Auditory processing tests for Spanish-speaking adults: An initial study

Active Bone Conduction Implant and Adhesive Bone Conduction Device: A Comparison of Audiological Performance and Subjective Satisfaction

Introduction  Atresia of the external auditory canal affects 1 in every 10 thousand to 20 thousand live births, with a much higher prevalence in Latin America, at 5 to 21 out of every 10 thousand newborns. The treatment involves esthetic and functional aspects. Regarding the functional treatment, there are surgical and nonsurgical alternatives like spectacle frames and rigid and softband systems. Active transcutaneous bone conduction implants (BCIs) achieve good sound transmission and directly stimulate the bone. Objective  To assess the audiological performance and subjective satisfaction of children implanted with an active transcutaneous BCI for more than one year and to compare the outcomes with a nonsurgical adhesive bone conduction device (aBCD) in the same users. Methods  The present is a prospective, multicentric study. The audiological performance was evaluated at 1, 6, and 12 months postactivation, and after a 1-month trial with the nonsurgical device. Results  Ten patients completed all tests. The 4-frequency pure-tone average (4PTA) in the unaided condition was of 65 dB HL, which improved significantly to 20 dB HL after using the BCI for 12 months. The speech recognition in quiet in the unaided condition was of 33% on average, which improved significantly, to 99% with the BCI, and to 91% with the aBCD. Conclusion  The aBCD demonstrated sufficient hearing improvement and subjective satisfaction; thus, it is a good solution for hearing rehabilitation if surgery is not desired or not possible. If surgery is an option, the BCI is the superior device in terms of hearing outcomes, particularly background noise and subjective satisfaction.

Choir Singing Practice and Temporal Ordering in the Elderly

Introduction  The importance of temporal ordering and sequencing in the auditory system is discussed because these are considered basic functions for language. Objective  To verify the correlation between the practice of choir music and the temporal ordering in elderly with no prior formal musical experience. Method  The study design is cross-sectional. The sample consisted of 85 elderly individuals of both genders, ≥ 60 years old, and it was composed of 43 elderly individuals with no prior formal musical experience but choir participation (research group) and 42 elderly individuals who never sang in a choir and had no music training during their life (control group). The research group was divided based on three categories of choir time. The performances of the research and control groups were compared with pitch pattern sequence (PPS), verbal condition (PPSverb), humming condition (PPShum), and duration pattern sequence (DPS) tests. Results  The mean PPShum and PPSverb showed a statistically significant difference by choir time with a different mean of PPShum between the no singing experience group (59%) and the > 10 years of singing experience group (90%) ( p  = 0.02). Regarding the averages of PPSverb, there was a statistically significant difference between the no singing experience (23%) and > 10 years of choir time (54%) ( p  = 0.02) groups. Conclusion  The findings indicate a better performance in the temporal ordering of the elderly who are not formal musicians but who have choir experience in the research group in relation to those with no choir experience in the control group.

Speech Perception and Dichotic Listening Are Associated With Hearing Thresholds and Cognition, Respectively, in Unaided Presbycusis

Presbycusis or age-related hearing loss is a prevalent condition in the elderly population, which affects oral communication, especially in background noise, and has been associated with social isolation, depression, and cognitive decline. However, the mechanisms that relate hearing loss with cognition are complex and still elusive. Importantly, recent studies show that the use of hearing aids in presbycusis, which is its standard management, can induce neuroplasticity and modify performance in cognitive tests. As the majority of the previous studies on audition and cognition obtained their results from a mixed sample of subjects, including presbycusis individuals fitted and not fitted with hearing aids, here, we revisited the associations between hearing loss and cognition in a controlled sample of unaided presbycusis. We performed a cross-sectional study in 116 non-demented Chilean volunteers aged ≥65 years from the Auditory and Dementia study cohort. Specifically, we explored associations between bilateral sensorineural hearing loss, suprathreshold auditory brain stem responses, auditory processing (AP), and cognition with a comprehensive neuropsychological examination. The AP assessment included speech perception in noise (SIN), dichotic listening (dichotic digits and staggered spondaic words), and temporal processing [frequency pattern (FP) and gap-in-noise detection]. The neuropsychological evaluations included attention, memory, language, processing speed, executive function, and visuospatial abilities. We performed an exploratory factor analysis that yielded four composite factors, namely, hearing loss, auditory nerve, midbrain, and cognition. These four factors were used for generalized multiple linear regression models. We found significant models showing that hearing loss is associated with bilateral SIN performance, while dichotic listening was associated with cognition. We concluded that the comprehension of the auditory message in unaided presbycusis is a complex process that relies on audition and cognition. In unaided presbycusis with mild hearing loss (<40 dB HL), speech perception of monosyllabic words in background noise is associated with hearing levels, while cognition is associated with dichotic listening and FP.

Development of central auditory processes in Polish children and adolescents at the age from 7 to 16 years

There are discrepancies in the literature regarding the course of central auditory processes (CAP) maturation in typically developing children and adolescents. The purpose of the study was to provide an overview of age – related improvement in CAP in Polish primary and secondary school students aged 7–16 years. 180 children/adolescents, subdivided into 9 age categories, and 20 adults (aged 18–24 years) performed the Dichotic Digit Test (DDT), Duration Pattern Test (DPT), Frequency Pattern Test (FPT), Gap Detection Test (GDT) and adaptive Speech-in-Noise (aSpN). The 12-year-olds was retested after w week. We found the age effects only for the DDT, DPT and FPT. In the right ear DDT the 7-year-olds performed more poorly than all groups ≥12. In the left ear DDT both 7- and 8-year-olds achieved less correct responses compared with the 13-, 14-, 15-year-olds and with the adults. The right ear advantage was greater in the 7-year-olds than in the 15-year-olds and adult group. At the age of 7 there was lower DPT and FPT scores than in all participants ≥13 whereas the 8-year-olds obtained less correct responses in the FPT than all age categories ≥12. Almost all groups (except for the 7-year-olds) performed better in the DPT than FPT. The test-retest reliability for all tests was satisfactory. The study demonstrated that different CAP have their own patterns of improvement with age and some of them are specific for the Polish population. The psychoacoustic battery may be useful in screening for CAP disorders in Poland.

Reference values for psychoacoustic tests on Polish school children 7-10 years old

Background

Good hearing is a fundamental skill that allows children to develop properly, both socially and intellectually. In contrast to defects in inner ear function, however, auditory processing disorders (APDs)–which can affect up to 2–3% of school-children–are not easily identified with basic screening programs and must be diagnosed using special tests. Although such psychoacoustic tests are available, the scores achieved depend highly on the social, cultural, and linguistic characteristics of the population, and norms must be established for each population separately. Reference values are still lacking for the Polish population, especially for children in school-age, so that practitioners must interpret test scores themselves, often intuitively or using potentially biased thresholds from other countries.

Materials and methods

We investigated a sample of 94 Polish schoolchildren with normal hearing, divided into four age groups: from 7 years-olds to 10 years-olds. All children had no speech or language development disorder, learning problem, or symptom of APD. Participants were volunteers who had previously taken part in a large screening study. The group consisted of 56 girls (60%) and 38 boys (40%) with an average age of 8.6 years (SD = 1.1). The test battery included the Duration Pattern Test (DPT), Frequency Pattern Test (FPT), Time-Compressed Speech Test (CST), and Dichotic Digit Test (DDT).

Results

The scores on all tests increased consistently with age. The difference between each age-group for DPT, CST, and left- and right-ear DDT tests was significant (Kruskal–Wallis test, p-values = 0.002, 0.006, 0.005, 0.020, respectively), but the effect of age on the FPT test was not (p-value = 0.143). The analysis showed a clear and significant separation between a merged group of ages 7 and 8 and another of ages 9 and 10. We, therefore, propose, for each test, separate reference values for these two particular age-groups. Using thresholds based on a 10% quantile, we offer the following reference values for ages 7–8 and 9–10 respectively: DPT, 28.5% and 53.8%; FPT, 18.5% and 27.5%; CST, 68.6% and 77.2%; left-ear DDT, 34.3% and 52.5%; right-ear DDT, 56% and 72.5%.

Conclusion

The scores on psychoacoustic tests to diagnose APD differ between cultures and linguistic backgrounds. Clinicians should, therefore, use norms that have been designed for the population most similar to their patients. Here, we report the use of a test battery designed for the Polish language that accounts for various aspects of APD when screening school children. Together with a full methodology of those tests, we provide norms that can be used as cut-offs in clinical diagnosis. Practitioners are invited to use them to obtain more accurate, evidence-based decisions.

Does Asymmetric Hearing Loss Affect the Ability to Understand in Noisy Environments?

OBJECTIVES

This study aimed to determine whether, in asymmetric hearing loss, the presence of an ear with a better or worse hearing threshold is related to either better or worse speech-in-noise (SiN) intelligibility.

MATERIALS AND METHODS

A total of 618 subjects with different degrees of hearing loss were evaluated for their ability to understand SiN. A stepwise forward logistic regression analysis was performed to identify the factors that affect performance. The influencing factors of very high or very low performance were determined.

RESULTS

Age, especially after 70 years of age, and hearing loss, especially from moderate hearing loss, negatively influence SiN intelligibility. Remarkably high intelligibility was identified in subjects with a contralateral ear presenting a better auditory threshold.

CONCLUSION

Although age and hearing loss are known factors that affect SiN intelligibility, the presence of a healthy contralateral ear is presented as the first description of preservation of SiN hearing ability.

The Danish test battery for auditory processing disorder evaluated with patient and control data

OBJECTIVE

This study evaluates the Danish test battery for auditory processing disorder (APD). The battery consists of four behavioural tests, two speech and two non-speech stimuli tests. The evaluation includes determination of: (1) new cut-off values (pass-fail criteria), (2) the sensitivity and the specificity of the entire test battery and (3) the failure rate of different test combinations.

DESIGN

For each test in the battery, cut-off values were determined using the weighted Youden index. Applying the newly derived cut-off values, the distribution of failing specific test combinations was determined.

STUDY SAMPLE

A group of 112 children diagnosed with APD (57 boys, 55 girls, aged 6-16 years) and a control group containing 158 children without auditory problems (75 boys, 83 girls, aged 6-16 years).

RESULTS

Cut-off values for different weights of the sensitivity and the specificity have been determined. Using the criterion that at least two tests have to be failed for APD to be suspected, the sensitivity and the specificity of the entire test battery were 95.3% and 91.6%, respectively. Some test combinations were found to have higher failure rates than others.

CONCLUSIONS

Due to the high sensitivity and specificity the test battery has good predictive value in APD assessment.

Adverse effects of pesticides on central auditory functions in tobacco growers

OBJECTIVE

To investigate the effects of exposure to pesticides on the central auditory functions (CAF) of Brazilian tobacco growers.

DESIGN

This was a cross-sectional study carried out between 2010 and 2012. Participants were evaluated with two behavioural procedures to investigate CAF, the random gap detection test (RGDT) and the dichotic digit test in Portuguese (DDT).

STUDY SAMPLE

A total of 22 growers exposed to pesticides (study group) and 21 subjects who were not exposed to pesticides (control group) were selected.

RESULTS

No significant differences between groups were observed for pure-tone thresholds. A significant association between pesticide exposure and the results for RGDT and DDT was found. Significant differences between pesticide-exposed and nonexposed subjects were found for RGDT frequency average and DDT binaural average, when including age and hearing level as covariates. Age was significantly associated with RGDT frequency average, DDT left ear score, DDT binaural average and DDT right ear advantage. Hearing levels were not significantly associated with any of the test scores. The relative risk of failing the DDT and RGDT for the study group was 1.88 (95% CI: 1.10-3.20) and 1.74 (95% CI: 1.06-2.86), respectively, as compared with the control group.

CONCLUSIONS

The results showed that tobacco growers exposed to pesticides exhibited signs of central auditory dysfunction characterised by decrements in temporal processing and binaural integration processes/abilities.

No association between plasma adiponectin levels and central auditory function in adults

Adiponectin might play a protective role in cardiometabolic and peripheral auditory disorders, but its role on central auditory function was still unclear. The aim of this study was to examine whether there is an association between plasma adiponectin levels and central auditory function in adults. We recruited 297 adults, with normal or symmetrical sensorineural hearing loss and normal cognitive functions. Multivariate linear regression was performed to assess the association between plasma adiponectin concentrations and pitch pattern sequence (PPS) score, which was one of central auditory tests. The results showed that there were 224 (75.4%) women and 73 (24.6%) men in this study. The mean age was 58.1 ± 8.4 years, the mean waist circumference (WC) was 81.1 ± 8.3 cm, and the mean body mass index (BMI) was 24.0 ± 3.0 kg/m(2). The mean PPS score was 71.5 ± 14.1%, and plasma adiponectin concentration was 12.7 ± 5.5 g/mL. After adjusting for age, gender, WC, coronary artery disease, hypertension, diabetes mellitus, chronic kidney disease, smoking and drinking, plasma adiponectin concentrations (coefficient ± standard error, β ± SE = -0.09 ± 0.16, p = 0.563) were found to have no significant associations with PPS score. When WC was excluded from these variables in the multivariate linear regression model, plasma adiponectin concentrations (β ± SE = -0.03 ± 0.15, p = 0.855) were still not significantly associated with PPS score. In conclusion, plasma adiponectin levels were not significantly associated with PPS score, which was one of central auditory function tests. More studies should be conducted for the underlying mechanisms of obesity-related central auditory dysfunction.

Speech audiometry and Spanish-English bilinguals: challenges in clinical practice

PURPOSE

The Spanish-English bilingual population has been on a steady rise in the United States and is projected to continue to grow. Speech audiometry, a key component of hearing care, must be customized for this linguistically unique and diverse population.

METHOD

The tutorial summarizes recent findings concerning Spanish-English bilinguals' performance on English and Spanish speech audiometric tests in the context of the psychometric properties of the tests and the language and dialect profile of the individual (language status, history, stability, competency, and use). The tutorial also provides arguments for evaluating bilingual clients in Spanish, in English, or in both languages, which may serve as rationales in support of varied bilingual clinical practices. Last, the tutorial provides information regarding Spanish speech audiometry, including available tests, issues that clinicians may encounter when administering them, and dialectal consideration.

CONCLUSIONS

It is a challenge as well as an opportunity for clinicians to expand service to the Spanish-English bilingual community. Understanding the characteristics of the individual and the test is essential for ensuring quality services to the bilingual client.

Waist circumference is associated with pitch pattern sequence score in older male adults

OBJECTIVE

While obesity may increase the risk for neurodegenerative diseases such as Alzheimer's disease, the relationship between waist circumference (WC) and central auditory dysfunction is unknown. We aimed to investigate the relationship of WC and pitch pattern sequence (PPS) score in adults.

DESIGN

The association of WC with PPS score was analysed.

STUDY SAMPLE

Volunteer helpers at a community hospital, 391 adults ≥40 years, with normal or symmetrical sensorineural hearing loss were randomly selected.

RESULTS

After adjusting for age, gender, pure-tone average, systemic diseases, and habits, WC was significantly negatively associated with PPS. In a subgroup analysis by gender and age, the PPS score was negatively associated with WC only for males who were older than 55 years old, but not for males who were younger than 55 years old or females in either age group. Meanwhile, central obesity showed positive association with abnormal PPS recognition ability (PPS score < 90%) of borderline significance only for males who were older than 55 years old, but not for males who were younger than 55 years old or females in both age groups.

CONCLUSIONS

WC or central obesity is an independent risk factor for poor central auditory function, especially in older male subjects.

Effects of tea drinking on auditory functions in aged subjects

The purpose of this study was to investigate the effects of Oolong tea drinking on the auditory functions in aged subjects. Retrospective cohort study was conducted on 265 subjects who were older than 55 years old. Tea drinking was determined from responses to a medical and food consumption questionnaires. The effects of Oolong tea drinking on pure tone thresholds (PTAs) for peripheral hearing and pitch pattern sequence (PPS) scores for central hearing were analyzed. Results showed that, before adjusting for other factors, PTAs were not significantly different between "non-tea drinkers" and "Oolong tea drinkes". But, the mean PPS score was higher in the "Oolong tea drinkers" (74.5 ± 12.7%) than in the "non-tea drinkers" (68.4 ± 13.9%). After adjusting for age, gender, waist circumference, and other variables, Oolong tea drinking (coefficient (β) ± standard error (SE) = 2.60 ± 0.67, P<0.001) was positively associated with PPS score, but not with PTAs, by multivariate linear regression analysis. In subgroup analysis for PPS score by gender, Oolong tea drinking showed a significant positive association with PPS score in males (β± SE=4.75 ± 0.95, P<0.001), but showed association of borderline significance with PPS score in females (β± SE=1.57 ± 0.94, P=0.097), with adjustment of other risk factors. In conclusion, Oolong tea drinking was associated with better central auditory function, but not with peripheral hearing thresholds, especially in male aged subjects.

Association of obstructive sleep apnea and auditory dysfunctions in older subjects

OBJECTIVE

Determine the association between obstructive sleep apnea (OSA) and auditory dysfunction in older subjects.

STUDY DESIGN

Cross-sectional study.

SETTING

Hospital volunteer helpers undergoing questionnaire, morphometry measurement, auditory examinations, and polysomnography between 2008 and 2009.

SUBJECTS AND METHODS

In total, 224 subjects older than 50 years were randomly sampled for above evaluation and testing. The effects of OSA on the peripheral auditory function, represented by averaged pure-tone threshold of low frequencies (PTA-low) and high frequencies (PTA-high), and central auditory function, shown by pitch pattern sequence (PPS scores), were analyzed.

RESULTS

The mean ± SD age was 61.2 ± 6.7 years. OSA was confirmed in 6 of 98 women (6.1%) and 28 of 126 men (22.2%). After adjusting for age, gender, and other variables, OSA did not show a significant positive association with PTA-low or PTA-high for all subjects. Conversely, there was a significant negative association between OSA and PPS scores for all subjects, even after adjusting for age, gender, and other variables. When OSA and central obesity together were taken into account in the multivariate linear regression analysis, OSA still showed significant association with PPS score for all subjects.

CONCLUSION

OSA is independently associated with poorer central auditory function in older subjects.

Central auditory processing effects induced by solvent exposure

OBJECTIVES

Various studies have demonstrated that organic solvent exposure may induce auditory damage. Studies conducted in workers occupationally exposed to solvents suggest, on the one hand, poorer hearing thresholds than in matched non-exposed workers, and on the other hand, central auditory damage due to solvent exposure. Taking into account the potential auditory damage induced by solvent exposure due to the neurotoxic properties of such substances, the present research aimed at studying the possible auditory processing disorder (APD), and possible hearing difficulties in daily life listening situations that solvent-exposed workers may acquire.

MATERIALS AND METHODS

Fifty workers exposed to a mixture of organic solvents (xylene, toluene, methyl ethyl ketone) and 50 non-exposed workers matched by age, gender and education were assessed. Only subjects with no history of ear infections, high blood pressure, kidney failure, metabolic and neurological diseases, or alcoholism were selected. The subjects had either normal hearing or sensorineural hearing loss, and normal tympanometric results. Hearing-in-noise (HINT), dichotic digit (DD), filtered speech (FS), pitch pattern sequence (PPS), and random gap detection (RGD) tests were carried out in the exposed and non-exposed groups. A self-report inventory of each subject's performance in daily life listening situations, the Amsterdam Inventory for Auditory Disability and Handicap, was also administered.

RESULTS

Significant threshold differences between exposed and non-exposed workers were found at some of the hearing test frequencies, for both ears. However, exposed workers still presented normal hearing thresholds as a group (equal or better than 20 dB HL). Also, for the HINT, DD, PPS, FS and RGD tests, non-exposed workers obtained better results than exposed workers. Finally, solvent-exposed workers reported significantly more hearing complaints in daily life listening situations than non-exposed workers.

CONCLUSIONS

It is concluded that subjects exposed to solvents may acquire an APD and thus the sole use of pure-tone audiometry is insufficient to assess hearing in solvent-exposed populations.