The Effect of Hearing Aids and Cochlear Implants on Balance During Gait.

The Effect of Hearing Aids and Cochlear Implants on Balance During Gait.

Otol Neurotol. 2017 Oct;38(9):1327-1332

Authors: Weaver TS, Shayman CS, Hullar TE

Abstract
HYPOTHESIS: Auditory input in people with hearing impairment will improve balance while walking.
BACKGROUND: Auditory input is increasingly recognized as an additional input for balance. Several studies have found auditory cues to improve static balance measured on a sway platform. The effect of audition on gait, a dynamic task also linked to fall risk, has not been fully examined. If a positive effect were shown between audition and balance, it would further indicate that improving hearing could also improve balance.
METHODS: Inertial sensors quantified gait parameters of 13 bilateral hearing aid users and 12 bilateral cochlear implant (CI) users with their hearing devices on and off. Outcome measures included gait velocity, stride length variability, swing time variability, and double support phase.
RESULTS: Group analysis of each of the gait outcomes showed no significant differences between the aided and unaided conditions in both the hearing aid and CI groups. Gait velocity, an outcome most strongly linked to fall risk had 95% confidence interval differences of -2.16 to 1.52 and -1.45 to 4.17 cm/s in hearing aid and CI users, respectively (aided versus unaided condition). There was considerable variation among participants with some individuals improving in all four parameters.
CONCLUSION: The overall findings were not statistically significant, however, a small subset of our population improved clinically across several outcomes. This demonstrates that audition may have a clinically beneficial effect on balance in some patients.

PMID: 28902805 [PubMed - in process]

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Using a multi-feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids.

Using a multi-feature paradigm to measure mismatch responses to minimal sound contrasts in children with cochlear implants and hearing aids.

Scand J Psychol. 2017 Oct;58(5):409-421

Authors: Uhlén I, Engström E, Kallioinen P, Nakeva von Mentzer C, Lyxell B, Sahlén B, Lindgren M, Ors M

Abstract
Our aim was to explore whether a multi-feature paradigm (Optimum-1) for eliciting mismatch negativity (MMN) would objectively capture difficulties in perceiving small sound contrasts in children with hearing impairment (HI) listening through their hearing aids (HAs) and/or cochlear implants (CIs). Children aged 5-7 years with HAs, CIs and children with normal hearing (NH) were tested in a free-field setting using a multi-feature paradigm with deviations in pitch, intensity, gap, duration, and location. There were significant mismatch responses across all subjects that were positive (p-MMR) for the gap and pitch deviants (F(1,43) = 5.17, p = 0.028 and F(1,43) = 6.56, p = 0.014, respectively) and negative (MMN) for the duration deviant (F(1,43) = 4.74, p = 0.035). Only the intensity deviant showed a significant group interaction with MMN in the HA group and p-MMR in the CI group (F(2,43) = 3.40, p = 0.043). The p-MMR correlated negatively with age, with the strongest correlation in the NH subjects. In the CI group, the late discriminative negativity (LDN) was replaced by a late positivity with a significant group interaction for the location deviant. Children with severe HI can be assessed through their hearing device with a fast multi-feature paradigm. For further studies a multi-feature paradigm including more complex speech sounds may better capture variation in auditory processing in these children.

PMID: 28901574 [PubMed - in process]

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Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Related Articles

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Int J Audiol. 2017 Sep 12;:1-15

Authors: Cupples L, Ching TY, Button L, Seeto M, Zhang V, Whitfield J, Gunnourie M, Martin L, Marnane V

Abstract
OBJECTIVE: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss.
DESIGN: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes.
STUDY SAMPLE: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study.
RESULTS: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs.
CONCLUSIONS: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

PMID: 28899200 [PubMed - as supplied by publisher]

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Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Related Articles

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Int J Audiol. 2017 Sep 12;:1-15

Authors: Cupples L, Ching TY, Button L, Seeto M, Zhang V, Whitfield J, Gunnourie M, Martin L, Marnane V

Abstract
OBJECTIVE: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss.
DESIGN: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes.
STUDY SAMPLE: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study.
RESULTS: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs.
CONCLUSIONS: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

PMID: 28899200 [PubMed - as supplied by publisher]

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Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Related Articles

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Int J Audiol. 2017 Sep 12;:1-15

Authors: Cupples L, Ching TY, Button L, Seeto M, Zhang V, Whitfield J, Gunnourie M, Martin L, Marnane V

Abstract
OBJECTIVE: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss.
DESIGN: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes.
STUDY SAMPLE: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study.
RESULTS: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs.
CONCLUSIONS: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

PMID: 28899200 [PubMed - as supplied by publisher]

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Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Related Articles

Spoken language and everyday functioning in 5-year-old children using hearing aids or cochlear implants.

Int J Audiol. 2017 Sep 12;:1-15

Authors: Cupples L, Ching TY, Button L, Seeto M, Zhang V, Whitfield J, Gunnourie M, Martin L, Marnane V

Abstract
OBJECTIVE: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss.
DESIGN: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes.
STUDY SAMPLE: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study.
RESULTS: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs.
CONCLUSIONS: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

PMID: 28899200 [PubMed - as supplied by publisher]

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Towards evidence-based practices in voice pedagogy

Publication date: Available online 12 September 2017
Source:Revista de Logopedia, Foniatría y Audiología
Author(s): Filipa M.B. Lã
Voice pedagogy was initially based on an orally transmitted master-apprentice teaching–learning model, applying observational type of learning centred in the final artistic product. Since then, this model has been continuously replaced. Nowadays, the social organization of work in globalized economies has called for the need of rethinking education so that future generations can meet the demands of lifelong learners, who are skilful at using systems of information, who are flexible and adapt to the lack of stability at work, and who are able to make their own career opportunities. How can this be applied to voice pedagogy? This work aims at finding answers to these questions, further contributing to the discussion raised at the voice pedagogy round table of the 10th Pan-European Voice Conference, “Vocal Pedagogy – What do we need?”. The rationale for reflective practices in voice education and for enhancing metacognitive skills in student's using evidence-based guided awareness is discussed. The provision of meaningful feedback and the use of a holistic approach to voice teaching are presented as means to meet individual needs of different types of learners. Problem-solving and student-centred teaching–learning models are proposed as key elements in developing reflective voice practitioners.



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