Auditory processing deficits are sometimes necessary and sometimes sufficient for language difficulties in children: Evidence from mild to moderate sensorineural hearing loss

Background: The ability to use interaural cues to segregate target speech from competing signals allows people with normal hearing to understand speech at significantly poorer signal-to-noise ratios. This ability, referred to as spatial processing ability or spatial release from masking, has been shown to be deficient in people with a sensorineural hearing loss even after amplification is applied. Spatial processing deficits in a population of children with auditory processing deficits have been found to be remediable through the use of a deficit-specific auditory training program called the LiSN & Learn. Purpose: The aim of the present study was to determine whether LiSN & Learn auditory training could improve the spatial processing ability of hearing-impaired adults and children. In addition, the research investigated whether the age of the participant would affect the efficacy of the training program. Research Design: In a repeated-measures design, participants’ spatial processing ability was assessed pretraining and posttraining using the Listening in Spatialized Noise-Sentences Test (LiSN-S). Questionnaire responses were also collected from participants pretraining and posttraining to provide a subjective measure of real-life listening difficulty. Between the two assessment periods, participants were asked to train with the LiSN & Learn for 15 min per day, 5 days per week for 60 training sessions. Study Sample: Participants were five children (aged 6–11 yr) and five adults (aged 60–74 yr) with up to a moderate sensorineural hearing loss. Data Collection and Analysis: The LiSN & Learn auditory training software incorporates five computer games in which target sentences, processed with head-related transfer functions, are perceived as coming from 0° azimuth, and simultaneous distracting speech streams are perceived as coming from ±90° azimuth. Participants are tasked with identifying a word from the target sentence and selecting the corresponding picture from a selection of four images displayed on the screen. The signal-to-noise ratio is adapted based on whether the response given is correct or incorrect. Results: Despite an average improvement of 10 dB on the LiSN & Learn training program, no significant improvements were seen posttraining in either of the spatially separated conditions of the LiSN-S (p ranging 0.47–0.75). A 1.2 dB improvement was found in the baseline condition of the LiSN-S, which incorporates no spatial separation between distracter and target stimuli (p < 0.01). Age did not significantly affect training outcomes (p = 0.21). No significant improvements were found posttraining on the self-report questionnaires (p = 0.84 and p = 0.20). Conclusions: This study has demonstrated that LiSN & Learn training does not significantly improve spatial processing deficits in adults or children with a sensorineural hearing loss. As auditory training did not prove to be effective, further research should be directed toward the development of hearing aid processing schemes that will compensate for the degraded interaural time difference and interaural level difference cues which underpin spatial processing.

Download Full-text

Towards personalized auditory models: predicting individual sensorineural-hearing-loss profiles from recorded human auditory physiology

10.1101/2020.11.17.387001 ◽

2020 ◽

Author(s):

Sarineh Keshishzadeh ◽

Markus Garrett ◽

Sarah Verhulst

Keyword(s):

Hearing Loss ◽

Hair Cell ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Auditory Evoked Potential ◽

Sensorineural Hearing ◽

Model Parameters ◽

Non Invasive ◽

Auditory Models ◽

Auditory Physiology

AbstractOver the past decades, different types of auditory models have been developed to study the functioning of normal and impaired auditory processing. Several models can simulate frequency-dependent sensorineural hearing loss (SNHL), and can in this way be used to develop personalized audio-signal processing for hearing aids. However, to determine individualized SNHL profiles, we rely on indirect and non-invasive markers of cochlear and auditory-nerve (AN) damage. Our progressive knowledge of the functional aspects of different SNHL subtypes stresses the importance of incorporating them into the simulated SNHL profile, but has at the same time complicated the task of accomplishing this on the basis of non-invasive markers. In particular, different auditory evoked potential (AEP) types can show a different sensitivity to outer-hair-cell (OHC), inner-hair-cell (IHC) or AN damage, but it is not clear which AEP-derived metric is best suited to develop personalized auditory models. This study investigates how simulated and recorded AEPs can be used to derive individual AN- or OHC-damage patterns and personalize auditory processing models. First, we individualized the cochlear-model parameters using common methods of frequency-specific OHC-damage quantification, after which we simulated AEPs for different degrees of AN-damage. Using a classification technique, we determined the recorded AEP metric that best predicted the simulated individualized CS profiles. We cross-validated our method using the dataset at hand, but also applied the trained classifier to recorded AEPs from a new cohort to illustrate the generalisability of the method.

Download Full-text

Chapter 26 AUDITORY PROCESSING IN SENSORINEURAL HEARING LOSS

Otolaryngology ◽

10.1055/b-0034-56027 ◽

2006 ◽

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Sensorineural Hearing

Download Full-text

Detailed Audiological Evaluation of a Patient with Xeroderma Pigmentosum with Neural Degeneration

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15112 ◽

2017 ◽

Vol 28 (01) ◽

pp. 080-090

Author(s):

Danielle Mercer ◽

Annette Hurley ◽

Fern Tsien

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Xeroderma Pigmentosum ◽

Genetic Disorder ◽

Sensorineural Hearing ◽

Central Component ◽

Neural Degeneration ◽

Hearing Sensitivity ◽

Charcot Marie Tooth Disease

AbstractXeroderma pigmentosum (XP) is a rare autosomal recessive condition characterized by extreme sensitivity to ultraviolet light. Individuals with XP lack the ability to repair DNA (deoxyribonucleic acid) damage caused by ultraviolet radiation, leading to sunburn and increased susceptibility to skin cancers. Approximately 25% of patients also exhibit neural degeneration, which includes progressive mental deterioration, cortical thinning, and sensorineural hearing loss.Herein, we describe the audiological and genetic findings in a patient with XP subtype D with neural degeneration and hearing loss.This is a case report of a patient with XP subtype D, type 1 diabetes, and some clinical features typical of Charcot-Marie-Tooth disease.We obtained audiological evaluations over a course of 11 yr, including serial audiograms, auditory processing disorders evaluations, and electrophysiological testing.Hearing sensitivity has progressed from a unilateral mild high-frequency sensorineural hearing loss to a bilateral sloping moderate to severe/profound sensorineural hearing loss. In addition to the dramatic decline in hearing sensitivity, the patient demonstrates global auditory processing deficits, indicating a central component to his hearing loss.These findings emphasize the importance of the contribution of audiological evaluations to the diagnosis of a genetic disorder. Periodic evaluations of hearing sensitivity and auditory processing can provide information on disease progression in patients with XP with neural degeneration.

Download Full-text

Characterizing auditory processing and perception in individual listeners with sensorineural hearing loss

The Journal of the Acoustical Society of America ◽

10.1121/1.3518768 ◽

2011 ◽

Vol 129 (1) ◽

pp. 262-281 ◽

Cited By ~ 33

Author(s):

Morten L. Jepsen ◽

Torsten Dau

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Sensorineural Hearing

Download Full-text

Impaired sensitivity to temporal fine structure but not the envelope for children with mild-to-moderate sensorineural hearing loss

10.31234/osf.io/h9x3p ◽

2019 ◽

Author(s):

Lorna Halliday ◽

Stuart Rosen ◽

Outi Tuomainen ◽

Axelle Calcus

Keyword(s):

Hearing Loss ◽

Fine Structure ◽

Sensorineural Hearing Loss ◽

Hearing Aids ◽

Auditory Processing ◽

Maternal Education ◽

Frequency Selectivity ◽

Sensorineural Hearing ◽

Temporal Fine Structure ◽

Speech Discrimination

Psychophysical thresholds were measured for 8-16 year-old children with mild-to-moderate sensorineural hearing loss (MMHL; N = 46) on a battery of auditory processing tasks that included measures designed to be predominantly reliant upon frequency selectivity, and sensitivity to temporal fine structure (TFS) or envelope cues. Children with MMHL who wore hearing aids were tested in both unaided and aided conditions, and all were compared to a group of normally hearing (NH) age-matched controls. Children with MMHL performed more poorly than NH controls on tasks considered to be dependent upon frequency selectivity, sensitivity to TFS, and speech discrimination (/bɑ/-/dɑ/), but not on tasks measuring sensitivity to envelope cues. Auditory processing deficits remained regardless of age, were observed in both unaided and aided conditions, and could not be attributed to differences in nonverbal IQ or attention between groups. However, better auditory processing for children with MMHL was predicted by better audiometric thresholds and, for aided tasks only, higher levels of maternal education. These results suggest that, as for adults with MMHL, children with MMHL may show deficits in their frequency selectivity and sensitivity to TFS, but that sensitivity to envelope cues may remain intact.

Download Full-text

Towards Personalized Auditory Models: Predicting Individual Sensorineural Hearing-Loss Profiles From Recorded Human Auditory Physiology

Trends in Hearing ◽

10.1177/2331216520988406 ◽

2021 ◽

Vol 25 ◽

pp. 233121652098840 ◽

Cited By ~ 1

Author(s):

Sarineh Keshishzadeh ◽

Markus Garrett ◽

Sarah Verhulst

Keyword(s):

Hearing Loss ◽

Hair Cell ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Auditory Evoked Potential ◽

Sensorineural Hearing ◽

Model Parameters ◽

Auditory Models ◽

Auditory Physiology ◽

Noninvasive Markers

Over the past decades, different types of auditory models have been developed to study the functioning of normal and impaired auditory processing. Several models can simulate frequency-dependent sensorineural hearing loss (SNHL) and can in this way be used to develop personalized audio-signal processing for hearing aids. However, to determine individualized SNHL profiles, we rely on indirect and noninvasive markers of cochlear and auditory-nerve (AN) damage. Our progressive knowledge of the functional aspects of different SNHL subtypes stresses the importance of incorporating them into the simulated SNHL profile, but has at the same time complicated the task of accomplishing this on the basis of noninvasive markers. In particular, different auditory-evoked potential (AEP) types can show a different sensitivity to outer-hair-cell (OHC), inner-hair-cell (IHC), or AN damage, but it is not clear which AEP-derived metric is best suited to develop personalized auditory models. This study investigates how simulated and recorded AEPs can be used to derive individual AN- or OHC-damage patterns and personalize auditory processing models. First, we individualized the cochlear model parameters using common methods of frequency-specific OHC-damage quantification, after which we simulated AEPs for different degrees of AN damage. Using a classification technique, we determined the recorded AEP metric that best predicted the simulated individualized cochlear synaptopathy profiles. We cross-validated our method using the data set at hand, but also applied the trained classifier to recorded AEPs from a new cohort to illustrate the generalizability of the method.

Download Full-text

The Effect of Mild Hearing Impairment on Auditory Processing Tests

Journal of the American Academy of Audiology ◽

10.3766/jaaa.15.1.3 ◽

2004 ◽

Vol 15 (01) ◽

pp. 006-016 ◽

Cited By ~ 17

Author(s):

Karin Neijenhuis ◽

Hans Tschur ◽

Ad Snik

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Auditory Processing ◽

Test Battery ◽

Sensorineural Hearing ◽

Central Auditory Processing ◽

Central Auditory Processing Disorders ◽

Presentation Level ◽

Speech Reception ◽

Filtered Speech

The application of auditory processing tests to patients with sensorineural hearing loss is controversial. Several studies have shown that it is difficult to separate peripheral from central hearing processes. In the present study, a Dutch auditory processing test battery was administered to 24 subjects with mild, relatively flat, symmetrical sensorineural hearing loss. Tests were administered twice; the second time, the presentation level in four out of the six tests was adjusted according to the speech reception threshold. The scores of the hearing-impaired subjects were significantly poorer than those of the subjects with normal hearing on five out of the six tests, even with the adjusted presentation level. Significant correlations were found between test scores and PTA (pure-tone average); scores on words-in-noise, filtered-speech and binaural-fusion tests were additionally corrected according to PTA. In contrast to previous studies in the literature, the present dichotic-digit and pattern-recognition tests were greatly influenced by mild hearing loss. Therefore, this auditory processing test battery cannot readily be used to diagnose central auditory processing disorders in patients with flat sensorineural hearing loss. At least, both adjustment of presentation level and additional correction are needed.

Download Full-text

Representation of speech in noise in the aging midbrain and cortex: aging may dominate over hearing-loss

10.1101/212159 ◽

2017 ◽

Author(s):

Alessandro Presacco ◽

Jonathan Z. Simon ◽

Samira Anderson

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Temporal Processing ◽

Normal Hearing ◽

Sensorineural Hearing ◽

Speech In Noise ◽

Age Related ◽

Cortical Responses ◽

Processing Deficits

ABSTRACTObjectiveTo understand the effect of peripheral hearing loss on the representation of speech in noise in the aging midbrain and cortex.MethodsSubjects comprised 17 normal-hearing younger adults, 15 normal-hearing older adults and 14 hearing-impaired older adults. The midbrain response, measured with Frequency-Following Responses (FFRs), and the cortical response, measured with magnetoencephalography (MEG) responses, were recorded from subjects listening to speech in quiet and noise at varying signal to noise ratios (SNRs).ResultsBoth groups of older listeners showed both weaker midbrain response amplitudes and overrepresentation of cortical responses compared to younger listeners. However, significant differences between the older groups were found in both midbrain-cortex relationships and in cortical processing durations, suggesting that hearing loss may alter reciprocal connections between lower and higher levels of the auditory pathway.ConclusionsThe paucity of differences in midbrain or cortical responses between the two older groups suggest that age-related temporal processing deficits may contribute to older adults’ communication difficulties beyond what might be predicted from peripheral hearing loss alone.SignificanceClinical devices, such as hearing aids, should not ignore age-related temporal processing deficits in the design of algorithms to maximize user benefit.HIGHLIGHTSMild sensorineural hearing loss does not appear to significantly exacerbate already appreciable age-related deficits in midbrain speech-in-noise encoding.Mild sensorineural hearing loss also does not appear to significantly exacerbate already appreciable age-related deficits in most measures of cortical speech-in-noise encoding.Central processing deficits caused by peripheral hearing loss in older adults are seen only in more subtle measures, including altered relationships between midbrain and cortex.

Download Full-text