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.

blur-brunette-cap-163375

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 

Advertisements

Tinnitus Week

Tinnitus Week takes place from 5-11 February 2018 and is an international awareness initiative led by a group of organisations, including the British Tinnitus Association, American Tinnitus Association, Tinnitus Hub and the Tinnitus Research Initiative.

tinitus

The aim of the week is to raise awareness of the condition, which affects approximately 1 in 10 of the population. The British Tinnitus Association campaign for the week will focus on children and young people.

The ‘Kids Talk Tinnitus’ campaign will engage with children, parents and schools to raise awareness of tinnitus amongst young people and drive the use of relevant support and resources. These can be found at www.tinnitus.org.uk/Pages/Category/tinnitus-in-children.

A new website has been set up, as a central resource collecting all the initiatives which will be taking place in 2018. This website can be found at www.tinnitusweek.com.

Find out more about Tinnitus Week  here.

Majority of UK parents are unaware children can have tinnitus

A survey by the British Tinnitus Association (BTA)  found just under a third of UK parents (32%) think children under the age of 10 can have tinnitus; and just 37% think it can affect children aged 10 to 16

Research commissioned by the BTA has revealed the worrying statistic, which the charity says reinforces the misconception that the hearing condition only affects older people.

The research also revealed many parents are unaware of the common signs of the hearing condition in children, such as anxiety or difficulty concentrating.
To help tackle the problem, the charity has created guidance for both parents and teachers:

  • Tinnitus: A Parents Guide:
    Includes the signs and symptoms to look out for, as well as advice on the best places to get help and support if parents suspect their child has tinnitus
  • Tinnitus: A Teachers Guide:
    Provides practical steps for use in the classroom.

Full BTA Press release here

Children with cochlear implant learn words faster than hearing children

Researchers have found that deaf children with a cochlear implant learn words even faster than those with normal hearing | Scientific Reports | via ScienceDaily

ear-2973126_1920

A current study at the Max Planck Institute for Human Cognitive and Brain Sciences has revealed that when deaf children get their cochlear implants, they learn words faster than those with normal hearing. Consequently, they build up certain word pools faster.

The reason for this finding could be that children with cochlear implants are older when they are first exposed to spoken language. Those with normal hearing learn aspects of language, such as the rhythm and melody of their mother tongue, from birth and even in the womb. In deaf children, this only starts at the time of their cochlear replacement, at the age of around one to four years. By this time certain brain structures necessary for language acquisition are already well developed.

Full story at ScienceDaily

Full reference: Vavatzanidis, N. K. et al. | Establishing a mental lexicon with cochlear implants: an ERP study with young children |Scientific Reports, 2018; 8 (1)

Early Hearing Detection and Vocabulary of Children With Hearing Loss.

The primary purpose of the current study was to examine the impact of the current EHDI 1-3-6 policy on vocabulary outcomes across a wide geographic area | Pediatrics

Background: To date, no studies have examined vocabulary outcomes of children meeting all 3 components of the Early Hearing Detection and Intervention (EHDI) guidelines (hearing screening by 1 month, diagnosis of hearing loss by 3 months, and intervention by 6 months of age). A secondary goal was to confirm the impact of other demographic variables previously reported to be related to language outcomes.

Results: The combination of 6 factors in a regression analysis accounted for 41% of the variance in vocabulary outcomes. Vocabulary quotients were significantly higher for children who met the EHDI guidelines, were younger, had no additional disabilities, had mild to moderate hearing loss, had parents who were deaf or hard of hearing, and had mothers with higher levels of education.

Conclusions: Vocabulary learning may be enhanced with system improvements that increase the number of children meeting the current early identification and intervention guidelines. In addition, intervention efforts need to focus on preventing widening delays with chronological age, assisting mothers with lower levels of education, and incorporating adults who are deaf/hard-of-hearing in the intervention process.

Yoshinaga-Itano, C. et al. (2017) Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics. Vol. 140 (no. 2) e20162964

Hearing aids for otitis media with effusion: Do children use them?

This study investigated what proportion of children referred for hearing aids actually receive them, and whether children use them | International Journal of Pediatric Otorhinolaryngology

https://www.flickr.com/photos/kristof_home/3630576026/
Image source: Kristof Borkowski – Flickr // CC BY-NC 2.0

ENT surgeons may refer children with otitis media with effusion (OME) to audiology for consideration of hearing aids. They are an option for the treatment of OME, but are only effective if the child actually wears them.

During the study period, there were 202 referrals of children to audiology, of which 70 (34.7%) were for consideration of hearing aids for OME. Of these 70 referred children, 37 (52.9%) were not fitted with hearing aids due to normal audiometry (23), asymptomatic mild hearing loss (7), nonattendance (3), clinical decision to just monitor hearing (1), parental decline (2), and unrecorded reason (1). A total of 38 children (including direct access patients) were fitted with hearing aids for OME. Majority (36/38) of children issued aids used them, 16 all day, 7 only at school, 1 only at home, 3 only when needed, and 9 used them for an unspecified duration; 1 child’s use of hearing aids was unrecorded, and 1 child refused to use it. 21 were fitted bilaterally and 17 unilaterally. 37 were behind the ear aids and 1 a BAHA softband.

A third of referrals to paediatric audiology by ENT are for consideration of hearing aids for OME. Only about half of children referred to audiology for hearing aids for OME actually receive them, as by the time they see audiology the hearing loss has frequently resolved or is asymptomatic so that aiding is unwarranted. Once fitted, they appear to be well accepted. Hearing aids have fair utilization in children fitted with them for OME.

Full reference: Gan, R.W.C. et al. (2017) Hearing aids for otitis media with effusion: Do children use them? International Journal of Pediatric Otorhinolaryngology. Vol. 99 (August) pp. 117–119.

Bilateral congenital cholesteatoma: Surgical treatment and considerations.

A multicenter study regarding surgical management of bilateral congenital cholesteatoma (BCC) and underline the importance of endoscopes in the management of this condition | International Journal of Pediatric Otorhinolaryngology

In BCC, hearing preservation is more crucial than in unilateral cases. The endoscopic approach allows complete removal of cholesteatoma via a minimally invasive technique offering low residual disease rates while preserving the normal physiology of the middle ear and possibly the ossicular chain.

From 2002 to November 2016, six patients were identified with bilateral congenital cholesteatoma and included in this study. Pre-operative assessments, surgical treatments and outcomes were collected and described.

The median age at presentation was 4 years (range 2-7 years). A microscopic post auricular tympanoplasty was performed in two ears, four underwent a canal wall up mastoidectomy procedure and in the other six a transcanal endoscopic approach (TEA) was used. No intra- or post-operative complications were observed in any patients. The mean follow up period was 54.5 months.

When both ears are involved with congenital cholesteatoma, it is particularly important to use a minimally invasive technique that preserves normal ossicular and mastoid structure and function whenever possible. In many cases this can be achieved with TEA, even in young children. In addition the endoscope allows good surgical control of cholesteatoma removal from hidden recesses.

Full reference: Marchioni, D. et al. (2017) Bilateral congenital cholesteatoma: Surgical treatment and considerations. International Journal of Pediatric Otorhinolaryngology. Vol. 99. (no. 08) pp. 146–151