Validation of the LittlEARS((R)) Auditory Questionnaire in children with normal hearing

OBJECTIVES: With more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS Auditory Questionnaire is presented here as the first module of the LittlEARS test battery. The LittlEARS Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who receive a cochlear implant or hearing aid prior to 24 months of age. This paper presents results from two studies: one validating the LittlEARS Auditory Questionnaire on children with normal hearing who are German speaking and a second validating the norm curves found after adaptation and administration of the questionnaire to children with normal hearing in 15 different languages. METHODS: Scores from a group of 218 German and Austrian children with normal hearing between 5 days and 24 months of age were used to create a norm curve. The questionnaire was adapted from the German original into English and then 15 other languages to date. Regression curves were found based on parental responses from 3309 normal hearing infants and toddlers. Curves for each language were compared to the original German validation curve. RESULTS: The results of the first study were a norm curve which reflects the age-dependence of auditory behaviour, reliability and homogeneity as a measure of auditory behaviour, and calculations of expected and critical values as a function of age. Results of the second study show that the regression curves found for all the adapted languages are essentially equal to the German norm curve, as no statistically significant differences were found. CONCLUSIONS: The LittlEARS Auditory Questionnaire is a valid, language-independent tool for assessing the early auditory behaviour of infants and toddlers with normal hearing. The results of this study suggest that the LittlEARS Auditory Questionnaire could also be very useful for documenting children's progress with their current amplification, providing evidence of the need for implantation, or highlighting the need for follow-up in other developmental areas.

Equivalent Hearing Loss in Children

Early intervention is the key to spoken language for hearing impaired children. A severe hearing loss diagnosis in young children raises the urgent question on the optimal type of hearing aid device. As there is no recent data on comparing selection criteria for a specific hearing aid device, the goal of the Hearing Evaluation of Auditory Rehabilitation Devices (hEARd) project (Coninx & Vermeulen, 2012) evolved to collect and analyze interlingually comparable normative data on the speech perception performances of children with hearing aids and children with cochlear implants (CI). METHOD: In various institutions for hearing rehabilitation in Belgium, Germany and the Netherlands the Adaptive Auditory Speech Test AAST was used in the hEARd project, to determine speech perception abilities in kindergarten and school aged hearing impaired children. Results in the speech audiometric procedures were matched to the unaided hearing loss values of children using hearing aids and compared to results of children using CI. 277 data sets of hearing impaired children were analyzed. Results of children using hearing aids were summarized in groups as to their unaided hearing loss values. The grouping was related to the World Health Organization’s (WHO) grading of hearing impairment from mild (25–40 dB HL) to moderate (41–60 dB HL), severe (61-80 dB HL) and profound hearing impairment (80 dB HL and higher). RESULTS: AAST speech recognition results in quiet showed a significantly better performance for the CI group in comparison to the group of profoundly impaired hearing aid users as well as the group of severely impaired hearing aid users. However the CI users’ performances in speech perception in noise did not vary from the hearing aid users’ performances. Within the collected data analyses showed that children with a CI show an equivalent performance on speech perception in quiet as children using hearing aids with a “moderate” hearing impairment.

Exploring Technology Evolution Using Patent Classification: A Case of Cochlear Implant Technology Patents

Understanding technology evolution through periodic landscaping is an important stage of strategic planning in R&D Management. In fields like that of healthcare, where the initial R&D investment is huge and good medical product serve patients better, these activities become crucial. Approximately five percentage of the world population has hearing disabilities. Current hearing aid products meet less than ten percent of the global needs. Patent data and classifications on cochlear implants from 1977-2010, show the landscapes and evolution in the area of such implant. We attempt to highlight emergence and disappearance of patent classes over period of time showing variations in cochlear implant technologies. A network analysis technique is used to explore and capture technology evolution in patent classes showing what emerged or disappeared over time. Dominant classes are identified. The sporadic influence of university research in cochlear implants is also discussed.

Ganancia funcional en niños con neuropatía auditiva

La neuropatía auditiva es un desorden caracterizado por hipoacusia neurosensorial y ausencia de potenciales evocados auditivos de tallo cerebral, con otoemisiones acústicas presentes, encontrando una pérdida de la audición en presencia de función coclear, siendo esta sugestiva anomalía de una alteración de la sincronía neural. La neuropatía presenta una baja incidencia en niños con funciones auditivas normales y una incidencia variable en niños con hipoacusias severas, el manejo actual de la neuropatía va encaminado a la rehabilitación auditiva, usando sistemas de amplificación (audífonos o implantes cocleares). Se realizo un estudio de corte transversal con el objetivo de comparar la respuesta en niños con neuropatía auditiva y niños con hipoacusia neurosensorial en cuanto a la ganancia funcional con sistemas de amplificación. Fueron tomados 4 niños con diagnostico confirmado de la patología y se compararon con un grupo control de 16 niños con hipoacusias neurosensoriales de otras etiologías, se comparo el valor de la ganancia funcional con audífono y con implante coclear, obtenido de las audiometrías. La ganancia funciona global con ambos sistemas de amplificación no muestra diferencias significativas comparados los dos grupos, comparando el grupo de pacientes con neuropatía auditiva se encontraron diferencias significativas entre audífono e implante para las frecuencias medias y agudas. Se puede concluir que el audífono en pacientes con neuropatía auditiva es el sistema de amplificación que ofrece mejores valores de ganancia funcional, aun mejor que el implante coclear.

Effect of auditory processing on the preference of monaural amplification for adults with symmetrical hearing loss

The purpose of this project was to determine if subjects with symmetrical hearing loss who prefer a monaural hearing aid fit to a binaural hearing aid fit may demonstrate an auditory processing disorder causing them to experience binaural interference when fit binaurally.

The effectiveness of noise cancellation headphones for hearing impaired listeners

This paper discusses the use of noise cancellation headphones for hearing aid users to reduce background noise in order to improve speech discrimination.

Tactile localization of acoustic stimuli with an earmold vibratrory aid

This study examines the tactile localization of sound sources utilizing an earmold vibratory hearing aid.

Effects of combined electric and acoustic hearing on speech perception of a pediatric cochlear implant user

The primary objective of this study was to document the benefits and possible detriments of combining ipsilateral acoustic hearing in the cochlear implant ear of a patient with preserved low frequency residual hearing post cochlear implantation. The secondary aim was to examine the efficacy of various cochlear implant mapping and hearing aid fitting strategies in relation to electro-acoustic benefits.

A study of threshold and loudness summation in listeners with sensorineural hearing impairments

This paper investigates loudness summation in a group of listeners with moderate to severe hearing losses and the applicability of this information to hearing aid fittings.

Identification of factors predicting spoken language development in young children with a cochlear implant

This paper examines the factors that are significant predictors of spoken language acquisition in children with cochlear implants. Factors identified include age of cochlear implantation, age of diagnosis, age started hearing aid use, parent educational level, and family income.

Most comfortable listening levels of hearing impaired people: effects of everyday auditory and visual environments

This paper discusses a study to evaluate the changes that may occur in most comfortable listening levels when hearing aid users encounter a realistic auditory and visual environment.

Difference between default telecoil and programmed microphone frequency response in behind-the-ear hearing aids

The notion that the default telecoil (t-coil) frequency response should match the programmed microphone frequency response to provide optimal telephone understanding for hearing aid patients has received little attention. This study addresses differences in the average frequency response of the two transducers in behind-the-ear (BTE) hearing aids.

Outcomes of conventional amplification for pediatric unilateral hearing loss

Although some children with unilateral hearing loss (UHL) are at-risk for educational difficulties and behavioral problems, research in treatment outcomes for pediatric UHL is limited. The objective of this study was to examine the benefits of a conventional hearing aid in children with mild to moderately severe UHL, using speech perception measures and subjective assessments from the child, parent, and teacher.

Evaluation of directional microphone drift in digital hearing aids

The occurrence of directional microphone drift following hearing aid use has been infrequently examined. This study uses the front-to-side ratio to evaluate changes in directional microphone output from new behind-the-ear hearing aids and following approximately three months of hearing aid use. Results indicate no overall significant differences in the front-to-side ratio between initial and follow-up measurements.

Anatomical study of the human middle ear for the design of implantable hearing aids

OBJECTIVE: To generate anatomical data on the human middle ear and adjacent structures to serve as a base for the development and optimization of new implantable hearing aid transducers. Implantable middle ear hearing aid transducers, i.e. the equivalent to the loudspeaker in conventional hearing aids, should ideally fit into the majority of adult middle ears and should utilize the limited space optimally to achieve sufficiently high maximal output levels. For several designs, more anatomical data are needed. METHODS: Twenty temporal bones of 10 formalin-fixed adult human heads were scanned by a computed tomography system (CT) using a slide thickness of 0.63 mm. Twelve landmarks were defined and 24 different distances were calculated for each temporal bone. RESULTS: A statistical description of 24 distances in the adult human middle ear which may limit or influence the design of middle ear transducers is presented. Significant inter-individual differences but no significant differences for gender, side, age or degree of pneumatization of the mastoid were found. Distances, which were not analyzed for the first time in this study, were found to be in good agreement with the results of earlier studies. CONCLUSION: A data set describing the adult human middle ear anatomy quantitatively from the point of view of designers of new implantable hearing aid transducers has been generated. In principle, the method employed in this study using standard CT scans could also be used preoperatively to rule out exclusion criteria.