Remediation of Spatial Processing Deficits in Hearing-Impaired Children and Adults

2014 ◽  
Vol 25 (06) ◽  
pp. 549-561 ◽  
Author(s):  
Helen Glyde ◽  
Sharon Cameron ◽  
Harvey Dillon ◽  
Louise Hickson
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Training Program ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Auditory Training ◽  
Spatial Processing ◽  
Signal To Noise ◽  
Processing Ability ◽  
Processing Deficits

Background: The ability to use interaural cues to segregate target speech from competing signals allows people with normal hearing to understand speech at significantly poorer signal-to-noise ratios. This ability, referred to as spatial processing ability or spatial release from masking, has been shown to be deficient in people with a sensorineural hearing loss even after amplification is applied. Spatial processing deficits in a population of children with auditory processing deficits have been found to be remediable through the use of a deficit-specific auditory training program called the LiSN & Learn. Purpose: The aim of the present study was to determine whether LiSN & Learn auditory training could improve the spatial processing ability of hearing-impaired adults and children. In addition, the research investigated whether the age of the participant would affect the efficacy of the training program. Research Design: In a repeated-measures design, participants’ spatial processing ability was assessed pretraining and posttraining using the Listening in Spatialized Noise-Sentences Test (LiSN-S). Questionnaire responses were also collected from participants pretraining and posttraining to provide a subjective measure of real-life listening difficulty. Between the two assessment periods, participants were asked to train with the LiSN & Learn for 15 min per day, 5 days per week for 60 training sessions. Study Sample: Participants were five children (aged 6–11 yr) and five adults (aged 60–74 yr) with up to a moderate sensorineural hearing loss. Data Collection and Analysis: The LiSN & Learn auditory training software incorporates five computer games in which target sentences, processed with head-related transfer functions, are perceived as coming from 0° azimuth, and simultaneous distracting speech streams are perceived as coming from ±90° azimuth. Participants are tasked with identifying a word from the target sentence and selecting the corresponding picture from a selection of four images displayed on the screen. The signal-to-noise ratio is adapted based on whether the response given is correct or incorrect. Results: Despite an average improvement of 10 dB on the LiSN & Learn training program, no significant improvements were seen posttraining in either of the spatially separated conditions of the LiSN-S (p ranging 0.47–0.75). A 1.2 dB improvement was found in the baseline condition of the LiSN-S, which incorporates no spatial separation between distracter and target stimuli (p < 0.01). Age did not significantly affect training outcomes (p = 0.21). No significant improvements were found posttraining on the self-report questionnaires (p = 0.84 and p = 0.20). Conclusions: This study has demonstrated that LiSN & Learn training does not significantly improve spatial processing deficits in adults or children with a sensorineural hearing loss. As auditory training did not prove to be effective, further research should be directed toward the development of hearing aid processing schemes that will compensate for the degraded interaural time difference and interaural level difference cues which underpin spatial processing.

scholarly journals Review of integrated solutions for rehabilitation of sensorineural hearing loss in adults

2020 ◽  
Vol 5 (1) ◽  
pp. 40-43
Author(s):  
Tatyana Yu. Vladimirova ◽  
Aleksandr V. Kurenkov ◽  
Lyubov V. Aizenshtadt ◽  
Kristina R. Galieva
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Depressive Disorders ◽  
State Level ◽  
Rehabilitation Program ◽  
Individual Characteristics ◽  
Sensorineural Hearing ◽  
Auditory Training ◽  
Normative Documents ◽  
The Disabled

Objectives - to analyse the complex solutions for rehabilitation of sensorineural hearing loss in adults and elderly people. Material and methods. We reviewed 27 articles on the problem, published in the recent 5 years, presented in the international databases PubMed, Scopus and E-library. Conclusion. The rehabilitation procedure for chronic SNHL is quite clearly regulated and defined at the state level only for the person with hearing disabilities. While determining the needs of the disabled person in rehabilitation, the recommended rehabilitation approaches are described. However, in the normative documents, there is no clearly defined rehabilitation algorithm, taking into account the patient's individual characteristics. A high index of multimorbidity in adults with SNHL, including anxiety-depressive disorders and cognitive deficit, determines the need for inclusion of the auditory training in the rehabilitation process. The use of various options for auditory training along with electro-acoustic correction of hearing or cochlear implantation is an essential component of an individual rehabilitation program.

scholarly journals Investigating the Impact of Hearing Aid Use and Auditory Training on Cognition, Depressive Symptoms, and Social Interaction in Adults With Hearing Loss: Protocol for a Crossover Trial (Preprint)

2017 ◽  
Author(s):  
Joanna Nkyekyer ◽  
Denny Meyer ◽  
Peter J Blamey ◽  
Andrew Pipingas ◽  
Sunil Bhar
Keyword(s):  
Hearing Loss ◽  
Depressive Symptoms ◽  
Social Interaction ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Sensorineural Hearing ◽  
Auditory Training ◽  
Face To Face ◽  
Hearing Aid Use

BACKGROUND Sensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training—formal listening activities designed to optimize speech perception—are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss. OBJECTIVE This study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own. METHODS This is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction. RESULTS Data analysis is currently under way and the first results are expected to be submitted for publication in June 2018. CONCLUSIONS Results from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials. CLINICALTRIAL ClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).

Limiting Spectral Resolution in Speech for Listeners With Sensorineural Hearing Loss

1999 ◽  
Vol 42 (4) ◽  
pp. 773-784 ◽  
Author(s):  
Christopher W. Turner ◽  
Siu-Ling Chi ◽  
Sarah Flock
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Spectral Resolution ◽  
Present Experiment ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Frequency Resolution ◽  
Limiting Factor ◽  
Speech Condition

Consonant recognition was measured as a function of the degree of spectral resolution of the speech stimulus in normally hearing listeners and listeners with moderate sensorineural hearing loss. Previous work (Turner, Souza, and Forget, 1995) has shown that listeners with sensorineural hearing loss could recognize consonants as well as listeners with normal hearing when speech was processed to have only one channel of spectral resolution. The hypothesis tested in the present experiment was that when speech was limited to a small number of spectral channels, both normally hearing and hearing-impaired listeners would continue to perform similarly. As the stimuli were presented with finer degrees of spectral resolution, and the poorer-than-normal spectral resolving abilities of the hearing-impaired listeners became a limiting factor, one would predict that the performance of the hearing-impaired listeners would then become poorer than the normally hearing listeners. Previous research on the frequency-resolution abilities of listeners with mild-to-moderate hearing loss suggests that these listeners have critical bandwidths three to four times larger than do listeners with normal hearing. In the present experiment, speech stimuli were processed to have 1, 2, 4, or 8 channels of spectral information. Results for the 1-channel speech condition were consistent with the previous study in that both groups of listeners performed similarly. However, the hearing-impaired listeners performed more poorly than the normally hearing listeners for all other conditions, including the 2-channel speech condition. These results would appear to contradict the original hypothesis, in that listeners with moderate sensorineural hearing loss would be expected to have at least 2 channels of frequency resolution. One possibility is that the frequency resolution of hearing-impaired listeners may be much poorer than previously estimated; however, a subsequent filtered speech experiment did not support this explanation. The present results do indicate that although listeners with hearing loss are able to use the temporal-envelope information of a single channel in a normal fashion, when given the opportunity to combine information across more than one channel, they show deficient performance.

Evaluation of Hearing-Impaired Listeners Using a Nonsense-Syllable Test II. Syllable Recognition and Consonant Confusion Patterns

1982 ◽  
Vol 25 (1) ◽  
pp. 141-148 ◽  
Author(s):  
Judy R. Dubno ◽  
Donald D. Dirks ◽  
Laurn R. Langhofer
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Nonsense Syllable ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Closed Set ◽  
Systematic Relationship ◽  
Place Of Articulation ◽  
Recognition Ability ◽  
Potential Use

Syllable recognition ability and consonant confusion patterns were evaluated for 38 listeners with mild-to-moderate sensorineural hearing loss using the closed-set Nonsense-Syllable Test (NST). Performance for these materials varies as a function of consonant voicing, the position of the consonant in the syllable, and the accompanying vowel. Scores for listeners with steeply sloping audiometric configurations were consistently poorer than those for listeners with gradually sloping or flat audiograms. Consonant confusion analyses revealed place of articulation errors to be the most frequent, regardless of the listener's audiometric configuration. Analysis of consonant confusion patterns indicates the existence of a systematic relationship between consonant confusions and audiometric configuration. The NST findings are discussed in terms of the test's potential use and are compared to the results of existing confusion analyses.

Understanding Excessive SNR Loss in Hearing-Impaired Listeners

2013 ◽  
Vol 24 (04) ◽  
pp. 258-273 ◽  
Author(s):  
Ken W. Grant ◽  
Therese C. Walden
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Frequency Selectivity ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Frequency Resolution ◽  
Control Group ◽  
Temporal Acuity ◽  
Speech In Noise ◽  
Noise Test

Background: Traditional audiometric measures, such as pure-tone thresholds or unaided word-recognition in quiet, appear to be of marginal use in predicting speech understanding by hearing-impaired (HI) individuals in background noise with or without amplification. Suprathreshold measures of auditory function (tolerance of noise, temporal and frequency resolution) appear to contribute more to success with amplification and may describe more effectively the distortion component of hearing. However, these measures are not typically measured clinically. When combined with measures of audibility, suprathreshold measures of auditory distortion may provide a much more complete understanding of speech deficits in noise by HI individuals. Purpose: The primary goal of this study was to investigate the relationship among measures of speech recognition in noise, frequency selectivity, temporal acuity, modulation masking release, and informational masking in adult and elderly patients with sensorineural hearing loss to determine whether peripheral distortion for suprathreshold sounds contributes to the varied outcomes experienced by patients with sensorineural hearing loss listening to speech in noise. Research Design: A correlational study. Study Sample: Twenty-seven patients with sensorineural hearing loss and four adults with normal hearing were enrolled in the study. Data Collection and Analysis: The data were collected in a sound attenuated test booth. For speech testing, subjects' verbal responses were scored by the experimenter and entered into a custom computer program. For frequency selectivity and temporal acuity measures, subject responses were recorded via a touch screen. Simple correlation, step-wise multiple linear regression analyses and a repeated analysis of variance were performed. Results: Results showed that the signal-to-noise ratio (SNR) loss could only be partially predicted by a listener's thresholds or audibility measures such as the Speech Intelligibility Index (SII). Correlations between SII and SNR loss were higher using the Hearing-in-Noise Test (HINT) than the Quick Speech-in-Noise test (QSIN) with the SII accounting for 71% of the variance in SNR loss for the HINT but only 49% for the QSIN. However, listener age and the addition of suprathreshold measures improved the prediction of SNR loss using the QSIN, accounting for nearly 71% of the variance. Conclusions: Two standard clinical speech-in-noise tests, QSIN and HINT, were used in this study to obtain a measure of SNR loss. When administered clinically, the QSIN appears to be less redundant with hearing thresholds than the HINT and is a better indicator of a patient's suprathreshold deficit and its impact on understanding speech in noise. Additional factors related to aging, spectral resolution, and, to a lesser extent, temporal resolution improved the ability to predict SNR loss measured with the QSIN. For the HINT, a listener's audibility and age were the only two significant factors. For both QSIN and HINT, roughly 25–30% of the variance in individual differences in SNR loss (i.e., the dB difference in SNR between an individual HI listener and a control group of NH listeners at a specified performance level, usually 50% word or sentence recognition) remained unexplained, suggesting the need for additional measures of suprathreshold acuity (e.g., sensitivity to temporal fine structure) or cognitive function (e.g., memory and attention) to further improve the ability to understand individual variability in SNR loss.

Analysis of Tympanometry of a Severe to Profound Hearing-Impaired Population of School-Age Children

1979 ◽  
Vol 44 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Nilda Morgenstern ◽  
Barbara Jones-Crymes
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
School Age Children ◽  
School Age ◽  
Reliable Technique ◽  
Screening Technique ◽  
Impedance Audiometry

Impedance audiometry provides a reliable technique for identifying undetected middle ear pathologies in children with severe to profound sensorineural hearing loss. In this study, tympanograms were obtained on 104 children with sensorineural hearing losses of 60 dB or more. The tympanograms were classified according to type and were compared for bilateral similarity. A high percentage of the younger children had abnormal tympanograms, with almost half of these children having the same type of abnormal tympanogram bilaterally. The use of impedance audiometry as a screening technique for hearing-impaired school-age children is discussed.

The Effects of Hearing Loss and Noise Masking on the Masking Release for Speech in Temporally Complex Backgrounds

1998 ◽  
Vol 41 (3) ◽  
pp. 549-563 ◽  
Author(s):  
Sid P. Bacon ◽  
Jane M. Opie ◽  
Danielle Y. Montoya
Keyword(s):  
Hearing Loss ◽  
Steady State ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Normal Hearing ◽  
Sensorineural Hearing ◽  
The Other ◽  
Signal To Noise ◽  
Noise Masking ◽  
Masking Release

Speech recognition was measured in three groups of listeners: those with sensorineural hearing loss of (presumably) cochlear origin (HL), those with normal hearing (NH), and those with normal hearing who listened in the presence of a spectrally shaped noise that elevated their pure-tone thresholds to match those of individual listeners in the HL group (NM). Performance was measured in four backgrounds that differed only in their temporal envelope: steady-state (SS) speech-shaped noise, speech-shaped noise modulated by the envelope of multi-talker babble (MT), speech-shaped noise modulated by the envelope of single-talker speech (ST), and speech-shaped noise modulated by a 10-Hz square wave (SQ). Threshold signal-to-noise ratios (SNRs) were typically best in the ST and especially the SQ conditions, indicating a masking release in those modulated backgrounds. SNRs in the SS and MT conditions were essentially identical to one another. The masking release was largest in the listeners in the NH group, and it tended to decrease as hearing loss increased. In 5 of the 11 listeners in the HL group, the masking release was nearly identical to that obtained in the NM group matched to those listeners; in the other 6 listeners, the release was smaller than that in the NM group. The reduced masking release was simulated best in those HL listeners for whom the masking release was relatively large. These results suggest that reduced masking release for speech in listeners with sensorineural hearing loss can only sometimes be accounted for entirely by reduced audibility.

scholarly journals Characterization of Sensorineural Hearing Loss in Children with Alport Syndrome

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 360
Author(s):  
Jan Boeckhaus ◽  
Nicola Strenzke ◽  
Celine Storz ◽  
Oliver Gross ◽  
◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Impairment ◽  
Alport Syndrome ◽  
Age Groups ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Pure Tone Average ◽  
Hearing Thresholds

Most adults with Alport syndrome (AS) suffer from progressive sensorineural hearing loss. However, little is known about the early characteristics of hearing loss in children with AS. As a part of the EARLY PRO-TECT Alport trial, this study was the first clinical trial ever to investigate hearing loss in children with AS over a timespan of up to six years Nine of 51 children (18%) had hearing impairment. Audiograms were divided into three age groups: in the 5–9-year-olds, the 4-pure tone average (4PTA) was 8.9 decibel (dB) (n = 15) in those with normal hearing and 43.8 dB (n = 2, 12%) in those with hearing impairment. Among the 10–13-year-olds, 4PTA was 4.8 dB (healthy, n = 12) and 41.4 dB (hearing impaired, n = 6.33%). For the 14–20-year-olds, the 4PTA was 7.0 dB (healthy; n = 9) and 48.2 dB (hearing impaired, n = 3.25%). On average, hearing thresholds of the hearing impaired group increased, especially at frequencies between 1–3 kHz. In conclusion, 18% of children developed hearing loss, with a maximum hearing loss in the audiograms at 1–3 kHz. The percentage of children with hearing impairment increased from 10% at baseline to 18% at end of trial as did the severity of hearing loss.

Management of Sensorineural Hearing Loss in Children

1995 ◽  
Vol 112 (5) ◽  
pp. P120-P120
Author(s):  
Nancy M. Young ◽  
Edwin M. Monsell
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Diagnostic Tests ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Infants And Children ◽  
Educational Objectives

Educational objectives: To order appropriate diagnostic tests in children with newly identified sensorineural hearing loss and to provide better counseling of families of hearing-impaired infants and children.

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