1
|
Maslin MRD, Wise KJ, Purdy SC. The mismatch response in normal hearing adults: a performance comparison with stimuli relevant for objective validation of hearing aid fittings. Int J Audiol 2023; 62:1084-1094. [PMID: 36628549 DOI: 10.1080/14992027.2022.2142682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE A long-standing observation is that the Mismatch Response (MMR) has the potential to offer a clinically feasible index of sound discrimination. However, findings that positively identify MMRs at the individual level have been mixed, even for those who are normally hearing and who can discriminate sounds behaviourally. This complicates interpretation when an MMR is not observed. The objective of this study was to determine the reliability of the MMR using an optimised paradigm and a range of stimuli relevant to audiological applications in relation to objective verification of hearing aid fittings. DESIGN MMRs were measured using an optimised 3-deviant paradigm in response to a range of sounds designed for aided and unaided sound field assessments, including complex tones (CTs) and speech-like signals. STUDY SAMPLE Seventeen normally hearing adults (18-56 years). RESULTS The most robust MMRs were recorded in response to CTs; responses were positively identified in 50 out of 51 instances (98%), assessed via objective Hotelling's T2 bias-free statistical analyses. CONCLUSIONS The results indicate that CTs in conjunction with optimised recording and analysis parameters offer the potential to elicit robust MMRs, supporting future utilisation of MMRs for clinical audiological applications.
Collapse
Affiliation(s)
- Michael R D Maslin
- School of Psychology, Speech and Hearing, The University of Canterbury, New Zealand
- Eisdell Moore Centre for Hearing and Balance Research, New Zealand
| | - Kim J Wise
- Eisdell Moore Centre for Hearing and Balance Research, New Zealand
- School of Psychology, Speech Science, The University of Auckland, New Zealand
| | - Suzanne C Purdy
- Eisdell Moore Centre for Hearing and Balance Research, New Zealand
- School of Psychology, Speech Science, The University of Auckland, New Zealand
| |
Collapse
|
2
|
Visram AS, Stone MA, Purdy SC, Bell SL, Brooks J, Bruce IA, Chesnaye MA, Dillon H, Harte JM, Hudson CL, Laugesen S, Morgan RE, O’Driscoll M, Roberts SA, Roughley AJ, Simpson D, Munro KJ. Aided Cortical Auditory Evoked Potentials in Infants With Frequency-Specific Synthetic Speech Stimuli: Sensitivity, Repeatability, and Feasibility. Ear Hear 2023; 44:1157-1172. [PMID: 37019441 PMCID: PMC10426785 DOI: 10.1097/aud.0000000000001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/27/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES The cortical auditory evoked potential (CAEP) test is a candidate for supplementing clinical practice for infant hearing aid users and others who are not developmentally ready for behavioral testing. Sensitivity of the test for given sensation levels (SLs) has been reported to some degree, but further data are needed from large numbers of infants within the target age range, including repeat data where CAEPs were not detected initially. This study aims to assess sensitivity, repeatability, acceptability, and feasibility of CAEPs as a clinical measure of aided audibility in infants. DESIGN One hundred and three infant hearing aid users were recruited from 53 pediatric audiology centers across the UK. Infants underwent aided CAEP testing at age 3 to 7 months to a mid-frequency (MF) and (mid-)high-frequency (HF) synthetic speech stimulus. CAEP testing was repeated within 7 days. When developmentally ready (aged 7-21 months), the infants underwent aided behavioral hearing testing using the same stimuli, to estimate the decibel (dB) SL (i.e., level above threshold) of those stimuli when presented at the CAEP test sessions. Percentage of CAEP detections for different dB SLs are reported using an objective detection method (Hotellings T 2 ). Acceptability was assessed using caregiver interviews and a questionnaire, and feasibility by recording test duration and completion rate. RESULTS The overall sensitivity for a single CAEP test when the stimuli were ≥0 dB SL (i.e., audible) was 70% for the MF stimulus and 54% for the HF stimulus. After repeat testing, this increased to 84% and 72%, respectively. For SL >10 dB, the respective MF and HF test sensitivities were 80% and 60% for a single test, increasing to 94% and 79% for the two tests combined. Clinical feasibility was demonstrated by an excellent >99% completion rate, and acceptable median test duration of 24 minutes, including preparation time. Caregivers reported overall positive experiences of the test. CONCLUSIONS By addressing the clinical need to provide data in the target age group at different SLs, we have demonstrated that aided CAEP testing can supplement existing clinical practice when infants with hearing loss are not developmentally ready for traditional behavioral assessment. Repeat testing is valuable to increase test sensitivity. For clinical application, it is important to be aware of CAEP response variability in this age group.
Collapse
Affiliation(s)
- Anisa S. Visram
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Michael A. Stone
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Suzanne C. Purdy
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Steven L. Bell
- Institute of Sound and Vibration Research, Faculty of Engineering and Physical Sciences, University of Southampton, United Kingdom
| | - Jo Brooks
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Iain A. Bruce
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Michael A. Chesnaye
- Institute of Sound and Vibration Research, Faculty of Engineering and Physical Sciences, University of Southampton, United Kingdom
| | - Harvey Dillon
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - James M. Harte
- Interacoustics Research Unit, c/o Technical University of Denmark, Denmark
- Eriksholm Research Centre, Denmark
| | - Caroline L. Hudson
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Søren Laugesen
- Interacoustics Research Unit, c/o Technical University of Denmark, Denmark
| | - Rhiannon E. Morgan
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Martin O’Driscoll
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - Stephen A. Roberts
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
| | - Amber J. Roughley
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| | - David Simpson
- Institute of Sound and Vibration Research, Faculty of Engineering and Physical Sciences, University of Southampton, United Kingdom
| | - Kevin J. Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, United Kingdom
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, United Kingdom
| |
Collapse
|
3
|
Phan L, Tariq A, Lam G, Mirza M, Paiva D, Lazic M, Emami Z, Anagnostou E, Gordon KA, Pang EW. Children with autism spectrum disorder who demonstrate normal language scores use a bottom-up semantic processing strategy: Evidence from N400 recordings. Brain Behav 2023; 13:e3158. [PMID: 37475679 PMCID: PMC10498076 DOI: 10.1002/brb3.3158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION The N400 is an electrophysiological component that reflects lexical access and integration of words with mental representations. METHODS Thirty-five young children with a range of language capabilities (n = 21 neurotypical controls, 10 males, mean age = 6.3 ± 0.9 years; n = 14 children with autism, 12 males, mean age = 6.4 ± 1.1 years) completed an auditory semantic categorization paradigm to evoke the N400. Electroencephalograph (EEG) data were acquired with a 64-channel electrode cap as children listened via ear inserts to binaurally presented single syllable words and decided whether the words were congruent (in) or incongruent (out) with a pre-specified category. EEG data were filtered, epoched, and averaged referenced, and global field power (GFP) was computed. The amplitude of the N400 peak in the GFP was submitted to a multiple linear regression analysis. RESULTS N400 amplitude was found to predict language scores only for the children with ASD who have language scores in the normal range (r2 = 0.72). CONCLUSIONS This finding that N400 amplitude only predicted language scores in children with ASD and normal language scores suggests that these children may rely more on basic semantic processing (as reflected by the N400) and less on anticipating and predicting upcoming words. This suggests preferential utilization of a bottom-up strategy to access higher order language.
Collapse
Affiliation(s)
- Lee Phan
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
| | - Alina Tariq
- SickKids Research InstituteTorontoOntarioCanada
| | - Garbo Lam
- SickKids Research InstituteTorontoOntarioCanada
- University of British ColumbiaPsychologyVancouverBritish ColumbiaCanada
| | - Maaz Mirza
- SickKids Research InstituteTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
| | - Dylan Paiva
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
| | - Milan Lazic
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
| | - Zahra Emami
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
| | - Evdokia Anagnostou
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
- Holland Bloorview Kids Rehabilitation HospitalEast YorkOntarioCanada
| | - Karen A. Gordon
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
| | - Elizabeth W. Pang
- SickKids Research InstituteTorontoOntarioCanada
- University of TorontoDepartment of PaediatricsTorontoOntarioCanada
- Division of NeurologyHospital for Sick ChildrenTorontoOntarioCanada
| |
Collapse
|
4
|
Ching TYC, Zhang VW, Ibrahim R, Bardy F, Rance G, Van Dun B, Sharma M, Chisari D, Dillon H. Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants. Clin Neurophysiol 2023; 149:121-132. [PMID: 36963143 DOI: 10.1016/j.clinph.2023.02.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/15/2023] [Accepted: 02/12/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE This study examined (1) the utility of a clinical system to record acoustic change complex (ACC, an event-related potential recorded by electroencephalography) for assessing speech discrimination in infants, and (2) the relationship between ACC and functional performance in real life. METHODS Participants included 115 infants (43 normal-hearing, 72 hearing-impaired), aged 3-12 months. ACCs were recorded using [szs], [uiu], and a spectral rippled noise high-pass filtered at 2 kHz as stimuli. Assessments were conducted at age 3-6 months and at 7-12 months. Functional performance was evaluated using a parent-report questionnaire, and correlations with ACC were examined. RESULTS The rates of onset and ACC responses of normal-hearing infants were not significantly different from those of aided infants with mild or moderate hearing loss but were significantly higher than those with severe loss. On average, response rates measured at 3-6 months were not significantly different from those at 7-12 months. Higher rates of ACC responses were significantly associated with better functional performance. CONCLUSIONS ACCs demonstrated auditory capacity for discrimination in infants by 3-6 months. This capacity was positively related to real-life functional performance. SIGNIFICANCE ACCs can be used to evaluate the effectiveness of amplification and monitor development in aided hearing-impaired infants.
Collapse
Affiliation(s)
- Teresa Y C Ching
- National Acoustic Laboratories, Australia; Macquarie School of Education, Macquarie University, Australia; NextSense Institute, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Australia.
| | - Vicky W Zhang
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia
| | - Ronny Ibrahim
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia
| | - Fabrice Bardy
- National Acoustic Laboratories, Australia; School of Psychology, University of Auckland, New Zealand
| | - Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | | | - Mridula Sharma
- Department of Linguistics, Macquarie University, Australia
| | - Donella Chisari
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | - Harvey Dillon
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia; Department of Hearing, University of Manchester, United Kingdom
| |
Collapse
|
5
|
Chesnaye MA, Bell SL, Harte JM, Simonsen LB, Visram AS, Stone MA, Munro KJ, Simpson DM. Modified T 2 Statistics for Improved Detection of Aided Cortical Auditory Evoked Potentials in Hearing-Impaired Infants. Trends Hear 2023; 27:23312165231154035. [PMID: 36847299 PMCID: PMC9974628 DOI: 10.1177/23312165231154035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 12/28/2022] [Accepted: 01/11/2023] [Indexed: 03/01/2023] Open
Abstract
The cortical auditory evoked potential (CAEP) is a change in neural activity in response to sound, and is of interest for audiological assessment of infants, especially those who use hearing aids. Within this population, CAEP waveforms are known to vary substantially across individuals, which makes detecting the CAEP through visual inspection a challenging task. It also means that some of the best automated CAEP detection methods used in adults are probably not suitable for this population. This study therefore evaluates and optimizes the performance of new and existing methods for aided (i.e., the stimuli are presented through subjects' hearing aid(s)) CAEP detection in infants with hearing loss. Methods include the conventional Hotellings T2 test, various modified q-sample statistics, and two novel variants of T2 statistics, which were designed to exploit the correlation structure underlying the data. Various additional methods from the literature were also evaluated, including the previously best-performing methods for adult CAEP detection. Data for the assessment consisted of aided CAEPs recorded from 59 infant hearing aid users with mild to profound bilateral hearing loss, and simulated signals. The highest test sensitivities were observed for the modified T2 statistics, followed by the modified q-sample statistics, and lastly by the conventional Hotelling's T2 test, which showed low detection rates for ensemble sizes <80 epochs. The high test sensitivities at small ensemble sizes observed for the modified T2 and q-sample statistics are especially relevant for infant testing, as the time available for data collection tends to be limited in this population.
Collapse
Affiliation(s)
- Michael Alexander Chesnaye
- Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - Steven Lewis Bell
- Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - James Michael Harte
- Interacoustics Research Unit, Technical University of Denmark, Lyngby, Denmark
- Eriksholm Research Centre, Snekkersten, Denmark
| | | | - Anisa Sadru Visram
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Michael Anthony Stone
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kevin James Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - David Martin Simpson
- Institute of Sound and Vibration Research, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| |
Collapse
|
6
|
Visram AS, Purdy SC, Kelly J, Munro KJ. Longitudinal assessment of listening skills in UK infants with hearing aids using the LittlEARS ® auditory questionnaire. Int J Audiol 2022; 62:334-342. [PMID: 35468301 DOI: 10.1080/14992027.2022.2048105] [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: 11/05/2022]
Abstract
OBJECTIVE To investigate listening skills in infant hearing aid users using the LittlEARS® Auditory Questionnaire (LEAQ). DESIGN Caregivers completed the LEAQ, and hearing aid data logging was recorded, at infant age 3-7 months and 7-21 months. STUDY SAMPLE Seventy infant hearing aid users with permanent bilateral hearing loss, no developmental comorbidities, aged 3-7 months at first visit. RESULTS Infants with mild and moderate losses tended to have scores within the normative range at the early time point (88%), but 29% were below the normative range when older. Thirty percent of infants with severe hearing loss were outside the normative range at the early time point and 60% outside the normative range when older. Infants with profound loss were almost always (95%) outside the normative range. At the later time point, and for infants with severe-to-profound loss, low LEAQ scores were associated with fewer daily hours hearing aid use. Scores were poorer than previous reports in the literature for infant hearing aid users. CONCLUSIONS This study provides further knowledge on infant listening performance and hearing aid use over time that can be used to guide management of individual cases and to develop and audit service quality improvements.
Collapse
Affiliation(s)
- Anisa Sadru Visram
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK.,Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Jack Kelly
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kevin James Munro
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK.,Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
7
|
Wermke K, Cebulla M, Salinger V, Ross V, Wirbelauer J, Shehata-Dieler W. Cry features of healthy neonates who passed their newborn hearing screening vs. those who did not. Int J Pediatr Otorhinolaryngol 2021; 144:110689. [PMID: 33799102 DOI: 10.1016/j.ijporl.2021.110689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/09/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Temporal and fundamental frequency (fo) variations in infant cries provide critical insights into the maturity of vocal control and hearing performances. Earlier research has examined the use of vocalisation properties (in addition to hearing tests) to identify infants at risk of hearing impairment. The aim of this study was to determine whether such an approach could be suitable for neonates. METHODS To investigate this, we recruited 74 healthy neonates within their first week of life as our participants, assigning them to either a group that passed the ABR-based NHS (PG, N = 36) or a group that did not, but were diagnosed as normally hearing in follow-up check at 3 months of life, a so-called false-positive group (NPG, N = 36). Spontaneously uttered cries (N = 2330) were recorded and analysed quantitatively. The duration, minimum, maximum and mean fo, as well as two variability measures (fo range, fo sigma), were calculated for each cry utterance, averaged for individual neonates, and compared between the groups. RESULTS A multiple analysis of variance (MANOVA) revealed no significant effects. This confirms that cry features reflecting vocal control do not differ between healthy neonates with normal hearing, irrespective of the outcome of their initial NHS. CONCLUSIONS Healthy neonates who do not pass the NHS but are normal hearing in the follow-up (false positive cases) have the same cry properties as those with normal hearing who do. This is an essential prerequisite to justify the research strategy of incorporating vocal analysis into NHS to complement ABR measures in identifying hearing-impaired newborns.
Collapse
Affiliation(s)
- Kathleen Wermke
- Center for Pre-Speech Development and Developmental Disorders, Department of Orthodontics, University of Würzburg, Germany.
| | - Mario Cebulla
- Comprehensive Hearing Center (CHC), Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital, University of Würzburg, Germany
| | - Vivien Salinger
- Center for Pre-Speech Development and Developmental Disorders, Department of Orthodontics, University of Würzburg, Germany
| | - Veronique Ross
- Center for Pre-Speech Development and Developmental Disorders, Department of Orthodontics, University of Würzburg, Germany
| | - Johannes Wirbelauer
- University Children's Hospital, Department of Neonatology, University of Würzburg, Germany
| | - Wafaa Shehata-Dieler
- Comprehensive Hearing Center (CHC), Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital, University of Würzburg, Germany
| |
Collapse
|