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Objective: Despite high rates of bilateral hearing aid fitting globally, a number of adults continue to reject one hearing aid. The current study aimed to identify a clinically suitable tool for determining, pre-fitting, which clients might prefer one hearing aid., Study Sample: Ninety-five new adult hearing aid candidates, aged 49-87 years, were assessed prior to a first hearing aid fitting. Sixty-eight participants adhered to the prescribed protocol for both bilateral and unilateral hearing aid use., Design: Performance was assessed on a modified version of the Listening in Spatialised Noise - Sentences test (LiSN-S), the Dichotic Digits difference Test, the Experiential Hearing Aid simulator, and the Grooved Pegboard Test. All participants were fitted bilaterally, but were instructed to alternate between unilateral and bilateral hearing aid use over fourteen weeks post-fitting. Participants' wearing preferences were assessed via a short questionnaire., Results: 78% of participants expressed an overall preference for bilateral hearing aid use. Only the LiSN-S bilateral advantage test outcomes significantly correlated with overall wearing preference., Conclusions: Although the LiSN-S bilateral advantage score related to overall wearing preference, the accuracy of the predictor was too low to warrant implementation of this test prior to hearing aid fitting. The current practice of recommending bilateral hearing aid use continues to be the best option for clinicians.

Objective: This study describes a new automated strategy to determine the detection status of an electrophysiological response. Design: Response, noise and signal-to-noise ratio of the cortical auditory evoked potential (CAEP) were characterised. Detection rules were defined: when to start testing, when to conduct subsequent statistical tests using residual noise as an objective criterion, and when to stop testing. Study sample: Simulations were run to determine optimal parameters on a large combined CAEP data set collected in 45 normal-hearing adults and 17 adults with hearing loss. Results: The proposed strategy to detect CAEPs is fully automated. The first statistical test is conducted when the residual noise level is equal to or smaller than 5.1 µV. The succeeding Hotelling's T 2 statistical tests are conducted using pre-defined residual noise levels criteria ranging from 5.1 to 1.2 µV. A rule was introduced allowing to stop testing before the maximum number of recorded epochs is reached, depending on a minimum p -value criterion. Conclusion: The proposed framework can be applied to systems which involves detection of electrophysiological responses in biological systems containing background noise. The proposed detection algorithm which optimise sensitivity, specificity, and recording time has the potential to be used in clinical setting.

Objective: This study investigated the factors influencing 5-year language, speech and everyday functioning of children with congenital hearing loss., Design: Standardised tests including PLS-4, PPVT-4 and DEAP were directly administered to children. Parent reports on language (CDI) and everyday functioning (PEACH) were collected. Regression analyses were conducted to examine the influence of a range of demographic variables on outcomes., Study Sample: Participants were 339 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study., Results: Children's average receptive and expressive language scores were approximately 1 SD below the mean of typically developing children, and scores on speech production and everyday functioning were more than 1 SD below. Regression models accounted for 70-23% of variance in scores across different tests. Earlier CI switch-on and higher non-verbal ability were associated with better outcomes in most domains. Earlier HA fitting and use of oral communication were associated with better outcomes on directly administered language assessments. Severity of hearing loss and maternal education influenced outcomes of children with HAs. The presence of additional disabilities affected outcomes of children with CIs., Conclusions: The findings provide strong evidence for the benefits of early HA fitting and early CI for improving children's outcomes.

Objective: To establish the effect of self-rated and measured functional hearing on depression, taking age and gender into account. Additionally, the study investigates if hearing-aid usage mitigates the effect, and if other physical health problems and social engagement confound it., Design: Cross-sectional data from the UK Biobank resource, including subjective and behavioural measures of functional hearing and multifactorial measures of depressive episodes and symptoms, were accessed and analysed using multi-regression analyses., Study Sample: Over 100 000 community-dwelling, 39-70 year-old volunteers., Results: Irrespective of measurement method, poor functional hearing was significantly (p < 0.001) associated with higher levels of depressive episodes (≤ 0.16 factor scores) and depressive symptoms (≤ 0.30 factor scores) when controlling for age and gender. Associations were stronger for subjective reports, for depressive symptoms, and the younger participants. Females generally reported higher levels of depression. Hearing-aid usage did not show a mitigating effect on the associations. Other physical health problems particularly partially confounded the effects., Conclusion: Data support an association between functional hearing and depression that is stronger in the younger participants (40-49 years old) and for milder depression. The association was not alleviated by hearing-aid usage, but was partially confounded by other physical health problems.

Objective: This paper presents a summary of otoacoustic emission (OAE) data collected as part of an Australian hearing health survey ( Carter, 2011 ; Williams et al, 2014 ) designed to: (1) examine the relationship between audiological indicators and participant characteristics, and (2) extract audiological data suitable for reference use., Design: Cross-sectional cohort study. Distortion product (DP) OAE and transient evoked (TE) OAE measures., Study Sample: Age range 11-35 years; N = 1386 participants (2672 test ears)., Results: Descriptive statistics for amplitude and signal-to-noise ratio (SNR) were calculated for 327 participants (589 test ears; age 13 to 32 years). DPOAE amplitudes down to the 25th percentile were > 0 dB SPL for test frequencies up to 6 kHz. TEOAE SNRs down to the 25th percentile were > 6 dB SPL up to 4 kHz., Summary: This dataset can be used as a clinical reference for similar populations, providing that the same test parameters are used., Conclusions: The clinical significance of OAE testing would be greater if agreed criteria were available. These data could be pooled with other datasets to build a substantial OAE database, similar to the existing international standards for pure-tone hearing threshold levels (HTLs) ( ISO, 2000 ).

Objective: To determine the influence of the presence of auditory neuropathy spectrum disorder (ANSD) on speech, language, and psycho-social development of children at three years of age., Design: A population-based, longitudinal study was performed on outcomes of children with hearing impairment (LOCHI) in Australia. The demographic characteristics of the children were described, and their developmental outcomes were evaluated at three years of age. Performance of children with ANSD was compared with that of children without ANSD in the LOCHI study., Study Sample: There were 47 children with ANSD in the study sample., Results: Sixty-four percent of children with ANSD have hearing sensitivity loss ranging from mild to severe degree, and the remaining have profound hearing loss. At three years, 27 children used hearing aids, 19 used cochlear implants, and one child did not use any hearing device. Thirty percent of children have disabilities in addition to hearing loss. On average, there were no significant differences in performance level between children with and without ANSD. Also, the variability of scores was not significantly different between the two groups., Conclusions: There was no significant difference in performance levels or variability between children with and without ANSD, both for children who use hearing aids, and children who use cochlear implants.

Objective: To determine the effect of nonlinear frequency compression (NLFC) on children's development of speech and language at three years of age., Design: A randomized controlled trial was conducted as part of the population-based longitudinal study on outcomes of children with hearing impairment (LOCHI). Participants were randomly assigned to fitting with NLFC (Phonak Naida V SP or UP) or with conventional processing in hearing aids, prescribed by using either the NAL or the DSL formula. Standardized tests of speech production, receptive and expressive language were administered, and parent ratings were collected. All assessments were double-blinded., Study Sample: Participants were 44 of the 450 children in the LOCHI cohort., Results: Compared to children using conventional processing, receptive and expressive language was higher but receptive vocabulary and consonant articulation scores were lower for children who use NLFC. There was increased substitution of affricates by fricatives for children using NLFC, compared to children using conventional amplification. After allowing for the effect of multiple demographic variables, the difference in global language scores between groups was not significant (effect: 0.8 [95% confidence interval: - 6.7, 8.3])., Conclusions: There is insufficient evidence to indicate a difference in language ability between children using NLFC and those using conventional amplification.

Objective: To investigate the predicted threshold shift associated with the use of nonlinear hearing aids fitted to the NAL-NL2 or the DSL m[i/o] prescription for children with the same audiograms. For medium and high input levels, we asked: (1) How does predicted asymptotic threshold shifts (ATS) differ according to the choice of prescription? (2) How does predicted ATS vary with hearing level for gains prescribed by the two prescriptions?, Design: A mathematical model consisting of the modified power law combined with equations for predicting temporary threshold shift (Macrae, 1994b) was used to predict ATS., Study Sample: Predicted threshold shift were determined for 57 audiograms at medium and high input levels., Results: For the 57 audiograms, DSL m[i/o] gains for high input levels were associated with increased risk relative to NAL-NL2. The variation of ATS with hearing level suggests that NAL-NL2 gains became unsafe when hearing loss > 90 dB HL. The gains prescribed by DSL m[i/o] became unsafe when hearing loss > 80 dB HL at a medium input level, and > 70 dB HL at a high input level., Conclusion: There is a risk of damage to hearing for children using nonlinear amplification. Vigilant checking for threshold shift is recommended.