Sladen, Douglas P.

PurposeSeveral studies have been devoted to understanding the frequency information available to adult users of cochlear implants when listening in quiet. The objective of this study was to construct frequency importance functions for a group of adults with cochlear implants and a group of adults with normal hearing both in quiet and in a +10 dB signal-to-noise ratio.MethodTwo groups of adults, 1 with cochlear implants and 1 with normal hearing, were asked to identify nonsense syllables in quiet and in the presence of 6-talker babble while “holes” were systematically created in the speech spectrum. Frequency importance functions were constructed.ResultsResults showed that adults with normal hearing placed greater weight on bands 1, 3, and 4 than on bands 2, 5, and 6, whereas adults with cochlear implants placed equal weight on all bands. The frequency importance functions for each group did not differ between listening in quiet and listening in noise.ConclusionsAdults with cochlear implants assign perceptual weight toward different frequency bands, though the weight assignment does not differ between quiet and noisy conditions. Generalizing these results to the broader population of adults with implants is constrained by a small sample size.

Objective To examine the validity of a tablet computer–based audiometer for measuring hearing thresholds in a moderately noisy environment. Study Design A prospective single‐cohort repeated measures study. Setting Tertiary care institution providing hearing health care to a diverse population. Subjects and Methods Subjects included 49 participants (44 adults, 5 children) with all degrees of hearing sensitivity. Potential participants were excluded if they were <4 years old or had cognitive deficits or ear drainage. Participants were tested with established audiometric tests and a tablet audiometer. Threshold values were measured for both ears using various stimuli (500, 1000, 2000, and 4000 Hz). Testing with the tablet audiometer was conducted in a non‐sound‐treated room; room properties were characterized by ambient noise level and reverberation testing. Calibration assessment of the tablet audiometer was performed on 3 occasions. Results Within the test thresholds for hearing level, results from the tablet device were within 10 dB of those determined by conventional audiometry for 164 of 172 hearing levels and did not show proportional bias over the testing range. Calibration assessment showed accurate proximity between output and target values, though crosstalk and linearity failed initial assessments. Conclusion The tablet‐based automated audiometer presents a new method for threshold hearing assessment outside conventional sound booths.

Consistent, full-time use of a well programmed cochlear implant (CI) is key for auditory and spoken language development. Young children with hearing loss often lack the requisite language skills to alert parents and clinicians when the CI needs to be re-programmed. The article within describes red flags used to indicate the levels of the device need to be reset.

Purpose To determine whether older cochlear implant (CI) listeners differ from younger CI listeners on measures of speech understanding, music perception, and health-related quality of life (HRQoL). In the study, the authors hypothesized that speech recognition would be more difficult for older adults, especially in noisy conditions. Performance on music perception was expected to be lower for older implanted listeners. No differences between age groups were expected on HRQoL. Method Twenty older (>60 years) and 20 younger (<60 years) implanted adults participated. Speech understanding was assessed using words and sentences presented in quiet, and sentences presented at +15, +10, and +5 dB signal-to-noise ratio conditions. Music perception was tested using the University of Washington Clinical Assessment of Music, and HRQoL was measured using the Njimegen CI survey. Results Speech understanding was significantly lower for the older compared with the younger group in all conditions. Older implanted adults showed lower performance on music perception compared with younger implanted adults on 1 of 3 subtests. Older adults reported lower HRQoL benefit than younger adults on 3 of 6 subdomains. Conclusion Data indicate that older CI listeners performed more poorly than younger CI listeners, although group differences appear to be task specific.

PurposePrevious research suggests that school-age children with minimal hearing loss (CMHL) are at risk for a variety of psychoeducational problems. However, CMHL are a heterogeneous group, and the profile of at-risk children is unknown. Data regarding the characteristics of early school-age CMHL are needed to extend previous findings and determine potential risk factors associated with psychoeducational difficulties.MethodPsychoeducational outcomes were evaluated at baseline and longitudinally in age-matched groups of 27 CMHL (ages 4–10 years) and 26 children with normal hearing (CNH) using assessments of language, reading, behavior, speech recognition in noise, and cognition. Additional analyses were used to identify demographic characteristics among CMHL that are associated with psychoeducational difficulties.ResultsAt the earliest age tested, CMHL had greater teacher-rated attention difficulties in the classroom than CNH. Differences in the rate of psychoeducational development were not observed between groups. Among CMHL, psychoeducational difficulties were associated with delays in identification of hearing loss and low maternal education.ConclusionsClassroom attention abilities should be monitored for early school-age CMHL. Late-identified CMHL and CMHL with low maternal education levels may be in particular need of academic and social support. Continued efforts for early identification of CMHL should be made to improve outcomes for these children.

Purpose In this study, the authors examined how signal clarity interacts with the use of sentence context information in determining speech-in-noise recognition for children with cochlear implants and children with normal hearing. Method One hundred and twenty sentences in which the final word varied in predictability (high vs. low semantic context) were produced in conversational and clear speech. Nine children with cochlear implants and 9 children with normal hearing completed the sentence-in-noise listening tests and a standardized language measure. Results Word recognition in noise improved significantly for both groups of children for high-predictability sentences in clear speech. Children with normal hearing benefited more from each source of information compared with children with cochlear implants. There was a significant correlation between more developed language skills and the ability to use contextual enhancements. The smaller context gain in clear speech for children with cochlear implants is in accord with the effortfulness hypothesis (McCoy et al., 2005) and points to the cumulative effects of noise throughout the processing system. Conclusion Modifications of the speech signal and the context of the utterances through changes in the talker output hold substantial promise as a communication enhancement technique for both children with cochlear implants and children with normal hearing.