Hearing Aids Research Articles

Using the Mismatch Negativity to Evaluate Hearing Aid Directional Enhancement Based on Multistream Architecture.

To evaluate whether hearing aid directivity based on multistream architecture (MSA) might enhance the mismatch negativity (MMN) evoked by phonemic contrasts in noise. Single-blind within-subjects design. Fifteen older adults (mean age = 72.7 years, range = 40 to 88 years, 8 females) with a moderate-to-severe degree of sensorineural hearing loss participated. Participants first performed an adaptive two-alternative forced choice phonemic discrimination task to determine the speech level-that is, signal to noise ratio (SNR)-required to reliably discriminate between two monosyllabic stimuli (/ba/ and /da/) presented in the presence of ongoing fixed-level background noise. Participants were then presented with a phonemic oddball sequence alternating on each trial between two loudspeakers located in the front at 0° and -30° azimuth. This sequence presented the same monosyllabic stimuli in the same background noise at individualized SNRs determined by the phonemic discrimination task. The MMN was measured as participants passively listened to the oddball sequence in two hearing aid conditions: MSA-ON and MSA-OFF. The magnitude of the MMN component was significantly enhanced when evoked in MSA-ON relative to MSA-OFF conditions. Unexpectedly, MMN magnitudes were also positively related to degrees of hearing loss. Neither MSA nor the participant's hearing loss was found to independently affect MMN latency. However, MMN latency was significantly affected by the interaction of hearing aid condition and individualized SNRs, where a negative relationship between individualized SNR and MMN latency was observed only in the MSA-OFF condition. Hearing aid directivity based on the MSA approach was found to improve preattentive detection of phonemic contrasts in a simulated multi-talker situation as indexed by larger MMN component magnitudes. The MMN may generally be useful for exploring the underlying nature of speech-in-noise benefits conferred by some hearing aid features.

Validation of the Vanderbilt Classroom Listening Assessment Short Survey for Children With Unilateral Hearing Loss.

Children with unilateral hearing loss experience difficulties in classroom listening situations. There are a limited number of validated questionnaires available for monitoring listening development and quantifying the challenges school-aged children with unilateral hearing loss experience. The purpose of this study was to evaluate a survey that describes the classroom listening challenges reported by children with unilateral hearing loss with and without the use of personal hearing devices (air conduction hearing aid, bone conduction hearing aid, cochlear implant, contralateral routing of signals system). Children aged 9 to 17 years with self-reported unilateral hearing loss completed an online survey about classroom listening difficulties when not using a personal hearing device (n = 1148) or with the use of a personal hearing device (n = 897). The survey includes 15 questions examining different situations common in modern classrooms. Each question includes a picture depicting the described listening situation. Exploratory factor analysis was used to develop subscales and the internal reliability of the subscales was evaluated. To validate the survey, the relationships between survey scores and self-reported hearing difficulties (without a personal hearing device) or type of device (with a personal hearing device) were evaluated using regression analyses. Factor analysis revealed survey scores for individual items statistically loaded onto three factors. On the basis of these factors, subscales were created, which are related to: (1) listening situations where the talker is faraway from the child, (2) listening situations where the talker is close to the child and they are inside a building, and (3) listening situations where the talker is close to the child and they are outside a building. Regression analyses revealed children reported the greatest difficulty in school settings when the sound of interest was faraway from them. Although scores were generally higher, indicating listening was easier, when children were wearing their personal hearing devices (i.e., air conduction hearing aid, bone conduction hearing aid, contralateral routing of signals system, cochlear implant), situations with faraway signals were still reported as more challenging than were situations where signals were close. This set of findings highlights the need to incorporate distance effects into laboratory evaluations that include children with unilateral hearing loss. In addition, the findings support clinical interventions that address talker-to-listener distances, such as preferential seating and remote microphone systems. Last, the results of this study validate the Vanderbilt Classroom Listening Assessment Short Survey for use with children aged 9 to 17 years of age with unilateral self-reported hearing difficulty. The subscales are empirically driven, internally reliable, and focus on three types of listening situations encountered in classrooms. It is important to note that the survey results demonstrate the expected pattern of results, with participants who have greater self-reported hearing difficulty rating classroom listening situations as more difficult than participants with less self-reported hearing difficulty.

Quality and Readability of Hearing Aid-Related Websites in English and Spanish.

To determine the readability and quality of both English and Spanish Web sites for the topic of hearing aids. Cross-sectional Web site analysis. Various online search engines. The term "hearing aid" was queried across four popular search engines. The first resulted 75 English Web sites and first resulted 75 Spanish Web sites were extracted for data collection. Web sites that met the inclusion criteria were stratified by the presence of a Health on the Net Code (HONCode) certificate. Articles were then compiled to be independently reviewed by experts on hearing aids, using the DISCERN criteria, which allowed assessment of the quality of the Web sites. Readability was assessed by calculating the Flesch Reading Ease Score in English and the Fernandez Huerta Formula in Spanish. Readability and quality were both analyzed, comparing scores to their respective language and cross-comparing. There were 37 English Web sites and 30 Spanish Web sites that met inclusion criteria. When analyzing readability, English Web sites were determined to be significantly more difficult to read (average = 55.37, standard deviation [SD] = 7.73, 95% confidence interval [CI] = 52.9-57.9) than the Spanish Web site counterparts (average = 58.64, SD = 5.26, 95% CI = 56.8-60.5, p = 0.035). For quality, Spanish Web sites (average = 38, SD = 9.7, 95% CI = 34.5-41.5) were determined to be of significantly higher quality than English Web sites (average = 32.16, SD = 10.60, 95% CI = 29.7-34.6). Additionally, there was a significant difference between the non-HONCode English Web sites versus the non-HONCode Spanish Web sites (p = 0.0081), signifying that Spanish non-HONCode certified Web sites were less reliable than non-HONCode certified English Web sites. The present study highlights the importance and necessity of providing quality, readable materials to patients seeking information regarding hearing aids. This study shows that both English and Spanish Web sites are written at a level that is much higher than the American Medical Association (AMA)-recommended sixth-grade reading level, and no Web site included in this study fell at or below the AMA-recommended sixth-grade reading level. English and Spanish Web sites also lacked consistency and quality, as evidenced by their wide variability in DISCERN scores. Specifically, Hispanic patients are more likely to suffer long-term consequences of their health care due to low levels of health literacy. It is important to bridge this gap by providing adequate reading materials. It is especially important to provide evidence-based claims that are directly supported by experts in the field.

Sentence Comprehension in Spanish-Speaking Children With Hearing Loss: On the Integration of Morphosyntactic and Lexico-Semantic Cues.

Children with hearing loss (CHL) who use hearing devices (cochlear implants or hearing aids) and communicate orally have trouble comprehending sentences with noncanonical order. This study explores sentence comprehension strategies in Spanish-speaking CHL, focusing on their ability to integrate morphosyntactic cues (word order, morphological case marking) with verbs differing in their syntax-to-semantics configuration. Fifty-eight Spanish-speaking CHL and 58 children with typical hearing (CTH) with a hearing age of 3;5-7;8 (years;months; i.e., time of adequate access to sound, in the case of CHL since effective fitting or implantation) were recruited in Argentina. A sentence comprehension task using the truth-value judgment paradigm was designed, including sentences with activity verbs and object-experiencer psych verbs in subject-verb-object (SVO) and object-verb-subject (OVS) orders, thus varying in canonicity. Both groups showed good comprehension of SVO sentences with activity verbs but had difficulties with structures that deviated from canonicity. Comprehension was at chance level in both groups and at all hearing ages for sentences with activity verbs in OVS order and sentences with object-experiencer psych verbs in SVO order (both are noncanonical for the verb type). Sentences with object-experiencer psych verbs in OVS order were also comprehended at chance level by CHL and by the youngest CTH. These results suggest that Spanish-speaking CTH aged 7 years prioritize semantic information over case marking in sentences with a noncanonical syntactic structure. In CHL, difficulties with noncanonical structures seem to extend to semantic deviations, at least until hearing age 7 years. CHL might also struggle with the semantic structures of object-experiencer psych verbs beyond the age when CTH do. These findings are relevant for the linguistic assessment and education of CHL.

Effect of Abstract Phonemic Complexity on Mismatch Negativity Amplitude.

Mismatch negativity (MMN) reflects a preperceptual neurophysiological response that is generated subconsciously due to the interruption of a memory trace of ongoing sensory events in the environment. It has been widely used by researchers to understand complex perceptual mechanisms. Furthermore, it has been recommended as an objective tool to investigate disorders related to auditory cognition in hearing aid and cochlear implant users. Many researchers suggest that utilizing a larger acoustic difference between standard and deviant stimuli within the oddball paradigm will lead to a more robust MMN response. The purpose of the present study is to examine if increasing the abstract phonemic contrast between standard and deviant stimuli in the oddball paradigm leads to a more robust MMN response. Fourteen young female adults participated in the present study. To ensure that the MMN response was elicited by phonemic and not acoustic differences in the stimuli, a one-to-many ratio was created for the abstract phonemic features while controlling the acoustic features when designing the oddball paradigm as described by Phillips et al. (2000). MMN amplitude was measured at the Cz and Fz electrodes in two conditions, with two trials in each condition. In condition 1, the standards and deviants differed by one distinctive feature: voicing in trial 1 (/tӕ/ was standard and /dӕ/ was deviant) and place of articulation in trial 2 (/bӕ/ was standard and /dӕ/ was deviant). In condition 2, the standards and deviants differed across two distinctive features: voicing and place of articulation. In trial 1, /pӕ/ was standard and /dӕ/ was deviant; in trial 2, /dӕ/ was standard and /pӕ/ was deviant. MMN amplitudes elicited by two distinctive features were significantly larger than MMN amplitudes elicited by one distinctive feature (p < 0.001). Trials 1 and 2 in each condition showed no statistical difference, and they were repeatable and highly correlated. Recordings from the Cz and Fz electrodes showed no statistical difference and were highly correlated and similar in morphology. It is known in the literature that increasing acoustic complexity elicits a more robust MMN. The present study showed that this assumption can be extended to abstract phonemic complexity. Increasing the phonemic complexity by utilizing more distinctive features in the oddball paradigm increased the amplitude and robustness of the MMN.

Research Progress on Embryonic Development, Genetic Regulation and Clinical Management of Congenital Middle Ear Malformations

ABSTRACTCongenital middle ear malformations are a common hearing defect in newborns, primarily characterised by abnormal middle ear structures, particularly underdeveloped or malformed ossicular chains, resulting in conductive hearing loss. This article provides a comprehensive review of the embryonic development process of the middle ear and the genetic regulatory mechanisms, with a focus on the Tbx1 gene, which is closely related to middle ear development. Studies have shown that the Tbx1 gene plays a crucial role in the migration of neural crest cells and the formation of middle ear structures, and its mutation or abnormal expression can lead to developmental defects of the middle ear structure. These gene mutations affect downstream signalling pathways (such as FGF8, FGF10 and BMP4), which are essential in the formation of the ossicles, ear canal and middle ear cavity. Additionally, this article discusses the aetiology of congenital middle ear malformations, associated syndromes, clinical manifestations, classification, diagnosis and treatment strategies. Diagnostic methods for middle ear malformations include audiological examinations, imaging studies and genetic testing. Early diagnosis and intervention, such as surgical correction and the use of hearing aids, can help improve the hearing and quality of life of patients. This article aims to provide a reference and basis for further etiological research and precise treatment by elucidating the mechanisms and clinical features of middle ear malformations.

A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank.

Observational studies have reported that hearing aid (HA) use is associated with a reduced risk of dementia diagnosis, suggesting a possible protective effect. However, extant observational studies do not explicitly model causal effects, while randomised controlled trials on the effect of HA on dementia exhibit short follow-up. Here we used self-report, hearing tests, and healthcare records in UK Biobank to design a hypothetical intervention for the effect of HA use on the risk of dementia diagnosis in people with incident hearing loss (HL). HA users exhibited a higher risk of dementia diagnosis than non-users (RR=1.43, 95%CI=1.08-1.88). Associations between HA use and dementia diagnosis were robust across sensitivity analyses (RRs: 1.34-1.59) but adjustment for primary healthcare utilisation (0.77, 0.44-1.33) or primary and secondary care utilisation (0.68, 0.39-1.18) substantially decreased the observed effect. The decrease in effect estimates upon adjustment for primary (1.30, 0.95-1.78) and primary and secondary healthcare utilisation (1.30, 0.94-1.78) was smaller when participants with relatively early diagnoses of HL were included in the sample compared to when they were not. While the findings are not conclusive, they suggest residual confounding by healthcare utilisation and dating of HL diagnosis in participants without primary care data in UK Biobank.

Reliability of connectivity for the assessment of hearing perception in cochlear implant recipients

Objective The cochlear implant (CI) is the gold standard treatment for profound hearing loss with insufficient hearing aid benefit. Using regular words and sentences as verbal stimuli showed a ceiling effect in patients with optimal perceptual abilities. The objectives of the study were: (1) to evaluate the reliability of auditory perception through connectivity, comparing it to the regular audiometry in soundbooth and (2) to analyse the use of logatomes to better assess the perceptual abilities of high-performing patients. Design and study sample Cross sectional analytic study Study sample A total of 32 CI patients with high auditory performances underwent pure-tone and speech audiometry in two methods: (1) in an audiometric booth and (2) via direct streaming to the processor using a connectivity system. Correlation and concordance analyses were performed. Results Pure-tone audiometry showed a low correlation between the two methods. Speech audiometry revealed a high correlation at 30 dB HL but a low concordance between the two instruments. The evaluation through connectivity showed better results in pure-tone and speech audiometry than those of regular audiometry in soundbooth. The use of logatomes was useful for discriminating patients with better performances. Conclusions Connectivity might be considered a useful additional method to assess the performance of CI recipients.

Bilateral Cochlear Implants and Bimodal Hearing: A Comparison of Quality of Life.

Despite significant advances in the field of cochlear implants (CIs), there is no widely accepted criterion for when to counsel on bilateral CIs in adults. This is partly due to conflicting findings on the advantages of bilateral CIs versus bimodal hearing (i.e., CI with a contralateral hearing aid). Because of this, clinicians rely on a poorly defined combination of clinical measures and patient discussion to evaluate a patient's listening needs and preferences. Patients' needs and preferences are often used to guide recommendations on whether bilateral CIs or bimodal hearing is best for that individual, suggesting that an in-depth comparison of each group's self-reported outcomes is warranted. Given the limited number of studies directly comparing quality of life (QoL) in bimodal and bilateral patients, the current study conducted a preliminary comparison of self-reported outcomes to better understand patient-reported benefits of each listening configuration. This was a between-subjects comparison. Fifteen bimodal and nine bilateral adult CI users made the study sample. Participants completed the Cochlear Implant Quality of Life (CIQOL) Profile 35. For group comparison purposes, monosyllabic word recognition and nonverbal intelligence were measured. Independent samples t-tests with Holm-Bonferroni corrections were used to compare bimodal and bilateral patients across domains of the CIQOL. Bilateral CI users self-reported better environmental, emotional, social, and global QoL when compared to bimodal users. The groups did not differ on age, nonverbal intelligence, speech recognition abilities, and duration of hearing loss; however, bimodal users had less experience listening with their CI than the bilateral CI users. Bilateral CI users showed widespread advantages in QoL when compared to bimodal users. Bilateral CI users self-reported significantly better environmental QoL which conflicts with previous in-lab and self-report results suggesting a bimodal advantage. Additionally, due to a lack of current literature, it is unclear why a bilateral advantage is observed for emotional and social QoL. Results of the current study not only provide additional support on the benefits of bilateral implantation but also stress the need to further explore the self-reported benefits of each listening configuration.

Speech recognition and real-ear-measured amplification in hearing-aid users with various grades of hearing loss

Objective The relationship between aided speech recognition and hearing-aid (HA) amplification was investigated in a retrospective study. Design and study sample Pure-tone thresholds, aided and unaided speech recognition and real-ear measurements of 635 ears in 374 HA users were reviewed. Ears were classified according to pure-tone average (PTA) and real-ear aided response (REAR) in relation to the targets of NAL-NL2 and DSL v5.0. Results For DSL v5.0, compared with NAL-NL2, higher amplification was calculated almost consistently for input levels of 65 and 80 dB SPL. Speech-recognition scores were best when the REAR reached ±5 dB or exceeded 5 dB the DSL v5.0 target and were lowest when the REAR fell more than 5 dB below the NAL-NL2 target. Conclusions The greatest impact of the REAR on speech recognition was observed at hearing losses between 50 and 80 dB HL. It was found that to optimise speech recognition and audibility for patients in this range HA fittings should target DSL v5.0 prescription values. For hearing losses below 50 dB HL, both NAL-NL2 and DSL v5.0 may be considered for HA fitting. However, for hearing losses above 80 dB HL, aided speech recognition is insufficient in most cases.

Device Use Among Spanish-English Bilingual and English Monolingual Children Who Are Deaf and Hard of Hearing.

This report compares device use in a cohort of Spanish-English bilingual and English monolingual children who are deaf and hard of hearing, including children fitted with traditional hearing aids, cochlear implants (CIs), and/or bone-conduction hearing devices. Participants were 84 Spanish-English bilingual children and 85 English monolingual children from clinical sites across the United States. The data represent a subset obtained in a larger clinical trial. Device use obtained via data logging was modeled as a function of language group, device type, child age, sex, and parental education. Among children with traditional hearing aids, bilingual children wore their devices significantly fewer hours per day than monolingual children, but this group difference was not observed for children with CIs or bone-conduction hearing devices. In the monolingual group, older children wore their devices significantly more hours than younger children, but this effect of age was not present in the bilingual group. Parent report was consistent with data logging for bilingual and monolingual children. Spanish-English bilingual hearing aid users wore their devices less than their English monolingual peers, particularly among older children. This group effect was not observed for children with CIs or bone-conduction hearing devices. Additional studies are needed to identify factors that contribute to device use among bilingual children with hearing aids.

Hearing aid verification: Practices and perceptions of South African audiologists.

Hearing aid verification is required to objectively measure hearing aid outputs by ensuring that the amplified speech spectrum closely approximates the prescription goals. This study aimed to determine audiologists' perceptions and practices regarding hearing aid verification and identify facilitators and barriers to its use. A cross-sectional national e-survey included questions related to demographics, perceptions of verification, verification practices and two open-ended questions regarding the facilitators and barriers to conducting hearing aid verification in South Africa. Seventy-eight South African audiologists, with experience ranging from less than a year to 34 years, completed the online survey. Of these, 76.3% conduct hearing aid verification, while 23.7% seldom or never perform this verification. Among the audiologists who conducted verification, 81.0% reported performing it on both adults and children. More than three-quarters (86.6%) indicated that they conduct verification only during the initial fitting, while half (53.8%) do so only when a problem arises. Thematic analysis revealed the following barriers to verification: improper equipment, a lack of equipment, non-standard clinical practices and time constraints. There are several challenges faced by South African audiologists in performing verification. It may be feasible to address these barriers by raising awareness about the value of verification, offering training, and advocating for the purchase and utilisation of verification equipment.Contribution:This study's findings provide information on the current practices of hearing aid verification in a socioeconomically diverse setting. Furthermore, it highlights important challenges such as a lack of equipment as well as time constraints.

Unveiling Disability Empowerment: Evaluating ICT Skill Enhancement Initiatives in Indonesia

This study examines the role of information and communication technology (ICT) skill development programs, such as the Digital Talent Scholarship and ICT Jamboree, in empowering people with disability across Indonesia. Grounded in empowerment theory, it investigates how these programs contribute to personal autonomy, economic engagement, and social inclusion. The research focuses on participants’ perceptions of the impact of ICT training on their independence and social integration. It also identifies challenges in applying ICT skills in daily life, including barriers to employment and limited access to assistive technologies like Braille displays and hearing aids. Through a qualitative approach—using semi-structured interviews and focus group discussions with 99 participants from diverse people with disability groups—the findings reveal significant improvements in self-confidence, digital literacy, and participants’ ability to overcome employment and online communication challenges. While ICT shows potential to reduce social isolation and foster digital inclusion, disparities in proficiency and access to adaptive tools remain. The study emphasizes the need for more tailored interventions and advocates for increased funding, better accessibility, and stronger public-private partnerships to advance disability inclusion through ICT, extending beyond Indonesia to Asia and the Middle East.

A real-time platform for Spanish Sign Language interpretation

AbstractMore than 13% of the Spanish population suffers from hearing impairment. Despite the existence of several hearing aids and implants making sounds clearer and louder, there are some people unable to use them and, consequently, their only means of communication is Sign Language. However, this language is not widely known in the society. Consequently, those who are deaf or hard of hearing may be socially excluded and experience frustration as a result of the lack of communication. In this context, Sign Language Recognition and interpretation would help to break down the existing communication barriers and facilitate the creation of inclusive environments. With that aim, this paper presents a real-time platform to recognize and interpret finger-spelt words in Spanish Sign Language (Lengua de Signos Española). As finger spelling implies the recognition of each signed letter, a comparative analysis of different deep learning techniques to properly recognize the Spanish Sign Language alphabet has been carried out. For that, due to the lack of Spanish Sign Language datasets, the first step was to capture and build an image dataset representing its 30 letters. As there are static and in-motion letters, spatial and temporal analysis has been conducted by considering different kind of neural networks (Convolutional Neural Networks, Recurrent Neural Networks, and Vision Transformers). The experimental results highlight the good performance of the studied architectures, obtaining a maximum accuracy of 79.96% on previously unseen data. Finally, a real-time platform for the recognition and interpretation of finger-spelt words in Spanish Sign Language has been implemented making the communication possible.

Intelligibility Sound Therapy Enhances the Ability of Speech-in-Noise Perception and Pre-Perceptual Neurophysiological Response

Aural rehabilitation with hearing aids can decrease the attentional requirements of cognitive resources by amplifying deteriorated-frequency sound in hearing loss patients and improving auditory discrimination ability like speech-in-noise perception. As aural rehabilitation with an intelligible-hearing sound also can be hopeful, the aim of this study was to evaluate the effectiveness of aural rehabilitation with intelligible-hearing sound for hearing loss patients. Adult native Japanese speakers (17 males and 23 females, 68.43 ± 9.23 years) with hearing thresholds exceeding 30 dB at any of the following frequencies: 125, 250, 500, 1000, 2000, 3000, 4000, 8000, 10,000, and 12,000 Hz in either ear, were recruited. on any side were recruited and underwent the Mini-Mental State Examination Japanese. We conducted a self-evaluation questionnaire for hearing problems of voice, a gap detection test, a fast speech test, a speech-in-noise test, a pure tone audiogram, and a speech perception test using a Japanese 67-S, cortical auditory-evoked fields, and magnetic mismatch negativity before and after the non-intelligible-hearing (N = 20) and intelligible-hearing (N = 20) sound therapy, which involved listening to music for one hour a day for 35 days. The better hearing ear was defined using a four-frequency pure-tone average at the thresholds of 500, 1000, 2000, and 4000 Hz. After the sound therapy, the speech-in-noise test with a signal-to-noise ratio +10 in the better hearing ear showed significant improvement (p &lt; 0.05), and N1m-P2m amplitudes showed a significant increase in the Lt superior temporal gyrus in response to the stimulus from the better hearing ear (p &lt; 0.05). A significant enhancement of the magnetic mismatch negativity amplitude at the Lt superior temporal gyrus was exhibited after the sound therapy (p &lt; 0.01). Intelligible-hearing sound therapy can improve the ability of speech-in-noise perception in the better hearing ear and enhancement of central cortex response, which reflects the ability of working memory, was proved by cortical auditory-evoked fields and magnetic mismatch negativity. Intelligible-hearing sound therapy can be a valuable aural rehabilitation method for sensory neural hearing loss, the same as hearing aids.

Comparison of Word Complexity and Speech Intelligibility in Deaf Children with Cochlear Implant and Hearing Aids

Background: Most people with profound hearing loss have problems in speech intelligibility that related to their phonological ability and linguistic skill. The objectives of this research are to assess the clarity of speech and the complexity of words in children with hearing impairments who use cochlear implants (CI) and those who use hearing aids (HA). Objectives: Additionally, it aims to explore the connection between speech clarity and word complexity in these children. Methods: A total of fifty children with hearing loss (average age = 4.5 ± 0.8 years) were divided into two equal groups: One group consisting of 25 children with CI and another group with 25 children using hearing aids. Speech intelligibility of participants was evaluated by the repetitive word list. The criterion for examining the word complexity was the syllable number of each word. Results: The results showed that the CI group had better speech intelligibility than the HA group. There is a significant positive correlation between word complexity and speech intelligibility in hearing impaired children (P &lt; 0.001). Conclusions: According to the results of this study, the CI children showed better speech intelligibility than HA because of the effectiveness of implantation on auditory input. On the other hand, the word complexity also contributes to the level of speech intelligibility. Therefore, experts working in the field of management and clinical education of these children need to consider the word complexity and other factors affecting the speech intelligibility.

Combining unequal variance signal detection theory with the health belief model to optimize shared decision making in tinnitus patients: part 1-model development.

The results from different Cochrane studies justify considerable professional equipoise concerning different treatment options for tinnitus. In case of professional equipoise, Shared Decision Making (SDM) is an indispensable tool for guiding patients to the intervention that best fits their needs. To improve SDM we developed a method to assess the accuracy and utility of decisions made by tinnitus patients when freely choosing between different treatment options during their patient journey. The different treatment options were audiological care and psychosocial counseling. We developed a statistical model by combining Signal Detection Theory (SDT) with the Health Belief Model (HBM). HBM states that perceived severity of an illness is strongly related to sick-role behavior. As proxies for perceived severity, we selected hearing loss and Tinnitus Handicap Inventory (THI) score at baseline. Next, we used these proxies as predictors in linear regression models based on SDT to determine the likelihood ratio of true positive decisions (choosing a treatment option and experiencing an improvement of more than 7 points in THI-score) and false positive decisions (choosing a treatment option and experiencing an improvement of less than 7 points in THI-score) for audiological care and psychosocial counseling, respectively. Data was gathered in a prospective cohort of 145 adults referred for tinnitus care to an outpatient audiology clinic in the Netherlands. The participants were asked to decide freely on uptake of audiological care (provision of hearing aids with or without a sound generator) and uptake of psychosocial counseling. Logistic regression with Bayesian inference was used to determine the cumulative distribution functions and the probability density functions of true positive decisions and false positive decisions as function of hearing loss and baseline THI-score for both treatment options, respectively. With the cumulative distribution functions, we determined the accuracy of the decisions. With the probability density functions we calculated the likelihood ratios of true positive decisions versus false positive decisions as function of hearing loss and baseline THI-score. These likelihood ratio functions allow assessment of the utility of the decisions by relating a decision criterion to perceived benefits and costs. Baseline THI-score drives decisions about psychosocial counseling and hearing loss drives decisions about audiological care. Decisions about psychosocial counseling are more accurate than decisions about audiological care. Both decisions have a low accuracy (0.255 for audiological care and - 0.429 for psychosocial counseling), however. For decisions about audiological care the unbiased decision criterion is 37 dB(HL), meaning that a lenient decision criterion (likelihood ratio < 1) is adopted by patients with a hearing loss below 37 dB and a strict criterion (likelihood ratio > 1) by patients with a hearing loss exceeding 37 dB. For psychosocial counseling uptake the decision criterion is always strict, regardless of baseline THI-score. The distributions of the populations, that do and do not experience a clinically important change in THI-score, have unequal variances for psychosocial counseling, while they have almost equal variances for audiological care. Combining SDT and HBM can help assess accuracy and utility of patient decisions and thus may provide valuable information that can help to improve SDM by combining patient related outcome measures, decision drivers, and perceived benefits and costs of a treatment.

Toward Alleviating the Stigma of Hearing Aids: A Review

Toward Alleviating the Stigma of Hearing Aids: A Review

Making a Difference from Day One: The Urgent Need for Universal Neonatal Hearing Screening

Neonatal hearing screening (NHS) is a critical public health measure for early identification of hearing loss, ensuring timely access to interventions that can dramatically improve a child’s language development, cognitive abilities, and social inclusion. Beyond clinical benefits, NHS provides long-term advantages in education and quality of life. Given that congenital hearing loss affects approximately 1–2 in every 1000 newborns worldwide, the case for universal screening is clear. Countries like the United States and Australia have successfully implemented NHS, leading to earlier diagnoses, improved language development, and better educational outcomes. In Europe, while many nations have adopted NHS, consistency remains a challenge. Countries such as Norway and the United Kingdom stand out for their well-established systems, whereas others, like Greece, have made notable progress but have yet to mandate NHS nationwide. This highlights the need for cohesive national policies across Europe to ensure universal coverage. Screening methods such as Transient Evoked Otoacoustic Emissions (TEOAE) and Automated Auditory Brainstem Response (AABR) are established tools for detecting hearing impairments in neonates. Despite their demonstrated efficacy, NHS remains inconsistent globally, particularly in low- and middle-income regions that lack mandatory policies or access to reliable screening technologies. This perspective advocates for the urgent need to make NHS mandatory in all countries, emphasizing its societal benefits and cost-effectiveness. Early diagnosis supports prompt intervention, like hearing aids or cochlear implants, which are most effective when implemented before six months. It also empowers families to make informed decisions, fosters educational inclusion, and mitigates the social and emotional challenges of undiagnosed hearing loss. Policymakers, healthcare providers, and international organizations must prioritize universal NHS to ensure no child is left behind due to unaddressed hearing loss.

Artificial intelligence enabled smart mask for speech recognition for future hearing devices

In recent years, Lip-reading has emerged as a significant research challenge. The aim is to recognise speech by analysing Lip movements. The majority of Lip-reading technologies are based on cameras and wearable devices. However, these technologies have well-known occlusion and ambient lighting limitations, privacy concerns as well as wearable device discomfort for subjects and disturb their daily routines. Furthermore, in the era of coronavirus (COVID-19), where face masks are the norm, vision-based and wearable-based technologies for hearing aids are ineffective. To address the fundamental limitations of camera-based and wearable-based systems, this paper proposes a Radio Frequency Identification (RFID)-based smart mask for a Lip-reading framework capable of reading Lips under face masks, enabling effective speech recognition and fostering conversational accessibility for individuals with hearing impairment. The system uses RFID technology to make Radio Frequency (RF) sensing-based Lip-reading possible. A smart RFID face mask is used to collect a dataset containing three different classes of vowels (A, E, I, O, U), Consonants (F, G, M, S), and words (Fish, Goat, Meal, Moon, Snake). The collected data are fed into well-known machine-learning models for classification. A high classification accuracy is achieved by individual classes and combined datasets. On the RFID combined dataset, the Random Forest model achieves a high classification accuracy of 80%.