Seminars in Hearing最新文献

Following from the World Health Organization's consideration of multiple systems (e.g., sensory, motor, and cognitive) in defining healthy aging, this study presents a review of research on training that has the primary goal of improving complex multitasking outcomes that approximate the everyday contexts in which hearing is important, whether or not older adults are living with clinically significant audiometric hearing loss. Background on the interplay between sensory, motor, and cognitive systems establishes the rationale for considering complex listening behaviors as primary outcomes, and for focusing training on domain-free executive function (EF) processes such as selection, inhibition, and working memory updating. Approaches to cognitive training in later life are discussed to provide a foundation for a deeper examination of targeted EF training and complex listening outcomes that reflect performance in everyday activities. Where available, studies involving older adults with hearing loss are included, although many studies include a mixture of older adults with good audiograms, sub-clinical audiometric loss, or clinically significant but untreated audiometric loss. Overall, the reviewed literature suggests that older adults, with or without audiometric hearing loss, can benefit from EF training that improves complex listening performance. Future clinical considerations are discussed, including rehabilitation that extends from communication training to realistic multitasking training.

Children who are deaf or hard-of-hearing (D/HH) are delayed in many aspects of language development, including acquisition of morphosyntax. One linguistic task that is particularly difficult for children who are D/HH is the acquisition of word-final bound morphemes. In this study, we adopted a training approach from second language (L2) acquisition, referred to as structured input , that has been successful in training a number of grammatical forms in L2 learners. Seventy-seven children who were D/HH and between the ages of 5 and 12 years took part in a 16-session training program designed to improve both perception and comprehension of four bound morphemes: contractions, plurals, past tense, and possessives. In addition, we used a recently developed assessment procedure to obtain independent measures of perception and comprehension. Perception scores at baseline (prior to training) all exceeded 80% and there were small, but nonsignificant, gains in perception following training. In contrast, baseline comprehension measures for three of the four bound morphemes (all except contractions) were below ceiling, and training produced significant gains in all three of these bound morphemes. Implications for training acquisition of morphosyntactic structures and developing personalized audiological rehabilitation protocols are discussed.

Cochlear implants (CIs) are an incredibly effective surgical intervention for many adults with moderate-to-profound sensorineural hearing loss and ideally improve communication ability and quality of life. However, although CIs restore sound access, they do not guarantee real-world speech communication abilities. To optimize communication outcomes, CI users have access to numerous auditory training (AT) approaches, including patient-directed and clinician-guided interventions. Despite the widespread use of AT, research on its benefits in adult CI users remains limited, resulting in a critical gap in understanding the individual factors that drive variability in training outcomes among adult CI users. This review paper synthesizes evidence on demographic, auditory, cognitive-linguistic, and psychosocial factors that influence responsiveness to AT. Given the well-documented influence of these factors on speech perception outcomes in adult CI users, we propose that a set of shared or unique factors likely predict CI users' responses to AT interventions. By understanding individual differences, future AT interventions can be better tailored to the needs of each CI user, moving beyond a one-size-fits-all model. In addition, we discuss the need to broaden our outcome assessments of AT beyond traditional speech recognition measures to real-world speech communicative and social functioning, which are likely to impact hearing-related and overall quality of life in this patient population. These insights provide a foundation for more effective, personalized AT strategies that address the diverse needs of adult CI users.

Hearing aids (HAs) improve speech perception in quiet environments but remain less effective in noisy conditions, posing significant communication challenges for older adults. Musical training has been proposed as a potential intervention to enhance speech-in-noise (SIN) perception through auditory neuroplasticity. This randomized controlled trial investigated the impact of a 14-week music-based intervention on auditory outcomes in older adult HA users. Forty-seven participants were randomly assigned to one of three groups: choir singing ( n  = 14; active music training), music appreciation ( n  = 13; passive music engagement), or a do-nothing control group ( n  = 12). Primary outcome measures included SIN perception, while secondary outcomes assessed pitch perception and frequency-following response (FFR). Results revealed that participants in the choir singing group demonstrated significant improvements in unaided SIN perception and FFR compared to the do-nothing control group, but not in aided conditions. No significant differences were found between the choir singing and music appreciation groups, suggesting that both active and passive music engagement may enhance auditory processing. These findings highlight the potential of music-based training as a complementary intervention for older adults with hearing loss, though further research is needed to establish long-term benefits and effects in everyday listening conditions.

Over-the-counter (OTC) hearing aids are designed to be accessible as a self-guided experience, not requiring professional support. However, some individuals may pursue OTC hearing aids and also desire (limited) professional support. The purpose of this article was to explore the potential role of audiologists in patients' self-guided journeys with OTC hearing aids by examining four related questions. (1) Why might audiologists want to know about OTCs? (2) What types of patient support for OTC hearing aids might be beneficial for patients? (3) What additional knowledge and skills, outside of those already obtained for current prescription service delivery models, are necessary or useful? (4) What is the evidence base around service delivery as it extends to OTC hearing aids? Several potential professional support approaches are considered. While speculative due to the constraints of the limited current evidence base, potentially important factors, including the impact on patient outcomes and cost-effectiveness, were included when possible. The introduction of OTC hearing aids has changed the hearing aid marketplace; however, the demand for both OTC and prescription hearing aids is only increasing. With these changes, interested audiologists have new and unique opportunities to support more patients by participating in the OTC hearing aid marketplace through the acquisition of new OTC-specific knowledge and through partnerships with other professionals and OTC providers.

Tinnitus is distressing and affects the quality of life for many patients. Yet, responses to tinnitus vary. To meet the individual needs of our patients, we developed a service delivery model that served several purposes: (1) to provide a time- and cost-effective program utilizing a care path, group delivery model, and the use of an interprofessional team approach; and (2) to offer quality, best-practice care to meet the needs of those individuals distressed by tinnitus. This article describes the Cleveland Clinic Tinnitus Management Clinic utilized, for more than 20 years, to provide care to patients with tinnitus.

Over-the-counter (OTC) hearing aids have the potential to greatly improve access to hearing health care in the United States. Though intended for self-care, health professionals should be at the forefront of determining service delivery models that will optimize the impact of OTC hearing aids. Collaborations between audiologists and pharmacists could be particularly successful due to pharmacists' high accessibility and audiologists' expertise in hearing health care. The two professions should continue to work together to help achieve optimum outcomes to best serve the public and their health. This will require education of both professions. Pharmacists now have continuing education opportunities to learn about OTC hearing aids.

This article describes the breadth of experiences associated with pursuing commercially available over-the-counter hearing aids (OTC-HAs). Dr. Katz behaved as a consumer pursuing various OTC-HAs. This activity was part of a larger project aimed at identifying overarching consumer listening goals, creating metrics to assess consumer-identified desired usability, features, and performance, and designing a consumer-friendly web-based application to support thoughtful hearing self-care. Additionally, we provide a review of the aims of the larger project to set the context for this work.