Audiology Capstone Projects

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Each candidate for the degree Doctor of Audiology (AuD) must submit an approved document that describes the project completed in the fourth year of the program. The Capstone Project must demonstrate the student's mastery in an individually-defined area of interest. The nature of each project may vary with the interests and plans of the individual student. The Capstone Project is expected to be a scholarly contribution to knowledge in a chosen area of specialization. Students may choose either a Research Track, for which they must conduct a clinical or laboratory research project; or a Specialization Track, for which they enroll in a minimum of 12 credit hours of course work outside the department in a specific topic area. The specialization must culminate in a scholarly and original paper on the specialization topic and its importance to the profession of audiology.


Recent Submissions

Now showing 1 - 20 of 70
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    Frequency Lowering in the Pediatric Population: Outcomes and Considerations for Fitting
    (Ohio State University. Department of Speech and Hearing Science, 2016) Ross, Lauren Virginia; Whitelaw, Gail
    Children with hearing loss are at a disadvantage for language learning because they are unable to hear many of the important, yet subtle, cues necessary for speech and language development. Even when using current digital hearing aids, children with hearing loss are often unable to hear speech cues in the high frequency range. Frequency lowering is a processing strategy in which the hearing aid transfers higher frequency inputs to a lower frequency range that can be adequately amplified by the device. Two types of frequency lowering algorithms are currently available for use in children and have been shown to be successful for improving high frequency audibility in children with high frequency hearing loss. The purpose of this capstone is to describe the use of frequency lowering techniques to improve high frequency audibility for children with hearing loss. Specifically, this capstone will focus on the different types of frequency lowering and recent research outcomes, fitting considerations in the pediatric population, and considerations in acclimatization and auditory training with frequency lowering technology. In addition, a case example is provided to demonstrate candidacy, fitting, and verification concepts in a real world situation.
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    Ear-Specific Cochlear Implant Outcomes in Younger and Older Adults
    (Ohio State University. Department of Speech and Hearing Science, 2016) Krygowski, Molly; Whitelaw, Gail
    Auditory information is transmitted from the ear to the brain along an intricate network of structures that comprise the central auditory nervous system. It is well documented that the neural pathway from the ear to the contralateral auditory cortex is stronger and more efficient than the pathway from the ear to the ipsilateral auditory cortex (Lazard et al., 2012; Lipschutz et al., 2002). In the majority of individuals, a functional specialization of the left cerebral hemisphere exists for language processing (Geschwind, 1972; Geschwind & Levitsky, 1968; Kimura, 1961; Jancke et al., 2002; Tervaniemi & Hugdahl, 2003). Due to this crossed nature of the central auditory system, the right ear has direct access to the language-dominant cerebral hemisphere, which results in superior right ear performance, or the Right Ear Advantage (REA), on dichotic listening tasks (Kimura, 1967). A body of literature reveals that the REA becomes more exaggerated with increased age (Martin & Cranford, 1991; Strouse et al., 2011; Roup et al., 2006; Jerger et al., 1995; Jerger & Johnson, 1992; Bellis & Wilber, 2001). The increase in the REA in older adults, in the presence of symmetrical hearing sensitivity, is thought to reflect age-related degradation of the corpus callosum, which compromises the transfer of auditory information between the cerebral hemispheres (Bellis & Wilber, 2001). Speech information presented to the left ear preferentially stimulates the right auditory cortex and must be transmitted by way of the corpus callosum in order to be processed in the language-rich left auditory cortex. Superior right-ear performance is therefore demonstrated in older adults, due to the primary projection of the right ear to the dominant hemisphere. The present study aimed to determine if ear-specific differences in speech understanding exist in younger and older adults who underwent unilateral cochlear implantation. Post-operative performance on speech outcome measures (Consonant-Nucleus-Consonant words and AZ-Bio Sentences) was compared between younger adults (18-69 years) and older adults (70+ years). Results revealed significant benefits in speech perception following implantation for both younger and older adults. Ear of implantation had no significant effect on post-operative speech outcomes in either group.
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    Evaluating the TEN Test in the Identification and Monitoring of Cochlear Dead Regions and Cochlear De-afferentation in Rats with Noise Induced Hearing Loss
    (Ohio State University. Department of Speech and Hearing Science, 2016) Kerns, Katherine Anne; Bielefeld, Eric C.
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    Privacy and Security in the Clinical Audiology Setting: Ohio Audiologists' Knowledge of the Health Insurance Portability and Accountability Act
    (Ohio State University. Department of Speech and Hearing Science, 2016) Antalovich, Anne Catherine; Whitelaw, Gail
    The purpose of this study was to investigate the knowledge possessed by professionally licensed audiologists regarding the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implications for clinical audiological practices. The study also aimed to examine the training and enforcement of HIPAA regulations in audiology clinics and facilities. A 30-question survey was distributed to professionally licensed audiologists in Ohio via an online survey instrument. The survey focused on audiologists’ knowledge of HIPAA regulations as well as corresponding sources of education and training. Subsequently, six pre-generated discussion questions were electronically distributed to Ohio audiologists. The discussion questions focused on the HIPAA training and education provided to audiologists in their employment settings. The results of the study indicated that audiologists possess limited knowledge regarding HIPAA regulations and that the majority of audiologists currently receive annual training and education through electronic sources. The results of the current study demonstrate the need for enhanced HIPAA training strategies in educating audiologists regarding the importance of federal privacy and security regulations as well as compliance with them.
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    The Use of Mild Gain Hearing Aids for Adults with Auditory Processing Difficulties
    (Ohio State University. Department of Speech and Hearing Science, 2015) Moore, Donna; Roup, Christina
    The purpose of the present study was to investigate the effect of mild gain hearing aids with directional microphones and noise reduction in adults with auditory processing difficulties. Eleven adults with normal peripheral hearing but complaints and case history consistent with auditory processing difficulties completed speech in noise testing with and without the use of hearing aids and completed questionnaires addressing listening difficulties following testing with and without hearing aids. They also answered a question about their perception of anxiety during testing with and without hearing aids. The adults demonstrated significant improvements on speech in noise testing and on the questionnaires regarding listening difficulty. The majority of them also reported less anxiety during testing when wearing the hearing aids. Future research should include a larger sample size, a longer trial of amplification, should investigate different settings for the hearing aids, and should address subject anxiety in a more specific and measurable way.
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    The effects of high-pass masking on stimulus rate changes in the auditory brainstem response
    (Ohio State University. Department of Speech and Hearing Science, 2014) Hambley, Ellen R.; Bielefeld, Eric C.
    The auditory brainstem response (ABR) to tonal stimuli is routinely used in a clinical setting to obtain estimates of hearing sensitivity. The latency and amplitude of ABR waveforms vary with stimulus frequency, intensity, and rate. However, interactions among these stimulus parameters on the ABR have only recently been fully examined. A study measuring effects of all three stimulus parameters in the same subjects demonstrated a latency shift of ABR Wave V in response to an increase in stimulus rate that was significantly greater for low frequency, low intensity stimuli than for other stimulus conditions tested (Hess and Hood, 2012). The goal of the current study was to replicate these findings and assure frequency regions being tested were appropriately isolated through the use of a high-pass masking paradigm. The current study was designed to further evaluate the interactions among stimulus parameters on the ABR in normal hearing adults. The ABR was recorded from sixteen adults with normal hearing for eight stimulus parameter conditions. Results revealed a significantly greater rate-induced latency shift in Wave V of the ABR for the low frequency, low intensity condition, confirming the results of the Hess and Hood (2012) study. The new finding in this study was that the latencies for all conditions remained similar in relationship with the addition of high-pass masking. These results suggest a frequency effect for lower intensity signals; however, the mechanisms behind this finding remain unknown.
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    Increasing Adherence: Learning to Counsel Your Patients for Better Outcomes
    (Ohio State University. Department of Speech and Hearing Science, 2015) Cherry, Megan M.; Whitelaw, Gail
    The biomedical conceptual model emphasizes the concept of disease or absence of disease for diagnosis whereas the biopsychosocial model emphasizes social and emotional factors for diagnosis. This concept of incorporating social and emotional factors has led to development and research into the importance of the patient-healthcare professional relationship. A patient who trusts his or her healthcare professional is more likely to divulge emotional issues. Additionally, it is important to train healthcare professionals to identify emotional issues and to work with the patient to increase quality of life. The patient’s concerns must be addressed for the patient to follow the clinician’s plan. For example, with a patient whose main concern is his or her relationship with a family member with whom they only speak on the phone, phone communication strategies must be addressed. It is important for clinicians to understand medical recall and medical literacy of their patient populations. A good relationship between the clinician and patient should identify recall patterns and strategies in order to facilitate treatment and increase quality of life. The purpose of this capstone is to provide a comprehensive overview of several of the tenets of patient-centered care, including the conceptual biomedical and biopsychosocial models, the formation of the patient-audiologist relationship, and the importance of medical recall and medical literacy.
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    Hearing Loss and Co-Occurring Developmental Disability: Recommendations for Improved Clinical Practice
    (Ohio State University. Department of Speech and Hearing Science, 2015) Grumm, Mandi; Whitelaw, Gail
    It is well-known that children with developmental disabilities are at greater risk for hearing loss. Although proper audiologic care is imperative for all children with hearing loss, those diagnosed with multiple disabilities often face unique challenges due to varying degrees of cognitive and physical impairment. For some children with critical health concerns, diagnosing and treating hearing loss may not always be a primary goal for families. Pediatric audiologists must be equipped to support these families by identifying, diagnosing, and providing intervention options for children with developmental disabilities. However, traditional audiologic protocols are not always appropriate for patients with unique needs. The field of special education has a wealth of knowledge and proficiency in working with children with developmental delays. Pediatric audiologists should be flexible in incorporating innovative techniques for diagnosing and treating children with co-occurring hearing loss and developmental disability. Communication barriers are common in children with developmental delays and common in children with hearing loss, further complicating oral communication development when hearing loss and developmental disability occur together. Interdisciplinary teams consisting of a range of pediatric specialists can support families in their endeavors towards a better quality of life for their children with multiple disabilities. Providing high-quality early intervention services can address individual needs across disciplines through offering appropriate comprehensive evaluations, as well as evidence-based interventions and therapies specific to each child’s needs. Although more research on this topic is desperately needed, pediatric audiologists working collaboratively with family-centered interdisciplinary teams can certainly facilitate successful hearing and communication outcomes for children with multiple disabilities.
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    The Development of an Assessment Manual for 4th Grade Oral and Written Narratives
    (Ohio State University. Department of Speech and Hearing Science, 2015) Low, Keri E.; Nittrouer, Susan
    Despite advances in hearing technology, children with hearing loss remain at risk for having oral and written language difficulties. Assessing a child’s narrative ability is one of the most informative methods of measuring language competence. In-depth analyses of narrative ability in children with hearing loss, particularly children who use cochlear implants, are lacking. Furthermore, there is a clear need for research examining the differences in oral and written narrative skills in children with hearing loss. The purpose of this project was to develop an assessment tool that evaluates oral and written narrative abilities in school age children. This document reviews current research on narrative abilities in children with hearing loss, discusses the need for a single assessment tool analyzing both oral and written narrative abilities, and presents the developed tool.
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    The Relationship Between Nonword Repetition, Vocabulary, and Reading in Children with Cochlear Implants
    (Ohio State University. Department of Speech and Hearing Science, 2014) Sansom, Emily; Nittrouer, Susan; Roup, Christina
    The aim of the present study was to investigate how children with cochlear implants (CI) perform on a nonword repetition (NWR) task compared to their normally-hearing (NH) peers. One hundred and four second-grade children participated in this study: 49 with NH and 55 with severe-to-profound hearing loss who wore CIs. Along with NWR, children were tested on four other measures: phonological processing and working memory, which were evaluated as skills that potentially underlie NWR skills; and expressive vocabulary knowledge and word reading, which were evaluated as skills that are potentially based on NWR skills. The groups’ performance on these four measures was compared to their performance on the NWR task. Results revealed that the largest group difference was seen in scores for the NWR task, with the NH group performing significantly better than the CI group. Additionally, all dependent language measures were found to have a significant positive correlation with NWR for both groups. Phonological awareness had the highest correlation with NWR for both the NH and CI groups. NWR had the highest correlation with word reading for the NH group. NWR had the highest correlation with expressive vocabulary for the CI group. NWR accounted for a significantly larger amount of variance in expressive vocabulary scores for the CI group when compared to the NH group. In conclusion, the relationship between NWR skills and the dependent language measures in the present study provides evidence for the role of phonological processing in the perception of spoken language and development of expressive vocabulary and reading skills. The results of the present study may have important implications for planning intervention strategies aimed at facilitating spoken language outcomes for children with CIs. Better understanding of the cognitive mechanisms that underlie spoken language skills may aid in the development of intervention strategies to facilitate successful language outcomes for children with CIs.
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    Oral Bilingualism in Children Who Are Deaf and Hard of Hearing
    (Ohio State University. Department of Speech and Hearing Science, 2015) Strang, Megan Lisbeth; Whitelaw, Gail
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    A Comprehensive Review of the Vestibular System
    (Ohio State University. Department of Speech and Hearing Science, 2014) Byerly, Alicia Michelle; Whitelaw, Gail
    The vestibular system is housed within the bony labyrinth of the inner ear and is made up of three semicircular canals, which respond to angular head movements, and two otolithic organs, which respond to linear head movements. There are multiple diseases and disorders that can negatively impact the function of the vestibular system and result in symptoms including vertigo and imbalance. Audiologists perform many diagnostic evaluations to assist with the differential diagnosis of vestibular disorders, including videonystagmography (VNG), posturography, rotational chair, and vestibular evoked myogenic potentials (VEMP). These evaluations are essential in determining the site of lesion and treatment options for the dizzy patient. The purpose of this capstone is to provide a comprehensive overview of the anatomy and physiology of the vestibular system, to review some common disorders that are often present in the dizzy patient, to summarize the evaluations that an audiologist may perform to assist in the differential diagnosis of a dizzy patient, and to present multiple case studies.
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    Survey on Knowledge and Attitudes of Hearing Loss and Assistive Listening Technology with Children
    (Ohio State University. Department of Speech and Hearing Science, 2014) Hayes, Danyelle Nicole; Whitelaw, Gail
    The aim of this study was to determine the level of experience obtained by classroom teachers located in Columbus, Ohio in the area of the educating children with hearing loss. Other areas of interest in the survey included the additional education regarding hearing loss in children and the willingness to make accommodations for children with hearing loss. A 35-question survey was sent to approximately 2,000 teachers in central Ohio. Questions in the survey focused on the teachers’ experience with hearing loss, educating children with hearing loss and their willingness to work with students with hearing impairment. Subjects were contacted twice via electronic mail requesting their voluntary and confidential participation. Results indicated that a significant minority of respondents reported having formal education about hearing loss. In contrast, many respondents reported they had classroom experience with teaching children with hearing loss. The majority of teachers responded that they would be willing to work with students with hearing loss and make accommodations for these students. These results supported the need for communication between audiologists and teachers to promote academic success of students with hearing loss.
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    The Speech Critical Band (S-CB) in Cochlear Implant Users: Frequency Resolution Employed During the Reception of Everyday Speech
    (Ohio State University. Department of Speech and Hearing Science, 2013) Wigand, Jason; Healy, Eric W.
    It is widely recognized that cochlear implant (CI) users have limited spectral resolution and that this represents a primary limitation. In contrast to traditional measures, Healy and Bacon [(2006) 119, J. Acoust. Soc. Am.] established a procedure for directly measuring the spectral resolution employed during processing of running speech. This Speech-Critical Band (S-CB) reflects the listeners’ ability to extract spectral detail from an acoustic speech signal. The goal of the current study was to better determine the resolution that CI users are able to employ when processing speech. Ten CI users between the ages of 32 and 72 years using Cochlear Ltd. devices participated. The original standard recordings from the Hearing In Noise Test (HINT) were filtered to a 1.5-octave band, which was then partitioned into sub-bands. Spectral information was removed from each partition and replaced with an amplitude-modulated noise carrier band; the modulated carriers were then summed for presentation. CI subject performance increased with increasing spectral resolution (increasing number of partitions), never reaching asymptote. This result stands in stark contrast to expectation, as it indicates that increases in spectral resolution up to that of normal hearing produced increases in performance. Accordingly, it is concluded that CI users can access spectral information as high as that of normal hearing (NH) when presented with narrowband speech stimuli. These results have implications for the design of future devices that allow better representation of tonal languages, music, and speech in noise.
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    The Effect of a Contract on Patient Compliance in an Auditory Training Program
    (Ohio State University. Department of Speech and Hearing Science, 2014) Tarney, Erin B.; Roup, Christina
    The purpose of the present study was to assess the effect of a signed contract on patient compliance rates with the Listening and Communication Enhancement (LACE) aural rehabilitation program. A secondary purpose of this study was to assess subjective and objective treatment outcomes of the LACE program related to patient compliance rates. Twenty older adults with bilateral sensorineural hearing loss and who are users of binaural hearing aids were randomly placed into either the no contract (i.e., control) group or the contract (i.e., experimental) group, with the experimental group signing a contract before beginning the LACE program, and the control group beginning the LACE program without signing a contract. While implementation of a signed contract did not demonstrate a significant increase in compliance rates when compared to the no contract group, it appeared to encourage subject completion of at least half of the LACE program. There were no significant differences present between outcome measure data from pre-treatment to post-treatment in the present study, however, many subjects had little room for improvement, as their baseline measures were good to begin with. Future research should consider determining compliance criteria of the LACE on an individual basis, and using more difficult outcome measures such as the SPIN test. Creation of additional methods that establish the patient as a decision-making partner in therapy and subsequently develop individualized patient motivation to complete recommended training in aural rehabilitation programs should also be considered.
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    Parent Experience with a Dual Diagnosis of Autism Spectrum Disorder and Hearing Impairment
    (Ohio State University. Department of Speech and Hearing Science, 2014) Stefanski, Julie; Whitelaw, Gail
    The aim of the present study was to evaluate the experiences of parents raising children with a dual diagnosis of hearing impairment and autism spectrum disorder (ASD). Subjects were recruited through outreach to a network of professionals in related fields, as well as the Autism Research Institute’s Network for Deaf/Hard of Hearing and Blind/Visually Impaired. Five qualifying parents consented to participation in the study and shared their experiences in a one-on-one interview. Results were analyzed using strategies from the thematic network analysis theory, a qualitative research model. Parents reflected on their experiences during the diagnostic processes, throughout interventions and therapy, and regarding their educational decisions. Results revealed unique experiences across families, as was anticipated; however, overlying themes included fluctuating emotional experiences with professionals during the diagnostic processes, eventual satisfaction with interventions received, and ongoing challenges regarding educational decisions. The results of this study support the goal of contributing to the limited body of research on the co-occurrence of hearing impairment and ASD, as well as raising awareness and insight for health care providers and educational professionals who provide services to individuals in this population.
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    Binaural Auditory Processing Among Middle-­Aged Adults
    (Ohio State University. Department of Speech and Hearing Science, 2013) Miller, Traci A.; Roup, Christina M.
    Binaural listening, or listening with both ears, allows a listener to better localize and understand speech than with one ear alone. For some aging adults, however, this binaural advantage does not exist, or is reduced relative to normal for speech-in-noise tasks. In addition, some older adults tend to exhibit an exaggerated right ear-­advantage (REA), or better recognition of signals presented to the right ear than the left during dichotic listening tasks, compared to young adults (i.e., Noffsinger et al., 1996). There is limited research, however, exploring if these age-­related changes in binaural listening begin to be demonstrated in mid-­life. The present study examined binaural versus monaural processing for 30 middle-­aged adults (ages 31-­59 years) possessing no more than a mild high-­frequency sensorineural hearing loss. Two types of word recognition assessments were implemented: (1) word recognition in noise and (2) dichotic word recognition. For the word recognition in noise tasks, subjects responded under three conditions: (1) monaural left ear, (2) monaural right ear, and (3) binaural. For the dichotic listening tasks, subjects responded in: (1) free recall, (2) directed-­recall right, and (3) directed-­recall left. Results were compared to previously-collected data for 30 young adults (ages 18-­30 years) and 30 older adults (ages 60-­89 years). Overall, middle-­aged adults performed slightly poorer than young adults but showed performance patterns more similar to young than older adults. In sum, these results suggest that age-related binaural auditory processing deficits may not present in middle age. Results do suggest, however, that individual variability exists within this age group and that individual performance patterns should be considered when making conclusions about binaural auditory processing in middle age. The present study supports future research regarding age-­related changes in the auditory system across the adult lifespan.
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    Utilizing Social Media to Connect Adolescents and Young Adults with Hearing Loss
    (Ohio State University. Department of Speech and Hearing Science, 2013) Middaugh, Jessica L.; Whitelaw, Gail M.
    The aim of the present study was to develop a social media network designed for adolescents and young adults with hearing loss. Five adolescents and young adults with hearing loss were recruited through central Ohio audiologists. Participants responded to two electronic surveys and took part in a focus group with their peers. Results indicated elements, or suggestions, that should be incorporated when designing a social media network for this population. A supplemental study was also conducted with four young adults with normal hearing who participated in a focus group and responded to the same questions relating to the social media network as the focus group of participants with hearing loss. Results indicated that the participants with normal hearing desired different resources and information on the social media network compared to the participants with a hearing loss. The results of the present study can be used to guide audiologists in the development of a social media network for adolescents and young adults with hearing loss.
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    Importance of Motivational Interviewing Therapeutic Techniques in Audiology Clinical Work
    (Ohio State University. Department of Speech and Hearing Science, 2014) Livorno, Kristyn A.; Bielefeld, Eric C.
    Hearing loss affects individuals, not just in a physical manner but in an emotional one. The beginning of a sensory loss is a form of psychological trauma that may cause shock and confusion. These emotional and psychological changes may create a reduced quality of life and increased social isolation. Individuals who are learning about their particular hearing loss or using hearing aids for the first time are likely to go through various emotions, which may include embarrassment, frustration, anxiety, depression, or fatigue which may affect how they interact socially. It is important that audiologists understand the necessity of counseling for individuals, as they are most likely going through new emotions and are not sure how best to cope with their new situation. Clinicians do not have training with therapeutic techniques and counseling strategies, and a minimum of a broad understanding of therapeutic techniques would help to provide clients with the best possible outcomes for reducing the negative impact of their hearing impairments.
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    Noise-Induced Changes in Electrocochleography in the Fischer 344/NHsd Rat
    (Ohio State University. Department of Speech and Hearing Science, 2014) Kobel, Megan Janette; Bielefeld, Eric C.
    There is a growing body of evidence suggesting that cochlear de-afferentation can occur without accompanying outer hair cell (OHC) loss after noise exposure. Due to the high incidence of noise exposure in the United States, there is a need to develop assessments that can identify and monitor this de-afferentation in noise-exposed listeners. The current study was undertaken to investigate changes in the components of electrocochleography (EcochG) in the Fischer F344/NHsd rat in order to assess long-term cochlear deafferentation from hazardous noise. Changes in the action potential (AP) and cochlear microphonic (CM) input-output (I/O) functions were measured after noise exposure. The CM/AP ratio was examined to account for between-test differences since electrode differences and OHC damage would impact each component. Noise-induced cochlear de-afferentation was predicted to result in reduction of AP amplitude without change in the CM amplitude, thus resulting in elevation of the CM/AP ratio. Fischer 344/NHsd rats were exposed to a narrowband noise to induce permanent (PTS) or temporary threshold shifts (TTS). After exposure, the AP and CM I/O functions were measured once every 4 weeks for 24 weeks in order to assess long term cochlear de-afferentation. Results showed that the AP I/O function was depressed at all levels in ears with PTS. The CM/AP ratios revealed depression of the AP at weeks 8-24, indicating possible cochlear de-afferentation. In ears that experienced TTS, a recruitment-like effect was seen in the iii AP I/O function at 4 weeks, indicating OHC pathology. Subsequent AP decreases were seen over the 4-24 week testing period, indicating cochlear de-afferentation. This was also seen in the CM/AP ratio, which increased over time due to reduction in AP amplitudes. The I/O functions obtained from ears that had experienced TTS or PTS displayed patterns consistent with long-term cochlear de-afferentation. The findings indicate that components of EcochG are sensitive to possible de-afferentation of the cochlea after noise-exposure.