Measuring Tinnitus Loudness Using Constrained Psychophysical Scaling

Results and Conclusions: Our 14 trained participants judged loudness similarly to normal hearing participants for pure tones at normal hearing, nontinnitus frequencies—implying that their judgments of tinnitus loudness were valid. Constrained scaling of tinnitus loudness yielded measurements that were substantially greater than the sensation level of sounds matched to tinnitus loudness. Our total of 16 participants fell into 2 groups on the basis of hearing loss, extent of abnormal loudness growth at the tinnitus frequency, and several aspects of tinnitus experience. Finally, as previously found, there was little correlation between tinnitus loudness, no matter how measured, and the impact of tinnitus on daily life as measured by the THI.

from the American Journal of Audiology

Is undernutrition a risk factor for sensorineural hearing loss in early infancy?

The present cross-sectional study set out to determine the nutritional status of infants aged 0-3 months with the WHO Multicentre Growth Reference (WHO-MGR) and examine the relationship between undernutrition and congenital or early-onset sensorineural hearing loss (CESHL) rarely reported for developing countries. The nutritional status of all infants attending community-based clinics for routine Bacille de Calmette-Guérin (BCG) immunisation from July 2005 to December 2006 was determined by weight-for-age, weight-for-length and BMI-for-age based on the WHO-MGR. Hearing loss status was determined by tympanometry, auditory brainstem response (ABR) and visual response audiometry after a two-stage screening with transient evoked otoacoustic emissions and automated ABR. The relationship between nutritional status and CESHL were explored after adjusting for potentially confounding maternal and infant characteristics using multivariable logistic regression analyses. Of the 3386 infants who completed the hearing evaluation protocol, seventy-one were confirmed with hearing loss (>30 dB hearing level). More than one-third (37.9 %) of all infants and over half (54.9 %) of those with CESHL were undernourished by at least one measure of growth. Stunting (35.3 %) was the most prevalent nutritional deficit in infants with CESHL. In the final logistic model, infants with any undernourished physical state were significantly likely to have CESHL (OR 1.67; 95 % CI 1.03, 2.77) and of a severe-to-profound degree (OR 3.92; 95 % CI 1.38, 11.17) compared with infants without any undernourishment. Prospective studies to establish the full spectrum of the relationship between undernutrition and CESHL, particularly in resource-poor countries, are therefore warranted.

from the British Journal of Nutrition

Geisinger Medical Center opens new ‘Vestibular and Balance Center’

Geisinger Medical Center recently opened a new Otolaryngology Head and Neck Surgery – Vestibular and Balance Center to help patients who are affected by vertigo, dizziness or balance problems.

from News-Medical.net

Auditory Processing Disorders

This Article does not have an abstract.

from the International Journal of Audiology

Benefit from spatial separation of multiple talkers in bilateral hearing-aid users: Effects of hearing loss, age, and cognition

To study the spatial hearing abilities of bilateral hearing-aid users in multi-talker situations, 20 subjects received fittings configured to preserve acoustic cues salient for spatial hearing. Following acclimatization, speech reception thresholds (SRTs) were measured for three competing talkers that were either co-located or spatially separated along the front-back or left-right dimension. In addition, the subjects’ working memory and attentional abilities were measured. Left-right SRTs varied over more than 14 dB, while front-back SRTs varied over more than 8 dB. Furthermore, significant correlations were observed between left-right SRTs, age, and low-frequency hearing loss, and also between front-back SRTs, age, and high-frequency aided thresholds. Concerning cognitive effects, left-right performance was most strongly related to attentional abilities, while front-back performance showed a relation to working memory abilities. Altogether, these results suggest that, due to raised hearing thresholds and aging, hearing-aid users have reduced access to interaural and monaural spatial cues as well as a diminished ability to ‘enhance’ a target signal by means of top-down processing. These deficits, in turn, lead to impaired functioning in complex listening environments.

from the International Journal of Audiology

Ethics for Speech-Language Pathologists and Audiologists: An Illustrative Casebook

This Article does not have an abstract.

from the International Journal of Audiology

Perception of speech by prelingual pre-adolescent and adolescent cochlear implant users

This study was undertaken to assess the speech perception benefits, 24 months after cochlear implantation (CI), in 20 young people (age at CI, 8-18.5 years) with prelingual profound hearing loss, in addition to the use of a proposed CI candidacy assessment profile. Speech perception was evaluated in terms of word and sentence perception before CI, and at six-monthly intervals for two years after CI. Before undergoing CI, all participants were tested on a pre-implantation assessment profile. Compared to the pre-CI findings, group results over 24 months post-CI demonstrated improved speech perception abilities reaching, on average, 46% for word recognition, 71.3% for sentences in quiet, and 33.6% for sentences in noise. Pre-CI profile scores correlated significantly with all speech perception results obtained 24 months after CI. Thus, despite their relatively late ages at implantation, all participants showed gradually improving performance in speech perception. The results showed a high variability in the outcomes of the participants. The pre-CI profile appeared to be useful in formulating realistic expectations of CI outcome during pre-implantation consultations, suggesting that expectations can and should be managed according to each patient’s pre-implantation assessment.

from the International Journal of Audiology

Sentence recognition in noise: Variables in compilation and interpretation of tests

Tests of sentence recognition in noise constitute an essential tool for the assessment of auditory abilities that are representative of everyday listening experiences. A number of recent articles have reported on the development of such tests, documenting different approaches and methods. However, both the development and interpretation of these tests require careful consideration of many variables. This article reviews and categorizes the stimulus, presentation, subject, response, and performance variables influencing the development and interpretation of tests of sentence recognition in noise. A systematic framework is utilized to document published findings on these variables. Recommendations and guidelines, based on test performance requirements and test objectives, are provided concerning the interpretation of results and the development of new test materials.

from the International Journal of Audiology

The effect of frequency-dependent microphone directionality on horizontal localization performance in hearing-aid users

Frequency-dependent microphone directionality alters the spectral shape of sound as a function of arrival azimuth. The influence of this on horizontal-plane localization performance was investigated. Using a 360° loudspeaker array and five stimuli with different spectral characteristics, localization performance was measured on 21 hearing-impaired listeners when wearing no hearing aids and aided with no directionality, partial (from 1 and 2 kHz) directionality, and full directionality. The test schemes were also evaluated in everyday life. Without hearing aids, localization accuracy was significantly poorer than normative data. Due to inaudibility of high-frequency energy, front/back reversals were prominent. Front/back reversals remained prominent when aided with omnidirectional microphones. For stimuli with low-frequency emphasis, directionality had no further effect on localization. For stimuli with sufficient mid- and high-frequency information, full directionality had a small positive effect on front/back localization but a negative effect on left/right localization. Partial directionality further improved front/back localization and had no significant effect on left/right localization. The field test revealed no significant effects. The alternative spectral cues provided by frequency-dependent directionality improve front/back localization in hearing-aid users.

from the International Journal of Audiology

Peer-mediated naturalistic teaching, both with and without a speech-generating device, has transient effect on communicative behaviors in preschool children with autism spectrum disorders

No abstract available.

from Evidence-Based Communication Assessment and Intervention

Teaching evidence-based practice to speech and language therapy students in the United Kingdom

We outline three ways in which evidence-based practice (EBP) is formally embedded into the curricula for pre-registration Speech and Language Therapy students and experienced Speech and Language Therapists at Newcastle University in the United Kingdom. We describe key features of an undergraduate module, an undergraduate clinical placement, and a new Master’s degree program, each aimed at encouraging critical thinking and clinical problem-solving skills in students.

from Evidence-Based Communication Assessment and Intervention

An Auditory Illusion of Infinite Tempo Change Based on Multiple Temporal Levels

Humans and a few select insect and reptile species synchronise inter-individual behaviour without any time lag by predicting the time of future events rather than reacting to them. This is evident in music performance, dance, and drill. Although repetition of equal time intervals (i.e. isochrony) is the central principle for such prediction, this simple information is used in a flexible and complex way that accommodates both multiples, subdivisions, and gradual changes of intervals. The scope of this flexibility remains largely uncharted, and the underlying mechanisms are a matter for speculation. Here I report an auditory illusion that highlights some aspects of this behaviour and that provides a powerful tool for its future study. A sound pattern is described that affords multiple alternative and concurrent rates of recurrence (temporal levels). An algorithm that systematically controls time intervals and the relative loudness among these levels creates an illusion that the perceived rate speeds up or slows down infinitely. Human participants synchronised hand movements with their perceived rate of events, and exhibited a change in their movement rate that was several times larger than the physical change in the sound pattern. The illusion demonstrates the duality between the external signal and the internal predictive process, such that people’s tendency to follow their own subjective pulse overrides the overall properties of the stimulus pattern. Furthermore, accurate synchronisation with sounds separated by more than 8 s demonstrate that multiple temporal levels are employed for facilitating temporal organisation and integration by the human brain. A number of applications of the illusion and the stimulus pattern are suggested.

from PLoS ONE

Improving the outcome of infants born at less than 30 weeks of gestation – a randomized controlled trial of preventative care at home

Early developmental interventions to prevent the high rate of neurodevelopmental problems in very preterm children, including cognitive, motor and behavioral impairments, are urgently needed. These interventions should be multi-faceted and include modules for caregivers given their high rates of mental health problems. Method/ Design: We have designed a randomized controlled trial to assess the effectiveness of a preventative care program delivered at home over the first 12 months of life for infants born very preterm (<30 weeks of gestational age) and their families, compared with standard medical follow-up. The aim of the program, delivered over nine sessions by a team comprising a physiotherapist and psychologist, is to improve infant development (cognitive, motor and language), behavioral regulation, caregiver-child interactions and caregiver mental health at 24 months' corrected age. The infants will be stratified by severity of brain white matter injury (assessed by magnetic resonance imaging) at term equivalent age, and then randomized. At 12 months' corrected age interim outcome measures will include motor development assessed using the Alberta Infant Motor Scale and the Neurological Sensory Motor Developmental Assessment. Caregivers will also complete a questionnaire at this time to obtain information on behavior, parenting, caregiver mental health, and social support. The primary outcomes are at 24 months' corrected age and include cognitive, motor and language development assessed with the Bayley Scales of Infant and Toddler Development (Bayley-III). Secondary outcomes at 24 months include caregiver-child interaction measured using an observational task, and infant behavior, parenting, caregiver mental health and social support measured via standardized parental questionnaires.

from BMC Pediatrics

3 Ounces Is All You Need

Accurate screening of individuals who are at risk for oropharyngeal dysphagia is critically important because of the negative outcomes associated with the disorder. This article provides a review of a recently published study in which results of the 3-ounce water swallow test were compared with results of instrumental dysphagia testing. Clinical implications are discussed.

Creating a Swallow Screening Program at Mass General Hospital: A Model for Development and Implementation

The Massachusetts General Hospital-Swallow Screening Tool (MGH-SST) is a two-part dysphagia screening tool for use by trained staff working with acute neuroscience patients. It was developed in 2004 for use on our neuroscience inpatient units using factors sensitive to aspiration risk. The MGH-SST provides early detection of those at risk for aspiration, guides the decision whether a patient can safely eat or drink, and acts as a trigger for appropriate speech–language pathology (SLP) consult for a comprehensive swallow evaluation. A staff education module was developed including a training video with clinical examples to simulate disordered clinical features, as well as a competency assessment. The MGH-SST was validated using trained nurses with patients with a broad range of neurological and neurosurgical injuries, comparing the MGH-SST results to an instrumental dysphagia assessment, fiberoptic endoscopic evaluation of swallowing (FEES). It was found to be a valid and effective screening to identify patients at risk for dysphagia. Elements critical to the success of a dysphagia screening program include multi-disciplinary collaboration, administrative support, comprehensive training to ensure reliable and consistent administration, and continuous performance measurements.

from Perspectives on Swallowing and Swallowing Disorders (Dysphagia)