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Background and Aim: To date, little research is available that objectively quantifies female adolescent singing-voice characteristics in light of the physiological and functional developments that occur from puberty to adulthood. This exploratory study sought to augment the pool of data available that offers objective voice analysis of female singers in late adolescence. Methods: Using long-term average spectra (LTAS) and inverse filtering techniques, dynamic range and voice-source characteristics were determined in a cohort of vocally healthy cis-gender female adolescent singers (17 to 19 years) from high-school choirs in Aotearoa New Zealand. Non-parametric statistics were used to determine associations and significant differences. Results: Wide intersubject variation was seen between dynamic range, spectral measures of harmonic organisation (formant cluster prominence, FCP), noise components in the spectrum (high-frequency energy ratio, HFER), and the normalised amplitude quotient (NAQ) suggesting great variability in ability to control phonatory mechanisms such as subglottal pressure (P sub ), glottal configuration and adduction, and vocal tract shaping. A strong association between the HFER and NAQ suggest that these non-invasive measures may offer complimentary insights into vocal function, specifically with regard to glottal adduction and turbulent noise in the voice signal. Conclusion: Knowledge of the range of variation within healthy adolescent singers is necessary for the development of effective and inclusive pedagogical practices, and for vocal-health professionals working with singers of this age. LTAS and inverse filtering are useful non-invasive tools for determining such characteristics.

Objective: A long-standing observation is that the Mismatch Response (MMR) has the potential to offer a clinically feasible index of sound discrimination. However, findings that positively identify MMRs at the individual level have been mixed, even for those who are normally hearing and who can discriminate sounds behaviourally. This complicates interpretation when an MMR is not observed. The objective of this study was to determine the reliability of the MMR using an optimised paradigm and a range of stimuli relevant to audiological applications in relation to objective verification of hearing aid fittings., Design: MMRs were measured using an optimised 3-deviant paradigm in response to a range of sounds designed for aided and unaided sound field assessments, including complex tones (CTs) and speech-like signals., Study Sample: Seventeen normally hearing adults (18-56 years)., Results: The most robust MMRs were recorded in response to CTs; responses were positively identified in 50 out of 51 instances (98%), assessed via objective Hotelling's T 2 bias-free statistical analyses., Conclusions: The results indicate that CTs in conjunction with optimised recording and analysis parameters offer the potential to elicit robust MMRs, supporting future utilisation of MMRs for clinical audiological applications.

Objective: To investigate listening skills in infant hearing aid users using the LittlEARS ® Auditory Questionnaire (LEAQ)., Design: Caregivers completed the LEAQ, and hearing aid data logging was recorded, at infant age 3-7 months and 7-21 months., Study Sample: Seventy infant hearing aid users with permanent bilateral hearing loss, no developmental comorbidities, aged 3-7 months at first visit., Results: Infants with mild and moderate losses tended to have scores within the normative range at the early time point (88%), but 29% were below the normative range when older. Thirty percent of infants with severe hearing loss were outside the normative range at the early time point and 60% outside the normative range when older. Infants with profound loss were almost always (95%) outside the normative range. At the later time point, and for infants with severe-to-profound loss, low LEAQ scores were associated with fewer daily hours hearing aid use. Scores were poorer than previous reports in the literature for infant hearing aid users., Conclusions: This study provides further knowledge on infant listening performance and hearing aid use over time that can be used to guide management of individual cases and to develop and audit service quality improvements.

Public speaking has been described as one of the most daunting tasks one can engage in, even more so for people with aphasia (PWA). Gavel Clubs (affiliated with Toastmasters International) were established over 20 years ago for those who want to engage in public speaking but do not meet the eligibility criteria for Toastmasters membership. This study is the first of its kind to systematically evaluate changes in the speeches of PWA attending a weekly Gavel Club. The aims were to compare Table Topics (TT) and Prepared Speeches (PS) which are two different tasks regularly performed in a Gavel Club; to measure linguistic change over time in the two speech types; and to determine the feasibility of a discourse measure for analysing public speeches. Thirty-six speeches (four each from nine PWA) were audio-recorded, transcribed and analysed using the Linguistic Communication Measure (LCM). The nine participants represented a wide range of aphasia severity. Analysis revealed that engaging in weekly speaking activities in the GC was associated with an improvement in conveying content and in grammaticality through an increase in total number of words and number of correct words produced. The LCM is a comprehensive analysis tool but proved to be challenging in its speed and utility when measuring linguistic change in public speeches of PWA. Regular GC participation appears to facilitate improved language abilities, but we have yet to find the best tool to demonstrate this.

Objective: This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems., Design: A cross-sectional observational study design nested within a birth cohort was employed., Study Sample: Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years., Conclusions: Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.

Objective: To determine whether children aged 7 to 12 years with listening difficulties show objective evidence for efferent auditory function based on measurements of medial olivo-cochlear and middle ear muscle reflexes., Design: Click-evoked otoacoustic emissions recorded with and without contralateral broadband noise and ipsilateral and contralateral tonal (1000, 2000 Hz) middle ear muscle reflex thresholds were examined., Study Sample: 29 children diagnosed with suspected auditory processing disorder (APD) and a control group of 34 typically developing children participated in this study., Results: Children with suspected APD had poorer performance on auditory processing tests than the control group. Middle ear muscle reflex thresholds were significantly higher at 2000 Hz in the suspected APD group for contralateral stimulation. MOC inhibition effects did not differ between APD and control groups., Conclusions: This research supports earlier studies showing altered acoustic reflexes in children with APD. No group differences were found for the MOC reflex measures, consistent with some earlier studies in children with APD.

Objective: This research investigates a novel method for identifying and measuring school-aged children with poor auditory processing through a tablet computer., Design: Feasibility and test-retest reliability are investigated by examining the percentage of Group 1 participants able to complete the tasks and developmental effects on performance. Concurrent validity was investigated against traditional tests of auditory processing using Group 2., Study Sample: There were 847 students aged 5 to 13 years in group 1, and 46 aged 5 to 14 years in group 2., Results: Some tasks could not be completed by the youngest participants. Significant correlations were found between results of most auditory processing areas assessed by the Feather Squadron test and traditional auditory processing tests. Test-retest comparisons indicated good reliability for most of the Feather Squadron assessments and some of the traditional tests., Conclusions: The results indicate the Feather Squadron assessment is a time-efficient, feasible, concurrently valid, and reliable approach for measuring auditory processing in school-aged children. Clinically, this may be a useful option for audiologists when performing auditory processing assessments as it is a relatively fast, engaging, and easy way to assess auditory processing abilities. Research is needed to investigate further the construct validity of this new assessment by examining the association between performance on Feather Squadron and objective evoked potential, lesion studies, and/or functional imaging measures of auditory function.

Objective: To describe the audiological journey of a group of infants with auditory neuropathy spectrum disorder (ANSD) following the fitting of hearing aids, and to investigate the potential benefits of including cortical auditory-evoked potentials (CAEPs) and a measure of functional auditory behaviour during early audiological management., Design: Results from chart revision of estimated hearing threshold, early behavioural testing, parental observation, and functional auditory behaviour assessments were described, and compared to visual reinforcement audiometry (VRA) thresholds obtained at a mean corrected age of 10 months (SD 3). The relationship with CAEPs and functional performance was examined., Study Sample: The study included 12 infants diagnosed with ANSD and fitted with amplification., Results: The estimated 4FA at a mean corrected age of four months (SD5) was within ± 10 dB of VRA results in 75% of infants when unaided and aided behavioural observation audiometry (BOA), together with unaided and aided parental observations was combined. Infants with a greater proportion of CAEPs present had higher PEACH scores., Conclusions: Delaying amplification until VRA results were available would have led to a significant period of auditory deprivation for infants in this study group. None of the assessments could accurately determine hearing thresholds when used in isolation, however when used in combination clinicians were able to obtain sufficient information to fit hearing aids early, and identify infants requiring closer monitoring.

Objectives: This study investigated prosodic perception and musical pitch discrimination in adults using cochlear implants (CI), and examined the relationship between prosody perception scores and non-linguistic auditory measures, demographic variables, and speech recognition scores., Design: Participants were given four subtests of the PEPS-C (profiling elements of prosody in speech-communication), the adult paralanguage subtest of the DANVA 2 (diagnostic analysis of non verbal accuracy 2), and the contour and interval subtests of the MBEA (Montreal battery of evaluation of amusia)., Study Sample: Twelve CI users aged 25;5 to 78;0 years participated., Results: CI participants performed significantly more poorly than normative values for New Zealand adults for PEPS-C turn-end, affect, and contrastive stress reception subtests, but were not different from the norm for the chunking reception subtest. Performance on the DANVA 2 adult paralanguage subtest was lower than the normative mean reported by Saindon (2010) . Most of the CI participants performed at chance level on both MBEA subtests., Conclusion: CI users have difficulty perceiving prosodic information accurately. Difficulty in understanding different aspects of prosody and music may be associated with reduced pitch perception ability.

Objective: To investigate speech stimuli and background-noise-dependent changes in cortical auditory-evoked potentials (CAEPs) in unaided and aided conditions, and determine amplification effects on CAEPs., Design: CAEPs to naturally produced syllables in quiet and in multi-talker babble were recorded, with and without a hearing aid in the right ear. At least 300 artifact-free trials for each participant were required to measure latencies and amplitudes of CAEPs. Acoustic characteristics of the hearing-aid-transduced stimuli were measured using in-the-canal probe microphone measurements to determine unaided versus aided SNR and to compare stimulus acoustic characteristics to CAEP findings., Study Sample: Ten participants with normal hearing, aged 19 to 35 years., Results: CAEP latencies and amplitudes showed significant effects of speech contrast, background noise, and amplification. N1 and P2 components varied differently across conditions. In general, cortical processing in noise was influenced by SNR and the spectrum of the speech stimuli. Hearing-aid-induced spectral and temporal changes to the speech stimuli affected P1-N1-P2 components. Amplification produced complex effects on latencies and amplitudes across speech stimuli and CAEP components, and for quiet versus noise conditions., Conclusion: CAEP components reflect spectral and temporal characteristics of speech stimuli and acoustic changes induced by background noise and amplification.

Primary Objective: This study investigated psychological disorders for patients receiving traumatic brain injury (TBI) rehabilitation within a community-based TBI service in New Zealand., Research Design: Cross-sectional study involving retrospective review of clinical notes for all referrals received in a 6-month period. This methodology was selected to gain a sample of individuals reflective of the range of patients seen in TBI rehabilitation services in New Zealand., Methods and Procedures: The clinical records for 279 patients were reviewed for formal psychiatric diagnoses and references to moderate or severe psychological symptoms., Main Outcomes and Results: Of the clinical records, 57.7% noted significant psychological problems post-injury (n = 161) and 8.6% had a psychiatric diagnosis recorded, with 10.8% reporting psychological disorders pre-injury. In comparison, 15.1% had input from a clinical psychologist and 2.2% had involvement from a mental health team., Conclusions: The rate of psychological symptoms was significantly higher post-TBI than pre-TBI and few of the patients reporting significant psychological symptoms were receiving intervention from mental health professionals. Further research is needed regarding the ability of TBI rehabilitation professionals in New Zealand to identify and respond to the psychological implications of TBI and on the ability of TBI and mental health teams to liaise effectively.

Objective: The primary purpose of the study was to compare intervention approaches for children with auditory processing disorder (APD): bottom-up training including activities focused on auditory perception, discrimination, and phonological awareness, and top-down training including a range of language activities. Another purpose was to determine the benefits of personal FM systems., Design: The study is a randomized control trial where participants were allocated to groups receiving one of the two interventions, with and without personal FM, or to the no intervention group. The six-week intervention included weekly one-hour sessions with a therapist in the clinic, plus 1-2 hours per week of parent-directed homework., Study Sample: 55 children (7 to 13 years) with APD participated in the study. Intervention outcomes included reading, language, and auditory processing., Results: Positive outcomes were observed for both training approaches and personal FM systems on several measures. Pre-intervention nonverbal IQ, age, and severity of APD did not influence outcomes. Performance of control group participants did not change when retested after the intervention period., Conclusions: Both intervention approaches were beneficial and there were additional benefits with the use of personal FM. Positive results were not limited to the areas specifically targeted by the interventions.

FM systems have been used to compensate for poor signal-to-noise ratios in classrooms. This study evaluates benefits of a 6-week trial of personal FM systems used during the school day for children with reading delay aged 6-11 years, using a randomized control design. Teachers and children completed the LIFE-UK questionnaire. Test-retest reliability of the LIFE-UK children's version was confirmed in a separate group of 18 children from the same school. The 23 children in the FM group had significantly improved teacher ratings, and the children's ratings of classroom listening for difficult situations were significantly better after the trial. These changes did not occur for the 23 control-group children. Most children (92%) commented positively about the FM after the trial. It is likely that a longer FM trial or a specific reading intervention combined with FM will be required for the benefits of enhanced listening to affect performance on standardized reading tests.

We investigated the acceptability of electrophysiologically derived MAPs and the effect of these MAPs on speech perception in elderly adults using Nucleus 24 cochlear implants. Eight implant recipients aged 75 years or older trialed an electrophysiologically derived MAP and a behavioral MAP. The electrophysiologically derived MAP was based on the threshold and maximum comfort level for electrode 10 and evoked compound action potential thresholds measured on six electrodes using neural response telemetry (NRT). Word perception at 55 dB SPL and sentence perception in noise at 70 dB SPL were assessed after six weeks take-home experience and again after an additional two weeks of experience. During the final two weeks of take-home experience participants indicated their preferred MAP for different listening situations. The NRT derived MAP estimated behavioral T levels well, but underestimated behavioral C levels for apical electrodes in some subjects. Speech perception with NRT derived MAPs was comparable to speech perception with behaviorally measured MAPs. MAPs estimated from NRT data provided good speech perception outcomes for elderly implant recipients and were well tolerated.

The purpose of this study was to determine whether rising-frequency chirps presented via earphones with an extended high-frequency response would optimize the post-auricular muscle response (PAMR). The PAMR was recorded in adults using three different stimuli (a click, a rising-frequency chirp, and a truncated speech stimulus, /t/). Conventional ER-3A insert earphones were compared to ER-2 insert earphones to determine whether the PAMR is enhanced by the ER-2's extended highfrequency response. There were significant stimulus and earphone effects on PAMR amplitudes. The PAMR was largest for the chirp stimulus and the ER-2 earphones. The poorest responses were obtained using the /t/ stimulus and conventional ER-3A earphones. The results support previous ABR studies that have demonstrated a significant advantage of chirps over clicks for evoked response audiometry, and indicate that the PAMR is enhanced by inclusion of additional high-frequency stimulus energy.

Post-auricular muscle responses (PAMRs) were recorded in sixteen adults with normal hearing and twenty adults with sensorineural hearing loss. Click stimuli were presented at 20 to 80 dB nHL via insert earphones. Only one ear was tested in hearing-impaired subjects, but normal-hearing subjects were tested monaurally and binaurally. PAMR amplitudes declined and latencies increased with decreasing click intensity. Both binaural stimulation and eye turn enhanced the PAMR. In hearing-impaired subjects, PAMR thresholds were correlated with audiometric thresholds for the eyes-turned condition. All normal-hearing subjects had PAMR when recording conditions were optimized and half had responses for the least optimal condition (20 dB nHL, monaural, eyes front). With eyes turned and monaural clicks at 35 dB nHL, the level widely used for infant hearing screening, most normal-hearing adults had a PAMR. Thus the PAMR is a robust response that may be a useful adjunct to ABR for objective hearing assessment.