Seminars In Hearing[JOURNAL]
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200 papers
Barriers to Adoption of Digital Therapeutics (DTx) into Audiology Clinical Practice: Acknowledging the Challenges, Adapting to the Future.
Roberts MJ, Wilson WJ, Recugnat M … +1 more , Bardy F
Semin Hear · 2023 Aug · PMID 37484989 · Full text
The continuous advancements in technologies supporting digital health and digital therapeutics (DTx) bring new possibilities to the field of audiology. This study considers a new DTx for tinnitus called Tinnibot and the...
The continuous advancements in technologies supporting digital health and digital therapeutics (DTx) bring new possibilities to the field of audiology. This study considers a new DTx for tinnitus called Tinnibot and the willingness of a group of Australian university audiology students to consider this new DTx in their future careers as practicing audiologists. A single-group case-series design (pretest/posttest) was used to examine the opinions of 10 university audiology students before and after participating in a 2-hour information workshop on the topics of tinnitus, DTx, cognitive behavioral therapy, and a new digital therapy tool for tinnitus called Tinnibot. Student knowledge levels of the main topic areas increased from poor (before the workshop) to moderate to high after the workshop, with 40% of participants reporting they would very likely use digital therapies for future patients. A common barrier to improving this rating was the need for direct hands-on training on the DTx before the students would be confident to recommend the DTx to patients. Incorporating direct training on DTx into university audiology programs would allow greater uptake of DTx by students as they begin their careers as practicing audiologists.
Effect of Determinants of Health on the Hearing Care Framework: An Economic Perspective.
Amlani AM
Semin Hear · 2023 Aug · PMID 37484988 · Full text
Hearing care is expanding accessibility to consumers through new service delivery channels and methods of technology distribution (see Brice et al, this issue). This diversification has the potential to overcome longstan...
Hearing care is expanding accessibility to consumers through new service delivery channels and methods of technology distribution (see Brice et al, this issue). This diversification has the potential to overcome longstanding consumer disparities (e.g., health, socioeconomic, psychological, environmental) in receiving care and provider constraints (e.g., accessibility, geography, direct access) to delivering care that adversely impacts quality of life (e.g., social isolation, depression, anxiety, self-esteem). In this article, the reader is provided with an overview of health outcomes factors (i.e., determinants of health)-in the context of an economic framework (i.e., supply, demand)-and their effect on consumer behavior and provider preferences toward hearing healthcare services. This overview also affords readers with strategic business insights to assess and integrate future hearing care services and technology to consumers in their local markets.
Exploring Hearing Care Technology from Clinic to Capability.
Penno KA, Zakis JA
Semin Hear · 2023 Aug · PMID 37484987 · Full text
Healthcare systems are traditionally a clinician-led and reactive structure that does not promote clients managing their health issues or concerns from an early stage. However, when clients are proactive in starting thei...
Healthcare systems are traditionally a clinician-led and reactive structure that does not promote clients managing their health issues or concerns from an early stage. However, when clients are proactive in starting their healthcare earlier than later, they can achieve better outcomes and quality of life. Hearing healthcare and the rehabilitation journey currently fit into this reactive and traditional model of care. With the development of service delivery models evolving to offer services to the consumer online and where they are predominately getting their healthcare information from the internet and the advancement of digital applications and hearing devices beyond traditional hearing aid structures, we are seeing a change in how consumers engage in hearing care. Similarly, as the range of hearing devices evolves with increasingly blended and standard levels of technology across consumer earbuds/headphones and medical grade hearing aids, we are seeing a convergence of consumers engaging earlier and becoming increasingly aware of hearing health needs. This article will discuss how the channels, service, and technology are coming together to reform traditionally clinician-led healthcare models to an earlier consumer-led model and the benefits and limitations associated with it. Additionally, we look to explore advances in hearing technologies and services, and if these will or can contribute to a behavioral change in the hearing healthcare journey of consumers.
Preserving the Role of the Audiologist in a Clinical Technology, Consumer Channel, Clinical Service Model of Hearing Healthcare.
Abrams HB, Singh J
Semin Hear · 2023 Aug · PMID 37484986 · Full text
The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing...
The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing aid dispensaries housed in large retail establishments and direct-to-consumer hearing aid sales by internet-based companies unaffiliated with major hearing aid manufacturers (e.g., Eargo). These developments have been accompanied by acceleration in the growth of teleaudiology services as a direct result of the COVID-19 pandemic. The resulting development of nontraditional hearing aid distribution and sales models can be categorized into distinct archetypes as reviewed earlier in this publication. This article will review the model as exemplified by Jabra Enhance. We will describe a completely digital model of hearing aid distribution and sales that maintains the professional service component throughout the client journey to include an online tone test, the use of a risk mitigation questionnaire, virtual consultations, remote hearing aid adjustments, and the establishment and monitoring of client-centered treatment goals. Furthermore, this article will review the Jabra Enhance model within the context of consumer healthcare decision-making theory with a focus on the Consumer Decision-Making Model.
Centering on People: How Hearing Care Professionals Can Adapt to Consumers' Need and Outcomes.
Brice S, Timmer BHB, Barr C
Semin Hear · 2023 Aug · PMID 37484985 · Full text
Audiology is experiencing exponential growth in technology, service, and provision options. These advancements give hearing care professionals the opportunity to revise, potentially improve, and adapt to the modern heari...
Audiology is experiencing exponential growth in technology, service, and provision options. These advancements give hearing care professionals the opportunity to revise, potentially improve, and adapt to the modern hearing care landscape to better serve the modern consumer. Consumer needs guide care planning and delivery, with the goal of achieving outcomes that are important to both the consumer and the clinician. The changes available to the hearing care industry can also enable consumers' needs to be identified and served in a more holistic and personalized manner than has previously been possible. The purpose of this article is to explain and encourage hearing care professionals to adopt a mindset of doing whatever is reasonable and clinically appropriate to meet the need and desires of the consumer by implementing choice in service, technology, and channel across whichever model of care adopted by a provider.
The Modern Hearing Care Landscape: Toward the Provision of Personalized, Dynamic, and Adaptive Care.
Glista D, Schnittker JA, Brice S
Semin Hear · 2023 Aug · PMID 37484984 · Full text
New technologies and developments in hearing healthcare are rapidly transforming service models, delivery channels, and available solutions. These advances are reshaping the ways in which care is provided, leading to gre...
New technologies and developments in hearing healthcare are rapidly transforming service models, delivery channels, and available solutions. These advances are reshaping the ways in which care is provided, leading to greater personalization, service efficiencies, and improved access to care, to name a few benefits. Connected hearing care is one model with the potential to embrace this "customized" hearing experience by forging a hybrid of health-technology connections, as well as traditional face-to-face interactions between clients, providers, and persons integral to the care journey. This article will discuss the many components of connected care, encompassing variations of traditional and teleaudiology-focused services, clinic-based and direct-to-consumer channels, in addition to the varying levels of engagement and readiness defining the touch points for clients to access a continuum of connected hearing care. The emerging hearing healthcare system is one that is dynamic and adaptive, allowing for personalized care, but also shifting the focus to the client's needs and preferences. This shift in the care model, largely driven by innovation and the growing opportunities for clients to engage with hearing technology, brings forth new, exciting, and sometimes uncomfortable discussion points for both the provider and client. The modern hearing care landscape benefits clients to better meet their needs and preferences in a more personalized style, and providers to better support and address those needs and preferences.
Test-Retest Reliability and the Role of Task Instructions when Measuring Listening Effort Using a Verbal Response Time Paradigm.
Gustafson SJ, Ortiz C, Nelson L
Semin Hear · 2023 May · PMID 37122885 · Full text
Listening amidst competing noise taxes one's limited cognitive resources, leading to increased listening effort. As such, there is interest in incorporating a reliable test of listening effort into the clinical test batt...
Listening amidst competing noise taxes one's limited cognitive resources, leading to increased listening effort. As such, there is interest in incorporating a reliable test of listening effort into the clinical test battery. One clinically promising method for measuring listening effort is verbal response time (VRT) because it can be obtained using already-established clinical tasks. In order for widespread implementation of the VRT paradigm, a better understanding of the psychometric properties is needed. The purpose of this work was to improve the understanding of the reliability and sensitivity of the VRT listening task. Using within-subject study designs, we completed a pilot study to evaluate the test-retest reliability (Study 1) and the effects of task instructions and listening condition (Study 2). Preliminary results show that the VRT paradigm enjoys good to excellent test-retest reliability and that neither task instructions nor listening condition meaningfully influence VRT once measurement error is accounted for. Future studies should account for measurement error when considering statistically significant versus meaningful effects of experimental parameters when using listening effort tasks.
Brightening the Study of Listening Effort with Functional Near-Infrared Spectroscopy: A Scoping Review.
Shatzer HE, Russo FA
Semin Hear · 2023 May · PMID 37122884 · Full text
Listening effort is a long-standing area of interest in auditory cognitive neuroscience. Prior research has used multiple techniques to shed light on the neurophysiological mechanisms underlying listening during challeng...
Listening effort is a long-standing area of interest in auditory cognitive neuroscience. Prior research has used multiple techniques to shed light on the neurophysiological mechanisms underlying listening during challenging conditions. Functional near-infrared spectroscopy (fNIRS) is growing in popularity as a tool for cognitive neuroscience research, and its recent advances offer many potential advantages over other neuroimaging modalities for research related to listening effort. This review introduces the basic science of fNIRS and its uses for auditory cognitive neuroscience. We also discuss its application in recently published studies on listening effort and consider future opportunities for studying effortful listening with fNIRS. After reading this article, the learner will know how fNIRS works and summarize its uses for listening effort research. The learner will also be able to apply this knowledge toward generation of future research in this area.
Listening Effort Methodologies: Challenges and Future Directions.
Picou EM
Semin Hear · 2023 May · PMID 37122883 · Full text
Abstract loading — click title to view on PubMed.
Combining Multiple Psychophysiological Measures of Listening Effort: Challenges and Recommendations.
Richter M, Buhiyan T, Bramsløw L … +9 more , Innes-Brown H, Fiedler L, Hadley LV, Naylor G, Saunders GH, Wendt D, Whitmer WM, Zekveld AA, Kramer SE
Semin Hear · 2023 May · PMID 37122882 · Full text
About one-third of all recently published studies on listening effort have used at least one physiological measure, providing evidence of the popularity of such measures in listening effort research. However, the specifi...
About one-third of all recently published studies on listening effort have used at least one physiological measure, providing evidence of the popularity of such measures in listening effort research. However, the specific measures employed, as well as the rationales used to justify their inclusion, vary greatly between studies, leading to a literature that is fragmented and difficult to integrate. A unified approach that assesses multiple psychophysiological measures justified by a single rationale would be preferable because it would advance our understanding of listening effort. However, such an approach comes with a number of challenges, including the need to develop a clear definition of listening effort that links to specific physiological measures, customized equipment that enables the simultaneous assessment of multiple measures, awareness of problems caused by the different timescales on which the measures operate, and statistical approaches that minimize the risk of type-I error inflation. This article discusses in detail the various obstacles for combining multiple physiological measures in listening effort research and provides recommendations on how to overcome them.
Time Scales and Moments of Listening Effort Revealed in Pupillometry.
Winn MB
Semin Hear · 2023 May · PMID 37122881 · Full text
This article offers a collection of observations that highlight the value of time course data in pupillometry and points out ways in which these observations create deeper understanding of listening effort. The main mess...
This article offers a collection of observations that highlight the value of time course data in pupillometry and points out ways in which these observations create deeper understanding of listening effort. The main message is that listening effort should be considered on a moment-to-moment basis rather than as a singular amount. A review of various studies and the reanalysis of data reveal distinct signatures of effort before a stimulus, during a stimulus, in the moments after a stimulus, and changes over whole experimental testing sessions. Collectively these observations motivate questions that extend beyond the "amount" of effort, toward understanding how long the effort lasts, and how precisely someone can allocate effort at specific points in time or reduce effort at other times. Apparent disagreements between studies are reconsidered as informative lessons about stimulus selection and the nature of pupil dilation as a reflection of decision making rather than the difficulty of sensory encoding.
Dual-Task Paradigm Measures of Listening Effort: To Include or Not to Include Secondary Task Responses with Incorrect Primary Task Responses.
Huang H, Oosthuizen I, Picou EM
Semin Hear · 2023 May · PMID 37122880 · Full text
Response time-based dual-task paradigms are commonly adopted to measure behavioral listening effort. Most extant studies used an all-response approach that included secondary task responses under both correct and incorre...
Response time-based dual-task paradigms are commonly adopted to measure behavioral listening effort. Most extant studies used an all-response approach that included secondary task responses under both correct and incorrect primary task responses during analysis. However, evidence supporting this strategy is limited. Therefore, the current study investigated the potential differences between including all responses versus only including correct responses. Data from two previous studies were reanalyzed. Experiment 1 included 16 listeners and used a dual-task paradigm to examine the effect of introducing background noise on listening effort. Experiment 2 included 19 participants and used a different dual-task paradigm to examine the effect of reverberation and loudspeaker-to-listener distance on listening effort. ANOVA results obtained using both analysis approaches were compared. The all-response and correct-only approaches revealed similar results. However, larger effect sizes and an additional main effect were found with the all-response approach. The current study supports the use of an all-response approach due to its greater sensitivity to changes in behavioral listening effort. However, a correct-only approach could be utilized to suit specific study purposes.
Performance Monitoring and Cognitive Inhibition during a Speech-in-Noise Task in Older Listeners.
Ryan DB, Eckert MA, Sellers EW … +4 more , Schairer KS, McBee MT, Ridley EA, Smith SL
Semin Hear · 2023 May · PMID 37122879 · Full text
The goal of this study was to examine the effect of hearing loss on theta and alpha electroencephalography (EEG) frequency power measures of performance monitoring and cognitive inhibition, respectively, during a speech-...
The goal of this study was to examine the effect of hearing loss on theta and alpha electroencephalography (EEG) frequency power measures of performance monitoring and cognitive inhibition, respectively, during a speech-in-noise task. It was hypothesized that hearing loss would be associated with an increase in the peak power of theta and alpha frequencies toward easier conditions compared to normal hearing adults. The shift would reflect how hearing loss modulates the recruitment of listening effort to easier listening conditions. Nine older adults with normal hearing (ONH) and 10 older adults with hearing loss (OHL) participated in this study. EEG data were collected from all participants while they completed the words-in-noise task. It hypothesized that hearing loss would also have an effect on theta and alpha power. The ONH group showed an inverted -shape effect of signal-to-noise ratio (SNR), but there were limited effects of SNR on theta or alpha power in the OHL group. The results of the ONH group support the growing body of literature showing effects of listening conditions on alpha and theta power. The null results of listening condition in the OHL group add to a smaller body of literature, suggesting that listening effort research conditions should have near ceiling performance.
Facial Expressions as an Index of Listening Difficulty and Emotional Response.
Venkitakrishnan S, Wu YH
Semin Hear · 2023 May · PMID 37122878 · Full text
Knowledge about listening difficulty experienced during a task can be used to better understand speech perception processes, to guide amplification outcomes, and can be used by individuals to decide whether to participat...
Knowledge about listening difficulty experienced during a task can be used to better understand speech perception processes, to guide amplification outcomes, and can be used by individuals to decide whether to participate in communication. Another factor affecting these decisions is individuals' emotional response which has not been measured objectively previously. In this study, we describe a novel method of measuring listening difficulty and affect of individuals in adverse listening situations using automatic facial expression algorithm. The purpose of our study was to determine if facial expressions of confusion and frustration are sensitive to changes in listening difficulty. We recorded speech recognition scores, facial expressions, subjective listening effort scores, and subjective emotional responses in 33 young participants with normal hearing. We used the signal-to-noise ratios of -1, +2, and +5 dB SNR and quiet conditions to vary the difficulty level. We found that facial expression of confusion and frustration increased with increase in difficulty level, but not with change in each level. We also found a relationship between facial expressions and both subjective emotion ratings and subjective listening effort. Emotional responses in the form of facial expressions show promise as a measure of affect and listening difficulty. Further research is needed to determine the specific contribution of affect to communication in challenging listening environments.
The Importance of High-Frequency Bandwidth on Speech and Language Development in Children: A Review of Patricia Stelmachowicz's Contributions to Pediatric Audiology.
Walker EA
Semin Hear · 2023 Feb · PMID 36970651 · Full text
We review the literature related to Patricia Stelmachowicz's research in pediatric audiology, specifically focusing on the influence of audibility in language development and acquisition of linguistic rules. Pat Stelmach...
We review the literature related to Patricia Stelmachowicz's research in pediatric audiology, specifically focusing on the influence of audibility in language development and acquisition of linguistic rules. Pat Stelmachowicz spent her career increasing our awareness and understanding of children with mild to severe hearing loss who use hearing aids. Using a variety of novel experiments and stimuli, Pat and her colleagues produced a robust body of evidence to support the hypothesis that development moderates the role of frequency bandwidth on speech perception, particularly for fricative sounds. The prolific research that came out of Pat's lab had several important implications for clinical practice. First, her work highlighted that children require access to more high-frequency speech information than adults in the detection and identification of fricatives such as /s/ and /z/. These high-frequency speech sounds are important for morphological and phonological development. Consequently, the limited bandwidth of conventional hearing aids may delay the formation of linguistic rules in these two domains for children with hearing loss. Second, it emphasized the importance of not merely applying adult findings to the clinical decision-making process in pediatric amplification. Clinicians should use evidence-based practices to verify and provide maximum audibility for children who use hearing aids to acquire spoken language.
Extending the High-Frequency Bandwidth and Predicting Speech-in-Noise Recognition: Building on the Work of Pat Stelmachowicz.
Monson BB, Trine A
Semin Hear · 2023 Feb · PMID 36970650 · Full text
Recent work has demonstrated that high-frequency (>6 kHz) and extended high-frequency (EHF; >8 kHz) hearing is valuable for speech-in-noise recognition. Several studies also indicate that EHF pure-tone thresholds predict...
Recent work has demonstrated that high-frequency (>6 kHz) and extended high-frequency (EHF; >8 kHz) hearing is valuable for speech-in-noise recognition. Several studies also indicate that EHF pure-tone thresholds predict speech-in-noise performance. These findings contradict the broadly accepted "speech bandwidth" that has historically been limited to below 8 kHz. This growing body of work is a tribute to the work of Pat Stelmachowicz, whose research was instrumental in revealing the limitations of the prior speech bandwidth work, particularly for female talkers and child listeners. Here, we provide a historical review that demonstrates how the work of Stelmachowicz and her colleagues paved the way for subsequent research to measure effects of extended bandwidths and EHF hearing. We also present a reanalysis of previous data collected in our lab, the results of which suggest that 16-kHz pure-tone thresholds are consistent predictors of speech-in-noise performance, regardless of whether EHF cues are present in the speech signal. Based on the work of Stelmachowicz, her colleagues, and those who have come afterward, we argue that it is time to retire the notion of a limited speech bandwidth for speech perception for both children and adults.
Building on the Academic Legacy of Pat Stelmachowicz and other Pioneers in Developmental Psychoacoustics and Pediatric Audiology: The Children's English/Spanish Speech Recognition Test (ChEgSS).
Leibold LJ, Calandruccio L, Buss E
Semin Hear · 2023 Feb · PMID 36970649 · Full text
Basic research investigating auditory development often has implications for clinical diagnosis and treatment of hearing loss in children, but it can be challenging to translate those findings into practice. Meeting that...
Basic research investigating auditory development often has implications for clinical diagnosis and treatment of hearing loss in children, but it can be challenging to translate those findings into practice. Meeting that challenge was a guiding principle of Pat Stelmachowicz's research and mentorship. Her example inspired many of us to pursue translational research and motivated the recent development of the Children's English/Spanish Speech Recognition Test (ChEgSS). This test evaluates word recognition in noise or two-talker speech, with target and masker speech produced in either English or Spanish. The test uses recorded materials and a forced-choice response, so the tester need not be fluent in the test language. ChEgSS provides a clinical measure of masked speech recognition outcomes for children who speak English, Spanish, or both, including estimates of performance in noise and two-talker speech, with the goal of maximizing speech and hearing outcomes for children with hearing loss. This article highlights several of Pat's many contributions to pediatric hearing research and describes the motivation and development of ChEgSS.
Speech Understanding in Complex Environments by School-Age Children with Mild Bilateral or Unilateral Hearing Loss.
Lewis DE
Semin Hear · 2023 Feb · PMID 36970648 · Full text
Numerous studies have shown that children with mild bilateral (MBHL) or unilateral hearing loss (UHL) experience speech perception difficulties in poor acoustics. Much of the research in this area has been conducted via...
Numerous studies have shown that children with mild bilateral (MBHL) or unilateral hearing loss (UHL) experience speech perception difficulties in poor acoustics. Much of the research in this area has been conducted via laboratory studies using speech-recognition tasks with a single talker and presentation via earphones and/or from a loudspeaker located directly in front of the listener. Real-world speech understanding is more complex, however, and these children may need to exert greater effort than their peers with normal hearing to understand speech, potentially impacting progress in a number of developmental areas. This article discusses issues and research relative to speech understanding in complex environments for children with MBHL or UHL and implications for real-world listening and understanding.
Quantifying Access to Speech in Children with Hearing Loss: The Influence of the Work of Pat Stelmachowicz on Measures of Audibility.
Wiseman KB, McCreery RW
Semin Hear · 2023 Feb · PMID 36970647 · Full text
This article reviews the research of Pat Stelmachowicz on traditional and novel measures for quantifying speech audibility (i.e., pure-tone average [PTA], the articulation/audibility index [AI], the speech intelligibilit...
This article reviews the research of Pat Stelmachowicz on traditional and novel measures for quantifying speech audibility (i.e., pure-tone average [PTA], the articulation/audibility index [AI], the speech intelligibility index, and auditory dosage) as predictors of speech perception and language outcomes in children. We discuss the limitations of using audiometric PTA as a predictor of perceptual outcomes in children and how Pat's research shed light on the importance of measures that characterize high-frequency audibility. We also discuss the AI, Pat's work on the calculation of the AI as a hearing aid outcome measure, and how this work led to the application of the speech intelligibility index as a clinically utilized measure of unaided and aided audibility. Finally, we describe a novel measure of audibility-auditory dosage-that was developed based on Pat's work on audibility and hearing aid use for children who are hard of hearing.
Common Sounds Audiograms: Quantitative Analyses and Recommendations.
Hillis CL, Uchanski RM, Davidson LS
Semin Hear · 2023 Feb · PMID 36970646 · Full text
A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named "common sounds audiogram" (CSA). Typically, a child's hearing detection thresholds are plotted on the CSA t...
A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named "common sounds audiogram" (CSA). Typically, a child's hearing detection thresholds are plotted on the CSA to indicate that child's audibility of speech and environmental sounds. Importantly, the CSA may be the first item that parents see when their child's hearing loss is explained. Thus, the accuracy of the CSA and its associated counseling information are integral to the parents' understanding of what their child can hear and to the parents' role in the child's future hearing care and interventions. Currently available CSAs were collected from professional societies, early intervention providers, device manufacturers, etc., and analyzed ( = 36). Analysis included quantification of sound elements, presence of counseling information, attribution of acoustic measurements, and errors. The analyses show that currently-available CSAs are wildly inconsistent as a group, not scientifically justified, and omit important information for counseling and interpretation. Variations found among currently available CSAs can lead to very different parental interpretations of the impact of a child's hearing loss on his/her access to sounds, especially spoken language. Such variations, presumably, could also lead to different recommendations regarding intervention and hearing devices. Recommendations are outlined for the development of a new, standard CSA.
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