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Purpose: In May 2001, to integrate biological, psychological, and social aspects of human functioning, the World Health Assembly endorsed the International Classification of Functioning, Disability and Health (ICF). The aim of this article is to describe the creation of Comprehensive and Brief ICF Core Sets for Hearing Loss. The core sets consist of the most relevant ICF categories for hearing loss. Method and Results: Four preparatory studies were carried out and presented at a consensus conference, resulting in a Comprehensive ICF Core Set for Hearing Loss, consisting of 117 ICF categories, and a Brief ICF Core Set for Hearing Loss, consisting of 27 categories (of the 117). Conclusion: The Comprehensive ICF Core Set for Hearing Loss can be a user-friendly tool for conducting comprehensive, multidisciplinary assessments. The Brief ICF Core Set can be used for many purposes, such as research and population studies. However, its most common use is by individuals seeking to provide a brief description and assessment of functioning of a person with hearing loss., Funding Agencies:Oticon Research Foundation Nordic Audiological Society Stinger Foundation Hearing Foundation ICF Research Branch

Purpose: In this explorative study, the authors investigated the relationship between auditory and cognitive abilities and self-reported hearing disability. less thanbrgreater than less thanbrgreater thanMethod: Thirty-two adults with mild to moderate hearing loss completed the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, andamp; Tobi, 1996) and performed the Text Reception Threshold (TRT; Zekveld, George, Kramer, Goverts, andamp; Houtgast, 2007) test as well as tests of spatial working memory (SWM) and visual sustained attention. Regression analyses examined the predictive value of age, hearing thresholds (pure-tone averages [PTAs]), speech perception in noise (speech reception thresholds in noise [SRTNs]), and the cognitive tests for the 5 AIADH factors. less thanbrgreater than less thanbrgreater thanResults: Besides the variance explained by age, PTA, and SRTN, cognitive abilities were related to each hearing factor. The reported difficulties with sound detection and speech perception in quiet were less severe for participants with higher age, lower PTAs, and better TRTs. Fewer sound localization and speech perception in noise problems were reported by participants with better SRTNs and smaller SWM. Fewer sound discrimination difficulties were reported by subjects with better SRTNs and TRTs and smaller SWM. less thanbrgreater than less thanbrgreater thanConclusions: The results suggest a general role of the ability to read partly masked text in subjective hearing. Large working memory was associated with more reported hearing difficulties. This study shows that besides auditory variables and age, cognitive abilities are related to self-reported hearing disability., Funding Agencies|Heinsius-Houbolt Foundation||The Netherlands Organisation for Scientific Research

Purpose: In this study, the authors assessed the influence of masking level (29% or 71% sentence perception) and test modality on the processing load during language perception as reflected by the pupil response. In addition, the authors administered a delayed cued stimulus recall test to examine whether processing load affected the encoding of the stimuli in memory. less thanbrgreater than less thanbrgreater thanMethod: Participants performed speech and text reception threshold tests, during which the pupil response was measured. In the cued recall test, the first half of correctly perceived sentences was presented, and participants were asked to complete the sentences. Reading and listening span tests of working memory capacity were presented as well. less thanbrgreater than less thanbrgreater thanResults: Regardless of test modality, the pupil response indicated higher processing load in the 29% condition than in the 71% correct condition. Cued recall was better for the 29% condition. less thanbrgreater than less thanbrgreater thanConclusions: The consistent effect of masking level on the pupil response during listening and reading support the validity of the pupil response as a measure of processing load during language perception. The absent relation between pupil response and cued recall may suggest that cued recall is not directly related to processing load, as reflected by the pupil response., Funding Agencies|Netherlands Organisation for Scientific Research|Veni 451-10-031

OBJECTIVE: Qualitative research methodologies are being used more frequently in audiology as it allows for a better understanding of the perspectives of people with hearing impairment. This article describes why and how international interdisciplinary qualitative research can be conducted. DESIGN: This paper is based on a literature review and our recent experience with the conduction of an international interdisciplinary qualitative study in audiology. RESULTS: We describe some available qualitative methods for sampling, data collection, and analysis and we discuss the rationale for choosing particular methods. The focus is on four approaches which have all previously been applied to audiologic research: grounded theory, interpretative phenomenological analysis, conversational analysis, and qualitative content analysis. CONCLUSIONS: This article provides a review of methodological issues useful for those designing qualitative research projects in audiology or needing assistance in the interpretation of qualitative literature.

OBJECTIVE: This study investigated the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. DESIGN: Individual semi-structured interviews were completed. STUDY SAMPLE: In total, 34 adults with hearing impairment in four countries (Australia, Denmark, UK, and USA) participated. Participants had a range of experience with hearing help-seeking and rehabilitation, from never having sought help to being satisfied hearing-aid users. RESULTS: Qualitative content analysis identified four main categories ('perceiving my hearing impairment', 'seeking hearing help', 'using my hearing aids', and 'perspectives and knowledge') and, at the next level, 25 categories. This article reports on the densest categories: they are described, exemplified with interview quotes, and discussed. CONCLUSIONS: People largely described hearing help-seeking and rehabilitation in the context of their daily lives. Adults with hearing impairment rarely described clinical encounters towards hearing help-seeking and rehabilitation as a connected process. They portrayed interactions with clinicians as isolated events rather than chronologically-ordered steps relating to a common goal. Clinical implications of the findings are discussed., Funding Agencies|University of Queensland Graduate School

It is often assumed that the benefit of hearing aids is not primarily reflected in better speech performance, but that it is reflected in less effortful listening in the aided than in the unaided condition. Before being able to assess such a hearing aid benefit the present study examined how processing load while listening to masked speech relates to inter-individual differences in cognitive abilities relevant for language processing. Pupil dilation was measured in thirty-two normal hearing participants while listening to sentences masked by fluctuating noise or interfering speech at either 50% and 84% intelligibility. Additionally, working memory capacity, inhibition of irrelevant information, and written text reception was tested. Pupil responses were larger during interfering speech as compared to fluctuating noise. This effect was independent of intelligibility level. Regression analysis revealed that high working memory capacity, better inhibition, and better text reception were related to better speech reception thresholds. Apart from a positive relation to speech recognition, better inhibition and better text reception are also positively related to larger pupil dilation in the single-talker masker conditions. We conclude that better cognitive abilities not only relate to better speech perception, but also partly explain higher processing load in complex listening conditions.

Purpose: This research aimed to increase the analogy between text reception threshold (TRT) and speech reception threshold (SRT) and to examine the TRT's value in estimating cognitive abilities important for speech comprehension in noise. Method: We administered five TRT versions, SRT tests in stationary (SRTSTAT) and modulated (SRTMOD) noise, and two cognitive tests: a reading span (RSpan) test for working memory capacity, and a letter-digit-substitution test for information processing speed. Fifty-five normal hearing adults (18–78 years, mean = 44) participated. We examined mutual associations of the tests and their predictive value for the SRTs with correlation and linear regression analyses. Results: SRTs and TRTs were well associated, also when controlling for age. Correlations for the SRTSTAT were generally lower than for the SRTMOD. The cognitive tests were only correlated to the SRTs when age was not controlled for. Age and the TRTs were the only significant predictors of SRTMOD. SRTSTATwas predicted by level of education and some of the TRT versions. Conclusions: TRTs and SRTs are robustly associated, nearly independent of age. The association between SRTs and RSpan is largely age-dependent. The TRT test and the RSpan test measure different non-auditory components of linguistic processing relevant for speech perception in noise., Journal of Speech, Language and Hearing Research

Objective: Hearing impairment is known to have various effects upon both the person with hearing impairment (PHI) and their communication partners (CPs). In addition, CPs are reported to play an important role in making the decision to seek a consultation and the acceptance of intervention by the PHI. The overall aim of this paper is to provide a comprehensive overview of the role of the CP in the audiological enablement/rehabilitation of the PHI keeping clinical practice in focus. Method: A literature review was conducted using a number of resources including electronic databases, books and websites. Results: An overview of the literature was presented in the following sections: 1) Factors influencing the audiological enablement/rehabilitation of the PHI; 2) Effect of the PHI's hearing impairment on their CPs; 3) CPs’ influence on their PHI's audiological enablement/rehabilitation; 4) Positive experiences reported by CPs of the PHI; 5) Models to represent CPs within the social network context of the PHI; and 6) CP involvement in the audiological enablement/rehabilitation. This paper also identifies gaps in the literature and provides recommendations for further research. Conclusion: It is clear that involvement of the CP in the audiological enablement/rehabilitation can result in mutual advantages for both the PHI and their CPs.

Objectives: Recent research has demonstrated that pupil dilation, a measure of mental effort (cognitive processing load), is sensitive to differences in speech intelligibility. The present study extends this outcome by examining the effects of masker type and age on the speech reception threshold (SRT) and mental effort. less thanbrgreater than less thanbrgreater thanDesign: In young and middle-aged adults, pupil dilation was measured while they performed an SRT task, in which spoken sentences were presented in stationary noise, fluctuating noise, or together with a single-talker masker. The masker levels were adjusted to achieve 50% or 84% sentence intelligibility. less thanbrgreater than less thanbrgreater thanResults: The results show better SRTs for fluctuating noise and a single-talker masker compared with stationary noise, which replicates results of previous studies. The peak pupil dilation, reflecting mental effort, was larger in the single-interfering speaker condition compared with the other masker conditions. Remarkably, in contrast to the thresholds, no differences in peak dilation were observed between fluctuating noise and stationary noise. This effect was independent of the intelligibility level and age. less thanbrgreater than less thanbrgreater thanConclusions: To maintain similar intelligibility levels, participants needed more mental effort for speech perception in the presence of a single-talker masker and then with the two other types of maskers. This suggests an additive interfering effect of speech information from the single-talker masker. The dissociation between these performance and mental effort measures underlines the importance of including measurements of pupil dilation as an independent index of mental effort during speech processing in different types of noisy environments and at different intelligibility levels., Funding Agencies|Netherlands Organisation for Scientific Research

Objectives: This descriptive summary of the literature provides an overview of the available studies (published between January 1980 and January 2009) on correlates of help-seeking behavior for hearing loss, hearing-aid uptake, hearing-aid use, and satisfaction with the device. Methods: Publications were identified by structured searches in Pubmed and Cinahl and by inspecting the reference lists of relevant articles. The articles covered different stages that a person with hearing impairment may go through: prior to hearing aid fitting, the period covering the fitting and the period post hearing aid fitting. Inclusion of articles occurred according to strict inclusion and exclusion criteria. Data were extracted by two independent researchers. Thirty-nine papers were included that identified 31 factors examined in relation to the four outcome measures. These covered personal factors (e.g., source of motivation, expectation, attitude), demographic factors (e.g., age, gender) and external factors (e.g., cost, counseling). Only two studies covered the actual fitting process. There was only one factor positively affecting all four outcome variables. This was self-reported hearing disability. The vast majority of studies showed no relationship of age and gender with any of the outcome domains. Discussion and conclusion: Whereas research of the last 28 years yielded valuable information regarding relevant and irrelevant factors in hearing aid health care, there are still many relevant issues that have never been investigated in controlled studies. These are discussed.

PURPOSE. The aims were to (i) translate the Amsterdam Inventory for Auditory Disability and Handicap (AIADH) into Swedish and evalute its usefulness, (ii) describe hearing difficulties and psychological well-being (quality of life) and (iii) explore variables related to psychological well-being in a Swedish population. METHOD. Seventy-nine consecutive patients, referred to the hearing clinic for hearing examination and audiological rehabilitation, formed the study sample. Along with pure-tone audiometry, the AIADH, the Psychological General Well-being index and the Communication Strategies Scale were used. RESULTS. Men had significantly worse hearing on the high frequencies (2, 3, 4 and 6 kHz) than women but their quality of life was significantly higher than for women. Men scored significantly lower on 'auditory localization' and adopted non-verbal communication strategies less often than women. A stepwise regression analysis showed that 'maladaptive behaviours' and 'intelligibility in quiet' explained 48% of the variance in quality of life. CONCLUSION. Psychosocial consequences of hearing loss, such as lowered quality of life, cannot be predicted from audiometric data alone. The adverse relationship between maladaptive behaviour and quality of life emphasizes the relevance of developing training programs aiming to improve coping with the consequences of a hearing impairment.The AIADH may be useful in assessing self-reported difficulties among patients with hearing problems, but needs to be further developed in terms of psychometric evaluations and reliability testings based on a larger representative sample.