The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss

A new article published in the journal Ear and Hearing considers how a hearing aid contributes to the ability to perceive a gap in noise for children and adults with hearing loss.

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ObjectivesThe objective of this experiment was to examine the contributions of audibility to the ability to perceive a gap in noise for children and adults. Sensorineural hearing loss (SNHL) in adulthood is associated with a deficit in gap detection. It is well known that reduced audibility in adult listeners with SNHL contributes to this deficit; however, it is unclear the extent to which hearing aid amplification can restore gap-detection thresholds, and the effect of childhood SNHL on gap-detection thresholds have not been described. For adults, it was hypothesized that restoring the dynamic range of hearing for listeners with SNHL would lead to approximately normal gap-detection thresholds. Children with normal hearing (NH) exhibit poorer gap-detection thresholds than adults. Because of their hearing losschildren with SNHL have less auditory experience than their peers with NH. Yet, it is unknown the extent to which auditory experience impacts their ability to perceive gaps in noise. Even with the provision of amplification, it was hypothesized that children with SNHL would show a deficit in gap detection, relative to their peers with normal hearing, because of reduced auditory experience.

DesignThe ability to detect a silent interval in noise was tested by adapting the stimulus level required for detection of gap durations between 3 and 20 ms for adults and children with and without SNHL. Stimulus-level thresholds were measured for participants with SNHL without amplification and with two prescriptive procedures—the adult and child versions of the desired sensation level i/o program—using a hearing aid simulator. The child version better restored the normal dynamic range than the adult version. Adults and children with NH were tested without amplification.

ResultsWhen fitted using the procedure that best restored the dynamic range, adults with SNHL had stimulus-level thresholds similar to those of adults with normal hearing. Compared to the children with NH, the children with SNHL required a higher stimulus level to detect a 5-ms gap, despite having used the procedure that better restored the normal dynamic range of hearing. Otherwise, the two groups of children had similar stimulus-level thresholds.

ConclusionThese findings suggest that apparent deficits in temporal resolution, as measured using stimulus-level thresholds for the detection of gaps, are dependent on age and audibility. These novel results indicate that childhood SNHL may impair temporal resolution as measured by stimulus-level thresholds for the detection of a gap in noise. This work has implications for understanding the effects of amplification on the ability to perceive temporal cues in speech.

Full reference: Brennan, M. A., McCreery, R. W., Buss, E., & Jesteadt, W. |2018| The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss|Ear and hearing| Vol. 39|(5)| P. 969-979.

This article can be requested by Rotherham NHS staff here 

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Hearing aids for mild to moderate hearing loss in adults

Ferguson MA, et al. | Hearing aids for mild to moderate hearing loss in adults Cochrane Database of Systematic Reviews 2017, Issue 9. | Published online 25th September 2017

This study reviewed the evidence on the effects that hearing aids have on everyday life in adults with mild to moderate hearing loss. Authors were interested in (1) a person’s ability to take part in everyday situations, (2) general health-related quality of life, (3) ability to listen to other people, and (4) harm, such as pain or over-exposure to noise.

Background

The main goal of hearing aids is to reduce the impact of hearing loss and to improve a person’s ability to take part in everyday life. Although hearing aids are the most common technology for adults with hearing loss and are in widespread use, it is not clear how beneficial they are.

Study characteristics

The evidence is up to date to 23 March 2017. Authors found five clinical studies involving 825 adults with mild to moderate hearing loss who were randomly given either hearing aids, no hearing aids or placebo hearing aids. Studies involved older adults with the average age within studies between 69 and 83 years. The duration of the studies was between six weeks and six months.

Key results

Evidence was found in three studies that hearing aids have a large beneficial effect in improving the ability of adults with mild to moderate hearing loss to take part in everyday situations. Hearing aids have a small beneficial effect in improving general health-related quality of life, such as physical, social, emotional and mental well-being, and have a large effect in improving the ability to listen to other people.

Only one study attempted to measure harms due to hearing aids. None were reported.

Conclusions

This review found that hearing aids improve the ability of adults with mild to moderate hearing loss to take part in everyday life, their general quality of life and their ability to listen to other people. If an adult with mild to moderate hearing loss seeks help for their hearing difficulties, hearing aids are an effective clinical option. It is important that future studies measure benefits consistently and report benefits separately for different age groups, genders, levels of hearing loss and types of hearing aids.

Hearing aids for mild to moderate hearing loss in adults:

 

Experiences of hearing loss and views towards interventions to promote uptake of rehabilitation support among UK adults

Rolfeab, . & Gardner, C. International Journal of Audiology. Published online: 5 July 2016

https://creativecommons.org/licenses/by-nc-nd/2.0/
Image source: clement127 – Flickr // CC BY-NC-ND 2.0

Objective: Effective hearing loss rehabilitation support options are available. Yet, people often experience delays in receiving rehabilitation support. This study aimed to document support-seeking experiences among a sample of UK adults with hearing loss, and views towards potential strategies to increase rehabilitation support uptake. People with hearing loss were interviewed about their experiences of seeking support, and responses to hypothetical intervention strategies, including public awareness campaigns, a training programme for health professionals, and a national hearing screening programme.

Design: Semi-structured qualitative interview design with thematic analysis.

Study sample: Twenty-two people with hearing loss, aged 66–88.

Results: Three themes, representing barriers to receiving rehabilitation support and potential areas for intervention, were identified: making the journey from realization to readiness, combatting social stigma, and accessing appropriate services. Barriers to receiving support mostly focused on appraisal of hearing loss symptoms. Interventions enabling symptom appraisal, such as routine screening, or demonstrating how to raise the topic effectively with a loved one, were welcomed.

Conclusions: Interventions to facilitate realization of hearing loss should be prioritized. Raising awareness of the symptoms and prevalence of hearing loss may help people to identify hearing problems and reduce stigma, in turn increasing hearing loss acceptance.

Read the abstract here

Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss

Stikaa, C.J. & Haysb, R.D. International Journal of Audiology. Published online: 22 Apr 2016

Objective: Self-reports of ‘hearing handicap’ are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL.

Design: The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews. Study sample: The 73-item field-test instrument was completed by 409 adults (22–91 years old) with varying degrees of AOHL and from different areas of the USA.

Results: Multitrait scaling analysis supported four multi-item scales and five individual items. Internal consistency reliabilities ranged from 0.93 to 0.96 for the scales. Construct validity was supported by correlations between the IHEAR-IT scales and scores on the 36-item Short Form Health Survey, version 2.0 (SF-36v2) mental composite summary (r = 0.32–0.64) and the Hearing Handicap Inventory for the Elderly/Adults (HHIE/HHIA) (r ≥ −0.70).

Conclusions: The field test provides initial support for the reliability and construct validity of the IHEAR-IT for evaluating HRQOL of individuals with AOHL. Further research is needed to evaluate the responsiveness to change of the IHEAR-IT scales and identify items for a short-form.

Read the abstract here

Long-Term Outcome Data in Patients following One Year’s Use of a Fully Implantable Active Middle Ear Implant

Uhler K., Anderson M.C. & Jenkins H.A. Audiol Neurotol 2016;21:105-112

This study examined the safety and efficacy of a fully implantable active middle ear (AMEI) system. Outcome measures assessed AMEI performance compared with an optimally fitted conventional hearing aid (CHA). Fifty adults with stable, symmetric moderate-to-severe sensorineural hearing loss were implanted at 9 ambulatory settings. Consonant-Nucleus-Consonant (CNC) words, Bamford-Kowel-Bench Speech in Noise test (BKB-SIN), Abbreviated Profile of Hearing Aid Benefit (APHAB), and unaided hearing thresholds in the implanted ear were compared to baseline measures obtained using a personal CHA. Changes in thresholds were observed from pre- to 12-month postoperative assessments. CNC word scores decreased (within 10%), and the BKB-SIN showed no change from pre- to 12-month postoperative time points. The APHAB revealed improvement. Findings suggest no difference in performance between an appropriately fit CHA and the AMEI at 12 months. This study indicates AMEIs have the potential to help individuals who choose not to use CHAs.

Read the abstract here

 

Evidence-based guidelines for recommending cochlear implantation for postlingually deafened adults

Leigh, J.R. et al. International Journal of Audiology. Published online: 10 March 2016.

N0019718 NORMAL ANATOMY, SOUND WAVES IN THE COCHLEAR
Image source: Medical Art Service. I, Christensen – Wellcome Images

Image shows artwork representing sound waves in the cochlear duct.

Objective: Adult selection criteria for cochlear implantation have been developed based on analysis of the post-operative performance of a large group of postlingually deafened adults. Original criteria published in 2004 were reviewed and amended to reflect outcomes currently being achieved by implant recipients.

Design: Retrospective review of 12-month post-operative speech perception performance of adults implanted at the Eye and Ear Hospital, Melbourne, Australia.

Study sample: A total of 382 postlingually deafened adults, using a Freedom, Nucleus 5, or CI422 Slim Straight cochlear implant were used to create a comparative set of data.

Results: Revised guidelines suggest that adults with postlingual hearing loss can now be considered cochlear implant candidates if they obtain scores of up to 55% for open-set phonemes in quiet in the ear to be implanted. Functional benefit may vary depending on the recipients’ contralateral hearing.

Conclusions: This study supports the provision of cochlear implants to candidates with significant residual hearing when at least one ear meets the criterion outlined above. Patient-specific counseling is required to ensure the potential to benefit predicted by the current model is acceptable to the individual patient and their family. Counseling regarding functional benefit must take into consideration hearing in the contralateral ear.

Read the abstract here

Making choice work well in NHS adult hearing services: resources for commissioners

Information and resources to help commissioners of NHS audiology services implement choice that works well for patients.

Documents:

via Making choice work well in NHS adult hearing services: resources for commissioners – Publications – GOV.UK.