Reliability in Hearing Threshold Prediction in Normal-Hearing and Hearing-Impaired Participants Using Mixed Multiple ASSR

2015 ◽  
Vol 26 (03) ◽  
pp. 299-310 ◽  
Author(s):  
Kjell-Erik Israelsson ◽  
Renata Bogo ◽  
Erik Berninger
Keyword(s):  
Growth Rate ◽  
Prediction Error ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Interquartile Range ◽  
Time Averaging ◽  
Intersubject Variability ◽  
Long Time

Background and Purpose: The rapidly evolving field of hearing aid fitting in infants requires rapid, objective, and highly reliable methods for diagnosing hearing impairment. The aim was to determine test-retest reliability in hearing thresholds predicted by multiple auditory steady-state response (ASSRthr) among normal-hearing (NH) and hearing-impaired (HI) adults, and to study differences between ASSRthr and pure-tone threshold (PTT) as a function of frequency in each participant. ASSR amplitude versus stimulus level was analyzed to study ASSR growth rate in NH and HI participants, especially at ASSRthr. Research Design and Study Sample: Mixed multiple ASSR (100% AM, 20% FM), using long-time averaging at a wide range of stimulus levels, and PTT were recorded in 10 NH and 14 HI adults. ASSRthr was obtained in 10 dB steps simultaneously in both ears using a test-retest protocol (center frequencies = 500, 1000, 2000, and 4000 Hz; modulation frequencies = 80–96 Hz). The growth rate at ASSRthr was calculated as the slope (nV/dB) of the ASSR amplitudes obtained at, and 10 dB above, ASSRthr. PTT was obtained in both ears in 1 dB steps using a fixed-frequency Békésy technique. All of the NH participants showed PTTs better than 20 dB HL (125–8000 Hz), and mean pure-tone average (PTA; 500–4000 Hz) was 1.8 dB HL. The HI participants exhibited quite symmetrical sensorineural hearing losses, as revealed by a mean interaural PTA difference of 6.5 dB. Their mean PTA in the better ear was 38.7 dB HL. Results: High ASSRthr reproducibility (independent of PTT) was found in both NH and HI participants (test-retest interquartile range = 10 dB). The prediction error was numerically higher in NH participants (f ≥1000 Hz), although only a significant difference existed at 1000 Hz. The median difference between ASSRthr (dB HL) and PTT (dB HL) was approximately 10 dB in the HI group at frequencies of 1000 Hz or greater, and 20 dB at 500 Hz. In general, the prediction error decreased (p < 0.001) with increasing hearing threshold, although large intersubject variability existed. Regression analysis (PTT versus ASSRthr) in HI participants revealed correlation coefficients between 0.72–0.88 (500–4000 Hz) and slopes at approximately 1.0. Large variability in ASSRthr-PTT versus frequency was demonstrated across HI participants (interquartile range approximately 20 dB). The maximum across-frequency difference (ASSRthr-PTT) in an individual participant was 50 dB. HI participants showed overall significantly higher amplitudes and slopes at ASSRthr than did NH participants (p < 0.02). The amplitude-intensity function revealed monotonically increasing ASSRs in NH participants (slope 2 nV/dB), whereas HI participants exhibited heterogeneous and mostly nonmonotonically increasing ASSRs. Conclusions: Long-time averaging of ASSR revealed high ASSRthr reproducibility and systematic decrease in prediction error with increasing hearing threshold, albeit large intersubject variability in prediction error existed. A plausible explanation for the systematic difference in ASSRthr between NH and HI adults might be significantly higher ASSR amplitudes and higher overall growth rates at ASSRthr among HI participants. Across-frequency comparison of PTT and ASSRthr in an individual HI participant demonstrated large variation; thus, ASSR may not be optimal for, e.g., reliable threshold prediction in infants and subsequent fine-tuning of hearing aids.

scholarly journals Speech audiometry test in modern Greek language with sentence lists for hearing impaired children

2017 ◽  
Author(s):  
Κωνσταντίνα Κολούτσου
Keyword(s):  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Speech Audiometry ◽  
Greek Language ◽  
Modern Greek ◽  
Speech Reception ◽  
Impaired Children ◽  
Hearing Impaired Children

Σκοπός: Σκοπός αυτής της μελέτης ήταν η ανάπτυξη της Δοκιμασίας -Τέστ, το G-SEBSAT τέστ, στην ακουστική ομιλία βασισμένο σε προτάσεις για παιδιά με προβλήματα ακοής.Μέθοδοι: Προσλήφθηκαν εβδομήντα έξι παιδιά κατόπιν έγκρισης από την τοπική επιτροπή δεοντολογίας και κατόπιν ενημέρωσης από τους γονείς τους. Η συλλογή του λεξιλογίου βασίστηκε στην προβολή εικόνων που επιλέχθηκαν από δημοφιλείς αναγνωστικές ύλες στα ελληνικά στα παιδιά με προβλήματα ακοής (Hearing Impaired-ΗΙ). Εκπονήθηκε μια γραμματική ανάλυση περιεχομένου για να προσδιοριστούν οι μέσες συντακτικές και μορφολογικές δομές των φράσεων που χρησιμοποιούνται από τα παιδιά της ΗΙ ομάδας . Δέκα λίστες που σχετίζονται με αντοίστοιχες εικόνες, δημιουργήθηκαν με βάση το λεξιλόγιο και τη γραμματική ανάλυση και καταγράφηκαν από έναν άνδρα ομιλητή με μητρική του γλώσσα την σύγχρονη ελληνική. Οι δέκα λίστες παρουσιάστηκαν σε παιδιά με κανονική ακοή (Normal Hearing-NH) και σε παιδιά με HI, ενώ και στις δύο ομάδες καταγράφηκε το μέσο όριο απόκρισης ομιλίας (Speech Reception Threshold-SRT) καθώς και η κλίση της καμπύλης SRT στο επίπεδο SRT των 50% σωστών αποκρίσεων (S50). Οι κατάλογοι καταγγελιών επικυρώθηκαν σε σχέση με τη μεταβλητότητα της δυσκολίας τους σε κάθε ομάδα, καθώς και με τη μεταβλητότητα δοκιμής-επανεξέτασης των αντίστοιχων βαθμολογιών SRT.Αποτελέσματα: Το μέσο όριο απόκρισης ομιλίας (SRT) σε όλες τις λίστες για παιδιά με ΗΙ ήταν 65,27 dB και η κλίση της καμπύλης SRT στο επίπεδο SRT των 50% των σωστών αποκρίσεων ήταν 3,11% / dB. Τα αντίστοιχα αποτελέσματα σε όλους τους καταλόγους για τα παιδιά με NH ήταν 17,66 dB και 9,7% / dB αντίστοιχα. Τα SRT των παιδιών με ΗΙ συσχετίστηκαν έντονα θετικά, με στατιστικά σημαντικό τρόπο με την μέτρηση ακουστικού τόνου (Pure Tone Audiometry-ΡΤΑ) τόσο στις δοκιμασίες όσο και στις δοκιμαστικές συνεδρίες (δοκιμασία: r = 0.750, Ρ <0.0005, επανέλεγχος: r = 0.753, Ρ <0.0005). Η συσχέτιση Spearman των βαθμολογιών των τιμών SRT και των τιμών κλίσης ήταν 0.998 και 0.997 αντίστοιχα για το ΗΙ και 0.939 και 0.88 για την ομάδα με ΝΗ, υποδεικνύοντας πολύ χαμηλή μεταβλητότητα σε όλες τις συνεδρίες δοκιμής και επανεξέτασης. Επιπλέον, η ανάλυση της διακύμανσης (ANOVA) του μέσου SRT στα παιδιά με NH και τα υπολείμματα SRT στην ομάδα με HI έδειξε ότι οι διαφορετικές προτάσεις ήταν της ίδιας δυσκολίας σε κάθε ομάδα. ((F (9,81) = 0,401, ρ = 0,930 και (F (9,93) = 2,241, ρ = 0,025 αντίστοιχα).Συμπεράσματα: Για πρώτη φορά δημιουργήθηκε στην ελληνική γλώσσα επικυρωμένη δοκιμή ομιλίας ακουστικής φωνής. Οι τιμές SRT και S50 και για τα παιδιά με NH και με HI είναι συγκρίσιμες με παρόμοιες δοκιμές που αναπτύχθηκαν σε άλλες γλώσσες.

Frequency-Discrimination Ability of Hearing-Impaired Listeners

1981 ◽  
Vol 24 (1) ◽  
pp. 108-112 ◽  
Author(s):  
P. M. Zurek ◽  
C. Formby
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Frequency Modulation ◽  
Hearing Threshold ◽  
Low Frequency ◽  
Frequency Discrimination ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Discrimination Ability ◽  
Hearing Sensitivity

Thresholds for frequency modulation were measured by an adaptive, two-alternative, forced-choice method with ten listeners: eight who showed varying degrees of sensorineural hearing impairment, and two with normal-hearing sensitivity. Results for test frequencies spaced at octave intervals between 125 and 4000 Hz showed that, relative to normal-hearing listeners, the ability of the hearing-impaired listeners to detect a sinusoidal frequency modulation: (1) is diminished above a certain level of hearing loss; and (2) is more disrupted for low-frequency tones than for high-frequency tones, given the same degree of hearing loss at the test frequency. The first finding is consistent with that of previous studies which show a general deterioration of frequency-discrimination ability associated with moderate, or worse, hearing loss. It is proposed that the second finding may be explained: 1) by differential impairment of the temporal and place mechanisms presumed to, encode pitch at the lower and higher frequencies, respectively; and/or, 2) for certain configurations of hearing loss, by the asymmetrical pattern of cochlear excitation that may lead to the underestimation, from measurements of threshold sensitivity, of hearing impairment for low-frequency tones and consequently to relatively large changes in frequency discrimination for small shifts in hearing threshold.

scholarly journals Dichotic Listening in Hearing-Impaired Children

1971 ◽  
Vol 14 (4) ◽  
pp. 793-803 ◽  
Author(s):  
Agnes H. Ling
Keyword(s):  
Dichotic Listening ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
The Other ◽  
Impaired Hearing ◽  
Intersubject Variability ◽  
Impaired Group ◽  
Ear Advantage ◽  
Impaired Children ◽  
Hearing Impaired Children

Ear asymmetry for dichotic digits was used in an attempt to estimate speech laterality in 19 children with impaired hearing and 19 with normal hearing. Sequences of digits were also presented monaurally. The normal-hearing group was significantly superior to the hearing-impaired in the recall of both monaural and dichotic digits. No ear advantage was observed for either group on the monaural test. Right-ear dichotic scores were significantly superior for the normal-hearing group, but intersubject variability resulted in a nonsignificant right-ear trend for the hearing-impaired group, with individuals showing marked right- or left-ear advantage. No correlation was found between degree of ear asymmetry on the dichotic test and vocabulary scores for hearing-impaired subjects. Both members of a dichotic pair were rarely reported by hearing-impaired subjects, with one digit apparently masking or suppressing the other. It was concluded that speech lateralization could not safely be inferred from dichotic digit scores of hearing-impaired children.

scholarly journals Change in Self-Evaluation of Hearing Status According to Age: A Population-Based Study

2021 ◽  
Vol 64 (12) ◽  
pp. 861-867
Author(s):  
Seok-Youl Choi ◽  
Jee Won Moon ◽  
June Choi ◽  
Jae-Jun Song ◽  
Gi Jung Im ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Pure Tone ◽  
Hearing Threshold ◽  
Pure Tone Audiometry ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Level ◽  
Cross Sectional ◽  
Self Evaluation

Background and Objectives Self-reported hearing levels determined by self-report questionnaires are not always correlated with the audiometric hearing level. It is necessary to ascertain the subjectively perceived normal hearing threshold to determine the need for hearing aids at the appropriate time. The objective is to identify the level of correlation between the self-reported hearing level and the audiometric hearing level and ascertain the subjectively perceived normal hearing threshold for each age group.Subjects and Method This cross-sectional study, using the data from the Korea National Health and Nutrition Examination Survey V, looked at participants with hearing loss who were aged ≥40 years. Pure tone audiometry was conducted bilaterally. Self-reported hearing level was ascertained via survey enquiring about hearing loss. The level of correlation between self-reported hearing level and audiometric hearing level, age-specific patterns of hear-ing self-evaluation and subjectively perceived normal hearing values at which participants complained of hearing loss were main outcomes.Results Mean audiometric thresholds (MATs) increased with the age and degree of self-reported hearing level. The accuracy of self-reported hearing level compared to the audiometric threshold decreased with age both in the better-ear and worse-ear groups. Younger participants tended to overestimate their hearing impairment, while older participants tended to underestimate it. Subjectively perceived normal hearing thresholds increased with age and they were very close to the MATs for each age group.Conclusion Results can be useful for devising different age-group specific pure tone audi-ometry-based diagnostic criteria for self-reported hearing loss, which can be used to determine the need for hearing aid in a timely manner.

Tone-on-Tone Masking in Subjects with Normal Hearing and with Sensorineural Hearing Loss

1981 ◽  
Vol 24 (4) ◽  
pp. 506-513 ◽  
Author(s):  
David Y. Chung
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
High Frequency ◽  
Hearing Threshold ◽  
Normal Subjects ◽  
Normal Hearing ◽  
Hearing Impaired ◽  
Sensorineural Hearing ◽  
Normal Case ◽  
Pure Tones

Quiet and masked thresholds were obtained from 5 subjects with normal hearing and 31 subjects with sensorineural hearing loss. Maskers were pure tones varying in frequency and intensity. The hearing-impaired subjects showed an abnormal spread of masking when masking was measured in terms of masked threshold. The abnormal spread of masking seems to be related to both the hearing threshold of the masker and the quiet threshold of the test signal. The notch due to detection of combination tones found on the high-frequency slope of masked audiograms of normal subjects (obscuring the actual extent to which the signal is masked) tends to accentuate the apparent abnormal upward spread of masking in the hearing-impaired subjects. The abnormal spread in the latter case is real, but comparison with the normal case must take the notch into account.

Hearing Aid Amplification Reduces Communication Effort of People With Hearing Impairment and Their Conversation Partners

2020 ◽  
Vol 63 (4) ◽  
pp. 1299-1311 ◽  
Author(s):  
Timothy Beechey ◽  
Jörg M. Buchholz ◽  
Gitte Keidser
Keyword(s):  
Hearing Impairment ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Referential Communication ◽  
Hearing Impaired ◽  
Directional Hearing ◽  
Acoustic Environment ◽  
Communication Task ◽  
Acoustic Environments ◽  
The Impact

Objectives This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions. Design Fifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs. Each pair consisted of one young normal-hearing participant and one older hearing-impaired participant. Hearing-impaired participants received directional hearing aid amplification, according to their audiogram, via a master hearing aid with gain provided according to the NAL-NL2 fitting formula. Pairs of participants were required to take part in naturalistic conversations through the use of a referential communication task. Each pair took part in five conversations, each of 5-min duration. During each conversation, participants were exposed to one of five different realistic acoustic environments presented through highly open headphones. The ordering of acoustic environments across experimental blocks was pseudorandomized. Resulting recordings of conversational speech were analyzed to determine the magnitude of speech modifications, in terms of vocal level and spectrum, produced by normal-hearing talkers as a function of both acoustic environment and the degree of high-frequency average hearing impairment of their conversation partner. Results The magnitude of spectral modifications of speech produced by normal-hearing talkers during conversations with aided hearing-impaired interlocutors was smaller than the speech modifications observed during conversations between the same pairs of participants in the absence of hearing aid amplification. Conclusions The provision of hearing aid amplification reduces the effort required to maintain communication in adverse conditions. This reduction in effort provides benefit to hearing-impaired individuals and also to the conversation partners of hearing-impaired individuals. By considering the impact of amplification on both sides of dyadic conversations, this approach contributes to an increased understanding of the likely impact of hearing impairment on everyday communication.

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