Blog Archives

Speech perception in noise: Exploring the effect of linguistic context in children with and without auditory processing disorder

Conclusion: Further study using a larger sample is warranted to deepen our understanding of the nature of APD and identify characteristic profiles to enable better tailoring of therapeutic programs

from the International Journal of Audiology

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Comparison of fluctuating maskers for speech recognition tests

Objective: To investigate the extent to which temporal gaps, temporal fine structure, and comprehensibility of the masker affect masking strength in speech recognition experiments. Design: Seven different masker types with Dutch speech materials were evaluated. Amongst these maskers were the ICRA-5 fluctuating noise, the international speech test signal (ISTS), and competing talkers in Dutch and Swedish. Study Sample: Normal-hearing and hearing-impaired subjects. Results: The normal-hearing subjects benefited from both temporal gaps and temporal fine structure in the fluctuating maskers. When the competing talker was comprehensible, performance decreased. The ISTS masker appeared to cause a large informational masking component. The stationary maskers yielded the steepest slopes of the psychometric function, followed by the modulated noises, followed by the competing talkers. Although the hearing-impaired group was heterogeneous, their data showed similar tendencies, but sometimes to a lesser extent, depending on individuals’ hearing impairment. Conclusions: If measurement time is of primary concern non-modulated maskers are advised. If it is useful to assess release of masking by the use of temporal gaps, a fluctuating noise is advised. If perception of temporal fine structure is being investigated, a foreign-language competing talker is advised.

from the International Journal of Audiology

Long term hearing degeneration after platinum-based chemotherapy in childhood

The aim of this study was to investigate long-term development of hearing in subjects who had received platinum-based chemotherapy in childhood or adolescence. Another aim was to assess the self-reported hearing loss handicap and compare it to audiometric measurements. Medical records from individuals diagnosed with childhood cancer and treated with platinum-based chemotherapy between 1985 and 2000 at the University Hospital in Lund Sweden were reviewed retrospectively. Fifteen subjects, who fulfilled the eligibility criteria set for the study, underwent a thorough audiometric evaluation. The results show that the hearing loss, in subjects with ototoxicity had increased after the end of treatment, to include also the lower frequencies. The largest deterioration in hearing thresholds, up to 55 dB HL, was found at frequencies above 2 kHz. The findings also reveal that the subjects have a considerably greater hearing loss handicap and disability than would be expected from the results of the audiometric evaluations. The conclusion of this study is that children and adolescence treated with platinum-based chemotherapy should have regular audiometric follow-up examinations, also many years after the end of treatment. Furthermore, assessments of self-reported hearing disability should be made during and after chemotherapy.

from the International Journal of Audiology

Older adults’ performance on the speech, spatial, and qualities of hearing scale (SSQ): Test-retest reliability and a comparison of interview and self-administration methods

The purposes of the study were to examine the test-retest properties of the speech, spatial, and qualities of hearing scale (SSQ) and to determine if the method of test administration affected these properties. Four groups of 40 older adult participants completed the SSQ twice at an interval of about a half year, using either the same or different administration methods at the two test times. The SSQ was administered using an interview method and/or it was self-administered and then returned by mail. Although the method of test administration did not systematically affect scores on the SSQ, the highest test-retest correlation (r = 0.83) was observed using the interview method at both test times, making it the best choice for the purpose of demonstrating the effectiveness of interventions. The other three combinations of dual-administration in this study also provided reliable results and may be preferable because the self-administration method is less time-consuming and labour-intensive. In conclusion, both the interview and self-administration methods are recommended, but with the best choice depending on the goals of the tester.

from the International Journal of Audiology

Studying tinnitus in the ICF framework

Activity limitation and participation restriction (AL/PR) on account of tinnitus was studied in the ICF framework in order to understand how tinnitus restricts individuals from fulfilling social and economic obligations. The objective of the study was to study the impact of tinnitus in the framework of ICF. Twenty-one adults in the age range of 20–60 years with chronic tinnitus (>3 months) and with normal hearing sensitivity were included in the study. THI was mapped to the framework of ICF. Twenty out of twenty-five items belonged to the domains under body function and five items addressed AL/PR. Five more AL/PR items applicable to tinnitus were added to THI. The THI+ICF questionnaire tested well on test reliability (0.987) and internal consistency (0.873). Body function was significantly more affected than AL/PR (P = 0.0005). These results suggest that tinnitus does not result in significant AL/PR from the ICF perspective. Further, psycho-acoustic characteristics such as intensity, frequency of tinnitus, and time since onset of tinnitus have only minimal if any impact on AL/PR.

from the International Journal of Audiology

Perception of speech with envelope enhancement in individuals with auditory neuropathy and simulated loss of temporal modulation processing

Individuals with auditory neuropathy (AN) often suffer from temporal processing deficits causing speech perception difficulties. In the present study an envelope enhancement scheme that incorporated envelope expansion was used to reduce the effects of temporal deficits. The study involved two experiments. In the first experiment, to simulate the effects of reduced temporal resolution, temporally smeared speech stimuli were presented to listeners with normal hearing. The results revealed that temporal smearing of the speech signal reduced identification scores. With the envelope enhancement of the speech signal prior to being temporally smeared, identification scores improved significantly compared to temporally smeared condition. The second experiment assessed speech perception in twelve individuals with AN, using unprocessed and envelope-enhanced speech signals. The results revealed improvement in speech identification scores for the majority of individuals with AN when the envelope of the speech signal was enhanced. However, envelope enhancement was not able to improve speech identification scores for individuals with AN who had very poor unprocessed speech scores. Overall, the results of the present study suggest that applying envelope enhancement strategies in hearing aids might provide some benefits to many individuals with AN.

from the International Journal of Audiology

Cognitive development in children with cochlear implants: Relations to reading and communication

The purpose of the present article is to present an overview of a set of studies conducted in our own laboratory on cognitive and communicative development in children with cochlear implants (CI). The results demonstrate that children with CIs perform at significantly lower levels on the majority of the cognitive tasks. The exceptions to this trend are tasks with relatively lower demands on phonological processing. A fairly high proportion of the children can reach a level of reading comprehension that matches hearing children, despite the fact that they have relatively poor phonological skills. General working memory capacity is further correlated with the type of questions asked in a referential communication task. The results are discussed with respect to issues related to education and rehabilitation.

from the International Journal of Audiology

Understanding tinnitus distress: Introducing the concepts of moderators and mediators

We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work.

from the International Journal of Audiology

Are individual differences in speech reception related to individual differences in cognitive ability? A survey of twenty experimental studies with normal and hearing-impaired adults

This paper summarizes twenty studies, published since 1989, that have measured experimentally the relationship between speech recognition in noise and some aspect of cognition, using statistical techniques such as correlation or factor analysis. The results demonstrate that there is a link, but it is secondary to the predictive effects of hearing loss, and it is somewhat mixed across study. No one cognitive test always gave a significant result, but measures of working memory (especially reading span) were mostly effective, whereas measures of general ability, such as IQ, were mostly ineffective. Some of the studies included aided listening, and two reported the benefits from aided listening: again mixed results were found, and in some circumstances cognition was a useful predictor of hearing-aid benefit.

from the International Journal of Audiology

Cognitive development in children with cochlear implants: Relations to reading and communication

The purpose of the present article is to present an overview of a set of studies conducted in our own laboratory on cognitive and communicative development in children with cochlear implants (CI). The results demonstrate that children with CIs perform at significantly lower levels on the majority of the cognitive tasks. The exceptions to this trend are tasks with relatively lower demands on phonological processing. A fairly high proportion of the children can reach a level of reading comprehension that matches hearing children, despite the fact that they have relatively poor phonological skills. General working memory capacity is further correlated with the type of questions asked in a referential communication task. The results are discussed with respect to issues related to education and rehabilitation.

from the International Journal of Audiology

Towards understanding the specifics of cochlear hearing loss: A modelling approach

It is well known that two patients suffering from a sensorineural hearing loss with similar audiograms can benefit significantly differently from amplified hearing even if the same settings of the hearing aids are used. The origin of this problem is complex but one part can be caused by the diagnosis itself; all inner-ear hearing losses are assumed similar. Such hypothesis is a simplification that probably leads to suboptimal hearing-aid fitting. For a better understanding of the signal degeneration caused by a cochlear lesion a model layout of the signal transmission in the peripheral hearing organ is presented. This model differentiates between processes in the inner ear caused by the outer hair cells, the inner hair cells, and the endocochlear potential driving the system. The model is intended to predict alteration of the signal caused by different types of cochlear lesions. Ultimately, the model may lead to improved hearing aids and fittings.

from the International Journal of Audiology

Understanding tinnitus distress: Introducing the concepts of moderators and mediators

We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work.

from the International Journal of Audiology