EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study

BackgroundHearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology.AimThis study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project.MethodsWe applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training.Key FindingsOlder users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user.ConclusionOlder and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes.

Visualization of Speech Perception Analysis via Phoneme Alignment: A Pilot Study

Objective: Speech tests assess the ability of people with hearing loss to comprehend speech with a hearing aid or cochlear implant. The tests are usually at the word or sentence level. However, few tests analyze errors at the phoneme level. So, there is a need for an automated program to visualize in real time the accuracy of phonemes in these tests.Method: The program reads in stimulus-response pairs and obtains their phonemic representations from an open-source digital pronouncing dictionary. The stimulus phonemes are aligned with the response phonemes via a modification of the Levenshtein Minimum Edit Distance algorithm. Alignment is achieved via dynamic programming with modified costs based on phonological features for insertion, deletions and substitutions. The accuracy for each phoneme is based on the F1-score. Accuracy is visualized with respect to place and manner (consonants) or height (vowels). Confusion matrices for the phonemes are used in an information transfer analysis of ten phonological features. A histogram of the information transfer for the features over a frequency-like range is presented as a phonemegram.Results: The program was applied to two datasets. One consisted of test data at the sentence and word levels. Stimulus-response sentence pairs from six volunteers with different degrees of hearing loss and modes of amplification were analyzed. Four volunteers listened to sentences from a mobile auditory training app while two listened to sentences from a clinical speech test. Stimulus-response word pairs from three lists were also analyzed. The other dataset consisted of published stimulus-response pairs from experiments of 31 participants with cochlear implants listening to 400 Basic English Lexicon sentences via different talkers at four different SNR levels. In all cases, visualization was obtained in real time. Analysis of 12,400 actual and random pairs showed that the program was robust to the nature of the pairs.Conclusion: It is possible to automate the alignment of phonemes extracted from stimulus-response pairs from speech tests in real time. The alignment then makes it possible to visualize the accuracy of responses via phonological features in two ways. Such visualization of phoneme alignment and accuracy could aid clinicians and scientists.

Auditory-Perceptual Judgement of Speech-Language Pathologists in Fricative Distortion by EPG Task

Objectives: In a clinical setting, a ‘trained ear’ is the essentials for speech–language pathologists (SLPs) because most SLPs rely on the auditory - perceptual method during assessment and treatment for speech difficulties. However, transcribing distortion errors using only auditory-perceptual judgement is a difficult task. This study investigated the auditory– perceptual ability in terms of distortion errors for pre and present SLPs.Methods: Sixty pre and present SLPs completed a survey, then performed a perceptual judgement task which was manufactured by electropalatography (EPG). The task consisted of 30 questions, including distorted (dentalized, palatalized, lateralized) and normal speech samples of Korean fricative /s/ with different types of vowels (/ɑ/, /u/) and lengths (1-syllabled, 2- syllabled, sentence).Results: There was no significant difference in the distortion task among three groups. All participants had the highest score in “dentalization”, the lowest in “lateralization”, and all distortion types were perceived better in the /u/ context than /ɑ/. Also, SLPs tended to judge “lateralization” errors as “normal articulation” and many of the participants perceived “palatalization” as “lateralization”.Conclusion: The results of this study indicated that active auditory training for SLPs is necessary to improve auditory perceptual ability, and suggests that EPG could be a useful instrument for the auditory training program.

Electrophysiology and Auditory Training

Electrophysiology is an objective evaluation method that allows investigating the responses of the central auditory nervous system arising from the capture of neuronal responses through surface electrodes. In addition to the possibility of investigating and diagnosing different pathologies, electrophysiology proves to be an effective and effective instrument in monitoring auditory intervention programs. Auditory rehabilitation programs is based on the premise of neuroplasticity that derives from a capacity for neuronal change due to intense sound stimulation, specific and directed to the patient’s needs. Throughout this chapter, current studies that correlate electrophysiology with auditory training programs in different clinical populations will be presented, such as: hearing in typically developed individuals, hearing and school difficulties, hearing and CAPD, hearing and otitis media, hearing and hearing loss, and hearing and voice. Electrophysiological tests are important objective measures in predicting the gains to be expected from auditory training programs.

Auditory-cognitive training for adult cochlear implant recipients: a study protocol for a randomised controlled trial

Background There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. Methods This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. Results The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. Discussion We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12619000609156. Registered on April 23 2019.

Auditory Processing Disorder Test Battery in European Portuguese—Development and Normative Data for Pediatric Population

There is an increasing need for state-of-the-art Central Auditory Processing assessment for Portuguese native speakers, applicable as early as possible. As a contribution to answering this need, this paper presents a new battery for Central Auditory Processing assessment for European Portuguese applicable to children aged 5 and above, named BAPA-PE, providing information regarding test selection and development. The battery consists of six behavioral tests: Staggered Spondaic Words (SSW) for European Portuguese, Filtered Speech, Speech in Noise, Detection Interval in Noise, Duration, and Frequency Pattern. The normative data for children aged 5 to 12 are also reported. A sample was obtained of 217 subjects without ear pathology and with typical development. Each age group was composed of at least 30 children. All children were evaluated using pure tone audiometry, speech audiometry, impedance, and otoacoustic emissions. Normative scores are reported for each of the six auditory processing tests. The assessment is applicable to young children (aged 5 and 6). The statistical analyses showed significant effects in scores of Age for all tests and of Ear for several tests. The main result from the work presented, the Auditory Processing Assessment Battery—European Portuguese (BAPA-PE), is available for clinical use with normative data. This battery is a new tool for behaviorism assessment of European Portuguese speakers with suspected central auditory pathology and for monitoring the results of auditory training.