The Bulgarian Hearing in Noise Test

Children with auditory processing disorders (APD) were fitted with Phonak EduLink FM devices for home and classroom use. Baseline measures of the children with APD, prior to FM use, documented significantly lower speech-perception scores, evidence of decreased academic performance, and psychosocial problems in comparison to an age- and gender-matched control group. Repeated measures during the school year demonstrated speech-perception improvement in noisy classroom environments as well as significant academic and psychosocial benefits. Compared with the control group, the children with APD showed greater speech-perception advantage with FM technology. Notably, after prolonged FM use, even unaided (no FM device) speech-perception performance was improved in the children with APD, suggesting the possibility of fundamentally enhanced auditory system function.     

Development of Mandarin monosyllabic speech test materials in China

In this study, monosyllabic Mandarin speech test materials (MSTMs) were developed for use in word recognition tests for speech audiometry in Chinese audiology clinics. Mandarin monosyllabic materials with high familiarity were designed with regard to phonological balance and recorded digitally with a male voice. Inter-list equivalence of difficulty was evaluated for a group of 60 subjects (aged 18–25 years) with normal hearing. Seven lists with 50 words each were found to be equivalent. These seven equivalent lists were used to measure performance-intensity (PI) functions for a group of 32 subjects with normal hearing and a group of 40 subjects with mild to moderate sensorineural hearing loss. The mean slope of PI function was found to be 4.1%/dB and 2.7%/dB, respectively. The seven lists of Mandarin monosyllabic materials were found to have sufficient reliability and validity to be used in clinical situations.     

听力损失老年人佩戴助听器前后皮层听觉诱发电位与言语感知的研究

目的 探讨皮层听觉诱发电位(cortical auditory evoked potential,CAEP)用于中度与重度听力损失老年人助听前后言语识别能力评估的可靠性和有效性.方法 26例中度与重度听力损失老年人均验配同一型号测试用助听器,于佩戴助听器前后在声场中分别测试/m/、/g/、/t/三个刺激声在65 dB ...     

Effectiveness of low-cut modified amplification strategy and channel-free hearing aid in individuals with auditory neuropathy spectrum disorder

Objective: The present study attempted to compare the aided benefit using low-cut modified amplification and channel-free hearing aids in individuals with auditory neuropathy spectrum disorder (ANSD). It was also attempted to determine these effects in good and poor performers with ANSD. Design: Cross-sectional within group pretest, post-test design. Study sample: Twenty-five individuals with acquired ANSD were selected for the study. The study sample included 11 males and 14 females between the age ranges of 17–40 years (mean age of 24.6 years). Results: The results of the repeated measures analysis of variance (ANOVA) showed that aided benefit was significantly higher with the channel-free hearing aid. Mixed ANOVA results showed that the improvement was more in good performers than poor performers with ANSD. Multiple regression analyses showed that speech identification scores are a strong predictor of aided benefit. Conclusions: The results of the present study suggest that channel-free hearing aids and low-cut modified amplification can be used as an efficient alternative technique during hearing aid fitting for individuals with ANSD. However, further evidence-based studies on a larger group are essential to validate the results.     

Classification of steady state gain reduction produced by amplitude modulation based noise reduction in digital hearing aids

Digital noise reduction systems in modern digital hearing aids aim to improve either speech intelligibility or listening comfort. Little is known, however, about the actual gain reduction produced by different noise reduction systems. The aim of this study is to compare the gain reduction of different noise reduction systems.

We applied a systematic variation of different presentation levels of the input signal, different signal-to-noise ratios, and different target hearing loss configurations. The gain reduction of 12 different hearing aids was compared both qualitatively and quantitatively by means of principal value decomposition.

The results show that these hearing aids differ considerably in their responses. These differences are presented qualitatively by plotting contour maps that give the gain reduction as function of signal-to-noise-ratio and frequency. The quantitative analysis shows that the gain reduction produced by most hearing aids can be characterized by two transfer functions. The most important being an overall gain reduction. In addition to this, the frequency response is tilted to achieve either more low-frequency reduction and less high-frequency reduction, or the opposite.     

Active Communication Education (ACE): A Program for Older People with Hearing Impairment

The threshold-duration function of the acoustic reflex was investigated in 5 male and 5 female adult, normal-hearing humans and in 3 adult male subjects with hearing loss of cochlear etiology. Reflex threshold was obtained at stimulus durations of 10, 20, 50, 100, 200, and 500 msec and at frequencies of 500, 1 000, 2 000, 3 000, and 4 000 Hz. Three commercially available acoustic bridges were employed, the Madsen ZO-70 and Grason-Stadler 1720 electroacoustic bridges, and the Grason-Stadler-Zwislocki model 3 mechanical-acoustic bridge. A probe-tone frequency of 220 Hz was used in all measures. The reflex threshold-duration function for normal-hearing subjects was found to encompass a much greater range of intensity than the psychophysically assessed auditory threshold temporal integration function. A sex difference was found which may be explained by subclinical noise-induced cochlear pathology in the male subjects with subsequent truncation of the reflex threshold-duration function. The function was also found to be truncated in the 3 subjects with hearing loss diagnosed to be of cochlear etiology. The implications of these findings for control of stimulus duration in clinical reflex measurement are discussed     

Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids

Objective: Processing delay is one of the important factors that limit the development of novel algorithms for hearing devices. In this study, both normal-hearing listeners and listeners with hearing loss were tested for their tolerance of processing delay up to 50?ms using a real-time setup for own-voice and external-voice conditions based on linear processing to avoid confounding effects of time-dependent gain. Design: Participants rated their perceived subjective annoyance for each condition on a 7-point Likert scale. Study sample: Twenty normal-hearing participants and twenty participants with a range of mild to moderate hearing losses. Results: Delay tolerance was significantly greater for the participants with hearing loss in two out of three voice conditions. The average slopes of annoyance ratings were negatively correlated with the degree of hearing loss across participants. A small trend of higher tolerance of delay by experienced users of hearing aids in comparison to new users was not significant. Conclusion: The increased tolerance of processing delay for speech production and perception with hearing loss and reduced sensitivity to changes in delay with stronger hearing loss may be beneficial for novel algorithms for hearing devices but the setup used in this study differed from commercial hearing aids.     

Wireless binaural hearing aid technology for telephone use and listening in wind noise

Objective: To assess the speech perception benefits of binaural streaming technology for bilateral hearing aid users in two difficult listening conditions.

Design: Two studies were conducted to compare hearing aid processing features relating to telephone use and wind noise. Speech perception testing was conducted in four different experimental conditions in each study.

Study sample: Ten bilaterally-aided children in each study.

Results: Significant improvements in speech perception were obtained with a wireless feature for telephone use. Significant speech perception benefits were also obtained with wireless hearing aid features when listening to speech in simulated wind noise.

Conclusions: Binaural signal processing algorithms can significantly improve speech perception for bilateral hearing aid users in challenging listening situations.     

言语、空间与听觉质量量表在老年听力损失者助听器验配中的应用

目的探讨言语、空间与听觉质量量表(speech,spatial and qualities of hearing scale,SSQ)用于老年听力损失患者佩戴助听器的效果评估作用。方法以100例老年感音神经性听力损失者(60~90岁)为研究对象,采用横断面研究和前瞻性研究,其中,无助听器使用经验者44例(75.8±8.1岁,气导纯音平均听阈59.8±13.3 dB HL)、有助听器使用经验者34例(77.5±6.3岁,气导纯音平均听阈64.5±17.8 dB HL,助听器佩戴时间大于三个月)进行横断面研究;22例(74.3±8.6岁,气导纯音平均听阈58.1±12.6 dB HL)首次配戴助听器者进行前瞻性研究;二组参与横断面研究者进行一次SSQ评估,前瞻性研究组分别在助听前和佩戴助听器1个月后进行二次SSQ评估,均采用面对面问答方式用SSQ量表评估三组受试者在言语理解能力、空间定位能力和声音聆听质量方面的变化。结果横断面研究结果显示,有助听经验组SSQ问卷言语理解(97.29±23.43分)、空间听觉(131.94±19.27分)、声音质量(143.53±20.31分)和总分(372.76±51.92分)均显著高于无助听经验组(分别为58.66±30.13、99.41±37.09、108.09±43.28、266.16±78.18分)。前瞻性研究结果显示,受试者初次佩戴助听器一个月后的SSQ问卷言语理解(106.27±13.86分)、空间听觉(136.00±14.09分)、声音质量(151.73±13.91分)和总分(394.00±34.70分)均显著高于佩戴助听器前(分别为65.64±21.89、115.09±17.17、111.91±25.41、292.64±45.58分),横断面研究和前瞻性研究结果均显示,老年听力损失患者佩戴助听器后在言语理解能力、空间声源定位能力和声音聆听质量方面均有显著改善(P<0.05)。结论SSQ量表可以有效评估老年听力损失患者助听器使用效果;老年听力损失患者佩戴助听器后在言语理解能力、空间定位能力和声音聆听质量方面均有显著提高。     

Cochrane corner: hearing aids for mild to moderate hearing loss in adults

This Cochrane corner features the review entitled “Hearing aids for mild to moderate hearing loss in adults” published in 2017. In their review, Ferguson et al. identified five randomised controlled trials (RCTs) involving 825 participants, with moderate quality of evidence shown for all domains except adverse effects. Results showed a large beneficial effect of hearing aids on hearing-specific health-related quality of life and listening ability, and a small yet significant beneficial effect on overall health-related quality of life. Ferguson et al. concluded that according to the available evidence, hearing aids are effective at improving hearing-specific health-related quality of life, general health-related quality of life and listening ability in adults with mild to moderate hearing loss. The evidence supports the widespread provision of hearing aids as the first-line clinical management for those seeking help for hearing difficulties.     

Self-assessment of classroom assistive listening devices

Abstract

Self-assessment of classroom assistive listening devices (ALDs) based on induction loop systems was carried out in Swedish classes for hearing-impaired students. A questionnaire was developed and completed by 25 students (bilateral hearing aid users, 10–20 years old). Responses for hearing aid microphone mode (M) and telecoil mode (T) were collected. Two attributes, audibility and awareness, were identified and assigned to either mode. Better audibility was achieved in T-mode. Students with severe hearing loss benefited more using T-mode when compared to the better hearing students, especially in more difficult listening situations. Better awareness was achieved in M-mode; students could better hear, locate and segregate sounds in the environment around them. Depending on the situation, students make different choices between audibility and awareness. Self-assessment is a promising approach for determining what combination of ALD design and function that will best benefit the students.

Sumario

Se realizó la auto-evaluación de dispositivos de ayuda auditiva (ALD) en el aula de clase con base en los sistemas de inducción en circuito cerrado, en aulas suecas para estudiantes con trastornos auditivos. Se desarrolló un cuestionario y éste fue completado por 25 estudiantes (usuarios de auxiliares auditivos bilaterales, con 10–20 años de edad). Se colectó información sobre las respuestas para el auxiliar auditivo en el modo de micrófono (M) y en el modo de telebobina (T). Se identificaron y asignaron dos atributos para cada modo: audibilidad y conciencia. Se logró una mejor audibilidad en el modo T. Los estudiantes con hipoacusias severas se beneficiaron más utilizando el modo T, cuando se comparan con los estudiantes con mejor audición, especialmente en situaciones de escucha más difíciles. Se logró una mejor conciencia en el modo M; los estudiantes pudieron escuchar, localizar y segregar mejor los sonidos en el ambiente a su alrededor. Dependiendo de la situación, los estudiantes realizaron diferentes escogencias entre audibilidad y conciencia. La auto-evaluación en un enfoque promisorio para determinar qué combinación de diseño y función de los ALD beneficiará más a los estudiantes.     

Evaluation of Speech-Perception Training for Hearing Aid Users: A Multisite Study in Progress

Following an overview of theoretical issues in speech-perception training and of previous efforts to enhance hearing aid use through training, a multisite study, designed to evaluate the efficacy of two types of computerized speech-perception training for adults who use hearing aids, is described. One training method focuses on the identification of 109 syllable constituents (45 onsets, 28 nuclei, and 36 codas) in quiet and in noise, and on the perception of words in sentences presented in various levels of noise. In a second type of training, participants listen to 6- to 7-minute narratives in noise and are asked several questions about each narrative. Two groups of listeners are trained, each using one of these types of training, performed in a laboratory setting. The training for both groups is preceded and followed by a series of speech-perception tests. Subjects listen in a sound field while wearing their hearing aids at their usual settings. The training continues over 15 to 20 visits, with subjects completing at least 30 hours of focused training with one of the two methods. The two types of training are described in detail, together with a summary of other perceptual and cognitive measures obtained from all participants.     

蓝牙伴侣辅助重度感音神经性聋患者接听移动电话效果观察

目的研究Epoq V蓝牙伴侣(Streamer)辅助重度感音神经性聋患者助听后接听移动电话的效果。方法选择具有数字耳背机助听器佩戴史的重度感音神经性聋患者16名,双耳试戴Epoq V并调试至最佳,在安静环境和噪声环境下,分别直接接听移动电话和使用蓝牙伴侣接听移动电话,通过言语识别率测试进行效果评估。结果在安静环境下,受试者直接接听移动电话和使用蓝牙伴侣接听移动电话的言语识别率相似,分别为62.3%±17.6%和58.3%±16.7%;在噪声环境下,受试者使用蓝牙伴侣接听移动电话时的言语识别率(58.3%±16.7%)比直接接听移动电话时(48.0%±18.9%)高约10%(P<0.05)。结论在噪声环境下,蓝牙技术能有效辅助重度听障者接听移动电话。     

非线性频率压缩助听器对耳聋患者噪声下言语识别的影响

目的 探讨非线性频率压缩(nonlinear frequency compression, NLFC)助听器对以汉语普通话为母语的耳聋患者噪声下言语识别的影响,为耳聋患者助听器选配及助听效果评估提供参考.方法 25例以汉语普通话为母语的感音神经性聋患者,均双耳佩戴助听器,根据患者是否有NLFC助听经验分为A、B两组:A组13例有NLFC助听经验,日常使用NLFC技术;B组12例无NLFC助听经验,日常使用传统放大(conventional process, CP)技术.所有患者分别在NLFC和CP条件下进行噪声下句子识别测试,比较其结果.结果 A组患者在NLFC和CP条件下的噪声下言语识别率分别为82.33%±16.06%、76.70%±18.08%,前者高于后者,差异有显著统计学意义(P<0.01);B组分别为83.04%±12.56%、81.79%±20.07%(P=0.19),差异无统计学意义.A组患者在NLFC和CP条件下的高频(4、6、8 kHz)助听听阈分别为53.54±7.30、57.01±6.81 dB SPL,B组分别为57.42±8.38和61.21±7.42 dB SPL,两组NLFC条件下的助听听阈低于CP条件,差异均有统计学意义(P<0.01).经统计学回归处理,患者在NLFC和CP条件下的高频助听听阈差值与言语识别率差值呈线性相关(r=0.63,t=3.89,P=0.007).结论 NLFC技术可改善患者高频可听度及噪声下言语识别,一定的NLFC使用经验可使NLFC助听效果最大化.     

Preliminary evaluation of a novel non-linear frequency compression scheme for use in children

Objective: The primary goal of this study was to evaluate a new form of non-linear frequency compression (NLFC) in children. The new NLFC processing scheme is adaptive and potentially allows for a better preservation of the spectral characteristics of the input sounds when compared to conventional NLFC processing. Design: A repeated-measures design was utilised to compare the speech perception of the participants with two configurations of the new adaptive NLFC processing to their performance with the existing NLFC. The outcome measures included the University of Western Ontario Plurals test, the Consonant-Nucleus-Consonant word recognition test, and the Phonak Phoneme Perception test. Study sample: Study participants included 14 children, aged 6–17 years, with mild-to-severe low-frequency hearing loss and severe-to-profound high-frequency hearing loss. Results: The results indicated that the use of the new adaptive NLFC processing resulted in significantly better average word recognition and plural detection relative to the conventional NLFC processing.

Conclusion: Overall, the adaptive NLFC processing evaluated in this study has the potential to significantly improve speech perception relative to conventional NLFC processing.     

正常听力受试者佩戴不同组合全向性与方向性麦克风的效果比较

目的 比较噪声环境下全向性麦克风与自适应方向性麦克风的不同组合佩戴方式对听力正常成年人言语识别率的影响,从而选择最佳的组合佩戴方式.方法 选择20例(40耳)听力正常青年人(男、女各10例)分别按照双耳全向性麦克风模式(组合1),双耳自适应方向性麦克风模式(组合2),一耳全向性麦克风、一耳自适应麦克风模式(组合3)3种方式,在信噪比变化的漫射声场中进行言语识别率测试,从而进行助听效果的评估.结果 组合1、2、3三种方式测出的L50值(50%言语识别率的信噪比)分别为-3.55±2.37 dB,-7.15±2.18 dB,-5.40±2.35 dB,三者之间两两比较差异均有显著统计学意义(P<0.05).结论 噪声环境下无论双耳佩戴自适应方向性麦克风模式还是一耳佩戴自适应方向性麦克风、另一耳佩戴全向性麦克风,其言语识别能力均高于双耳佩戴全向性麦克风模式,且双耳佩戴自适应方向性麦克风模式的言语识别率高于一耳自适应麦克风、一耳全向性麦克风模式.     

Speech perception in noise: Exploring the effect of linguistic context in children with and without auditory processing disorder

Abstract

Objective: The objective of this study was to investigate whether the speech perception problems in noise of children with auditory processing disorder (APD) stem from an auditory or a higher order dysfunction. Design: A repeated measures design comparing the sentence key word recognition scores of children with APD and a control group was used. Four sentence lists from the Test de phrases dans le bruit (TPB) were presented with a babble masker at four different signal-to-noise ratios. The TPB is a Canadian French adaptation of the speech perception in noise test. Study Sample: Ten participants between 9–12 years with APD participated in this study, as well as ten age- and gender-matched children with no sign of APD. Results: Group analyses revealed that children with APD had poorer overall sentence key word recognition scores than the control group. Analysis of the difference scores between the high and low predictability sentences indicated that the benefit derived from linguistic context is similar between the groups. However, individual patterns of results revealed different profiles within the APD group. Conclusion: Further study using a larger sample is warranted to deepen our understanding of the nature of APD and identify characteristic profiles to enable better tailoring of therapeutic programs.

Sumario

Objetivo: El objetivo de este estudio fue investigar cuándo los problemas de percepción del habla en ruido, en niños con trastornos del procesamiento auditivo (APD), son producto de una disfunción auditiva o de niveles superiores. Diseño: Repetición de mediciones para comparar las puntuaciones de reconocimiento de palabras clave en una oración, entre niños con APD y los de un grupo control. Estudio: Se presentaron cuatro listas de oraciones del Test de Phrases dans le Bruit (TPB – Prueba de frases en ruido-) en presencia de balbuceo enmascarante, a cuatro diferentes relaciones señal/ruido. El TPB es una adaptación al Francés del Canadá, de la prueba de Percepción del Habla en Ruido. Muestra: Participaron en este estudio diez niños con APD entre 9-12 años y 10 niños sin signos de APD, pareados por edad y sexo. Resultados: El análisis de grupos reveló que los niños con APD tienen puntuaciones generales más pobres en el reconocimiento de palabras clave en oraciones, que los del grupo control. El análisis de las diferencias entre las puntuaciones de las oraciones de mayor o menor predictabilidad, indicaron que el beneficio que se deriva del contexto lingüístico es similar entre los dos grupos. Sin embargo, los patrones de resultados individuales, revelan diferentes perfiles en el grupo de niños con APD. Conclusiones: Se justifican estudios adicionales usando una muestra más amplia, para profundizar nuestro conocimiento sobre la naturaleza de los APD y para identificar perfiles característicos que nos permitan la mejor individualización de programas terapéuticos.     

Manufacturer Predicted And Measured REAR Values In Adult Hearing Aid Fitting: Accuracy And Clinical Usefulness

Audiologists may fit hearing aids using real-ear aided response (REAR) values predicted by manufacturer's fitting software, rather than actual measured REARs. This study examined how well one manufacturer's software was able to predict REARs for a DSP behind-the-ear product in 41 adults (N?=?79 ears) under four conditions (two hearing loss configurations and two inputs). Results showed that for all ears tested, measured REAR values were significantly different from predicted for most of the audiometric frequencies for all four test conditions. Discrepancies between measured and predicted REAR values were greater in males’ ears than females’. Few ears’ REAR values (≤12%) were judged to be clinically similar to predicted. Results suggest audiologists should consider using individual real-ear measures in adult hearing aid fittings until manufacturer software is shown to accurately predict real-ear hearing aid performance.