ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe aim of the present study was to evaluate a particular sound-quality rating procedure, referred to here as the Judgments of Sound Quality (JSQ) test, for potential use as an outcome measure with elderly hearing aid wearers. The validity and reliability of the JSQ as an outcome measure were determined for unaided and aided listening conditions.DesignA repeated-measures design was employed with two primary independent variables, each with two values: 1) aided condition (aided versus unaided listening); and 2) trial (test versus retest). Sixteen elderly, hearing-impaired hearing aid users participated in the study. The participants provided ratings on eight dimensions of sound quality (softness, brightness, clarity, fullness, nearness, loudness, spaciousness, and total impression) under four stimulus conditions (speech at 65 dB SPL with a +8 dB signal-to-noise ratio, speech at 65 dB SPL in quiet, music at 90 dB SPL, and music at 75 dB SPL). Test and retest ratings were obtained in both unaided and aided conditionsResultsNo significant differences were found between median test and retest scores on the JSQ. The median ratings for each sound-quality dimension were found to have moderate test-retest reliability, with test-retest correlations (r) ranging from 0.20 to 0.73 (medianrvalue = 0.58) for the unaided listening condition, and from 0.23 to 0.85 (medianrvalue = 0.51) for the aided listening condition. Test validity was established through significant differences in JSQ ratings for various stimulus pairs (e.g., speech in quiet versus speech in noise). In addition, significant differences were observed between unaided and aided ratings for the dimensions of clarity, nearness, loudness, and total impression with aided JSQ ratings approaching normative “ideal” values established previously.ConclusionsThe JSQ appears to be a potentially useful measure of hearing aid outcome, especially when using group data to document the benefits of amplification. Additional efforts should be directed at improving the reliability of the JSQ, however, before application to hearing aid wearers on an individual basis.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo evaluate the performance of the various speech processing strategies supported by the Clarion S-Series implant processor.DesignFive different speech-processing strategies [the Continuous Interleaved Sampler (CIS), the Simultaneous Analog Stimulation (SAS), the Paired Pulsatile Sampler (PPS), the Quadruple Pulsatile Sampler (QPS) and the hybrid (HYB) strategies] were implemented on the Clarion Research Interface platform. These speech-processing strategies varied in the degree of electrode simultaneity, with the SAS strategy being fully simultaneous (all electrodes are stimulated at the same time), the PPS and QPS strategies being partially simultaneous and the CIS strategy being completely sequential. In the hybrid strategy, some electrodes were stimulated using SAS, and some were stimulated using CIS. Nine Clarion CIS users were fitted with the above speech processing strategies and tested on vowel, consonant and word recognition in quiet.ResultsThere were no statistically significant differences in the mean group performance between the CIS and SAS strategies on vowel and sentence recognition. A statistically significant difference was found only on consonant recognition. Individual results, however, indicated that most subjects performed worse with the SAS strategy compared with the CIS strategy on all tests. About 33% of the cochlear implant users benefited from the PPS and QPS strategies on consonant and word recognition.ConclusionsIf temporal information were the primary factor in speech recognition with cochlear implants then SAS should consistently produce higher speech recognition scores than CIS. That was not the case, however, because most CIS users performed significantly worse with the SAS strategy on all speech tests. Hence, there seems to be a trade-off between improving the temporal resolution with an increasing number of simultaneous channels and introducing distortions from electrical-field interactions. Performance for some CI users improved when the number of simultaneous channels increased to two (PPS strategy) and four (QPS strategy). The improvement with the PPS and QPS strategies must be due to the higher rates of stimulation. The above results suggest that CIS users are less likely to benefit with the SAS strategy, and they are more likely to benefit from the PPS and QPS strategies, which provide higher rates of stimulation with small probability of channel interaction.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveThe primary purpose of this study was to determine the distortion product otoacoustic emission (DPOAE) and noise response characteristics in a large sample of older adults. Another purpose was to evaluate how specific absolute DPOAE levels or DPOAE/Noise ratios differentiated hearing status in these individuals.DesignA cross-sectional design was utilized for this study. As a part of the Epidemiology of Hearing Loss Study (EHLS), DPOAEs were measured in 937 of the 3429 participants aged 48 to 92 yr. The DPOAE and noise response characteristics were evaluated at 1000, 2000, 4000, and 8000 Hz. Absolute DPOAE level and DPOAE/Noise ratios were measured in the participants. The DPOAE data were compared with individual pure-tone frequencies (1000, 2000, 4000, and 8000 Hz) in the participants to investigate how DPOAE responses differentiated ears with normal hearing from impaired ears. Sensitivity, specificity, positive and negative predictive values, and accuracies were calculated for various absolute DPOAE levels and DPOAE/Noise ratios.ResultsDue to the considerable overlap between DPOAE responses and the noise levels at 1000 Hz, this frequency was not used for any analyses. Sensitivity and specificity were calculated for various DPOAE responses. Sensitivity and specificity varied by frequency for absolute DPOAE levels and DPOAE/Noise ratios. Receiver operator characteristic (ROC) analyses were used to determine which DPOAE responses differentiated normal hearing from hearing loss. The ROC analyses demonstrated that −6 dB SPL at 2000 Hz, −14 dB SPL at 4000 Hz, and −22 dB SPL at 8000 Hz and a +9 dB DPOAE/Noise ratio at each of these frequencies yielded the highest discrimination.ConclusionsSensitivity and specificity varied by DPOAE response characteristics and frequency. The decision as to which DPOAE response criterion used should be based on careful consideration of objectives and the possible consequences of misdiagnosis. The results of this study support the use of DPOAEs as a clinical measure for older adults.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Theobjectiveof this study was to examine the hypothesis that aging would adversely effect speech sound discrimination in the Mongolian gerbil, as assessed by behavioral techniques. Thedesigninvolved measuring difference limens (DLs) for frequency changes along three synthetic speech continua (vowel, liquid, stop-consonant) in 25 gerbils as a function of age up to 36 mo. Absolute thresholds were also measured in the aging gerbils to verify normal hearing. Theresultsindicated no adverse effects of aging on the DLs for any of the speech continua. Thus theconclusionwas that “intrinsic” aging processes in the gerbil, considered apart from “extrinsic” insulting factors, are not detrimental to speech discrimination, at least under quiet conditions. The clinical implications for humans are that the deficits typically observed in elderly humans for speech sound discrimination may be insult-related, and not the result of normal aging processes.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveAs part of a prospective study of possible effects of early-life otitis media on speech, language, cognition, and psychosocial development, we evaluated hearing both during episodes of middle-ear effusion (MEE) and when MEE was not present. The objective of this report is to describe age-specific hearing threshold levels in relation to the presence or absence of MEE in a large sample of young children.DesignParticipants were 1055 children drawn from a sample of 6350 children who were enrolled in the larger study by 2 mo of age. Otologic evaluation of each child was conducted at least monthly. The protocol of the larger study called for hearing evaluations 1) after 8 wk of continuous unilateral or bilateral MEE and every 4 wk thereafter until one test had been conducted when MEE was no longer present; 2) immediately before developmental testing; and 3) in a sample of children without MEE to obtain age-specific normative data.ResultsResults are presented by testing technique, age group, and middle-ear condition. In general, hearing threshold levels were highest in the youngest children tested with visual reinforcement audiometry and lowest in the oldest children tested with conventional audiometry. In general also, thresholds were lowest in children with normal middle-ear status, intermediate in children with unilateral MEE, and highest in children with bilateral MEE. On average, the presence of bilateral MEE was associated with hearing threshold levels 10 to 15 dB higher than the normative values for the corresponding age group.ConclusionsIn infants and young children, audiometric results are influenced by testing technique, age group, and the presence or absence of effusion in each ear.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesThe purposes of this investigation were 1) to describe speech/voice physiological characteristics of prelingually deafened children before and after cochlear implantation and determine whether they fall into a range that would be considered deviant, 2) to determine whether selected deviant articulatory and phonatory behaviors of children with cochlear implants persist despite long-term cochlear implant use and continued participation in aural rehabilitation services, and 3) to determine whether further development of deviant articulatory and phonatory behaviors occurs postimplantation.DesignSeven prelingually deafened children who received cochlear implants after 5 yr of age were followed from shortly before implantation until 5 to 6 yr postimplantation. These children received their early education in a Total Communication environment and used the Nucleus 22-electrode cochlear implant. All of them initially used the MPEAK speech processing strategy, and five of them eventually upgraded to the SPEAK speech processing strategy. Speech/voice physiological measurements that were obtained periodically from the children included intraoral air pressure (Po), nasal and phonatory air flow, voice onset time (VOT), and fundamental frequency (Fo). Data from the deaf children were compared with a database from 56 children with normal hearing to determine when the deaf children exhibited “deviant” speech/voice behaviors. Speech/voice behaviors were considered “deviant” if they never occurred for children with normal hearing or were associated with z-scores that were outside the range of ±2.0.ResultsThe deaf children showed a wide range of deviant speech and voice behaviors both pre- and post-cochlear implant. The most frequently occurring atypical behaviors were use of negative Po, high Pofor [b, m], long and short VOT for [p], and high Fo. Some deviant behaviors improved post-cochlear implant. However, deviant behaviors often persisted for several years post-cochlear implant. There was considerable evidence of further development of deviant behaviors post-cochlear implant. All of the deaf children demonstrated deviancy on at least two of our measures at the last data collection interval (5 to 6 yr post-cochlear implant).ConclusionsChildren who received cochlear implants after 5 yr of age and who were educated in a Total Communication setting showed persistence and further development of deviant speech/voice behaviors for several years post-cochlear implant. Although our findings cannot be generalized to other populations of children with cochlear implants (i.e., those who were implanted earlier, those educated in auditory-oral programs), it seems wisest at the present time not to assume that children’s deviant speech/voice behaviors will remit spontaneously with continued cochlear implant use. Our data provide an important comparative database for future investigations of pediatric cochlear implant users who have had shorter periods of auditory deprivation and who have received cochlear implants with more current technological features.Longitudinal Changes in Children’s Speech and Voice Physiology after Cochlear Implantation

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveIn a previous study (Sherbecoe & Studebaker, 2002), we derived a frequency-importance function and a transfer function for the audio compact disc version of the Connected Speech Test (CST). The current investigation evaluated the validity of these audibility-index (AI) functions based on how well they predicted data from four published studies that presented the CST to normal-hearing and hearing-impaired subjects.DesignAI values were calculated for the test conditions received by 78 normal-hearing and 72 hearing-impaired subjects from the selected studies. The observed CST scores and AI values for these conditions/subjects were then plotted and the dispersion of the data compared to the expected range based on critical differences. The AI values for the conditions/subjects were also converted into expected CST scores and subtracted from their corresponding observed scores to determine the distribution of the resulting difference scores and the relationship between the difference scores and subject age.ResultsGood predictions were obtained for normal-hearing subjects who had been tested under audio-only conditions but not those who had received audiovisual tests. The expected scores for the latter subjects were too low when the AI accounted only for audibility and too high when it included the correction for visual cues from ANSI S3.5-1997. All of the hearing-impaired subjects had been tested under audio-only conditions. In their case, the mean difference between the observed and the expected scores was comparable with the audio-only mean for the normal-hearing subjects when the AI included corrections for speech level distortion and hearing loss desensitization. However, the hearing-impaired subject data had greater variability. The predictions for these subjects also decreased in accuracy when subject age increased beyond 70 yr despite the application of an AI correction for age.ConclusionsThe results of this study suggest that the AI functions derived for the CST satisfactorily predict the scores of normal-hearing subjects when they listen in speech babble under audio-only conditions but not when they receive visual cues. To obtain accurate predictions for the audiovisual form of the CST, it will be necessary to develop new ANSI-style AI correction equations for visual cues or new AI functions based on audiovisual test scores. If the current AI functions are used to predict the scores of hearing-impaired listeners tested under audio-only conditions, the AI should include corrections for the effects of speech level and hearing loss. A correction for subject age also could be applied, if it seems appropriate to do so. In either case, however, the predictions are still likely to be less accurate than the predictions for normal-hearing subjects. This may be because speech recognition deficits in people with hearing loss are not due solely to diminished audibility. Hearing-impaired subjects, particularly if they are elderly, also may be more susceptible to masking effects or other factors not accounted for by the AI.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveIn 1993, 11 hospitals in the United States were known to screen more than 90% of newborns for hearing loss. By 2000, approximately 1000 hospitals reported screening at least 90% of their babies. This study was designed to identify trends in the age of identification and intervention for infants and young children with hearing loss in light of expanded implementation of newborn hearing screening.DesignParents of children under 6 yr of age with a confirmed hearing loss were surveyed. The survey instrument was designed to investigate three questions: 1) is the age of identification and intervention earlier for babies whose hearing is screened at birth compared with those whose hearing is not screened; 2) when hearing is screened at birth, do ages of dia-gnosis of hearing loss and intervention meet the guide-lines established in 2000, by the Joint Committee on Infant Hearing (Reference Note 1), and 3) what are the barriers to timely identification and intervention? Six hundred fifty-seven parents received the mailing.ResultsResponses of 151 parents of children with hearing loss, born between 1996 and 2000, were analyzed. Parents from 41 states provided information. Approximately half the children reported on were screened for hearing loss at birth. Age of identification and hearing aid fitting varied substantially based on degree of hearing loss and whether the cause of hearing loss was known or unknown; however, diagnosis and intervention occurred at an earlier age for infants screened at birth. Findings indicate that when hearing is screened at birth, infants with more severe degrees of hearing loss and an unknown cause tend to be identified and receive intervention within the 2000 timelines proposed by the Joint Committee on Infant Hearing. Barriers to timely identification and intervention are discussed.ConclusionsBefore widespread implementation of newborn hearing screening, age of identification and intervention were consistently reported to exceed 2 yr of age. The results reported here indicate a trend toward earlier identification and hearing aid fitting with the implementation of newborn hearing screening. Although limited to literate and English speaking respondents, the study provides supporting evidence that newborn hearing screening lowers the ages of identification and intervention.

ISSN:0196-0202    

出版商:OVID    

年代:2003

数据来源: OVID