Successful and unsuccessful users of bilateral amplification: Differences and similarities in binaural performance

Listening to speech-in-noise with hearing aids: Do the self-reported outcomes reflect the behavioral speech perception task performance?

BACKGROUND

The aim of this study is to examine the relationship between behavioral speech-in-noise listening tasks and self-reported speech-in-noise outcomes of hearing aid user adult listeners.

METHOD

To measure the self-reported outcomes of hearing, the Hearing Handicap Inventory for Adults [HHI-A], Speech, Spatial and Qualities of Hearing Scale (SSQ) and Amsterdam Inventory for Auditory Disability and Handicap were employed. To screen the cognitive abilities, Montreal Cognitive Assessment (MoCA) tool was used. Turkish matrix sentence test (TMST) was used for speech-in-noise test. Eighteen adult hearing aid users (mean age of 36.6 years) were participated.

CONCLUSIONS

Results showed that some self-reported listening-in-noise outcomes are correlated with lab-based measurements of speech-in-noise test scores but not with the aided speech intelligibility thresholds. Given the present limitations of relying solely on self-report measures, it is important to complement them with objective measures to ensure a comprehensive evaluation.

Applying the Hearing Aid Fitting Standard to Selection for Adults

The recent hearing aid fitting standard for adults outlines the minimum practice for audiologists fitting adult patients with hearing loss. This article focuses on three items of the standard (5, 6, and 7), which focus on the selection of unilateral/bilateral hearing aids, hearing aid style, and coupling, in addition to feature selection. The standard emphasizes that decisions around these three aspects should be recommended for a patient in an individualized manner, based on their needs assessment. For these decisions, the needs assessment might include measures of speech-in-noise ability, social network size, patient preference, and a trial period. Additional elements could include assessments of manual dexterity, binaural interference, and attitude toward hearing aids. However, there are a multitude of ways to practice clinically and still meet the items outlined in the standard. As long as the selection decisions consider individualized patient factors and are capable of meeting validated prescriptive targets, a clinician would be meeting the adult hearing aid fitting minimum standard guidance. In addition, despite the large number of past studies supporting these standards, additional, high-quality research including randomized, controlled, clinical trials are still needed to further support appropriate minimum standard recommendations.

Predicting Hearing Aid Satisfaction in Adults: A Systematic Review of Speech-in-noise Tests and Other Behavioral Measures

OBJECTIVES

Adults with hearing loss report a wide range of hearing aid satisfaction that does not significantly correlate to degree of hearing loss. It is not clear which auditory behavioral factors do contribute to hearing aid satisfaction. While poor speech understanding in noise is known to contribute to dissatisfaction, there are many categories of this type of assessment. The purpose of this systematic review is to answer the question, "Are behavioral pre-fitting measures using speech and nonspeech materials related to hearing aid satisfaction among adults?"

DESIGN

Six electronic databases were searched to find peer-reviewed studies published before June 2020. The included studies reported on the relationship between auditory behavioral measures and hearing aid satisfaction alone or globally with other outcome domains among adults with hearing loss. Six types of behavioral prefitting measures were evaluated: speech recognition in quiet (% correct), speech recognition in noise (% correct), reception thresholds for speech-in-noise, speech-based subjective ratings, dichotic speech tests, and tests using nonspeech material. Each relevant study was independently reviewed by two reviewers. Methodological quality was evaluated in each included study using the American Speech-Language-Hearing Association's level of evidence ratings.

RESULTS

There were 1342 articles identified in the systematic review process. After duplicates were removed and specific inclusion criteria were applied, 21 studies were included. All studies included had a 0 to 4 methodological quality rating indicating weak to moderate internal validity. The tests that showed potential for clinical application due to significant correlations with satisfaction were the QuickSIN, the synthetic sentence identification, the hearing in noise test, and the acceptable noise level test. Audibility, as measured by degree of hearing loss, was not significantly correlated to hearing aid satisfaction in the 13 studies that reported on this measure.

CONCLUSIONS

Based on this review, results indicated that speech-in-noise tests had the highest associations to hearing aid satisfaction, suggesting a greater role for assessment of speech-in-noise perception in auditory rehabilitation. This is an important finding for clinical practice, given that audibility was not a significant factor in predicting satisfaction. Overall, the results from this review show a need for well-designed, high-quality, prospective studies assessing the predictive value of prefitting measures on hearing aid satisfaction with current hearing aid models.

Determining unilateral or bilateral hearing aid preference in adults: a prospective study

OBJECTIVE

Despite high rates of bilateral hearing aid fitting globally, a number of adults continue to reject one hearing aid. The current study aimed to identify a clinically suitable tool for determining, pre-fitting, which clients might prefer one hearing aid.

Study Sample: Ninety-five new adult hearing aid candidates, aged 49-87 years, were assessed prior to a first hearing aid fitting. Sixty-eight participants adhered to the prescribed protocol for both bilateral and unilateral hearing aid use.

DESIGN

Performance was assessed on a modified version of the Listening in Spatialised Noise - Sentences test (LiSN-S), the Dichotic Digits difference Test, the Experiential Hearing Aid simulator, and the Grooved Pegboard Test. All participants were fitted bilaterally, but were instructed to alternate between unilateral and bilateral hearing aid use over fourteen weeks post-fitting. Participants' wearing preferences were assessed via a short questionnaire.

RESULTS

78% of participants expressed an overall preference for bilateral hearing aid use. Only the LiSN-S bilateral advantage test outcomes significantly correlated with overall wearing preference.

CONCLUSIONS

Although the LiSN-S bilateral advantage score related to overall wearing preference, the accuracy of the predictor was too low to warrant implementation of this test prior to hearing aid fitting. The current practice of recommending bilateral hearing aid use continues to be the best option for clinicians.

Does bimodal hearing increase self-assessed abilities and hearing outcomes when compared to unilateral cochlear implantation?

Objective: The primary objective of this study was to compare the applicability and benefit of providing unilateral cochlear implant (CI) users with a contralateral hearing aid (HA).Design: This retrospective (case-control) study was conducted in a hospital-based CI centre. Participants self-assessed their hearing via two questionnaires (SSQ₁₂ and HISQUI₁₉). Objective postoperative speech perception was assessed via aided thresholds and speech perception tests (monosyllabic words, disyllabic words, and sentences) in quiet and noise.Study sample: A CI-only group (n = 113, mean age 55.1 ± 14.2 years) and a bimodal group (n = 50, mean age 56.7 ± 15.2) participated in the study.Results: No significant difference in SSQ₁₂ or HISQUI₁₉ scores was observed between groups. The bimodal group had a significantly better aided hearing level (p = 0.020) and speech discrimination score (p = 0.019).Conclusions: Bimodal (CI + HA) users have significantly better speech understanding than unilateral CI-only users, although this benefit may not be reflected in self-assessed outcomes. Counselling about bimodal hearing must cover expectations about potential benefits.

Degree of Hearing Loss Affects Bilateral Hearing Aid Benefits in Ecologically Relevant Laboratory Conditions

Purpose Previous evidence supports benefits of bilateral hearing aids, relative to unilateral hearing aid use, in laboratory environments using audio-only (AO) stimuli and relatively simple tasks. The purpose of this study was to evaluate bilateral hearing aid benefits in ecologically relevant laboratory settings, with and without visual cues. In addition, we evaluated the relationship between bilateral benefit and clinically viable predictive variables. Method Participants included 32 adult listeners with hearing loss ranging from mild-moderate to severe-profound. Test conditions varied by hearing aid fitting type (unilateral, bilateral) and modality (AO, audiovisual). We tested participants in complex environments that evaluated the following domains: sentence recognition, word recognition, behavioral listening effort, gross localization, and subjective ratings of spatialization. Signal-to-noise ratio was adjusted to provide similar unilateral speech recognition performance in both modalities and across procedures. Results Significant and similar bilateral benefits were measured for both modalities on all tasks except listening effort, where bilateral benefits were not identified in either modality. Predictive variables were related to bilateral benefits in some conditions. With audiovisual stimuli, increasing hearing loss, unaided speech recognition in noise, and unaided subjective spatial ability were significantly correlated with increased benefits for many outcomes. With AO stimuli, these same predictive variables were not significantly correlated with outcomes. No predictive variables were correlated with bilateral benefits for sentence recognition in either modality. Conclusions Hearing aid users can expect significant bilateral hearing aid advantages for ecologically relevant, complex laboratory tests. Although future confirmatory work is necessary, these data indicate the presence of vision strengthens the relationship between bilateral benefits and degree of hearing loss.

[Validation of the Russian language version of the SSQ questionnaire]

The Speech, Spatial and Qualities of Hearing Scale (SSQ) is applied worldwide as a highly reliable tool for the characteristic of the quality of life and subjective sensations of the patients presenting with hearing impairment as well as for the estimation of the efficiency of hearing aids. The objective of the present study was to validate and adapt the Russian language version of the SSQ questionnaire (SSQrus) for its application in the audiological practice under conditions of this country. After the cultural and language adaptation of SSQrus, it was validated by means of repeat interviewing of three groups of the respondents (a total of 93 subjects with normal, moderately and severely impaired hearing). The results of the validation give evidence of the high reliability of the modified questionnaire. Specifically, high reproducibility of the data estimated from the results of the second interview has been demonstrated (r=0.85--0.99). High sensitivity of SSQruswas confirmed by the agreement between the results of the estimation (in scores) and the degree of the observed loss of hearing. The estimates obtained by the application of the SSQrus questionnaire are comparable with those reported by the foreign authors. It is concluded that the SSQrus questionnaire can be used in routine audiological practice as an additional diagnostic instrument for the estimation of hearing problems experienced by a patient, monitoring efficiency of therapy and surgical treatment of hearing impairment, improvement of hearing aids, and hearing dysfunction research.

Adaptação cultural do questionário Speech, Spatial and Qualities of Hearing Scale (SSQ) para o Português Brasileiro

Objetivo Traduzir e adaptar, culturalmente, o questionário Speech, Spatial and Qualities of Hearing Scale(SSQ) para o Português Brasileiro.Métodos Foi realizada a tradução, retrotradução, avaliação por comitê de especialistas e adaptação cultural (pré-teste). A fase de adaptação cultural constou da aplicação do questionário em 40 brasileiros adultos, normo-ouvintes e alfabetizados em português. Foram elaboradas duas versões do SSQ em português, a primeira aplicada no Grupo Piloto 1 (20 sujeitos) e, após revisão do comitê de especialistas, uma segunda versão foi aplicada no Grupo Piloto 2 (20 sujeitos). Para haver equivalência cultural do questionário, é necessário que 85% dos indivíduos não apresentem dificuldades para compreender as questões. A consistência interna do SSQ, em português, foi verificada por meio do coeficiente alfa de Cronbach.Resultados Foi identificada dificuldade de compreensão na questão 14 da Parte 2 e na questão 5 da Parte 3. As demais questões foram compreendidas por mais de 85% dos participantes. As questões problemáticas foram revistas e modificadas, de forma a não alterar o contexto. Na aplicação da versão final do SSQ foi obtida uma boa equivalência cultural para o Português Brasileiro, já que 91,6% dos participantes relataram fácil entendimento de todas as questões. A análise estatística revelou alto coeficiente alpha de Cronbach (>0,8), demonstrando boa consistência interna entre os diversos itens do questionário.Conclusão A metodologia empregada foi eficaz para estabelecer a tradução e equivalência cultural do SSQ para o Português Brasileiro.

Better together: reduced compliance after sequential versus simultaneous bilateral hearing aids fitting

PURPOSE

The purpose of this study was to determine the effects of sequential versus simultaneous bilateral hearing aids fitting on patient compliance.

METHOD

Thirty-six older adults with hearing impairment participated in this study. Twelve were fitted with bilateral hearing aids simultaneously. The remaining participants were fitted sequentially: One hearing aid (to the left or to the right ear) was used initially; 1 month later, the other ear was also fitted with a hearing aid for bilateral use. Self-reports on usefulness and compliance were elicited after the first and second months of hearing aid use. In addition, the number of hours the hearing aids were used was extracted from the data loggings of each device.

RESULTS

Simultaneous fitting resulted in high levels of compliance and consistent usage throughout the study period. Sequential fitting resulted in abrupt reduction in compliance and hours of use once the second hearing aid was added, both in the clinical scoring and in the data loggings.

CONCLUSIONS

Simultaneous fitting of bilateral hearing aids results in better compliance compared with sequential fitting. The addition of a second hearing aid after a relatively short period of monaural use may lead to inconsistent use of both hearing aids.

Individual Differences in Behavioral and Electrophysiological Measures of Binaural Processing Across the Adult Life Span

PURPOSE

The purpose of the present study was to examine individual differences in binaural processing across the adult life span.

METHOD

Sixty listeners (aged 23-80 years) with symmetrical hearing were tested. Binaural behavioral processing was measured by the Words-in-Noise Test, the 500-Hz masking level difference, and the Dichotic Digit Test. Electrophysiologic responses were assessed by the auditory middle latency response binaural interaction component.

RESULTS

No correlations among binaural measures were found. Age accounted for the greatest amount of variability in speech-in-noise performance. Age was significantly correlated with the Words-in-Noise Test binaural advantage and dichotic ear advantage. Partial correlations, however, revealed that this was an effect of hearing status rather than age per se. Inspection of individual results revealed that 20% of listeners demonstrated reduced binaural performance for at least 2 of the binaural measures.

CONCLUSIONS

The lack of significant correlations among variables suggests that each is an important measurement of binaural abilities. For some listeners, binaural processing was abnormal, reflecting a binaural processing deficit not identified by monaural audiologic tests. The inclusion of a binaural test battery in the audiologic evaluation is supported given that these listeners may benefit from alternative forms of audiologic rehabilitation.

O desempenho de idosos com perda auditiva neurossensorial nos testes de processamento auditivo: um estudo longitudinal

OBJETIVOS: verificar o desempenho de idosos nos testes de processamento auditivo na entrega do Aparelho de Amplificação Sonora Individual, após um mês de uso deste dispositivo e após o treinamento auditivo. MÉTODOS: o estudo foi realizado com 11 idosos, entre 60 e 79 anos, protetizados num Centro de Saúde. Todos foram submetidos aos testes Fala no Ruído, Random Gap Detection Test normal ou expandido e Dicótico de Dígitos na etapa de integração binaural em três momentos: na entrega do Aparelho de Amplificação Sonora Individual, após um mês de uso do mesmo e após as cinco sessões de treinamento auditivo. RESULTADOS: em relação ao sexo, 7 (63,64%) eram mulheres. A média de idade foi 71,27 (±5,33) anos. O tempo médio de uso diário do Aparelho de Amplificação Sonora Individual foi de 10,18 horas (±2,44) e o de privação sensorial foi 5,82 anos (±5,29). Todos os participantes aumentaram os escores nos testes de processamento auditivo gradativamente, obtendo melhor desempenho após o treinamento auditivo, sendo o comparativo entre os três momentos estatisticamente significantes (p<0,001). CONCLUSÃO: o processo de adaptação do Aparelho de Amplificação Sonora Individual bem como o treinamento auditivo proporcionou melhora no reconhecimento de fala com e sem mensagem competitiva pois refletindo o período de aclimatização após a segunda avaliação e o efeito do treinamento auditivo após a terceira avaliação.

Desempenho de idosos com adaptação binaural x monoaural em testes de fala no silêncio e no ruído

OBJETIVO:avaliar o reconhecimento de sentenças no silêncio e no ruído de indivíduos idosos com perdas auditivas simétricas, usuários de próteses auditivas com adaptação mono e binaural; investigar em qual das duas situações pode ser verificado o melhor desempenho em condições que simulam situações de comunicação do dia a dia.MÉTODOS:foram avaliados 27 indivíduos, 20 do gênero masculino e sete do feminino, com idades entre 60 e 80 anos, com perda auditiva neurossensorial de grau leve a moderadamente severo e configuração simétrica. Utilizando o teste Listas de Sentenças em Português, realizou-se a pesquisa dos Limiares de Reconhecimento de Sentenças no Silêncio e no Ruído e Índice Percentual de Reconhecimento de Sentenças no Silêncio e no Ruído, em diferentes situações de escuta, com adaptação binaural e monoaural.RESULTADOS:os valores médios obtidos para os índices no silêncio foram de 80,89% com adaptação binaural, 76,33% com aparelho somente na orelha direita e 71,16% com aparelho somente na orelha esquerda. Já as médias obtidas nos índices no ruído foram 62,05 % com adaptação binaural, 60,52% com aparelho somente na orelha direita e 60,33% com aparelho somente na orelha esquerda. Ao comparar as diferentes condições de escuta, não foi encontrada diferença estatisticamente significante.CONCLUSÃO:não foi encontrada diferença estatisticamente significante entre os idosos usuários de próteses auditivas com adaptação mono e binaural, tanto no silêncio como no ruído.

A factor analysis of the SSQ (Speech, Spatial, and Qualities of Hearing Scale)

OBJECTIVE

The speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure.

DESIGN

Statistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals.

STUDY SAMPLE

1220 people who have attended MRC IHR over the last decade.

RESULTS

We found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed "speech understanding", "spatial perception", and "clarity, separation, and identification". Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, "effort and concentration", representing two more questions.

CONCLUSIONS

These results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores.

Interferência binaural no processo de seleção e adaptação de próteses auditivas: revisão sistemática

O tema deste estudo é a interferência binaural e tem como objetivo descrever, por meio de revisão teórica, o fenômeno caracterizado por interferência binaural. Será realizada revisão sistemática por meio de pesquisa nas bases de dados LILACS, MEDLINE, PUBMED e SCIELO. O fenômeno interferência binaural é uma realidade relatada na literatura, que precisa ser investigado. Pode se confirmar por testes específicos de processamento auditivo, o mais descrito foi o dicótico de dígitos.

Relationships between self-report and cognitive measures of hearing aid outcome

This present study examined the relationship between cognitive measures and self-report hearing aid outcome. A sentence-final word identification and recall (SWIR) test was used to investigate how hearing aid use may relate to experienced explicit cognitive processing. A visually based cognitive test battery was also administered. To measure self-report hearing aid outcome, the International Outcome Inventory – Hearing Aids (IOI-HA) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) were employed. Twenty-six experienced hearing aid users (mean age of 59 years) with symmetrical moderate-to-moderately severe sensorineural hearing loss were recruited. Free recall performance in the SWIR test correlated negatively with item 3 of IOI-HA, which measures residual difficulty in adverse listening situations. Cognitive abilities related to verbal information processing were correlated positively with self-reported hearing aid use and overall success. The present study showed that reported residual difficulty with hearing aid may relate to experienced explicit processing in difficult listening conditions, such that individuals with better cognitive capacity tended to report more remaining difficulty in challenging listening situations. The possibility of using cognitive measures to predict hearing aid outcome in real life should be explored in future research.

Everyday hearing functioning in unilateral versus bilateral hearing aid users

PURPOSE

The purpose of the present study was to assess hearing functioning in everyday listening situations of bilateral and unilateral hearing aid (HA) users.

METHOD

80 Arabic-speaking HA users: 46 bilateral and 34 unilateral HA users with various degrees of HL. Participants completed the Speech, Spatial, and Qualities (SSQ) self-report questionnaire.

RESULTS

In general, bilateral users performed better than unilateral users on the speech and spatial scales. For participants with symmetrical unaided HL, the bilateral group significantly surpassed the unilateral group on all three scales. For participants with asymmetrical unaided HL, no significant intergroup differences emerged. Regarding degree of HL, the moderate HL group outperformed the severe, and profound HL groups. No differences emerged between the severe and profound groups. Finally, more severe HL correlated with poorer SSQ performance. Similarly, better speech discrimination scores correlated with better SSQ performance.

CONCLUSION

Results support the need for subjective questionnaires when assessing HA benefits.

The speech intelligibility benefit of a unilateral wireless system for hearing-impaired adults

OBJECTIVE

This study measured the effects of two previously untested practical considerations-venting and transmission delays-on speech intelligibility in a simulated unilateral wireless system, where a target signal in background noise was transmitted wirelessly to the hearing-impaired (HI) listener.

DESIGN

Speech reception thresholds (SRTs) relative to the signal-to-noise ratio (SNR) were measured by varying the surrounding babble noise level. The target signal was presented at 0° azimuth in the soundfield and unilaterally via an insert earphone, using open and closed fittings with simulated-wireless delays ranging between 0-160 ms. SRTs were also measured unaided and with participants' current hearing aid(s).

STUDY SAMPLE

Thirty-three mild-to-moderate sensorineural HI adults participated in the experiment.

RESULTS

For an open fitting, the results showed a 5-dB SNR benefit in SRT compared to unaided performance at shorter delays. For a closed fitting, the majority of participants could accurately recognize speech below - 20 dBSNR across delays.

CONCLUSIONS

These results highlight the efficacy of wireless systems with HI adults. Speech-intelligibility benefits are affected by transmission delays only when the delay is greater than 40 ms and the coupling is vented.