Is Putting SUGAR (Sampling Utterances of Grammatical Analysis Revised) Into Language Sample Analysis a Good Thing? A Response to Pavelko and Owens (2017)

Purpose

In this letter, the authors respond to Pavelko and Owens' (2017) newly advanced set of procedures for language sample analysis: Sampling Utterances and Grammatical Analysis Revised (SUGAR).

Method

The authors contrast some of the new guidelines for transcription, morpheme segmentation, and language sample elicitation in SUGAR with traditional conventions for language sample analysis (LSA). They address the potential impact of the new guidelines on some of the target measures in SUGAR—mean length of utterances in morphemes (MLU_m), words per sentence (WPS), and clauses per sentence (CPS)—and provide their suggestions.

Results

Inclusion of partially intelligible utterances in SUGAR may over- or underestimate children's MLU_m and reduce the reliability of computing WPS. Counting derivational morphemes and the component morphemes of catenatives (e.g., gonna) may result in overestimation of children's morphosyntactic skills.

Conclusion

Further data are needed to determine whether MLU_m including derivational morphemes and the component morphemes of catenatives is a better measure of children's morphosyntactic skills than MLU_m excluding those morphemes. Pending such data, the authors recommend maintaining traditional LSA conventions and measures. Furthermore, free, fast automated utilities already exist that reduce barriers for clinicians to conduct informative, in-depth LSA.

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Is Putting SUGAR (Sampling Utterances of Grammatical Analysis Revised) Into Language Sample Analysis a Good Thing? A Response to Pavelko and Owens (2017)

Purpose

In this letter, the authors respond to Pavelko and Owens' (2017) newly advanced set of procedures for language sample analysis: Sampling Utterances and Grammatical Analysis Revised (SUGAR).

Method

The authors contrast some of the new guidelines for transcription, morpheme segmentation, and language sample elicitation in SUGAR with traditional conventions for language sample analysis (LSA). They address the potential impact of the new guidelines on some of the target measures in SUGAR—mean length of utterances in morphemes (MLU_m), words per sentence (WPS), and clauses per sentence (CPS)—and provide their suggestions.

Results

Inclusion of partially intelligible utterances in SUGAR may over- or underestimate children's MLU_m and reduce the reliability of computing WPS. Counting derivational morphemes and the component morphemes of catenatives (e.g., gonna) may result in overestimation of children's morphosyntactic skills.

Conclusion

Further data are needed to determine whether MLU_m including derivational morphemes and the component morphemes of catenatives is a better measure of children's morphosyntactic skills than MLU_m excluding those morphemes. Pending such data, the authors recommend maintaining traditional LSA conventions and measures. Furthermore, free, fast automated utilities already exist that reduce barriers for clinicians to conduct informative, in-depth LSA.

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Is Putting SUGAR (Sampling Utterances of Grammatical Analysis Revised) Into Language Sample Analysis a Good Thing? A Response to Pavelko and Owens (2017)

Purpose

In this letter, the authors respond to Pavelko and Owens' (2017) newly advanced set of procedures for language sample analysis: Sampling Utterances and Grammatical Analysis Revised (SUGAR).

Method

The authors contrast some of the new guidelines for transcription, morpheme segmentation, and language sample elicitation in SUGAR with traditional conventions for language sample analysis (LSA). They address the potential impact of the new guidelines on some of the target measures in SUGAR—mean length of utterances in morphemes (MLU_m), words per sentence (WPS), and clauses per sentence (CPS)—and provide their suggestions.

Results

Inclusion of partially intelligible utterances in SUGAR may over- or underestimate children's MLU_m and reduce the reliability of computing WPS. Counting derivational morphemes and the component morphemes of catenatives (e.g., gonna) may result in overestimation of children's morphosyntactic skills.

Conclusion

Further data are needed to determine whether MLU_m including derivational morphemes and the component morphemes of catenatives is a better measure of children's morphosyntactic skills than MLU_m excluding those morphemes. Pending such data, the authors recommend maintaining traditional LSA conventions and measures. Furthermore, free, fast automated utilities already exist that reduce barriers for clinicians to conduct informative, in-depth LSA.

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Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Int J Audiol. 2018 May;57(5):323-334

Authors: Soli SD, Amano-Kusumoto A, Clavier O, Wilbur J, Casto K, Freed D, Laroche C, Vaillancourt V, Giguère C, Dreschler WA, Rhebergen KS

Abstract
OBJECTIVE: Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs.
DESIGN: Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions.
STUDY SAMPLE: A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies.
RESULTS: Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r2 ≥ 0.94). Pooled predictions were slightly less accurate (0.78 ≤ r2 ≤ 0.92).
CONCLUSIONS: An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

PMID: 29668374 [PubMed - in process]

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Speech mapping and probe microphone measurements.

Speech mapping and probe microphone measurements.

Int J Audiol. 2018 May;57(5):398

Authors: Jenstad L

PMID: 29668373 [PubMed - in process]

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Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Int J Audiol. 2018 May;57(5):321-322

Authors: Dubno JR

Abstract
This manuscript provides a Commentary on a paper published in the current issue of the International Journal of Audiology and the companion paper published in Ear and Hearing by Soli et al. These papers report background, rationale and results of a novel modelling approach to assess "auditory fitness for duty," or an individual's ability to perform hearing-critical tasks related to their job, based on their likelihood of effective speech communication in the listening environment in which the task is performed.

PMID: 29668372 [PubMed - in process]

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Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Int J Audiol. 2018 May;57(5):323-334

Authors: Soli SD, Amano-Kusumoto A, Clavier O, Wilbur J, Casto K, Freed D, Laroche C, Vaillancourt V, Giguère C, Dreschler WA, Rhebergen KS

Abstract
OBJECTIVE: Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs.
DESIGN: Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions.
STUDY SAMPLE: A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies.
RESULTS: Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r2 ≥ 0.94). Pooled predictions were slightly less accurate (0.78 ≤ r2 ≤ 0.92).
CONCLUSIONS: An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

PMID: 29668374 [PubMed - in process]

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Speech mapping and probe microphone measurements.

Speech mapping and probe microphone measurements.

Int J Audiol. 2018 May;57(5):398

Authors: Jenstad L

PMID: 29668373 [PubMed - in process]

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Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Int J Audiol. 2018 May;57(5):321-322

Authors: Dubno JR

Abstract
This manuscript provides a Commentary on a paper published in the current issue of the International Journal of Audiology and the companion paper published in Ear and Hearing by Soli et al. These papers report background, rationale and results of a novel modelling approach to assess "auditory fitness for duty," or an individual's ability to perform hearing-critical tasks related to their job, based on their likelihood of effective speech communication in the listening environment in which the task is performed.

PMID: 29668372 [PubMed - in process]

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The test–retest reliability of questionnaires regarding attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults

Sofie Degeest, Leen Maes, Laura Leyssens, Hannah Keppler

Noise and Health 2018 20(93):31-36

Context: Young people expose themselves to high noise levels during leisure activities, and might thus be at risk of acquiring hearing-related problems. Therefore, information regarding risk-taking behavior is necessary to prevent future hearing problems and to optimize future preventive campaigns. Aim: This study evaluated the test–retest reliability of the Youth Attitude to Noise Scale (YANS) and beliefs about hearing protection and hearing loss (BAHPHL) instrument. Settings and Design: Forty-three young adults between 18 and 29 years filled in a questionnaire at two test moments. Materials and Methods: The YANS and BAHPHL instrument were used to evaluate the attitudes toward noise, hearing loss, and hearing protection. Each participant completed the retest within 21–55 days after the first administration of the questionnaire. Results: Paired Student’s t-tests showed no significant differences in mean scores between test and retest for both the entire YANS and BAHPHL instrument as well as their factors. Furthermore, a good agreement between test and retest scores was seen by Bland–Altman analyses. Intraclass correlation coefficients were above 0.70 for the entire YANS and the factor related to youth culture as well as for the entire BAHPHL and all the factors of the BAHPHL instrument, except for the factor related to the severity of the consequences of hearing loss. Conclusion: Reliable test–retest measurements of the YANS and BAHPHL instrument can be performed. Hence, these questionnaires can be used in longitudinal studies to explore young adults’ changes in attitudes toward noise, hearing loss, and hearing protection, with or without an educational intervention.

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A profile of noise sensitivity on the health-related quality of life among young motorcyclists

Anila Ali, Roslinah M Hussain, Nazri C Dom, Razi Ikhwan Md Rashid

Noise and Health 2018 20(93):53-59

Introduction: Motorcycle riders with noise sensitivity (NS) may suffer from degraded health-related quality of life (HRQOL) because they are exposed to acute noise levels on a daily basis. Materials and Methods: This study was aimed to identify the relationship between NS and HRQOL among young motorcycle riders (undergraduate university students) aged between 19 and 25 years (n = 301) through a cross-sectional questionnaire-based study, that is, Weinstein noise sensitivity scale and the World Health Organization Quality of Life. The effects of NS on HRQOL were assessed based on gender, the years of motorcycle driving experience, and noise sensitive among groups using one-way analysis of variances with an alpha value of 0.05. Results: The results showed no significant difference in NS between males and females. On the other hand, motorcycle driving experience for <4 years displayed a higher tendency toward NS. Moreover, a significantly (P = 0.004) decreasing trend among low, moderate, and high NS with their respective HRQOL was observed, while a high NS showed significantly (P = 0.015) lower scores on the social domain of the quality of life. Conclusion: The overall premise of the study has statistical significance and shows that individuals with high NS tend to have degraded HRQOL compared to individuals with low NS. Furthermore, in-depth studies are required from the other demographical background of participants to investigate the motorcyclist’s NS and HRQOL as an integral requirement for the rider’s safety and health.

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Association between polymorphism of tumor necrosis factor alpha (tnfα) in the region −308 g/a with tinnitus in the elderly with a history of occupational noise exposure

Luciana L.M Marchiori, Ana C.M Dias, Alyne S Gonçalvez, Regina C Poly-Frederico, Marcelo Y Doi

Noise and Health 2018 20(93):37-41

Context: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern and is often associated with different forms of the hearing loss of varying severity. Aims: To investigate the association between the polymorphism of tumor necrosis factor alpha (TNFα) in the region −308 G/A with the susceptibility to tinnitus in individuals with the history of exposure to occupational noise. Settings and Design: This was a cross-sectional study with a sample of 179 independent elderly people above 60 years of age. Materials and Methods: Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through polymerase chain reaction by restriction fragment length polymorphism. Statistical Analysis Used: Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%. Results: Among elderly with tinnitus (43.01%), 33.76% had a history of exposure to occupational noise. A statistically significant association was found between genotype frequencies of the TNFα gene in the −308 G/A region and the complaint of tinnitus (P = 0.04 and χ2 = 4.19). The elderly with the G allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the A allele (OR = 2.74; 95% CI: 1.56–4.81; P < 0.0005). Conclusion: This study suggests an association between the TNFα with susceptibility to tinnitus in individuals with a history of exposure to occupational noise.

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Effects of parenteral papaverine and piracetam administration on cochlea following acoustic trauma

Nurcan Yurtsever Kum, Yavuz F Yilmaz, Seren G Gurgen, Rauf O Kum, Muge Ozcan, Adnan Unal

Noise and Health 2018 20(93):47-52

Introduction: Noise exposure, the main cause of hearing loss in countries with lot of industries, may result both in temporary or permanent hearing loss. The goal of this study was to investigate the effects of parenteral papaverine and piracetam administration following an acoustic trauma on hearing function with histopathologic correlation. Materials and Methods: Eighteen Wistar albino rats exposed to noise for 8 h in a free environment were included. We divided the study population into three groups, and performed daily intraperitoneal injections of papaverine, piracetam, and saline, respectively, throughout the study. We investigated the histopathologic effects of cellular apoptosis on inner hair cells (IHCs) and outer hair cells (OHCs) and compared the distortion product otoacoustic emissions (DPOAEs) thresholds among the groups. Results and Discussion: On the 3rd and 7th days, DPOAE thresholds at 8 kHz were significantly higher both in papaverine and piracetam groups compared with the control group (P = 0.004 for 3rd day, P = 0.016 and P = 0.028 for 7th day, respectively). On the 14th day, piracetam group had significantly higher mean thresholds at 8 kHz (P = 0.029); however, papaverine group had similar mean thresholds compared to the control group (P = 0.200). On the 3rd and 7th days following acoustic trauma, both IHC and OHC loss were significantly lower in both papaverine and piracetam groups. On the 7th day, the mean amount of apoptotic IHCs and OHCs identified using Caspase-3 method were significantly lower in both groups, but the mean amount identified using terminal deoxynucleotidyl transferase dUTP nick end labeling method were similar in both groups compared to the control group. Conclusion: We demonstrated the effects of papaverine and piracetam on the recovery of cochlear damage due to acoustic trauma on experimental animals using histopathologic and electrophysiologic examinations.

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Noise exposure and hearing loss in classical orchestra musicians: A five-year follow-up

Alberto Behar, Marshall Chasin, Steve Mosher, Mohammad Abdoli-Eramaki, Frank A Russo

Noise and Health 2018 20(93):42-46

Introduction: This study is a follow-up to prior research from our group that attempts to relate noise exposure and hearing thresholds in active performing musicians of the National Ballet of Canada Orchestra. Materials and Methods: Exposures obtained in early 2010 were compared to exposures obtained in early 2017 (the present study). In addition, audiometric thresholds obtained in early 2012 were compared to thresholds obtained in early 2017 (the present study). This collection of measurements presents an opportunity to observe the regularities in the patterns of exposure as well as threshold changes that may be expected in active orchestra musicians over a 5-year span. Results: The pattern of noise exposure across instrument groups, which was consistent over the two time points, reveals highest exposures among brass, percussion/basses, and woodwinds. However, the average noise exposure across groups and time was consistently below 85 dBA, which suggests no occupational hazard. These observations were corroborated by audiometric thresholds, which were generally (a) in the normal range and (b) unchanged in the 5-year period between measurements. Conclusion: Because exposure levels were consistently below 85 dBA and changes in audiometric thresholds were minimal, we conclude that musicians experienced little-to-no risk of noise-induced hearing loss.

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Realizing modeling and mapping tools to study the upsurge of noise pollution as a result of open-cast mining and transportation activities

Satish K Lokhande, Mohindra C Jain, Satyajeet A Dhawale, Rakesh Gautam, Ghanshyam L Bodhe

Noise and Health 2018 20(93):60-67

Introduction: In open-cast mines, noise pollution has become a serious concern due to the extreme use of heavy earth moving machinery (HEMM). Materials and Methods: This study is focused to measure and assess the effects of the existing noise levels of major operational mines in the Keonjhar, Sundergadh, and Mayurbhanj districts of Odisha, India. The transportation noise levels were also considered in this study, which was predicted using the modified Federal Highway Administration (FHWA) model. Result and Discussion: It was observed that noise induced by HEMM such as rock breakers, jackhammers, dumpers, and excavators, blasting noise in the mining terrain, as well as associated transportation noise became a major source of annoyance to the habitants living in proximity to the mines. The noise produced by mechanized mining operations was observed between 74.3 and 115.2 dB(A), and its impact on residential areas was observed between 49.4 and 58.9 dB(A). In addition, the noise contour maps of sound level dispersion were demonstrated with the utilization of advanced noise prediction software tools for better understanding. Conclusion: Finally, the predicted values at residential zone and traffic noise are correlated with observed values, and the coefficient of determination, R2, was calculated to be 0.6891 and 0.5967, respectively.

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Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Int J Audiol. 2018 May;57(5):323-334

Authors: Soli SD, Amano-Kusumoto A, Clavier O, Wilbur J, Casto K, Freed D, Laroche C, Vaillancourt V, Giguère C, Dreschler WA, Rhebergen KS

Abstract
OBJECTIVE: Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs.
DESIGN: Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions.
STUDY SAMPLE: A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies.
RESULTS: Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r2 ≥ 0.94). Pooled predictions were slightly less accurate (0.78 ≤ r2 ≤ 0.92).
CONCLUSIONS: An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

PMID: 29668374 [PubMed - in process]

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Speech mapping and probe microphone measurements.

Speech mapping and probe microphone measurements.

Int J Audiol. 2018 May;57(5):398

Authors: Jenstad L

PMID: 29668373 [PubMed - in process]

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Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Int J Audiol. 2018 May;57(5):321-322

Authors: Dubno JR

Abstract
This manuscript provides a Commentary on a paper published in the current issue of the International Journal of Audiology and the companion paper published in Ear and Hearing by Soli et al. These papers report background, rationale and results of a novel modelling approach to assess "auditory fitness for duty," or an individual's ability to perform hearing-critical tasks related to their job, based on their likelihood of effective speech communication in the listening environment in which the task is performed.

PMID: 29668372 [PubMed - in process]

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via IFTTT

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability.

Int J Audiol. 2018 May;57(5):323-334

Authors: Soli SD, Amano-Kusumoto A, Clavier O, Wilbur J, Casto K, Freed D, Laroche C, Vaillancourt V, Giguère C, Dreschler WA, Rhebergen KS

Abstract
OBJECTIVE: Validate use of the Extended Speech Intelligibility Index (ESII) for prediction of speech intelligibility in non-stationary real-world noise environments. Define a means of using these predictions for objective occupational hearing screening for hearing-critical public safety and law enforcement jobs.
DESIGN: Analyses of predicted and measured speech intelligibility in recordings of real-world noise environments were performed in two studies using speech recognition thresholds (SRTs) and intelligibility measures. ESII analyses of the recordings were used to predict intelligibility. Noise recordings were made in prison environments and at US Army facilities for training ground and airborne forces. Speech materials included full bandwidth sentences and bandpass filtered sentences that simulated radio transmissions.
STUDY SAMPLE: A total of 22 adults with normal hearing (NH) and 15 with mild-moderate hearing impairment (HI) participated in the two studies.
RESULTS: Average intelligibility predictions for individual NH and HI subjects were accurate in both studies (r2 ≥ 0.94). Pooled predictions were slightly less accurate (0.78 ≤ r2 ≤ 0.92).
CONCLUSIONS: An individual's SRT and audiogram can accurately predict the likelihood of effective speech communication in noise environments with known ESII characteristics, where essential hearing-critical tasks are performed. These predictions provide an objective means of occupational hearing screening.

PMID: 29668374 [PubMed - in process]

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Speech mapping and probe microphone measurements.

Speech mapping and probe microphone measurements.

Int J Audiol. 2018 May;57(5):398

Authors: Jenstad L

PMID: 29668373 [PubMed - in process]

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via IFTTT

Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world.

Int J Audiol. 2018 May;57(5):321-322

Authors: Dubno JR

Abstract
This manuscript provides a Commentary on a paper published in the current issue of the International Journal of Audiology and the companion paper published in Ear and Hearing by Soli et al. These papers report background, rationale and results of a novel modelling approach to assess "auditory fitness for duty," or an individual's ability to perform hearing-critical tasks related to their job, based on their likelihood of effective speech communication in the listening environment in which the task is performed.

PMID: 29668372 [PubMed - in process]

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Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

Related Articles

Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

J Am Acad Audiol. 2018 Apr;29(4):348-356

Authors: Johnstone PM, Yeager KR, Pomeroy ML, Hawk N

Abstract
BACKGROUND: Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.
PURPOSE: To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.
RESEARCH DESIGN: A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).
STUDY SAMPLE: Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr).
DATA COLLECTION AND ANALYSIS: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.
RESULTS: A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.
CONCLUSIONS: OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.

PMID: 29664727 [PubMed - in process]

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Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.

Related Articles

Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.

J Am Acad Audiol. 2018 Apr;29(4):337-347

Authors: Wolfe J, Gifford R, Schafer E

Abstract
BACKGROUND: The electrically evoked stapedial reflex threshold (ESRT) has been shown to be a good predictor of upper stimulation level for cochlear implant recipients. Previous research has shown that the ESRT may be recorded at lower stimulation levels and with a higher incidence of success with the use of higher frequency probe tones (e.g., 678 and 1000 Hz) relative to the use of the conventional 226-Hz probe tone. Research has also shown that the acoustic reflex may be recorded at lower stimulus levels with the use of wideband reflectance when compared to the acoustic reflex threshold recorded with a conventional acoustic immittance measurement.
PURPOSE: The objective of this study was to compare the ESRT recorded with acoustic immittance and wideband reflectance measurements.
RESEARCH DESIGN: A repeated measures design was used to evaluate potential differences in ESRTs with stimulation at an apical, middle, and basal electrode contact with the use of two different techniques, acoustic immittance measurement and wideband reflectance.
STUDY SAMPLE: Twelve users of Cochlear Nucleus cochlear implants were included in the study.
DATA COLLECTION AND ANALYSIS: Participants' ESRTs were evaluated in response to simulation at three different electrode contact sites (i.e., an apical, middle, and basal electrode contact) with the use of two different middle ear measurement techniques, acoustic immittance with the use of a 226-Hz probe tone and wideband reflectance with the use of a chirp stimulus.
RESULTS: The mean ESRT recorded with wideband reflectance measurement was significantly lower when compared to the ESRT recorded with acoustic immittance. For one participant, the ESRT was not recorded with acoustic immittance before reaching the participant's loudness discomfort threshold, but it was successfully recorded with the use of wideband reflectance.
CONCLUSIONS: The ESRT may potentially be recorded at lower presentation levels with the use of wideband reflectance measures relative to the use of acoustic immittance with a 226-Hz probe tone. This may allow for the ESRT to be obtained at levels that are more comfortable for the cochlear implant recipient, which may also allow for a higher incidence in the successful recording of the ESRT.

PMID: 29664726 [PubMed - in process]

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Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

Related Articles

Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

J Am Acad Audiol. 2018 Apr;29(4):313-336

Authors: Husain FT, Gander PE, Jansen JN, Shen S

Abstract
BACKGROUND: Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling.
PURPOSE: This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients' and audiologists' expectations for tinnitus care were in agreement and areas in which they differed.
RESEARCH DESIGN: The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format.
STUDY SAMPLE: We received 230 completed Patient Surveys and 68 completed Audiologist Surveys.
DATA COLLECTION AND ANALYSIS: All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (https://ift.tt/fUqr8B). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success.
RESULTS: Differences were noted between the two groups' responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly, whereas patients reported reduction of tinnitus loudness (63%) and complete elimination of tinnitus (57%) most often. The topic of greatest agreement was the desire for more information on tinnitus; 62% of patients felt more information from their healthcare provider would be the most important factor for improved tinnitus management, and 67% of audiologists reported currently having "some access" or less to appropriate resources for tinnitus treatment. Modeling results for effective tinnitus management and definitions of treatment success highlighted the importance of resource access and information sharing for both audiologists and patients.
CONCLUSIONS: Patients and audiologists differed in terms of their expectations for successful treatment, with the patients focusing on perceptual factors and the audiologists on the reaction to the sound. Patient satisfaction with tinnitus treatment may be improved through access to more information, specifically, more information about current tinnitus treatment options and how these focus on the patient's reaction to the tinnitus rather than the percept itself. Providing credible tinnitus information resources to audiologists, and focusing resources on training a small number of tinnitus specialist audiologists could greatly improve patient satisfaction with the current state of tinnitus palliative care.

PMID: 29664725 [PubMed - in process]

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Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.

Related Articles

Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.

J Am Acad Audiol. 2018 Apr;29(4):300-312

Authors: Gallagher NE, Woodside JV

Abstract
BACKGROUND: Despite a high prevalence of age-related hearing loss in older people, there is an unexplained low level of hearing aid adoption and use. Further research is required to determine the reason because hearing aids can vastly improve the quality of life for those with hearing loss.
PURPOSE: The aim of this study was to explore factors associated with hearing aid adoption and use, and to determine whether these differed between groups with different hearing aid use behaviors.
RESEARCH DESIGN: Individual face-to-face semistructured interviews.
STUDY SAMPLE: Three groups of older people with hearing loss in Northern Ireland were recruited: (1) regular hearing aid users (n = 12), (2) irregular hearing aid users (n = 10), and (3) hearing aid nonowners (n = 10).
DATA COLLECTION AND ANALYSIS: Qualitative thematic analysis, using principles of grounded theory, was used to code the data and extract emerging themes for each of the three groups to distinguish similarities and differences between the groups. One-way analysis of variance and χ² tests were used to determine the difference in continuous and categorical variables, respectively, between the three groups.
RESULTS: Similar themes emerged across the three groups: the complexity of low hearing aid use and attitudes to hearing loss/hearing aid use. A third theme, inadequacy of audiology services, was identified in both groups using hearing aids. Older age people having more severe hearing loss and longer duration of hearing aid ownership were associated with greater hearing aid adoption and use.
CONCLUSIONS: Similar themes emerged from qualitative analysis across groups of people with hearing loss. More information for those with hearing loss and those with hearing aids and scheduled follow-up appointments for those with hearing aids are essential to improve hearing aid adoption and use in older people. Further research should focus on the most suitable methods of distributing this information and how often follow-up appointments should take place to achieve optimal hearing aid adoption and use.

PMID: 29664724 [PubMed - in process]

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The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.

Related Articles

The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.

J Am Acad Audiol. 2018 Apr;29(4):292-299

Authors: de Andrade KCL, Muniz LF, Menezes PL, Neto SDSC, Carnaúba ATL, Leal MC

Abstract
BACKGROUND: One of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.
PURPOSE: To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.
RESEARCH DESIGN: Cross-sectional analytical observational case series study.
STUDY SAMPLE: We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.
INTERVENTION: Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer's software (custom sound Ep 3-2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.
DATA COLLECTION AND ANALYSIS: Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey's honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov-Smirnov test examined whether significant relationships existed between these other factors.
RESULTS: The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.
CONCLUSION: The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.

PMID: 29664723 [PubMed - in process]

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Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.

Related Articles

Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.

J Am Acad Audiol. 2018 Apr;29(4):279-291

Authors: Klein KE, Wu YH, Stangl E, Bentler RA

Abstract
BACKGROUND: Auditory environments can influence the communication function of individuals with hearing loss and the effects of hearing aids. Therefore, a tool that can objectively characterize a patient's real-world auditory environments is needed.
PURPOSE: To use the Language Environment Analysis (LENA) system to quantify the auditory environments of adults with hearing loss, to examine if the use of hearing aids changes a user's auditory environment, and to determine the association between LENA variables and self-report hearing aid outcome measures.
RESEARCH DESIGN: This study used a crossover design.
STUDY SAMPLE: Participants included 22 adults with mild-to-moderate hearing loss, age 64-82 yr.
INTERVENTION: Participants were fitted with bilateral behind-the-ear hearing aids from a major manufacturer.
DATA COLLECTION AND ANALYSIS: The LENA system consists of a digital language processor (DLP) that is worn by an individual and records up to 16 hr of the individual's auditory environment. The recording is then automatically categorized according to time spent in different types of auditory environments (e.g., meaningful speech and TV/electronic sound) by the LENA algorithms. The LENA system also characterizes the user's auditory environment by providing the sound levels of different auditory categories. Participants in the present study wore a LENA DLP in an unaided condition and aided condition, which each lasted six to eight days. Participants wore bilateral hearing aids in the aided condition. Percentage of time spent in each auditory environment, as well as median levels of TV/electronic sounds and speech, were compared between subjects' unaided and aided conditions using paired sample t tests. LENA data were also compared to self-report measures of hearing disability and hearing aid benefit using Pearson correlations.
RESULTS: Overall, participants spent the greatest percentage of time in silence (∼40%), relative to other auditory environments. Participants spent ∼12% and 26% of their time in meaningful speech and TV/electronic sound environments, respectively. No significant differences were found between mean percentage of time spent in each auditory environment in the unaided and aided conditions. Median TV/electronic sound levels were on average 2.4 dB lower in the aided condition than in the unaided condition; speech levels were not significantly different between the two conditions. TV/electronic sound and speech levels did not significantly correlate with self-report data.
CONCLUSIONS: The LENA system can provide rich data to characterize the everyday auditory environments of older adults with hearing loss. Although TV/electronic sound level was significantly lower in the aided than unaided condition, the use of hearing aids seemed not to substantially change users' auditory environments. Because there is no significant association between objective LENA variables and self-report questionnaire outcomes, these two types of measures may assess different aspects of communication function. The feasibility of using LENA in clinical settings is discussed.

PMID: 29664722 [PubMed - in process]

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Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.

Related Articles

Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.

J Am Acad Audiol. 2018 Apr;29(4):273-278

Authors: Liu H, Liu Y, Li Y, Jin X, Li J, Zhou Y, Ge W, Ni X

Abstract
BACKGROUND: Wide dynamic range compression (WDRC) has been widely used in hearing aid technology. However, several reports indicate that WDRC may improve audibility at the expense of speech intelligibility. As such, a modified amplification compression scheme, named adaptive compression, was developed. However, the effect of compression strategies on speech perception in pediatric hearing aid users has not been clearly reported.
PURPOSE: The purpose of the present study was to investigate the effect of adaptive compression and fast-acting WDRC processing strategies on sentence recognition in noise with Mandarin, pediatric hearing aid users.
RESEARCH DESIGN: This study was set up using a double-blind, within-subject, repeated-measures design.
STUDY SAMPLE: Twenty-six children who spoke Mandarin Chinese as their primary language and had bilateral sensorineural hearing loss participated in the study.
DATA COLLECTION AND ANALYSIS: Sentence recognition in noise was evaluated in behind-the-ear technology with both adaptive compression processing and fast-acting WDRC processing and was selected randomly for each child. Percent correct sentence recognition in noise with fast-acting WDRC and adaptive compression was collected from each participant. Correlation analysis was performed to examine the effect of gender, age at assessment, and hearing threshold of the better ear on signal-to-noise ratio, and a paired-samples t test was employed to compare the performance of the adaptive compression strategy and fast-acting WDRC processing.
RESULTS: The mean percentage correct of sentence recognition in noise with behind-the-ear technology with fast-acting WDRC and adaptive compression processing were 62.24% and 68.71%, respectively. The paired-samples t test showed that the performance of the adaptive compression strategy was significantly better than the fast-acting WDRC processing (t = 3.190, p = 0.004).
CONCLUSIONS: Compared with the fast-acting WDRC, adaptive compression provided better sentence recognition in noise for Mandarin pediatric hearing aid users.

PMID: 29664721 [PubMed - in process]

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Functional Outcomes in Audiology: There is Room for Improvement.

Related Articles

Functional Outcomes in Audiology: There is Room for Improvement.

J Am Acad Audiol. 2018 Apr;29(4):272

Authors: McCaslin DL

PMID: 29664720 [PubMed - in process]

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Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world

Volume 57, Issue 5, May 2018, Page 321-322
.


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Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability

Volume 57, Issue 5, May 2018, Page 323-334
.


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Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

Related Articles

Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes.

J Am Acad Audiol. 2018 Apr;29(4):348-356

Authors: Johnstone PM, Yeager KR, Pomeroy ML, Hawk N

Abstract
BACKGROUND: Open-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.
PURPOSE: To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.
RESEARCH DESIGN: A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).
STUDY SAMPLE: Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10-16 yr) and younger children (6-9 yr).
DATA COLLECTION AND ANALYSIS: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, "baseball": the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.
RESULTS: A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.
CONCLUSIONS: OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.

PMID: 29664727 [PubMed - in process]

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Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.

Related Articles

Measurement of the Electrically Evoked Stapedial Reflex Response with Wideband Acoustic Reflectance Measurement.

J Am Acad Audiol. 2018 Apr;29(4):337-347

Authors: Wolfe J, Gifford R, Schafer E

Abstract
BACKGROUND: The electrically evoked stapedial reflex threshold (ESRT) has been shown to be a good predictor of upper stimulation level for cochlear implant recipients. Previous research has shown that the ESRT may be recorded at lower stimulation levels and with a higher incidence of success with the use of higher frequency probe tones (e.g., 678 and 1000 Hz) relative to the use of the conventional 226-Hz probe tone. Research has also shown that the acoustic reflex may be recorded at lower stimulus levels with the use of wideband reflectance when compared to the acoustic reflex threshold recorded with a conventional acoustic immittance measurement.
PURPOSE: The objective of this study was to compare the ESRT recorded with acoustic immittance and wideband reflectance measurements.
RESEARCH DESIGN: A repeated measures design was used to evaluate potential differences in ESRTs with stimulation at an apical, middle, and basal electrode contact with the use of two different techniques, acoustic immittance measurement and wideband reflectance.
STUDY SAMPLE: Twelve users of Cochlear Nucleus cochlear implants were included in the study.
DATA COLLECTION AND ANALYSIS: Participants' ESRTs were evaluated in response to simulation at three different electrode contact sites (i.e., an apical, middle, and basal electrode contact) with the use of two different middle ear measurement techniques, acoustic immittance with the use of a 226-Hz probe tone and wideband reflectance with the use of a chirp stimulus.
RESULTS: The mean ESRT recorded with wideband reflectance measurement was significantly lower when compared to the ESRT recorded with acoustic immittance. For one participant, the ESRT was not recorded with acoustic immittance before reaching the participant's loudness discomfort threshold, but it was successfully recorded with the use of wideband reflectance.
CONCLUSIONS: The ESRT may potentially be recorded at lower presentation levels with the use of wideband reflectance measures relative to the use of acoustic immittance with a 226-Hz probe tone. This may allow for the ESRT to be obtained at levels that are more comfortable for the cochlear implant recipient, which may also allow for a higher incidence in the successful recording of the ESRT.

PMID: 29664726 [PubMed - in process]

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Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

Related Articles

Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

J Am Acad Audiol. 2018 Apr;29(4):313-336

Authors: Husain FT, Gander PE, Jansen JN, Shen S

Abstract
BACKGROUND: Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling.
PURPOSE: This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients' and audiologists' expectations for tinnitus care were in agreement and areas in which they differed.
RESEARCH DESIGN: The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format.
STUDY SAMPLE: We received 230 completed Patient Surveys and 68 completed Audiologist Surveys.
DATA COLLECTION AND ANALYSIS: All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (https://ift.tt/fUqr8B). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success.
RESULTS: Differences were noted between the two groups' responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly, whereas patients reported reduction of tinnitus loudness (63%) and complete elimination of tinnitus (57%) most often. The topic of greatest agreement was the desire for more information on tinnitus; 62% of patients felt more information from their healthcare provider would be the most important factor for improved tinnitus management, and 67% of audiologists reported currently having "some access" or less to appropriate resources for tinnitus treatment. Modeling results for effective tinnitus management and definitions of treatment success highlighted the importance of resource access and information sharing for both audiologists and patients.
CONCLUSIONS: Patients and audiologists differed in terms of their expectations for successful treatment, with the patients focusing on perceptual factors and the audiologists on the reaction to the sound. Patient satisfaction with tinnitus treatment may be improved through access to more information, specifically, more information about current tinnitus treatment options and how these focus on the patient's reaction to the tinnitus rather than the percept itself. Providing credible tinnitus information resources to audiologists, and focusing resources on training a small number of tinnitus specialist audiologists could greatly improve patient satisfaction with the current state of tinnitus palliative care.

PMID: 29664725 [PubMed - in process]

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Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.

Related Articles

Factors Affecting Hearing Aid Adoption and Use: A Qualitative Study.

J Am Acad Audiol. 2018 Apr;29(4):300-312

Authors: Gallagher NE, Woodside JV

Abstract
BACKGROUND: Despite a high prevalence of age-related hearing loss in older people, there is an unexplained low level of hearing aid adoption and use. Further research is required to determine the reason because hearing aids can vastly improve the quality of life for those with hearing loss.
PURPOSE: The aim of this study was to explore factors associated with hearing aid adoption and use, and to determine whether these differed between groups with different hearing aid use behaviors.
RESEARCH DESIGN: Individual face-to-face semistructured interviews.
STUDY SAMPLE: Three groups of older people with hearing loss in Northern Ireland were recruited: (1) regular hearing aid users (n = 12), (2) irregular hearing aid users (n = 10), and (3) hearing aid nonowners (n = 10).
DATA COLLECTION AND ANALYSIS: Qualitative thematic analysis, using principles of grounded theory, was used to code the data and extract emerging themes for each of the three groups to distinguish similarities and differences between the groups. One-way analysis of variance and χ² tests were used to determine the difference in continuous and categorical variables, respectively, between the three groups.
RESULTS: Similar themes emerged across the three groups: the complexity of low hearing aid use and attitudes to hearing loss/hearing aid use. A third theme, inadequacy of audiology services, was identified in both groups using hearing aids. Older age people having more severe hearing loss and longer duration of hearing aid ownership were associated with greater hearing aid adoption and use.
CONCLUSIONS: Similar themes emerged from qualitative analysis across groups of people with hearing loss. More information for those with hearing loss and those with hearing aids and scheduled follow-up appointments for those with hearing aids are essential to improve hearing aid adoption and use in older people. Further research should focus on the most suitable methods of distributing this information and how often follow-up appointments should take place to achieve optimal hearing aid adoption and use.

PMID: 29664724 [PubMed - in process]

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The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.

Related Articles

The Value of Electrically Evoked Stapedius Reflex in Determining the Maximum Comfort Level of a Cochlear Implant.

J Am Acad Audiol. 2018 Apr;29(4):292-299

Authors: de Andrade KCL, Muniz LF, Menezes PL, Neto SDSC, Carnaúba ATL, Leal MC

Abstract
BACKGROUND: One of the most important steps for good user performance with a cochlear implant (CI) is activation and programming, aimed at determining the dynamic range. In adults, current levels are determined by psychophysical measures. In babies, small children, or individuals with multiple disorders, this procedure requires techniques that may provide inconsistent responses because of auditory inexperience or the age of the child, making it a very difficult process that demands the collaboration of both the patient and the family.
PURPOSE: To study the relationship between the electrically evoked stapedius reflex threshold (ESRT) and maximum comfort level for stimulating electrodes (C-level) in postoperative CI users.
RESEARCH DESIGN: Cross-sectional analytical observational case series study.
STUDY SAMPLE: We assessed 24 patients of both sexes, aged between 18 and 68 yr, submitted to CI surgery.
INTERVENTION: Otoscopy and immittance. Next, an implant speech processor connected to an Itautec® computer containing the manufacturer's software (custom sound Ep 3-2) was used, as well as an AT 235h probe inserted into the ear contralateral to the CI to capture the stapedius reflex, obtaining electrically evoked stapedius reflex thresholds.
DATA COLLECTION AND ANALYSIS: Data from the last programming, defining C-levels for each electrode studied, were extracted from the databank of each patient. The manual decay function of the AT 235h middle ear analyzer was used to observe ESRT response in a same window for a longer response capture time. Electrodes 22, 16, 11, 6, and 1 were tested when active, with the aim of using electrodes over the entire length of the CI, and ESRT was considered present when compliance was ≥0.05 ml. Stimuli, in current units, were always initiated at 20 cu above the C-level. The analysis of variance parametric test, Tukey's honest significant difference test, the t-test, Wilcoxon nonparametric test, and the Kolmogorov-Smirnov test examined whether significant relationships existed between these other factors.
RESULTS: The results demonstrate that all the electrodes selected for the study exhibited higher mean reflex threshold values than their mean C-level counterparts. However, there was no significant difference between them, for electrodes 1, 6, 11, and 16. The data provided allow the use of ESRT to define C-level values and make it possible to stipulate a correction factor ranging between 6 and 25.6 electrical units.
CONCLUSION: The use of electrically evoked stapedius reflex thresholds can help the team in charge of programming CIs, making the process faster and safer, mainly for infants, small children, or individuals with multiple disorders.

PMID: 29664723 [PubMed - in process]

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Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.

Related Articles

Using a Digital Language Processor to Quantify the Auditory Environment and the Effect of Hearing Aids for Adults with Hearing Loss.

J Am Acad Audiol. 2018 Apr;29(4):279-291

Authors: Klein KE, Wu YH, Stangl E, Bentler RA

Abstract
BACKGROUND: Auditory environments can influence the communication function of individuals with hearing loss and the effects of hearing aids. Therefore, a tool that can objectively characterize a patient's real-world auditory environments is needed.
PURPOSE: To use the Language Environment Analysis (LENA) system to quantify the auditory environments of adults with hearing loss, to examine if the use of hearing aids changes a user's auditory environment, and to determine the association between LENA variables and self-report hearing aid outcome measures.
RESEARCH DESIGN: This study used a crossover design.
STUDY SAMPLE: Participants included 22 adults with mild-to-moderate hearing loss, age 64-82 yr.
INTERVENTION: Participants were fitted with bilateral behind-the-ear hearing aids from a major manufacturer.
DATA COLLECTION AND ANALYSIS: The LENA system consists of a digital language processor (DLP) that is worn by an individual and records up to 16 hr of the individual's auditory environment. The recording is then automatically categorized according to time spent in different types of auditory environments (e.g., meaningful speech and TV/electronic sound) by the LENA algorithms. The LENA system also characterizes the user's auditory environment by providing the sound levels of different auditory categories. Participants in the present study wore a LENA DLP in an unaided condition and aided condition, which each lasted six to eight days. Participants wore bilateral hearing aids in the aided condition. Percentage of time spent in each auditory environment, as well as median levels of TV/electronic sounds and speech, were compared between subjects' unaided and aided conditions using paired sample t tests. LENA data were also compared to self-report measures of hearing disability and hearing aid benefit using Pearson correlations.
RESULTS: Overall, participants spent the greatest percentage of time in silence (∼40%), relative to other auditory environments. Participants spent ∼12% and 26% of their time in meaningful speech and TV/electronic sound environments, respectively. No significant differences were found between mean percentage of time spent in each auditory environment in the unaided and aided conditions. Median TV/electronic sound levels were on average 2.4 dB lower in the aided condition than in the unaided condition; speech levels were not significantly different between the two conditions. TV/electronic sound and speech levels did not significantly correlate with self-report data.
CONCLUSIONS: The LENA system can provide rich data to characterize the everyday auditory environments of older adults with hearing loss. Although TV/electronic sound level was significantly lower in the aided than unaided condition, the use of hearing aids seemed not to substantially change users' auditory environments. Because there is no significant association between objective LENA variables and self-report questionnaire outcomes, these two types of measures may assess different aspects of communication function. The feasibility of using LENA in clinical settings is discussed.

PMID: 29664722 [PubMed - in process]

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Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.

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Effect of Adaptive Compression and Fast-Acting WDRC Strategies on Sentence Recognition in Noise in Mandarin-Speaking Pediatric Hearing Aid Users.

J Am Acad Audiol. 2018 Apr;29(4):273-278

Authors: Liu H, Liu Y, Li Y, Jin X, Li J, Zhou Y, Ge W, Ni X

Abstract
BACKGROUND: Wide dynamic range compression (WDRC) has been widely used in hearing aid technology. However, several reports indicate that WDRC may improve audibility at the expense of speech intelligibility. As such, a modified amplification compression scheme, named adaptive compression, was developed. However, the effect of compression strategies on speech perception in pediatric hearing aid users has not been clearly reported.
PURPOSE: The purpose of the present study was to investigate the effect of adaptive compression and fast-acting WDRC processing strategies on sentence recognition in noise with Mandarin, pediatric hearing aid users.
RESEARCH DESIGN: This study was set up using a double-blind, within-subject, repeated-measures design.
STUDY SAMPLE: Twenty-six children who spoke Mandarin Chinese as their primary language and had bilateral sensorineural hearing loss participated in the study.
DATA COLLECTION AND ANALYSIS: Sentence recognition in noise was evaluated in behind-the-ear technology with both adaptive compression processing and fast-acting WDRC processing and was selected randomly for each child. Percent correct sentence recognition in noise with fast-acting WDRC and adaptive compression was collected from each participant. Correlation analysis was performed to examine the effect of gender, age at assessment, and hearing threshold of the better ear on signal-to-noise ratio, and a paired-samples t test was employed to compare the performance of the adaptive compression strategy and fast-acting WDRC processing.
RESULTS: The mean percentage correct of sentence recognition in noise with behind-the-ear technology with fast-acting WDRC and adaptive compression processing were 62.24% and 68.71%, respectively. The paired-samples t test showed that the performance of the adaptive compression strategy was significantly better than the fast-acting WDRC processing (t = 3.190, p = 0.004).
CONCLUSIONS: Compared with the fast-acting WDRC, adaptive compression provided better sentence recognition in noise for Mandarin pediatric hearing aid users.

PMID: 29664721 [PubMed - in process]

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Functional Outcomes in Audiology: There is Room for Improvement.

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Functional Outcomes in Audiology: There is Room for Improvement.

J Am Acad Audiol. 2018 Apr;29(4):272

Authors: McCaslin DL

PMID: 29664720 [PubMed - in process]

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Beyond the audiogram: application of models of auditory fitness for duty to assess communication in the real world

Volume 57, Issue 5, May 2018, Page 321-322
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Evidence-based occupational hearing screening II: validation of a screening methodology using measures of functional hearing ability

Volume 57, Issue 5, May 2018, Page 323-334
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