Understanding Self-reported Hearing Disability in Adults With Normal Hearing

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.

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Adaptation of the Connected Speech Test: Rerecording and Passage Equivalency

American Journal of Audiology ◽

10.1044/2019_aja-19-00052 ◽

2020 ◽

Vol 29 (2) ◽

pp. 259-264 ◽

Cited By ~ 2

Author(s):

Hasan K. Saleh ◽

Paula Folkeard ◽

Ewan Macpherson ◽

Susan Scollie

Keyword(s):

Speech Perception ◽

North American ◽

First Language ◽

Intraclass Correlation ◽

Normal Hearing ◽

Connected Speech ◽

Internal Reliability ◽

Speech Test ◽

The Mean ◽

Unit Standard

Purpose The original Connected Speech Test (CST; Cox et al., 1987) is a well-regarded and often utilized speech perception test. The aim of this study was to develop a new version of the CST using a neutral North American accent and to assess the use of this updated CST on participants with normal hearing. Method A female English speaker was recruited to read the original CST passages, which were recorded as the new CST stimuli. A study was designed to assess the newly recorded CST passages' equivalence and conduct normalization. The study included 19 Western University students (11 females and eight males) with normal hearing and with English as a first language. Results Raw scores for the 48 tested passages were converted to rationalized arcsine units, and average passage scores more than 1 rationalized arcsine unit standard deviation from the mean were excluded. The internal reliability of the 32 remaining passages was assessed, and the two-way random effects intraclass correlation was .944. Conclusion The aim of our study was to create new CST stimuli with a more general North American accent in order to minimize accent effects on the speech perception scores. The study resulted in 32 passages of equivalent difficulty for listeners with normal hearing.

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Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00053 ◽

2020 ◽

Vol 63 (6) ◽

pp. 2016-2026

Author(s):

Tamara R. Almeida ◽

Clayton H. Rocha ◽

Camila M. Rabelo ◽

Raquel F. Gomes ◽

Ivone F. Neves-Lobo ◽

...

Keyword(s):

Sound Pressure ◽

Daily Basis ◽

Cross Sectional Study ◽

Normal Hearing ◽

Chi Square ◽

Cross Sectional ◽

The Real ◽

Significant Difference ◽

Sound Pressure Levels ◽

Audio System

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435

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Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

American Journal of Audiology ◽

10.1044/2020_aja-19-00051 ◽

2020 ◽

Vol 29 (3) ◽

pp. 419-428

Author(s):

Jasleen Singh ◽

Karen A. Doherty

Keyword(s):

Hearing Aids ◽

Background Noise ◽

Middle Age ◽

Hearing Aid ◽

Normal Hearing ◽

Self Report ◽

Hearing Aid Use ◽

Hearing Handicap ◽

Before And After ◽

Hearing Problems

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.

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An Eye-Tracking Study on Audiovisual Speech Perception Strategies Adopted by Normal-Hearing and Deaf Adults Under Different Language Familiarities

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00223 ◽

2020 ◽

Vol 63 (7) ◽

pp. 2245-2254 ◽

Cited By ~ 1

Author(s):

Jianrong Wang ◽

Yumeng Zhu ◽

Yu Chen ◽

Abdilbar Mamat ◽

Mei Yu ◽

...

Keyword(s):

Speech Perception ◽

Eye Tracking ◽

Normal Hearing ◽

Audiovisual Speech ◽

Audiovisual Speech Perception ◽

Allocation Pattern ◽

Deaf Adults ◽

Bilingual Speaker ◽

Primary Hypothesis ◽

Standard Chinese

Purpose The primary purpose of this study was to explore the audiovisual speech perception strategies.80.23.47 adopted by normal-hearing and deaf people in processing familiar and unfamiliar languages. Our primary hypothesis was that they would adopt different perception strategies due to different sensory experiences at an early age, limitations of the physical device, and the developmental gap of language, and others. Method Thirty normal-hearing adults and 33 prelingually deaf adults participated in the study. They were asked to perform judgment and listening tasks while watching videos of a Uygur–Mandarin bilingual speaker in a familiar language (Standard Chinese) or an unfamiliar language (Modern Uygur) while their eye movements were recorded by eye-tracking technology. Results Task had a slight influence on the distribution of selective attention, whereas subject and language had significant influences. To be specific, the normal-hearing and the d10eaf participants mainly gazed at the speaker's eyes and mouth, respectively, in the experiment; moreover, while the normal-hearing participants had to stare longer at the speaker's mouth when they confronted with the unfamiliar language Modern Uygur, the deaf participant did not change their attention allocation pattern when perceiving the two languages. Conclusions Normal-hearing and deaf adults adopt different audiovisual speech perception strategies: Normal-hearing adults mainly look at the eyes, and deaf adults mainly look at the mouth. Additionally, language and task can also modulate the speech perception strategy.

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Auditory Gating and Extended High-Frequency Thresholds in Normal-Hearing Adults With Minimal Tinnitus

American Journal of Audiology ◽

10.1044/2019_aja-ttr17-18-0036 ◽

2019 ◽

Vol 28 (1S) ◽

pp. 209-224 ◽

Cited By ~ 6

Author(s):

Julia Campbell ◽

Alison LaBrec ◽

Connor Bean ◽

Mashhood Nielsen ◽

Won So

Keyword(s):

High Frequency ◽

Normal Hearing ◽

Auditory Gating

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When Hearing Does Not Mean Understanding: On the Neural Processing of Syntactically Complex Sentences by Listeners With Hearing Loss

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-20-00262 ◽

2021 ◽

pp. 1-13

Author(s):

Margreet Vogelzang ◽

Christiane M. Thiel ◽

Stephanie Rosemann ◽

Jochem W. Rieger ◽

Esther Ruigendijk

Keyword(s):

Hearing Loss ◽

Sentence Processing ◽

Secondary Task ◽

Sentence Comprehension ◽

Inferior Frontal Gyrus ◽

Normal Hearing ◽

Cognitive Demands ◽

Sentence Complexity ◽

Complex Sentences ◽

And Task

Purpose Adults with mild-to-moderate age-related hearing loss typically exhibit issues with speech understanding, but their processing of syntactically complex sentences is not well understood. We test the hypothesis that listeners with hearing loss' difficulties with comprehension and processing of syntactically complex sentences are due to the processing of degraded input interfering with the successful processing of complex sentences. Method We performed a neuroimaging study with a sentence comprehension task, varying sentence complexity (through subject–object order and verb–arguments order) and cognitive demands (presence or absence of a secondary task) within subjects. Groups of older subjects with hearing loss ( n = 20) and age-matched normal-hearing controls ( n = 20) were tested. Results The comprehension data show effects of syntactic complexity and hearing ability, with normal-hearing controls outperforming listeners with hearing loss, seemingly more so on syntactically complex sentences. The secondary task did not influence off-line comprehension. The imaging data show effects of group, sentence complexity, and task, with listeners with hearing loss showing decreased activation in typical speech processing areas, such as the inferior frontal gyrus and superior temporal gyrus. No interactions between group, sentence complexity, and task were found in the neuroimaging data. Conclusions The results suggest that listeners with hearing loss process speech differently from their normal-hearing peers, possibly due to the increased demands of processing degraded auditory input. Increased cognitive demands by means of a secondary visual shape processing task influence neural sentence processing, but no evidence was found that it does so in a different way for listeners with hearing loss and normal-hearing listeners.

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Age at Full-Time Use Predicts Language Outcomes Better Than Age of Surgery in Children Who Use Cochlear Implants

American Journal of Audiology ◽

10.1044/2019_aja-19-0073 ◽

2019 ◽

Vol 28 (4) ◽

pp. 986-992 ◽

Cited By ~ 2

Author(s):

Lisa R. Park ◽

Erika B. Gagnon ◽

Erin Thompson ◽

Kevin D. Brown

Keyword(s):

Cochlear Implants ◽

Time Use ◽

Expressive Language ◽

Normal Hearing ◽

Full Time ◽

Language Outcomes ◽

Age At Surgery ◽

Device Placement ◽

Device Use ◽

Better Than

Purpose The aims of this study were to (a) determine a metric for describing full-time use (FTU), (b) establish whether age at FTU in children with cochlear implants (CIs) predicts language at 3 years of age better than age at surgery, and (c) describe the extent of FTU and length of time it took to establish FTU in this population. Method This retrospective analysis examined receptive and expressive language outcomes at 3 years of age for 40 children with CIs. Multiple linear regression analyses were run with age at surgery and age at FTU as predictor variables. FTU definitions included 8 hr of device use and 80% of average waking hours for a typically developing child. Descriptive statistics were used to describe the establishment and degree of FTU. Results Although 8 hr of daily wear is typically considered FTU in the literature, the 80% hearing hours percentage metric accounts for more variability in outcomes. For both receptive and expressive language, age at FTU was found to be a better predictor of outcomes than age at surgery. It took an average of 17 months for children in this cohort to establish FTU, and only 52.5% reached this milestone by the time they were 3 years old. Conclusions Children with normal hearing can access spoken language whenever they are awake, and the amount of time young children are awake increases with age. A metric that incorporates the percentage of time that children with CIs have access to sound as compared to their same-aged peers with normal hearing accounts for more variability in outcomes than using an arbitrary number of hours. Although early FTU is not possible without surgery occurring at a young age, device placement does not guarantee use and does not predict language outcomes as well as age at FTU.

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Hearing Aid Amplification Reduces Communication Effort of People With Hearing Impairment and Their Conversation Partners

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00350 ◽

2020 ◽

Vol 63 (4) ◽

pp. 1299-1311 ◽

Cited By ~ 2

Author(s):

Timothy Beechey ◽

Jörg M. Buchholz ◽

Gitte Keidser

Keyword(s):

Hearing Impairment ◽

Hearing Aid ◽

Normal Hearing ◽

Referential Communication ◽

Hearing Impaired ◽

Directional Hearing ◽

Acoustic Environment ◽

Communication Task ◽

Acoustic Environments ◽

The Impact

Objectives This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions. Design Fifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs. Each pair consisted of one young normal-hearing participant and one older hearing-impaired participant. Hearing-impaired participants received directional hearing aid amplification, according to their audiogram, via a master hearing aid with gain provided according to the NAL-NL2 fitting formula. Pairs of participants were required to take part in naturalistic conversations through the use of a referential communication task. Each pair took part in five conversations, each of 5-min duration. During each conversation, participants were exposed to one of five different realistic acoustic environments presented through highly open headphones. The ordering of acoustic environments across experimental blocks was pseudorandomized. Resulting recordings of conversational speech were analyzed to determine the magnitude of speech modifications, in terms of vocal level and spectrum, produced by normal-hearing talkers as a function of both acoustic environment and the degree of high-frequency average hearing impairment of their conversation partner. Results The magnitude of spectral modifications of speech produced by normal-hearing talkers during conversations with aided hearing-impaired interlocutors was smaller than the speech modifications observed during conversations between the same pairs of participants in the absence of hearing aid amplification. Conclusions The provision of hearing aid amplification reduces the effort required to maintain communication in adverse conditions. This reduction in effort provides benefit to hearing-impaired individuals and also to the conversation partners of hearing-impaired individuals. By considering the impact of amplification on both sides of dyadic conversations, this approach contributes to an increased understanding of the likely impact of hearing impairment on everyday communication.

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