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The article discusses research which examined the development of hearing, speech and language in infants and toddlers born prematurely. The study determined the prevalence of speech and language disorders (SLD) and hearing loss in preterm children, early detection of SLD, and speech-language and pre-literacy deficits in premature children. It analyzed auditory measures and speech-language outcomes and described intervention methods such as enhanced speech environments and amplification.

Procedures are described to measure acoustic reflectance and admittance in human adult and infant ears at frequencies from 0.2 to 8 kHz. Transfer functions were measured at ambient pressure in the ear canal, and as down- or up-swept tympanograms. Acoustically estimated ear-canal area was used to calculate ear reflectance, which was parameterized by absorbance and group delay over all frequencies (and pressures), with substantial data reduction for tympanograms. Admittance measured at the probe tip in adults was transformed into an equivalent admittance at the eardrum using a transmission-line model for an ear canal with specified area and ear-canal length. Ear-canal length was estimated from group delay around the frequency above 2 kHz of minimum absorbance. Illustrative measurements in ears with normal function are described for an adult, and two infants at 1 month of age with normal hearing and a conductive hearing loss. The sensitivity of this equivalent eardrum admittance was calculated for varying estimates of area and length. Infant-ear patterns of absorbance peaks aligned in frequency with dips in group delay were explained by a model of resonant canal-wall mobility. Procedures will be applied in a large study of wideband clinical diagnosis and monitoring of middle-ear and cochlear function. [ABSTRACT FROM AUTHOR]

Transient-evoked otoacoustic emission (TEOAE) responses were measured in normal-hearing adult ears over frequencies from 0.7 to 8 kHz, and analyzed with reflectance/admittance data to measure absorbed sound power and the tympanometric peak pressure (TPP). The mean TPP was close to ambient. TEOAEs were measured in the ear canal at ambient pressure, TPP, and fixed air pressures from 150 to −200 daPa. Both click and chirp stimuli were used to elicit TEOAEs, in which the incident sound pressure level was constant across frequency. TEOAE levels were similar at ambient and TPP, and for frequencies from 0.7 to 2.8 kHz decreased with increasing positive and negative pressures. At 4–8 kHz, TEOAE levels were larger at positive pressures. This asymmetry is possibly related to changes in mechanical transmission through the ossicular chain. The mean TEOAE group delay did not change with pressure, although small changes were observed in the mean instantaneous frequency and group spread. Chirp TEOAEs measured in an adult ear with Eustachian tube dysfunction and TPP of −165 daPa were more robust at TPP than at ambient. Overall, results demonstrate the feasibility and clinical potential of measuring TEOAEs at fixed pressures in the ear canal, which provide additional information relative to TEOAEs measured at ambient pressure. [ABSTRACT FROM AUTHOR]

Human ear-canal properties of transient acoustic stimuli are contrasted that utilize measured ear-canal pressures in conjunction with measured acoustic pressure reflectance and admittance. These data are referenced to the tip of a probe snugly inserted into the ear canal. Promising procedures to calibrate across frequency include stimuli with controlled levels of incident pressure magnitude, absorbed sound power, and forward pressure magnitude. An equivalent pressure at the eardrum is calculated from these measured data using a transmission-line model of ear-canal acoustics parameterized by acoustically estimated ear-canal area at the probe tip and length between the probe tip and eardrum. Chirp stimuli with constant incident pressure magnitude and constant absorbed sound power across frequency were generated to elicit transient-evoked otoacoustic emissions (TEOAEs), which were measured in normal-hearing adult ears from 0.7 to 8 kHz. TEOAE stimuli had similar peak-to-peak equivalent sound pressure levels across calibration conditions. Frequency-domain TEOAEs were compared using signal level, signal-to-noise ratio (SNR), coherence synchrony modulus (CSM), group delay, and group spread. Time-domain TEOAEs were compared using SNR, CSM, instantaneous frequency and instantaneous bandwidth. Stimuli with constant incident pressure magnitude or constant absorbed sound power across frequency produce generally similar TEOAEs up to 8 kHz. [ABSTRACT FROM AUTHOR]

Transient-evoked otoacoustic emission (TEOAE) responses (0.7–8 kHz) were measured in normal-hearing adult ears using click stimuli and chirps whose local frequency increased or decreased linearly with time over the stimulus duration. Chirp stimuli were created by allpass filtering a click with relatively constant incident pressure level over frequency. Chirp TEOAEs were analyzed as a nonlinear residual signal by inverse allpass filtering each chirp response into an equivalent click response. Multi-window spectral and temporal averaging reduced noise levels compared to a single-window average. Mean TEOAE levels using click and chirp stimuli were similar with respect to their standard errors in adult ears. TEOAE group delay, group spread, instantaneous frequency, and instantaneous bandwidth were similar overall for chirp and click conditions, except for small differences showing nonlinear interactions differing across stimulus conditions. These results support the theory of a similar generation mechanism on the basilar membrane for both click and chirp conditions based on coherent reflection within the tonotopic region. TEOAE temporal fine structure was invariant across changes in stimulus level, which is analogous to the intensity invariance of click-evoked basilar-membrane displacement data. [ABSTRACT FROM AUTHOR]

Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 “normally hearing,” mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (≤8 kHz), DIN hearing thresholds were significantly better (P < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with “normal hearing” frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss. [ABSTRACT FROM AUTHOR]

Background Aminoglycosides (AGs) and glycopeptides are antibiotics essential for treating life-threatening respiratory infections in patients with cystic fibrosis (CF). The goal of this study was to examine the effects of cumulative intravenous (IV)-AG (amikacin and/or tobramycin) and/or glycopeptide (vancomycin) dosing on hearing status in patients with CF. Methods Hearing thresholds were measured from 0.25 to 16.0 kHz, in 81 participants with CF. Participants were categorized into two groups: normal hearing in both ears (≤ 25 dB HL for all frequency bands) or hearing loss (> 25 dB HL for any frequency band in either ear). Participants were also characterized into quartiles by their cumulative IV-AG (with or without vancomycin) exposure. Dosing was calculated using two strategies: (i) total number of lifetime doses, and (ii) total number of lifetime doses while accounting for the total doses per day. This was referred to as the “weighted” method. Results Participants in the hearing loss group were significantly older than those in the normal-hearing group. After adjusting for gender and age at the time of hearing test, participants in the two highest-quartile exposure groups were almost 5 X more likely to have permanent sensorineural hearing loss than those in the two lowest-quartile exposure groups. There was a small group of CF patients who had normal hearing despite high exposure to IV-antibiotics. Conclusions Cumulative IV-antibiotic dosing has a significant negative effect on hearing sensitivity in patients with CF, when controlling for age and gender effects. A trend for increasing odds of hearing loss was associated with increasing cumulative IV-antibiotic dosing. [ABSTRACT FROM AUTHOR]