An analysis of the communication tactics used by hearing-impaired adults

The aim of this study was to establish whether and to what degree certain types of communication strategies (hearing tactics) used by hearing-impaired adults could be shown to co-occur, and to find out which strategies were more likely to be used in which type of communicative situations. A consecutive series of 100 patients attending an audiological rehabilitation clinic was given a questionnaire asking how often they used each of five different hearing tactics in 11 different situations. 'Avoidance' and 'request for repetition' were the tactics used most commonly. 'Pretending to hear/understand' and 'positioning self to improve hearing' were used less frequently, with 'interruption' the least commonly used. There was some association between tactics and situations but no clear picture emerged. In a reassessment of our methodology and results, we suggest that the future research of communication strategies would benefit from a sociolinguistic approach based on the qualitative analysis of naturally occurring discourse (conversation) of hard-of-hearing people, focusing on the use of different strategies in relation to communicators' goals in interaction.     

Perception of voiceless fricatives by normal-hearing and hearing-impaired children and adults.

This study examined the perceptual-weighting strategies and performance-audibility functions of 11 moderately hearing-impaired (HI) children, 11 age-matched normal-hearing (NH) children, 11 moderately HI adults, and 11 NH adults. The purpose was to (a) determine the perceptual-weighting strategies of HI children relative to the other groups and (b) determine the audibility required by each group to achieve a criterion level of performance. Stimuli were 4 nonsense syllables (see text). The vowel, transition, and fricative segments of each nonsense syllable were identified along the temporal domain, and each segment was amplified randomly within each syllable during presentation. Point-biserial correlation coefficients were calculated using the amplitude variation of each segment and the correct and incorrect responses for the corresponding syllable. Results showed that for /see text/ and /see text/, all four groups heavily weighted the fricative segments during perception, whereas the vowel and transition segments received little or no weight. For /see text/, relatively low weights were given to each segment by all four groups. For /see text/, the NH children and adults weighted the transition segment more so than the vowel and fricative segments, whereas the HI children and adults weighted all three segments equally low. Performance-audibility functions of the fricative segments of /see text/ and /see text/ were constructed for each group. In general, maximum performance for each group was reached at lower audibility levels for /see text/ than for /see text/ and steeper functions were observed for the HI groups relative to the NH groups. A decision theory approach was used to confirm the audibility required by each group to achieve a > or =90% level of performance. Results showed both hearing sensitivity and age effects. The HI listeners required lower levels of audibility than the NH listeners to achieve similar levels of performance. Likewise, the adult listeners required lower levels of audibility than the children, although this difference was more substantial for the NH listeners than for the HI listeners.     

Probe-tube microphone measures in hearing-impaired children and adults

This study was designed to investigate the reliability of real-ear measurements of sound pressure level (SPL) and to compare these values with two coupler measures of SPL. A commercially available probe tube microphone system was used to measure real ear SPL in both children and adults. Test-retest reliability decreased as a function of frequency for both groups and, in general, was slightly poorer for the children. For both groups, coupler to real ear differences were larger for the 2 cm3 coupler than for the reduced volume coupler; however, no significant differences were observed between groups. In addition, a measure of ear canal volume was not found to be a good predictor of coupler to real ear discrepancies.     

Click-evoked oto-acoustic emissions in normal and hearing-impaired adults

Click-evoked oto-acoustic emissions have been recorded in 18 normal subjects and 19 hearing-impaired subjects taken from an ENT outpatient clinic. An emission could be recorded in all but 1 ear of those subjects where the psychoacoustic threshold to the click stimulus was 13 dB nHL or lower. No emission could be recorded in all subjects where this threshold was 18 dB nHL or higher. The level of stimulus required to obtain a recordable emission was found to be correlated with the psycho-acoustical threshold of the click stimuli but not to a high enough level to make this a useful measure of hearing loss.     

Nonverbal sensitivity of normal-hearing and hearing-impaired older adults

The study compared the nonverbal decoding abilities of normal-hearing and hard-of-hearing older adults using the Profile of Nonverbal Sensitivity (PONS). The PONS test allowed the measurement of subjects' decoding accuracy for a variety of nonverbal cues presented under two auditory, three visual, and six audiovisual conditions. Nonverbal perceptual scores were lower for the hearing-impaired group under all presentation conditions. Perception of prosodic features of speech by hearing-impaired subjects was significantly related to low-frequency hearing sensitivity. Between-group differences in the decoding of visually transmitted nonverbal cues varied across visual presentation conditions. Results are compared to past deaf studies and related to processing strategies used by normal-hearing and hearing-impaired persons.     

优化聋健合一活动模式促进聋儿多渠道交往

“聋健合一”的康复教育模式已推行多年，教育机会应该是均等的，“聋健合一”不是康复效果好的聋孩子的“专利”，而是每位聋孩子都能享有的权利。广州市聋人学校附属海印南苑幼儿园在实践中不断优化聋健合一的教育活动，努力完善融合教育模式。通过聋健同训、混龄活动、社会交往、社区活动、聋健家长交流等途径，让每个聋儿有丰富的交往渠道，从而学会交往、学会合作，学会生活、学会做人，达到全面康复的目标。     

Investigation of binaural interference in normal-hearing and hearing-impaired adults

When speech recognition testing is performed under diotic conditions, some elderly persons with asymmetric hearing loss exhibit a phenomenon in which the performance of the poorer ear interferes with that of the better ear. This binaural interference phenomenon has been estimated to occur in 8 to 10 percent of elderly hearing aid users. The purpose of the present study was to investigate the prevalence of this phenomenon in groups (n = 12) of young and elderly listeners with normal hearing, plus groups of elderly listeners with hearing loss who were aided or unaided. Of 48 subjects tested, only 2 exhibited significant evidence of binaural interference, a result that is close to that expected by chance. Although both of these subjects were elderly, one had normal hearing and the other was aided binaurally. A third elderly unaided subject exhibited a significant binaural advantage. Further studies are needed to determine the prevalence of binaural interference in normal-hearing or hearing-impaired listeners in any decade of life.     

Otoacoustic emissions in normal and hearing-impaired children and normal adults

Although distortion-product otoacoustic emissions (DPOEs) have been studied in adults recently, there is little information regarding them in young children. DPOEs and click-evoked otoacoustic emissions (CEOEs) were measured from a same group of normal and hearing-impaired children (age 4 through 10 years) and normal adults (age 22 through 29 years). Measurements of DPOEs in 13 children's ears with normal hearing showed higher levels of emissions in the 700- to 1400-Hz and 5.7-kHz regions relative to the data obtained in 10 normal adult ears. The 22 ears of children with sensorineural hearing loss demonstrated agreement between pure-tone audiograms and "DPOE audiograms." Measurements of CEOEs revealed that the average level of emission in 15 normal-hearing children's ears was slightly lower than that previously obtained in newborns, but slightly higher than that of adults. In children, the CEOE spectral components in the 4- to 6-kHz region were lower than in newborns, but higher than in adults. These results support the view that the DPOEs and CEOEs comprise a valuable tool in assessment of cochlear function in subjects of all ages.     

An exploratory study into perception of acoustic speech cues by hearing-impaired adults

The aims of the present study were to assess discrimination and identification based on two classes of acoustic cue by adults with acquired sensorineural hearing impairment. Eight hearing-impaired and eight normally hearing adults were asked to identify and discriminate two different sets of speech stimuli. A plosive voicing continuum (coat/goat) varied in voice onset time. The plosive place of articulation continuum (date/gate) varied in burst spectra and second formant transition. Subjects were tested in the unaided condition with the exception of one hearing-impaired subject for whom speech was completely inaudible without a hearing aid. There was no significant between-group difference in discrimination or identification of the voicing contrast. There was no significant between-group difference in identification of stimuli varying by place of articulation. However, three of the eight hearing-impaired subjects were very poor at identification. The hearing-impaired subjects also showed significantly impaired place of articulation discrimination. Both measures were significantly correlated with threshold at 2000 Hz. The results support the view that hearing impairment can have different effects on perception of different acoustic contrasts and on different psychophysical tasks.     

The UCSF tracking procedure for evaluation and training of speech reception by hearing-impaired adults

A tracking procedure that emphasizes practical coping strategies for hearing-impaired patients, along with practice in responding to other cues in the perception of connected speech, is described in detail in the course of its use with one subject. The subject's tracking scores before and after training illustrate the potential value of the procedure both as an evaluative measure and as a training tool. The organization of the materials and the design of the training protocol allow for a wide range of practice activities in tracking, including the use of nonverbatim as well as verbatim responses.     

Effect of two approaches to auditory training on speech recognition by hearing-impaired adults

Twenty adults with mild to moderate sensorineural hearing impairments were given three tests of speech recognition: the CUNY Nonsense Syllable Test (NST), the low predictability items of the Revised Speech Perception in Noise (RSPIN) test, and the high predictability items of the RSPIN test. They were tested on four occasions: at the beginning of the study, after one month of "no treatment," after a month of intensive auditory training, and after a further month of "no treatment." During the treatment period, 10 of the subjects spent all of the time on activities involving sentence perception and perceptual strategy while the other 10 spent half of the time on activities involving consonant recognition. A small, but statistically significant increase in speech recognition performance on the high probability material was observed in both groups subsequent to training, but the effect of training method was not significant. In addition, the gains achieved were not lost in the month following the end of training. The findings suggest that the benefits of auditory training were found in an increased use of sentence context as an aid to word recognition.     

Auditory steady-state responses and word recognition scores in normal-hearing and hearing-impaired adults

OBJECTIVE: The number of steady-state responses evoked by the independent amplitude and frequency modulation (IAFM) of tones has been related to the ability to discriminate speech sounds as measured by word recognition scores (WRS). In the present study IAFM stimulus parameters were adjusted to resemble the acoustic properties of everyday speech to see how well responses to these speech-modeled stimuli were related to WRS. DESIGN: We separately measured WRS and IAFM responses at a stimulus intensity of 70 dB SPL in three groups of subjects: young normal-hearing, elderly normal-hearing, and elderly hearing-impaired. We used two series of IAFM stimuli, one with modulation frequencies near 40 Hz and the other with modulation frequencies near 80 Hz. The IAFM stimuli, consisting of four carrier frequencies each independently modulated in frequency and amplitude, could evoke up to eight separate responses in one ear. We recorded IAFM responses and WRS measurements in quiet and in the presence of speech-masking noise at 67 dB SPL or 70 dB SPL. We then evaluated the hearing-impaired subjects with and without their hearing aids to see whether an improvement in WRS would be reflected in an increased number of responses to the IAFM stimulus. RESULTS: The correlations between WRS and the number of IAFM responses recognized as significantly different from the background were between 0.70 and 0.81 for the 40 Hz stimuli, between 0.73 and 0.82 for the 80 Hz stimuli, and between 0.76 and 0.85 for the combined assessment of 40 and 80 Hz responses. Response amplitudes at 80 Hz were smaller in the hearing-impaired than in the normal-hearing subjects. Response amplitudes for the 40 Hz stimuli varied with the state of arousal and this effect made it impossible to compare amplitudes across the different groups. Hearing aids increased both the WRS and the number of significant IAFM responses at 40 Hz and 80 Hz. Masking decreased the WRS and the number of significant responses. CONCLUSIONS: IAFM responses are significantly correlated with WRS and may provide an objective tool for examining the brain's ability to process the auditory information needed to perceive speech.     

Acquisition of spoken and signed English by hearing-impaired children of hearing-impaired or hearing parents

This study examines the degree to which hearing-impaired children of hearing-impaired parents (HIP) demonstrate an advantage in their acquisition of signed and spoken English over hearing-impaired children of hearing parents (HP). A subset from the normative sample of the Grammatical Analysis of Elicited Language, 50 HIP children and 50 HP children, were matched in terms of their educational program, hearing level, and age. Results indicate that both groups had comparably poor expressive English language ability at 5 and 6 years of age. However, at age 7 and 8 HIP children demonstrated a significant linguistic advantage in both their spoken and signed English over HP children. Because the production of English by HIP children closely resembled that of orally educated hearing-impaired children of hearing parents, consistent language stimulation throughout the child's early years may be a critical factor in the development of English, regardless of the language or mode of expression.     

Spectrographic and perceptual features of vocal tension/harshness in hearing-impaired adults.

Twenty hearing-impaired adult males exhibiting a range of severity of vocal tension/harshness sustained the vowels /a/ and /u/, at a constant intensity level and read the first two sentences of the Rainbow Passage. Recordings of the vowels and sentences were rated for degree of severity of vocal tension/harshness on a 5-point, equal-appearing-interval scale by three speech pathologists. Each vowel production was analyzed to produce a narrow-hand (10 Hz) frequency-by-amplitude acoustic spectrum in which the levels of inharmonic energy, i.e., noise components, were measured in dB SPL over the frequency range 100--3000 Hz. Significant correlations were obtained between: mean ratings of vocal tension for sentences and for vowels; mean ratings of vocal tension for vowels and average spectral noise levels for vowels; and mean ratings of vocal tension for sentences and average spectral noise levels for vowels.     

Visual evoked-response components related to speechreading and spatial skills in hearing and hearing-impaired adults

Averaged visual evoked responses (VER) to light flashes which varied systematically in brightness and predictability were collected from 24 hearing and 24 hearing-impaired adults. In addition, speechreading, abstract reasoning, and spatial relations tests were administered. Separate principal components analyses of the VERs were conducted on each group to replicate and extend our previous report of an early VER component (VF16) which reflected individual differences in the speechreading skills of hearing subjects. VF16 appeared in both analyses, confirming its replicability as a latent VER component. VF16 correlated with speechreading skill in hearing-impaired males (r = -.73), under stimulus conditions identical to those in our previous study. However, its correlations with speechreading skills in hearing subjects were not significant. VF16 also varied systematically with stimulus predictability and correlated with spatial ability in both groups only when the time of occurrence of the light flashes was predictable. These data tentatively suggest that VF16 is a VER correlate of individual differences in a psychologically dynamic process, perhaps involving expectancy, which may relate to the performance of hearing-impaired and hearing people in visually based communication or cognitive processing situations.     

Subjective benefit of communication aids evaluated by postlingually deaf adults

Three groups of postlingually deaf adults were selected, trained and followed for about 2 years. The subjects with residual hearing were fitted with a powerful hearing aid (HA group, N = 10), the rest were given a single channel vibrotactile aid (V group, N = 8) or received a single channel cochlear implant (CI group, N = 10). The subjects were asked to evaluate the subjective benefit, disadvantage and magnitude of hearing impairment after the rehabilitation. Although the HA group achieved the highest scores in the audiological tests, the interviews revealed that the CI group found the implant quite beneficial in everyday life and in changing their attitude towards the handicap. After 2 years of use, this group reported the highest index of benefit, the best discrimination of everyday sounds and used the device most frequently. The V group were not as satisfied with their devices as the CI and HA groups.