Associations Between Auditory Working Memory, Self-Perceived Listening Effort, and Hearing Difficulty in Adults With Mild Traumatic Brain Injury.

OBJECTIVES: Mild traumatic brain injury (TBI) can have persistent effects in the auditory domain (e.g., difficulty listening in noise), despite individuals having normal pure-tone auditory sensitivity. Individuals with a history of mild TBI often perceive hearing difficulty and greater listening effort in complex listening situations. The purpose of the present study was to examine self-perceived hearing difficulty, listening effort, and performance on an auditory processing test battery in adults with a history of mild TBI compared with a control group. DESIGN: Twenty adults ages 20 to 53 years old participated divided into a mild TBI (n = 10) and control group (n = 10). Perceived hearing difficulties were measured using the Adult Auditory Processing Scale and the Hearing Handicap Inventory for Adults. Listening effort was measured using the National Aeronautics and Space Administration-Task Load Index. Listening effort ratings were obtained at baseline, after each auditory processing test, and at the completion of the test battery. The auditory processing test battery included (1) dichotic word recognition, (2) the 500-Hz masking level difference, (3) the Listening in Spatialized Noise-Sentences test, and (4) the Word Auditory Recognition and Recall Measure (WARRM). RESULTS: Results indicated that individuals with a history of mild TBI perceived significantly greater degrees of hearing difficulty and listening effort than the control group. There were no significant group differences on two of the auditory processing tasks (dichotic word recognition or Listening in Spatialized Noise-Sentences). The mild TBI group exhibited significantly poorer performance on the 500-Hz MLD and the WARRM, a measure of auditory working memory, than the control group. Greater degrees of self-perceived hearing difficulty were significantly associated with greater listening effort and poorer auditory working memory. Greater listening effort was also significantly associated with poorer auditory working memory. CONCLUSIONS: Results demonstrate that adults with a history of mild TBI may experience subjective hearing difficulty and listening effort when listening in challenging acoustic environments. Poorer auditory working memory on the WARRM task was observed for the adults with mild TBI and was associated with greater hearing difficulty and listening effort. Taken together, the present study suggests that conventional clinical audiometric battery alone may not provide enough information about auditory processing deficits in individuals with a history of mild TBI. The results support the use of a multifaceted battery of auditory processing tasks and subjective measures when evaluating individuals with a history of mild TBI.

The relationship between extended high-frequency hearing and the binaural spatial advantage in young to middle-aged firefightersa).

Relationships between extended high-frequency (EHF) thresholds and speech-in-spatialized noise were examined in firefighters with a history of occupational noise and airborne toxin exposure. Speech recognition thresholds were measured for co-located and spatially separated (±90° azimuth) sentences in a competing signal using the Listening in Spatialized Noise-Sentences test. EHF hearing was significantly correlated with the spatial advantage, indicating that firefighters with poorer EHF thresholds experienced less benefit from spatial separation. The correlation between EHF thresholds and spatial hearing remained significant after controlling for age. Deficits in EHF and spatial hearing suggest firefighters may experience compromised speech understanding in job-related complex acoustic environments.

The Impact of Traumatic Brain Injury on Binaural Processing in Young and Middle-Age Adults.

PURPOSE: This study examined the impact of traumatic brain injury (TBI) on self-perceived hearing and suprathreshold binaural processing in young and middle-age adults. METHOD: Ninety-three adults with normal hearing (thresholds ≤ 25 dB HL, 250-4000 Hz) participated in one of four groups: 38 young adults, 23 young adults with TBI, 16 middle-age adults, and 16 middle-age adults with TBI. Self-perceived hearing difficulty was measured via questionnaires. Binaural processing was measured using dichotic word recognition, the Listening in Spatialized Noise-Sentences Test (LiSN-S), and the 500-Hz masking level difference (MLD). For each participant, a composite binaural processing (CBP) score was calculated to obtain a global metric of binaural processing performance. The CBP was composed of six measures from the three behavioral tests, including the S0N0 and SπN0 thresholds from the 500-Hz MLD, the low- and high-cue speech recognition thresholds from the LiSN-S, and the free and directed recall ear advantages from the dichotic word test. RESULTS: The middle-age TBI group reported significantly greater degrees of self-perceived hearing difficulty than the other groups. On average, the middle-age TBI group performed poorer on the individual binaural processing tests; however, the differences were significant for the S0N0 and SπN0 MLD thresholds only. Results for the global metric of binaural processing revealed significantly poorer CBP scores for the middle-age TBI group compared to the other groups. CONCLUSIONS: Results demonstrate that both age and a positive history of TBI contributed to deficits in suprathreshold binaural processing. Middle-age adults with a history of TBI are at risk for experiencing presenescent deficits in suprathreshold binaural processing deficits, despite having clinically normal hearing.

The Importance of Professional Advocacy at the State Level: A Coalition Model.

Professional advocacy communicates a viewpoint for or against a policy or issue, and is used to influence change to public policy, legislation, and/or regulations. State audiology associations are perfectly positioned to organize advocacy efforts for the profession at the state level. Therefore, the purpose of this article is to review the types of advocacy available to state organizations and the steps for hiring a lobbyist. In addition, the article presents a unique advocacy model in which multiple audiology and speech-language pathology organizations in the state of Ohio joined to form the Ohio Speech and Hearing Governmental Affairs Coalition (OSHGAC). There are numerous advantages of an advocacy coalition, most importantly a shared financial responsibility. Finally, several examples of the OSHGAC recent legislative and regulatory advocacy efforts are reviewed.

Hearing Health Care Utilization Following Automated Hearing Screening.

BACKGROUND: The study examined follow-up rates for pursuing hearing health care (HHC) 6 to 8 months after participants self-administered one of three hearing screening methods: an automated method for testing of auditory sensitivity (AMTAS), a four-frequency pure-tone screener (FFS), or a digits-in-noise test (DIN), with and without the presentation of a 2-minute educational video about hearing. PURPOSE: The study aims to determine if the type of self-administered hearing screening method (with or without an educational video) affects HHC follow-up rates. RESEARCH DESIGN: The study is a randomized controlled trial of three automated hearing screening methods, plus control group, with and without an educational video. The control group completed questionnaires and provided follow-up data but did not undergo a hearing screening test. STUDY SAMPLE: The study sample includes 1,665 participants (mean age 50.8 years; 935 males) at two VA Medical Centers and at university and community centers in Portland, OR; Bay Pines, FL; Minneapolis, MN; Mauston, WI; and Columbus, OH. DATA COLLECTION AND ANALYSIS: HHC follow-up data at 6 to 8 months were obtained by contacting participants by phone or mail. Screening methods and participant characteristics were compared in relation to the probability of participants pursuing HHC during the follow-up period. RESULTS: The 2-minute educational video did not have a significant effect on HHC follow-up rates. When all participants who provided follow-up data are considered (n = 1012), the FFS was the only test that resulted in a significantly greater percentage of HHC follow-up (24.6%) compared with the control group (16.8%); p = 0.03. However, for participants who failed a hearing screening (n = 467), follow-up results for all screening methods were significantly greater than for controls. The FFS resulted in a greater probability for HHC follow-up overall than the other two screening methods. Moreover, veterans had higher follow-up rates for all screening methods than non-veterans. CONCLUSION: The FFS resulted in a greater HHC follow-up rate compared with the other screening methods. This self-administered test may be more motivational for HHC follow-up because participants who fail the screening are aware of sounds they could not hear which does not occur with adaptive assessments like AMTAS or the DIN test. It is likely that access to and reduced personal cost of audiological services for veterans contributed to higher HHC follow-up rates in this group compared with non-veteran participants.

The Impact of Speech Recognition Testing on State Anxiety in Young, Middle-Age, and Older Adults.

Purpose This study assessed state anxiety as a function of speech recognition testing using three clinical measures of speech in noise and one clinical measure of dichotic speech recognition. Method Thirty young adults, 30 middle-age adults, and 25 older adults participated. State anxiety was measured pre- and post-speech recognition testing using the State-Trait Anxiety Inventory. Speech recognition was measured with the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, the Words-in-Noise Test, and the Dichotic Digits Test (DDT). Results Speech recognition performance was as expected: Older adults performed significantly poorer on all measures as compared to the young adults and significantly poorer on the Revised Speech Perception in Noise Test, the Quick Speech-in-Noise Test, and the Words-in-Noise Test as compared to the middle-age adults. On average, State-Trait Anxiety Inventory scores increased posttesting, with the middle-age adults exhibiting significantly greater increases in state anxiety as compared to the young and older adults. Increases in state anxiety were significantly greater for the DDT relative to the speech-in-noise tests for the middle-age adults only. Poorer DDT recognition performance was associated with higher levels of state anxiety. Conclusions Increases in state anxiety were observed after speech-in-noise and dichotic listening testing for all groups, with significant increases seen for the young and middle-age adults. Although the exact mechanisms could not be determined, multiple factors likely influenced the observed increases in state anxiety, including task difficulty, individual proficiency, and age.

Hearing Difficulties as a Result of Traumatic Brain Injury.

BACKGROUND: Traumatic brain injury (TBI) has been shown to result in hearing difficulties (i.e., deficits in the processing of auditory information) without impacting pure-tone threshold detection. A missed diagnosis of hearing difficulties due to TBI because of normal hearing can lead to reductions in quality of life and missed opportunities to provide an appropriate treatment regimen. PURPOSE: This study presents a case report of a female patient with a history of TBI due to a motor vehicle accident that resulted in a broad range of symptoms, including self-perceived hearing difficulties and poorer-than-normal auditory processing performance. RESEARCH DESIGN: Case report. STUDY SAMPLE: A 58-year-old woman with a history of a mild TBI due to a motor vehicle accident. DATA COLLECTION: A neuro-audiology evaluation was conducted to address the patient's hearing complaints. The evaluation included standard audiometric and auditory processing test batteries. RESULTS: The case report focuses on the patient's history of TBI and her presentation to our clinic with hearing complaints. Her clinical audiological outcomes, including an auditory processing assessment, and treatment with mild-gain hearing aids are discussed. The use of mild-gain hearing aids resulted in improved auditory processing skills and a significant improvement in quality of life. CONCLUSIONS: Patients with a history of TBI often have multiple and debilitating symptoms, including hearing difficulties. Accurate diagnosis of auditory processing deficits in the face of normal pure-tone detection abilities is essential to provide treatment options that can improve daily function and quality of life.

Mild-Gain Hearing Aids as a Treatment for Adults with Self-Reported Hearing Difficulties.

BACKGROUND: There is a growing body of evidence demonstrating self-reported hearing difficulties (HD; i.e., substantial difficulty in understanding speech in complex listening situations) in adults with normal pure-tone sensitivity. Anecdotally, some audiologists have tried personal mild-gain amplification as a treatment option for adults with HD. In 2008, Kuk and colleagues reported positive results of a mild-gain hearing aid trial for children with auditory processing disorders. To date, however, there have been no studies investigating the benefit of mild-gain amplification to treat HD in adults with normal audiograms. PURPOSE: The effectiveness of a four-week trial with mild-gain amplification for adults with self-reported HD and clinically normal hearing sensitivity was investigated. RESEARCH DESIGN: Two participant groups with normal pure-tone audiograms (thresholds ≤20 dB HL 250-8000 Hz) were recruited to study the effects of self-reported HD on hearing handicap, self-perceived auditory processing difficulties, and performance on a speech-in-noise task. Furthermore, the benefit of mild-gain amplification was examined after a four-week hearing aid trial on self-perceived hearing handicap and auditory processing difficulties, and performance on an aided speech-in-noise task. Effects were analyzed using a mixed-model repeated measures analysis of variance. Posthoc analyses were performed for each significant main effect. STUDY SAMPLE: Thirty-nine participants participated in two groups. Twenty normal hearing adults (19-27 yr) without complaints of HD were recruited as a control group. Nineteen normal hearing adults (18-58 yr) with self-reported HD were recruited for the mild-gain hearing aid trial. DATA COLLECTION AND ANALYSIS: Subjective complaints of HD were assessed with two questionnaires (the Hearing Handicap Inventory for Adults [HHIA] and the Auditory Processing Questionnaire [APQ]) and an auditory processing test battery (SCAN:3-A, dichotic digit recognition, gaps-in-noise test, and the 500-Hz masking level difference). Speech-in-noise abilities were assessed before and after hearing aid trial using the Revised Speech Perception in Noise Test (R-SPIN) at multiple signal-to-noise ratios. Hearing aid use and impressions during the hearing aid trial were recorded. RESULTS: Results demonstrated that participants with HD perceived significantly greater hearing handicap (HHIA) and greater self-perceived auditory processing difficulties (APQ) than the control group. Participants with HD performed significantly poorer on the R-SPIN relative to controls, especially for low-predictability items. Results of the hearing aid trial for participants with HD revealed significant improvements in hearing handicap, self-perceived auditory processing difficulties, and speech-in-noise performance relative to prehearing aid trial measures. The hearing aids were well tolerated by the majority of participants with HD , with most of them wearing the hearing aids an average of 1-4 h per day. CONCLUSIONS: The results from the present study suggest that adults who present with complaints of HD even in the presence of normal hearing sensitivity represent a unique population that warrants further evaluation beyond the standard hearing test. Furthermore, results from the hearing aid trial suggest that mild-gain amplification is a viable treatment option for at least some individuals with HD.

The Effect of Lexical Content on Dichotic Speech Recognition in Older Adults.

BACKGROUND: Age-related auditory processing deficits have been shown to negatively affect speech recognition for older adult listeners. In contrast, older adults gain benefit from their ability to make use of semantic and lexical content of the speech signal (i.e., top-down processing), particularly in complex listening situations. Assessment of auditory processing abilities among aging adults should take into consideration semantic and lexical content of the speech signal. PURPOSE: The purpose of this study was to examine the effects of lexical and attentional factors on dichotic speech recognition performance characteristics for older adult listeners. RESEARCH DESIGN: A repeated measures design was used to examine differences in dichotic word recognition as a function of lexical and attentional factors. STUDY SAMPLE: Thirty-five older adults (61-85 yr) with sensorineural hearing loss participated in this study. DATA COLLECTION AND ANALYSIS: Dichotic speech recognition was evaluated using consonant-vowel-consonant (CVC) word and nonsense CVC syllable stimuli administered in the free recall, directed recall right, and directed recall left response conditions. RESULTS: Dichotic speech recognition performance for nonsense CVC syllables was significantly poorer than performance for CVC words. Dichotic recognition performance varied across response condition for both stimulus types, which is consistent with previous studies on dichotic speech recognition. Inspection of individual results revealed that five listeners demonstrated an auditory-based left ear deficit for one or both stimulus types. CONCLUSIONS: Lexical content of stimulus materials affects performance characteristics for dichotic speech recognition tasks in the older adult population. The use of nonsense CVC syllable material may provide a way to assess dichotic speech recognition performance while potentially lessening the effects of lexical content on performance (i.e., measuring bottom-up auditory function both with and without top-down processing).

Individual Differences in Behavioral and Electrophysiological Measures of Binaural Processing Across the Adult Life Span.

PURPOSE: The purpose of the present study was to examine individual differences in binaural processing across the adult life span. METHOD: Sixty listeners (aged 23-80 years) with symmetrical hearing were tested. Binaural behavioral processing was measured by the Words-in-Noise Test, the 500-Hz masking level difference, and the Dichotic Digit Test. Electrophysiologic responses were assessed by the auditory middle latency response binaural interaction component. RESULTS: No correlations among binaural measures were found. Age accounted for the greatest amount of variability in speech-in-noise performance. Age was significantly correlated with the Words-in-Noise Test binaural advantage and dichotic ear advantage. Partial correlations, however, revealed that this was an effect of hearing status rather than age per se. Inspection of individual results revealed that 20% of listeners demonstrated reduced binaural performance for at least 2 of the binaural measures. CONCLUSIONS: The lack of significant correlations among variables suggests that each is an important measurement of binaural abilities. For some listeners, binaural processing was abnormal, reflecting a binaural processing deficit not identified by monaural audiologic tests. The inclusion of a binaural test battery in the audiologic evaluation is supported given that these listeners may benefit from alternative forms of audiologic rehabilitation.

Evaluation of a telephone speech-enhancement algorithm among older adults with hearing loss.

PURPOSE: In this study, the authors evaluated a processing algorithm aimed at improving speech recognition via the telephone among older adults with sensorineural hearing loss (SNHL). METHOD: Thirty older adults with SNHL participated. Speech recognition was measured in quiet using the Modified Rhyme Test (MRT; Kreul et al., 1968) and the Speech Perception in Noise (SPIN; Bilger et al., 1984) sentences, and in noise using the Quick Speech in Noise (QSIN; Killion et al., 2004) test. Each test was presented via the telephone with and without processing. RESULTS: Significant improvements in recognition performance due to processing were observed for the SPIN and QSIN. The improvement on the QSIN was significantly greater than on the MRT and SPIN, likely because the MRT and SPIN sentences were presented in quiet, whereas the QSIN was presented in noise. Significant improvements in recognition performance were observed for both an offline version and a real-time version of the algorithm relative to the unprocessed condition, although no difference was noted between the 2 versions. CONCLUSIONS: Results indicate that preprocessing the acoustic signal is a viable method of improving speech recognition via the telephone. The algorithm has the potential to benefit older adults with SNHL who struggle to communicate via the telephone with or without hearing aids.

Behavioral and electrophysiologic binaural processing in persons with symmetric hearing loss.

BACKGROUND: Binaural hearing improves our ability to understand speech and to localize sounds. Hearing loss can interfere with binaural cues, and despite the success of amplification, ∼25% of people with bilateral hearing loss fit with two hearing aids choose to wear only one (e.g., Brooks and Bulmer, 1981). One explanation is reduced binaural processing, which occurs when the signal presented to one ear interferes with the perception of the signal presented to the other ear (e.g., Jerger et al, 1993). Typical clinical measures, however, are insensitive to binaural processing deficits. PURPOSE: The purpose of this study was to determine the extent to which behavioral measures of binaural performance were related to electrophysiological measures of binaural processing in subjects with symmetrical pure-tone sensitivity. RESEARCH DESIGN: The relationship between middle latency responses (MLRs) and behavioral performance on binaural listening tasks was assessed by Spearman's rho correlation analyses. Separate repeated measures analyses of variance (RMANOVAs) were performed for MLR latency and MLR amplitude. STUDY SAMPLE: Nineteen subjects were recruited for the present study based on a clinical presentation of symmetrical pure-tone sensitivity with asymmetrical performance on a word-recognition in noise test. This subpopulation of patients included both subjects with and subjects without hearing loss. DATA COLLECTION AND ANALYSIS: Monaural and binaural auditory processing was measured behaviorally and electrophysiologically in right-handed subjects. The behavioral tests included the Words-in-Noise test (WIN), the dichotic digits test (DDT), and the 500 Hz masking level difference (MLD). Electrophysiologic responses were measured by the binaural interaction component (BIC) of the MLR. The electrophysiological responses were analyzed to examine the effects of peak (Na, Pa, and Nb) and condition (monaural left, monaural right, binaural, and BIC) on MLR amplitude and latency. RESULTS: Significant correlations were found among electrophysiological measures of binaural hearing and behavioral tests of binaural hearing. A strong correlation between the MLD and the binaural Na-Pa amplitude was found (r = .816). CONCLUSIONS: The behavioral and electrophysiological measures used in the present study clearly showed evidence of reduced binaural processing in ∼10 of the subjects in the present study who had symmetrical pure-tone sensitivity. These results underscore the importance of understanding binaural auditory processing and how these measures may or may not identify functional auditory problems.

Masking of low-frequency signals by high-frequency, high-level narrow bands of noise.

Low-frequency masking by intense high-frequency noise bands, referred to as remote masking (RM), was the first evidence to challenge energy-detection models of signal detection. Its underlying mechanisms remain unknown. RM was measured in five normal-hearing young-adults at 250, 350, 500, and 700 Hz using equal-power, spectrally matched random-phase noise (RPN) and low-noise noise (LNN) narrowband maskers. RM was also measured using equal-power, two-tone complex (TC2) and eight-tone complex (TC8). Maskers were centered at 3000 Hz with one or two equivalent rectangular bandwidths (ERBs). Masker levels varied from 80 to 95 dB sound pressure level in 5 dB steps. LNN produced negligible masking for all conditions. An increase in bandwidth in RPN yielded greater masking over a wider frequency region. Masking for TC2 was limited to 350 and 700 Hz for one ERB but shifted to only 700 Hz for two ERBs. A spread of masking to 500 and 700 Hz was observed for TC8 when the bandwidth was increased from one to two ERBs. Results suggest that high-frequency noise bands at high levels could generate significant low-frequency masking. It is possible that listeners experience significant RM due to the amplification of various competing noises that might have significant implications for speech perception in noise.

Dichotic speech recognition using CVC word and nonsense CVC syllable stimuli.

BACKGROUND: The effects of stimulus material, lexical content, and response condition on dichotic speech recognition performance characteristics were examined for normal-hearing young adult listeners. No previous investigation has systematically examined the effects of stimulus material with constant phonetic content but varied lexical content across three response conditions typically used to evaluate binaural auditory processing abilities. PURPOSE: To examine how dichotic speech recognition performance varies for stimulus materials with constant phonetic content but varied lexical content across the free recall, directed recall right, and directed recall left response conditions. RESEARCH DESIGN: Dichotic speech recognition was evaluated using consonant-vowel-consonant (CVC) word and nonsense CVC syllable stimuli administered in the free recall, directed right, and directed left response conditions, a repeated measures experimental design. STUDY SAMPLE: Thirty normal-hearing young adults (15 male, 15 female) served as participants. Participants ranged in age from 18 to 31 yr and were all right-handed. DATA COLLECTION AND ANALYSIS: Participants engaged in monaural speech recognition and dichotic speech recognition tasks. Percent correct recognition per ear, as well as ear advantage for dichotic speech recognition, were calculated and evaluated using a repeated measures analysis of variance (ANOVA) statistical procedure. RESULTS: Dichotic speech recognition performance for nonsense CVC syllables was significantly poorer than performance for CVC words, suggesting that lexical content impacts performance on dichotic speech recognition tasks. Performance also varied across response condition, which is consistent with previous studies of dichotic speech recognition. CONCLUSIONS: Lexical content of stimulus materials impacts performance characteristics for dichotic speech recognition tasks in the normal-hearing young adult population. The use of nonsense CVC syllable material may provide a way to assess dichotic speech recognition performance while potentially lessening the effects of lexical content on performance.

Dichotic word recognition in noise and the right-ear advantage.

PURPOSE: This study sought to compare dichotic right-ear advantages (REAs) of young adults to older adult data (C. M. Roup, T. L. Wiley, & R. H. Wilson, 2006) after matching for overall levels of recognition performance. Specifically, speech-spectrum noise was introduced in order to reduce dichotic recognition performance of young adults to a level consistent with that of older adults with hearing loss. METHOD: Dichotic word-recognition performance was evaluated in the free-recall response paradigm across 2 conditions: (a) quiet and (b) noise (+11 dB signal-to-noise ratio). Participants included a group of right-handed young adults (n = 32) with normal hearing. RESULTS: The introduction of noise resulted in significantly poorer dichotic word-recognition performance than in the quiet condition for the young adults. REAs, however, did not differ between the 2 conditions. Relative to the Roup et al. (2006) older adult data, performance of the young adults in the noise condition resulted in (a) similar levels of overall recognition performance and (b) significantly smaller REAs. CONCLUSIONS: Results suggest that the magnitude of the REA is not dependent upon the difficulty of the dichotic task. Rather, the large REAs exhibited by older adults are more likely related to age-related deficits in auditory processing.

Effect of dichotic listening on self-reported state anxiety.

The present study examined the relationship between dichotic speech recognition and state anxiety. State anxiety, as determined by the State-Trait anxiety inventory (STAI), was measured pre- and post-dichotic testing in a group of young adults with normal hearing. Dichotic speech recognition was measured for three types of speech stimuli: 3-pair digits, monosyllabic words, and consonant-vowels. Results revealed significant increases in state anxiety as a function of dichotic testing for all stimulus types. There was not a significant difference, however, in state anxiety between the stimulus types. A subset of subjects (n=44) repeated the experiment a second time. There were no significant differences in state anxiety experienced due to dichotic listening between the two sessions. Results from the present study confirm that dichotic listening induces significant increases in state anxiety in a group of young adults with normal hearing. Although statistically significant, the mean increase in state anxiety does not exceed normative levels for college students. Further, the effect of anxiety on dichotic speech recognition performance appears minimal in this population.

Hearing aid outcomes for listeners with high-frequency hearing loss.

PURPOSE: To determine whether listeners with primarily high-frequency sensorineural hearing loss (HF SNHL) perceived benefit from amplification provided by completely-in-the-canal (CIC) hearing aids. METHOD: The Hearing Handicap for the Elderly-Screening version, the Abbreviated Profile of Hearing Aid Benefit, and the Satisfaction With Amplification in Daily Life questionnaires were mailed to 2 groups of listeners (n = 79) who matched preset criteria, including threshold at 2000 Hz and use of CIC amplification. Sixty-seven percent (n = 53) of the questionnaires were returned and were divided into 2 groups. Group I (n = 26) consisted of listeners with normal hearing through 2000 Hz, and Group II (n = 27) consisted of listeners with normal hearing only through 1000 Hz. RESULTS: Results revealed that both groups perceived significant hearing handicap, hearing aid benefit, and hearing aid satisfaction. Differences between the 2 groups on the 3 measures, however, were not statistically significant. CONCLUSIONS: Listeners with HF SNHL perceived benefit and satisfaction from amplification with CIC hearing aids. Individuals with SNHL limited to the high frequencies should be considered candidates for amplification.

Perceptual training improves syllable identification in new and experienced hearing aid users.

We assessed the effects of perceptual training of syllable identification in noise on nonsense syllable test (NST) performance of new (Experiment 1) and experienced (Experiment 2) hearing aid (HA) users with sensorineural hearing loss. In Experiment 1, new HA users were randomly assigned to either immediate training (IT) or delayed training (DT) groups. IT subjects underwent 8 weeks of at-home syllable identification training and in-laboratory testing, whereas DT subjects underwent identical in-laboratory testing without training. Training produced large improvements in syllable identification in IT subjects, whereas spontaneous improvement was minimal in DT subjects. DT subjects then underwent training and showed performance improvements comparable with those of the IT group. Training-related improvement in NST scores significantly exceeded improvements due to amplification. In Experiment 2, experienced HA users received identical training and testing procedures as users in Experiment 1. The experienced users also showed significant training benefit. Training-related improvements generalized to untrained voices and were maintained on retention tests. Perceptual training appears to be a promising tool for improving speech perception in new and experienced HA users.

Acclimatization in wide dynamic range multichannel compression and linear amplification hearing aids.

Acclimatization was studied in hearing-impaired patients with no previous hearing aid (HA) experience who were fit bilaterally with either wide dynamic range multichannel compression (WDRMCC) or linear amplification (LA) HAs. Throughout 40 weeks of normal HA use, we monitored changes in nonsense syllable perception in speech-spectrum noise. Syllable recognition for WDRMCC users improved by 4.6% over the first 8 weeks, but the 2.2% improvement for LA users was complete in 2 to 4 weeks. Consonant confusion analyses indicated that WDRMCC experience facilitated consonant identification, while LA users primarily changed their response biases. Furthermore, WDRMCC users showed greater improvement for aided than unaided stimuli, while LA users did not. These results demonstrate acclimatization in new users of WDRMCC HAs but not in new users of LA HAs. A switch in amplification type after 32 weeks produced minimal performance change. Thus, acclimatization depended on the type of amplification and the previous amplification experience.