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Showing papers in "International Journal of Audiology in 2003"


Journal ArticleDOI
TL;DR: Auditory steady-state responses are generated throughout the auditory nervous system, with cortical regions contributing more than brainstem generators to responses at lower modulation frequencies, and are useful for objectively evaluating auditory thresholds, assessing suprathreshold hearing, and monitoring the state of arousal during anesthesia.
Abstract: Steady-state evoked potentials can be recorded from the human scalp in response to auditory stimuli presented at rates between 1 and 200 Hz or by periodic modulations of the amplitude and/or frequency of a continuous tone. Responses can be objectively detected using frequency-based analyses. In waking subjects, the responses are particularly prominent at rates near 40 Hz. Responses evoked by more rapidly presented stimuli are less affected by changes in arousal and can be evoked by multiple simultaneous stimuli without significant loss of amplitude. Response amplitude increases as the depth of modulation or the intensity increases. The phase delay of the response increases as the intensity or the carrier frequency decreases. Auditory steady-state responses are generated throughout the auditory nervous system, with cortical regions contributing more than brainstem generators to responses at lower modulation frequencies. These responses are useful for objectively evaluating auditory thresholds, assessing suprathreshold hearing, and monitoring the state of arousal during anesthesia.

802 citations


Journal ArticleDOI
TL;DR: Several studies have shown that uncorrected hearing loss gives rise to poorer quality of life, related to isolation, reduced social activity, and a feeling of being excluded, leading to an increased prevalence of symptoms of depression, indicating the importance of early identification of hearing loss and offers of rehabilitative support.
Abstract: Hearing loss gives rise to a number of disabilities. Problems in recognizing speech, especially in difficult environments, give rise to the largest number of complaints. Other kinds of disabilities...

531 citations


Journal ArticleDOI
TL;DR: Investigation of possible relationships between cognitive function and hearing aid use indicates significant correlations exist between the measures of cognitive performance and speech recognition in noise, both with and without hearing aids.
Abstract: Two experiments were conducted to investigate possible relationships between cognitive function and hearing aid use. In Experiment 1. 72 first-time hearing aid users were tested for speech recognition in noise (Hagerman sentence test) with and without hearing aids. Cognitive function was assessed by tests of working memory (reading span test) and verbal information-processing speed. The results indicate that. after controlling for age and hearing loss, significant correlations exist between the measures of cognitive performance and speech recognition in noise, both with and without hearing aids. High cognitive performance was associated with high performance in the speech recognition task. In Experiment 2, 17 first-time hearing aid users with either high or low working-memory capacity tested ail experimental hearing aid which processed the sound differently depending on whether or not speech was detected. The results revealed that those with high working-memory capacity were better than those with low capacity at identifying and reporting the specific processing effects of the aid. This may have implications for how reported results should be interpreted in a research context, how a person's rehabilitation needs are formulated, and how hearing aid controls should be supervised. In conclusion, careful attention should be paid to the cognitive status of listeners, as it can have a significant influence on their ability to utilize their hearing aids.

362 citations


Journal ArticleDOI
TL;DR: The focus of this paper is on the effects of age on speech perception, with reference to pertinent psychoacoustic findings, and the implications of age-related changes in auditory speech processing relative to interactions between older individuals and their acoustic environments.
Abstract: The focus of this paper is on the effects of age on speech perception, with reference to pertinent psychoacoustic findings. The difficulties of older listeners are related to the well-known effects of high-frequency hearing loss on speech perception in quiet, and to temporal processing declines not predictable from the audiogram that account for reduced ability to listen in complex, noisy conditions. We also discuss issues of research interpretation; e.g. the need for researchers and clinicians to be alert to the frequent confound between degree of hearing loss and age. The implications of age-related changes in auditory speech processing for future practice and research are discussed relative to interactions between older individuals and their acoustic environments.

354 citations


Journal ArticleDOI
TL;DR: It is argued that the significance of age-related processing problems during discourse depends on social-emotional factors, and goals for new signal-processing technologies designed for older adults who are hard of hearing can be framed not only in terms of improving signal audibility but also in Terms of reducing stress on the listener during information processing.
Abstract: Over the last decade, much research has been conducted to investigate why older listeners report more difficulty in understanding spoken language than would be expected given their degree of audiometric hearing loss. Of particular relevance to audiological rehabilitation is recent research on older listeners when they are engaged in complex tasks involving the auditory processing of naturalistic signals in realistic social and physical environments Discourse epitomizes such activity. By understanding age-related and individual differences in perceptual and cognitive performance, we gain important insights into how hearing impairments influence activity and participation in context. In this paper, the problems of older adults as communicators in everyday life are illuminated by studies showing that auditory processing problems affect cognitive processing. Age-related problems in understanding spoken language are exacerbated by perceptual stressors such as noise and by cognitive stressors such as memory load. It is argued that the significance of these processing problems during discourse depends on social-emotional factors Therefore, goals for new signal-processing technologies designed for older adults who are hard of hearing can be framed not only in terms of improving signal audibility but also in terms of reducing stress on the listener during information processing. Furthermore, goals for therapeutic interventions can be framed in terms of reducing stress during information processing by modifying behaviors and physical and social environments to achieve the listener's goals.

286 citations


Journal ArticleDOI
TL;DR: A working-memory framework is proposed for the cognitive involvement in language understanding (sign and speech) and four important parameters for language understanding are described in some detail: quality and precision of phonology, long-term memory access speed, degree of explicit processing, and general processing and storage capacity.
Abstract: This paper focuses on the role of cognition in visual language processing in the deaf and hard of hearing. Although there are modality-specific cognitive findings in the literature on comparisons across speech communication modes and language (sign and speech), there is an impressive bulk of evidence that supports the notion of general modality-free cognitive functions in speech and sign processing. A working-memory framework is proposed for the cognitive involvement in language understanding (sign and speech). On the basis of multiple sources of behavioural and neuroscience data, four important parameters for language understanding are described in some detail: quality and precision of phonology, long-term memory access speed, degree of explicit processing, and general processing and storage capacity. Their interaction forms an important parameter space, and general predictions and applications can be derived for both spoken and signed language conditions. The model is mathematically formulated at a general level, hypothetical ease-of-language-understanding (ELU) functions are presented, and similarities and differences from current working-memory and speech perception formulations are pointed out.

258 citations


Journal ArticleDOI
TL;DR: The Denmark sentence test DANTALE II was developed in analogy to the Swedish sentence test by Hagerman and the German Oldenburg sentence test as a new Danish sentence test in noise to determine the speech reception threshold in noise (SRT, i.e. the signal-to-noise ratio that yields 50% intelligibility).
Abstract: The Danish sentence test DANTALE II was developed in analogy to the Swedish sentence test by Hagerman and the German Oldenburg sentence test as a new Danish sentence test in noise to determine the speech reception threshold in noise (SRT, i.e. the signal-to-noise ratio (SNR) that yields 50% intelligibility). Each sentence is generated by a random combination of the alternatives of a base list. This base list consists of 10 sentences with the same syntactical structure (name, verb, numeral, adjective, object). The test sentences were recorded and segmented in such a way that the coarticulation effects were taken into account in order to achieve a high perceived sound quality of the resynthesized sentences: 100 sentences were recorded, each coarticulation between each word and the 10 possible following word alternatives were recorded, and the correct coarticulation was used to generate the test sentences. Word-specific speech recognition curves were measured for each recorded word to optimize the homogeneit...

248 citations


Journal ArticleDOI
TL;DR: The interaction between the audiometric and cognitive characteristics of listeners, and the test conditions under which speech identification procedures are conducted, shows that listeners with greater cognitive ability derive greater benefit from temporal structure in background noise when listening via fast time constants.
Abstract: It is becoming increasingly recognized that, in addition to the influence of audiometric variables and associated psychoacoustic abilities, the benefits from and candidature for various signal-processing schemes in hearing aids are strongly influenced by listeners' characteristics (such as motivations, expectations, and personality), and also the auditory environments in which those listeners are required to function (i.e. their auditory ecology). We will report elsewhere an experiment on a group of 50 listeners in a within-subject, randomized, blind, crossover design of five different hearing aid rationales, of which two contained linear amplification and three contained non-linear amplification which differed only in release-time constant. This article reports the interaction between the audiometric and cognitive characteristics of listeners, and the test conditions under which speech identification procedures are conducted (presentation level, signal-to-noise ratio, and temporal characteristics of inte...

233 citations


Journal ArticleDOI
TL;DR: Canada, Australia, -Communication Disiibility in Ageing Rcscarch Unit, The IJnivcrsity of Queensland.
Abstract: (2003) Candidature for and delivery of audiological services: special needs of older people International Journal of Audiology: Vol 42, No sup2, pp 92-101

221 citations


Journal ArticleDOI
TL;DR: After age adjustment, subjects reporting tinnitus had significantly worse hearing at both lower and higher frequencies (p < 0.001) than in older subjects, and this difference was more marked in younger than in Older subjects.
Abstract: There have been few recent estimates of the prevalence of tinnitus from large population-based samples of older persons. Our study aimed to assess the prevalence and characteristics of prolonged tinnitus in a representative sample of 2015 adults aged 55-99 years, residing in the Blue Mountains, west of Sydney, Australia, during 1997-99. All participants underwent a detailed hearing examination by an audiologist, including comprehensive questions about hearing. After age adjustment, subjects reporting tinnitus had significantly worse hearing at both lower and higher frequencies (p < 0.001). This difference was more marked in younger than in older subjects (p < 0.05). Overall, 602 subjects (30.3%) reported having experienced tinnitus, with 48% reporting symptoms in both ears. Tinnitus had been present for at least 6 years in 50% of cases, and most (55%) reported a gradual onset. Despite tinnitus being described as mildly to extremely annoying by 67%, only 37% had sought professional help, and only 6% had received any treatment.

176 citations


Journal ArticleDOI
TL;DR: This article explored the link between age-related differences in auditory temporal processing and slowing in cognitive processing in an effort to illuminate how older adults listen to language spoken in challenging everyday conditions and found that at least some of the apparent age related differences in cognitive performance during spoken language comprehension may be secondary to auditory temporal processes.
Abstract: Age-related differences are observed on many measures of both perceptual and cognitive processing, Indeed, strong correlations between basic measures of hearing and vision and age-related variations in intelligence have highlighted the powerful links between perception and cognition. In this paper, links between age-related differences in auditory temporal processing and slowing in cognitive processing are explored in an effort to illuminate how older adults listen to language spoken in challenging everyday conditions. Experiments in which the signal-to-noise condition is varied to equate listening difficulty for younger and older adults and experiments that simulate auditory aging in younger listeners provide evidence that at least some of the apparent age-related differences in cognitive performance during spoken language comprehension may be secondary to auditory temporal processing differences.

Journal ArticleDOI
TL;DR: The purpose of this review is to provide a framework for considering how the biological aspects of the aging auditory system interact with the most common current therapeutic intervention for age-related hearing loss—the use of amplification—and also how the Biological aspects point to other potential intervention strategies.
Abstract: Over the last century, research in the area of age-related hearing loss has provided a vast amount of knowledge regarding age-related effects on the anatomy and physiology of the auditory system. As we enter the new millennium, researchers are beginning to shift their attention towards developing methods of modulating the effects of age-related hearing loss and the development of efficacious intervention strategies to meet all of an individual's hearing-related rehabilitative needs. The purpose of this review is to provide a framework for considering how the biological aspects of the aging auditory system interact with the most common current therapeutic intervention for age-related hearing loss--the use of amplification--and also how the biological aspects point to other potential intervention strategies.

Journal ArticleDOI
TL;DR: The results indicate that the multiple-ASSR method provides good estimates of the degree and configuration of hearing in individuals with sensorineural hearing impairments.
Abstract: This study evaluated the use of multiple auditory steady-state responses (ASSRs) to estimate the degree and configuration of behavioral audiograms of subjects with sensorineural hearing impairments. Place specificity of the multiple-ASSR method was also assessed. Multiple amplitude-modulated (77-105 Hz) tones (500, 1000, 2000 and 4000 Hz) were simultaneously presented to one ear. The results showed that, on average, multiple-ASSR thresholds were 14 +/- 13, 8 +/- 9, 10 +/- 10 and 3 +/- 10 dB above behavioral thresholds for 500, 1000, 2000 and 4000 Hz, respectively. Behavioral and multiple-ASSR thresholds were significantly correlated (r = 0.75-0.89). There were no significant differences between behavioral and multiple-ASSR measures of the audiogram configuration. In subjects with steep-sloping > or = 30 dB/ octave) hearing losses, multiple-ASSR thresholds did not underestimate behavioral thresholds revealing good place specificity. These results indicate that the multiple-ASSR method provides good estimates of the degree and configuration of hearing in individuals with sensorineural hearing impairments.

Journal ArticleDOI
TL;DR: The aim of this study was to outline the psycho-pathological characteristics of a population of outpatients affected by tinnitus and to consider its impact on their mental state and ability to function in major areas of their lives.
Abstract: The aim of this study was to outline the psychopathological characteristics of a population of outpatients affected by tinnitus and to consider its impact on their mental state and ability to function in major areas of their lives. Seventy-five consecutive tinnitus patients were enrolled on their first visit to the outpatients clinic of the Audiology Department of the 'Federico II' University of Naples, for audiological and psychiatric evaluation. A series of audiometric and vestibular tests was performed for tinnitus rating assessment, and further information was obtained from the patient via a semi-structural interview. For the psychopathological examination, patients underwent the Mini International Neuropsychiatric Interview (MINI), by means of which a multiaxial diagnosis (five axes) was expressed, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). For a better understanding of the personality aspects, the Minnesota Multiphasic Personality Inventory (MMPI) test was administered to a subgroup of 55 subjects whose cultural background permitted their full cooperation. The results of the study show that 58 subjects (77% of the total) met the criteria for psychiatric disorder diagnosis, according to the DSM-IV system: Axis I comprises anxiety, affective and somatoform disorders and psychoses; Axis II comprises personality disorders. Multiple diagnoses were expressed in some subjects. The findings of the examination via MMPI show a high percentage of depression, hysteria, and hypochondria. Although we are not seeking to establish a cause-effect relationship between the unpleasant experience of tinnitus and psychopathological disorders, our findings are consistent with those of other authors. Tinnitus can indeed have severe consequences for the subject's ability to function in many areas of their life. In this paper, the implications of such results for the diagnosis and therapy of tinnitus are discussed.

Journal ArticleDOI
TL;DR: In this paper, the authors evaluated the effectiveness of a noise reduction system implemented in a commercial digital multichannel compression hearing aid and found that the performance of the system was similar with and without noise reduction.
Abstract: We evaluated the effectiveness of a noise reduction system implemented in a commercial digital multichannel compression hearing aid. Eight experienced hearing aid wearers with moderate sensorineural hearing loss were fitted bilaterally according to the manufacturer's fitting guidelines. After a 3-month period of regular use of two programs, one with and one without the noise reduction system, speech recognition thresholds (SRTs) were measured in four types of background noise, including steady noise, and noises with spectral and/or temporal dips. SRTs were very similar with and without the noise reduction system; in both cases, SRTs were markedly lower than for unaided listening. SRTs were lower for the noises with dips than for the steady noise, especially for the aided conditions, indicating that amplification can help to 'listen in the dips'. Ratings of sound quality and listening comfort in the aided conditions were uniformly high and very similar with and without the noise reduction system.

Journal ArticleDOI
TL;DR: It is suggested that hearing problems such as tinnitus, hyperacusis, distortion and/ or diplacusis should, in addition to hearing loss, be defined as hearing disorders.
Abstract: The aim of this study was to assess hearing and hearing disorders among rock/jazz musicians. One hundred and thirty-nine (43 women and 96 men) musicians participated. The results are based on pure-tone audiometry and questionnaire responses. According to our definition of hearing loss, tinnitus, hyperacusis, distortion and/ or diplacusis as hearing disorders, we found disorders in 74% of the rock/jazz musicians studied. Hearing loss, tinnitus and hyperacusis were most common, and the latter two were found significantly more frequently than in different reference populations. The women showed bilateral, significantly better hearing thresholds at 3-6 kHz than the men. Hyperacusis, and the combination of both hyperacusis and tinnitus, were found to be significantly more frequent among women than among men. Hearing loss and tinnitus were significantly more common among men than among women. It is important to evaluate all kinds of hearing problems (other than hearing loss) in musicians, since they represent an occupational group especially dependent on optimal, functional hearing. On the basis of our results, we suggest that hearing problems such as tinnitus, hyperacusis, distortion and/ or diplacusis should, in addition to hearing loss, be defined as hearing disorders.

Journal ArticleDOI
TL;DR: In this paper, the authors examined group differences on a variety of measures for three groups of elderly hearing aid candidates matched for gender, age and hearing loss, and found that the non-adherents who declined amplification differed from the two groups who purchased hearing aids on their scores for the Hearing Handicap Inventory for the Elderly (HHIE) and for several scales of the Communication Profile for Hearing Impaired (CPHI) that assessed the individual's personal adjustment to hearing impairment.
Abstract: This study examined group differences on a variety of measures for three groups of elderly hearing aid candidates matched for gender, age and hearing loss. These three groups were: (1) 26 candidates who declined amplification (non-adherents): (2) 24 individuals who purchased hearing aids, but subsequently returned them (rejected HA); and (3) 26 who purchased hearing aids and continued to use their hearing aids for at least the first 6 months following delivery (accepted HA). Following demonstration of adequate reliability for these measures, using the non-adherents as the test-retest study sample, group differences were examined for each pre-fit measure. The group of non-adherents who declined amplification differed from the two groups who purchased hearing aids on their scores for the Hearing Handicap Inventory for the Elderly (HHIE) and for several scales of the Communication Profile for the Hearing Impaired (CPHI) that assessed the individual's personal adjustment to hearing impairment. These findings ...

Journal ArticleDOI
TL;DR: It is stressed that self-report data provide a unique view of the way that clients function and feel in their daily lives with regard to their hearing health.
Abstract: This paper provides an overview of the measurement of hearing aid fitting outcomes in real life using self-report methods Three topics are addressed: (1) why we should measure real-life outcomes; (2) seven different types of self-report outcome data; and (3) issues to consider in self-report outcome measurement It is stressed that self-report data provide a unique view of the way that clients function and feel in their daily lives with regard to their hearing health Self-report outcome data are multidimensional, and the different domains are only moderately correlated When these types of data are gathered, it is essential to control relevant variables to safeguard validity and reliability

Journal ArticleDOI
TL;DR: How non-auditory aspects of aging can affect a person's ability to manage daily communication with an acquired hearing loss and to manipulate and maintain hearing aids that may be prescribed is discussed.
Abstract: Acquired hearing loss is prevalent among older people. As people age, they also may develop impairments in other sensory systems, such as vision and touch. The purpose of this paper is to examine the communicative effects of a combined sensory loss and discuss how non-auditory aspects of aging can affect a person's ability: (1) to manage daily communication with an acquired hearing loss; and (2) to manipulate and maintain hearing aids that may be prescribed.

Journal ArticleDOI
TL;DR: The results demonstrate that one specific component in the phonological processing system is deteriorating, whereas other parts are preserved intact in deafened adults and individuals with a severe hearing impairment.
Abstract: The purpose of the present article is to review a number of studies conducted in our own laboratory with respect to working memory capacity and phonological processing in deafened adults and individuals with a severe hearing impairment, and how these two cognitive components relate to speech processing. The results demonstrate that one specific component in the phonological processing system (i.e., the phonological representation system) is deteriorating, whereas other parts are preserved intact. The characteristic of the individual's phonological representation is further correlated with success in speech reading and speech understanding with some cochlear implant systems. Working memory capacity is a capacity that remains intact despite a long duration of deafness/severe hearing loss. The size of the working memory is related to skill in speech reading and level of speech understanding with cochlear implants and perceived effort in a noisy environment.

Journal ArticleDOI
TL;DR: It is concluded that communication programs represent an important adjunct to, or supplement for, the traditional approach that focuses on hearing aid fitting.
Abstract: Many older adults with hearing impairment continue to have substantial communication difficulties after being fitted with hearing aids, and many do not choose to wear hearing aids. Two group communication education programs aimed at such older people are described. The 'Keep on Talking' program has a health promotion focus, and is aimed at maintaining communication for older adults living in the community. An experimental group (n = 120) attended the program, and a control group (n = 130) received a communication assessment but no intervention. Significant improvements were found in the experimental participants in terms of knowledge about communication changes with age and about strategies to maintain communication skills. At the follow-up evaluation at 1 year, 45% of the experimental group, compared to 10% of the control group, had acted to improve their communication skills. The 'Active Communication Education' program focuses on the development of problem-solving strategies to improve communication in everyday life situations. Preliminary outcomes have been assessed on a small scale (n = 14) to date. It is concluded that communication programs represent an important adjunct to, or supplement for, the traditional approach that focuses on hearing aid fitting.

Journal ArticleDOI
TL;DR: An epidemiological study was carried out, based on 590 randomly selected subjects aged from 20 to 80 years, in the province of Östergötland in Sweden, with an overall prevalence of subjects with average hearing threshold levels over the frequencies similar to published results from other countries.
Abstract: An epidemiological study was carried out, based on 590 randomly selected subjects, aged from 20 to 80 years, in the province of Ostergotland in Sweden. The results obtained were similar to published results from other countries, with an overall prevalence of subjects with average hearing threshold levels over the frequencies 0.5, 1, 2 and 4 kHz (M4) equal to or exceeding 25 dB HL for the better ear (BE) of 16.9% (95% CI: 13.819.9%). For M4 BE > or = 35 dB HL, the prevalence was 7.7% (95% CI: 5.5-9.8%), for M4 BE > or = 45 dB HL, the prevalence was 3.3% (95% CI: 1.9-4.8%), and for M4 BE > or = 65 dB HL, the prevalence was 0.2% (95% Cl: 0.0-0.6%). The overall prevalence of reported tinnitus was 13.2% (95% CI: 10.5-16.0%). In the population under study, 7.7% of the subjects were estimated to benefit from a hearing aid, while the prevalence of hearing aid users was 2.4%.

Journal ArticleDOI
TL;DR: No significant effects of freq uent use of personal stereo players or regular attendance at discotheques or rock concerts could be demonstrated, but there were clear effects of recurrent ear infections and head injury.
Abstract: Pure-tone audiometry was administered to the adult population in Nord-Trondelag County, Norway, 1995–97. The 51975 participants also provided questionnaire information about occupational and leisure noise exposure, previous ear infections, and head injury. Values averaged over both ears were calculated for low (250 and 500 Hz), middle (1 and 2 kHz) and high frequencies (3, 4, 6 and 8 kHz). The aim was to estimate the magnitude of hearing loss associated with various types of exposure by age and sex. Noise, ear infections and head injury explained 1–6% of the variance in hearing loss (varying with age, sex, and frequency range), in addition to what could be explained by age alone (30–58%). Only moderate effects of noise could be detected among women. The upper tenth percentile regarding occupational noise among men older than 44 years had on average an 8–9-dB high-frequency loss, adjusted for other predictors. Exposure to impulse noise (hunting, sports shooting) caused a 7–8-dB high-frequency loss in the s...

Journal ArticleDOI
TL;DR: The test-retest reliability of distortion-product otoacoustic emissions (DPOAEs) at four frequencies (550, 1000, 2000 and 4000 Hz) over three time intervals was assessed, suggesting that there is a 95% probability that an individual's true DPOAE will fall within 5 dB of the obtained distortion product at 1000–4000 Hz and within 10 dB at 550 Hz.
Abstract: This study assessed the test-retest reliability of distortion-product otoacoustic emissions (DPOAEs) at four frequencies (550, 1000, 2000 and 4000 Hz) over three time intervals. The time intervals were: (1) immediate test retest reliability, in which the retest followed the test without any delay or repositioning of the probe tip; (2) very short-term test-retest reliability, in which the retest followed a 10–20-min break and involved removal and re-insertion of the probe tip; and (3) short-term test-retest reliability, in which the retest was conducted 5–10 days after the test. Fifty normal-hearing women were tested with a commercially available system for measuring DPOAEs (Grason-Stadler, GSI-60), which generated primary tones at 65 dB SPL (L1=L2). Standard errors of measurement at 550 Hz (∼4.6 dB) were nearly twice as large as those found for 1000 Hz, 2000 Hz, and 4000 Hz (∼2.5 dB). The short-term test-retest data suggest that there is a 95% probability that an individual's true DPOAE will fall within 5...

Journal ArticleDOI
TL;DR: The prevalence and clinical characteristics of congenital hearing loss sufficient to require hearing aid fitting in the first 6 years of life for the 1993 birth cohort of the state of Victoria indicate the possible yield from neonatal screening, and hence the likely benefit of such screening.
Abstract: The aim of this study was to report the incidence, prevalence and clinical characteristics of congenital hearing loss sufficient to require hearing aid fitting in the first 6 years of life for the 1993 birth cohort of the state of Victoria (population 4.4 million), Australia. In 1993, 64,116 infants born in the state of Victoria survived the neonatal period. Subjects included all children with congenital hearing loss for which hearing aids were fitted, at any time up to and including 31 December 1999, when the youngest member of the cohort reached 6 years of age. Data on the degree, type and etiology of hearing loss were available from the Australian Hearing database for all subjects. Sociodemographic and health data were available from the Victorian Infant Hearing Screening Program (VIHSP) and parent questionnaires. The known prevalence of identified congenital hearing loss increased as the cohort aged. By the time the youngest member had reached the age of 6 years, 134 children (78 boys, 56 girls) had been fitted with hearing aids for permanent congenital hearing loss of any degree (2.09/1000). Fifty-four (40%) of these had known mild losses (20-40 dB HL). The prevalence of known moderate or greater loss (> 40 dB HL) was 1.12/1000; the data suggest that over 90% could have been detectable by neonatal hearing screening. A further seven children from the birth cohort were fitted with hearing aids due to acquired forms of hearing loss (0.11/1000). The etiology was known in only 57 (43%) congenital cases, with known non-syndromal genetic causes accounting for 21 (37%) of these. This study reports on the prevalence of congenital hearing loss requiring hearing aid fitting for an entire birth cohort. These data indicate the possible yield from neonatal screening, and hence the likely benefit of such screening. For a large proportion of cases, the etiology remains unknown. These data have implications for health service delivery and illustrate the usefulness of a population database in monitoring the prevalence of congenital hearing loss.

Journal ArticleDOI
TL;DR: The results demonstrate the value of identifying psychosocial factors, as well as disease characteristics, among patients presenting at neurootology clinics, and highlight the importance of screening for emotional distress in this patient group, regardless of clinical test results or severity of self-reported symptoms.
Abstract: The experience of depression and anxiety among a sample of 91 patients with complaints of vertigo or dizziness was assessed using a widely available screening instrument, the Hospital Anxiety and Depression Scale (HADS). Questionnaires to assess reported symptoms, self-esteem and social support were also administered. On the basis of clinical vestibular testing, 53% of participants were classified as having a labyrinthine disorder (canal paresis or positional vertigo), 22% as having a vestibular imbalance (spontaneous nystagmus or directional preponderance), and 251% as having no identifiable vestibular abnormality (negative test results). Based on the self-report measures using the screening instrument, 17% of the sample could be classified as depressed, and 29% as anxious. The presence of a vestibular lesion (based on clinical findings) was not associated with reported depression (F (3, 72) = 0.98, p = 0.41). The variables were entered into a hierarchical multiple regression analysis with depression as the dependent variable. A model emerged which accounted for 50% of the variance. Three variables comprised the final model: anxiety (beta = 0.44, p < 0.001), self-esteem (beta = 0.27, p < 0.01), and satisfaction with social support (beta = 0.25, p < 0.01). The results demonstrate the value of identifying psychosocial factors, as well as disease characteristics, among patients presenting at neurootology clinics. In particular, the findings highlight the importance of screening for emotional distress in this patient group, regardless of clinical test results or severity of self-reported symptoms.

Journal ArticleDOI
TL;DR: The study showed that hearing aid fitting solved problems with paid employment, but did not seem to affect unpaid work, and the Amsterdam Inventory proved to be a useful questionnaire to assess the effects on hearing disability.
Abstract: The objective of this study was to evaluate hearing aid fitting from a societal viewpoint, rather than the more traditional patient perspective. The effects of hearing aid fitting on generic quality of life (EuroQol), social functioning (SF36), auditory disability, productivity at paid and unpaid labour, and medical consumption, were assessed in a prospective study among 80 moderately hearing-impaired first-time hearing aid applicants. The study showed that hearing aid fitting solved problems with paid employment, but did not seem to affect unpaid work. Use of medical services remained relatively stable after first-time hearing aid fitting. The Amsterdam Inventory proved to be a useful questionnaire to assess the effects on hearing disability. No effects of hearing aid fitting on generic quality of life could be determined with the EuroQol, while hearing aid fitting did lead to an improvement in one aspect of generic quality of life; namely social functioning.

Journal ArticleDOI
TL;DR: The psychometric adequacy of the (modified) Amsterdam Inventory for Auditory Disability and Handicap ((m)AIAD) was determined by measuring its reliability and validity, with good internal consistency, high split-half correlations, and high test-retest correlations.
Abstract: This study investigated the psychometric adequacy of the (modified) Amsterdam Inventory for Auditory Disability and Handicap ((m)AIAD). The original version of the AIAD was developed by Kramer et al in 1995. Special emphasis was placed on the statistical aspects of the scores, because these properties place limits on the clinical utility of the instrument. The AIAD is a self-assessment questionnaire that consists of 30 questions covering all the relevant factors of disability in individual hearing functioning in daily life. This paper reports data from 94 subjects, aged 17-65 years, with different hearing abilities, who completed a modified version of the AIAD and the Hearing Disability Questionnaire (HDQ), on two occasions 1 month apart. The psychometric adequacy of the AIAD was determined by measuring its reliability and validity. Factor analysis was performed, and the reliability was tested by measuring internal consistency, split-half correlation, and test-retest reproducibility. The validity was tested by measuring construct and criterion validity. The results showed that the reliability of the (m)AIAD was highly satisfactory, with good internal consistency, high split-half correlations, and high test-retest correlations. Construct validity showed a high correlation between scores on the (m)AIAD and scores on the HDQ. Criterion validity showed a moderate but significant correlation between scores on the (m)AIAD and hearing thresholds in dB HL.

Journal ArticleDOI
TL;DR: The overall pattern of results support screening and providing hearing aids to those who do not currently have an aid, and suggests that there would be considerable population benefit.
Abstract: About 40% of 55-74-year-olds have an impairment in at least one ear of 25+ dB HL, and 27% have bilateral impairment at this level, with 11% being impaired bilaterally at 35+ dB HL. Only 6% currently use a hearing aid. The performance of a random sample of participants aged 55-74 years on speech-in-noise tasks shows that significant statistical benefit was obtained from bilateral amplification in over 20% of the population who do not currently use a hearing aid. The offer of a hearing aid to all those who exceeded a 25 dB HL criterion in the worse car was accepted and taken up by 40%, with 16% declining and the remainder being excluded for pathological and logistic reasons (e.g. hearing loss profile not suitable for aid). This is a very high rate of 71% acceptance. One in four fitted with the hearing aid showed a statistical advantage for hearing speech in noise in freefield (noise and speech from in front) with the hearing aid. Thus at least 10% of the population who do not currently use an aid would benefit substantially from a hearing aid in a quiet speech-in-noise environment. Those with poorer cognitive function show greater benefit overall and less disadvantage in very bad signal-to-noise environments. The overall pattern of results support screening and providing hearing aids to those who do not currently have an aid(s), and suggests that there would be considerable population benefit. At least two main questions for further research remain: (1) would bilateral aiding strategies give greater benefit; and (2) would different hearing aids and fitting strategies be more appropriate for people with differing 'cognitive task' loadings on phonological memory and lexical decision factors?

Journal ArticleDOI
TL;DR: The aim of this paper is to highlight some strengths and limitations in the ICF that have been found during a study of people with deafblindness, as well as those with some remaining vision and hearing.
Abstract: A strain of Saccharomyces cerevisiae lacking the GPD2 gene, encoding one of the glycerol-3-phosphate dehydrogenases, grows slowly under anaerobic conditions, due to reductive stress caused by the a ...