American Journal of Audiology最新文献

Purpose: This study aimed to identify individual factors associated with older adults' ability to manage commercially available over-the-counter (OTC) hearing aids (HAs).

Method: Participants completed an OTC HA skills assessment, scored on a 4-point Likert scale (3 = independent with no difficulty, 0 = unable to complete). Steps included downloading the application (app), inserting the HAs, and cleaning them with a brush. Scores were averaged to calculate an overall mean; higher scores indicated better OTC HA skills. Each independent variable was analyzed in separate linear regression models, and geometric mean ratios (GMRs) were calculated for significant factors. OTC HA skills were also examined dichotomously, with unsuccessful performance defined as any unresolved error.

Results: Eighty-two adults participated in the study, 66% (n = 54) of whom were new HA users. After adjusting for covariates, education remained a strong predictor of OTC HA skills: Individuals with less than a college degree demonstrated 45% lower performance compared to those with a master's degree or higher (GMR = 0.55, 95% confidence interval [0.34, 0.89]). Overall, 68% (n = 56) of participants were unsuccessful in completing the OTC HA assessment. The most challenging tasks across all participants were manually adjusting the volume, pairing the HAs with a smartphone, and replacing the wax guard. New HA users performed significantly worse than experienced users on the task of putting the HAs on, t(52) = -2.58, p = .013, with a moderate effect size (Cohen's d = -0.44).

Conclusions: Education emerged as a strong predictor of OTC HA skills, underscoring the need to address disparities in device usability. These findings highlight the importance of developing tailored devices and educational materials to support users with lower educational attainment. Such efforts may help promote more equitable access and prevent the exacerbation of existing hearing health disparities in the era of OTC HAs.

Supplemental material: https://doi.org/10.23641/asha.29847827.

Purpose: Numerous individuals in the United States are bothered enough by tinnitus that it affects normal daily activities, including sleep and concentration. There is a high prevalence of self-reported bothersome tinnitus in the U.S. military, and therefore, it is important to assess the impact of tinnitus on functional performance. The primary aim of this study was to examine the effects of tinnitus on a range of subjective, objective, auditory, and cognitive measures. A secondary aim was to determine which factors best predict whether individuals ever self-reported tinnitus. A prospective study was conducted to address the primary aim, and an exploratory machine learning approach was used to address the second.

Method: The study included 463 active duty U.S. Service members being seen for annual hearing surveillance. Participants completed several auditory and cognitive tests, along with questionnaires regarding tinnitus, depression, anxiety, and sleep difficulty.

Results: The primary aim found no significant performance differences on tasks of selective attention, short-term memory, or speech in noise between the tinnitus groups. However, there were significant group differences in extended high-frequency hearing. A machine learning algorithm was used to predict whether an individual self-reported experiencing tinnitus. The model had approximately 80% accuracy, excellent sensitivity, and modest specificity.

Conclusions: Study findings corroborated other evidence that extended high-frequency thresholds are poorer in those who reported ever experiencing tinnitus, regardless of tinnitus bother. Our results suggest that combining results from audiometric testing, high-frequency hearing, and subjective assessment of sleep achieved 80% accuracy in predicting tinnitus presence.

Purpose: This study aimed to explore the integrated digit-in-noise test (iDIN) as a tool for assessing speech recognition in noise among older hearing aid (HA) users, including those who cannot be tested using conventional sentence-in-noise tests.

Method: The study involved 81 older HA users with moderate-to-severe hearing loss. Participants underwent the iDIN, along with two sentence-in-noise tests (Mandarin Hearing in Noise Test [MHINT] and Mandarin Chinese Matrix Sentence Test [CMNmatrix]) and two working memory (WM) tests (reading span test and digit span test). Correlation analysis and hierarchical multiple regression were employed to relate iDIN outcomes to conventional sentence-in-noise test results.

Results: Among 56 participants who completed all tests, high correlations (ranging from .66 to .73) were observed between speech recognition thresholds (SRTs) measured using sentence-in-noise tests and SRTs measured with two-, three-, four-, and five-digit sequences on the iDIN. Reading span and two-digit SRT were significant predictors for SRTs measured using the CMNmatrix test. The two-digit SRT and the difference between five-digit and two-digit SRTs accounted for 57.9% and 61.3% of the variance in MHINT and CMNmatrix SRTs, respectively. When using 0.5 as the cutoffs for the two-digit SRT, among the 81 participants, the two-digit SRT (sensitivity: 0.818; specificity: 0.895) effectively differentiated those who could successfully complete sentence-in-noise tests.

Conclusions: The findings highlight the potential of the iDIN as a simple, quick, and reliable tool for measuring speech recognition that correlates well with performance on conventional sentence-in-noise tests and for those who could not be tested using these conventional measures. While results on short digit sequences primarily reflect auditory function, longer digit sequences involve the contribution of WM function, providing additional information regarding an individual's ability to understand speech in noise.

Purpose: The aim of the study was to investigate genotype-phenotype correlations in Usher syndrome (USH).

Method: Thirty-five USH patients were included, categorized into three genetic-based groups: USH1 (n = 11), USH2 (n = 22), and USH4 (n = 2). The functional and emotional impact of dizziness and equilibrium was assessed using the Dizziness Handicap Inventory (DHI), the Hospital Anxiety and Depression Scale (HADS), and the Activities-Specific Balance Confidence (ABC) Scale. Participants underwent pure-tone threshold testing, bithermal caloric testing, rotary chair testing (RCT), video head impulse test (vHIT), ocular (oVEMP) and cervical (cVEMP) vestibular evoked myogenic potentials, and posturography. Genotype-phenotype associations were analyzed.

Results: Total DHI could only distinguish USH1 (25.71 ± 21.04) from USH2 (50.13 ± 22.54, p = .024) but not between the three groups (p = .084). ABC and HADS could not also distinguish between the three USH subgroups (p = .286 and .180). Hearing loss in USH1 was significantly greater than in USH2 and USH4 (p < .001). USH1 showed greater caloric weakness than USH2 and USH4 (p < .004). RCT was not completed in USH4 but could distinguish between USH1 and USH2 (sinus 0.16 Hz, p = .033; sinus 0.32 Hz, p = .011; and sinus 0.64 Hz, p = .003). vHIT in USH1 demonstrated lower overall gain than in USH2 and USH4 (p < .001). USH1 showed higher number of absent cVEMP responses in the right and/or left ear when compared to USH2/USH4 (p < .001). USH1 showed a higher number of absent oVEMP responses in the right and/or left ear when compared to USH2 and USH4 (right ear, p < .007; left ear, p < .023). In posturography, no relevant differences were found between the three USH groups.

Conclusions: Contemporary hearing and vestibular assessment successfully differentiated between distinct USH groups. However, varying degrees of vestibular dysfunction were observed across all groups.

Purpose: The Connected Speech Test (CST) assesses an individual's ability to understand everyday contextualized running speech amidst competing background babble. To minimize accent effects on speech perception scores and reduce the noise floor of the original recordings, an updated version was developed by Saleh et al. (2020). The updated recordings feature a speaker with a General American accent to replace the Southern U.S. accent in the original test, and modern recording equipment was used to achieve a lower noise floor. The aim of this study was to collect normative data, characterizing performance on the updated CST. Self-reported speech intelligibility and listening effort ratings were collected to examine how subjective perceptions of the task vary across test conditions.

Method: To evaluate normative performance on this updated test, 40 native English-speaking adults (36 females and four males) with normal hearing were recruited from The University of Western Ontario. Multitalker babble was presented at a fixed level, and speech was presented at fixed signal-to-babble ratios (SBRs) to participants in both co-located and separated loudspeaker conditions. At each SBR, participants were scored based on key words correctly identified. Subjective speech intelligibility and listening effort were evaluated using self-report scales. For each measure, data were fitted with transfer functions to characterize performance on the task.

Results: Participants demonstrated significantly better performance in the separated loudspeaker condition, indicating a spatial release from masking. For both conditions, increased SBR was associated with increased performance and subjective speech intelligibility, and decreased listening effort.

Conclusion: The study provides normative data to characterize expected performance for the updated version of the CST.

Purpose: The aim of this study was to describe psychological inflexibility for hearing difficulty for a sample of adults seeking hearing help and explore associations with demographic and audiological characteristics.

Method: Archival data from 226 clinical electronic medical records at one university clinic were analyzed for this retrospective exploratory study. Audiometric test findings and results from the Acceptance and Action Questionnaire-Adult Hearing Loss (AAQ-AHL) were extracted for adult patients seen between June 1, 2022, and February 29, 2024.

Results: The majority had a bilateral hearing loss (64%), 10% had a unilateral hearing loss, and 26% had bilateral pure-tone averages better than 25 dB HL. The AAQ-AHL total scores ranged from 0 to 51, and 8% had a high likelihood of distress from internal struggles related to their difficulty hearing. On individual items, up to one third of the sample expressed internal challenges. The AAQ-AHL total scores were moderately correlated with word recognition in noise, weakly correlated with better ear pure-tone average and word recognition in quiet, and were not correlated with age.

Conclusions: The current study adds to the previous research describing psychosocial challenges that can be experienced by people with hearing difficulties. Our research demonstrates that psychological inflexibility for hearing loss can be experienced by individuals of all ages and hearing status. Based on the present findings, we recommend that audiologists intentionally assess for psychosocial challenges for people seeking hearing help.

Purpose: Audiologists play an essential role in hearing health care. It has been predicted that the supply of audiologists may fail to meet future market demand. One way to improve the number of available audiologists is to improve retention. The purpose of this study was an exploration of audiologist attrition as a first step toward creating strategies to improve retention.

Method: A survey completed by 47 former audiologists included questions about demographics, why participants entered and exited the audiology profession, and job satisfaction.

Results: Participants cited lack of reward as the most common reason for leaving the profession. About a third disliked the for-profit hearing aid dispensing aspect of the profession, and a few would return to the profession for an audiology job that did not involve hearing aid dispensing. About a quarter left audiology to pursue other opportunities (e.g., selling a private practice), and about a quarter reported poor psychosocial work environment.

Conclusion: Findings highlight the need for national efforts focused on (a) improving audiology awareness so students have a greater understanding of audiology as they are exploring career choices, (b) advocating for improved compensation overall and compensation models that de-emphasize sales-based financial incentives, and (c) creating strategies to help improve audiologists' work environment and opportunities for leadership roles.

Supplemental material: https://doi.org/10.23641/asha.28599341.

Purpose: The majority of college-level musicians exceed the daily recommended noise dose level during instrumental practices and performances, although less than one third report wearing hearing protection while playing their instruments. Although the hazardous effects of music on the auditory system have been established, even in young adult musicians still early in their musical careers, the effects of music on the vestibular system are still unclear. The purpose of the present study was to examine vestibular/balance differences between young adult musicians and nonmusicians to determine the effects of music exposure on the vestibular system.

Method: Young adult participants aged 18-27 years without any history of hearing loss, vestibular/balance disorder, otologic disorder, or nervous system disorder were included in this study. Participants were divided into musician (n = 19) and nonmusician (n = 18) groups. Vestibular function was assessed and compared via the cervical vestibular evoked myogenic potential (cVEMP), ocular vestibular evoked myogenic potential (oVEMP), video head impulse test (vHIT), and modified clinical test of sensory interaction in balance (mCTSIB).

Results: Musicians were found to produce significantly more saccades in the left horizontal semicircular canal during vHIT assessment compared to nonmusicians. Group differences were not found in the cVEMP, oVEMP, or mCTSIB.

Conclusions: This study shows the effects of music exposure on the vestibular system in young adult musicians who show early-onset, subclinical findings on the vHIT that could develop into abnormal results on vestibular assessments if hearing protection use is not increased.

Purpose: The effectiveness of a dedicated bimodal hearing aid and fitting formula was investigated in pediatric cochlear implant recipients who were experienced Desired Sensation Level (DSL) v5.0 users.

Method: In Experiment 1, five children assessed four hearing aid fittings based on combinations of fitting formula (Adaptive Phonak Digital Bimodal [APDB], DSL v5.0, APDB fit to DSL v5.0 targets), hearing aid type (dedicated hearing aid for bimodal listeners, independent hearing aid), and/or prescriptive targets. Speech recognition scores were obtained in a sound booth in quiet and in noise. In Experiment 2, two participants from Experiment 1 were retested with an updated bimodal system.

Results: Bimodal speech recognition in quiet in both experiments was similar across all fitting formulas. In Experiment 1, bimodal speech recognition in noise was similar across fitting formulas; however, both in noise and in quiet, individual differences were observed. In Experiment 2, optimized APDB improved speech recognition in noise performance compared to APDB and similar performance compared to DSL v5.0 in a small set of bimodal listeners.

Conclusion: Preliminary results point to the value of individualized selection of hearing aid fitting formula settings for pediatric bimodal recipients.

Purpose: This scoping review aimed to identify behavioral tests for central auditory processing (CAP) assessment that can be used to investigate early manifestations of pathological cognitive decline in adults and the older adults. Early detection of cognitive decline and dementias is a strategy for delaying the progression of these clinical conditions.

Method: This scoping review was conducted using various online databases and gray literature sources, including the Latin American and Caribbean Literature in Health Sciences, PubMed/Medline, Scopus, Web of Science, Google Scholar, and ProQuest Dissertations & Theses. Studies were included if they assessed individuals who underwent behavioral tests for CAP evaluation and had completed at least one cognitive test.

Results: A total of 1,190 references were retrieved from the databases, with 151 identified as duplicates. After screening 1,039 articles by title and abstract, eight studies were selected for full-text review, and five were included in the final synthesis. The behavioral tests for CAP evaluation used to investigate preclinical manifestations of cognitive decline and dementia were: Synthetic Sentence Identification With Ipsilateral Competing Message, Staggered Spondaic Word test, Dichotic Sentence Identification, and Dichotic Digits Test. Among these, dichotic tests were identified as having the strongest association with cognitive decline, probable Alzheimer's disease, or dementia.

Conclusions: The findings indicate that dichotic tests are the most frequently utilized behavioral tests for CAP evaluation and serve as valuable tools for detecting early manifestations of cognitive decline and dementias. These tests could play a significant role in the early diagnosis and management of cognitive impairments.