A Pediatric Prescription for Listening in Noise

Hearing aid prescriptions are traditionally developed for the application of accessing speech in quiet listening conditions. This month we review an article from Crukley and Scollie that describes a version of the DSL v5.0 designed for listening in noisy situations.

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On the prevalence of hearing loss and barriers to hearing aid uptake

Dawes and his colleagues examine the prevalence of hearing impairment among 164,700 middle-aged respondents in the U.K., assessing how audiologic and demographic factors relate to hearing impairment and the use of hearing aids among individuals in this age group.

They report that 10.7 % of participants had hearing impairment; tinnitus was reported by 16.9% of the subjects, which is consistent with previous reports (Davis 1995).  The results show, not surprisingly, that the prevalence of hearing loss increases with increasing age, with an acceleration of prevalence beginning in the 55-59 year old age group.

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The most important factors behind directional microphone benefit

In this month’s blog the three primary goals from a recent study by Keidser and colleagues are reviewed. The authors report on a series of factors that affect benefit from directional microphones in hearing aids. Specifically, they were interested in the effects and interaction of three potential sources of variability: differences in the individual SNR achieved by physical directional benefit, differences in the ability to make use of SNR improvements and variability related to measurement error.

Read more: http://buff.ly/1qskoJK

Acclimatizing to hearing aids may not mean what you think it means

New patients frequently report that their new hearing aids sound tinny, metallic, loud, or unnatural. The clinical audiologist recognizes that these comments will decrease in frequency with time. This process is often described as acclimatization: a reaction to new hearing aids that occurs because the patient has adjusted to hearing sound filtered by their hearing loss. When amplification is introduced, the subsequent increase in audibility and loudness perception is unfamiliar and therefore unnatural…

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American Auditory Society 2014

I’m happy to share some of the research content that we are presenting at the 2014 American Auditory Society in Scottsdale, Arizona. Below are links to PDFs of the research posters.

Viability of RECD in Fitting Vented and Open-Canal Hearing Aids
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Speech Recognition in Noise with Four Remote Microphone Technologies
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Do Combination Tinnitus Instruments Reduce the Effects of Tinnitus?
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A Live Voice Test of Plural Detection

Very few people take action to verify or validate frequency lowering at the time of prescription. It may be the case that the audiologist lacks appropriate equipment to complete electroacoustic verification or they are unaware of, or do not have access to, test options that can be calibrated in the sound field. For this reason, I assembled a casual test of word-final plural detection that should be administered with live voice at a soft conversational level.

It is important to understand that this is not a scientifically validated tool, it is intended as a fast and free utility that provides some insight into the effect of any frequency lowering algorithm.

Download the PDF

On the Prevalence of Cochlear Dead Regions

As more information is gained about prevalence and risk factors, what remains missing are clinical guidelines for management of hearing aid users with diagnosed high-frequency dead regions. Conflicting recommendations have been proposed for either limiting high frequency amplification or preserving high frequency amplification and working within prescribed targets. The data available today suggest that prevalence of contiguous multi-octave dead regions is very low and only a smaller subset of hearing aid users with contiguous dead regions experience any negative effects of high-frequency amplification.

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Should you prescribe digital noise reduction to children?

For years it was the case that digital noise reduction was not a recommended signal processing strategy for pediatric hearing aid fittings. The advancement of these algorithms and new research findings have shifted this perception.

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The Top 5 Hearing Aid Research Articles from 2013!

Top 5

1) The Clinical Practice Guidelines in Pediatric Amplification

After a 10-year wait, the guidelines for prescription of hearing aids to children were updated in 2013—making them the most modern of any peer-reviewed guidelines. There is little doubt that these recommendations will impact future publication and fitting protocols at clinical sites around the world. The guidelines are freely available at the link below.

American Academy of Audiology. (2013). Clinical Practice Guidelines Pediatric Amplification. Reston, VA: Ching, T., Galster, J., Grimes, A., Johnson, C., Lewis, D., McCreery, R…Yoshinago-Itano, C.

http://buff.ly/18TNGsz

2) Placebo effects in hearing aid trials are reliable

This article echoes publications from the early 2000’s (e.g., Bentler et al., 2003) that reported on blinded comparisons of analog and digital hearing aids. In those early studies, participants showed clear bias when primed to believe that option ‘A’ was a higher technology than option ‘B’. That early work was more focused on comparing technologies than this insightful report on placebo effects. Dawes and colleagues share an important reminder that placebo is real and should be accounted for in experimental design, whenever possible.

Dawes, P., Hopkins, R., & Munro, K. (2013). Placebo effects in hearing aid trials are reliable. International Journal of Audiology, 52(7), 472-477.

http://buff.ly/JF7DHM

3) Effects of hearing aid use on listening effort and mental fatigue

In the last few years, a number of research audiologists and hearing scientists have worked to document relationships between cognitive capacity, listening effort, and hearing aid use. An undertone of these efforts has been the assumption that a person with hearing loss will be less fatigued when listening with hearing aids. This article is one of the first published attempts at clearly documenting this fatiguing effect.

Hornsby, B.W. (2013). Effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands. Ear & Hearing, 34(5), 523-534.

http://buff.ly/JF7vrH

4) Characteristics of hearing aid fittings in infants and young children

The recent publication of updated pediatric fitting guidelines leads one to wonder how well fundamental aspects of these recommendations are being followed. This report from McCreery and colleagues is a clear indication that superior pediatric hearing care is uncommon and most often found in large pediatric medical centers. They also reinforce the consideration that consistent care from a single center may result in the most prescriptively appropriate hearing aid fitting.

McCreery, R., Bentler, R., & Roush, P. (2013). Characteristics of hearing aid fittings in infants and young children. Ear & Hearing, 34(6), 701-710.

http://buff.ly/18TNnhp

5) The Style Preference Survey (SPS): a report on psychometric properties and a cross-validation experiment

Closing out the Top 5: this article warrants high regard for rigor in design and quality of reporting. The authors delivered an article that will educate future researchers on the development and validation of questionnaires. Beyond this utility, the results are some of the first to identify the dimensions of preference that underlie the well-established bias toward preference of open-canal hearing aids.

Smith, S., Ricketts, T., McArdle, R., Chisolm, T., Alexander, G., & Bratt, G. (2013). Style preference survey: a report on the psychometric properties and a cross-validation experiement. Journal of the American Academy of Audiology, 24(2), 89-104.

http://buff.ly/JF740H

#acoustics

A plastic cup makes for a simple and effective instant speaker.