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

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.

1964 ◽  
Vol 7 (3) ◽  
pp. 279-289
Author(s):  
Allan J. Heffler ◽  
Martin C. Schultz

Clinical techniques for evaluating binaural hearing aids have been inconclusive. This paper offers some explanations of shortcomings in present approaches, concentrating upon several characteristics to be included in an adequate clinical procedure. These are the presence of competing sound; S/N ratios permitting measurable increases in discrimination from advantageous listening conditions; elimination of localization and sidedness effects; and the requirement of long duration signals with credit for partial responses. The study was an approach on normal-hearing individuals under several S/N ratios, with occlusion of one ear as an experimental variable. Listening was accomplished under homophasic and antiphasic conditions for each combination of the other conditions. Results demonstrated significant differences among the listening conditions and the results have been rationalized in schema for testing binaural hearing aids under various hearing-loss circumstances. Applications to auditory training are discussed.


2019 ◽  
Vol 62 (9) ◽  
pp. 3234-3247 ◽  
Author(s):  
Céline Hidalgo ◽  
Jacques Pesnot-Lerousseau ◽  
Patrick Marquis ◽  
Stéphane Roman ◽  
Daniele Schön

Purpose In this study, we investigate temporal adaptation capacities of children with normal hearing and children with cochlear implants and/or hearing aids during verbal exchange. We also address the question of the efficiency of a rhythmic training on temporal adaptation during speech interaction in children with hearing loss. Method We recorded electroencephalogram data in children while they named pictures delivered on a screen, in alternation with a virtual partner. We manipulated the virtual partner's speech rate (fast vs. slow) and the regularity of alternation (regular vs. irregular). The group of children with normal hearing was tested once, and the group of children with hearing loss was tested twice: once after 30 min of auditory training and once after 30 min of rhythmic training. Results Both groups of children adjusted their speech rate to that of the virtual partner and were sensitive to the regularity of alternation with a less accurate performance following irregular turns. Moreover, irregular turns elicited a negative event-related potential in both groups, showing a detection of temporal deviancy. Notably, the amplitude of this negative component positively correlated with accuracy in the alternation task. In children with hearing loss, the effect was more pronounced and long-lasting following rhythmic training compared with auditory training. Conclusion These results are discussed in terms of temporal adaptation abilities in speech interaction and suggest the use of rhythmic training to improve these skills of children with hearing loss.


2018 ◽  
Vol 29 (06) ◽  
pp. 477-494 ◽  
Author(s):  
Christina M. Roup ◽  
Emily Post ◽  
Jessica Lewis

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.


2013 ◽  
Vol 22 (2) ◽  
pp. 335-338 ◽  
Author(s):  
Judy R. Dubno

PurposeIn this article, the authors provide an overview of auditory training programs for aided listening by older adults, review criteria for evaluating effectiveness, summarize results of published studies, report on 2 training programs currently undergoing assessment, and discuss directions and needs for future research.MethodExperiments are ongoing to evaluate 2 individual, computer-based speech-perception training programs: Indiana University (IU) word-based training and the Speech Perception Assessment and Training System (SPATS). Training and control subjects are older adults with mild-to-severe hearing loss. Subjects train for about 30 hr with monaurally presented, spectrally shaped stimuli (IU) or through loudspeakers with their own hearing aids (SPATS). Displays and feedback use auditory and visual/orthographic cues. Outcome measures include objective measures of speech recognition in noise and other training benefits.ResultsSignificant improvements were observed in open-set recognition of trained sounds, words, phrases, and sentences. Large individual differences in training benefit were apparent. Generalization varied with the speech-perception task, competing noise, listening strategy, and pretraining scores.ConclusionsHigh-level evidence is needed to support the effectiveness of auditory training for older adults as a supplement to aided listening. Studies are needed to predict who will benefit from specific types of training, to assess compliance and engagement, and to discover benefits beyond communication.


2021 ◽  
Vol 25 ◽  
pp. 233121652110499
Author(s):  
Erin M. Picou ◽  
Lori Rakita ◽  
Gabrielle H. Buono ◽  
Travis M. Moore

Adults with hearing loss demonstrate a reduced range of emotional responses to nonspeech sounds compared to their peers with normal hearing. The purpose of this study was to evaluate two possible strategies for addressing the effects of hearing loss on emotional responses: (a) increasing overall level and (b) hearing aid use (with and without nonlinear frequency compression, NFC). Twenty-three adults (mean age  =  65.5 years) with mild-to-severe sensorineural hearing loss and 17 adults (mean age  =  56.2 years) with normal hearing participated. All adults provided ratings of valence and arousal without hearing aids in response to nonspeech sounds presented at a moderate and at a high level. Adults with hearing loss also provided ratings while using individually fitted study hearing aids with two settings (NFC-OFF or NFC-ON). Hearing loss and hearing aid use impacted ratings of valence but not arousal. Listeners with hearing loss rated pleasant sounds as less pleasant than their peers, confirming findings in the extant literature. For both groups, increasing the overall level resulted in lower ratings of valence. For listeners with hearing loss, the use of hearing aids (NFC-OFF) also resulted in lower ratings of valence but to a lesser extent than increasing the overall level. Activating NFC resulted in ratings that were similar to ratings without hearing aids (with a moderate presentation level) but did not improve ratings to match those from the listeners with normal hearing. These findings suggest that current interventions do not ameliorate the effects of hearing loss on emotional responses to sound.


1984 ◽  
Vol 27 (4) ◽  
pp. 627-633 ◽  
Author(s):  
Diane Rines ◽  
Patricia G. Stelmachowicz ◽  
Michael P. Gorga

The functional gain of a hearing aid typically is determined by comparing aided and unaided behavioral thresholds. With this method, however, true gain may be underestimated in frequency regions of normal or near-normal hearing sensitivity (i.e., in cases of sloping, rising, or trough-shaped audiograms). Internal hearing-aid noise and/or amplified room noise imposes a lower limit on obtainable aided thresholds. In these cases, comparing aided and unaided acoustic-reflex thresholds may be a valuable clinical alternative to traditional means of determining real-ear gain. This study compared sound-field behavioral threshold and acoustic-reflex threshold estimates of functional gain for individuals with a variety of audiometric configurations. The sound-field behavioral threshold measurements were found to underestimate functional gain if unaided thresholds approached the normal hearing range. In regions of greater hearing loss, behavioral and acoustic-reflex estimates of functional gain were in good agreement.


1997 ◽  
Vol 6 (3) ◽  
pp. 48-63 ◽  
Author(s):  
Colleen M. Noe ◽  
Stephanie A. Davidson ◽  
Pamela J. Mishler

During a hearing loss management workshop, 10 listeners with normal hearing sensitivity and 18 listeners with sensorineural hearing loss compared four group assistive listening devices (ALDs)—FM, induction loop, infrared, and soundfield amplification—to no system. Listeners with hearing loss were tested using the ALDs alone and using the ALDs inductively coupled to personal in-the-ear (ITE) hearing aids. Significant improvements in word recognition ability with the FM, induction loop, and infrared systems were noted in listeners with normal hearing and with all ALD systems in listeners with hearing loss, as compared to performance with no system. Listeners with hearing loss performed better and preferred using the FM, induction loop, and infrared systems with headsets, but preferred the soundfield amplification system with their hearing aids. Both groups of listeners preferred the FM system over other systems in terms of performance, comfort, and ease of use.


2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.


2014 ◽  
Vol 155 (38) ◽  
pp. 1524-1529
Author(s):  
Ádám Bach ◽  
Ferenc Tóth ◽  
Vera Matievics ◽  
József Géza Kiss ◽  
József Jóri ◽  
...  

Introduction: Cortical auditory evoked potentials can provide objective information about the highest level of the auditory system. Aim: The purpose of the authors was to introduce a new tool, the “HEARLab” which can be routinely used in clinical practice for the measurement of the cortical auditory evoked potentials. In addition, they wanted to establish standards of the analyzed parameters in subjects with normal hearing. Method: 25 adults with normal hearing were tested with speech stimuli, and frequency specific examinations were performed utilizing pure tone stimuli. Results: The findings regarding the latency and amplitude analyses of the evoked potentials confirm previously published results of this novel method. Conclusions: The HEARLAb can be a great help when performance of the conventional audiological examinations is complicated. The examination can be performed in uncooperative subjects even in the presence of hearing aids. The test is frequency specific and does not require anesthesia. Orv. Hetil., 2014, 155(38), 1524–1529.


2003 ◽  
Vol 27 (08) ◽  
pp. 301-304
Author(s):  
Gavin Reid ◽  
Mark Hughson

Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.


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