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Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

Objective: Sounds in the daily environment may cause loudness and annoyance. The present study investigated the perception of loudness and annoyance for eight different sounds present in a daily sound environment and at nine different levels varying by ±20 dB around the recorded level. The outcomes were related to tests of participants' auditory and cognitive abilities. Design: The participants undertook auditory and working memory (WM) tests prior to ratings of everyday sounds previously shown to be disturbing for persons with hearing impairment (hearing aid users). Study sample: Twenty-one participants aged between 24 and 71 years, with normal hearing threshold levels. Results: Both perceived loudness and annoyance were primarily driven by the sound level. Sounds emitted from paper were rated as having greater loudness and being more annoying than the other sound sources at the same sound level. Auditory and cognitive abilities did not influence the perception of loudness and annoyance. Conclusions: Loudness and annoyance ratings were mainly driven by sound level. Expectations of a sound seemed to influence the assessment of loudness and annoyance while auditory performance and WM capacity showed no influence on the ratings. [ABSTRACT FROM AUTHOR]

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Objective: This paper provides a detailed description of the Nucleus 6 system, and clinically evaluates user performance compared to the previous Nucleus 5 system in cochlear implant recipients. Additionally, it clinically evaluates a range of Nucleus 6 and Nucleus 5 programs to determine the performance benefits provided by new input processing technologies available in SmartSound iQ. Design: Speech understanding tests were used to clinically validate the default Nucleus 6 program, by comparing performance outcomes against up to five custom Nucleus 5 or Nucleus 6 programs in a range of listening environments. Clinical comparisons between programs were conducted across the following listening environments; quiet, speech weighted noise (co-located and spatially separated noise), and 4-talker babble (co-located and spatially separated noise). Study sample: Twenty-one adult cochlear implant recipients participated. Results: Significant speech understanding benefits were found with the default Nucleus 6 program compared to the participants' preferred program using their Nucleus 5 processor and compared to a range of custom Nucleus 6 programs. All participants successfully accepted and upgraded to the new default Nucleus 6 SmartSound iQ program. Conclusion: This study demonstrates the acceptance and clinical benefits of the Nucleus 6 cochlear implant system and SmartSound iQ. [ABSTRACT FROM AUTHOR]

Objective: The present paper reports the results of a study on a group of newborns whose chirp-evoked auditory brainstem responses (ABR) were recorded at different repetition rates. The study was aimed at finding an optimum repetition rate for the chirp stimulus that facilitates a short response detection time in the frequency domain. Design: Chirp-evoked ABR were recorded at six different stimulation rates between 20/s and 100/s. The stimulation level was 35 dB nHL. The mean harmonic related SNR was calculated, and the response detection time and rate were assessed using a detection algorithm. Study sample: A group of 80 sleeping and 27 awake newborns with normal hearing were included. Results: The highest mean harmonic-related SNR in both groups was found at 60/s. The signal-to-noise ratio (SNR) was significantly smaller for the awake newborns. A significantly shorter detection time can be achieved for both newborn groups at 60/s compared to the other rates tested. Response detection in the group of awake newborns profited more from the change to 60/s compared to the sleeping newborns. Conclusions: It can be expected that with this optimized stimulus paradigm a shorter test time and a higher specificity of the hearing screening can be reached. [ABSTRACT FROM AUTHOR]

Objective: Auditory steady-state responses (ASSR) evoked by recurrent brief tones were assessed over a wide range of stimulus repetition rates apropos the traditionally measured obligatory, transient, auditory evoked potentials. Repetition rates of ≤ 10 Hz have received little attention in the context of the ASSR stimulus-response analysis approach, speculated to provide technical advantages/additional information over more traditional transient stimulus-response paradigms. Design: Magnitudes were measured at repetition rates from 0.75 to 80 Hz, using trains of repeated tone-burst stimuli. Study sample: Twelve normal-hearing children and a reference sample of 25 young adults. Results: Results show that response magnitudes were significantly larger in children than adults at repetition rates of ≤ 5 Hz. Magnitudes were largest at the two lowest repetition rates, following the trends expected from the transient auditory evoked potential (AEP) literature. The harmonic sum is proposed as a more appropriate measure of response magnitude than amplitude of the fundamental alone. Conclusions: The analysis methods used in this paper may give information that will have applications for clinical testing. Of pragmatic importance is that the stimulus rate profile could be determined without subjective wave identification and/or interpretation, and thus by a method that is inherently more objective than conventional AEP analysis. [ABSTRACT FROM AUTHOR]

Objectives: To establish normative amplitude values for relative difference measurements of the middle latency response (MLR) in normal-hearing pediatrics and to determine if these measurements provided a significant reduction of within-group variability when compared to raw, absolute amplitude measures. A relative amplitude difference is defined in the present paper as the difference in Na-Pa amplitude between two electrodes (e.g. ||Na-Pa at C3 minus Na-Pa at C4||, or electrode effects) or between two ears (e.g. ||Na-Pa on left ear stimulation minus Na-Pa on right ear stimulation||, or ear effects). In contrast, an absolute amplitude is defined as a single Na-Pa measurement made at one electrode for stimulation of one ear (e.g. Na-Pa measured at C3 on left ear stimulation). Design: Cross-sectional study. Study sample: 155 pediatrics with normal peripheral and central hearing, and no history of psychological, neurological, or learning disability issues. Results: Within-group variability was significantly smaller for relative differences when compared to absolute amplitude measures. Electrode effects showed significantly less variability than ear effects. Normative values for ear and electrode effects were reported. Conclusions: Relative differences may provide better utility in the clinical diagnosis of central auditory pathology in pediatrics when compared to absolute amplitude measures because these difference measures show significantly lower variability when examined across subjects. [ABSTRACT FROM AUTHOR]

Abstract Objective: The purpose of this study is to present normative data on the Chinese version of the international outcome inventory for hearing aids (IOI-HA) and examine the effective-ness of the hearing aid service. Design: Cross-sectional study. The IOI-HA was administered in a paper and pencil format. Study sample: The IOI-HA and self-designed questionnaire were mailed to 1502 experienced hearing-aid users who received their hearing aids from 14 hearing service centers in mainland China. In all, 1049 completed responses were included in the final analysis, and descriptive statistics were reported. Results: The mean scores of each item of the IOI-HA ranged from 3.55 to 4.16. The IOI-HA scores showed a skewed distribution, with the maximum frequency for a score of 4 or 5. The total IOI-HA scores ranged from 9 to 35, and the mean total score was 26.3. The results compared favorably with the previous reports, and slightly higher than the published norms, indicating a high level of self-reported outcomes. Conclusiones: The IOI-HA could be used as an effective tool to measure the general effectiveness of the hearing aid outcomes in China. The implementation of the IOI-HA is time-efficient, imposing little burden on the clinician and patient. Sumario Objetivo: El propósito de este estudio es presentar datos normativos de la versión en chino del Inventario Internacional de Resultados con Auxiliares Auditivos (IOI-HA) y examinar la efectividad del servicio de auxiliares auditivos. Diseño: Estudio transversal. El IOI-HA fue administrado en formato de papel y lápiz. Muestra Del Estudio: El IOI-HA y un cuestionario auto-diseñado fueron enviados por correo a 1502 usuarios con experiencia de auxiliares auditivos, quien habían recibido sus auxiliares auditivos de 14 centros de servicio auditivo en China continental. Globalmente, 1049 respuestas completas fueron incluidas en el análisis final, y se reportaron estadísticas descriptivas. Resultados: Los puntajes medios de cada ítem del IOI-HA fluctuaron de 3.55 a 4.16. Los puntajes del IOI-HA mostrados una distribución sesgada, con la mayor frecuencia para un puntaje de 4 o 5. Los puntajes totales del IOI-HA variaron de 9 a 35, el puntaje medio total fue de 26.3. Los resultados se compararon favorablemente con los reportes previos, y levemente más altos que las normas publicadas, indicando un alto nivel de resultados auto-reportados. Conclusiones: El IOI-HA puede servir como una herramienta efectiva para medir la efectividad general de los resultados en la adaptación de auxiliares auditivos en China. La implementación del IOI-HA es tiempo-efectivo, imponiendo una carga pequeña sobre el clínico y el paciente. [ABSTRACT FROM AUTHOR]

Abstract The bone-anchored-hearing-aid (BAHA) transduces airborne sound into skull vibration. Current bilateral BAHA configurations, for sounds directly facing listeners, will apply forces that are in-phase with each other and directed roughly towards the center of the head. Below approximately 1000 Hz the two cochleae respond in approximately the same direction and with approximately the same phase to each BAHA, thus it may be preferable to drive bilateral BAHAs such that when one pushes, the other pulls. This can be achieved by adjusting the relative phase offset of the BAHAs, and doing so results in greater vibration and improved hearing threshold. In this paper we compare performance of bilateral BAHAs driven in this configuration to the standard configuration. In twelve normal participants we show significant improvements in low-frequency (≤750 Hz) hearing thresholds using out-of-phase BAHAs. The threshold measurements are further supported by velocimetric measurements taken at the cochlear promontory in a cadaveric head. Comparing vibration arising from each configuration confirms that out-of-phase driving results in greater vibration. Neither dataset shows either improved or reduced threshold at high frequencies. Sumario Los auxiliares auditivos osteo-integrados (BAHA), convierten el sonido del aire, en vibración en el cráneo. Las configuraciones bilaterales actuales del BAHA, para sonidos que están directamente frente a los oyentes, aplican fuerzas que están en fase entre si y dirigidas alrededor del centro de la cabeza. Aproximadamente por debajo de 1000 Hz, las cócleas responden aproximadamente en la misma dirección y la misma fase en cada BAHA, por lo que es preferible el manejo de BAHAs bilaterales para que cuando uno empuja, el otro arrastre. Esto puede lograrse ajustando los controles de fase relativa de los BAHAs, que así resultan en mayor vibración y mejoría de umbrales auditivos. En este trabajo comparamos el desempeño de BAHAs bilaterales con esta configuración frente a la configuración estándar. En doce participantes normales mostramos mejorías significativas en umbrales auditivos de frecuencia baja (≤750 Hz) usando BAHAS fuera de fase. Las mediciones de umbrales son además apoyadas por mediciones velocimétricas tomadas en el promontorio coclear de la cabeza de un cadáver. Al comparar la vibración que surge de cada configuración, se confirma que los resultados obtenidos fuera de fase, resultan en una mayor vibración. Ninguno de los datos muestra mejoría o reducción de umbrales en las frecuencias agudas. [ABSTRACT FROM AUTHOR]

This paper addresses the development and effectiveness of a home education program. The program, designed for hearing-impaired elders and their significant others (SO), deals with communication strategies and speech reading. Participants were randomly assigned to a training group (hearing aid fitting?+?home education program) or a control group (hearing aid fitting). The training group included 24 hearing-impaired subjects and 24 SO's. Controls were 24 affected individuals and 22 SO's. Questionnaires addressing emotional response, communication strategies and the IOI-HA, IOI-AI and IOI-SO were used. A repeated measures analysis of variance was applied to test group differences between pre, post, and 6-months follow-up measures. Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only (p? [ABSTRACT FROM AUTHOR]

Create a language-independent, ecologically valid auditory processing assessment and evaluate relative stimuli intelligibility in native and non-native English speakers. The Language-Independent Speech in Noise and Reverberation Test (LISiNaR) targets comprised consonant-vowel (CVCV) pseudo-words. Distractors comprised CVCVCVCV pseudo-words. Stimuli were presented over headphones using an iPad either face-to-face or remotely. Scoring occurred adaptively to establish a participant's speech reception threshold in noise (SRT). The listening environment was simulated using reverberant and anechoic head-related transfer functions. In four test conditions, targets originated from 0°. Distractors originated from either ±90°, ±67.5° and ±45° (spatially separated) or 0° azimuth (co-located). Reverberation impact (RI) was calculated as the difference in SRTs between the anechoic and reverberant conditions and spatial advantage (SA) as the difference between the spatially separated and co-located conditions. Young adult native speakers of Australian (n = 24) and Canadian (25) and non-native English speakers (34). No significant effects of language occurred for the test conditions, RI or SA. A small but significant effect of delivery mode occurred for RI. Reverberation impacted SRT by 5 dB relative to anechoic conditions. Performance on LISiNaR is not affected by the native language or accent of groups tested in this study. [ABSTRACT FROM AUTHOR]

The research-oriented objective of this study was to document the effectiveness of online support for hearing aid (HA) users compared with traditional support. This study is a randomised controlled trial with parallel group design. The research-oriented objectives were evaluated using the Hearing Handicap Inventory for the Elderly (HHIE) and the Communication Strategies Scale (CSS) at baseline and immediately postintervention. Selected clients at five different clinics were randomised to an intervention group (n = 78) that took part in online hearing support and a control group (n = 58) that received standard care. The analyses (intention-to-treat) showed statistically significant improvements in the HHIE-total and Emotional subscale scores for the intervention group compared with the control group. The intervention group also showed significantly greater improvement in the CSS-total and Verbal and Nonverbal subscale scores. A subgroup analysis was performed including two groups: HA use <1 year and HA use >1 year. A statistically significant improvement was found for the HA users >1 year compared with HA use <1 year. It is effective to clinically include online hearing support for HA users when addressing self-perceived hearing difficulties and to sharpen communication strategy skills. [ABSTRACT FROM AUTHOR]

The delay in digital hearing aids is known to cause distortions due to the mixing of the delayed hearing aid sound with the undelayed direct sound. The most apparent delay-based distortion is a pitch sensation referred to as coloration-pitch. This study investigated coloration-pitch discrimination at the lower end of typical hearing aid delays and aimed at establishing thresholds where a large change in coloration-pitch is just perceptible. Simulations were verified against a reference hearing aid for numerous conditions of delay, insertion gain and incident direction. The simulations were used in a psycho-acoustics experiment in which coloration-pitch discrimination thresholds were measured as a function of hearing aid delay and gain. Participants discriminated between coloration-pitches produced by delay changes of 12%. Insertion gains compensating for mild to moderate hearing losses were used. Nine normal-hearing and twelve hearing-impaired participants with mild to moderate hearing loss participated. The simulations accurately reflected the acoustics of the open-fit hearing aid. Discrimination thresholds were between 0.3 ms and 1 ms depending on insertion gain and hearing status. High sensitivity for changes in coloration-pitch was found for delays >1 ms. For shorter delays participants were increasingly insensitive to changes in coloration-pitch. [ABSTRACT FROM AUTHOR]

To monitor ototoxicity, air conduction (AC) extended high frequency (EHF) thresholds can be measured up to 16 kHz. However, conductive hearing loss might influence these results. This is unfortunate because the EHF thresholds are important to follow the impact of ototoxic medication during therapy. Therefore a suitable bone conduction (BC) transducer and norm values for EHF BC measurements are needed. In this study three different BC transducers were used: the B71 (Radioear), the KH70 (Präcitronic), and the KLH96 (Westra). Hearing thresholds were measured from 0.125 to 16 kHz using AC transducers (Telephonics TDH39, Sennheiser HDA200), and BC thresholds from 0.25 to 8 kHz with the B71, and from 0.25 to 16 kHz with the KLH96 and KH70. 60 ears of 30 normal hearing subjects were measured. The KLH96 showed the highest output for the high frequencies, and distortion measurements were similar to the KH70. The results show that EHF measurements are possible using the KLH96 and KH70 bone conductors. EHF BC measurements are reliable when using the KLH96 and KH70 bone conductors. The extended force sensitivity of the used artificial mastoid should be determined for a proper EHF BC calibration. [ABSTRACT FROM AUTHOR]

Localisation of low- and high-frequency sounds in single-sided deaf cochlear implant users was investigated using noise stimuli designed to mitigate monaural localisation cues. Within subject design. Sound source localisation was tested in the horizontal plane using an array of seven loudspeakers along the azimuthal angle span from −90° to +90°. Stimuli were broadband noise and high- and low-frequency noise. Twelve adult subjects with single-sided deafness participated in the study. All had normal hearing in the healthy ear and were supplied with a cochlear implant (CI) in their deaf ear. With broadband noise, the mean angular localisation error was 39° in aided condition as compared to a median angular error of 83.6° when the speech processor was not worn. For high-frequency noise, the median angular error was 30° and for low-frequency noise, it was 46° in the CI-aided condition. Single-sided deaf CI users show the best sound localisation for high-frequency sounds. This supports the view that interaural level differences are dominant for sound localisation in these listeners. Nonetheless, a limited ability to localise low-frequency sounds was observed, which may be based on the supportive perception of interaural time differences. [ABSTRACT FROM AUTHOR]

To examine the benefits of home-delivered auditory training for adult hearing aid users using live-voice conversations in the presence of a single-talker distractor (experimental group) or in quiet (active-control group). Randomised controlled trial. The experimental group held conversations with their nominated communication partner in the presence of a single-talker distractor set to a challenging level, 30 min/day, 5 days/week over 4 weeks. The active-control group held comparable conversations in quiet. Behavioural outcome measures of speech-in-noise perception, cognition and self-reported hearing difficulties were assessed pre- and post-training. Participant feedback was obtained. Thirty-nine hearing aid users (32 males, 7 females, mean age = 73.02 years, SD = 4.71 years) and their communication partners. The experimental group significantly improved and outperformed the active-control group for words-in-noise perception. Both groups achieved improvements in self-reported hearing difficulty while only the experimental group improved on dual-task. Subjectively, both groups found live-voice conversations beneficial and reported increased concentration and listening skills. Home-delivered live-voice auditory training with communication partners shows potential to improve outcomes for adult hearing aid users, regardless of the presence or absence of a competing speech distractor. Further research is required to assess mechanisms of benefit and distractor effects within carefully controlled experiments. [ABSTRACT FROM AUTHOR]

This study aimed to adapt a method used in sound quality measurements named CI-MUSHRA (the multiple stimuli with hidden reference and anchor for cochlear implant users) to the Turkish language. The effect of low-frequency information and non-native musical stimuli on sound quality perception was investigated. Subjects completed the Turkish version of the MUSHRA test, called TR-MUSHRA, and the original CI-MUSHRA test. Participants also completed the Turkish monosyllabic word recognition test and the spectral temporal modulated ripple test (SMRT). 19 cochlear implant (CI) users and 16 normal-hearing (NH) adults were included. CI users demonstrated a lack of ability to detect the sound quality differences between original stimuli and stimuli with omitted low-frequency information up to 600 Hz in both tests. There was no significant main effect of the test version on sound quality ratings for the two groups. No significant correlation was found between mean sound quality scores, SMRT, and speech recognition in quiet and noise conditions. Our study suggests that CI users perform poorly in discriminating high-pass filtered musical sounds regardless of the language of the musical stimuli. The TR-MUSHRA can be used as a reliable research tool to evaluate the perceived sound quality. [ABSTRACT FROM AUTHOR]

To investigate the role of the spatial position of conversing talkers, that is, spatially separated or co-located, in the listener's short-term memory of running speech and listening effort. In two experiments (between-subject), participants underwent a dual-task paradigm, including a listening (primary) task wherein male and female talkers spoke coherent texts. Talkers were either spatially separated or co-located (within-subject). As a secondary task, visually presented tasks were used. Experiment I involved a number-judgement task, and Experiment II entailed switching between number and letter-judgement task. Twenty-four young adults who reported normal hearing and normal or corrected to normal vision participated in each experiment. They were all students from the RWTH Aachen University. In both experiments, similar short-term memory performance of running speech was found independently of talkers being spatially separated or co-located. Performance in the secondary tasks, however, differed between these two talkers' auditory stimuli conditions, indicating that spatially separated talkers imposed reduced listening effort compared to their co-location. The findings indicated that auditory-perceptive information, such as the spatial position of talkers, plays a role in higher-level auditory cognition, that is, short-term memory of running speech, even when listening in quiet. [ABSTRACT FROM AUTHOR]

The aim was to create and validate an audiovisual version of the German matrix sentence test (MST), which uses the existing audio-only speech material. Video recordings were recorded and dubbed with the audio of the existing German MST. The current study evaluates the MST in conditions including audio and visual modalities, speech in quiet and noise, and open and closed-set response formats. One female talker recorded repetitions of the German MST sentences. Twenty-eight young normal-hearing participants completed the evaluation study. The audiovisual benefit in quiet was 7.0 dB in sound pressure level (SPL). In noise, the audiovisual benefit was 4.9 dB in signal-to-noise ratio (SNR). Speechreading scores ranged from 0% to 84% speech reception in visual-only sentences (mean = 50%). Audiovisual speech reception thresholds (SRTs) had a larger standard deviation than audio-only SRTs. Audiovisual SRTs improved successively with increasing number of lists performed. The final video recordings are openly available. The video material achieved similar results as the literature in terms of gross speech intelligibility, despite the inherent asynchronies of dubbing. Due to ceiling effects, adaptive procedures targeting 80% intelligibility should be used. At least one or two training lists should be performed. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the effect of electrode configuration, stimulus rate, and EEG rejection level on the efficiency of ABR testing in babies. Design: ABR to click stimuli at 40 dB nHL were simultaneously recorded from two electrode configurations, ipsilateral mastoid to high forehead (Mi-Fh) and nape to high forehead (N-Fh), with two EEG rejection levels (± 5 μV and ± 10 μV). Stimulus rates were between 39.1 and 69.1 per second. Efficiency was measured by confidence in the ABR for a given test time. Study sample: Thirty babies who had passed a targeted newborn hearing screen with ABR thresholds ≤ 40 dB nHL. Results: The N-Fh configuration, as expected, gave on average a larger response amplitude compared to the Mi-Fh configuration but was only marginally significantly better in terms of test efficiency. There was no significant effect of stimulus rate on test efficiency between 39.1/s and 59.1/s. The lower ± 5 μV EEG rejection level was more test efficient. Conclusions: This study provides some evidence that, for ABR threshold testing in babies, alternatives of ipsilateral mastoid or nape electrode and a range of stimulus rates have little or no effect on test efficiency. The results support the use of low EEG rejection limits. [ABSTRACT FROM AUTHOR]

This work presents the design and verification of a simplified measurement setup for wireless remote microphone systems (WRMSs), which has been incorporated into guidelines of the European Union of Hearing Aid Acousticians (EUHA). Three studies were conducted. First, speech intelligibility scores within the simplified setup were compared to that in an actual classroom. Second, different WRMSs were compared in the simplified setup, and third, normative data for normal-hearing people with and without WRMS were collected. The first two studies include 40 older hearing impaired and the third study 20 young normal-hearing adults. Speech intelligibility with WRMS was not different across actual classroom and simplified setup. An analog omnidirectional WRMS showed poorer speech intelligibility and poorer quality ratings than digital WMRSs. The usage of a WRMS in the simplified setup resulted in significantly higher speech intelligibility across all tested background noise levels. Despite being a simplified measurement setup, it realistically emulates a situation where people are listening to speech in noise from a distance, such as in a classroom or meeting room. Hence, with standard audiological equipment, the individual benefit of WRMSs can be measured and experienced by the user in clinical practice. [ABSTRACT FROM AUTHOR]

To investigate the effects of listening demands and motivation on listening effort (LE) in a novel speech recognition task. We manipulated listening demands and motivation using vocoded speech and financial reward, respectively, and measured task performance (correct response rate) and indices of LE (response times (RTs), subjective ratings of LE and likelihood of giving up). Effects of inter-individual differences in cognitive skills and personality on task performance and LE were also assessed within the context of the Cognitive Energetics Theory (CET). Twenty-four participants with normal-hearing (age range: 19 − 33 years, 6 male). High listening demands decreased the correct response rate and increased RTs, self-rated LE and self-rated likelihood of giving up. High financial reward increased subjective LE ratings only. Mixed-effects modelling showed small fixed effects for competitiveness on LE measured using RTs. Small fixed effects were found for cognitive skills (lexical decision RTs and backwards digit span) on LE measured using RTs and correct response rate, respectively. The effects of listening demands on LE in the speech recognition task aligned with CET, whereas predictions regarding the influence of motivation, cognitive skills and personality were only partially supported. [ABSTRACT FROM AUTHOR]

The aim of the current study was to develop a reliable instrument for the Active Communication Education (ACE) programme evaluating changes in communication strategies and the emotional consequences, knowledge and acceptance of hearing loss and to examine its reliability and face, content and construct validity. Semistructured interviews and questionnaires were conducted with participants and clinicians engaged in the ACE intervention. The psychometric properties were evaluated in two phases for two samples of adults with hearing loss who participated in the ACE programme, including 61 and 41 participants, respectively. The final Communication and Acceptance Scale (CAS) contained 18 items, and the reliability of the overall scale (Cronbach's alpha 0.86) and the test–retest reliability (r = 0.89, p < 0.001) were good. The construct validity, evaluated with principal component analysis, suggested a five-factor solution explaining 72% of the variance. The questionnaire revealed statistically significant short- and long-term effects of the ACE programme. Both participants and clinicians found the questionnaire relevant, useful and easy to administer. The CAS questionnaire was found to be valid and reliable, but because of the low sample size, further analysis with a larger population is needed. [ABSTRACT FROM AUTHOR]

To determine the association between self-reported hearing status and risk of hospitalisation among Chinese middle-aged and older adults. Prospective cohort study. Discrete-time hazards models and negative binomial models were fitted to examine the relationship. About 11,902 participants aged 45 years or older with no hospitalisation at baseline. 49.28–62.70% of the participants reported their hearing as fair or poor. For older adults aged 60 and above, compared to people with excellent and very good hearing, those with good, fair or poor hearing reported shorter time to first hospitalisation [hazard ratio (HR) = 1.38, 1.38, 1.63, respectively]. They also manifested greater number of hospitalisations [incident rate ratio (IRR) = 1.21, 1.25, 1.54, respectively], and longer duration of hospitalisation (IRR = 1.36, 1.26, 1.53, respectively). However, there was no significant association between hearing status and hospitalisation for middle-aged adults for none of the hearing categories. Although no significant relationship between hearing and hospitalisation was found for middle-aged adults, older adults with poorer hearing experienced greater risk of hospitalisation. Given that hearing impairment is highly prevalent among older adults, future analyses are needed to investigate whether hearing rehabilitative therapies could help mitigate hospitalisations in hearing-impaired older adults. [ABSTRACT FROM AUTHOR]

The medial olivocochlear (MOC) reflex provides efferent feedback from the brainstem to cochlear outer hair cells. Physiologic studies have demonstrated that the MOC reflex is involved in "unmasking" of signals-in-noise at the level of the auditory nerve; however, its functional importance in human hearing remains unclear. This study examined relationships between pre-neural measurements of MOC reflex strength (click-evoked otoacoustic emission inhibition; CEOAE) and neural measurements of speech-in-noise encoding (speech frequency following response; sFFR) in four conditions (Quiet, Contralateral Noise, Ipsilateral Noise, and Ipsilateral + Contralateral Noise). Three measures of CEOAE inhibition (amplitude reduction, effective attenuation, and input-output slope inhibition) were used to quantify pre-neural MOC reflex strength. Correlations between pre-neural MOC reflex strength and sFFR "unmasking" (i.e. response recovery from masking effects with activation of the MOC reflex in time and frequency domains) were assessed. 18 young adults with normal hearing. sFFR unmasking effects were insignificant, and there were no correlations between pre-neural MOC reflex strength and sFFR unmasking in the time or frequency domain. Our results do not support the hypothesis that the MOC reflex is involved in speech-in-noise neural encoding, at least for features that are represented in the sFFR at the SNR tested. [ABSTRACT FROM AUTHOR]

To explore the trends in actions and factors influencing families of children with hearing loss, regarding early treatment following the implementation of a newborn hearing screening (NHS) in Taiwan. A retrospective study was conducted by extracting data from the treatment histories of families with children who had hearing loss and who were contacted and assessed by the non-profit organisation (NPO). Children born between 2012 and 2018 were included. The time lapse between initial NHS and early treatment sought by each family was documented and the factors predicting the timing of those actions were identified. Data of 2095 families of children with hearing loss and who received treatment from an NPO for the annual birth cohort of 2012 through 2018 were included. The median age at treatments initiation improved through the years. Parental educational level and the child's degree of hearing loss were significant indicators of the child's initial age at treatment intervention, age when hearing aids were fitted, and days taken to contact the organisation. The NHS in Taiwan promoted earlier treatment for children with hearing loss. Furthermore, patient instructions and education may be important to enable parents to take actions for early intervention. [ABSTRACT FROM AUTHOR]

Objective: Hearing aid technology can allow users to "geo-tag" hearing aid preferences using the Global Positioning System (GPS). This technology assumes that listening environment characteristics that affect hearing aid benefit change little in a location over time. The purpose of this study was to investigate whether certain characteristics (reverberation, signal type, listening activity, noise location, noisiness, talker familiarity, talker location, and visual cues) changed in a location over time. Design: Participants completed GPS-tagged surveys on smartphones to report on characteristics of their listening environments. Coordinates were used to create indices that described how much listening environment characteristics changed in a location over time. Indices computed in one location were compared to indices computed across all locations for each participant. Study sample: 54 adults with hearing loss participated in this study (26 males and 38 females; 30 experienced hearing aid users and 24 new users). Results: A location dependency was observed for all characteristics. Characteristics were significantly different from one another in their stability over time. Conclusions: Listening environment characteristics changed less over time in a given location than in participants' lives generally. The effectiveness of GPS-dependent hearing aid settings likely depends on the accuracy and location definition of the GPS feature. [ABSTRACT FROM AUTHOR]

Speech-in-noise tests are widely used in hearing diagnostics but typically without reverberation, although reverberation is an inextricable part of everyday listening conditions. To support the development of more real-life-like test paradigms, the objective of this study was to explore how spatially reproduced reverberation affects speech recognition thresholds in normal-hearing and hearing-impaired listeners. Thresholds were measured with a Finnish speech-in-noise test without reverberation and with two test conditions with reverberation times of ∼0.9 and 1.8 s. Reverberant conditions were produced with a multichannel auralisation technique not used before in this context. Thirty-four normal-hearing and 14 hearing-impaired listeners participated in this study. Five people were tested with and without hearing aids. No significant differences between test conditions were found for the normal-hearing listeners. Results for the hearing-impaired listeners indicated better performance for the 0.9 s reverberation time compared to the reference and the 1.8 s conditions. Benefit from hearing aid use varied between individuals; for one person, an advantage was observed only with reverberation. Auralisations may offer information on speech recognition performance that is not obtained with a test without reverberation. However, more complex stimuli and/or higher signal-to-noise ratios should be used in the future. [ABSTRACT FROM AUTHOR]

Objective: Speech production in noise with varying talker-to-listener distance has been well studied for the open ear condition. However, occluding the ear canal can affect the auditory feedback and cause deviations from the models presented for the open-ear condition. Communication is a main concern for people wearing hearing protection devices (HPD). Although practical, radio communication is cumbersome, as it does not distinguish designated receivers. A smarter radio communication protocol must be developed to alleviate this problem. Thus, it is necessary to model speech production in noise while wearing HPDs. Such a model opens the door to radio communication systems that distinguish receivers and offer more efficient communication between persons wearing HPDs.Design: This paper presents the results of a pilot study aimed to investigate the effects of occluding the ear on changes in voice level and fundamental frequency in noise and with varying talker-to-listener distance.Study sample: Twelve participants with a mean age of 28 participated in this study.Results: Compared to existing data, results show a trend similar to the open ear condition with the exception of the occluded quiet condition.Conclusions: This implies that a model can be developed to better understand speech production for the occluded ear. [ABSTRACT FROM PUBLISHER]

This study measured the performance of normal-hearing listeners on the Repeat-Recall Test (RRT) in two noise types (2-talker babble [2TBN] and continuous speech-shaped noise [SSN]) by two noise azimuths (0° and 180°) configurations at signal-to-noise ratios (SNRs) of 0, 5, 10, and 15 dB and quiet. Within-subject repeated measures. Twenty-one listeners with normal hearing who also passed cognitive screening were tested in the sound-field with the speech stimulus presented from 0° at 75 dB SPL in 4 noise configurations. The order of SNRs, noise configurations, and RRT topic conditions was counterbalanced across listeners. Analysis revealed that repeat scores were significantly better for 2TBN, for noise at 180°, and for high context (HC) sentences. Recall performance was significantly better for SSN and HC sentences. Listening effort ratings were higher for SSN and for noise front condition at SNR ≤ 10 dB. The 2TBN noise was tolerated longer than SSN. Performance on all measures improved with SNRs. These data showed performance differences among noise configurations and provided a preliminary basis for comparison with hearing-impaired listeners' performance on the RRT. [ABSTRACT FROM AUTHOR]

To assess test-retest reliability of the Listening in Spatialised Noise – Universal test (LiSN-U). Test-retest reliability study. Participants completed the LiSN-U twice, four to eight weeks apart. Study sample: Test-retest reliability was analysed for 23 adults and 109 children. ANOVA showed significant group average score improvement on LiSN-U spatially-separated and co-located conditions on retest (by 1.3 and 0.9 dB, respectively), but not on the difference between them (spatial advantage). Critical difference scores for children were −3.6 dB for the spatially-separated condition, −5.8 dB for the co-located condition, and 5.5 dB for spatial advantage. Critical difference scores for adults were −2.0 dB for the spatially-separated condition, −4.9 dB for the co-located condition, and 5.4 dB for spatial advantage. A correlation analysis was run to determine the relationship between test and retest speech reception thresholds. The correlation was r = 0.63, p < 0.001 for the spatially-separated condition, r = 0.50, p < 0.001 for the co-located condition, and r = 0.37, p < 0.001 for the spatial advantage measure. The LiSN-U, which is potentially useable for speakers of any language, shows mean test-retest difference and test-retest reliability comparable to other tests that have proven useful in clinical practice. [ABSTRACT FROM AUTHOR]

Available data on dichotic listening using tonal Chinese words have been limited, and conflicting results on a right-ear advantage (REA) have been reported. The current study developed a set of Mandarin CV-words based on the Bergen dichotic listening paradigm. The test materials consisted of two sets of stimuli. The English set, derived from the iDichotic application, consisted of six nonsense syllables with plosives conjugated to /a/. The Mandarin set had these 6 CV-syllables spoken as real words according to the Mandarin phonology. Study sample: Forty young, native Mandarin speakers were tested dichotically with both sets of test materials. Twenty participants were right-handed, and the other twenty were left-handed. Fourteen participants were randomly selected to repeat the test with the Mandarin set. The mean difference of correct recognition responses between two ears indicated a REA with both sets of stimuli for the right-handers, but not for left-handers. For the right-handers, performance with the Mandarin set was significantly better than performance with the English set. Dichotic listening with the Mandarin set had strong correlation between two time points, r = 0.8. Performance using the Mandarin set is reliable in dichotic listening; a REA is observed for the right-handers. [ABSTRACT FROM AUTHOR]

The objective was to assess the effect of age on thresholds for the TEN(HL) test for diagnosing dead regions in the cochlea, as a function of signal frequency and TEN(HL) level. The TEN(HL) test was administered twice for each ear of each participant (in two separate sessions) using signal frequencies from 0.5 to 4 kHz and TEN(HL) levels of 30, 50 and 70 dB HL/ERBN. 19 young participants (mean age 24 years) and 17 older participants (mean age 65 years). All had near-normal audiograms with no history of hearing problems. There was no systematic change from session 1 to session 2 and repeatability was good. There was no significant effect of ear or gender. The average signal-to-TEN(HL) ratio at threshold was greater for the older than for the young group, especially for the highest level at high frequencies. An equation is presented that can be used to predict the "normal" threshold as a function of age, TEN(HL) level and signal frequency. Thresholds for the TEN(HL) test were greater for the older group and increased at high frequencies and high TEN levels. The results can be used to give a more accurate diagnosis of dead regions. [ABSTRACT FROM AUTHOR]

Objective: Recent changes to cochlear implant (CI) candidacy criteria have led to the inclusion of candidates with greater levels of hearing in the contralateral and/or implanted ear. This study assessed the impact of various hearing loss configurations on CI uptake rates (those assessed as eligible for CI, who proceed to CI). Design: Retrospective cohort study. Study sample: Post-lingually deaf adult CI candidates (n = 619) seen at a Western Australian cochlear implant clinic. Results: An overall CI uptake rate of 44% was observed. Hearing loss configuration significantly impacted uptake rates. Uptake rates of 62% for symmetrical hearing loss, 48% for asymmetrical hearing loss (four-frequency average hearing loss (4FAHL) asymmetry ≤60 dB), 25% for highly asymmetrical hearing loss (4FAHL asymmetry >60 dB), 38% for hearing losses eligible for electric-acoustic stimulation, and 22% for individuals with single-sided hearing loss were observed. Hearing loss configuration and age were both significant factors in relation to CI uptake although the impact of age was limited. Conclusion: CI clinics who apply or are considering applying expanded CI candidacy criteria within their practice should be aware that candidates with greater levels of residual hearing in at least the contralateral ear are less likely to proceed to CI. [ABSTRACT FROM AUTHOR]

Objective: A simplified version of the Finnish matrix sentence test (FMST) was developed to improve the reliability of hearing diagnostic for children and for patients with limited working memory capacity and/or vocabulary. Design: Study 1 evaluated the word matrix of the Finnish simplified matrix sentence test (FINSIMAT) to rule out systematic differences between the new FINSIMAT test lists, and to provide reference values for normal-hearing (NH) young adults (YA). In Study 2, the FINSIMAT and the FMST were evaluated in elderly listeners with mild-to-moderate hearing impairment (HI). Study sample: Twenty NH YAs participated in Study 1, and 16 elderly HI adults participated in Study 2. Results: For NH YAs, the reference speech reception threshold (SRT50) estimate and the slope for the FINSIMAT were −11.2 ± 1.0 dB signal-to-noise ratio (SNR) and 19.4 ± 1.9%/dB SNR. For the elderly HI listeners, the mean SRT50 estimates for the FINSIMAT and FMST were −4.1 and −3.6 dB SNR, respectively. The correlation between the FMST and FINSIMAT results was strong (r2 = 0.78, p < 0.001). Conclusion: The FINSIMAT showed comparable characteristics to the FMST and proved feasible for measurements in elderly HI listeners. [ABSTRACT FROM AUTHOR]

Objective: To explore the prevalence of device-related problems associated with hearing aid use, participants' help-seeking behaviours for these problems, and factors associated with hearing aid problems. Design: A prospective convenience cohort design surveying 413 adult hearing aid users (34–97 years of age) recruited from seven clinics across Australia. Results: Almost all participants (98%) indicated that they were experiencing at least one of the hearing aid problems included on the survey. The number of hearing aid related problems reported by participants ranged from 0 to 25 (of a possible 26), with a mean of 10 problems (SD = 5). The three most reported problems were related to difficulty hearing in noisy environments, hearing in windy environments, and understanding certain voices. Participants had reported less than half (46.33%) of the total problems identified to their clinic (range = 0–100%, mean = 43.40, SD = 13.92). Participants who reported experiencing a greater number of hearing aid problems also reported lower levels of hearing aid benefit, and satisfaction with their hearing aids. Conclusions: The majority of hearing aid owners experience problems with their hearing aids. Addressing these problems would likely contribute to improved hearing aid outcomes. [ABSTRACT FROM AUTHOR]

Objective: The present study was motivated by a need for a speech intelligibility test capable of indexing dynamic changes in the environment and adaptive processing in hearing aids. The Continuous Number Identification Test (CNIT) was developed to meet these aims. Design: From one location in the free field, speech was presented in noise (∼2 words/s) with a 100-ms inter-word interval. On average, every fourth word was a target digit and all other words were monosyllabic words. Non-numeric words had a fixed presentation level such that the dominant signal-to-noise-ratio (SNR) was held at +6 dB SNR relative to background maskers. To prevent ceiling effects, however, targets were presented at a user-specific SNR, determined by an initial adaptive-tracking procedure that estimated the 79.4% speech reception threshold. Study sample: Ten normal-hearing listeners participated. Results: The CNIT showed comparable psychometric qualities of other established speech tests for long time scales (Exp. 1). Target-location changes did not affect performance on the CNIT (Exp. 2), but the test did show high temporal resolution in assessing sudden changes to SNR (Exp. 3). Conclusions: The CNIT is highly customisable, and the initial experiments tested feasibility of its primary features which set it apart from currently available speech-in-noise tests. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ototoxic effect of the exposure to different organic solvents and noise using distortion product otoacoustic emissions (DPOAEs). Design: The exposure to different solvents was evaluated by measuring, before and at the end of the work-shift, the urinary concentrations of solvent metabolites used as dose biomarkers. The urinary concentrations of DNA and RNA oxidation products were also measured as biomarkers of oxidative damage. The simultaneous exposure to noise was also evaluated. DPOAEs and pure tone audiometry (PTA) were used as outcome variables, and were correlated to the exposure variables using mixed effect linear regression models. Study sample: Seventeen industrial painters exposed to a solvent mixture in a naval industry. A sample size of 15 was estimated from previous studies as sufficient for discriminating small hearing level and DPOAE level differences (5 dB and 2 dB, respectively) at a 95% confidence level. Results: Statistically significant associations were found between the DPOAE level and the urinary dose biomarkers and the oxidative damage biomarkers. DPOAE level and the logarithm of the metabolite concentration showed a significant negative correlation. Conclusions: DPOAE are sensitive biomarkers of exposure to ototoxic substances and can be effectively used for the early detection of hearing dysfunction. [ABSTRACT FROM AUTHOR]

Objective: The satisfaction experienced with using an audio processor is very important to hearing implant system users. Currently there are no measures that can be used to assess user satisfaction with an audio processor. This study aims to develop and validate a specific and standardised questionnaire that focuses on user satisfaction with their audio processor. Design: A preliminary version of the questionnaire was initially developed by experts in the field. Following validation of these results, the final version of the Audio Processor Satisfaction Questionnaire (APSQ) was developed consisting of 15 items. Item analyses and questionnaire validation measurements were assessed. Study sample: Sixty-nine subjects were recruited and asked to complete the APSQ twice within 2–4 weeks. Results: Subjects reported a high user satisfaction with the questionnaire and with their audio processor. The questionnaire had good reliability and results for test-retest reliability were high and significant across all items and across subscale analyses. Conclusion: Item analyses and reliability analyses show that the questionnaire is a valid and reliable tool to assess user satisfaction across different audio processors and hearing implant systems. The APSQ is a quick and easy tool to measure user satisfaction with their audio processor. [ABSTRACT FROM AUTHOR]

Objective: To create a language independent version of the Listening in Spatialised Noise – Sentences test (LiSN-S) and evaluate it in an English-speaking population. Design: Test development and normative data collection. LiSN-Universal (LiSN-U) targets consisted of CVCV pseudo-words (e.g. /mupa/). Two looped distracter tracks consisted of CVCVCVCV pseudo-words. The listener's task was to repeat back the target pseudo-words. Stimuli were presented over headphones using an iPad. Speech reception thresholds were measured adaptively. In the co-located condition all stimuli came from directly in front. In the spatially-separated condition the distracters emanated from +90° and −90° azimuth. Perceived location was manipulated using head-related transfer functions. Spatial advantage was calculated as the difference in dB between the co-located and spatially separated conditions. Study samples: Stimulus intelligibility data were collected from 20 adults. Normative data were collected from native English speakers (23 adults and 127 children). Results: Children's spatially separated, co-located, and spatial advantage results improved significantly with age. Spatial advantage was 4–6 dB larger in the LiSN-U than LiSN-S depending on age group. Conclusion: Whereas additional research in non-native English populations is required, the LiSN-U appears to be an effective tool for measuring spatial processing ability. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the outcomes of the Oticon Medical Neuro Zti cochlear implant and the Neuro 2 sound processor. Design: Neuro One users were upgraded to Neuro 2. Monosyllabic word identification was evaluated in adults with Neuro One after ≥5 months, with Neuro 2 at upgrade, and with Neuro 2 after 3 months. Self-reported listening ability, satisfaction, and usability were measured in adults and children. Study sample: Participants were 44 adults and 26 children. Results: Speech identification scores in quiet and noise were 58% and 45% with Neuro One and 67% and 55% with Neuro 2 after 3 months, respectively. Hearing impairment duration and number of active electrodes significantly predicted speech identification in noise with Neuro 2. Significantly higher questionnaire ratings were obtained for Neuro 2 than Neuro One regarding listening ability in complex listening situations, comfort and music, as well as nine aspects of satisfaction and usability. Conclusion: This study demonstrates the clinical superiority of the Neuro 2 sound processor over Neuro One in terms of speech identification in quiet and in noise and reported patient benefit and satisfaction. Given the study design, sources of improvement may include factors unrelated to the sound processor itself. [ABSTRACT FROM AUTHOR]

Objective: Tinnitus Handicap Inventory (THI) is one of the world's most commonly used tools to assess tinnitus severity. The aim of the current study was to establish a revised THI grading system using standard Z-scores and percentiles. Design: Cross-sectional observational study. Study sample: Adult patients (1042 participants – 518 (49.7%) female and 524 (50.3%) male) reporting tinnitus duration of a minimum of 6 months with complete documentation on patient's clinical status (age, gender, tinnitus duration and laterality, tinnitus handicap based on THI and hearing status based on pure-tone audiometry) were included in the study. Results: Multivariate analysis of variance was used to analyse the effects of gender and hearing loss on THI scores and revealed there was a significant effect of both. Consequently, separate grading systems for women and men, as well as for subjects with normal hearing and hearing loss, is proposed. Conclusions: Our findings are generally consistent with existing grading. Normative values proposed for THI scores, based on a large group of tinnitus patients, could be useful to guide decisions about appropriate intervention options or to evaluate treatment outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between hearing loss (HL) and general quality of life (QoL) in adults seeking hearing aids (HAs). Design: The patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire's general part and a questionnaire measuring self-assessed communication ability (Abbreviated Profile of hearing Aid Benefit—APHAB). These responses were compared with EORTC scores from a general population and patients with former head and neck cancer. Study sample: One-hundred and fifty-eight adults with HL were recruited prior to hearing aid (HA) fitting with one half seeking renewal of their HA. Results: General QoL scores among patients with HL were similar to those in the general population, but higher than in many chronic serious diseases. Patients with unilateral HL reported slightly worse social function and more fatigue than patients with bilateral HL. Self-assessed communication ability correlated with general QoL scores. Also, we found that best ear pure tone average (PTA), cognitive and physical QoL function predicted APHAB scores. Conclusion: In the investigated HL group, general QoL scores seem to be relatively close to those seen in the general population. [ABSTRACT FROM AUTHOR]

Objective: Data with regard to the Mandarin dichotic digits test (DDT) are limited, with conflicting results reported between the Mandarin and English DDTs. The current study examined factors that might affect the performance in the Mandarin DDT. Design: The digits were arranged in 3 sets of 20 dichotic pairs; each set comprised 2, 3 or 4 digits in a pair. Study sample: Forty-one young, native Mandarin speakers with normal hearing were tested; 30 of them were right-handed and 11 left-handed. Six participants repeated the test. Results: The prevalence of ceiling effect in recognition score decreased systematically as the digit-pair length increased. At digit sets of 3-pair and 4-pair, the right-handed group showed a significant higher recognition score at right ear than left ear, while the left-handed group reversed the performance. The score difference between ears is significantly different between the right- and left-handed groups. The retest of the Mandarin DDT was reliable. Conclusions: For the right-handed group, a right-ear advantage can exist in the Mandarin DDT at a longer digit-pair length, similar to what was reported in the English DDT. Moreover, for the left-handed group, the attended right hemisphere in processing the tonal digits can result in a left-ear advantage. [ABSTRACT FROM AUTHOR]

Objective: To determine if the auditory middle latency responses (AMLR), auditory late latency response (ALLR) and auditory P300 were sensitive to auditory processing disorder (APD) and listening difficulties in children, and further to elucidate mechanisms regarding level of neurobiological problems in the central auditory nervous system. Design: Three-group, repeated measure design. Study sample: Forty-six children aged 8–14 years were divided into three groups: children with reported listening difficulties fulfilling APD diagnostic criteria, children with reported listening difficulties not fulfilling APD diagnostic criteria and normally hearing children. Results: AMLR Na latency and P300 latency and amplitude were sensitive to listening difficulties. No other auditory evoked potential (AEP) measures were sensitive to listening difficulties, and no AEP measures were sensitive to APD only. Moderate correlations were observed between P300 latency and amplitude and the behavioural AP measures of competing words, frequency patterns, duration patterns and dichotic digits. Conclusions: Impaired thalamo-cortical (bottom up) and neurocognitive function (top-down) may contribute to difficulties discriminating speech and non-speech sounds. Cognitive processes involved in conscious recognition, attention and discrimination of the acoustic characteristics of the stimuli could contribute to listening difficulties in general, and to APD in particular. [ABSTRACT FROM AUTHOR]

Objective: To detect cervical vestibular evoked myogenic potential (cVEMP) responses using objective statistical approaches and to apply this approach to estimate saccular frequency-tuning curves in volunteers and Ménière's disease (MD) patients. Design: Estimates of cVEMP threshold were carried out by 3 expert raters at 500 Hz and compared to objective threshold estimates (using Hotelling's T2 [HT2] and Fsp). Saccular tuning curves were objectively estimated. Study sample: Objective and subjective estimates of cVEMP response thresholds were compared for 13 normal hearing adults. Objective measurement of saccular tuning curves was explored in 20 healthy adults and 15 patients with MD. Results: Significant variability was seen between subjective estimates of cVEMP thresholds. Objective analysis with the HT2 test was more sensitive than 2 of 3 experts in detecting responses. The measurement time of cVEMP was considerably reduced with the HT2 test. Objective saccular tuning curves in volunteers showed strongest responses at 500 Hz. A flatter tuning curve was seen for MD patients. Conclusions: There is significant variability in subjective estimations of cVEMP thresholds. Objective analysis methods are more sensitive than subjective analysis, can detect responses rapidly and have potential to reduce variability in threshold estimates, hence they appear well suited to measure cVEMP tuning curves. [ABSTRACT FROM AUTHOR]

Objective: To investigate modifications of the Flemish Digit Triplet Test (DTT) to improve its efficiency, i.e. the use of a low-pass filtered noise and variable adaptive step sizes according to a digit scoring procedure, targeting different recognition probabilities. Design and study sample: Speech reception thresholds (SRT) were evaluated in terms of their test-retest reliability and correlation with pure tone averages (PTA) in a group of 68 adult participants with different degrees of hearing impairment. Results: The use of a low-pass filtered noise did not result in better test-retest reliability or an improved SRT-PTA correlation. Using digit scoring with adaptive step sizes parametrised to target a recognition probability of 79% (D79), corresponding to the recognition probability of the currently used DTT with triplet scoring and fixed adaptive step sizes of 2 dB, increased test-retest reliability. Lower recognition probabilities of 57 and 35% demonstrated worse reliability and worse SRT-PTA correlations. Conclusions: Given the increased test-retest reliability of D79, a similar reliability as for the currently used DTT could be obtained after considerably fewer trials, leading to a profit in test duration. [ABSTRACT FROM AUTHOR]

Objective: To externally validate the Swedish version of the LittlEARS® Auditory Questionnaire (LEAQ) in children with normal hearing followed longitudinally, and to examine to what extent the LEAQ correlates to other measures of auditory and language development. Design: The Swedish version of the LEAQ was completed every other month over a 2-year period and correlated with the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) and McArthur-Bates Communicative Development Inventory (CDI) to examine overlapping areas of development. Normative curve was derived through linear mixed models and the effect of time investigated with repeated measures ANOVA. Study sample: Parents of 25 typically developing children with normal hearing (13 girls, 12 boys). Results: The norm curve of the Swedish LEAQ showed a similar equation as the original German version and the effect of time was significant. Correlations between LEAQ and CDI were moderate to high, and between LEAQ and PEACH weak or non-existing. Conclusion: The Swedish version of the LEAQ is a reliable tool in accordance with the original version. However, results indicate that this questionnaire to a large extent measures language skill rather than audition specifically. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speech-processing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient σ. A recent acute pilot study showed improved spectral-temporally modulated ripple test (SMRT) scores at low loudness levels, but battery life was reduced to 1.5–4 hours. Design: Within-subject comparisons were made for the clinical versus. DCF strategy after 5 weeks of at-home usage. Speech intelligibility in noise, spectral ripple discrimination, temporal modulation detection, loudness growth, and subjective ratings were assessed. Study sample: Twenty HiRes90K (Advanced Bionics, Valencia, USA) cochlear implant (CI) users. Results: Average battery life was 9 hours with the newly implemented DCF compared to 13.4 hours with the clinical strategy. Compared with measurements made at the beginning of the study, SMRT-scores and speech intelligibility in noise were significantly improved with DCF. However, both measures suffered from unexpected learning effects over time. The improvement disappeared and speech intelligibility in noise declined significantly relative to the final control measurement with the clinical strategy. Conclusion: Most CI users can adapt to the DCF strategy in a take-home setting. Although DCF has the potential to improve performance on the SMRT test, learning effects complicate the interpretation of the current results. [ABSTRACT FROM AUTHOR]

Objective: The ability to determine the location of the sound source is often important for effective communication. However, it is not clear how the localisation is affected by background noise. In the current study, localisation in quiet versus noise was evaluated in adults both behaviourally, and using MMN and P3b. Design: The speech token/da/was presented in a multi-deviant oddball paradigm in quiet and in presence of speech babble at +5 dB SNR. The deviants were presented at locations that differed from the standard by 30°, 60° and 90°. Study sample: Sixteen normal hearing adults between the age range of 18–35 years participated in the study. Results: The results showed that participants were significantly faster and more accurate at identifying deviants presented at 60° and 90° as compared to 30°. Neither reaction times nor electrophysiological measures (MMN/P3b) were affected by the background noise. The deviance magnitude (30°, 60° and 90°) did not affect the MMN amplitude, but the smaller deviant (30°) generated P3b with smaller amplitude. Conclusions: Under the stimulus paradigm and measures employed in this study, localisation ability as effectively sampled appeared resistant to speech babble interference. [ABSTRACT FROM AUTHOR]