Dr Jacqueline Young is a Clinical Scientist at the Royal South Hants hospital and part of the Research Leaders Programme (RLP).

Her research is focused on improving care for children with deafness - any degree of hearing loss, either permanent or temporary.

Helping parents understand

Jacquline works in the Audiology team at the Royal South Hants hospital, managed by University Hospital Southampton (UHS) NHS Foundation Trust. 

One in 1000 babies are born with a permanent deafness, and a further one in 1000 will develop deafness during their childhood.

Alongside her clinical colleagues, Jacqueline performs hearing assessments and fits hearing aids for babies and children of all ages. She and her colleagues also help children and families navigate the challenges that can come with a diagnosis of deafness.

“I really enjoy the technical aspects of this role, but it also involves working very much alongside children and their families” she says. 

“For example, you can share detailed and accurate test results, but unless you share them in a way that families understand and feel motivated to act on, then those results are only ever going to have a limited effect.”

Jacqueline’s research focuses not just on improving test methods, but also explores and evaluates approaches that could help children and families to better understand and discuss their results and management options with clinicians and others.

Her most recent project investigates the impact of using hearing loss simulators in clinic to allow parents and other family members to understand how their child experiences the world.

During the simulation, parents listen to someone speaking – an audio book of Harry Potter, for example – and experience at first hand the difference when the simulation recreates what their child hears. 

Background noise such as the child might experience in a classroom can also be mixed in, helping parents appreciate how that could make it harder for their child to hear someone talk.

Jacqueline’s research explores whether parents find the simulation helpful and whether it has an effect on the length of time children wear their hearing aids each day.

“Other studies have shown that not all children use their hearing aids as much as they need, to keep their speech development at a similar pace to their hearing peers” she says. 

“There can be multiple barriers to hearing aid use for families, but we want to give parents the best possible understanding of their child’s hearing so that they can make informed choices about daily hearing aid use for their child."

Developing better tests and discussion tools

Previous research completed by Jacqueline and the Audiology team has informed national guidelines on how to test children who hear at different levels in each ear. 

Hearing tests typically rely on a child wearing earphones and responding to sounds, but good testing procedures are required for accurate results.

For example, Jacqueline explains: “If there is a big difference in hearing level between the ears, there is a risk that if you present a sound to the deaf side, it passes across the head and the child responds because they have heard it on their hearing side.”

There are national guidelines that advise audiologists on how to avoid this by “masking” – using a distracting sound in the better hearing ear. Jacqueline’s team found that these guidelines needed amending for younger children when using particular types of earphones to avoid incorrect results.

Jacqueline and the Audiology team also evaluated a free counselling tool, designed to be used by audiologists when talking to children and young adults with deafness. 

“Our study showed that most children and parents liked the tool," she says, "and that audiologists found it didn’t take up too much clinic time, and that it promoted helpful conversation topics.”

Mentoring her team

Jacqueline will use her RLP time to support the Audiology team to expand and deepen their research skills and confidence, promote evidence-based care, and ensure patient care at RSH is continually improving. 

She intends to extend the contribution that the team can make to the wider profession, through larger research projects. Jaqueline also hopes to mentor others in her team to design and implement their own audiology research projects.

Demand for more research-confident audiologists is also created by drug and treatment trials run by other UHS medical specialties. 

“Hearing tests are needed for any medical trial where there is a risk to hearing due to the condition or treatment, so there’s a lot of opportunity for audiologists to get involved in improving patient care and outcomes across the hospital,” Jacqueline explains.

Expanding horizons

Through her RLP award, Jaqueline aims to build on her experience to form wider networks with which to deliver future research projects. 

She plans to collaborate both with commercial partners to evaluate new test equipment as well as researchers at University of Southampton who are actively developing more automated approaches to hearing assessment.

Jaqueline’s PhD investigated Distortion Product Otoacoustic Emissions (DPOEs) - the mechanisms that underpin the testing used in newborn hearing screening. She is therefore especially keen to see if that approach can be extended, to offer more detailed information about hearing levels for patients who cannot complete conventional behavioural hearing tests.

“So far, our team’s projects have been small but impactful for the group of patients we see,” she says.

“We’ve amended national guidelines on how you test, made evidence-based changes to how we counsel a whole pathway of our patients with the counselling tool, and I think the hearing simulator will change how we talk to all families about hearing levels from now on. I’m looking forward to seeing what we can do next.”