September 1, 2013 Departments

From the Journals: September 2013

In June 2012 more than 300 clinicians, scientists and key experts from 45 countries participated in AHS 2012—the Second International Conference on Adult Hearing Screening—in Cernobbio (Lake Como), Italy. The conference was designed to provide state-of-the-art scientific and clinical information and to promote active debate on the rapidly changing landscape of adult hearing care.

After the event, researchers developed a series of articles to highlight several key studies presented there. The articles appeared in the American Journal of Audiology's June 2013 issue. We highlight two of them.

Speech Understanding in Noise Test Viable for Adult Hearing Screening

The Speech Understanding in Noise test is fast, repeatable, easy to use, self-explanatory and specific to the impairment, and remains robust in ambient noise. Researchers say the SUN test may be a viable approach for adult hearing screening in clinical and nonclinical settings.

Researchers sought to develop a novel speech-in-noise test for adult hearing screening that is fast, automated and easy to use to identify difficulties in speech communication. The SUN test consists of a short list of intervocalic consonants in noise presented on a touch screen, in a forced-choice paradigm. Test time was less than one minute for each ear, and test-retest reliability was very good. The test showed good agreement with conventional clinical measures (for example, pure-tone testing, speech-in-noise testing and self-reported hearing handicap). The test's sensitivity and specificity to identify disabling hearing impairment were 84 percent and 75 percent, respectively. Testers obtained the same results in low and high ambient noise.

The SUN test was developed and evaluated in an overall population of more than 6,000 participants. It is available in English, French, German and Italian, and development continues for Spanish, Portuguese and Mandarin versions.

Tool Kit Helps Older Adults Screen Their Hearing Health

A proposed hearing health care "tool kit," which helps people determine the possible benefits of hearing intervention, may promote older adults' quality of care and life. The tool kit includes a new, comprehensive and easy-to-administer self-report tool—the Screening for Otologic Functional Impairments. Researchers found the SOFI to have high reliability and validity, and the potential to identify older adults requiring audiologic intervention.

The tool kit, for use by primary caregivers, includes several components integral to help-seeking behavior: a multifactorial risk assessment of chronic conditions, use of otoscopy or hand-held audiometry, a self-report screening tool, and a list of possible audiologic interventions and their benefits.

To assess the SOFI's reliability and validity, 29 older adults with varying levels of hearing impairment had hearing tests and completed a series of self-report tools designed to assess otologic function and depression. All participants completed the SOFI on two occasions.

The proposed tool kit's target population includes older adults with multiple conditions who are at risk for hearing-related functional deficits, and those likely to benefit from targeted audiologic interventions designed to optimize function, support independence, maximize safety, and cultivate self-sufficiency and social connectedness.

How Much Articulatory Effort? It Depends on the Consonant

In a comparison of articulatory contact pressure, oral air pressure and speech acoustics for conversational versus clear speech—and how these measures relate to listener perception—researchers found articulatory effort to be increased by varying degrees depending on the consonant uttered. The study, published in the June 2013 issue of the Journal of Speech, Language, and Hearing Research, also found that duration at both the segment and phrase level was important for predicting listeners' ratings of speech clarity.

Speakers can adopt "clear speech" if a communication breaks down because of the listener's hearing difficulties, background noise or a different primary language. Researchers asked 12 adults with normal speech to produce monosyllables in a phrase using conversational and clear speech. Target phonemes were /t, d, s, z, l, n/. Articulatory contact pressure was measured at a point of articulatory contact; an open catheter in the posterior oral cavity sensed oral air pressure.

The greatest changes in articulatory effort occurred for the phonemes /t, d/.  Articulatory contact pressure was increased to a greater extent in clear speech for /t, d, z/. Oral air pressure was increased to a greater extent for /t, d/. Acoustic changes also occurred in terms of segment durations, speaking rate, and consonant and vowel durations. A regression analysis indicated that segment duration was the strongest predictor of listener ratings of speech clarity, followed by an index of articulatory effort and speaking rate.


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