scholarly journals Segmental and Suprasegmental Perception in Children Using Hearing Aids

2017 ◽  
Vol 28 (10) ◽  
pp. 901-912 ◽  
Author(s):  
Kaitlyn A. Wenrich ◽  
Lisa S. Davidson ◽  
Rosalie M. Uchanski
Keyword(s):  
Speech Perception ◽  
Outcome Measures ◽  
Hearing Aids ◽  
Low Frequency ◽  
Receptive Language ◽  
Acoustic Properties ◽  
Frequency Resolution ◽  
Residual Hearing ◽  
Hearing Thresholds ◽  
Hearing Device

Background: Suprasegmental perception (perception of stress, intonation, “how something is said” and “who says it”) and segmental speech perception (perception of individual phonemes or perception of “what is said”) are perceptual abilities that provide the foundation for the development of spoken language and effective communication. While there are numerous studies examining segmental perception in children with hearing aids (HAs), there are far fewer studies examining suprasegmental perception, especially for children with greater degrees of residual hearing. Examining the relation between acoustic hearing thresholds, and both segmental and suprasegmental perception for children with HAs, may ultimately enable better device recommendations (bilateral HAs, bimodal devices [one CI and one HA in opposite ears], bilateral CIs) for a particular degree of residual hearing. Examining both types of speech perception is important because segmental and suprasegmental cues are affected differentially by the type of hearing device(s) used (i.e., cochlear implant [CI] and/or HA). Additionally, suprathreshold measures, such as frequency resolution ability, may partially predict benefit from amplification and may assist audiologists in making hearing device recommendations. Purpose: The purpose of this study is to explore the relationship between audibility (via hearing thresholds and speech intelligibility indices), and segmental and suprasegmental speech perception for children with HAs. A secondary goal is to explore the relationships among frequency resolution ability (via spectral modulation detection [SMD] measures), segmental and suprasegmental speech perception, and receptive language in these same children. Research Design: A prospective cross-sectional design. Study Sample: Twenty-three children, ages 4 yr 11 mo to 11 yr 11 mo, participated in the study. Participants were recruited from pediatric clinic populations, oral schools for the deaf, and mainstream schools. Data Collection and Analysis: Audiological history and hearing device information were collected from participants and their families. Segmental and suprasegmental speech perception, SMD, and receptive vocabulary skills were assessed. Correlations were calculated to examine the significance (p < 0.05) of relations between audibility and outcome measures. Results: Measures of audibility and segmental speech perception are not significantly correlated, while low-frequency pure-tone average (unaided) is significantly correlated with suprasegmental speech perception. SMD is significantly correlated with all measures (measures of audibility, segmental and suprasegmental perception and vocabulary). Lastly, although age is not significantly correlated with measures of audibility, it is significantly correlated with all other outcome measures. Conclusions: The absence of a significant correlation between audibility and segmental speech perception might be attributed to overall audibility being maximized through well-fit HAs. The significant correlation between low-frequency unaided audibility and suprasegmental measures is likely due to the strong, predominantly low-frequency nature of suprasegmental acoustic properties. Frequency resolution ability, via SMD performance, is significantly correlated with all outcomes and requires further investigation; its significant correlation with vocabulary suggests that linguistic ability may be partially related to frequency resolution ability. Last, all of the outcome measures are significantly correlated with age, suggestive of developmental effects.

scholarly journals Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-Electrode Cochlear Implant

2010 ◽  
Vol 21 (01) ◽  
pp. 044-051 ◽  
Author(s):  
Camille C. Dunn ◽  
Ann Perreau ◽  
Bruce Gantz ◽  
Richard S. Tyler
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Frequency ◽  
Noise Sources ◽  
Speech Perception In Noise ◽  
Hearing Aid Use ◽  
Significant Difference ◽  
Array Performance

Background: Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose: The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Research Design: Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results: Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion: Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

scholarly journals Effects of Early Acoustic Hearing on Speech Perception and Language for Pediatric Cochlear Implant Recipients

2019 ◽  
Vol 62 (9) ◽  
pp. 3620-3637 ◽  
Author(s):  
Lisa S. Davidson ◽  
Ann E. Geers ◽  
Rosalie M. Uchanski ◽  
Jill B. Firszt
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Language Skills ◽  
Spoken Language ◽  
Receptive Language ◽  
Receptive Vocabulary ◽  
Residual Hearing ◽  
Regression Analyses ◽  
Optimal Duration ◽  
Spoken Language Skills

Purpose The overall goal of the current study was to identify an optimal level and duration of acoustic experience that facilitates language development for pediatric cochlear implant (CI) recipients—specifically, to determine whether there is an optimal duration of hearing aid (HA) use and unaided threshold levels that should be considered before proceeding to bilateral CIs. Method A total of 117 pediatric CI recipients (ages 5–9 years) were given speech perception and standardized tests of receptive vocabulary and language. The speech perception battery included tests of segmental perception (e.g., word recognition in quiet and noise, and vowels and consonants in quiet) and of suprasegmental perception (e.g., talker and stress discrimination, and emotion identification). Hierarchical regression analyses were used to determine the effects of speech perception on language scores, and the effects of residual hearing level (unaided pure-tone average [PTA]) and duration of HA use on speech perception. Results A continuum of residual hearing levels and the length of HA use were represented by calculating the unaided PTA of the ear with the longest duration of HA use for each child. All children wore 2 devices: Some wore bimodal devices, while others received their 2nd CI either simultaneously or sequentially, representing a wide range of HA use (0.03–9.05 years). Regression analyses indicate that suprasegmental perception contributes unique variance to receptive language scores and that both segmental and suprasegmental skills each contribute independently to receptive vocabulary scores. Also, analyses revealed an optimal duration of HA use for each of 3 ranges of hearing loss severity (with mean PTAs of 73, 92, and 111 dB HL) that maximizes suprasegmental perception. Conclusions For children with the most profound losses, early bilateral CIs provide the greatest opportunity for developing good spoken language skills. For those with moderate-to-severe losses, however, a prescribed period of bimodal use may be more advantageous for developing good spoken language skills.

A Comparison of the Benefit Provided by Well-Fit Linear Hearing Aids and Instruments With Automatic Reductions of Low-Frequency Gain

1997 ◽  
Vol 40 (3) ◽  
pp. 666-685 ◽  
Author(s):  
Larry E. Humes ◽  
Laurel A. Christensen ◽  
Fred H. Bess ◽  
Andrea Hedley-Williams
Keyword(s):  
Outcome Measures ◽  
Hearing Aids ◽  
Paired Comparison ◽  
Hearing Aid ◽  
Low Frequency ◽  
Linear Amplification ◽  
Comparison Task ◽  
Listening Effort ◽  
Processing Scheme ◽  
Study Results

In this clinical study, 110 patients seen at three different clinical facilities were fit binaurally with linear, in-the-canal (ITC) hearing aids. All patients were new hearing aid users. Each of the hearing aids was equipped with an adjustable control that could be set by one of the audiologists (Audiologist A) at each site to convert it from a linear instrument to an experimental nonlinear one with automatic reduction of low-frequency gain at high input levels (or base increase at low levels, BILL). Both the patient and the audiologist performing the outcome testing at each site (Audiologist B) were blind as to the present setting of the hearing aid. Each participant was enrolled in the study for a total of 12 weeks, with the hearing aid set to either the linear or BILL-processing mode of operation for the first 8 weeks and the opposite setting for a subsequent 4-week period. In summary, this was a prospective, doubleblind, crossover study of 110 new hearing-aid users. Outcome measures focused on hearing-aid benefit and included both objective and subjective measures. Objective measures were derived from scores on the Northwestern University Auditory Test No. 6 (NU-6) and the Connected Speech Test (CST) obtained for all possible combinations of two speech presentation levels (60 and 75 dB SPL), two types of background noise (cafeteria noise and multitalker babble), and two signal-to-noise ratios (+5 and +10 dB). Subjective outcome measures included magnitude estimation of listening effort (MELE), the abbreviated form of the Hearing Aid Performance Inventory (HAPI), and estimations of hearing-aid usage based on daily-use logs kept by the participants. All of these measures were used to evaluate the benefit provided by linear amplification and the benefit resulting from the experimental BILL processing. Participant preferences for the experimental BILL-processing scheme or linear processing were also examined by using a paired-comparison task at the end of the study. Results were analyzed separately for three subgroups of patients (mild, moderate, severe) formed on the basis of their average hearing loss at 500, 1000, 2000, and 4000 Hz. In all three subgroups, significant improvement in performance was observed for linear amplification and for BILL processing when compared to unaided performance. There were no significant differences in aided performance, however, between linear processing and the experimental BILL processing.

scholarly journals Neural correlates of individual differences in speech-in-noise performance in a large cohort of cochlear implant users

2021 ◽  
Author(s):  
Joel I. Berger ◽  
Phillip E. Gander ◽  
Subong Kim ◽  
Adam T. Schwalje ◽  
Jihwan Woo ◽  
...  
Keyword(s):  
Individual Differences ◽  
Speech Perception ◽  
Word Recognition ◽  
Cochlear Implant ◽  
Low Frequency ◽  
Normal Hearing ◽  
Large Cohort ◽  
Noise Performance ◽  
Speech In Noise ◽  
Hearing Thresholds

AbstractObjectivesUnderstanding speech in noise (SiN) is a complex task that recruits multiple cortical subsystems. Individuals vary in their ability to understand SiN. This cannot be explained by simple peripheral hearing profiles, but recent work by our group (Kim et al., 2021, Neuroimage) highlighted central neural factors underlying the variance in SiN ability in normal hearing (NH) subjects. The current study examined neural predictors of speech-in-noise ability in a large cohort of cochlear-implant (CI) users, with the long-term goal of developing a simple electrophysiological correlate that could be implemented in clinics.DesignWe recorded electroencephalography (EEG) in 114 post-lingually deafened CI users while they completed the California Consonant Test (CCT): a word-in-noise task. In many subjects, data were also collected on two other commonly used clinical measures of speech perception: a word-in-quiet task (Consonant-Nucleus-Consonant [CNC]) word and a sentence-in-noise task (AzBio sentences). Neural activity was assessed at a single vertex electrode (Cz), to maximize generalizability to clinical situations. The N1-P2 complex of event-related potentials (ERPs) at this location were included in multiple linear regression analyses, along with several other demographic and hearing factors as predictors of speech in noise performance.ResultsIn general, there was a good agreement between the scores on the three speech perception tasks. ERP amplitudes did not predict AzBio performance which was predicted by the duration of device use, low-frequency hearing thresholds, and age. However, ERP amplitudes were strong predictors for performance for both word recognition tasks: the CCT (which was conducted simultaneously with EEG recording), and the CNC (conducted offline). These correlations held even after accounting for known predictors of performance including residual low-frequency hearing thresholds. In CI-users, better performance was predicted by an increased cortical response to the target word, in contrast to previous reports in normal-hearing subjects in whom speech perception ability was accounted for by the ability to suppress noise.ConclusionsThese data indicate a neurophysiological correlate of speech-in-noise performance that can be relatively easily captured within the clinic, thereby revealing a richer profile of an individual’s hearing performance than shown by psychoacoustic measures alone. These results also highlight important differences between sentence and word recognition measures of performance and suggest that individual differences in these measures may be underwritten by different mechanisms. Finally, the contrast with prior reports of NH listeners in the same task suggests CI-users performance may be explained by a different weighting of neural processes than NH listeners.

scholarly journals Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Guilherme Machado de Carvalho ◽  
Alexandre C. Guimaraes ◽  
Alexandre S. M. Duarte ◽  
Eder B. Muranaka ◽  
Marcelo N. Soki ◽  
...  
Keyword(s):  
Speech Perception ◽  
Surgical Technique ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Low Frequencies ◽  
Great Satisfaction ◽  
New Device

Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery.Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience.Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device.Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America.

scholarly journals Electric and Acoustic Stimulation in Cochlear Implant Recipients with Hearing Preservation

2018 ◽  
Vol 39 (04) ◽  
pp. 414-427 ◽  
Author(s):  
Christopher Welch ◽  
Margaret Dillon ◽  
Harold Pillsbury
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
High Frequency ◽  
Low Frequency ◽  
Hearing Preservation ◽  
The United States ◽  
Acoustic Stimulation ◽  
Electric Hearing

AbstractHearing loss affects 30 million people in the United States, and a subset of these patients have normal low-frequency hearing and ski-sloped high-frequency hearing loss. For these patients, hearing aids alone may not provide adequate benefit. Cochlear implantation alone has been utilized to improve speech perception. The addition of high-frequency electric hearing to low-frequency acoustic hearing in these patients is beneficial. Technical improvements have allowed preservation of low-frequency hearing in cochlear implant recipients, allowing for electric and acoustic stimulation in the same ear with significant improvements in speech perception, sound localization, music appreciation, and quality of life.

Improvements in Speech Perception With Use of the AVR TranSonic Frequency-Transposing Hearing Aid

1999 ◽  
Vol 42 (6) ◽  
pp. 1323-1335 ◽  
Author(s):  
Hugh J. McDermott ◽  
Voula P. Dorkos ◽  
Michelle R. Dean ◽  
Teresa Y. C. Ching
Keyword(s):  
Speech Perception ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Frequency ◽  
Sensorineural Hearing ◽  
Limited Evidence ◽  
Acoustic Characteristics ◽  
Sensorineural Hearing Impairment

Five adults with sensorineural hearing impairment participated in a trial comparing the performance of the AVR TranSonic frequency-transposing hearing aid with that of their own conventional aids. They used the TranSonic for approximately 12 weeks, during which time systematic changes were made to the transposition parameters. Speech perception was assessed with each setting of those parameters and with the participants’ own hearing aids. Four participants obtained significantly higher scores with the TranSonic than with their own aids on at least one of the tests. However, analysis of the consonant confusions suggested that the improvement resulted mostly from the TranSonic’s low-frequency electro-acoustic characteristics. There was only limited evidence for 2 of the participants that the frequency-lowering function was effective at improving speech perception.

Evaluation of Special Hearing Aids for Deaf Children

1971 ◽  
Vol 36 (4) ◽  
pp. 527-537 ◽  
Author(s):  
Norman P. Erber
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Hearing Aid ◽  
Low Frequency ◽  
Acoustic Stimulation ◽  
Deaf Children ◽  
Frequency Range ◽  
Frequency Limit ◽  
Unpublished Studies ◽  
Published Research

Two types of special hearing aid have been developed recently to improve the reception of speech by profoundly deaf children. In a different way, each special system provides greater low-frequency acoustic stimulation to deaf ears than does a conventional hearing aid. One of the devices extends the low-frequency limit of amplification; the other shifts high-frequency energy to a lower frequency range. In general, previous evaluations of these special hearing aids have obtained inconsistent or inconclusive results. This paper reviews most of the published research on the use of special hearing aids by deaf children, summarizes several unpublished studies, and suggests a set of guidelines for future evaluations of special and conventional amplification systems.

Effect of Bimodal Hearing in Speech Perception Under Noisy Environment According to Residual Hearing

2009 ◽  
Vol 52 (1) ◽  
pp. 29 ◽  
Author(s):  
Eun-Jung Lim ◽  
Kyu-Yup Lee ◽  
Yee-Hyuk Kim ◽  
Chang-Min Sin ◽  
Sung-Jae Youn ◽  
...  
Keyword(s):  
Speech Perception ◽  
Residual Hearing ◽  
Noisy Environment ◽  
Bimodal Hearing

scholarly journals Evaluation of the efficacy of hearing aids in older adults: a multiparametric longitudinal study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Domenico Cuda ◽  
Sara Ghiselli ◽  
Alessandra Murri
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Speech Perception ◽  
Hearing Aids ◽  
Assessment Tools ◽  
Elderly Subjects ◽  
Single Subject ◽  
Measurement Tools ◽  
First Time

Abstract Background Prevalence of hearing loss increases with age. Its estimated prevalence is 40–50 % in people over 75 years of age. Recent studies agree that declinein hearing threshold contribute to deterioration in sociality, sensitivity, cognition, and quality of life for elderly subjects. The aim of the study presented in this paper is to verify whether or not rehabilitation using first time applied Hearing Aids (HA) in a cohort of old people with hearing impairment improves both speech perception in a noisy environment over time and the overall health-related quality of life. Methods The monocentric, prospective, repeated measurements, single-subject, clinical observational study is to recruit 100 older adults, first-time HA recipients (≥ 65 years).The evaluation protocol is designed to analyze changes in specific measurement tools a year after the first HA usage in comparison with the evaluation before HA fitting. Evaluations will consist of multiparametric details collected through self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in speech perception in noise to be used is the Italian version of Oldenburg Satz (OLSA) test whereas the indicator of changes in overall quality of life will be the Assessment of Quality of Life (AQoL) and Hearing Handicap Inventory for the Elderly (HHIE) questionnaires. The Montreal Cognitive Assessment (MoCA) will help in screening the cognitive state of the subjects. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare the effects of HA rehabilitation in the older adults immediately before first HA usage (Pre) and after 1 year of experience (Post). This broad approach will lead to a greater understanding of how useful hearing influences the quality of life in older individuals, and therefore improves potentials for healthy aging. The data is to be analyzed by using an intrasubject endpoint comparison. Outcomes will be described and analyzed in detail. Trial registration This research was retrospectively registered underno. NCT04333043at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.

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