The Bulgarian hearing in noise test

from the International Journal of Audiology

Bulgaria is a small country (111.001.9 sq. km; population 7.761.000) in southeastern Europe. Bulgarian, the mother language of 84.8% of the population, is an Indo-European language and a member of the southern branch of the Slavic languages. Currently, there are approximately 10 million people speaking Bulgarian, including 1.5 to 2 million second-language speakers. Some communities in Canada, Greece, Hungary, Israel, Moldova, Romania, Serbia, Montenegro, Turkey (Europe), Ukraine, and the USA also speak Bulgarian (Wikipedia, 2006). The aim of this report is to present the current state of the development of the Bulgarian HINT.

The American English hearing in noise test

from the International Journal of Audiology

The American English hearing in noise test (HINT) was originally developed for use in the evaluation of binaural hearing aid fittings (Nilsson et al, 1994). The American English HINT is based on the work of Plomp and Mimpen (1979), who developed the first adaptive speech reception threshold test using Dutch sentences. This report provides an overview of the development of the American English HINT. The norms, reliability, and measurement characteristics of the HINT are also presented.

LIST and LINT: Sentences and numbers for quantifying speech understanding in severely impaired listeners for Flanders and the Netherlands

from the International Journal of Audiology

A Dutch sentence test (LIST) and a Dutch number test (LINT) have been developed and validated for the accurate measurement of speech reception thresholds (SRT) in quiet and in noise with severely hearing-impaired individuals and cochlear implant recipients in Flanders and the Netherlands. The LIST consists of 35 lists of 10 sentences of equal known difficulty uttered by a female speaker; while the LINT consists of 400 numbers (1-100) by two male and two female speakers. Normative values were determined at fixed S/N ratios and using the adaptive method (Plomp & Mimpen, 1979), yielding identical results for SRT and slope. For the LIST, average fitted SRTs were 27.1 (0.9) dB SPL in quiet and -7.8 dB (0.2) SNR in noise. In addition, the LIST in noise displayed a steep discrimination function (17%/dB) and good reliability (within-subject standard deviation=1.2 dB). For the LINT average fitted SRTs in quiet were 20.7 (0.9) dB SPL and about -9.0 dB SNR in noise. Again, the slopes of the performance intensity functions were relatively steep, i.e. 8.5%/dB in quiet and 15.2%/dB in noise, suggesting that the LINT is accurate and efficient and thus capable of reflecting subtle changes in performance. First data with cochlear implanted subjects show that both LIST and LINT are feasible and are capable of mapping a large range of hearing disabilities.

How should hearing screening tests be offered?

from the International Journal of Audiology

This paper deals with the question of how the general public should be addressed when offering hearing screening. Postal-based questionnaires in the United Kingdom, Germany, and the Netherlands were sent to users of hearing devices, those that are in the process of obtaining one, or those that have indicated that they have special interest in hearing. Results of the survey indicated that respondents were enthusiastic about the idea of being able to carry out hearing self-screening tests via the internet, telephone, or questionnaires. A questionnaire as a method to screen on hearing was generally preferred above using the internet, which was preferred over using the telephone for the test. About 27% of the respondents indicated to use exclusively one method. Most respondents indicated that either method provided would be of interest (41%), 17% indicated not to be interested in conducting screening tests using the internet.

Proceedings of the 25th Anniversary Meeting of the International Tinnitus Forum, September 15, 2007, Washington, DC, USA

from the International Tinnitus Journal

No abstract available.

The Malay hearing in noise test

from the International Journal of Audiology

The Malay language is an Austronesian language spoken by the Malay people in Malaysia, southern Thailand, the Philippines, Singapore, central eastern Sumatra, the Riau Islands, and parts of the coast of Borneo. It is an official language of Malaysia, Brunei, and Singapore. In Malaysia, the Malay language, also known as Bahasa Melayu or Bahasa Malaysia, is the national language of the country. This report summarizes the procedures for developing the hearing in noise test in Malay language.

Timbral influences on vocal pitch-matching accuracy

from Logopedics Phoniatrics Vocology

The purpose of this study was to investigate how vocal fundamental frequency control was influenced by the timbre of target auditory stimuli. Nineteen female participants were asked to vocally reproduce the pitch of target tones, which consisted of female, male, violin, and clarinet timbres at three different fundamental frequencies. Results revealed that the participants were significantly more accurate at matching the pitch of female target tones compared to the instrumental timbres. This was interpreted as being due to an effect of spectral similarity of the female timbre to that of the female participants. The results of this study support the hypothesis of a perceptual integrality between timbre and pitch, and that stimulus timbre can influence the accuracy of vocal reproduction.

Methodological quality of intervention research in speech-language pathology: Analysis of 10 years of group-design studies

from Evidence-Based Communication Assessment and Intervention

The aim of this work was to critically examine the methodological quality of recent treatment research in speech-language pathology, focusing specifically on group-design studies (randomized, controlled trials and quasi-experimental-design studies). We also considered whether methodological quality differed as a function of a particular study’s treatment focus (i.e. literacy, language, speech, fluency, voice), the age group studied (pre-school-age child; school-age child; adult), the year of publication, or the publishing journal. In total, 53 treatment studies published in the last 10 years in three journals of the American Speech-Language-Hearing Association (ASHA) were selected for analysis using Downs and Black’s (1998) reliable, valid rating tool for examining methodological quality. The results indicated that the quality of the treatment studies was highly variable in terms of the 25 indicators of quality studied, and that there were few systematic differences in quality attributable to treatment focus, age group studied, year of publication, or the publishing journal. Implications for evidence-based practice and study reporting are discussed.

Print-referencing techniques, implemented during a shared storybook-reading activity, hold promise for increasing the print-concept knowledge of preschoolers with language impairment

from Evidence-Based Communication Assessment and Intervention

No abstract available.

Unaided and aided performance with a directional open-fit hearing aid

from the International Journal of Audiology

Differences in performance between unaided and aided performance (omnidirectional and directional) were measured using an open-fit behind-the-ear (BTE) hearing aid. Twenty-six subjects without prior experience with amplification were fitted bilaterally using the manufacturer’s recommended procedure. After wearing the hearing aids for one week, the fitting parameters were fine-tuned, based on subjective comments. Four weeks later, differences in performance between unaided and aided (omnidirectional and directional) were assessed by measuring reception thresholds for sentences (RTS in dB), using HINT sentences presented at 0° with R-SpaceTM restaurant noise held constant at 65 dBA and presented via eight loudspeakers set 45° apart. In addition, the APHAB was administered to assess subjective impressions of the experimental aid.

Results revealed that significant differences in RTS (in dB) were present between directional and omnidirectional performance, as well as directional and unaided performance. Aided omnidirectional performance, however, was not significantly different from unaided performance. These findings suggest for the hearing aids and experimental condition used in this study, a patient would require directional microphones in order to perform significantly better than unaided or aided with omnidirectional microphones, and that performance with an omnidirectional microphone would not be significantly better than unaided. Finally, the APHAB-aided scores were significantly better than unaided scores for the EC, BN, RV, and AV subscales indicating the subjects, on average, perceived the experimental aid to provide significantly better performance than unaided, and that aided performance was more aversive than unaided.

The role of sensory dysfunction in the development of voice disorders, chronic cough and paradoxical vocal fold movement

from the International Journal of Speech-Language Pathology

Sensory function may be important in the pathogenesis of Chronic Cough (CC) and Paradoxical Vocal Fold Movement (PVFM). This paper aims to explore sensory issues related to the pathogenesis, classification, assessment and management of these conditions. Sensory disruption of the vagus nerve can occur through neural plasticity whereby a change occurs in the way a central neuron reacts to an incoming stimulus. Such disruption can be demonstrated through assessment of cough reflex sensitivity and extrathoracic airway hyperresponsiveness both of which may be increased in CC and PVFM. In addition, sensory function may be determined by measuring the laryngeal adductor reflex, however this phenomenon is yet to be explored in CC and PVFM. The similarity in sensory dysfunction between CC and PVFM provides support for a link between the two conditions. There are also similarities in underlying medical conditions and symptom profiles between CC/PVFM and voice disorders such as muscle tension dysphonia. Although coughing and throat clearing may be contributing factors in the development and maintenance of voice disorders, they may occur in response to extrathoracic airway hyperresponsiveness. Dysphonia can occur in CC/PVFM and may improve following behavioural treatment of CC.

Speech and language development in cri du chat syndrome: A critical review

from Clinical Linguistics and Phonetics

This article reviews research on speech and language abilities in people with cri du chat syndrome (CCS). CCS is a rare genetic disorder, with an estimated incidence between 1 in 15,000 and 1 in 50,000 births, resulting from a deletion on the short arm of chromosome 5. In general, individuals have delayed speech and language development, and some never develop spoken language. Their receptive language is better than their expressive language, although both are delayed. Regarding phonetics and phonology, substitutions, omissions, and distortions are frequent; consonant inventories are small; syllable shapes are restricted; and vowels are variable and overlap with each other acoustically. Persons with CCS have been found to inflect words from all major word classes. Little is known about syntactic skills, but some individuals are reported to express themselves in utterances of two or more words. Knowledge about speech and language development in CCS is sparse, and the need for more research is considerable.

Age Inconsistency in the American Academy of Pediatrics Guidelines for Acute Otitis Media

from Pediatrics

OBJECTIVE. The American Academy of Pediatrics acute otitis media guidelines could reduce antibiotic use. The objective was to compare strategies for diagnosing and treating otitis: (1) a commonly used, 2-criteria strategy, (2) the guidelines’ 3-criteria algorithm, and (3) initially watching without antibiotics.

METHODS. A decision analysis was performed with literature-based parameter. The target population was children presenting to primary care physicians with possible otitis media. Main outcomes were antibiotic use, sick days, mild adverse drug events, and number needed to treat/avoided sick day.

RESULTS. For children 2 to <6 months of age, compared with the 2-criteria strategy, guideline use predicted 21% less antibiotic use, 13% more sick days, and 23% fewer adverse drug events; the number needed to treat for the 2-criteria strategy versus the American Academy of Pediatrics strategy was 1.2 children per avoided sick day. For children 6 to 2 years of age, guideline use, compared with the 2-criteria strategy, predicted 67% less antibiotic use, 4% more sick days, and 68% fewer adverse drug events. The number needed to treat for the guideline strategy versus the watch strategy was 6.3 children per avoided sick day; that for the 2-criteria strategy versus the guideline strategy was 12.3. Guideline use for children <2 years implies that our number needed to treat to avoid a sick day is 2, guideline use implies we are willing to treat at least 6.3 children to avoid a sick day. Thus, the guidelines imply a greater willingness to treat older children, compared with younger children.

CONCLUSIONS. The American Academy of Pediatrics guidelines are inconsistent in their outcomes across age groups. Guideline implementation under age 2 reduces antibiotic use but at a relatively heavy cost of sick days and parental missed work days. This trade-off may be particularly unfavorable for working parents, who might reasonably prefer greater antibiotic use.

Trends in Otitis Media Treatment Failure and Relapse

from Pediatrics

OBJECTIVES. The goals were to describe trends in acute otitis media, treatment failure, and relapse and in high-dose amoxicillin use and to determine whether treatment of acute otitis media with high-dose amoxicillin was associated with treatment failure or relapse.

METHODS. We conducted a retrospective study of acute otitis media visits made between 1996 and 2004 by children 2 months to 12 years of age in a large group practice, using computerized data. We defined acute otitis media as an otitis media visit with antibiotics dispensed (preceded by 30 days without otitis media visits), treatment failure as initiation of treatment with a second antibiotic before the first prescription was finished, and relapse as initiation of antibiotic treatment after the first prescription was finished but within 30 days after the index acute otitis media episode. The primary independent measure was high-dose amoxicillin (>70 mg/kg per day). We evaluated changes over time and determined whether high-dose amoxicillin use was associated with otitis media treatment failure or relapse.

RESULTS. We identified 111335 acute otitis media visits over a 9-year period. The incidence of acute otitis media decreased from 385.1 visits per 1000 enrollees in 1996 to 188.8 visits per 1000 enrollees in 2004. The proportion of acute otitis media visits treated with high-dose amoxicillin increased from 1.7% in 1996 to 41.9% in 2004. Both otitis media treatment failure and relapse rates decreased from 1996 to 2004 (from 3.9% to 2.6% and from 9.2% to 8.9%, respectively). The odds of treatment failure or relapse did not differ between acute otitis media episodes treated with high-dose and low-dose amoxicillin.

CONCLUSIONS. During the past decade, acute otitis media, treatment failure, and relapse became less common and high-dose amoxicillin use increased. However, high-dose amoxicillin treatment did not reduce the risk of individual infections resulting in adverse outcomes.

Valuing Reduced Antibiotic Use for Pediatric Acute Otitis Media

from Pediatrics

OBJECTIVE. The 2004 American Academy of Pediatrics acute otitis media guidelines urge parents to weigh the benefits of reduced antibiotic use, adverse drug events, and future resistance versus risks of extra costs and sick days resulting from guideline use. The value of decreased antibiotic resistance has not been quantified. The objective was to perform cost-utility analysis, estimating the resistance value of implementing the guidelines for acute otitis media treatment for children <2 years of age. Outcomes were described with a common denominator and the value of avoiding resistance was estimated using a parental perspective.

METHODS. Decision analysis results were used for outcome probabilities. Published utilities were used to describe outcomes in quality-adjusted life-day units. The minimum resistance benefit value, where the benefits of the American Academy of Pediatrics guidelines would at least balance their costs, was defined as the guidelines’ incremental costs minus their other benefits.

RESULTS. For a child 2 to <6 months of age presenting to a primary care physician with possible otitis media, parents would need to value the resistance benefit at 0.77 quality-adjusted life-days per antibiotic prescription avoided for the guidelines’ benefits to balance their costs. For the 6- to <24-month-old group, results were 0.67 quality-adjusted life-days per prescription avoided. Results were sensitive to the dollar cost utility; when willingness to pay ranged from $20000 to $200000 per quality-adjusted life-year, results ranged from 0.36 and 0.30 quality-adjusted life-days up to 4.10 and 3.57 quality-adjusted life-days for the 2- to <6-month-old and 6- to <24-month-old groups, respectively. Costs were driven by missed parent work days.

CONCLUSIONS. From a societal perspective, trading 0.30 to 4 quality-adjusted life-days to avoid 1 antibiotic course might be desirable; from a parental perspective, this may not be as desirable. Parent demand for antibiotics may be rational when driven by the value of parent time. Other approaches that have the potential to reduce antibiotic use, such as wider use of influenza vaccine and improved rapid viral diagnostic techniques, might be more successful.