| 1. |
- Aliakbaryhosseinabadi, Susan, et al.
(författare)
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The Effects of Noise and Simulated Conductive Hearing Loss on Physiological Response Measures During Interactive Conversations
- 2023
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Ingår i: Journal of Speech, Language and Hearing Research. - : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1092-4388 .- 1558-9102. ; 66:10, s. 4009-4024
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this work was to study the effects of background noise and hearing attenuation associated with earplugs on three physiological measures, assumed to be markers of effort investment and arousal, during interactive communication. Method: Twelve pairs of older people (average age of 63.2 years) with ageadjusted normal hearing took part in a face-to-face communication to solve a Diapix task. Communication was held in different levels of babble noise (0, 60, and 70 dBA) and with two levels of hearing attenuation (0 and 25 dB) in quiet. The physiological measures obtained included pupil size, heart rate variability, and skin conductance. In addition, subjective ratings of perceived communication success, frustration, and effort were obtained. Results: Ratings of perceived success, frustration, and effort confirmed that communication was more difficult in noise and with approximately 25-dB hearing attenuation and suggested that the implemented levels of noise and hearing attenuation resulted in comparable communication difficulties. Background noise at 70 dBA and hearing attenuation both led to an initial increase in pupil size (associated with effort), but only the effect of the background noise was sustained throughout the conversation. The 25-dB hearing attenuation led to a significant decrease of the high-frequency power of heart rate variability and a significant increase of skin conductance level, measured as the average z value of the electrodermal activity amplitude. Conclusion: This study demonstrated that several physiological measures appear to be viable indicators of changing communication conditions, with pupillometry and cardiovascular as well as electrodermal measures potentially being markers of communication difficulty.
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| 2. |
- Beechey, Timothy, et al.
(författare)
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Eliciting Naturalistic Conversations: A Method for Assessing Communication Ability, Subjective Experience, and the Impacts of Noise and Hearing Impairment
- 2019
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech Language Hearing Association. - 1092-4388 .- 1558-9102. ; 62:2, s. 470-484
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to introduce a method of eliciting conversational behavior with many aspects of realism, which may be used to study the impacts of hearing impairment and noise on verbal communication; to describe the characteristics of speech and language participants produced during the task; and to assess participants' engagement and motivation while completing the task.Method: Twenty young adults with normal hearing and 20 older adults with hearing impairment took part in face-to-face conversations while completing a referential communication puzzle task designed to elicit natural conversational speech production and language with a number of realistic characteristics. Participants rated the difficulty and relevance of acoustic scenes for communication and their engagement in conversations.Results: The communication task elicited speech production in a natural conversational register and language with many realistic characteristics, including complex linguistic constructions and typical disfluencies found in everyday speech, and approximately balanced contributions within dyads. Subjective ratings suggest that the task is robust to learning and fatigue effects and that participants remained highly engaged throughout the experiment. All participants were able to maintain successful communication regardless of background noise level and degree of hearing impairment.Conclusions: The communication task described here may be used as part of a functional assessment of the ability to communicate in the presence of noise and hearing impairment. Although existing speech assessments have many strengths, they do not take into account the inherently interactive nature of spoken communication or the effects of motivation and engagement.
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| 3. |
- Beechey, Timothy, et al.
(författare)
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Hearing Aid Amplification Reduces Communication Effort of People With Hearing Impairment and Their Conversation Partners
- 2020
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 63:4, s. 1299-1311
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions.DesignFifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs. Each pair consisted of one young normal-hearing participant and one older hearing-impaired participant. Hearing-impaired participants received directional hearing aid amplification, according to their audiogram, via a master hearing aid with gain provided according to the NAL-NL2 fitting formula. Pairs of participants were required to take part in naturalistic conversations through the use of a referential communication task. Each pair took part in five conversations, each of 5-min duration. During each conversation, participants were exposed to one of five different realistic acoustic environments presented through highly open headphones. The ordering of acoustic environments across experimental blocks was pseudorandomized. Resulting recordings of conversational speech were analyzed to determine the magnitude of speech modifications, in terms of vocal level and spectrum, produced by normal-hearing talkers as a function of both acoustic environment and the degree of high-frequency average hearing impairment of their conversation partner.ResultsThe magnitude of spectral modifications of speech produced by normal-hearing talkers during conversations with aided hearing-impaired interlocutors was smaller than the speech modifications observed during conversations between the same pairs of participants in the absence of hearing aid amplification.ConclusionsThe provision of hearing aid amplification reduces the effort required to maintain communication in adverse conditions. This reduction in effort provides benefit to hearing-impaired individuals and also to the conversation partners of hearing-impaired individuals. By considering the impact of amplification on both sides of dyadic conversations, this approach contributes to an increased understanding of the likely impact of hearing impairment on everyday communication.
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| 4. |
- Beechey, Timothy, et al.
(författare)
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Hearing Impairment Increases Communication Effort During Conversations in Noise
- 2020
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Ingår i: Journal of Speech, Language and Hearing Research. - : American Speech-Language-Hearing Association. - 1092-4388 .- 1558-9102. ; 63:1, s. 305-320
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThis article describes patterns of speech modifications produced by talkers as a function of the degree of hearing impairment of communication partners during naturalistic conversations in noise. An explanation of observed speech modifications is proposed in terms of a generalization of the concept of effort. This account complements existing theories of listening effort by extending the concept of effort to the domain of interactive communication.MethodTwenty young adult normal hearing participants and 20 older adult hearing-impaired participants were tested in pairs. Each pair consisted of 1 young normal hearing participant and 1 older hearing-impaired participant. Pairs of participants took part in naturalistic conversations through the use of a referential communication task. Each pair completed a 5-min conversation in each of 5 different realistic acoustic environments.ResultsTalkers modified their speech, in terms of level and spectrum, in a gradient manner reflecting both the acoustic environment and the degree of hearing impairment of their conversation partner. All pairs of participants were able to maintain communication across all acoustic environments regardless of degree of hearing impairment and the level of environmental noise. Contrasting effects of noise and hearing impairment on speech production revealed distinct patterns of speech modifications produced by normal hearing and hearing-impaired talkers during conversation. This may reflect the fact that only the speech modifications produced by normal hearing talkers functioned to compensate for the hearing impairment of a conversation partner.ConclusionsThe data presented support the concept of communication effort as a dynamic feedback system between conversation participants. Additionally, these results provide insight into the nature of realistic speech signals, which are encountered by people with hearing impairment in everyday communication scenarios.
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| 5. |
- Carlile, Simon, et al.
(författare)
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Conversational Interaction Is the Brain in Action: Implications for the Evaluation of Hearing and Hearing Interventions
- 2020
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 41, s. 56S-67S
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Tidskriftsartikel (refereegranskat)abstract
- Humans have evolved the unique capacity to efficiently communicate using the spoken word. Hearing plays a key role as a receiver in this process and dysfunction leads to difficulties in listening and communication. It is widely accepted that effective communication is not adequately captured with current behavioral speech tests that principally focus on passive sound detection and speech recognition with idealized stimuli. To address the question of what it will take to obtain more ecologically valid outcomes from behavioral speech tests, recent approaches, and test paradigms devised to address some of the acknowledged shortcomings of current speech tests were reviewed. Additionally, some recent work which has focused on understanding brain function in social and dynamic interaction scenarios, so-called second person neuroscience, was reviewed. These reviews revealed that, while recent efforts in bridging the gap between behavioral speech tests and everyday communication situations represent important steps in the right direction, they are unlikely to provide a complete account of everyday communication situations. Further, brain imaging studies, together with our growing understanding of "mirror" neurons and the development of theories around embodied cognition, have demonstrated that the brain networks recruited during emotionally engaged interaction between interlocutors are far more complex when compared to that of a passive listener. Speech and nonspeech (e.g., gaze direction, body posture, etc.) interactions between the interlocutors give rise to the perception of effective interaction (sense of "agency") and activate neural networks important in decision-making and subsequent communication interaction. Successful conversational interaction represents the negotiation of a dynamic context and the emergence of a state of shared understanding between participants. In conclusion, to achieve highly ecologically valid outcomes related to communication, future testing will most likely require an interactive or conversational paradigm to elicit the brain states that are present in everyday social interactions.
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| 6. |
- Convery, Elizabeth, et al.
(författare)
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A Smartphone App to Facilitate Remote Patient-Provider Communication in Hearing Health Care: Usability and Effect on Hearing Aid Outcomes
- 2020
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 26:6, s. 798-804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients often need multiple fine-tuning appointments with their hearing health care provider to achieve satisfactory hearing aid outcomes. A smartphone app that enables patients to remotely request and receive new hearing aid settings could improve hearing health care access and efficiency. Introduction: We assessed the usability of ReSound Assist™, (ReSound America, Bloomington, MN) the remote communication feature of a hearing aid app, and investigated whether hearing aid outcomes are influenced by app-based versus in-person patient-provider communication. Materials and Methods: Thirty adults were fit bilaterally with hearing aids and randomized to intervention and control groups. During a 6-week field trial, participants reported hearing aid problems via ReSound Assist (intervention) or at a scheduled face-to-face follow-up appointment (control). Usability of ReSound Assist was assessed with a questionnaire and interview. Hearing aid performance, benefit, satisfaction, and daily usage were compared for both groups. Results: ReSound Assist was rated as highly usable. Participants identified specific aspects of effectiveness and efficiency that could be improved. Similar problems were reported by intervention and control participants regardless of communication mode (app-based vs. in-person). However, almost half the requests received via ReSound Assist were for problems that required advice from the provider or physical modifications to the hearing aids rather than fine-tuning, highlighting the continued importance of in-person hearing health care. There was no significant difference in hearing aid outcomes between intervention and control participants. Conclusions: Apps enabling remote patient-provider communication are a viable method for hearing aid users to seek and receive help with hearing aid problems that can be addressed through fine-tuning. © Elizabeth Convery et al. 2019; Published by Mary Ann Liebert, Inc.
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| 7. |
- Convery, Elizabeth, et al.
(författare)
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Factors Associated With Successful Setup of a Self-Fitting Hearing Aid and the Need for Personalized Support
- 2018
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Ingår i: Ear & Hearing. - : Ovid Technologies (Wolters Kluwer Health). - 0196-0202. ; 40:4, s. 794-804
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledgeable, personalized support in performing the self-fitting procedure; and (3) evaluate performance of the individual steps in the self-fitting procedure.Design: Sixty adults with hearing loss between the ages of 51 and 85 took part in the study. Half of the participants were current users of bilateral hearing aids; the other half had no previous hearing aid experience. At the first appointment, participants underwent assessments of health locus of control, hearing aid self-efficacy, cognitive status, problem-solving skills, demographic characteristics, and hearing thresholds. At the second appointment, participants followed a set of computer-based instructions accompanied by video clips to self-fit the hearing aids. The self-fitting procedure required participants to customize the physical fit of the hearing aids, insert the hearing aids into the ear, perform self-directed in situ audiometry, and adjust the resultant settings according to their preference. Participants had access to support with the self-fitting procedure from a trained clinical assistant (CA) at all times.Results: Forty-one (68%) of the participants achieved a successful self-fitting. Participants who self-fit successfully were significantly more likely than those who were unsuccessful to have had previous experience with hearing aids and to own a mobile device (when controlling for four potential covariates). Of the 41 successful self-fitters, 15 (37%) performed the procedure independently and 26 (63%) sought support from the CA. The successful self-fitters who sought CA support were more likely than those who self-fit independently to have a health locus of control that is externally oriented toward powerful others. Success rates on the individual steps in the self-fitting procedure were relatively high. No one step was more problematic than any other, nor was there a systematic tendency for particular participants to make more errors than others. Steps that required use of the hearing aids in conjunction with the self-fitting app on the participant’s mobile device had the highest rates of support use.Conclusions: The findings of this study suggest that nonaudiologic factors should be considered when selecting suitable candidates for the self-fitting hearing aids evaluated in this study. Although computer-based instructions and video clips were shown to improve self-fitting skill acquisition relative to past studies in which printed instruction booklets were used, the majority of people are still likely to require access to support from trained personnel while carrying out the self-fitting procedure, especially when this requires the use of an app.
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| 8. |
- Convery, Elizabeth, et al.
(författare)
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Predictors of hearing loss self-management in older adults
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 41:17, s. 2026-2035
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores.Materials and methods: Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment was determined by exploratory factor analysis. Multiple linear regression analyses identified significant contributors to the total score and to each of the extracted factors.Results: Three factors were identified, each representing a distinct domain of hearing loss self-management: Actions, Psychosocial Behaviours, and Knowledge. The most common significant predictor was hearing health care experience, which predicted self-management overall and in the Actions and Knowledge domains. Health literacy predicted hearing loss self-management overall and in the Psychosocial Behaviours domain. Actions were additionally predicted by hearing aid self-efficacy and gender, Psychosocial Behaviours by health locus of control, and Knowledge by age.Conclusions: The results of the factor analysis suggested that hearing loss self-management is a multidimensional construct. Each domain of hearing loss self-management was influenced by different contextual factors. Subsequent interventions to improve hearing loss self-management should therefore be domain-specific and tailored to relevant contextual factors.
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| 9. |
- Convery, Elizabeth, et al.
(författare)
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The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction
- 2019
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Ingår i: American Journal of Audiology. - : American Speech Language Hearing Association. - 1059-0889 .- 1558-9137. ; 28:2, s. 274-284
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction.Method: Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study. The participants completed self-report inventories probing their hearing loss self-management and hearing aid benefit and satisfaction. Correlation analysis was used to investigate the relationship between individual domains of hearing loss self-management and hearing aid benefit and satisfaction.Results: Participants who reported better self-management of the effects of their hearing loss on their emotional well-being and social participation were more likely to report less aided listening difficulty in noisy and reverberant environments and greater satisfaction with the effect of their hearing aids on their self-image. Participants who reported better self-management in the areas of adhering to treatment, participating in shared decision making, accessing services and resources, attending appointments, and monitoring for changes in their hearing and functional status were more likely to report greater satisfaction with the sound quality and performance of their hearing aids.Conclusion: Study findings highlight the potential for using information about a patient's hearing loss self-management in different domains as part of clinical decision making and management planning.
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| 10. |
- Hickson, Louise, et al.
(författare)
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The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists
- 2019
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Ingår i: Seminars in Hearing. - : Georg Thieme Verlag KG. - 0734-0451 .- 1098-8955. ; 40:01, s. 007-025
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Tidskriftsartikel (refereegranskat)abstract
- Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics—all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions—may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt. We further introduce the concept of chronic condition self-management, a key component of chronic care that refers to the knowledge and skills patients use to manage the effects of a chronic condition on all aspects of daily life. Drawing on the chronic condition evidence base, we demonstrate a link between the provision of effective self-management support and improved clinical outcomes and discuss validated methods with which clinicians can support the acquisition and application of self-management skills in their patients. We examine the extent to which elements of chronic condition self-management have been integrated into clinical practice in audiology and suggest directions for further research in this area.
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| 11. |
- Hygge, Staffan, et al.
(författare)
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The effect of functional hearing loss and age on long- and short-term visuospatial memory: evidence from the UK Biobank resource: a longitudinal follow up
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In a recent study (Rönnberg, Hygge, Keidser & Rudner, 2014) we reported cross-sectional epidemiological data from the UK Biobank, which in total contains >500,000 individuals in the UK. The focus in that study was on the effects of functional hearing loss and age on long- and short-term visuospatial memory. Our selection of variables resulted in a sub-sample of 138,098 participants after discarding extreme values.A digit triplets functional hearing test was used to divide the participants into three groups: poor, insufficient and normal hearers. We found negative relationships between functional hearing loss and both visuospatial working memory (i.e., a card pair matching task) and visuospatial, episodic long-term memory (i.e., a prospective memory task), with the strongest association for episodic long-term memory. The use of hearing aids showed a small positive effect for working memory performance for the poor hearers, but did not have any influence on episodic long-term memory. Age also showed strong main effects for both memory tasks and interacted with gender and education for the long-term memory task.Close to 20,000 of the original (>500,000) participants recently went through the very same test battery a second time, 2-7 years after the first time. In the present study, we will scrutinize in which respects the addition of extra years in the longitudinal analysis is commensurable with extra years from our previous cross-sectional analysis, for the same sets of original moderators and mediators.
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| 12. |
- Keidser, Gitte, et al.
(författare)
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A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies
- 2019
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 28:4, s. 993-1005
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery.MethodEleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones. A template analysis was applied to data.ResultsFive themes emerged from the interviews: (a) prerequisites to the successful implementation of user-driven and app-controlled technologies, (b) benefits and advantages of user-driven and app-controlled technologies, (c) barriers to the acceptance and use of user-driven and app-controlled technologies, (d) beliefs that age is a significant factor in how well people will adopt new technology, and (e) consequences that flow from the adoption of user-driven and app-controlled technologies. Specifically, suggested benefits of the technology included fostering empowerment and providing cheaper and more discrete options, while challenges included lack of technological self-efficacy among older adults. Training and support were emphasized as necessary for successful adaptation and were suggested to be a focus of audiologic services in the future.ConclusionUser perceptions of user-driven and app-controlled hearing technologies challenge the audiologic profession to provide adequate support and training for use of the technology and manufacturers to make the technology more accessible to older people.
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| 13. |
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Keidser, Gitte, et al.
(författare)
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On the relationship between functional hearing and depression
- 2015
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Ingår i: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 54:10, s. 653-664
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it.DESIGN: Cross-sectional data from the UK Biobank resource, including subjective and behavioural measures of functional hearing and multifactorial measures of depressive episodes and symptoms, were accessed and analysed using multi-regression analyses.STUDY SAMPLE: Over 100 000 community-dwelling, 39-70 year-old volunteers.RESULTS: Irrespective of measurement method, poor functional hearing was significantly (p < 0.001) associated with higher levels of depressive episodes (≤ 0.16 factor scores) and depressive symptoms (≤ 0.30 factor scores) when controlling for age and gender. Associations were stronger for subjective reports, for depressive symptoms, and the younger participants. Females generally reported higher levels of depression. Hearing-aid usage did not show a mitigating effect on the associations. Other physical health problems particularly partially confounded the effects.CONCLUSION: Data support an association between functional hearing and depression that is stronger in the younger participants (40-49 years old) and for milder depression. The association was not alleviated by hearing-aid usage, but was partially confounded by other physical health problems.
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| 18. |
- Keidser, Gitte, et al.
(författare)
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The Effect of Functional Hearing and Hearing Aid Usage on Verbal Reasoning in a Large Community-Dwelling Population
- 2016
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 37:1, s. e26-e36
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage mitigated the effect and examined different routes from hearing to verbal reasoning.Design: Cross-sectional data on 40- to 70-year-old community-dwelling participants from the UK Biobank resource were accessed. Data consisted of behavioral and subjective measures of functional hearing, assessments of numerical and linguistic verbal reasoning, measures of executive function, and demographic and lifestyle information. Data on 119,093 participants who had completed hearing and verbal reasoning tests were submitted to multiple regression analyses, and data on 61,688 of these participants, who had completed additional cognitive tests and provided relevant lifestyle information, were submitted to structural equation modeling.Results: Poorer performance on the behavioral measure of functional hearing was significantly associated with poorer verbal reasoning in both the numerical and linguistic domains (p < 0.001). There was no association between the subjective measure of functional hearing and verbal reasoning. Functional hearing significantly interacted with education (p < 0.002), showing a trend for functional hearing to have a greater impact on verbal reasoning among those with a higher level of formal education. Among those with poor hearing, hearing aid usage had a significant positive, but not necessarily causal, effect on both numerical and linguistic verbal reasoning (p < 0.005). The estimated effect of hearing aid usage was less than the effect of poor functional hearing. Structural equation modeling analyses confirmed that controlling for education reduced the effect of functional hearing on verbal reasoning and showed that controlling for executive function eliminated the effect. However, when computer usage was controlled for, the eliminating effect of executive function was weakened.Conclusions: Poor functional hearing was associated with poor verbal reasoning in a 40- to 70-year-old community-dwelling population after controlling for age, gender, and education. The effect of functional hearing on verbal reasoning was significantly reduced among hearing aid users and completely overcome by good executive function skills, which may be enhanced by playing computer games.
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| 19. |
- Keidser, Gitte, et al.
(författare)
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The Quest for Ecological Validity in Hearing Science: What It Is, Why It Matters, and How to Advance It
- 2020
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 41, s. 5S-19S
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Tidskriftsartikel (refereegranskat)abstract
- Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hearing research in a consistent and productive manner. Inspired by relevant debate within the field of psychology, and taking into account the World Health Organizations International Classification of Functioning, Disability, and Health framework, the attendees at the workshop reached a consensus on the following definition: "In hearing science, ecological validity refers to the degree to which research findings reflect real-life hearing-related function, activity, or participation." Four broad purposes for striving for greater ecological validity in hearing research were determined: A (Understanding) better understanding the role of hearing in everyday life; B (Development) supporting the development of improved procedures and interventions; C (Assessment) facilitating improved methods for assessing and predicting ability to accomplish real-world tasks; and D (Integration and Individualization) enabling more integrated and individualized care. Discussions considered the effects of variables and phenomena commonly present in hearing-related research on the level of ecological validity of outcomes, supported by examples from a few selected outcome domains and for different types of studies. Illustrated with examples, potential strategies were offered for promoting a high level of ecological validity in a study and for how to evaluate the level of ecological validity of a study. Areas in particular that could benefit from more research to advance ecological validity in hearing science include: (1) understanding the processes of hearing and communication in everyday listening situations, and specifically the factors that make listening difficult in everyday situations; (2) developing new test paradigms that include more than one person (e.g., to encompass the interactive nature of everyday communication) and that are integrative of other factors that interact with hearing in real-life function; (3) integrating new and emerging technologies (e.g., virtual reality) with established test methods; and (4) identifying the key variables and phenomena affecting the level of ecological validity to develop verifiable ways to increase ecological validity and derive a set of benchmarks to strive for.
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| 20. |
- Keidser, Gitte, et al.
(författare)
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The relationship between functional hearing and verbal reasoning
- 2015
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Konferensbidrag (refereegranskat)abstract
- Verbal reasoning performance is an indicator of the ability to think constructively in everyday life, and relies particularly on semantic long-term memory and working memory. Using cross-sectional data from the UK Biobank resource, obtained on over 100,000 40-70 year olds, this study investigated the effect of functional hearing on numerical and linguistic verbal reasoning when controlling for age, gender, and education. The study further investigated if hearing aid usage mitigated the effect, and examined different pathways from hearing to verbal reasoning. Multiple regression analyses showed that poor functional hearing was significantly associated with reduced numerical and linguistic verbal reasoning scores, and that hearing aid usage mitigated the association among those with poor hearing. Hearing significantly interacted with education as larger negative effects of hearing were seen among those with higher levels of qualifications. Structural equation modelling showed that education partially confounded, and the central executive function completely mediated the association between hearing and verbal reasoning when controlling for age. The mediation effect by the central executive function was further partially confounded by computer usage. Findings encourage further investigations into a possible positive effect of hearing aid usage on verbal reasoning (and other cognitive tasks) and of multi-tasking computer games on the central executive function/working memory in middle-aged hearing-impaired adults.
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| 21. |
- Lunner, Thomas, et al.
(författare)
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Three New Outcome Measures That Tap Into Cognitive Processes Required for Real-Life Communication
- 2020
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 41, s. 39S-47S
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Tidskriftsartikel (refereegranskat)abstract
- To increase the ecological validity of outcomes from laboratory evaluations of hearing and hearing devices, it is desirable to introduce more realistic outcome measures in the laboratory. This article presents and discusses three outcome measures that have been designed to go beyond traditional speech-in-noise measures to better reflect realistic everyday challenges. The outcome measures reviewed are: the Sentence-final Word Identification and Recall (SWIR) test that measures working memory performance while listening to speech in noise at ceiling performance; a neural tracking method that produces a quantitative measure of selective speech attention in noise; and pupillometry that measures changes in pupil dilation to assess listening effort while listening to speech in noise. According to evaluation data, the SWIR test provides a sensitive measure in situations where speech perception performance might be unaffected. Similarly, pupil dilation has also shown sensitivity in situations where traditional speech-in-noise measures are insensitive. Changes in working memory capacity and effort mobilization were found at positive signal-to-noise ratios (SNR), that is, at SNRs that might reflect everyday situations. Using stimulus reconstruction, it has been demonstrated that neural tracking is a robust method at determining to what degree a listener is attending to a specific talker in a typical cocktail party situation. Using both established and commercially available noise reduction schemes, data have further shown that all three measures are sensitive to variation in SNR. In summary, the new outcome measures seem suitable for testing hearing and hearing devices under more realistic and demanding everyday conditions than traditional speech-in-noise tests.
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| 22. |
- Miles, Kelly M., et al.
(författare)
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Development of the Everyday Conversational Sentences in Noise test
- 2020
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Ingår i: Journal of the Acoustical Society of America. - : American Institute of Physics (AIP). - 0001-4966 .- 1520-8524. ; 147:3, s. 1562-1576
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Tidskriftsartikel (refereegranskat)abstract
- To capture the demands of real-world listening, laboratory-based speech-in-noise tasks must better reflect the types of speech and environments listeners encounter in everyday life. This article reports the development of original sentence materials that were produced spontaneously with varying vocal efforts. These sentences were extracted from conversations between a talker pair (female/male) communicating in different realistic acoustic environments to elicit normal, raised and loud vocal efforts. In total, 384 sentences were extracted to provide four equivalent lists of 16 sentences at the three efforts for the two talkers. The sentences were presented to 32 young, normally hearing participants in stationary noise at five signal-to-noise ratios from -8 to 0 dB in 2 dB steps. Psychometric functions were fitted for each sentence, revealing an average 50% speech reception threshold (SRT50) of -5.2 dB, and an average slope of 17.2%/dB. Sentences were then level-normalised to adjust their individual SRT50 to the mean (-5.2 dB). The sentences may be combined with realistic background noise to provide an assessment method that better captures the perceptual demands of everyday communication.
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| 23. |
- Rudner, Mary, et al.
(författare)
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Better visuospatial working memory in adults who report profound deafness compared to those with normal or poor hearing : data from the UK Biobank resource
- 2016
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Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 37:5, s. 620-622
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Tidskriftsartikel (refereegranskat)abstract
- Experimental work has shown better visuospatial working memory (VSWM) in profoundly deaf individuals compared to those with normal hearing. Other data, including the UK Biobank resource shows poorer VSWM in individuals with poorer hearing. Using the same database, the authors investigated VSWM in individuals who reported profound deafness. Included in this study were 112 participants who were profoundly deaf, 1310 with poor hearing and 74,635 with normal hearing. All participants performed a card-pair matching task as a test of VSWM. Although variance in VSWM performance was large among profoundly deaf participants, at group level it was superior to that of participants with both normal and poor hearing. VSWM in adults is related to hearing status but the association is not linear. Future study should investigate the mechanism behind enhanced VSWM in profoundly deaf adults.
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| 24. |
- Rudner, Mary, et al.
(författare)
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Poorer Speech Reception Threshold in Noise Is Associated With Lower Brain Volume in Auditory and Cognitive Processing Regions
- 2019
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Ingår i: Journal of Speech, Language and Hearing Research. - : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1092-4388 .- 1558-9102. ; 62:4, s. 1117-1130
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Hearing loss is associated with changes in brain volume in regions supporting auditory and cognitive processing. The purpose of this study was to determine whether there is a systematic association between hearing ability and brain volume in cross-sectional data from a large nonclinical cohort of middle-aged adults available from the UK Biobank Resource (http://www.ukbiobank.ac.uk). Method: We performed a set of regression analyses to determine the association between speech reception threshold in noise (SRTn) and global brain volume as well as predefined regions of interest (ROIs) based on T1-weighted structural images, controlling for hearing-related comorbidities and cognition as well as demographic factors. In a 2nd set of analyses, we additionally controlled for hearing aid (HA) use. We predicted statistically significant associations globally and in ROIs including auditory and cognitive processing regions, possibly modulated by HA use. Results: Whole-brain gray matter volume was significantly lower for individuals with poorer SRTn. Furthermore, the volume of 9 predicted ROIs including both auditory and cognitive processing regions was lower for individuals with poorer SRTn. The greatest percentage difference (-0.57%) in ROI volume relating to a 1 SD worsening of SRTn was found in the left superior temporal gyrus. HA use did not substantially modulate the pattern of association between brain volume and SRTn. Conclusions: In a large middle-aged nonclinical population, poorer hearing ability is associated with lower brain volume globally as well as in cortical and subcortical regions involved in auditory and cognitive processing, but there was no conclusive evidence that this effect is moderated by HA use. This pattern of results supports the notion that poor hearing leads to reduced volume in brain regions recruited during speech understanding under challenging conditions. These findings should be tested in future longitudinal, experimental studies.
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| 25. |
- Rönnberg, Jerker, et al.
(författare)
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Hearing loss and episodic long-term memory
- 2015
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Konferensbidrag (refereegranskat)abstract
- The UK Biobank offers cross-sectional epidemiological data collected on >500,000 individuals in the UK between 40 and 70 years of age. Using the UK Biobank data, the aim of this study was to investigate the effects of functional hearing loss and hearing aid usage on visuospatial memory function. A sub-sample of 138,098 participants was selected. A digit triplets functional hearing test was used to divide the participants into three groups: poor, insufficient and normal hearers. We found negative relationships between functional hearing loss and both visuospatial working memory (i.e., a card pair matching task) and visuospatial, episodic long-term memory (i.e., a prospective memory task), with the strongest association for episodic long-term memory (Rönnberg et al., 2014). The selectivity in effect on memory systems replicate previous results (Rönnberg et al., 2011). In addition, the collective results suggest that the selectivity is independent of encoding format in the memory task (auditory, motor or visuospatial), implying an effect of hearing loss on a multimodal episodic long-term memory system.
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| 26. |
- Rönnberg, Jerker, et al.
(författare)
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The effect of functional hearing loss and age on long- and short-term visuospatial memory : evidence from the UK biobank resource
- 2014
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- The UK Biobank offers cross-sectional epidemiological data collected on > 500 000 individuals in the UK between 40 and 70 years of age. Using the UK Biobank data, the aim of this study was to investigate the effects of functional hearing loss and hearing aid usage on visuospatial memory function. This selection of variables resulted in a sub-sample of 138 098 participants after discarding extreme values. A digit triplets functional hearing test was used to divide the participants into three groups: poor, insufficient and normal hearers. We found negative relationships between functional hearing loss and both visuospatial working memory (i.e., a card pair matching task) and visuospatial, episodic long-term memory (i.e., a prospective memory task), with the strongest association for episodic long-term memory. The use of hearing aids showed a small positive effect for working memory performance for the poor hearers, but did not have any influence on episodic long-term memory. Age also showed strong main effects for both memory tasks and interacted with gender and education for the long-term memory task. Broader theoretical implications based on a memory systems approach will be discussed and compared to theoretical alternatives.
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| 27. |
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| 28. |
- Shiell, Martha M, et al.
(författare)
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Eye-movement patterns of hearing-impaired listeners measure comprehension of a multitalker conversation
- 2021
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Ingår i: Journal of the Acoustical Society of America. - : American Institute of Physics (AIP). - 0001-4966 .- 1520-8524. ; 149:4, s. A77-A77
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Tidskriftsartikel (refereegranskat)abstract
- The ability to understand speech in complex listening environments reflects an interaction of cognitive and sensory capacities that are difficult to capture with behavioural tests. The study of natural listening behaviours may lead to the development of new metrics that better reflect real-life communication abilities. To this end, we investigated the relationship between speech comprehension and eye-movements among hearing-impaired people in a challenging listening situation. While previous research has investigated the effect of background noise on listeners’ gaze patterns with single talkers, the effect of noise in multitalker conversations remains unknown. We tracked eye-movements of seven aided hearing-impaired adults while they viewed video recordings of two life-sized talkers engaged in an unscripted dialogue. Hearing loss ranged from moderate to severe. We used multiple-choice questions to measure participants’ comprehension of the conversation in multitalker babble noise at three different signal-to-noise ratios. All participants made saccades between the two talkers more frequently than the talkers’ conversational turns. This measure tended to correlate positively with participants’ comprehension scores, but the effect was significant in only one signal-to-noise ratio condition. Post-hoc investigation suggests that intertalker saccade rate is driven by an interaction of hearing ability and conversational turn-taking events, which will be further discussed.
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| 29. |
- Shiell, Martha M., et al.
(författare)
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Multilevel Modeling of Gaze From Listeners With Hearing Loss Following a Realistic Conversation
- 2023
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Ingår i: Journal of Speech, Language and Hearing Research. - : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1092-4388 .- 1558-9102. ; 66:11, s. 4575-4589
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: There is a need for tools to study real-world communication abilities in people with hearing loss. We outline a potential method for this that analyzes gaze and use it to answer the question of when and how much listeners with hearing loss look toward a new talker in a conversation.Method: Twenty-two older adults with hearing loss followed a prerecorded two person audiovisual conversation in the presence of babble noise. We compared their eye-gaze direction to the conversation in two multilevel logistic regression (MLR) analyses. First, we split the conversation into events classified by the number of active talkers within a turn or a transition, and we tested if these predicted the listener's gaze. Second, we mapped the odds that a listener gazed toward a new talker over time during a conversation transition.Results: We found no evidence that our conversation events predicted changes in the listener's gaze, but the listener's gaze toward the new talker during a silence-transition was predicted by time: The odds of looking at the new talker increased in an s-shaped curve from at least 0.4 s before to 1 s after the onset of the new talker's speech. A comparison of models with different random effects indicated that more variance was explained by differences between individual conversation events than by differences between individual listeners.Conclusions: MLR modeling of eye-gaze during talker transitions is a promising approach to study a listener's perception of realistic conversation. Our experience provides insight to guide future research with this method.
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| 30. |
- Skoglund, Martin, et al.
(författare)
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Comparing In-ear EOG for Eye-Movement Estimation With Eye-Tracking : Accuracy, Calibration, and Speech Comprehension
- 2022
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Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-4548 .- 1662-453X. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- This presentation details and evaluates a method for estimating the attended speaker during a two-person conversation by means of in-ear electro-oculography (EOG). Twenty-five hearing-impaired participants were fitted with molds equipped with EOG electrodes (in-ear EOG) and wore eye-tracking glasses while watching a video of two life-size people in a dialog solving a Diapix task. The dialogue was directionally presented and together with background noise in the frontal hemisphere at 60 dB SPL. During three conditions of steering (none, in-ear EOG, conventional eye-tracking), participants comprehension was periodically measured using multiple-choice questions. Based on eye movement detection by in-ear EOG or conventional eye-tracking, the estimated attended speaker was amplified by 6 dB. In the in-ear EOG condition, the estimate was based on one selected channel pair of electrodes out of 36 possible electrodes. A novel calibration procedure introducing three different metrics was used to select the measurement channel. The in-ear EOG attended speaker estimates were compared to those of the eye-tracker. Across participants, the mean accuracy of in-ear EOG estimation of the attended speaker was 68%, ranging from 50 to 89%. Based on offline simulation, it was established that higher scoring metrics obtained for a channel with the calibration procedure were significantly associated with better data quality. Results showed a statistically significant improvement in comprehension of about 10% in both steering conditions relative to the no-steering condition. Comprehension in the two steering conditions was not significantly different. Further, better comprehension obtained under the in-ear EOG condition was significantly correlated with more accurate estimation of the attended speaker. In conclusion, this study shows promising results in the use of in-ear EOG for visual attention estimation with potential for applicability in hearing assistive devices.
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| 31. |
- Weisser, Adam, et al.
(författare)
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The Ambisonic Recordings of Typical Environments (ARTE) Database
- 2019
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Ingår i: Acta Acoustica united with Acustica. - : S. Hirzel Verlag. - 1610-1928 .- 1861-9959. ; 105:4, s. 695-713
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Tidskriftsartikel (refereegranskat)abstract
- Everyday listening environments are characterized by far more complex spatial, spectral and temporal sound field distributions than the acoustic stimuli that are typically employed in controlled laboratory settings. As such, the reproduction of acoustic listening environments has become important for several research avenues related to sound perception, such as hearing loss rehabilitation, soundscapes, speech communication, auditory scene analysis, automatic scene classification, and room acoustics. However, the recordings of acoustic environments that are used as test material in these research areas are usually designed specifically for one study, or are provided in custom databases that cannot be universally adapted, beyond their original application. In this work we present the Ambisonic Recordings of Typical Environments (ARTE) database, which addresses several research needs simultaneously: realistic audio recordings that can be reproduced in 3D, 2D, or binaurally, with known acoustic properties, including absolute level and room impulse response. Multichannel higher-order ambisonic recordings of 13 realistic typical environments (e.g., office, cafè, dinner party, train station) were processed, acoustically analyzed, and subjectively evaluated to determine their perceived identity. The recordings are delivered in a generic format that may be reproduced with different hardware setups, and may also be used in binaural, or single-channel setups. Room impulse responses, as well as detailed acoustic analyses, of all environments supplement the recordings. The database is made open to the research community with the explicit intention to expand it in the future and include more scenes.
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