Objective: To develop a self-report tinnitus handicap measure that is brief, easy to administer and interpret, broad in scope, and psychometrically robust. Design: A standardization study of a self-report tinnitus handicap measure was conducted to determine its internal consistency reliability and convergent and construct validity. Setting: Audiology clinics in tertiary care centers in two sites. Participants: In the first investigation, 84 patients reporting tinnitus as their primary complaint or secondary to hearing loss completed the 45-item alpha version of the Tinnitus Handicap Inventory (THI). In the second investigation, 66 subjects also reporting tinnitus completed the 25-item beta version. Outcome Measures: Convergent validity was assessed using another measure of perceived tinnitus handicap (Tinnitus Handicap Questionnaire). Construct validity was assessed using the Beck Depression Inventory, Modified Somatic Perception Questionnaire, symptom rating scales (annoyance, sleep disruption, depression, and concentration), and perceived tinnitus pitch and loudness judgments. Results: From the alpha version of the THI, we derived a 25-item beta version with the items grouped into functional, emotional, and catastrophic subscales. The total scale yielded excellent internal consistency reliability (Cronbach's alpha=.93). No significant age or gender effects were seen. Weak correlations were observed between the THI and the Beck Depression Inventory, Modified Somatic Perception Questionnaire, and pitch and loudness judgments. Significant correlations were found between the THI and the symptom rating scales. Conclusion: The THI is a self-report measure that can be used in a busy clinical practice to quantify the impact of tinnitus on daily living. (Arch Otolaryngol Head Neck Surg. 1996;122:143-148)

Development of the Tinnitus Handicap Inventory

Phantom auditory perception (tinnitus): mechanisms of generation and perception

Purpose To develop a reliable and valid questionnaire of bilingual language status with predictable relationships between self-reported and behavioral measures Method In Study 1, the internal vali

The Language Experience and Proficiency Questionnaire (LEAP-Q): assessing language profiles in bilinguals and multilinguals.

The health impacts of environmental noise are a growing concern. At least one million healthy life years are lost every year from traffic-related noise in the western part of Europe. This publication summarises the evidence on the relationship between environmental noise and health effects, including cardiovascular disease, cognitive impairment, sleep disturbance, tinnitus, and annoyance. For each one, the environmental burden of disease methodology, based on exposure-response relationship, exposure distribution, background prevalence of disease and disability weights of the outcome, is applied to calculate the burden of disease in terms of disability-adjusted life-years. Data are still lacking for the rest of the WHO European Region. This publication provides policy-makers and their advisers with technical support in their quantitative risk assessment of environmental noise. International, national and local authorities can use the procedure for estimating burdens presented here to prioritize and plan environmental and public health policies.

Burden of Disease from Environmental Noise: Quantification of Healthy Life Years Lost in Europe

Objective. Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis...

/pdf/clinical-practice-guideline-sudden-hearing-loss-8acwe9fo8a.pdf

Clinical practice guideline: sudden hearing loss.

The psychometric properties of a tinnitus handicap questionnaire are reported. There were two phases in this study. In Phase I, 87 questions were administered to 100 tinnitus patients. From their responses, 59 items that were either redundant, insensitive, or had low item-total correlations were eliminated. In Phase II, the resulting 27-item questionnaire was administered to 319 patients. Fifty-three of these patients also completed psychological and psychophysical measures that were used to validate the questionnaire. A factor analysis of patients' responses revealed a three-factor structure. These three factors appeared to reflect the physical, emotional, and social consequences of tinnitus (Factor 1), hearing ability of the patient (Factor 2), and the patients' view of tinnitus (Factor 3). Although the 27-item questionnaire had high internal consistency reliability and validity as reflected by correlations with life satisfaction and depression scales, it is recommended that only the items on the Factor 1 and the Factor 2 subscales be scored because of the low internal consistency reliability of the Factor 3 subscale. This questionnaire can be used to compare a patient's tinnitus handicap with the norm, identify specific areas of handicaps, and to monitor a patient's progress with particular treatment programs.

The psychometric properties of a tinnitus handicap questionnaire.

Background
The use of bilateral amplification is now common clinical practice for hearing aid users but not for cochlear implant recipients. In the past, most cochlear implant recipients were implanted in one ear and wore only a monaural cochlear implant processor. There has been recent interest in benefits arising from bilateral stimulation that may be present for cochlear implant recipients. One option for bilateral stimulation is the use of a cochlear implant in one ear and a hearing aid in the opposite nonimplanted ear (bimodal hearing).

Recognition and Localization of Speech by Adult Cochlear Implant Recipients Wearing a Digital Hearing Aid in the Nonimplanted Ear (Bimodal Hearing)

Background: Frequency transposition has gained renewed interest in recent years. This type of processing takes sounds in the unaidable high-frequency region and moves them to the lower frequency region. One concern is that the transposed sounds mask or distort the original low-frequency sounds and lead to a poorer performance. On the other hand, experience with transposition may allow the listeners to relearn the new auditory percepts and benefit from transposition. Purpose: The current study was designed to examine the effect of linear frequency transposition on consonant identification in quiet (50 dB SPL and 68 dB SPL) and in noise at three intervals—the initial fit, after one month of use (along with auditory training), and a further one month of use (without directed training) of transposition. Research Design: A single-blind, factorial repeated-measures design was used to study the effect of test conditions (three) and hearing aid setting/time interval (four) on consonant identification. Study Sample: Eight adults with a severe-to-profound high-frequency sensorineural hearing loss participated. Intervention: Participants were fit with the Widex m4-m behind-the-ear hearing aids binaurally in the frequency transposition mode, and their speech scores were measured initially. They wore the hearing aids home for one month and were instructed to complete a self-paced “bottom-up” training regimen. They returned after the training, and their speech performance was measured. They wore the hearing aids home for another month, but they were not instructed to complete any auditory training. Their speech performance was again measured at the end of the two-month trial. Data Collection and Analysis: Consonant performance was measured with a nonsense syllable test (ORCA-NST) that was developed at this facility (Office of Research in Clinical Amplification [Widex]). The test conditions included testing in quiet at 50 dB SPL and 68 dB SPL, and at 68 dB SPL in noise (SNR [signal-to-noise ratio] = +5). The hearing aid conditions included no transposition at initial fit (V1), transposition at initial fit (V2), transposition at one month post-fit (V3), and transposition at 2 months post-fit (V4). Identification scores were analyzed for each individual phoneme and phonemic class. Repeated-measures ANOVA were conducted using SPSS software to examine significant differences. Results: For all test conditions (50 dB SPL in quiet, 68 dB SPL in quiet, and 68 dB SPL in noise), a statistically significant difference (p Conclusions: Linear frequency transposition improved fricative identification over time. Proper candidate selection with appropriate training is necessary to fully realize the potential benefit of this type of processing.

/pdf/efficacy-of-linear-frequency-transposition-on-consonant-3ama98qz4w.pdf

Efficacy of linear frequency transposition on consonant identification in quiet and in noise.

Purpose: To investigate the clinical efficacy of linear frequency transposition (LFT) for a group of school-age children. Research Design: A nonrandomized, within-subject design was implemented to investigate vowel and consonant recognition and fricative articulation of school-age children utilizing this feature. Study Sample: Ten children, aged 6 years and 3 months, to 13 years and 6 months from a special education school district participated in this study. Individual hearing thresholds ranged from normal to moderate in the low frequencies and from severe to profound in the high frequencies. Average language age of children was within 2.2 years of chronological age. Data Collection and Analysis: Phoneme recognition and fricative articulation performance were compared for three conditions: (1) with the children’s own hearing aids, (2) with an advanced hearing instrument utilizing LFT, and (3) with the same instrument without LFT. Nonsense syllable materials were administered at 30 and 50 dB HL input levels. Fricative articulation was measured by analyzing speech samples of conversational speech and oral reading passages. Repeated measures general linear model was utilized to determine the significance of any noted effects. Results: Results indicated significant improvements in vowel and consonant recognition with LFT for the 30 dB HL input level. Significant improvement in the accuracy of production of high-frequency (HF) fricatives after six weeks of use of LFT was also observed. Conclusions: These results suggest that LFT is a potentially useful hearing aid feature for school-age children with a precipitous HF sensorineural hearing loss.

/pdf/effect-of-linear-frequency-transposition-on-speech-2rum8d450j.pdf

Effect of linear frequency transposition on speech recognition and production of school-age children.

The reliability of a modified simplex procedure to select the preferred frequency response on a programmable hearing aid was studied. The effect of stimulus materials on the selected frequency resp...

Francis Kuk

Papers

The psychometric properties of a tinnitus handicap questionnaire.

Recognition and Localization of Speech by Adult Cochlear Implant Recipients Wearing a Digital Hearing Aid in the Nonimplanted Ear (Bimodal Hearing)

Efficacy of linear frequency transposition on consonant identification in quiet and in noise.

Effect of linear frequency transposition on speech recognition and production of school-age children.

The Reliability of a Modified Simplex Procedure in Hearing Aid Frequency-Response Selection