of hearing-aid success.  The results of this study confirm that hearing-aid success is a multi-dimensional issue that is not easily defined or predicted based on performances on unaided speech measures (Smith, Wilson, & Nblek, in preparation).

Student Projects

Kelley Dwyer, B.S.
Audiology Doctoral Student

Kelley is a 4th year audiology doctoral student who completed her undergraduate training at the University of Georgia. She has been a member of the lab since 2010 and believes her experience in the lab has helped her to develop effective interpersonal skills as well as, data collection skills. She completed her capstone project in the lab which explored the unique difficulties that Dual Sensory Impaired (hearing impaired and vision impaired) Veterans experience while using their hearing aids.

Diana Wilson, B.A.
Audiology Doctoral Student

Diana is currently a third-year audiology doctoral student at ETSU and is completing her capstone research project within the Audiologic Rehabilitation Laboratory. Dianas project will determine the test-retest reliability of the Listening Self-Efficacy Questionnaire (LSEQ). Diana enjoys the work that she does within the laboratory as she believes the skills she has developed will help her be a better clinician and that the information gleaned from her project will impact the clinical use of the LSEQ.

Kelsey King, B.S.
Audiology Doctoral Student

Kelsey is currently a second-year audiology doctoral student at ETSU and is beginning to work on her capstone research project within the Audiologic Rehabilitation Laboratory. Kelseys project is examining the relations between working memory for speech and speech materials that vary in linguistic and contextual complexity. Kelsey enjoys the work that she does within the laboratory as she believes the skills she has developed will lead to her being a better clinician.

Current Equipment/Technology

The Audiologic Rehabilitation Laboratory includes a double-wall 10X10 sq. ft. sound booth that is equipped with standard audiologic instrumentation including an audiometer (Grason Stadler Model 61), three sound-field speakers, a Sony CD player (Model Model CDP-497), and a middle ear immittance bridge (Grason Stadler Tympstar). A real-ear and electroacoustic analysis system with WinChap for hearing-aid verification (Frye Fonix 7000) and a hearing-aid fitting station also is housed in the lab. A Tucker Davis Technology System 3 is available for use with delivering stimuli for experimental protocols. The lab also is equipped with an Optec 5000G with slides for screening for visual acuity, contrast sensitivity, depth perception, and visual field. A Type I sound level meter (Larson Davis) is available for calibration purposes. In addition, sound editing software (Cool Edit Pro and Adobe Audition), CD burner, and VU meters are available.



Smith, S. L., Bennett, L. W., & Wilson, R. H. (2008). Prevalence and characteristics of dual-sensory impairment (hearing and vision) in a veteran population. Journal of Rehabilitation Research and Development, 45, 597-610. PMID: 18712645 

Smith, S. L., Noe, C. M., & Alexander, G. (2009). Evaluation of the International Outcomes Inventory for Hearing Aids in a veteran sample. Journal of the American Academy of Audiology, 20, 374-380. PMID: 19594085 

Echt, K. V., Smith, S. L., Backscheider-Burridge, A., & Spiro III, A. (2010). Longitudinal changes in hearing sensitivity among men: the Veterans Affairs Normative Aging Study. Journal of the Acoustical Society of America, 128 (4), 1992-2002. 

Smith, S. L., Pichora-Fuller, M. K., Watts, K. W., & La More, C. (2011). Development of the Listening Self-Efficacy Questionnaire (LSEQ). International Journal of Audiology, 50, 417-425. 

Smith, S. L. & Fagelson, M. (2011). Development of the Self-Efficacy for Tinnitus Management Questionnaire. Journal of the American Academy of Audiology, 22, 424-440. 

Smith, S. L., Pichora-Fuller, M. K., Wilson, R. H., & MacDonald, E. N. (2012). Word recognition for temporally and spectrally distorted materials: the effects of age and hearing loss. Ear and Hearing. 

Wilson, R. H., McArdle, R. A., Watts, K. L., & Smith, S. L. (2012). The Revised Speech Perception In Noise Test (R-SPIN) in a Multiple Signal-to-Noise Ratio Paradigm. Journal of the American Academy of Audiology. 

Smith, S. L., Ricketts, T., McArdle, R. A., Chisolm, T. H., & Bratt, G. (2013). Style Preference Survey: A Report on the Psychometric Properties and a Cross-Validation Experiment. Journal of the American Academy of Audiology. .

Smith, S. L. (2013). Self-Efficacy Theory in Audiologic Rehabilitation. In Joseph J. Montano & Jacyln B. Spitzer (Eds.), Adult Audiologic Rehabilitation.


McDaniel, L., Fagelson, M., & Smith, S. L. Changes in scores of Tinnitus Handicap Inventory over time. Presented at the Association of Veteran Affairs Audiologists, Charlotte, NC, April, 2, 2008. 

Smith, S. L. & Fagelson, M.A. Preliminary psychometric results of a tinnitus self-efficacy questionnaire. Poster presented at the IXth International Tinnitus Congress; Goteborg, Sweden, June 15-18, 2008. 

Fagelson, M.A., Smith, S. L., & McDaniel, L.M. Analysis of self-assessed tinnitus handicap in patients with Posttraumatic Stress Disorder. Poster presented at the IXth International Tinnitus Congress; Goteborg, Sweden, June 15-18, 2008. 

Smith, S. L., & Noe, C. M. Evaluation of the IOI-HA in a veteran population. Poster presented at the International Hearing Aid Research Conference, Lake Tahoe, California, August 13-17, 2008. 

Smith, S. L. & Ricketts, T. Development of the Style Specific Satisfaction Survey. Presentation at the Fifth International Adult Audiologic Rehabilitation Conference, Tampa, FL, March 16-18, 2009. 

Smith, S. L. & Pichora-Fuller, M. K. Listening self-efficacy of older adults with hearing loss. Presented at the Academy of Rehabilitative Audiology, Bettendorf, IA, September 9-11, 2009. 

Smith, S. L., Pichora-Fuller, M. K., & Wilson, R. H. Effects of signal quality and level, background noise, age, and hearing loss on word-recognition performances. Poster presented at the Aging and Speech Communication: Third International and Interdisciplinary Research Conference, Bloomington, IN, October 12-14, 2009. 

Smith, S. L., Pichora-Fuller, M. K., & Wilson, R. H. Development of an auditory working memory word-span test: Test design and preliminary results. Poster presented at the Phonak Hearing Care for Adults 2009 The Challenge of Aging, Chicago, IL, November, 15-18, 2009. 

Cambron, N., Wargo, M., & Smith, S. L. VA bilateral cochlear implant candidacy protocol. Presented at the Joint Department of Defense and Veterans Affairs Audiology Conference, Orlando, FL, February 21-23, 2010. 

Draper, S., Smith, S. L., & Smurzynski, J. "Listening in the dips" and temporal fine structure abilities. Poster presented at the American Academy of Audiology Annual Convention, Chicago, IL, April 7-9, 2011. 

Chisolm, T.H., McArdle, R., Saunders, G.H., Smith, S.L., Wilson, R. Efficacy of auditory training for adults: preliminary results. Presented at the International Conference on Adult Hearing Screening AHS 2010. Cernobbio (Como Lake), Italy, June 10-12, 2010. 

Saunders, G.H., Chisolm, T.H., McArdle, R., Smith, S.L., Wilson, R. Evaluation of auditory training with veterans: preliminary results. Presented at the International Hearing Aid Conference (IHCON). Lake Tahoe CA, August 11-15, 2010. 

Teahen, M., Saunders, G.H., Chisolm, T.H., Smith, S.L., McArdle, R., Wilson, R., Silverman, S., Boyle, C., Hatcher, M., Vachhani, J.J. Training habits and outcomes from a computerized auditory training program. Poster presented at the Institute of the Academy of Rehabilitative Audiology, San Francisco CA, September 12-14, 2010. 

Chisolm, T., McArdle, R., Saunders, G., Smith, S.L., & Wilson, R. A randomized controlled trial of auditory training for adults. Presented at the International Collegium for Rehabilitative Audiology Biannual Meeting, Toronto, Canada, May 18-20, 2011. 

Pichora-Fuller, M.K., Singh, G., Chasteen, A., & Smith, S. The convergence of psychological and behavioral measures reflected in self-report measures of hearing. Presentation, International Collegium of Rehabilitative Audiology Conference, Toronto, May 2011. 

Smith, S. L., Pichora-Fuller, M. K., Wilson, R. H., & Watts, K. Development of a clinically feasible auditory word-span memory measure. Poster presentation at the International Aging and Speech Communication Conference, Bloomington, IN, October 9-12, 2011. 

Hnath-Chisolm, T., Wilson, R. H., Teahen, M., Saunders, G., Smith, S. L., & McArdle, R. Can we teach "old ears" new tricks? auditory training in older adults? Oral presentation at the International Aging and Speech Communication Conference, Bloomington, IN, October 9-12, 2011. 

Pichora-Fuller, M. K., Chasteen, A. L. Dupuis, K., Singh, G. & Smith, S. L. Negative beliefs of aging influence hearing through beliefs about listening abilities. Poster presentation at the American Acoustical Society Scientific and Technology Meeting, Scottsdale AZ, March 8-10, 2012. 

Chasteen, A.L., Dupuis, K., Pichora-Fuller, M.K., Singh, G., & Smith, S. L. Sunny side down: How negative views of aging influence memory function and metacognitive beliefs. Plenary Presentation (selected for plenary presentation from abstract submissions by organizing committee), Cognitive Aging Conference, Atlanta, April, 2012. 

Dupuis, K., Chasteen, A.L., Marchuk, V., Pichora-Fuller, M.K., Singh, G., & Smith, S. L. Are "community-dwelling healthy older adults" cognitively "normal"? Poster, Cognitive Aging Conference, Atlanta, April, 2012. 

Smith, S. L. Development of a new auditory working memory measure: Preliminary results. Academy of Rehabilitative Audiology Institute, Providence, RI, September 10, 2012


2009 VA Leadership and Effectiveness Development Trainee (local)
2009 Travel Scholarship ($900) to attend Ear-to-Brain Conference, VA National Center for Rehabilitative Auditory Research, Portland, OR 2007 Hearing Journal Best Article in Audiologic Rehabilitation Category

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