Auditory and language skills of children using hearing aids

IntroductionHearing loss may impair the development of a child. The rehabilitation process for individuals with hearing loss depends on effective interventions.ObjectiveTo describe the linguistic profile and the hearing skills of children using hearing aids, to characterize the rehabilitation process and to analyze its association with the children's degree of hearing loss.MethodsCross-sectional study with a non-probabilistic sample of 110 children using hearing aids (6–10 years of age) for mild to profound hearing loss. Tests of language, speech perception, phonemic discrimination, and school performance were performed. The associations were verified by the following tests: chi-squared for linear trend and Kruskal–Wallis.ResultsAbout 65% of the children had altered vocabulary, whereas 89% and 94% had altered phonology and inferior school performance, respectively. The degree of hearing loss was associated with differences in the median age of diagnosis; the age at which the hearing aids were adapted and at which speech therapy was started; and the performance on auditory tests and the type of communication used.ConclusionThe diagnosis of hearing loss and the clinical interventions occurred late, contributing to impairments in auditory and language development.     

Hearing aids for high-frequency hearing loss

This cross-over study compares the relative benefits of a standard NHS contracted hearing aid with a high-frequency emphasis commercial aid in subjects with high-frequency hearing loss. Disability questionnaires and free-field speech-in-noise (FAAF II) tests were used to assess subjects unaided and after 6 weeks of wearing each aid. Total FAAF II test scores showed no significant difference with either aid, but analysis of frequency-specific subscores demonstrated less use of low-frequency information when using the high-frequency emphasis aid. Overall questionnaire responses relating to conversation showed more benefit with the high-frequency emphasis aid. Subjects generally preferred this aid, possibly due to less low-tone gain than the standard NHS aid.     

Hearing in the elderly and hearing aids

Statistically progressive deteriorations in the population, due more to pathological impairments than to aging properly speaking, must be distinguished from presbycusis. The onset of auditive impairment varies with genetic factors. In a statistical audiometric study, it is found that the better the hearing of a subject before the impact of presbycusis, the better the chances are of maintaining hearing; the opposite applies in the case of major auditive deterioration. Loss of hearing due to presbycusis affects all frequencies. The elderly patient has a better social value of hearing in the phonetic test than that expected from tonal audiometry, except in the case of disorders of central auditive integration.     

Hearing and language ability in mild and moderate hearing impaired children

102 children (mean age-7 years 9 mo.) with mild and moderate perceptive hearing impairment who had neither any auditory training nor had used a hearing aid were studied. Mean hearing level was 51.9 dB. Our findings: (1) Speech discrimination score (SDS) correlated with the hearing level at 2, 4 and 1 kHz, in that order. In all patients, SDS gradually worsened to 60 dB before registering a sharp decline; SDS was better than in patients who had acute unilateral hearing impairment and similar audiogram patterns, especially in vowels. (2) Correlation existed between the rate of accurate articulation and hearing levels at 2 and 4 kHz; it improved with age but plateaued at around 8 years. In children with a high tone loss, distortion and confusion of fricatives, explosives, unvoiced affricates and postconsonantal vowel /i/ were marked besides articulation errors commonly attributable to normal speech development. (3) On the WISC and WISC-R intelligence scale, verbal intelligence score had little correlation with performance intelligence and was influenced by hearing levels at 2, 4 and 1 kHz, in that order. When the mean hearing level was over 40 dB, verbal intelligence was frequently below par. Performance intelligence grew worse with age. (4) Children with a mild hearing loss exhibited a slight delay in vocalizing the 1st word and combining 2 words together while in those with a moderate loss, the delay in combining 2 words was pronounced. In both mild and moderate hearing loss, verbal intelligence was low when there was a delay in the ability to vocalize two words together.     

听障老年人的助听器验配

目的探讨听障老年人助听器验配的方法和技巧。方法对112名受试者进行跟踪随访，客观记录他们使用助听器的感受，分析助听器验配方法和技巧对助听器效果的影响。结果老年人的行为认知和听觉反应能力极大地左右着助听器的配戴效果；气骨导听阈，舒适阈，不适阈、言语识别阈的检查和使用对于老年人助听器验配十分重要；低频部分的听力补偿要低于目标值，高频部分要略高于目标增益值；老年人助听器配戴的适应期平均为3个月；双耳配戴的效果明显优于单耳。结论完全按照助听器验配软件设计的程序给老年人验配助听器很难达到理想的效果，而验配经验、技巧和验配后的适应性训练在其中发挥着巨大的作用。     

Visual attention in children with normal hearing, children with hearing aids, and children with cochlear implants.

Previous studies have reported both positive and negative effects of deafness on visual attention. The purpose of this study was to replicate and expand findings of previous studies by examining visual attention abilities in children with deafness and children with normal hearing. Twenty-eight children, ages 8-14 years, were evaluated. There were two groups of children with prelingual deafness and one group with normal hearing. The children with deafness were divided further into two groups: those with cochlear implants and those with conventional hearing aids. Unlike previous studies, the current study found no substantial differences in performance among these three groups of children on a continuous-performance visual attention task or on a letter cancellation task. Children in all three groups performed very well on the visual attention tasks. Furthermore, there was little association between performance on the visual attention tasks and parent or teacher ratings of behavior and attention. Age and nonverbal intelligence were significantly correlated with performance on visual attention tasks. The theoretical implications of these findings are discussed, along with directions for future research.     

A comparison of language achievement in children with cochlear implants and children using hearing aids.

English language achievement of 29 prelingually deaf children with 3 or more years of cochlear implant (CI) experience was compared to the achievement levels of prelingually deaf children who did not have such CI experience. Language achievement was measured by the Rhode Island Test of Language Structure (RITLS), a measure of signed and spoken sentence comprehension, and the Index of Productive Syntax (IPSyn), a measure of expressive (signed and spoken) English grammar. When the CI users were compared with their deaf age mates who contributed to the norms of the RITLS, it was found that CI users achieved significantly better scores. Likewise, we found that CI users performed better than 29 deaf children who used hearing aids (HAs) with respect to English grammar achievement as indexed by the IPSyn. Additionally, we found that chronological age highly correlated with IPSyn levels only among the non-CI users, whereas length of CI experience was significantly correlated with IPSyn scores for CI users. Finally, clear differences between those with and without CI experience were found by 2 years of post-implant experience. These data provide evidence that children who receive CIs benefit in the form of improved English language comprehension and production.     

Rehabilitation of patients with hearing disorders using hearing aids and tactical hearing measures

After a brief summary of the problems of rehabilitation of hearing-impaired subjects, the optimal conditions for rehabilitation with hearing aids are presented: a) The right timing is crucial. b) Optimal provision of hearing aids must be carried out in close co-operation between the patient, the hearing aid technician and the otolaryngologist. c) Easy handling of the hearing aid and the use of attachments must be guaranteed. d) The hearing-impaired person must be fully informed as to the extent and type of hearing loss. He/she must accept the affliction and know about the possibilities of rehabilitation. The patient's motivation is a pre-requisite for all further steps. e) The patients must learn tactical measures to make optimal use of their hearing ability in relation to their environment. Hearing tactics consist of hearing training and a change in the attitude of the hearing-impaired patients themselves and their attitude towards their surroundings.     

Tone perception in Cantonese-speaking children with hearing aids

OBJECTIVES: In this study we investigated the benefit of using hearing aids for Cantonese tone perception among children with various degrees of hearing impairment. METHODS: Forty-eight children with moderate to profound hearing loss were investigated. They were required to perform a lexical tone perception test with recorded test stimuli presented at 65 dB in soundproof booths. To allow for comparison, the subjects performed the test under 2 conditions: with their hearing aids turned off (unaided condition) and with them turned on (aided condition). RESULTS: The mean tone perception scores for the aided condition were higher than those for the unaided condition across all of the subject groups. Paired sample t-tests showed statistically significant improvement in tone perception in the moderate and severe hearing loss groups (p = .02 and p = .03, respectively). The result obtained from the moderately severe hearing loss group was marginally significant (p = .058). The improvement in tone perception in the profound hearing loss group was insignificant (p = .55). CONCLUSIONS: The use of a hearing aid is beneficial for Cantonese tone perception in children who have moderate to severe hearing impairment. When a hearing loss is greater than 90 dB, ie, in children who are classified as having profound hearing loss, a hearing aid is not effective in aiding Cantonese tone perception.     

The cognition and behaviour of children with cochlear implants, children with hearing aids and their hearing peers: a comparison

Hearing impairment has been associated with cognitive deficits. It is not yet clear whether cochlear implants enable children to reduce or overcome these deficits. This study examined whether hearing impaired children with cochlear implants differed from hearing impaired children without cochlear implants or from hearing children. The three age-matched groups were compared on a non-verbal measure of cognition, the Leiter International Performance Scale-Revised (LIPS-R), and a measure of behaviour, the Child Behaviour Checklist (CBCL). Apart from their scores on the Attention Sustained Subtest of the LIPS-R, the performance of the implanted group and the hearing group closely corresponded, while the hearing impaired children without cochlear implants performed below the level achieved by both these groups. There were no differences between any groups on the CBCL. It was concluded that hearing impaired children with cochlear implants were able to perform at the same non-verbal cognitive level as hearing children.