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Picou EM, Davis H, Lunsford KH, Tharpe AM. Validation of the Vanderbilt Classroom Listening Assessment Short Survey for Children With Unilateral Hearing Loss. Ear Hear 2024:00003446-990000000-00376. [PMID: 39699124 DOI: 10.1097/aud.0000000000001612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
OBJECTIVES Children with unilateral hearing loss experience difficulties in classroom listening situations. There are a limited number of validated questionnaires available for monitoring listening development and quantifying the challenges school-aged children with unilateral hearing loss experience. The purpose of this study was to evaluate a survey that describes the classroom listening challenges reported by children with unilateral hearing loss with and without the use of personal hearing devices (air conduction hearing aid, bone conduction hearing aid, cochlear implant, contralateral routing of signals system). DESIGN Children aged 9 to 17 years with self-reported unilateral hearing loss completed an online survey about classroom listening difficulties when not using a personal hearing device (n = 1148) or with the use of a personal hearing device (n = 897). The survey includes 15 questions examining different situations common in modern classrooms. Each question includes a picture depicting the described listening situation. Exploratory factor analysis was used to develop subscales and the internal reliability of the subscales was evaluated. To validate the survey, the relationships between survey scores and self-reported hearing difficulties (without a personal hearing device) or type of device (with a personal hearing device) were evaluated using regression analyses. RESULTS Factor analysis revealed survey scores for individual items statistically loaded onto three factors. On the basis of these factors, subscales were created, which are related to: (1) listening situations where the talker is faraway from the child, (2) listening situations where the talker is close to the child and they are inside a building, and (3) listening situations where the talker is close to the child and they are outside a building. Regression analyses revealed children reported the greatest difficulty in school settings when the sound of interest was faraway from them. Although scores were generally higher, indicating listening was easier, when children were wearing their personal hearing devices (i.e., air conduction hearing aid, bone conduction hearing aid, contralateral routing of signals system, cochlear implant), situations with faraway signals were still reported as more challenging than were situations where signals were close. CONCLUSIONS This set of findings highlights the need to incorporate distance effects into laboratory evaluations that include children with unilateral hearing loss. In addition, the findings support clinical interventions that address talker-to-listener distances, such as preferential seating and remote microphone systems. Last, the results of this study validate the Vanderbilt Classroom Listening Assessment Short Survey for use with children aged 9 to 17 years of age with unilateral self-reported hearing difficulty. The subscales are empirically driven, internally reliable, and focus on three types of listening situations encountered in classrooms. It is important to note that the survey results demonstrate the expected pattern of results, with participants who have greater self-reported hearing difficulty rating classroom listening situations as more difficult than participants with less self-reported hearing difficulty.
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Affiliation(s)
- Erin M Picou
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Hilary Davis
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Anne Marie Tharpe
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee, USA
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Mealings K, Miles K, Buchholz JM. A Methodological Review of Stimuli Used for Classroom Speech-in-Noise Tests. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:4850-4866. [PMID: 39560502 DOI: 10.1044/2024_jslhr-24-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2024]
Abstract
PURPOSE Listening is the gateway to learning in the mainstream classroom; however, classrooms are noisy environments, making listening challenging. Therefore, speech-in-noise tests that realistically incorporate the complexity of the classroom listening environment are needed. The aim of this article was to review the speech stimuli, noise stimuli, presentation mode, and presentation levels of current classroom speech-in-noise tests to determine how representative they are of real-world classroom listening. METHOD A comprehensive search of Scopus database following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines was conducted to identify classroom speech-in-noise tests used in the research literature. The search term was classroom AND (listening OR (speech AND (perception OR intelligibility OR recognition OR discrimination) AND noise) OR speech-in-noise) AND (test OR task OR measure OR assessment) AND children in the article title, abstract, and key word fields. RESULTS A total of 97 papers met the criteria to be included in the review. While the speech and noise stimuli were generally presented at realistic speech and noise levels, the speech materials were not representative of real-world classroom listening. Additionally, unrealistic noise and presentation modes were used in several studies. CONCLUSION This review will help researchers choose appropriate speech-in-noise test stimuli in future research and also help researchers understand what to consider when creating new speech-in-noise tests for classroom listening. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.27659619.
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Affiliation(s)
- Kiri Mealings
- ECHO Laboratory, Department of Linguistics, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Kelly Miles
- ECHO Laboratory, Department of Linguistics, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Joerg M Buchholz
- ECHO Laboratory, Department of Linguistics, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
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Easwar V, Hou S, Zhang VW. Parent-Reported Ease of Listening in Preschool-Aged Children With Bilateral and Unilateral Hearing Loss. Ear Hear 2024; 45:1600-1612. [PMID: 39118218 DOI: 10.1097/aud.0000000000001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
OBJECTIVES Evidence from school-aged children suggests that the ease with which children listen varies with the presence of hearing loss and the acoustic environment despite the use of devices like hearing aids. However, little is known about the ease of listening in preschool-aged children with hearing loss-an age at which rapid learning occurs and increased listening difficulty or effort may diminish the required capacity to learn new skills. To this end, the objectives of the present study were to (i) assess parent-reported aided ease of listening as a function of hearing loss configuration (hearing loss in one versus both ears) and device configuration among children with hearing loss in one ear (unilateral hearing loss), and (ii) investigate factors that influence children's ease of listening. DESIGN Parents of 83 children with normal hearing, 54 aided children with bilateral hearing loss (hearing loss in both ears), and 139 children with unilateral hearing loss participated in the study. Of the 139 children with unilateral loss, 72 were unaided, 54 were aided with a device on the ear with hearing loss (direct aiding) and 13 were aided with a device that routed signals to the contralateral normal hearing ear (indirect aiding). Mean age of children was 40.2 months (1 SD = 2.5; range: 36 to 51). Parents completed the two subscales of the Parents' Evaluation of Aural/Oral Performance of Children+ (PEACH+) questionnaire, namely functional listening and ease of listening. Individual percent scores were computed for quiet and noisy situations. Linear mixed-effects models were used to assess the effect of hearing loss configuration and device configuration in children with unilateral hearing loss. Multiple regression was used to assess factors that influenced ease of listening. Factors included hearing thresholds, age at first device fit, consistency in device use, condition (quiet/noise), presence of developmental disabilities, and functional listening abilities. RESULTS Children with direct aiding for their hearing loss, either unilateral or bilateral, had similarly lower functional listening skills and ease of listening than their normal hearing peers. Unaided children with unilateral hearing loss had lower functional listening skills and ease of listening than their normal hearing peers in noise but not in quiet. All aided children with unilateral hearing loss, irrespective of direct or indirect aiding had lower functional listening skills and ease of listening relative to normal hearing children in both quiet and noise. Furthermore, relative to unaided children with unilateral hearing loss, those with indirect aiding had lower functional listening and ease of listening. Regression analyses revealed functional listening as a significant predictor of ease of listening in all children with hearing loss. In addition, worse degrees of hearing loss and presence of noise reduced ease of listening in unaided children with unilateral hearing loss. CONCLUSIONS Bilateral hearing loss is associated with poorer-than-typical ease of listening in preschoolers even when aided. The impact of unilateral hearing loss on ease of listening is similar to that observed in children with bilateral hearing loss, despite good hearing in one ear and aiding. Given increased difficulties experienced by children with unilateral loss, with or without a device, additional strategies to facilitate communication abilities in noise should be a priority.
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Klein KE, Harris LA, Humphrey EL, Noss EC, Sanderson AM, Yeager KR. Predictors of Listening-Related Fatigue in Adolescents With Hearing Loss. Lang Speech Hear Serv Sch 2024; 55:724-740. [PMID: 38501931 DOI: 10.1044/2024_lshss-23-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Self-reported listening-related fatigue in adolescents with hearing loss (HL) was investigated. Specifically, the extent to which listening-related fatigue is associated with school accommodations, audiologic characteristics, and listening breaks was examined. METHOD Participants were 144 adolescents with HL ages 12-19 years. Data were collected online via Qualtrics. The Vanderbilt Fatigue Scale-Child was used to measure listening-related fatigue. Participants also reported on their use of listening breaks and school accommodations, including an Individualized Education Program (IEP) or 504 plan, remote microphone systems, closed captioning, preferential seating, sign language interpreters, live transcriptions, and notetakers. RESULTS After controlling for age, HL laterality, and self-perceived listening difficulty, adolescents with an IEP or a 504 plan reported lower listening-related fatigue compared to adolescents without an IEP or a 504 plan. Adolescents who more frequently used remote microphone systems or notetakers reported higher listening-related fatigue compared to adolescents who used these accommodations less frequently, whereas increased use of a sign language interpreter was associated with decreased listening-related fatigue. Among adolescents with unilateral HL, higher age was associated with lower listening-related fatigue; no effect of age was found among adolescents with bilateral HL. Listening-related fatigue did not differ based on hearing device configuration. CONCLUSIONS Adolescents with HL should be considered at risk for listening-related fatigue regardless of the type of hearing devices used or the degree of HL. The individualized support provided by an IEP or 504 plan may help alleviate listening-related fatigue, especially by empowering adolescents with HL to be self-advocates in terms of their listening needs and accommodations in school. Additional research is needed to better understand the role of specific school accommodations and listening breaks in addressing listening-related fatigue.
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Affiliation(s)
- Kelsey E Klein
- Center for Pediatric Hearing Health Research, The House Institute Foundation, Los Angeles, CA
| | - Lauren A Harris
- Department of Otolaryngology - Head and Neck Surgery, University of Kentucky, Lexington
| | - Elizabeth L Humphrey
- Department of Audiology and Speech Pathology, The University of Tennessee Health Science Center, Knoxville
| | - Emily C Noss
- Department of Audiology and Speech Pathology, The University of Tennessee Health Science Center, Knoxville
| | - Autumn M Sanderson
- Department of Audiology and Speech Pathology, The University of Tennessee Health Science Center, Knoxville
| | - Kelly R Yeager
- Department of Audiology and Speech Pathology, The University of Tennessee Health Science Center, Knoxville
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Gustafson SJ, Ortiz C, Nelson L. Test-Retest Reliability and the Role of Task Instructions when Measuring Listening Effort Using a Verbal Response Time Paradigm. Semin Hear 2023; 44:140-154. [PMID: 37122885 PMCID: PMC10147505 DOI: 10.1055/s-0043-1767667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Listening amidst competing noise taxes one's limited cognitive resources, leading to increased listening effort. As such, there is interest in incorporating a reliable test of listening effort into the clinical test battery. One clinically promising method for measuring listening effort is verbal response time (VRT) because it can be obtained using already-established clinical tasks. In order for widespread implementation of the VRT paradigm, a better understanding of the psychometric properties is needed. The purpose of this work was to improve the understanding of the reliability and sensitivity of the VRT listening task. Using within-subject study designs, we completed a pilot study to evaluate the test-retest reliability (Study 1) and the effects of task instructions and listening condition (Study 2). Preliminary results show that the VRT paradigm enjoys good to excellent test-retest reliability and that neither task instructions nor listening condition meaningfully influence VRT once measurement error is accounted for. Future studies should account for measurement error when considering statistically significant versus meaningful effects of experimental parameters when using listening effort tasks.
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Affiliation(s)
- Samantha J. Gustafson
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Crystal Ortiz
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Loren Nelson
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
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Lewis DE. Speech Understanding in Complex Environments by School-Age Children with Mild Bilateral or Unilateral Hearing Loss. Semin Hear 2023; 44:S36-S48. [PMID: 36970648 PMCID: PMC10033204 DOI: 10.1055/s-0043-1764134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Numerous studies have shown that children with mild bilateral (MBHL) or unilateral hearing loss (UHL) experience speech perception difficulties in poor acoustics. Much of the research in this area has been conducted via laboratory studies using speech-recognition tasks with a single talker and presentation via earphones and/or from a loudspeaker located directly in front of the listener. Real-world speech understanding is more complex, however, and these children may need to exert greater effort than their peers with normal hearing to understand speech, potentially impacting progress in a number of developmental areas. This article discusses issues and research relative to speech understanding in complex environments for children with MBHL or UHL and implications for real-world listening and understanding.
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Affiliation(s)
- Dawna E. Lewis
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, Nebraska
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Gustafson SJ, Camarata S, Hornsby BWY, Bess FH. Perceived Listening Difficulty in the Classroom, Not Measured Noise Levels, Is Associated With Fatigue in Children With and Without Hearing Loss. Am J Audiol 2021; 30:956-967. [PMID: 34464548 PMCID: PMC9126126 DOI: 10.1044/2021_aja-21-00065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to examine if classroom noise levels and perceived listening difficulty were related to fatigue reported by children with and without hearing loss. METHOD Measures of classroom noise and reports of classroom listening difficulty were obtained from 79 children (ages 6-12 years) at two time points on two different school days. Forty-four children had mild to moderately severe hearing loss in at least one ear. Multiple regression analyses were conducted to evaluate if measured noise levels, perceived listening difficulty, hearing status, language abilities, or grade level would predict self-reported fatigue ratings measured using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. RESULTS Higher perceived listening difficulty was the only predictor variable that was associated with greater self-reported fatigue. CONCLUSIONS Measured classroom noise levels showed no systematic relationship with fatigue ratings, suggesting that actual classroom noise levels do not contribute to increased reports of subjective fatigue. Instead, perceived challenges with listening appears to be an important factor for consideration in future work examining listening-related fatigue in children with and without hearing loss.
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Affiliation(s)
- Samantha J. Gustafson
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City
| | - Stephen Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Benjamin W. Y. Hornsby
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN
| | - Fred H. Bess
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine, Nashville, TN
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