American Journal of Audiology最新文献

Purpose: The main objective of this study was to examine the effect of a classifier-based noise management algorithm (AutoSense Sky OS 3.0) on speech perception in noise in pediatric cochlear implant (CI) recipients and to compare the speech perception outcomes with typically hearing peers.

Method: This prospective observational study included nine children (ages 9-15 years) with bilateral CIs and nine age-matched, typically hearing peers. Speech perception outcomes were measured in noise using Pediatric AzBio sentences to compare performance in the omnidirectional microphone mode with the classifier-based automatic noise management mode at four signal-to-noise ratios. Ratings of listening ease and speech clarity were recorded to obtain subjective measures of benefit. Results from the bilateral CI recipients were compared to a group of typically hearing children. Paired t tests were used to evaluate outcomes.

Results: Classifier-based noise management improved speech perception in noise compared to listening in the omnidirectional microphone mode. CI group averages revealed a 21.4 percentage point and 47.1 percentage point improvement in speech perception when using the Sky OS 3.0 algorithm at 0 and -5 dB SNR, respectively. Listening ease and speech clarity were improved when using the classifier-based noise management algorithm.

Conclusions: Pediatric CI recipients can benefit from classifier-based noise management. Given the difficult listening environments children face, especially in typical classroom settings while listening for learning, audiologists should consider activating classifier-based noise management in this population.

Purpose: Digital and remote technologies are commonly used in audiology, which require digital literacy skills. The study objectives were to (a) assess digital literacy in adults with hearing loss attending an audiology clinic in Australia and (b) establish the relationship of digital literacy with demographic factors.

Method: A single-center, cross-sectional survey on self-report of skill and confidence with mobile technologies using two measures (a) the validated Mobile Device Proficiency Questionnaire-16 items (MDPQ-16), and (b) the short two-item Digital Literacy-2Q (DL-2Q) for clinical use asking about Mobile Skill and Mobile Confidence. The study sample was adults with primarily mild-moderate hearing loss (n = 110), aged 52-96 years (M = 73.9).

Results: Age was negatively associated with MDPQ-16 scores, r(108) = -0.454, p < .001. However, in the mid-age range 65-85 years, more than twice as many participants (69.7%) had good mobile proficiency compared to those who had poorer mobile proficiency (30.3%). For the DL-2Q, the 92% who rated themselves as competent, and the 58.3% and 41.0% who rated themselves as confident or depends on task, respectively, had good MDPQ-16 scores. However, in 25% there was a mismatch between ratings of competent and confident. No other demographic factors were significantly associated with digital literacy.

Conclusions: Although age overall was a factor in digital literacy, there were many older adults attending audiology appointments who were shown to have good digital literacy, irrespective of their age. The DL-2Q is a quick and easy measure to assess digital literacy in audiology clinics. This can help to ensure that age is not barrier to remote hearing health technologies, which should be accessible to all those who would benefit.

Supplemental material: https://doi.org/10.23641/asha.30853604.

Purpose: Our study aimed to compare the new M&RIE (Microphone & Receiver-In-Ear) hearing aid directionality technology with the traditional omnidirectional mode in terms of speech intelligibility (SI) skills in noise.

Method: Twenty-four participants (12 women and 12 men) with bilateral symmetrical sensorineural hearing loss and no hearing aid experience, aged 28-65 years, were included in our study. Audiologic evaluations were performed, and eligible participants were fitted with hearing aids set to M&RIE and omnidirectional modes. Free-field hearing assessments and Turkish Matrix Tests under different signal/noise conditions were conducted.

Results: Significant differences were found between M&RIE and omnidirectional mode for both speech reception threshold and SI in noise when the signal was from the front and noise from the back (p < .01), as well as for SI when both signal and noise were presented from the front (p < .01).

Conclusions: In our study, M&RIE outperformed the omnidirectional mode in speech understanding tests under quiet and different noise conditions. Since placing the microphone in the ear canal is the most natural place for sound collection, M&RIE could potentially benefit any hearing aid user within the gain range of the device.

Purpose: Audiologic assessment is crucial for managing hearing loss across the lifespan. Routine evaluations typically include pure-tone audiometry and word recognition in quiet (WRQ), the clinical standard for over 60 years. More recently, speech-in-noise tests such as the Quick Speech-in-Noise Test (QuickSIN) have been adopted. This study investigated the effects of age, sex, and hearing sensitivity on WRQ and QuickSIN performance in a large clinical cohort.

Method: Data from 9,042 patients (17,414 ears; aged 18-90 years) who underwent audiometric assessment at the Stanford Ear Institute were analyzed. All completed pure-tone audiometry, WRQ, and monaural QuickSIN. Analyses focused on individuals with hearing loss (9,373 ears) and those with normal hearing (4,277 ears), using stepwise linear regression. In a subset of normal-hearing individuals (1,095 ears), perceived auditory disability was also assessed using the 12-item Speech, Spatial, and Qualities of Hearing Scale (SSQ12).

Results: In the hearing-loss cohort, high-frequency pure-tone average (HFPTA) predicted both WRQ and QuickSIN performance. Sex also contributed, with females performing better on QuickSIN but worse on WRQ. After adjusting for HFPTA and sex, age affected QuickSIN but not WRQ. In the normal-hearing group, hearing sensitivity had no effect on WRQ, but thresholds at 2000 and 4000 Hz influenced QuickSIN. Sex predicted QuickSIN performance, with males performing better. After accounting for thresholds, age was associated with both WRQ and QuickSIN. QuickSIN, but not WRQ, predicted perceived auditory disability on the SSQ12.

Conclusions: After accounting for hearing sensitivity, age showed minimal effects on speech performance in normal-hearing and hearing-loss groups, explaining less than 1% of WRQ variance and < 0.5 dB on QuickSIN. These findings suggest age has limited impact on speech recognition once hearing thresholds are considered. Small but consistent sex effects aligned with prior work. For WRQ, ceiling effects may mask age-related changes, while for QuickSIN, the small effect may be driven by additional peripheral or central auditory factors.

Purpose: The aim of this scoping review was to examine key elements of school-based hearing conservation programs (HCPs) for children and adolescents, with a focus on intervention program components, delivery strategies, outcome measures, and reported results. This review serves as a preliminary step in developing an HCP for children and adolescents.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, four bibliographic databases were searched to identify relevant articles. After screening titles, abstracts, and full texts against the eligibility criteria, seven studies were included in the review.

Results: The included studies addressed a range of themes, several of which were informed by health behavior theories. Most interventions were conducted in classroom settings by members of the research team. These interventions typically comprised one or two sessions of less than 60 min, using various delivery methods. Outcomes were assessed primarily through questionnaires, with study designs commonly following a pretest-intervention-posttest format; some studies also incorporated short-term follow-up assessments. Findings revealed that older students showed more resistance to behavior change.

Conclusions: Program effectiveness was strongly associated with multiple, repeated intervention sessions; various delivery modalities; and long-term follow-up. Moreover, early intervention is particularly important, as younger children demonstrate better long-term retention than adolescents.

Purpose: Cognitive decline may affect how older listeners tolerate noise. Our purpose was to determine which cognitive variables are associated with older adults' acceptance of background noise, as measured by the acceptable noise level (ANL).

Method: Fifteen adults with hearing within normal limits, aged 50-72 years, were administered the following tests: the ANL, the digit span and letter-number sequencing subtests of the Wechsler Adult Intelligence Scale-Fourth Edition, the auditory attention subtest from the Woodcock-Johnson Tests of Cognitive Abilities, the Hearing in Noise Test (HINT), and the operation span test. We then compared data from the older adults with an earlier data set obtained from younger adults with normal hearing, aged 20-29 years.

Results: Older adults had significantly larger ANL values (were less tolerant of noise) than younger adults, and older adults scored significantly lower on auditory attention than the younger adults. There was no significant relation between scores on the HINT test and the ANL scores.

Conclusions: Older adults' reduced attention control may make them less tolerant of noise than younger adults. Older adults who are not yet hearing aid candidates may still be more adversely affected by noise and may benefit from auditory rehabilitation-related tools to address noise.

Purpose: Telemedicine can increase access to services, reduce wait time, and decrease patient travel. The COVID-19 pandemic revolutionized telemedicine with the rapid removal of barriers that have historically challenged the implementation and adoption of telemedicine. Yet, despite this evidence, telemedicine utilization is declining postpandemic, and barriers have been reinstated, such as lack of payment parity and more stringent regulation. Alaska is dependent on telemedicine services to provide care with the majority of the state's population living in remote communities. Innovation in the early 2000s resulted in a cutting-edge customized telemedicine solution that created a network of specialty care access across the Tribal Health System in Alaska and was one of the largest telemedicine programs in the world. A shift in focus away from telemedicine to electronic health records stalled innovation, and reduced investment in funding, equipment, and research. This created a lack of clarity around system integration and functionality that eroded the utilization and effectiveness of telemedicine solutions. Today, there is much we can learn from renewed research efforts in innovative applications of telemedicine that can be used to inform policymakers and drive adoption.

Conclusions: If hearing health care professionals are to address the public health crisis of a lack of access to care for the majority of the one in five individuals with hearing loss today, technology solutions such as telemedicine will need to be leveraged. This will require provider training and education; implementation of integrated telemedicine services; continued generation of evidence; and advocacy for regulatory, reimbursement, and payment reform.

Purpose: This study investigated the effects of a soft speech enhancement algorithm on distant speech perception for adults with severe-to-profound hearing loss (SPHL), examining speech intelligibility, listening effort, and sound quality.

Method: Participants were 16 Mandarin-speaking adults (13 men, 3 women; M_age = 58 years) with symmetrical severe-to-profound sensorineural hearing loss. They had at least 1 year of hearing aid experience. A within-subject experimental design compared two hearing aid conditions: with the Speech Enhancer algorithm activated and deactivated. Speech intelligibility was assessed using the Mandarin Chinese matrix sentence test at individual speech reception thresholds. Subjective listening effort was measured using a categorical rating scale for speech presented at three distances (2, 4, and 8 m). Sound quality ratings were collected for loudness, speech understanding, and overall impression using a visual analog scale.

Results: Activation of the speech enhancement algorithm led to a notable increase in speech intelligibility from 45% to 67%. Subjective listening effort decreased significantly with the algorithm activated at all distances, with greater benefits observed at farther distances. Similarly, sound quality ratings were significantly higher with the algorithm on for all attributes across all distances, with the largest improvements in overall impression ratings at greater distances.

Conclusions: The soft speech enhancement algorithm significantly improved speech intelligibility, reduced listening effort, and enhanced sound quality for distant speech perception in Mandarin-speaking adults with SPHL. These findings suggest that targeted signal processing for soft speech can provide substantial benefits for individuals with SPHL, including speakers of tonal languages, potentially improving communication in challenging listening situations.

Purpose: Tinnitus may be an early indication of cochleovestibular pathology in individuals with normal hearing. The present study characterizes the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) among normal-hearing individuals with tinnitus.

Method: Forty-five normal-hearing individuals with unilateral tinnitus and 45 normal-hearing individuals without tinnitus underwent both the HIMP and the SHIMP. The vestibulo-ocular reflex (VOR) gains in the HIMP and SHIMP, interaural VOR gain asymmetry, and the presence/absence of compensatory saccades in the HIMP and anticompensatory saccades in the SHIMP were measured for all participants.

Results: Significant reductions in both HIMP and SHIMP VOR gains were recorded among the normal-hearing individuals with tinnitus, exclusively in the ears presenting with tinnitus compared with their nontinnitus ears (p < .05) and their healthy counterparts (p < .05). The interaural gain asymmetry in both the HIMP and the SHIMP was significantly higher among the normal-hearing individuals with tinnitus (p < .05). Moreover, individuals with tinnitus exhibited various patterns of anticompensatory saccades that were distinct from those of healthy individuals. The study also found a negative correlation between the duration of tinnitus and the VOR gain values in both the HIMP and the SHIMP (p < .05).

Conclusions: The findings indicate that the VOR and its suppression mechanism are affected among normal-hearing individuals with tinnitus. Reduced VOR gains and altered saccadic patterns on the HIMP and SHIMP suggest subtle peripheral vestibular involvement in these individuals. The results of the study highlight the potential utility of video head impulse test paradigms in identifying subclinical vestibular deficits in normal-hearing individuals with tinnitus.

Objectives: The purpose of this study was to determine if the pattern of an adult cochlear implant (CI) participant's band importance function (BIF) was associated with speech perception performance using standard assessments (i.e., consonant-nucleus-consonant [CNC] words, Arizona Biomedical [AzBio] sentences).

Design: A total of seven adults (nine ears) with CIs participated, along with nine adults with normal hearing (NH) as a control group. Each participant completed speech recognition measures (CNC word recognition and AzBio sentence recognition) in addition to BIF testing for six 1-octave-wide bands centered on frequencies between 256 and 8487 Hz using filtered monosyllabic words.

Results: The BIFs of NH and CI participants showed highest importance for mid-frequency bands. The BIFs for NH participants were uniform across participants with peak importance for the band with a center frequency around 2 kHz. BIFs for CI participants were variable, although, on average, they placed greater weight on the 2-kHz band. Additionally, the band with a center frequency of around 8 kHz carried the least importance for both groups. Higher speech perception outcomes were not obviously associated with a specific pattern of BIF among CI participants.

Conclusion: Results of this study suggest that adults with CIs have more variable BIFs compared to adults with NH and that higher speech recognition outcomes are not associated with specific patterns of BIFs.