Sound Localization Acuity in Children with Unilateral Hearing Loss Who Wear a Hearing Aid in the Impaired Ear

2010 ◽  
Vol 21 (08) ◽  
pp. 522-534 ◽  
Author(s):  
Patti M. Johnstone ◽  
Anna K. Náblek ◽  
Velma S. Robertson
Keyword(s):  
Hearing Loss ◽  
Early Intervention ◽  
Experimental Design ◽  
Sound Localization ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Older Children

Background: Disrupted binaural hearing is thought to contribute in part to the academic, social, and communication problems often associated with unilateral hearing loss (UHL) in childhood. It is not known, however, if putting a hearing aid in the impaired ear of a child with UHL will lead to bilateral or binaural benefit. This study seeks to utilize sound localization acuity measurements to assess hearing aid amplification efficacy in children with UHL. Purpose: To measure sound localization ability in children with UHL who use a hearing aid in the impaired ear to determine the extent to which amplification, age, early intervention, and degree of hearing loss affects localization acuity. Research Design: A within-subjects experimental design using repeated measures is used to determine the effect of amplification on localization acuity in children with UHL. A between-subjects experimental design is used to compare localization acuity between children with UHL and age-matched controls with normal hearing. Study Sample: Twelve children with UHL who used a hearing aid in the impaired ear and 12 age-matched controls with normal hearing. Children with UHL were divided into two groups based on degree of hearing loss. Children in both groups were divided into two age groups: older children (10–14 yr) and younger children (6–9 yr). Data Collection and Analysis: All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Results: In the experimental study a significant interaction was found between hearing aid amplification and child age. A hearing aid significantly improved localization acuity in younger children with UHL and significantly impaired localization acuity in older children. A significant correlation was found between age at intervention and localization bilateral benefit. Children who were fit earlier showed bilateral benefit whereas children who were fit later showed bilateral interference. Development, however, may play a role in sound localization acuity. When unaided, older children had significantly better localization acuity than younger children with UHL. Conclusions: A hearing aid can provide bilateral localization benefit to some children with UHL. Early intervention may increase the likelihood of bilateral benefit. However, developmental factors appear to play a role in improving localization abilities over time for children with UHL. Nonetheless, without a means of establishing bilateral benefit with hearing aid amplification, localization performance in children with UHL will rarely equal that of peers.

Open-Fit Domes and Children with Bilateral High-Frequency Sensorineural Hearing Loss: Benefits and Outcomes

2018 ◽  
Vol 29 (04) ◽  
pp. 348-356 ◽  
Author(s):  
Patti M. Johnstone ◽  
Kelly R. Yeager ◽  
Marnie L. Pomeroy ◽  
Nicole Hawk
Keyword(s):  
Hearing Loss ◽  
Experimental Design ◽  
Sound Localization ◽  
Hearing Aids ◽  
High Frequency ◽  
Repeated Measures ◽  
Age Groups ◽  
Localization Error ◽  
Older Children ◽  
Localization Accuracy

AbstractOpen-fit domes (OFDs) coupled with behind-the-ear (BTE) hearing aids were designed for adult listeners with moderate-to-severe bilateral high-frequency hearing loss (BHFL) with little to no concurrent loss in the lower frequencies. Adult research shows that BHFL degrades sound localization accuracy (SLA) and that BTE hearing aids with conventional earmolds (CEs) make matters worse. In contrast, research has shown that OFDs enhance spatial hearing percepts in adults with BHFL. Although the benefits of OFDs have been studied in adults with BHFL, no published studies to date have investigated the use of OFDs in children with the same hearing loss configuration. This study seeks to use SLA measurements to assess efficacy of bilateral OFDs in children with BHFL.To measure SLA in children with BHFL to determine the extent to which hearing loss, age, duration of CE use, and OFDs affect localization accuracy.A within-participant experimental design using repeated measures was used to determine the effect of OFDs on localization accuracy in children with BHFL. A between-participant experimental design was used to compare localization accuracy between children with BHFL and age-matched controls with normal hearing (NH).Eighteen children with BHFL who used CE and 18 age-matched NH controls. Children in both groups were divided into two age groups: older children (10–16 yr) and younger children (6–9 yr).All testing was done in a sound-treated booth with a horizontal array of 15 loudspeakers (radius of 1 m). The stimulus was a spondee word, “baseball”: the level averaged 60 dB SPL and randomly roved (±8 dB). Each child was asked to identify the location of a sound source. Localization error was calculated across the loudspeaker array for each listening condition.A significant interaction was found between immediate benefit from OFD and duration of CE usage. Longer CE usage was associated with degraded localization accuracy using OFDs. Regardless of chronological age, children who had used CEs for <6 yr showed immediate localization benefit using OFDs, whereas children who had used CEs for >6 yr showed immediate localization interference using OFDs. Development, however, may play a role in SLA in children with BHFL. When unaided, older children had significantly better localization acuity than younger children with BHFL. When compared to age-matched controls, children with BHFL of all ages showed greater localization error. Nearly all (94% [17/18]) children with BHFL spontaneously reported immediate own-voice improvement when using OFDs.OFDs can provide sound localization benefit to younger children with BHFL. However, immediate benefit from OFDs is reduced by prolonged use of CEs. Although developmental factors may play a role in improving localization abilities over time, children with BHFL will rarely equal that of peers without early use of minimally disruptive hearing aid technology. Also, the occlusion effect likely impacts children far more than currently thought.

Are Two Ears Not Better Than One?

2012 ◽  
Vol 23 (03) ◽  
pp. 171-181 ◽  
Author(s):  
Rachel A. McArdle ◽  
Mead Killion ◽  
Monica A. Mennite ◽  
Theresa H. Chisolm
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Binaural Hearing ◽  
Analysis Experiment ◽  
Insert Earphones ◽  
Speech Recognition In Noise

Background: The decision to fit one or two hearing aids in individuals with binaural hearing loss has been debated for years. Although some 78% of U.S. hearing aid fittings are binaural (Kochkin , 2010), Walden and Walden (2005) presented data showing that 82% (23 of 28 patients) of their sample obtained significantly better speech recognition in noise scores when wearing one hearing aid as opposed to two. Purpose: To conduct two new experiments to fuel the monaural/binaural debate. The first experiment was a replication of Walden and Walden (2005), whereas the second experiment examined the use of binaural cues to improve speech recognition in noise. Research Design: A repeated measures experimental design. Study Sample: Twenty veterans (aged 59–85 yr), with mild to moderately severe binaurally symmetrical hearing loss who wore binaural hearing aids were recruited from the Audiology Department at the Bay Pines VA Healthcare System. Data Collection and Analysis: Experiment 1 followed the procedures of the Walden and Walden study, where signal-to-noise ratio (SNR) loss was measured using the Quick Speech-in-Noise (QuickSIN) test on participants who were aided with their current hearing aids. Signal and noise were presented in the sound booth at 0° azimuth under five test conditions: (1) right ear aided, (2) left ear aided, (3) both ears aided, (4) right ear aided, left ear plugged, and (5) unaided. The opposite ear in (1) and (2) was left open. In Experiment 2, binaural Knowles Electronics Manikin for Acoustic Research (KEMAR) manikin recordings made in Lou Malnati's pizza restaurant during a busy period provided a typical real-world noise, while prerecorded target sentences were presented through a small loudspeaker located in front of the KEMAR manikin. Subjects listened to the resulting binaural recordings through insert earphones under the following four conditions: (1) binaural, (2) diotic, (3) monaural left, and (4) monaural right. Results: Results of repeated measures ANOVAs demonstrated that the best speech recognition in noise performance was obtained by most participants with both ears aided in Experiment 1 and in the binaural condition in Experiment 2. Conclusions: In both experiments, only 20% of our subjects did better in noise with a single ear, roughly similar to the earlier Jerger et al (1993) finding that 8–10% of elderly hearing aid users preferred one hearing aid.

scholarly journals Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss and Children Receiving Bilateral Cochlear Implants

2021 ◽  
Vol 25 ◽  
pp. 233121652110512
Author(s):  
Claire McSweeny ◽  
Sharon L. Cushing ◽  
Jennifer L. Campos ◽  
Blake C. Papsin ◽  
Karen A. Gordon
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Cochlear Implants ◽  
Verbal Memory ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Visuospatial Memory ◽  
Bilateral Cochlear Implants ◽  
Academic Deficits

Poor binaural hearing in children was hypothesized to contribute to related cognitive and academic deficits. Children with unilateral hearing have normal hearing in one ear but no access to binaural cues. Their cognitive and academic deficits could be unique from children receiving bilateral cochlear implants (CIs) at young ages who have poor access to spectral cues and impaired binaural sensitivity. Both groups are at risk for vestibular/balance deficits which could further contribute to memory and learning challenges. Eighty-eight children (43 male:45 female, aged 9.89  ±  3.40 years), grouped by unilateral hearing loss ( n = 20), bilateral CI ( n = 32), and typically developing ( n = 36), completed a battery of sensory, cognitive, and academic tests. Analyses revealed that children in both hearing loss groups had significantly poorer skills (accounting for age) on most tests than their normal hearing peers. Children with unilateral hearing loss had more asymmetric speech perception than children with bilateral CIs ( p < .0001) but balance and language deficits ( p = .0004, p < .0001, respectively) were similar in the two hearing loss groups ( p > .05). Visuospatial memory deficits occurred in both hearing loss groups ( p = .02) but more consistently across tests in children with unilateral hearing loss. Verbal memory was not significantly different than normal ( p > .05). Principal component analyses revealed deficits in a main cluster of visuospatial memory, oral language, mathematics, and reading measures (explaining 46.8% data variability). The remaining components revealed clusters of self-reported hearing, balance and vestibular function, and speech perception deficits. The findings indicate significant developmental impacts of poor binaural hearing in children.

scholarly journals Using background noise to improve sound localization following simulated hearing loss

2019 ◽  
Author(s):  
Lindsey Ryan-Warden ◽  
Eva Ng ◽  
Peter Keating
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Background Noise ◽  
Human Subjects ◽  
Normal Hearing ◽  
Unilateral Hearing Loss ◽  
Noisy Environments ◽  
Negative Effects ◽  
Neurophysiological Studies ◽  
Continuous Background

AbstractMany listening abilities become more difficult in noisy environments, particularly following hearing loss. Sound localization can be disrupted even if target sounds are clearly audible and distinct from background noise. Since subjects locate sounds by comparing the input to the two ears, sound localization is also considerably impaired by unilateral hearing loss. Currently, however, it is unclear whether the effects of unilateral hearing loss are worsened by background noise. To address this, we measured sound localization abilities in the presence or absence of broadband background noise. Adult human subjects of either sex were tested with normal hearing or with a simulated hearing loss in one ear (earplug). To isolate the role of binaural processing, we tested subjects with narrowband target sounds. Surprisingly, we found that continuous background noise improved narrowband sound localization following simulated unilateral hearing loss. By contrast, we found the opposite effect under normal hearing conditions, with background noise producing illusory shifts in sound localization. Previous attempts to model these shifts are inconsistent with behavioural and neurophysiological data. However, here we found that a simple hemispheric model of sound localization provides an explanation for our results, and provides key hypotheses for future neurophysiological studies. Overall, our results suggest that continuous background noise may be used to improve sound localization under the right circumstances. This has important implications for real-world hearing, both in normal-hearing subjects and the hearing-impaired.Significance StatementIn noisy environments, many listening abilities become more difficult, even if target sounds are clearly audible. For example, background noise can produce illusory shifts in the perceived direction of target sounds. Because sound localization relies on the two ears working together, it is also distorted by a hearing loss in one ear. We might therefore expect background noise to worsen the effects of unilateral hearing loss. Surprisingly, we found the opposite, with background noise improving sound localization when we simulated a hearing loss in one ear. A simple hemispheric model of sound localization also helped explain the negative effects of background noise under normal hearing conditions. Overall, our results highlight the potential for using background noise to improve sound localization.

Assessment of expressive vocabulary outcomes in hearing-impaired children with hearing aids: do bilaterally hearing-impaired children catch up?

2006 ◽  
Vol 120 (8) ◽  
pp. 619-626 ◽  
Author(s):  
C Kiese-Himmel ◽  
M Reeh
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Expressive Vocabulary ◽  
Clinical Tool ◽  
Impaired Children ◽  
Hearing Impaired Children

Objective: To evaluate expressive vocabulary growth in hearing-impaired preschool children wearing hearing aids.Design: Prospective analysis of the outcomes of children included in the 1994 German ‘Goettinger Hoer-Sprachregister’ (GHR) series, using a repeated-measures paradigm in six- to nine-month intervals (t1–t3).Subjects: Twenty-seven children (aged 2.0–4.4 years) with bilateral sensorineural hearing loss (with averages at frequencies of 0.5, 1, 2 and 4 kHz of >20 to >90 dB in the better ear) from the 1994 GHR series. The children were diagnosed at a mean age of 31.4 months (standard deviation (SD) 10.6 months) and fitted with a binaural hearing aid at a mean age of 32.3 months (SD 10.5 months). Nonverbal intelligence was average (five missing data entries). Standardized, age-appropriate picture naming tests (the ‘Sprachentwicklungstest für 2-jährige Kinder’, the Kaufman Assessment Battery for Children subtest vocabulary, and the ‘Aktiver Wortschatztest für drei- bis sechsjährige Kinder’) were carried out at three time points and results compared with data from children with normal hearing. The test raw scores were converted to T scores (mean = 50; SD = 10).Results: On average, the children scored far below the normative population at t1 (mean = 28.9; SD = 11.3) and slowly improved as they got older (at t3, mean = 34.1; SD = 16.1; p = 0.010). Children with mild or moderate hearing loss improved most notably (mean difference t1–t3; p = 0.001), except for one child of deaf parents. Two of the five mildly hearing-impaired children and two of the eleven moderately hearing-impaired children caught up with their normal hearing peers with regards to expressive vocabulary. Such expressive vocabulary achievements were not seen in any children with >70 dB hearing loss or in six of the eleven children (55 per cent) with a 40–70 dB hearing loss, despite receiving adequate personal amplification.Conclusion: Testing expressive vocabulary size is a useful clinical tool in assessing linguistic lexical outcome.

scholarly journals Influence of Instantaneous Compression on Recognition of Speech in Noise with Temporal Dips

2019 ◽  
Vol 30 (01) ◽  
pp. 016-030 ◽  
Author(s):  
Daniel M. Rasetshwane ◽  
David A. Raybine ◽  
Judy G. Kopun ◽  
Michael P. Gorga ◽  
Stephen T. Neely
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Repeated Measures ◽  
Hearing Aid ◽  
Processing Condition ◽  
Simultaneous Presentation ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
Signal Processing Algorithm ◽  
Masking Release

AbstractIn listening environments with background noise that fluctuates in level, listeners with normal hearing can “glimpse” speech during dips in the noise, resulting in better speech recognition in fluctuating noise than in steady noise at the same overall level (referred to as masking release). Listeners with sensorineural hearing loss show less masking release. Amplification can improve masking release but not to the same extent that it does for listeners with normal hearing.The purpose of this study was to compare masking release for listeners with sensorineural hearing loss obtained with an experimental hearing-aid signal-processing algorithm with instantaneous compression (referred to as a suppression hearing aid, SHA) to masking release obtained with fast compression. The suppression hearing aid mimics effects of normal cochlear suppression, i.e., the reduction in the response to one sound by the simultaneous presentation of another sound.A within-participant design with repeated measures across test conditions was used.Participants included 29 adults with mild-to-moderate sensorineural hearing loss and 21 adults with normal hearing.Participants with sensorineural hearing loss were fitted with simulators for SHA and a generic hearing aid (GHA) with fast (but not instantaneous) compression (5 ms attack and 50 ms release times) and no suppression. Gain was prescribed using either an experimental method based on categorical loudness scaling (CLS) or the Desired Sensation Level (DSL) algorithm version 5a, resulting in a total of four processing conditions: CLS-GHA, CLS-SHA, DSL-GHA, and DSL-SHA.All participants listened to consonant-vowel-consonant nonwords in the presence of temporally-modulated and steady noise. An adaptive-tracking procedure was used to determine the signal-to-noise ratio required to obtain 29% and 71% correct. Measurements were made with amplification for participants with sensorineural hearing loss and without amplification for participants with normal hearing.Repeated-measures analysis of variance was used to determine the influence of within-participant factors of noise type and, for participants with sensorineural hearing loss, processing condition on masking release. Pearson correlational analysis was used to assess the effect of age on masking release for participants with sensorineural hearing loss.Statistically significant masking release was observed for listeners with sensorineural hearing loss for 29% correct, but not for 71% correct. However, the amount of masking release was less than masking release for participants with normal hearing. There were no significant differences among the amplification conditions for participants with sensorineural hearing loss.The results suggest that amplification with either instantaneous or fast compression resulted in similar masking release for listeners with sensorineural hearing loss. However, the masking release was less for participants with hearing loss than it was for those with normal hearing.

scholarly journals Sound localization latency in normal hearing and simulated unilateral hearing loss

2020 ◽  
Vol 395 ◽  
pp. 108011
Author(s):  
Martin Eklöf ◽  
Filip Asp ◽  
Erik Berninger
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Normal Hearing ◽  
Unilateral Hearing Loss

scholarly journals Sound Localization and Lateralization by Bilateral Bone Conduction Devices, Middle Ear Implants, and Cartilage Conduction Hearing Aids

2021 ◽  
Vol 11 (4) ◽  
pp. 508-523
Author(s):  
Kimio Shiraishi
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Sound Localization ◽  
Hearing Aids ◽  
Bone Conduction ◽  
Binaural Hearing ◽  
Normal Hearing ◽  
Aural Atresia ◽  
Middle Ear Implants ◽  
And Cartilage

Sound localization in daily life is one of the important functions of binaural hearing. Bilateral bone conduction devices (BCDs), middle ear implants, and cartilage conduction hearing aids have been often applied for patients with conductive hearing loss (CHL) or mixed hearing loss, for example, resulting from bilateral microtia and aural atresia. In this review, factors affecting the accuracy of sound localization with bilateral BCDs, middle ear implants, and cartilage conduction hearing aids were classified into four categories: (1) types of device, (2) experimental conditions, (3) participants, and (4) pathways from the stimulus sound to both cochleae. Recent studies within the past 10 years on sound localization and lateralization by BCDs, middle ear implants, and cartilage conduction hearing aids were discussed. Most studies showed benefits for sound localization or lateralization with bilateral devices. However, the judgment accuracy was generally lower than that for normal hearing, and the localization errors tended to be larger than for normal hearing. Moreover, it should be noted that the degree of accuracy in sound localization by bilateral BCDs varied considerably among patients. Further research on sound localization is necessary to analyze the complicated mechanism of bone conduction, including suprathreshold air conduction with bilateral devices.

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