The Effect of Presentation Level on the SCAN-3 in Children and Adults

2018 ◽  
Vol 27 (2) ◽  
pp. 238-245 ◽  
Author(s):  
Tina M. Stoody ◽  
Chelsea E. Cottrell
Keyword(s):  
Auditory Processing ◽  
Normal Hearing ◽  
Stimulus Level ◽  
Effect Sizes ◽  
Order Effects ◽  
Hearing Sensitivity ◽  
Presentation Level ◽  
Normal Limits ◽  
Test Order ◽  
Composite Scores

PurposeThe pediatric and adult versions of the SCAN-3 test (Keith, 2009a, 2009b) are widely used to screen and diagnose auditory processing disorders. According to the instruction manual, the test administration is flexible in that it may be administered through an audiometer at 50 dB HL or a portable CD player at the patient or administrator's most comfortable listening level (MCL). Because MCL may vary across individuals, even in those with normal hearing sensitivity, this study explored whether the presentation level affected scores on the SCAN-3 for both pediatric and adult populations.MethodTwenty-two young adults and 23 children with normal hearing sensitivity and middle ear function were administered the SCAN-3 three different times at 1-month intervals, at 40, 50, and 60 dB HL. The stimulus level of the SCAN-3 was counterbalanced across participants to eliminate test order effects. In addition, MCL was measured in the pediatric participants during each session.ResultsMCL varied significantly across children as well as between test sessions, ranging from 40 to 75 dB HL. Performance on 3 of the 4 subtests administered, as well as composite scores, was significantly different across presentation levels (based on scaled scores). Effect sizes were also calculated and found to be strong. The number of composite scores interpreted as within normal limits versus borderline or disordered was also statistically different across presentation levels.ConclusionsPresentation level appears to affect performance on auditory figure ground, monaural low-redundancy, and binaural integration types of auditory processing tasks that are measured by the SCAN-3. In children, MCL was found to vary significantly both between and within individuals. Although several professions outside audiology are qualified to administer the SCAN-3, it is likely that many of these individuals administer the test without an audiometer and would use an MCL to determine presentation level. It is recommended that SCAN-3 users administer the test through an audiometer at 50 dB HL, rather than with a portable CD player, using MCL values to avoid any presentation level effects.

Effects of Test Order on Most Comfortable and Uncomfortable Loudness Levels for Speech

2004 ◽  
Vol 13 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Jerry Punch ◽  
Brad Rakerd ◽  
Antony Joseph
Keyword(s):  
Order Effect ◽  
Normal Hearing ◽  
Order Effects ◽  
Test Order ◽  
Group 2 ◽  
Comfortable Loudness ◽  
Group 1 ◽  
Temporal Spacing

This study examined test-order effects on most comfortable loudness (MCL) and uncomfortable loudness (UCL) levels for spondaic words in 2 groups of 30 normal hearing listeners each. For Group 1, MCL was measured first, followed by UCL. For Group 2, UCL was measured first, and then MCL. A retest was conducted for both groups. Results showed that MCL was significantly elevated for Group 2, but not for Group 1. There was no effect on UCL for either group. In a follow-up experiment, the magnitude of the test-order effect on MCL increased significantly when MCL measurements followed UCL measurements closely in time. These results argue for management of the ordering and temporal spacing of MCL and UCL testing in clinical loudness measurements.

Fitting and Verification of Frequency Modulation Systems on Children with Normal Hearing

2014 ◽  
Vol 25 (06) ◽  
pp. 529-540 ◽  
Author(s):  
Erin C. Schafer ◽  
Danielle Bryant ◽  
Katie Sanders ◽  
Nicole Baldus ◽  
Katherine Algier ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Frequency Modulation ◽  
Auditory Processing ◽  
Signal To Noise Ratio ◽  
Recognition Performance ◽  
Normal Hearing ◽  
Signal To Noise ◽  
The Real ◽  
Hearing Sensitivity ◽  
Speech Recognition In Noise

Background: Several recent investigations support the use of frequency modulation (FM) systems in children with normal hearing and auditory processing or listening disorders such as those diagnosed with auditory processing disorders, autism spectrum disorders, attention-deficit hyperactivity disorder, Friedreich ataxia, and dyslexia. The American Academy of Audiology (AAA) published suggested procedures, but these guidelines do not cite research evidence to support the validity of the recommended procedures for fitting and verifying nonoccluding open-ear FM systems on children with normal hearing. Documenting the validity of these fitting procedures is critical to maximize the potential FM-system benefit in the abovementioned populations of children with normal hearing and those with auditory-listening problems. Purpose: The primary goal of this investigation was to determine the validity of the AAA real-ear approach to fitting FM systems on children with normal hearing. The secondary goal of this study was to examine speech-recognition performance in noise and loudness ratings without and with FM systems in children with normal hearing sensitivity. Research Design: A two-group, cross-sectional design was used in the present study. Study Sample: Twenty-six typically functioning children, ages 5–12 yr, with normal hearing sensitivity participated in the study. Intervention: Participants used a nonoccluding open-ear FM receiver during laboratory-based testing. Data Collection and Analysis: Participants completed three laboratory tests: (1) real-ear measures, (2) speech recognition performance in noise, and (3) loudness ratings. Four real-ear measures were conducted to (1) verify that measured output met prescribed-gain targets across the 1000–4000 Hz frequency range for speech stimuli, (2) confirm that the FM-receiver volume did not exceed predicted uncomfortable loudness levels, and (3 and 4) measure changes to the real-ear unaided response when placing the FM receiver in the child’s ear. After completion of the fitting, speech recognition in noise at a –5 signal-to-noise ratio and loudness ratings at a +5 signal-to-noise ratio were measured in four conditions: (1) no FM system, (2) FM receiver on the right ear, (3) FM receiver on the left ear, and (4) bilateral FM system. Results: The results of this study suggested that the slightly modified AAA real-ear measurement procedures resulted in a valid fitting of one FM system on children with normal hearing. On average, prescriptive targets were met for 1000, 2000, 3000, and 4000 Hz within 3 dB, and maximum output of the FM system never exceeded and was significantly lower than predicted uncomfortable loudness levels for the children. There was a minimal change in the real-ear unaided response when the open-ear FM receiver was placed into the ear. Use of the FM system on one or both ears resulted in significantly better speech recognition in noise relative to a no-FM condition, and the unilateral and bilateral FM receivers resulted in a comfortably loud signal when listening in background noise. Conclusions: Real-ear measures are critical for obtaining an appropriate fit of an FM system on children with normal hearing.

Age-Dependent Changes in Temporal-Fine-Structure Processing in the Absence of Peripheral Hearing Loss

2013 ◽  
Vol 22 (2) ◽  
pp. 313-315 ◽  
Author(s):  
Christian Füllgrabe
Keyword(s):  
Fine Structure ◽  
Auditory Processing ◽  
Normal Hearing ◽  
Point Of View ◽  
Temporal Fine Structure ◽  
Cross Sectional ◽  
Hearing Sensitivity ◽  
Clinically Normal ◽  
Processing Abilities ◽  
Cross Sectional Design

Purpose In this study, the author sought to investigate if and when the ability to process temporal-fine-structure (TFS) cues deteriorates with age in adults with audiometrically normal hearing sensitivity. Method Using a cross-sectional design, the author assessed TFS sensitivity in 102 normal-hearing adults sampled from across the entire range of adulthood (ages 18–90 years), using 2 psychophysical tests for the assessment of within- and across-ear TFS processing. Results Both types of TFS sensitivity (monaural and binaural) declined gradually starting in young adulthood, with the earliest significant deficit already apparent in early midlife (i.e., between ages 40 and 49 years). TFS sensitivity was not correlated with absolute sensitivity at the test frequency. Conclusions Some suprathreshold auditory processing abilities decline throughout adulthood, even when an individual's peripheral hearing is clinically normal. These deficits are not captured by a conventional, audiometric hearing assessment but may contribute to the increasing difficulties with age to identify speech in noisy environments. From a methodological point of view, the existence of such age effects warrants the use of age-matched participant groups when comparing normal and impaired peripheral hearing.

Mild-Gain Hearing Aids as a Treatment for Adults with Self-Reported Hearing Difficulties

2018 ◽  
Vol 29 (06) ◽  
pp. 477-494 ◽  
Author(s):  
Christina M. Roup ◽  
Emily Post ◽  
Jessica Lewis
Keyword(s):  
Hearing Aids ◽  
Auditory Processing ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Control Group ◽  
Hearing Sensitivity ◽  
Speech In Noise ◽  
Hearing Handicap ◽  
Noise Test ◽  
And Performance

AbstractThere is a growing body of evidence demonstrating self-reported hearing difficulties (HD; i.e., substantial difficulty in understanding speech in complex listening situations) in adults with normal pure-tone sensitivity. Anecdotally, some audiologists have tried personal mild-gain amplification as a treatment option for adults with HD. In 2008, Kuk and colleagues reported positive results of a mild-gain hearing aid trial for children with auditory processing disorders. To date, however, there have been no studies investigating the benefit of mild-gain amplification to treat HD in adults with normal audiograms.The effectiveness of a four-week trial with mild-gain amplification for adults with self-reported HD and clinically normal hearing sensitivity was investigated.Two participant groups with normal pure-tone audiograms (thresholds ≤20 dB HL 250–8000 Hz) were recruited to study the effects of self-reported HD on hearing handicap, self-perceived auditory processing difficulties, and performance on a speech-in-noise task. Furthermore, the benefit of mild-gain amplification was examined after a four-week hearing aid trial on self-perceived hearing handicap and auditory processing difficulties, and performance on an aided speech-in-noise task. Effects were analyzed using a mixed-model repeated measures analysis of variance. Posthoc analyses were performed for each significant main effect.Thirty-nine participants participated in two groups. Twenty normal hearing adults (19–27 yr) without complaints of HD were recruited as a control group. Nineteen normal hearing adults (18–58 yr) with self-reported HD were recruited for the mild-gain hearing aid trial.Subjective complaints of HD were assessed with two questionnaires (the Hearing Handicap Inventory for Adults [HHIA] and the Auditory Processing Questionnaire [APQ]) and an auditory processing test battery (SCAN:3-A, dichotic digit recognition, gaps-in-noise test, and the 500-Hz masking level difference). Speech-in-noise abilities were assessed before and after hearing aid trial using the Revised Speech Perception in Noise Test (R-SPIN) at multiple signal-to-noise ratios. Hearing aid use and impressions during the hearing aid trial were recorded.Results demonstrated that participants with HD perceived significantly greater hearing handicap (HHIA) and greater self-perceived auditory processing difficulties (APQ) than the control group. Participants with HD performed significantly poorer on the R-SPIN relative to controls, especially for low-predictability items. Results of the hearing aid trial for participants with HD revealed significant improvements in hearing handicap, self-perceived auditory processing difficulties, and speech-in-noise performance relative to prehearing aid trial measures. The hearing aids were well tolerated by the majority of participants with HD , with most of them wearing the hearing aids an average of 1–4 h per day.The results from the present study suggest that adults who present with complaints of HD even in the presence of normal hearing sensitivity represent a unique population that warrants further evaluation beyond the standard hearing test. Furthermore, results from the hearing aid trial suggest that mild-gain amplification is a viable treatment option for at least some individuals with HD.

Effects of Stimulus Presentation Level on Stop Consonant Identification in Normal-Hearing and Hearing-Impaired Listeners

2002 ◽  
Vol 13 (03) ◽  
pp. 154-159 ◽  
Author(s):  
Patrick N. Plyler ◽  
Mark S. Hedrick
Keyword(s):  
Stop Consonant ◽  
Stimulus Presentation ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Impaired Hearing ◽  
Boundary Values ◽  
Hearing Sensitivity ◽  
Speech Stimuli ◽  
Presentation Level ◽  
Boundary Shift

The purpose of the present study was to determine whether varying the presentation level of stop consonant stimuli resulted in similar phonetic boundary shifts for listeners with normal and impaired hearing. Sixteen normal-hearing and 16 hearing-impaired listeners categorized synthetic speech stimuli as /b/, /d/, or /g/. The onset frequency of F2 varied from 900 to 2300 Hz (100-Hz steps), and the presentation level varied from 92 to 62 dB SPL (10-dB steps) for each stimulus presentation. Hearing-impaired listeners had significantly more missing boundary values than normal-hearing listeners; however, the correlation between the number of missing boundary values and hearing sensitivity was not significant. Comparison of boundary shift with level demonstrated that hearing-impaired listeners had a smaller boundary shift with increasing level than normal-hearing listeners. The amount of boundary shift was not correlated with audibility. The results of the current study suggest that increasing the presentation level of a signal does not result in performance similar to that of listeners with normal hearing.

A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 738-761
Author(s):  
Tess K. Koerner ◽  
Melissa A. Papesh ◽  
Frederick J. Gallun
Keyword(s):  
Hearing Aids ◽  
Questionnaire Survey ◽  
Patient Population ◽  
Clinical Care ◽  
Normal Hearing ◽  
Auditory Training ◽  
Training Methods ◽  
Hearing Sensitivity ◽  
Considerable Benefit ◽  
High Level

Purpose A questionnaire survey was conducted to collect information from clinical audiologists about rehabilitation options for adult patients who report significant auditory difficulties despite having normal or near-normal hearing sensitivity. This work aimed to provide more information about what audiologists are currently doing in the clinic to manage auditory difficulties in this patient population and their views on the efficacy of recommended rehabilitation methods. Method A questionnaire survey containing multiple-choice and open-ended questions was developed and disseminated online. Invitations to participate were delivered via e-mail listservs and through business cards provided at annual audiology conferences. All responses were anonymous at the time of data collection. Results Responses were collected from 209 participants. The majority of participants reported seeing at least one normal-hearing patient per month who reported significant communication difficulties. However, few respondents indicated that their location had specific protocols for the treatment of these patients. Counseling was reported as the most frequent rehabilitation method, but results revealed that audiologists across various work settings are also successfully starting to fit patients with mild-gain hearing aids. Responses indicated that patient compliance with computer-based auditory training methods was regarded as low, with patients generally preferring device-based rehabilitation options. Conclusions Results from this questionnaire survey strongly suggest that audiologists frequently see normal-hearing patients who report auditory difficulties, but that few clinicians are equipped with established protocols for diagnosis and management. While many feel that mild-gain hearing aids provide considerable benefit for these patients, very little research has been conducted to date to support the use of hearing aids or other rehabilitation options for this unique patient population. This study reveals the critical need for additional research to establish evidence-based practice guidelines that will empower clinicians to provide a high level of clinical care and effective rehabilitation strategies to these patients.

scholarly journals Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shuping Sun ◽  
Michelle R. Kapolowicz ◽  
Matthew Richardson ◽  
Raju Metherate ◽  
Fan-Gang Zeng
Keyword(s):  
Frequency Modulation ◽  
Auditory Processing ◽  
Frequency Discrimination ◽  
Normal Hearing ◽  
Post Treatment ◽  
Intensity Discrimination ◽  
Modulation Identification ◽  
Baseline Performance ◽  
Auditory Performance ◽  
Pre Treatment

AbstractElectrophysiological studies show that nicotine enhances neural responses to characteristic frequency stimuli. Previous behavioral studies partially corroborate these findings in young adults, showing that nicotine selectively enhances auditory processing in difficult listening conditions. The present work extended previous work to include both young and older adults and assessed the nicotine effect on sound frequency and intensity discrimination. Hypotheses were that nicotine improves auditory performance and that the degree of improvement is inversely proportional to baseline performance. Young (19–23 years old) normal-hearing nonsmokers and elderly (61–80) nonsmokers with normal hearing between 500 and 2000 Hz received nicotine gum (6 mg) or placebo gum in a single-blind, randomized crossover design. Participants performed three experiments (frequency discrimination, frequency modulation identification, and intensity discrimination) before and after treatment. The perceptual differences were analyzed between pre- and post-treatment, as well as between post-treatment nicotine and placebo conditions as a function of pre-treatment baseline performance. Compared to pre-treatment performance, nicotine significantly improved frequency discrimination. Compared to placebo, nicotine significantly improved performance for intensity discrimination, and the improvement was more pronounced in the elderly with lower baseline performance. Nicotine had no effect on frequency modulation identification. Nicotine effects are task-dependent, reflecting possible interplays of subjects, tasks and neural mechanisms.

Effect of Realistic Test Conditions on Spectral and Temporal Processing in Normal-Hearing Listeners

2021 ◽  
Vol 30 (1) ◽  
pp. 160-169
Author(s):  
Yang-Soo Yoon ◽  
Callie Michelle Boren ◽  
Brianna Diaz
Keyword(s):  
Temporal Processing ◽  
Detection Threshold ◽  
Frequency Discrimination ◽  
Normal Hearing ◽  
Discrimination Threshold ◽  
Test Environment ◽  
Test Conditions ◽  
Significant Difference ◽  
Test Order ◽  
Pure Tones

Purpose To measure the effect of testing conditions (in the soundproof booth vs. quiet room), test order, and number of test sessions on spectral and temporal processing in normal-hearing (NH) listeners. Method Thirty-two adult NH listeners participated in the three experiments. For all three experiments, the stimuli were presented to the left ear at the subjects' most comfortable level through headphones. All tests were administered in an adaptive three-alternative forced-choice paradigm. Experiment 1 was designed to compare the effect of soundproof booth and quiet room test conditions on amplitude modulation detection threshold and modulation frequency discrimination threshold with each of the five modulation frequencies. Experiment 2 was designed to compare the effect of two test orders on the frequency discrimination thresholds under the quiet room test conditions. The thresholds were first measured in the ascending and descending order of four pure tones, and then with counterbalanced order. For Experiment 3, the amplitude discrimination threshold under the quiet room testing condition was assessed 3 times to determine the effect of the number of test sessions. Then the thresholds were compared over the sessions. Results Results showed no significant effect of test environment. The test order is an important variable for frequency discrimination, particularly between piano tunes and pure tones. Results also show no significant difference across test sessions. Conclusions These results suggest that a controlled test environment may not be required in spectral and temporal assessment for NH listeners. Under the quiet test environment, a single outcome measure is sufficient, but test orders should be counterbalanced.

scholarly journals Cognitive Restoration from Nature Across Multiple Exposure Types - A Meta-Analysis Delineating the Effects of Test Order and Affect

2018 ◽  
Author(s):  
Cecilia Stenfors ◽  
Stephen Charles Van Hedger ◽  
Kathryn E Schertz ◽  
Francisco Calvache Meyer ◽  
Karen Smith ◽  
...  
Keyword(s):  
Digit Span ◽  
Meta Analysis ◽  
Urban Environments ◽  
Order Effects ◽  
Natural Environments ◽  
Repeated Testing ◽  
Directed Attention ◽  
Beneficial Effects ◽  
Unpublished Studies ◽  
Test Order

Interactions with natural environments and nature-related stimuli have been found to be beneficial to cognitive performance, in particular on executive cognitive tasks with high demands on directed attention processes. However, results vary across different studies.The aim of the present study was to perform a meta-analysis of all our published and unpublished studies testing the effect of different interactions with nature versus urban/built control environments, on an executive test with high demands on directed attention: the backwards digit span (BDS) task. Specific aims were to evaluate the effect of nature versus urban environment interactions on BDS across different exposure types (e.g. being in real environments, or viewing videos, images, or listening to sounds) and disentangle the effects of testing order (i.e. practice with repeated testing) and the role of affective changes on BDS performance. We also reviewed the literature and compared and contrasted our meta-analysis with results from other studies. Results from our meta-analysis comprising 12 studies (N=567 participants) showed significant environment-by-time interactions with beneficial effects of nature compared to urban environments on BDS performance. This effect was magnified after parceling out initial practice effects on the BDS. Changes in positive or negative affect did not mediate the beneficial effects of nature on BDS performance. These results mirrored effects that we reviewed from outside of our laboratories. Uncontrolled and confounding order effects may explain some of the inconsistent findings in the literature. In all, these results highlight the robustness of the effects of natural environments on cognition when confounding order effects have been considered, and also provide a more nuanced account of when a nature intervention will be most effective.

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