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Auditory deprivation and the restoration of hearing via a cochlear implant (CI) can induce functional plasticity in auditory cortical areas. How these plastic changes affect the ability to integrate combined auditory (A) and visual (V) information is not yet well understood. In the present study, we used electroencephalography (EEG) to examine whether age, temporary deafness and altered sensory experience with a CI can affect audio–visual (AV) interactions in post-lingually deafened CI users. Young and elderly CI users and age-matched NH listeners performed a speeded response task on basic auditory, visual and audio–visual stimuli. Regarding the behavioral results, a redundant signals effect, that is, faster response times to cross-modal (AV) than to both of the two modality-specific stimuli (A, V), was revealed for all groups of participants. Moreover, in all four groups, we found evidence for audio–visual integration. Regarding event-related responses (ERPs), we observed a more pronounced visual modulation of the cortical auditory response at N1 latency (approximately 100 ms after stimulus onset) in the elderly CI users when compared with young CI users and elderly NH listeners. Thus, elderly CI users showed enhanced audio–visual binding which may be a consequence of compensatory strategies developed due to temporary deafness and/or degraded sensory input after implantation. These results indicate that the combination of aging, sensory deprivation and CI facilitates the coupling between the auditory and the visual modality. We suggest that this enhancement in multisensory interactions could be used to optimize auditory rehabilitation, especially in elderly CI users, by the application of strong audio-visually based rehabilitation strategies after implant switch-on. [ABSTRACT FROM AUTHOR]

This study was done to evaluate the use of functional measures in hearing aid benefit assessment of children ( n = 60) in a rural community. Children with age ranging from 6 months to 15 years with moderately severe to profound hearing loss were evaluated. They were evaluated by functional measures PEACH and TEACH which were translated into local language (Tamil). The relationship between PEACH and TEACH was calculated using SPSS and Chi-square tests. It was found that PEACH and TEACH questionnaires can be easily administered in the rural community and gives a quantitative measure of the effect of amplification. It gave caregivers a motivation to take an active part in the rehabilitation. This model of using functional evaluation tools to evaluate the suitability and effectiveness of amplification can be applied in children in developing countries. [ABSTRACT FROM AUTHOR]

This study aimed to 1) assess the hearing-related Quality of Life (QoL) of children with cochlear implants (CIs) in China and 2) investigate the impact of CI in children and of the socio-demographic backgrounds of their guardians on the hearing-related QoL of children with CIs in the Chinese mainstream education system. This study used the Mandarin Children with Cochlear Implants: Parental Perspectives questionnaire (MPP), which assessed the communication capability, auditory perception, self-independence, level of happiness with family, social interaction, academic performance, outcome assessment for CI, and level of family support in children with CIs. Both univariate and multiple linear regression analyses were performed to identify the relationship of CI in children and the socio-demographic backgrounds of their guardians with hearing-related QoL in children with CI. A total of 124 responses were collected, and they indicated satisfaction and improvement across all aspects of the MPP Questionnaire. Statistical analysis revealed that an earlier age of cochlear implantation (≤3 years old) could improve the communication capabilities, self-independence, social interaction performance, and academic performance of children with CIs. In addition, children with CI from the urban regions demonstrated better social interaction performance than that by those from the rural regions of China. CIs can improve hearing-related QoL in children with pre-lingual or congenital hearing loss entering the mainstream education system in China. This study showed that early age of cochlear implantation was critical for successful long-term auditory development and academic achievement in children with CIs in China. Therefore, healthcare professionals and educators in China should advocate for CI for children with severe congenital or pre-lingual hearing loss. • Cochlear implantation (CI) can improve the hearing-related Quality of Life (QoL) of children with pre-lingual hearing loss. • CIs can improve the hearing aspect of QoL of children with congenital hearing loss. • Early age of cochlear implantation is critical for long-term auditory development. • Early age of cochlear implantation is critical for academic achievement. [ABSTRACT FROM AUTHOR]

The “Cochrane Corner” is a section in the journal that highlights systematic reviews relevant to otolaryngology–head and neck surgery, with invited commentary to aid clinical decision making. This installment features the Cochrane review “Interventions to Improve Hearing Aid Use in Adult Auditory Rehabilitation,” which identified 32 randomized controlled trials and concluded that there is low-quality evidence to support using self-management support and complex interventions (support plus delivery system design) in adult auditory rehabilitation. [ABSTRACT FROM PUBLISHER]

Introduction In this paper, the authors analyze the auditory rehabilitation after cochlear implantation in adults with hearing impairment after head trauma, comparing their performance with that of other cochlear implant (CI) adult users who have post-lingual hearing impairment with other etiologies. Methods The participants were divided into two groups: group 1 (N = 14) composed of CI adult users who have acquired severe to profound hearing loss after head trauma; group 2 (N = 231) composed of CI adult users who have severe to profound hearing loss from other etiologies. Performance was assessed using the following tests: tonal audiometry, speech audiometry, consonantal phonemes identification test, 100 words test, 100 words through the telephone test, monosyllables test, numbers test, sentences test, and sentences through the telephone test. Results Average results from group 1 were lower when compared with those of group 2 in all the tests used. No statistically significant difference was found for most tests. Statistically significant difference was found for consonantal phonemes identification test, 100 words through the telephone test, monosyllables test (when analyzed regarding the phonemes correctly repeated), and sentences through the telephone test. Discussion The performance of the group of CI adult users who have acquired hearing impairment after head trauma was globally lower than that observed on the group of hearing impairment with other etiologies. However, the difference was not statistically significant for most tests. Despite this difference in performance, the results from the group of CI adult users who have acquired hearing impairment after head trauma show the effectiveness of auditory rehabilitation through cochlear implantation in these situations. [ABSTRACT FROM AUTHOR]

Background: Preference for speech and music processed with nonlinear frequency compression (NFC) and two controls (restricted bandwidth [RBW] and extended bandwidth [EBW] hearing aid processing) was examined in adults and children with hearing loss. Purpose: The purpose of this study was to determine if stimulus type (music, sentences), age (children, adults), and degree of hearing loss influence listener preference for NFC, RBW, and EBW. Research Design: Design was a within-participant, quasi-experimental study. Using a round-robin procedure, participants listened to amplified stimuli that were (1) frequency lowered using NFC, (2) low-pass filtered at 5 kHz to simulate the RBW of conventional hearing aid processing, or (3) low-pass filtered at 11 kHz to simulate EBW amplification. The examiner and participants were blinded to the type of processing. Using a two-alternative forced-choice task, participants selected the preferred music or sentence passage. Study Sample: Participants included 16 children (ages 8-16 yr) and 16 adults (ages 19-65 yr) with mild to severe sensorineural hearing loss. Intervention: All participants listened to speech and music processed using a hearing aid simulator fit to the Desired Sensation Level algorithm v5.0a. Results: Children and adults did not differ in their preferences. For speech, participants preferred EBW to both NFC and RBW. Participants also preferred NFC to RBW. Preference was not related to the degree of hearing loss. For music, listeners did not show a preference. However, participants with greater hearing loss preferred NFC to RBW more than participants with less hearing loss. Conversely, participants with greater hearing loss were less likely to prefer EBW to RBW. Conclusions: Both age groups preferred access to high-frequency sounds, as demonstrated by their preference for either the EBW or NFC conditions over the RBW condition. Preference for EBW can be limited for those with greater degrees of hearing loss, but participants with greater hearing loss may be more likely to prefer NFC. Further investigation using participants with more severe hearing loss may be warranted. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the benefits of 3 types of remote microphone hearing assistance technology (HAT), adaptive digital broadband, adaptive frequency modulation (FM), and fixed FM, through objective and subjective measures of speech recognition in clinical and real-world settings. Method: Participants included 11 adults, ages 16 to 78 years, with primarily moderate-to-severe bilateral hearing impairment (HI), who wore binaural behind-the-ear hearing aids; and 15 adults, ages 18 to 30 years, with normal hearing. Sentence recognition in quiet and in noise and subjective ratings were obtained in 3 conditions of wireless signal processing. Results: Performance by the listeners with HI when using the adaptive digital technology was significantly better than that obtained with the FM technology, with the greatest benefits at the highest noise levels. The majority of listeners also preferred the digital technology when listening in a real-world noisy environment. The wireless technology allowed persons with HI to surpass persons with normal hearing in speech recognition in noise, with the greatest benefit occurring with adaptive digital technology. Conclusion: The use of adaptive digital technology combined with speechreading cues would allow persons with HI to engage in communication in environments that would have otherwise not been possible with traditional wireless technology. [ABSTRACT FROM AUTHOR]

The aim of our study was to identify clinical criteria for optimizing rehabilitation of patients with unilateral deafness using the Baha device. We made a retrospective study of 102 patients with unilateral deafness requesting auditory rehabilitation over a period of 5 years. All subjects underwent a series of stereo audiometric tests, with and without Baha worn on a headband, and were then referred to a hearing care specialist for a real life trial of 15 days. The Glasgow Health Status Inventory (GHSI) questionnaire was administered. Patients refusing the implantation were retrospectively submitted to a questionnaire specifically designed to ask the reasons for refusal. We measured stereo audiometric test results, age, aetiology of deafness, duration of auditory deprivation on the rehabilitated ear, and GHSI score. At the conclusion of testing, the implantation rate was 29%. During preoperative testing, the improvement in understanding of speech-in-noise was 22 ± 11% for patients agreeing to the implantation versus 13 ± 11% for patients refusing the implantation. Age, aetiology of deafness and duration of auditory deprivation had no influence on the implantation decision. Speech-in-noise testing and aided stereo audiometric gain were the only two measures showing statistically significant differences between the groups agreeing to and refusing the implantation. There were multiple reasons for refusal of the implantation. Among these, the four principal reasons were: absence of perceived benefit during stereo audiometric testing (59%), requirement for surgery (35%), cost of the solution (44%), and aesthetics (41%). Hence, no other criteria except the preoperative improvement in understanding of speech-in-noise and the aided gain from Baha worn on a headband were found to be predictive of the patient's acceptance of surgical implantation of a bone-anchored implant/abutment for Baha. Speech-in-noise testing with and without Baha worn on a headband has a role to play in deciding on the implantation of a bone-anchored hearing solution. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Because chronic tinnitus is a condition that negatively impacts the quality of life of millions of people worldwide, a safe and effective treatment for tinnitus has been sought for millennia. However, effective treatments for tinnitus are greatly outnumbered by ineffective strategies, medications, devices, and surgeries that continue to be developed and promoted for the condition. Purpose: This article describes and critiques experimental, controversial, and potential treatments for chronic tinnitus. The purpose of this review is to provide information that should help patients and clinicians to select tinnitus treatment and management strategies most likely to be effective for each set of symptoms and circumstances. Research Design: PubMed and MEDLINE databases (National Center for Biotechnology Information, U.S. National Library of Medicine) were searched for the term tinnitus in articles published from 1940 to 2012. Other historical documents and publications were also reviewed as needed for particular topics. Study Sample: Studies included in this review were selected to represent a sampling of treatment methodologies that have been used for tinnitus. Data Collection and Analysis: Due to the heterogeneity of the studies reviewed, it was not appropriate to perform a meta-analysis. A selective review of the literature was conducted to summarize and critique published research results. Results: Most invasive treatments for tinnitus should be avoided because (1) at best, there is scant evidence that any of these treatments is effective, and (2) the risk to patients for most invasive procedures is much greater than the risk posed by the tinnitus perception. Effective and noninvasive treatments for tinnitus include acoustic therapy (which includes hearing aids and other types of environmental sound enrichment); cognitive-behavioral therapy; psychological counseling; hypnosis; biofeedback; and relaxation training. Over-the-counter or prescription medications may be used as needed to facilitate sleep and to reduce anxiety, depression, or obsessive-compulsiveness. Conclusions: Patients and clinicians should be especially cautious when considering invasive (and potentially harmful) treatments for tinnitus, which is a non-life-threatening symptom. Unless well-designed clinical trials verify that a tinnitus therapy demonstrates effectiveness above and beyond the placebo effect, consumers should be wary of medications, devices, or procedures promoted as a "cure." Although a true cure for tinnitus has not yet been found, effective and noninvasive tinnitus management strategies are available now. If progress is made to medically (or genetically) treat sensorineural hearing loss in humans, this breakthrough should also help to simultaneously reduce the perception of tinnitus for many patients. [ABSTRACT FROM AUTHOR]

Purpose: Previously, Gygi and Shafiro (2011) found that when environmental sounds are semantically incongruent with the background scene (e.g., horse galloping in a restaurant), they can be identified more accurately by young normal-hearing listeners (YNH) than sounds congruent with the scene (e.g., horse galloping at a racetrack). This study investigated how age and high-frequency audibility affect this Incongruency Advantage (IA) effect. Method: In Experiments 1a and 1b, elderly listeners (N = 18 for 1a; N = 10 for 1b) with age-appropriate hearing (EAH) were tested on target sounds and auditory scenes in 5 sound-to scene ratios (So/Sc) between -3 and -18 dB. Experiment 2 tested 11 YNH on the same sound-scene pairings lowpass-filtered at 4 kHz (YNH-4k). Results: The EAH and YNH-4k groups exhibited an almost identical pattern of significant IA effects, but both were at approximately 3.9 dB higher So/Sc than the previously tested YNH listeners. However, the psychometric functions revealed a shallower slope for EAH listeners compared with YNH listeners for the congruent stimuli only, suggesting a greater difficulty for the EAH listeners in attending to sounds expected to occur in a scene. Conclusions: These findings indicate that semantic relationships between environmental sounds in soundscapes are mediated by both audibility and cognitive factors and suggest a method for dissociating these factors. [ABSTRACT FROM AUTHOR]

Purpose: Cerumen management (CM) is within the scope of practice of audiology, and the Doctor of Audiology (AuD) is now the entry-level degree for persons practicing the profession. However, little recent information is available about whether and how CM is presently being taught in AuD programs or even if and how audiologists are currently practicing CM. This study surveyed audiologists about their training for, experience with, opinions about, and practices involving CM. Method: A questionnaire was designed for this study and was e-mailed with a link to Surveymonkey.com in April and May 2011 to 1,575 audiologists with AuD degrees, randomly sampled from the American Academy of Audiology's membership directory. Results: The return rate was 29% (447 returned). Overall, 69% of these audiologists performed CM compared to only 29% reported in earlier studies. More audiologists in private practice (87%) performed CM than those in medical settings (65%). Almost half (48%) of the audiologists who had completed residential AuD programs believed that their training programs inadequately prepared them to perform CM. Conclusion: More audiologists are performing CM than in the past. The respondents reported that they were inadequately trained in CM and believed that educational programs need to improve their coverage of CM. [ABSTRACT FROM AUTHOR]

Purpose: Ten percent of adults in England have some type of hearing loss and would greatly benefit from hearing aids or other forms of hearing management. However, 76% of these adults do not have hearing aids or other management. The impact of this unmet need can be substantial and has been linked to depression, social isolation, employment problems, loss of independence, and dementia. This article explores how hearing screening--universal, targeted, or opportunistic--can address prevalent, incident, and future needs for hearing services as well as better define the extent of need. Method: Adults age ?60 years living at home in England took part in a health survey, part of which was to determine the extent of need for hearing services in this population. Survey methods included a face-to-face interview and hearing screening using pure tones as well as a self-report questionnaire on other health issues. Results: The survey highlighted additional hearing-related factors that will enable referral decisions in primary care to be made with reasonable confidence that patients will use hearing aids and benefit from them. Some relevant nonhearing factors are also reported. Conclusion: There is a growing aging population with increasing needs and expectations for hearing services. Targeted screening and triage in primary care, as well as use of advanced technologies, are discussed for the future. [ABSTRACT FROM AUTHOR]

Background: The recent introduction of digital hearing aid technology for bone-conduction devices employing percutaneous stimulation may be beneficial for patients with conductive and mixed hearing loss and single sided deafness. Purpose: Performance of a recently released sound processor for bone-anchored implants, the Ponto Pro Power from Oticon Medical (bone-conduction device 2 [BCD2]), was compared with that of the Baha Intenso from Cochlear (bone-conduction device 1 [BCD1]). Research Design: Direct comparison of the subject's own device (BCD1) with the new device (BCD2) was examined in a nonrandomized design. Subjects were initially tested with BCD1. BCD2 was tested after a 4 wk acclimatization period. Study Sample: Eighteen subjects with mixed hearing loss and with at least 4 mo experience with BCD1 completed the study. Mean air-conduction and bone-conduction thresholds averaged across the frequencies of 500, 1000, 2000, and 4000 Hz were 73.9 and 34.2 dB HL, respectively. Data Collection and Analysis: Performance of the two devices was evaluated objectively by measuring aided free-field thresholds, speech perception in quiet, and speech perception in noise. A subjective evaluation was carried out with the Abbreviated Profile of Hearing Aid Benefit (APHAB) (Cox and Alexander, 1995) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire (Gatehouse and Noble, 2004). In addition, user experiences, user satisfaction, and device preference were obtained via proprietary questionnaires. Statistical significance was established with analysis-of-variance (ANOVA) and paired t-statistics with Bonferroni correction. Results: Aided free-field thresholds and speech reception thresholds (SRTs) in quiet were not statistically significantly different for either device (p > 0.05). In contrast, SRTs in noise were 2.0 dB lower (p< 0.001) for BCD2 than for BCD1. APHAB questionnaire scores on all subscales provided statistically significantly greater benefit (p < 0.05) for BCD2 than for BCD1. Also, with the SSQ most items in the speech and sound quality domain were significantly more favorable (p < 0.05) for BCD2 than for BCD1. Finally, all subjects preferred BCD2 over BCD1 with 14 subjects reporting a strong preference and four subjects an average preference for the digital signal processing provided by BCD2 over previous technology provided by BCD1. [ABSTRACT FROM AUTHOR]

Purpose: To provide a brief history of speech comprehension training systems and an overview of research on auditory and cognitive aging as background to recommendations for future directions for rehabilitation. Method: Two distinct domains were reviewed: one concerning technological and the other concerning psychological aspects of training. Historical trends and advances in these 2 domains were interrelated to highlight converging trends and directions for future practice. Results: Over the last century, technological advances have influenced both the design of hearing aids and training systems. Initially, training focused on children and those with severe loss for whom amplification was insufficient. Now the focus has shifted to older adults with relatively little loss but difficulties listening in noise. Evidence of brain plasticity from auditory and cognitive neuroscience provides new insights into how to facilitate perceptual (re-)learning by older adults. Conclusions: There is a new imperative to complement training to increase bottom-up processing of the signal with more ecologically valid training to boost top-down information processing based on knowledge of language and the world. Advances in digital technologies enable the development of increasingly sophisticated training systems incorporating complex meaningful materials such as music, audiovisual interactive displays, and conversation. [ABSTRACT FROM AUTHOR]

Purpose: To review the current literature on help seeking for hearing health care among older adults. Method: The authors conducted a literature review regarding help seeking for hearing-related communication difficulties as well as for other chronic medical conditions. Results: Untreated hearing loss can lead to numerous negative secondary consequences; uptake and use of hearing aids remain low, despite the fact that hearing aids provide an effective treatment option for older adults with hearing loss. The authors describe models relevant to understanding the help-seeking and decision-making behaviors of older adults with hearing loss and discuss recommendations for future research. Conclusion: Because of the considerable overlap in factors associated with help-seeking behaviors across chronic medical conditions and because help-seeking behaviors are complex, help seeking should be examined within the framework of a multifactorial model, such as the health belief model or the transtheoretical stages of change model. [ABSTRACT FROM AUTHOR]

This study examines the efficiency and effectiveness of three types of training on recognition of musical instruments by adults with cochlear implants (CI). Seventy-one adults with CIs were randomly assigned to one of three training conditions: feedback on response accuracy, feedback-plus (response accuracy plus correct answer), and direct instruction. Each participant completed three training sessions per week over a five-week time period in which they listened to recorded excerpts of eight different musical instruments. Results showed significant pre-to-posttest improvement in music instrument recognition accuracy for all three training conditions (22.9-25.7%, p < 0.0001). Time when tested (week), bilateral CI use, and age were significant predictors of performance. Participants who wore bilateral implants scored significantly higher than participants with unilateral implants at all three time points; hearing aid use was not a significant predictor. These results may have practical implications for numerous types of auditory rehabilitation for persons who use CIs. [ABSTRACT FROM AUTHOR]

Background and Aim: Early diagnosis of hearing loss lead to early intervention and improvement of developmental skills of children with hearing loss. The present study aimed to determine the mean age of hearing loss diagnosis and cochlear implantation (CI) in hearing impaired children and to compare the age of performing cochlear implantation in children who were identified by newborn hearing screening with those who were not. Methods: This cross-sectional study was conducted on 96 children with severe to profound sensorineural hearing loss who received cochlear implantation in Amir-e-Alam cochlear implantation center between the years 2008 and 2010. For data gathering, we assessed subjects' medical archives, interviewed with their parents and took medical history including demographic information, birth history and hearing loss history. Results: Mean age of hearing loss suspicion, diagnosis, hearing aids administration, Initiation of rehabilitation program, performing cochlear implantation and mean age when cochlear implantation was utilized were 6.73 (SD=5.79), 9.35 (SD=5.79), 13.41 (SD=6.10), 16 (SD=6.36), 41.25 (SD=11.12), and 42.15 (SD=11.00) months, respectively. There was statistically significant difference between them (p<0.05). 43.8% of hearing impaired children had been identified by newborn hearing screening. There was statistically significant difference between cochlear implantation operation age of children who were identified by newborn hearing screening with those who were not (p<0.0001). Conclusion: In spite of notable reduction in the age of hearing loss diagnosis and intervention during recent years, compared to international indices it is still tardy. Conducting newborn hearing screening can significantly reduce these ages. [ABSTRACT FROM AUTHOR]

This report highlights research projects relevant to binaural and spatial hearing in adults and children. In the past decade we have made progress in understanding the impact of bilateral cochlear implants (BiCIs) on performance in adults and children. However, BiCI users typically do not perform as well as normal hearing (NH) listeners. In this article we describe the benefits from BiCIs compared with a single cochlear implant (CI), focusing on measures of spatial hearing and speech understanding in noise. We highlight the fact that in BiCI listening the devices in the two ears are not coordinated; thus binaural spatial cues that are available to NH listeners are not available to BiCI users. Through the use of research processors that carefully control the stimulus delivered to each electrode in each ear, we are able to preserve binaural cues and deliver them with fidelity to BiCI users. Results from those studies are discussed as well, with a focus on the effect of age at onset of deafness and plasticity of binaural sensitivity. Our work with children has expanded both in number of subjects tested and age range included. We have now tested dozens of children ranging in age from 2 to 14 yr. Our findings suggest that spatial hearing abilities emerge with bilateral experience. While we originally focused on studying performance in free field, where real world listening experiments are conducted, more recently we have begun to conduct studies under carefully controlled binaural stimulation conditions with children as well. We have also studied language acquisition and speech perception and production in young CI users. Finally, a running theme of this research program is the systematic investigation of the numerous factors that contribute to spatial and binaural hearing in BiCI users. By using CI simulations (with vocoders) and studying NH listeners under degraded listening conditions, we are able to tease apart limitations due to the hardware/software of the CI systems from limitations due to neural pathology. [ABSTRACT FROM AUTHOR]

Since the early 1980s, the DeVault Otologic Research Laboratory at the Indiana University School of Medicine has been on the forefront of research on speech and language outcomes in children with cochlear implants. This paper highlights work over the last decade that has moved beyond collecting speech and language outcome measures to focus more on investigating the underlying cognitive, social, and linguistic skills that predict speech and language outcomes. This recent work reflects our growing appreciation that early auditory deprivation can affect more than hearing and speech perception. The new directions include research on attention to speech, word learning, phonological development, social development, and neurocognitive processes. We have also expanded our subject populations to include infants and children with additional disabilities [ABSTRACT FROM AUTHOR]

Background: Adults with severe and profound hearing loss tend to be long-term, full-time users of amplification who are highly reliant on their hearing aids. As a result of these characteristics, they are often reluctant to update their hearing aids when new features or signal-processing algorithms become available. Due to the electroacoustic constraints of older devices, many severely and profoundly hearing-impaired adults continue to wear hearing aids that provide more low- and mid-frequency gain and less high-frequency gain than would be prescribed by the National Acoustic Laboratories' revised formula with profound correction factor (NAL-RP). Purpose: To investigate the effect of a gradual change in gain/frequency response on experienced hearing-aid wearers with moderately severe to profound hearing loss. Research Design: Double-blind, randomized controlled trial. Study Sample: Twenty-three experienced adult hearing-aid users with severe and profound hearing loss participated in the study. Participants were selected for inclusion in the study if the gain/frequency response of their own hearing aids differed significantly from their NAL-RP prescription. Participants were assigned either to a control or to an experimental group balanced for aided ear three-frequency pure-tone average (PTA) and age. Intervention: Participants were fitted with Siemens Artis 2 SP behind-the-ear (BTE) hearing aids that were matched to the gain/frequency response of their own hearing aids for a 65 dB SPL input level. The experimental group progressed incrementally to their NAL-RP targets over the course of 15 wk, while the control group maintained their initial settings throughout the study. Data Collection and Analysis: Aided speech discrimination testing, loudness scaling, and structured questionnaires were completed at 3, 6, 9, 12, and 15 wk postfitting. A paired comparison between the old and new gain/frequency responses was completed at 1 and 15 wk postfitting. Statistical analysis was conducted to examine differences between the experimental and control groups and changes in objective performance and subjective perception over time. Results: The results of the study showed that participants in the experimental group were subjectively accepting of the changes to their amplification characteristics, as evidenced by nonsignificant changes in the ratings of device performance over time. Perception of loudness, sound quality, speech intelligibility, and own voice volume did not change significantly throughout the study. Objectively, participants in the experimental group demonstrated poorer speech discrimination performance as the study progressed, although there was no change in objective loudness perception. According to the paired comparison, there was an overall subjective preference for the original gain/frequency response among all participants, although participants in the experimental group did show an increase in preference for the NAL-RP response by the end of the study. Conclusions: Based on the findings of this study, we suggest that undertaking a gradual change to a new gain/frequency response with severely and profoundly hearing-impaired adults is a feasible procedure. However, we recommend that clinicians select transition candidates carefully and initiate the procedure only if there is a clinical reason for doing so. A validated prescriptive formula should be used as a transition target, and speech discrimination performance should be monitored throughout the transition. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to explore the self-reported consequences of profound unilateral deafness regarding communication and social interaction and to compare subjects' speech perception scores to those of normal-hearing individuals who were rendered temporarily unilaterally deaf. Methods: Cross-sectional data from 30 individuals with unilateral deafness and 30 individuals with normal hearing (age, 14 to 75 years) were obtained through structured interviews and tests of audiovisual, auditory-only, and visual-only speech perception. Results: In individuals with permanent unilateral deafness, 93% reported that hearing loss affected communication. Eighty-seven percent reported problems with speech perception in noisy settings. Other consequences were feelings of exclusion, reduced well-being, and extensive use of speech perception strategies. Inducing temporary unilateral deafness (through short-term blocking of one ear) in normal-hearing subjects produced similar effects on speech perception (27% score) as those experienced by unilaterally deaf subjects (25% score). Conclusions: Individuals with unilateral deafness experienced a significant disability in auditory function that affected their communication and social interaction. The major challenges were communicating in situations with background noise, in poor acoustic surroundings, and with limited access to speech-reading or direct listening. Under certain listening conditions, long-standing unilateral deafness seemed to yield no advantage over temporary deafness on one side. [ABSTRACT FROM AUTHOR]

Summary: There is a growing and unprecedented interest in the objective evaluation of the subcortical processes that are involved in speech perception, with potential clinical applications in speech and language impairments. Here, we review the studies illustrating the development of electrophysiological methods for assessing speech encoding in the human brainstem: from the pioneer recordings of click-evoked auditory brainstem responses (ABR), via studies of frequency-following responses (FFR) to the most recent measurements of speech ABR (SABR) or ABR in response to speech sounds. Recent research on SABR has provided new insights in the understanding of subcortical auditory processing mechanisms. The SABR test is an objective and non-invasive tool for assessing individual capacity of speech encoding in the brainstem. SABR characteristics are potentially useful both as a diagnosis tool of speech encoding deficits and as an assessment tool of the efficacy of rehabilitation programs in patients with learning and/or auditory processing disorders. [ABSTRACT FROM AUTHOR]