Clinical Importance of Binaural Information: Extending Auditory Assessment in Clinical Populations Using a Portable Testing Platform.

Anna C Diedesch,S J Adelaide Bock,Frederick J Gallun

doi:10.1044/2021_aja-20-00168

Abstract

PurposeThe purpose of this study is to use variability on tests of basic auditory processing to allow identification of those tests that could be used clinically to describe functional hearing ability beyond the pure-tone audiogram and clinical speech-in-noise tests.MethodPsychoacoustic tests implemented using the Portable Automated Rapid Testing system on a calibrated iPad were evaluated for nine young normal-hearing participants (M age = 21.3, SD = 2.5) and seven hearing-impaired participants (M age = 64.9, SD = 13.5). Participants completed 10 psychoacoustic subtests in a quiet room. Correlational analyses were used to compare performance on the psychoacoustic test battery with performance on a clinical speech-in-noise test and with the 4-frequency pure-tone average (4FreqPTA).ResultsSpectral processing ability was highly correlated with 4FreqPTA, and temporal processing ability showed minimal variability across the hearing-impaired group. Tests involving binaural processing captured variability across hearing-impaired listeners not associated with 4FreqPTA or speech-in-noise performance.ConclusionsTests that capture the ability to use binaural cues may add information to what current clinical protocols reveal about patients with auditory complaints. Further testing with a larger sample size is needed to confirm the need for binaural measurements and to develop normative data for clinical settings.

Highlights

The purpose of this study is to use variability on tests of basic auditory processing to allow identification of those tests that could be used clinically to describe functional hearing ability beyond the pure-tone audiogram and clinical speech-in-noise tests
Further testing of basic auditory abilities may be useful when counseling a patient with functional auditory complaints, such as an individual with normal or near-normal pure-tone hearing reporting difficulty communicating in noisy environments
Tests showing variability in responses for participants with similar pure-tone hearing thresholds would be viewed as potential candidates for informative additions to the clinical diagnostic test battery

Summary

Introduction

The purpose of this study is to use variability on tests of basic auditory processing to allow identification of those tests that could be used clinically to describe functional hearing ability beyond the pure-tone audiogram and clinical speech-in-noise tests. Tests involving binaural processing captured variability across hearing-impaired listeners not associated with 4FreqPTA or speech-in-noise performance. When pure-tone hearing fails to accurately describe a patient’s functional auditory ability, clinicians are able to use speech-in-noise tests in attempting to validate real-world complaints of difficulty hearing in noisy or reverberant situations. Further testing of basic auditory abilities may be useful when counseling a patient with functional auditory complaints, such as an individual with normal or near-normal pure-tone hearing reporting difficulty communicating in noisy environments. Additional tests may be useful in refining hearing aid fittings with information beyond

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