Testimonial from a satisfied AudioNotch user

Recently – we sent out an e-mail asking AudioNotch users what we could do better.

I received this lovely reply:

I don’t really see a need to do anything better.  It helped my tinnitus tremendously.  It didn’t cure it of course but it did quiet down the noise.  I would have liked to continue using it but the cost of it is not feasible at this time.  I tried the lowest trial period as I had my doubts but was pleasantly surprised at the results.  If the price ever comes down, I would definitely be interested in becoming a long term subscriber.  Please keep me updated and thank you for the follow up.

Steve Engelmeyer

Steve – thank you for kind words. You’re the reason we’re doing this.

Cheers!

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The effects of attentional focus and cognitive tasks on postural sway may be the result of automaticity

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Natalie Richer, Deanna Saunders, Nadia Polskaia, Yves Lajoie
Research reveals improvements in postural control when focus is placed on movement effects rather than movement production, and further improvements during the performance of a concurrent cognitive task. It has yet to be determined if these changes are due to the use of an ankle stiffening strategy or to the use of more automatic postural control processes. The objectives of the present study were to replicate the effect of attentional focus and cognitive tasks on postural control and to test that no change occurs in lower leg muscle activity in these conditions. Twenty five healthy young adults (20.7±2.76years, 10 male) were asked to stand still while performing various tasks: baseline standing, internally focusing on minimizing movement of the ankles, externally focusing on minimizing movement of an apparatus placed on their ankle joint, and two cognitive tasks consisting of counting and simultaneously summing one or two single digits in a series of three-digit numbers. Compared to baseline and internal focus, sway decreased in external focus conditions and decreased further in cognitive task conditions. Furthermore, sway velocity increased in cognitive task conditions and sway frequency increased in the medial-lateral direction in the more difficult cognitive task. Finally, no effect of condition was found on muscle activity around the ankle joint. Collectively, the findings lend support to the hypothesis that changes in postural control were the result of an automatic type of postural control rather than due to stiffening occurring at the ankle joint.



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Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: A systematic review

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Scott A. Galey, Zachary F. Lerner, Thomas C. Bulea, Seymour Zimbler, Diane L. Damiano
BackgroundCerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP.MethodsComprehensive searches of five medical databases yielded 38 papers with 30 focused on orthopaedic management.ResultsEvidence supports the use of initial hamstring lengthenings and rectus femoris transfers, where indicated, for improving objective gait measures with limited data on improving gait speed or gross motor function. In contrast, evidence argues against hamstring transfers and revision hamstring lengthening, with recent interest in more technically demanding corrective procedures. Only eight studies evaluated alternatives to surgery, specifically strength training, botulinum toxin or orthoses, with inconsistent and/or short-lived results.ConclusionsAlthough crouch in CP is recognized clinically as a complex multi-joint, multi-planar gait disorder, this review largely failed to identify interventions beyond those which directly address sagittal plane knee motion, indicating a major knowledge gap. Quality of existing data was notably weak, with few studies properly controlled or adequately sized. Outcomes from specific procedures are confounded by multilevel surgeries. Successful longer term strategies to prevent worsening of crouch and subsequent functional decline are needed.Level of EvidenceSystematic review.



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The effects of attentional focus and cognitive tasks on postural sway may be the result of automaticity

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Natalie Richer, Deanna Saunders, Nadia Polskaia, Yves Lajoie
Research reveals improvements in postural control when focus is placed on movement effects rather than movement production, and further improvements during the performance of a concurrent cognitive task. It has yet to be determined if these changes are due to the use of an ankle stiffening strategy or to the use of more automatic postural control processes. The objectives of the present study were to replicate the effect of attentional focus and cognitive tasks on postural control and to test that no change occurs in lower leg muscle activity in these conditions. Twenty five healthy young adults (20.7±2.76years, 10 male) were asked to stand still while performing various tasks: baseline standing, internally focusing on minimizing movement of the ankles, externally focusing on minimizing movement of an apparatus placed on their ankle joint, and two cognitive tasks consisting of counting and simultaneously summing one or two single digits in a series of three-digit numbers. Compared to baseline and internal focus, sway decreased in external focus conditions and decreased further in cognitive task conditions. Furthermore, sway velocity increased in cognitive task conditions and sway frequency increased in the medial-lateral direction in the more difficult cognitive task. Finally, no effect of condition was found on muscle activity around the ankle joint. Collectively, the findings lend support to the hypothesis that changes in postural control were the result of an automatic type of postural control rather than due to stiffening occurring at the ankle joint.



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Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: A systematic review

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Scott A. Galey, Zachary F. Lerner, Thomas C. Bulea, Seymour Zimbler, Diane L. Damiano
BackgroundCerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP.MethodsComprehensive searches of five medical databases yielded 38 papers with 30 focused on orthopaedic management.ResultsEvidence supports the use of initial hamstring lengthenings and rectus femoris transfers, where indicated, for improving objective gait measures with limited data on improving gait speed or gross motor function. In contrast, evidence argues against hamstring transfers and revision hamstring lengthening, with recent interest in more technically demanding corrective procedures. Only eight studies evaluated alternatives to surgery, specifically strength training, botulinum toxin or orthoses, with inconsistent and/or short-lived results.ConclusionsAlthough crouch in CP is recognized clinically as a complex multi-joint, multi-planar gait disorder, this review largely failed to identify interventions beyond those which directly address sagittal plane knee motion, indicating a major knowledge gap. Quality of existing data was notably weak, with few studies properly controlled or adequately sized. Outcomes from specific procedures are confounded by multilevel surgeries. Successful longer term strategies to prevent worsening of crouch and subsequent functional decline are needed.Level of EvidenceSystematic review.



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The effects of attentional focus and cognitive tasks on postural sway may be the result of automaticity

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Natalie Richer, Deanna Saunders, Nadia Polskaia, Yves Lajoie
Research reveals improvements in postural control when focus is placed on movement effects rather than movement production, and further improvements during the performance of a concurrent cognitive task. It has yet to be determined if these changes are due to the use of an ankle stiffening strategy or to the use of more automatic postural control processes. The objectives of the present study were to replicate the effect of attentional focus and cognitive tasks on postural control and to test that no change occurs in lower leg muscle activity in these conditions. Twenty five healthy young adults (20.7±2.76years, 10 male) were asked to stand still while performing various tasks: baseline standing, internally focusing on minimizing movement of the ankles, externally focusing on minimizing movement of an apparatus placed on their ankle joint, and two cognitive tasks consisting of counting and simultaneously summing one or two single digits in a series of three-digit numbers. Compared to baseline and internal focus, sway decreased in external focus conditions and decreased further in cognitive task conditions. Furthermore, sway velocity increased in cognitive task conditions and sway frequency increased in the medial-lateral direction in the more difficult cognitive task. Finally, no effect of condition was found on muscle activity around the ankle joint. Collectively, the findings lend support to the hypothesis that changes in postural control were the result of an automatic type of postural control rather than due to stiffening occurring at the ankle joint.



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Effectiveness of surgical and non-surgical management of crouch gait in cerebral palsy: A systematic review

Publication date: Available online 24 February 2017
Source:Gait & Posture
Author(s): Scott A. Galey, Zachary F. Lerner, Thomas C. Bulea, Seymour Zimbler, Diane L. Damiano
BackgroundCerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP.MethodsComprehensive searches of five medical databases yielded 38 papers with 30 focused on orthopaedic management.ResultsEvidence supports the use of initial hamstring lengthenings and rectus femoris transfers, where indicated, for improving objective gait measures with limited data on improving gait speed or gross motor function. In contrast, evidence argues against hamstring transfers and revision hamstring lengthening, with recent interest in more technically demanding corrective procedures. Only eight studies evaluated alternatives to surgery, specifically strength training, botulinum toxin or orthoses, with inconsistent and/or short-lived results.ConclusionsAlthough crouch in CP is recognized clinically as a complex multi-joint, multi-planar gait disorder, this review largely failed to identify interventions beyond those which directly address sagittal plane knee motion, indicating a major knowledge gap. Quality of existing data was notably weak, with few studies properly controlled or adequately sized. Outcomes from specific procedures are confounded by multilevel surgeries. Successful longer term strategies to prevent worsening of crouch and subsequent functional decline are needed.Level of EvidenceSystematic review.



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Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners

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Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners

.


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Coping together with hearing loss: a qualitative meta-synthesis of the psychosocial experiences of people with hearing loss and their communication partners

.


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A Longitudinal Investigation of the Home Literacy Environment and Shared Book Reading in Young Children With Hearing Loss.

Objectives: The principle goal of this longitudinal study was to examine parent perceptions of home literacy environment (e.g., frequency of book reading, ease of book reading with child) and observed behaviors during shared book reading (SBR) interactions between parents and their children with hearing loss (HL) as compared with parents and their children with normal hearing (NH) across 3 time points (12, 24, and 36 months old). Relationships were also explored among home literacy environment factors and SBR behaviors and later language outcomes, across all three time points for parents of children with and without HL. Design: Participants were a group of parents and their children with HL (N = 17) and typically developing children with NH (N = 34). Parent perceptions about the home literacy environment were captured through a questionnaire. Observed parent behaviors and their use of facilitative language techniques were coded during videotaped SBR interactions. Children's oral language skills were assessed using a standardized language measure at each time point. Results: No significant differences emerged between groups of parents (HL and NH) in terms of perceived home literacy environment at 12 and 36 months. However, significant group differences were evident for parent perceived ease of reading to their child at 24 months. Group differences also emerged for parental SBR behaviors for literacy strategies and interactive reading at 12 months and for engagement and interactive reading at 36 months, with parents of children with HL scoring lower in all factors. No significant relationships emerged between early home literacy factors and SBR behaviors at 12 months and oral language skills at 36 months for parents of children with NH. However, significant positive relationships were evident between early home literacy environment factors at 12 months and oral language skills at 36 months for parents and their children with HL. Conclusions: Although both groups of parents increased their frequency of SBR behaviors over time, parents of children with HL may need additional support to optimize SBR experiences to better guide their toddlers' and preschoolers' language skills. Early intervention efforts that focus on SBR interactions that are mutually enjoyed and incorporate specific ways to encourage parent-child conversations will be essential as children with HL acquire language. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Objective: Define the indications and outcomes for subjects undergoing treatment utilizing the extended middle cranial fossa approach (EMCF). Study Design: Retrospective records review. Setting: University-based tertiary referral center. Patients: Subjects undergoing treatment of posterior cranial fossa (PCF) lesions. Intervention(s): EMCF exposure and treatment of the indicating PCF lesion. Main Outcome Measure(s): Demographic, audiometric, and cranial nerve functioning variables were assessed. Results: Thirty-five subjects who underwent an EMCF exposure were identified over a 12-year period. The most common indication was meningioma (18; 51%) followed by schwannomas (six, 17%), and vascular lesions (five, 14%). Preoperative cranial nerve complaints were common (32, 94%) as were objective cranial nerve abnormalities on physical examination (21; 60%). Preoperative audiometric data from subjects with hearing demonstrated good functioning including pure-tone average (PTA) (21.7 +/- 15.6 dB HL) and word understanding scores (95.1 +/- 7.4%). Most (34, 97%) subjects had intact facial nerve function. The average length of stay was 11.6 days (median = 9). Cranial neuropathies were common postoperatively with 27 (79%) subjects demonstrating some objective cranial nerve dysfunction, the most common of which was trigeminal nerve hypesthesia (21, 61.7%). Subjects with identifiable pre- and postoperative audiometric data and preoperative hearing demonstrated small declines in the four-tone average (16.2 dB) and word recognition scores (22.4%). Two subjects (6%) had new profound hearing loss postoperatively. Conclusions: The EMCF approach can provide safe and effective exposure of the anterior PCF. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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A Longitudinal Investigation of the Home Literacy Environment and Shared Book Reading in Young Children With Hearing Loss.

Objectives: The principle goal of this longitudinal study was to examine parent perceptions of home literacy environment (e.g., frequency of book reading, ease of book reading with child) and observed behaviors during shared book reading (SBR) interactions between parents and their children with hearing loss (HL) as compared with parents and their children with normal hearing (NH) across 3 time points (12, 24, and 36 months old). Relationships were also explored among home literacy environment factors and SBR behaviors and later language outcomes, across all three time points for parents of children with and without HL. Design: Participants were a group of parents and their children with HL (N = 17) and typically developing children with NH (N = 34). Parent perceptions about the home literacy environment were captured through a questionnaire. Observed parent behaviors and their use of facilitative language techniques were coded during videotaped SBR interactions. Children's oral language skills were assessed using a standardized language measure at each time point. Results: No significant differences emerged between groups of parents (HL and NH) in terms of perceived home literacy environment at 12 and 36 months. However, significant group differences were evident for parent perceived ease of reading to their child at 24 months. Group differences also emerged for parental SBR behaviors for literacy strategies and interactive reading at 12 months and for engagement and interactive reading at 36 months, with parents of children with HL scoring lower in all factors. No significant relationships emerged between early home literacy factors and SBR behaviors at 12 months and oral language skills at 36 months for parents of children with NH. However, significant positive relationships were evident between early home literacy environment factors at 12 months and oral language skills at 36 months for parents and their children with HL. Conclusions: Although both groups of parents increased their frequency of SBR behaviors over time, parents of children with HL may need additional support to optimize SBR experiences to better guide their toddlers' and preschoolers' language skills. Early intervention efforts that focus on SBR interactions that are mutually enjoyed and incorporate specific ways to encourage parent-child conversations will be essential as children with HL acquire language. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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A Longitudinal Investigation of the Home Literacy Environment and Shared Book Reading in Young Children With Hearing Loss.

Objectives: The principle goal of this longitudinal study was to examine parent perceptions of home literacy environment (e.g., frequency of book reading, ease of book reading with child) and observed behaviors during shared book reading (SBR) interactions between parents and their children with hearing loss (HL) as compared with parents and their children with normal hearing (NH) across 3 time points (12, 24, and 36 months old). Relationships were also explored among home literacy environment factors and SBR behaviors and later language outcomes, across all three time points for parents of children with and without HL. Design: Participants were a group of parents and their children with HL (N = 17) and typically developing children with NH (N = 34). Parent perceptions about the home literacy environment were captured through a questionnaire. Observed parent behaviors and their use of facilitative language techniques were coded during videotaped SBR interactions. Children's oral language skills were assessed using a standardized language measure at each time point. Results: No significant differences emerged between groups of parents (HL and NH) in terms of perceived home literacy environment at 12 and 36 months. However, significant group differences were evident for parent perceived ease of reading to their child at 24 months. Group differences also emerged for parental SBR behaviors for literacy strategies and interactive reading at 12 months and for engagement and interactive reading at 36 months, with parents of children with HL scoring lower in all factors. No significant relationships emerged between early home literacy factors and SBR behaviors at 12 months and oral language skills at 36 months for parents of children with NH. However, significant positive relationships were evident between early home literacy environment factors at 12 months and oral language skills at 36 months for parents and their children with HL. Conclusions: Although both groups of parents increased their frequency of SBR behaviors over time, parents of children with HL may need additional support to optimize SBR experiences to better guide their toddlers' and preschoolers' language skills. Early intervention efforts that focus on SBR interactions that are mutually enjoyed and incorporate specific ways to encourage parent-child conversations will be essential as children with HL acquire language. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Dr. Kevin Munro Gives Fourth Annual Judith S. Gravel Lecture at Vanderbilt University

​Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester, gave Vanderbilt University's fourth annual Judith S. Gravel Lecture in Pediatric Audiology on Aug 30, 2016. His lecture entitled "The Importance of Being Early: A Talk in Three Acts" took place at the Vanderbilt Bill Wilkerson Center, home of the university's department of hearing and speech sciences.

Dr. Munro is the research director of the Manchester Center for Audiology and Deafness. He leads the research theme on plasticity and aging there, which focuses on understanding the changes that occur over time in the auditory system due to training, deafness, development, or restoration of input to a deaf auditory system. The goal of that research is to guide fitting and management options for hearing devices. Dr. Munro's other research interests include assessment and management of hearing disorders, epidemiology of hearing loss, and auditory genetics. ​

From left to right: Anne Marie Tharpe, PhD, professor and chair of the department of hearing and speech sciences at Vanderbilt University; Mr. Bruce Taylor; Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester; and Fred H. Bess, PhD, professor of audiology and director of the National Center for Childhood Deafness and Family Communication at Vanderbilt University.​

Published: 2/24/2017 9:30:00 AM

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Dr. Kevin Munro Gives Fourth Annual Judith S. Gravel Lecture at Vanderbilt University

​Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester, gave Vanderbilt University's fourth annual Judith S. Gravel Lecture in Pediatric Audiology on Aug 30, 2016. His lecture entitled "The Importance of Being Early: A Talk in Three Acts" took place at the Vanderbilt Bill Wilkerson Center, home of the university's department of hearing and speech sciences.

Dr. Munro is the research director of the Manchester Center for Audiology and Deafness. He leads the research theme on plasticity and aging there, which focuses on understanding the changes that occur over time in the auditory system due to training, deafness, development, or restoration of input to a deaf auditory system. The goal of that research is to guide fitting and management options for hearing devices. Dr. Munro's other research interests include assessment and management of hearing disorders, epidemiology of hearing loss, and auditory genetics. ​

From left to right: Anne Marie Tharpe, PhD, professor and chair of the department of hearing and speech sciences at Vanderbilt University; Mr. Bruce Taylor; Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester; and Fred H. Bess, PhD, professor of audiology and director of the National Center for Childhood Deafness and Family Communication at Vanderbilt University.​

Published: 2/24/2017 9:30:00 AM

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Dr. Kevin Munro Gives Fourth Annual Judith S. Gravel Lecture at Vanderbilt University

​Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester, gave Vanderbilt University's fourth annual Judith S. Gravel Lecture in Pediatric Audiology on Aug 30, 2016. His lecture entitled "The Importance of Being Early: A Talk in Three Acts" took place at the Vanderbilt Bill Wilkerson Center, home of the university's department of hearing and speech sciences.

Dr. Munro is the research director of the Manchester Center for Audiology and Deafness. He leads the research theme on plasticity and aging there, which focuses on understanding the changes that occur over time in the auditory system due to training, deafness, development, or restoration of input to a deaf auditory system. The goal of that research is to guide fitting and management options for hearing devices. Dr. Munro's other research interests include assessment and management of hearing disorders, epidemiology of hearing loss, and auditory genetics. ​

From left to right: Anne Marie Tharpe, PhD, professor and chair of the department of hearing and speech sciences at Vanderbilt University; Mr. Bruce Taylor; Kevin J. Munro, PhD, Ewing Professor of Audiology at the University of Manchester; and Fred H. Bess, PhD, professor of audiology and director of the National Center for Childhood Deafness and Family Communication at Vanderbilt University.​

Published: 2/24/2017 9:30:00 AM

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Vocal Loading and Environmental Humidity Effects in Older Adults

Publication date: Available online 24 February 2017
Source:Journal of Voice
Author(s): Anusha Sundarrajan, Robert Brinton Fujiki, Sara E. Loerch, Anumitha Venkatraman, M. Preeti Sivasankar
The goal of this study was to investigate the effects of a vocal loading challenge that combined prolonged speaking, in child-directed voice within a noisy environment, in older adults. An additional goal was to determine whether increased environmental humidity would attenuate the negative effects of this vocal loading challenge.MethodThirteen healthy subjects (five males and eight females; >65 years) completed a vocal loading challenge. The challenge involved 45 minutes of child-directed speech in the presence of 65 dB multitalker babble background noise. Subjects completed this challenge in both low humidity and moderate humidity in counterbalanced order. Vocal function was assessed before and after the challenge using phonation threshold pressure (PTP), cepstral peak prominence (CPP), low/high spectral ratio (LHR), perceived phonatory effort (PPE), and perceived vocal tiredness.ResultsNegative changes were observed in the aging larynx following the 45-minute vocal loading challenge. Measures of PTP, PPE, and perceived vocal tiredness demonstrated statistically significant loading effects. Increased ambient humidity significantly alleviated the negative changes observed in PPE and perceived vocal tiredness. Increased humidity significantly improved CPP measures both before and after the vocal loading challenge.ConclusionsThis study furthers our understanding of how older adults respond to a vocal loading challenge of prolonged nonhabitual speech in a noisy environment. Our data suggest that the aging voice is negatively affected by prolonged loud speaking and that humidification may be beneficial in reducing some of these negative effects.



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