ORCID Profile
0000-0002-7036-7890
Current Organisations
Macquarie University
,
University of Manchester
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Publications
Cortical auditory evoked potentials in the assessment of auditory neuropathy
Publisher: Georg Thieme Verlag KG
Date: 05-2007
DOI: 10.3766/JAAA.18.5.3
Abstract: Infants with auditory neuropathy and possible hearing impairment are being identified at very young ages through the implementation of hearing screening programs. The diagnosis is commonly based on evidence of normal cochlear function but abnormal brainstem function. This lack of normal brainstem function is highly problematic when prescribing lification in young infants because prescriptive formulae require the input of hearing thresholds that are normally estimated from auditory brainstem responses to tonal stimuli. Without this information, there is great uncertainty surrounding the final fitting. Cortical auditory evoked potentials may, however, still be evident and reliably recorded to speech stimuli presented at conversational levels. The case studies of two infants are presented that demonstrate how these higher order electrophysiological responses may be utilized in the audiological management of some infants with auditory neuropathy. Los niños con neuropatía auditiva y posibles posibles trastornos auditivos están siendo identificados a edades tempranas con la implementación de programas de tamizaje auditivo. El diagnóstico se basa en la evidencia de una función coclear normal pero de una función anormal del tallo cerebral. Esta falta de función normal de tallo cerebral es muy problemática cuando se trata de prescribir lificación en niños pequeños, porque las fórmulas de prescripción requieren el insumo de los umbrales auditivos que se estiman normalmente a partir de las respuestas del tallo cerebral ante estímulos tonales. Sin esta información, existe una gran incertidumbre en cuanto a la adaptación final. Los potenciales evocados auditivos corticales pueden, sin embargo, registrarse con confiabilidad a partir de estímulos de lenguaje presentados a niveles de intensidad para la conversación. Se presenta el estudio de dos casos de niños, que demuestran como estas respuestas electrofisiológicas de orden mayor pueden utilizarse en el manejo audiológico de algunos niños con neuropatía auditiva.
Web- and app-based tools for remote hearing assessment: a scoping review protocol
Publisher: INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols
Date: 20-10-2020
Preferred Low- and High-Frequency Compression Ratios among Hearing Aid Users with Moderately Severe to Profound Hearing Loss
Publisher: Georg Thieme Verlag KG
Date: 2007
DOI: 10.3766/JAAA.18.1.3
Abstract: This study aimed to determine the low- and high-frequency compression ratios of a fast-acting device that were preferred by people with moderately severe to profound hearing loss. Three compression ratios (1:1, 1.8:1, and 3:1) were combined in the low and high frequencies to produce nine schemes that were evaluated pair-wise for three weeks in the field using an adaptive procedure. The evaluation was performed by 21 experienced hearing aid users with a moderately severe to profound hearing loss. Diaries and an exit interview were used to monitor preferences. Generally, the subjects preferred lower compression ratios than are typically prescribed, especially in the low frequencies. Specifically, 11 subjects preferred linear lification in the low frequencies, and 14 subjects preferred more compression in the high than in the low frequencies. Preferences could not be predicted from audiometric data, onset of loss, or past experience with lification. The data suggest that clients with moderately severe to profound hearing loss should be fitted with low-frequency compression ratios in the range 1:1 to 2:1 and that fine-tuning is essential. Este estudio trató de determinar las tasas de compresión de alta y baja frecuencia de un dispositivo de acción rápida, que resultara preferido por personas con hipoacusias moderadamente severas a profundas. Se combinaron tres tasas de compresión (1:1, 1.8:1, y 3:1) en las frecuencias graves y agudas para producir nueve esquemas que fueron evaluados en el c o, en pares, durante tres semanas, utilizando un procedimiento de adaptación. La evaluación fue realizada por 21 usuarios experimentados de audífono con hipoacusias moderadamente severas a profundas. Se usaron diarios y un cuestionario final para monitorear las preferencias. Generalmente, los sujetos prefirieron menores tasas de compresión de lo que típicamente se prescribe, especialmente en las bajas frecuencias. Específicamente, 11 sujetos prefirieron la lificación lineal en las frecuencias graves y 14 sujetos prefirieron más compresión en las frecuencias altas. Las preferencias no podían predecirse a partir de los datos audiométricos, del inicio de la pérdida, o por experiencias anteriores con lificación. Los datos sugieren que los clientes con hipoacusias moderadamente severas a profundas, deberían adaptarse con tasas de compresión en las frecuencias graves en el rango de 1:1 a 2:1, y que un ajuste fino es esencial.
Compression, Noise, and Audibility: A Reply to Villchur
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-1997
Early language outcomes of children with cochlear implants: Interim findings of the NAL study on longitudinal outcomes of children with hearing impairment
Publisher: Maney Publishing
Date: 2008
DOI: 10.1002/CII.382
Effects of lifetime noise exposure on the middle-age human auditory brainstem response, tinnitus and speech-in-noise intelligibility
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.HEARES.2018.06.003
Abstract: Recent animal studies have shown that the synapses between inner hair cells and the dendrites of the spiral ganglion cells they innervate are the elements in the cochlea most vulnerable to excessive noise exposure. Particularly in rodents, several studies have concluded that exposure to high level octave-band noise for 2 h leads to an irreversible loss of around 50% of synaptic ribbons, leaving audiometric hearing thresholds unaltered. Cochlear synaptopathy following noise exposure is hypothesized to degrade the neural encoding of sounds at the subcortical level, which would help explain certain listening-in-noise difficulties reported by some subjects with otherwise 'normal' hearing. In response to this peripheral damage, increased gain of central stages of the auditory system has been observed across several species of mammals, particularly in association with tinnitus. The auditory brainstem response (ABR) wave I litude and waves I-V litude ratio have been suggested as non-invasive indicators of cochlear synaptopathy and central gain activation respectively, but the evidence for these hearing disorders in humans is inconclusive. In this study, we evaluated the influence of lifetime noise exposure (LNE) on the human ABR and on speech-in-noise intelligibility performance in a large cohort of adults aged 29 to 55. Despite large inter-subject variability, results showed a moderate, but statistically significant, negative correlation between the ABR wave I litude and LNE, consistent with cochlear synaptopathy. The results also showed (a) that central gain mechanisms observed in animal studies might also occur in humans, in which higher stages of the auditory pathway appear to compensate for reduced input from the cochlea (b) that tinnitus was associated with activation of central gain mechanisms (c) that relevant cognitive and subcortical factors influence speech-in-noise intelligibility, in particular, longer ABR waves I-V interpeak latencies were associated with poorer performance in understanding speech in noise when central gain mechanisms were active and (d) absence of a significant relationship between LNE and tinnitus, central gain activation or speech-in-noise performance. Although this study supports the possible existence of cochlear synaptopathy in humans, the great degree of variability, the lack of uniformity in central gain activation and the significant involvement of attention in speech-in-noise performance suggests that noise-induced cochlear synaptopathy is, at most, one of several factors that play a role in humans' speech-in-noise performance.
The audiological journey and early outcomes of twelve infants with auditory neuropathy spectrum disorder from birth to two years of age
Publisher: Informa UK Limited
Date: 27-03-2015
DOI: 10.3109/14992027.2015.1007214
Abstract: To describe the audiological journey of a group of infants with auditory neuropathy spectrum disorder (ANSD) following the fitting of hearing aids, and to investigate the potential benefits of including cortical auditory-evoked potentials (CAEPs) and a measure of functional auditory behaviour during early audiological management. Results from chart revision of estimated hearing threshold, early behavioural testing, parental observation, and functional auditory behaviour assessments were described, and compared to visual reinforcement audiometry (VRA) thresholds obtained at a mean corrected age of 10 months (SD 3). The relationship with CAEPs and functional performance was examined. The study included 12 infants diagnosed with ANSD and fitted with lification. The estimated 4FA at a mean corrected age of four months (SD5) was within ± 10 dB of VRA results in 75% of infants when unaided and aided behavioural observation audiometry (BOA), together with unaided and aided parental observations was combined. Infants with a greater proportion of CAEPs present had higher PEACH scores. Delaying lification until VRA results were available would have led to a significant period of auditory deprivation for infants in this study group. None of the assessments could accurately determine hearing thresholds when used in isolation, however when used in combination clinicians were able to obtain sufficient information to fit hearing aids early, and identify infants requiring closer monitoring.
Detection of hearing problems in Aboriginal and Torres strait islander children: a comparison between clinician-administered and self-administrated hearing tests
Publisher: Informa UK Limited
Date: 03-02-2020
Relative loudness perception of low and high frequency sounds in the open and occluded ear
Publisher: Acoustical Society of America (ASA)
Date: 06-2000
DOI: 10.1121/1.429406
Abstract: A comparison of published equal loudness contours indicates that different shapes are obtained at a comfortable level when the measurements are done in an occluded ear than when they are done in an open ear, even though all measurements are expressed as dB SPL at the eardrum. This paper presents the result from a loudness balancing test which confirms this observation. Eleven normal-hearing listeners balanced the level of a 500- and a 3000-Hz octave band babble-noise to the level of a 1500-Hz octave band babble-noise. The balancing test was completed in open and occluded ears using a loudspeaker and a hearing aid receiver, respectively. A probe tube microphone was used to measure the actual levels presented near the in idual’s eardrum. The results show that an average of 10 dB higher level was selected for the 500-Hz octave band when listening with the occluded ear than when listening with the open ear. A large range of factors is discussed, but no physical explanation for the discrepancy was found. The findings could have consequences for psychoacoustic experiments and for the use of loudness measurements for hearing aid prescription.
Evolving concepts of developmental auditory processing disorder (APD): A British Society of Audiology APD Special Interest Group ‘white paper’
Publisher: Informa UK Limited
Date: 05-10-2012
DOI: 10.3109/14992027.2012.723143
Abstract: Children with listening difficulties, but normal audiometry, may be diagnosed with APD. The diagnosis is typically based on poor performance on tests of perception of both non-speech and speech stimuli. However, non-speech test results correlate only weakly with evaluations of speech-in-noise processing, cognitive skills, and caregiver evaluations of listening ability. The interpretation of speech test results is confounded by the involvement of language processing mechanisms. Overall, listening ability is associated more with higher-level, cognitive and analytic processing than with lower-level sensory processing. Current diagnosis of a child with APD, rather than another problem (e.g. language impairment, LI), is determined more by the referral route than by the symptoms. Co-occurrence with other learning problems suggests that APD may be a symptom of a more varied neurodevelopmental disorder. Alternately, APD has been proposed as a cause of language-based disorders, but there is no one-to-one mapping between listening and language among in iduals. Screening for APD may be most appropriately based on a well-validated, caregiver questionnaire that captures the fundamental problem of listening difficulties and identifies areas for further assessment and management. This approach has proved successful for LI, and may in future serve as a metric to help assess other, objective testing methods.
Binaural-Bimodal Fitting or Bilateral Implantation for Managing Severe to Profound Deafness: A Review
Publisher: SAGE Publications
Date: 09-2007
Abstract: There are now many recipients of unilateral cochlear implants who have usable residual hearing in the non-implanted ear. To avoid auditory deprivation and to provide binaural hearing, a hearing aid or a second cochlear implant can be fitted to that ear. This article addresses the question of whether better binaural hearing can be achieved with binaural/bimodal fitting (combining a cochlear implant and a hearing aid in opposite ears) or bilateral implantation. In the first part of this article, the rationale for providing binaural hearing is examined. In the second part, the literature on the relative efficacy of binaural/bimodal fitting and bilateral implantation is reviewed. Most studies on comparing either mode of bilateral stimulation with unilateral implantation reported some binaural benefits in some test conditions on average but revealed that some in iduals benefited, whereas others did not. There were no controlled comparisons between binaural/bimodal fitting and bilateral implantation and no evidence to support the efficacy of one mode over the other. In the third part of the article, a crossover trial of two adults who had binaural/bimodal fitting and who subsequently received a second implant is reported. The findings at 6 and 12 months after they received their second implant indicated that binaural function developed over time, and the extent of benefit depended on which abilities were assessed for the in idual. In the fourth and final parts of the article, clinical issues relating to candidacy for binaural/ bimodal fitting and strategies for bimodal fitting are discussed with implications for future research.
Separating the Causes of Listening Difficulties in Children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-06-2021
DOI: 10.1097/AUD.0000000000001069
Abstract: Auditory processing disorder, defined here as a deficit in the way sounds are analyzed by the brain, has remained a controversial topic within audiology for decades. Some of the controversy concerns what it is called. More substantively, even its existence has been questioned. That view has likely emerged because there has not been sufficient rigor in determining when difficulty in understanding speech has been the consequence of some type of auditory processing deficit, versus when it is the consequence of a cognitive deficit or a language deficit. This article suggests that the field use the term “listening difficulty” as an umbrella term to indicate a reported deficit in recognizing sounds or understanding speech, one possible cause of which is an auditory processing disorder. Other possible causes are hearing deficits, cognitive deficits, and language deficits. This article uses a plausible, and hopefully noncontroversial, model of speech understanding that comprises auditory processing, speech processing, and language processing, all potentially affected by the degree of attention applied and the listener’s memory ability. In a fresh approach to the construction of test batteries, the stages of the model are linked to tests designed to assess either all or selected parts of the processes involved. For two of the stages, a listener’s performance is quantified as the additional signal to noise ratio that he or she needs to function equivalently to his or her age peers. Subtraction of the deficits revealed by each test enables the contributions of each processing stage to a listening deficit to be quantified. As a further novel contribution, the impact of memory and attention on each test score is quantitatively allowed for, by an amount that depends on each test’s dependence on memory and attention. Attention displayed during the test is estimated from the fluctuations in performance during the test. The article concludes with a summary of the research that must be conducted before the structured tests can be used to quantify the extent to which different potential causes of listening difficulties are responsible for real-life difficulties in an in idual child.
The preferred response slopes and two-channel compression ratios in twenty listening conditions by hearing-impaired and normal-hearing listeners and their relationship to the acoustic input
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1080/14992020500266803
Abstract: This paper presents the results from two experiments in which normal-hearing and hearing-impaired listeners used an adaptive procedure to select their preferred frequency response slope and two-channel compression ratios in twenty listening conditions. Whereas the preferred response slope mostly depended on the difference in SNR between frequency bands, the preferred output levels in two channels depended highly on the intensity level entering each band. In both cases, subjects preferred less gain in frequency bands where noise was more intrusive and they preferred less gain for listening comfort than for speech understanding. The preferred response slope also depended on the slope of the audiogram. Relative to the prescribed NAL-RP response, the preferred gain variations improved the broadband SNR and hence listening comfort, but not the estimated speech intelligibility index. Overall, the findings confirm the approach used in many commercial products of applying wide dynamic range compression in multiple bands with additional gain reductions in bands where the noise is estimated to be dominant.
Direct-to-Consumer Hearing Devices: Capabilities, Costs, and Cosmetics
Publisher: SAGE Publications
Date: 2019
Abstract: Direct-to-consumer (DTC) hearing devices can be purchased without consulting a hearing health professional. This project aims to compare 28 DTC devices with the most popular hearing aid supplied by the U.K. National Health Service (NHS). The comparison was based on technical performance, cosmetic acceptability, and the ability to match commonly used gain and slope targets. Electroacoustic performance was evaluated in a 2-cc coupler. Match to prescription target for both gain and slope was measured on a Knowles Electronic Manikin for Acoustic Research using a mild and also a moderate sloping hearing loss. Using an online blinded paired comparison of each DTC and the NHS reference device, 126 participants (50 were hearing aid users and 76 were nonhearing aid users) assessed the cosmetic appearance and rated their willingness-to-wear the DTC devices. The results revealed that higher purchase prices were generally associated with a better match to prescribed gain–frequency response shapes, lower distortion, wider bandwidth, better cosmetic acceptability, and higher willingness-to-wear. On every parameter measured, there were devices that performed worse than the NHS device. Most of the devices were rated lower in terms of aesthetic design than the NHS device and provided gain–frequency responses and maximum output levels that were markedly different from those prescribed for commonly encountered audiograms. Because of the absence or inflexibility of most of the devices, they have the potential to deliver poor sound quality and uncomfortably loud sounds. The challenge for manufacturers is to develop low-cost products with cosmetic appeal and appropriate electroacoustic characteristics.
Do we need audiogram-based prescriptions? A systematic review
Publisher: Informa UK Limited
Date: 09-05-2022
DOI: 10.1080/14992027.2022.2064925
Abstract: Hearing aids are typically programmed using the in idual's audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the in idual's audiometric thresholds. This review aimed to identify whether programming hearing aids using the in idual's validated audiogram-based prescription, and verified using real-ear measures, results in better outcomes for adults with hearing loss. The review was registered in PROSPERO and reported in accordance with PRISMA guidelines. After screening more than 1370 records, seven experimental studies met the eligibility criteria. Studies were categorised under three methods of fitting: (i) comparative fitting evaluating different settings based on the beliefs of the audiologist (ii) client choice of preset responses and (iii) self-fit by adjustment. The findings suggest that using a prescription based on the in idual's audiogram improves outcomes relative to the comparative and client choice fitting approaches. Self-adjustment during daily use may produce equivalent (or better) outcomes than an audiogram-based prescription. The quality of evidence for the outcomes ranged from low to very low. This review has highlighted the dearth of high-quality studies on which to make evidence-based decisions on hearing aid fitting methods.
An evaluation of the performance of two binaural beamformers in complex and dynamic multitalker environments
Publisher: Informa UK Limited
Date: 03-07-2015
Australian Hearing Protocols for the Audiological Management of Infants Who Have Auditory Neuropathy
Publisher: Portico
Date: 05-2005
Directional Effects on Infants and Young Children in Real Life: Implications for Amplification
Publisher: American Speech Language Hearing Association
Date: 10-2009
DOI: 10.1044/1092-4388(2009/08-0261)
Abstract: This study examined the head orientation of young children in naturalistic settings and the acoustics of their everyday environments for quantifying the potential effects of directionality. Twenty-seven children (11 with normal hearing, 16 with impaired hearing) between 11 and 78 months of age were video recorded in naturalistic settings for analyses of head orientation. Reports on daily activities were obtained from caregivers. The effect of directionality in different environments was quantified by measuring the Speech Transmission Index (STI H. J. M. Steeneken & T. Houtgast, 1980). Averaged across 4 scenarios, children looked in the direction of a talker for 40% of the time when speech was present. Head orientation was not affected by age or hearing status. The STI measurements revealed a directional advantage of 3 dB when a child looked at a talker but a deficit of 2.8 dB when the talker was sideways or behind the child. The overall directional effect in real life was between −0.4 and 0.2 dB. The findings suggest that directional microphones in personal hearing devices for young children are not detrimental and have much potential for benefits in real life. The benefits may be enhanced by fitting directionality early and by counseling caregivers on ways to maximize benefits in everyday situations.
Longitudinal Outcomes of Children with Hearing Impairment (LOCHI)
Publisher: Informa UK Limited
Date: 12-2013
Does probe-tube verification of real-ear hearing aid amplification characteristics improve outcomes in adult hearing aid users? A protocol for a systematic review
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2020-038113
Abstract: Using a probe-tube microphone to measure and adjust the real-ear performance of the hearing aid to match the prescription target is recommended and widely used in clinical practice. Hearing aid fitting software can approximately match the lification characteristics of the hearing aid to the prescription without real-ear measurements (REMs), but using REM improves the match to the prescribed target. What is unclear is if the improved match results in a better patient-reported outcome. The primary objective of this review is to determine whether the use of REM improves patient-reported outcomes in adult hearing aid users. The review’s methods are in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science and CENTRAL via Cochrane Library will be searched to identify relevant studies. The review’s population of interest will include adults with any degree of sensorineural or mixed hearing loss who have been prescribed with acoustic hearing aids. The included studies should compare REM fitting to the initial fit provided by the manufacturer’s fitting software. Hearing-specific health-related quality of life is the primary outcome but secondary outcomes include self-reported listening ability, speech recognition scores, generic health-related quality of life, hours of use, number of required follow-up sessions and adverse events. Randomised and non-randomised controlled trials will be included. The risk of bias in the included studies will be evaluated using Down and Black’s checklist. The quality of the overall evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations tool. Ethical approval will not be sought because this systematic review will only retrieve and analyse data from published studies. Review results will be published in a peer-reviewed journal and presented at relevant scientific conferences. CRD42020166074.
The detection of adult cortical auditory evoked potentials (CAEPs) using an automated statistic and visual detection
Publisher: Informa UK Limited
Date: 2009
DOI: 10.3109/14992020903140928
Abstract: The detection of adult cortical auditory evoked potentials (CAEPs) can be challenging when the stimulus is just audible. The effectiveness of a statistic compared with expert examiners in (1) detecting the presence of CAEPs when stimuli were present, and (2) reporting the absence of CAEPs when no stimuli were present, was investigated. CAEPs recorded from ten adults, using two speech-based stimuli, five stimulus presentation levels, and non-stimulus conditions, were given to four experienced examiners who were asked to determine if responses to auditory stimulation could be observed, and their degree of certainty in making their decision. These recordings were also converted to multiple dependent variables and Hotelling's T2 was applied to calculate the probability that the mean value of any linear combination of these variables was significantly different from zero. Results showed that Hotelling's T2 was equally sensitive to the best of in idual experienced examiners in differentiating a CAEP from random noise. It is reasonable to assume that the difference in response detection for a novice examiner and Hotelling's T2 would be even greater.
List Equivalency and Critical Differences of a Mandarin Bamford-Kowal-Bench Sentence in Babble Noise Test for Adults and Preschool Children With Normal Hearing
Publisher: American Speech Language Hearing Association
Date: 27-10-2023
Determining unilateral or bilateral hearing aid preference in adults: a prospective study
Publisher: Informa UK Limited
Date: 08-10-2021
Cost-Effective Hearing Rehabilitation—
Publisher: SAGE Publications
Date: 12-2011
Web- and app-based tools for remote hearing assessment: a scoping review
Publisher: Informa UK Limited
Date: 09-06-2022
DOI: 10.1080/14992027.2022.2075798
Abstract: Remote hearing screening and assessment may improve access to, and uptake of, hearing care. This review, the most comprehensive to date, aimed to (i) identify and assess functionality of remote hearing assessment tools on smartphones and online platforms, (ii) determine if assessed tools were also evaluated in peer-reviewed publications and (iii) report accuracy of existing validation data. Protocol was registered in INPLASY and reported according to PRISMA-Extension for Scoping Reviews. In total, 187 remote hearing assessment tools (using tones, speech, self-report or a combination) and 101 validation studies met the inclusion criteria. Quality, functionality, bias and applicability of each app were assessed by at least two authors. Assessed tools showed considerable variability in functionality. Twenty-two (12%) tools were peer-reviewed and 14 had acceptable functionality. The validation results and their quality varied greatly, largely depending on the category of the tool. The accuracy and reliability of most tools are unknown. Tone-producing tools provide approximate hearing thresholds but have calibration and background noise issues. Speech and self-report tools are less affected by these issues but mostly do not provide an estimated pure tone audiogram. Predicting audiograms using filtered language-independent materials could be a universal solution.
The Effect of Stimulus Duration and Inter-Stimulus Interval on Cortical Responses in Infants
Publisher: Portico
Date: 11-2006
Determinants of age‐appropriate breastfeeding, dietary diversity, and consumption of animal source foods among Indonesian children
Publisher: Wiley
Date: 02-10-2019
DOI: 10.1111/MCN.12889
Impact of the presence of auditory neuropathy spectrum disorder (ANSD) on outcomes of children at three years of age
Publisher: Informa UK Limited
Date: 12-2013
Problems hearing in noise in older adults: A review of spatial processing disorder
Publisher: SAGE Publications
Date: 09-2011
Abstract: Difficulty understanding speech in background noise, even with lification to restore audibility, is a common problem for hearing-impaired in iduals and is especially frequent in older adults. Despite the debilitating nature of the problem the cause is not yet completely clear. This review considers the role of spatial processing ability in understanding speech in noise, highlights the potential impact of disordered spatial processing, and attempts to establish if aging leads to reduced spatial processing ability. Evidence supporting and opposing the hypothesis that spatial processing is disordered among the aging population is presented. With a few notable exceptions, spatial processing ability was shown to be reduced in an older population in comparison to young adults, leading to poorer speech understanding in noise. However, it is argued that to conclude aging negatively effects spatial processing ability may be oversimplified or even premature given potentially confounding factors such as cognitive ability and hearing impairment. Further research is required to determine the effect of aging and hearing impairment on spatial processing and to investigate possible remediation options for spatial processing disorder.
Children's speech perception and loudness ratings when fitted with hearing aids using the DSL v.4.1 and the NAL-NL1 prescriptions
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/14992020903121159
Abstract: This paper reports speech and loudness measures on a group of children in a double-blind cross-over trial comparing the NAL-NL1 and DSL[i/o] prescriptions. Twenty-four children with hearing impairment were fitted with digital WDRC hearing aids at each site (Australia, Canada). Speech recognition was measured for nonsense syllables and for the 50% correct threshold for sentence recognition in noise. Loudness ratings for sentences were made on a 7-point scale. Measures were made at fitting and repeated following 8-week trials. Fitting orders were randomized and counterbalanced. Significant differences in consonant recognition occurred for in idual children. On average, scores at the 80 dB SPL presentation level were better with the NAL-NL1 fitting. Loudness ratings differed at baseline but did not differ following home trials. Speech recognition scores revealed a small but significant interaction of prescription with level in quiet but not in noise. In idual children had significant performance differences. Loudness ratings showed significant acclimatization effects for children at both sites.
The case for simplifying and using absolute targets for viral hepatitis elimination goals
Publisher: Wiley
Date: 04-11-2020
DOI: 10.1111/JVH.13412
Abstract: The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1‐year‐olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year‐to‐year decrease in new HCV‐ and HBV‐related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.
Aided Cortical Auditory Evoked Potentials in Infants With Frequency-Specific Synthetic Speech Stimuli: Sensitivity, Repeatability, and Feasibility
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-04-2023
DOI: 10.1097/AUD.0000000000001352
Abstract: The cortical auditory evoked potential (CAEP) test is a candidate for supplementing clinical practice for infant hearing aid users and others who are not developmentally ready for behavioral testing. Sensitivity of the test for given sensation levels (SLs) has been reported to some degree, but further data are needed from large numbers of infants within the target age range, including repeat data where CAEPs were not detected initially. This study aims to assess sensitivity, repeatability, acceptability, and feasibility of CAEPs as a clinical measure of aided audibility in infants. One hundred and three infant hearing aid users were recruited from 53 pediatric audiology centers across the UK. Infants underwent aided CAEP testing at age 3 to 7 months to a mid-frequency (MF) and (mid-)high-frequency (HF) synthetic speech stimulus. CAEP testing was repeated within 7 days. When developmentally ready (aged 7-21 months), the infants underwent aided behavioral hearing testing using the same stimuli, to estimate the decibel (dB) SL (i.e., level above threshold) of those stimuli when presented at the CAEP test sessions. Percentage of CAEP detections for different dB SLs are reported using an objective detection method (Hotellings T 2 ). Acceptability was assessed using caregiver interviews and a questionnaire, and feasibility by recording test duration and completion rate. The overall sensitivity for a single CAEP test when the stimuli were ≥0 dB SL (i.e., audible) was 70% for the MF stimulus and 54% for the HF stimulus. After repeat testing, this increased to 84% and 72%, respectively. For SL dB, the respective MF and HF test sensitivities were 80% and 60% for a single test, increasing to 94% and 79% for the two tests combined. Clinical feasibility was demonstrated by an excellent % completion rate, and acceptable median test duration of 24 minutes, including preparation time. Caregivers reported overall positive experiences of the test. By addressing the clinical need to provide data in the target age group at different SLs, we have demonstrated that aided CAEP testing can supplement existing clinical practice when infants with hearing loss are not developmentally ready for traditional behavioral assessment. Repeat testing is valuable to increase test sensitivity. For clinical application, it is important to be aware of CAEP response variability in this age group.
Preferred overall loudness. II: Listening through hearing aids in field and laboratory tests
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/14992020500190177
Abstract: In a laboratory study, we found that normal-hearing and hearing-impaired listeners preferred less than normal overall calculated loudness (according to a loudness model of Moore & Glasberg, 1997). The current study verified those results using a research hearing aid. Fifteen hearing-impaired and eight normal-hearing participants used the hearing aid in the field and adjusted a volume control to give preferred loudness. The hearing aid logged the preferred volume control setting and the calculated loudness at that setting. The hearing-impaired participants preferred, in median, loudness levels of -14 phon re normal for input levels from 50 to 89 dB SPL. The normal-hearing participants preferred close to normal overall loudness. In subsequent laboratory tests, using the same hearing aid, both hearing-impaired and normal-hearing listeners preferred less than normal overall calculated loudness, and larger reductions for higher input levels In summary, the hearing-impaired listeners preferred less than normal overall calculated loudness, whereas the results for the normal-hearing listeners were inconclusive.
A cross-over, double-blind comparison of the NAL-NL1 and the DSL v4.1 prescriptions for children with mild to moderately severe hearing loss
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/14992020903148020
Abstract: The relative effectiveness of the NAL-NL1 and the DSL4.1 prescriptions for 48 children with mild to moderately severe hearing loss was studied using a double-blind, four-period, two-treatment cross-over design in Australia and in Canada. Evaluations included speech perception tests, loudness ratings, reports from parents and teachers on functional performance in real life, children's self-reports, paired-comparison judgements of intelligibility, and children's preferences in real-world environments. Electroacoustic measures of hearing aids revealed that gain differences dominated the comparison. Across trials and measures, in idual Australian children consistently preferred either the NAL-NL1 or the DSL v.4.1 prescription. An overall figure of merit (FOM), calculated by averaging the standardized difference scores between prescriptions for all measures, revealed that the strongest prescription-related differences were found in Australia. On average, an advantage and preference for the NAL-NL1 prescription was associated with lesser degrees of hearing loss. This research provides evidence on the effectiveness of the NAL-NL1 and DSL v.4.1 prescriptions, and highlights the need for evaluating and fine-tuning lification to meet the erse needs of in idual children in real life.
The effect of multi-channel wide dynamic range compression, noise reduction, and the directional microphone on horizontal localization performance in hearing aid wearers
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/14992020600920804
Abstract: This study examined the effect that signal processing strategies used in modern hearing aids, such as multi-channel WDRC, noise reduction, and directional microphones have on interaural difference cues and horizontal localization performance relative to linear, time-invariant lification. Twelve participants were bilaterally fitted with BTE devices. Horizontal localization testing using a 360 degrees loudspeaker array and broadband pulsed pink noise was performed two weeks, and two months, post-fitting. The effect of noise reduction was measured with a constant noise present at 80 degrees azimuth. Data were analysed independently in the left/right and front/back dimension and showed that of the three signal processing strategies, directional microphones had the most significant effect on horizontal localization performance and over time. Specifically, a cardioid microphone could decrease front/back errors over time, whereas left/right errors increased when different microphones were fitted to left and right ears. Front/back confusions were generally prominent. Objective measurements of interaural differences on KEMAR explained significant shifts in left/right errors. In conclusion, there is scope for improving the sense of localization in hearing aid users.
Client-based adjustments of hearing aid gain: The effect of different control configurations
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2008
Investigation of the actions taken by adults who failed a telephone-based hearing screen
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
Factors influencing the intention of Indonesian nursing students to work in rural areas
Publisher: BMJ
Date: 07-2019
Abstract: The aim of this study was to analyse the factors associated with the intention of Indonesian nursing students to work in rural areas. This was a cross-sectional study. The instrument used was a self-developed questionnaire consisting of 13 questions.The data were analysed using the χ2 statistics test and binary logistic regression with a level of significance .05. The study was conducted at a public nursing school located in urban Surabaya, East Java, Indonesia, in December 2017. A total of 714 nursing students from four different programmes were involved. This study found that almost 60% of nursing students were reluctant to work in rural areas. Of the three variables which were significant in the χ2 analysis, only two were significant following the logistic regression test, namely the class programmes of undergraduate regulars (OR=2.274 95% CI 1.326 to 3.900), profession regulars (OR=2.262 95% CI 1.110 to 4.607) and rural place of origin (OR=1.405 95% CI 1.036 to 1.906). The education programme and place of origin were associated with the intention of nursing students to work in rural areas. Therefore, the recruitment of prospective nurses should consider these factors by considering the local context.
Effect of leakage on the low-frequency calibration of supraaural headphones
Publisher: Acoustical Society of America (ASA)
Date: 05-1977
DOI: 10.1121/1.381408
Abstract: The general validity of calibration of supra-aural headphones by the method of an inserted probe tube is examined. In particular, the possibility of the probe tube affecting the seal between the headphone and the ear is considered. Experimental proof that this can occur is obtained by the use of a small microphone located within the ear canal. Furthermore, attention is drawn to the fact that single cavity couplers such as the NBS9A make no attempt to simulate the ear’s impedance and so a discrepancy between probe and coupler responses can be expected. In the light of these factors, some recommendations about the design of artificial ears are made.
An investigation into how the acoustics of different sized open plan classrooms affects speech perception in Kindergarten children
Publisher: Acoustical Society of America (ASA)
Date: 04-2015
DOI: 10.1121/1.4920880
Abstract: Open plan classrooms, where several classes share the same space, have recently re-emerged in Australian primary schools. This paper examined how the acoustics of four Kindergarten classrooms (an enclosed classroom (25 students), a double classroom (44 students), a linear fully open plan triple classroom (91 students), and a semi-open plan K-6 classroom (205 students)) affect speech perception. Twenty-two to 23 children in each classroom participated in an online four-picture choice speech perception task while adjacent classes engaged in quiet versus noisy activities. The noise levels recorded during the task were higher in the larger open plan classrooms compared to the smaller classrooms for both the quiet and noisy conditions. A linear mixed effects model revealed that children’s performance accuracy decreased as noise level increased. Additionally, children’s speech perception abilities decreased the further away they were seated from the loudspeaker, and this effect was stronger the higher the noise level. Children’s response time was also slower in the noisiest compared to quietest classroom. These results suggest that open plan classrooms may not be appropriate learning environments for didactic-style teaching with young children due to their high intrusive noise levels which negatively impact speech perception.
A Self-Fitting Hearing Aid: Need and Concept
Publisher: SAGE Publications
Date: 12-2011
Abstract: The need for reliable access to hearing health care services is growing globally, particularly in developing countries and in remotely located, underserved regions in many parts of the developed world. In iduals with hearing loss in these areas are at a significant disadvantage due to the scarcity of local hearing health care professionals and the high cost of hearing aids. Current approaches to making hearing rehabilitation services more readily available to underserved populations include teleaudiology and the provision of lification devices outside of the traditional provider-client relationship. Both strategies require access to such resources as dedicated equipment and/or specially trained staff. Another possible strategy is a self-fitting hearing aid, a personal lification device that is equipped with an onboard tone generator to enable user-controlled, automated, in situ audiometry an onboard prescription to determine the initial hearing aid settings and a trainable algorithm to enable user-controlled fine-tuning. The device is thus assembled, fitted, and managed by the user without the need for audiological or computer support. This article details the self-fitting concept and its potential application in both developing and developed countries. Potential advantages and disadvantages of such a device are discussed, and considerations for further investigations into the concept are presented. Overall, the concept is considered technologically viable with the main challenges anticipated to be development of clear, simple user instructions and a delivery model that ensures reliable supplies of instant-fit ear tips and batteries.
Toward a Real-World Technical Test Battery for Remote Microphone Systems Used with Hearing Prostheses
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/23312165231182518
Abstract: Remote microphones (RMs) enable clearer reception of speech than would be normally achievable when relying on the acoustic sound field at the listener's ear (Hawkins, J Sp Hear Disord 49, 409–418, 1984). They are used in a wide range of environments, with one ex le being for children in educational settings. The international standards defining the assessment methods of the technical performance of RMs rely on free-field (anechoic) delivery, a rarely met acoustic scenario. Although some work has been offered on more real-world testing (Husstedt et al., Int J Audiol 61, 34–45. 2022), the area remains under-investigated. The electroacoustic performance of five RMs in a low-reverberation room was compared in order to assess just the RM link, rather than measurements at the end of the signal chain, for ex le, speech intelligibility in human observers. It pilots physical- and electro-acoustic measures to characterize the performance of RMs. The measures are based on those found in the IEC 60118 standards relating to hearing aids, but modified for diffuse-field delivery, as well as adaptive signal processing. Speech intelligibility and quality are assessed by computer models. Noise bands were often processed into irrelevance by adaptive systems that could not be deactivated. Speech-related signals were more successful. The five RMs achieved similar levels of good predicted intelligibility, for each of two background noise levels. The main difference observed was in the transmission delay between microphone and ear. This ranged between 40 and 50 ms in two of the systems, on the upper edge of acceptability necessary for audio-visual synchrony.
Major findings of the LOCHI study on children at 3 years of age and implications for audiological management
Publisher: Informa UK Limited
Date: 12-2013
Comparison of stimuli used in sound field audiometric testing
Publisher: Acoustical Society of America (ASA)
Date: 1982
DOI: 10.1121/1.387343
Abstract: The problems associated with performing pure-tone threshold measurements in reverberant or diffuse sound fields are illustrated with the use of three-dimensional representations of the sound field within a typical test booth. A microphone mounted on a motorized trolley is used to perform these measurements. A comprehensive comparison is then made of the efficiency with which FM tones, AM tones, d ed wave trains, and narrow bands of noise provide a uniform sound field. The conclusion is reached that the bandwidth of the stimulus is the major factor determining the uniformity of the field. A decision about the most appropriate stimulus for sound field work must thus be based on factors other than field uniformity. When the constraints of obtaining suitable spectral distributions, and being able to relate thresholds obtained with complex stimuli to those obtained with pure tones are also considered, FM tones and suitably generated narrow bands of noise appear to be the most suitable stimuli. The selection of suitable parameters is discussed and an Appendix discusses the spectrum and bandwidth of FM signals with different modulation waveforms. The relative accuracy of testing in the direct and reverberant regions in a nonanechoic environment is also discussed.
Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder
Publisher: Georg Thieme Verlag KG
Date: 26-10-2015
Speech recognition of hearing-impaired listeners: Predictions from audibility and the limited role of high-frequency amplification
Publisher: Acoustical Society of America (ASA)
Date: 02-1998
DOI: 10.1121/1.421224
Abstract: Two experiments were conducted to examine the relationship between audibility and speech recognition for in iduals with sensorineural hearing losses ranging from mild to profound degrees. Speech scores measured using filtered sentences were compared to predictions based on the Speech Intelligibility Index (SII). The SII greatly overpredicted performance at high sensation levels, and for many listeners, it underpredicted performance at low sensation levels. To improve predictive accuracy, the SII needed to be modified. Scaling the index by a multiplicative proficiency factor was found to be inappropriate, and alternative modifications were explored. The data were best fitted using a method that combined the standard level distortion factor (which accounted for decrease in speech intelligibility at high presentation levels based on measurements of normal-hearing people) with in idual frequency-dependent proficiency. This method was evaluated using broadband sentences and nonsense syllables tests. Results indicate that audibility cannot adequately explain speech recognition of many hearing-impaired listeners. Considerable variations from audibility-based predictions remained, especially for people with severe losses listening at high sensation levels. The data suggest that, contrary to the basis of the SII, information contained in each frequency band is not strictly additive. The data also suggest that for people with severe or profound losses at the high frequencies, lification should only achieve a low or zero sensation level at this region, contrary to the implications of the unmodified SII.
Efficacy of the LiSN & Learn Auditory Training Software: Randomized Blinded Controlled Study
Publisher: MDPI AG
Date: 18-09-2012
DOI: 10.4081/AUDIORES.2012.E15
Abstract: Children with a spatial processing disorder (SPD) require a more favorable signal-to-noise ratio in the classroom because they have difficulty perceiving sound source location cues. Previous research has shown that a novel training program - LiSN & Learn - employing spatialized sound, overcomes this deficit. Here we investigate whether improvements in spatial processing ability are specific to the LiSN & Learn training program. Participants were ten children (aged between 6 [years months] and 9 ) with normal peripheral hearing who were diagnosed as having SPD using the Listening in Spatialized Noise - Sentences test (LiSN-S). In a blinded controlled study, the participants were randomly allocated to train with either the LiSN & Learn or another auditory training program - Earobics - for approximately 15 min per day for twelve weeks. There was a significant improvement post-training on the conditions of the LiSN-S that evaluate spatial processing ability for the LiSN & Learn group (P=0.03 to 0.0008, η2=0.75 to 0.95, n=5), but not for the Earobics group (P=0.5 to 0.7, η2=0.1 to 0.04, n=5). Results from questionnaires completed by the participants and their parents and teachers revealed improvements in real-world listening performance post-training were greater in the LiSN & Learn group than the Earobics group. LiSN & Learn training improved binaural processing ability in children with SPD, enhancing their ability to understand speech in noise. Exposure to non-spatialized auditory training does not produce similar outcomes, emphasizing the importance of deficit-specific remediation.
A Brief Overview of Factors Affecting Speech Intelligibility of People With Hearing Loss: Implications for Amplification
Publisher: American Speech Language Hearing Association
Date: 12-2013
DOI: 10.1044/1059-0889(2013/12-0075)
Abstract: The authors aimed to determine the predictability of speech intelligibility of people with different degrees of hearing loss from audibility and other factors. After a brief overview of why people with hearing loss have greater difficulty in understanding speech than people with normal hearing, the authors describe a study that was aimed to predict speech intelligibility from audibility, psychoacoustic abilities, cognitive ability, and age. The study showed that the ability of people with hearing loss to extract speech information from an audible signal decreased with increase in hearing loss. This hearing loss desensitization was significantly related to hearing thresholds, sharpness of psychophysical tuning curves, presence of dead regions, age, and cognitive ability. After allowing for the effects of hearing loss, the authors found that speech intelligibility was significantly related to age and cognitive ability. The effects did not vary with frequency. The current evidence supports the allowance of hearing loss desensitization in prescribing lification that is aimed to maximize speech intelligibility. There is insufficient evidence to recommend the inclusion of estimates of frequency resolution or dead regions in prescribing lification.
Learning from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: summary of 5-year findings and implications
Publisher: Informa UK Limited
Date: 12-10-2017
Factors influencing individual variation in perceptual directional microphone benefit
Publisher: Georg Thieme Verlag KG
Date: 11-2013
DOI: 10.3766/JAAA.24.10.7
Abstract: Background: Large variations in perceptual directional microphone benefit, which far exceed the variation expected from physical performance measures of directional microphones, have been reported in the literature. The cause for the in idual variation has not been systematically investigated. Purpose: To determine the factors that are responsible for the in idual variation in reported perceptual directional benefit. Research Design: A correlational study. Physical performance measures of the directional microphones obtained after they had been fitted to in iduals, cognitive abilities of in iduals, and measurement errors were related to perceptual directional benefit scores. Study S le: Fifty-nine hearing-impaired adults with varied degrees of hearing loss participated in the study. Data Collection and Analysis: All participants were bilaterally fitted with a Motion behind-the-ear device (500 M, 501 SX, or 501 P) from Siemens according to the National Acoustic Laboratories' non-linear prescription, version two (NAL-NL2). Using the Bamford-Kowal-Bench (BKB) sentences, the perceptual directional benefit was obtained as the difference in speech reception threshold measured in babble noise (SRTn) with the devices in directional (fixed hypercardioid) and in omnidirectional mode. The SRTn measurements were repeated three times with each microphone mode. Physical performance measures of the directional microphone included the angle of the microphone ports to loudspeaker axis, the frequency range dominated by lified sound, the in situ signal-to-noise ratio (SNR), and the in situ three-dimensional, articulation-index weighted directivity index (3D AI-DI). The cognitive tests included auditory selective attention, speed of processing, and working memory. Intraparticipant variation on the repeated SRTn's and the interparticipant variation on the average SRTn were used to determine the effect of measurement error. A multiple regression analysis was used to determine the effect of other factors. Results: Measurement errors explained 52% of the variation in perceptual directional microphone benefit (95% confidence interval [CI]: 34–78%), while another 37% of variation was explained primarily by the physical performance of the directional microphones after they were fitted to in iduals. The most contributing factor was the in situ 3D AI-DI measured across the low frequencies. Conclusions: Repeated SRTn measurements are needed to obtain a reliable indication of the perceptual directional benefit in an in idual. Further, to obtain optimum benefit from directional microphones, the effectiveness of the microphones should be maximized across the low frequencies.
Converting Insertion Gain to and from Headphone Coupler Responses
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-1997
DOI: 10.1097/00003446-199708000-00009
Abstract: The paper aims to show how insertion gain responses can be translated into equivalent headphone responses, and vice versa. The relationship between the response types is theoretically derived by allowing for real ear to coupler differences and for real ear unaided responses. The necessary corrections for each of these factors are obtained from published data, and the combined correction factors are compared with independently obtained published data. The equations and data presented can be used to translate insertion gain responses into responses suitable for use with equipment using headphones and, by inference, insert phones.
Validity and reliability of in-situ air conduction thresholds measured through hearing aids coupled to closed and open instant-fit tips
Publisher: Informa UK Limited
Date: 03-09-2010
DOI: 10.3109/14992027.2010.503664
Abstract: Audiometric measurements through a hearing aid ('in-situ') may facilitate provision of hearing services where these are limited. This study investigated the validity and reliability of in-situ air conduction hearing thresholds measured with closed and open domes relative to thresholds measured with insert earphones, and explored sources of variability in the measures. Twenty-four adults with sensorineural hearing impairment attended two sessions in which thresholds and real-ear-to-dial-difference (REDD) values were measured. Without correction, significantly higher low-frequency thresholds in dB HL were measured in-situ than with insert earphones. Differences were due predominantly to differences in ear canal SPL, as measured with the REDD, which were attributed to leaking low-frequency energy. Test-retest data yielded higher variability with the closed dome coupling due to inconsistent seals achieved with this tip. For all three conditions, inter-participant variability in the REDD values was greater than intra-participant variability. Overall, in-situ audiometry is as valid and reliable as conventional audiometry provided appropriate REDD corrections are made and ambient sound in the test environment is controlled.
The effects of hearing impairment and aging on spatial processing
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
Analysis of Alertness Status of Subjects Undergoing the Cortical Auditory Evoked Potential Hearing Test
Publisher: Springer Berlin Heidelberg
Date: 2012
A comparison of NAL and DSL prescriptive methods for paediatric hearing-aid fitting: Predicted speech intelligibility and loudness
Publisher: Informa UK Limited
Date: 12-2013
Slowing the progression of age-related hearing loss: Rationale and study design of the ASPIRIN in HEARING, retinal vessels imaging and neurocognition in older generations (ASPREE-HEARING) trial
Publisher: Elsevier BV
Date: 2016
Introduction to the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study: Background, design, sample characteristics
Publisher: Informa UK Limited
Date: 12-2013
Introducing the Australian Hearing Hub
Publisher: SAGE Publications
Date: 28-07-2017
Cortical Auditory Evoked Potentials in (Un)aided Normal-Hearing and Hearing-Impaired Adults
Publisher: Georg Thieme Verlag KG
Date: 04-02-2016
The importance of interaural time differences and level differences in spatial release from masking
Publisher: Acoustical Society of America (ASA)
Date: 11-07-2013
DOI: 10.1121/1.4812441
Abstract: Numerous studies have described improvements in speech understanding when interaural time differences (ITDs) and interaural level differences (ILDs) are present. The present study aimed to investigate whether either cue in isolation can elicit spatial release from masking (SRM) in a speech-on-speech masking paradigm with maskers positioned symmetrically around the listener. Twelve adults were tested using three presentations of the Listening in Spatialized Noise–Sentences Test, with each presentation modified to contain different interaural cues in the stimuli. Results suggest that ILDs provide a similar amount of SRM as ITDs and ILDs combined. ITDs alone provide significantly less benefit.
The one-up one-down adaptive (staircase) procedure in speech-in-noise testing: Standard error of measurement and fluctuations in the track
Publisher: Acoustical Society of America (ASA)
Date: 10-2022
DOI: 10.1121/10.0014898
Abstract: The one-up one-down adaptive (staircase or up-down) procedure is often used to estimate the speech recognition threshold (SRT) in speech-in-noise testing. This article provides a brief historical overview of the one-up one-down procedure in psychophysics, discussing the groundbreaking early work that is still relevant to clinical audiology and scientific research. Next, this article focuses on two aspects of the one-up one-down adaptive procedure: first, the standard error of measurement (SEM) and, second, the fluctuations in the track [i.e., the standard deviation of the signal-to-noise ratios of the stimuli within the track (SDtrack)]. Simulations of ideal and non-ideal listeners and experimental data are used to determine and evaluate different relationships between the parameters slope of the speech recognition function, SRT, SEM, and SDtrack. Hearing loss and non-ideal behavior (inattentiveness, fatigue, and giving up when the task becomes too difficult) slightly increase the average value of SDtrack. SDtrack, however, poorly discriminates between reliable and unreliable SRT estimates.
The Cortical Automatic Threshold Estimation in Adults
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Cortical Auditory-Evoked Potentials (CAEPs) in Adults in Response to Filtered Speech Stimuli
Publisher: Georg Thieme Verlag KG
Date: 10-2013
DOI: 10.3766/JAAA.24.9.5
Abstract: Background: Previous studies have demonstrated that cortical auditory-evoked potentials (CAEPs) can be reliably elicited in response to speech stimuli in listeners wearing hearing aids. It is unclear, however, how close to the aided behavioral threshold (i.e., at what behavioral sensation level) a sound must be before a cortical response can reliably be detected. Purpose: The purpose of this study was to systematically examine the relationship between CAEP detection and the audibility of speech sounds (as measured behaviorally), when the listener is wearing a hearing aid fitted to prescriptive targets. A secondary aim was to investigate whether CAEP detection is affected by varying the frequency emphasis of stimuli, so as to simulate variations to the prescribed gain-frequency response of a hearing aid. The results have direct implications for the evaluation of hearing aid fittings in nonresponsive adult clients, and indirect implications for the evaluation of hearing aid fittings in infants. Research Design: Participants wore hearing aids while listening to speech sounds presented in a sound field. Aided thresholds were measured, and cortical responses evoked, under a range of stimulus conditions. The presence or absence of CAEPs was determined by an automated statistic. Study S le: Participants were adults (6 females and 4 males). Participants had sensorineural hearing loss ranging from mild to severe-profound in degree. Data Collection and Analysis: Participants' own hearing aids were replaced with a test hearing aid, with linear processing, during assessments. Pure-tone thresholds and hearing aid gain measurements were obtained, and a theoretical prediction of speech stimulus audibility for each participant (similar to those used for audibility predictions in infant hearing aid fittings) was calculated. Three speech stimuli, (/m/, /t/, and /g/) were presented aided (monaurally, nontest ear occluded), free field, under three conditions (+4 dB/octave, −4 dB/octave, and without filtering), at levels of 40, 50, and 60 dB SPL (measured for the unfiltered condition). Behavioral thresholds were obtained, and CAEP recordings were made using these stimuli. The interaction of hearing loss, presentation levels, and filtering conditions resulted in a range of CAEP test behavioral sensation levels (SLs), from −25 to +40 dB. Results: Statistically significant CAEPs (p .05) were obtained for virtually every presentation where the behavioral sensation level was dB, and for only 5% of occasions when the sensation level was negative. In these (“false-positive”) cases, the greatest (negative) sensation level at which a CAEP was judged to be present was −6 dB SL. Conclusions: CAEPs are a sensitive tool for directly evaluating the audibility of speech sounds, at least for adult listeners. CAEP evaluation was found to be more accurate than audibility predictions, based on threshold and hearing aid response measures.
NAL-NL2 Empirical Adjustments
Publisher: SAGE Publications
Date: 30-11-2012
Abstract: NAL-NL1, the first procedure from the National Acoustic Laboratories (NAL) for prescribing nonlinear gain, was a purely theoretically derived formula aimed at maximizing speech intelligibility for any input level of speech while keeping the overall loudness of speech at or below normal loudness. The formula was obtained through an optimization process in which speech intelligibility and loudness were predicted from selected models. Using updated models and applying some revisions to the derivation process, a theoretically derived NAL-NL2 formula was obtained in a similar way. Further adjustments, directed by empirical data collected in studies using NAL-NL1 as the baseline response, have been made to the theoretically derived formula. Specifically, empirical data have demonstrated that (a) female hearing aid users prefer lower overall gain than male users (b) new hearing aid users with more than a mild hearing loss prefer increasingly less gain with increasing degree of hearing loss than experienced hearing aid users, and require up to 2 years to adapt to gain levels selected by experienced hearing aid users (c) unilaterally and bilaterally fitted hearing aid users prefer overall gain levels that vary less than estimated by the bilateral correction factor (d) adults prefer lower overall gain than children and (e) people with severe rofound hearing loss prefer lower compression ratios than predicted when fitted with fast-acting compression. The literature and data leading to these conclusions are summarized and discussed in this article, and the procedure for implementing the adjustments to the theoretically derived NAL-NL2 formula is described.
An investigation into the acoustics of different sized open plan and enclosed Kindergarten classrooms
Publisher: Acoustical Society of America (ASA)
Date: 04-2015
DOI: 10.1121/1.4920707
Abstract: Open plan classrooms, where several class bases share the same space, have recently re-emerged in Australian primary schools. This study compared the acoustics of four different Kindergarten classrooms: an enclosed classroom with 25 students, a double classroom with 44 students, a linear fully open plan triple classroom with 91 students, and a semi-open plan K-6 classroom with 205 students. Ambient noise levels, intrusive noise levels, occupied background noise levels, and teacher’s speech levels were recorded during different activities. Room impulse responses using logarithmic sweeps were also recorded for different teaching scenarios. From these recordings, signal-to-noise ratios, speech transmission index scores, and reverberation times were calculated. The results revealed much higher intrusive noise levels in the two largest open plan classrooms, resulting in signal-to-noise ratios and speech transmission index scores to be well below those recommended in classrooms with students of this age. Additionally, occupied background noise levels in all classrooms were well above recommended levels. These results suggest students may have difficulty listening and learning in open plan classrooms and teachers are likely to strain their voice. Therefore, open plan classrooms are unlikely to be appropriate learning environments for young children unless high intrusive noise levels are moderated.
Evaluation of the NAL-NL1 and DSL v4.1 prescriptions for children: Preference in real world use
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/14992020903148038
Abstract: This paper reports real world preferences of children in a double-blind, cross-over trial comparing NAL-NL1 and DSL v.4.1 prescriptions. Twenty-four children wore digital WDRC hearing aids at each site (Australia, Canada). Multi-memory hearing aids provided the NAL and DSL programs in each of two memories. Diaries were completed during two counterbalanced trials, providing overall preference, situational preference, and preference comments. Ratings were reliable, and situational preferences factored into quiet/low level situations versus noisy/reverberant/high level situations. Children at both sites used DSL v4.1 for hearing low level speech, or when they wanted to hear loudly and clearly. Children used NAL-NL1 when they wished to hear sounds at a lower level, or to reduce background noise. Children expressed strong preferences for having the choice of both programs. Canadian children were more likely to prefer DSL than were the Australian children. Factors such as listening environment and prior listening experience are discussed in interpreting these findings.
It Is Neither Necessary nor Desirable to Test for Abnormalities in Other Modalities When Diagnosing Auditory Processing Disorder (APD)
Publisher: Georg Thieme Verlag KG
Date: 07-2014
DOI: 10.3766/JAAA.25.7.9
Prescribing Amplification for Children: Adult-Equivalent Hearing Loss, Real-Ear Aided Gain, and NAL-NL1
Publisher: SAGE Publications
Date: 12-2003
DOI: 10.1177/108471380300700102
Abstract: This paper focuses on how the acoustical differences between the ear canals of adults and children affect lification requirements and describes efficient strategies to allow for these differences when prescribing and verifying lification. We will first summarize the problem for hearing assessment and then describe how adult-equivalent hearing loss can be calculated to circumvent this problem. Ex le cases demonstrate manual calculation and automatic derivation by using the NAL-NL1 software. The advantage of using real-ear aided gain prescriptions rather than real-ear insertion gain prescriptions for young children is explained. The practical benefit of deriving coupler gain targets to achieve the required real-ear aided gain by using in idually measured real-ear-to-coupler differences is emphasized, together with a discussion on the practical issues relating to calibration and probe tube placement in measuring real-ear-to-coupler differences. Finally, an illustrative case exemplifies the derivation of in idualized coupler gain targets by using the NAL-NL1 software system to achieve the required real-ear aided gain for a young child.
Cost-effectiveness of screening preschool children for hearing loss in Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-11-2022
DOI: 10.1097/AUD.0000000000001134
Abstract: While all newborns in Australia are tested for congenital hearing loss through universal newborn hearing screening programs, some children will acquire hearing loss in their first five years of life. Delayed diagnosed or undiagnosed hearing loss in children can have substantial immediate- and long-term consequences. It can significantly reduce school readiness, language and communication development, social and emotional development, and mental health. It can also compromise lifetime educational achievements and employment opportunities and future economic contribution to society through lost productivity. The need for a universal hearing screening program for children entering their first year of primary school has been noted in two separate Australian Government hearing inquiries in the last decade. Sound Scouts is a hearing screening application (app) that tests for hearing loss in children using a tablet or mobile device, supervised by parents at home. It tests for sensorineural or permanent conductive hearing loss and central auditory processing disorder in children. In 2018 the Australian Government funded the roll-out of Sound Scouts to allow up to 600,000 children to test their hearing using Sound Scouts. This study estimated the cost-effectiveness of screening 5-year-old children for hearing loss using Sound Scouts at home, compared with no screening. A decision-analytic model was developed to estimate the incremental costs and quality-adjusted life years (QALYs) of administering Sound Scouts over a 20-year time horizon. Testing accuracy was based on comparing Sound Scouts test results to clinical test results while other parameters were based on published data. Costs were estimated from the perspective of the Australian health care system. Univariate and probabilistic sensitivity analyses were undertaken. Sound Scouts is estimated to result in an average incremental cost of A$61.02 and an average incremental increase in QALYs of 0.01. This resulted in an incremental cost-effectiveness ratio of A$5392 per QALY gained, which is likely to be considered cost-effective by Australian decision makers. Screening with Sound Scouts was found to have a 96.2 per cent probability of being cost-effective using a threshold of A$60,000 per QALY gained. Using Sound Scouts to screen five-year-old children for hearing loss (at home) is likely to be cost-effective. Screening children using Sound Scouts will result in early identification and intervention in childhood hearing loss, thereby reducing early childhood disadvantage through cumulative gains in quality of life, education, and economic outcomes over their lifetime.
The Impact of Auditory Processing and Cognitive Abilities in Children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2015
Spatial release from masking in normal-hearing children and children who use hearing aids
Publisher: Acoustical Society of America (ASA)
Date: 2011
DOI: 10.1121/1.3523295
Abstract: Listening to speech in competing sounds poses a major difficulty for children with impaired hearing. This study aimed to determine the ability of children (3–12 yr of age) to use spatial separation between target speech and competing babble to improve speech intelligibility. Fifty-eight children (31 with normal hearing and 27 with impaired hearing who use bilateral hearing aids) were assessed by word and sentence material. Speech reception thresholds (SRTs) were measured with speech presented from 0° azimuth, and competing babble from either 0° or ±90° azimuth. Spatial release from masking (SRM) was defined as the difference between SRTs measured with co-located speech and babble and SRTs measured with spatially separated speech and babble. On average, hearing-impaired children attained near-normal performance when speech and babble originated from the frontal source, but performed poorer than their normal-hearing peers when babble was spatially separated from target speech. On average, normal-hearing children obtained an SRM of 3 dB whereas children with hearing loss did not demonstrate SRM. Results suggest that hearing-impaired children may need enhancement in signal-to-noise ratio to hear speech in difficult listening conditions as well as normal-hearing children.
Listening in Spatialized Noise – Universal Test (LiSN-U) test-retest reliability study
Publisher: Informa UK Limited
Date: 27-07-2020
Fuzzy Logic-Based Automatic Alertness State Classification Using Multi-channel EEG Data
Publisher: Springer Berlin Heidelberg
Date: 2013
Adoption, use and non-use of hearing aids: a robust estimate based on Welsh national survey statistics
Publisher: Informa UK Limited
Date: 12-06-2020
Attend to this: The relationship between auditory processing disorders and attention deficits
Publisher: Georg Thieme Verlag KG
Date: 07-2014
DOI: 10.3766/JAAA.25.7.6
Abstract: Background: Children clinically diagnosed with auditory processing disorders (APDs) are often described as easily distracted and inattentive, leading some researchers to propose that APDs might be a consequence of underlying attention difficulties or a subtype of attention disorders. Purpose: The aim of this study was to investigate the link between AP and attention by determining the relationship between performance on an auditory and visual sustained attention task and performance on a common APD test battery. Research Design: This study was a cross-sectional correlation study of school-aged children. Study S le: Participants were a clinical group of 101 children considered by their parents or teachers to have listening difficulties, and a control group of 18 children with no suspected listening difficulties. All children were 7–12 yr old. Data Collection and Analysis: All children passed a standard peripheral audiologic assessment and were assessed using a clinical APD test battery and reading accuracy, nonverbal intelligence, and visual and auditory continuous performance tests. Results: There were significant correlations within the APD test scores except for masking level difference values, which did not correlate significantly with any other measure. Dichotic Digit and Frequency Pattern scores also correlated significantly with Nonverbal Intelligence and Sustained Auditory and Visual Attention scores. Within the clinical group, there were twice as many children outside normal limits on both the APD test battery and the attention tests as there were children who were outside normal limits on only the APD test battery or only the attention tests. Significant predictors of reading ability were the Frequency Pattern, Gaps In Noise, and Nonverbal Intelligence scores. Conclusions: The degree of correlation between the APD and attention measures indicates that although deficits in both AP and sustained attention co-occur in some children (more than would be expected from chance alone), and the two conditions may have similar symptoms, they are separate, largely independent conditions.
Mapping the optimization of groundwater abstraction research: A bibliometric review in the context of South Asian region
Publisher: Elsevier BV
Date: 06-2023
The Listening in Spatialized Noise test: Normative data for children
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/14992020500377931
Abstract: The Listening in Spatialized Noise test (LISN) produces a three-dimensional auditory environment under headphones, using only a PC and an audiometer, and was designed to provide an ecologically valid assessment of auditory figure-ground skills in children. The listener is required to indicate the intelligibility level of a story presented at 0 degree azimuth, in the presence of distracter sentences simultaneously presented at either 0 degree or +/- 90 degrees azimuth. Various measures assess the extent to which either spatial, vocal, or spatial and vocal cues combined, increase a listener's ability to comprehend the story, without being affected by differences between participants in variables such as linguistic skills. There was a trend of improved performance with increasing age for 48 normally hearing seven-, eight-, and nine-year-olds, and sixteen adults. Whereas some significant differences were found between adults and children, there were no significant differences in performance between the seven-, eight-, and nine-year-olds on any measure, and no significant gender or practice effects were observed. Future studies on children with suspected auditory processing disorder were considered warranted.
An interdisciplinary approach to enhance children’s listening, learning, and wellbeing in the classroom
Publisher: Frontiers Media SA
Date: 07-09-2023
A randomized controlled trial of nonlinear frequency compression versus conventional processing in hearing aids: Speech and language of children at three years of age
Publisher: Informa UK Limited
Date: 12-2013
Obligatory Cortical Auditory Evoked Potential Waveform Detection and Differentiation Using a Commercially Available Clinical System: HEARLab™
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
A review of auditory processing and cognitive change during normal ageing, and the implications for setting hearing aids for older adults
Publisher: Frontiers Media SA
Date: 20-06-2023
DOI: 10.3389/FNEUR.2023.1122420
Abstract: Throughout our adult lives there is a decline in peripheral hearing, auditory processing and elements of cognition that support listening ability. Audiometry provides no information about the status of auditory processing and cognition, and older adults often struggle with complex listening situations, such as speech in noise perception, even if their peripheral hearing appears normal. Hearing aids can address some aspects of peripheral hearing impairment and improve signal-to-noise ratios. However, they cannot directly enhance central processes and may introduce distortion to sound that might act to undermine listening ability. This review paper highlights the need to consider the distortion introduced by hearing aids, specifically when considering normally-ageing older adults. We focus on patients with age-related hearing loss because they represent the vast majority of the population attending audiology clinics. We believe that it is important to recognize that the combination of peripheral and central, auditory and cognitive decline make older adults some of the most complex patients seen in audiology services, so they should not be treated as “standard” despite the high prevalence of age-related hearing loss. We argue that a primary concern should be to avoid hearing aid settings that introduce distortion to speech envelope cues, which is not a new concept. The primary cause of distortion is the speed and range of change to hearing aid lification (i.e., compression). We argue that slow-acting compression should be considered as a default for some users and that other advanced features should be reconsidered as they may also introduce distortion that some users may not be able to tolerate. We discuss how this can be incorporated into a pragmatic approach to hearing aid fitting that does not require increased loading on audiology services.
The effects of multichannel compression/expansion amplification on the intelligibility of nonsense syllables in noise
Publisher: Acoustical Society of America (ASA)
Date: 09-1984
DOI: 10.1121/1.391261
Abstract: The effects of six-channel compression and expansion lification on the intelligibility of nonsense syllables embedded in speech spectrum noise were examined for four hearing-impaired subjects. For one condition (linear) the stimulus was given six-channel lification with frequency shaping to suit the subject’s hearing loss. The other condition (nonlinear) was the same except that low level inputs, to any given channel, received expansion lification and high level inputs received compression. For each condition, each subject received the nonsense syllables at three different input levels, representing low, average, and high intensity speech. The results of this study, like those of most other studies of multichannel compression, are mainly negative. Nonlinear processing (mainly expansion) of low intensity speech resulted in a significant degradation of speech intelligibility for two subjects and in no improvement for the others. One subject showed a significant improvement in intelligibility for the nonlinearly processed average intensity speech and another subject showed significant improvement for the high intensity input (mainly compression). Clearly, nonlinear processing is beneficial for some subjects, under some listening conditions, but further research is needed to identify the relevent characteristics of such subjects. An acoustic analysis of selected items revealed that the failure of expansion to improve intelligibility was primarily due to the very low intensity consonants /O/ and /k/, in final position, being presented at an even lower intensity in the expansion condition than in the linear condition. Expansion may be worth further investigation with different parameters. Several other problems caused by the multichannel processing were also revealed. These included alteration of spectral shapes and band interaction effects. Ways of overcoming these problems, and of capitalizing on the likely advantages of multichannel lification, are currently being investigated.
Electrophysiological measures of binaural interaction in cochlear implantees
Publisher: Elsevier BV
Date: 11-2004
Three Case Studies of Children With Suspected Auditory Processing Disorder
Publisher: Portico
Date: 11-2005
DOI: 10.1375/AUDI.27.2.97
The development of the listening in spatialised noise – universal test (LiSN-U) and preliminary evaluation in English-speaking listeners
Publisher: Informa UK Limited
Date: 13-11-2020
Development of a corpus of Mandarin sentences in babble with homogeneity optimized via psychometric evaluation
Publisher: Informa UK Limited
Date: 27-12-2011
DOI: 10.3109/14992027.2011.642011
Abstract: To develop a corpus of sentences in babble noise that is suitable for Mandarin-speaking children. Two experiments were conducted with specific aims of (1) developing sentence material that is grammatically and semantically within the linguistic abilities of children and (2) improving the efficiency of the test by equalizing the relative intelligibility of in idual items in sentences. Sentences were extracted from spoken material of Chinese children aged between 4 and 5 years of age. The sentences were tested for intelligibility in a four-talker babble by 96 adult native speakers of Mandarin. Psychometric functions were generated, and used for adjusting signal-to-noise ratios of in idual items by varying the level of the time-locked babble to equate intelligibility of the target speech. These adjusted stimuli were tested for intelligibility using a different group of 64 adult listeners. The signal-to-noise ratio for 50% correct was not different before and after adjustments (- 6.1 dB and - 6.0 dB, respectively). However, there was a significant reduction in standard deviation from 2.3 dB before adjustment to 1.1 dB after adjustment (p < 0.05). The experiments established a corpus of Mandarin BKB-like sentences with four-talker babble as competing noise, in which the test items' homogeneity was optimized via psychometric evaluation (HOPE).
The Lived Experiences of Indonesian Nurses Who Worked as Care Workers in Taiwan
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-11-2019
DOI: 10.1097/JNR.0000000000000355
Abstract: Despite the large number of Indonesian nurses currently working as migrant care workers in Taiwan, no studies in the literature have been found that explore this phenomenon or assess the working situation of Indonesian nurses working in care facilities in Taiwan. This study aimed to elicit and describe the lived experiences of Indonesian nurses serving as care workers in Taiwan. Phenomenological research was used to explore the experiences of Indonesian nurses working in long-term care facilities. The participants were recruited from care facilities in Taiwan. This study utilized semistructured interviews conducted with 16 Indonesian nurses in a suitable setting. All of the interviews were transcribed, and the work of Van Manen was used to analyze the data. Four main themes were identified, including motives for working abroad, feelings of being trapped, experiencing a difficult journey, and the feeling of being supported. These themes reflect the lived experiences of Indonesian nurses who work in Taiwan's long-term care industry. Nurses from Indonesia choose to who work as nurses in Taiwan because of poor financial background and the chance of gaining a better life. However, the participants in this study felt stressed, challenged, and disappointed when faced with the unmet expectations of being employed as care workers without a clear career path. Furthermore, the need to communicate in an unfamiliar language was mentioned as a significant barrier to fulfilling their role. Better policies should be put in place to achieve improved outcomes for both countries.
Development of Telscreen: a telephone-based speech-in-noise hearing screening test with a novel masking noise and scoring procedure
Publisher: Informa UK Limited
Date: 03-05-2016
DOI: 10.3109/14992027.2016.1172268
Abstract: In 2006 the National Acoustic Laboratories was commissioned to create a telephone-based hearing screening test. NAL developed 'Telscreen', a speech-in-noise test modelled on the Dutch and UK telephone tests. The first version, Telscreen I, had several novel features: in idual scoring of digits in idual equalization of digit intelligibility and accuracy-determined test termination. Evaluation of Telscreen I revealed that it did not discriminate satisfactorily between those with and without hearing impairment. Subsequently Telscreen II, which included a novel sensitized masking noise, was developed. Telscreen I was evaluated by 105 participants (22-86 years), 37% with normal hearing (all thresholds 20 dB HL in the test ear). Telscreen II was evaluated by 75 participants (25-86 years), 33% with normal hearing, 67% with hearing impairment. Correlations between Telscreen I results and hearing thresholds, r = 0.57, and hearing disability scores, r = 0.51 were highly significant, but lower than expected. Correlations for Telscreen II were higher: r = 0.77 and 0.65, respectively. Telscreen II was found to have high sensitivity: 90% and specificity: 90.2%. Telscreen II is an efficient, reliable, and innovative hearing screening test that provides a solid foundation for future tests delivered via mobile and internet technologies.
British children's performance on the listening in spatialised noise-sentences test (LISN-S)
Publisher: Informa UK Limited
Date: 14-06-2019
The mechanical properties of earmuffs
Publisher: Institute of Noise Control Engineering (INCE)
Date: 2012
DOI: 10.3397/1.3673768
Association between women’s empowerment and diarrhea in children under two years in Indonesia
Publisher: Elsevier BV
Date: 06-2020
An efficient, adaptive method of measuring loudness growth functions
Publisher: Informa UK Limited
Date: 1999
Abstract: This paper presents a new categorical loudness scaling procedure that differs from previously published loudness scaling procedures by (i) adaptively selecting a new set of levels for each new sequence, (ii) deriving levels that are equispaced on the loudness scale, and (iii) using a continuous scale with few labels. A major advantage of the adaptive procedure is that the in idual dynamic range need not be measured prior to loudness testing. The adaptive procedure proved to be time efficient and to produce complete loudness functions from Not heard to Uncomfortably loud for normal hearing and hearing impaired subjects. The pattern of short-term and long-term reliability was similar to that reported for non-adaptive loudness scaling procedures. Three presentations produced a stable loudness function. Normative curves for one octave babble-noise at six test frequencies are presented and compared to normative data obtained with a selection of published categorical scaling procedures.
Deconvolution of overlapping cortical auditory evoked potentials recorded using short stimulus onset-asynchrony ranges
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.CLINPH.2013.09.031
Abstract: The first aim of this study is to validate the theoretical framework of least-squares (LS) deconvolution on experimental data. The second is to investigate the waveform morphology of the cortical auditory evoked potential (CAEP) for five stimulus onset-asynchronies (SOAs) and effects of alternating stimulus frequency in normally hearing adults. Eleven adults (19-55 years) with normal hearing were investigated using tone-burst stimuli of 500 and 2000 Hz with SOAs jittered around 150, 250, 450, and 850 ms in a paired-interval paradigm with fixed or alternating stimulus frequency. The LS deconvolution technique disentangled the overlapping responses, which then provided the following insights. The CAEP litude reached a minimum value for SOAs jittered around 450 ms, in contrast with significantly larger litudes for SOAs jittered around 150 and 850 ms. Despite this, longer latencies of N1 and P2 consistently occurred for decreasing SOAs. Alternating stimulus frequency significantly increased the litude of the CAEP response and decreased latencies for SOAs jittered around 150 ms. Effects of SOAs and alternating stimuli on CAEP litude can be modelled using a quantitative model of latent inhibition. LS deconvolution allows correction for cortical response overlap. The litude of the CAEP is sensitive to SOA and stimulus frequency alternation. CAEPs are emerging as an important tool in the objective evaluation of hearing aid and cochlear implant fittings. Responses to closely spaced stimuli provide objective information about integration and inhibition mechanisms in the auditory cortex.
The Listening in Spatialized Noise Test: An Auditory Processing Disorder Study
Publisher: Georg Thieme Verlag KG
Date: 05-2006
DOI: 10.3766/JAAA.17.5.2
Abstract: The Listening in Spatialized Noise test (LISN)® produces a virtual three-dimensional auditory environment under headphones. Various measures assess the extent to which either spatial, vocal, or spatial and vocal cues combined increase a listener's ability to comprehend a target story in the presence of distracter sentences, without being affected by differences between participants in variables such as linguistic skills. Ten children at risk for auditory processing disorder (APD group) were assessed on the LISN, as well as a traditional APD test battery. The APD group performed significantly more poorly on all LISN measures than 48 age-matched controls. On the spatial advantage measure, the APD group achieved a mean advantage of only 3.7 dB when the distracters were spatially separated from the target by ±90°, compared to 10.0 dB for the controls—the 6.3 dB difference significant at p 0.000001, with nine children scoring outside the normal range. The LISN was considered a promising addition to an APD test battery.
Least-squares deconvolution of evoked potentials and sequence optimization for multiple stimuli under low-jitter conditions
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.CLINPH.2013.09.030
Abstract: Rapid presentation of stimuli in an evoked response paradigm can lead to overlap of multiple responses and consequently difficulties interpreting waveform morphology. This paper presents a deconvolution method allowing overlapping multiple responses to be disentangled. The deconvolution technique uses a least-squared error approach. A methodology is proposed to optimize the stimulus sequence associated with the deconvolution technique under low-jitter conditions. It controls the condition number of the matrices involved in recovering the responses. Simulations were performed using the proposed deconvolution technique. Multiple overlapping responses can be recovered perfectly in noiseless conditions. In the presence of noise, the amount of error introduced by the technique can be controlled a priori by the condition number of the matrix associated with the used stimulus sequence. The simulation results indicate the need for a minimum amount of jitter, as well as a sufficient number of overlap combinations to obtain optimum results. An aperiodic model is recommended to improve reconstruction. We propose a deconvolution technique allowing multiple overlapping responses to be extracted and a method of choosing the stimulus sequence optimal for response recovery. This technique may allow audiologists, psychologists, and electrophysiologists to optimize their experimental designs involving rapidly presented stimuli, and to recover evoked overlapping responses.
Preferred overall loudness. I: Sound field presentation in the laboratory
Publisher: Informa UK Limited
Date: 2006
DOI: 10.1080/14992020500190144
Abstract: This study questions the basic assumption that prescriptive methods for nonlinear, wide dynamic range compression (WDRC) hearing aids should restore overall loudness to normal. Fifteen normal-hearing listeners and twenty-four hearing-impaired listeners (with mild to moderate hearing loss, twelve with and twelve without hearing aid experience) participated in laboratory tests. The participants first watched and listened to video sequences and rated how loud and how interesting the situations were. For the hearing-impaired participants, gain was applied according to the NAL-NL1 prescription. Despite the fact that the NAL-NL1 prescription led to less than normal overall calculated loudness, according to the loudness model of Moore and Glasberg (1997), the hearing-impaired participants rated loudness higher than the normal-hearing participants. The participants then adjusted a volume control to preferred overall loudness. Both normal-hearing and hearing-impaired participants preferred less than normal overall calculated loudness. The results from the two groups of hearing-impaired listeners did not differ significantly.
Bigger Is Better
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Prevalence and remediation of spatial processing disorder (SPD) in Indigenous children in regional Australia
Publisher: Informa UK Limited
Date: 28-01-2014
DOI: 10.3109/14992027.2013.871388
Abstract: This study aimed to determine the prevalence of spatial processing disorder (SPD) in the Indigenous Australian population and the benefit of and logistical issues arising from remediation of the disorder. Participants were assessed for SPD with the Listening in Spatialized Noise - Sentences test (LiSN-S). Participants diagnosed with SPD were instructed to use the LiSN & Learn auditory training software until 100 games had been completed. Participants were 144 Indigenous Australian children (aged between 6 [years months] and 12 ). Ten participants (6.9%) presented with SPD. Nine took part in the auditory training study. Post-training LiSN-S performance improved on average by 0.9 population standard deviations (1.4 dB). There was a significant correlation (r = 0.71, p = 0.031, η(2) = 0.51) between total number of LiSN & Learn games played (mean = 65, SD = 27) and improvement in LiSN-S performance. Teachers rated all participants as improving in their listening abilities post-intervention. There is a high prevalence of SPD in the Indigenous Australian population. LiSN & Learn training is effective in remediating SPD in this population and is considered a beneficial intervention by teachers, however improvement in spatial processing is dependent on training program uptake.
Hearing loss and speech understanding in noise in Aboriginal and Torres Strait Islander children from locations varying in remoteness and socio-educational advantage
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.IJPORL.2019.109741
Abstract: Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage. 288 Aboriginal and Torres Strait Islander children aged 4-14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise - Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population. The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote. The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages.
The Listening in Spatialized Noise–Sentences Test (LISN-S): Comparison to The Prototype Lisn and Results From Children With Either a Suspected (Central) Auditory Processing Disorder or a Confirmed Lan
Publisher: Georg Thieme Verlag KG
Date: 05-2008
DOI: 10.3766/JAAA.19.5.2
Abstract: Background: The Listening in Spatialized Noise—Sentences test (LISN-S®) is a revised version of the Listening in Spatialized Noise (Continuous Discourse) test (LISN® Cameron et al, 2006a). The software produces a three-dimensional auditory environment under headphones and was developed to assess auditory stream segregation skills in children. A simple repetition response protocol is utilized to determine speech reception thresholds (SRTs) for sentences presented from 0° azimuth in competing speech. The competing speech is manipulated with respect to its location in auditory space (0° vs. + and −90° azimuth) and the vocal quality of the speaker(s) (same as, or different to, the speaker of the target stimulus). Performance is measured as two SRT and three advantage measures. The advantage measures represent the benefit in dB gained when either talker, spatial, or both talker and spatial cues combined are incorporated in the maskers. Purpose: To document LISN-S performance in a group of nine children with suspected (central) auditory processing disorder ([C]APD), who presented with difficulties hearing in the classroom in the absence of any routine audiological or language, learning or attention deficits to explain such a difficulty (SusCAPD group). The study also aimed to research the effect of higher-order deficits on LISN-S performance in a group of 11 children with a range of documented learning or attention disorders (LD Group). Correlation between performance on the LISN-S and a traditional (C)APD test battery was also compared. Research Design: In a descriptive design, SusCAPD and LD group performance on the LISN-S was compared to published normative data from 70 age-matched controls. A correlational design was used to compare performance on the various tests in the traditional (C)APD battery to the SRT and advantage measures of the LISN-S. Results: There were no significant differences between the SusCAPD, LD, or control groups on the conditions of the LISN-S where both the target and maskers emanated from 0° azimuth (low-cue SRT, p = 0.978 talker advantage, p = 0.307). However, there were significant differences between groups on the performance measures where the maskers were separated from the target by + and −90°. Post hoc tests revealed that there were no significant differences between the LD group and controls on any of these measures. There were, however, significant differences between the SusCAPD group and the controls on all the conditions where the maskers were spatially separated from the target (high-cue SRT, p = 0.001 spatial advantage, p 0.0001 total advantage, p 0.0001). The LISN-S did not correlate significantly with any test in the traditional test battery, nor were the nonspatial and spatial performance measures of the LISN-S correlated. Conclusions: The study supports the hypothesis that a high proportion of children with suspected (C)APD have a deficit in the mechanisms that normally use the spatial distribution of sources to suppress unwanted signals. The LISN-S is a potentially valuable assessment tool for assessing auditory stream segregation deficits, and is sensitive in differentiating various forms of auditory streaming.
The North American Listening in Spatialized Noise—Sentences Test (NA LiSN-S): Normative Data and Test-Retest Reliability Studies for Adolescents and Young Adults
Publisher: Georg Thieme Verlag KG
Date: 11-2010
DOI: 10.3766/JAAA.21.10.3
Abstract: Background: The Listening in Spatialized Noise—Sentences test (LiSN-S Cameron and Dillon, 2009) was originally developed to assess auditory stream segregation skills in children aged 6 to 11 yr with suspected central auditory processing disorder. The LiSN-S creates a three-dimensional auditory environment under headphones. A simple repetition-response protocol is used to assess a listener's speech reception threshold (SRT) for target sentences presented in competing speech maskers. Performance is measured as the improvement in SRT in dB gained when either pitch, spatial, or both pitch and spatial cues are incorporated in the maskers. A North American-accented version of the LiSN-S (NA LiSN-S) is available for use in the United States and Canada. Purpose: To develop normative data for adolescents and adults on the NA LiSN-S, to compare these data with those of children aged 6 to 11 yr as documented in Cameron et al (2009), and to consolidate the child, adolescent, and adult normative and retest data to allow the software to be used with a wider population. Research Design: In a descriptive design, normative data and test-retest reliability data were collected. Study S le: One hundred and twenty normally hearing participants took part in the normative data study (67 adolescents aged 12 yr, 1 mo, to 17 yr, 10 mo, and 53 adults aged 19 yr, 10 mo, to 30 yr, 30 mo). Forty-nine participants returned between 1 and 4 mo after the initial assessment for retesting. Participants were recruited from sites in Cincinnati, Dallas, and Calgary. Results: When combined with data collected from children aged 6 to 11 yr, a trend of improved performance as a function of increasing age was found across performance measures. ANOVA (analysis of variance) revealed a significant effect of age on performance. Planned contrasts revealed that there were no significant differences between adults and children aged 13 yr and older on the low-cue SRT 14 yr and older on talker and spatial advantage 15 yr and older on total advantage and 16 yr and older on the high-cue SRT. Mean test-retest differences on the various NA LiSN-S performance measures for the combined child, adult, and adolescent data ranged from 0.05 to 0.5 dB. Paired comparisons revealed test-retest differences were not significant on any measure of the NA LiSN-S except low-cue SRT. Test-retest differences across measures did not differ as a function of age. Test and retest scores were significantly correlated for all NA LiSN-S measures. Conclusions: The ability to use either spatial or talker cues in isolation becomes adultlike by about 14 yr of age, whereas the ability to combine spatial and talker cues does not fully mature until closer to adulthood. By consolidating child, adolescent, and adult normative and retest data the NA LiSN-S can now been utilized to assess auditory processing skills in a wider population.
Is the outcome of fitting hearing aids to adults affected by whether an audiogram-based prescription formula is individually applied? A systematic review protocol
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2020-045899
Abstract: Hearing aids are typically programmed using the in idual’s audiometric thresholds. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not programmed using the in idual’s audiometric thresholds. This review aims to identify whether programming hearing aids using the in idual’s audiogram-based prescription results in better outcomes for adults with hearing loss. The methods of this review are reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. On 23 August 2020, eight different databases were systematically searched without any restrictions: EMBASE, MEDLINE, PubMed, PsycINFO, Web of Science, Cochrane Library, Emcare and Academic Search Premier. To ensure that this review includes the most recent evidence, the searches will be repeated at the final write-up stage. The population of interest of this review will be adults with any degree or type of hearing loss. The studies should compare hearing aids programmed using an audiogram-based prescription (and verified in the real ear) with those not programmed on the basis of the in idual’s audiogram. The primary outcome of interest is consumers’ listening preferences. Hearing-specific health-related quality of life, self-reported listening ability, speech intelligibility of words and sentences in quiet and noisy situations, sound quality ratings and adverse events are the secondary outcomes of interest. Both randomised and non-randomised controlled trials will be included. The quality of each in idual study and the overall evidence will be assessed using Downs and Black’s checklist and the Grading of Recommendations, Assessment, Development and Evaluations tool, respectively. We will only retrieve and analyse data from published studies, so no ethical approval is required. The review findings will be published in a peer-reviewed journal and presented at scientific conferences. CRD42020197232.
Use of Questionnaire-Based Measures in the Assessment of Listening Difficulties in School-Aged Children
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Perceived Sound Quality of Hearing Aids With Varying Placements of Microphone and Receiver
Publisher: American Speech Language Hearing Association
Date: 03-2023
DOI: 10.1044/2022_AJA-22-00061
Abstract: Perceived sound quality was variously compared between either no aiding or aiding with three models of hearing aid that varied the microphone position around the pinna, depth of the receiver in the auditory meatus, degree of meatal occlusion, and processing sophistication. The hearing aids were modern designs and commercially available at the time of testing. Binaural recordings of multichannel spatially separated speech and music excerpts were made in a manikin, either open ear or aided. Recordings were presented offline over wide-bandwidth, high-quality insert earphones. Participants listened to pairs of the recordings and made preference ratings both by clarity and externality (a proxy for “spaciousness”). Two separate groups of adults were tested, 20 with audiometrically normal hearing (NH) and 20 with mild-to-moderate sensorineural hearing loss (hearing impaired [HI]). For ratings of speech clarity, the NH group expressed no preference between the open ear and a deeply inserted occluding aid, both of which were preferred to a low-pass filtered output of the same aid. For the music signal, a small preference emerged for the open-ear recording over that of the aid. For the HI group, clarity of the deeply inserted aid was similar to in-the-ear and behind-the-ear devices for speech, but worse for music. Ratings of spaciousness produced no clear result in either group, which can be attributed to study limitations and/or participant factors. Based on clarity, a wide bandwidth, particularly to beyond 5 kHz generally and below 300 Hz for music, is desirable, independent of hearing aid design.
The development of the mealings, Demuth, Dillon, and buchholz classroom speech perception test
Publisher: American Speech Language Hearing Association
Date: 08-2015
DOI: 10.1044/2015_JSLHR-H-14-0332
Abstract: Open-plan classroom styles are increasingly being adopted in Australia despite evidence that their high intrusive noise levels adversely affect learning. The aim of this study was to develop a new Australian speech perception task (the Mealings, Demuth, Dillon, and Buchholz Classroom Speech Perception Test) and use it in an open-plan classroom to assess how intrusive noise affects speech perception. The first part of this article describes how the online 4-picture choice speech perception task materials were created. The second part focuses on the study involving twenty-two 5- to 6-year-old children in an open-plan classroom who completed the task while other classes engaged in quiet and noisy activities. Children's performance accuracy, number of responses, and speed were lower in the noisy condition compared with the quiet condition. In addition, children's speech perception scores decreased the farther away they were seated from the loudspeaker. Overall, the children understood and were engaged in the task, demonstrating that it is an appropriate tool for assessing speech perception live in the classroom with 5- to 6-year-old children. The results suggest that the Mealings, Demuth, Dillon, and Buchholz Classroom Speech Perception Test is a helpful tool for assessing speech perception in classrooms and that it would be beneficial to use in future research investigating how classroom design and noise affect speech perception.
Investigating the Interaction between Dichotic Deficits and Cognitive Abilities Using the Dichotic Digits difference Test (DDdT) Part 2
Publisher: Georg Thieme Verlag KG
Date: 06-2016
DOI: 10.3766/JAAA.15085
Abstract: Background: The Dichotic Digits difference Test (DDdT) was developed to investigate the relationship between dichotic processing and cognitive abilities and, through the use of differential test scores, to provide professionals with a clinical tool that could aid in differentiation of clients with genuine dichotic deficits from those where cognitive disorders affect test performance. The DDdT consists of four subtests: dichotic free recall (FR), dichotic directed left ear, dichotic directed right ear, and diotic. Scores are calculated for six conditions: FR left ear (LE), right ear (RE), and total, as well as the directed left ear, directed right ear, and diotic, and four difference measures: dichotic advantage, RE advantage FR, RE advantage directed, and attention advantage. Purpose: To investigate the role of cognitive abilities on DDdT test performance. Research Design: Correlational analysis between the various DDdT conditions and difference measures, as well as between dichotic, diotic, and cognitive factors (memory, intelligence, and attention). Study S le: Fifty typically developing children (aged 7 yr 0 mo to 12 yr 1 mo, mean = 9 yr 2 mo) and ten children recruited from the Australian Hearing CAPD Service who were diagnosed with a memory or dichotic deficit (aged 7 yr 0 mo to 15 yr 0 mo, mean = 9 yr 5 mo) took part in the study. Data Collection and Analysis: The Pearson product moment correlations were used to determine the strength of relationships between DDdT conditions as well as relationships between scores on these conditions and performance on the various cognitive assessment tools, which included the number memory forward and reversed subtests of the Test of Auditory Processing Skills – Third Edition, IVA + Plus Continuous Performance Test, and the Test of Non-Verbal Intelligence-4 (TONI-4). A parent questionnaire (Fisher’s Auditory Checklist) and a participant questionnaire (Listening Inventory for Education) were also administered. Results: Diotic performance was significantly correlated with performance on all the DDdT dichotic FR conditions (r = 0.6–0.8 p 0.00001). Further, significant correlations were found between the FR LE, total, and diotic conditions, and the cognitive measures of attention and memory, with r ranging from 0.4 to 0.5 (p 0.01–0.001). Right-ear performance was not significantly correlated to any cognitive measure, except for FR RE and number memory forward (r = 0.35 p = 0.006). The DDdT dichotic advantage measure was investigated in a subset of clinical children and found to aid in differentiating true dichotic from spurious results. Conclusions: As found in the DDdT normative data study that precedes in the companion paper (DDdT Study Part 1 Cameron et al, 2016), the high correlation between dichotic and diotic performances by the clinical and typically developing participants suggests that factors other than dichotic performance play a substantial role in a child’s ability to perform a dichotic listening task. Indeed, 61% of the variance in FR total scores for the children in this study was accounted for by factors that do not involve the perception of dichotic stimuli. This view is supported by the correlations between measures of attention and memory and dichotic scores. This result has wide-spread implications in respect to interpretation of central auditory processing disorder test results and further investigation of the use of the DDdT in a clinical population is warranted.
A randomized controlled comparison of NAL and DSL prescriptions for young children: Hearing-aid characteristics and performance outcomes at three years of age
Publisher: Informa UK Limited
Date: 30-08-2012
An Opinion on the Assessment of People Who May Have an Auditory Processing Disorder
Publisher: Georg Thieme Verlag KG
Date: 02-2012
DOI: 10.3766/JAAA.23.2.4
Abstract: We need to rethink how we assess auditory processing disorder (APD). The current use of test batteries, while necessary and well accepted, is at risk of failing as the size of these batteries increases. To counter the statistical, fatigue, and clinical efficiency problems of large test batteries, we propose a hierarchical approach to APD assessment. This begins with an overall test of listening difficulty in which performance is measurably affected for anyone with an impaired ability to understand speech in difficult listening conditions. It proceeds with a master test battery containing a small number of single tests, each of which assesses a different group of skills necessary for understanding speech in difficult listening conditions. It ends with a detailed test battery, where the in idual tests administered from this battery are only those that differentiate the skills assessed by the failed test(s) from the master test battery, so that the specific form of APD can be diagnosed. An ex le of how hierarchical interpretation of test results could be performed is illustrated using the Listening in Spatialized Noise—Sentences test (LiSN-S). Although consideration of what abilities fall within the realm of auditory processing should remain an important issue for research, we argue that patients will be best served by focusing on whether they have difficulty understanding speech, identifying the specific characteristics of this difficulty, and specifically remediating and/or managing those characteristics.
The Dichotic Digits difference Test (DDdT): Development, Normative Data, and Test–Retest Reliability Studies Part 1
Publisher: Georg Thieme Verlag KG
Date: 06-2016
DOI: 10.3766/JAAA.15084
Abstract: Background: The dichotic digits test is one of the most widely used assessment tools for central auditory processing disorder. However, questions remain concerning the impact of cognitive factors on test results. Purpose: To develop the Dichotic Digits difference Test (DDdT), an assessment tool that could differentiate children with cognitive deficits from children with genuine dichotic deficits based on differential test results. The DDdT consists of four subtests: dichotic free recall (FR), dichotic directed left ear (DLE), dichotic directed right ear (DRE), and diotic. Scores for six conditions are calculated (FR left ear [LE], FR right ear [RE], and FR total, as well as DLE, DRE, and diotic). Scores for four difference measures are also calculated: dichotic advantage, right-ear advantage (REA) FR, REA directed, and attention advantage. Research Design: Experiment 1 involved development of the DDdT, including error rate analysis. Experiment 2 involved collection of normative and test–retest reliability data. Study S le: Twenty adults (aged 25 yr 10 mo to 50 yr 7 mo, mean 36 yr 4 mo) took part in the development study 62 normal-hearing, typically developing, primary-school children (aged 7 yr 1 mo to 11 yr 11 mo, mean 9 yr 4 mo) and 10 adults (aged 25 yr 0 mo to 51 yr 6 mo, mean 34 yr 10 mo) took part in the normative and test–retest reliability study. Data Collection and Analysis: In Experiment 1, error rate analysis was conducted on the 36 digit-pair combinations of the DDdT. Normative data collected in Experiment 2 were arcsine transformed to achieve a distribution that was closer to a normal distribution and z-scores calculated. Pearson product-moment correlations were used to determine the strength of relationships between DDdT conditions. Results: The development study revealed no significant differences in the adult population between test and retest on any DDdT condition. Error rates on 36 digit pairs ranged from 1.5% to 16.7%. The most and the least error-prone digits were removed before commencement of the normative data study, leaving 25 unique digit pairs. Average z-scores calculated from the arcsine-transformed data collected from the 62 children who took part in the normative data study revealed that FR dichotic processing (LE, RE, and total) was highly correlated with diotic processing (r ranging from 0.5 to 0.6 p 0.0001). Significant improvements in performance on retest occurred for the FR LE, RE, total, and diotic conditions (p ranging from 0.05 to 0.0004), the conditions that would be expected to improve with practice if the participant’s response strategies are better the second time around. Conclusions: The addition of a diotic control task—that shares many response demands with the usual dichotic tasks—opens up the possibility of differentiating children who perform below expectations because of poor dichotic processing skills from those who perform poorly because of impaired attention, memory, or other cognitive abilities. The high correlation between dichotic and diotic performance suggests that factors other than dichotic performance play a substantial role in a child’s ability to perform a dichotic listening task. This hypothesis is investigated further in the cognitive correlation study that follows in the companion paper (DDdT Study Part 2 Cameron et al, 2016).
An international comparison of long-term average speech spectra
Publisher: Acoustical Society of America (ASA)
Date: 10-1994
DOI: 10.1121/1.410152
Abstract: The long-term average speech spectrum (LTASS) and some dynamic characteristics of speech were determined for 12 languages: English (several dialects), Swedish, Danish, German, French (Canadian), Japanese, Cantonese, Mandarin, Russian, Welsh, Singhalese, and Vietnamese. The LTASS only was also measured for Arabic. Speech s les (18) were recorded, using standardized equipment and procedures, in 15 localities for (usually) ten male and ten female talkers. All analyses were conducted at the National Acoustic Laboratories, Sydney. The LTASS was similar for all languages although there were many statistically significant differences. Such differences were small and not always consistent for male and female s les of the same language. For one-third octave bands of speech, the maximum short-term rms level was 10 dB above the maximum long-term rms level, consistent across languages and frequency. A ‘‘universal’’ LTASS is suggested as being applicable, across languages, for many purposes including use in hearing aid prescription procedures and in the Articulation Index.
The trainable hearing aid
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2006
The effects of noise exposure and musical training on suprathreshold auditory processing and speech perception in noise
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.HEARES.2017.07.006
Abstract: Recent animal research has shown that exposure to single episodes of intense noise causes cochlear synaptopathy without affecting hearing thresholds. It has been suggested that the same may occur in humans. If so, it is hypothesized that this would result in impaired encoding of sound and lead to difficulties hearing at suprathreshold levels, particularly in challenging listening environments. The primary aim of this study was to investigate the effect of noise exposure on auditory processing, including the perception of speech in noise, in adult humans. A secondary aim was to explore whether musical training might improve some aspects of auditory processing and thus counteract or ameliorate any negative impacts of noise exposure. In a s le of 122 participants (63 female) aged 30-57 years with normal or near-normal hearing thresholds, we conducted audiometric tests, including tympanometry, audiometry, acoustic reflexes, otoacoustic emissions and medial olivocochlear responses. We also assessed temporal and spectral processing, by determining thresholds for detection of litude modulation and temporal fine structure. We assessed speech-in-noise perception, and conducted tests of attention, memory and sentence closure. We also calculated participants' accumulated lifetime noise exposure and administered questionnaires to assess self-reported listening difficulty and musical training. The results showed no clear link between participants' lifetime noise exposure and performance on any of the auditory processing or speech-in-noise tasks. Musical training was associated with better performance on the auditory processing tasks, but not the on the speech-in-noise perception tasks. The results indicate that sentence closure skills, working memory, attention, extended high frequency hearing thresholds and medial olivocochlear suppression strength are important factors that are related to the ability to process speech in noise.
Does Probe-Tube Verification of Real-Ear Hearing Aid Amplification Characteristics Improve Outcomes in Adults? A Systematic Review and Meta-Analysis
Publisher: SAGE Publications
Date: 2021
Abstract: This systematic review, the first on this topic, aimed to investigate if probe-tube verification of real-ear hearing aid lification characteristics improves outcomes in adults. The review was preregistered in the Prospective Register of Systematic Reviews and performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. After assessing more than 1,420 records from seven databases, six experimental studies (published between 2012 and 2019) met the inclusion criteria five were included in the meta-analyses. The primary outcome of interest (hearing-specific, health-related quality of life) was not reported in any study. There were moderate and statistically significant positive effects of probe-tube real-ear measurement (REM), compared with the manufacturer’s initial fit, on speech intelligibility in quiet settings (standardized mean difference [SMD]: 0.59) and user’s final preference (proportion difference: 52.2%). There were small but statistically significant positive effects of REM on self-reported listening abilities (SMD: 0.22) and speech intelligibility in noise (SMD: 0.15). The quality of evidence for these outcomes ranged from high to very low. The findings show that REMs improve outcomes statistically, but this is based on a small number of studies and a limited number of participants. It is currently unclear if the benefits are of material importance because minimum clinically important differences have not been established for most of the outcomes. Ultimately, there needs to be a cost-effectiveness analysis to show that statistically significant benefits, which exceed the minimum clinically important difference, are worth the cost involved.
Effect of low-frequency gain and venting effects on the benefit derived from directionality and noise reduction in hearing aids
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/14992020701481698
Abstract: When the frequency range over which vent-transmitted sound dominates lification increases, the potential benefit from directional microphones and noise reduction decreases. Fitted with clinically appropriate vent sizes, 23 aided listeners with varying low-frequency hearing thresholds evaluated six schemes comprising three levels of gain at 250 Hz (0, 6, and 12 dB) combined with two features (directional microphone and noise reduction) enabled or disabled in the field. The low-frequency gain was 0 dB for vent-dominated sound, while the higher gains were achieved by lifier-dominated sounds. A majority of listeners preferred 0-dB gain at 250 Hz and the features enabled. While the amount of low-frequency gain had no significant effect on speech recognition in noise or horizontal localization, speech recognition and front/back discrimination were significantly improved when the features were enabled, even when vent-transmitted sound dominated the low frequencies. The clinical implication is that there is no need to increase low-frequency gain to compensate for vent effects to achieve benefit from directionality and noise reduction over a wider frequency range.
Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants
Publisher: Elsevier BV
Date: 05-2023
Detection of alertness states using electroencephalogram and cortical auditory evoked potential responses
Publisher: IEEE
Date: 11-2013
Determinants of Facility-Based Childbirth in Indonesia
Publisher: Hindawi Limited
Date: 20-06-2019
DOI: 10.1155/2019/9694602
Abstract: Background . Reducing maternal mortality remains a significant challenge in Indonesia, especially for achieving the country’s Sustainable Development Goals (SDGs) by 2030. One of the challenges is increasing delivery at healthcare facilities to ensure safe and healthy births. In Indonesia, research on factors affecting women’s use of facility-based childbirth services is scarce. Objective . This study was conducted to identify the determinants of facility-based deliveries in Indonesia. Methods . This study used data from the Indonesia Demographic and Health Survey of 2012, with a cross-sectional design. An odds ratio with 95% confidence intervals (CI) was employed to outline the independent variables for the determinants, including maternal age and education, place of residence, involvement in decision-making, employment status, economic status, and number of antenatal care visits. The dependent variable in this study was the place of delivery: whether it took place in healthcare or nonhealthcare facilities. The statistical significance was set at p .05 using bivariate analysis and binary logistic regression. Results . This study showed that a high level of education (OR: 3.035, 95% CI: 2.310–3.987), high economic status (OR: 6.691, 95% CI: 5.768–7.761), urban residence (OR: 2.947, 95% CI: 2.730–3.181), working status (OR: 0.853, 95% CI: 0.793–0.918), involvement in decision-making (OR: 0.887, 95% CI: 0.804–0.910), and having more than four visits to antenatal care centers (OR: 1.917, 95% CI: 1.783–2.061) were significant determinants of delivery at healthcare facilities. Conclusion . Efforts to improve facility-based childbirth in Indonesia must strengthen initiatives that promote women’s education, women’s autonomy, opportunities for wealth creation, and increased uptake of antenatal care, among others. Any barriers related to maternal healthcare services and cultural factors on the use of health facilities for childbirth in Indonesia require further monitoring and evaluation.
Effect of bone-conduction harmonic distortions on hearing thresholds
Publisher: Acoustical Society of America (ASA)
Date: 11-07-2014
DOI: 10.1121/1.4885771
Abstract: This study compares bone conduction (BC) thresholds obtained with two bone vibrators (BV): The Radioear B71 and an advanced BV, the Radioear B81. B81 has less distortion and is capable of higher output levels. Two tests with 20 normal hearing subjects were conducted to determine if the low distortion of B81 offers any advantages for audiometry. Hearing threshold differences between B71 and B81 are only significant at 250 Hz for levels between 20 dB hearing level (HL) and 30 dB HL. At other frequencies and higher levels, where B81 also performs with less distortion than B71, tactile responses interfere before B81 can be advantageous.
Automated cortical auditory response detection strategy
Publisher: Informa UK Limited
Date: 26-06-2020
The effect of the base line response on self-adjustments of hearing aid gain
Publisher: Acoustical Society of America (ASA)
Date: 09-2008
DOI: 10.1121/1.2951500
Abstract: Self-adjustments of variable hearing aid parameters are essential for trainable hearing aids to provide customized lification for different listening environments. Prompted by a finding of Dreschler et al. [Ear Hear. 29, 214–227 (2008)], this study investigates the effect of the base line (starting) response on self-adjustments of gain in different frequency bands. In a laboratory test, 24 hearing-impaired listeners adjusted the bass, treble, and overall gain to reach their preferred responses from two different base line responses for 12 different listening situations. The adjustments were repeated five times using the preferred response after each adjustment as base line response for the next adjustment. Half of the listeners further compared three different response shapes, within the range of preferred responses, pairwise ten times for preferential and perceptual discrimination. The results revealed that base line response biases were more pronounced at low frequencies and for listeners with a flat hearing loss configuration. While 83% of listeners reliably discriminated between the average selected biased responses, only 25% demonstrated reliable preferences for one response over the other. Listeners who showed preferential discrimination ability were those who were less biased by the base line response. The clinical implication is that self-adjustments should begin from an appropriately prescribed starting response.
Are “Dichotic” Deficits Uniquely Dichotic? Investigating Dichotic Performance with the Dichotic Digits Difference Test (DDdT) in a Large Clinical Population of Children Referred for an Auditory Proces
Publisher: Georg Thieme Verlag KG
Date: 03-2020
DOI: 10.3766/JAAA.19037
Abstract: Previous studies in a large population of typically developing (TD) children and a small clinical group showed high correlations between the dichotic and diotic conditions of the Dichotic Digits difference Test (DDdT), as well as between DDdT performance and measures of memory and attention. The purpose of the study was to investigate the performance on the DDdT in a large clinical s le. Correlational analysis between the DDdT diotic condition and the dichotic free recall (FR) right-ear, left-ear, and total (ear-averaged) conditions, as well as between DDdT and memory performance. One hundred one children (6 years 3 months to 15 years 0 month, mean 9 years 6 months) were referred for assessment to the Australian Hearing Central Auditory Processing Disorder (CAPD) service. Results were compared with data from 112 TD children collected from previously published studies. Z-scores were used to account for the effect of age on performance. Mean differences between clinical and TD children were investigated using analysis of variance (ANOVA). Pearson product-moment correlations determined the strength of relationships between DDdT conditions and the number memory forward (NMF) and reversed (NMR) subtests of the Test of Auditory Processing Skills—Third Edition. Performance by the clinical group on the DDdT dichotic FR (RE, LE, and total) conditions was significantly correlated with the diotic condition (r = 0.7 0.7, 0.8 p 0.001). Significant correlations were found between the DDdT diotic and dichotic FR conditions and the NMF (r = 0.5–0.6, p 0.001) and NMR (r = 0.2–0.5, p 0.025–0.001). ANOVA revealed no significant difference between the TD and clinical groups (p = 1.0000) in respect to the advantage they got from dichotic listening (calculated as dichotic FR total minus diotic score). Multiple regression revealed that diotic performance and short-term memory accounted for 68% of the variation in dichotic performance. Random measurement error accounted for a further 16%. Factors other than dichotic performance strongly impact a child’s ability to perform a dichotic digit listening task. This result has widespread implications in respect to the interpretation of CAPD test results.
Comparison of Two Working Memory Test Paradigms: Correlation with Academic Performance in School-Aged Children
Publisher: OMICS Publishing Group
Date: 2014
The Relations Between Auditory Processing Scores and Cognitive, Listening and Reading Abilities
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-01-2021
DOI: 10.1097/AUD.0000000000000984
Abstract: To investigate associations between auditory processing abilities, cognitive abilities, listening ability, and reading ability in children. This was a cross-sectional study involving 155 children (105 referred for auditory processing assessment and 50 with no reported listening concerns) aged between 7 and 13 years. Each child was assessed on auditory processing tests, cognitive tests, and a reading test. Additional data on reading ability were provided by the reading score from a national test. Questionnaires about the child’s listening ability were completed by a parent, a teacher, and the child. Structural equation models relating auditory processing abilities, cognitive abilities, listening ability, and reading ability were developed. There was evidence that listening and reading abilities were associated with cognitive abilities when adjusting for auditory processing abilities, but little evidence that listening and reading abilities were associated with auditory processing abilities when adjusting for cognitive abilities. It should not be assumed that auditory processing tests and cognitive tests measure separate abilities. When investigating the association between auditory processing abilities and real-world abilities, it is important to adjust for cognitive abilities. Children with listening difficulties should undergo cognitive assessments in addition to auditory processing assessments.
Effects of identification technique, extraction method, and stimulus type on mismatch negativity in adults and children
Publisher: Georg Thieme Verlag KG
Date: 10-2004
DOI: 10.3766/JAAA.15.9.3
Abstract: The overall aims of the study were to determine optimal methods and stimuli for eliciting mismatch negativity (MMN), extracting MMN from the deviant and standard waveforms, and identifying the response in children and adults. Several stimulus types were compared (pure tones, chords, and natural speech tokens) to determine which optimally elicit MMN. Deviant-alone and flip-flop MMN extraction methods that control for stimulus effects on MMN were compared for the speech stimuli (/da/ and /ga/). Visual identification, an area criterion, and integral-distribution techniques were used to identify MMN. Eight adults (20 to 28 years) and eight children (8 to 12 years) participated in the study. The deviant-alone method elicited bigger MMN area and duration than the flip-flop method for the speech stimuli. An area criterion of 110 μV x msec identified 90% of visually identified MMN compared to 62% identified using the integral-distribution technique. For both children and adults, speech stimuli and one of the chords most consistently elicited MMN.
Threshold Measurements by Self-Fitting Hearing Aids
Publisher: SAGE Publications
Date: 12-2011
Abstract: A self-fitting, self-contained hearing aid is a device that can be managed entirely by the user, without assistance from a hearing health care professional or the need for special equipment. A key component of such a device is an automated audiometer that will enable the user to self-administer measurements of in situ thresholds, which the hearing aid will use to prescribe a baseline setting for the wearer. The success of the device therefore depends on the validity and reliability of in situ threshold measurements and automatically measured thresholds. To produce a complete and self-contained device, the self-fitting hearing aid will also enable identification of audiograms that are contraindicative of hearing aid usage. The feasibility and challenges of achieving these characteristics are explored and discussed. While the overall concept seems feasible, several challenges were identified that need thorough investigation and/or development. These include the use of instructions to self-manage hearing aid insertion and in situ threshold measurements, selection of an appropriate transducer and instant-fit tip that will allow measurements of a wide range of threshold levels, control of ambient noise during threshold measurements, and self-manageable procedures that enable identification of such audiogram characteristics as asymmetry and conductive hearing loss.
Uptake of internet-delivered UK adult hearing assessment
Publisher: Informa UK Limited
Date: 06-04-2021
Analysis of data from the International Outcome Inventory for Hearing Aids (IOI-HA) using Bayesian Item Response Theory
Publisher: Informa UK Limited
Date: 11-09-2020
Allowing for Asymmetric Distributions When Comparing Auditory Processing Test Percentage Scores with Normative Data
Publisher: Georg Thieme Verlag KG
Date: 06-2014
DOI: 10.3766/JAAA.25.6.4
Abstract: Background: Raw percentage scores can be transformed to age-specific Z scores, despite the asymmetric distribution of normative data using a process that is applicable to any percentage (or proportion)-based result. Purpose: Normative values are generated for the commonly used dichotic digit and frequency pattern behavioral tests of auditory processing. Study S le: A total of 180 normal-hearing children aged 7 yr 0 mo to 12 yr 2 mo took part in this study. Research Design: A transformation and regression method is incorporated that allows for the asymmetric distribution of normative results and the development of the response across the 7–12-yr-age range. Data Collection and Analysis: Percentage correct scores were determined for each ear in the dichotic digit and frequency pattern tests, delivered at 50 dB HL. The scores were arcsine transformed, then regressed against using an exponential equation, providing an age specific estimated mean score. The residual error of the regression was then used to estimate age specific variance. Results and Conclusions: The ability to express results along an age continuum (while accounting for the asymmetric distribution and significant developmental influences) as a standard unit across all ages enables a simplified expression of performance ability on a task.
Investigating the acoustics of a sample of open plan and enclosed Kindergarten classrooms in Australia
Publisher: Elsevier BV
Date: 12-2015
Remediation of spatial processing deficits in hearing-impaired children and adults
Publisher: Georg Thieme Verlag KG
Date: 06-2014
DOI: 10.3766/JAAA.25.6.5
Abstract: Background: The ability to use interaural cues to segregate target speech from competing signals allows people with normal hearing to understand speech at significantly poorer signal-to-noise ratios. This ability, referred to as spatial processing ability or spatial release from masking, has been shown to be deficient in people with a sensorineural hearing loss even after lification is applied. Spatial processing deficits in a population of children with auditory processing deficits have been found to be remediable through the use of a deficit-specific auditory training program called the LiSN & Learn. Purpose: The aim of the present study was to determine whether LiSN & Learn auditory training could improve the spatial processing ability of hearing-impaired adults and children. In addition, the research investigated whether the age of the participant would affect the efficacy of the training program. Research Design: In a repeated-measures design, participants’ spatial processing ability was assessed pretraining and posttraining using the Listening in Spatialized Noise-Sentences Test (LiSN-S). Questionnaire responses were also collected from participants pretraining and posttraining to provide a subjective measure of real-life listening difficulty. Between the two assessment periods, participants were asked to train with the LiSN & Learn for 15 min per day, 5 days per week for 60 training sessions. Study S le: Participants were five children (aged 6–11 yr) and five adults (aged 60–74 yr) with up to a moderate sensorineural hearing loss. Data Collection and Analysis: The LiSN & Learn auditory training software incorporates five computer games in which target sentences, processed with head-related transfer functions, are perceived as coming from 0° azimuth, and simultaneous distracting speech streams are perceived as coming from ±90° azimuth. Participants are tasked with identifying a word from the target sentence and selecting the corresponding picture from a selection of four images displayed on the screen. The signal-to-noise ratio is adapted based on whether the response given is correct or incorrect. Results: Despite an average improvement of 10 dB on the LiSN & Learn training program, no significant improvements were seen posttraining in either of the spatially separated conditions of the LiSN-S (p ranging 0.47–0.75). A 1.2 dB improvement was found in the baseline condition of the LiSN-S, which incorporates no spatial separation between distracter and target stimuli (p 0.01). Age did not significantly affect training outcomes (p = 0.21). No significant improvements were found posttraining on the self-report questionnaires (p = 0.84 and p = 0.20). Conclusions: This study has demonstrated that LiSN & Learn training does not significantly improve spatial processing deficits in adults or children with a sensorineural hearing loss. As auditory training did not prove to be effective, further research should be directed toward the development of hearing aid processing schemes that will compensate for the degraded interaural time difference and interaural level difference cues which underpin spatial processing.
Active cancellation of occlusion: An electronic vent for hearing aids and hearing protectors
Publisher: Acoustical Society of America (ASA)
Date: 07-2008
DOI: 10.1121/1.2908279
Abstract: The occlusion effect is commonly described as an unnatural and mostly annoying quality of the voice of a person wearing hearing aids or hearing protectors. As a result, it is often reported by hearing aid users as a deterrent to wearing hearing aids. This paper presents an investigation into active occlusion cancellation. Measured transducer responses combined with models of an active feedback scheme are first examined in order to predict the effectiveness of occlusion reduction. The simulations predict 18dB of occlusion reduction in completely blocked ear canals. Simulations incorporating a 1mm vent (providing passive occlusion reduction) predict a combined active and passive occlusion reduction of 20dB. A prototype occlusion canceling system was constructed. Averaged across 12 listeners with normal hearing, it provided 15dB of occlusion reduction. Ten of the subjects reported a more natural own voice quality and an appreciable increase in comfort with the cancellation active, and 11 out of the 12 preferred the active system over the passive system.
Electrophysiological and behavioral evidence of auditory processing deficits in children with reading disorder
Publisher: Elsevier BV
Date: 05-2006
DOI: 10.1016/J.CLINPH.2006.02.001
Abstract: The aim of the research was to investigate auditory processing abilities in children with reading disorders using electrophysiological and behavioral tasks. Differences in auditory processing between control, compensated (age appropriate reading skills with a history of reading disorder), and reading disordered groups were systematically investigated. The reading disorder group had significantly lower results than control and compensated reader groups for most tests in the reading and auditory processing test battery. All children with a reading disorder did not pass at least one behavioral test of auditory processing, and hence would be diagnosed clinically as having an auditory processing disorder (APD). The reading disorder group also had significantly smaller /ga/-evoked mismatch negativity (MMN) area than the control group. Compensated and control groups had similar results for the electrophysiological and behavioral auditory processing tests. Correlation analyses showed that reading fluency and accuracy and nonword scores (measured using Castle and Coltheart's word/nonword test) correlated significantly with most APD measures. The general profile of auditory processing deficits in children with reading disorder was a combination of deficits on frequency patterns (i.e. frequency pattern test) and absent or small /ga/-evoked MMN. Significant results from the correlation analyses support the co-morbidity of reading and auditory processing disorders. Children with reading disorders are likely to have auditory processing disorders.
Factor Analysis on Multiple Auditory Processing Assessment–2 and Listening in Spatialized Noise–Sentences Test in Children
Publisher: American Speech Language Hearing Association
Date: 14-06-2021
DOI: 10.1044/2021_AJA-20-00158
Abstract: There is need for greater understanding of tests used in assessing all aspects of auditory processing disorder (APD). This is important so that specific deficits can be identified and later remediated with the smallest possible test battery. The American Speech-Language-Hearing Association (ASHA) recommends five areas/domains for behavioral assessment: (a) temporal, (b) binaural (dichotic) separation/integration, (c) monaural low redundancy, (d) binaural interaction/localization/lateralization, and (e) auditory discrimination. Multiple-factor studies support the first three domains, which are most often used for APD assessment and which can be measured in a test battery normed within the United States (Multiple Auditory Processing Assessment–2 [MAPA-2]). This study was designed to determine if factored results from children would clarify whether a behavioral test (Listening in Spatialized Noise–Sentences Test [LiSN-S]) would factor within one of the first three domains or be separate, possibly within the fourth domain, binaural interaction. Fifty-one 8- and 9-year-olds with normal development and normal otoscopy and hearing responses bilaterally from 500 to 4000 Hz at 20 dB HL were recruited. Two sets of APD tests were administered: MAPA-2 and LiSN-S. Results verified the expected three-factor structure for MAPA-2. LiSN-S did not factor within one of those three, suggesting that some processes involved in the LiSN-S tasks require interactions between the two ears different from those involved in dichotic perception and thus better belong in the ASHA binaural interaction/lateralization domain. Auditory processing abilities are sufficiently independent of each other that test batteries spanning the first three ASHA domains are not sensitive to at least some abilities in the fourth domain. This additional factor evidence is helpful. Future research should examine the utility of measuring additional factors within APD in order to achieve the most efficient and comprehensive test battery.
Evaluation of the NAL-NL1 and the DSL v.4.1 prescriptions for children: Paired-comparison intelligibility judgments and functional performance ratings
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/14992020903095791
Abstract: This paper reports intelligibility judgments and real-life functional performance of 48 children in a double-blind, cross-over trial comparing the NAL-NL1 and the DSL v.4.1 prescriptions. Intelligibility judgments were obtained by using a paired-comparisons procedure with audiovisual stimuli. Functional performance of children during two eight-week periods, each with hearing aids adjusted to one prescription, was assessed by parents and teachers (PEACH and TEACH) and by children's self reports (SELF). Consistently across reports, performance was significantly better in quiet than in noise. On average, better performance in noise (a higher Noise subscale score) was associated with NAL-NL1 than with DSL v.4.1, both for the PEACH and the SELF. This difference was significant for the SELF in Australia. Intelligibility judgments revealed preferences that were equally split between prescriptions in both countries, on average. In the Australian s le, intelligibility judgments agreed with the questionnaire ratings and with parents' ratings. An increase in preference for NAL was significantly associated with lesser hearing loss. The effect was not significant in the Canadian s le.
Comment on Ahmmed (2021): The Search for Evidence-Based Auditory Processing Disorder Diagnostic Criteria
Publisher: American Speech Language Hearing Association
Date: 09-12-2021
DOI: 10.1044/2021_AJA-21-00100
Abstract: Ahmmed (2021) presented a study to advance the goal of an evidence-based diagnostic criteria for auditory processing disorder. We offer some cautions about the interpretation of these results, as well as suggestions for future strategies for developing evidence-based criteria for auditory processing disorder.
Binaural redundancy and inter-aural time difference cues for patients wearing a cochlear implant and a hearing aid in opposite ears
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1080/14992020500190003
Abstract: We investigated speech perception advantages arising from the use of inter-aural time difference cues, and from the provision of redundant information by the use of a hearing aid contralateral to a cochlear implant (bimodal hearing devices). Thirty-eight subjects (14 normally hearing and 23 hearing-impaired) participated in this study. The effect of binaural redundancy was assessed by comparing the signal-to-noise ratio (SNR) required for 50% correct identification of sentences in noise when listening monaurally to that when listening binaurally. The use of inter-aural time difference cues was determined by comparing the binaural SNRs obtained with or without a noise delay of 700 micros between ears. Results indicated adults who used bimodal hearing devices benefited from binaural redundancy, but children did not. Whereas normally hearing subjects used inter-aural time difference cues to improve speech perception in noise, neither adults nor children who used bimodal hearing devices were able to do so.
An optimum value for detection probability
Publisher: Springer Science and Business Media LLC
Date: 03-1981
DOI: 10.3758/BF03204475
The Selection of Modulation Rates for Frequency Modulated Sound Field Stimuli
Publisher: Informa UK Limited
Date: 1983
DOI: 10.3109/01050398309076240
Abstract: Frequency modulated (FM) tones are used in sound field audiometry in order to avoid problems caused by standing waves. The FM stimuli to be used must be specified in terms of bandwidth (twice the frequency deviation), modulation rate and modulation waveform. This paper deals with selection of the modulation rate. Improved field uniformity obtained with FM tones relies upon the ear averaging the sound intensity as the frequency sweeps. The modulation rate must be less than about 1/3 of the frequency deviation in order to provide sufficient spectral components to ensure reasonable averaging across the frequency band. If the rate is too low threshold will be determined by the peak intensity during the sweep. For normal listeners a modulation rate of 5 Hz is just satisfactory but in the hearing impaired a higher rate is required because of their altered temporal integration characteristics. A suitable value for the modulation rate can be inferred from the literature on temporal integration and the acoustic characteristics of typical test rooms. The optimum rate increases with the stimulus centre frequency, but a constant rate of 20 Hz appears to be acceptable.
Prediction of Speech Recognition From Audibility and Psychoacoustic Abilities of Hearing-Impaired Listeners
Publisher: Routledge
Date: 04-01-2019
The Relationship between Obligatory Cortical Auditory Evoked Potentials (CAEPs) and Functional Measures in Young Infants
Publisher: Georg Thieme Verlag KG
Date: 02-2007
DOI: 10.3766/JAAA.18.2.4
Abstract: Finding ways to evaluate the success of hearing aid fittings in young infants has increased in importance with the implementation of hearing screening programs. Cortical auditory evoked potentials (CAEP) can be recorded in infants and provides evidence for speech detection at the cortical level. The validity of this technique as a tool of hearing aid evaluation needs, however, to be demonstrated. The present study examined the relationship between the presence/absence of CAEPs to speech stimuli and the outcomes of a parental questionnaire in young infants who were fitted with hearing aids. The presence/absence of responses was determined by an experienced examiner as well as by a statistical measure, Hotelling's T2. A statistically significant correlation between CAEPs and questionnaire scores was found using the examiner's grading (rs = 0.45) and using the statistical grading (rs = 0.41), and there was reasonably good agreement between traditional response detection methods and the statistical analysis. La búsqueda de formas de evaluar el éxito de una adaptación de auxiliares auditivos en niños pequeños ha aumentado en importancia con la implementación de los programas de tamizaje auditivo. Se pueden registrar potenciales evocados auditivos corticales (CAEP) en infantes y aportar evidencia sobre la detección del lenguaje a nivel cortical. La validez de esta técnica como una herramienta para la evaluación de las necesidades de adaptación de auxiliares auditivos necesita, sin embargo, ser demostrada. El presente estudio examinó la relación entre la presencia/ausencia de CAEP ante estímulos de lenguaje y el resultado de un cuestionario a los padres de infantes a los que se adaptaron auxiliares auditivos. La presencia/ausencia de respuestas fue determinada por un examinador con experiencia, así como por un procedimiento de medición estadística: la T2 de Hotelling. Se encontró una correlación estadísticamente significativa entre los CAEP y los puntajes del cuestionario, utilizando la gradación del examinador (rs = 0.45) y utilizando la gradación estadística (rs = 0.41), y existió un acuerdo razonablemente bueno entre los métodos tradicionales de detección de respuesta y el análisis estadístico.
Denis John Byrne (1935–2000)
Publisher: Informa UK Limited
Date: 2000
The relationship between cortical auditory evoked potential (CAEP) detection and estimated audibility in infants with sensorineural hearing loss
Publisher: Informa UK Limited
Date: 02-07-2012
DOI: 10.3109/14992027.2012.690076
Abstract: To determine the effectiveness of objective statistical detection in CAEP testing to evaluate audibility in young infants with sensorineural hearing loss. CAEP recordings to speech-based stimuli were made at three presentation levels (55, 65, or 75 dB SPL) when a group of hearing-impaired infants were either aided or unaided. Later-obtained behavioral audiograms were used as the gold standard against which to evaluate the accuracy of the automatic detection of the presence/absence of CAEP responses. Participants were 18 infants with confirmed sensorineural hearing loss. Higher sensation levels led to a greater number of present CAEP responses being detected. More CAEP waveforms were detected in the aided condition than in the unaided condition. Our results suggest that the presence/absence of CAEP responses defined by the automatic statistical criterion was effective in showing whether increased sensation levels provided by lification were sufficient to reach the cortex. This was clearly apparent from the significant increase in cortical detections when comparing unaided with aided testing.
Cortical Auditory-Evoked Potentials in Response to Multitone Stimuli in Hearing-Impaired Adults
Publisher: Georg Thieme Verlag KG
Date: 05-2016
DOI: 10.3766/JAAA.15068
Abstract: Purpose: To determine if one-octave multitone (MT) stimuli increase the litude of cortical auditory-evoked potentials (CAEPs) in in iduals with a hearing loss when compared to standard pure-tone (PT) stimuli and narrow-band noise (NBN). Research Design: CAEPs were obtained from 16 hearing-impaired adults in response to PT and MT auditory stimuli centered around 0.5, 1, 2, and 4 kHz and NBN centered around 1 and 2 kHz. Hearing impairment ranged from a mild to a moderate hearing loss in both ears. Auditory stimuli were monaurally delivered through insert earphones at 10 and 20 dB above threshold. The root mean square litude of the CAEP and the detectability of the responses using Hotelling’s T2 were calculated and analyzed. Results: CAEP litudes elicited with MT stimuli were on average 29% larger than PT stimuli for frequencies centered around 1, 2, and 4 kHz. No significant difference was found for responses to 0.5-kHz stimuli. Significantly higher objective detection scores were found for MT when compared to PT. For the 1- and 2-kHz stimuli, the CAEP litudes to NBN were not significantly different to those evoked by PT but a significant difference was found between MT stimuli and both NBN and PT. The mean detection sensitivity of MT for the four frequencies was 80% at 10 dB SL and 95% at 20 dB SL, and was comparable with detection sensitivities observed in normal-hearing participants. Conclusions: Using MT stimuli when testing CAEPs in adults with hearing impairment showed larger litudes and a higher objective detection sensitivity compared to using traditional PT stimuli for frequencies centered around 1, 2, and 4 kHz. These findings suggest that MT stimuli are a clinically useful tool to increase the efficiency of frequency-specific CAEP testing in adults with hearing impairment.
A Comparison of Gain for Adults from Generic Hearing Aid Prescriptive Methods: Impacts on Predicted Loudness, Frequency Bandwidth, and Speech Intelligibility
Publisher: Georg Thieme Verlag KG
Date: 07-2011
DOI: 10.3766/JAAA.22.7.5
Abstract: Background: Prescriptive methods have been at the core of modern hearing aid fittings for the past several decades. Every decade or so, there have been revisions to existing methods and/or the emergence of new methods that become widely used. In 2001 Byrne et al provided a comparison of insertion gain for generic prescriptive methods available at that time. Purpose: The purpose of this article was to compare National Acoustic Laboratories—Non-linear 1 (NAL-NL1), National Acoustic Laboratories—Non-linear 2 (NAL-NL2), Desired Sensation Level Multistage Input/Output (DSL m[i/o]), and Cambridge Method for Loudness Equalization 2—High-Frequency (CAMEQ2-HF) prescriptive methods for adults on the lification characteristics of prescribed insertion gain and compression ratio. Following the differences observed in prescribed insertion gain among the four prescriptive methods, analyses of predicted specific loudness, overall loudness, and bandwidth of cochlear excitation and effective audibility as well as speech intelligibility of the international long-term average speech spectrum (ILTASS) at an average conversational input level were completed. These analyses allow for the discussion of similarities and differences among the present-day prescriptive methods. Research Design: The impact of insertion gain differences among the methods is examined for seven hypothetical hearing loss configurations using models of loudness perception and speech intelligibility. Study S le: Hearing loss configurations for adults of various types and degrees were selected, five of which represent sensorineural impairment and were used by Byrne et al the other two hearing losses provide an ex le of mixed and conductive impairment. Data Collection and Analysis: Prescribed insertion gain data were calculated in 1/3-octave frequency bands for each of the seven hearing losses from the software application of each prescriptive method over multiple input levels. The insertion gain data along with a diffuse field-to-eardrum transfer function were used to calculate output levels at the eardrums of the hypothetical listeners. Levels of hearing loss and output were then used in the Moore and Glasberg loudness model and the ANSI S3.5-1997 Speech Intelligibility Index model. Results: NAL-NL2 and DSL m[i/o] provided comparable overall loudness of approximately 8 sones for the five sensorineural hearing losses for a 65 dB SPL ILTASS input. This loudness was notably less than that perceived by a normal-hearing person for the same input signal, 18.6 sones. NAL-NL2 and DSL m[i/o] also provided comparable predicted speech intelligibility in quiet and noise. CAMEQ2-HF provided a greater average loudness, similar to NAL-NL1, with more high-frequency bandwidth but no significant improvement to predicted speech intelligibility. Conclusions: Definite variation in prescribed insertion gain was present among the prescriptive methods. These differences when averaged across the hearing losses were, by and large, negligible with regard to predicted speech intelligibility at normal conversational speech levels. With regard to loudness, DSL m[i/o] and NAL-NL2 provided the least overall loudness, followed by CAMEQ2-HF and NAL-NL1 providing the most loudness. CAMEQ2-HF provided the most audibility at high frequencies even so, the audibility became less effective for improving speech intelligibility as hearing loss severity increased.
Control of hearing-aid saturated sound pressure level by frequency-shaped output compression limiting
Publisher: Informa UK Limited
Date: 1999
Abstract: To fit a hearing aid successfully, it is important to set the Saturated Sound Pressure Level (SSPL) or Maximum Power Output (MPO) appropriately. The SSPL should be low enough to prevent sounds from being lified to uncomfortable loudness, and yet high enough to maximize speech intelligibility and signal quality. To help attain an optimum SSPL setting, a novel output compression limiting scheme, with shapable MPO (ShaMPO), has been devised. In ShaMPO, the SSPL is shaped across frequencies in accordance with the in idual user's loudness discomfort levels (LDLs). The contributions of different frequency regions to loudness are controlled by summing the lified signal power relative to the LDLs across frequencies, and using this signal to control a wideband compressor. This scheme and a conventional output compression limiting (AGCo) scheme have been implemented in a digital hearing aid. Ten subjects, with moderately-severe to profound sensorineural hearing losses, participated in a study comparing speech intelligibility and listening comfort for the two schemes. Results showed that there were no significant differences in the speech perception scores between AGCo and ShaMPO, even when the speech was presented at 80 dBA, at which level both schemes were in compression much of the time. However, an examination of how subjects selected the SSPL for the two schemes revealed that, in many instances, AGCo would permit some sounds with compact spectra to be lified above LDL, whereas ShaMPO would not. Thus the ShaMPO scheme can improve listening comfort for some intense sounds without a loss of speech intelligibility. In contrast, half the subjects found speech at 80 dBA to be uncomfortably loud when listening through their own aids.
Towards a listening in spatialized noise test using complex tones
Publisher: ASA
Date: 2013
DOI: 10.1121/1.4799666
The development of the Language-Independent Speech in Noise and Reverberation test (LISiNaR) and evaluation in listeners with English as a second language
Publisher: Informa UK Limited
Date: 02-06-2022
DOI: 10.1080/14992027.2022.2078432
Abstract: Create a language-independent, ecologically valid auditory processing assessment and evaluate relative stimuli intelligibility in native and non-native English speakers. The Language-Independent Speech in Noise and Reverberation Test (LISiNaR) targets comprised consonant-vowel (CVCV) pseudo-words. Distractors comprised CVCVCVCV pseudo-words. Stimuli were presented over headphones using an iPad either face-to-face or remotely. Scoring occurred adaptively to establish a participant's speech reception threshold in noise (SRT). The listening environment was simulated using reverberant and anechoic head-related transfer functions. In four test conditions, targets originated from 0°. Distractors originated from either ±90°, ±67.5° and ±45° (spatially separated) or 0° azimuth (co-located). Reverberation impact (RI) was calculated as the difference in SRTs between the anechoic and reverberant conditions and spatial advantage (SA) as the difference between the spatially separated and co-located conditions. Young adult native speakers of Australian ( No significant effects of language occurred for the test conditions, RI or SA. A small but significant effect of delivery mode occurred for RI. Reverberation impacted SRT by 5 dB relative to anechoic conditions. Performance on LISiNaR is not affected by the native language or accent of groups tested in this study.
The Detection of Infant Cortical Auditory Evoked Potentials (CAEPs) Using Statistical and Visual Detection Techniques
Publisher: Georg Thieme Verlag KG
Date: 05-2010
DOI: 10.3766/JAAA.21.5.6
Abstract: Background: With the advent of newborn hearing screening programs, the need to verify the fit of hearing aids in young infants has increased. The recording of cortical auditory evoked potentials (CAEPs) for this purpose is quite feasible, but rapid developmental changes that affect response morphology and the presence of electrophysiological noise can make subjective response detection challenging. Purpose: The purpose of this study was to investigate the effectiveness of an automated statistic versus experienced examiners in detecting the presence of infant CAEPs when stimuli were present and reporting the absence of CAEPs when no stimuli were present. Research Design: A repeated-measures design was used where infant-generated CAEPs were interpreted by examiners and an automated statistic. Study S le: There were nine male and five female infants (mean age, 12 mo SD, 3.4) who completed behavioral and electrophysiological testing using speech-based stimuli. Data Collection and Analysis: In total, 87 infant CAEPs were recorded to three sensation levels, 10, 20 and 30 dB relative to the behavioral thresholds and to nonstimulus trials. Three examiners were presented with these responses: (1) “in series,” where waveforms were presented in order of decreasing stimulus presentation levels, and (2) “nonseries,” where waveforms were randomized completely and presented as independent waveforms. The examiners were given no information about the stimulus levels and were asked to determine whether responses to auditory stimulation could be observed and their degree of certainty in making their decision. Data from the CAEP responses were also converted to multiple dependent variables and analyzed using Hotelling's T2. Results from both methods of response detection were analyzed using a repeated measures ANOVA (analysis of variance) and parameters of signal detection theory known as d-prime (d′) and the area under the receiver operating characteristic (ROC) curve. Results: Results showed that as the stimulus level increased, the sensitivity index, d′, increased for both methods of response detection, but neither reached the maximum possible d′ value with a sensation level of 30 dB. The examiners with the greatest experience and Hotelling's T2 were equally sensitive in differentiating the CAEP from noise. Conclusions: Hotelling's T2 appears to detect CAEPs from normal hearing infants at a rate equal to that of an experienced examiner. A clinical instrument that applies Hotelling's T2 on-line, so that the likelihood of response detection can be assessed objectively, should be of particular benefit to the novice or less experienced examiner.
Prescribed real-ear and achieved real-life differences in children's hearing aids adjusted according to the NAL-NL1 and the DSL v.4.1 prescriptions
Publisher: Informa UK Limited
Date: 2010
DOI: 10.3109/14992020903082096
Abstract: This paper examined how hearing aids adjusted for comparing NAL-NL1 with DSLv.4.1 prescription formulas matched prescriptive targets. The real-ear-to-coupler differences (RECD) of 48 children (24 in Australia and 24 in Canada) were measured and used to derive coupler gain targets. Verification of gain and output were carried out in an HA2-2cc coupler. Electroacoustic measurements revealed a minimal difference between NAL-NL1 and DSLv.4.1 frequency-response slopes due to practical limitations of the devices, even though the prescribed differences were large (up to 13 dB/octave). The difference in overall gain was generally achieved in the hearing aids, with DSLv.4.1 prescribing higher overall gain than NAL-NL1. The mean RECD at 4 kHz was 5 dB higher for children in Australia than in Canada. As the same RECDs were used in deriving targets for both prescriptions, this is unlikely to affect the results of the comparison. The impact of a gain difference between prescriptions on children's performance and preferences in real life is reported in separate papers.
An algorithm that administers adaptive speech-in-noise testing to a specified reliability at selectable points on the psychometric function
Publisher: Informa UK Limited
Date: 19-08-2013
DOI: 10.3109/14992027.2013.817688
Abstract: To introduce and verify an algorithm designed to administer adaptive speech-in- noise testing to a specified reliability at selectable points on the psychometric function. Speech-in-noise performances were measured using BKB sentences presented in diffuse babble-noise, using morphemic scoring. Target of the algorithm was a test-retest standard deviation of 1.13 dB within the presentation of 32 sentences. Normal-hearing participants completed repeated measures using manual administration targeting 50% correct, and the automated procedure targeting 25%, 50%, and 75% correct. Aided hearing-impaired participants completed testing with the automated procedure targeting 25%, 50%, and 75% correct, repeating measurements at the 50% point three times. Twelve normal-hearing and 63 hearing-impaired people who had English as first language. Relative to the manual procedure, the algorithm produced the same speech reception threshold in noise (p = 0.96) and lower test-retest reliability on normal-hearing listeners. Both groups obtained significantly different results at the three target points (p < 0.04) with observed reliability close to expected. Target accuracy was not reached within 32 sentences for 18% of measurements on hearing-impaired participants. The reliability of the algorithm was verified. A second test is recommended if the target variability is not reached during the first measurement.
Estimating Hearing Thresholds in Hearing-Impaired Adults through Objective Detection of Cortical Auditory Evoked Potentials
Publisher: Georg Thieme Verlag KG
Date: 04-2015
DOI: 10.3766/JAAA.26.4.5
Abstract: Background: Hearing threshold estimation based on cortical auditory evoked potentials (CAEPs) has been applied for some decades. However, available research is scarce evaluating the accuracy of this technique with an automated paradigm for the objective detection of CAEPs. Purpose: To determine the difference between behavioral and CAEP thresholds detected using an objective paradigm based on the Hotelling’s T 2 statistic. To propose a decision tree to choose the next stimulus level in a s le of hearing-impaired adults. This knowledge potentially could increase the efficiency of clinical hearing threshold testing. Research Design: Correlational cohort study. Thresholds obtained behaviorally were compared with thresholds obtained through cortical testing. Study S le: Thirty-four adults with hearing loss participated in this study. Data Collection and Analysis: For each audiometric frequency and each ear, behavioral thresholds were collected with both pure-tone and 40-msec tone-burst stimuli. Then, corresponding cortical hearing thresholds were determined. An objective cortical-response detection algorithm based on the Hotelling’s T 2 statistic was applied to determine response presence. A decision tree was used to select the next stimulus level. In total, 241 behavioral-cortical threshold pairs were available for analysis. The differences between CAEP and behavioral thresholds (and their standard deviations [SDs]) were determined for each audiometric frequency. Cortical litudes and electroencephalogram noise levels were extracted. The practical applicability of the decision tree was evaluated and compared to a Hughson-Westlake paradigm. Results: It was shown that, when collapsed over all audiometric frequencies, behavioral pure-tone thresholds were on average 10 dB lower than 40-msec cortical tone-burst thresholds, with an SD of 10 dB. Four percent of CAEP thresholds, all obtained from just three in idual participants, were more than 30 dB higher than their behavioral counterparts. The use of a decision tree instead of a Hughson-Westlake procedure to obtain a CAEP threshold did not seem to reduce test time, but there was significantly less variation in the number of CAEP trials needed to determine a threshold. Conclusions: Behavioral hearing thresholds in hearing-impaired adults can be determined with an acceptable degree of accuracy (mean threshold correction and SD of both 10 dB) using an objective statistical cortical-response detection algorithm in combination with a decision tree to determine the test levels.
Development and Evaluation of a Language-Independent Test of Auditory Discrimination for Referrals for Cochlear Implant Candidacy Assessment
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 19-11-2022
DOI: 10.1097/AUD.0000000000001166
Abstract: The purpose of this study was to (1) develop a Language-independent Test of Auditory Discrimination (LIT-AD) between speech sounds so that people with hearing loss who derive limited speech perception benefits from hearing aids (HAs) may be identified for consideration of cochlear implantation and (2) examine the relationship between the scores for the new discrimination test and those of a standard sentence test for adults wearing either HAs or cochlear implants (CIs). The test measures the ability of the listener to correctly discriminate pairs of nonsense syllables, presented as sequential triplets in an odd-one-out format, implemented as a game-based software tool for self-administration using a tablet computer. Stage 1 included first a review of phonemic inventories in the 40 most common languages in the world to select the consonants and vowels. Second, discrimination testing of 50 users of CIs at several signal to noise ratios (SNRs) was carried out to generate psychometric functions. These were used to calculate the corrections in SNR for each consonant-pair and vowel combination required to equalize difficulty across items. Third, all items were in idually equalized in difficulty and the overall difficulty set. Stage 2 involved the validation of the LIT-AD in English-speaking listeners by comparing discrimination scores with performance in a standard sentence test. Forty-one users of HAs and 40 users of CIs were assessed. Correlation analyses were conducted to examine test–retest reliability and the relationship between performance in the two tests. Multiple regression analyses were used to examine the relationship between demographic characteristics and performance in the LIT-AD. The scores of the CI users were used to estimate the probability of superior performance with CIs for a non-CI user having a given LIT-AD score and duration of hearing loss. The LIT-AD comprises 81 pairs of vowel–consonant–vowel syllables that were equalized in difficulty to discriminate. The test can be self-administered on a tablet computer, and it takes about 10 min to complete. The software automatically scores the responses and gives an overall score and a list of confusable items as output. There was good test–retest reliability. On average, higher LIT-AD discrimination scores were associated with better sentence perception for users of HAs ( r = −0.54, p .001) and users of CIs ( r = −0.73, p .001). The probability of superior performance with CIs for a certain LIT-AD score was estimated, after allowing for the effect of duration of hearing loss. The LIT-AD could increase access to CIs by screening for those who obtain limited benefits from HAs to facilitate timely referrals for CI candidacy evaluation. The test results can be used to provide patients and professionals with practical information about the probability of potential benefits for speech perception from cochlear implantation. The test will need to be evaluated for speakers of languages other than English to facilitate adoption in different countries.
Least-squares (LS) deconvolution of a series of overlapping cortical auditory evoked potentials: a simulation and experimental study
Publisher: IOP Publishing
Date: 25-06-2014
DOI: 10.1088/1741-2560/11/4/046016
Abstract: To evaluate the viability of disentangling a series of overlapping 'cortical auditory evoked potentials' (CAEPs) elicited by different stimuli using least-squares (LS) deconvolution, and to assess the adaptation of CAEPs for different stimulus onset-asynchronies (SOAs). Optimal aperiodic stimulus sequences were designed by controlling the condition number of matrices associated with the LS deconvolution technique. First, theoretical considerations of LS deconvolution were assessed in simulations in which multiple artificial overlapping responses were recovered. Second, biological CAEPs were recorded in response to continuously repeated stimulus trains containing six different tone-bursts with frequencies 8, 4, 2, 1, 0.5, 0.25 kHz separated by SOAs jittered around 150 (120-185), 250 (220-285) and 650 (620-685) ms. The control condition had a fixed SOA of 1175 ms. In a second condition, using the same SOAs, trains of six stimuli were separated by a silence gap of 1600 ms. Twenty-four adults with normal hearing (<20 dB HL) were assessed. Results showed disentangling of a series of overlapping responses using LS deconvolution on simulated waveforms as well as on real EEG data. The use of rapid presentation and LS deconvolution did not however, allow the recovered CAEPs to have a higher signal-to-noise ratio than for slowly presented stimuli. The LS deconvolution technique enables the analysis of a series of overlapping responses in EEG. LS deconvolution is a useful technique for the study of adaptation mechanisms of CAEPs for closely spaced stimuli whose characteristics change from stimulus to stimulus. High-rate presentation is necessary to develop an understanding of how the auditory system encodes natural speech or other intrinsically high-rate stimuli.
Relative loudness of low- and high-frequency bands of speech-shaped babble, including the influence of bandwidth and input level
Publisher: Acoustical Society of America (ASA)
Date: 02-2002
DOI: 10.1121/1.1436070
Abstract: In a balancing test, ten normal-hearing listeners adjusted filtered speech-shaped babble-noise to equally loud levels. On average, they selected about 10 dB less gain for bands below 1 kHz than for bands above and including 1 kHz. The findings applied to two bandwidths (octave and equivalent rectangular bandwidth) and two levels (65 and 85 dB SPL). The outcome suggests that hearing aid fitting procedures aiming to equalize loudness of speech bands should prescribe less low-frequency gain than procedures aiming to normalize loudness of speech bands. A significant interaction was found between bandwidth and input level for the high-frequency bands.
A simulation model to explore the relative value of stock enhancement versus harvest regulations for fishery sustainability
Publisher: Elsevier BV
Date: 03-2010
Hearing tests are just child’s play: the sound scouts game for children entering school
Publisher: Informa UK Limited
Date: 27-04-2018
DOI: 10.1080/14992027.2018.1463464
Abstract: To create a hearing test useable without the involvement of a clinician or calibrated equipment, suitable for children aged 5 or older. The tablet-based app (Sound Scouts) includes tests of speech in quiet, speech in noise and tones in noise, all embedded in game designed to maintain attention. Data were collected to intelligibility-equalize the stimuli, establish normative performance, and evaluate the sensitivity with which Sound Scouts detected known hearing problems and identified their type. Participants were children from age 5 to 14 (394 with normal hearing, 97 with previously identified hearing loss) and 50 adults with normal hearing. With pass-fail criteria set such that 98% of children with normal hearing passed Sound Scouts, 85% of children with hearing loss failed Sound Scouts (after exclusion of children in either group who received an inconclusive result or had incomplete results). No child with four-frequency average hearing thresholds of 30 dB HL or greater in their poorer ear passed Sound Scouts. Hearing loss type was correctly identified in only two-thirds of those cases where the algorithm attempted to identify a single type of loss. Sound Scouts has specificity and sensitivity sufficiently high to provide hearing screening around the time children typically enter school.
English language and language-free detection of spatial processing disorders in Aboriginal and Torres Strait Islander children
Publisher: Informa UK Limited
Date: 28-02-2020
The Design and Evaluation of a Hearing Aid with Trainable Amplification Parameters
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2007
Effect of variations in hearing-aid frequency response on real-life functional performance of children with severe or profound hearing loss
Publisher: Informa UK Limited
Date: 2008
DOI: 10.1080/14992020802116128
Abstract: This study examined the effect of variations in hearing-aid frequency response on real-life functional performance of children with severe to profound hearing loss. A cross-over design was used in a double-blind comparison of the NAL prescription with alternatives that produced either a BOOST or a CUT (6 dB/octave from 0.5 to 2 kHz), relative to the NAL response. The functional performance of 30 children (aged 7 months to 16 years) when wearing hearing aids adjusted to each response over two to four weeks was assessed by using parents' and teachers' observations (PEACH and TEACH scales). Intelligibility judgments and self-reports were also obtained from school-aged children. Results indicated that on average, variations in frequency response resulted in differences in functional performance in real life. There were significant correlations between PEACH and TEACH, and also between children's intelligibility judgments and subjective reports from children and their parents and teachers. The findings support the use of the NAL response for initial fitting, and the evaluation of children's lification needs by a systematic use of parents' and teachers' observations.
The effect of better-ear glimpsing on spatial release from masking
Publisher: Acoustical Society of America (ASA)
Date: 10-2013
DOI: 10.1121/1.4817930
Abstract: The current experiment investigated whether better-ear glimpsing can explain the spatial release achieved by normal-hearing adults when situations are high in informational masking. Both modeling and behavioral methods were used. The speech reception thresholds of 38 young adults were measured for co-located, spatially separated and two better-ear glimpsed conditions. In the better-ear glimpsed conditions the binaural signals were processed so that in each time-frequency segment, the signal with the better SNR (left or right ear) was presented diotically. To investigate the effect of widening auditory filters on better-ear glimpsing, adjacent frequency bands were combined in one of the better-ear glimpsing conditions. Twenty-two participants were tested with maskers high in informational masking, while 16 participants were tested with maskers lower in informational masking. The mean speech reception thresholds achieved in the glimpsed conditions were significantly worse than in the spatially separated condition. This suggests that better-ear glimpsing can explain some but not all of the observed spatial release from masking. The difference between performance in the spatially separated and glimpsed conditions was largest when informational masking was high, suggesting better-ear glimpsing may release energetic rather than informational masking. Reducing the number of frequency bands s led had a small effect on performance.
INDO-SPRITT: DEVELOPMENT AND NORMS OF AN INDONESIAN SPEECH RECOGNITION THRESHOLD TEST FOR CHILDREN
Publisher: Institute of Sensory Organs
Date: 29-12-2022
Abstract: Well-designed audiometric speech tests for Indonesian children are not currently available. This paper describes the development of the Indonesian Speech Recognition Threshold Test (INDO-SPRITT). A list of Indonesian words with response foils and pictures was developed. Presentation level was varied and the 50% recognition threshold was calculated as the average of the midpoints of each reversal. A normative reference was established using a s le of 118 normal hearing participants,16 children with severe to profound hearing loss, and 25 adults. The effects of age on speech reception thresholds and test reliability were also assessed. INDO-SPRITT material was found to be appropriate for children older than 4 years and 6 months. The speech reception threshold (SRT) improved on average from 18 dB HL for 4 to 5 year old children to 13 dB for children aged 10 to 13 years, providing a normative reference against which the SRT of children with unknown hearing status can be compared. Five reversals are enough to estimate the SRT. Suitable words, phonemic balance, and pictures have been created for Indonesian children. The reliability of different lengths of the test was similar, with 5 reversals being enough to estimate the SRT. The mean SRT decreased with age, but did not vary with the number of reversals.
Development of the Listening in Spatialized Noise-Sentences Test (LISN-S)
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2007
Atypical brain responses to illusory auditory pitch in children with autism
Publisher: SAGE Publications
Date: 07-2012
FreeHear: A New Sound-Field Speech-in-Babble Hearing Assessment Tool
Publisher: SAGE Publications
Date: 2019
Abstract: Pure-tone threshold audiometry is currently the standard test of hearing. However, in everyday life, we are more concerned with listening to speech of moderate loudness and, specifically, listening to a particular talker against a background of other talkers. FreeHear delivers strings of three spoken digits (0–9, not 7) against a background babble via three loudspeakers placed in front and to either side of a listener. FreeHear is designed as a rapid, quantitative initial assessment of hearing using an adaptive algorithm. It is designed especially for children and for testing listeners who are using hearing devices. In this first report on FreeHear, we present developmental considerations and protocols and results of testing 100 children (4–13 years old) and 23 adults (18–30 years old). Two of the six 4 year olds and 91% of all older children completed full testing. Speech reception threshold (SRT) for digits and noise colocated at 0° or separated by 90° both improved linearly across 4 to 12 years old by 6 to 7 dB, with a further 2 dB improvement for the adults. These data suggested full maturation at approximately 15 years old SRTs at 90° digits/noise separation were better by approximately 6 dB than SRTs colocated at 0°. This spatial release from masking did not change significantly across age. Test–retest reliability was similar for children and adults (standard deviation of 2.05–2.91 dB SRT), with a mean practice improvement of 0.04–0.98 dB. FreeHear shows promise as a clinical test for both children and adults. Further trials in people with hearing impairment are ongoing.
Age at intervention for permanent hearing loss and 5-year language outcomes
Publisher: American Academy of Pediatrics (AAP)
Date: 09-2017
Abstract: Universal newborn hearing screening has been implemented to detect permanent childhood hearing loss (PCHL) early, with the ultimate goal of improving outcomes through early treatment. However, there is disagreement between studies on the size of this benefit and in some cases whether it is significantly different from 0. There have been no studies of sufficient size in which researchers have determined reliably whether the effect varies with degree of PCHL. We aimed to explore how intervention timing influences 5-year language in children with PCHL. Via a prospective study of 350 children, we used standard multiple regression analyses to investigate the effect of age at intervention or hearing screening on language outcomes after allowing for the effects of nonverbal IQ, degree of PCHL, sex, birth weight, maternal education, additional disabilities, and communication mode. The benefit of early intervention for language development increased as hearing loss increased. Children whose lification started at age 24 months had poorer language than those whose lification started at 3 months. The difference was larger for 70-dB HL (−11.8 score points 95% confidence interval [95% CI]: −18.7 to −4.8) than for 50-dB HL (−6.8 95% CI: −10.8 to −2.8). Children who received cochlear implants at 24 months had poorer language than those implanted at 6 months (−21.4 95% CI: −33.8 to −9.0). There was no significant effect of screening on outcomes. Early intervention improves language outcomes, thereby lending support to streamlining clinical pathways to ensure early lification and cochlear implantation after diagnosis.
The Phoneme Identification Test for Assessment of Spectral and Temporal Discrimination Skills in Children: Development, Normative Data, and Test–Retest Reliability Studies
Publisher: Georg Thieme Verlag KG
Date: 02-2018
DOI: 10.3766/JAAA.16145
Abstract: Previous research suggests that a proportion of children experiencing reading and listening difficulties may have an underlying primary deficit in the way that the central auditory nervous system analyses the perceptually important, rapidly varying, formant frequency components of speech. The Phoneme Identification Test (PIT) was developed to investigate the ability of children to use spectro-temporal cues to perceptually categorize speech sounds based on their rapidly changing formant frequencies. The PIT uses an adaptive two-alternative forced-choice procedure whereby the participant identifies a synthesized consonant-vowel (CV) (/ba/ or /da/) syllable. CV syllables differed only in the second formant (F2) frequency along an 11-step continuum (between 0% and 100%—representing an ideal /ba/ and /da/, respectively). The CV syllables were presented in either quiet (PIT Q) or noise at a 0 dB signal-to-noise ratio (PIT N). Development of the PIT stimuli and test protocols, and collection of normative and test–retest reliability data. Twelve adults (aged 23 yr 10 mo to 50 yr 9 mo, mean 32 yr 5 mo) and 137 typically developing, primary-school children (aged 6 yr 0 mo to 12 yr 4 mo, mean 9 yr 3 mo). There were 73 males and 76 females. Data were collected using a touchscreen computer. Psychometric functions were automatically fit to in idual data by the PIT software. Performance was determined by the width of the continuum for which responses were neither clearly /ba/ nor /da/ (referred to as the uncertainty region [UR]). A shallower psychometric function slope reflected greater uncertainty. Age effects were determined based on raw scores. Z scores were calculated to account for the effect of age on performance. Outliers, and in idual data for which the confidence interval of the UR exceeded a maximum allowable value, were removed. Nonparametric tests were used as the data were skewed toward negative performance. Across participants, the median value of the F2 range that resulted in uncertain responses was 33% in quiet and 40% in noise. There was a significant effect of age on the width of this UR (p 0.00001) in both quiet and noise, with performance becoming adult like by age 9 on the PIT Q and age 10 on the PIT N. A skewed distribution toward negative performance occurred in both quiet (p = 0.01) and noise (p = 0.006). Median UR scores were significantly wider in noise than in quiet (T = 2041, p 0.0000001). Performance (z scores) across the two tests was significantly correlated (r = 0.36, p = 0.000009). Test–retest z scores were significantly correlated in both quiet and noise (r = 0.4 and 0.37, respectively, p 0.0001). The PIT normative data show that the ability to identify phonemes based on changes in formant transitions improves with age, and that some children in the general population have performance much worse than their age peers. In children, uncertainty increases when the stimuli are presented in noise. The test is suitable for use in planned studies in a clinical population.
The Parsing Syllable Envelopes Test for Assessment of Amplitude Modulation Discrimination Skills in Children: Development, Normative Data, and Test–Retest Reliability Studies
Publisher: Georg Thieme Verlag KG
Date: 02-2018
DOI: 10.3766/JAAA.16146
Abstract: Intensity peaks and valleys in the acoustic signal are salient cues to syllable structure, which is accepted to be a crucial early step in phonological processing. As such, the ability to detect low-rate (envelope) modulations in signal litude is essential to parse an incoming speech signal into smaller phonological units. The Parsing Syllable Envelopes (ParSE) test was developed to quantify the ability of children to recognize syllable boundaries using an litude modulation detection paradigm. The envelope of a 750-msec steady-state /a/ vowel is modulated into two or three pseudo-syllables using notches with modulation depths varying between 0% and 100% along an 11-step continuum. In an adaptive three-alternative forced-choice procedure, the participant identified whether one, two, or three pseudo-syllables were heard. Development of the ParSE stimuli and test protocols, and collection of normative and test–retest reliability data. Eleven adults (aged 23 yr 10 mo to 50 yr 9 mo, mean 32 yr 10 mo) and 134 typically developing, primary-school children (aged 6 yr 0 mo to 12 yr 4 mo, mean 9 yr 3 mo). There were 73 males and 72 females. Data were collected using a touchscreen computer. Psychometric functions (PFs) were automatically fit to in idual data by the ParSE software. Performance was related to the modulation depth at which syllables can be detected with 88% accuracy (referred to as the upper boundary of the uncertainty region [UBUR]). A shallower PF slope reflected a greater level of uncertainty. Age effects were determined based on raw scores. z Scores were calculated to account for the effect of age on performance. Outliers, and in idual data for which the confidence interval of the UBUR exceeded a maximum allowable value, were removed. Nonparametric tests were used as the data were skewed toward negative performance. Across participants, the performance criterion (UBUR) was met with a median modulation depth of 42%. The effect of age on the UBUR was significant (p 0.00001). The UBUR ranged from 50% modulation depth for 6-yr-olds to 25% for adults. Children aged 6–10 had significantly higher uncertainty region boundaries than adults. A skewed distribution toward negative performance occurred (p = 0.00007). There was no significant difference in performance on the ParSE between males and females (p = 0.60). Test–retest z scores were strongly correlated (r = 0.68, p 0.0000001). The ParSE normative data show that the ability to identify syllable boundaries based on changes in litude modulation improves with age, and that some children in the general population have performance much worse than their age peers. The test is suitable for use in planned studies in a clinical population.
Differences between speech-shaped test stimuli in analyzing systems and the effect on measured hearing aid gain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
The listening in spatialized noise-sentences test (LISN-S): test-retest reliability study
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/14992020601164170
Abstract: The objective of the study was to collect data on the Listening in Spatialized Noise - Sentences Test (LISN-S(R) Cameron & Dillon, 2006) from a group of children with normal hearing, over two test sessions, to determine test-retest reliability. The LISN-S produces a three-dimensional auditory environment under headphones, and is presented using a personal computer. Speech reception threshold (SRT) is determined for target sentences presented in competing speech that is manipulated in respect to location (0 degrees versus+/-90 degrees azimuth) and/or the vocal identity of the speaker/s of the stories (same as, or different to, the speaker of the target sentences). Forty-six children aged five to eleven years took part in the study. Mean changes in performance on retest on the LISN-S conditions and advantage measures ranged from 0.1 dB to 1.1 dB. Reliability (r) ranged from 0.3 to 0.8. All correlations were significant (p < 0.05). Across the range of performance measures, critical differences for test score improvements ranged from 2.5 dB to 4.4 dB, making this test suitable for detecting improvements in performance in an in idual child diagnosed with central auditory processing disorder following a period of auditory compensation (such as an FM system), or training.
Identification of conductive hearing loss using air conduction tests alone: Reliability and validity of an automatic test battery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2014
Correlating performance on the Listening in Spatialised Noise – Sentences test (LiSN-S) with the Listening in Spatialised Noise – Universal test (LiSN-U)
Publisher: Informa UK Limited
Date: 23-04-2020
Development and Evaluation of the Listening in Spatialized Noise Test
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2006
Sound quality comparisons of advanced hearing aids
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2003
Development of the North American Listening in Spatialized Noise–Sentences Test (NA LiSN-S): Sentence Equivalence, Normative Data, and Test–Retest Reliability Studies
Publisher: Georg Thieme Verlag KG
Date: 02-2009
DOI: 10.3766/JAAA.20.2.6
Abstract: Background: The Listening in Spatialized Noise–Sentences test (LiSN-S®) was originally developed in Australia to assess auditory stream segregation skills in children with suspected central auditory processing disorder (CAPD). The software produces a three-dimensional auditory environment under headphones. A simple repetition-response protocol is utilized to determine speech reception thresholds (SRTs) for sentences presented from 0 degrees azimuth in competing speech. The competing speech (looped children's stories) is manipulated with respect to its location (0 degrees vs. +90 degrees and −90 degrees azimuth) and the vocal quality of the speaker(s) (same as, or different to, the speaker of the target stimulus). Performance is measured as two SRT and three advantage measures. The advantage measures represent the benefit in dB gained when either talker, spatial, or both talker and spatial cues combined are incorporated in the maskers. Purpose: The objective of this research was to develop a version of the LiSN-S suitable for use in the United States and Canada. The original sentences and children's stories were reviewed for unfamiliar semantic items and rerecorded by native North American speakers. Research Design: In a descriptive design, a sentence equivalence study was conducted to determine the relative intelligibility of the rerecorded sentences and adjust the litude of the sentences for equal intelligibility. Normative data and test–retest reliability data were then collected. Study S le: Twenty-four children with normal hearing aged 8 years, 3 months, to 10 years, 0 months, took part in the sentence equivalence study. Seventy-two normal-hearing children aged 6 years, 2 months, to 11 years, 10 months, took part in the normative data study. Thirty-six children returned between two and three months after the initial assessment for retesting. Participants were recruited from sites in Cincinnati, Dallas, and Calgary. Results: The sentence equivalence study showed that post-adjustment, sentence intelligibility increased by 18.7 percent for each 1 dB increase in signal-to-noise ratio. Analysis of the normative data revealed no significant differences on any performance measure as a consequence of data collection site or gender. Inter- and intra-participant variation was minimal. A trend of improved performance as a function of increasing age was found across performance measures, and cutoff scores, calculated as two standard deviations below the mean, were adjusted for age. Test–retest differences were not significant on any measure of the North American (NA) LiSN-S (p ranging from .080 to .862). Mean test–retest differences on the various NA LiSN-S performance measures ranged from 0.1 dB to 0.6 dB. One-sided critical difference scores calculated from the retest data ranged from 3 to 3.9 dB. These scores, which take into account mean practice effects and day-to-day fluctuations in performance, can be used to determine whether a child has improved on the NA LiSN-S on retest. Conclusions: The NA LiSN-S is a potentially valuable tool for assessing auditory stream segregation skills in children. The availability of one-sided critical difference scores makes the NA LiSN-S useful for monitoring listening performance over time and determining the effects of maturation, compensation (such as an assistive listening device), or remediation.
Effect of audibility on spatial release from speech-on-speech masking
Publisher: Acoustical Society of America (ASA)
Date: 11-2015
DOI: 10.1121/1.4934732
Abstract: This study investigated to what extent spatial release from masking (SRM) deficits in hearing-impaired adults may be related to reduced audibility of the test stimuli. Sixteen adults with sensorineural hearing loss and 28 adults with normal hearing were assessed on the Listening in Spatialized Noise–Sentences test, which measures SRM using a symmetric speech-on-speech masking task. Stimuli for the hearing-impaired listeners were delivered using three lification levels (National Acoustic Laboratories - Revised Profound prescription (NAL-RP) +25%, and NAL-RP +50%), while stimuli for the normal-hearing group were filtered to achieve matched audibility. SRM increased as audibility increased for all participants. Thus, it is concluded that reduced audibility of stimuli may be a significant factor in hearing-impaired adults' reduced SRM even when hearing loss is compensated for with linear gain. However, the SRM achieved by the normal hearers with simulated audibility loss was still significantly greater than that achieved by hearing-impaired listeners, suggesting other factors besides audibility may still play a role.
Experimental Evaluation of Different Methods of Limiting the Maximum Output of Hearing Aids
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2006
The effect of different open plan and enclosed classroom acoustic conditions on speech perception in Kindergarten children
Publisher: Acoustical Society of America (ASA)
Date: 10-2015
DOI: 10.1121/1.4931903
Abstract: Open plan classrooms, where several classes are in the same room, have recently re-emerged in Australian primary schools. This paper explores how the acoustics of four Kindergarten classrooms [an enclosed classroom (25 children), double classroom (44 children), fully open plan triple classroom (91 children), and a semi-open plan K–6 “21st century learning space” (205 children)] affect speech perception. Twenty-two to 23 5–6-year-old children in each classroom participated in an online four-picture choice speech perception test while adjacent classes engaged in quiet versus noisy activities. The noise levels recorded during the test were higher the larger the classroom, except in the noisy condition for the K–6 classroom, possibly due to acoustic treatments. Linear mixed effects models revealed children's performance accuracy and speed decreased as noise level increased. Additionally, children's speech perception abilities decreased the further away they were seated from the loudspeaker in noise levels above 50 dBA. These results suggest that fully open plan classrooms are not appropriate learning environments for critical listening activities with young children due to their high intrusive noise levels which negatively affect speech perception. If open plan classrooms are desired, they need to be acoustically designed to be appropriate for critical listening activities.
Development and Evaluation of the LiSN & Learn Auditory Training Software for Deficit-Specific Remediation of Binaural Processing Deficits in Children: Preliminary Findings
Publisher: Georg Thieme Verlag KG
Date: 11-2011
DOI: 10.3766/JAAA.22.10.6
Abstract: Background: The LiSN & Learn auditory training software was developed specifically to improve binaural processing skills in children with suspected central auditory processing disorder who were diagnosed as having a spatial processing disorder (SPD). SPD is defined here as a condition whereby in iduals are deficient in their ability to use binaural cues to selectively attend to sounds arriving from one direction while simultaneously suppressing sounds arriving from another. As a result, children with SPD have difficulty understanding speech in noisy environments, such as in the classroom. Purpose: To develop and evaluate the LiSN & Learn auditory training software for children diagnosed with the Listening in Spatialized Noise—Sentences Test (LiSN-S) as having an SPD. The LiSN-S is an adaptive speech-in-noise test designed to differentially diagnose spatial and pitch-processing deficits in children with suspected central auditory processing disorder. Study S le: Participants were nine children (aged between 6 yr, 9 mo, and 11 yr, 4 mo) who performed outside normal limits on the LiSN-S. Research Design: In a pre–post study of treatment outcomes, participants trained on the LiSN & Learn for 15 min per day for 12 weeks. Participants acted as their own control. Participants were assessed on the LiSN-S, as well as tests of attention and memory and a self-report questionnaire of listening ability. Performance on all tasks was reassessed after 3 mo where no further training occurred. Intervention: The LiSN & Learn produces a three-dimensional auditory environment under headphones on the user's home computer. The child's task was to identify a word from a target sentence presented in background noise. A weighted up-down adaptive procedure was used to adjust the signal level of the target based on the participant's response. Results: On average, speech reception thresholds on the LiSN & Learn improved by 10 dB over the course of training. As hypothesized, there were significant improvements in posttraining performance on the LiSN-S conditions where the target and distracter stimuli are spatially separated and which specifically evaluate binaural processing ability (p ranging from .003 to .0001, η2 ranging from 0.694 to 0.873). In contrast, there was no improvement on the LiSN-S control conditions where the target and distracter stimuli emanate from the same direction (p ranging from .07 to .86, η2 ranging from 0.362 to 0.004). Significant improvements were found posttraining on measures of memory, on one measure of attention, and on self-reported ratings of listening ability. There were no significant differences between post- and 3 mo posttraining scores on any of the assessment tools. Conclusions: The initial LiSN & Learn study has shown that children as young as 6 yr of age are able to complete the training (although some coaxing was needed in a minority of cases). Both parents and children have reported benefits from the training, and feedback from the trial has resulted in extra features being added to the software. In order to further evaluate the efficacy of LiSN & Learn to remediate binaural processing deficits in children a clinical trial is currently under way utilizing a randomized blinded control group design.
Listening in Spatialized Noise—Sentences Test (LiSN-S): Normative and Retest Reliability Data for Adolescents and Adults up to 60 Years of Age
Publisher: Georg Thieme Verlag KG
Date: 11-2011
DOI: 10.3766/JAAA.22.10.7
Abstract: Background: The Australian version of the Listening in Spatialized Noise—Sentences Test (LiSN-S) was originally developed to assess auditory stream segregation skills in children aged 6 to 11 yr with suspected central auditory processing disorder. The LiSN-S creates a three-dimensional auditory environment under headphones. A simple repetition-response protocol is used to assess a listener's speech reception threshold (SRT) for target sentences presented in competing speech maskers. Performance is measured as the improvement in SRT in decibels gained when either pitch, spatial, or both pitch and spatial cues are incorporated in the maskers. Purpose: To collect additional normative data on the Australian LiSN-S for adolescents and adults up to 60 yr of age, to analyze the effects of age on LiSN-S performance, to examine retest reliability in the older population, and to extrapolate findings from the Australian data so that the North American version of the test can also be used clinically with older adults. Research Design: In a descriptive design, normative and test–retest reliability data were collected from adolescents and adults and combined with previously published data from Australian children aged 6 to 11 yr. Study S le: One hundred thirty-two participants with normal hearing aged 12 yr, 0 mo, to 60 yr, 7 mo, took part in the normative data study. Fifty-five participants returned between 2 and 4 mo after the initial assessment for retesting. Results: Analysis of variance revealed a significant effect of age on LiSN-S performance (p .01 for all LiSN-S measures, ηp 2 ranging from 0.16 to 0.54). On the low and high cue SRT measures, planned contrasts revealed significant differences between adults and children aged 13 yr and younger, as well as between 50- to 60-yr-olds and younger adults aged 18–29 yr. Whereas there were significant differences between adults and children on the talker, spatial, and total advantage measures, there were no significant differences in performance in adults aged 18–60 yr. There was a small but significant improvement on retest ranging from 0.5 to 1.2 dB across the four LiSN-S test conditions (p ranging from .01 to .001). However, there was no significant difference between test and retest on the advantage measures (p ranging from .143 to .768). Test–retest differences across all LiSN-S measures were significantly correlated (r ranging from 0.2 to 0.7, p ranging from .023 to .00000001) and did not differ as a function of age (p ranging from .178 to .980). Conclusions: As there was no significant difference among adults aged 18–60 yr on the LiSN-S talker, spatial, and total advantage measures, it appears that the decline in ability to understand speech in noise experienced by 50- to 60-yr-olds is not related to their ability to use either spatial or pitch cues. This result suggests that some other factor/s contributes to the decline in speech perception in noise experienced by older adults that is reported in the literature and was demonstrated in this study on the LiSN-S low and high cue SRT measures.
Outcomes of early- and late-identified children at 3 years of age: Findings from a prospective population-based study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2013
Related Organisations
University Of Manchester
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Harvey Dillon.