Paediatric audiology measures for Spanish-speaking patients: current practice & state of knowledge.

OBJECTIVE: The objective of this study was to obtain an understanding of audiologists' knowledge of Spanish speech perception materials for the paediatric hearing loss population. DESIGN: An electronic survey, the Knowledge of Spanish Audiology & Speech Tools (KSAST) was distributed via Qualtrics to audiologists who worked with Spanish-speaking children. STUDY SAMPLE: One hundred and fifty-three audiologists practicing in the United States completed the electronic survey over a period of six months. RESULTS: Audiologists lacked knowledge of current Spanish measures and there was no consensus on what providers were administering for the paediatric population. The largest gaps in knowledge existed for the infancy through early childhood age groups. Notably, even when Spanish measures exist, audiologists reported feeling uncomfortable using them in clinic due to a variety of reasons (e.g., did not know how to access measure, did not know how to administer). CONCLUSIONS: This study highlights the lack of consensus in managing Spanish-speaking patients with hearing loss. There is a lack of validated age-appropriate measures to accurately assess speech perception for Spanish-speaking children. Future research should focus on improving training on management of Spanish-speaking patients, as well as development of speech measures and best practice guidelines for this population.

The role of working memory in speech recognition by hearing-impaired older listeners: does the task matter?

OBJECTIVE: Working memory refers to a cognitive system that holds a limited amount of information in a temporarily heightened state of availability, for use in ongoing cognitive tasks. Research suggests a link between working memory and speech recognition. In this study, we investigated this relationship using two working memory tests that differed in regard to the operationalisation of the link between working memory and attention: the auditory visual divided attention test (AVDAT) and the widely used reading span test. DESIGN: The relationship between speech-in-noise recognition and working memory was examined for two different working memory tests that varied in methodological and theoretical aspects, using a within-subject design. STUDY SAMPLE: Nineteen hearing-impaired older listeners participated. RESULTS: We found a strong link between the reading span test and speech-in-noise recognition and a less robust link between the AVDAT and speech-in-noise recognition. There was evidence for the role of selective attention in speech-in-noise recognition, shown via the new AVDAT measure. CONCLUSION: Our findings suggest that the strength of the relationship between speech-in-noise recognition and working memory may be influenced by the match between the demands and the stimuli of the speech-in-noise task and those of the working memory test.

From asking to observing. Behavioural measures of socio-emotional and motivational skills in large-scale assessments.

Socio-emotional and motivational skills are routinely measured using self-reports in large-scale educational assessments. Measures exploiting test-takers' behaviour during the completion of questionnaires or cognitive tests are increasingly used as alternatives to self-reports in the economics of education literature. We compute behavioural measures of socio-emotional and motivational skills using data from the Programme for International Student Assessment (PISA). We find that these measures capture important aspects of students' academic profiles: some are importantly associated with contemporaneous performance and educational attainment and most measures have a high degree of stability over time. However, these measures are only limitedly correlated among themselves and have low correlations with self-report measures of the same constructs. This is likely a reflection of the fact that behavioural measures are representations of the test taker current 'state', rather than descriptions of the participant view of their own 'trait' like the self-report measures. Moreover, the low correlation across measures suggests that they capture different behavioural responses to the test-taking situation. These differences are still limitedly understood because the measures are constructed ex-post using collateral information collected during the administration of assessments rather than developed ex ante in line with theoretical models of human cognition and affect.

Effects of text supplementation on speech intelligibility for listeners with normal and impaired hearing: a systematic review with implications for telecommunication.

OBJECTIVE: Telecommunication can be difficult in the presence of noise or hearing loss. The purpose of this study was to systematically review evidence regarding the effects of text supplementation (e.g. captions, subtitles) of auditory or auditory-visual signals on speech intelligibility for listeners with normal or impaired hearing. DESIGN: Three databases were searched. Articles were evaluated for inclusion based on the Population Intervention Comparison Outcome framework. The Effective Public Health Practice Project instrument was used to evaluate the quality of the identified articles. STUDY SAMPLE: After duplicates were removed, the titles and abstracts of 2019 articles were screened. Forty-six full texts were reviewed; ten met inclusion criteria. RESULTS: The quality of all ten articles was moderate or strong. The articles demonstrated that text added to auditory (or auditory-visual) signals improved speech intelligibility and that the benefits were largest when auditory signal integrity was low, accuracy of the text was high, and the auditory signal and text were synchronous. Age and hearing loss did not affect benefits from the addition of text. CONCLUSIONS: Although only based on ten studies, these data support the use of text as a supplement during telecommunication, such as while watching television or during telehealth appointments.

Your pain, my gain: The relationship between self-report and behavioral measures of everyday sadism and COVID-19 vaccination intention.

Vaccination plays a crucial role in containing the spread of the COVID-19 pandemic. However, a significant fraction of the global population is reluctant to take a coronavirus vaccine. A burgeoning literature has considered mainly adaptive personality traits as antecedents of vaccine hesitancy (i.e., Big Five and HEXACO), while maladaptive personality traits (i.e., "Dark Tetrad" of personality) are often a comparatively neglected area. In this research, we examined the relationship between everyday sadism and intention to get vaccinated against COVID-19. We theorized that driven by antisocial tendencies and social indifference, individuals with higher sadism may be less willing to obtain a vaccine. Employing a bug-killing paradigm to capture everyday sadism, we tested this prediction in a Chinese sample of non-student adults (N = 188). Support for this proposition was found in the lab task, which demonstrates that sadism was associated with more vaccine refusal spanning the self-report and behavioral domains. In addition, we showed that the sadistic behavioral choices can be predicted with self-report measure of sadistic personality. These findings highlight the important role of maladaptive personality traits in predicting vaccination attitudes and intentions.

A scalable computational approach to assessing response to name in toddlers with autism.

BACKGROUND: This study is part of a larger research program focused on developing objective, scalable tools for digital behavioral phenotyping. We evaluated whether a digital app delivered on a smartphone or tablet using computer vision analysis (CVA) can elicit and accurately measure one of the most common early autism symptoms, namely failure to respond to a name call. METHODS: During a pediatric primary care well-child visit, 910 toddlers, 17-37 months old, were administered an app on an iPhone or iPad consisting of brief movies during which the child's name was called three times by an examiner standing behind them. Thirty-seven toddlers were subsequently diagnosed with autism spectrum disorder (ASD). Name calls and children's behavior were recorded by the camera embedded in the device, and children's head turns were coded by both CVA and a human. RESULTS: CVA coding of response to name was found to be comparable to human coding. Based on CVA, children with ASD responded to their name significantly less frequently than children without ASD. CVA also revealed that children with ASD who did orient to their name exhibited a longer latency before turning their head. Combining information about both the frequency and the delay in response to name improved the ability to distinguish toddlers with and without ASD. CONCLUSIONS: A digital app delivered on an iPhone or iPad in real-world settings using computer vision analysis to quantify behavior can reliably detect a key early autism symptom-failure to respond to name. Moreover, the higher resolution offered by CVA identified a delay in head turn in toddlers with ASD who did respond to their name. Digital phenotyping is a promising methodology for early assessment of ASD symptoms.

Development of the mandarin hearing in noise test for children.

Objectives: To develop a Mandarin version of the Hearing in Noise Test for Children (MHINT-C) and examine the maturational effects on sentence recognition.Design: Sentences suitable for evaluating children aged 6-18 years were selected from the adult MHINT to form 12 lists of 10 MHINT-C sentences (Study 1). List equivalence, inter-list reliability, response variability, and maturational effects on sentence recognition were examined using the MHINT-C (Study 2).Study sample: A total of 246 children aged 6.1-17.11 years were included. Six children participated in Study 1; the rest were included in Study 2. To compare these results with adults, 20 native Mandarin-speaking adults aged 18 or above were included in Study 2.Results: MHINT-C list equivalency, inter-list reliability, and response variability were similar to those of the adult MHINT and the Cantonese HINT for children. Sentence recognition in children reached adult-like performance around age 8 in quiet and at ages 15 and 14 in front and side noise conditions, respectively.Conclusions: The MHINT-C can reliably measure sentence recognition in quiet and noise in Mandarin-speaking children. Age-specific correction factors were established.

Multidimensional assessment of impulsivity-related measures in relation to externalizing behaviors.

BACKGROUND: Trait impulsivity is thought to play a key role in predicting behaviors on the externalizing spectrum, such as drug and alcohol use and aggression. Research suggests that impulsivity may not be a unitary construct, but rather multidimensional in nature with dimensions varying across self-report assessments and laboratory behavioral tasks. Few studies with large samples have included a range of impulsivity-related measures and assessed several externalizing behaviors to clarify the predictive validity of these assessments on important life outcomes. METHODS: Community adults (N = 1295) between the ages of 30 and 54 completed a multidimensional assessment of impulsivity-related traits (including 54 self-report scales of personality traits implicated in impulsive behaviors, and four behavioral tasks purporting to assess a construct similar to impulsivity) and reported on five externalizing behavioral outcomes (i.e. drug, alcohol, and cigarette use, and physical and verbal aggression). We ran an exploratory factor analysis on the trait scales, and then a structural equation model predicting the externalizing behaviors from the three higher-order personality factors (i.e. Disinhibition v. Constraint/Conscientiousness, Neuroticism/Negative Emotionality, and Extraversion/Positive Emotionality) and the four behavioral tasks. RESULTS: Relations between the self-report factors and behavioral tasks were small or nonexistent. Associations between the self-report factors and the externalizing outcomes were generally medium to large, but relationships between the behavioral tasks and externalizing outcomes were either nonexistent or small. CONCLUSIONS: These results partially replicate and extend recent meta-analytic findings reported by Sharma et al. (2014) to further clarify the predictive validity of impulsivity-related trait scales and laboratory behavioral tasks on externalizing behaviors.

Development of a hearing help-seeking questionnaire based on the theory of planned behavior.

OBJECTIVE: Our objective was to develop and assess a questionnaire measuring the constructs of the theory of planned behaviour (TPB) regarding older adults' behaviours towards seeking a hearing test. DESIGN: Older adults who failed a hearing screening completed a newly developed Theory of Planned Behavior-Hearing Help Seeking (TPB-HHS) questionnaire. A principal components analysis (PCA) examined the factor structure of the questionnaire, and a reliability analysis determined the internal consistency of the factors. An examination of six-month follow-up data determined whether the questionnaire differentiated between individuals who did and did not seek out a hearing test by comparing their TPB-HHS scores. STUDY SAMPLE: Participants were 407 adults aged 50 to 89 recruited at community hearing screenings. RESULTS: PCA and reliability analyses resulted in a 4-factor, 18 item questionnaire. Three of four factors demonstrated acceptable internal consistency. The TPB-HHS explained 60.18% of the variance and factors were interpreted to be measuring the constructs of Intentions, Perceived Behavioral Control, Attitudes, and Subjective Norms. Individuals who sought a hearing test scored significantly higher on the Intentions, Perceived Behavioral Control, and Attitudes scales than those who did not. CONCLUSIONS: The TPB-HHS provides insight into underlying psychological mechanisms that drive behaviours related to hearing help-seeking in older adults.

Development and validation of an item response theory-based Social Responsiveness Scale short form.

BACKGROUND: Research and practice in autism spectrum disorder (ASD) rely on quantitative measures, such as the Social Responsiveness Scale (SRS), for characterization and diagnosis. Like many ASD diagnostic measures, SRS scores are influenced by factors unrelated to ASD core features. This study further interrogates the psychometric properties of the SRS using item response theory (IRT), and demonstrates a strategy to create a psychometrically sound short form by applying IRT results. METHODS: Social Responsiveness Scale analyses were conducted on a large sample (N = 21,426) of youth from four ASD databases. Items were subjected to item factor analyses and evaluation of item bias by gender, age, expressive language level, behavior problems, and nonverbal IQ. RESULTS: Item selection based on item psychometric properties, DIF analyses, and substantive validity produced a reduced item SRS short form that was unidimensional in structure, highly reliable (α = .96), and free of gender, age, expressive language, behavior problems, and nonverbal IQ influence. The short form also showed strong relationships with established measures of autism symptom severity (ADOS, ADI-R, Vineland). Degree of association between all measures varied as a function of expressive language. CONCLUSIONS: Results identified specific SRS items that are more vulnerable to non-ASD-related traits. The resultant 16-item SRS short form may possess superior psychometric properties compared to the original scale and emerge as a more precise measure of ASD core symptom severity, facilitating research and practice. Future research using IRT is needed to further refine existing measures of autism symptomatology.

Usage of personal music players in adolescents and its association with noise-induced hearing loss: A cross-sectional analysis of Ohrkan cohort study data.

OBJECTIVE: To describe personal music player (PMP) usage among adolescents, sociodemographic determinants and association with audiometric notches. DESIGN: Audiometric evaluation to assess hearing status, and standardized questionnaires to evaluate PMP listening behaviors, leisure noise exposures and self-reported hearing loss symptoms. Sociodemographic information was collected using a parent questionnaire. Noise exposure by PMP usage equivalent for a 40 h week was estimated based on self-reported volume and duration of use. STUDY SAMPLE: A total of 2143 students (54% females) attending 9th grade in Regensburg, Germany, during 2009 to 2011. RESULTS: Overall, 85% of the students reported using PMPs. Exposure level exceeded 80 dB(A) in approximately one third, and 85 dB(A) in one quarter, of those who used PMP. An audiometric notch was found in 2.3% of participants, but was not significantly associated with higher PMP exposure. CONCLUSIONS: PMP exposure above the occupational limits of 80 and 85 dB(A) set by the Directive 2003/10/EC may be a risk factor for developing noise-induced hearing loss. Educational measures to ameliorate high risk behaviors in PMP usage are needed, particularly for socially disadvantaged groups.

Use of noise cancellation earphones in out-of-booth audiometric evaluations.

OBJECTIVE: To assess the utility of noise cancelation earphones (NCE) in audiometric evaluations. DESIGN: Degree of noise reduction of Bose QuietComfort 15 NCE was assessed through probe-microphone measures and sound-field audiometry. Occlusion effects from NCE were assessed for potential effects on bone-conduction thresholds. STUDY SAMPLE: Twenty participants were tested to determine average occlusion effect values during bone-conduction testing with and without NCE. Noise reduction values of the NCE were assessed on a single subject through probe-microphone measures and sound-field testing. RESULTS: NCE sufficiently reduced ambient noise to levels acceptable for air-conduction testing as well as for bone-conduction testing for most patients when adding minimal adjustment to acceptable levels as outlined by the ANSI S3.1-1999 standard. In addition, NCE did not create a clinically significant change in the occlusion effect for bone-conduction testing. CONCLUSION: NCE placed over insert earphones provide a sound pressure level at the tympanic membrane that is below ANSI standards for routine air-conduction testing and result in sufficient ambient noise reduction for bone-conduction testing with most patients. There is no clinically significant occlusion effect from NCE during routine bone-conduction audiometry. These findings support the utility of using NCE for offsite audiometric testing.

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

OBJECTIVE: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR. DESIGN: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject. STUDY SAMPLE: Twenty hearing-impaired test subjects participated over two visits. RESULTS: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ± 45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from -4.0 to 3.3 dB. CONCLUSION: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3 dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.

Hearing protector fit testing with off-shore oil-rig inspectors in Louisiana and Texas.

OBJECTIVE: This field study aimed to assess the noise reduction of hearing protection for individual workers, demonstrate the effectiveness of training on the level of protection achieved, and measure the time required to implement hearing protector fit testing in the workplace. DESIGN: The National Institute for Occupational Safety and Health (NIOSH) conducted field studies in Louisiana and Texas to test the performance of HPD Well-Fit. STUDY SAMPLE: Fit tests were performed on 126 inspectors and engineers working in the offshore oil industry. RESULTS: Workers were fit tested with the goal of achieving a 25-dB PAR. Less than half of the workers were achieving sufficient protection from their hearing protectors prior to NIOSH intervention and training; following re-fitting and re-training, over 85% of the workers achieved sufficient protection. Typical test times were 6-12 minutes. CONCLUSIONS: Fit testing of the workers' earplugs identified those workers who were and were not achieving the desired level of protection. Recommendations for other hearing protection solutions were made for workers who could not achieve the target PAR. The study demonstrates the need for individual hearing protector fit testing and addresses some of the barriers to implementation.

An initial investigation into the validity of a computer-based auditory processing assessment (Feather Squadron).

OBJECTIVE: This research investigates a novel method for identifying and measuring school-aged children with poor auditory processing through a tablet computer. DESIGN: Feasibility and test-retest reliability are investigated by examining the percentage of Group 1 participants able to complete the tasks and developmental effects on performance. Concurrent validity was investigated against traditional tests of auditory processing using Group 2. STUDY SAMPLE: There were 847 students aged 5 to 13 years in group 1, and 46 aged 5 to 14 years in group 2. RESULTS: Some tasks could not be completed by the youngest participants. Significant correlations were found between results of most auditory processing areas assessed by the Feather Squadron test and traditional auditory processing tests. Test-retest comparisons indicated good reliability for most of the Feather Squadron assessments and some of the traditional tests. CONCLUSIONS: The results indicate the Feather Squadron assessment is a time-efficient, feasible, concurrently valid, and reliable approach for measuring auditory processing in school-aged children. Clinically, this may be a useful option for audiologists when performing auditory processing assessments as it is a relatively fast, engaging, and easy way to assess auditory processing abilities. Research is needed to investigate further the construct validity of this new assessment by examining the association between performance on Feather Squadron and objective evoked potential, lesion studies, and/or functional imaging measures of auditory function.

Refining the audiological assessment in children using narrow-band CE-Chirp-evoked auditory steady state responses.

OBJECTIVE: To demonstrate the feasibility and reliability of simultaneous binaural recording of auditory steady-state responses (ASSR) in young children using narrow-band CE-Chirps as stimuli. DESIGN: Prospective cohort study comparing ASSR thresholds to four frequency stimuli (0.5, 1, 2, and 4 kHz), with click-evoked auditory brainstem responses (ABR) and behavioral response audiometry. STUDY SAMPLE: Thirty-two young children (mean age 7.4 ± 5.2 months) referred for auditory assessment were evaluated. RESULTS: The mean duration for ABR recordings was 13.3 ± 7.2 min versus 22.9 ± 15.8 min for ASSR (p < 0.01). ASSR (means of 2 and 4 kHz thresholds) were highly correlated with ABR thresholds (R2 = 0.935, p < 0.001), though significantly different (3 ± 10.7 dB, p = 0.02). ASSR (means of 0.5, 1, 2, and 4 kHz thresholds) were highly correlated with mean behavioral response audiometry thresholds (R2 = 0.968, p < 0.001). ASSRs were highly and significantly correlated with behavioral response audiometry at 0.5, 1, 2, and 4 kHz (R2 = 0.845, 0.907, 0.929, and 0.859 respectively, p < 0.001). 87.5% and 90.7% ASSR thresholds were within a ± 10 dB range around their corresponding ABR and mean behavioral response audiometry thresholds. CONCLUSIONS: Narrow-band CE-Chirps allow a fast and reliable assessment of auditory thresholds in children, especially in the low-frequency range, by comparison with other stimuli.

Dichotic listening training in children with autism spectrum disorder: A single subject design.

OBJECTIVE: Previous research has shown that dichotic listening training has improved auditory and language processing for individuals with large interaural asymmetries on dichotic listening tasks. This training can be a useful treatment for children with autism spectrum disorder (ASD). DESIGN: A single subject, multiple baseline across subjects study was utilized. STUDY SAMPLE: Three children with ASD, between the ages of 8-12, participated in the study. RESULTS: This training demonstrated improvement in language and auditory processing tasks following completion of up to twelve weeks of auditory training. CONCLUSION: This study supports the idea that deficit specific, dichotic auditory training can remediate auditory and language deficits for children with ASD. More research is needed, with a group design and controls, in order to generalize these results to the larger ASD population.

International Collegium of Rehabilitative Audiology (ICRA) recommendations for the construction of multilingual speech tests. ICRA Working Group on Multilingual Speech Tests.

OBJECTIVE: To provide guidelines for the development of two types of closed-set speech-perception tests that can be applied and interpreted in the same way across languages. The guidelines cover the digit triplet and the matrix sentence tests that are most commonly used to test speech recognition in noise. They were developed by a working group on Multilingual Speech Tests of the International Collegium of Rehabilitative Audiology (ICRA). DESIGN: The recommendations are based on reviews of existing evaluations of the digit triplet and matrix tests as well as on the research experience of members of the ICRA Working Group. They represent the results of a consensus process. RESULTS: The resulting recommendations deal with: Test design and word selection; Talker characteristics; Audio recording and stimulus preparation; Masking noise; Test administration; and Test validation. CONCLUSIONS: By following these guidelines for the development of any new test of this kind, clinicians and researchers working in any language will be able to perform tests whose results can be compared and combined in cross-language studies.

Effects of tonal language background on tests of temporal sequencing in children.

OBJECTIVE: The aims of the present study were to determine the effects of language background on the performance of the pitch pattern sequence test (PPST) and duration pattern sequence test (DPST). As temporal order sequencing may be affected by age and working memory, these factors were also studied. DESIGN: Performance of tonal and non-tonal language speakers on PPST and DPST were compared. STUDY SAMPLE: Twenty-eight native Mandarin (tonal language) speakers and twenty-nine native Malay (non-tonal language) speakers between seven to nine years old participated in this study. RESULTS: The results revealed that relative to native Malay speakers, native Mandarin speakers demonstrated better scores on the PPST in both humming and verbal labeling responses. However, a similar language effect was not apparent in the DPST. An age effect was only significant in the PPST (verbal labeling). Finally, no significant effect of working memory was found on the PPST and the DPST. CONCLUSION: These findings suggest that the PPST is affected by tonal language background, and highlight the importance of developing different normative values for tonal and non-tonal language speakers.

A cognitive therapy program for hearing-impaired employees suffering from mental distress.

OBJECTIVE: To develop a cognitive therapy program to reduce mental distress among hearing-impaired employees. DESIGN: In a pilot study we measured the development of mental distress and avoidant coping among hearing-impaired employees. Levels of mental distress were assessed using the hospital anxiety and depression scale (HAD), and the extent of avoidance with conversation tactics checklist CONV(AVOID). The findings were compared with the development in a treatment as usual (TAU) sample. STUDY SAMPLE: Fifteen participants with an equal distribution of male and female participants (M = 49.2 years) took part. The majority had mild to moderate hearing impairment. RESULTS: The program appeared to be feasible and the adherence was good. The mean depression score was identical at pre- and post-intervention in the intervention group, and increased from 2.9 (SD 2.1) to 3.1 (SD 2.0) in the TAU group. Symptoms of anxiety (p < 0.01, 95 % CI (.82, 3.98)) and avoidant communication (p < 0.05, 95% CI (.5, 4.61)) decreased significantly in the intervention group, while an opposite pattern was observed during the TAU program. CONCLUSIONS: The program showed promising results. However, the preliminary results should be further investigated in a randomized controlled trial using a larger sample.