Audiol. Res., Volume 1, Issue 1 (March 2011) – 27 articles

A series of pilot initiatives of adult hearing screening programs were organized in eight large and small-size cities in Italy in the past two years. The screening initiatives were held in public places, supermarkets, drugstores, and in some universities of the third age, and involved an overall population of 2,278 screened subjects with age ranging from 13 to 93 years. Three different screening tests were used to assess hearing ability in the participants, i.e.: screening pure tone audiometry (PTA), an automated speech-in-noise screening test (the SUN-test), and a screening questionnaire of self-perceived hearing handicap (the HHIE-S). This paper describes the organization and management of these screening initiatives and reviews the main results obtained in the screened population, using the three different screening tests. Results obtained in these pilot initiatives showed that screening adults for hearing problems might be feasible, on a local level, in non clinical settings and can be performed quite easily with the support of local coordinators and partners, such as associations or local authorities. It is recognized that further initiatives and studies will have to be performed to better define the key aspects related to the organization and management of adult hearing screening programs, either at a local, regional, or national level. Full article

Several studies have reported age-related decline in auditory temporal resolution and in working memory. However, earlier studies did not provide evidence as to whether these declines reflect overall changes in the same mechanisms, or reflect age-related changes in two independent mechanisms. In the current study we examined whether the age-related decline in auditory temporal resolution and in working memory would remain significant even after controlling for their shared variance. Eighty-two participants, aged 21-82 performed the dichotic temporal order judgment task and the backward digit span task. The findings indicate that age-related decline in auditory temporal resolution and in working memory are two independent processes. Full article

The development of hearing diagnosis methods and hearing screening methods are not isolated phenomena: they are intimately related to changes in the cultural background and to advances in fields of medicine and engineering. In the recent years, there has been a rapid evolution in the development of fast, easy and reliable techniques for lowcost hearing screening initiatives. Since adults and elderly people typically experience a reduced hearing ability in challenging listening situations [e.g., in background noise, in reverberation, or with competing speech (Pichora‑Fuller & Souza, 2003)], these newly developed screening tests mainly rely on the recognition of speech stimuli in noise, so that the real experienced listening difficulties can be effectively targeted (Killion & Niquette, 2000). New tests based on the recognition of speech in noise are being developed on portable, battery- operated devices (see, for example, Paglialonga et al., 2011), or distributed diffusely using information and communication technologies. The evolutions of e-Health and telemedicine have shifted focus from patients coming to the hearing clinic for hearing health evaluation towards the possibility of evaluating the hearing status remotely at home. So far, two ways of distributing the hearing test have primarily been used: ordinary telephone networks (excluding mobile networks) and the internet. When using the telephone network for hearing screening, the predominantly test is a speech-in-noise test often referred to as the digit triplet test where the subjects hearing status is evaluated as the speech-to-noise threshold for spoken digits. This test is today available in some ten countries in Europe, North America and Australia. The use of internet as testing platform allows several different types of hearing assessment tests such as questionnaires, different types of speech in noise tests, temporal gap detection, sound localization (minimum audible angle), and spectral (un)masking tests. Also, the use of the internet allows audiovisual presentations as well as visual interaction and cues in the tests for a more ecological approach. Even if several new and novel approaches for hearing assessment using the internet are surfacing, the validated tests are based on questionnaires or speech-in-noise. Although the internet allows for a broader flora of pure auditory and audiovisual tests for hearing health assessment, calibration problems such as timing uncertainty, output levels and modes of presentation (speakers or earphones) limits the usability at present. Full article

The SUN-test (Speech Understanding in Noise) is a speech-innoise test to screen adults and older adults for hearing disability. The SUN-test consists in a short list of intervocalic consonants (VCV, vowel-consonant-vowel) in noise that are presented in a three-alternatives forced choice (3AFC) paradigm by means of a touch-screen interface. Based on the number of stimuli correctly identified, the tested subject gets one of three possible test outcomes: no listening difficulties, a hearing check would be advisable, or a hearing check is recommended. This paper reviews the main results obtained with the SUNtest in the Italian language in a population of nearly 1,300 adults and older adults with varying degrees of audiometric thresholds and audiometric configurations, tested both in low and in high ambient noise settings. Results obtained in the tested population revealed that the outcomes of the SUN-test were in line with the outcomes of pure-tone testing, and that the test performance was similar both in low and in high ambient noise (up to 65 dB A). Results obtained with the SUNtest were not biased by the age of the subject because the performance of younger and older subjects in the test was similar. The mean duration of the SUN-test was nearly 40 s/ear, and was lower than 1 minute per ear even in subjects older than 80 years so that both ears could be tested, on average, in 2 minutes. The SUN-test was considered easy or slightly difficult by nearly 90% of subjects; test duration was judged short or fair by nearly 95% of subjects, and the overall evaluation of the test was pleasant, or neutral, in more than 90% of subjects. Overall, results of this study indicated that the SUN-test might be feasible for application in adult hearing screening. The test is fast, easy, self convincing, and reflects differences in hearing sensitivity between the tested subjects. The outcomes of the SUN-test were not influenced by the noise level in the test room (up to 65 dB A) indicating that the test, as such, might be feasible to screen adults and older adults both in clinical and in non clinical settings, such as convenient care clinics, hearing aid providers, or pharmacies, where the ambient noise is, typically, not controlled. Full article

Among the most prevalent of chronic conditions affecting older adults globally, hearing loss prevalence is increasing and its impact on society growing. Untreated hearing loss diminishes ones ability to communicate and its strong association with depression and cognitive decline adds further to the burden of hearing loss. Hearing health care is rarely included in the traditional medical exam for older adults, it is typically not considered a risk factor for cognitive decline or falls, and it is not a condition for which routine screening has been recommended by the U.S. Preventive Services Task Force. Yet in older adults, disability typically results from many small risks acting together with different people having a different pattern of multifactorial risk (U.S. Preventive Services Task Force, 2010). The importance of preventive hearing health care in primary care is discussed along with a screening strategy with targeted interventions designed to target older at risk adults. Full article

In this study, we investigated the relation between the use of hearing aids at the initial stages of hearing loss and age-related changes in the auditory and cognitive abilities of elderly persons. 12 healthy elderly persons participated in an annual auditory and cognitive longitudinal examination for three years. According to their hearing level, they were divided into 3 subgroups - the normal hearing group, the hearing loss without hearing aids group, and the hearing loss with hearing aids group. All the subjects underwent 4 tests: pure-tone audiometry, syllable intelligibility test, dichotic listening test (DLT), and Wechsler Adult Intelligence Scale-Revised (WAIS-R) Short Forms. Comparison between the 3 groups revealed that the hearing loss without hearing aids group showed the lowest scores for the performance tasks, in contrast to the hearing level and intelligibility results. The other groups showed no significant difference in the WAIS-R subtests. This result indicates that prescription of a hearing aid during the early stages of hearing loss is related to the retention of cognitive abilities in such elderly people. However, there were no statistical significant correlations between the auditory and cognitive tasks. Full article

Speech auditory brainstem responses (speech ABR) reflect activity that is phase-locked to the harmonics of the fundamental frequency (F0) up to at least the first formant (F1). Recent evidence suggests that responses at F0 in the presence of noise are more robust than responses at F1, and are also dissociated in some learning-impaired children. Peripheral auditory processing can be broadly divided into resolved and unresolved harmonic regions. This study investigates the contribution of these two regions to the speech ABR, and their susceptibility to noise. We recorded, in quiet and in background white noise, evoked responses in twelve normal hearing adults in response to three variants of a synthetic vowel: i) Allformants, which contains all first three formants, ii) F1Only, which is dominated by resolved harmonics, and iii) F2&F3Only, which is dominated by unresolved harmonics. There were no statistically significant differences in the response at F0 due to the three variants of the stimulus in quiet, nor did the noise affect this response with the Allformants and F1Only variants. On the other hand, the response at F0 with the F2&F3Only variant was significantly weaker in noise than with the two other variants (p<0.001). With the response at F1, there was no difference with the Allformants and F1Only variants in quiet, but was expectedly weaker with the F2&F3Only variant (p<0.01). The addition of noise significantly weakened the response at F1 with the F1Only variant (p<0.05), but this weakening only tended towards significance with the Allformants variant (p=0.07). The results of this study indicate that resolved and unresolved harmonics are processed in different but interacting pathways that converge in the upper brainstem. The results also support earlier work on the differential susceptibility of responses at F0 and F1 to added noise. Full article

Current estimates of the prevalence of age-related hearing loss among those over 65 years in the U.S. converge on an overall prevalence rate of approximately 50%, suggesting that there are currently 20 million senior citizens with significant hearing loss (Agrawal et al., 2008; Cruickshanks et al., 1998; Moscicki et al., 1985)[...] Full article

To participate effectively in multi-talker conversations, listeners need to do more than simply recognize and repeat speech. They have to keep track of who said what, extract the meaning of each utterance, store it in memory for future use, integrate the incoming information with what each conversational participant has said in the past, and draw on the listener’s own knowledge of the topic under consideration to extract general themes and formulate responses. In other words, to acquire and use the information contained in spoken language requires the smooth and rapid functioning of an integrated system of perceptual and cognitive processes. Here we review evidence indicating that the operation of this integrated system of perceptual and cognitive processes is more easily disrupted in older than in younger adults, especially when there are competing sounds in the auditory scene. Full article