The effects of a temporal processing-based auditory training program on the auditory skills of elderly users of hearing aids: a study protocol for a randomized clinical trial

Training Programs for Improving Speech Perception in Noise: A Review

Understanding speech in the presence of noise is difficult and challenging, even for people with normal hearing. Accurate pitch perception, coding and decoding of temporal and intensity cues, and cognitive factors are involved in speech perception in noise (SPIN); disruption in any of these can be a barrier to SPIN. Because the physiological representations of sounds can be corrected by exercises, training methods for any impairment can be used to improve speech perception. This study describes the various types of bottom-up training methods: pitch training based on fundamental frequency (F0) and harmonics; spatial, temporal, and phoneme training; and top-down training methods, such as cognitive training of functional memory. This study also discusses music training that affects both bottom-up and top-down components and speech training in noise. Given the effectiveness of all these training methods, we recommend identifying the defects underlying SPIN disorders and selecting the best training approach.

Auditory Perceptual Exercises in Adults Adapting to the Use of Hearing Aids

Older adults with age-related hearing loss often use hearing aids (HAs) to compensate. However, certain challenges in speech perception, especially in noise still exist, despite today's HA technology. The current study presents an evaluation of a home-based auditory exercises program that can be used during the adaptation process for HA use. The home-based program was developed at a time when telemedicine became prominent in part due to the COVID-19 pandemic. The study included 53 older adults with age-related symmetrical sensorineural hearing loss. They were divided into three groups depending on their experience using HAs. Group 1: Experienced users (participants who used bilateral HAs for at least 2 years). Group 2: New users (participants who were fitted with bilateral HAs for the first time). Group 3: Non-users. These three groups underwent auditory exercises for 3 weeks. The auditory tasks included auditory detection, auditory discrimination, and auditory identification, as well as comprehension with basic (syllables) and more complex (sentences) stimuli, presented in quiet and in noisy listening conditions. All participants completed self-assessment questionnaires before and after the auditory exercises program and underwent a cognitive test at the end. Self-assessed improvements in hearing ability were observed across the HA users groups, with significant changes described by new users. Overall, speech perception in noise was poorer than in quiet. Speech perception accuracy was poorer in the non-users group compared to the users in all tasks. In sessions where stimuli were presented in quiet, similar performance was observed among new and experienced uses. New users performed significantly better than non-users in all speech in noise tasks; however, compared to the experienced users, performance differences depended on task difficulty. The findings indicate that HA users, even new users, had better perceptual performance than their peers who did not receive hearing aids.

Developing the computer-based auditory training program for adults with hearing impairment

Although it is known that auditory training is essential for hearing-impaired individuals, patients do not willingly participate in auditory training sessions, because individual training is a time-consuming and costly process. Computer-based auditory training programs are under development for reducing the cost and time. The aim of this study is to develop a computer-based auditory training program and to evaluate the usability of the program by applying it to adults with normal hearing indifferent age groups and professions. The developed auditory training program consists of nine modules: identification, discrimination, recognition, auditory closure, comprehension, auditory sequencing, phonological awareness, auditory memory, and attention. Forty adults (age ranges of 25-34, 35-44, 45-54, and 55-65 years), nine audiologists, and one software engineer were included in this study. The computer-based auditory training program was applied to all individuals. An evaluation form was filled out by the participants to evaluate the usability of and satisfaction with the program, and the average performances of the individuals were calculated for each module. The form measures five usability subscales: ease of use, comprehensibility, design, satisfaction, and motivation. The professionals evaluated the program and found it to be quite positive in terms of design, ease of use, motivation, and comprehensibility, and positive in terms of the satisfaction subscale. The participants evaluated all factors and found them to be quite positive. There were no statistically significant differences between the gender, age, and computer use groups in terms of the average performance value of the modules (p > 0.05). However, a significant difference was found in the average performance for the auditory sequencing module considering the educational status of individuals (p = 0.019). Furthermore, it was determined that computer experience (> 5 years) and having a personal computer have a significant effect on auditory memory (p = 0.049) and identification (p = 0.027). These results show that the instructions and information used in the program are clear and understandable, the colors and texts used in the program are readable, the program is easy to use, and the individuals are not disturbed by the sounds used in the program. However, it would be valuable to apply it to individuals with hearing losses to evaluate the efficacy of the program.

The effects of a temporal processing-based auditory training program on the auditory skills of elderly users of hearing aids: a study protocol for a randomized clinical trial

Background: One of the most important effects of age-related declines in neural processing speed is the impairment of temporal resolution, which leads to difficulty hearing in noisy environments. Since the central auditory system is highly plastic, by designing and implementing a temporal processing-based auditory training program, we can help the elderly improve their listening skills and speech understanding in noisy environments.

Methods: In the first phase of this research, based on the theoretical framework of temporal processing, an auditory training solution was developed as a software program. In the second phase, which will be described in the present study, the effects of the designed program on the listening skills of the elderly users of hearing aids (age: 60-75 years) will be studied in the control and intervention groups. In the intervention group, the auditory training program will be implemented for three months (36 sessions), and the results of central tests (GIN, DPT, QuickSIN) and the electrophysiological speech-ABR test will be compared in both groups before, immediately and one month after the intervention.

Discussion: Since temporal processing is not sufficient in auditory training programs for the elderly with hearing impairments, implementation of a temporal processing-based auditory training program can reduce hearing problems in noisy environments among elderly users of hearing aids.

Trial registration: This study was registered as a clinical trial in the Iranian Registry of Clinical Trials ( IRCT20190921044838N1) on December 25, 2019.