VKC member Angela Yarnell Bonino, Ph.D., is assistant professor of Hearing and Speech Sciences. The long-term goal of Dr. Bonino’s research is to improve hearing health care for children who have intellectual and developmental disabilities (IDD) by transforming the standard of clinical care to include developmentally informed behavioral testing methods and practices. Her work includes defining key methodology parameters that result in obtaining high-quality hearing sensitivity data from young children with IDD as well as identifying gaps in current clinical hearing assessment practices for those same children by using Electronic Health Record (EHR) data. Bonino believes these goals will pave the way in reducing hearing health care disparities for children with IDD, who are associated with a higher risk of hearing difficulty than seen in the general population.
In the interview below, Bonino shares what inspires her research, what she has learned through her work, and how membership with the Vanderbilt Kennedy Center helps her achieve her goals.
Tell us about your attraction to developmental disabilities research.
As an undergraduate student, I became interested in brain development, especially language acquisition, and how it is affected by sensory deprivation. This interest led me to complete my clinical training in pediatric audiology – where the focus is on early diagnosis of reduced hearing and fitting of technology to support access to spoken language. Over time, because of my clinical and research experiences, my research program has shifted focus to addressing gaps in hearing health care practices for children who have developmental disabilities.
What are your current research interests and what challenges do they address?
Audiologists routinely see children in the clinic who have developmental differences. One reason for this is that a diagnostic hearing evaluation is often part of a communication or developmental assessment. The second reason is because many disabilities are associated with a higher risk of reduced hearing – including Down syndrome, cerebral palsy, and intellectual disability – than what we see in the general population. Despite the high occurrence of children with complex or diverse developmental profiles in the audiology clinic, the current gold-standard assessment of hearing – the audiogram – largely assumes that children have typical development. Moreover, there is a limited evidence base to guide the diagnosis or management of reduced hearing in this population. Consequently, children who have developmental disabilities are at risk for late identification of their reduced hearing, which can adversely impact developmental outcomes.
The long-term goal of my research is to improve hearing health care for children who have developmental disabilities by transforming assessment practices. Current work is focused on:
- Identifying gaps in the current state of clinical assessment for children who have developmental disabilities by harnessing Electronic Health Record data from three hospitals in the United States;
- Using a behavioral method in the laboratory, we are identifying factors that influence obtaining accurate behavioral thresholds for toddlers and preschoolers who have a diagnosis of Down syndrome or autism or have typical development; and
- Evaluating the feasibility and utility of screening for autism during a hearing evaluation in audiology clinics.
Do you have a story about research that illustrates the impact of your work?
One of our goals has been to release free tools that can help audiologists test children who have developmental disabilities. For example, with a team comprised of clinicians and audiology students who are also LEND trainees, we developed picture schedules and video models that can be used to familiarize children with test procedures before they come to the clinic. We also released a library of pictures and videos that can be used during testing to reward the child. These materials are aligned with commonly reported focused interests for autistic children. We have received feedback from audiologists and these materials have been helpful in their clinics.
What are your reasons for becoming a Vanderbilt Kennedy Center (VKC) Member?
My science is directly impacted by having frequent and meaningful conversations with individuals from different perspectives. This may be a conversation with a developmental psychologist on how my method can be enhanced by modifying the frequency or type of reinforcement, a parent who shares their frustrating experience with having their child’s hearing evaluated, or the data scientist who discusses the challenges of using data from the medical records. Being involved with VKC is critical for my research program.