Focusing on Positive Listening Experiences Improves Speech Intelligibility in Experienced Hearing Aid Users.

Negativity bias is a cognitive bias that results in negative events being perceptually more salient than positive ones. For hearing care, this means that hearing aid benefits can potentially be overshadowed by adverse experiences. Research has shown that sustaining focus on positive experiences has the potential to mitigate negativity bias. The purpose of the current study was to investigate whether a positive focus (PF) intervention can improve speech-in-noise abilities for experienced hearing aid users. Thirty participants were randomly allocated to a control or PF group (N = 2 × 15). Prior to hearing aid fitting, all participants filled out the short form of the Speech, Spatial and Qualities of Hearing scale (SSQ12) based on their own hearing aids. At the first visit, they were fitted with study hearing aids, and speech-in-noise testing was performed. Both groups then wore the study hearing aids for two weeks and sent daily text messages reporting hours of hearing aid use to an experimenter. In addition, the PF group was instructed to focus on positive listening experiences and to also report them in the daily text messages. After the 2-week trial, all participants filled out the SSQ12 questionnaire based on the study hearing aids and completed the speech-in-noise testing again. Speech-in-noise performance and SSQ12 Qualities score were improved for the PF group but not for the control group. This finding indicates that the PF intervention can improve subjective and objective hearing aid benefits.

Automated Speech Audiometry: Can It Work Using Open-Source Pre-Trained Kaldi-NL Automatic Speech Recognition?

A practical speech audiometry tool is the digits-in-noise (DIN) test for hearing screening of populations of varying ages and hearing status. The test is usually conducted by a human supervisor (e.g., clinician), who scores the responses spoken by the listener, or online, where software scores the responses entered by the listener. The test has 24-digit triplets presented in an adaptive staircase procedure, resulting in a speech reception threshold (SRT). We propose an alternative automated DIN test setup that can evaluate spoken responses whilst conducted without a human supervisor, using the open-source automatic speech recognition toolkit, Kaldi-NL. Thirty self-reported normal-hearing Dutch adults (19-64 years) completed one DIN + Kaldi-NL test. Their spoken responses were recorded and used for evaluating the transcript of decoded responses by Kaldi-NL. Study 1 evaluated the Kaldi-NL performance through its word error rate (WER), percentage of summed decoding errors regarding only digits found in the transcript compared to the total number of digits present in the spoken responses. Average WER across participants was 5.0% (range 0-48%, SD = 8.8%), with average decoding errors in three triplets per participant. Study 2 analyzed the effect that triplets with decoding errors from Kaldi-NL had on the DIN test output (SRT), using bootstrapping simulations. Previous research indicated 0.70 dB as the typical within-subject SRT variability for normal-hearing adults. Study 2 showed that up to four triplets with decoding errors produce SRT variations within this range, suggesting that our proposed setup could be feasible for clinical applications.

[Analysis of hearing aids application in elderly patients.]

The aim of the study is to evaluate the possibility to implement machine learning to create a digital auditory profile for elderly patients and to analyze the hearing aid fitting efficacy depending on involvement of the peripheral and central auditory pathways in a pathological process. Data analysis of 375 people aged 60-93 years is presented. 355 patients with chronic bilateral hearing loss (230 of them used hearing aids) were included in the main group, and 20 normal hearing elderly people were included in the control group. Audiological examination consisted of standard tests (pure tone audiometry, impedancemetry, speech audiometry in quiet) and tests to evaluate the central auditory processing (binaural fusion, dichotic digits, speech audiometry in noise, random gap detection). The Montreal Cognitive Assessment was used to detect cognitive impairment. The hearing aid fitting efficiency was evaluated with COSI questionnaire and speech audiometry in free field. Processing of the results was carried out using Pearson's correlation analysis aimed at creating a polynomial model of a patient's hearing on the basis of the limited test battery. There were close correlations between the state of cognitive functions and age, results of tests to evaluate the central auditory processing, as well as patients' satisfaction of hearing aid. The results of the work indicate the possibility of using computer technologies of data analysis to develop rehabilitation programs for elderly hearing impaired patients.

Further Evaluation of a Protocol for Integrated Speech Audiometry.

PURPOSE: When a bilateral evaluation is conducted with the integrated speech protocol described in Punch and Rakerd (2019), testing for the first ear concludes with a measurement of the uncomfortable loudness level for speech (UCL). The purpose of this study was to assess the possibility that exposure to the high speech intensities required for that UCL test might bias the subsequent measurement of a listener's most comfortable loudness level for speech (MCL) in the opposite ear. METHOD: Across 32 test runs, the left and right ear MCLs were established for 16 young adult listeners with normal hearing (five women, 11 men). The MCL assessed on each test run was measured twice. The first measurement was made at the start of the run and before a full integrated speech evaluation was conducted in the opposite ear (pretest); the second was made after that evaluation (posttest). RESULTS: The difference between the MCL means measured on the pretest (37.7 dB) and the posttest (38.5 dB) was less than 1 dB, and it did not approach statistical significance, t(15) = 0.69, p = .50. CONCLUSIONS: There was no evidence that UCL testing done in one ear on a bilateral speech test will have carryover effects that bias the subsequent measurement of a listener's MCL in the other ear. The results, therefore, support the potential clinical use of an integrated protocol when conducting bilateral speech audiometric evaluations.

Clinical utility of response time in speech audiometry in elderly with mild cognitive impairment.

OBJECTIVES: This study investigated whether verbal response time (RT) as a measure of listening effort in speech audiometry could be an indicator for identifying elderly individuals with mild cognitive impairment (MCI). DESIGN: Korean sentence recognition tests were conducted in favourable (+5 dB signal-to-noise ratio [SNR]) and adverse (-5 dB SNR) conditions in the presence of noise. Sentence recognition scores (SRSs) and RTs for the two groups were measured and analysed with other demographic variables. STUDY SAMPLES: Fourteen elderly adults who were diagnosed with MCI and 14 age-matched adults with normal cognition participated in this study. RESULTS: No statistical difference was found between the SRSs of the two groups. RTs for the MCI elderly were significantly longer than the control group. We found significant correlations of RTs with SRSs, Korean Mini-Mental State Examination (K-MMSE) scores, and age at -5 dB SNR. Only the SRSs were correlated with the RTs at +5 dB SNR. CONCLUSIONS: This study found that elderly individuals with MCI need a longer time for sentence recognition in noise. These findings suggest that measuring RT in speech audiometry could potentially be a cost-effective and time-saving method that could characterise elderly with MCI at hearing-care clinics.

Benefits of amplification for unaided speech discrimination in age-related hearing loss with flat type audiogram.

OBJECTIVE: The present study aimed to investigate whether hearing aid use can induce improvement as acclimatization effect in unaided speech perception in patients with age-related hearing loss. METHODS: Fifty ears in 41 patients (age range: 65-91 years) diagnosed as age-related hearing loss were enrolled in this study. They used hearing aids for more than 8 hours per day. Unaided speech audiometry using 67-S Japanese monosyllabic word list was performed one or two years after the commencement of hearing aid use. The changes in the unaided speech discrimination score before and after the commencement of hearing aid use were analyzed. To investigate factors for improvement, the patients' backgrounds in terms of age, sex, pure tone average, unaided maximum speech discrimination score, fitting period (one year/two years), fitting ear (bilateral/unilateral), audiogram type (flat-type/other-type), and the level of amplification were also analyzed. RESULTS: Significant improvement in the unaided speech discrimination score after hearing aid use was seen only in the flat-type audiogram group. More than half of older patients in the flat-type audiogram group improved their unaided maximum speech discrimination score 10 % or more. The analysis of aided hearing thresholds revealed that the flat-type audiogram group had significantly lower thresholds of 3kHz and 4kHz than the other-type audiogram group. The age, sex, pure tone average, fitting period, fitting ear, functional gain were not influential factors for improvement. On the other hand, unaided maximum speech discrimination score before using hearing aid and aided hearing threshold at 4kHz had a negative correlation with improvement. CONCLUSION: The findings suggested that older patients with age-related hearing loss whose audiogram is a flat type can benefit from amplification as means of improving their unaided speech perception since flat-type audiogram can be more easily adjusted to sufficiently amplify speech sound at high frequencies. It should be considered that the potential for experience-dependent plasticity is retained even in older adults.

Associations between aided speech audiometry and subjective assessment of hearing aid outcomes.

OBJECTIVE: This study aimed to analyse outcomes with hearing aid (HA) use and to determine whether common audiological tests, including pure-tone audiometry or word recognition test, correlate with HA wearers' subjective benefit. DESIGN: A retrospective chart review. STUDY SAMPLE: A total of 129 patients who adopted new HAs between January 2011 and December 2018 were enrolled. Outcome measures including pure tone thresholds, word recognition score (WRS), and self-reported questionnaires were obtained 1, 4, and 12 months post fit. RESULTS: The mean aided threshold and WRS at each post-fit visit significantly improved from the unaided condition. Self-reported outcomes confirmed by the Hearing Handicap Inventory for the Elderly (HHIE) scores significantly improved compared to the unaided condition at 1- and 4-month follow-up. Results of the regression analysis indicated that the aided WRS score is a significant factor at all post-fit visits that explains less than 10% of the variance in HHIE scores. CONCLUSIONS: Aided WRS is the factor most associated with subjectively reported HA outcomes, both in the short- and long term. Therefore, aided WRS should be considered as a useful tool for evaluating HA benefits, even after the prolonged use of HAs.

[OLSA level control in monaural speech audiometry in background noise for the evaluation of the CI fitting result]. / OLSA-Pegelsteuerung bei monauraler Sprachaudiometrie im Störschall zur Evaluation des CI-Versorgungsergebnisses.

SCIENTIFIC BACKGROUND: Speech audiometry measurements under the influence of background noise are a fundamental part of evaluating the outcome of hearing care. As yet far, there are no recommendations for selecting a suitable method for adaptive speech audiometry measurements in background noise in cochlear implant (CI) care, so either the choice the adaptive level change of the speech signal (S) with constant noise (N) or the adaptive level change of N with constant S. OBJECTIVES: Do the measurement results of the monaural speechrecognition threshold in noise (SRT) with the Oldenburg Sentence Test (OLSA) depend on the choice of level control? MATERIAL AND METHODS: A total of 50 series of measurements with OLSA in noise and the Freiburg speech intelligibility test in quiet (FBE) on middle-aged CI patients from clinical routine. RESULTS: There is no significant difference in the measurement results with different level controls when the SRT is less than 5 [Formula: see text]. Below 55 % monosyllabic intelligibility in quiet, the SRT in noise becomes greater than 5 [Formula: see text]. CONCLUSION: From a clinical, audiological and methodological point of view, it is advisable to carry out the adaptive monaural speech intelligibility measurement with a constant speech signal at 65 [Formula: see text].

Development and Validation of a Mandarin Chinese Adaptation of AzBio Sentence Test (CMnBio).

A new sentence recognition test in Mandarin Chinese was developed and validated following the principles and procedures of development of the English AzBio sentence materials. The study was conducted in two stages. In the first stage, 1,020 sentences spoken by 4 talkers (2 males and 2 females) were processed through a 5-channel noise vocoder and presented to 17 normal-hearing Mandarin-speaking adults for recognition. A total of 600 sentences (150 from each talker) in the range of approximately 62 to 92% correct (mean = 78.0% correct) were subsequently selected to compile 30, 20-sentence lists. In the second stage, 30 adult CI users were recruited to verify the list equivalency. A repeated-measures analysis of variance followed by the post hoc Tukey's test revealed that 26 of the 30 lists were equivalent. Finally, a binomial distribution model was adopted to account for the inherent variability in the lists. It was found that the inter-list variability could be best accounted for with a 65-item binomial distribution model. The lower and upper limits of the 95% critical differences for one- and two-list recognition scores were then generated to provide guidance for detection of a significant difference in recognition scores in clinical settings. The final set of 26 equivalent lists contains sentence materials more difficult than those found in other speech audiometry materials in Mandarin Chinese. This test should help minimize the ceiling effects when testing sentence recognition in Mandarin-speaking CI users.

[Hearing tests in practice : Audiometric masking in pure-tone and speech audiometry]. / Hörtests in der Praxis : Vertäubung in der Ton- und Sprachaudiometrie.

Correct execution of hearing tests is essential for audiologic diagnostics and selection of treatment by the ENT physician. Especially in the case of pure-tone and speech audiometry, incorrectly performed audiometric masking can lead to false measurement results. Often, hearing that is too good is feigned by overhearing in the contralateral ear. Herein, a masking strategy is described by which errors in the execution of masking can be recognized and corrected. The aim of this paper is to identify and prevent the most common errors made during the masking process in pure-tone and speech audiometry.

Automated Speech Audiometry for Integrated Voice Over Internet Protocol Communication Services.

PURPOSE: Problems in speech recognition are often apparent in telecommunication situations. For ecologically valid assessments of such conditions, it is important to quantify the impact of real environments including acoustic conditions at a far-end communication device and all paths of transmission degradation. This study presents an automated matrix sentence test procedure based on automatic speech recognition (ASR) integrated in a Voice over Internet Protocol (VoIP) infrastructure and compares the individual effects of transmission degradations with results from laboratory measurements. METHOD: Speech recognition thresholds (SRTs) were measured in 16 normal-hearing subjects in four test conditions: (a) a laboratory condition guided by a human experimenter, (b) a laboratory condition with reduced bandwidth and (c) additionally reduced headset quality to simulate typical communication systems, and (d) an automated, ASR-controlled adaptive test procedure over a real VoIP infrastructure. Errors of the ASR system were analyzed to show possible effects on measurement outcome Results: Measured SRTs showed a highly significant correlation (r = .93) between the fully automatic and "laboratory" conditions, with a constant bias of about 1 dB indicating a linear shift of the data without affecting the distribution around the mean. The individual impact of the different system degradations on SRTs could be quantified Conclusions: This study provides a proof of concept for automated ASR-based SRT measurements over VoIP systems for speech audiometric testing in real communication systems, as it produced results comparable to traditional laboratory settings for this group of 16 normal-hearing subjects. This makes VoIP services a promising candidate for speech audiometric testing in real communication systems.

Extended wear hearing aids: a comparative, pilot study.

PURPOSE: The study evaluated if there were differences between three types of hearing aids, Lyric extended wear (EW), receiver-in-the-ear canal (RITE), completely-in-the-canal (CIC) hearing aids in terms of audiological and psychosocial outcomes. METHODS: Fifteen patients were selected. INCLUSION CRITERIA: Pure-Tone Average (PTA) air conduction range of hearing threshold at 500, 1000, and 2000 Hz from 15 dB HL to 75 dB HL. Patients were assigned in three groups according to the hearing aid used: Extended wear, RITE, and CIC. Pure-tone audiometry, speech audiometry, free-field pure-tone and speech audiometry with hearing aids, and Matrix sentence test were performed. The Satisfaction with Amplification in Daily Life (SADL) questionnaire and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire were used to assess the psychosocial and audiological benefits provided by hearing aids. RESULTS: No differences were demonstrated in the Matrix sentence test between the groups. A statistically significant difference was present between the "Personal image" of patients with EW and RITE with a p value of 0.01 (better outcome using EW). For the APHAB questionnaire, a significant difference was present in the "Aversiveness" of the patients with EW in comparison to CIC and RITE with a p value of 0.01 (higher aversiveness of sound using EW). CONCLUSION: In terms of audiological advantage, extended ear hearing aids are similar to RITE and CIC as demonstrated from the Matrix speech reception threshold. The result was confirmed using the APHAB questionnaire. Extended wear devices are better than daily hearing aids concerning the "personal image".

[Correlation between the APHAB questionnaire and the Freiburg monosyllabic test without + with noise]. / Korrelationen zwischen dem APHAB-Fragebogen und dem Freiburger Einsilbertest ohne und mit Störschall.

BACKGROUND: Questionnaires, e. g. the APHAB, and speech-audiometry are the most used elements in measuring the success of hearing aid fitting (HAF). This study investigates the correlations between the results of the Freiburg monosyllabic word test without and with noise (FBE, FBE-S) and the results of the APHAB before and after HAF. METHODS: Data of the FBE, the FBE-S, and the APHAB, generated within HAF of 156 subjects were analyzed. After exclusion of a normal distribution of the data, Spearman's correlation and Cohen's effect size were determined. RESULTS: 73 (46.8 %) of the 156 subjects were females, and 83 (53.2 %) males. No significant correlation could be found between the EC-, the RV-, and the cumulative ECBNRV-subscale and the benefit of HAF in the FBE and FBE-S (EC: ease of communication, BN: background noise, RV: reverberation). Most of the remaining coefficients of correlation had a weak positive effect size. A middle positive effect size could only be demonstrated for 6 combinations, for the EC-subscale mostly. CONCLUSION: The not strong effect sizes could assume that the results in speech-audiometry and the APHAB are not independent and complementing each other as parameters of hearing loss and benefit in HAF. The effect size could be explained by individually different possibilities for the compensation of hearing loss.

Speech audiometry in noise: SNR Loss per age-group in normal hearing subjects.

OBJECTIVES: The present study aimed to determine normal SNR values per age group for the 50% speech reception threshold in noise (SNR Loss) on the VRB (Vocale Rapide dans le Bruit: rapid speech in noise) test. MATERIAL AND METHODS: Two hundred patients underwent pure-tone threshold and VRB speech-in-noise audiometry. Six ages groups were distinguished: 20-30, 30-40, 40-50, 50-60, 60-70 and>70 years. All subjects had normal hearing for age according to ISO 7029. SNR Loss was measured according to age group. RESULTS: Mean SNR Loss ranged from -0.37dB in the youngest age group (20-30 years) to +6.84dB in the oldest (>70 years). Range and interquartile range increased with age: 3.66 and 1.49dB respectively for 20-30 year-olds; 6 and 3.5dB for>70 year-olds. Linear regression between SNR Loss and age showed a coefficient R2 of 0.83. CONCLUSION: The present study reports SNR Loss values per age group in normal-hearing subjects (ISO 7029), confirming that SNR Loss increases with age. Scatter also increased with age, suggesting that other age-related factors combine with inner-ear aging to impair hearing in noise.

Speech Audiometrical Results Before and After Reimplantation of Cochlear Implants.

OBJECTIVES: This study aimed to compare the audiological outcomes of cochlear reimplantation with those of the first cochlear implant (CI). DESIGN: A retrospective analysis was performed on the data of all CI recipients who received the first CI at the age of 8 years or above and who were subsequently reimplanted on the same side. All participants who received their first implant after January 1, 2000, and who were reimplanted before January 1, 2021, were included. CI recipients who were unable to perform an open-set of Flemish monosyllable speech audiometry were excluded. The participants' clinical files were reviewed in terms of the cause of hearing loss, age at the first and second implantation, device types, the time between the first and second surgery, speech reception scores before and after reimplantation, and the reason for reimplantation. RESULTS: Reimplantation was due to device failure in 19 out of 22 patients, performance decrement in two patients, and medical reasons in one patient. The interval between the first and second CI ranged from 8 to 218 mo. Within-subject analysis showed the speech reception performance with the second CI to be significantly better than that with the first CI at all follow-up time points, with average within-patient gains of 17%, 16%, 12%, and 15% at 3 mo, 9 mo, 3 years, and the highest scores achieved, respectively. After reimplantation, the performance was better than the last results before reimplantation, and this was significant from 9 mo after reimplantation onwards. Three patients (14%) had a performance degradation with the second CI, which was probably owing to (1) difficulties in reimplantation surgery leading to a reduced number of active channels, (2) insufficient experience with the second CI as the reimplantation has been performed recently, and (3) advanced fenestral and retrofenestral otosclerosis. CONCLUSIONS: The present study shows that speech reception performance after reimplantation yields faster and better results than the first implant. It takes a couple of months to get better results than those before the reimplantation. Only in a minority of participants, a small deterioration may be observed. It seems that soft failures in the absence of measurable technical abnormalities call for caution with regard to reimplantation.

Audiología pediátrica: el arte de armar rompecabezas / Pediatric Audiology: The Art of Putting Puzzles Together

La audición funcional ­para fines prácticos­ consiste en la posibilidad de despertar sensaciones precisas en regiones específicas del cerebro, a partir del procesamiento y extracción de mensajes ocultos en los cambios en la presión de las moléculas del aire que nos rodea. Medir la funcionalidad de la audición en un ser humano se convierte en un reto titánico que implica que nuestra vida profesional transcurra analizando información tanto subjetiva como objetiva de nuestros pacientes, ambas con un valor diagnóstico innegable. En cuanto a la primera, la historia clínica, las observaciones de la conducta auditiva del paciente, los reportes de la casa, la escuela y la terapia, o de estudios como la audiometría tonal y la logoaudiometría, resultan fundamentales no solo para el diagnóstico, sino para el seguimiento de nuestros pacientes. Sin embargo, en el caso de los pacientes más pequeños, o ante la necesidad de evaluar aspectos como la presión del oído medio, la función de las células ciliadas, o la presencia de microfónica coclear, la utilidad de esas herramientas subjetivas se encuentra limitada y entonces los registros, trazos, curvas y cifras relativas a intensidades, presiones, latencias, frecuencias, amplitudes y demás datos obtenidos a través de estudios objetivos, son los recursos que usamos para diagnosticar e iniciar la habilitación o rehabilitación de nuestros pacientes.

Functional hearing ­ for practical purposes ­ consists of the possibility of awakening precise sensations in specific regions of the brain from the processing and extraction of hidden messages in changes in the pressure of the molecules of the air that surrounds us. Measuring the functionality of hearing in a human being becomes a titanic challenge that implies that our professional life is spent analyzing both subjective and objective information from our patients, both with an undeniable diagnostic value: as for the first, the clinical history, observations of the patient's listening behavior, reports from home, school and therapy, or studies such as pure tone audiometry and speech audiometry, are essential not only for diagnosis but also for the follow-up of our patients. However, in the case of smaller patients, or when faced with the need to evaluate aspects such as middle ear pressure, hair cell function, or the presence of cochlear microphonics; The usefulness of these subjective tools is limited and therefore the records, traces, curves and figures related to intensities, pressures, latencies, frequencies, amplitudes and other data obtained through objective studies are the resources we use to diagnose and start the investigation. rehabilitation or rehabilitation of our patients.

Pediatric Arabic Closed-Set Word-Recognition Test: Development and Evaluation of Psychometric Characteristics.

BACKGROUND: Speech audiometry materials are widely available in many different languages. However, there are no known standardized materials for the assessment of speech recognition in Arabic-speaking children. PURPOSE: The aim of the study was to develop and validate phonetically balanced and psychometrically equivalent monosyllabic word recognition lists for children through a picture identification task. RESEARCH DESIGN: A prospective repeated-measure design was used. Monosyllabic words were chosen from children's storybooks and were evaluated for familiarity. The selected words were then divided into four phonetically balanced word lists. The final lists were evaluated for homogeneity and equivalency. STUDY SAMPLE: Ten adults and 32 children with normal hearing sensitivity were recruited. DATA COLLECTION AND ANALYSES: Lists were presented to adult subjects in 5 dB increment from 0 to 60 dB hearing level. Individual data were then fitted using a sigmoid function from which the 50% threshold, slopes at the 50% points, and slopes at the 20 to 80% points were derived to determine list psychometric properties. Lists were next presented to children in two separate sessions to assess their equivalency, validity, and reliability. Data were subjected to a mixed design analysis of variance. RESULTS: No statistically significant difference was found among the word lists. CONCLUSION: This study provided an evidence that the monosyllabic word lists had comparable psychometric characteristics and reliability. This supports that the constructed speech corpus is a valid tool that can be used in assessing speech recognition in Arabic-speaking children.

Cochlear Synaptopathy: A Primary Factor Affecting Speech Recognition Performance in Presbycusis.

The results of recent animal studies have suggested that cochlear synaptopathy may be an important factor involved in presbycusis. Therefore, here, we aimed to examine whether cochlear synaptopathy frequently exists in patients with presbycusis and to describe the effect of cochlear synaptopathy on speech recognition in noise. Based on the medical history and an audiological examination, 94 elderly patients with bilateral, symmetrical, sensorineural hearing loss were diagnosed as presbycusis. An electrocochleogram, auditory brainstem responses, auditory cortical evoked potentials, and speech audiometry were recorded to access the function of the auditory pathway. First, 65 ears with hearing levels of 41-50 dB HL were grouped based on the summating potential/action potential (SP/AP) ratio, and the amplitudes of AP and SP were compared between the two resulting groups. Second, 188 ears were divided into two groups: the normal SP/AP and abnormal SP/AP groups. The speech recognition abilities in the two groups were compared. Finally, the relationship between abnormal electrocochleogram and poor speech recognition (signal-to-noise ratio loss ≥7 dB) was analyzed in 188 ears. The results of the present study showed: (1) a remarkable reduction in the action potential amplitude was observed in patients with abnormal SP/AP ratios; this suggests that cochlear synaptopathy was involved in presbycusis. (2) There was a large proportion of patients with poor speech recognition in the abnormal SP/AP group. Furthermore, a larger number of cases with abnormal SP/AP ratios were confirmed among patients with presbycusis and poor speech recognition. We concluded that cochlear synaptopathy is not uncommon among elderly individuals who have hearing ability deficits, and it may have a more pronounced effect on ears with declining auditory performance in noisy environments.

Hearing function, perception of disability (handicap) and cognition in the elderly: a relation to be elucidated. / Função auditiva, percepção da incapacidade e cognição em idosos: uma relação a elucidar.

PURPOSE: To analyze auditory perception, hearing and cognition in the elderly referred for audiological evaluation and search for correlations between hearing and cognitive abilities. METHOD: An observational and descriptive study, carried out with 135 elderly people. The participants did the auditory (tonal audiometry, speech audiometry, immittance measures, HHIE Questionnaire - Hearing Handicap Inventory for the Elderly) and the cognitive (MMSE - Mini Mental State Examination) assessments. RESULTS: There is a high prevalence of hearing complaints (91.85%) and hearing loss (91.85%) in the elderly referred for audiological assessment, but there was no relation between the degree of hearing loss (p = 0.537) and the auditory perception (p = 0.930) in relation to cognitive performance. CONCLUSION: In this study, the degree of hearing loss did not influence the cognitive performance of the elderly, and the auditory handicap perception did not differ between individuals with normal or altered cognition.

OBJETIVO: Analisar a percepção da incapacidade auditiva, a audição e a cognição em idosos encaminhados para avaliação audiológica e verificar a existência de correlação entre a audição e as habilidades cognitivas. MÉTODO: Estudo observacional e descritivo, realizado com 135 idosos. Os participantes realizaram a avaliação auditiva (Audiometria Tonal Limiar, Logoaudiometria, Imitanciometria) responderam a um inventário que avalia a percepção da incapacidade auditiva (questionário HHIE - Hearing Handicap Inventory for the Elderly) e foram submetidos a um rastreio cognitivo (teste Mini Exame do Estado Mental - MEEM). RESULTADOS: Houve elevada prevalência de queixa auditiva e perda da audição nos idosos encaminhados para avaliação auditiva, mas não houve relação do grau da perda auditiva e da percepção da incapacidade auditiva em relação ao desempenho cognitivo. CONCLUSÃO: Neste estudo, o grau da perda auditiva não influenciou o desempenho cognitivo dos idosos, e a percepção da incapacidade auditiva não diferiu entre indivíduos com cognição normal ou alterada.

Phonemically Balanced Arabic Monosyllabic Word Lists for Speech Audiometry Testing in Jordan.

BACKGROUND: Many of the Arabic monosyllabic word lists that are currently available in the literature have some limitations and drawbacks. Some of these available lists include word structures that are not consonant-nucleus-consonant (CNC) such as cluster and disyllabic word structures. Other lists have poor phonetic or phonemic distribution balance and do not represent some phoneme appropriately in each list. PURPOSE: The purpose of the present study is to create and validate eight digitally recorded lists of phonemically balanced CNC words that represent all Arabic phonemes, to be used in the evaluation of word recognition score (WRS) of Jordanian Arabic-speaking adults. These lists should be easily adapted by other Arab countries because of the simplicity of the words, and the balanced inclusion of all the Arabic phonemes. RESEARCH DESIGN: The present study is a prospective cross-sectional study. STUDY SAMPLE: Thirty-one (23 females, 8 males) normal hearing and healthy young adults (18-29 years old) participated in the present study. All participants were native speakers of Jordanian Arabic and had no history of ear disease or surgery. LISTS: The authors created all possible combinations of Arabic CNC words, and then created eight phonemically balanced lists with 26 words in each list. Each consonant was presented only once at the beginning of a word and once at the end of a word in each list. The lists were recorded using a Jordanian male voice and the intensity of each word was digitally calibrated. DATA COLLECTION AND ANALYSIS: The pure tone average (PTA) of 0.5, 1, 2, 4 kHz was calculated for each participant, and the WRS was obtained for each intensity level in the range of -10 to 55 dB SL (ref. PTA) in 5 dB steps. RESULTS: No significant difference between right and left ear WRS was found at any intensity level. The WRSs from both ears were averaged and used in the repeated measure analysis of variance. Performance-intensity functions for all the lists showed some small but statistically significant differences between lists. However, none of these differences were clinically significant (<4%). All the lists showed WRS exceeding 96% at 40 dB SL, and none of the lists showed statistically significant improvement in WRS beyond 40 dB SL. CONCLUSION: The present study provides eight lists of recorded and calibrated CNC word lists. The obtained PI functions showed that these lists are suitable for Jordanian Arabic speaking adults. These lists can be easily generalized to other Arab countries after conducting the required follow-up research.