Moderately-severe Hearing Loss Research Articles

Production of Persian Morphosyntactic Structures Based on P-LARSP: Comparing Children With/Without Hearing Loss

Objective Despite all advancements in hearing amplification, screening, and interventions, concerns still exist about the language outcomes in children with mild to severe hearing loss. The present study aimed to investigate the production of inflectional morphemes, phrase, and clause structures of children with Moderately Severe Hearing Loss (MSHL) and compare with those of the children with Normal Hearing (NH). Materials & Methods The study participants were 88 NH children, aged 2-5 years, and 10 MSHL children, aged 5-6 years. They were recruited by a convenient sampling method. Speech therapists collected language samples in a free play context of the study children, and then the language samples were transcribed and segmented according to P-LARSP (language assessment, remedy, and screening procedure). Of 100 analyzable units, the speech therapists identified, allocated, and counted 14 inflectional morphemes and all clause and phrase structures in each language sample. Results Children with MSHL used significantly fewer numbers of inflectional morphemes (P=0.004), verb/complement+personal pronoun (P=0.009), and prefix/mi/as a tense marker (P=0.025), lower mean length of morpheme/analyzable utterances (P=0.003), higher percentages of one-word utterances (P=0.001), and lower numbers of clause structures in stage V (P=0.002) compared with NH children aged 4-5 years. While the types of clause structures in children with MSHL were similar to those in NH children aged 24-36 months. However, the types of produced inflectional morphemes were restricted compared with all groups of children with NH. Conclusion The present study revealed that children with MSHL are behind younger children with NH in grammatical aspects of the Persian language. They used simpler clauses, limited numbers, and types of inflectional morphemes, as well as clause and phrase structures, and mainly relied on one-word utterances. Continued monitoring of grammatical outcomes is warranted, considering that children who are MSHL are at increased risk for language problems.

Hearing and Speech Perception for People With Hearing Loss Using Personal Sound Amplification Products.

BackgroundHearing loss (HL) is the most common chronic disease and has been linked to negative health outcomes. Hearing aids (HAs) are regarded as the gold standard for HL management, however, the adoption rate of HAs is relatively low for various reasons. With this background, hearing devices, such as personal sound amplification products (PSAPs) received significant attention as an alternative to conventional HAs. This study aimed to evaluate the clinical efficacy of PSAPs in patients with mild to moderately severe HL.MethodsNineteen patients with mild hearing loss (MHL), 23 with moderate hearing loss (MDHL), and 15 with moderately severe hearing loss (MSHL) participated in the study. Electroacoustic analysis, simulated real-ear measurements (REMs), and three clinical evaluations were implemented.ResultsAll devices satisfied the electroacoustic tolerances. All devices provided sufficient gain for MHL and MDHL audiograms. However, in MSHL audiogram, the gains of PSAPs were insufficient, especially for high frequencies. In terms of clinical evaluations, sound-field audiometry showed significant improvements between aided and unaided thresholds in all groups for all devices (P < 0.001). Significant improvements of word recognition scores were only shown for HAs between aided and unaided conditions. The Korean version of the Hearing In Noise Test did not show any consistent findings for all devices and groups.ConclusionCertain PSAPs are beneficial for improving hearing and speech perception in patients with HL. Well-chosen PSAPs could be an alternative hearing rehabilitation option for these patients.

Aided Hearing Moderates the Academic Outcomes of Children With Mild to Severe Hearing Loss.

There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes. The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained. Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but <76 dB HL) had significantly poorer oral language and reading skills than the CNH at each grade. The children with mild and moderate HL did not differ from the CNH in oral language or reading. No differences were found between the CHH regardless of severity and CNH with regard to spelling, passage writing, or calculation. The degree to which hearing aids provided audible speech information played a moderating role in the oral language outcomes of CHH and this moderation of language mediated the relationship between the unaided hearing ability of the CHH and their academic outcomes. As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.

Exploring Factors Related to Self-perceived Hearing Handicap in the Elderly with Moderate to Moderately-severe Hearing Loss

Exploring Factors Related to Self-perceived Hearing Handicap in the Elderly with Moderate to Moderately-severe Hearing Loss

Acoustic characteristics of voice in examinees with moderately-severe hearing loss

&amp;lt;p&amp;gt;Introduction.Voice is the result of vocal cord vibrations and resonance effects of the vocal tract, therefore, the instrumental monitoring of the vibrations themselves is one of the essential aspects of objective instrumental assessment of voice. Inadequate height and volume, as well as increased nasality, represent the basic characteristics of voice in hearing-impaired persons. The aim of the study was to perform a detailed analysis of the acoustic structure of vowel /a/ in the hearing-impaired persons and in those with normal hearing and voice. Methods. The sample comprised 40 participants, aged 17 to 20 years (18.50 &amp;amp;plusmn;1.13), both sexes (50% males), divided into two groups. The first group consisted of 20 participants with moderately-severe hearing loss (56-70 dB), while the second group included 20 normal-hearing participants. Members of both groups were equal to each other in sex and age (&amp;amp;plusmn; 3 months). The research was conducted in secondary schools, the Faculty of Medicine in Foča, as well as in Special School with a Student's Dormitory &amp;quot;Bubanj&amp;quot; in Ni&amp;amp;scaron; during May 2018. Results. A statistically significant difference between hearing-impaired and normal-hearing speakers was found in 11 out of 14 tested acoustic parameters of vowel /a/: Standard Deviation of Fundamental Frequency (STD), Absolute Jitter (Jitta), Percentage of Jitter (Jitt), Relative Average Perturbation (RAP), Fundamental Frequency Variation (vFo), Shimmer (Shdb), Percentage of Shimmer (Shim), Amplitude Perturbation Quotient (APQ), Noise-to-Harmonic Ratio (NHR), Soft Phonation Index (SPI) and Frequency Tremor Intensity Index (FTRI) whereby the hearing-impaired participants showed higher values of the above-mentioned parameters. Conclusion: The obtained results show pathological changes in the voice of hearing-impaired persons, as well as the need for voice rehabilitation.&amp;lt;/p&amp;gt;

A novel study on association between untreated hearing loss and cognitive functions of older adults: Baseline non-verbal cognitive assessment results.

Age-related hearing loss (ARHL) is highly prevalent in older adults, and more than two-thirds above age of 70years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment; however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in overestimation of cognitive impairment in such individuals. This baseline cross-sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non-verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined. Prospective case-controlled study. A total of 119 participants (54 males, M=66.33±10.50years; 65 females M=61.51±11.46years) were recruited. All participants completed a hearing assessment, a computerised test battery of non-verbal cognitive functions and the depression, anxiety and stress scale. Hierarchical multiple regression analysis results revealed that hearing thresholds significantly associated with the working memory (P<0.05), paired associative learning scores (P<0.05), depression (P<0.001), and anxiety (P<0.001) and stress (P<0.001) scores. Analysis of covariance results revealed that participants with moderately-severe hearing loss performed significantly poorer in paired associative learning and working memory tasks and psychological function tests compared to those with normal hearing. Results of the current study suggest a significant relationship between ARHL and both cognition and psychological status. Our results also have some implications for using non-verbal cognitive tests to evaluate cognitive functions in post-lingually hearing impaired ageing adults, at least for those with more than moderately-severe levels of hearing loss.

Clinical and audiological study of chronic suppurative otitis media tubotympanic type

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Chronic suppurative otitis media (CSOM), tubotymapanic type, despite a commonly encountered disease in otorhinolaryngology has many controversies involved. This study was aimed at bringing few of these aspects to limelight. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;The study was conducted in Otorhinolaryngology department, Aarupadai Veedu Medical College and Hospital, Pondicherry, India between September 2015 - August 2016. Total of 207 ears of 180 patients with CSOM tubotympanic type were included. Selected patients were subjected to ENT examination and pure tone audiometry after obtaining history. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;In this study 35.9% patients belonged to 4th decade and 29.4% to 3rd decade. Among patients with discharge for more than 30 years, 68.8% had moderately-severe hearing impairment and those with discharge for less than 10 years, 60.2% had mild hearing loss. Among patients with large central perforation, 51.4% had moderately-severe hearing loss and those with small central perforation, 68.4% had mild hearing loss. Hearing loss was nearly same in anterior and posterior perforations. On chi square test p value was 0.0874 i.e. &amp;gt;0.05, difference insignificant. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;In our study most patients were in 4th decade, incidence is equal in both genders. Hearing loss is directly proportional to disease duration and perforation size. Site of perforation does not influence hearing loss.&lt;/span&gt;&lt;/p&gt;

Effect of the degree of sensorineural hearing impairment on the results of subjective evaluations of a noise-reduction algorithm

Subjective evaluations of the perceptual effects of a specific noise-reduction (NR) algorithm for hearing-support devices have frequently been performed using normal-hearing (NH) participants because of financial, time, and ethical constraints. However, the perceptual effects of the same NR algorithm in a subjective evaluation may differ in accordance with the degree of hearing ability of the subjects. In this study, we performed subjective evaluations using 45 participants with different degrees of sensorineural hearing impairment to assess whether the perceptual effects of a certain NR algorithm in aspects of preference, quality, and intelligibility are affected by the degree of hearing ability. We recruited 15 NH subjects, 15 sensorineural hearing-impaired (SNHI) subjects with moderate hearing loss, and 15 SNHI subjects with moderately-severe hearing loss, and performed preference, intelligibility, and quality tests using three NR algorithms. Experimental results demonstrated that the perceptual effects of a certain NR algorithm were not significantly affected by the degree of hearing ability in regards to preference and improvement of speech intelligibility, but were significantly affected in regards to the improvement of speech quality.

Long-term effects of non-linear frequency compression for children with moderate hearing loss

Objective: To evaluate non-linear frequency compression (NLFC) as a means to improve speech recognition for children with moderate to moderately-severe hearing loss following a six-month acclimatization period. Design: Within subject design with repeated measures across test conditions. Study Sample: Fifteen children, ages 5 to 13 years, with moderate to moderately-severe high-frequency sensorineural hearing loss were fitted with Phonak Nios, micro-sized, BTE hearing aids and evaluated after two six-week intervals with and without NLFC and again after a six-month period of consecutive NLFC use. Results: Using repeated measures analyses, the six-month results were compared to data that was collected following six-week trials with and without NLFC hearing aids (). Improvements seen with NLFC in the initial study () were maintained or significantly increased in the present study. When compared to the six-week data, aided non-sense syllable speech recognition thresholds in quiet and speech recognition in noise were significantly better at the six-month interval. Conclusions: These results suggest that NLFC improves audibility for and recognition of high-frequency speech sounds for children with moderate to moderately-severe hearing loss. In many cases, improvements found with NLFC increased with a longer period of acclimatization to the technology.SumarioObjetivo: Evaluar la compresión no lineal de la frecuencia (NLFC) como un medio para mejorar el reconocimiento del lenguaje en niños con pérdidas auditivas moderadas a moderadamente severas, luego de un periodo de seis meses de aclimatación. Diseño: Es un diseño intra-sujeto con mediciones repetidas en todas las condiciones de la prueba Muestra del Estudio: Quince niños, edades de 5 a 13 años, con hipoacusia sensorineural moderada a moderadamente severa en altas frecuencias, fueron adaptados con auxiliares auditivos retroauriculares, de micro-tamaño, Phonak Nios, y evaluado luego de dos intervalos de seis semanas, con o sin NLFC y de nuevo, luego de un periodo de seis meses de uso consecutivo de NLFC. Resultados: Usando análisis de medidas repetidas, los resultados a seis meses se compararon con datos que fueron recogidos luego de periodos de seis semanas, con y sin auxiliares auditivos NLFC (Wolfe y col, en prensa). Las mejorías que se ven con NLFC en el estudio inicial (Wolfe y col, en prensa) se mantuvieron o fueron significativamente aumentadas en el presente estudio. Cuando se compararon con los datos de seis semanas, los umbrales no amplificados de reconocimiento del lenguaje para sílabas sin sentido en silencio y de reconocimiento del lenguaje en ruido, fueron significativamente mejores en el intervalo de seis meses. Conclusiones: Estos resultados sugieren que la NLFC mejora la audibilidad y el reconocimiento de sonidos lingüísticos de alta frecuencia para niños con hipoacusias moderadas a moderadamente severas. En muchos casos, la mejoría encontrada con NLFC aumentó con un periodo más largo de aclimatación a la tecnología.

Auditory function and hearing loss in children and adults with Williams syndrome: Cochlear impairment in individuals with otherwise normal hearing

Hearing loss is common in school-age individuals with Williams syndrome (WS) and extensive in adults. Prior studies with relatively small sample sizes suggest that hearing loss in WS has an early onset and may be progressive, yet the auditory phenotype and the scope of the hearing loss have not been adequately characterized. We used standard audiometric tools: Otoscopy, tympanometry, air-conduction (bone conduction when available) behavioral testing, and distortion product otoacoustic emissions (DPOAEs) to measure hearing sensitivity and outer hair cell function. We tested 81 individuals with WS aged 5.33-59.50 years. Sixty-three percent of the school-age and 92% of the adult participants had mild to moderately-severe hearing loss. The hearing loss in at least 50% was sensorineural. DPOAE testing corroborated behavioral results. Strikingly, 12 of 14 participants with hearing within normal limits bilaterally had 4,000-Hz DPOAE input/output (DPOAE IO) functions indicative of outer hair cell damage and impaired cochlear compression. Our results indicate that hearing loss is very common in WS. Furthermore, individuals with WS who have "normal" hearing as defined by behavioral thresholds may actually have sub-clinical impairments or undetected cochlear pathology. Our findings suggest outer hair cell dysfunction in otherwise normal hearing individuals. The DPOAE IO in this same group revealed growth functions typically seen in groups with noise-induced damage. Given this pattern of findings, individuals with WS may be at increased risk of noise-induced hearing loss. Recommendations regarding audiological testing for individuals with WS and accommodations for these individuals in both academic and nonacademic settings are provided.

DFNB3, spectrum of MYO15A recessive mutant alleles and an emerging genotype-phenotype correlation.

We have now identified seven MYO15A mutations that cause congenital profound neurosensory hearing loss and a possible hypomorphic allele of MYO15A associated with moderately-severe hearing loss in 1 of 8 SMS patients. Because myosin XVA is encoded by 66 exons, screening for mutations in hearing-impaired individuals is expensive and labor-intensive in comparison to a screen for mutations in GJB2 (Cx26), for example, which has only a single protein coding exon. Among consanguineous families segregating profound, congenital hearing loss from Pakistan, approximately 10% are consistent with linkage to DFNB3 (11 of 112 DFNB families). In one-half of these DFNB3 families, we found a homozygous mutation in 1 of the 66 exons of MYO15A [25]. This suggests that mutations of MYO15A are responsible for at least 5% of recessively inherited, profound hearing loss in Pakistan. However, without the benefit of a pre-screen for linkage to DFNB3, it will be a challenge to determine the extent to which mutations of MYO15A contribute to hereditary hearing loss among isolated cases and small families in other populations.