Community-based hearing aid fitting model for adults in low-income communities facilitated by community health workers: a feasibility study.

Background: Hearing loss affects more than 1.5 billion people worldwide, yet fewer than 10% of those who could benefit from hearing aids are able to access them. Barriers such as high costs, limited availability, and a critical shortage of trained professionals in low- and middle-income countries contribute to this gap, while emerging models of care-such as task-shifting to community healthcare workers (CHWs) supported by mHealth technologies-show promise in improving access, affordability, and outcomes in underserved communities.

AI-enhanced behavioral approach to measuring hearing in infants and toddlers: Proof-of-Concept Study.

Objective: Show that a basic unsupervised machine-learning algorithm can give information on whether a child reacted to a sound using facial, non-identifyable features recorded with a camera.

Design: Infants and toddlers were presented warble tones or single-syllable utterances 45 degrees to the left or to the right. A camera recorded their reactions, from which features like head turns or eye gaze were extracted with OpenFace.

Reduced Neural Speech Tracking in Adolescents with Listening Difficulty.

Objective: To investigate neural mechanisms underlying speech-in-speech listening in adolescents with listening difficulties (LiD).

Methods: Neural speech tracking (NST) was assessed using magnetoencephalography (MEG) in 21 adolescents with LiD and 25 typically developing (TD) peers, all with audiometrically normal hearing. Participants performed a cocktail party task involving target speech presented alone or alongside competitor speech streams differing in talker identity and spatial location.

Structural and pragmatic language skills in school-age children relate to resting state functional connectivity.

Language difficulties are common in school-age children but their etiology is often unknown. Although neural underpinnings of language have been well-studied in neurotypical individuals, functional connectivity differences between children with language difficulties and their typically-developing peers have not. There is little evidence regarding patterns of neural connectivity for children with language difficulties.

Frontal cortex hyperactivation and gamma desynchrony in Fragile X syndrome: Correlates of auditory hypersensitivity.

Fragile X syndrome (FXS) is an X-linked disorder that often leads to intellectual disability, anxiety, and sensory hypersensitivity. While sound sensitivity (hyperacusis) is a distressing symptom in FXS, its neural basis is not well understood. It is postulated that hyperacusis may stem from temporal lobe hyperexcitability or dysregulation in top-down modulation.

Multidisciplinary Clinical Assessment and Interventions for Childhood Listening Difficulty and Auditory Processing Disorder: Relation Between Research Findings and Clinical Practice.

Purpose: Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our SICLiD (Sensitive Indicators of Childhood Listening Difficulties) research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests.

Automatic development of speech-in-noise hearing tests using machine learning.

Understanding speech in noisy environments is a primary challenge for individuals with hearing loss, affecting daily communication and quality of life. Traditional speech-in-noise tests are essential for screening and diagnosing hearing loss but are resource-intensive to develop, making them less accessible in low and middle-income countries. This study introduces an artificial intelligence-based approach to automate the development of these tests.

Remote self-report and speech-in-noise measures predict clinical audiometric thresholds.

Objective: Developments in smartphone technology and the COVID-19 pandemic have highlighted the feasibility and need for remote, but reliable hearing tests. Previous studies used remote testing but did not directly compare results in the same listeners with standard lab or clinic testing. This study investigated validity and reliability of remote, self-administered digits-in-noise (remote-DIN) compared with lab-based, supervised (lab-DIN) testing.

A longitudinal study investigating the effects of noise exposure on behavioural, electrophysiological and self-report measures of hearing in musicians with normal audiometric thresholds.

Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicians has involved cross-sectional study designs that may capture only a snapshot of hearing health in relation to noise exposure.

Comparing Self-Fitting Strategies for Over-the-Counter Hearing Aids: A Crossover Clinical Trial.

Importance: Fewer than 20% of US adults with hearing loss use hearing aids due to barriers like high cost. Over-the-counter (OTC) hearing aids offer a potential solution, incorporating self-fitting strategies via smartphone apps. Self-fitting strategies have been validated for Food and Drug Administration (FDA)-approved OTC hearing aids compared with prescription-based approaches.

Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids.

Importance: With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy.

Objective: To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists.

Multidisciplinary clinical assessment and interventions for childhood listening difficulty and auditory processing disorder: Relation between research findings and clinical practice.

Purpose: Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our "SICLiD" research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests.

Frontal Cortex Hyperactivation and Gamma Desynchrony in Fragile X Syndrome: Correlates of Auditory Hypersensitivity.

Fragile X syndrome (FXS) is an X-linked disorder that often leads to intellectual disability, anxiety, and sensory hypersensitivity. While sound sensitivity (hyperacusis) is a distressing symptom in FXS, its neural basis is not well understood. It is postulated that hyperacusis may stem from temporal lobe hyperexcitability or dysregulation in top-down modulation.

A Multi-Sample Comparison and Rasch Analysis of the Evaluation of Children's Listening and Processing Skills Questionnaire.

Objectives: Assessing listening difficulties and associated complaints can be challenging. Often, measures of peripheral auditory functions are within normal ranges, making clinicians feel unsure about proper management strategies. The range and nature of observed or experienced difficulties might be better captured using a qualitative measure.

Childhood Listening and Associated Cognitive Difficulties Persist Into Adolescence.

Objective: Listening difficulty (LiD) refers to the challenges individuals face when trying to hear and comprehend speech and other sounds. LiD can arise from various sources, such as hearing sensitivity, language comprehension, cognitive function, or auditory processing. Although some children with LiD have hearing loss, many have clinically normal audiometric thresholds.

Smartphone-Facilitated In-Situ Hearing Aid Audiometry for Community-Based Hearing Testing.

Objectives: Hearing loss prevalence is increasing, with an estimated 2.5 billion people affected globally by 2050. Scalable service delivery models using innovative technologies and task-shifting are World Health Organization priorities to improve access to hearing care, particularly in low- and middle-income countries.

Amplitude Modulation Perception and Cortical Evoked Potentials in Children With Listening Difficulties and Their Typically Developing Peers.

Purpose: Amplitude modulations (AMs) are important for speech intelligibility, and deficits in speech intelligibility are a leading source of impairment in childhood listening difficulties (LiD). The present study aimed to explore the relationships between AM perception and speech-in-noise (SiN) comprehension in children and to determine whether deficits in AM processing contribute to childhood LiD. Evoked responses were used to parse the neural origins of AM processing.

Amplitude modulation perception and cortical evoked potentials in children with listening difficulties and their typically-developing peers.

Purpose: Amplitude modulations (AM) are important for speech intelligibility, and deficits in speech intelligibility are a leading source of impairment in childhood listening difficulties (LiD). The present study aimed to explore the relationships between AM perception and speech-in-noise (SiN) comprehension in children and to determine whether deficits in AM processing contribute to childhood LiD. Evoked responses were used to parse the neural origin of AM processing.

Mobile Health Hearing Aid Acclimatization and Support Program in Low-Income Communities: Feasibility Study.

Background: The most common management option for hearing loss is hearing aids. In addition to devices, patients require information and support, including maintenance and troubleshooting. Mobile health (mHealth) technologies can support hearing aid management, acclimatization, and use.

Auditory Deprivation during Development Alters Efferent Neural Feedback and Perception.

Auditory experience plays a critical role in hearing development. Developmental auditory deprivation because of otitis media, a common childhood disease, produces long-standing changes in the central auditory system, even after the middle ear pathology is resolved. The effects of sound deprivation because of otitis media have been mostly studied in the ascending auditory system but remain to be examined in the descending pathway that runs from the auditory cortex to the cochlea via the brainstem.

Brainstem auditory physiology in children with listening difficulties.

Children who have listening difficulties (LiD) despite having normal audiometry are often diagnosed as having an auditory processing disorder. A lack of evidence regarding involvement of specific auditory mechanisms has limited development of effective treatments for these children. Here, we examined electrophysiologic evidence for brainstem pathway mechanisms in children with and without defined LiD.

Speech-in-noise testing: Innovative applications for pediatric patients, underrepresented populations, fitness for duty, clinical trials, and remote services.

Speech perception testing, defined as providing standardized speech stimuli and requiring a listener to provide a behavioral and scored response, has been an integral part of the audiologic test battery since the beginning of the audiology profession. Over the past several decades, limitations in the diagnostic and prognostic validity of standard speech perception testing as routinely administered in the clinic have been noted, and the promotion of speech-in-noise testing has been highlighted. This review will summarize emerging and innovative approaches to speech-in-noise testing with a focus on five applications: (1) pediatric considerations promoting the measurement of sensory and cognitive components separately; (2) appropriately serving underrepresented populations with special attention to racial, ethnic, and linguistic minorities, as well as considering biological sex and/or gender differences as variables of interest; (3) binaural fitness for duty assessments of functional hearing for occupational settings that demand the ability to detect, recognize, and localize sounds; (4) utilization of speech-in-noise tests in pharmacotherapeutic clinical trials with considerations to the drug mechanistic action, the patient populations, and the study design; and (5) online and mobile applications of hearing assessment that increase accessibility and the direct-to-consumer market.

The one-up one-down adaptive (staircase) procedure in speech-in-noise testing: Standard error of measurement and fluctuations in the track.

The one-up one-down adaptive (staircase or up-down) procedure is often used to estimate the speech recognition threshold (SRT) in speech-in-noise testing. This article provides a brief historical overview of the one-up one-down procedure in psychophysics, discussing the groundbreaking early work that is still relevant to clinical audiology and scientific research. Next, this article focuses on two aspects of the one-up one-down adaptive procedure: first, the standard error of measurement (SEM) and, second, the fluctuations in the track [i.