Abstract
The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world. Qualities of hearing experience include ease of listening, and the naturalness, clarity and identifiability of different speakers, different musical pieces and instruments, and different everyday sounds. Application of the SSQ to 153 new clinic clients prior to hearing aid fitting showed that the greatest difficulty was experienced with simultaneous speech streams, ease of listening, listening in groups and in noise, and judging distance and movement. SSQ ratings were compared with an independent measure of handicap. After differences in hearing level were controlled for, it was found that identification, attention and effort problems, as well as spatial hearing problems, feature prominently in the disability-handicap relationship, along with certain features of speech hearing. The results implicate aspects of temporal and spatial dynamics of hearing disability in the experience of handicap. The SSQ shows promise as an instrument for evaluating interventions of various kinds, particularly (but not exclusively) those that implicate binaural function.
Highlights
What are the disabling effects of a deficit in hearing, and what are the relative impacts of those disabilities on the degree of handicap experienced by the person whose hearing is impaired? These are the questions we offer answers to in the present paper, at least with reference to adult clients of a typical audiology clinic
The better-ear average (BEA) hearing threshold over 500, 1000, 2000 and 4000 kHz was 38.8 dB (SD 15.5), where, for each person, better represents the ear with lower hearing level averaged over the frequencies 500, 1000, 2000 and 4000 Hz; the worse-ear average (WEA) was 52.7 dB (SD 24.4)
In general terms, observations regarding the connections among measures of impairment, disability and handicap are consistent with previous research, so we can be reasonably confident that the novel results are not idiosyncratic
Summary
What are the disabling effects of a deficit in hearing, and what are the relative impacts of those disabilities on the degree of handicap experienced by the person whose hearing is impaired? These are the questions we offer answers to in the present paper, at least with reference to adult clients of a typical audiology clinic. The universal view in the rehabilitative enterprise is that reduced hearing for speech is the primary issue, such that if this function can be properly addressed, the handicaps of the person with diminishing. The auditory system serves other functions besides speech hearing, such as the localization of sounds. The importance of this aspect of hearing has been argued for within the context of audiological rehabilitation Hearing has been characterized by Bregman (1990), using the concept of ‘auditory scene analysis’. This construes the task of hearing as one of partitioning (‘parsing’) the various overlapping sound streams that a listener is typically confronted with, in order to recover a coherent array of signals
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