Personal and social conditions potentially influencing women's hearing loss management.

Little gender-specific data related to hearing loss and hearing loss management are available. The purpose of this investigation was to examine personal and social conditions affecting women at selected stages of the adult life course that may influence hearing loss management. In all, 191 women in three age groups, ranging from 35 to 85 years old, participated. None reported hearing problems. Participants completed a demographic data form and were given a standard audiometric evaluation to confirm age-normal hearing. Each completed assessments of speech understanding in quiet and noise, auditory signal duration discrimination, and binaural processing. Measures of hearing knowledge, behaviors, and attitudes; health-related locus of control; ego strength; and, social support were administered. Results revealed that although some variables deteriorate among subsequent age groups (i.e., hearing thresholds, central auditory processing, and ego strength), the reverse is true for others (i.e., social interaction and satisfaction with income). Age-specific sociodemographic burdens that may interfere with hearing loss management were noted. New psychosocial data are revealed against which women and men with impaired hearing may be compared.

Older adult performance on the Communication Profile for the Hearing Impaired: gender difference.

Gender difference in auditory function with age is well documented. However, little is known about the influence of interacting sensory, psycho-social, and economic variables on adjustment to hearing loss. Adjustment to acquired, mild-to-moderate hearing loss by advantaged older women and men was examined using the Communication Profile for the Hearing Impaired (CPHI) (Demorest & Erdman, 1987). Correlational analyses revealed relationships between scales to be similar for women and men. Controlling for socio-demographic and hearing variables, group responses for the majority of CPHI scales did not differ significantly. Six scales differed significantly, and those results are discussed. When compared to men, women assigned greater importance to effective social communication, were more likely to use nonverbal communication strategies, reported greater anger and stress, and reported greater problem awareness and less denial associated with hearing loss. The CPHI is a useful tool for specifying parameters of perceived communication handicap for both older men and women. Findings underscore the need to consider gender-specific self-assessment of communication and personal adjustment in clinical management of older adults with age-related hearing loss.

Hearing loss, control, and demographic factors influencing hearing aid use among older adults.

Preference for non-use of hearing aids among older adults who are candidates for amplification remains to be explained. Clinical studies have examined the contribution of consumer attitudes, behaviors, and life circumstances to this phenomenon. The present study extends the interests of earlier investigators in that it examines psychological control tendencies in combination with hearing loss and demographic variables among older adults who elected to accept (adherents) or ignore (nonadherents) advice from hearing professionals to acquire and use hearing aids. One hundred thirty-one individuals participated by completing measures of hearing, hearing handicap, psychological control, depression, and ego strength. Participants were asked to provide demographic information and personal opinions regarding hearing aid use. Adherence group and gender differences were noted on measures of hearing sensitivity, psychological control, and demographic factors. Female adherents demonstrated greater hearing loss and poorer word recognition ability but less hearing handicap, higher internal locus of control, higher ego strength, and fewer depressive tendencies than female nonadherents. They reported demographic advantages. Female adherents assumed responsibility for effective communication. Although male adherents and nonadherents did not differ significantly demographically, male adherents were more accepting of their hearing loss, took responsibility for communication problems, and found hearing aids less stigmatizing. Implications for clinical practice and future clinical investigations are identified and discussed. Results are expected to be of interest to clinicians, clinical investigators, and health care policymakers.

Older adult performance on the communication profile for the hearing impaired.

The Communication Profile for the Hearing Impaired (CPHI) (Demorest & Erdman, 1986) is a self-assessment inventory that was developed on a clinical population that included predominantly male, active-duty military personnel. They spanned a 50-year age range (M = 39.5 years) and typically demonstrated bilateral, noise-induced, high-frequency, sensorineural hearing loss. The present study examined CPHI data obtained from approximately equal numbers of advantaged older men and women (M = 75 years) with acquired, mild-moderate, sensorineural hearing loss. Mean, standard deviation, t-test, omega-squared statistics, response frequency distribution, and skewness data are reported. Comparisons of hearing handicap in older adults and generally younger members of the military group are highlighted. Performance differences potentially related to age, personality, lifestyle, and other factors are identified. Results describe the older adult's approach to self-management of hearing loss and associated communication problems. Clinical implications are discussed.

Real-ear measures in evaluation of frequency response and volume control characteristics of telephone amplifiers.

The spectral frequency response, frequency response range, and volume control linearity of five telephone amplifiers were examined using real-ear measures. All measurements were performed in KEMAR's (Knowles Electronics Manikin for Acoustic Research) ear canal using a composite speech-shaped waveform as the stimulus. Spectral frequency response and response range of each device was obtained at four volume control settings and compared to those of a standard telephone receiver. Only two of the amplifiers replicate the spectral frequency response of the standard receiver and show an increase in the amount of gain provided with increasing volume control rotation. The remaining three amplifiers show a more restricted spectral frequency response and response range when compared to those of the standard receiver. The volume control characteristics of the amplifiers were somewhat more uniform. Overall results indicate that the spectral frequency response and response range of telephone amplifiers can be objectively evaluated using real-ear measures, and these measures are essential in determining the usefulness of certain telephone amplifying devices.

Rehabilitation of hearing-handicapped elderly adults.

This paper describes procedures used in the development and implementation of an aural rehabilitation program for hearing-impaired elderly adults. Program emphasis is directed toward meeting the self-perceived needs of this population. Suggestions for ways to enhance the elderly adult's interest in self-management of hearing problems are gleaned from consumer workshop reports as well as clinical observations. Suggestions for identification of program candidates were offered with emphasis on dissemination of informational literature. Intake procedures were described with mention of the client's possible expectations from the program, as well as the program's expectations from the participants. Finally, program goals and procedures were described. Emphasis was directed toward three interrelated goal areas: amplification, communication remediation, and counseling-education. The role of the hearing aid as a critical tool in the rehabilitation process was highlighted. A controlled approach toward communication assessment was described, along with a scheme for determining remediation goals. Topics for personal and family counseling or education were listed along with suggestions for facilitating individual and group discussion.

Normal adult performance on a temporally modified staggered spondaic word task.

Competing syllables in the Staggered Spondaic Work (SSW) test exhibit considerable variation in alignment. These alignment variations have shown discrepant effects on selected subject populations. Since Berlin et al. (1973) found that dichotic presentation of temporally off-set CV syllables may result in improved intelligibility of the trailing syllable, the same lag effect would be expected to influence performance on a staggered spondaic word identification task. The purpose of this study was to examine the effect of temporal alignment of competing syllables in a staggered spondaic word identification task. Forty-eight adults having no prior experience with or knowledge of the SSW test and no history of speech, language, hearing or reading disorders participated in the study. Each subject was administered two recorded versions of the SSW test. One recording contained items as presented on the commercially available test. The second recording contained SSW test items in which competing monosyllables were temporally aligned. Results revealed no significant difference in performance between the two alignment conditions. In addition, no significant ear effect was demonstrated. Variables which may influence subject performance are described.

Situational cue and strategy influence on speechreading.

The influence of situational cues and reasoning strategies on speechreading was studied in normal-hearing and minimally hearing-impaired adults. Everyday Speech Sentences (Davis & Silverman, 1968) produced by a female talker were videotaped without sound in the context of a visual background scene. A non-verbal acoustic signal was matched to each sentence and dubbed onto the recording. Thus, each test item consisted of an inaudible sentence presented with an optical and acoustic situational cue. The experimental task was structured so that subjects speechread sentences using deductive or inductive reasoning strategies. Results demonstrated greater success in speechreading when sentences were matched with related situational cues than when unrelated cues were provided. This difference was noted only when inductive reasoning was used. The findings suggest that situational cues are most useful to the speechreader when he can be assured that a strong relationship exists between the spoken message and the talker's situational background.

Situational cues in visual speech perception by geriatric subjects.

Situational cues have been known to enhance visual speech perception. In the present study the influence of relevant and nonrelevant visual and auditory background information on visual perception of everyday sentences was measured in geriatric subjects using videotaped material. Results indicated that visual speech perception with relevant situational cues was significantly different from performance when nonrelevant cues were provided and when situational cues were absent. Individual subject deviations in performance were noted and their therapeutic implications were presented.

Aided and unaided narrow band noise thresholds in listeners with sensorineural hearing impairment.

This study explored the relationship between narrow band noise thresholds obtained under aided and unaided conditions with normal listeners and with subjects demonstrating sensorineural hearing impairment. Pure-tone and narrow band noise thresholds obtained under earphone conditions were found to approximate each other within 3 dB. Mean noise thresholds obtained in sound field required less sound pressure than thresholds obtained under earphone conditions. In comparing the predicted aided noise thresholds with the observed thresholds, a 4-dB mean difference was found. The close relationship between hearing aid acoustic gain and changes in aided narrow band noise thresholds suggests the use of narrow band noise audiometry in hearing-aid selection when traditional measures cannot be used.

Linguistic background and test material considerations in assessing sentence identification ability in English- and Spanish-English-speaking adolescents.

This study investigated the influence of linguistic background differences on sentence identification by groups of English- and Spanish-English-speaking adolescents. Subjects were required to identify recorded meaningful and nonmeaningful (synthetic) sentences presented in a white noise background using a closed message set-response format. The results indicate that linguistic background variables significantly influence sentence identification ability and that these variables are not adequately controlled for by a closed message set. A significant difference in the ability to identify meaningful and nonmeaningful sentences was revealed. Contrary to previous indications, synthetic sentence identification appeared to be contingent upon key work or phrase recognition.