Measuring Perceptions of Classroom Listening in Typically Developing Children and Children with Auditory Difficulties Using the LIFE-UK Questionnaire.

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Measuring Perceptions of Classroom Listening in Typically Developing Children and Children with Auditory Difficulties Using the LIFE-UK Questionnaire.

J Am Acad Audiol. 2018 Jul/Aug;29(7):656-667

Authors: Purdy SC, Sharma M, Morgan A

Abstract
BACKGROUND: Classrooms can be noisy and are challenging listening environments for children with auditory processing disorder (APD). This research was undertaken to determine if the Listening Inventory for Education-UK version (LIFE-UK) can differentiate children with listening difficulties and APD from their typically developing peers.
PURPOSE: To investigate reliability and validity of the student and teacher versions LIFE-UK questionnaire for assessing classroom listening difficulties.
RESEARCH DESIGN: Cross-sectional quantitative study comparing children with listening difficulties with typically developing children.
STUDY SAMPLE: In total, 143 children (7-12 yr) participated; 45 were diagnosed with APD. Fifteen participants with reported listening difficulties who passed the APD test battery were assigned to a "listening difficulty" (LiD) group. Eighty three children from nine classrooms formed a Control group.
DATA COLLECTION AND ANALYSIS: Children and teachers completed the LIFE-UK questionnaire student and teacher versions. Factor analysis was undertaken, and item reliability was assessed using Cronbach's alpha. Teacher and student ratings were compared using Spearman correlations. Correlations between LIFE-UK ratings and APD test results were also investigated.
RESULTS: Factor analysis revealed three factors accounting for 60% of the variance in the Control group LIFE-UK ratings. After removing six items with low factor loadings, a shortened seven-item version with three factors accounted for 71.8% of the variance for the student questionnaire; Cronbach's alpha indicated good internal reliability for this seven-item version of the student questionnaire. Factors were also derived for the teacher questionnaire. Teacher and student ratings were correlated when participant groups were combined. LIFE-UK ratings correlated weakly with some APD measures, providing some support for the questionnaire validity.
CONCLUSIONS: The results support the use of either the 13- or 7-item student and the teacher versions of the LIFE-UK to evaluate classroom listening and functional consequences of APD. Factor analysis resulted in groupings of items reflecting differences in listening demands in quiet versus noise for the student questionnaire and attentional versus class participation demands for the teacher questionnaire. Further research is needed to confirm the robustness of these factors in other populations.

PMID: 29988013 [PubMed - in process]

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Impact of Hearing Loss and Amplification on Performance on a Cognitive Screening Test.

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Impact of Hearing Loss and Amplification on Performance on a Cognitive Screening Test.

J Am Acad Audiol. 2018 Jul/Aug;29(7):648-655

Authors: Saunders GH, Odgear I, Cosgrove A, Frederick MT

Abstract
BACKGROUND: There have been numerous recent reports on the association between hearing impairment and cognitive function, such that the cognition of adults with hearing loss is poorer relative to the cognition of adults with normal hearing (NH), even when amplification is used. However, it is not clear the extent to which this is testing artifact due to the individual with hearing loss being unable to accurately hear the test stimuli.
PURPOSE: The primary purpose of this study was to examine whether use of amplification during cognitive screening with the Montreal Cognitive Assessment (MoCA) improves performance on the MoCA. Secondarily, we investigated the effects of hearing ability on MoCA performance, by comparing the performance of individuals with and without hearing impairment.
STUDY SAMPLE: Participants were 42 individuals with hearing impairment and 19 individuals with NH. Of the individuals with hearing impairment, 22 routinely used hearing aids; 20 did not use hearing aids.
DATA COLLECTION AND ANALYSIS: Following a written informec consent process, all participants completed pure tone audiometry, speech testing in quiet (Maryland consonant-nucleus-consonant [CNC] words) and in noise (Quick Speech in Noise [QuickSIN] test), and the MoCA. The speech testing and MoCA were completed twice. Individuals with hearing impairment completed testing once unaided and once with amplification, whereas individuals with NH completed unaided testing twice.
RESULTS: The individuals with hearing impairment performed significantly less well on the MoCA than those without hearing impairment for unaided testing, and the use of amplification did not significantly change performance. This is despite the finding that amplification significantly improved the performance of the hearing aid users on the measures of speech in quiet and speech in noise. Furthermore, there were strong correlations between MoCA score and the four frequency pure tone average, Maryland CNC score and QuickSIN, which remain moderate to strong when the analyses were adjusted for age.
CONCLUSIONS: It is concluded that the individuals with hearing loss here performed less well on the MoCA than individuals with NH and that the use of amplification did not compensate for this performance deficit. Nonetheless, this should not be taken to suggest the use of amplification during testing is unnecessary because it might be that other unmeasured factors, such as effort required to perform or fatigue, were decreased with the use of amplification.

PMID: 29988012 [PubMed - in process]

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An Evaluation of the World Health Organization and American Medical Association Ratings of Hearing Impairment and Simulated Single-Sided Deafness.

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An Evaluation of the World Health Organization and American Medical Association Ratings of Hearing Impairment and Simulated Single-Sided Deafness.

J Am Acad Audiol. 2018 Jul/Aug;29(7):634-647

Authors: Vermiglio AJ, Griffin S, Post C, Fang X

Abstract
BACKGROUND: According to the World Health Organization (WHO), a pure-tone threshold average (PTA) ≤25 dB HL for the better ear represents "no impairment." This implies that patients with single-sided deafness (SSD) would have "no or very slight hearing problems." According to the American Medical Association (AMA), a patient with SSD would receive a binaural hearing impairment rating of 16.7%. The premise of the WHO and AMA methods is that PTA is related to the ability to perceive speech in everyday environments.
PURPOSE: The overall goal of the study was to evaluate the WHO and AMA criteria for the rating of hearing impairment. The purpose of this study was to quantify the impact of simulated SSD on the ability to recognize speech in the presence of background noise in terms of binaural and spatial advantage measures.
RESEARCH DESIGN: Study participants were tested using the standard protocol for the Hearing in Noise Test (HINT) in both binaural and monaural conditions using a simulated soundfield environment under headphones. The target sentences were presented at 0°. Binaural thresholds were obtained for the Noise Front (0°), Noise Left (270°), and Noise Right (90°) listening conditions. Monaural thresholds were collected for each ear for the Noise Front condition and for the unshadowed ear for the Noise Left and Noise Right conditions. Binaural advantage was determined by subtracting the binaural from the monaural thresholds. Spatial advantage was determined by subtracting the Noise Side from the Noise Front thresholds.
STUDY SAMPLE: Twenty-five young native speakers of English with normal pure-tone thresholds (≤25 dB HL, 250-8000 Hz) participated in the study.
DATA COLLECTION AND ANALYSIS: Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Speech recognition in noise data were collected using a Windows-based HINT software system. The binaural and spatial advantage measures were calculated from the HINT thresholds. Statistical analyses included descriptive statistics, correlation coefficients, and matched-pairs t-tests.
RESULTS: The average binaural advantage for the Noise Front conditions was 1.21 dB (p < 0.01) or a maximum estimated intelligibility improvement of 12.01% when the speech and noise were presented at 0°. The average binaural advantage across the Noise Side conditions was 11.25 dB (p < 0.01) or a maximum estimated intelligibility improvement of 84.09% when the noise was spatially separated from the speech. The average spatial advantage for the binaural conditions was 6.72 dB (p < 0.01) or a maximum estimated intelligibility improvement of 60.03%. The average spatial advantage for the monaural conditions was -3.32 dB or a maximum estimated decrease in intelligibility of 32.27%.
CONCLUSIONS: The results do not support the WHO or AMA hearing impairment ratings for SSD. The WHO and AMA criteria for the determination of hearing impairment should be updated to include speech recognition in noise testing with and without the spatial separation of the speech and noise stimuli. In this way actual, as opposed to inferred perceptions of speech in noisy environments, may be determined. This will provide a much-needed improvement in the ratings of hearing impairment.

PMID: 29988011 [PubMed - in process]

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Prevalence and Characteristics of Patients with Severe Hyperacusis among Patients Seen in a Tinnitus and Hyperacusis Clinic.

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Prevalence and Characteristics of Patients with Severe Hyperacusis among Patients Seen in a Tinnitus and Hyperacusis Clinic.

J Am Acad Audiol. 2018 Jul/Aug;29(7):626-633

Authors: Aazh H, Moore BCJ

Abstract
PURPOSE: The purpose was to assess the proportion of patients seeking help for tinnitus and/or hyperacusis who have severe hyperacusis and to examine factors associated with severe hyperacusis.
RESEARCH DESIGN: This was a retrospective cross-sectional study based on 362 consecutive patients who attended a National Health Service audiology clinic for tinnitus and/or hyperacusis rehabilitation and for whom uncomfortable loudness levels (ULLs) had been measured. The criterion for severe hyperacusis was taken as a ULL of 30 dB HL or less for at least one of the measured frequencies for at least one ear.
RESULTS: Thirteen patients had severe hyperacusis, and eight of those had normal hearing. The lowest average ULL across frequencies was 28 dB HL. The difference in average ULLs between ears was 5 dB or less for nine patients. The range of ULLs across frequencies was between 5 and 60 dB, ULLs often being lowest at 8 kHz. Eleven patients had tinnitus, eight had otological abnormalities, twelve had mental health problems, and six were taking antidepressants.
CONCLUSIONS: Severe hyperacusis is characterized by low ULLs for specific frequencies and no or mild hearing loss. Given the high incidence of tinnitus, otological abnormalities, and mental health problems, the management of patients with severe hyperacusis should involve otologists and psychiatrists in addition to audiologists.

PMID: 29988010 [PubMed - in process]

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Psychometric Validity, Reliability, and Responsiveness of the Tinnitus Functional Index.

Related Articles

Psychometric Validity, Reliability, and Responsiveness of the Tinnitus Functional Index.

J Am Acad Audiol. 2018 Jul/Aug;29(7):609-625

Authors: Chandra N, Chang K, Lee A, Shekhawat GS, Searchfield GD

Abstract
BACKGROUND: The effects of treatments on tinnitus have been difficult to quantify. The Tinnitus Functional Index (TFI) has been proposed as a standard questionnaire for measurement of tinnitus treatment outcomes. For a questionnaire to achieve wide acceptance, its psychometric properties need to be confirmed in different populations.
OBJECTIVE: To determine if the TFI is a reliable and valid measure of tinnitus, and if its psychometric properties are suitable for use as an outcome measure.
RESEARCH DESIGN: A psychometric evaluation of the TFI from secondary data obtained from a cross-sectional clinic survey and a clinical trial undertaken in New Zealand.
STUDY SAMPLE: Confirmatory factor analysis and evaluation of internal consistency reliability were undertaken on a sample of 318 patients with the primary complaint of tinnitus. In a separate sample of 40 research volunteers, test-retest reliability, convergent and divergent validity were evaluated. Both samples consisted of predominantly older Caucasian male patients with tinnitus.
RESULTS: The internal structure of the original US TFI was confirmed. The Cronbach's Alpha and Intraclass correlation coefficients were >0.7 for the TFI overall and each of its subscales, indicating high internal consistency and test-retest reliability. Strong Pearson correlations with the Tinnitus Handicap Questionnaire and tinnitus numerical rating scales indicated excellent convergent validity, and a moderate correlation with the Hearing Handicap Inventory, indicated moderate divergent validity. Evaluation of the clinical trial showed good test-retest reliability and agreement between no-treatment baselines with a smallest detectable change of 4.8 points.
CONCLUSIONS: The TFI is a reliable and valid measure of tinnitus severity in the population tested and is responsive to treatment-related change. Further research as to the TFI's responsiveness to treatment is needed across different populations.

PMID: 29988009 [PubMed - in process]

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The Influence of Speech Rate on Acceptable Noise Levels.

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The Influence of Speech Rate on Acceptable Noise Levels.

J Am Acad Audiol. 2018 Jul/Aug;29(7):596-608

Authors: Tiffin S, Gordon-Hickey S

Abstract
BACKGROUND: Older adults often struggle with accurate perception of rate-altered speech and have difficulty understanding speech in noise. The acceptable noise level (ANL) quantifies a listener's willingness to listen to speech in background noise and has been found to accurately predict hearing aid success. Based on the difficulty older adults experience with rapid speech, we were interested in how older adults may change the amount of background noise they willingly accept in a variety of speech rate conditions.
PURPOSE: To determine the effects of age and speech rate on the ANL.
RESEARCH DESIGN: A quasi-experimental mixed design was employed.
STUDY SAMPLE: Fifteen young adults (19-27 yr) and fifteen older adults (55-73 yr) with audiometrically normal hearing or hearing loss within age-normed limits served as participants.
DATA COLLECTION AND ANALYSIS: Most comfortable listening levels (MCLs) and background noise levels (BNLs) were measured using three different speech rates (slow, normal, and fast). The ANL was calculated by subtracting BNL from MCL. Repeated measures analysis of variances were used to analyze the effects of age and speech rate on ANL.
RESULTS: A significant main effect of speech rate was observed; however, a significant main effect of age was not found. Results indicated that as speech rate increased the ANLs increased. This suggests that participants became less accepting of background noise as speech rates increased.
CONCLUSIONS: The findings of the present study provide support for communication strategies that recommend slowing an individual's speaking rate and/or reducing background noise, if possible. Participants in the present study were better able to cope with background noise when the primary stimulus was presented at slow and normal speaking rates.

PMID: 29988008 [PubMed - in process]

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The Influence of Caffeine on Rotary Chair and Oculomotor Testing.

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The Influence of Caffeine on Rotary Chair and Oculomotor Testing.

J Am Acad Audiol. 2018 Jul/Aug;29(7):587-595

Authors: McNerney KM, Coad ML, Burkard R

Abstract
BACKGROUND: When patients are given instructions before vestibular function testing, they are often asked to refrain from ingesting caffeine 24 h before testing. However, research regarding the effects of caffeine on the outcome of vestibular function testing is limited.
PURPOSE: To evaluate whether the results from rotational chair tests are influenced by caffeine.
RESEARCH DESIGN: Participants were tested after consuming a caffeinated beverage (i.e., coffee containing ∼300 mg of caffeine), as well as after abstaining from caffeinated beverages. The participants underwent oculomotor testing, sinusoidal harmonic acceleration testing, optokinetic testing, visual enhancement/suppression testing, subjective visual vertical/horizontal testing, trapezoidal step testing, and unilateral utricular centrifugation testing.
STUDY SAMPLE: Thirty healthy young controls aged 18-40 yr (mean = 23.28 yr; 9 males, 21 females) participated in the study.
DATA COLLECTION AND ANALYSIS: Rotational chair tests were completed with the Neuro Kinetics rotary chair (Pittsburgh, PA). VEST 7.0 software was used to collect and analyze the participants' eye movements (I-Portal VOG; Neuro Kinetics). IBM SPSS was used to statistically analyze the results.
RESULTS: Statistically significant differences were found for the results from several oculomotor tests (i.e., vertical saccades [SCs], horizontal SCs, and optokinetics), whereas the remaining rotational chair tests did not reveal any statistically significant differences between sessions. If a statistically significant difference was found, the participants were then stratified based on the amount of caffeine they consumed on a daily basis. This stratification was accomplished based on the guidelines from the International Coffee Organization. When the data were analyzed based on the stratified groups, statistically significant results remained in the no/low caffeine intake group, whereas no statistically significant results remained in the moderate/high caffeine intake group. Clinically speaking, the largest effect was seen in those individuals who did not typically ingest large amounts of caffeine, whereas the results were not found to be significantly different in those individuals who were typical caffeine consumers. This strengthens the argument that it is not necessary to require that individuals refrain from consuming caffeinated beverages before oculomotor/rotary chair testing as the results from typical caffeine consumers are not significantly affected.
CONCLUSIONS: Although statistically significant results were found for a number of the oculomotor function tests, the ingestion of caffeine had little influence on the clinical interpretation of the responses. Therefore, the results from the present study indicate that it is not necessary to require that healthy young individuals abstain from caffeine before undergoing rotary chair/oculomotor testing. Further research is necessary to determine whether there is also a limited effect of caffeine on rotary chair/oculomotor test results from older individuals, as well as individuals diagnosed with a vestibular impairment.

PMID: 29988007 [PubMed - in process]

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Impact of Personal Frequency Modulation Systems on Behavioral and Cortical Auditory Evoked Potential Measures of Auditory Processing and Classroom Listening in School-Aged Children with Auditory Processing Disorder.

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Impact of Personal Frequency Modulation Systems on Behavioral and Cortical Auditory Evoked Potential Measures of Auditory Processing and Classroom Listening in School-Aged Children with Auditory Processing Disorder.

J Am Acad Audiol. 2018 Jul/Aug;29(7):568-586

Authors: Smart JL, Purdy SC, Kelly AS

Abstract
BACKGROUND: Personal frequency modulation (FM) systems are often recommended for children diagnosed with auditory processing disorder (APD) to improve their listening environment in the classroom. Further evidence is required to support the continuation of this recommendation.
PURPOSE: To determine whether personal FM systems enhance auditory processing abilities and classroom listening in school-aged children with APD.
RESEARCH DESIGN: Two baseline assessments separated by eight weeks were undertaken before a 20-week trial of bilateral personal FM in the classroom. The third assessment was completed immediately after the FM trial. A range of behavioral measures and speech-evoked cortical auditory evoked potentials (CAEPs) in quiet and in noise were used to assess auditory processing and FM outcomes. Perceived listening ability was assessed using the Listening Inventory for Education-United Kingdom version (LIFE-UK) questionnaire student and teacher versions, and a modified version of the LIFE-UK questionnaire for parents.
STUDY SAMPLE: Twenty-eight children aged 7-12 years were included in this intervention study. Of the 28 children, there were 22 males and six females.
DATA COLLECTION AND ANALYSIS: APD Tests scores and CAEP peak latencies and amplitudes were analyzed using repeated measures analysis of variance to determine whether results changed over the two baseline assessments and after the FM trial. The LIFE-UK was administered immediately before and after the FM trial. Student responses were analyzed using paired t-tests. Results are described for the (different) pre- and post-trial teacher versions of the LIFE-UK.
RESULTS: Speech in spatial noise (SSN) scores improved by 13% on average when participants wore the FM system in the laboratory. Noise resulted in increased P1 and N2 latencies and reduced N2 amplitudes. The impact of noise on CAEP latencies and amplitudes was significantly reduced when participants wore the FM. Participants' LIFE-UK responses indicated significant improvements in their perceived listening after the FM trial. Most teachers (74%) reported the trial as successful, based on LIFE-UK ratings. Teachers' and parents' questionnaire ratings indicated good agreement regarding the outcomes of the FM trial. There was no change in compressed and reverberated words, masking level difference, and sustained attention scores across visits. Gaps in noise, dichotic digits test, and SSN (hard words) showed practice effects. Frequency pattern test and SSN easy word scores did not change between baseline visits, and improved significantly after the FM trial. CAEP N2 latencies and amplitudes changed significantly across visits; changes occurred across the baseline and the FM trial period.
CONCLUSIONS: Personal FM systems produce immediate speech perception benefits and enhancement of speech-evoked cortical responses in noise in the laboratory. The 20-week FM trial produced significant improvements in behavioral measures of auditory processing and participants' perceptions of their listening skills. Teacher and parent questionnaires also indicated positive outcomes.

PMID: 29988006 [PubMed - in process]

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Stopping Medications before Vestibular Testing: Evidence-Based or Neuromythology?

Related Articles

Stopping Medications before Vestibular Testing: Evidence-Based or Neuromythology?

J Am Acad Audiol. 2018 Jul/Aug;29(7):566-567

Authors: McCaslin DL

PMID: 29988005 [PubMed - in process]

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Measuring Perceptions of Classroom Listening in Typically Developing Children and Children with Auditory Difficulties Using the LIFE-UK Questionnaire.

Related Articles

Measuring Perceptions of Classroom Listening in Typically Developing Children and Children with Auditory Difficulties Using the LIFE-UK Questionnaire.

J Am Acad Audiol. 2018 Jul/Aug;29(7):656-667

Authors: Purdy SC, Sharma M, Morgan A

Abstract
BACKGROUND: Classrooms can be noisy and are challenging listening environments for children with auditory processing disorder (APD). This research was undertaken to determine if the Listening Inventory for Education-UK version (LIFE-UK) can differentiate children with listening difficulties and APD from their typically developing peers.
PURPOSE: To investigate reliability and validity of the student and teacher versions LIFE-UK questionnaire for assessing classroom listening difficulties.
RESEARCH DESIGN: Cross-sectional quantitative study comparing children with listening difficulties with typically developing children.
STUDY SAMPLE: In total, 143 children (7-12 yr) participated; 45 were diagnosed with APD. Fifteen participants with reported listening difficulties who passed the APD test battery were assigned to a "listening difficulty" (LiD) group. Eighty three children from nine classrooms formed a Control group.
DATA COLLECTION AND ANALYSIS: Children and teachers completed the LIFE-UK questionnaire student and teacher versions. Factor analysis was undertaken, and item reliability was assessed using Cronbach's alpha. Teacher and student ratings were compared using Spearman correlations. Correlations between LIFE-UK ratings and APD test results were also investigated.
RESULTS: Factor analysis revealed three factors accounting for 60% of the variance in the Control group LIFE-UK ratings. After removing six items with low factor loadings, a shortened seven-item version with three factors accounted for 71.8% of the variance for the student questionnaire; Cronbach's alpha indicated good internal reliability for this seven-item version of the student questionnaire. Factors were also derived for the teacher questionnaire. Teacher and student ratings were correlated when participant groups were combined. LIFE-UK ratings correlated weakly with some APD measures, providing some support for the questionnaire validity.
CONCLUSIONS: The results support the use of either the 13- or 7-item student and the teacher versions of the LIFE-UK to evaluate classroom listening and functional consequences of APD. Factor analysis resulted in groupings of items reflecting differences in listening demands in quiet versus noise for the student questionnaire and attentional versus class participation demands for the teacher questionnaire. Further research is needed to confirm the robustness of these factors in other populations.

PMID: 29988013 [PubMed - in process]

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Impact of Hearing Loss and Amplification on Performance on a Cognitive Screening Test.

Related Articles

Impact of Hearing Loss and Amplification on Performance on a Cognitive Screening Test.

J Am Acad Audiol. 2018 Jul/Aug;29(7):648-655

Authors: Saunders GH, Odgear I, Cosgrove A, Frederick MT

Abstract
BACKGROUND: There have been numerous recent reports on the association between hearing impairment and cognitive function, such that the cognition of adults with hearing loss is poorer relative to the cognition of adults with normal hearing (NH), even when amplification is used. However, it is not clear the extent to which this is testing artifact due to the individual with hearing loss being unable to accurately hear the test stimuli.
PURPOSE: The primary purpose of this study was to examine whether use of amplification during cognitive screening with the Montreal Cognitive Assessment (MoCA) improves performance on the MoCA. Secondarily, we investigated the effects of hearing ability on MoCA performance, by comparing the performance of individuals with and without hearing impairment.
STUDY SAMPLE: Participants were 42 individuals with hearing impairment and 19 individuals with NH. Of the individuals with hearing impairment, 22 routinely used hearing aids; 20 did not use hearing aids.
DATA COLLECTION AND ANALYSIS: Following a written informec consent process, all participants completed pure tone audiometry, speech testing in quiet (Maryland consonant-nucleus-consonant [CNC] words) and in noise (Quick Speech in Noise [QuickSIN] test), and the MoCA. The speech testing and MoCA were completed twice. Individuals with hearing impairment completed testing once unaided and once with amplification, whereas individuals with NH completed unaided testing twice.
RESULTS: The individuals with hearing impairment performed significantly less well on the MoCA than those without hearing impairment for unaided testing, and the use of amplification did not significantly change performance. This is despite the finding that amplification significantly improved the performance of the hearing aid users on the measures of speech in quiet and speech in noise. Furthermore, there were strong correlations between MoCA score and the four frequency pure tone average, Maryland CNC score and QuickSIN, which remain moderate to strong when the analyses were adjusted for age.
CONCLUSIONS: It is concluded that the individuals with hearing loss here performed less well on the MoCA than individuals with NH and that the use of amplification did not compensate for this performance deficit. Nonetheless, this should not be taken to suggest the use of amplification during testing is unnecessary because it might be that other unmeasured factors, such as effort required to perform or fatigue, were decreased with the use of amplification.

PMID: 29988012 [PubMed - in process]

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An Evaluation of the World Health Organization and American Medical Association Ratings of Hearing Impairment and Simulated Single-Sided Deafness.

Related Articles

An Evaluation of the World Health Organization and American Medical Association Ratings of Hearing Impairment and Simulated Single-Sided Deafness.

J Am Acad Audiol. 2018 Jul/Aug;29(7):634-647

Authors: Vermiglio AJ, Griffin S, Post C, Fang X

Abstract
BACKGROUND: According to the World Health Organization (WHO), a pure-tone threshold average (PTA) ≤25 dB HL for the better ear represents "no impairment." This implies that patients with single-sided deafness (SSD) would have "no or very slight hearing problems." According to the American Medical Association (AMA), a patient with SSD would receive a binaural hearing impairment rating of 16.7%. The premise of the WHO and AMA methods is that PTA is related to the ability to perceive speech in everyday environments.
PURPOSE: The overall goal of the study was to evaluate the WHO and AMA criteria for the rating of hearing impairment. The purpose of this study was to quantify the impact of simulated SSD on the ability to recognize speech in the presence of background noise in terms of binaural and spatial advantage measures.
RESEARCH DESIGN: Study participants were tested using the standard protocol for the Hearing in Noise Test (HINT) in both binaural and monaural conditions using a simulated soundfield environment under headphones. The target sentences were presented at 0°. Binaural thresholds were obtained for the Noise Front (0°), Noise Left (270°), and Noise Right (90°) listening conditions. Monaural thresholds were collected for each ear for the Noise Front condition and for the unshadowed ear for the Noise Left and Noise Right conditions. Binaural advantage was determined by subtracting the binaural from the monaural thresholds. Spatial advantage was determined by subtracting the Noise Side from the Noise Front thresholds.
STUDY SAMPLE: Twenty-five young native speakers of English with normal pure-tone thresholds (≤25 dB HL, 250-8000 Hz) participated in the study.
DATA COLLECTION AND ANALYSIS: Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Speech recognition in noise data were collected using a Windows-based HINT software system. The binaural and spatial advantage measures were calculated from the HINT thresholds. Statistical analyses included descriptive statistics, correlation coefficients, and matched-pairs t-tests.
RESULTS: The average binaural advantage for the Noise Front conditions was 1.21 dB (p < 0.01) or a maximum estimated intelligibility improvement of 12.01% when the speech and noise were presented at 0°. The average binaural advantage across the Noise Side conditions was 11.25 dB (p < 0.01) or a maximum estimated intelligibility improvement of 84.09% when the noise was spatially separated from the speech. The average spatial advantage for the binaural conditions was 6.72 dB (p < 0.01) or a maximum estimated intelligibility improvement of 60.03%. The average spatial advantage for the monaural conditions was -3.32 dB or a maximum estimated decrease in intelligibility of 32.27%.
CONCLUSIONS: The results do not support the WHO or AMA hearing impairment ratings for SSD. The WHO and AMA criteria for the determination of hearing impairment should be updated to include speech recognition in noise testing with and without the spatial separation of the speech and noise stimuli. In this way actual, as opposed to inferred perceptions of speech in noisy environments, may be determined. This will provide a much-needed improvement in the ratings of hearing impairment.

PMID: 29988011 [PubMed - in process]

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Prevalence and Characteristics of Patients with Severe Hyperacusis among Patients Seen in a Tinnitus and Hyperacusis Clinic.

Related Articles

Prevalence and Characteristics of Patients with Severe Hyperacusis among Patients Seen in a Tinnitus and Hyperacusis Clinic.

J Am Acad Audiol. 2018 Jul/Aug;29(7):626-633

Authors: Aazh H, Moore BCJ

Abstract
PURPOSE: The purpose was to assess the proportion of patients seeking help for tinnitus and/or hyperacusis who have severe hyperacusis and to examine factors associated with severe hyperacusis.
RESEARCH DESIGN: This was a retrospective cross-sectional study based on 362 consecutive patients who attended a National Health Service audiology clinic for tinnitus and/or hyperacusis rehabilitation and for whom uncomfortable loudness levels (ULLs) had been measured. The criterion for severe hyperacusis was taken as a ULL of 30 dB HL or less for at least one of the measured frequencies for at least one ear.
RESULTS: Thirteen patients had severe hyperacusis, and eight of those had normal hearing. The lowest average ULL across frequencies was 28 dB HL. The difference in average ULLs between ears was 5 dB or less for nine patients. The range of ULLs across frequencies was between 5 and 60 dB, ULLs often being lowest at 8 kHz. Eleven patients had tinnitus, eight had otological abnormalities, twelve had mental health problems, and six were taking antidepressants.
CONCLUSIONS: Severe hyperacusis is characterized by low ULLs for specific frequencies and no or mild hearing loss. Given the high incidence of tinnitus, otological abnormalities, and mental health problems, the management of patients with severe hyperacusis should involve otologists and psychiatrists in addition to audiologists.

PMID: 29988010 [PubMed - in process]

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Psychometric Validity, Reliability, and Responsiveness of the Tinnitus Functional Index.

Related Articles

Psychometric Validity, Reliability, and Responsiveness of the Tinnitus Functional Index.

J Am Acad Audiol. 2018 Jul/Aug;29(7):609-625

Authors: Chandra N, Chang K, Lee A, Shekhawat GS, Searchfield GD

Abstract
BACKGROUND: The effects of treatments on tinnitus have been difficult to quantify. The Tinnitus Functional Index (TFI) has been proposed as a standard questionnaire for measurement of tinnitus treatment outcomes. For a questionnaire to achieve wide acceptance, its psychometric properties need to be confirmed in different populations.
OBJECTIVE: To determine if the TFI is a reliable and valid measure of tinnitus, and if its psychometric properties are suitable for use as an outcome measure.
RESEARCH DESIGN: A psychometric evaluation of the TFI from secondary data obtained from a cross-sectional clinic survey and a clinical trial undertaken in New Zealand.
STUDY SAMPLE: Confirmatory factor analysis and evaluation of internal consistency reliability were undertaken on a sample of 318 patients with the primary complaint of tinnitus. In a separate sample of 40 research volunteers, test-retest reliability, convergent and divergent validity were evaluated. Both samples consisted of predominantly older Caucasian male patients with tinnitus.
RESULTS: The internal structure of the original US TFI was confirmed. The Cronbach's Alpha and Intraclass correlation coefficients were >0.7 for the TFI overall and each of its subscales, indicating high internal consistency and test-retest reliability. Strong Pearson correlations with the Tinnitus Handicap Questionnaire and tinnitus numerical rating scales indicated excellent convergent validity, and a moderate correlation with the Hearing Handicap Inventory, indicated moderate divergent validity. Evaluation of the clinical trial showed good test-retest reliability and agreement between no-treatment baselines with a smallest detectable change of 4.8 points.
CONCLUSIONS: The TFI is a reliable and valid measure of tinnitus severity in the population tested and is responsive to treatment-related change. Further research as to the TFI's responsiveness to treatment is needed across different populations.

PMID: 29988009 [PubMed - in process]

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The Influence of Speech Rate on Acceptable Noise Levels.

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The Influence of Speech Rate on Acceptable Noise Levels.

J Am Acad Audiol. 2018 Jul/Aug;29(7):596-608

Authors: Tiffin S, Gordon-Hickey S

Abstract
BACKGROUND: Older adults often struggle with accurate perception of rate-altered speech and have difficulty understanding speech in noise. The acceptable noise level (ANL) quantifies a listener's willingness to listen to speech in background noise and has been found to accurately predict hearing aid success. Based on the difficulty older adults experience with rapid speech, we were interested in how older adults may change the amount of background noise they willingly accept in a variety of speech rate conditions.
PURPOSE: To determine the effects of age and speech rate on the ANL.
RESEARCH DESIGN: A quasi-experimental mixed design was employed.
STUDY SAMPLE: Fifteen young adults (19-27 yr) and fifteen older adults (55-73 yr) with audiometrically normal hearing or hearing loss within age-normed limits served as participants.
DATA COLLECTION AND ANALYSIS: Most comfortable listening levels (MCLs) and background noise levels (BNLs) were measured using three different speech rates (slow, normal, and fast). The ANL was calculated by subtracting BNL from MCL. Repeated measures analysis of variances were used to analyze the effects of age and speech rate on ANL.
RESULTS: A significant main effect of speech rate was observed; however, a significant main effect of age was not found. Results indicated that as speech rate increased the ANLs increased. This suggests that participants became less accepting of background noise as speech rates increased.
CONCLUSIONS: The findings of the present study provide support for communication strategies that recommend slowing an individual's speaking rate and/or reducing background noise, if possible. Participants in the present study were better able to cope with background noise when the primary stimulus was presented at slow and normal speaking rates.

PMID: 29988008 [PubMed - in process]

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The Influence of Caffeine on Rotary Chair and Oculomotor Testing.

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The Influence of Caffeine on Rotary Chair and Oculomotor Testing.

J Am Acad Audiol. 2018 Jul/Aug;29(7):587-595

Authors: McNerney KM, Coad ML, Burkard R

Abstract
BACKGROUND: When patients are given instructions before vestibular function testing, they are often asked to refrain from ingesting caffeine 24 h before testing. However, research regarding the effects of caffeine on the outcome of vestibular function testing is limited.
PURPOSE: To evaluate whether the results from rotational chair tests are influenced by caffeine.
RESEARCH DESIGN: Participants were tested after consuming a caffeinated beverage (i.e., coffee containing ∼300 mg of caffeine), as well as after abstaining from caffeinated beverages. The participants underwent oculomotor testing, sinusoidal harmonic acceleration testing, optokinetic testing, visual enhancement/suppression testing, subjective visual vertical/horizontal testing, trapezoidal step testing, and unilateral utricular centrifugation testing.
STUDY SAMPLE: Thirty healthy young controls aged 18-40 yr (mean = 23.28 yr; 9 males, 21 females) participated in the study.
DATA COLLECTION AND ANALYSIS: Rotational chair tests were completed with the Neuro Kinetics rotary chair (Pittsburgh, PA). VEST 7.0 software was used to collect and analyze the participants' eye movements (I-Portal VOG; Neuro Kinetics). IBM SPSS was used to statistically analyze the results.
RESULTS: Statistically significant differences were found for the results from several oculomotor tests (i.e., vertical saccades [SCs], horizontal SCs, and optokinetics), whereas the remaining rotational chair tests did not reveal any statistically significant differences between sessions. If a statistically significant difference was found, the participants were then stratified based on the amount of caffeine they consumed on a daily basis. This stratification was accomplished based on the guidelines from the International Coffee Organization. When the data were analyzed based on the stratified groups, statistically significant results remained in the no/low caffeine intake group, whereas no statistically significant results remained in the moderate/high caffeine intake group. Clinically speaking, the largest effect was seen in those individuals who did not typically ingest large amounts of caffeine, whereas the results were not found to be significantly different in those individuals who were typical caffeine consumers. This strengthens the argument that it is not necessary to require that individuals refrain from consuming caffeinated beverages before oculomotor/rotary chair testing as the results from typical caffeine consumers are not significantly affected.
CONCLUSIONS: Although statistically significant results were found for a number of the oculomotor function tests, the ingestion of caffeine had little influence on the clinical interpretation of the responses. Therefore, the results from the present study indicate that it is not necessary to require that healthy young individuals abstain from caffeine before undergoing rotary chair/oculomotor testing. Further research is necessary to determine whether there is also a limited effect of caffeine on rotary chair/oculomotor test results from older individuals, as well as individuals diagnosed with a vestibular impairment.

PMID: 29988007 [PubMed - in process]

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Impact of Personal Frequency Modulation Systems on Behavioral and Cortical Auditory Evoked Potential Measures of Auditory Processing and Classroom Listening in School-Aged Children with Auditory Processing Disorder.

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Impact of Personal Frequency Modulation Systems on Behavioral and Cortical Auditory Evoked Potential Measures of Auditory Processing and Classroom Listening in School-Aged Children with Auditory Processing Disorder.

J Am Acad Audiol. 2018 Jul/Aug;29(7):568-586

Authors: Smart JL, Purdy SC, Kelly AS

Abstract
BACKGROUND: Personal frequency modulation (FM) systems are often recommended for children diagnosed with auditory processing disorder (APD) to improve their listening environment in the classroom. Further evidence is required to support the continuation of this recommendation.
PURPOSE: To determine whether personal FM systems enhance auditory processing abilities and classroom listening in school-aged children with APD.
RESEARCH DESIGN: Two baseline assessments separated by eight weeks were undertaken before a 20-week trial of bilateral personal FM in the classroom. The third assessment was completed immediately after the FM trial. A range of behavioral measures and speech-evoked cortical auditory evoked potentials (CAEPs) in quiet and in noise were used to assess auditory processing and FM outcomes. Perceived listening ability was assessed using the Listening Inventory for Education-United Kingdom version (LIFE-UK) questionnaire student and teacher versions, and a modified version of the LIFE-UK questionnaire for parents.
STUDY SAMPLE: Twenty-eight children aged 7-12 years were included in this intervention study. Of the 28 children, there were 22 males and six females.
DATA COLLECTION AND ANALYSIS: APD Tests scores and CAEP peak latencies and amplitudes were analyzed using repeated measures analysis of variance to determine whether results changed over the two baseline assessments and after the FM trial. The LIFE-UK was administered immediately before and after the FM trial. Student responses were analyzed using paired t-tests. Results are described for the (different) pre- and post-trial teacher versions of the LIFE-UK.
RESULTS: Speech in spatial noise (SSN) scores improved by 13% on average when participants wore the FM system in the laboratory. Noise resulted in increased P1 and N2 latencies and reduced N2 amplitudes. The impact of noise on CAEP latencies and amplitudes was significantly reduced when participants wore the FM. Participants' LIFE-UK responses indicated significant improvements in their perceived listening after the FM trial. Most teachers (74%) reported the trial as successful, based on LIFE-UK ratings. Teachers' and parents' questionnaire ratings indicated good agreement regarding the outcomes of the FM trial. There was no change in compressed and reverberated words, masking level difference, and sustained attention scores across visits. Gaps in noise, dichotic digits test, and SSN (hard words) showed practice effects. Frequency pattern test and SSN easy word scores did not change between baseline visits, and improved significantly after the FM trial. CAEP N2 latencies and amplitudes changed significantly across visits; changes occurred across the baseline and the FM trial period.
CONCLUSIONS: Personal FM systems produce immediate speech perception benefits and enhancement of speech-evoked cortical responses in noise in the laboratory. The 20-week FM trial produced significant improvements in behavioral measures of auditory processing and participants' perceptions of their listening skills. Teacher and parent questionnaires also indicated positive outcomes.

PMID: 29988006 [PubMed - in process]

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Stopping Medications before Vestibular Testing: Evidence-Based or Neuromythology?

Related Articles

Stopping Medications before Vestibular Testing: Evidence-Based or Neuromythology?

J Am Acad Audiol. 2018 Jul/Aug;29(7):566-567

Authors: McCaslin DL

PMID: 29988005 [PubMed - in process]

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P 080 - Development of gait in children with Cerebral Palsy following selective dorsal rhizotomy surgery, and considerations for post-surgery rehabilitation

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): L. Milner, K.T. Tang, S. Michael, K. McCune, J. Goodden

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P 077 - Foot as a marker of biomechanical status of uneven lower limbs

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): E. Kononova, I.E. Nikityuk, Y.E. Garkavenko, T.S. Vinokurova, O.N. Maricheva, T.V. Murashko, A.N. Melchenko

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P 044 - Effects of the Equistasi® neurological rehabilitation’s device on Parkinson’s Disease patients gait

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): F. Spolaor, A. Guiotto, D. Pavan, L. Arab Yaghoubi, A. Peppe, P. Paone, Z. Sawacha, D. Volpe

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P 080 - Development of gait in children with Cerebral Palsy following selective dorsal rhizotomy surgery, and considerations for post-surgery rehabilitation

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): L. Milner, K.T. Tang, S. Michael, K. McCune, J. Goodden

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P 077 - Foot as a marker of biomechanical status of uneven lower limbs

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): E. Kononova, I.E. Nikityuk, Y.E. Garkavenko, T.S. Vinokurova, O.N. Maricheva, T.V. Murashko, A.N. Melchenko

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P 044 - Effects of the Equistasi® neurological rehabilitation’s device on Parkinson’s Disease patients gait

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): F. Spolaor, A. Guiotto, D. Pavan, L. Arab Yaghoubi, A. Peppe, P. Paone, Z. Sawacha, D. Volpe

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P 089 - Effect of planovalgus foot deformity on the vertical displacement of center of mass in children with bilateral spastic cerebral palsy

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): M. Ahmed, E. WALY

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P 089 - Effect of planovalgus foot deformity on the vertical displacement of center of mass in children with bilateral spastic cerebral palsy

Publication date: Available online 11 July 2018

Source: Gait & Posture

Author(s): M. Ahmed, E. WALY

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James Jerger, a life in audiology.

James Jerger, a life in audiology.

Int J Audiol. 2018 Jul 10;:1

Authors: Moncrieff D

PMID: 29987954 [PubMed - as supplied by publisher]

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James Jerger, a life in audiology.

James Jerger, a life in audiology.

Int J Audiol. 2018 Jul 10;:1

Authors: Moncrieff D

PMID: 29987954 [PubMed - as supplied by publisher]

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James Jerger, a life in audiology.

James Jerger, a life in audiology.

Int J Audiol. 2018 Jul 10;:1

Authors: Moncrieff D

PMID: 29987954 [PubMed - as supplied by publisher]

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James Jerger, a life in audiology.

James Jerger, a life in audiology.

Int J Audiol. 2018 Jul 10;:1

Authors: Moncrieff D

PMID: 29987954 [PubMed - as supplied by publisher]

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Rapid analysis of neomycin in cochlear perilymph of guinea pigs using disposable SPE cartridges and high performance liquid chromatography-tandem mass spectrometry.

Rapid analysis of neomycin in cochlear perilymph of guinea pigs using disposable SPE cartridges and high performance liquid chromatography-tandem mass spectrometry.

J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jun 26;1093-1094:52-59

Authors: Zu M, Jiang J, Zhao H, Zhang S, Yan Y, Qiu S, Yuan S, Han J, Zhang Y, Guo W, Yang S

Abstract
Irreversible hearing loss induced by aminoglycoside in human through local or systemic administration route negatively impacts quality of life. The aim of this work was to develop and validate an analytical method suitable for the detection and quantification of neomycin in cochlear perilymph of guinea pig after local application. The SupelMIP SPE column was used for the pre-treatment of matrix. Chromatographic separation was conducted by a reversed phase ODS column (100 × 2.1 mm, 3 μm) at 40 °C in gradient mode with 0.2‰ (v/v) HFBA in water and 0.2‰ (v/v) HFBA in acetonitrile as mobile phase, at a flow rate of 0.30 mL/min, with retention time of 3.50 and 3.62 min for internal standard tobramycin and analyte neomycin, respectively. The MS was performed with positive ionization mode, with data acquisition in Multi Reaction Monitor (MRM) mode. This method was proved to be specific, accurate (97.1-115% of nominal values) and precise (CV% < 15%). Calibration curves for matrix matched standard of neomycin ranged from 1.25 to 200 μg/mL, with LOD and LLOQ of 0.625 and 1.25 μg/mL in blank matrix. The matrix effect was corrected to (-0.1) - 1.33 by adding internal standard. The relative SPE recovery values were ≥98.9% in low, medium and high QC samples. Neomycin in matrix proved to be stable under room temperature - and -20 °C, or under three freeze-thawing cycles, or under processing as well. Finally, the proposed method was successfully applied to a toxicokinetics study of neomycin in perilymph after round window membrane (RWM) administration, which was in accordance with threshold shift of auditory brainstem response (ABR) test related to hearing loss.

PMID: 29990713 [PubMed - as supplied by publisher]

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Rapid analysis of neomycin in cochlear perilymph of guinea pigs using disposable SPE cartridges and high performance liquid chromatography-tandem mass spectrometry.

Rapid analysis of neomycin in cochlear perilymph of guinea pigs using disposable SPE cartridges and high performance liquid chromatography-tandem mass spectrometry.

J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Jun 26;1093-1094:52-59

Authors: Zu M, Jiang J, Zhao H, Zhang S, Yan Y, Qiu S, Yuan S, Han J, Zhang Y, Guo W, Yang S

Abstract
Irreversible hearing loss induced by aminoglycoside in human through local or systemic administration route negatively impacts quality of life. The aim of this work was to develop and validate an analytical method suitable for the detection and quantification of neomycin in cochlear perilymph of guinea pig after local application. The SupelMIP SPE column was used for the pre-treatment of matrix. Chromatographic separation was conducted by a reversed phase ODS column (100 × 2.1 mm, 3 μm) at 40 °C in gradient mode with 0.2‰ (v/v) HFBA in water and 0.2‰ (v/v) HFBA in acetonitrile as mobile phase, at a flow rate of 0.30 mL/min, with retention time of 3.50 and 3.62 min for internal standard tobramycin and analyte neomycin, respectively. The MS was performed with positive ionization mode, with data acquisition in Multi Reaction Monitor (MRM) mode. This method was proved to be specific, accurate (97.1-115% of nominal values) and precise (CV% < 15%). Calibration curves for matrix matched standard of neomycin ranged from 1.25 to 200 μg/mL, with LOD and LLOQ of 0.625 and 1.25 μg/mL in blank matrix. The matrix effect was corrected to (-0.1) - 1.33 by adding internal standard. The relative SPE recovery values were ≥98.9% in low, medium and high QC samples. Neomycin in matrix proved to be stable under room temperature - and -20 °C, or under three freeze-thawing cycles, or under processing as well. Finally, the proposed method was successfully applied to a toxicokinetics study of neomycin in perilymph after round window membrane (RWM) administration, which was in accordance with threshold shift of auditory brainstem response (ABR) test related to hearing loss.

PMID: 29990713 [PubMed - as supplied by publisher]

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