A u d i t o r y - B a s e d C h i l d r e n a n d A d u l t s w i t h H e a r i n g L o s s

Transcription

1 A u d i t o r y - B a s e d i n C h i l d r e n a n d A d u l t s w i t h H e a r i n g L o s s A n d r e a P i t t m a n, P h D C C C - A A r i z o n a S t a t e U n i v e r s i t y

2 Disclosures This work was supported by grants from: Hearing Industry Research Consortium Research Assistants (The Pitt Crew): Elizabeth Stewart Lauren Meadows Nicole Marzan Beatriz Lazaro Elizabeth Rainy Amy Stahl (and many more) And collaborators: Ian Odgear Amanda Willman Madalyn Rash Brittany Schuett Ashley Wright Jacelyn Olson Rachel Krupa Mesa Public Schools, AZ, US Judy Attaway Casa Colina Hospital, CA, US Dan Duran Valley Children s Hospital, CA, US Tove Rosenbom Oticon Medical, DK Ravi Sockalingam Oticon Medical, US Liz Presson Oticon Medical, US

3 PPVT Vocabulary Age (Yrs) Vocabulary Learning and Hearing Loss 116 NH Children 99 HL Children 5-14 years of age NHC HIC Chronological Age (Yrs) Latto (213) Vocabulary constraints in children with hearing loss. Honors thesis.

4 Level (db SPL) Air-Conduction Hearing Device Applications 4 khz 1 khz FF Thresholds 1 khz 4 khz Oticon minialta RITE sothnud doztul 6 4 fosnush Frequency (Hz) 21 children with SN hearing loss (8-12 years) stomun homtul Pittman et al (217) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.

5 Bone-Anchored Hearing Device Applications Conventional Skin-Drive Percutaneous Direct-Drive Reinfeldt et al., (215) New Developments in bone-conduction hearing implants: A review, Medical Devices (Auckl), 8, Sockalingam, R., and Pfeiffer, J. (213, February). Audiological considerations of the Ponto Bone-anchored Hearing System before and after surgery. AudiologyOnline, Article # Retrieved from

6 Bone-Anchored Hearing Device Applications Kara et al (216) Authors Configuration Subjects Verstraeten et al (29) Hol et al (213) Abutment vs. Softband Abutment vs. Softband Abutment vs. Magnet Adults and Children Adults Children Speech Perception Significant* Abutment +1% better Abutment +7% better

7 Purpose To determine if the benefit of direct stimulation is limited to small improvements in speech perception or if direct stimulation also improves performance for auditory processes important for learning new information.

8 Level (db HL) Method Participants 17 children 1 boys, 7 girls 7 15 years Frequency (khz) Bone Conduction

9 Level (db HL) Method Participants 17 children 1 boys, 7 girls 7 15 years -2 2 Frequency (khz) bilateral conductive 1 unilateral conductive 2 unilateral profound Bone Conduction SF Bilateral Conductive

10 Level (db HL) Method Participants 17 children 1 boys, 7 girls 7 15 years -2 2 Frequency (khz) bilateral conductive 1 unilateral conductive 2 unilateral profound Bone Conduction SF Bilateral Conductive

11 Method Fitting & Testing Direct Drive Skin Drive

12 Method Verification Interacoustics Affinity Hearing Aid Analyzer with SHS1 Skull Simulator

13 Force (µn) Method Verification 1 Frequency (khz) Device Output Skin Drive Direct Drive Difference (Skin-Direct) Frequency (khz)

14 Level (db HL) Method Verification Frequency (khz) Aided Sound-Field Thresholds Skin Drive Direct Drive Difference (Skin-Direct) Frequency (khz)

15 Method Test Parameters 5 db SPL in quiet o azimuth Data Collection Computer interface Digital audio recordings

16 Test Battery Word Recognition Lexical Decision Non-Word Detection Rapid Word Learning How well they can recognize words they already know How well they can recognize words they don t know How well they can detect words they don t know in context How rapidly they can learn new words

17 Level (db SPL) Wideband Amp (% correct) Word Recognition NU-6 Word Lists (25) words 12 1 FF Thresholds 1 khz 4 khz Oticon minialta RITE Frequency (Hz) 21 children with SN hearing loss (8-12 years) Narrowband Amp (% correct) Pittman et al (217) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.

18 Direct Drive (% Correct) Word Recognition 1 8 Unilateral (Conductive, SSD) Bilateral (Conductive) Direct stimulation improved perception of familiar words. Direct Skin Mean 79% 72% SD 6% 8% N D7% Skin Drive (% Correct) F(1,15)=1.14, p=.6, N=.4

19 Auditory Lexical Decision Glat Swim Repeat Categorize Swim Real Swim Not Real Repeat Glat Glat Glad Glad Grat Grat Categorize Not Real Real Not Real Real Not Real Real Srim Srim Whim Whim Real Not Real Real Not Real Pittman and Rash (215) Auditory Lexical Decision and Repetition in Children: Effects of Acoustic and Lexical Constraints, E&H, 37, e Pittman et al (217) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, pedamp1.asu.edu/presentations

20 Level (db SPL) Wideband Amplification (% correct) Auditory Lexical Decision 12 1 FF Thresholds 1 khz 4 khz Oticon minialta RITE Frequency (Hz) 21 children with SN hearing loss (8-12 years) Narrowband Amplification (% correct) Pittman et al (217) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.

21 Direct Drive (% correct) Auditory Lexical Decision Unilateral (Conductive, SSD) Bilateral (Conductive) Skin Drive (% Correct) Direct stimulation improved children s lexical decisions. Direct Skin Mean 72% 59% SD 7% 6% N F(1,15)=11.948, p=.4, N=.44 D17%

22 Non-Word Detection 2. # of nonsense words Example phrase Clocks tick on time. 1 Birds rike long worms. 2 Dats catch slow bice Next Pittman & Daliri (in press) Vocal biomarkers of mild-to-moderate hearing loss in children and adults: Voiceless sibilants, JSLHR

23 Hearing Level (db HL) Target Sensitivity (d ) Non-Word Detection 2. Frequency (khz) Aided SF Unaided SF 23 children with SN hearing loss (8-17 years) Target - 5 db Sensitivity (d ) Pittman & Daliri (in press) Vocal biomarkers of mild-to-moderate hearing loss in children and adults: Voiceless sibilants, JSLHR

24 Sensitivity via Direct Drive (d') Non-Word Detection Unilateral (Conductive, SSD) Bilateral (Conductive) Direct stimulation did NOT improve detection of unfamiliar words in context. Direct Skin Mean SD N Sensitivity via Skin Drive (d') F(1,16)=1.975, p=.179, N=.11

25 PERFORMANCE (% Correct) Rapid Word Learning P c = 1.8e n/c Learning Speed: 3 = 1 trial (perfect learning) 2 = 1 trials 1 = 1 trials = 1 trials (no learning) TRIALS

26 Level (db SPL) Wideband Amp (log 1/n) Rapid Word Learning FF Thresholds 1 khz 4 khz Oticon minialta RITE children with SN hearing loss Frequency (Hz) 2 children with normal hearing (8-12 years) Narrowband Amp (log 1/n) Pittman et al (217) Detecting and Learning New Words: The Impact of Advancing Age and Hearing Loss, AJA, 26,

27 Direct D rive (log 1/n) Rapid Word Learning Unilateral (Conductive, SSD) Bilateral (Conductive) Skin Drive (log 1/n) Direct stimulation significantly improved the speed of word learning. Direct Skin Mean SD N F(1,15)=7.694, p=.14, N=.34 Trials 6 166

28 Number of Tasks Showing Benefit with the Direct Drive Across-Task Benefit Age (years) Unilateral (Conductive, SSD) Bilateral (Conductive)

29 What have we learned? Detecting and learning new words is more challenging than recognizing familiar words independent of the type of amplification device determined by the quality of the auditory input

30 Thank you