Assessment of basal sound identification skills and communication abilities in profoundly deaf children fitted with hearing aids or a cochlear implant

Basal auditory functions and early verbal communication skills were examined in young, profoundly deaf children with hearing aids or a cochlear implant. The hearing aid users (n = 23) were subdivided on the basis of their (unaided) hearing thresholds into: group A (pure tone average (PTA) at 0.5, 1 and 2 kHz: 90–100 dB HL); group B (PTA: 100–110 dB HL); and group C (PTA > 110 dB HL). All the children with a cochlear implant (n = 20) had a profound sensorineural hearing loss with a PTA that exceeded 120 dB HL. Functional hearing was evaluated by means of basal sound identification. The child’s communication abilities with hearing aids or a cochlear implant were assessed using structured observations on the Scales of Early Communication Skills for Hearing Impaired Children. The basal auditory functions on a sound identification level improved over time in the cochlear implant users and groups A and B. Hardly any improvement was seen in group C. The performance of all the groups (either hearing aid or cochlear implant) on the Scales of Early Communication Skills for Hearing Impaired Children at 6 months after fitting the device and at later evaluations, was close to the average level for their age.     

Communication abilities of children with aided residual hearing: comparison with cochlear implant users

OBJECTIVE: To compare the communication outcomes between children with aided residual hearing and children with cochlear implants. DESIGN: Measures of speech recognition and language were administered to pediatric hearing aid users and cochlear implant users followed up longitudinally as part of an ongoing investigation on cochlear implant outcomes. The speech recognition measures included the Lexical Neighborhood Test, Phonetically Balanced-Kindergarten Word Lists, and the Hearing in Noise Test for Children presented in quiet and noise (+5 dB signal-to-noise ratio). Language measures included the Peabody Picture Vocabulary Test: Third Edition (PPVT-III), the Reynell Developmental Language Scales, and the Clinical Evaluation of Language Fundamentals-Revised.Subjects The experimental group was composed of 39 pediatric hearing aid users with a mean unaided pure-tone average threshold of 78.2 dB HL (hearing level). The comparison group was composed of 117 pediatric cochlear implant users with a mean unaided pure-tone average threshold of 110.2 dB HL. On average, both groups lost their hearing at younger than 1 year and were fitted with their respective sensory aids at 2 to 2.6 years of age. Not every child was administered every test for a variety of reasons. RESULTS: Between-group performance was equivalent on most speech recognition and language measures. The primary difference found between groups was on the PPVT-III, in which the hearing aid group had a significantly higher receptive vocabulary language quotient than the cochlear implant group. Notably, the cochlear implant group was substantially younger than the hearing aid group and had less experience with their sensory devices on this measure. CONCLUSION: Data obtained from children with aided residual hearing can be useful in determining cochlear implant candidacy.     

Speech recognition performance of patients with sensorineural hearing loss under unaided and aided conditions using linear and compression hearing AIDS

OBJECTIVES: This study compared speech recognition performance on the Northwestern University Auditory Test No. 6 (NU-6) and the Connected Speech Test (CST) for three hearing aid circuits (peak clipping [PC], compression limiting [CL], and wide dynamic range compression [WDRC]) in adults with symmetrical sensorineural hearing loss. The study also questioned whether or not hearing aid benefit for the three circuits was dependent upon the speech level and the signal-to-babble ratio (S/B) and upon the degree and slope of hearing loss. DESIGN: Unaided speech recognition performance for NU-6 and CST materials presented from a loudspeaker at 0 degrees was measured during Visit 1, and both unaided and aided performance was measured at 3-mo intervals during Visits 2 to 4. The NU-6 was presented in quiet at a conversational speech level of 62 dB SPL. The CST was presented in 10 listening conditions-three S/B (-3, 0, and 3 dB) at each of three speech levels (soft speech at 52 dB SPL, conversational speech at 62 dB SPL, and loud speech at 74 dB SPL) and in quiet at 74 dB SPL. Uncorrelated multi-talker babble was presented from two loudspeakers at 45 degrees on each side of the main speaker. Hearing aid benefit was examined for 360 subjects divided into four groups of hearing loss, pure tone average <40 dB HL and slope <10 dB/octave or >10 dB/octave and hearing loss >40 dB HL for the two slope categories. RESULTS: Hearing aid benefit (aided minus unaided performance) measured on the NU-6 in quiet exceeded 31 rau for all three circuits. Although small statistical advantages were found for the WDRC, the differences were approximately 2% and are not considered clinically relevant. Unaided CST performance showed a complex relationship between presentation level and signal-to-babble ratio that was further confounded by the degree of hearing loss. For the two mild hearing loss groups and for each of the three nominal signal-to-babble ratios, CST performance decreased by 20 rau for the -3 dB S/B to 6 rau for the 3 dB S/B as speech level increased from 52 to 74 dB SPL. In contrast, unaided performance increased by 32 to 13 rau with signal level for all signal-to-babble ratios for the two >40 dB hearing loss groups. Overall, aided CST performance exceeded unaided performance for all 10 conditions. As expected, hearing aid benefit was greatest (27 rau) for soft speech and smallest for loud speech (6 rau). Differences among the hearing aid circuits were small with only one significant difference; the WDRC at 62/0 was poorer by 3 rau than the other two circuits. When the CST data were analyzed as a function of hearing loss, five pair-wise comparisons were significant. In contrast to the unaided performance, aided performance for all hearing loss groups decreased as presentation level increased, even though the signal-to-babble ratio was constant. CONCLUSIONS: All three hearing aids circuits provided benefit over the unaided condition in both quiet and noise. The greatest benefit was measured for soft speech in the more severe hearing loss groups. Although only small differences were measured among the three hearing aid circuits, significant differences favored the PC and CL circuits over the WDRC in the mild hearing loss groups and favored the WDRC over the PC in the more severe, sloping hearing loss group. An interesting interaction between speech level, signal-to-babble ratio, degree of hearing loss, and amplification was found. For a constant signal-to-babble ratio, recognition performance decreased as speech level increased from 52 to 74 dB SPL. The effect was most marked in the milder hearing loss groups and in the aided conditions, and occurred at even the lowest speech levels.     

全植入式助听器治疗中重度耳聋

目的 探讨全植入式助听器(Carina)治疗中重度和重度耳聋的安全性和效果.方法 分析随访12个月以上的三例接受全植入式助听器手术的中重度至重度耳聋患者术后康复的效果.比较术前术后纯音测听和言语测听的差异,观察植入体日常使用情况及与传统助听器效果的比较.结果 手术顺利,无并发症.术后手术侧无助听听阈(听力级,下同)平均升高8.3 dB,四个频率(0.5、1、2、4 kHz)纯音听阈功能性增益平均为35.4 dB,言语听阈平均降低22.5 dB,患者主观满意度评分明显高于传统助听器.结论 全植入式助听器是治疗中重度和重度耳聋患者的有效方法 ,其远期疗效需要进一步观察.     

Audibility and speech perception of children using wide dynamic range compression hearing AIDS

PURPOSE: This study examined the relation of audibility for frequency-specific sounds and the Speech Intelligibility Index (SII) to speech perception abilities of children with sensorineural hearing loss using digital signal-processing hearing aids with wide dynamic range compression. METHOD: Twenty-six children age 5-15 years with pure-tone averages (0.5, 1.0, and 2.0 kHz) from 60-98 dB HL participated. Three subgroups were created based on the compression characteristics of each hearing aid. Minimum audibility was determined using aided thresholds for frequency-modulated tones and the SII calculated at 55 and 70 dB SPL using the simulated real-ear output of the hearing aid. The Lexical Neighborhood Test (LNT; K. I. Kirk, D. B. Pisoni, & M. J. Osberger, 1995) was presented at 50 and 70 dB SPL. RESULTS: LNT scores at 70 dB SPL were significantly higher than at 50 dB SPL. Average aided thresholds at 0.5, 1.0, and 2.0 kHz were negatively correlated with LNT scores at 50 dB SPL, and SIIs at 55 and 70 dB SPL were positively correlated with LNT scores at 50 and 70 dB SPL. CONCLUSIONS: Results support using aided thresholds and speech test scores at soft to loud levels as part of the amplification fitting process.     

影响语前聋患儿人工耳蜗植入术后前语言交流能力的因素分析

目的 探讨影响语前聋患儿人工耳蜗植入术后前语言交流能力的相关因素.方法 对接受人工耳蜗植入术的语前聋患儿 31例进行随访调查,平均植入年龄为46.71±24.78月,术后1个月开机进行康复训练;采用视频分析法于开机后12个月对患儿的轮流交流、主动交流、视觉交流及听觉注意等进行分析,并根据以下方面分组:按植入年龄分为≤36个月组16例,>36个月组15例;按术前有无正规康复训练(时间超过3个月)分为康复组14例,未康复组17例;按术前残余听力分为≤80 dB HL组6例,>80 dB HL组25例;按术前是否使用助听器(时间超过3个月)分为使用组21例,未使用组10例.应用Wilcoxon秩和检验分析各组前语言交流能力的差别.结果 术前进行康复训练、术前佩戴助听器、术前残余听力好的人工耳蜗植入患儿的前语言交流能力得分高于术前未进行康复训练、术前未佩戴助听器、术前残余听力差的人工耳蜗植入患儿(P<0.05);植入年龄≤36个月组与>36个月组间比较差异无统计学意义(P>0.05).结论 术前残余听力好、佩戴助听器、进行过正规康复训练的语前聋患儿人工耳蜗植入术后其前语言交流能力较好,而植入年龄对其无明显影响.     

Monosyllable speech perception of Japanese hearing aid users with prelingual hearing loss: implications for surgical indication of cochlear implant

OBJECTIVE: The monosyllable speech perception ability after years of educational intervention was compared between prelingually deafened pediatric hearing aid users and their cochlear implant counterparts. DESIGN: An open-set monosyllabic speech perception test was conducted on all subjects. The test required subjects to indicate a corresponding Japanese character to that spoken by the examiner. Fifty-two subjects with prelingual hearing impairment (47 hearing aid users and 5 cochlear implant users) were examined. RESULTS: Hearing aid users with average pure-tone thresholds less than 90 dB HL demonstrated generally better monosyllable perception than 70%, which was equivalent or better performance than that of the cochlear implant group. Widely dispersed speech perception was observed within the 90-99 dB HL hearing-aid user group with most subjects demonstrating less than 50% speech perception. In the cluster of >100 dB HL, few cases demonstrated more than 50% in speech perception. The perception ability of the vowel part of each mora within the cochlear implant group was 100% and corresponding to that of hearing aid users with moderate and severe hearing loss. CONCLUSION: Hearing ability among cochlear implant users can be comparable with that of hearing aid users with average unaided pure-tone thresholds of 90 dB HL, after monosyllabic speech perception testing was performed.     

使用人工耳蜗和助听器的语前聋儿童言语识别能力的研究

目的 通过对使用人工耳蜗和助听器的语前聋儿童的言语识别能力的比较研究,为人工耳蜗植入适应证提供参考.方法实验对象包括18例人工耳蜗植入和40例配戴助听器的先天性语前聋儿童,先在自由声场测试双耳裸耳听阈,根据装置使用时间和平均裸耳听阈值分组,测试并比较使用人工耳蜗和助听器的语前聋儿童封闭项的声母、韵母、单音节词识别率.结果人工耳蜗植入时间≥2年组儿童的韵母、声母和单音节词识别率明显高于＜2年组患者.助听器使用时间≥2年组的各测试项识别率与＜2年组差异无统计学意义.装置使用时间＜2年的语前聋儿童,人工耳蜗植入者的各测试项识别率均明显高于平均裸耳听阈＞100 dB HL的助听器使用者,与平均裸耳听阈≤100 dB HL的助听器使用者的各测试项识别率差异均无统计学意义.装置使用时间≥2年的语前聋儿童,人工耳蜗植入者的各测试项识别率均明显高于平均裸耳听阈＞90 dB HL的助听器使用者,但与平均裸耳听阈＞70 dB HL但≤90 dB HL的助听器使用者差异无统计学意义.结论极重度语前聋儿童人工耳蜗植入后能获得比助听器使用者更好的言语识别能力.     

Do you hear the noise? The German matrix sentence test with a fixed noise level in subjects with normal hearing and hearing impairment

Objective: The aim of this study was to determine the relationship between hearing loss and speech reception threshold (SRT) in a fixed noise condition using the German Oldenburg sentence test (OLSA). Design: After training with two easily-audible lists of the OLSA, SRTs were determined monaurally with headphones at a fixed noise level of 65 dB SPL using a standard adaptive procedure, converging to 50% speech intelligibility. Study sample: Data was obtained from 315 ears of 177 subjects with hearing losses ranging from ? 5 to 90 dB HL pure-tone average (PTA, 0.5, 1, 2, 3 kHz). Results: Two domains were identified with a linear dependence of SRT on PTA. The SRT increased with a slope of 0.094 ± 0.006 dB SNR/dB HL (standard deviation (SD) of residuals = 1.17 dB) for PTAs < 47 dB HL and with a slope of 0.811 ± 0.049 dB SNR/dB HL (SD of residuals = 5.54 dB) for higher PTAs. Conclusion: The OLSA can be applied to subjects with a wide range of hearing losses. With 65 dB SPL fixed noise presentation level the SRT is determined by listening in noise for PTAs < ～47 dB HL, and above it is determined by listening in quiet.     

Evaluating the benefit of speech recoding hearing aids in children

Children with significant high-frequency hearing loss may be difficult to fit with hearing aids using conventional amplification. Frequency-lowering hearing aids using dynamic speech recoding (DSR) technology have been proposed as a possible means to achieve full speech audibility. The current study investigated 78 children from ages 1.3 to 21.6 years (M = 10.6 years) who wore DSR hearing aids. These hearing aids provided significant improvements in pure-tone average (PTA; mean improvement for the aided versus unaided condition of 49 dB) and high-frequency PTA (mean improvement for the aided versus unaided condition of 56 dB). A subgroup of 19 children were previous users of conventional hearing aids. These participants demonstrated a mean improvement of 11 dB in PTA and 12.5% in word recognition scores for DSR versus conventional amplification. However, DSR hearing aids required repair 3 times as often as conventional hearing aids. The greatest benefit was observed in children whose word recognition scores were poorest using conventional hearing aids.     

Bilateral cochlear implants in children: localization acuity measured with minimum audible angle

OBJECTIVE: To evaluate sound localization acuity in a group of children who received bilateral (BI) cochlear implants in sequential procedures and to determine the extent to which BI auditory experience affects sound localization acuity. In addition, to investigate the extent to which a hearing aid in the nonimplanted ear can also provide benefits on this task. DESIGN: Two groups of children participated, 13 with BI cochlear implants (cochlear implant + cochlear implant), ranging in age from 3 to 16 yrs, and six with a hearing aid in the nonimplanted ear (cochlear implant + hearing aid), ages 4 to 14 yrs. Testing was conducted in large sound-treated booths with loudspeakers positioned on a horizontal arc with a radius of 1.5 m. Stimuli were spondaic words recorded with a male voice. Stimulus levels typically averaged 60 dB SPL and were randomly roved between 56 and 64 dB SPL (+/-4 dB rove); in a few instances, levels were held fixed (60 dB SPL). Testing was conducted by using a "listening game" platform via computerized interactive software, and the ability of each child to discriminate sounds presented to the right or left was measured for loudspeakers subtending various angular separations. Minimum audible angle thresholds were measured in the BI (cochlear implant + cochlear implant or cochlear implant + hearing aid) listening mode and under monaural conditions. RESULTS: Approximately 70% (9/13) of children in the cochlear implant + cochlear implant group discriminated left/right for source separations of 相似文献   

Zur Indikationserweiterung des „cochlear-implant”Freiburger Ergebnisse bei Patienten mit Resthörigkeit

The usual indication for a cochlear implant (CI) is acquired deafness in patients for whom conventional hearing aids are of no benefit. The question is whether CI is superior to the best conventional hearing aids for patients with some residual hearing, but who achieve only minimal speech recognition (< 30% in the Freiburg monosyllable word test at 70 dB (I) SPL) with optimal hearing aids. We report our experience with five patients with residual hearing who underwent cochlear implantation (Nucleus Mini 22 and 24) on the worse side. The patients were examined preoperatively and at 1, 6 and 12 months following activation of the implant. The Freiburg monosyllabic word test, the G?ttingen sentence test and consonant recognition were used to assess postoperative results. All patients benefitted from CI when test scores were compared with preoperative ones. All patients achieved a score in the Freiburg monosyllabic word test of more than 60% at 70 dB (I) SPL 12 months post switch-on. Four patients achieved a score of more than 85% in the G?ttingen sentence test. These results and the progress made in cochlear implant technology are an impetus to continue discussions of various considerations of criteria for cochlear implants and possibly extend these for patients with severe hearing impairment.     

Cochlear implant in patients with residual hearing

Objective: The postoperative speech perception abilities of severely hearing-impaired patients with multi-channel cochlear implant were compared with preoperative speech perception performance with conventional hearing aids. Methods: Cochlear implantation was performed in six severely to profoundly hearing-impaired patients. They had unaided pure-tone thresholds of 70–100-dB HL and aided thresholds of 35–90-dB HL in the better ear, but were not able to perceive speech sounds well with hearing aids. Results: Postoperatively, all the patients had significantly improved speech perception performance, exceeded the average skills of profoundly deaf cochlear implant users, and were able to communicate without writing. Conclusion: These results imply that cochlear implant may be indicated for severely to profoundly deaf subjects, if they receive little or no benefit from conventional hearing aids.     

Evidence-based guidelines for recommending cochlear implantation for young children: Audiological criteria and optimizing age at implantation

Abstract

Objective: Establish up-to-date evidence-based guidelines for recommending cochlear implantation for young children. Design: Speech perception results for early-implanted children were compared to children using traditional amplification. Equivalent pure-tone average (PTA) hearing loss for cochlear implant (CI) users was established. Language of early-implanted children was assessed over six years and compared to hearing peers. Study sample: Seventy-eight children using CIs and 62 children using traditional amplification with hearing losses ranging 25–120?dB HL PTA (speech perception study). Thirty-two children who received a CI before 2.5 years of age (language study). Results: Speech perception outcomes suggested that children with a PTA greater than 60?dB HL have a 75% chance of benefit over traditional amplification. More conservative criteria applied to the data suggested that children with PTA greater than 82?dB HL have a 95% chance of benefit. Children implanted under 2.5 years with no significant cognitive deficits made normal language progress but retained a delay approximately equal to their age at implantation. Conclusions: Hearing-impaired children under three years of age may benefit from cochlear implantation if their PTA exceeds 60?dB HL bilaterally. Implantation as young as possible should minimize any language delay resulting from an initial period of auditory deprivation.     

Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing.

Eighty-seven primary-school children with impaired hearing were evaluated using speech perception, production, and language measures over a 3-year period. Forty-seven children with a mean unaided pure-tone-average hearing loss of 106 dB HL used a 22-electrode cochlear implant, and 40 with a mean unaided pure-tone-average hearing loss of 78 dB HL were fitted with hearing aids. All children were enrolled in oral/aural habilitation programs, and most attended integrated classes with normally hearing children for part of the time at school. Multiple linear regression was used to describe the relationships among the speech perception, production, and language measures, and the trends over time. Little difference in the level of performance and trends was found for the two groups of children, so the perceptual effect of the implant is equivalent, on average, to an improvement of about 28 dB in hearing thresholds. Scores on the Peabody Picture Vocabulary Test (PPVT) and the Clinical Evaluation of Language Fundamentals showed an upward trend at about 60% of the rate for normally hearing children. Rates of improvement for individual children were not correlated significantly with degree of hearing loss. The children showed a wide scatter about the average speech production score of 40% of words correctly produced in spontaneous conversations, with no significant upward trend with age. Scores on the open-set Consonant-Nucleus-Consonant (CNC) monosyllabic word test and the Bench-Kowal-Bamford (BKB) sentence test were strongly related to language level (as measured by an equivalent age on the PPVT) and speech production scores for both auditory-visual and auditory test conditions. After allowing for differences in language, speech perception scores in the auditory test condition showed a slight downward trend over time, which is consistent with the known biological effects of hearing loss on the auditory periphery and brainstem. Speech perception scores in the auditory condition also decreased significantly by about 5% for every 10 dB of hearing loss in the hearing aid group. The regression analysis model allows separation of the effects of language, speech production, and hearing levels on speech perception scores so that the effects of habilitation and training in these areas can be observed and/or predicted. The model suggests that most of the children in the study will reach a level of over 90% sentence recognition in the auditory-visual condition when their language becomes equivalent to that of a normally hearing 7-year-old, but they will enter secondary school at age 12 with an average language delay of about 4 or 5 years unless they receive concentrated and effective language training.     

Audiological application criteria for implantable hearing aid devices: a clinical experience at the Nijmegen ORL clinic

Objectives/Hypothesis: To define audiological application criteria for different implantable hearing aid devices. Study Design: Retrospective study. Methods: Comparisons were made between aided speech recognition scores obtained at conversational level (65 dB) in patients with the Vibrant Soundbridge (VSB) (n = 22), the Otologics middle ear transducer (MET) (n = 10), conventional hearing aids (behind-the-ears) (n = 47), and cochlear implants (CIs) (n = 123). Results: In relation to hearing loss, only for mild hearing loss, speech recognition scores with VSB were comparable to that with conventional hearing aids. In the Otologics MET users, speech recognition scores were comparable with those of the conventional hearing aid users until a mean hearing loss of about 75 dB HL. At a sensorineural hearing loss of about 65 dB HL or more, the Otologics MET users have better speech recognition scores than the VSB users. For comparison with CI users, we followed a more conservative approach. In 90% of the users of a CI, speech recognition scores were better than those in: 1) patients with a conventional hearing aid and a mean hearing loss of about 95 dB HL or worse; 2) patients with an Otologics MET and a mean hearing loss of 85 dB HL or worse. Conclusions: Patients fitted with a VSB or an Otologics MET middle ear implant do not demonstrate better speech recognition scores than patients fitted with today's conventional hearing aids. Results might even been worse. However, the VSB and Otologics MET are a good option in patients with moderate (VSB) to severe (Otologics MET) sensorineural hearing loss and external otitis.     

学龄前听障儿童助听后言语流畅性的特征及影响因素

目的 分析学龄前听障儿童助听后言语流畅性的特征,探讨辅听装置、年龄、性别、语训时长对其言语流畅性的影响.方法 以109例3.5~6.5岁学龄前健听及听障儿童为研究对象,其中健听儿童30例(健听组),双耳佩戴助听器的听障儿童28例(助听器组),右耳植入人工耳蜗的听障儿童26例(人工耳蜗组),同时佩戴助听器和人工耳蜗双耳双模式助听的听障儿童25例(双模式组),通过主题对话的形式分别采集各组儿童的语音样本,比较各组儿童在自发性言语语言任务下的语速、停顿、重复和拖延差异;分析辅听装置、年龄、性别、语训时长等因素对听障儿童言语流畅性的影响.结果 ①健听组儿童的语速显著高于其他三组(P<0.05),健听组停顿次数显著低于人工耳蜗组(P=0.001)和双模式组(P=0.032);健听组拖延次数显著低于助听器组(P=0.001)和双模式组(P=0.001),极显著低于人工耳蜗组(P<0.001);②不同性别听障儿童语速、停顿、重复次数和拖延次数差异无统计学意义(P>0.05),而助听器组语速显著高于人工耳蜗组(P=0.045),人工耳蜗组停顿次数显著高于助听器组(P=0.028);3.5~5岁听障儿童语速显著低于5.1~6.5岁组(P=0.042);语训0~2.5年听障儿童语速显著低于语训>2.5年者(P=0.002),停顿及重复次数均高于语训>2.5年者(分别P=0.047,P=0.02).结论 听障儿童的语速低于健听儿童,停顿次数、拖延次数高于健听儿童;年龄、辅听装置、语训时长影响学龄前听障儿童的言语流畅性,性别影响不大.     

Effects of sensorineural hearing loss and personal hearing AIDS on cortical event-related potential and behavioral measures of speech-sound processing

OBJECTIVE: To systematically investigate the combined effects of sensorineural hearing loss and prescribed personal hearing aid(s) on cortical event-related potentials (ERPs) (waves N1, MMN, N2b, and P3b) and their related behavioral measures of discrimination (d-prime sensitivity and reaction time) to the speech sounds /ba/ and /da/ presented at 65 and 80 dB peak-to-peak equivalent SPL. DESIGN: Cortical ERPs were recorded to /ba/ and /da/ speech stimuli presented at 65 and 80 dB peak-to-peak equivalent SPL from 20 normal-hearing adults and 14 adults with sensorineural hearing losses. The degree of sensorineural impairment at 1000 to 2000 Hz ranged from moderate losses (50 to 74 dB HL) to severe-profound losses (75 to 120 dB HL). The speech stimuli were presented in an oddball paradigm and cortical ERPs were recorded in both active and passive listening conditions at both stimulus intensities. The adults with hearing impairments were tested in the unaided and aided conditions at each stimulus intensity. Electroacoustic and real-ear testing was performed on each subject's hearing aid(s) before electrophysiology testing to ensure that the hearing aids were functioning at the time of testing. RESULTS: The use of personal hearing aids substantially improved the detectability of all the cortical ERPs and behavioral d-prime performance scores at both stimulus intensities. This was especially true for individuals with severe-profound hearing losses. At 65 dB SPL, mean ERP amplitudes and d-prime sensitivity scores were all significantly higher or better in the aided versus unaided condition. At 80 dB SPL, only the N1 amplitudes and d-prime sensitivity scores were significantly better in the aided condition. Even though the majority of the hearing-impaired subjects showed increased amplitudes, decreased latencies, and better waveform morphology in the aided condition, the amount of response change (improvements) seen in these measures showed considerable variability across subjects. When compared with the responses obtained from the normal-hearing subjects, both hearing-impaired groups had significantly prolonged aided RT latencies at both stimulus intensities and N2b latencies at the higher stimulus intensities. CONCLUSIONS: These results suggest that hearing-impaired individuals' brains process speech stimuli with greater accuracy and in a more effective manner when these individuals use their personal hearing aids. This is especially true at the lower stimulus intensity. The effects of sensorineural hearing loss and personal hearing aids on cortical ERPs and behavioral measures of discrimination are dependent on the degree of sensorineural loss, the intensity of the stimuli, and the level of cortical auditory processing that the response measure is assessing. The possible clinical significance of these cortical ERP and behavioral findings is discussed.     

Speech and music quality ratings for linear and nonlinear hearing aid circuitry

This study evaluated quality ratings for speech and music stimuli processed using peak clipping (PC), compression limiting (CL), and wide-dynamic range compression (WDRC) hearing aid circuitry. Eighteen listeners with mild-to-moderate hearing loss were binaurally fitted with behind-the-ear (BTE) hearing aids and instructed to rate the quality of speech under various conditions in quiet and noise and two genres of music. Results for speech revealed a slight preference for WDRC at 80 dB SPL, and equivalent ratings for the three circuits under all other listening conditions. Music ratings revealed a marginally significant preference for WDRC and a preference for classical over popular music. For music, judgments on pleasantness were the most influential on overall circuit preference.