scholarly journals Minimal and mild hearing loss in children: Association with auditory perception, cognition, and communication problems

2019 ◽  
Author(s):  
David R. Moore ◽  
Oliver Zobay ◽  
Melanie A. Ferguson

ABSTRACTObjectives‘Minimal’ and ‘mild’ hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a “disabling level of hearing loss”. We examined in a population of 6 - 11 year olds how hearing level ≤ 40.0 dB HL (1 and 4 kHz pure tone average, PTA, threshold) related to auditory perception, cognition and communication.DesignSchool children (n=1638) were recruited in four centres across the UK. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children’s communication and listening skills. Children included in this study (702 male; 752 female) had four reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal hearing children (n=1124, 77.1%) had all four thresholds and PTA < 15 dB HL. Children with ≥ 15 dB HL for at least one threshold, and PTA < 20 dB (n=245, 16.8%) had Minimal hearing loss. Children with 20 ≤ PTA < 40 dB HL (n=88, 6.0%) had Mild hearing loss. Interaural Asymmetric hearing loss (|Left PTA – Right PTA| ≥ 10 dB) was found in 28.9% of those with Minimal and 39.8% of those with Mild hearing loss.ResultsSpeech perception in noise, indexed by VCV pseudoword repetition in speech modulated noise, was impaired in children with Minimal and Mild hearing loss, relative to Normal hearing children. Effect size was largest (d=0.63) in Asymmetric Mild hearing loss and smallest (d=0.21) in Symmetric Minimal hearing loss. Spectral (filter width) and temporal (backward masking) perception were impaired in children with both forms of hearing loss, but supra-threshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with Mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with Minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as Symmetric hearing loss. Nonverbal IQ, attention and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modelling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss.ConclusionsHearing loss between 15 - 30 dB PTA is, at ~20%, much more prevalent in 6-11 y.o. children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss < 30 dB HL is most closely related to speech perception in noise, and to cognitive abilities underpinning language and reading. The results suggest wider use of speech-in-noise measures to diagnose and assess management of hearing loss and reduction of the clinical hearing loss threshold for children to 15 dB HL.

2019 ◽  
Vol 116 (47) ◽  
pp. 23753-23759 ◽  
Author(s):  
Lina Motlagh Zadeh ◽  
Noah H. Silbert ◽  
Katherine Sternasty ◽  
De Wet Swanepoel ◽  
Lisa L. Hunter ◽  
...  

Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 “normally hearing,” mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (≤8 kHz), DIN hearing thresholds were significantly better (P < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with “normal hearing” frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss.


2011 ◽  
Vol 7 (1) ◽  
pp. 8-14
Author(s):  
Robert Moore ◽  
Susan Gordon-Hickey

The purpose of this article is to propose 4 dimensions for consideration in hearing aid fittings and 4 tests to evaluate those dimensions. The 4 dimensions and tests are (a) working memory, evaluated by the Revised Speech Perception in Noise test (Bilger, Nuetzel, & Rabinowitz, 1984); (b) performance in noise, evaluated by the Quick Speech in Noise test (QSIN; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004); (c) acceptance of noise, evaluated by the Acceptable Noise Level test (ANL; Nabelek, Tucker, & Letowski, 1991); and (d) performance versus perception, evaluated by the Perceptual–Performance test (PPT; Saunders & Cienkowski, 2002). The authors discuss the 4 dimensions and tests in the context of improving the quality of hearing aid fittings.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Younes Lotfi ◽  
Mahdieh Hasanalifard ◽  
Abdollah Moossavi ◽  
Enayatollah Bakhshi ◽  
Mohammad Ajalloueyan

Abstract Background The objective of this study was to evaluate the effect of “Spatially separated speech in noise” auditory training on the ability of speech perception in noise among bimodal fitting users. The assumption was that the rehabilitation can enhance spatial hearing and hence speech in noise perception. This study was an interventional study, with a pre/post-design. Speech recognition ability was assessed with the specific tests. After performing the rehabilitation stages in the intervention group, the speech tests were again implemented, and by comparing the pre- and post-intervention data, the effect of auditory training on the speech abilities was assessed. Twenty-four children of 8–12 years who had undergone cochlear implantation and continuously used bimodal fitting were investigated in two groups of control and intervention. Results The results showed a significant difference between the groups in different speech tests after the intervention, which indicated that the intervention group have improved more than the control group. Conclusion It can be concluded that “Spatially separated speech in noise” auditory training can improve the speech perception in noise in bimodal fitting users. In general, this rehabilitation method is useful for enhancing the speech in noise perception ability.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rosamaria Santarelli ◽  
Pietro Scimemi ◽  
Marco Costantini ◽  
María Domínguez-Ruiz ◽  
Montserrat Rodríguez-Ballesteros ◽  
...  

2018 ◽  
Vol 36 (2) ◽  
pp. 156-174 ◽  
Author(s):  
Ritva Torppa ◽  
Andrew Faulkner ◽  
Teija Kujala ◽  
Minna Huotilainen ◽  
Jari Lipsanen

The perception of speech in noise is challenging for children with cochlear implants (CIs). Singing and musical instrument playing have been associated with improved auditory skills in normal-hearing (NH) children. Therefore, we assessed how children with CIs who sing informally develop in the perception of speech in noise compared to those who do not. We also sought evidence of links of speech perception in noise with MMN and P3a brain responses to musical sounds and studied effects of age and changes over a 14–17 month time period in the speech-in-noise performance of children with CIs. Compared to the NH group, the entire CI group was less tolerant of noise in speech perception, but both groups improved similarly. The CI singing group showed better speech-in-noise perception than the CI non-singing group. The perception of speech in noise in children with CIs was associated with the amplitude of MMN to a change of sound from piano to cymbal, and in the CI singing group only, with earlier P3a for changes in timbre. While our results cannot address causality, they suggest that singing and musical instrument playing may have a potential to enhance the perception of speech in noise in children with CIs.


1997 ◽  
Vol 106 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Craig W. Newman ◽  
Gerald A. Hug ◽  
Gary P. Jacobson ◽  
Sharon A. Sandridge

Using the Hearing Handicap Inventory for Adults (HHIA), we assessed self-perceived hearing handicap in a sample of 63 patients having either unilaterally normal hearing or a mild hearing loss (pure tone average ≤40 dB hearing level). Large intersubject variability in responses to the HHIA confirmed observations that reactions to minimal hearing impairment vary greatly among patients. The individual differences in responses highlight the importance of quantifying the perceived communication and psychosocial handicap, which cannot be determined from the audiogram alone. An item examination of responses to the HHIA revealed a number of emotional and social-situational problems encountered by patients with minimal hearing loss.


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