Sonority’s Effect as a Surface Cue on Lexical Speech Perception of Children With Cochlear Implants

Objectives: Sonority is the relative perceptual prominence/loudness of speech sounds of the same length, stress, and pitch. Children with cochlear implants (CIs), with restored audibility and relatively intact temporal processing, are expected to benefit from the perceptual prominence cues of highly sonorous sounds. Sonority also influences lexical access through the sonority-sequencing principle (SSP), a grammatical phonotactic rule, which facilitates the recognition and segmentation of syllables within speech. The more nonsonorous the onset of a syllable is, the larger is the degree of sonority rise to the nucleus, and the more optimal the SSP. Children with CIs may experience hindered or delayed development of the language-learning rule SSP, as a result of their deprived/degraded auditory experience. The purpose of the study was to explore sonority’s role in speech perception and lexical access of prelingually deafened children with CIs. Design: A case–control study with 15 children with CIs, 25 normal-hearing children (NHC), and 50 normal-hearing adults was conducted, using a lexical identification task of novel, nonreal CV–CV words taught via fast mapping. The CV–CV words were constructed according to four sonority conditions, entailing syllables with sonorous onsets/less optimal SSP (SS) and nonsonorous onsets/optimal SSP (NS) in all combinations, that is, SS–SS, SS–NS, NS–SS, and NS–NS. Outcome measures were accuracy and reaction times (RTs). A subgroup analysis of 12 children with CIs pair matched to 12 NHC on hearing age aimed to study the effect of oral-language exposure period on the sonority-related performance. Results: The children groups showed similar accuracy performance, overall and across all the sonority conditions. However, within-group comparisons showed that the children with CIs scored more accurately on the SS–SS condition relative to the NS–NS and NS–SS conditions, while the NHC performed equally well across all conditions. Additionally, adult-comparable accuracy performance was achieved by the children with CIs only on the SS–SS condition, as opposed to NS–SS, SS–NS, and SS–SS conditions for NHC. Accuracy analysis of the subgroups of children matched in hearing age showed similar results. Overall longer RTs were recorded by the children with CIs on the sonority-treated lexical task, specifically on the SS–SS condition compared with age-matched controls. However, the subgroup analysis showed that both groups of children did not differ on RTs. Conclusions: Children with CIs performed better in lexical tasks relying on the sonority perceptual prominence cues, as in SS–SS condition, than on SSP initial relying conditions as NS–NS and NS–SS. Template-driven word learning, an early word-learning strategy, appears to play a role in the lexical access of children with CIs whether matched in hearing age or not. The SS–SS condition acts as a preferred word template. The longer RTs brought about by the highly accurate SS–SS condition in children with CIs is possibly because listening becomes more effortful. The lack of RTs difference between the children groups when matched on hearing age points out the importance of oral-language exposure period as a key factor in developing the auditory processing skills. 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: The authors thank the children participants and their families, as well as the adult participants whom devoted the time and effort to volunteer in this study. The authors also thank AHEPA Hospital/First University ENT clinic, Thessaloniki, Greece, with special thanks to Eleni Karabetsoy for recording the audio stimuli and assisting in testing the participants. The authors also thank Michelle MacRoy-Higgins for providing permission to use the pictures of the funny objects and Pelagia Dinopoulou and Xristina Adamidou for assisting in testing the participants. A. O. is grateful to Richard G. Schwartz and Gita Martohardjono for their insightful suggestion on investigating sonority and also would like to thank Richard G. Schwartz for the training received in his lab and for fostering pilot work in this field. Y. H. prepared and conducted the experiment using the design, methodology, and resources developed at University of Macedonia by Y. H., based on a framework provided by A. O. and contributions by A. v. W. Y. H., A. O., and A. v. W. have worked on the results, the discussion, and the paper writing at all stages of the study. G. K. was involved during the implementation of the experiment at AHEPA Hospital by Y. H. The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme FP7/2007–2013/under REA grant agreement no. FP7-607139 (iCARE). Publication of this article was funded in Greece, by General Secretariat of Research and Technology for years 2016-2017 for iCARE-FP7-607139. A. v. W. is a member of the Editorial board of Ear & Hearing. The other authors have no conflicts of interest to disclose. Portions of the article were presented by Y. H. at the HEaring Across Lifespan (HEAL) Conference, Lake Como, Italy, June 2–4, 2016, and at the IFOS Conference, Paris, France, June 24–28, 2017. Address for correspondence: Yasmeen Hamza, Department of Neurosciences, Research Group Experimental ORL, KU Leuven - University of Leuven, O&N II, Herestraat 49/721, Leuven, Belgium, 3000. E-mail: yasmeenabdelkarimmohamed.hamza@student.kuleuven.be Received January 16, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via xlomafota13 on Inoreader http://ift.tt/2IbO1e4
via IFTTT

Optimizing Clinical Interpretation of Distortion Product Otoacoustic Emissions in Infants

Objectives: The purpose of this study was to analyze distortion product otoacoustic emission (DPOAE) level and signal to noise ratio in a group of infants from birth to 4 months of age to optimize prediction of hearing status. DPOAEs from infants with normal hearing (NH) and hearing loss (HL) were used to predict the presence of conductive HL (CHL), sensorineural HL (SNHL), and mixed HL (MHL). Wideband ambient absorbance was also measured and compared among the HL types. Design: This is a prospective, longitudinal study of 279 infants with verified NH and HL, including conductive, sensorineural, and mixed types that were enrolled from a well-baby nursery and two neonatal intensive care units in Cincinnati, Ohio. At approximately 1 month of age, DPOAEs (1–8 kHz), wideband absorbance (0.25–8 kHz), and air and bone conduction diagnostic tone burst auditory brainstem response (0.5–4 kHz) thresholds were measured. Hearing status was verified at approximately 9 months of age with visual reinforcement audiometry (0.5–4 kHz). Auditory brainstem response air conduction thresholds were used to assign infants to an NH or HL group, and the efficacy of DPOAE data to classify ears as NH or HL was analyzed using receiver operating characteristic (ROC) curves. Two summary statistics of the ROC curve were calculated: the area under the ROC curve and the point of symmetry on the curve at which the sensitivity and specificity were equal. DPOAE level and signal to noise ratio cutoff values were defined at each frequency as the symmetry point on their respective ROC curve, and DPOAE results were combined across frequency in a multifrequency analysis to predict the presence of HL. Results: Single-frequency test performance of DPOAEs was best at mid to high frequencies (3–8 kHz) with intermediate performance at 1.5 and 2 kHz and chance performance at 1 kHz. Infants with a conductive component to their HL (CHL and MHL combined) displayed significantly lower ambient absorbance values than the NH group. No differences in ambient absorbance were found between the NH and SNHL groups. Multifrequency analysis resulted in the best prediction of HL for the SNHL/MHL group with poorer sensitivity values when infants with CHL were included. Conclusions: Clinical interpretation of DPOAEs in infants can be improved by using age-appropriate normative ranges and optimized cutoff values. DPOAE interpretation is most predictive at higher F2 test frequencies in young infants (2–8 kHz) due to poor test performance at 1 to 1.5 kHz. Multifrequency rules can be used to improve sensitivity while balancing specificity. Last, a sensitive middle ear measure such as wideband absorbance should be included in the test battery to assess possibility of a conductive component to the HL. 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). ACKNOWLEDGEMENTS: The efforts of Alaaelddin Elsayed, MD, AuD, Leigh Shaid, AuD, several research coordinators, and the families who participated is gratefully acknowledged. The authors are appreciative of the anonymous reviewers who substantially improved the manuscript. C. M. B. performed experiments, analyzed data, and co-wrote the article. L. L. H. designed and performed experiments, co-wrote the article, and provided interpretive analysis and critical revision to the article. D. H. K. and M. P. F. designed experiments, and provided interpretative analysis and critical revision to article. D. K. B helped design and perform experiments and provided interpretative analysis and critical revision to article. A. M. assisted in enrollment and data analysis as part of her AuD capstone. D. F. F. designed experiments, and provided interpretative analysis and critical revision to article. L. L. provided statistical analysis and critical revision to the article. All authors discussed the results and implications and commented on the manuscript at all stages.. Portions of this study were presented as poster presentations at the American Academy of Audiology; March 2014; Orlando, FL; and at the American Auditory Society; March 2016; Scottsdale, AZ. This research was supported by the National Institute of Deafness and other Communication Disorders of the National Institutes of Health under Award Number R01 DC010202 and an American Recovery and Reinvestment Act of 2009 supplement (DC010202-01S1). Co-author D. H. K. is involved in commercializing devices to assess middle ear function in infants. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health. The content of this article does not represent the views of the Department of Veterans Affairs or of the United States Government. D. K. B. collected data while employed at Cincinnati Children’s Hospital Medical Center. Address for correspondence: Chelsea M. Blankenship, Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. E-mail: chelsea.blankenship@cchmc.org Received January 27, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via xlomafota13 on Inoreader http://ift.tt/2oUDsTG
via IFTTT

Sonority’s Effect as a Surface Cue on Lexical Speech Perception of Children With Cochlear Implants

Objectives: Sonority is the relative perceptual prominence/loudness of speech sounds of the same length, stress, and pitch. Children with cochlear implants (CIs), with restored audibility and relatively intact temporal processing, are expected to benefit from the perceptual prominence cues of highly sonorous sounds. Sonority also influences lexical access through the sonority-sequencing principle (SSP), a grammatical phonotactic rule, which facilitates the recognition and segmentation of syllables within speech. The more nonsonorous the onset of a syllable is, the larger is the degree of sonority rise to the nucleus, and the more optimal the SSP. Children with CIs may experience hindered or delayed development of the language-learning rule SSP, as a result of their deprived/degraded auditory experience. The purpose of the study was to explore sonority’s role in speech perception and lexical access of prelingually deafened children with CIs. Design: A case–control study with 15 children with CIs, 25 normal-hearing children (NHC), and 50 normal-hearing adults was conducted, using a lexical identification task of novel, nonreal CV–CV words taught via fast mapping. The CV–CV words were constructed according to four sonority conditions, entailing syllables with sonorous onsets/less optimal SSP (SS) and nonsonorous onsets/optimal SSP (NS) in all combinations, that is, SS–SS, SS–NS, NS–SS, and NS–NS. Outcome measures were accuracy and reaction times (RTs). A subgroup analysis of 12 children with CIs pair matched to 12 NHC on hearing age aimed to study the effect of oral-language exposure period on the sonority-related performance. Results: The children groups showed similar accuracy performance, overall and across all the sonority conditions. However, within-group comparisons showed that the children with CIs scored more accurately on the SS–SS condition relative to the NS–NS and NS–SS conditions, while the NHC performed equally well across all conditions. Additionally, adult-comparable accuracy performance was achieved by the children with CIs only on the SS–SS condition, as opposed to NS–SS, SS–NS, and SS–SS conditions for NHC. Accuracy analysis of the subgroups of children matched in hearing age showed similar results. Overall longer RTs were recorded by the children with CIs on the sonority-treated lexical task, specifically on the SS–SS condition compared with age-matched controls. However, the subgroup analysis showed that both groups of children did not differ on RTs. Conclusions: Children with CIs performed better in lexical tasks relying on the sonority perceptual prominence cues, as in SS–SS condition, than on SSP initial relying conditions as NS–NS and NS–SS. Template-driven word learning, an early word-learning strategy, appears to play a role in the lexical access of children with CIs whether matched in hearing age or not. The SS–SS condition acts as a preferred word template. The longer RTs brought about by the highly accurate SS–SS condition in children with CIs is possibly because listening becomes more effortful. The lack of RTs difference between the children groups when matched on hearing age points out the importance of oral-language exposure period as a key factor in developing the auditory processing skills. 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: The authors thank the children participants and their families, as well as the adult participants whom devoted the time and effort to volunteer in this study. The authors also thank AHEPA Hospital/First University ENT clinic, Thessaloniki, Greece, with special thanks to Eleni Karabetsoy for recording the audio stimuli and assisting in testing the participants. The authors also thank Michelle MacRoy-Higgins for providing permission to use the pictures of the funny objects and Pelagia Dinopoulou and Xristina Adamidou for assisting in testing the participants. A. O. is grateful to Richard G. Schwartz and Gita Martohardjono for their insightful suggestion on investigating sonority and also would like to thank Richard G. Schwartz for the training received in his lab and for fostering pilot work in this field. Y. H. prepared and conducted the experiment using the design, methodology, and resources developed at University of Macedonia by Y. H., based on a framework provided by A. O. and contributions by A. v. W. Y. H., A. O., and A. v. W. have worked on the results, the discussion, and the paper writing at all stages of the study. G. K. was involved during the implementation of the experiment at AHEPA Hospital by Y. H. The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme FP7/2007–2013/under REA grant agreement no. FP7-607139 (iCARE). Publication of this article was funded in Greece, by General Secretariat of Research and Technology for years 2016-2017 for iCARE-FP7-607139. A. v. W. is a member of the Editorial board of Ear & Hearing. The other authors have no conflicts of interest to disclose. Portions of the article were presented by Y. H. at the HEaring Across Lifespan (HEAL) Conference, Lake Como, Italy, June 2–4, 2016, and at the IFOS Conference, Paris, France, June 24–28, 2017. Address for correspondence: Yasmeen Hamza, Department of Neurosciences, Research Group Experimental ORL, KU Leuven - University of Leuven, O&N II, Herestraat 49/721, Leuven, Belgium, 3000. E-mail: yasmeenabdelkarimmohamed.hamza@student.kuleuven.be Received January 16, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via ola Kala on Inoreader http://ift.tt/2IbO1e4
via IFTTT

Optimizing Clinical Interpretation of Distortion Product Otoacoustic Emissions in Infants

Objectives: The purpose of this study was to analyze distortion product otoacoustic emission (DPOAE) level and signal to noise ratio in a group of infants from birth to 4 months of age to optimize prediction of hearing status. DPOAEs from infants with normal hearing (NH) and hearing loss (HL) were used to predict the presence of conductive HL (CHL), sensorineural HL (SNHL), and mixed HL (MHL). Wideband ambient absorbance was also measured and compared among the HL types. Design: This is a prospective, longitudinal study of 279 infants with verified NH and HL, including conductive, sensorineural, and mixed types that were enrolled from a well-baby nursery and two neonatal intensive care units in Cincinnati, Ohio. At approximately 1 month of age, DPOAEs (1–8 kHz), wideband absorbance (0.25–8 kHz), and air and bone conduction diagnostic tone burst auditory brainstem response (0.5–4 kHz) thresholds were measured. Hearing status was verified at approximately 9 months of age with visual reinforcement audiometry (0.5–4 kHz). Auditory brainstem response air conduction thresholds were used to assign infants to an NH or HL group, and the efficacy of DPOAE data to classify ears as NH or HL was analyzed using receiver operating characteristic (ROC) curves. Two summary statistics of the ROC curve were calculated: the area under the ROC curve and the point of symmetry on the curve at which the sensitivity and specificity were equal. DPOAE level and signal to noise ratio cutoff values were defined at each frequency as the symmetry point on their respective ROC curve, and DPOAE results were combined across frequency in a multifrequency analysis to predict the presence of HL. Results: Single-frequency test performance of DPOAEs was best at mid to high frequencies (3–8 kHz) with intermediate performance at 1.5 and 2 kHz and chance performance at 1 kHz. Infants with a conductive component to their HL (CHL and MHL combined) displayed significantly lower ambient absorbance values than the NH group. No differences in ambient absorbance were found between the NH and SNHL groups. Multifrequency analysis resulted in the best prediction of HL for the SNHL/MHL group with poorer sensitivity values when infants with CHL were included. Conclusions: Clinical interpretation of DPOAEs in infants can be improved by using age-appropriate normative ranges and optimized cutoff values. DPOAE interpretation is most predictive at higher F2 test frequencies in young infants (2–8 kHz) due to poor test performance at 1 to 1.5 kHz. Multifrequency rules can be used to improve sensitivity while balancing specificity. Last, a sensitive middle ear measure such as wideband absorbance should be included in the test battery to assess possibility of a conductive component to the HL. 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). ACKNOWLEDGEMENTS: The efforts of Alaaelddin Elsayed, MD, AuD, Leigh Shaid, AuD, several research coordinators, and the families who participated is gratefully acknowledged. The authors are appreciative of the anonymous reviewers who substantially improved the manuscript. C. M. B. performed experiments, analyzed data, and co-wrote the article. L. L. H. designed and performed experiments, co-wrote the article, and provided interpretive analysis and critical revision to the article. D. H. K. and M. P. F. designed experiments, and provided interpretative analysis and critical revision to article. D. K. B helped design and perform experiments and provided interpretative analysis and critical revision to article. A. M. assisted in enrollment and data analysis as part of her AuD capstone. D. F. F. designed experiments, and provided interpretative analysis and critical revision to article. L. L. provided statistical analysis and critical revision to the article. All authors discussed the results and implications and commented on the manuscript at all stages.. Portions of this study were presented as poster presentations at the American Academy of Audiology; March 2014; Orlando, FL; and at the American Auditory Society; March 2016; Scottsdale, AZ. This research was supported by the National Institute of Deafness and other Communication Disorders of the National Institutes of Health under Award Number R01 DC010202 and an American Recovery and Reinvestment Act of 2009 supplement (DC010202-01S1). Co-author D. H. K. is involved in commercializing devices to assess middle ear function in infants. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health. The content of this article does not represent the views of the Department of Veterans Affairs or of the United States Government. D. K. B. collected data while employed at Cincinnati Children’s Hospital Medical Center. Address for correspondence: Chelsea M. Blankenship, Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. E-mail: chelsea.blankenship@cchmc.org Received January 27, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via ola Kala on Inoreader http://ift.tt/2oUDsTG
via IFTTT

Sonority’s Effect as a Surface Cue on Lexical Speech Perception of Children With Cochlear Implants

Objectives: Sonority is the relative perceptual prominence/loudness of speech sounds of the same length, stress, and pitch. Children with cochlear implants (CIs), with restored audibility and relatively intact temporal processing, are expected to benefit from the perceptual prominence cues of highly sonorous sounds. Sonority also influences lexical access through the sonority-sequencing principle (SSP), a grammatical phonotactic rule, which facilitates the recognition and segmentation of syllables within speech. The more nonsonorous the onset of a syllable is, the larger is the degree of sonority rise to the nucleus, and the more optimal the SSP. Children with CIs may experience hindered or delayed development of the language-learning rule SSP, as a result of their deprived/degraded auditory experience. The purpose of the study was to explore sonority’s role in speech perception and lexical access of prelingually deafened children with CIs. Design: A case–control study with 15 children with CIs, 25 normal-hearing children (NHC), and 50 normal-hearing adults was conducted, using a lexical identification task of novel, nonreal CV–CV words taught via fast mapping. The CV–CV words were constructed according to four sonority conditions, entailing syllables with sonorous onsets/less optimal SSP (SS) and nonsonorous onsets/optimal SSP (NS) in all combinations, that is, SS–SS, SS–NS, NS–SS, and NS–NS. Outcome measures were accuracy and reaction times (RTs). A subgroup analysis of 12 children with CIs pair matched to 12 NHC on hearing age aimed to study the effect of oral-language exposure period on the sonority-related performance. Results: The children groups showed similar accuracy performance, overall and across all the sonority conditions. However, within-group comparisons showed that the children with CIs scored more accurately on the SS–SS condition relative to the NS–NS and NS–SS conditions, while the NHC performed equally well across all conditions. Additionally, adult-comparable accuracy performance was achieved by the children with CIs only on the SS–SS condition, as opposed to NS–SS, SS–NS, and SS–SS conditions for NHC. Accuracy analysis of the subgroups of children matched in hearing age showed similar results. Overall longer RTs were recorded by the children with CIs on the sonority-treated lexical task, specifically on the SS–SS condition compared with age-matched controls. However, the subgroup analysis showed that both groups of children did not differ on RTs. Conclusions: Children with CIs performed better in lexical tasks relying on the sonority perceptual prominence cues, as in SS–SS condition, than on SSP initial relying conditions as NS–NS and NS–SS. Template-driven word learning, an early word-learning strategy, appears to play a role in the lexical access of children with CIs whether matched in hearing age or not. The SS–SS condition acts as a preferred word template. The longer RTs brought about by the highly accurate SS–SS condition in children with CIs is possibly because listening becomes more effortful. The lack of RTs difference between the children groups when matched on hearing age points out the importance of oral-language exposure period as a key factor in developing the auditory processing skills. 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: The authors thank the children participants and their families, as well as the adult participants whom devoted the time and effort to volunteer in this study. The authors also thank AHEPA Hospital/First University ENT clinic, Thessaloniki, Greece, with special thanks to Eleni Karabetsoy for recording the audio stimuli and assisting in testing the participants. The authors also thank Michelle MacRoy-Higgins for providing permission to use the pictures of the funny objects and Pelagia Dinopoulou and Xristina Adamidou for assisting in testing the participants. A. O. is grateful to Richard G. Schwartz and Gita Martohardjono for their insightful suggestion on investigating sonority and also would like to thank Richard G. Schwartz for the training received in his lab and for fostering pilot work in this field. Y. H. prepared and conducted the experiment using the design, methodology, and resources developed at University of Macedonia by Y. H., based on a framework provided by A. O. and contributions by A. v. W. Y. H., A. O., and A. v. W. have worked on the results, the discussion, and the paper writing at all stages of the study. G. K. was involved during the implementation of the experiment at AHEPA Hospital by Y. H. The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme FP7/2007–2013/under REA grant agreement no. FP7-607139 (iCARE). Publication of this article was funded in Greece, by General Secretariat of Research and Technology for years 2016-2017 for iCARE-FP7-607139. A. v. W. is a member of the Editorial board of Ear & Hearing. The other authors have no conflicts of interest to disclose. Portions of the article were presented by Y. H. at the HEaring Across Lifespan (HEAL) Conference, Lake Como, Italy, June 2–4, 2016, and at the IFOS Conference, Paris, France, June 24–28, 2017. Address for correspondence: Yasmeen Hamza, Department of Neurosciences, Research Group Experimental ORL, KU Leuven - University of Leuven, O&N II, Herestraat 49/721, Leuven, Belgium, 3000. E-mail: yasmeenabdelkarimmohamed.hamza@student.kuleuven.be Received January 16, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via ola Kala on Inoreader http://ift.tt/2IbO1e4
via IFTTT

Optimizing Clinical Interpretation of Distortion Product Otoacoustic Emissions in Infants

Objectives: The purpose of this study was to analyze distortion product otoacoustic emission (DPOAE) level and signal to noise ratio in a group of infants from birth to 4 months of age to optimize prediction of hearing status. DPOAEs from infants with normal hearing (NH) and hearing loss (HL) were used to predict the presence of conductive HL (CHL), sensorineural HL (SNHL), and mixed HL (MHL). Wideband ambient absorbance was also measured and compared among the HL types. Design: This is a prospective, longitudinal study of 279 infants with verified NH and HL, including conductive, sensorineural, and mixed types that were enrolled from a well-baby nursery and two neonatal intensive care units in Cincinnati, Ohio. At approximately 1 month of age, DPOAEs (1–8 kHz), wideband absorbance (0.25–8 kHz), and air and bone conduction diagnostic tone burst auditory brainstem response (0.5–4 kHz) thresholds were measured. Hearing status was verified at approximately 9 months of age with visual reinforcement audiometry (0.5–4 kHz). Auditory brainstem response air conduction thresholds were used to assign infants to an NH or HL group, and the efficacy of DPOAE data to classify ears as NH or HL was analyzed using receiver operating characteristic (ROC) curves. Two summary statistics of the ROC curve were calculated: the area under the ROC curve and the point of symmetry on the curve at which the sensitivity and specificity were equal. DPOAE level and signal to noise ratio cutoff values were defined at each frequency as the symmetry point on their respective ROC curve, and DPOAE results were combined across frequency in a multifrequency analysis to predict the presence of HL. Results: Single-frequency test performance of DPOAEs was best at mid to high frequencies (3–8 kHz) with intermediate performance at 1.5 and 2 kHz and chance performance at 1 kHz. Infants with a conductive component to their HL (CHL and MHL combined) displayed significantly lower ambient absorbance values than the NH group. No differences in ambient absorbance were found between the NH and SNHL groups. Multifrequency analysis resulted in the best prediction of HL for the SNHL/MHL group with poorer sensitivity values when infants with CHL were included. Conclusions: Clinical interpretation of DPOAEs in infants can be improved by using age-appropriate normative ranges and optimized cutoff values. DPOAE interpretation is most predictive at higher F2 test frequencies in young infants (2–8 kHz) due to poor test performance at 1 to 1.5 kHz. Multifrequency rules can be used to improve sensitivity while balancing specificity. Last, a sensitive middle ear measure such as wideband absorbance should be included in the test battery to assess possibility of a conductive component to the HL. 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). ACKNOWLEDGEMENTS: The efforts of Alaaelddin Elsayed, MD, AuD, Leigh Shaid, AuD, several research coordinators, and the families who participated is gratefully acknowledged. The authors are appreciative of the anonymous reviewers who substantially improved the manuscript. C. M. B. performed experiments, analyzed data, and co-wrote the article. L. L. H. designed and performed experiments, co-wrote the article, and provided interpretive analysis and critical revision to the article. D. H. K. and M. P. F. designed experiments, and provided interpretative analysis and critical revision to article. D. K. B helped design and perform experiments and provided interpretative analysis and critical revision to article. A. M. assisted in enrollment and data analysis as part of her AuD capstone. D. F. F. designed experiments, and provided interpretative analysis and critical revision to article. L. L. provided statistical analysis and critical revision to the article. All authors discussed the results and implications and commented on the manuscript at all stages.. Portions of this study were presented as poster presentations at the American Academy of Audiology; March 2014; Orlando, FL; and at the American Auditory Society; March 2016; Scottsdale, AZ. This research was supported by the National Institute of Deafness and other Communication Disorders of the National Institutes of Health under Award Number R01 DC010202 and an American Recovery and Reinvestment Act of 2009 supplement (DC010202-01S1). Co-author D. H. K. is involved in commercializing devices to assess middle ear function in infants. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health. The content of this article does not represent the views of the Department of Veterans Affairs or of the United States Government. D. K. B. collected data while employed at Cincinnati Children’s Hospital Medical Center. Address for correspondence: Chelsea M. Blankenship, Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. E-mail: chelsea.blankenship@cchmc.org Received January 27, 2017; accepted January 3, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from #Audiology via ola Kala on Inoreader http://ift.tt/2oUDsTG
via IFTTT

The Centre of Mass Trajectory is a Sensitive and Responsive Measure of Functional Compensations in Individuals with Knee Osteoarthritis Performing the Five Times Sit-to-Stand Test

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Josefine E. Naili, Eva W. Broström, Elena M. Gutierrez-Farewik, Michael H. Schwartz
This study aimed to evaluate whether the trajectory of the body’s Centre of Mass (CoM) is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis (OA) performing the Five Times Sit-to-Stand test (5STS). This prospective study included 21 individuals with OA and 21 age- and gender-matched controls. Motion analysis data was collected while participants performed the 5STS, one month prior and one year after total knee arthroplasty (TKA). Pain was evaluated using a visual analogue scale. Repeated measures ANOVAs were used to evaluate (1) differences in the area under the curve (AUC) of CoM trajectories, and (2) the effect of number of sit-to-stand cycles on the AUC. Preoperatively, individuals with OA displayed a larger contralateral shift (p = 0.009) and forward displacement of the CoM (p < 0.004) than controls. Postoperatively, CoM trajectories of OA individuals were not statistically different from controls. However, upon comparison of specific cycles, OA individuals displayed a larger forward displacement during the final cycle. Pain was significantly reduced postoperatively (p = 0.001). The CoM trajectory appears to be a sensitive and responsive measure of functional compensations. The increased contralateral shift of the CoM represents a strategy to reduce pain by unloading the affected knee. Postoperatively, when pain was substantially reduced, OA individuals were comparable to controls. The increased forward CoM displacement characterises a strategy to reduce muscular effort by reducing the required knee extension moment. Postoperatively, OA individuals were comparable to controls in all cycles but the last, possibly suggesting residual muscle weakness.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/2G3tHen
via IFTTT

Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jill Alexander, Jim Richards, Obed Attah, Sam Cheema, Joanna Snook, Chloe Wisdell, Karen May, James Selfe
Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period.IntroductionThe effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb.ObjectivesThe aim of this study was to investigate whether a 20 minute application of crushed ice at the knee affects knee joint position sense immediately post and up to 20 mins post ice removal, during a small knee bend.Method17 healthy male participants took part in the study performing a functional task. Using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden), kinematics of the knee were measured during a weight bearing functional task pre and immediately post, 5, 10, 15 and 20 minutes post cryotherapy intervention. Skin surface temperature (Tsk) cooling was measured via infrared non-contact thermal imaging (Flir Systems, Danderyd, Sweden) over the anterior and medial aspect of the knee.ResultsResults demonstrated significant reductions in the ability to accurately replicate knee joint positioning. A significant increase (P ≧ 0.05) in rotational movement in the transverse plane occurred, 20 minutes post ice removal.DiscussionA 20-minute application of crushed ice to the anterior aspect of the non-dominant knee has an adverse effect on knee joint repositioning and dynamic stability, 20 minutes after ice is removed. In consideration of returning a land-based athlete to dynamic functional activities, post cryotherapeutic intervention at the knee, clinicians should consider these findings due to the potential increase risk of injury.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/2D5zz3y
via IFTTT

Contralateral limb foot rotation during unilateral toe-in or toe-out walking in people with knee osteoarthritis

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jesse M. Charlton, Natasha M. Krowchuk, Gillian L. Hatfield, Jordan A. Guenette, Michael A. Hunt
BackgroundGait modification is a treatment approach often used for a variety of neuromuscular and musculoskeletal pathologies. Gait modification is commonly applied to a single limb, as is done with foot rotation (FR) in people with knee osteoarthritis (KOA). However, the extent to which gait changes observed in the trained limb are also exhibited in the untrained, contralateral limb during a training session is unknown.Research QuestionThe purpose of this study was to examine the within-limb FR differences across four unilateral FR modifications compared to natural walking.MethodsSixteen individuals with KOA walked on a treadmill while performing four different FR conditions: 10° toe-in, 0°, 10° toe-out and 20° toe-out. Motion capture was conducted to track FR magnitude after five minutes of practice.ResultsThe change in contralateral FR angle compared to natural walking significantly increased during toe-in 10° walking (3.1°) compared to toe-out −10° and −20° walking (-1.2° and −1.5°, respectively). As expected, the ipsilateral FR angle was significantly different between all conditions.SignificanceThese results suggest that small, but statistically significant changes in the untrained contralateral limb FR are observed during FR training of the ipsilateral limb. This may indicate a desire for symmetry, or a compensation when modifying the ipsilateral limb. Therefore, clinicians may need to maintain baseline FR magnitudes in the untrained limb when a patient exhibits unilateral KOA characteristics or lateral compartment KOA.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/2G3tGXR
via IFTTT

The Centre of Mass Trajectory is a Sensitive and Responsive Measure of Functional Compensations in Individuals with Knee Osteoarthritis Performing the Five Times Sit-to-Stand Test

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Josefine E. Naili, Eva W. Broström, Elena M. Gutierrez-Farewik, Michael H. Schwartz
This study aimed to evaluate whether the trajectory of the body’s Centre of Mass (CoM) is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis (OA) performing the Five Times Sit-to-Stand test (5STS). This prospective study included 21 individuals with OA and 21 age- and gender-matched controls. Motion analysis data was collected while participants performed the 5STS, one month prior and one year after total knee arthroplasty (TKA). Pain was evaluated using a visual analogue scale. Repeated measures ANOVAs were used to evaluate (1) differences in the area under the curve (AUC) of CoM trajectories, and (2) the effect of number of sit-to-stand cycles on the AUC. Preoperatively, individuals with OA displayed a larger contralateral shift (p = 0.009) and forward displacement of the CoM (p < 0.004) than controls. Postoperatively, CoM trajectories of OA individuals were not statistically different from controls. However, upon comparison of specific cycles, OA individuals displayed a larger forward displacement during the final cycle. Pain was significantly reduced postoperatively (p = 0.001). The CoM trajectory appears to be a sensitive and responsive measure of functional compensations. The increased contralateral shift of the CoM represents a strategy to reduce pain by unloading the affected knee. Postoperatively, when pain was substantially reduced, OA individuals were comparable to controls. The increased forward CoM displacement characterises a strategy to reduce muscular effort by reducing the required knee extension moment. Postoperatively, OA individuals were comparable to controls in all cycles but the last, possibly suggesting residual muscle weakness.



from #Audiology via ola Kala on Inoreader http://ift.tt/2G3tHen
via IFTTT

Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jill Alexander, Jim Richards, Obed Attah, Sam Cheema, Joanna Snook, Chloe Wisdell, Karen May, James Selfe
Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period.IntroductionThe effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb.ObjectivesThe aim of this study was to investigate whether a 20 minute application of crushed ice at the knee affects knee joint position sense immediately post and up to 20 mins post ice removal, during a small knee bend.Method17 healthy male participants took part in the study performing a functional task. Using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden), kinematics of the knee were measured during a weight bearing functional task pre and immediately post, 5, 10, 15 and 20 minutes post cryotherapy intervention. Skin surface temperature (Tsk) cooling was measured via infrared non-contact thermal imaging (Flir Systems, Danderyd, Sweden) over the anterior and medial aspect of the knee.ResultsResults demonstrated significant reductions in the ability to accurately replicate knee joint positioning. A significant increase (P ≧ 0.05) in rotational movement in the transverse plane occurred, 20 minutes post ice removal.DiscussionA 20-minute application of crushed ice to the anterior aspect of the non-dominant knee has an adverse effect on knee joint repositioning and dynamic stability, 20 minutes after ice is removed. In consideration of returning a land-based athlete to dynamic functional activities, post cryotherapeutic intervention at the knee, clinicians should consider these findings due to the potential increase risk of injury.



from #Audiology via ola Kala on Inoreader http://ift.tt/2D5zz3y
via IFTTT

Contralateral limb foot rotation during unilateral toe-in or toe-out walking in people with knee osteoarthritis

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jesse M. Charlton, Natasha M. Krowchuk, Gillian L. Hatfield, Jordan A. Guenette, Michael A. Hunt
BackgroundGait modification is a treatment approach often used for a variety of neuromuscular and musculoskeletal pathologies. Gait modification is commonly applied to a single limb, as is done with foot rotation (FR) in people with knee osteoarthritis (KOA). However, the extent to which gait changes observed in the trained limb are also exhibited in the untrained, contralateral limb during a training session is unknown.Research QuestionThe purpose of this study was to examine the within-limb FR differences across four unilateral FR modifications compared to natural walking.MethodsSixteen individuals with KOA walked on a treadmill while performing four different FR conditions: 10° toe-in, 0°, 10° toe-out and 20° toe-out. Motion capture was conducted to track FR magnitude after five minutes of practice.ResultsThe change in contralateral FR angle compared to natural walking significantly increased during toe-in 10° walking (3.1°) compared to toe-out −10° and −20° walking (-1.2° and −1.5°, respectively). As expected, the ipsilateral FR angle was significantly different between all conditions.SignificanceThese results suggest that small, but statistically significant changes in the untrained contralateral limb FR are observed during FR training of the ipsilateral limb. This may indicate a desire for symmetry, or a compensation when modifying the ipsilateral limb. Therefore, clinicians may need to maintain baseline FR magnitudes in the untrained limb when a patient exhibits unilateral KOA characteristics or lateral compartment KOA.



from #Audiology via ola Kala on Inoreader http://ift.tt/2G3tGXR
via IFTTT

The Centre of Mass Trajectory is a Sensitive and Responsive Measure of Functional Compensations in Individuals with Knee Osteoarthritis Performing the Five Times Sit-to-Stand Test

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Josefine E. Naili, Eva W. Broström, Elena M. Gutierrez-Farewik, Michael H. Schwartz
This study aimed to evaluate whether the trajectory of the body’s Centre of Mass (CoM) is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis (OA) performing the Five Times Sit-to-Stand test (5STS). This prospective study included 21 individuals with OA and 21 age- and gender-matched controls. Motion analysis data was collected while participants performed the 5STS, one month prior and one year after total knee arthroplasty (TKA). Pain was evaluated using a visual analogue scale. Repeated measures ANOVAs were used to evaluate (1) differences in the area under the curve (AUC) of CoM trajectories, and (2) the effect of number of sit-to-stand cycles on the AUC. Preoperatively, individuals with OA displayed a larger contralateral shift (p = 0.009) and forward displacement of the CoM (p < 0.004) than controls. Postoperatively, CoM trajectories of OA individuals were not statistically different from controls. However, upon comparison of specific cycles, OA individuals displayed a larger forward displacement during the final cycle. Pain was significantly reduced postoperatively (p = 0.001). The CoM trajectory appears to be a sensitive and responsive measure of functional compensations. The increased contralateral shift of the CoM represents a strategy to reduce pain by unloading the affected knee. Postoperatively, when pain was substantially reduced, OA individuals were comparable to controls. The increased forward CoM displacement characterises a strategy to reduce muscular effort by reducing the required knee extension moment. Postoperatively, OA individuals were comparable to controls in all cycles but the last, possibly suggesting residual muscle weakness.



from #Audiology via ola Kala on Inoreader http://ift.tt/2G3tHen
via IFTTT

Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jill Alexander, Jim Richards, Obed Attah, Sam Cheema, Joanna Snook, Chloe Wisdell, Karen May, James Selfe
Delayed effects of a 20-minute crushed ice application on knee joint position sense assessed by a functional task during a re-warming period.IntroductionThe effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play following cryotherapy application at the lower limb.ObjectivesThe aim of this study was to investigate whether a 20 minute application of crushed ice at the knee affects knee joint position sense immediately post and up to 20 mins post ice removal, during a small knee bend.Method17 healthy male participants took part in the study performing a functional task. Using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden), kinematics of the knee were measured during a weight bearing functional task pre and immediately post, 5, 10, 15 and 20 minutes post cryotherapy intervention. Skin surface temperature (Tsk) cooling was measured via infrared non-contact thermal imaging (Flir Systems, Danderyd, Sweden) over the anterior and medial aspect of the knee.ResultsResults demonstrated significant reductions in the ability to accurately replicate knee joint positioning. A significant increase (P ≧ 0.05) in rotational movement in the transverse plane occurred, 20 minutes post ice removal.DiscussionA 20-minute application of crushed ice to the anterior aspect of the non-dominant knee has an adverse effect on knee joint repositioning and dynamic stability, 20 minutes after ice is removed. In consideration of returning a land-based athlete to dynamic functional activities, post cryotherapeutic intervention at the knee, clinicians should consider these findings due to the potential increase risk of injury.



from #Audiology via ola Kala on Inoreader http://ift.tt/2D5zz3y
via IFTTT

Contralateral limb foot rotation during unilateral toe-in or toe-out walking in people with knee osteoarthritis

Publication date: Available online 6 March 2018
Source:Gait & Posture
Author(s): Jesse M. Charlton, Natasha M. Krowchuk, Gillian L. Hatfield, Jordan A. Guenette, Michael A. Hunt
BackgroundGait modification is a treatment approach often used for a variety of neuromuscular and musculoskeletal pathologies. Gait modification is commonly applied to a single limb, as is done with foot rotation (FR) in people with knee osteoarthritis (KOA). However, the extent to which gait changes observed in the trained limb are also exhibited in the untrained, contralateral limb during a training session is unknown.Research QuestionThe purpose of this study was to examine the within-limb FR differences across four unilateral FR modifications compared to natural walking.MethodsSixteen individuals with KOA walked on a treadmill while performing four different FR conditions: 10° toe-in, 0°, 10° toe-out and 20° toe-out. Motion capture was conducted to track FR magnitude after five minutes of practice.ResultsThe change in contralateral FR angle compared to natural walking significantly increased during toe-in 10° walking (3.1°) compared to toe-out −10° and −20° walking (-1.2° and −1.5°, respectively). As expected, the ipsilateral FR angle was significantly different between all conditions.SignificanceThese results suggest that small, but statistically significant changes in the untrained contralateral limb FR are observed during FR training of the ipsilateral limb. This may indicate a desire for symmetry, or a compensation when modifying the ipsilateral limb. Therefore, clinicians may need to maintain baseline FR magnitudes in the untrained limb when a patient exhibits unilateral KOA characteristics or lateral compartment KOA.



from #Audiology via ola Kala on Inoreader http://ift.tt/2G3tGXR
via IFTTT