Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children With Hearing Aids

Expressive vocabulary word categories of children who are deaf and hard-of-hearing

This study investigated the acquisition of early expressive vocabulary among young children who are deaf and hard-of-hearing (DHH; n = 68) using auditory technology (hearing aids and cochlear implants). Parents completed a standardized vocabulary checklist, which allowed analyses of (i) the size of their child's spoken vocabulary; (ii) composition of the expressive lexicon (e.g., parts of speech such as nouns and verbs; semantic categories such as routines and body parts); and (iii) demographic and audiologic factors (e.g., chronologic age, degree of hearing access) potentially associated with these metrics. Young children who are DHH and use auditory technology acquired fewer spoken words than peers with typical hearing (TH) matched for chronologic age but more spoken words than peers with TH matched for listening experience. Action verbs-not nouns-significantly increased the odds of a child who is DHH achieving a vocabulary quotient within the normative range. These findings support the exploration of early expressive vocabulary size and composition-especially the number of active verbs-to guide clinical management and decision-making for young children who are DHH.

Examining Force Level Output of Skin-Drive Bone Conduction Hearing Devices in Adults With Simulated Conductive Hearing Loss

PURPOSE

Bone conduction hearing devices (BCDs) that deliver sound across the skin (i.e., transcutaneous) are suitable for some individuals who have conductive or mixed hearing losses. Prescriptive targets for percutaneous devices are available, for example, from the Desired Sensation Level-Bone Conduction Hearing Device (DSL-BCD) algorithm. These targets, however, may require modification for use with transcutaneous BCDs. The current study investigated three key variables that may inform target modification: (a) comparison of thresholds measured using an audiometric bone conduction (BC) transducer versus transcutaneous BCDs that offer in situ threshold measurement, (b) transcutaneous BCD default force level outputs versus recommended DSL percutaneous BC targets, and (c) the preferred listening levels (PLLs) of adults wearing transcutaneous BCDs in a laboratory setting.

METHOD

Bilateral conductive hearing loss was simulated in 20 normal-hearing adults via earplugs. Thresholds were measured using a B-71 BC transducer and two commercially available BCDs coupled to a soft headband. DSL percutaneous BC targets were generated, and PLLs were obtained for a 60-dB SPL speech stimulus. Force level outputs were measured using a skull simulator on the Audioscan Verifit2 at the hearing aids' default settings and at the participants' PLL for each device.

RESULTS

On average, audiometric BC thresholds were significantly better than those measured in situ with each BCD. PLLs were similar to prescribed targets for one device with the smoother response shape and agreed in the high frequencies for both devices.

CONCLUSIONS

In situ thresholds are significantly higher than audiometric BC thresholds, suggesting that device-based in situ measurement more accurately accounts for the signal transmission from transcutaneous BCDs. PLLs differed from the percutaneous targets and varied between devices, which may indicate that either target modifications or manipulations of device frequency response shaping are needed to approximate PLL with transcutaneous BCD devices.

Safety and Early Outcomes of Cochlear Implantation of Nucleus Devices in Infants: A Multi-Centre Study

This multi-center study examined the safety and effectiveness of cochlear implantation of children between 9 and 11 months of age. The intended impact was to support practice regarding candidacy assessment and prognostic counseling of pediatric cochlear implant candidates. Data in the clinical chart of children implanted at 9-11 months of age with Cochlear Ltd devices at five cochlear implant centers in the United States and Canada were included in analyses. The study included data from two cohorts implanted with one or two Nucleus devices during the periods of January 1, 2012-December 31, 2017 (Cohort 1, n = 83) or between January 1, 2018 and May 15, 2020 (Cohort 2, n = 50). Major adverse events (requiring another procedure/hospitalization) and minor adverse events (managed with medication alone or underwent an expected course of treatment that did not require surgery or hospitalization) out to 2 years post-implant were monitored and outcomes measured by audiometric thresholds and parent-reports on the IT-MAIS and LittlEARS questionnaires were collected. Results revealed 60 adverse events in 41 children and 227 ears implanted (26%) of which 14 major events occurred in 11 children; all were transitory and resolved. Improved hearing with cochlear implant use was shown in all outcome measures. Findings reveal that the procedure is safe for infants and that they show clear benefits of cochlear implantation including increased audibility and hearing development.

Comparing criteria for deviation from hearing aid prescriptive targets in children

OBJECTIVE

To determine if a stricter criterion for paediatric hearing aid fitting for proximity of fit-to-target of <3 dB root-mean-square (RMS) error produces better audibility and outcomes compared to the current <5 dB criterion, and to examine the relationship between aided audibility and RMS error by degree of hearing loss.

DESIGN

We evaluated the influence of unaided hearing level on the relationship between RMS error and aided audibility. We assessed the effect of RMS error category (<3, 3-5, >5 dB) on aided audibility, speech recognition, expressive vocabulary, and morphosyntax.

STUDY SAMPLE

The study included 2314 hearing aid verification measurements from 307 children with hearing aids.

RESULTS

Children who met a <3 dB criterion had higher aided audibility than children who met no criterion (>5 dB error). Results showed no differences in speech recognition or vocabulary by error category, but children with <3 dB error demonstrated better morphosyntax than children with 3-5 and >5 dB RMS error.

CONCLUSIONS

Fittings that are close to prescriptive targets provide a more positive outcome for children with hearing aids. Using probe microphone measures to adjust hearing aids to within 3 dB may benefit language abilities in children.

EEG Alpha Band Responses Reveal Amplification Benefits in Infants with Hearing Loss

Our objective was to examine the effects of hearing aid amplification on auditory detection and discrimination in infants who were hard of hearing (IHH) using a physiological measure of auditory perception. We recorded EEG from 41 sleeping IHH aged 1.04 to 5.62 months while presenting auditory stimuli in a mismatch response paradigm. Responses were recorded during two listening conditions for each participant: aided and unaided. Temporal envelopes of the mismatch response in the EEG alpha band (6-12 Hz) were extracted from the latent, time-frequency transformed data. Aided alpha band responses were greater than unaided responses for the deviant trials but were not different for the standard trials. Responses to the deviant trials were greater than responses to the standard trials for the aided conditions but were not different for the unaided conditions. These results suggest that the alpha band mismatch can be used to examine both detection and discrimination of speech and non-speech sounds in IHH. With further study, the alpha band mismatch could expand and refine our abilities to validate hearing aid fittings at younger ages than current clinical protocols allow.

A Systematic Literature Review on Human Ear Biometrics: Approaches, Algorithms, and Trend in the Last Decade

Biometric technology is fast gaining pace as a veritable developmental tool. So far, biometric procedures have been predominantly used to ensure identity and ear recognition techniques continue to provide very robust research prospects. This paper proposes to identify and review present techniques for ear biometrics using certain parameters: machine learning methods, and procedures and provide directions for future research. Ten databases were accessed, including ACM, Wiley, IEEE, Springer, Emerald, Elsevier, Sage, MIT, Taylor & Francis, and Science Direct, and 1121 publications were retrieved. In order to obtain relevant materials, some articles were excused using certain criteria such as abstract eligibility, duplicity, and uncertainty (indeterminate method). As a result, 73 papers were selected for in-depth assessment and significance. A quantitative analysis was carried out on the identified works using search strategies: source, technique, datasets, status, and architecture. A Quantitative Analysis (QA) of feature extraction methods was carried out on the selected studies with a geometric approach indicating the highest value at 36%, followed by the local method at 27%. Several architectures, such as Convolutional Neural Network, restricted Boltzmann machine, auto-encoder, deep belief network, and other unspecified architectures, showed 38%, 28%, 21%, 5%, and 4%, respectively. Essentially, this survey also provides the various status of existing methods used in classifying related studies. A taxonomy of the current methodologies of ear recognition system was presented along with a publicly available occlussion and pose sensitive black ear image dataset of 970 images. The study concludes with the need for researchers to consider improvements in the speed and security of available feature extraction algorithms.