Experienced Hearing Aid Users Research Articles

Speech perception outcomes in hearing-impaired individuals with microphone & receiver in the ear (M&RIE) hearing aids.

The Microphone and Receiver in the ear (M&RIE) hearing aid is designed to consider the pinna cues by placing an additional microphone along with a standard receiver at the entrance of the ear canal. There is a need to clinically validate the technology using speech identification measures, as a literature shortage exists. The objective of the study was to evaluate speech identification and quality rating with hearing aids fitted with standard and M&RIE receivers. Twenty individuals (mean ± SD age being 34.10 ± 11.9years) with mild-to-moderately severe sensorineural hearing loss were divided into two groups: naïve and experienced. Their speech identification obtained using the receiver in the ear hearing aid compatible with standard and M&RIE receivers were compared. The study assessed speech identification in quiet using ten sentences, calculated SNR-50 using the Spearman-Karber equation, and used an 11-point scale for self-perceived quality rating. The study analyzed data using SPSS and found no significant difference between naive and experienced hearing aid users in quiet and SNR-50 conditions (p > 0.05). However, naive users rated higher in clarity, naturalness, pleasantness, and overall impression of standard receiver settings. Across different receiver settings, both naïve and experienced groups revealed better speech identification with the M&RIE receiver for both SIS (p < 0.05) and SNR-50 (p < 0.05) measures. The study found that placing a third microphone in the ear canal improves speech identification and quality rating in both naïve and experienced users, with pinna and ear canal resonance playing a crucial role in prescribing hearing aid gain.

How Individuals Shape Their Acoustic Environment: Implications for Hearing Aid Comparison in Ecological Momentary Assessment.

When using ecological momentary assessment (EMA) to compare different hearing aid programs, it is usually assumed that for sufficiently long study durations similar situations will be experienced in both programs. However, conscious or subconscious adaptation of situations to one's hearing ability (e.g., asking a conversation partner to speak up, increasing TV volume)-which might be different across the time spent in different hearing aid programs-may challenge this assumption. In the present study, we investigated how test participants modify their acoustic environment and if these modifications depend on the hearing program. Twenty-nine experienced hearing aid users were provided with hearing aids containing two hearing programs differing in directionality and noise reduction (NR). The hearing programs called NR-on and NR-off changed each day automatically. Over the course of 3 weeks, participants were asked to answer a questionnaire every time they encountered an acoustic situation they modified or would have liked to modify to improve the listening situation. Objective data on sound pressure level and classification of the acoustic situation were collected from the hearing aids. At the beginning of the study participants recollected modifications of the acoustic environments they typically do when using their own hearing aids and reported on the frequency of this behavior. During the field trial, participants reported on average 2.3 situations per day that they modified or would have liked to modify. Modifications were usually performed quickly after the onset of the situation and significantly improved the pleasantness of the listening situation. While the number of the reported situations did not differ between the programs, modifications increasing the volume of the target signal and increasing the hearing aid volume were more frequent for the NR-on hearing program. Changes in the objective data at the time of the modification were consistent with the reported modifications. Further, the usage time as well as the distribution of the acoustic situations over the entire study period differed between the two hearing programs. The large improvement in pleasantness due to the modification might explain the generally positive ratings observed in EMA studies. Furthermore, the results found here suggest that caution is needed when comparing ratings of audiological attributes in EMA, because the different modification behavior across hearing programs may lead to an underestimation of hearing problems and reduced sensitivity when comparing two technologies.

Evaluating Real-World Benefits of Hearing Aids With Deep Neural Network-Based Noise Reduction: An Ecological Momentary Assessment Study.

Noise reduction technologies in hearing aids provide benefits under controlled conditions. However, differences in their real-life effectiveness are not established. We propose that a deep neural network (DNN)-based noise reduction system trained on naturalistic sound environments will provide different real-life benefits compared to traditional systems. Real-life listening experiences collected with Ecological Momentary Assessments (EMAs) of participants who used two premium models of hearing aid are compared. One hearing aid model (HA1) used traditional noise reduction; the other hearing aid model (HA2) used DNN-based noise reduction. Participants reported listening experiences several times a day while ambient SPL, SNR, and hearing aid volume adjustments were recorded. Forty experienced hearing aid users completed a total of 3,614 EMAs and recorded 6,812 hr of sound data across two 14-day wear periods. Linear mixed-effects analysis document that participants' assessments of ambient noisiness were positively associated with SPL and negatively associated with SNR but were not otherwise affected by hearing aid model. Likewise, mean satisfaction with the two models did not differ. However, individual satisfaction ratings for HA1 were dependent on ambient SNR, which was not the case for HA2. Hearing aids with DNN-based noise reduction resulted in consistent sound satisfaction regardless of the level of background noise compared to hearing aids implementing noise reduction based on traditional statistical models. While the two hearing aid models also differed on other parameters (e.g., shape), these differences are unlikely to explain the difference in how background noise impacts sound satisfaction with the aids. https://doi.org/10.23641/asha.25114526.

Measuring hearing aid satisfaction in everyday listening situations: Retrospective and in-situ assessments complement each other

Background: Recently, we developed a hearing-related lifestyle questionnaire (HEARLI-Q) which asks respondents to rate their hearing aid (HA) satisfaction in 23 everyday listening situations. It is unknown how HA satisfaction on the retrospective HEARLI-Q scale compares to HA satisfaction measured on the same scale implemented in Ecological Momentary Assessments (EMA). Purpose: To learn how retrospective (HEARLI-Q) and in-situ (EMA) assessments can complement each other. Research Design: An observational study. Study Sample: Twenty-one experienced HA users. Data Collection and Analysis: The participants first filled out the HEARLI-Q questionnaire, followed by a one-week EMA trial using their own hearing aids. HA satisfaction ratings were compared between the two questionnaires and the underlying drivers of discrepancies in HA satisfaction ratings were evaluated. Results: HA satisfaction scores were significantly higher in EMA for speech communication with one or several people. Hearing difficulty in these situations was rated higher in HEARLI-Q than in EMA, but occurrence of those difficult listening situations was also rated to be lower. When comparing only the situations that occur on daily or weekly basis, the two questionnaires had similar HA satisfaction ratings. Conclusions: Lower occurrence of difficult listening situations seems to be the key driver of discrepancies in HA satisfaction ratings between EMA and HEARLI-Q. The advantage of EMA is that it provides insight into an individual’s day-to-day life and is not prone to memory bias. HEARLI-Q, on the other hand, can capture situations which occur infrequently or are inconvenient to report in the moment. Administering HEARLI-Q and EMA in combination could give a more holistic view of HA satisfaction.

The effect of auditory training on listening effort in hearing-aid users: insights from a pupillometry study

Objective The study investigated how auditory training affects effort exerted by hearing-impaired listeners in speech-in-noise task. Design Pupillometry was used to characterise listening effort during a hearing in noise test (HINT) before and after phoneme-in-noise identification training. Half of the study participants completed the training, while the other half formed an active control group. Study sample Twenty 63-to-79 years old experienced hearing-aid users. Results Higher peak pupil dilations (PPDs) were obtained at the end of the study compared to the beginning in both groups of the participants. The analysis of pupil dilation in an extended time window revealed, however, that the magnitude of pupillary response increased more in the training than in the control group. The effect of training on effort was observed in pupil responses even when no improvement in HINT was found. Conclusion The results demonstrate that using a listening effort metric adds additional insights into the effectiveness of auditory training compared to the situation when only speech-in-noise performance is considered. Trends observed in pupil responses suggested increased effort—both after the training and the placebo intervention—most likely reflecting the effect of the individual’s motivation.

Focusing on Positive Listening Experiences Improves Speech Intelligibility in Experienced Hearing Aid Users.

Negativity bias is a cognitive bias that results in negative events being perceptually more salient than positive ones. For hearing care, this means that hearing aid benefits can potentially be overshadowed by adverse experiences. Research has shown that sustaining focus on positive experiences has the potential to mitigate negativity bias. The purpose of the current study was to investigate whether a positive focus (PF) intervention can improve speech-in-noise abilities for experienced hearing aid users. Thirty participants were randomly allocated to a control or PF group (N = 2 × 15). Prior to hearing aid fitting, all participants filled out the short form of the Speech, Spatial and Qualities of Hearing scale (SSQ12) based on their own hearing aids. At the first visit, they were fitted with study hearing aids, and speech-in-noise testing was performed. Both groups then wore the study hearing aids for two weeks and sent daily text messages reporting hours of hearing aid use to an experimenter. In addition, the PF group was instructed to focus on positive listening experiences and to also report them in the daily text messages. After the 2-week trial, all participants filled out the SSQ12 questionnaire based on the study hearing aids and completed the speech-in-noise testing again. Speech-in-noise performance and SSQ12 Qualities score were improved for the PF group but not for the control group. This finding indicates that the PF intervention can improve subjective and objective hearing aid benefits.

Difference in SII provided by initial fit and NAL-NL2 and its relation to self-reported hearing aid outcomes

Objective The speech intelligibility index (SII) is used to quantify the audibility of the speech. This study examined the relationship between self-reported hearing aid (HA) outcomes and the difference in aided SII (SIIA) calculated from the initial fit (IF) gain and that prescribed as per the second generation of National Acoustic Laboratory Non-Linear (NAL-NL2). Design A prospective observational study. Study sample The study included 718 first-time and 253 experienced HA users. All users had a valid real-ear measurement (REM) at three input levels (55, 65 and 80 dB SPL). Results The gain provided by IF was lower than NAL-NL2 at 55 and 65 dB SPL. IF gain exhibited reduced compression than NAL-NL2 as input levels increased from 55 to 80 dB SPL. On average, the SIIA provided by IF was significantly lower than that for NAL-NL2 at all input levels. The difference in SIIA between IF and NAL-NL2 at 80 dB SPL input level with 0 dB signal-to-noise ratio (SNR) turned out to be a predictor for self-reported outcome for first-time HA users. Conclusion The study suggests that an SIIA close to that provided by NAL-NL2 at high input levels would be preferred to obtain a better self-reported outcome.

Effectiveness of Television Streaming on Hearing Aid User Performance and Satisfaction in Quiet and in Noise.

The purpose of this study was to determine the effectiveness of television (TV) streaming on hearing aid user performance and satisfaction in quiet and in noise. Twenty experienced hearing aid users were evaluated in quiet and in noise (5 dB SNR) under three hearing aid conditions: hearing aids, streaming with hearing aid microphones attenuated by 6 dB, and streaming with hearing aid microphones muted. The audiovisual Connected Speech Test served as the signal, and the ipsilateral competing message from the Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) served as the noise. Measures of speech understanding, satisfaction with sound quality and clarity, and preference were obtained. Speech understanding was significantly better in quiet than in noise, and streaming improved performance in noise when the hearing aid microphones were muted. Sound quality satisfaction was significantly better in quiet than in noise but was not impacted significantly by the hearing aid settings. Speech clarity satisfaction was significantly better in quiet than in noise, and streaming improved satisfaction in noise when the hearing aid microphones were muted. More participants preferred streaming with the microphones muted in quiet, in noise, and overall; however, results did not reach statistical significance. Hearing aid users did not benefit from TV streaming with the microphones attenuated or muted when listening in quiet. TV streaming was more beneficial to hearing aid users when listening in noise with the microphones muted. Hearing aid users should be counseled on the impact of the hearing aid microphone settings when using a TV streamer, particularly in noise.

Hearing aids with tinnitus sound support reduce tinnitus severity for new and experienced hearing aid users

ObjectiveThis interventional study tested the hypothesis that hearing aids with a tinnitus sound support feature would reduce the impact of tinnitus for both new and experienced hearing aid users over a 12-week trial period.MethodsA total of 19 experienced hearing aid users and 21 participants with no previous hearing aid experience completed the study. Hearing aids were fitted and dispensed with tinnitus masking sounds adjusted to individual preferences. The primary outcome measure was the Tinnitus Functional Index (TFI) score change between baseline and the end of the 12-week trial. This trial was registered on the Australian New Zealand Clinical Trials Registry, trial ID: ACTRN12621001754831.ResultsThe TFI scores and secondary measures indicated significant improvements (reductions in tinnitus impact) at the end of the trial compared to the baseline for both experienced and new hearing aid users. Since no group differences were observed, pooled data are presented in this study. The median TFI total score before treatment was 49.0 (IQR = 40.0), and the median TFI total score after treatment was 26.0 (IQR = 26.0). A significant reduction (p = 0.0001) in the total TFI score of 24 points was observed after treatment, producing a large effect size (d = 0.60).ConclusionsThe results confirm previous findings that hearing aids assist in reducing the impact of tinnitus on daily life. The Oticon miniRITE R combination hearing aids used in this study resulted in similar improvements for both new and existing hearing aid users. This suggests that the tinnitus-reducing effects of these aids were greater than those already being used by participants.

The effect of hearing aid treatment on health-related quality of life in older adults with hearing loss

Objective To investigate the effect of hearing aid (HA) intervention on long-term health-related quality of life (HRQoL) changes in first-time and experienced HA users using the 15D questionnaire. Secondly, the study explored the relationship between clinical parameters and changes in 15D scores. Design A prospective observational study. Study sample The study population included 1562 patients (1113 first-time and 449 experienced HA users) referred for HA rehabilitation. All patients responded to the 15D at baseline, two months after HA fitting, and at long-term follow-up (698 ± 298 d). Results Among both first-time and experienced HA users, significant improvements in hearing-dimension (15D-3) score were observed at two-month follow-up which sustained at long-term follow-up. 15D total scores significantly decreased at long-term follow-up. Self-reported hearing abilities, word recognition scores, and HA use time were significantly and positively correlated to increased 15D. Conclusions Both groups of HA users reported improved hearing-related QoL after HA treatment which sustained at long-term follow-up but the improvement in total 15D total score did not sustain for either group. The results suggest that HA intervention positively affects hearing-related QoL among older adults with hearing loss, and the findings support the use of 15D as a tool for the evaluation of HA treatment effects.

Evaluation of adjustment behaviour in a semi-supervised self-adjustment fine-tuning procedure for hearing aids

Objective This study investigated the adjustment behaviour of hearing aid (HA) users participating in a semi-supervised self-adjustment fine-tuning procedure for HAs. The aim was to link behaviour with the reproducibility and duration of the adjustments. Design Participants used a two-dimensional user interface to identify their HA gain preferences while listening to realistic sound scenes presented in a laboratory environment. The interface allowed participants to adjust amplitude (vertical axis) and spectral slope (horizontal axis) simultaneously. Participants were clustered according to their interaction with the user interface, and their search directions were analysed. Study sample Twenty older experienced HA users were invited to participate in this study. Results We identified four different archetypes of adjustment behaviour (curious, cautious, semi-browsing, and full-on browsing) by analysing the trace points of all measurements for each participant. Furthermore, participants used predominantly horizontal or vertical paths when searching for their preference. Neither the archetype, nor the search directions, nor the participants’ technology commitment was predictive of the reproducibility or the adjustment duration. Conclusions The findings suggest that enforcement of a specific adjustment behaviour or search direction is not necessary to obtain fast, reliable self-adjustments. Furthermore, no strict requirements with respect to technology commitment are necessary.

Value Propositions of Public Adult Hearing Rehabilitation in Denmark.

Objective: To obtain and evaluate detailed descriptions of potential value propositions as seen by adults undergoing hearing rehabilitation with hearing aids. Design: Semi-structured interviews with patients and audiologists, a literature search, and the inclusion of domain knowledge from experts and scientists were used to derive value propositions. A two-alternative forced-choice paradigm and probabilistic choice models were used to investigate hearing aid users' preferences for the value propositions through an online platform. Study sample: Twelve hearing aid users (mean age 70, range 59-70) and eleven clinicians were interviewed. A total of 173 experienced hearing aid users evaluated the value propositions. Results: Twenty-nine value propositions as described by patients, clinicians, and hearing care experts where identified, from which twenty-one value propositions were evaluated. Results of the pair-wise evaluation method show that the value propositions judged to be the most important for the hearing aid users were: "13. To solve the hearing problem you have", "09. Thorough diagnosis of the hearing", and "16. The hearing aid solution is adapted to individual needs", which are related to finding the correct hearing solution and to be considered in the process. The value propositions judged to be least important were: "04 Next of kin and others involved in the process", "26. To be in the same room as the practitioner", and "29. The practitioner's human characteristics", related to the involvement of others in the process and the proximity and personal manner of the practitioners.

Focusing on positive listening experiences improves hearing aid outcomes in experienced hearing aid users

Objective The purpose of this study was to investigate whether focusing on positive listening experiences improves hearing aid outcomes in experienced hearing aid users. Design The participants were randomised into a control or positive focus (PF) group. At the first laboratory visit, the Client-Oriented Scale of Improvement (COSI) questionnaire was administered followed by hearing aid fitting. The participants wore the hearing aids for three weeks. The PF group was asked to report their positive listening experiences via an app. During the third week, all the participants answered questionnaires related to hearing aid benefit and satisfaction. This was followed by the second laboratory visit where the COSI follow-up questionnaire was administered. Study sample Ten participants were included in the control and eleven in the PF group. Results Hearing aid outcome ratings were significantly better in the PF group in comparison to the control group. Further, COSI degree of change and the number of positive reports were positively correlated. Conclusions These results point to the importance of asking hearing aid users to focus on positive listening experiences and talk about them. The potential outcome is increased hearing aid benefit and satisfaction which could lead to more consistent use of the devices.

Synchronous remote fine-tuning and follow-up within aural rehabilitation: a randomised controlled trial

Objective The objective of the study was to evaluate the effect of including synchronous remote fine-tuning and follow-up as a part of the aural rehabilitation process. Design A randomised controlled trial (RCT). Study sample Experienced hearing aid users who were due for renewed aural rehabilitation were randomised to either an intervention group (n = 46) or a control group (n = 49). Both groups underwent all stages of the conventional renewed aural rehabilitation process within our clinics, but the intervention group was also offered remote follow-up visits, including an opportunity for synchronous remote fine-tuning of hearing aids. The Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the International Outcome Intervention for Hearing Aid Users (IOI-HA) were used as outcome measures. Results Both groups improved in self-rated hearing difficulties and hearing aid benefits measured with HHIE/A and APHAB. No significant differences were found between the intervention and the control group. Conclusion Including synchronous remote follow-up and fine-tuning as a part of an aural rehabilitation process may effectively complement clinical visits. Additionally, the synchronous remote follow-up has the potential to further develop person-centred care by enabling hearing aid users to identify individual needs directly in an everyday environment.

Development of a self-report measure of empowerment along the hearing health journey: a content evaluation study

Objective To conduct the first phases in the development of a self-report measure of empowerment on the hearing health journey, specifically, item generation and content evaluation of the initial pool of items generated. Design A content expert panel survey and cognitive interviews were conducted. Descriptive statistics were obtained for the quantitative data, and the cognitive interviews were analysed using thematic analysis. Study sample Eleven researchers and clinicians participated in the content expert surveys. Sixteen experienced hearing aid users participated in the cognitive interviews, recruited from the USA and Australia. Results The items underwent five iterations based on feedback from the survey and interview data. This resulted in a set of 33 quality-tested potential survey items that were rated highly for relevance (mean = 3.96), clarity (mean = 3.70) and fit to dimensions of empowerment (mean = 3.92) (scale 0-4, where 4 was the maximum rating). Conclusions Involving stakeholders in item generation and content evaluation increased relevance, clarity, fit to dimension, comprehensiveness, and acceptability of the items. This preliminary version of the 33-item measure underwent further psychometric refinement (Rasch analysis and traditional classical test theory testing) to validate it for clinical and research use (reported separately).

Effectiveness of Auditory Training in Experienced Hearing-Aid Users, and an Exploration of Their Health-Related Quality of Life and Coping Strategies.

Hearing aids (HA) are a fundamental component in restoring auditory function; however, they cannot completely alleviate all problems encountered by adults with hearing impairment. The aim of this study is twofold. Firstly, we assess the health-related quality of life and coping strategies of experienced HA users. Secondly, we assess whether HA users can benefit from auditory training. To this end, 40 participants who had worn HAs for more than 6 months participated in this study. Half of the participants received auditory training, while the other half served as a passive control. The training consisted of a personalized training scheme, with outcome measures including speech in noise perception in free-field and via direct streaming to the HA, phoneme identification, cognitive control, and health-related quality of life. Results showed that experienced HA users reported a relatively good quality of life. Health-related quality of life was correlated with aided speech perception in noise, but not with aided pure tone audiometry. Coping strategies were adaptive, leading to improved communication. Participants showed improvements in trained tasks, consonant identification, and speech in noise perception. While both groups yielded improved speech in noise perception at the end, post hoc analysis following a three-way interaction showed a significantly larger pre-post difference for the trained group in the streaming condition. Although training showed some improvements, the study suggests that the training paradigm was not sufficiently challenging for HA users. To optimize daily life listening, we recommend that future training should incorporate more exercises in noise and focus on cognitive control.

Assessment of Hearing-Related Lifestyle Based on the Common Sound Scenarios Framework.

Auditory lifestyle can play a role in hearing care needs, and, as such, it needs to be considered when treating people with hearing loss. In this study, we propose a questionnaire consisting of 24 listening situations based on the Common Sound Scenarios (CoSS) framework. Seventeen experienced hearing aid (HA) users filled out the Hearing-Related Lifestyle Questionnaire four times: Days 1, 2, 15, and 29. The questionnaire consisted of 24 listening situations that participants rated on frequency of occurrence, importance to hear well, difficulty to hear, and HA satisfaction. Four questionnaire outcomes were extracted from these ratings: richness of hearing-related lifestyle, hearing demand, hearing difficulty, and HA satisfaction. Additionally, the participants were asked whether any listening situations are not understandable or relatable, whether any situations are missing from the questionnaire, and whether the number of questions is acceptable. Test-retest reliability analyses were done to assess whether the questionnaire outcomes are reliable across the four reports. Correlation analyses were done to assess whether there is a relationship between the questionnaire outcomes. The questionnaire outcomes have excellent reliability. The listening situations in the questionnaire are generally complete and relatable, and the number of questions is acceptable. Correlation analyses revealed that the questionnaire outcomes are related to each other. Currently, there are no other hearing-related lifestyle questionnaires that purely assess listening situations. The proposed questionnaire has the potential to add to our understanding of hearing-related lifestyle of people needing or undergoing hearing care. https://doi.org/10.23641/asha.21514044.

Adaptive Hearing Aid Benefit in Children With Mild/Moderate Hearing Loss: A Registered, Double-Blind, Randomized Clinical Trial.

We completed a registered double-blind randomized control trial to compare acclimatization to two hearing aid fitting algorithms by experienced pediatric hearing aid users with mild to moderate hearing loss. We hypothesized that extended use (up to 13 months) of an adaptive algorithm with integrated directionality and noise reduction, OpenSound Navigator (OSN), would result in improved performance on auditory, cognitive, academic, and caregiver- or self-report measures compared with a control, omnidirectional algorithm (OMNI). Forty children aged 6 to 13 years with mild to moderate/severe symmetric sensorineural hearing loss completed this study. They were all experienced hearing aid users and were recruited through the Cincinnati Children's Hospital Medical Center Division of Audiology. The children were divided into 20 pairs based on similarity of age (within 1 year) and hearing loss (level and configuration). Individuals from each pair were randomly assigned to either an OSN (experimental) or OMNI (control) fitting algorithm group. Each child completed an audiology evaluation, hearing aid fitting using physically identical Oticon OPN hearing aids, follow-up audiological appointment, and 2 research visits up to 13 months apart. Research visit outcome measures covered speech perception (in quiet and in noise), novel grammar and word learning, cognition, academic ability, and caregiver report of listening behaviors. Analysis of outcome differences between visits, groups, ages, conditions and their interactions used linear mixed models. Between 22 and 39 children provided useable data for each task. Children using the experimental (OSN) algorithm did not show any significant performance differences on the outcome measures compared with those using the control (OMNI) algorithm. Overall performance of all children in the study increased across the duration of the trial on word repetition in noise, sentence repetition in quiet, and caregivers' assessment of hearing ability. There was a significant negative relationship between age at first hearing aid use, final Reading and Mathematical ability, and caregiver rated speech hearing. A significant positive relationship was found between daily hearing aid use and study-long change in performance on the Flanker test of inhibitory control and attention. Logged daily use of hearing aids related to caregiver rated spatial hearing. All results controlled for age at testing/evaluation and false discovery rate. Use of the experimental (OSN) algorithm neither enhanced nor reduced performance on auditory, cognitive, academic or caregiver report measures compared with the control (OMNI) algorithm. However, prolonged hearing aid use led to benefits in hearing, academic skills, attention, and caregiver evaluation.

Relationship between Auditory Processing Abilities and Hearing Aid Benefit in Elderly Individuals with Hearing Impairment

Background and Aim: Cognitive and auditory processing deficits are seen in older individuals with normal hearing sensitivity. Studies on older individuals with hearing impairment have assessed the cognitive function and correlated with hearing devices benefit. Since auditory processing can also affect speech perception abilities, and there is a possible relationship between cognition and some of the auditory processing abilities, it is essential to assess the relationship between auditory processing abilities and hearing aid benefit in naïve and experienced hearing aid users in older adults.&#x0D; Methods: Fifty individuals in the age range of 51 to 70 years with mild to moderate hearing loss participated in the study. There were 30 participants without any hearing aid experience and 20 participants with hearing aid experience for at least six weeks. Their auditory processing abilities were tested using gap detection test, duration pattern test, speech perception in noise, dichotic consonant-vowel test, masking level difference, forward and backward span tests. The hearing aid benefit was assessed using aided speech perception in noise measures and International Outcome Inventory-Hearing Aids questionnaire in Kannada.&#x0D; Results: Spearman’s correlation showed only correlation between auditory closure ability and binaural integration abilities with hearing aid benefit in experienced users. There was no correlation between any other auditory processing abilities and hearing aid benefit.&#x0D; Conclusion: There is a correlation between a few auditory processes and hearing aid use in elderly individuals with mild to moderate hearing loss.&#x0D; Keywords: Auditory processing abilities; hearing aid benefit; hearing aid users; working memory

Can real-ear insertion gain deviations from generic fitting prescriptions predict self-reported outcomes?

Objective The aim of this study was to determine whether the differences in insertion gains from the first fit to generic prescriptions of hearing aids can predict the self-reported hearing aid (HA) outcomes for first-time and experienced HA users. Design This was a prospective observational study. Study Sample The study included 885 first-time and 330 experienced HA users with a valid real-ear measurement on both ears and answers to the abbreviated version of the Speech, Spatial, and Quality of Hearing (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires. Results K-means clustering of gain differences between individual real-ear insertion gain to three generic gain prescriptions (NAL-NL2, NAL-RP, and one-third gain rules) was performed. The gain difference at higher frequencies generally differentiated the clusters. The experienced users in the cluster with fittings closest to NAL-NL2 and NAL-RP prescription were found to exhibit a higher IOI-HA Factor 1 score (representing the overall benefit of the hearing aid use). The gain differences to generic prescription did not affect other self-reported outcomes for first-time and experienced HA users. Conclusion The experienced HA users with minimal gain deviations from generic prescriptions reported better self-perceived benefits than users with larger deviations. However, this was not apparent in first-time users.