ABSTRACT
PURPOSE: Standard clinical audiologic assessment is limited in its ability to capture variance in self-reported hearing difficulty. Additionally, the costs associated with clinical testing in audiology create financial barriers for hearing health care in developing countries like Mexico. This study used an open-source Spanish-language tool called PART (Portable Automated Rapid Testing) to test the hypothesis that a battery of assessments of auditory processing can complement standard clinical audiological assessment to better capture the variance of self-reported hearing difficulty. METHOD: Forty-three adults between 40 and 69 years of age were tested in Mexico City using a traditional clinical pure-tone audiogram, cognitive screening, and a battery of PART-based auditory processing assessments including a speech-on-speech competition spatial release from masking task. Results were compared to self-reported hearing difficulty, assessed with a Spanish-language adaptation of the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S). RESULTS: Several measures from the PART battery exhibited stronger correlations with self-reported hearing difficulties than the pure-tone audiogram. The spatial release from masking task best captured variance in HHIE-S scores and remained significant after controlling for the effects of age, audibility, and cognitive score. CONCLUSIONS: The spatial release from masking task can complement traditional clinical measures to better account for patient's self-reported hearing difficulty. Open-source access to this test in PART supports its implementation for Spanish speakers in clinical settings around the world at low cost. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24470140.
ABSTRACT
PURPOSE: Difficulty understanding speech in noise is a common communication problem. Clinical tests of speech in noise differ considerably from real-world listening and offer patients limited intrinsic motivation to perform well. In order to design a test that captures motivational aspects of real-world communication, this study investigated effects of gamification, or the inclusion of game elements, on a laboratory spatial release from masking test. METHOD: Fifty-four younger adults with normal hearing completed a traditional laboratory and a gamified test of spatial release from masking in counterbalanced order. Masker level adapted based on performance, with the traditional test ending after 10 reversals and the gamified test ending when participants solved a visual puzzle. Target-to-masker ratio thresholds (TMRs) with colocated maskers, separated maskers, and estimates of spatial release were calculated after the 10th reversal for both tests and from the last six reversals of the adaptive track from the gamified test. RESULTS: Thresholds calculated from the 10th reversal indicated no significant differences between the traditional and gamified tests. A learning effect was observed with spatially separated maskers, such that TMRs were better for the second test than the first, regardless of test order. Thresholds calculated from the last six reversals of the gamified test indicated better TMRs in the separated condition compared to the traditional test. CONCLUSIONS: Adding gamified elements to a traditional test of spatial release from masking did not negatively affect test validity or estimates of spatial release. Participants were willing to continue playing the gamified test for an average of 30.2 reversals of the adaptive track. For some listeners, performance in the separated condition continued to improve after the 10th reversal, leading to better TMRs and greater spatial release from masking at the end of the gamified test compared to the traditional test. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22028789.
