Associate Professor Joseph Kei

Associate Professor in Audiology

School of Health and Rehabilitation Sciences
Faculty of Health and Behavioural Sciences
k.kei@uq.edu.au
+61 7 336 52824

Overview

Joseph is the Director of the Hearing Research Unit for Children, leading three research teams investigating (1) middle ear assessments in neonates, infants, (2) hearing screening and assessment of school-age children, and (3) assessment of auditory function of adults and children using electrophysiologic measures including otoacoustic emissions, auditory evoked potentials and wideband acoustic immittance. He is an associate editor of the International Journal of Audiology, and editorial board member of two international journals: International editorial member of the Journal of the American Academy of Audiology and Communication Disorders Quarterly (USA). As a world leader in the field of middle ear assessment for children, Joseph’s research has a significant impact on the policy and clinical practice of paediatric diagnostic audiology at both national and international levels. To date, he has published over 116 publications in national and international peer-reviewed journals.

Research Interests

  • Assessment of outer and middle ear function in infants and children
    With my background in physical sciences, I am interested in the use of advanced technology to assess the function of the outer ear and middle ear in infants and children. Currently, I am investigating the use of an innovative wideband absorbance technology to detect otitis media in infants and children.
  • Assessing hearing ability in children with learning difficulties
    Children who experience poor academic performance at school have been described as having learning difficulties (LD). Recent studies indicate that these children are at high risk for peripheral and central hearing deficits. I am interested in investigating whether hearing deficits affect the learning ability of these children.
  • Evaluation of middle ear diseases using wideband acoustic immittance
    Wideband acoustic immittance (WAI) is an emerging technology to evaluate outer and middle ear function in humans. Recent studies indicate that WAI is more accurate than tympanometry to detect middle ear diseases. I am interested in applying this technology to various age and ethnic groups.

Research Impacts

Prior to 2000, there were no efficient tests of middle ear function for neonates. There was a delay of 7 months in diagnosing middle ear effusion (MEE) in newborns. To address this shortcoming, our research program investigated the use of advanced technologies to detect MEE in newborns. To date, our research program has contributed to improving the health services, policy and guidelines for clinical practice in three phases.

(1) The successful application of high frequency tympanometry (HFT) to neonates did not only make detection of MEE earlier by 7 months, but it also facilitated early intervention to reduce the risk of chronic otitis media and eardrum perforation. My research team was the first in the world to publish the article, Kei et al. (2003), on the successful use of HFT with healthy newborns. This study has been cited 81 times in publications from 117 institutions around the world, including highly ranked universities such as Harvard Medical School and Albert Einstein College of Medicine of Yeshiva University. Subsequently, the Joint Committee on Infant Hearing (JCIH) Year 2007 Position statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs recommended the use of HFT with newborns. In 2012, I published a book [Kei, J. & Zhao, F. (Eds.) Assessing Middle Ear Function in Infants. San Diego: Plural Publishing] which describes all available methods to detect conductive conditions in infants. This book is being held in 797 libraries worldwide (WorldCat, Feb 2021) and is currently a useful reference for postgraduate audiology students and clinicians around the world.

(2) Before 2009, the traditional acoustic stapedial reflex (ASR) test was not performed on newborns in any part of the world because it could not reliably predict MEE and auditory neuropathy spectrum disorders. I investigated the use of an advanced technology (high-frequency ASR test) with newborns and young infants, and published three articles at national and international journals from 2009 to 2012. In particular, the Kei (2012) article which established clinical guidelines and standards for testing neonates, attracted international attention and was cited in JCIH (2019), American Academy of Audiology Clinical Guidance Document: Assessment of Hearing in Infants and Young Children (2020), and World Health Organization & International Telecommunication Union (‎2019).

(3) Since 2009, I have been investigating the use of an emerging WBA technology with neonates and young infants in Australia. My research team has, to date, published 22 articles in peer-reviewed international journals. Overall, these publications have been cited 133 times by highly ranked institutions such as Harvard Medical School, National Center for Rehabilitative Auditory Research (Portland, USA). These publications make a strong impact on the international policy and guidelines such as the JCIH (2019) and American Academy of Audiology Clinical Guidance Document (2020).

Qualifications

  • PhD, The University of Queensland
  • Graduate Diploma in Audiology, University of Melbourne
  • Graduate Diploma on Special Education, University of Melbourne
  • Certificate in Education, The University of Hong Kong
  • Bachelor of Science (Honours), The University of Hong Kong

Publications

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Grants

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Supervision

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Available Projects

  • Young children (2-5 years) have the highest incidence rates of otitis media (OM).The pathogenesis of OM is multi-factorial with numerous risk factors. An appreciation of the risk factors for OM is crucial as education of the community to mitigate these factors is amongst the most effective strategies to reduce the burden of OM. Although the prevention and treatment of OM in Aboriginal and Torres Strait Islander (ATSI) children have been broadly studied, risk factors for OM in the general population of Australian children have not been reported. This project aims to identify the risk factors for OM with a view to reduce the incidence of OM in young children.

  • Early detection of otitis media (OM) is vital for timely management of the disease. However, diagnosing OM in young children (2-5 years) presents a great challenge to audiologists and otolaryngologists. Traditional audiologic measures such as pure tone audiometry, tympanometry and otoacoustic emission tests are failing to diagnose otitis media with effusion (OME) in young children because these measures are not highly accurate and young children are not always cooperative in undertaking these tests, making the diagnosis of OME unreliable or uncertain. This issue can be addressed by using an innovative wideband absorbance (WBA) test that is capable of not only showing abnormal middle ear function results due to OME, but also determining if a significant hearing loss is present. This project aims to determine the predictive accuracy of wideband absorbance (WBA) in diagnosing OME in young children using a statistical modelling approach and machine learning algorithms.

  • Hearing Australia provides hearing aids for children with hearing loss. While appropriate amplifications are needed for children with chronic otitis media (OM) to reduce the effects of auditory deprivation on speech, language, psychological and cognitive development, the uptake and low use of hearing aids by these children presents a challenge to audiologists and professionals working with their families. As these children may experience chronic OM and otorrhoea (discharging ear), they are prescribed with a bone-conduction hearing aid (BCHA), whereby a transducer (bone vibrator) has to be held tightly against the mastoid bone using a headband. However, there are disadvantages in using the BCHAs resulting in low uptake and use of these aids. To overcome the shortcomings of BCHAs, Professor Hosoi of Nara Medical School in Japan developed a new behind-the-ear cartilage-conduction (CCHA) for use with people with chronic outer and middle ear conditions. As the CCHA does not occlude the ear canal, it would be suitable for children with chronic OM or discharging ears. This project aims to evaluate the functional benefits of wearing a CCHA versus a BCHA in terms of hearing capability and usage by children with chronic OM.

View all Available Projects

Publications

Book

Book Chapter

Journal Article

Conference Publication

Other Outputs

PhD and MPhil Supervision

Current Supervision

  • Doctor Philosophy — Principal Advisor

  • Doctor Philosophy — Associate Advisor

Completed Supervision

Possible Research Projects

Note for students: The possible research projects listed on this page may not be comprehensive or up to date. Always feel free to contact the staff for more information, and also with your own research ideas.

  • Young children (2-5 years) have the highest incidence rates of otitis media (OM).The pathogenesis of OM is multi-factorial with numerous risk factors. An appreciation of the risk factors for OM is crucial as education of the community to mitigate these factors is amongst the most effective strategies to reduce the burden of OM. Although the prevention and treatment of OM in Aboriginal and Torres Strait Islander (ATSI) children have been broadly studied, risk factors for OM in the general population of Australian children have not been reported. This project aims to identify the risk factors for OM with a view to reduce the incidence of OM in young children.

  • Early detection of otitis media (OM) is vital for timely management of the disease. However, diagnosing OM in young children (2-5 years) presents a great challenge to audiologists and otolaryngologists. Traditional audiologic measures such as pure tone audiometry, tympanometry and otoacoustic emission tests are failing to diagnose otitis media with effusion (OME) in young children because these measures are not highly accurate and young children are not always cooperative in undertaking these tests, making the diagnosis of OME unreliable or uncertain. This issue can be addressed by using an innovative wideband absorbance (WBA) test that is capable of not only showing abnormal middle ear function results due to OME, but also determining if a significant hearing loss is present. This project aims to determine the predictive accuracy of wideband absorbance (WBA) in diagnosing OME in young children using a statistical modelling approach and machine learning algorithms.

  • Hearing Australia provides hearing aids for children with hearing loss. While appropriate amplifications are needed for children with chronic otitis media (OM) to reduce the effects of auditory deprivation on speech, language, psychological and cognitive development, the uptake and low use of hearing aids by these children presents a challenge to audiologists and professionals working with their families. As these children may experience chronic OM and otorrhoea (discharging ear), they are prescribed with a bone-conduction hearing aid (BCHA), whereby a transducer (bone vibrator) has to be held tightly against the mastoid bone using a headband. However, there are disadvantages in using the BCHAs resulting in low uptake and use of these aids. To overcome the shortcomings of BCHAs, Professor Hosoi of Nara Medical School in Japan developed a new behind-the-ear cartilage-conduction (CCHA) for use with people with chronic outer and middle ear conditions. As the CCHA does not occlude the ear canal, it would be suitable for children with chronic OM or discharging ears. This project aims to evaluate the functional benefits of wearing a CCHA versus a BCHA in terms of hearing capability and usage by children with chronic OM.