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Crum R, Chowsilpa S, Kaski D, Giunti P, Bamiou DE, Koohi N. Hearing rehabilitation of adults with auditory processing disorder: a systematic review and meta-analysis of current evidence-based interventions. Front Hum Neurosci 2024; 18:1406916. [PMID: 38974481 PMCID: PMC11224551 DOI: 10.3389/fnhum.2024.1406916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/31/2024] [Indexed: 07/09/2024] Open
Abstract
Background For adults with auditory processing disorder (APD), listening and communicating can be difficult, potentially leading to social isolation, depression, employment difficulties and certainly reducing the quality of life. Despite existing practice guidelines suggesting treatments, the efficacy of these interventions remains uncertain due to a lack of comprehensive reviews. This systematic review and meta-analysis aim to establish current evidence on the effectiveness of interventions for APD in adults, addressing the urgent need for clarity in the field. Methods Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search across MEDLINE (Ovid), Embase (Ovid), Web of Science and Scopus, focusing on intervention studies involving adults with APD. Studies that met the inclusion criteria were grouped according to intervention with a meta-analysis only conducted where intervention, study design and outcome measure were comparable. Results Out of 1,618 screened records, 13 studies were included, covering auditory training (AT), low-gain hearing aids (LGHA), and personal remote microphone systems (PRMS). Our analysis revealed: AT, Mixed results with some improvements in speech intelligibility and listening ability, indicating potential benefits but highlighting the need for standardized protocols; LGHA, The included studies demonstrated significant improvements in monaural low redundancy speech testing (p < 0.05), suggesting LGHA could enhance speech perception in noisy environments. However, limitations include small sample sizes and potential biases in study design. PRMS, Demonstrated the most consistent evidence of benefit, significantly improving speech testing results, with no additional benefit from combining PRMS with other interventions. Discussion PRMS presents the most evidence-supported intervention for adults with APD, although further high-quality research is crucial for all intervention types. The establishment and implementation of standardized intervention protocols alongside rigorously validated outcome measures will enable a more evidence-based approach to managing APD in adults.
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Affiliation(s)
- Rachel Crum
- The Ear Institute, University College London, London, United Kingdom
| | - Sanathorn Chowsilpa
- The Ear Institute, University College London, London, United Kingdom
- Otology Neurotology and Communication Disorder Unit, Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Diego Kaski
- The Ear Institute, University College London, London, United Kingdom
- Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, United Kingdom
- Neuro-otology Department, University College London Hospitals, London, United Kingdom
- Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Paola Giunti
- Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, United Kingdom
- Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
| | - Doris-Eva Bamiou
- The Ear Institute, University College London, London, United Kingdom
- Neuro-otology Department, University College London Hospitals, London, United Kingdom
- Biomedical Research Centre, National Institute for Health Research, London, United Kingdom
| | - Nehzat Koohi
- The Ear Institute, University College London, London, United Kingdom
- Department of Clinical and Movement Neurosciences, Institute of Neurology, University College London, London, United Kingdom
- Ataxia Centre, National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom
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Tepe V, Guillory L, Boudin-George A, Cantelmo T, Murphy S. Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-28. [PMID: 37379242 DOI: 10.1044/2023_jslhr-23-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
PURPOSE Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions. METHOD We explored relevant literature to inform the treatment of auditory processing dysfunction in adults, with emphasis on findings involving active or former military personnel. We were able to identify a limited number of studies, pertaining primarily to the treatment of auditory processing deficits through the use of assistive technologies and training strategies. We assessed the current state of the science for knowledge gaps that warrant additional study. CONCLUSIONS Auditory processing deficits often co-occur with other military injuries and may pose significant risk in military operational and occupational settings. Research is needed to advance clinical diagnostic and rehabilitative capabilities, guide treatment planning, support effective multidisciplinary management, and inform fitness-for-duty standards. We emphasize the need for an inclusive approach to the assessment and treatment of auditory processing concerns in Service members and Veterans and for evidence-based solutions to address complex military risk factors and injuries.
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Affiliation(s)
- Victoria Tepe
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- The Geneva Foundation, Tacoma, WA
| | - Lisa Guillory
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO
| | - Amy Boudin-George
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
| | - Tasha Cantelmo
- Alexander T. Augusta Military Medical Center, Fort Belvoir, VA
| | - Sara Murphy
- Department of Defense Hearing Center of Excellence, JBSA Lackland, TX
- The Geneva Foundation, Tacoma, WA
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Moberly AC, Vasil K, Baxter J, Klamer B, Kline D, Ray C. Comprehensive auditory rehabilitation in adults receiving cochlear implants: A pilot study. Laryngoscope Investig Otolaryngol 2020; 5:911-918. [PMID: 33134539 PMCID: PMC7585234 DOI: 10.1002/lio2.442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE In the United States, most adults who receive cochlear implants (CIs) do not undergo a comprehensive auditory rehabilitation (CAR) approach, which may result in suboptimal outcomes. The objectives of this pilot study were to demonstrate that a CAR approach incorporating auditory training (AT) by a speech-language pathologist (SLP) is feasible in adults receiving CIs and to explore whether this approach results in improved outcomes. METHODS Twenty-four postlingually deaf adult CI candidates were serially assigned to one of three groups: (a) a "CAR group" that received standard of care implantation, programming by an audiologist, an additional preoperative counseling session, and eight one-hour AT sessions; (b) a "passive control" standard-of-care group; and (c) an "active control" group that also received the extra preoperative counseling session. Participants were tested preoperatively and 1, 3, and 6 months after CI using measures of word and sentence recognition in quiet and in babble, as well as measures of quality of life (QOL). RESULTS The CAR approach was feasible, but this pilot study was underpowered to determine efficacy. Differential time courses of speech recognition improvement were seen for sentence and word recognition. All QOL measurements showed improvement from pre-CI to 1 month post-CI activation. Results revealed issues to consider for a larger-scale study of CAR revolving around participant selection, study measures, and sample size. CONCLUSION The CAR approach is feasible in new CI users. A larger trial is needed to investigate whether CAR leads to better outcomes or faster improvement in this clinical population. LEVEL OF EVIDENCE 2.
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Affiliation(s)
- Aaron C. Moberly
- Department of Otolaryngology – Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Kara Vasil
- Department of Otolaryngology – Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Jodi Baxter
- Department of Speech and Hearing ScienceThe Ohio State UniversityColumbusOhioUSA
| | - Brett Klamer
- Center for Biostatistics, Department of Biomedical InformaticsThe Ohio State UniversityColumbusOhioUSA
| | - David Kline
- Center for Biostatistics, Department of Biomedical InformaticsThe Ohio State UniversityColumbusOhioUSA
| | - Christin Ray
- Department of Otolaryngology – Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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Mishra SK, Panda MR. Rapid auditory learning of temporal gap detection. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:EL50. [PMID: 27475211 DOI: 10.1121/1.4955004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The rapid initial phase of training-induced improvement has been shown to reflect a genuine sensory change in perception. Several features of early and rapid learning, such as generalization and stability, remain to be characterized. The present study demonstrated that learning effects from brief training on a temporal gap detection task using spectrally similar narrowband noise markers defining the gap (within-channel task), transfer across ears, however, not across spectrally dissimilar markers (between-channel task). The learning effects associated with brief training on a gap detection task were found to be stable for at least a day. These initial findings have significant implications for characterizing early and rapid learning effects.
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Affiliation(s)
- Srikanta K Mishra
- Department of Special Education and Communication Disorders, New Mexico State University, Las Cruces, New Mexico 88011, USA
| | - Manasa R Panda
- Department of Audiology and Speech Language Pathology, SRM Medical College Hospital and Research Center, Sri Ramaswamy Memorial University, Kattankulathur, Tamil Nadu, 603 203, India
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