American Journal of Audiology最新文献

Purpose: Hyperacusis (sound sensitivity) is well documented among adults, but little is known about hyperacusis in children. Here, we assess relationships among the presence of hyperacusis, audiometric profiles, and nonauditory factors in a pediatric clinical population.

Method: A retrospective review of clinical records from 329 children, ages 2-17 years, was performed to assess the prevalence of hyperacusis and correlations among hearing status, behavioral or communication concerns, and the presence of hyperacusis.

Results: In 329 study participants, 18% reported hyperacusis (58% male and 42% female). No significant sex or age differences were found. Hyperacusis was more likely to occur alongside normal hearing or with unilateral hearing loss relative to bilateral hearing loss. Among children with hyperacusis, there was a high prevalence of audiovestibular problems, mental health concerns, speech and language delays, difficulty in school, and behavioral problems. Tinnitus was also found to be comorbid with hyperacusis, but the comorbidity was less than that reported in adults.

Conclusions: This study identified common hearing profiles and critical comorbidities in a large clinical cohort of children with hyperacusis. These results demonstrate the urgent need for standardized multidisciplinary assessment and treatment protocols for pediatric hyperacusis.

Purpose: This systematic review examines the role of augmented reality (AR) and virtual reality (VR) in enhancing communication for individuals who are hard of hearing.

Method: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a comprehensive search across databases including PubMed, WoS, EMBASE, and IEEE. Of the 5,981 records initially identified, 22 studies met our inclusion criteria after screening. Most of these studies (68%) focused on nonverbal communication modalities using tools such as sign language and visual cues, while the remainder focused on verbal communication. A descriptive synthesis was used due to the expected diversity in study characteristics.

Results: Our assessment showed a substantial emphasis on educational impacts, speech perception, and cognitive skills development through AR and VR. The reviewed articles provide preliminary evidence on the efficacy of these technologies in teaching sign language, enhancing cognitive skills such as reasoning, and improving speech perception among the deaf or hard of hearing individuals.

Conclusion: This review underscores the transformative potential of AR and VR in addressing communication challenges faced by individuals who are hard of hearing, emphasizing the need for further research with diverse, larger sample sizes to investigate these technologies for broader communication support.

Purpose: Telepractice is a growing service model that delivers aural rehabilitation to deaf and hard-of hearing children via telecommunications technology. Despite known benefits of telepractice, this delivery approach may increase patients' listening effort (LE) characterized as an allocation of cognitive resources toward an auditory task. The study tested techniques for collecting physiological measures of LE in normal-hearing (NH) children during remote (referred to as tele-) and in-person communication using the wearable Empatica E4 wristband.

Method: Participants were 10 children (age range: 9-12 years old) who came to two tele- and two in-person weekly sessions, order counterbalanced. During each session, the children heard a short passage read by the clinical provider, completed an auditory passage comprehension task, and self-rated their effort as a part of the larger study. Measures of electrodermal activity and blood volume pulse amplitude were collected from the child E4 wristband.

Results: No differences in child subjective, physiological measures of LE or passage comprehension scores were found between in-person sessions and telesessions. However, an effect of treatment duration on subjective and physiological measures of LE was identified. Children self-reported a significant increase in LE over time. However, their physiological measures demonstrated a trend indicating a decrease in LE. A significant association between subjective measures and the passage comprehension task was found suggesting that those children who reported more effort demonstrated a higher proportion of correct responses.

Conclusions: The study demonstrated the feasibility of collection of physiological measures of LE in NH children during remote and in-person communication using the E4 wristband. The results suggest that measures of LE are multidimensional and may reflect different sources of, or cognitive responses to, increased listening demand.

Supplemental material: https://doi.org/10.23641/asha.27122064.

Purpose: Children and young adults diagnosed with autism spectrum disorder (ASD) often report and exhibit significant auditory processing difficulties, particularly in background noise. This study extends our previous work by examining the potential benefits of a 12-week auditory processing training (APT) program designed to address the auditory processing difficulties in individuals with ASD via auditory training and the use of remote-microphone technology. Effect sizes of training benefits also were calculated, and principal component analysis (PCA) was used to consolidate performance across various tests into fewer meaningful constructs related to auditory processing in this population.

Method: Twenty-eight children and young adults with ASD participated in a 12-week APT program that included one-on-one speech-in-noise training, computerized dichotic training, and use of remote-microphone technology at home and at school. Before and after training, each participant completed tests of speech recognition in noise, spatial processing, binaural integration, and general auditory processing skills.

Results: Significant performance improvements and medium-to-large effect sizes were found across most test measures after the participants completed the APT program and when using the remote-microphone system. PCA identified strong relationships among all test measures as well as documented the relationships between behavioral performance, training duration, and training improvements.

Conclusions: The APT program significantly improved spatial processing, binaural integration, phonological processing, auditory memory, auditory cohesion, and speech recognition in noise in individuals with ASD when the remote-microphone system was used. PCA analysis of pre- and posttraining data showed a strong relationship among all test measures, suggesting an abbreviated auditory processing test battery may be feasible for individuals with ASD. Training duration (minutes) and training improvements were associated with performance outcomes measured by the test battery.

Purpose: The aim of this study was to describe the audiological test results from a sample of 60 adults with self-reported misophonia.

Method: Audiological testing was completed prior to participant randomization in a controlled trial for misophonia treatment. Participants completed the Inventory of Hyperacusis Symptoms Survey (IHS), the Tinnitus and Hearing Survey (THS), the Misophonia Questionnaire (MQ), and behavioral and objective audiometric measures.

Results: Hearing thresholds were less than 25 dBHL for 97% of the participants. Loudness discomfort levels for tonal stimuli suggested hyperacusis in 25% of the sample. Total scores on the IHS indicated that 12% met the clinical cutoff for hyperacusis, and, on the THS, 27% experienced problems with tinnitus, 77% experienced problems with hearing, and 53% experienced problems with sound tolerance. On the MQ, 37% indicated mild levels of misophonia and 58% indicated moderate levels. For speech-in-noise testing, a mild signal-to-noise ratio loss was present for 15% of participants. Most of the participants had present distortion product otoacoustic emissions (DPOAEs).

Conclusions: Audiological data on individuals with misophonia are lacking. In this article, we present results from audiological testing on 60 adults with self-reported misophonia. Most had normal peripheral hearing sensitivity based on pure-tone audiometry and DPOAE measures; some had difficulties with sound sensitivities and understanding speech-in-noise, self-report indicated problems with hyperacusis, tinnitus, and hearing difficulty.

Purpose: This scoping review aims to map the effects of dosage levels, dosage intervals, duration of exposure, and serum concentration levels of gentamicin, amikacin, vancomycin, furosemide, and bumetanide on newborn hearing.

Method: Using PubMed, Scopus, and Ovid databases (January 2010-2022), a scoping review was conducted to identify studies on ototoxic drug exposure in neonates. The review included articles that described details on ototoxic drug exposure and hearing status, dosage levels, duration of exposure, and serum concentration levels. The search results were summarized using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Results: Out of 4,395 entries, 28 were selected for inclusion in the scoping review. The studies were separated according to the exposed drugs: gentamicin, amikacin, vancomycin, furosemide, bumetanide, and a combination of drugs. Four out of five studies on amikacin exposure revealed an increased association with ototoxicity and abnormal trough levels. Six of seven studies on gentamicin exposure reported elevated trough concentration levels in a small number of infants, but no studies reported hearing loss. Two out of four studies on vancomycin exposure reported a dose-dependent risk for infants to develop hearing loss.

Conclusions: Gentamicin exposure in neonates has been extensively studied and considered relatively safe, except in cases of elevated peak or trough concentration levels. Amikacin exposure was reported to be more ototoxic, as the elevation of trough concentration levels was associated with refer results in hearing. Loop-diuretic exposure demonstrated a significant ototoxic effect. When used with other ototoxic medications, vancomycin is said to have a greater effect on ototoxicity.

Supplemental material: https://doi.org/10.23641/asha.26814700.

Purpose: While general practice parameter recommendations for children with unilateral hearing loss or single-sided deafness (SSD) have been published, clinically utilized subjective instruments specifically designed to assess this population are scarce. Treatment options are evaluated using audiometric data, speech perception data, and quality of life instruments. The Unilateral Hearing Loss in Youth (uniHELO) is a subjective assessment instrument that aims to evaluate the listening challenges in this population, but it has not yet been studied in a clinical setting. This study examined the reliability of the uniHELO among children with SSD.

Method: This was a prospective within-subject study. Nine patients with SSD, aged 8-14 years, were enrolled. Participants had not used a personal hearing device for at least 6 months prior to enrollment. The uniHELO instrument was administered at two clinic visits separated by 3-4 weeks. For comparison, the Pediatric and Parent Speech, Spatial, and Qualities of Hearing Scale (SSQ) instruments were administered during the same visits.

Results: uniHELO scores were not significantly different between the first and second visits. The correlations of scale scores over time were: .96 for the uniHELO, which suggests excellent test-retest reliability; .84 for the Parent SSQ, which also suggests excellent test-retest reliability; and .27 for the Pediatric SSQ, which suggests poor test-retest reliability compared to the Parent SSQ and uniHELO.

Conclusions: Within-subject scale uniHELO scores between clinic visits showed excellent test-retest reliability across items. The test-retest reliability scores for the uniHELO were also stronger than those for the Parent and Pediatric SSQ. These data support the use of the uniHELO to evaluate listening challenges in children with SSD.

Purpose: The aim of the study was to evaluate whether behavioral speech-in-noise (SiN) benefits of hearing aid directivity based on multistream architecture (MSA) might result in reduced electroencephalographic activity in the alpha-band, as is often associated with task difficulty.

Method: A single-blind within-subject design was used in this study. Thirteen older adults (M_age = 73.5 years, range: 62-82 years, six women) with sensorineural hearing loss participated in the study. Participants wearing study hearing aids first performed an adaptive sentence-level SiN test in an MSA-enabled condition (i.e., MSA-ON) to determine the signal-to-noise ratios (SNRs) corresponding to speech reception thresholds for 50% correct performance (i.e., SRT-50s). Participants were then tested at their individualized SNRs with target sentences alternating on each trial between two loudspeakers positioned in the front at 0° and -30° azimuth, such as to simulate turn-taking between two talkers seated across from the listener. Electroencephalographic activity was recorded as participants performed this SiN test in two hearing aid conditions: MSA-OFF and MSA-ON.

Results: Neural oscillations in the alpha-band were significantly reduced over centroparietal electrode sites when listeners performed SiN testing in MSA-ON versus MSA-OFF conditions. Alpha-band power was also observed to increase significantly over the course of 60 test trials, possibly indicative of listener fatigue. Reductions in alpha-band power were not significantly related to likewise improvements in SiN performance.

Conclusions: Hearing aid directivity based on the MSA algorithm resulted in significantly lower neural activity associated with listening task difficulty in a simulated multitalker situation. Although these results align with the behavioral SiN improvements associated with MSA, magnitudes of change in alpha-band power did not correlate with the degree of behavioral benefit at the level of individual listeners. Measuring neural oscillations in the alpha-band might be useful for evaluating and gaining greater insight into the impact of hearing aid processing on listening effort in challenging acoustic environments.

Objective: Phone- and tablet-based hearing testing systems are now widely available. Here, we evaluated one such system from TympaHealth by comparing air conduction thresholds and resultant hearing aid targets and output, measured with the TympaHealth system with those measured using standard audiometry.

Design: The hearing thresholds of 35 adults were measured using standard audiometry and the TympaHealth system. Each set of thresholds was used to generate NAL-NL2 targets and program a hearing aid. The data from each system were compared.

Results: Bland-Altman analyses showed overall mean differences between thresholds measured with each system to be small, with 85% of TympaHealth thresholds being within ±5 dB of the standard audiometric thresholds, although TympaHealth thresholds were higher (poorer) than the standard audiometric thresholds. The hearing aid targets and gains generated from the standard audiometric thresholds were lower (less amplification) than those generated from the TympaHealth thresholds but again, mean differences at each frequency were small and likely imperceptible.

Conclusion: These findings support the possibility that valid hearing testing can take place outside of a clinical booth using portable systems like that from TympaHealth, opening up the possibility of testing hearing and fitting hearing aids through pharmacies, opticians, and in care homes.