| 1. |
- Andersson, Ulf, et al.
(författare)
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Bottom-up driven speechreading in a speechreading expert : The case of AA (JK023)
- 2005
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Ingår i: Ear and Hearing. - : Ovid Technologies (Wolters Kluwer Health). - 0196-0202 .- 1538-4667. ; 26:2, s. 214-224
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This case study tested the threshold hypothesis (Rönnberg et al., 1998), which states that superior speechreading skill is possible only if high-order cognitive functions, such as capacious verbal working memory, enable efficient strategies. Design: In a case study, a speechreading expert (AA) was tested on a number of speechreading and cognitive tasks and compared with control groups (z scores). Sentence-based speechreading tests, a word-decoding test, and a phoneme identification task were used to assess speechreading skill at different analytical levels. The cognitive test battery used included tasks of working memory (e.g., reading span), inference-making, phonological processing (e.g., rhyme-judgment), and central-executive functions (verbal fluency, Stroop task). Results: Contrary to previous cases of extreme speechreading skill, AA excels on both low-order (phoneme identification: z = +2.83) and high-order (sentence-based: z = +8.12 and word-decoding: z = +4.21) speechreading tasks. AA does not display superior verbal inference-making ability (sentence-completion task: z = -0.36). Neither does he possess a superior working memory (reading span: z = +0.80). However, AA outperforms the controls on two measures of executive retrieval functions, the semantic (z = +3.77) and phonological verbal fluency tasks (z = +3.55). Conclusions: The performance profile is inconsistent with the threshold hypothesis. Extreme speechreading accuracy can be obtained in ways other than via well-developed high-order cognitive functions. It is suggested that AA's extreme speechreading skill, which capitalizes on low-order functions in combination with efficient central executive functions, is due to early onset of hearing impairment. Copyright © 2005 by Lippincott Williams & Wilkins.
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| 2. |
- Arehart, Kathryn, et al.
(författare)
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Relationship Among Signal Fidelity, Hearing Loss, and Working Memory for Digital Noise Suppression
- 2015
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:5, s. 505-516
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study considered speech modified by additive babble combined with noise-suppression processing. The purpose was to determine the relative importance of the signal modifications, individual peripheral hearing loss, and individual cognitive capacity on speech intelligibility and speech quality. Design: The participant group consisted of 31 individuals with moderate high-frequency hearing loss ranging in age from 51 to 89 years (mean = 69.6 years). Speech intelligibility and speech quality were measured using low-context sentences presented in babble at several signal-to-noise ratios. Speech stimuli were processed with a binary mask noise-suppression strategy with systematic manipulations of two parameters (error rate and attenuation values). The cumulative effects of signal modification produced by babble and signal processing were quantified using an envelope-distortion metric. Working memory capacity was assessed with a reading span test. Analysis of variance was used to determine the effects of signal processing parameters on perceptual scores. Hierarchical linear modeling was used to determine the role of degree of hearing loss and working memory capacity in individual listener response to the processed noisy speech. The model also considered improvements in envelope fidelity caused by the binary mask and the degradations to envelope caused by error and noise. Results: The participants showed significant benefits in terms of intelligibility scores and quality ratings for noisy speech processed by the ideal binary mask noise-suppression strategy. This benefit was observed across a range of signal-to-noise ratios and persisted when up to a 30% error rate was introduced into the processing. Average intelligibility scores and average quality ratings were well predicted by an objective metric of envelope fidelity. Degree of hearing loss and working memory capacity were significant factors in explaining individual listeners intelligibility scores for binary mask processing applied to speech in babble. Degree of hearing loss and working memory capacity did not predict listeners quality ratings. Conclusions: The results indicate that envelope fidelity is a primary factor in determining the combined effects of noise and binary mask processing for intelligibility and quality of speech presented in babble noise. Degree of hearing loss and working memory capacity are significant factors in explaining variability in listeners speech intelligibility scores but not in quality ratings.
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| 3. |
- Arlinger, Stig, 1939-
(författare)
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Can we establish internationally equivalent outcome measures in audiological rehabilitation?
- 2000
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Ingår i: Ear and Hearing. - 0196-0202 .- 1538-4667. ; 21:4 SUPPL.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This paper intends to discuss issues related to cultural, ethnic, and other nonaudiological variables that may affect the response when trying to determine outcome of audiological rehabilitation in different countries. Design: The ideal measure for the determination of outcome of audiological rehabilitation would be sensitive to changes in disability as well as handicap. Further, it would allow unforeseen effects to be identified and not be limited by language borders or cultural and ethnic differences. A variety of critical factors are discussed that are related to culture, social traditions, ethnic factors, etc. that may affect outcome measures and thus make international equivalence difficult. Conclusions: With careful consideration of the factors discussed, a basic set of questions could be formulated and agreed on, calibrated on suitable populations in different countries, and thereafter used as a bridge across borders to allow comparison of different procedures or meta-analyses of studies performed by different laboratories.
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| 4. |
- Asp, Filip, et al.
(författare)
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Effects of Simulated and Profound Unilateral Sensorineural Hearing Loss on Recognition of Speech in Competing Speech
- 2020
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Ingår i: Ear and Hearing. - 1538-4667 .- 0196-0202. ; 41:2, s. 411-419
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Unilateral hearing loss (UHL) is a condition as common as bilateral hearing loss in adults. Because of the unilaterally reduced audibility associated with UHL, binaural processing of sounds may be disrupted. As a consequence, daily tasks such as listening to speech in a background of spatially distinct competing sounds may be challenging. A growing body of subjective and objective data suggests that spatial hearing is negatively affected by UHL. However, the type and degree of UHL vary considerably in previous studies. The aim here was to determine the effect of a profound sensorineural UHL, and of a simulated UHL, on recognition of speech in competing speech, and the binaural and monaural contributions to spatial release from masking, in a demanding multisource listening environment. DESIGN: Nine subjects (25 to 61 years) with profound sensorineural UHL [mean pure-tone average (PTA) across 0.5, 1, 2, and 4 kHz = 105 dB HL] and normal contralateral hearing (mean PTA = 7.2 dB HL) were included based on the criterion that the target and competing speech were inaudible in the ear with hearing loss. Thirteen subjects with normal hearing (19 to 60 years; mean left PTA = 4.1 dB HL; mean right PTA = 5.5 dB HL) contributed data in normal and simulated "mild-to-moderate" UHL conditions (PTA = 38.6 dB HL). The main outcome measure was the threshold for 40% correct speech recognition in colocated (0°) and spatially and symmetrically separated (±30° and ±150°) competing speech conditions. Spatial release from masking was quantified as the threshold difference between colocated and separated conditions. RESULTS: Thresholds in profound UHL were higher (worse) than normal hearing in separated and colocated conditions, and comparable to simulated UHL. Monaural spatial release from masking, that is, the spatial release achieved by subjects with profound UHL, was significantly different from zero and 49% of the magnitude of the spatial release from masking achieved by subjects with normal hearing. There were subjects with profound UHL who showed negative spatial release, whereas subjects with normal hearing consistently showed positive spatial release from masking in the normal condition. The simulated UHL had a larger effect on the speech recognition threshold for separated than for colocated conditions, resulting in decreased spatial release from masking. The difference in spatial release between normal-hearing and simulated UHL conditions increased with age. CONCLUSIONS: The results demonstrate that while recognition of speech in colocated and separated competing speech is impaired for profound sensorineural UHL, spatial release from masking may be possible when competing speech is symmetrically distributed around the listener. A "mild-to-moderate" simulated UHL decreases spatial release from masking compared with normal-hearing conditions and interacts with age, indicating that small amounts of residual hearing in the UHL ear may be more beneficial for separated than for colocated interferer conditions for young listeners.
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| 5. |
- Baigi, Amir, 1953, et al.
(författare)
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Tinnitus in the General Population With a Focus on Noise and Stress: A Public Health Study.
- 2011
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Ingår i: Ear and hearing. - 1538-4667 .- 0196-0202.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:: To evaluate the influence of noise and stress on the probability of tinnitus in the general population. DESIGN:: Questionnaire data from 12,166 subjects. RESULTS:: Each year of age increased the odds ratio of tinnitus by about 3%. Men generally showed a higher risk for tinnitus compared with women. Exposure to noise and stress emerged important for the probability of tinnitus. However, for the transition from mild to severe tinnitus, stress turned out to be especially important. CONCLUSIONS:: Stress management strategies should be included in hearing conservation programs, especially for individuals with mild tinnitus who report a high stress load.
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| 6. |
- Bennett, Rebecca J., et al.
(författare)
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Exploring Hearing Aid Problems: Perspectives of Hearing Aid Owners and Clinicians
- 2018
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 39:1, s. 172-187
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To gather perspectives of hearing aid owners and hearing healthcare clinicians with regard to problems that arise after hearing aid fitting and use these perspectives to generate a conceptual framework to gain a better understanding of these problems. Design: Participants included a group of 17 hearing aid owners and a group of 21 hearing healthcare clinicians; data collection occurred separately for each group. Participants each attended two group sessions in Perth, Western Australia, wherein they: (1) generated statements describing the problems associated with hearing aids and (2) grouped and rated the statements to identify key themes. Concept mapping was used to generate a conceptual framework. Results: Participants identified four concepts regarding hearing aid problems as follows: (1) hearing aid management; (2) hearing aid sound quality and performance; (3) feelings, thoughts, and behaviors; and (4) information and training. While hearing aid owners and clinicians generated similar results regarding the concepts derived, the clinicians reported that the problems identified had a greater negative impact on hearing aid success than did hearing aid owners. Conclusions: The magnitude and diversity of hearing aid problems identified in this study highlight the ongoing challenges that hearing aid owners face and suggest that current processes for hearing aid fitting can be improved. Problems relating to hearing aid management were most often deemed to have the greatest impact on hearing aid success and be the most preventable/solvable, and thus are a good starting point when addressing hearing aid-related problems.
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| 7. |
- Bennett, Rebecca J., et al.
(författare)
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How Do Hearing Aid Owners Respond to Hearing Aid Problems?
- 2019
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 40:1, s. 77-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although hearing aids can improve hearing and communication, problems that arise following the acquisition of hearing aids can result in their disuse. This study aimed to gather perspectives of hearing aid owners and hearing health care clinicians about how hearing aid owners respond to problems that arise following hearing aid fitting, and then use these perspectives to generate a conceptual framework to better understand these responses. Methods: Seventeen hearing aid owners and 21 hearing health care clinicians generated, sorted, and rated statements regarding how hearing aid owners respond to problems associated with hearing aid use. Concept mapping was used to identify key themes and to develop a conceptual framework. Results: Participants identified four concepts regarding how hearing aid owners respond to problems associated with hearing aids: (1) Seeking External Help; (2) Problem Solving; (3) Putting Up with Problems; and (4) Negative Emotional Response. Participants described behaviors of the clinician and significant others that influenced their decision to seek help for hearing aid problems. Participants recognized that these behaviors could either have a helpful or unhelpful impact. Conclusions: Despite the ongoing support offered to clients after they acquire hearing aids, they are hesitant to seek help from their clinician and instead engage in a myriad of helpful and unhelpful behaviors in response to problems that arise with their hearing aid. Previous positive or negative experiences with the clinic, clinician, or significant other influenced these actions, highlighting the influential role of these individuals in the success of the rehabilitation program. The data generated from this study suggests that clinicians could improve hearing aid problem resolution by providing technical and emotional support, including to significant others, and promoting client empowerment and self-management.
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| 8. |
- Berninger, Erik, et al.
(författare)
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Analysis of Click-Evoked Auditory Brainstem Responses Using Time Domain Cross-Correlations Between Interleaved Responses
- 2014
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Ingår i: Ear and Hearing. - : Ovid Technologies (Wolters Kluwer Health). - 0196-0202 .- 1538-4667. ; 35:3, s. 318-329
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The rapidly evolving field of early diagnostics after the introduction of newborn hearing screening requires rapid, valid, and objective methods, which have to be thoroughly evaluated in adults before use in infants. The aim was to study cross-correlation analysis of interleaved auditory brainstem responses (ABRs) in a wide dynamic range in normal-hearing adults. Off-line analysis allowed for comparison with psychoacoustical click threshold (PCT), pure-tone threshold, and determination of ABR input/output function. Specifically, nonfiltered and band-pass filtered ABRs were studied in various time segments along with time elapsed for ensemble of sweeps reaching a specific detection criterion. Design: Fourteen healthy normal-hearing subjects (18 to 35 years of age, 50% females) without any history of noise exposure participated. They all had pure-tone thresholds better than 20 dB HL (125 to 8000 Hz). ABRs were recorded in both ears using 100 sec clicks, from 71.5 dB nHL down to -18.5 dB nHL, in 10 dB steps (repetition rate, 39 Hz; time window, 15 msec; filter, 30 to 8000 Hz). The number of sweeps increased from 2000 at 71.5 dB nHL, up to 30000 at -18.5 dB nHL. Each sweep was stored in a data base for off-line analysis. Cross-correlation analysis between two subaverages of interleaved responses was performed in the time domain for nonfiltered and digitally band-pass filtered (300 to 1500 Hz) entire and time-windowed (1 to 11 and 5 to 11 msec) responses. PCTs were measured using a Bekesy technique with the same insert phone and stimulus as used for the ABR (repetition rate, 20 Hz). Time elapsed (approximate to number of accepted sweeps/repetition rate) for the ensemble of sweeps needed to reach a cross-correlation coefficient () of 0.70 (=3.7 dB signal-to-noise ratio [SNR]) was analyzed. Results: Mean cross-correlation coefficients exceeded 0.90 in both ears at stimulus levels 11.5 dB nHL for the entire nonfiltered ABR. At 1.5 dB nHL, mean(SD) was 0.53(0.32) and 0.44(0.40) for left and right ears, respectively (n = 14) (=0 dB SNR). In comparison, mean(SD) PCT was -1.9(2.9) and -2.5(3.2) dB nHL for left and right ears, respectively (n = 14), while mean pure-tone average (500 to 2000 Hz) was 2.5 dB HL (n = 28). Almost no effect of band-pass filtering or reduced analysis time window existed. Average time elapsed needed to reach = 0.70 was approximately 20 seconds or less at stimulus levels 41.5 dB nHL, and approximate to 30 seconds at 31.5 dB nHL. The average (interpolated) stimulus level corresponding to =0.70 for the entire nonfiltered ABR was 6.5 dB nHL (n = 28), which coincided with the estimated psychoacoustical threshold for single clicks. Conclusions: ABR could be identified in a short period of time using cross-correlation analysis between interleaved responses. The average stimulus level corresponding to 0 dB SNR in the entire nonfiltered ABR occurred at 1.5 dB nHL, 4 dB above the average PCT. The mean input/output function for the ensemble of sweeps required to reach = 0.70 increased monotonically with increasing stimulus level, in parallel with the ABR based on all sweeps (1.5 dB nHL). Time domain cross-correlation analysis of ABR might form the basis for automatic response identification and future threshold-seeking procedures.
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| 9. |
- Besser, Jana, et al.
(författare)
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Speech-in-Speech Listening on the LiSN-S Test by Older Adults With Good Audiograms Depends on Cognition and Hearing Acuity at High Frequencies
- 2015
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:1, s. 24-41
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The main objective was to investigate age-related differences on the listening in spatialized noise-sentences (LiSN-S) test in adults with normal audiometric thresholds in most of the speech range. A second objective was to examine the contributions of auditory, cognitive, and linguistic abilities to LiSN-S outcomes. Design: The LiSN-S test was administered to participants in an older group (M-Age = 72.0, SD = 4.3 years) and a younger group (M-Age = 21.7, SD = 2.6 years) with N = 26 per group. All the participants had clinically normal audiometric thresholds at frequencies up to and including 3000 Hz. The LiSN-S test yields a speech reception threshold (SRT) in each of the four speech-in-speech listening conditions that differ in the availability of voice difference cues and/or spatial separation cues. Based on these four SRTs, the scores were calculated for the talker advantage, the spatial advantage, and the total advantage as a result of both the types of cues. Additionally, the participants completed four auditory temporal-processing tests, a cognitive screening test, a vocabulary test, and tests of linguistic closure for high-and low-context sentences. The contributions of these predictor variables and measures of pure-tone hearing acuity to LiSN-S outcomes were analyzed for both the groups using regression analyses. Results: Younger listeners outperformed the older listeners on all four LiSN-S SRTs and all the three LiSN-S advantage measures. Age-related differences were larger for conditions involving the use of spatial cues. For the younger group, all LiSN-S SRTs were predicted by the measure of linguistic closure in low-context sentences; in addition, the SRT for the condition with voice difference cues but without spatial separation cues was predicted by vocabulary, and the SRT for the condition with both voice difference cues and spatial separation cues was predicted by temporal resolution at low frequencies. Vocabulary also contributed to the talker advantage in the younger group, whereas the spatial advantage was predicted by high-frequency pure-tone hearing acuity in the range 6,000 to 10,000 Hz (pure-tone average [ PTA] HIGH). For the older group, the LiSN-S SRT in the condition with neither voice difference cues nor spatial separation cues was predicted by age; their other three LiSN-S SRTs and all advantage measures were predicted by PTA HIGH. In addition, for the older group, cognition predicted LiSN-S SRT outcomes in three of the four conditions. Measures of auditory temporal processing, linguistic abilities, or hearing acuity up to and including 4000 Hz did not predict LiSN-S outcomes in this group. Conclusions: LiSN-S outcomes were poorer for adults aged 65 years or older, even those with good audiograms, compared with younger adults and also compared with people up to the age of 60 years from a previous study. In the present study, regardless of the types of cues, auditory and cognitive interactions were reflected by the combined influences on LiSN-S outcomes of high-frequency hearing acuity and measures of linguistic and cognitive processing. The data also suggest a hierarchy in the deployment of processing resources, which would account for the observed shift from linguistic abilities in the younger group to general cognitive abilities in the older group.
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| 10. |
- Beukes, Eldre W., et al.
(författare)
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Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial
- 2018
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 39:3, s. 423-433
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Specialist tinnitus services are in high demand as a result of the negative effect tinnitus may have on quality of life. Additional clinically and cost-effective tinnitus management routes are needed. One potential route is providing Cognitive Behavioural Therapy for tinnitus via the Internet (iCBT). This study aimed to determine the efficacy of guided iCBT, using audiological support, on tinnitus distress and tinnitus-related comorbidities, in the United Kingdom. A further aim was to establish the stability of intervention effects 2-months postintervention. The hypothesis was that iCBT for tinnitus would be more effective at reducing tinnitus distress than weekly monitoring. Design: A randomized, delayed intervention efficacy trial, with a 2-month follow-up was implemented to evaluate the efficacy of iCBT in the United Kingdom. Participants were randomly assigned to the experimental (n = 73) or weekly monitoring control group (n = 73) after being stratified for tinnitus severity and age. After the experimental group completed the 8-week long iCBT intervention, the control group undertook the same intervention. Intervention effects were, therefore, evaluated in two independent groups at two time points. The primary outcome was a change in tinnitus distress between the groups as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. These were completed at baseline, postintervention, and at a 2-month postintervention follow-up. Results: After undertaking the iCBT intervention, the experimental group had a greater reduction in tinnitus distress when compared with the control group. This reduction was statistically significant (Cohens d = 0.7) and was clinically significant for 51% of the experimental group and 5% of the control group. This reduction was evident 4 weeks after commencing the iCBT intervention. Furthermore, the experimental group had a greater reduction in insomnia, depression, hyperacusis, cognitive failures, and a greater improvement in quality of life, as evidenced by the significant differences in these assessment measures postintervention. Results were maintained 2 months postintervention. Conclusions: Guided (using audiological support) iCBT for tinnitus resulted in statistically significant reductions in tinnitus distress and comorbidities (insomnia, depression, hyperacusis, cognitive failures) and a significant increase in quality of life. These effects remained stable at 2-months postintervention. Further trials to determine the longer term efficacy of ICBT to investigate predictors of outcome and to compare iCBT with standard clinical care in the United Kingdom are required.
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