Huey Lewis Hearing Loss

If I had to pick a song title to describe hearing loss associated tinnitus, it would be Huey Lewis’ Stuck With You. The song might not be a fit, but the title definitely is. Huey Lewis might even agree, as he is one of several prominent musicians to suffer from both hearing loss and chronic tinnitus.

A Sad Thought

Huey Lewis has brought a lot of joy to people. Songs like Workin’ for a Livin’, (She’s) Some Kind of Wonderful, and Back to the Future’s Back In Time are justifiably considered classics. So there’s a genuine sense of loss and frustration as one realizes that this talented, capable front man for Huey Lewis and the News has lost a significant portion of his hearing. For someone like Huey Lewis hearing loss has to be an utterly infuriating condition.

One symptom he has discussed in relation to his hearing loss is that he has developed tinnitus as well. Tinnitus is a ringing in the ears with no active external cause. It can develop as a result of long exposure to loud sounds. Even a single concert can cause damage to the ears that takes years to manifest as tinnitus. There are very few treatments for it, unfortunately.

An Ounce of Prevention

Fortunately, to Huey Lewis hearing loss presented a challenge rather than simply an unbearable condition. He is a supporter of HEAR: Hearing Education and Awareness for Rockers. This organization seeks to educate people in the music community, both performers and audience members, about the potential risks caused by exposure to loud music. They also promote access to hearing aids and other relief devices to alleviate suffering caused by hearing related ailments.

Saves A Pound of (no) Cure

The case of Huey Lewis hearing loss and tinnitus is a symbol of how artists put their health at risk for the sake of the art and their fans. It’s a humbling thought when someone is injured, in any way, in an attempt to make other people happy. It isn’t, or at least shouldn’t be, any less inspiring that Huey Lewis and other musicians have done so through their performances. What happened to them can’t be treated, their hearing is effectively gone in many cases. This is absolutely the opposite of cool, and should be something that everyone seeking a musical career considers carefully.

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20Q: Hearing Loss and Dementia - Association, Link or Causation?

1. I think I pretty much know what dementia is, but what is your definition? ‘Dementia’ describes a set of symptoms that include memory problems, language problems, personality changes or thinking difficulties. More than one hundred types of dementia have been identified. The most common type is Alzheimer’s dementia. The cause of dementia is damage to the brain due to disease (in the case of Alzheimer’s dementia) or a series of strokes (in the case of vascular dementia). Dementia is a progressive degenerative disease, which means that a person with dementia has more and more difficulty with memory, understanding and communication over time.

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20Q: Hearing Loss and Dementia - Association, Link or Causation?

1. I think I pretty much know what dementia is, but what is your definition? ‘Dementia’ describes a set of symptoms that include memory problems, language problems, personality changes or thinking difficulties. More than one hundred types of dementia have been identified. The most common type is Alzheimer’s dementia. The cause of dementia is damage to the brain due to disease (in the case of Alzheimer’s dementia) or a series of strokes (in the case of vascular dementia). Dementia is a progressive degenerative disease, which means that a person with dementia has more and more difficulty with memory, understanding and communication over time.

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20Q: Hearing Loss and Dementia - Association, Link or Causation?

1. I think I pretty much know what dementia is, but what is your definition? ‘Dementia’ describes a set of symptoms that include memory problems, language problems, personality changes or thinking difficulties. More than one hundred types of dementia have been identified. The most common type is Alzheimer’s dementia. The cause of dementia is damage to the brain due to disease (in the case of Alzheimer’s dementia) or a series of strokes (in the case of vascular dementia). Dementia is a progressive degenerative disease, which means that a person with dementia has more and more difficulty with memory, understanding and communication over time.

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The Impact of Contrastive Stress on Vowel Acoustics and Intelligibility in Dysarthria

Purpose

To compare vowel acoustics and intelligibility in words produced with and without contrastive stress by speakers with spastic (mixed-spastic) dysarthria secondary to cerebral palsy (DYS_CP) and healthy controls (HCs).

Method

Fifteen participants (9 men, 6 women; age M = 42 years) with DYS_CP and 15 HCs (9 men, 6 women; age M = 36 years) produced sentences containing target words with and without contrastive stress. Forty-five healthy listeners (age M = 25 years) completed a vowel identification task of DYS_CP productions. Vowel acoustics were compared across stress conditions and groups using 1st (F1) and 2nd (F2) formant measures. Perceptual intelligibility was compared across stress conditions and dysarthria severity.

Results

F1 and F2 significantly increased in stressed words for both groups, although the degree of change differed. Mean Euclidian distance between vowels also increased with stress. The relative probability of vowels falling within the target F1 × F2 space was greater for HCs but did not differ with stress. Stress production resulted in greater listener vowel identification accuracy for speakers with mild dysarthria.

Conclusions

Contrastive stress affected vowel formants for both groups. Perceptual results suggest that some speakers with dysarthria may benefit from a contrastive stress strategy to improve vowel intelligibility.

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Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging

Purpose

The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters.

Method

HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and 41 patients with sulcus vocalis (33 men and 8 women). Then HSDI data were evaluated by assessing the visual–perceptual rating, digital kymography, and glottal area waveform.

Results

Patients with sulcus vocalis frequently had spindle-shaped glottal gaps and a decreased mucosal wave. Compared with the control group, the sulcus vocalis group showed higher open quotient as well as a shorter duration of the visible mucosal wave, a smaller speed index, and a smaller glottal area difference index ([maximal glottal area – minimal glottal area]/maximal glottal area). These parameters deteriorated in order of the control group and Type I, II, and III sulcus vocalis. There were no gender-related differences. Strong correlations were noted between the open quotient and the type of sulcus vocalis.

Conclusions

HSDI was an effective method for documenting the characteristics of vocal fold vibrations in patients with sulcus vocalis and estimating the severity of dysphonia.

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A Clinical Evaluation of the Competing Sources of Input Hypothesis

Purpose

Our purpose was to test the competing sources of input (CSI) hypothesis by evaluating an intervention based on its principles. This hypothesis proposes that children's use of main verbs without tense is the result of their treating certain sentence types in the input (e.g., Was she laughing ?) as models for declaratives (e.g., She laughing).

Method

Twenty preschoolers with specific language impairment were randomly assigned to receive either a CSI-based intervention or a more traditional intervention that lacked the novel CSI features. The auxiliary is and the third-person singular suffix –s were directly treated over a 16-week period. Past tense –ed was monitored as a control.

Results

The CSI-based group exhibited greater improvements in use of is than did the traditional group (d = 1.31), providing strong support for the CSI hypothesis. There were no significant between-groups differences in the production of the third-person singular suffix –s or the control (–ed), however.

Conclusions

The group differences in the effects on the 2 treated morphemes may be due to differences in their distribution in interrogatives and declaratives (e.g., Is he hiding/He is hiding vs. Does he hide/He hide s ). Refinements in the intervention could address this issue and lead to more general effects across morphemes.

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The Effects of Directional Processing on Objective and Subjective Listening Effort

Purpose

The purposes of this investigation were (a) to evaluate the effects of hearing aid directional processing on subjective and objective listening effort and (b) to investigate the potential relationships between subjective and objective measures of effort.

Method

Sixteen adults with mild to severe hearing loss were tested with study hearing aids programmed with 3 settings: omnidirectional, fixed directional, and bilateral beamformer. A dual-task paradigm and subjective ratings were used to assess objective and subjective listening effort, respectively, in 2 signal-to-noise ratios. Testing occurred in rooms with either low or moderate reverberation.

Results

Directional processing improved subjective and objective listening effort, although benefit for objective effort was found only in moderate reverberation. Subjective reports of work and tiredness were more highly correlated with word recognition performance than objective listening effort. However, subjective ratings about control were significantly correlated with objective listening effort.

Conclusions

Directional microphone technology in hearing aids has the potential to improve listening effort in moderately reverberant environments. In addition, subjective questions that probe a listener's desire to exercise control may be a viable method for eliciting ratings that are significantly related to objective listening effort.

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Self-Assessed Hearing Handicap in Older Adults With Poorer-Than-Predicted Speech Recognition in Noise

Purpose

Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility.

Method

We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility.

Results

One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds.

Conclusion

The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function.

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Gap Detection in School-Age Children and Adults: Center Frequency and Ramp Duration

Purpose

The age at which gap detection becomes adultlike differs, depending on the stimulus characteristics. The present study evaluated whether the developmental trajectory differs as a function of stimulus frequency region or duration of the onset and offset ramps bounding the gap.

Method

Thresholds were obtained for wideband noise (500–4500 Hz) with 4- or 40-ms raised-cosine ramps and for a 25-Hz-wide low-fluctuation narrowband noise centered on either 500 or 5000 Hz with 40-ms ramps. Stimuli were played continuously at 70 dB SPL, and the task was to indicate which of 3 intervals contained a gap. Listeners were 5.2- to 15.1-year-old children (n = 40) and adults (n = 10) with normal hearing.

Results

Regardless of listener age, gap detection thresholds for the wideband noise tended to be lower when gaps were shaped using 4-ms rather than 40-ms ramps. Thresholds also tended to be lower for the low-fluctuation narrowband noise centered on 5000 Hz than 500 Hz. Performance reached adult levels after 11 years of age for all 4 stimuli. Maturation was not uniform across individuals, however; a subset of young children performed like adults, including some 5-year-olds.

Conclusion

For these stimuli, the developmental trajectory was similar regardless of narrowband noise center frequency or wideband noise onset and offset ramp duration.

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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance

Purpose

Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Method

A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3–6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.

Results

Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.

Conclusions

Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

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Efficacy of a Supplemental Phonemic Awareness Curriculum to Instruct Preschoolers With Delays in Early Literacy Development

Purpose

Children who do not develop early literacy skills, especially phonological awareness (PA) and alphabet knowledge, prior to kindergarten are at risk for reading difficulties. We investigated a supplemental curriculum with children demonstrating delays in these skills.

Method

A cluster randomized design with 104 preschool-age children in 39 classrooms was used to determine the efficacy of a supplemental PA curriculum, PAth to Literacy. The curriculum consists of 36 daily scripted 10-min lessons with interactive games designed to teach PA and alphabet skills. A vocabulary intervention (Story Friends), which also uses a small-group format, served as the comparison condition.

Results

Multilevel modeling indicated that children in the experimental condition demonstrated significantly greater gains on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) First Sound Fluency (Dynamic Measurement Group, 2006) and Word Parts Fluency (Kaminski & Powell-Smith, 2011) measures. Educational relevance was evident: 82% of the children in the experimental condition met the kindergarten benchmark for First Sound Fluency compared with 34% of the children in the comparison condition. Teachers reported overall satisfaction with the lessons.

Conclusions

Results indicated that the vast majority of children demonstrating early literacy delays in preschool may benefit from a supplemental PA curriculum that has the potential to prevent reading difficulties as children transition to kindergarten.

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The Impact of Contrastive Stress on Vowel Acoustics and Intelligibility in Dysarthria

Purpose

To compare vowel acoustics and intelligibility in words produced with and without contrastive stress by speakers with spastic (mixed-spastic) dysarthria secondary to cerebral palsy (DYS_CP) and healthy controls (HCs).

Method

Fifteen participants (9 men, 6 women; age M = 42 years) with DYS_CP and 15 HCs (9 men, 6 women; age M = 36 years) produced sentences containing target words with and without contrastive stress. Forty-five healthy listeners (age M = 25 years) completed a vowel identification task of DYS_CP productions. Vowel acoustics were compared across stress conditions and groups using 1st (F1) and 2nd (F2) formant measures. Perceptual intelligibility was compared across stress conditions and dysarthria severity.

Results

F1 and F2 significantly increased in stressed words for both groups, although the degree of change differed. Mean Euclidian distance between vowels also increased with stress. The relative probability of vowels falling within the target F1 × F2 space was greater for HCs but did not differ with stress. Stress production resulted in greater listener vowel identification accuracy for speakers with mild dysarthria.

Conclusions

Contrastive stress affected vowel formants for both groups. Perceptual results suggest that some speakers with dysarthria may benefit from a contrastive stress strategy to improve vowel intelligibility.

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Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging

Purpose

The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters.

Method

HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and 41 patients with sulcus vocalis (33 men and 8 women). Then HSDI data were evaluated by assessing the visual–perceptual rating, digital kymography, and glottal area waveform.

Results

Patients with sulcus vocalis frequently had spindle-shaped glottal gaps and a decreased mucosal wave. Compared with the control group, the sulcus vocalis group showed higher open quotient as well as a shorter duration of the visible mucosal wave, a smaller speed index, and a smaller glottal area difference index ([maximal glottal area – minimal glottal area]/maximal glottal area). These parameters deteriorated in order of the control group and Type I, II, and III sulcus vocalis. There were no gender-related differences. Strong correlations were noted between the open quotient and the type of sulcus vocalis.

Conclusions

HSDI was an effective method for documenting the characteristics of vocal fold vibrations in patients with sulcus vocalis and estimating the severity of dysphonia.

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A Clinical Evaluation of the Competing Sources of Input Hypothesis

Purpose

Our purpose was to test the competing sources of input (CSI) hypothesis by evaluating an intervention based on its principles. This hypothesis proposes that children's use of main verbs without tense is the result of their treating certain sentence types in the input (e.g., Was she laughing ?) as models for declaratives (e.g., She laughing).

Method

Twenty preschoolers with specific language impairment were randomly assigned to receive either a CSI-based intervention or a more traditional intervention that lacked the novel CSI features. The auxiliary is and the third-person singular suffix –s were directly treated over a 16-week period. Past tense –ed was monitored as a control.

Results

The CSI-based group exhibited greater improvements in use of is than did the traditional group (d = 1.31), providing strong support for the CSI hypothesis. There were no significant between-groups differences in the production of the third-person singular suffix –s or the control (–ed), however.

Conclusions

The group differences in the effects on the 2 treated morphemes may be due to differences in their distribution in interrogatives and declaratives (e.g., Is he hiding/He is hiding vs. Does he hide/He hide s ). Refinements in the intervention could address this issue and lead to more general effects across morphemes.

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The Effects of Directional Processing on Objective and Subjective Listening Effort

Purpose

The purposes of this investigation were (a) to evaluate the effects of hearing aid directional processing on subjective and objective listening effort and (b) to investigate the potential relationships between subjective and objective measures of effort.

Method

Sixteen adults with mild to severe hearing loss were tested with study hearing aids programmed with 3 settings: omnidirectional, fixed directional, and bilateral beamformer. A dual-task paradigm and subjective ratings were used to assess objective and subjective listening effort, respectively, in 2 signal-to-noise ratios. Testing occurred in rooms with either low or moderate reverberation.

Results

Directional processing improved subjective and objective listening effort, although benefit for objective effort was found only in moderate reverberation. Subjective reports of work and tiredness were more highly correlated with word recognition performance than objective listening effort. However, subjective ratings about control were significantly correlated with objective listening effort.

Conclusions

Directional microphone technology in hearing aids has the potential to improve listening effort in moderately reverberant environments. In addition, subjective questions that probe a listener's desire to exercise control may be a viable method for eliciting ratings that are significantly related to objective listening effort.

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Self-Assessed Hearing Handicap in Older Adults With Poorer-Than-Predicted Speech Recognition in Noise

Purpose

Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility.

Method

We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility.

Results

One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds.

Conclusion

The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function.

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Gap Detection in School-Age Children and Adults: Center Frequency and Ramp Duration

Purpose

The age at which gap detection becomes adultlike differs, depending on the stimulus characteristics. The present study evaluated whether the developmental trajectory differs as a function of stimulus frequency region or duration of the onset and offset ramps bounding the gap.

Method

Thresholds were obtained for wideband noise (500–4500 Hz) with 4- or 40-ms raised-cosine ramps and for a 25-Hz-wide low-fluctuation narrowband noise centered on either 500 or 5000 Hz with 40-ms ramps. Stimuli were played continuously at 70 dB SPL, and the task was to indicate which of 3 intervals contained a gap. Listeners were 5.2- to 15.1-year-old children (n = 40) and adults (n = 10) with normal hearing.

Results

Regardless of listener age, gap detection thresholds for the wideband noise tended to be lower when gaps were shaped using 4-ms rather than 40-ms ramps. Thresholds also tended to be lower for the low-fluctuation narrowband noise centered on 5000 Hz than 500 Hz. Performance reached adult levels after 11 years of age for all 4 stimuli. Maturation was not uniform across individuals, however; a subset of young children performed like adults, including some 5-year-olds.

Conclusion

For these stimuli, the developmental trajectory was similar regardless of narrowband noise center frequency or wideband noise onset and offset ramp duration.

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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance

Purpose

Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Method

A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3–6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.

Results

Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.

Conclusions

Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

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Efficacy of a Supplemental Phonemic Awareness Curriculum to Instruct Preschoolers With Delays in Early Literacy Development

Purpose

Children who do not develop early literacy skills, especially phonological awareness (PA) and alphabet knowledge, prior to kindergarten are at risk for reading difficulties. We investigated a supplemental curriculum with children demonstrating delays in these skills.

Method

A cluster randomized design with 104 preschool-age children in 39 classrooms was used to determine the efficacy of a supplemental PA curriculum, PAth to Literacy. The curriculum consists of 36 daily scripted 10-min lessons with interactive games designed to teach PA and alphabet skills. A vocabulary intervention (Story Friends), which also uses a small-group format, served as the comparison condition.

Results

Multilevel modeling indicated that children in the experimental condition demonstrated significantly greater gains on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) First Sound Fluency (Dynamic Measurement Group, 2006) and Word Parts Fluency (Kaminski & Powell-Smith, 2011) measures. Educational relevance was evident: 82% of the children in the experimental condition met the kindergarten benchmark for First Sound Fluency compared with 34% of the children in the comparison condition. Teachers reported overall satisfaction with the lessons.

Conclusions

Results indicated that the vast majority of children demonstrating early literacy delays in preschool may benefit from a supplemental PA curriculum that has the potential to prevent reading difficulties as children transition to kindergarten.

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The Impact of Contrastive Stress on Vowel Acoustics and Intelligibility in Dysarthria

Purpose

To compare vowel acoustics and intelligibility in words produced with and without contrastive stress by speakers with spastic (mixed-spastic) dysarthria secondary to cerebral palsy (DYS_CP) and healthy controls (HCs).

Method

Fifteen participants (9 men, 6 women; age M = 42 years) with DYS_CP and 15 HCs (9 men, 6 women; age M = 36 years) produced sentences containing target words with and without contrastive stress. Forty-five healthy listeners (age M = 25 years) completed a vowel identification task of DYS_CP productions. Vowel acoustics were compared across stress conditions and groups using 1st (F1) and 2nd (F2) formant measures. Perceptual intelligibility was compared across stress conditions and dysarthria severity.

Results

F1 and F2 significantly increased in stressed words for both groups, although the degree of change differed. Mean Euclidian distance between vowels also increased with stress. The relative probability of vowels falling within the target F1 × F2 space was greater for HCs but did not differ with stress. Stress production resulted in greater listener vowel identification accuracy for speakers with mild dysarthria.

Conclusions

Contrastive stress affected vowel formants for both groups. Perceptual results suggest that some speakers with dysarthria may benefit from a contrastive stress strategy to improve vowel intelligibility.

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via IFTTT

Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging

Purpose

The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters.

Method

HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and 41 patients with sulcus vocalis (33 men and 8 women). Then HSDI data were evaluated by assessing the visual–perceptual rating, digital kymography, and glottal area waveform.

Results

Patients with sulcus vocalis frequently had spindle-shaped glottal gaps and a decreased mucosal wave. Compared with the control group, the sulcus vocalis group showed higher open quotient as well as a shorter duration of the visible mucosal wave, a smaller speed index, and a smaller glottal area difference index ([maximal glottal area – minimal glottal area]/maximal glottal area). These parameters deteriorated in order of the control group and Type I, II, and III sulcus vocalis. There were no gender-related differences. Strong correlations were noted between the open quotient and the type of sulcus vocalis.

Conclusions

HSDI was an effective method for documenting the characteristics of vocal fold vibrations in patients with sulcus vocalis and estimating the severity of dysphonia.

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via IFTTT

A Clinical Evaluation of the Competing Sources of Input Hypothesis

Purpose

Our purpose was to test the competing sources of input (CSI) hypothesis by evaluating an intervention based on its principles. This hypothesis proposes that children's use of main verbs without tense is the result of their treating certain sentence types in the input (e.g., Was she laughing ?) as models for declaratives (e.g., She laughing).

Method

Twenty preschoolers with specific language impairment were randomly assigned to receive either a CSI-based intervention or a more traditional intervention that lacked the novel CSI features. The auxiliary is and the third-person singular suffix –s were directly treated over a 16-week period. Past tense –ed was monitored as a control.

Results

The CSI-based group exhibited greater improvements in use of is than did the traditional group (d = 1.31), providing strong support for the CSI hypothesis. There were no significant between-groups differences in the production of the third-person singular suffix –s or the control (–ed), however.

Conclusions

The group differences in the effects on the 2 treated morphemes may be due to differences in their distribution in interrogatives and declaratives (e.g., Is he hiding/He is hiding vs. Does he hide/He hide s ). Refinements in the intervention could address this issue and lead to more general effects across morphemes.

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via IFTTT

The Effects of Directional Processing on Objective and Subjective Listening Effort

Purpose

The purposes of this investigation were (a) to evaluate the effects of hearing aid directional processing on subjective and objective listening effort and (b) to investigate the potential relationships between subjective and objective measures of effort.

Method

Sixteen adults with mild to severe hearing loss were tested with study hearing aids programmed with 3 settings: omnidirectional, fixed directional, and bilateral beamformer. A dual-task paradigm and subjective ratings were used to assess objective and subjective listening effort, respectively, in 2 signal-to-noise ratios. Testing occurred in rooms with either low or moderate reverberation.

Results

Directional processing improved subjective and objective listening effort, although benefit for objective effort was found only in moderate reverberation. Subjective reports of work and tiredness were more highly correlated with word recognition performance than objective listening effort. However, subjective ratings about control were significantly correlated with objective listening effort.

Conclusions

Directional microphone technology in hearing aids has the potential to improve listening effort in moderately reverberant environments. In addition, subjective questions that probe a listener's desire to exercise control may be a viable method for eliciting ratings that are significantly related to objective listening effort.

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via IFTTT

Self-Assessed Hearing Handicap in Older Adults With Poorer-Than-Predicted Speech Recognition in Noise

Purpose

Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility.

Method

We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility.

Results

One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds.

Conclusion

The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function.

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Gap Detection in School-Age Children and Adults: Center Frequency and Ramp Duration

Purpose

The age at which gap detection becomes adultlike differs, depending on the stimulus characteristics. The present study evaluated whether the developmental trajectory differs as a function of stimulus frequency region or duration of the onset and offset ramps bounding the gap.

Method

Thresholds were obtained for wideband noise (500–4500 Hz) with 4- or 40-ms raised-cosine ramps and for a 25-Hz-wide low-fluctuation narrowband noise centered on either 500 or 5000 Hz with 40-ms ramps. Stimuli were played continuously at 70 dB SPL, and the task was to indicate which of 3 intervals contained a gap. Listeners were 5.2- to 15.1-year-old children (n = 40) and adults (n = 10) with normal hearing.

Results

Regardless of listener age, gap detection thresholds for the wideband noise tended to be lower when gaps were shaped using 4-ms rather than 40-ms ramps. Thresholds also tended to be lower for the low-fluctuation narrowband noise centered on 5000 Hz than 500 Hz. Performance reached adult levels after 11 years of age for all 4 stimuli. Maturation was not uniform across individuals, however; a subset of young children performed like adults, including some 5-year-olds.

Conclusion

For these stimuli, the developmental trajectory was similar regardless of narrowband noise center frequency or wideband noise onset and offset ramp duration.

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A Longitudinal Study in Children With Sequential Bilateral Cochlear Implants: Time Course for the Second Implanted Ear and Bilateral Performance

Purpose

Whether, and if so when, a second-ear cochlear implant should be provided to older, unilaterally implanted children is an ongoing clinical question. This study evaluated rate of speech recognition progress for the second implanted ear and with bilateral cochlear implants in older sequentially implanted children and evaluated localization abilities.

Method

A prospective longitudinal study included 24 bilaterally implanted children (mean ear surgeries at 5.11 and 14.25 years). Test intervals were every 3–6 months through 24 months postbilateral. Test conditions were each ear and bilaterally for speech recognition and localization.

Results

Overall, the rate of progress for the second implanted ear was gradual. Improvements in quiet continued through the second year of bilateral use. Improvements in noise were more modest and leveled off during the second year. On all measures, results from the second ear were poorer than the first. Bilateral scores were better than either ear alone for all measures except sentences in quiet and localization.

Conclusions

Older sequentially implanted children with several years between surgeries may obtain speech understanding in the second implanted ear; however, performance may be limited and rate of progress gradual. Continued contralateral ear hearing aid use and reduced time between surgeries may enhance outcomes.

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Efficacy of a Supplemental Phonemic Awareness Curriculum to Instruct Preschoolers With Delays in Early Literacy Development

Purpose

Children who do not develop early literacy skills, especially phonological awareness (PA) and alphabet knowledge, prior to kindergarten are at risk for reading difficulties. We investigated a supplemental curriculum with children demonstrating delays in these skills.

Method

A cluster randomized design with 104 preschool-age children in 39 classrooms was used to determine the efficacy of a supplemental PA curriculum, PAth to Literacy. The curriculum consists of 36 daily scripted 10-min lessons with interactive games designed to teach PA and alphabet skills. A vocabulary intervention (Story Friends), which also uses a small-group format, served as the comparison condition.

Results

Multilevel modeling indicated that children in the experimental condition demonstrated significantly greater gains on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) First Sound Fluency (Dynamic Measurement Group, 2006) and Word Parts Fluency (Kaminski & Powell-Smith, 2011) measures. Educational relevance was evident: 82% of the children in the experimental condition met the kindergarten benchmark for First Sound Fluency compared with 34% of the children in the comparison condition. Teachers reported overall satisfaction with the lessons.

Conclusions

Results indicated that the vast majority of children demonstrating early literacy delays in preschool may benefit from a supplemental PA curriculum that has the potential to prevent reading difficulties as children transition to kindergarten.

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Improving Art Museum Accessibility for Adults With Acquired Hearing Loss

Purpose

Adults with hearing loss rated the accessibility of guided or docent-led art museum tours with and without hearing assistive technology (HAT).

Method

Nineteen individuals (average age 64 years, range 35–87 years) with acquired hearing loss participated. All participants had a bilateral hearing loss (mild to profound) using hearing aids (n = 12), cochlear implants (n = 5), or no technology (n = 2). Two docents who were previously trained to modify their presentations and use clear speech led the tours. Participants experienced a tour with and without the museum's HAT and rated its effectiveness using a rating scale. The study used a pre–post test design.

Results

The docent-led tours with HAT were rated significantly higher (p = .003) than the tours without HAT. Participants made several suggestions on improving museum accessibility for individuals with hearing loss.

Conclusions

The use of HAT during a museum tour was beneficial for individuals with hearing loss. Training docents to modify their presentations, use clear speech, and HAT improved the accessibility of docent-led tours for individuals with hearing loss.

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Exploring the Relevance of Items in the Communicative Participation Item Bank (CPIB) for Individuals With Hearing Loss

Purpose

The Communicative Participation Item Bank (CPIB) was developed to evaluate participation restrictions in communication situations for individuals with speech and language disorders. This study evaluated the potential relevance of CPIB items for individuals with hearing loss.

Method

Cognitive interviews were conducted with 17 adults with a range of treated and untreated hearing loss, who responded to 46 items. Interviews were continued until saturation was reached and prevalent trends emerged. A focus group was also conducted with 3 experienced audiologists to seek their views on the CPIB. Analysis of data included qualitative and quantitative approaches.

Results

The majority of the items were applicable to individuals with hearing loss; however, 12 items were identified as potentially not relevant. This was largely attributed to the items' focus on speech production rather than hearing. The results from the focus group were in agreement for a majority of items.

Conclusions

The next step in validating the CPIB for individuals with hearing loss is a psychometric analysis on a large sample. Possible outcomes could be that the CPIB is considered valid in its entirety or the creation of a new questionnaire or a hearing loss–specific short form with a subset of items is necessary.

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Improving Art Museum Accessibility for Adults With Acquired Hearing Loss

Purpose

Adults with hearing loss rated the accessibility of guided or docent-led art museum tours with and without hearing assistive technology (HAT).

Method

Nineteen individuals (average age 64 years, range 35–87 years) with acquired hearing loss participated. All participants had a bilateral hearing loss (mild to profound) using hearing aids (n = 12), cochlear implants (n = 5), or no technology (n = 2). Two docents who were previously trained to modify their presentations and use clear speech led the tours. Participants experienced a tour with and without the museum's HAT and rated its effectiveness using a rating scale. The study used a pre–post test design.

Results

The docent-led tours with HAT were rated significantly higher (p = .003) than the tours without HAT. Participants made several suggestions on improving museum accessibility for individuals with hearing loss.

Conclusions

The use of HAT during a museum tour was beneficial for individuals with hearing loss. Training docents to modify their presentations, use clear speech, and HAT improved the accessibility of docent-led tours for individuals with hearing loss.

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Exploring the Relevance of Items in the Communicative Participation Item Bank (CPIB) for Individuals With Hearing Loss

Purpose

The Communicative Participation Item Bank (CPIB) was developed to evaluate participation restrictions in communication situations for individuals with speech and language disorders. This study evaluated the potential relevance of CPIB items for individuals with hearing loss.

Method

Cognitive interviews were conducted with 17 adults with a range of treated and untreated hearing loss, who responded to 46 items. Interviews were continued until saturation was reached and prevalent trends emerged. A focus group was also conducted with 3 experienced audiologists to seek their views on the CPIB. Analysis of data included qualitative and quantitative approaches.

Results

The majority of the items were applicable to individuals with hearing loss; however, 12 items were identified as potentially not relevant. This was largely attributed to the items' focus on speech production rather than hearing. The results from the focus group were in agreement for a majority of items.

Conclusions

The next step in validating the CPIB for individuals with hearing loss is a psychometric analysis on a large sample. Possible outcomes could be that the CPIB is considered valid in its entirety or the creation of a new questionnaire or a hearing loss–specific short form with a subset of items is necessary.

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Improving Art Museum Accessibility for Adults With Acquired Hearing Loss

Purpose

Adults with hearing loss rated the accessibility of guided or docent-led art museum tours with and without hearing assistive technology (HAT).

Method

Nineteen individuals (average age 64 years, range 35–87 years) with acquired hearing loss participated. All participants had a bilateral hearing loss (mild to profound) using hearing aids (n = 12), cochlear implants (n = 5), or no technology (n = 2). Two docents who were previously trained to modify their presentations and use clear speech led the tours. Participants experienced a tour with and without the museum's HAT and rated its effectiveness using a rating scale. The study used a pre–post test design.

Results

The docent-led tours with HAT were rated significantly higher (p = .003) than the tours without HAT. Participants made several suggestions on improving museum accessibility for individuals with hearing loss.

Conclusions

The use of HAT during a museum tour was beneficial for individuals with hearing loss. Training docents to modify their presentations, use clear speech, and HAT improved the accessibility of docent-led tours for individuals with hearing loss.

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Exploring the Relevance of Items in the Communicative Participation Item Bank (CPIB) for Individuals With Hearing Loss

Purpose

The Communicative Participation Item Bank (CPIB) was developed to evaluate participation restrictions in communication situations for individuals with speech and language disorders. This study evaluated the potential relevance of CPIB items for individuals with hearing loss.

Method

Cognitive interviews were conducted with 17 adults with a range of treated and untreated hearing loss, who responded to 46 items. Interviews were continued until saturation was reached and prevalent trends emerged. A focus group was also conducted with 3 experienced audiologists to seek their views on the CPIB. Analysis of data included qualitative and quantitative approaches.

Results

The majority of the items were applicable to individuals with hearing loss; however, 12 items were identified as potentially not relevant. This was largely attributed to the items' focus on speech production rather than hearing. The results from the focus group were in agreement for a majority of items.

Conclusions

The next step in validating the CPIB for individuals with hearing loss is a psychometric analysis on a large sample. Possible outcomes could be that the CPIB is considered valid in its entirety or the creation of a new questionnaire or a hearing loss–specific short form with a subset of items is necessary.

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And Here Comes the Pop

Last week, we gave you the fizz, now we give you the pop. Staying with the popular sounds of the season, we thought it appropriate to dissect the pop of a champagne cork. After all, you would want to have your audiologic senses on the alert as you ring in the new year.

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Comparison of Alternative Coupling Methods of the Vibrant Soundbridge Floating Mass Transducer

The active middle ear implant Vibrant Soundbridge© provides a variety of coupling modalities of the floating mass transducer (FMT) to various structures of the ossicular chain and the round window. A retrospective analysis was performed on 125 subjects (n = 137 ears) (1) to compare the efficacy of the different FMT coupling modalities with increasing degree of hearing loss, (2) to compare the performance in speech outcome and the effective gain between the coupling types, and (3) to evaluate the risk of additional hearing loss of each coupling procedure. The patients were grouped according to their type of FMT coupling into incus vibroplasty (incus group, n = 59), round window vibroplasty with coupler (RWC group, n = 23), round window vibroplasty without coupler (RW group, n = 22), and oval window vibroplasty with coupler (OWC group, n = 33). For each coupling group, pre- and postoperative thresholds, the results of the Freiburg monosyllable test at 65 dB SPL, and the effective gain across frequencies (0.5-6 kHz) were evaluated. A logistic regression function was used to describe the relationship between word recognition scores (WRS, in % correct) and the mean bone conduction (BC) hearing loss. The surgical procedure had no clinically relevant effect on BC thresholds of patients in each coupling group. The BC pure tone average (PTA₄) for 50% WRS predicted by the model function was similar for the incus (48.2 dB nHL), RW (47.8 dB nHL), and OWC (49.0 dB nHL) groups, but higher for the RWC group (67.9 dB nHL). However, the median WRS was 80% or better with no significant differences in speech perception between coupling types (Kruskal-Wallis test, p = 0.229). The effective gain shows an advantage for the incus coupling between 0.5 and 2 kHz over the other coupling types. The performance of the FMT coupling modalities is equally good for patients with a mild-to-moderate hearing loss, but the efficacy of coupling types differs for patients with greater hearing loss (>48 dB BC HL).
Audiol Neurotol 2016;21:347-355

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Hearing Loss after Round Window Surgery in Mice Is due to Middle Ear Effusion

Background: Delivery of therapeutic agents directly through the round window (RW) offers promise for treating sensorineural hearing loss. However, hearing loss can result from the surgical approach itself, and the reasons for this are poorly understood. We examined the hearing loss following the 3 major steps involved with the RW approach to access the mouse cochlea: bullostomy, RW puncture, and RW injection. Methods: Twenty-one adult CBA/J mice underwent bullostomy alone, 10 underwent RW puncture, and 8 underwent RW injection with PBS with 5% glycerol. Auditory brainstem responses (ABR) and otoscopy were performed preoperatively and up to 6 weeks postoperatively. Hair cells were stained, and survival was assessed using immunofluorescence. Results: One week postoperatively, mice in all groups showed significant threshold shifts. Otoscopy revealed approximately half of all mice had middle ear effusion (MEE), with a higher incidence of effusion in the RW puncture and RW injection groups. Those with MEE had significant ABR threshold shifts, whereas those without MEE had minimal hearing loss. MEE persisted through 6 weeks in a majority of cases, but in those mice with MEE resolution, there was at least partial improvement in hearing. Immunohistochemistry showed minimal loss of hair cells in all animals. Conclusion: MEE is highly correlated with hearing loss in mice undergoing RW surgery. Otoscopy is an important adjunct to consider after ear surgery in mice, as MEE may contribute to postsurgical hearing loss.
Audiol Neurotol 2016;21:356-364

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