Experiences of an Internet-based aural rehabilitation (IAR) program for hearing aid users: a qualitative study.

OBJECTIVE: Internet interventions for hearing aid (HA) users have been shown to be effective in helping persons with hearing problems. As earlier research refers to objective data on these effects, little is known about how participants experience the Internet interventions subjectively. The aim of the present study was to explore participants' experiences of an Internet-based aural rehabilitation (IAR) program for HA-users, and to explore the possible subjective benefits of such a program. DESIGN: A qualitative exploratory design was implemented involving semi-structured telephone interviews. The interviews were transcribed and analysed using content analysis. STUDY SAMPLE: Interviews were conducted with 20 participants (9 men and 11 women) who had completed an IAR program for HA-users. The participants were 57-81 years old and had used HAs for 2-25 years. RESULTS: The results are organised in three main categories: general experiences associated with participating in the program, knowledge obtained from the program and perceived impact of taking part in the program. CONCLUSIONS: The overall results indicate positive experiences of the IAR program, and an overreaching theme of increased self-esteem was identified. The findings provide some valuable information for developers of future IAR programs.

Danish reading span data from 283 hearing-aid users, including a sub-group analysis of their relationship to speech-in-noise performance.

OBJECTIVE: This study provides descriptive statistics of the Danish reading span (RS) test for hearing-impaired adults. The combined effect of hearing loss, RS score, and age on speech-in-noise performance in different spatial settings was evaluated in a subset of participants. DESIGN: Data from published and unpublished studies were re-analysed. Data regarding speech-in-noise performance with co-located or spatially separated sound sources were available for a subset of participants. STUDY SAMPLE: RS scores from 283 hearing-impaired participants were extracted from past studies, and 239 of these participants had completed a speech-in-noise test. RESULTS: RS scores (mean = 41.91%, standard deviation = 11.29%) were related to age (p <0.01), but not pure-tone average (PTA) (p = 0.29). Speech-in-noise performance for co-located sound sources was related to PTA and RS score (both p < 0.01, adjusted R-squared = 0.226). Performance for spatially separated sounds was related to PTA (p < 0.01, adjusted R-squared = 0.10) but not RS score (p = 0.484). We found no differences between the standardized coefficients of the two regression models. CONCLUSIONS: The distribution of RS scores indicated a high test difficulty. We found that age should be controlled when RS scores are compared across populations. The experimental setup of the speech-in-noise test may influence the relationship between performance and RS score.

Phonological mismatch and explicit cognitive processing in a sample of 102 hearing-aid users.

Rudner et al (2008) showed that when compression release settings are manipulated in the hearing instruments of Swedish habitual users, the resulting mismatch between the phonological form of the input speech signal and representations stored in long-term memory leads to greater engagement of explicit cognitive processing under taxing listening conditions. The mismatch effect is manifest in significant correlations between performance on cognitive tests and aided-speech-recognition performance in modulated noise and/or with fast compression release settings. This effect is predicted by the ELU model (Rönnberg et al, 2008). In order to test whether the mismatch effect can be generalized across languages, we examined two sets of aided speech recognition data collected from a Danish population where two cognitive tests, reading span and letter monitoring, had been administered. A reanalysis of all three datasets, including 102 participants, demonstrated the mismatch effect. These findings suggest that the effect of phonological mismatch, as predicted by the ELU model (Rönnberg et al, this issue) and tapped by the reading span test, is a stable phenomenon across these two Scandinavian languages.

Interactions between cognition, compression, and listening conditions: effects on speech-in-noise performance in a two-channel hearing aid.

This study which included 23 experienced hearing aid users replicated several of the experiments reported in Gatehouse et al (2003, 2006) with new speech test material, language, and test procedure. The performance measure used was SNR required for 80% correct words in a sentence test. Consistent with Gatehouse et al, this study indicated that subjects showing a low score in a cognitive test (visual letter monitoring) performed better in the speech recognition test with slow time constants than with fast time constants, and performed better in unmodulated noise than in modulated noise, while subjects with high scores on the cognitive test showed the opposite pattern. Furthermore, cognitive test scores were significantly correlated with the differential advantage of fast-acting versus slow-acting compression in conditions of modulated noise. The pure tone average threshold explained 30% of the variance in aided speech recognition in noise under relatively simple listening conditions, while cognitive test scores explained about 40% of the variance under more complex, fluctuating listening conditions, where the pure tone average explained less than 5% of the variance. This suggests that speech recognition under steady-state noise conditions may underestimate the role of cognition in real-life listening.