Efficacy and Effectiveness of Advanced Hearing Aid Directional and Noise Reduction Technologies for Older Adults With Mild to Moderate Hearing Loss

Objectives: The purpose of the present study was to investigate the laboratory efficacy and real-world effectiveness of advanced directional microphones (DM) and digital noise reduction (NR) algorithms (i.e., premium DM/NR features) relative to basic-level DM/NR features of contemporary hearing aids (HAs). The study also examined the effect of premium HAs relative to basic HAs and the effect of DM/NR features relative to no features. Design: Fifty-four older adults with mild-to-moderate hearing loss completed a single-blinded crossover trial. Two HA models, one a less-expensive, basic-level device (basic HA) and the other a more-expensive, advanced-level device (premium HA), were used. The DM/NR features of the basic HAs (i.e., basic features) were adaptive DMs and gain-reduction NR with fewer channels. In contrast, the DM/NR features of the premium HAs (i.e., premium features) included adaptive DMs and gain-reduction NR with more channels, bilateral beamformers, speech-seeking DMs, pinna-simulation directivity, reverberation reduction, impulse NR, wind NR, and spatial NR. The trial consisted of four conditions, which were factorial combinations of HA model (premium versus basic) and DM/NR feature status (on versus off). To blind participants regarding the HA technology, no technology details were disclosed and minimal training on how to use the features was provided. In each condition, participants wore bilateral HAs for 5 weeks. Outcomes regarding speech understanding, listening effort, sound quality, localization, and HA satisfaction were measured using laboratory tests, retrospective self-reports (i.e., standardized questionnaires), and in-situ self-reports (i.e., self-reports completed in the real world in real time). A smartphone-based ecological momentary assessment system was used to collect in-situ self-reports. Results: Laboratory efficacy data generally supported the benefit of premium DM/NR features relative to basic DM/NR, premium HAs relative to basic HAs, and DM/NR features relative to no DM/NR in improving speech understanding and localization performance. Laboratory data also indicated that DM/NR features could improve listening effort and sound quality compared with no features for both basic- and premium-level HAs. For real-world effectiveness, in-situ self-reports first indicated that noisy or very noisy situations did not occur very often in participants’ daily lives (10.9% of the time). Although both retrospective and in-situ self-reports indicated that participants were more satisfied with HAs equipped with DM/NR features than without, there was no strong evidence to support the benefit of premium DM/NR features and premium HAs over basic DM/NR features and basic HAs, respectively. Conclusions: Although premium DM/NR features and premium HAs outperformed their basic-level counterparts in well-controlled laboratory test conditions, the benefits were not observed in the real world. In contrast, the effect of DM/NR features relative to no features was robust both in the laboratory and in the real world. Therefore, the present study suggests that although both premium and basic DM/NR technologies evaluated in the study have the potential to improve HA outcomes, older adults with mild-to-moderate hearing loss are unlikely to perceive the additional benefits provided by the premium DM/NR features in their daily lives. Limitations concerning the study’s generalizability (e.g., participant’s lifestyle) are discussed. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal’s Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: Yu-Hsiang Wu is currently receiving grants from the National Institute on Deafness and Other Communication Disorders, the National Institute on Disability, Independent Living, and Rehabilitation Research, and the Retirement Research Foundation. Octav Chipara is currently receiving grants from the National Institute on Disability, Independent Living, and Rehabilitation Research and the National Science Foundation. Jacob Oleson is currently receiving grants from the National Institute on Deafness and Other Communication Disorders, National Heart, Lung, and Blood Institute, Department of Defense, Centers for Disease Control and Prevention, Fogarty International Center, and the Iowa Department of Public Health. The current research was supported by National Institute on Deafness and Other Communication Disorders (R03DC012551) and the National Institute on Disability, Independent Living, and Rehabilitation Research (90RE5020-01-00). The current research was supported by NIH/NIDCD R03DC012551 (title: Minimal Technologies for Hearing Aid Success in Elderly Adults) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 90RE5020-01-00 (title: RERC on Improving the Accessibility, Usability, and Performance of Technology for Individuals Who are Deaf or Hard of Hearing). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policy of NIDILRR, ACL, HHS, and the reader should not assume endorsement by the Federal Government. Portions of this paper were presented at the annual conference of the American Auditory Society, March 3, 2016, Scottsdale, AZ. Y.-H.W. designed experiments, interpreted data, and wrote the article; E.S. collected data; O.C. and S.S.H. developed EMA software and processed EMA data; S.D. and J.O. provided statistical analysis. All authors discussed the results and implications and commented on the manuscript at all stages. The authors have no conflicts of interest to declare. Address for correspondence: Yu-Hsiang Wu, 125C SHC, Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, IA 52242, USA. E-mail: yu-hsiang-wu@uiowa.edu Received March 8, 2018; accepted August 29, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Efficacy and Effectiveness of Advanced Hearing Aid Directional and Noise Reduction Technologies for Older Adults With Mild to Moderate Hearing Loss

Objectives: The purpose of the present study was to investigate the laboratory efficacy and real-world effectiveness of advanced directional microphones (DM) and digital noise reduction (NR) algorithms (i.e., premium DM/NR features) relative to basic-level DM/NR features of contemporary hearing aids (HAs). The study also examined the effect of premium HAs relative to basic HAs and the effect of DM/NR features relative to no features. Design: Fifty-four older adults with mild-to-moderate hearing loss completed a single-blinded crossover trial. Two HA models, one a less-expensive, basic-level device (basic HA) and the other a more-expensive, advanced-level device (premium HA), were used. The DM/NR features of the basic HAs (i.e., basic features) were adaptive DMs and gain-reduction NR with fewer channels. In contrast, the DM/NR features of the premium HAs (i.e., premium features) included adaptive DMs and gain-reduction NR with more channels, bilateral beamformers, speech-seeking DMs, pinna-simulation directivity, reverberation reduction, impulse NR, wind NR, and spatial NR. The trial consisted of four conditions, which were factorial combinations of HA model (premium versus basic) and DM/NR feature status (on versus off). To blind participants regarding the HA technology, no technology details were disclosed and minimal training on how to use the features was provided. In each condition, participants wore bilateral HAs for 5 weeks. Outcomes regarding speech understanding, listening effort, sound quality, localization, and HA satisfaction were measured using laboratory tests, retrospective self-reports (i.e., standardized questionnaires), and in-situ self-reports (i.e., self-reports completed in the real world in real time). A smartphone-based ecological momentary assessment system was used to collect in-situ self-reports. Results: Laboratory efficacy data generally supported the benefit of premium DM/NR features relative to basic DM/NR, premium HAs relative to basic HAs, and DM/NR features relative to no DM/NR in improving speech understanding and localization performance. Laboratory data also indicated that DM/NR features could improve listening effort and sound quality compared with no features for both basic- and premium-level HAs. For real-world effectiveness, in-situ self-reports first indicated that noisy or very noisy situations did not occur very often in participants’ daily lives (10.9% of the time). Although both retrospective and in-situ self-reports indicated that participants were more satisfied with HAs equipped with DM/NR features than without, there was no strong evidence to support the benefit of premium DM/NR features and premium HAs over basic DM/NR features and basic HAs, respectively. Conclusions: Although premium DM/NR features and premium HAs outperformed their basic-level counterparts in well-controlled laboratory test conditions, the benefits were not observed in the real world. In contrast, the effect of DM/NR features relative to no features was robust both in the laboratory and in the real world. Therefore, the present study suggests that although both premium and basic DM/NR technologies evaluated in the study have the potential to improve HA outcomes, older adults with mild-to-moderate hearing loss are unlikely to perceive the additional benefits provided by the premium DM/NR features in their daily lives. Limitations concerning the study’s generalizability (e.g., participant’s lifestyle) are discussed. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal’s Web site (www.ear-hearing.com). ACKNOWLEDGMENTS: Yu-Hsiang Wu is currently receiving grants from the National Institute on Deafness and Other Communication Disorders, the National Institute on Disability, Independent Living, and Rehabilitation Research, and the Retirement Research Foundation. Octav Chipara is currently receiving grants from the National Institute on Disability, Independent Living, and Rehabilitation Research and the National Science Foundation. Jacob Oleson is currently receiving grants from the National Institute on Deafness and Other Communication Disorders, National Heart, Lung, and Blood Institute, Department of Defense, Centers for Disease Control and Prevention, Fogarty International Center, and the Iowa Department of Public Health. The current research was supported by National Institute on Deafness and Other Communication Disorders (R03DC012551) and the National Institute on Disability, Independent Living, and Rehabilitation Research (90RE5020-01-00). The current research was supported by NIH/NIDCD R03DC012551 (title: Minimal Technologies for Hearing Aid Success in Elderly Adults) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 90RE5020-01-00 (title: RERC on Improving the Accessibility, Usability, and Performance of Technology for Individuals Who are Deaf or Hard of Hearing). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this article do not necessarily represent the policy of NIDILRR, ACL, HHS, and the reader should not assume endorsement by the Federal Government. Portions of this paper were presented at the annual conference of the American Auditory Society, March 3, 2016, Scottsdale, AZ. Y.-H.W. designed experiments, interpreted data, and wrote the article; E.S. collected data; O.C. and S.S.H. developed EMA software and processed EMA data; S.D. and J.O. provided statistical analysis. All authors discussed the results and implications and commented on the manuscript at all stages. The authors have no conflicts of interest to declare. Address for correspondence: Yu-Hsiang Wu, 125C SHC, Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, IA 52242, USA. E-mail: yu-hsiang-wu@uiowa.edu Received March 8, 2018; accepted August 29, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Wideband Absorbance and 226-Hz Tympanometry in the Prediction of Optimal Distortion Product Otoacoustic Emission Primary Tone Levels

Purpose

Distortion product otoacoustic emission (DPOAE) amplitude is sensitive to the primary tone level separation effective within the cochlea. Despite potential for middle ear sound transmission characteristics to affect this separation, no primary tone level optimization formula accounts for its influence. This study was conducted to determine if inclusion of ear- and frequency-specific immittance features improves primary tone level optimization formula performance beyond that achieved using a univariate, L ₂-based formula.

Method

For 30 adults with normal hearing, DPOAE, wideband absorbance, and 226-Hz tympanometry measures were completed. A mixed linear modeling technique, incorporating both primary tone and acoustic immittance features, was used to generate a multivariable formula for the middle ear–specific recommendation of primary tone level separations for f ₂ = 1–6 kHz. The accuracy with which L _1OPT, or the L ₁ observed to maximize DPOAE level for each given L ₂, could be predicted using the multivariable formula was then compared with that of a traditional, L ₂-based univariate formula for each individual ear.

Results

Use of the multivariable formula L ₁ = 0.47L ₂ + 2.40A + f _2param + 38 [dB SPL] resulted in significantly more accurate L _1OPT predictions than did the univariate formula L ₁ = 0.49L ₂ + 41 [dB SPL]. Although average improvement was small, meaningful improvements were identified within individual ears, especially for f ₂ = 1 and 6 kHz.

Conclusion

Incorporation of a wideband absorbance measure into a primary tone level optimization formula resulted in a minor average improvement in L _1OPT prediction accuracy when compared with a traditional univariate optimization formula. Further research is needed to identify characteristics of ears that might disproportionately benefit from the additional measure.

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Comparing the Effect of Different Hearing Aid Fitting Methods in Bimodal Cochlear Implant Users

Purpose

The aim of the study was to investigate the effect of 3 hearing aid fitting procedures on provided gain of the hearing aid in bimodal cochlear implant users and their effect on bimodal benefit.

Method

This prospective study measured hearing aid gain and auditory performance in a cross-over design in which 3 hearing aid fitting methods were compared. Hearing aid fitting methods differed in initial gain prescription rule (NAL-NL2 and Audiogram+) and loudness balancing method (broadband vs. narrowband loudness balancing). Auditory functioning was evaluated by a speech-in-quiet test, a speech-in-noise test, and a sound localization test. Fourteen postlingually deafened adult bimodal cochlear implant users participated in the study.

Results

No differences in provided gain and in bimodal performance were found for the different hearing aid fittings. For all hearing aid fittings, a bimodal benefit was found for speech in noise and sound localization.

Conclusion

Our results confirm that cochlear implant users with residual hearing in the contralateral ear substantially benefit from bimodal stimulation. However, on average, no differences were found between different types of fitting methods, varying in prescription rule and loudness balancing method.

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Wideband Absorbance and 226-Hz Tympanometry in the Prediction of Optimal Distortion Product Otoacoustic Emission Primary Tone Levels

Purpose

Distortion product otoacoustic emission (DPOAE) amplitude is sensitive to the primary tone level separation effective within the cochlea. Despite potential for middle ear sound transmission characteristics to affect this separation, no primary tone level optimization formula accounts for its influence. This study was conducted to determine if inclusion of ear- and frequency-specific immittance features improves primary tone level optimization formula performance beyond that achieved using a univariate, L ₂-based formula.

Method

For 30 adults with normal hearing, DPOAE, wideband absorbance, and 226-Hz tympanometry measures were completed. A mixed linear modeling technique, incorporating both primary tone and acoustic immittance features, was used to generate a multivariable formula for the middle ear–specific recommendation of primary tone level separations for f ₂ = 1–6 kHz. The accuracy with which L _1OPT, or the L ₁ observed to maximize DPOAE level for each given L ₂, could be predicted using the multivariable formula was then compared with that of a traditional, L ₂-based univariate formula for each individual ear.

Results

Use of the multivariable formula L ₁ = 0.47L ₂ + 2.40A + f _2param + 38 [dB SPL] resulted in significantly more accurate L _1OPT predictions than did the univariate formula L ₁ = 0.49L ₂ + 41 [dB SPL]. Although average improvement was small, meaningful improvements were identified within individual ears, especially for f ₂ = 1 and 6 kHz.

Conclusion

Incorporation of a wideband absorbance measure into a primary tone level optimization formula resulted in a minor average improvement in L _1OPT prediction accuracy when compared with a traditional univariate optimization formula. Further research is needed to identify characteristics of ears that might disproportionately benefit from the additional measure.

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Comparing the Effect of Different Hearing Aid Fitting Methods in Bimodal Cochlear Implant Users

Purpose

The aim of the study was to investigate the effect of 3 hearing aid fitting procedures on provided gain of the hearing aid in bimodal cochlear implant users and their effect on bimodal benefit.

Method

This prospective study measured hearing aid gain and auditory performance in a cross-over design in which 3 hearing aid fitting methods were compared. Hearing aid fitting methods differed in initial gain prescription rule (NAL-NL2 and Audiogram+) and loudness balancing method (broadband vs. narrowband loudness balancing). Auditory functioning was evaluated by a speech-in-quiet test, a speech-in-noise test, and a sound localization test. Fourteen postlingually deafened adult bimodal cochlear implant users participated in the study.

Results

No differences in provided gain and in bimodal performance were found for the different hearing aid fittings. For all hearing aid fittings, a bimodal benefit was found for speech in noise and sound localization.

Conclusion

Our results confirm that cochlear implant users with residual hearing in the contralateral ear substantially benefit from bimodal stimulation. However, on average, no differences were found between different types of fitting methods, varying in prescription rule and loudness balancing method.

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Predictors of Vocabulary Outcomes in Children Who Are Deaf or Hard of Hearing From Spanish-Speaking Families

Purpose

The goal of this study was to identify predictors of expressive vocabulary in young Spanish-speaking children who are deaf or hard of hearing living in the United States.

Method

This cross-sectional study considered 53 children with bilateral hearing loss between 8 and 34 months of age (M = 24, SD = 6.9). Demographic variables, variables related to the hearing loss, and intervention variables were included in a hierarchical regression analysis to predict expressive vocabulary quotients from the MacArthur Inventario del Desarrollo de Habilidades Comunicativas (Communicative Development Inventories; Jackson-Maldonado et al., 2003).

Results

Chronological age, degree of hearing loss, functional hearing ability ratings, age of enrollment in early intervention, and the interaction between chronological age and age of intervention accounted for 61.5% of the vocabulary variance. Children who received intervention by 6 months of age achieved significantly higher vocabulary outcomes than children who started intervention later.

Conclusion

The children's mean vocabulary outcomes were below average when compared with hearing peers. This was especially true for older children, children with moderately-severe-to-profound hearing loss, and children who began intervention after 6 months of age. This delay in vocabulary outcomes has the potential to interfere with future reading and academic outcomes.

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Screening Children's Speech: The Impact of Imitated Elicitation and Word Position

Purpose

Diagnostic decision making is influenced by the attributes of assessments. In order to propose time-efficient protocols for screening children's speech, this study aimed to determine whether eliciting imitated responses and analyzing productions in different word positions resulted in different levels of consonant accuracy.

Method

Participants were 267 English-speaking preschool-age children in the Sound Start Study whose parents were concerned about their speech. They were assessed using the International Speech Screener: Research Version (ISS; McLeod, 2013) using either imitated or spontaneous elicitation. Productions were compared with an established diagnostic assessment of speech accuracy (Diagnostic Evaluation of Articulation and Phonology; Dodd, Hua, Crosbie, Holm, & Ozanne, 2002).

Results

Participants' performance on the ISS was significantly correlated with performance on the Diagnostic Evaluation of Articulation and Phonology. Eliciting imitated productions on the ISS (M = 2:18 min, SD = 0:59 min) took significantly less time than spontaneous productions (M = 6:32 min, SD = 2:34 min). There was no significant difference in accuracy of imitated versus spontaneous productions in word-initial position; however, consonants were significantly less accurate in spontaneous than imitated productions in other word positions. Overall, participants had significantly lower consonant accuracy in word-initial position than within-word or word-final positions. Examination of the influence of word position on test discrimination, using receiver operating characteristic analyses, revealed acceptable test discrimination for percentage of consonants correct across word positions.

Conclusion

This research supports using imitated elicitation and analysis of percentage of consonants correct in word-initial position as a time-efficient procedure when screening the speech of English-speaking preschool children.

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Orthographic Learning in Children Who Are Deaf or Hard of Hearing

Purpose

The purpose of the current study was to investigate the relationship between orthographic learning and language, reading, and cognitive skills in 9-year-old children who are deaf or hard of hearing (DHH) and to compare their performance to age-matched typically hearing (TH) controls.

Method

Eighteen children diagnosed with moderate-to-profound hearing loss who use hearing aids and/or cochlear implants participated. Their performance was compared with 35 age-matched controls with typical hearing. Orthographic learning was evaluated using a spelling task and a recognition task. The children were assessed on measures of reading ability, language, working memory, and paired-associate learning.

Results

On average, the DHH group performed more poorly than the TH controls on the spelling measure of orthographic learning, but not on the recognition measure. For both groups of children, there were significant correlations between orthographic learning and phonological decoding and between visual–verbal paired-associate learning and orthographic learning.

Conclusions

Although the children who are DHH had lower scores in the spelling test of orthographic learning than their TH peers, measures of their reading ability revealed that they acquired orthographic representations successfully. The results are consistent with the self-teaching hypothesis in suggesting that phonological decoding is important for orthographic learning.

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Measuring Articulation Rate: A Comparison of Two Methods

Purpose

Mean articulatory rate (MAR) is an alternative approach to measure articulation rate and is defined as the mean of 5 rate measures in minimally 10 to maximally 20 consecutive syllables in perceptually fluent speech without pauses. This study examined the validity of this approach.

Method

Reading and spontaneous speech samples were collected from 80 typically fluent adults ranging in age between 20 and 59 years. After orthographic transcription, all samples were subjected to an articulation rate analysis first using the prevailing “global” method, which takes into account the entire speech sample and involves manipulation of the speech sample, and then again applying the MAR method. Paired-samples t tests were conducted to compare global measurements to MAR measurements.

Results

For both spontaneous speech and reading, a strong correlation was found between the 2 methods. However, for both speech tasks, the paired-samples t tests revealed a significant difference with MAR values being higher than the global method values.

Conclusions

The MAR method is a valid method to measure articulation rate. However, it cannot be used interchangeably with the prevailing global method. Further standardization of the MAR method is needed before general clinical use can be suggested.

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Predictors of Vocabulary Outcomes in Children Who Are Deaf or Hard of Hearing From Spanish-Speaking Families

Purpose

The goal of this study was to identify predictors of expressive vocabulary in young Spanish-speaking children who are deaf or hard of hearing living in the United States.

Method

This cross-sectional study considered 53 children with bilateral hearing loss between 8 and 34 months of age (M = 24, SD = 6.9). Demographic variables, variables related to the hearing loss, and intervention variables were included in a hierarchical regression analysis to predict expressive vocabulary quotients from the MacArthur Inventario del Desarrollo de Habilidades Comunicativas (Communicative Development Inventories; Jackson-Maldonado et al., 2003).

Results

Chronological age, degree of hearing loss, functional hearing ability ratings, age of enrollment in early intervention, and the interaction between chronological age and age of intervention accounted for 61.5% of the vocabulary variance. Children who received intervention by 6 months of age achieved significantly higher vocabulary outcomes than children who started intervention later.

Conclusion

The children's mean vocabulary outcomes were below average when compared with hearing peers. This was especially true for older children, children with moderately-severe-to-profound hearing loss, and children who began intervention after 6 months of age. This delay in vocabulary outcomes has the potential to interfere with future reading and academic outcomes.

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Screening Children's Speech: The Impact of Imitated Elicitation and Word Position

Purpose

Diagnostic decision making is influenced by the attributes of assessments. In order to propose time-efficient protocols for screening children's speech, this study aimed to determine whether eliciting imitated responses and analyzing productions in different word positions resulted in different levels of consonant accuracy.

Method

Participants were 267 English-speaking preschool-age children in the Sound Start Study whose parents were concerned about their speech. They were assessed using the International Speech Screener: Research Version (ISS; McLeod, 2013) using either imitated or spontaneous elicitation. Productions were compared with an established diagnostic assessment of speech accuracy (Diagnostic Evaluation of Articulation and Phonology; Dodd, Hua, Crosbie, Holm, & Ozanne, 2002).

Results

Participants' performance on the ISS was significantly correlated with performance on the Diagnostic Evaluation of Articulation and Phonology. Eliciting imitated productions on the ISS (M = 2:18 min, SD = 0:59 min) took significantly less time than spontaneous productions (M = 6:32 min, SD = 2:34 min). There was no significant difference in accuracy of imitated versus spontaneous productions in word-initial position; however, consonants were significantly less accurate in spontaneous than imitated productions in other word positions. Overall, participants had significantly lower consonant accuracy in word-initial position than within-word or word-final positions. Examination of the influence of word position on test discrimination, using receiver operating characteristic analyses, revealed acceptable test discrimination for percentage of consonants correct across word positions.

Conclusion

This research supports using imitated elicitation and analysis of percentage of consonants correct in word-initial position as a time-efficient procedure when screening the speech of English-speaking preschool children.

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Orthographic Learning in Children Who Are Deaf or Hard of Hearing

Purpose

The purpose of the current study was to investigate the relationship between orthographic learning and language, reading, and cognitive skills in 9-year-old children who are deaf or hard of hearing (DHH) and to compare their performance to age-matched typically hearing (TH) controls.

Method

Eighteen children diagnosed with moderate-to-profound hearing loss who use hearing aids and/or cochlear implants participated. Their performance was compared with 35 age-matched controls with typical hearing. Orthographic learning was evaluated using a spelling task and a recognition task. The children were assessed on measures of reading ability, language, working memory, and paired-associate learning.

Results

On average, the DHH group performed more poorly than the TH controls on the spelling measure of orthographic learning, but not on the recognition measure. For both groups of children, there were significant correlations between orthographic learning and phonological decoding and between visual–verbal paired-associate learning and orthographic learning.

Conclusions

Although the children who are DHH had lower scores in the spelling test of orthographic learning than their TH peers, measures of their reading ability revealed that they acquired orthographic representations successfully. The results are consistent with the self-teaching hypothesis in suggesting that phonological decoding is important for orthographic learning.

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Measuring Articulation Rate: A Comparison of Two Methods

Purpose

Mean articulatory rate (MAR) is an alternative approach to measure articulation rate and is defined as the mean of 5 rate measures in minimally 10 to maximally 20 consecutive syllables in perceptually fluent speech without pauses. This study examined the validity of this approach.

Method

Reading and spontaneous speech samples were collected from 80 typically fluent adults ranging in age between 20 and 59 years. After orthographic transcription, all samples were subjected to an articulation rate analysis first using the prevailing “global” method, which takes into account the entire speech sample and involves manipulation of the speech sample, and then again applying the MAR method. Paired-samples t tests were conducted to compare global measurements to MAR measurements.

Results

For both spontaneous speech and reading, a strong correlation was found between the 2 methods. However, for both speech tasks, the paired-samples t tests revealed a significant difference with MAR values being higher than the global method values.

Conclusions

The MAR method is a valid method to measure articulation rate. However, it cannot be used interchangeably with the prevailing global method. Further standardization of the MAR method is needed before general clinical use can be suggested.

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3 (or more) spooky ways to trick your brain this Halloween

Did you really see that pale face just now? What was that sound? This Halloween, test the limits of your brain with these easy spooky experiments.

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3 (or more) spooky ways to trick your brain this Halloween

Did you really see that pale face just now? What was that sound? This Halloween, test the limits of your brain with these easy spooky experiments.

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Dynamic Knee Joint Stiffness and Contralateral Knee Joint Loading during Prolonged Walking in Patients with Unilateral Knee Osteoarthritis

Publication date: Available online 30 October 2018

Source: Gait & Posture

Author(s): Jonathan A. Gustafson, William Anderton, Gwendolyn A. Sowa, Sara R. Piva, Shawn Farrokhi

ABSTRACT

Background

Long duration walking, a commonly recommended treatment option for knee osteoarthritis (OA), may lead to increased knee joint loading.

Research question

To evaluate the effects of prolonged walking on dynamic knee joint stiffness and contralateral knee joint contact forces (KCFs) in individuals with unilateral symptomatic knee OA.

Methods

Twenty-six older adults with knee OA completed a 45-minute bout of walking on a treadmill. Dynamic knee joint stiffness, estimated KCFs, measured ground reaction forces (GRFs), and simulated muscle forces were evaluated for both the symptomatic and asymptomatic limbs at 15-minute intervals using repeated measures, analysis of variance (ANOVA).

Results

Dynamic knee joint stiffness during the early weight-acceptance phase of gait was significantly higher for the symptomatic limb throughout the 45-minute bout of walking. A significant increase in peak KCFs and simulated muscle forces were also observed during the weight-acceptance phase of gait for both limbs after 30 and 45 minutes of walking. Additionally, significantly elevated peak KCFs and muscle forces were observed during the late-stance phase of gait for the contralateral asymptomatic limb throughout the 45-minute bout of walking.

Significance

Walking durations of 30 minutes or greater lead to increased knee joint loading. Additionally, the elevated dynamic knee joint stiffness observed for the symptomatic knee during the weight acceptance phase of gait appears to be unrelated to the knee joint loading profile. Finally, the greater KCFs during the late-stance phase of gait observed for the asymptomatic limb are consistent with previously demonstrated risk factors for OA development and progression.

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Dynamic Knee Joint Stiffness and Contralateral Knee Joint Loading during Prolonged Walking in Patients with Unilateral Knee Osteoarthritis

Publication date: Available online 30 October 2018

Source: Gait & Posture

Author(s): Jonathan A. Gustafson, William Anderton, Gwendolyn A. Sowa, Sara R. Piva, Shawn Farrokhi

ABSTRACT

Background

Long duration walking, a commonly recommended treatment option for knee osteoarthritis (OA), may lead to increased knee joint loading.

Research question

To evaluate the effects of prolonged walking on dynamic knee joint stiffness and contralateral knee joint contact forces (KCFs) in individuals with unilateral symptomatic knee OA.

Methods

Twenty-six older adults with knee OA completed a 45-minute bout of walking on a treadmill. Dynamic knee joint stiffness, estimated KCFs, measured ground reaction forces (GRFs), and simulated muscle forces were evaluated for both the symptomatic and asymptomatic limbs at 15-minute intervals using repeated measures, analysis of variance (ANOVA).

Results

Dynamic knee joint stiffness during the early weight-acceptance phase of gait was significantly higher for the symptomatic limb throughout the 45-minute bout of walking. A significant increase in peak KCFs and simulated muscle forces were also observed during the weight-acceptance phase of gait for both limbs after 30 and 45 minutes of walking. Additionally, significantly elevated peak KCFs and muscle forces were observed during the late-stance phase of gait for the contralateral asymptomatic limb throughout the 45-minute bout of walking.

Significance

Walking durations of 30 minutes or greater lead to increased knee joint loading. Additionally, the elevated dynamic knee joint stiffness observed for the symptomatic knee during the weight acceptance phase of gait appears to be unrelated to the knee joint loading profile. Finally, the greater KCFs during the late-stance phase of gait observed for the asymptomatic limb are consistent with previously demonstrated risk factors for OA development and progression.

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Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

Cochrane Database Syst Rev. 2018 Oct 30;10:CD009764

Authors: Herath SC, Normansell R, Maisey S, Poole P

Abstract
BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD).
OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life.
SEARCH METHODS: We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018.
SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD.
DATA COLLECTION AND ANALYSIS: We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third review author.
MAIN RESULTS: We included 14 studies involving 3932 participants in this review. We identified two further studies meeting inclusion criteria but both were terminated early without providing results. All studies were published between 2001 and 2015. Nine studies were of continuous macrolide antibiotics, two studies were of intermittent antibiotic prophylaxis (three times per week) and two were of pulsed antibiotic regimens (e.g. five days every eight weeks). The final study included one continuous, one intermittent and one pulsed arm. The antibiotics investigated were azithromycin, erythromycin, clarithromycin, doxycyline, roxithromycin and moxifloxacin. The study duration varied from three months to 36 months and all used intention-to-treat analysis. Most of the pooled results were of moderate quality. The risk of bias of the included studies was generally low.The studies recruited participants with a mean age between 65 and 72 years and mostly at least moderate-severity COPD. Five studies only included participants with frequent exacerbations and two studies recruited participants requiring systemic steroids or antibiotics or both, or who were at the end stage of their disease and required oxygen. One study recruited participants with pulmonary hypertension secondary to COPD and a further study was specifically designed to asses whether eradication of Chlamydia pneumoniae reduced exacerbation rates.The co-primary outcomes for this review were the number of exacerbations and quality of life.With use of prophylactic antibiotics, the number of participants experiencing one or more exacerbations was reduced (odds ratio (OR) 0.57, 95% CI 0.42 to 0.78; participants = 2716; studies = 8; moderate-quality evidence). This represented a reduction from 61% of participants in the control group compared to 47% in the treatment group (95% CI 39% to 55%). The number needed to treat for an additional beneficial outcome with prophylactic antibiotics given for three to 12 months to prevent one person from experiencing an exacerbation (NNTB) was 8 (95% CI 5 to 17). The test for subgroup difference suggested that continuous and intermittent antibiotics may be more effective than pulsed antibiotics (P = 0.02, I² = 73.3%).The frequency of exacerbations per patient per year was also reduced with prophylactic antibiotic treatment (rate ratio 0.67; 95% CI 0.54 to 0.83; participants = 1384; studies = 5; moderate-quality evidence). Although we were unable to pool the result, six of the seven studies reporting time to first exacerbation identified an increase (i.e. benefit) with antibiotics, which was reported as statistically significant in four studies.There was a statistically significant improvement in quality of life as measured by the St George's Respiratory Questionnaire (SGRQ) with prophylactic antibiotic treatment, but this was smaller than the four unit improvement that is regarded as being clinically significant (mean difference (MD) -1.94, 95% CI -3.13 to -0.75; participants = 2237; studies = 7, high-quality evidence).Prophylactic antibiotics showed no significant effect on the secondary outcomes of frequency of hospital admissions, change in forced expiratory volume in one second (FEV1), serious adverse events or all-cause mortality (moderate-quality evidence). There was some evidence of benefit in exercise tolerance, but this was driven by a single study of lower methodological quality.The adverse events that were recorded varied among the studies depending on the antibiotics used. Azithromycin was associated with significant hearing loss in the treatment group, which was in many cases reversible or partially reversible. The moxifloxacin pulsed study reported a significantly higher number of adverse events in the treatment arm due to the marked increase in gastrointestinal adverse events (P < 0.001). Some adverse events that led to drug discontinuation, such as development of long QTc or tinnitus, were not significantly more frequent in the treatment group than the placebo group but pose important considerations in clinical practice.The development of antibiotic resistance in the community is of major concern. Six studies reported on this, but we were unable to combine results. One study found newly colonised participants to have higher rates of antibiotic resistance. Participants colonised with moxifloxacin-sensitive pseudomonas at initiation of therapy rapidly became resistant with the quinolone treatment. A further study with three active treatment arms found an increase in the degree of antibiotic resistance of isolates in all three arms after 13 weeks treatment.
AUTHORS' CONCLUSIONS: Use of continuous and intermittent prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients. All studies of continuous and intermittent antibiotics used macrolides, hence the noted benefit applies only to the use of macrolide antibiotics prescribed at least three times per week. The impact of pulsed antibiotics remains uncertain and requires further research.The studies in this review included mostly participants who were frequent exacerbators with at least moderate-severity COPD. There were also older individuals with a mean age over 65 years. The results of these studies apply only to the group of participants who were studied in these studies and may not be generalisable to other groups.Because of concerns about antibiotic resistance and specific adverse effects, consideration of prophylactic antibiotic use should be mindful of the balance between benefits to individual patients and the potential harms to society created by antibiotic overuse. Monitoring of significant side effects including hearing loss, tinnitus, and long QTc in the community in this elderly patient group may require extra health resources.

PMID: 30376188 [PubMed - as supplied by publisher]

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Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

Cochrane Database Syst Rev. 2018 Oct 30;10:CD009764

Authors: Herath SC, Normansell R, Maisey S, Poole P

Abstract
BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD).
OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life.
SEARCH METHODS: We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018.
SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD.
DATA COLLECTION AND ANALYSIS: We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third review author.
MAIN RESULTS: We included 14 studies involving 3932 participants in this review. We identified two further studies meeting inclusion criteria but both were terminated early without providing results. All studies were published between 2001 and 2015. Nine studies were of continuous macrolide antibiotics, two studies were of intermittent antibiotic prophylaxis (three times per week) and two were of pulsed antibiotic regimens (e.g. five days every eight weeks). The final study included one continuous, one intermittent and one pulsed arm. The antibiotics investigated were azithromycin, erythromycin, clarithromycin, doxycyline, roxithromycin and moxifloxacin. The study duration varied from three months to 36 months and all used intention-to-treat analysis. Most of the pooled results were of moderate quality. The risk of bias of the included studies was generally low.The studies recruited participants with a mean age between 65 and 72 years and mostly at least moderate-severity COPD. Five studies only included participants with frequent exacerbations and two studies recruited participants requiring systemic steroids or antibiotics or both, or who were at the end stage of their disease and required oxygen. One study recruited participants with pulmonary hypertension secondary to COPD and a further study was specifically designed to asses whether eradication of Chlamydia pneumoniae reduced exacerbation rates.The co-primary outcomes for this review were the number of exacerbations and quality of life.With use of prophylactic antibiotics, the number of participants experiencing one or more exacerbations was reduced (odds ratio (OR) 0.57, 95% CI 0.42 to 0.78; participants = 2716; studies = 8; moderate-quality evidence). This represented a reduction from 61% of participants in the control group compared to 47% in the treatment group (95% CI 39% to 55%). The number needed to treat for an additional beneficial outcome with prophylactic antibiotics given for three to 12 months to prevent one person from experiencing an exacerbation (NNTB) was 8 (95% CI 5 to 17). The test for subgroup difference suggested that continuous and intermittent antibiotics may be more effective than pulsed antibiotics (P = 0.02, I² = 73.3%).The frequency of exacerbations per patient per year was also reduced with prophylactic antibiotic treatment (rate ratio 0.67; 95% CI 0.54 to 0.83; participants = 1384; studies = 5; moderate-quality evidence). Although we were unable to pool the result, six of the seven studies reporting time to first exacerbation identified an increase (i.e. benefit) with antibiotics, which was reported as statistically significant in four studies.There was a statistically significant improvement in quality of life as measured by the St George's Respiratory Questionnaire (SGRQ) with prophylactic antibiotic treatment, but this was smaller than the four unit improvement that is regarded as being clinically significant (mean difference (MD) -1.94, 95% CI -3.13 to -0.75; participants = 2237; studies = 7, high-quality evidence).Prophylactic antibiotics showed no significant effect on the secondary outcomes of frequency of hospital admissions, change in forced expiratory volume in one second (FEV1), serious adverse events or all-cause mortality (moderate-quality evidence). There was some evidence of benefit in exercise tolerance, but this was driven by a single study of lower methodological quality.The adverse events that were recorded varied among the studies depending on the antibiotics used. Azithromycin was associated with significant hearing loss in the treatment group, which was in many cases reversible or partially reversible. The moxifloxacin pulsed study reported a significantly higher number of adverse events in the treatment arm due to the marked increase in gastrointestinal adverse events (P < 0.001). Some adverse events that led to drug discontinuation, such as development of long QTc or tinnitus, were not significantly more frequent in the treatment group than the placebo group but pose important considerations in clinical practice.The development of antibiotic resistance in the community is of major concern. Six studies reported on this, but we were unable to combine results. One study found newly colonised participants to have higher rates of antibiotic resistance. Participants colonised with moxifloxacin-sensitive pseudomonas at initiation of therapy rapidly became resistant with the quinolone treatment. A further study with three active treatment arms found an increase in the degree of antibiotic resistance of isolates in all three arms after 13 weeks treatment.
AUTHORS' CONCLUSIONS: Use of continuous and intermittent prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients. All studies of continuous and intermittent antibiotics used macrolides, hence the noted benefit applies only to the use of macrolide antibiotics prescribed at least three times per week. The impact of pulsed antibiotics remains uncertain and requires further research.The studies in this review included mostly participants who were frequent exacerbators with at least moderate-severity COPD. There were also older individuals with a mean age over 65 years. The results of these studies apply only to the group of participants who were studied in these studies and may not be generalisable to other groups.Because of concerns about antibiotic resistance and specific adverse effects, consideration of prophylactic antibiotic use should be mindful of the balance between benefits to individual patients and the potential harms to society created by antibiotic overuse. Monitoring of significant side effects including hearing loss, tinnitus, and long QTc in the community in this elderly patient group may require extra health resources.

PMID: 30376188 [PubMed - as supplied by publisher]

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Spinal segments do not move together predictably during daily activities

Publication date: Available online 29 October 2018

Source: Gait & Posture

Author(s): Enrica Papi, Anthony M.J. Bull, Alison H. McGregor

Abstract

Background

Considering the thoracic, lumbar spine or whole spine as rigid segments has been the norm until recent studies highlighted the importance of more detailed modelling. A better understanding of the requirement for spine multi-segmental analysis could guide planning of future studies and avoid missing clinically-relevant information.

Research question

This study aims to assess the correlation between adjacent spine segments movement thereby evaluating segmental redundancy in both healthy and participants with low back pain (LBP).

Methods

A 3D motion capture system tracked the movement of upper and lower thoracic and lumbar spine segments in twenty healthy and twenty participants with LBP. Tasks performed included walking, sit-to-stand and lifting, repeated 3 times. 3D angular kinematics were calculated for each spine segment. Segmental redundancy was evaluated through cross-correlation (R_xy) analysis of kinematics time series and correlation of range of motion (R_ROM) of adjacent spine segments.

Results

The upper/lower lumbar pairing showed weak correlations in the LBP group for all tasks and anatomical planes (R_xyrange:0.02-0.36) but moderate and strong correlations during walking (R_xy _frontalplane:0.4) and lifting (R_xy _sagittalplane:0.64) in the healthy group. The lower thoracic/upper lumbar pairing had weak correlations for both groups during lifting and sit-to-stand in the frontal plane and for walking (R_xy:0.01) in the sagittal plane only. The upper/lower thoracic pairing had moderate correlations during sit-to-stand in sagittal and transverse plane in patients with LBP (R_xy _sagittalplane:0.41; R_xy _transverse plane:-0.42) but weak in healthy (R_xy _sagittalplane:0.23; R_xy _transverseplane:-0.34); the contrary was observed during lifting.

The majority of R_ROM values (55/72) demonstrated weak correlations.

Significance

The results suggest that multi-segmental analysis of the spine is necessary if spine movement characteristics are to be fully understood. We cannot establish a priori where redundancy occurs based on healthy data, therefore extra consideration should be made when planning studies with pathological cohorts.

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Spinal segments do not move together predictably during daily activities

Publication date: Available online 29 October 2018

Source: Gait & Posture

Author(s): Enrica Papi, Anthony M.J. Bull, Alison H. McGregor

Abstract

Background

Considering the thoracic, lumbar spine or whole spine as rigid segments has been the norm until recent studies highlighted the importance of more detailed modelling. A better understanding of the requirement for spine multi-segmental analysis could guide planning of future studies and avoid missing clinically-relevant information.

Research question

This study aims to assess the correlation between adjacent spine segments movement thereby evaluating segmental redundancy in both healthy and participants with low back pain (LBP).

Methods

A 3D motion capture system tracked the movement of upper and lower thoracic and lumbar spine segments in twenty healthy and twenty participants with LBP. Tasks performed included walking, sit-to-stand and lifting, repeated 3 times. 3D angular kinematics were calculated for each spine segment. Segmental redundancy was evaluated through cross-correlation (R_xy) analysis of kinematics time series and correlation of range of motion (R_ROM) of adjacent spine segments.

Results

The upper/lower lumbar pairing showed weak correlations in the LBP group for all tasks and anatomical planes (R_xyrange:0.02-0.36) but moderate and strong correlations during walking (R_xy _frontalplane:0.4) and lifting (R_xy _sagittalplane:0.64) in the healthy group. The lower thoracic/upper lumbar pairing had weak correlations for both groups during lifting and sit-to-stand in the frontal plane and for walking (R_xy:0.01) in the sagittal plane only. The upper/lower thoracic pairing had moderate correlations during sit-to-stand in sagittal and transverse plane in patients with LBP (R_xy _sagittalplane:0.41; R_xy _transverse plane:-0.42) but weak in healthy (R_xy _sagittalplane:0.23; R_xy _transverseplane:-0.34); the contrary was observed during lifting.

The majority of R_ROM values (55/72) demonstrated weak correlations.

Significance

The results suggest that multi-segmental analysis of the spine is necessary if spine movement characteristics are to be fully understood. We cannot establish a priori where redundancy occurs based on healthy data, therefore extra consideration should be made when planning studies with pathological cohorts.

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Investigating Auditory Spectral and Temporal Resolution Deficits in Children with Reading Difficulties.

Related Articles

Investigating Auditory Spectral and Temporal Resolution Deficits in Children with Reading Difficulties.

J Am Acad Audiol. 2018 Oct 25;:

Authors: Mealings K, Cameron S

Abstract
BACKGROUND: The types of reading difficulties experienced by children are highly heterogeneous in nature, which makes diagnosis and intervention difficult. Over the past 30 years, there has been much debate over the cause of dyslexia. The two most popular theories for phonological deficits in dyslexia are the rate-processing constraint hypothesis, which relates to short timescale processing, and the temporal sampling framework hypothesis, which relates to longer timescale processing.
PURPOSE: To investigate the relationship between sublexical (i.e., nonword) reading skills and auditory spectral and temporal resolution patterns in children with reading difficulties using the Phoneme Identification Test (PIT) and the Parsing Syllable Envelopes Test (ParSE). These tests were developed to assess the rate-processing constraint and the temporal sampling framework hypotheses, respectively. We hypothesized that a proportion of children who have sublexical reading difficulties may have an underlying auditory-resolution deficit which may impact their ability to form letter-sound correspondences. We predicted that children's sublexical reading difficulties may not be explained by one theory, but instead that both theories may describe different types of reading difficulties found in different children. We also hypothesized that children with lexical (i.e., irregular word) reading difficulties but intact sublexical reading skills would not show atypical results on PIT or ParSE.
RESEARCH DESIGN: Behavioral experimental clinical study with children who have reading difficulties.
STUDY SAMPLE: Sixteen children with nonword, irregular word, or mixed reading difficulties diagnosed by the Castles and Coltheart Test 2.
DATA COLLECTION AND ANALYSIS: Children completed a test battery consisting of a hearing screen and tests of reading, auditory resolution, phonological awareness, attention, spatial auditory processing, auditory memory, and intelligence. Categorization and correlational analyses were conducted.
RESULTS: All four children with a pure sublexical reading deficit also had an auditory-resolution deficit. Four of seven children with a mixed reading deficit had an auditory-resolution deficit. Only one of five children with a lexical reading deficit had an auditory-resolution deficit. Individual children's specific deficits were related to either rate processing (n = 5) or temporal sampling (n = 4), but never both. Children's nonword reading scores were strongly correlated with their performance on the PIT in noise, but not with the PIT in quiet or the ParSE. Children's irregular word scores were not significantly correlated with their performance on the PIT in quiet or in noise, or the ParSE, as hypothesized. Strong correlations were also found between children's nonword scores and their phonological awareness scores.
CONCLUSIONS: The results of this study suggest that neither the rate-processing hypothesis nor the temporal sampling framework is the single cause of reading difficulties in children. Instead, both of these hypotheses are likely to account for different types of reading deficits found in children. This is an important finding as the specific mechanisms driving different reading impairments must be identified to create tools to better diagnose and treat different types of reading difficulties. Further investigation of the PIT and ParSE as potential diagnostic tools for specific auditory-resolution-based reading difficulties in a larger group of children is currently underway.

PMID: 30372414 [PubMed - as supplied by publisher]

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The Mystery of Unexplained Variance-Some Comments on Brenneman et al (2017).

Related Articles

The Mystery of Unexplained Variance-Some Comments on Brenneman et al (2017).

J Am Acad Audiol. 2018 Oct 25;:

Authors: McFarland DJ

PMID: 30372413 [PubMed - as supplied by publisher]

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Investigating Auditory Spectral and Temporal Resolution Deficits in Children with Reading Difficulties.

Related Articles

Investigating Auditory Spectral and Temporal Resolution Deficits in Children with Reading Difficulties.

J Am Acad Audiol. 2018 Oct 25;:

Authors: Mealings K, Cameron S

Abstract
BACKGROUND: The types of reading difficulties experienced by children are highly heterogeneous in nature, which makes diagnosis and intervention difficult. Over the past 30 years, there has been much debate over the cause of dyslexia. The two most popular theories for phonological deficits in dyslexia are the rate-processing constraint hypothesis, which relates to short timescale processing, and the temporal sampling framework hypothesis, which relates to longer timescale processing.
PURPOSE: To investigate the relationship between sublexical (i.e., nonword) reading skills and auditory spectral and temporal resolution patterns in children with reading difficulties using the Phoneme Identification Test (PIT) and the Parsing Syllable Envelopes Test (ParSE). These tests were developed to assess the rate-processing constraint and the temporal sampling framework hypotheses, respectively. We hypothesized that a proportion of children who have sublexical reading difficulties may have an underlying auditory-resolution deficit which may impact their ability to form letter-sound correspondences. We predicted that children's sublexical reading difficulties may not be explained by one theory, but instead that both theories may describe different types of reading difficulties found in different children. We also hypothesized that children with lexical (i.e., irregular word) reading difficulties but intact sublexical reading skills would not show atypical results on PIT or ParSE.
RESEARCH DESIGN: Behavioral experimental clinical study with children who have reading difficulties.
STUDY SAMPLE: Sixteen children with nonword, irregular word, or mixed reading difficulties diagnosed by the Castles and Coltheart Test 2.
DATA COLLECTION AND ANALYSIS: Children completed a test battery consisting of a hearing screen and tests of reading, auditory resolution, phonological awareness, attention, spatial auditory processing, auditory memory, and intelligence. Categorization and correlational analyses were conducted.
RESULTS: All four children with a pure sublexical reading deficit also had an auditory-resolution deficit. Four of seven children with a mixed reading deficit had an auditory-resolution deficit. Only one of five children with a lexical reading deficit had an auditory-resolution deficit. Individual children's specific deficits were related to either rate processing (n = 5) or temporal sampling (n = 4), but never both. Children's nonword reading scores were strongly correlated with their performance on the PIT in noise, but not with the PIT in quiet or the ParSE. Children's irregular word scores were not significantly correlated with their performance on the PIT in quiet or in noise, or the ParSE, as hypothesized. Strong correlations were also found between children's nonword scores and their phonological awareness scores.
CONCLUSIONS: The results of this study suggest that neither the rate-processing hypothesis nor the temporal sampling framework is the single cause of reading difficulties in children. Instead, both of these hypotheses are likely to account for different types of reading deficits found in children. This is an important finding as the specific mechanisms driving different reading impairments must be identified to create tools to better diagnose and treat different types of reading difficulties. Further investigation of the PIT and ParSE as potential diagnostic tools for specific auditory-resolution-based reading difficulties in a larger group of children is currently underway.

PMID: 30372414 [PubMed - as supplied by publisher]

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The Mystery of Unexplained Variance-Some Comments on Brenneman et al (2017).

Related Articles

The Mystery of Unexplained Variance-Some Comments on Brenneman et al (2017).

J Am Acad Audiol. 2018 Oct 25;:

Authors: McFarland DJ

PMID: 30372413 [PubMed - as supplied by publisher]

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Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Int J Audiol. 2018 Oct 27;:1-9

Authors: Grasmeder ML, Verschuur CA, van Besouw RM, Wheatley AMH, Newman TA

Abstract
An experiment was conducted to investigate the possibility that speech perception could be improved for some cochlear implant (CI) users by adjustment of the frequency allocation to the electrodes, following assessment of pitch perception along the electrode array. Thirteen adult CI users with MED-EL devices participated in the study. Pitch perception was assessed for individual CI electrode pairs using the Pitch Contour Test (PCT), giving information on pitch discrimination and pitch ranking for adjacent electrodes. Sentence perception in noise was also assessed with ten different frequency allocations, including the default. Pitch perception was found to be poorer for both discrimination and ranking scores at either end of the electrode array. A significant effect of frequency allocation was found for sentence scores [F(4.24,38.2) = 7.14, p < 0.001] and a significant interaction between sentence score and PCT ranking score for basal electrodes was found [F(4.24,38.2) = 2.95, p = 0.03]. Participants with poorer pitch perception at the basal end had poorer scores for some allocations with greater basal shift. The results suggest that speech perception could be improved for CI users by assessment of pitch perception using the PCT and subsequent adjustment of pitch-related stimulation parameters.

PMID: 30370800 [PubMed - as supplied by publisher]

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Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Int J Audiol. 2018 Oct 27;:1-9

Authors: Grasmeder ML, Verschuur CA, van Besouw RM, Wheatley AMH, Newman TA

Abstract
An experiment was conducted to investigate the possibility that speech perception could be improved for some cochlear implant (CI) users by adjustment of the frequency allocation to the electrodes, following assessment of pitch perception along the electrode array. Thirteen adult CI users with MED-EL devices participated in the study. Pitch perception was assessed for individual CI electrode pairs using the Pitch Contour Test (PCT), giving information on pitch discrimination and pitch ranking for adjacent electrodes. Sentence perception in noise was also assessed with ten different frequency allocations, including the default. Pitch perception was found to be poorer for both discrimination and ranking scores at either end of the electrode array. A significant effect of frequency allocation was found for sentence scores [F(4.24,38.2) = 7.14, p < 0.001] and a significant interaction between sentence score and PCT ranking score for basal electrodes was found [F(4.24,38.2) = 2.95, p = 0.03]. Participants with poorer pitch perception at the basal end had poorer scores for some allocations with greater basal shift. The results suggest that speech perception could be improved for CI users by assessment of pitch perception using the PCT and subsequent adjustment of pitch-related stimulation parameters.

PMID: 30370800 [PubMed - as supplied by publisher]

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Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Int J Audiol. 2018 Oct 27;:1-9

Authors: Grasmeder ML, Verschuur CA, van Besouw RM, Wheatley AMH, Newman TA

Abstract
An experiment was conducted to investigate the possibility that speech perception could be improved for some cochlear implant (CI) users by adjustment of the frequency allocation to the electrodes, following assessment of pitch perception along the electrode array. Thirteen adult CI users with MED-EL devices participated in the study. Pitch perception was assessed for individual CI electrode pairs using the Pitch Contour Test (PCT), giving information on pitch discrimination and pitch ranking for adjacent electrodes. Sentence perception in noise was also assessed with ten different frequency allocations, including the default. Pitch perception was found to be poorer for both discrimination and ranking scores at either end of the electrode array. A significant effect of frequency allocation was found for sentence scores [F(4.24,38.2) = 7.14, p < 0.001] and a significant interaction between sentence score and PCT ranking score for basal electrodes was found [F(4.24,38.2) = 2.95, p = 0.03]. Participants with poorer pitch perception at the basal end had poorer scores for some allocations with greater basal shift. The results suggest that speech perception could be improved for CI users by assessment of pitch perception using the PCT and subsequent adjustment of pitch-related stimulation parameters.

PMID: 30370800 [PubMed - as supplied by publisher]

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via IFTTT

Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Measurement of pitch perception as a function of cochlear implant electrode and its effect on speech perception with different frequency allocations.

Int J Audiol. 2018 Oct 27;:1-9

Authors: Grasmeder ML, Verschuur CA, van Besouw RM, Wheatley AMH, Newman TA

Abstract
An experiment was conducted to investigate the possibility that speech perception could be improved for some cochlear implant (CI) users by adjustment of the frequency allocation to the electrodes, following assessment of pitch perception along the electrode array. Thirteen adult CI users with MED-EL devices participated in the study. Pitch perception was assessed for individual CI electrode pairs using the Pitch Contour Test (PCT), giving information on pitch discrimination and pitch ranking for adjacent electrodes. Sentence perception in noise was also assessed with ten different frequency allocations, including the default. Pitch perception was found to be poorer for both discrimination and ranking scores at either end of the electrode array. A significant effect of frequency allocation was found for sentence scores [F(4.24,38.2) = 7.14, p < 0.001] and a significant interaction between sentence score and PCT ranking score for basal electrodes was found [F(4.24,38.2) = 2.95, p = 0.03]. Participants with poorer pitch perception at the basal end had poorer scores for some allocations with greater basal shift. The results suggest that speech perception could be improved for CI users by assessment of pitch perception using the PCT and subsequent adjustment of pitch-related stimulation parameters.

PMID: 30370800 [PubMed - as supplied by publisher]

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The effects of electrical stimulation of the peripheral vestibular system on neurochemical release in the rat striatum.

The effects of electrical stimulation of the peripheral vestibular system on neurochemical release in the rat striatum.

PLoS One. 2018;13(10):e0205869

Authors: Stiles L, Zheng Y, Smith PF

Abstract
For over a century, it has been speculated that the vestibular system transmits information about self-motion to the striatum. There have been inconsistent reports of such a connection, and interest in the subject has been increased by the experimental use of galvanic vestibular stimulation in the treatment of Parkinson's Disease patients. Nonetheless, there are few data available on the effects of vestibular stimulation on neurochemical changes in the striatum. We used in vivo microdialysis to analyse changes in the extracellular levels of amino acids and monoamines in the rat striatum, following electrical vestibular stimulation. Stimulation caused a significant decrease in serine and threonine, compared to the no-stimulation controls (P ≤ 0.005 and P ≤ 0.01, respectively). The ratio of DOPAC:dopamine, decreased on the ipsilateral side following stimulation (P ≤ 0.005). There was a significant treatment x side x intensity interaction for taurine levels (P ≤ 0.002), due to a decrease on the contralateral side in stimulated animals, which varied as a function of current. These results show that peripheral vestibular stimulation causes some neurochemical changes in the striatum and support the view that activaton of the vestibular system exerts effects on the function of the striatum.

PMID: 30372453 [PubMed - in process]

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Spinal Surgery With Electrically Evoked Potential Monitoring and Monopolar Electrocautery: Is Prior Removal of a Cochlear Implant Necessary?

Spinal Surgery With Electrically Evoked Potential Monitoring and Monopolar Electrocautery: Is Prior Removal of a Cochlear Implant Necessary?

Otol Neurotol. 2018 Oct 26;:

Authors: Studer D, Stieger C, Reichlin CJ, Terrier A, Allum JHJ

Abstract
: Transcranial electric stimulation to generate motor evoked potentials in lower limb muscles is the standard technique used to monitor spinal cord efferent pathways during surgical correction for spinal deformities. Monopolar electrical cauterization is also used by default in the thoracic and lumbar area of the spine during this kind of surgery to prevent major blood loss. Owing to the high levels of current used, both techniques are considered contraindicative if the patient has a cochlear implant (CI). Here, we present a CI patient who underwent corrective spinal fusion surgery for a severe kyphoscoliotic spinal deformity on whom both techniques were used without any negative effects on the CI function. A major improvement in sagittal body balance was achieved with no loss in implant-aided hearing levels. These results add to reports that CI manufactures should review their evidence underlying recommendations that transcranial electric stimulation and upper thoracic monopolar electrical cauterization are high risk for CI users, possibly initiating verification studies.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP.

PMID: 30371634 [PubMed - as supplied by publisher]

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The effects of electrical stimulation of the peripheral vestibular system on neurochemical release in the rat striatum.

The effects of electrical stimulation of the peripheral vestibular system on neurochemical release in the rat striatum.

PLoS One. 2018;13(10):e0205869

Authors: Stiles L, Zheng Y, Smith PF

Abstract
For over a century, it has been speculated that the vestibular system transmits information about self-motion to the striatum. There have been inconsistent reports of such a connection, and interest in the subject has been increased by the experimental use of galvanic vestibular stimulation in the treatment of Parkinson's Disease patients. Nonetheless, there are few data available on the effects of vestibular stimulation on neurochemical changes in the striatum. We used in vivo microdialysis to analyse changes in the extracellular levels of amino acids and monoamines in the rat striatum, following electrical vestibular stimulation. Stimulation caused a significant decrease in serine and threonine, compared to the no-stimulation controls (P ≤ 0.005 and P ≤ 0.01, respectively). The ratio of DOPAC:dopamine, decreased on the ipsilateral side following stimulation (P ≤ 0.005). There was a significant treatment x side x intensity interaction for taurine levels (P ≤ 0.002), due to a decrease on the contralateral side in stimulated animals, which varied as a function of current. These results show that peripheral vestibular stimulation causes some neurochemical changes in the striatum and support the view that activaton of the vestibular system exerts effects on the function of the striatum.

PMID: 30372453 [PubMed - in process]

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Spinal Surgery With Electrically Evoked Potential Monitoring and Monopolar Electrocautery: Is Prior Removal of a Cochlear Implant Necessary?

Spinal Surgery With Electrically Evoked Potential Monitoring and Monopolar Electrocautery: Is Prior Removal of a Cochlear Implant Necessary?

Otol Neurotol. 2018 Oct 26;:

Authors: Studer D, Stieger C, Reichlin CJ, Terrier A, Allum JHJ

Abstract
: Transcranial electric stimulation to generate motor evoked potentials in lower limb muscles is the standard technique used to monitor spinal cord efferent pathways during surgical correction for spinal deformities. Monopolar electrical cauterization is also used by default in the thoracic and lumbar area of the spine during this kind of surgery to prevent major blood loss. Owing to the high levels of current used, both techniques are considered contraindicative if the patient has a cochlear implant (CI). Here, we present a CI patient who underwent corrective spinal fusion surgery for a severe kyphoscoliotic spinal deformity on whom both techniques were used without any negative effects on the CI function. A major improvement in sagittal body balance was achieved with no loss in implant-aided hearing levels. These results add to reports that CI manufactures should review their evidence underlying recommendations that transcranial electric stimulation and upper thoracic monopolar electrical cauterization are high risk for CI users, possibly initiating verification studies.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. https://ift.tt/OBJ4xP.

PMID: 30371634 [PubMed - as supplied by publisher]

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New Research Show Benefits of Person-Centered Hearing Care Tools

Since 2016, the Ida Institute Research Committee has awarded research grants to projects that investigate the outcomes of using Ida Institute methods and tools and develop evidence to show the effect of person-centered hearing care. The first grant recipients have now submitted their reports. Their findings add to a growing body of evidence that demonstrates the value of Ida Institute methods and tools and the use of person-centered care in clinical practice.

Living Well Tool Creates Patient-Centered Framework

Project: Researchers explored the way audiologists convey information about communication and hearing loss management in appointments with adults with hearing loss and their communication partners.

Ida Tool: Living Well  idainstitute.com/tools/living_well

The study found that using the Ida Living Well tool shifted the emphasis in appointments away from difficulties of living with hearing loss to more positive and proactive communication and lifestyle decisions.

The audiologists who participated in the study found that the Living Well tool was a helpful, easy-to-use tool, particularly at the start of the session where it provided context that helped to determine client goals. Clients described the Living Well tool as a good starting point for appointments that allowed them to fast-track discussion and spend valuable time on one-on-one problem solving with the clinician. Researchers concluded that the tool enabled them to move the appointment focus beyond the deficit model in audiological rehabilitation to more positive aspects of hearing loss management, such as social engagement and successful communication.

Lead Researcher: Dr. Nerina Scarinci, The University of Queensland  
Co-Investigators: Dr. Carly Meyer, The University of Queensland, Dr. Katie Ekberg, The University of Queensland and Dr. Christopher Lind, Flinders University

Readiness for Rehabilitation

Project: Researchers examined how incorporating the Ida Motivation Tools into initial assessment appointments with adult clients can help audiologists better identify clients' readiness for hearing rehabilitation.

Ida Tools: Motivation tools idainstitute.com/tools/motivation_tools
Audiologists in the study who used the tools improved their ability to identify their clients' stages in the patient journey and successfully solicited clients' readiness for rehabilitation and potential concerns regarding hearing aids. The findings emphasized the importance of the discussion that is initiated by using the tools and not relying solely on the clients' scores. Evaluating only on the client's scores can lead practitioners to over-estimate clients' readiness. These study findings support the overall aim of the Motivational Tools as "conversation starters" and reinforced the need for audiologists to actively listen to clients' responses.

Lead Researcher: Dr. Katie Ekberg, The University of Queensland

Co-Investigator: Dr. Caitlin Barr, The University of Melbourne

Ototoxic Hearing Loss Among Childhood Cancer Survivors

Project: Researchers explored the support needs of childhood cancer survivors and their parents during the hearing rehabilitation process.

Parents whose children acquire hearing loss through cancer treatment must deal with the stress of both cancer and hearing loss. Many of the children will need hearing aids and special support to help their language and speech skills develop. Their parents will need support to provide an environment that encourages listening, speech and language skills.

In the study, parents, teachers, and audiologists all described the intense emotional demands on both parents and children. They also noted a frequent misunderstanding by parents of the far-reaching impact of hearing loss on their child's wellbeing. Both teachers and audiologists acknowledged the families' need for support of all kinds, but primarily social-emotional support to facilitate family adjustment. The researchers determined that audiologists and teachers of deaf and hard-of-hearing children need both person-centered and family-centered awareness and skills and are well positioned to provide limited but important support through collaboration and consistency.

Lead Researcher: Dr. Janet Jamieson, The University of British Columbia

Co-Investigators: Beth Brooks, MSc RAUD and Dr. Marla Buchanan, The University of
British Columbia

Visit the Ida Institute website for more information on the grant and previous receipeints.

Published: 10/29/2018 1:48:00 PM

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New Research Show Benefits of Person-Centered Hearing Care Tools

Since 2016, the Ida Institute Research Committee has awarded research grants to projects that investigate the outcomes of using Ida Institute methods and tools and develop evidence to show the effect of person-centered hearing care. The first grant recipients have now submitted their reports. Their findings add to a growing body of evidence that demonstrates the value of Ida Institute methods and tools and the use of person-centered care in clinical practice.

Living Well Tool Creates Patient-Centered Framework

Project: Researchers explored the way audiologists convey information about communication and hearing loss management in appointments with adults with hearing loss and their communication partners.

Ida Tool: Living Well  idainstitute.com/tools/living_well

The study found that using the Ida Living Well tool shifted the emphasis in appointments away from difficulties of living with hearing loss to more positive and proactive communication and lifestyle decisions.

The audiologists who participated in the study found that the Living Well tool was a helpful, easy-to-use tool, particularly at the start of the session where it provided context that helped to determine client goals. Clients described the Living Well tool as a good starting point for appointments that allowed them to fast-track discussion and spend valuable time on one-on-one problem solving with the clinician. Researchers concluded that the tool enabled them to move the appointment focus beyond the deficit model in audiological rehabilitation to more positive aspects of hearing loss management, such as social engagement and successful communication.

Lead Researcher: Dr. Nerina Scarinci, The University of Queensland  
Co-Investigators: Dr. Carly Meyer, The University of Queensland, Dr. Katie Ekberg, The University of Queensland and Dr. Christopher Lind, Flinders University

Readiness for Rehabilitation

Project: Researchers examined how incorporating the Ida Motivation Tools into initial assessment appointments with adult clients can help audiologists better identify clients' readiness for hearing rehabilitation.

Ida Tools: Motivation tools idainstitute.com/tools/motivation_tools
Audiologists in the study who used the tools improved their ability to identify their clients' stages in the patient journey and successfully solicited clients' readiness for rehabilitation and potential concerns regarding hearing aids. The findings emphasized the importance of the discussion that is initiated by using the tools and not relying solely on the clients' scores. Evaluating only on the client's scores can lead practitioners to over-estimate clients' readiness. These study findings support the overall aim of the Motivational Tools as "conversation starters" and reinforced the need for audiologists to actively listen to clients' responses.

Lead Researcher: Dr. Katie Ekberg, The University of Queensland

Co-Investigator: Dr. Caitlin Barr, The University of Melbourne

Ototoxic Hearing Loss Among Childhood Cancer Survivors

Project: Researchers explored the support needs of childhood cancer survivors and their parents during the hearing rehabilitation process.

Parents whose children acquire hearing loss through cancer treatment must deal with the stress of both cancer and hearing loss. Many of the children will need hearing aids and special support to help their language and speech skills develop. Their parents will need support to provide an environment that encourages listening, speech and language skills.

In the study, parents, teachers, and audiologists all described the intense emotional demands on both parents and children. They also noted a frequent misunderstanding by parents of the far-reaching impact of hearing loss on their child's wellbeing. Both teachers and audiologists acknowledged the families' need for support of all kinds, but primarily social-emotional support to facilitate family adjustment. The researchers determined that audiologists and teachers of deaf and hard-of-hearing children need both person-centered and family-centered awareness and skills and are well positioned to provide limited but important support through collaboration and consistency.

Lead Researcher: Dr. Janet Jamieson, The University of British Columbia

Co-Investigators: Beth Brooks, MSc RAUD and Dr. Marla Buchanan, The University of
British Columbia

Visit the Ida Institute website for more information on the grant and previous receipeints.

Published: 10/29/2018 1:48:00 PM

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Human Voice as a Measure of Mental Load Level

Purpose

The aim of this study was to determine a reliable and efficient set of acoustic parameters of the human voice able to estimate individuals' mental load level. Implementing detection methods and real-time analysis of mental load is a major challenge for monitoring and enhancing human task performance, especially during high-risk activities (e.g., flying aircraft).

Method

The voices of 32 participants were recorded during a cognitive task featuring word list recall. The difficulty of the task was manipulated by varying the number of words in each list (i.e., between 1 and 7, corresponding to 7 mental load conditions). Evoked pupillary response, known to be a useful proxy of mental load, was recorded simultaneously with speech to attest variations in mental load level during the experimental task.

Results

Classic features (fundamental frequency, its standard deviation, number of periods) and original features (frequency modulation and short-term variation in digital amplitude length) of the acoustic signals were predictive of memory load condition. They varied significantly according to the number of words to recall, specifically beyond a threshold of 3–5 words to recall, that is, when memory performance started to decline.

Conclusions

Some acoustic parameters of the human voice could be an appropriate and efficient means for detecting mental load levels.

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The Dimensionality of Oral Language in Kindergarten Spanish–English Dual Language Learners

Purpose

The purpose of this study was to examine the latent dimensionality of language in dual language learners (DLLs) who spoke Spanish as their native language and were learning English as their second language.

Method

Participants included 259 Spanish–English DLLs attending kindergarten. In the spring of their kindergarten year, children completed vocabulary, grammar, listening comprehension, and higher level language measures (comprehension monitoring and inferencing) in Spanish and English.

Results

Two models with similar fits best describe the data. The first was a bifactor model with a single general language factor “l,” plus 2 additional language factors, 1 for Spanish and 1 for English. The second model was a 4-factor model, 1 for English that included all English language measures and 3 additional factors that included Spanish vocabulary, Spanish grammar, and Spanish higher level language.

Conclusions

These results indicate that a general language ability may underlie development in both Spanish and English. In contrast to a unidimensional structure found for monolingual English-speaking kindergarteners, oral language appears to be multidimensional in Spanish–English DLL kindergarteners, but multidimensionality is reflected in Spanish, not English.

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Human Voice as a Measure of Mental Load Level

Purpose

The aim of this study was to determine a reliable and efficient set of acoustic parameters of the human voice able to estimate individuals' mental load level. Implementing detection methods and real-time analysis of mental load is a major challenge for monitoring and enhancing human task performance, especially during high-risk activities (e.g., flying aircraft).

Method

The voices of 32 participants were recorded during a cognitive task featuring word list recall. The difficulty of the task was manipulated by varying the number of words in each list (i.e., between 1 and 7, corresponding to 7 mental load conditions). Evoked pupillary response, known to be a useful proxy of mental load, was recorded simultaneously with speech to attest variations in mental load level during the experimental task.

Results

Classic features (fundamental frequency, its standard deviation, number of periods) and original features (frequency modulation and short-term variation in digital amplitude length) of the acoustic signals were predictive of memory load condition. They varied significantly according to the number of words to recall, specifically beyond a threshold of 3–5 words to recall, that is, when memory performance started to decline.

Conclusions

Some acoustic parameters of the human voice could be an appropriate and efficient means for detecting mental load levels.

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