Mitigating the risk of falling in elders by identifying age-related changes in inner ear control of equilibrium and balance: The Vestibular Laboratory in the Department of Audiology

By: Dr. Shaum Bhagat

The risk of suffering a fall causing significant injury, such as a broken hip, increases exponentially with age. Many elders are interested in learning about improving their balance and equilibrium in their daily living to prevent falls from occurring. In some cases, disturbances in balance and equilibrium can be attributed to age-related changes in the inner ear. Each ear can be categorized into three main components: the outer ear, the middle ear, and the inner ear. The inner ear is a tiny fluid-filled structure housed deep within the temporal bone of the skull. The inner ear contains five sensory organs contributing to balance and equilibrium and one sensory organ for hearing. The sensory organs for balance and equilibrium in a given inner ear include the saccule, the utricle, and three semicircular canals. These sensory organs connect to the muscles of the eyes controlling eye movements through complex neural pathways within the brain. Coordinated activity between these inner ear organs and the muscles controlling eye movements contribute to maintaining one’s balance and upright stance.

In elders, the aging process can lead to deterioration of the inner ear sensory organs contributing to balance and equilibrium. In turn, this can lead to the loss of maintenance of balance and an increased risk of falling. Identifying the factors that make elders more susceptible to falls remains an area of intensive research focus.

The Vestibular Laboratory in the Department of Audiology is equipped with state-of-the-art instrumentation designed to assess equilibrium and balance. This instrumentation includes videonystagmography goggles with high definition cameras that capture and record eye movements [Insert Photo 1]. The recorded eye movements can be analyzed by Doctor of Audiology students and research faculty members in order to determine if an elderly individual may have an increased risk of suffering a fall. The Vestibular Laboratory is also equipped with a rotary chair system that uses cutting-edge technology [Insert Photo 2]. The rotary chair system provides computerized control of a rotating chair to determine if diminished eye movements associated with age-related compromise of inner ear function occurs while the individual is seated in the rotating chair.

For more information about the Vestibular Laboratory, contact the Department of Audiology at 408-924-1754 or

CHHS DEI Profile – Dr. Shaum Bhagat

Dr. Shaum BhagatShaum Bhagat – Department of Audiology 

What is your role in your department/school?

My role is Professor and Department Chair for the Department of Audiology.

What would you identify as one of the most significant actions you have taken to advance the cause for diversity either in the classroom, your community, or your profession?

The most significant actions I have taken to advance the cause of diversity include participating in mentorship opportunities for a diverse group of young people interested in the professions of Audiology and Speech-Language Pathology. Through these opportunities, I have met young people and provided guidance concerning future careers in Audiology and Speech-Language Pathology. I have also been fortunate in having the opportunity to serve as a faculty mentor for students conducting Doctor of Audiology research projects. These opportunities have allowed me to listen and learn from young people interested in our professions, and have been instrumental in shaping my thinking concerning the importance of DEI in the higher education environment.

How have you integrated topics of DEI into hiring new faculty and/or admitting students?

In our department mission statement, we indicate that graduates of our program will be ethical, culturally sensitive, and committed to evidence-based practices. In order to help our students achieve these goals that are a necessity for professional practices in the 21st century, we must integrate DEI topics in recruiting both students and faculty. I have also been influenced by the CHHS mission statement concerning promoting health equity and social justice.  I have contributed to a team-based approach of developing our program using DEI principles in order to provide a welcoming environment for diverse faculty members and students.

Tell us about how and why you became attentive to DEI topics.

As a child from a middle-class family with an immigrant heritage from South Asia, my experiences and those of my family members allowed me to realize that there are health inequities and social injustices that need to be addressed, and it is imperative that solutions are created for these social problems. I believe that there should be equal opportunities for all people to access health care.

Tell us one book, one article, one documentary, or one movie you’ve read or watched that you would like to suggest to others that helped shape your thinking about DEI work. 

If I were to have only one choice, it would be “Letter from Birmingham Jail” by Dr. Martin Luther King, Jr. The passages from the letter that are particularly inspiring for me include “We are caught in an inescapable network of mutuality tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”  These words are at the heart of my personal philosophy and remind me that there is much work to be done that requires direct action.

Collaboration and the Scientific Process: Important Work is Rarely Accomplished Alone

By: Dr. Adam Svec

As a society, we are often told that competition is what makes us generally successful as individuals. However, we’re beginning to understand that collaboration, not competition, might be the stronger evolutionary underpinning for our success as a species. After all, we need to be able to live a generally collaborative lifestyle to agree on communal attributes, such as a red light means “stop” and a green light means “go”.

Dr. Adam Svec, Audiology

Dr. Adam Svec, Audiology

As a scientist, collaboration is arguably essential. While competition may drive some new discoveries at the very beginning and end of the scientific process, collaboration is required to facilitate everything that happens in the middle. For example, a community of scientists must agree on a common unit of measurement to describe a new phenomenon that has just been discovered. One scientist may happen to have their name attached to the measurement, but for the most part, scientists within a discipline collaborate to design the methods and procedures used to explore dimensions of any new phenomenon. This collaborative process often produces results such as normative values for clinical diagnoses of newly discovered pathologies, or the firing rate patterns observed in a neighborhood of neurons.

Currently, a colleague of mine, Dr. Nidhi Mahendra, and I are collaborating on a project to explore the value of a choral singing intervention for individuals with aphasia, a condition which can make verbal and written communication difficult. Aphasia is often the result of a brain injury, commonly caused by a left hemisphere stroke, and prior work has suggested that involvement in a choir may help improve speech and language production outcomes beyond those afforded by traditional therapeutic approaches. However, previous investigations have left gaps in the literature, spaces to be filled with related work that continues to explore new ways of designing experimental conditions and measuring the associated outcomes. Not only are Dr. Mahendra and I collaborating with each other, but we are collaborating with the body of work that has preceded this project. We are collaborating with the research participants, in as much as they are volunteering to help us complete the study, as well as the funding bodies and organizations that facilitate our ability to do the work. We are also collaborating with future investigators that may find gaps in the literature that we have left unfilled.

While a few steps in the process involve competition, such as the grant proposal at the very beginning and the publication submissions at the very end, the rest of the work in the middle is collaborative. We are hoping that, through the power of music, we will discover new ways to help individuals with aphasia unlock potentials within themselves that have previously gone undiscovered, and we couldn’t have done it alone.

The Future of California Audiology Involves More Than Technology

By: Dr. Adam Svec

Audiology is a healthcare field dedicated to the diagnosis and treatment of hearing and balance disorders. If someone in your family wears a hearing aid or uses a cochlear implant, it is likely that the device was fit by an audiologist. Among the many roles an audiologist plays, a top priority is using a combination of technology and aural rehabilitation in an attempt to improve the communication abilities for individuals with hearing loss.

In California, there is currently a shortage of audiologists, and a reasonably large portion of the community is underserved in terms of hearing and balance healthcare. One of the reasons for this paucity of care is that, until recently, California only had two accredited audiology graduate programs. With a population of nearly 40 million and audiology programs that collectively graduated under 50 audiologists per year, California communities have proportionally few opportunities for clinical services.

Fortunately, the audiology landscape in California is changing. Since 2019, new graduate programs have been introduced at California State University – Los Angeles, California State University – Northridge, California State University – Sacramento, and San José State University. The development of these new programs is a good thing for a variety of reasons.

At SJSU, the College of Health and Human Sciences aims to realize its mission through four pillars: 1) Promoting health equity and social justice; 2) Building capacity for interprofessional and collaborative practice and research; 3) Generating and applying health technology and innovation; and 4) Building community capacity and wellness through community engagement and partnerships.

Since SJSU is located in Silicon Valley, it may seem natural to perseverate on the third pillar. Hearing aid technology is rapidly changing, and the traditional hearing aid manufacturers are constantly developing new features for devices. However, hearing aids are rarely covered by insurance, and an individual can spend more than $6000 out-of-pocket for a pair, not to mention that those hearing aids will need to be replaced approximately every three to six years. In an effort to improve accessibility to affordable assistive devices, recent legislation has approved the expansion of “over-the-counter” hearing aids.

While the discussion regarding the impacts of more affordable devices is ongoing within the discipline of audiology, there are good reasons to focus our efforts, instead, on the first pillar. Dr. Michelle DeCoux Hampton and colleagues within the CSU system recently hosted a workshop titled, “Antiracism Reprogramming in Health Professions Education.” Dr. Alicia Swartz and Dr. Claire Valderama-Wallace walked the group through the alarming reality of racism that is built into the scaffolding of the healthcare system. The speakers asserted that healthcare education will keep reproducing inequality under systems developed by colonialism unless antiracism is considered a cornerstone of these educational systems, not just a component. As the CSU system re-emboldens its commitment to equity, diversity, and inclusion, the state has an opportunity to train a new generation of audiologists who represent the communities that are historically underrepresented in hearing healthcare.

So, the challenge for all the CSU institutions has been demonstrated in plain sight: How do we ensure that the long-term effects of racism and inequity are reduced within hearing healthcare in California?

An Evolving Plan for Clinical Education: Doctoral Training Amidst Physical Distancing Directives

By: Shealyn Bissell

The current global public health crisis is affecting all sectors of society. The swiftness that the virus infiltrated the global community and economy forced many to adapt and make changes to everyday life. Changes caused by the pandemic will reverberate for years to come. Education has completely transformed, and educators and students alike will rise to face the obstacles that present themselves day by day. Together, educators must shift the way that we prepare students for success in their field. When the majority of clinical education experiences require learning through physical patient contact, how can students prepare for a career in healthcare?

Audiology is a clinical profession in which licensed professionals examine hearing and balance in patients at regular intervals throughout the work day. In order to develop the clinical skills needed during the evaluation, diagnosis, and treatment of patients students require hands-on experiences in a clinical Audiology setting. The locations Audiologists can provide audiological services include private practices, physician offices, hospitals, schools, colleges and universities, rehabilitation centers, and long-term residential health care facilities. Many of these facilities are now severely impacted by policies designed to limit the spread of COVID-19. Audiology professionals are reluctant to act as preceptors for student supervision during internships and externships, and consequently student placements are looking drastically different than in previous years.

In the SJSU Department of Audiology, our goal is to provide our cohort of students with a well-rounded clinical education. This work involves innovative ideas proposed by all faculty members. Open lines of communication between faculty, staff, and students and the synergy of minds is essential to developing new concepts of socially-distanced clinical practicum experiences. The cohort’s first clinical practicum course is scheduled to begin Spring semester 2021. Prior to social distancing guidelines this would have involved direct clinical observation and direct clinical experience supervised by a faculty preceptor. A state of the art clinical lab is currently under construction where students of Audiology will eventually serve members of the campus community and local community at large. We have adjusted our proposed in-person clinical lab sizes, come up with a rotating schedule, acquired cutting edge equipment that students can use individually, and executed clinical observation contracts with medical professionals throughout the state. Until it is safe for our students and faculty to work and learn in our on campus clinical space alongside community members, we will continuously evolve to accommodate state and county guidelines while also offering our first cohort the highest quality clinical experience.

Simulation software is an essential part of clinical distance learning. The pressures of COVID-19 have created an environment where clinicians in academic roles across the nation have done the necessary work of creating software that is realistic to the day to day tasks of the profession. Our faculty have individually tested and assessed all of the viable software related to Audiology and hearing science that is currently on the market. As a new and upcoming department, our faculty is determined to implement the best audiological simulation software to supplement didactic discourse. With a collaborative and interdisciplinary approach, San José State University educators stand in solidarity with each other to cultivate excellent training for our students. The Department of Audiology will present clinical education in the Spring of 2021 that will showcase all of the diligent and enthusiastic work the Clinical Director and entire faculty has done to ensure the students of Audiology receive an unsurpassed clinical experience.