Actual Hearing Research Articles

Determining Hearing Thresholds in Dogs Using the Staircase Method.

There is a growing interest in performing playback experiments to understand which acoustical cues trigger specific behavioral/emotional responses in dogs. However, very limited studies have focused their attention on more basic aspects of hearing such as sensitivity, i.e., the identification of minimal intensity thresholds across different frequencies. Most previous studies relied on electrophysiological methods for audiograms for dogs, but these methods are considered less accurate than assessments based on behavioral responses. To our knowledge, only one study has established hearing thresholds using a behavioral assessment on four dogs but using a method that did not allow potential improvement throughout the sessions. In the present study, we devised an assessment procedure based on a staircase method. Implying the adaptation of the assessed intensity on the dogs' performance, this approach grants several assessments around the actual hearing threshold of the animal, thereby increasing the reliability of the result. We used such a method to determine hearing thresholds at three frequencies (0.5, 4.0, and 20.0 kHz). Five dogs were tested in each frequency. The hearing thresholds were found to be 19.5 ± 2.8 dB SPL at 0.5 kHz, 14.0 ± 4.5 dB SPL at 4.0 kHz, and 8.5 ± 12.8 dB SPL at 20.0 kHz. No improvement in performance was visible across the procedure. While the thresholds at 0.5 and 4.0 kHz were in line with the previous literature, the threshold at 20 kHz was remarkably lower than expected. Dogs' ability to produce vocalization beyond 20 kHz, potentially used in short-range communication, and the selective pressure linked to intraspecific communication in social canids are discussed as potential explanations for the sensitivity to higher frequencies.

Comparison of ASSR and frequency specificity ABR induced by NB CE-Chirp for prediction of behavioral hearing thresholds in children with conductive hearing loss

BackgroundElectrophysiological tests are often used to evaluate hearing loss in infants and young children with conductive hearing loss, no matter to quantify or characterize. However, there are advantages and disadvantages associated with the various electrophysiological tests that are currently available. Therefore, there is no gold standard test. This study aimed to compare the value of narrow-band (NB) CE-Chirp-induced auditory steady-state response (ASSR) and auditory brainstem response (ABR) for assessing hearing thresholds in children with conductive hearing loss. We hope to identify an effective electrophysiological testing method to evaluate conductive hearing loss and provide a reference for clinical hearing assessment of infants with conductive hearing loss. Subjectsand Methods: We selected 27 children (41 ears) aged 3–6 years with otitis media with effusion (OME). Within 1 day, they underwent behavioral audiometry and NB CE-Chirp-induced ASSR and ABR tests in sequence. Pearson's correlation analysis was performed to compare behavioral audiometry thresholds and ASSR and ABR response thresholds at 500, 1000, 2000, and 4000 Hz. ResultsThe behavioral audiometry thresholds of all children were strongly correlated with the response thresholds of the two electrophysiological tests, with correlation coefficients of 0.659, 0.605, 0.723, and 0.857 for ASSR, and 0.587, 0.684, 0.753, and 0.802 for ABR. The proportion of children with a difference of ≤10 dB between ASSR and behavioral audiometry thresholds or between ABR and behavioral audiometry thresholds was not high, especially in the low frequencies. ABR results were superior to ASSR results in terms of predicting actual hearing levels. At 0.5, 1, 2, and 4 kHz, the average differences between the behavioral hearing thresholds and ASSR thresholds in the 41 ears were 5.6, 5.7, 2, and 5.6 dB, respectively. The average differences between behavioral hearing thresholds and ABR thresholds was −5.6, −1.4, −6.8, and 3.2 dB, respectively. The hearing loss configuration of the ASSR exhibited a peaked pattern, similar to behavioral audiometry, whereas the ABR exhibited an ascending pattern. The time to perform the single-ear ASSR test was 5.9 min, whereas the ABR test took 17.0 min. ConclusionASSR and ABR induced by the NB CE-Chirp correlated well with behavioral audiometry in children with conductive hearing loss. The NB CE-Chirp ASSR has advantages in terms of testing time and hearing configuration evaluation, whereas ABR has better reliability than ASSR. However, the stability of ASSR and ABR induced by the NB CE-Chirp is poor, and the thresholds obtained cannot replace behavioral audiometry in evaluating the true hearing of children with conductive hearing loss. However, ASSR and ABR can be used as auxiliary tests for cross-validation.

Hearing loss classification algorithm based on the insertion gain of hearing aid

AbstractHearing loss is one of the most prevalent chronic health problems worldwide and a common intervention is the wearing of hearing aids. However, the tedious fitting procedures and limited hearing experts pose restrictions for the popularity of hearing aids. This paper introduced a hearing loss classification method based on the insertion gain of hearing aids, which aims to simplify the fitting procedure and achieve a fitting-free effect of the hearing aid, in line with current research trends in key algorithms for fitting-free hearing aids. The proposed method innovatively combines the insertion gain of hearing aids with the covariates of patient’s gender, age, wearing history to form a new set of hearing loss vectors, and then classifies the hearing loss into six categories by unsupervised cluster analysis method. Each category of representative parameters characterizes a typical type of hearing loss, which can be used as the initial parameter to improve the efficiency of hearing aid fitting. Compared with the traditional audiogram classification method AMCLASS (Automated Audiogram Classification System), the proposed classification method reflect the actual hearing loss of hearing impaired patients better. Moreover, the effectiveness of the new classification method was verified by the comparison between the obtained six sets of representative insertion gains and the inferred hearing personalization information.

오순택 동시에 나타난 공기적 상상력

The poet, Oh Soon-taek pursues beauty, purity, and brightness, features of human’s nature in his children’s poetry. There are frangrances and sounds on the foundation of the beauty, purity, and brightness. He makes his readers dream new things and opens an entry for them to experience new world of imagination, through olfactory and auditory images. Fresh airy embodiment provides readers invigoration, definitely. Therefore, this study aims to analyze olfactory and auditory languages focusing on the entire poems of Oh Soon-taek and to trace airy imagination expressed in his children’s poetry. Though the poetic words related to fragrances are not signified in the poet’s works, he is not afraid of trying freely to olfactoryize hearing and to auditoryize olfaction. In addition, he is a subject who experiences more diverse auditory illusions than actual hearing and nature is like a mouth containing every auditory element to him. As mentioned above, the poet puts richly attractive fragrances and sounds in nature with his own imagination, and they are tied in his fantasy world as embodiment of infinite words and images in spite of no forms. Like this, Oh Soon-taek’s poetry showing the images of hearing and olfaction at the same time awake all things and make them live and breathe. There are fun as well as philosophy of life in the poet’s works. They open our eyes to forgotten realities and show freedom when feeling lightness from the materials offering happiness of small things. This is well expressed in Bell Sounds which hopes “all the sounds in the world will be pure like first cry of a newborn baby.” Sounds have no weight. Many things are put down, and then, there is a clean sound. How much this poem resounds! When reading the poet Oh Soon-taek’s poetry, our ears become clean. When we would rather hear it than read it through eyes, we seem to hear pure and bright sounds in the world. In addition, his collection of poems expressing love with fragrances contains lots of perfumes of flowers, grasses, and trees, awaking his readers’ olfactory sense. Someone says sounds last longest and fragrances last for a long and long time. His children’s poems reflecting universality of human emotions will be remembered as sounds or as fragrances to us.

Is Auditory Steady-State Response Testing the Key for Diagnosing Non-Organic Hearing Disorders? Implications for Current Audiological Practice.

Background and ObjectivesTo describe all possible facets of non-organic hearing disorders (NOHD) and emphasize the superiority of auditory steady-state response (ASSR) over previously employed hearing assessment tools.Subjects and MethodsA series of seven patients consisting of three males and four females with NOHD were assessed at Attikon University Hospital (age range: 17-59 years). Three patients had Munchausen syndrome, three intentionally feigned hearing loss, and one intentionally feigned normal hearing. The audiological evaluation consisted of tympanometry, pure-tone audiometry, and ASSR testing.ResultsThe hearing of all patients was accurately determined using ASSR. The results were confirmed by auditory brainstem responses (ABR) and otoacoustic emissions.ConclusionsNOHD is a multi-faceted condition encompassing various etiologies. ASSR testing represents an objective and reliable method of hearing assessment, which can serve as a gold standard method for distinguishing NOHD from actual hearing loss. It can reliably indicate the hearing levels at the four main frequencies (500, 1,000, 2,000, and 4,000 Hz) by obtaining a valid estimated audiogram through statistical measures. Compared to ABR testing, ASSR thresholds are closer to the actual audiometric thresholds in the presence of hearing impairment and are superior when the corresponding pure-tone audiogram is widely ranging between the adjacent frequencies or when the obtained ABR curves are not easily distinguished. A non-confrontational approach should be adopted by ENT doctors towards cases of suspected NOHD as the use of ASSR could reliably assess hearing even when medical or medico-legal implications are involved.

Test-Retest Differences of the Speech Discrimination Score in Patients with Hearing Loss

Background and Objectives The diagnosis of hearing impairment is based on repeated audiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), and speech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeated testing, while malingering is suspected when having more than 12% difference between 3 individual SDT results. Therefore, in this study, we compared the proportion of malingering found in repeated SDT with that found in other audiometric tests and analyzed the characteristics of malingering group in order to reevaluate the current criteria of defining malingering.Subjects and Method We retrospectively assessed the audiometry results of 113 patients (226 ears) with hearing impairment. Each ear was divided into a malingering group and a true hearing loss group. The proportion of ears corresponding to each malingering criterion was compared using a chi-square test. An independent sample t-test was performed to identify the differences between the characteristics between the two groups.Results The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15 (6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportion of malingering between the 3 hearing test modalities (p<0.001). There was no significant difference in auditory brainstem response, mean age and sex distribution between the malingering group and the true hearing loss group.Conclusion When conducting repeated SDT, there is a risk of misdiagnosing an actual hearing loss patient as a malingering patient under the current malingering criteria. Therefore, the current criteria on SDT requires reevaluation.

You Can’t Always Get What You Want: Appealing CMS Enforcement Actions

You Can’t Always Get What You Want: Appealing CMS Enforcement Actions

An alternative approach for detecting hearing loss in adults with learning disabilities

Accessible Summary Annual health checks for people with learning disabilities should include a check of hearing. However, this hearing check only involves asking questions about hearing and does not include an actual hearing test. We tested the hearing of people with learning disabilities in the community. We found that some people had hearing problems that had not been picked up at their annual health check. We think the annual health check should be changed to include a hearing test. AbstractBackgroundAnnual health checks in primary care include hearing assessment, though current guidance recommends subjective assessment only. Previous studies suggest this is inadequate and recommend objective alternatives such as hearing screening. This study aimed to assess the feasibility of hearing screening and examine the last recorded annual health check outcome for hearing, for those diagnosed with hearing loss as a result of the screening process.MethodHearing screening took place in four locations and 75 people with learning disabilities participated. Contact was made with each individual's GP to share results and to request onward referral where indicated.FindingsWax occlusion prevented screening for 23%. Fifty‐seven people completed the screen, and 25 had suspected hearing loss. Of these, 22 people required referral to Audiology to verify their hearing thresholds. Only 13 were actually referred, and 11 individuals underwent assessment in Audiology, resulting in 10 being diagnosed with hearing loss. The most recent annual health check outcomes for hearing were examined for those diagnosed with hearing loss. Of the records we accessed, hearing loss had not been identified or actioned in every case.ConclusionsHearing screening is shown here to be a suitable method for detecting hearing loss. We recommend changing current annual health check practice to incorporate objective screening. Only 12% of those with suspected hearing loss were known to Audiology services, suggesting a substantial proportion of undetected hearing loss in the community. We found evidence of apparent reluctance around referral and hearing aid fitting and make suggestions for improvement.

Automatic Subtitle Synchronization and Positioning System Dedicated to Deaf and Hearing Impaired People

In this paper, we introduce a subtitle synchronization and positioning system designed to increase the accessibility of deaf and hearing impaired people to multimedia documents. The main contributions of the paper concern: a novel synchronization algorithm able to robustly align, without any human intervention, the closed caption with the audio transcript and a timestamp refinement technique that adjusts the subtitle segments duration with respect to the audiovisual recommendations. Finally, we introduce a novel method that performs a high level understanding of the multimedia content, in order to determine the subtitle optimal positions, within the video frame, such that they do not overlap with other relevant textual information. The experimental evaluation performed on a large dataset of 30 videos taken from the French national television validates the approach with average accuracy scores superior to 90% regardless on the video genre. The subjective evaluation of the proposed subtitle synchronization and positioning system, performed with actual hearing impaired people, demonstrates the effectiveness of our approach.

Speech Enhancement for Hearing Aids with Deep Learning on Environmental Noises

Hearing aids are small electronic devices designed to improve hearing for persons with impaired hearing, using sophisticated audio signal processing algorithms and technologies. In general, the speech enhancement algorithms in hearing aids remove the environmental noise and enhance speech while still giving consideration to hearing characteristics and the environmental surroundings. In this study, a speech enhancement algorithm was proposed to improve speech quality in a hearing aid environment by applying noise reduction algorithms with deep neural network learning based on noise classification. In order to evaluate the speech enhancement in an actual hearing aid environment, ten types of noise were self-recorded and classified using convolutional neural networks. In addition, noise reduction for speech enhancement in the hearing aid were applied by deep neural networks based on the noise classification. As a result, the speech quality based on the speech enhancements removed using the deep neural networks—and associated environmental noise classification—exhibited a significant improvement over that of the conventional hearing aid algorithm. The improved speech quality was also evaluated by objective measure through the perceptual evaluation of speech quality score, the short-time objective intelligibility score, the overall quality composite measure, and the log likelihood ratio score.

Reconfigurable Filter Bank Design Techniques for Hearing Aid Performance Improvement

Hearing is one of the most crucial sense for human beings as it connects them to external world. Hearing loss impairs communication which is an essential human function. Hearing disability has massive negative impact on life, work, physical and emotional well-being as well as relationships and is rated as the third most common health problem affecting relations and quality of life. Hearing aid devices can selectively intensify sound signals in order to suit the hearing characteristics of the patients and is a boon for people with hearing misfortune. However, there is a huge gap between the potential and actual hearing aid users. This work provides a critical look into the various challenges posed by hearing aid users, the comparative of the existing state-of-art hearing devices and throws light on bottlenecks in hearing aid design and performance. Filter bank, being the holy grail of Digital Hearing aid, needs special attention for improving the hearing aid performance. Reconfigurability is the need of the hour for providing flexible and tailormade hearing aids that can suit individual hearing requirements. The paper discusses and gives an in-depth insight into the techniques for reconfigurable Filter bank design for performance augmentationin terms of parameters like Signal quality, Auditory compensation, Computational and Hardware complexity, area, speed, power, etc.

Comparison of Pure-Tone Average Methods for Estimation of Hearing Loss Caused by Environmental Exposure to Lead and Cadmium: Does the Pure-Tone Average Method Which Uses Low-Frequency Ranges Underestimate the Actual Hearing Loss Caused by Environmental Lead and Cadmium Exposure?

Previous studies have reported that exposure to lead and cadmium can damage the inner ear receptor, which perceives high-frequency sounds. However, few studies have used the pure-tone average (PTA), including high-frequency ranges, for the estimation of hearing loss caused by lead and cadmium exposure. We estimated hearing loss using the PTA test, in low-frequency, speech frequency, and high-frequency ranges and compared the differences in the results using 3 PTA calculation methods. We analyzed the data of 2,387 participants, between the ages of 19 and 85 years, that were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) of 2010–2012. A dose-response relationship between hearing loss and heavy metal exposure was observed in the high-frequency method after adjustment for confounding factors. When using the high-frequency PTA, it was found that doubling of the levels of lead and cadmium in the blood was associated with a 1.88- (95% CI 1.11–3.17) and 1.89-fold (95% CI 1.02–3.50) increase in the OR for hearing loss. In the case of the low-frequency and speech frequency PTA, however, there were no significant relationships between hearing loss and the concentrations of lead and cadmium in the blood. The outcomes of the present study suggest that the estimation of hearing loss caused by environmental exposure to lead and cadmium is affected by the frequencies used in the PTA calculation.

Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia.

The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

Comparison of the Reynell Developmental Language Scale II and the Galker test of word-recognition-in-noise in Danish day-care children

ObjectiveTo search for predictive factors for language development measured by two receptive language tests for children, the Galker test (a word-recognition-in-noise test) testing hearing and vocabulary, and the Danish version of Reynell Developmental Language Scale (2nd revision, RDLS II) test, a language comprehension test. The study analysed if information about background variables and parents and pre-school teachers was predictive for test scores; if earlier middle ear disease, actual hearing loss and tympanometry was important for language development; and if the two receptive tests differed in terms of the degree to which variables were able to predict test scores at the age of three to five years. MethodsAll children aged three and five years attending 20 day-care centres for children without cognitive development issues from the Municipality of Hillerød, Denmark, were invited to participate. We used questionnaires to the parents and day-care teachers and examined the children using tympanometry, hearing test and the two receptive language tests. We performed unadjusted and adjusted analyses of raw and grouped scores and background variables, as well as stepwise regression analysis with group scores as outcome. ResultsThe results of the two tests were surprisingly similar in relation to background variables. The same variables were predictive for scores in the two receptive language tests. The predictive variables were: age group (22–31%), having no sibling (2–3%), being a boy (1%), information from the parents about the child's vocabulary (3%), phonology (0–2%). information from the pre-school teachers on the child's vocabulary (4–6%), and hearing beyond 25 dB in best ear (mean of four frequencies) (1%). ConclusionWe found that nearly the same variables were predictive for the test score and the grouped score in pre-school children in the RDLS II and the Galker test. Information from the pre-school teachers was more predictive of the test score than information from the parents. In the adjusted analysis, beside age group, information about the child's vocabulary was the most predictive information explaining 4–6% of the variation.

Effects of Simulated Hearing Loss on Bilingual Children's Consonant Recognition in Noise.

This study investigated the possible impact of simulated hearing loss on speech perception in Spanish-English bilingual children. To avoid confound between individual differences in hearing-loss configuration and linguistic experience, threshold-elevating noise simulating a mild-to-moderate sloping hearing loss was used with normal-hearing listeners. The hypotheses were that: (1) bilingual children can perform similarly to English-speaking monolingual peers in quiet; (2) for both bilingual and monolingual children, noise and simulated hearing loss would have detrimental impacts consistent with their acoustic characteristics (i.e., consonants with high-frequency cues remain highly intelligible in speech-shaped noise, but suffer from simulated hearing loss more than other consonants); (3) differences in phonology and acquisition order between Spanish and English would have additional negative influence on bilingual children's recognition of some English consonants. Listeners were 11 English-dominant, Spanish-English bilingual children (6 to 12 years old) and 12 English-speaking, monolingual age peers. All had normal hearing and age-appropriate nonverbal intelligence and expressive English vocabulary. Listeners performed a listen-and-repeat speech perception task. Targets were 13 American English consonants embedded in vowel-consonant-vowel (VCV) syllables. VCVs were presented in quiet and in speech-shaped noise at signal-to-noise ratios (SNRs) of -5, 0, 5 dB (normal-hearing condition). For the simulated hearing-loss condition, threshold-elevating noise modeling a mild-to-moderate sloping sensorineural hearing loss profile was added to the normal-hearing stimuli for 0, 5 dB SNR, and quiet. Responses were scored for consonant correct. Individual listeners' performance was summarized for average across 13 consonants (overall) and for individual consonants. Groups were compared for the effects of background noise and simulated hearing loss. As predicted, group performed similarly in quiet. The simulated hearing loss had a considerable detrimental impact on both groups, even in the absence of speech-shaped noise. Contrary to our prediction, no group difference was observed at any SNR in either condition. However, although nonsignificant, the greater within-group variance for the bilingual children in the normal-hearing condition indicated a wider "normal" range than for the monolingual children. Interestingly, although it did not contribute to the group difference, bilingual children's overall consonant recognition in both conditions improved with age, whereas such a developmental trend for monolingual children was observed only in the simulated hearing-loss condition, suggesting possible effects of experience. As for the recognition of individual consonants, the influence of background noise or simulated hearing loss was similar between groups and was consistent with the prediction based on their acoustic characteristics. The results demonstrated that school-age, English-dominant, Spanish-English bilingual children can recognize English consonants in a background of speech-shaped noise with similar average accuracy as English-speaking monolingual age peers. The general impact of simulated hearing loss was also similar between bilingual and monolingual children. Thus, our hypothesis that bilingual children's English consonant recognition would suffer from background noise or simulated hearing loss more than the monolingual peers was rejected. However, the present results raise several issues that warrant further investigation, including the possible difference in the "normal" range for bilingual and monolingual children, influence of experience, impact of actual hearing loss on bilingual children, and stimulus quality.

Spatiotemporal properties of magnetic fields induced by auditory speech sound imagery and perception.

Brain computer interface (BCI) technologies, which enable direct communication between the brain and external devices, have been developed. BCI technology can be utilized in neural prosthetics to restore impaired movement, including speech production. However, most of the BCI systems that have been developed are the "P300-speller" type, which can only detect objects that users direct his/her attention at. To develop more versatile BCI systems that can detect a user's intention or thoughts, the brain responses associated with verbal imagery need to be clarified. In this study, the brain magnetic fields associated with auditory verbal imagery and speech hearing were recorded using magnetoencephalography (MEG) carried out on 8 healthy adults. Although the magnetic fields lagged slightly and were long-lasting, significant deflections were observed even for verbal imagery, in the temporal regions, as well as for actual speech hearing. Also, sources for the deflections were localized in the association auditory cortices. Cross-correlations were calculated between envelopes of the imagined/presented speech sound and the evoked brain responses in the temporal areas. Measurable correlations were obtained for the presented speech sound; however, no significant correlations were observed for the imagined speech sound. These results indicate that auditory verbal imagery undoubtedly activates the auditory cortex, at least, and generates some observable neural responses.

Meningioma in the Middle Ear: An Unusual Case of Hearing Loss

Meningioma in the Middle Ear: An Unusual Case of Hearing Loss

Using software to predict occupational hearing loss in the mining industry.

Powerful mining systems typically generate high-level noise that can damage the hearing ability of miners. Engineering noise controls are the most desirable and effective control for overexposure to noise. However, the effects of these noise controls on the actual hearing status of workers are not easily measured. A tool that can provide guidance in assigning workers to jobs based on the noise levels to which they will be exposed is highly desirable. Therefore, the Pittsburgh Mining Research Division (PMRD) of the U.S. National Institute for Occupational Safety and Health (NIOSH) developed a tool to estimate in a systematic way the hearing loss due to occupational noise exposure and to evaluate the effectiveness of developed engineering controls. This computer program is based on the ISO 1999 standard and can be used to estimate the loss of hearing ability caused by occupational noise exposures. In this paper, the functionalities of this software are discussed and several case studies related to mining machinery are presented to demonstrate the functionalities of this software.

Screening for hearing loss in children

Abstract Assessment of hearing in children is important because early identification of hearing loss results in better developmental and educational outcomes. In the UK slightly more than 1 in 1000 children have significant permanent hearing loss diagnosed by the Neonatal Hearing Screening Programme (NHSP). This is based on Otoacoustic Emission (OAE) testing and Auditory Brainstem Response Testing (ABR). OAE testing is performed in the first few weeks of life and identifies infants who warrant further testing with automated ABR. Automated ABR uses an encephalogram to monitor response to sounds. Infants who meet the ‘high risk' criteria will be referred directly for automated ABR testing. If automated ABR suggests abnormality the child is referred for diagnostic ABR testing, which is a more detailed investigation capable of giving actual hearing thresholds and differentiating between conductive and sensorineural hearing loss. Childhood hearing screening in the UK is also performed at school age, with the School Entry Hearing Screen (SEHS) at the age of 5. Outside of screening programmes there are a variety of hearing assessments available for children of all ages. This review article will outline the screening pathways, methods of assessment, and follow up of children from neonates to school age. The management of hearing loss in children is detailed in an accompanying article.

Video communication and ‘camera actions’: The production of wide video shots in courtrooms with remote defendants

We consider here the use of videoconference for remote testimonies in the courtroom. Based on video recordings of actual hearings with remote participants, we analyze the systematic organization of camera motions in this setting, and show how they constitute interactional moves in their own right, i.e. ‘camera actions’, characteristic of ‘video communication contextures’. We focus on the production of wide shot, as a situated and timed camera-mediated accomplishment in the course of the hearing, and show: (a) how such an accomplishment is sensitive to its sequential environment; (b) how it is accountable as a way to mark the particular relevance of a group of participants with respect to the ongoing talk, and therefore oriented-to as a resource to visually highlight collective forms of speakership or recipiency; (c) how such camera motions are sequentially relevant and sequentially implicative with respect to the ongoing video interaction; (d) how such camera motion, and more generally the video communication ecologies which enable them make visible a particular member's interactional competence, that of being able to recognize the relevance of subtle changes in participation frames, routinely, unreflexively and on the fly.