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Background/Objectives: A heterozygous mutation in the WFS1 gene is responsible for autosomal dominant non-syndromic hearing loss (DFNA6/14/38) and Wolfram-like syndrome, which is characterized by bilateral sensorineural hearing loss with optic atrophy and/or diabetes mellitus. However, detailed clinical features for the patients with the heterozygous p.A684V variant remain unknown. Methods: We report the clinical details of 14 cases with a heterozygous p.A684V variant in the WFS1 gene identified from target resequencing analysis of 63 previously reported deafness genes by next-generation sequencing of 15,684 hearing loss patients (mean age 27.5 ± 23.1 years old, 6574 male, 8612 female and 498 for whom information was unavailable). Results: Among the 14 patients from 13 families with the p.A684V variant, nine were sporadic cases. In addition, we confirmed de novo occurrence of this variant in seven families. This result strongly supports the notion that this variant was located on a mutational hotspot. When comparing previously reported cases of autosomal dominant WFS1 gene-associated hearing loss, most of the patients in this study showed severe-to-profound bilateral sensorineural hearing loss (genotype–phenotype correlation). Two patients had optic atrophy, while the others did not have any other complications. Conclusions: The identified heterozygous p.A684V variant appears to be a hotspot mutation and likely to cause severe-to-profound hearing loss in early childhood. Cochlear implantation is considered favorable in cases of hearing impairment due to this variant. [ABSTRACT FROM AUTHOR]

Despite the significant advancements in hearing aid technology, their adoption rates remain low, with stigma continuing to be a major barrier for many. This review aims to assess the origins and current state of hearing aid stigma, as well as explore potential strategies for alleviating it. This review examines the societal perceptions, psychological impacts, and recent technological advancements that can influence hearing aid adoption and reduce stigma. Methods: A narrative-focused review of the literature from peer-reviewed journals and reputable sources was conducted, analyzing papers on hearing aid stigma, adoption rates, and technological solutions. The research works were categorized based on their focus on the drivers and alleviation strategies for the stigma of hearing aids. Results: This review identifies stigma as a complex, multifaceted issue driven primarily by ageism, disability perception, and the association of hearing aids with aging and incapability. Despite technological improvements, the studies surveyed listed stigma as a major factor in non-adoption. Technological advancements such as artificial intelligence in sound processing, multifunctional features, and innovative design have shown potential in reducing stigma and improving user experience. Conclusions: Alleviating the stigma of hearing aids requires a multi-pronged approach, combining improvements in technology with changes in societal perceptions. Multifunctional devices including both health and communications functions, advanced signal processing, and esthetic improvements can drive their adoption, but broader public health awareness and education are also essential to changing societal attitudes and fostering greater acceptance of hearing aids. [ABSTRACT FROM AUTHOR]

Auditory neuropathy spectrum disorder (ANSD) is often missed by standard hearing tests, accounting for up to 10% of hearing impairments (HI) and commonly linked to variants in 23 genes. We assessed 122 children with HI, including 102 with sensorineural hearing loss (SNHL) and 20 with ANSD. SNHL patients were genotyped for common GJB2 variants using qPCR, while ANSD patients underwent whole exome sequencing, with variants analyzed across 249 genes. Homozygous GJB2 variants were found in 54.9% of SNHL patients. In 60% of ANSD patients, variants were detected in OTOF (25%), CDH23, TMC1, COL11A1, PRPS1, TWNK, and HOMER2 genes, including eight novel variants. Transient evoked otoacoustic emissions testing revealed differences at 4000 Hz (p = 0.0084) between the ANSD and SNHL groups. The auditory steady-state response (ASSR) test showed significant differences at 500 Hz (p = 2.69 × 10−4) and 1000 Hz (p = 0.0255) compared to pure-tone audiometry (PTA) in ANSD patients. Our questionnaire shows that the parents of children with SNHL often report an improved quality of life with hearing aids or cochlear implants, while parents of children with ANSD frequently experience uncertainty about outcomes (p = 0.0026), leading to lower satisfaction. [ABSTRACT FROM AUTHOR]

Background: Hearing loss (HL) among older adults is a major global health concern. Hearing aids (HAs) offer an effective solution to manage HL and enhance the quality of life. However, the adoption and the consistent use of HAs remain low, making non-use a significant barrier to successful audiological rehabilitation. The aim of the study was to assess the benefit of HAs among patients with different degrees of HL and to determine the profiles of patients who have the least benefit from HAs. Methods: the HA benefits were assessed by using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Participants were assigned to the study groups based on the pure-tone audiometry. This paper presents the results obtained by using HAs in various listening environments among 167 patients. Results: The majority of individuals benefited from HAs in a noisy environment while a reverberant environment provided the lowest benefit. It was observed that the degree of HL had a statistically significant impact on the benefits of HAs in terms of the communication ease, the reverberation, the background noise, and the global score. A moderately positive correlation was observed between the unaided APHAB and the HL degree. The subjects' APHAB scores ranged from the 50th to the 65th percentile. Additionally, women had a significantly better improvement than men. Conclusions: HAs improved communication in everyday life situations among 91.6% of HA users. The degree of HL influences APHAB scores. Patients with a severe degree of HL achieved the greatest APHAB scores while male patients with mild HL received the lowest benefits of HAs. Both HL and the age, gender, and HA type are factors that also play important roles. The APHAB questionnaire is a reliable screening test for patients with hearing difficulties. [ABSTRACT FROM AUTHOR]

To address the performance and computational complexity issues in speech enhancement for hearing aids, a speech enhancement algorithm based on a microphone array and a lightweight two-stage convolutional recurrent network (CRN) is proposed. The algorithm consists of two main modules: a beamforming module and a post-filtering module. The beamforming module utilizes directional features and a complex time-frequency long short-term memory (CFT-LSTM) network to extract local representations and perform spatial filtering. The post-filtering module uses analogous encoding and two symmetric decoding structures, with stacked CFT-LSTM blocks in between. It further reduces residual noise and improves filtering performance by passing spatial information through an inter-channel masking module. Experimental results show that this algorithm outperforms existing methods on the generated hearing aid dataset and the CHIME-3 dataset, with fewer parameters and lower model complexity, making it suitable for hearing aid scenarios with limited computational resources. [ABSTRACT FROM AUTHOR]

Hearing aids (HAs), especially those with sound generators (SGs), are used in the management of tinnitus. However, their comparative efficacies and long-term outcomes remain unknown. Therefore, we investigated the efficacy and long-term outcomes of tinnitus therapy using various HA SG models. We retrospectively reviewed 666 patients with chronic tinnitus characterized by persistent symptoms for >6 months. At the initial visit, the patients received educational counselling on tinnitus (Utsunomiya method) and completed a comprehensive questionnaire comprising the tinnitus handicap inventory, a visual analog scale, the state–trait anxiety inventory, and the emotional intelligence scale. The scores were compared among various models of HA SGs and SGs. The patients underwent follow-ups for up to 2 years. Our results indicated that tinnitus retraining therapy using SGs and conventional HAs effectively managed chronic tinnitus. The prolonged use of HAs appeared to exacerbate tinnitus symptoms, emphasizing the superior long-term effectiveness of SG HAs, particularly ZEN (Widex ZEN, WS Audiology, Lynge, Denmark). Our findings indicate that HAs are useful in the first year, but their prolonged use may exacerbate tinnitus symptoms, whereas HA SGs are effective in the long term. Future studies should account for the variations in tinnitus treatment effects based on the type of sound employed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to conduct a cross-sectional analysis of the association between hearing aid use and cognitive decline in community-dwelling older adults with hearing impairment, stratified by cardiovascular risk level. This cross-sectional study covers 1857 hearing-impaired individuals selected among 10,674 community-dwelling older adults (≥65 years of age) in Japan. We investigate the association between hearing aid use and cognitive decline stratified by cardiovascular risk level, by assessing self-reported hearing impairment and hearing aid use, absolute cardiovascular risk, cognitive function, and potential confounding factors. The association between hearing impairment severity and increased cardiovascular risk, and the benefit of hearing aid use in preventing cognitive decline, were examined in a binomial logistic regression analysis, with the presence of cognitive decline as the objective variable. In the low cardiovascular risk group, hearing aid users had a lower odds ratio for decline in executive function than non-users (odds ratio = 0.61, 95% confidence interval: 0.39–0.98). However, there was no significant association between hearing aid use and cognitive decline in the high cardiovascular risk group (p > 0.05). Among older adults with hearing impairment, hearing aid use was associated with the maintenance of executive function in individuals of low cardiovascular risk. [ABSTRACT FROM AUTHOR]

Hearing impairment is a global issue, affecting billions of people; however, there is a gap between the population affected by hearing loss and those able to access hearing healthcare. Tele-audiology, the application of telemedicine in audiology, serves as a new form of technology which aims to provide synchronous or asynchronous hearing healthcare. In this article, we reviewed some recent studies of tele-audiology-related topics to have a glimpse of the current development, associated challenges, and future advancement. Through the utilization of tele-audiology, patients can conveniently access hearing healthcare, and thus save travel costs and time. Recent studies indicate that remote hearing screening and intervention are non-inferior to the performance of traditional clinical pathways. However, despite its potential benefits, the implementation of tele-audiology faces numerous challenges, and audiologists have varying attitudes on this technology. Overcoming obstacles such as high infrastructure costs, limited reimbursement, and the lack of quality standards calls for concerted efforts to develop effective strategies. Ethical concerns, reimbursement, and patient privacy are all crucial aspects requiring in-depth discussion. Enhancing the education and training of students and healthcare workers, along with providing relevant resources, will contribute to a more efficient, systematic hearing healthcare. Future research will aim to develop integrated models with evidence-based protocols and incorporating AI to enhance the affordability and accessibility of hearing healthcare. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate audiological characteristics and parents' opinions on hearing device use in children with unilateral sensorineural hearing loss (USNHL) who attended a tertiary-level audiologic center. The medical charts of 70 children aged 6 to 12 years with USNHL were reviewed. In 51.4% of cases, the children were diagnosed with USNHL after the age of 2 years. The main causes of USNHL were congenital cytomegalovirus infection (21.4%) and unilateral cochlear nerve hypoplasia (12.9%). The percentage of patients wearing a hearing device was 45.7% (32/70); of these, 28 (87.5%) wore a conventional hearing aid, 2 (6.3%) a CROS device, and 2 (6.3%) a cochlear implant. Regarding the choice to use a hearing device, no significant differences were found between the subcategories of hearing loss degree (p = 0.55) and audiometric configuration (p = 0.54). Most parents of children with mild-to-severe USNHL observed improved attention (90.9%), and reduced fatigue and restlessness (86.4%) using the hearing aid. These children performed significantly better on all audiological tests (speech perception in quiet and in noise conditions, and sound localization) while wearing the hearing aid (p < 0.001). More efforts should be made to raise awareness among professionals and parents about the negative consequences of uncorrected USNHL. [ABSTRACT FROM AUTHOR]

Background: The cochlear implant (CI) is an established treatment option for patients with inadequate speech understanding and insufficient aided scores. Nevertheless, reliable predictive models and specific therapy goals regarding achievable speech understanding are still lacking. Method: In this retrospective study, 601 cases of CI fittings between 2005 and 2021 at the University Medical Center Freiburg were analyzed. We investigated the preoperative unaided maximum word recognition score (mWRS) as a minimum predictor for post-interventional scores at 65 dB SPL, WRS65(CI). The WRS65(CI) was compared with the preoperative-aided WRS, and a previously published prediction model for the WRS65(CI) was reviewed. Furthermore, the effect of duration of hearing loss, duration of HA fitting, and etiology on WRS65(CI) were investigated. Results: In 95.5% of the cases, a significant improvement in word recognition was observed after CI. WRS65(CI) achieved or exceeded mWRS in 97% of cases. Etiology had a significant impact on WRS65(CI). The predicted score was missed by more than 20 percentage points in 12.8% of cases. Discussion: Our results confirmed the minimum prediction via mWRS. A more precise prediction of the expected WRS65(CI) is possible. The etiology of hearing loss should be considered in the indication and postoperative care to achieve optimal results. [ABSTRACT FROM AUTHOR]

Among hearing aid (HA) users, there is a considerable variability in word recognition scores (WRSs). This variability is most pronounced among individuals with moderately severe to severe hearing loss. The variability cannot be adequately explained by factors such as pure-tone audiogram, audiogram type or age. This prospective study was designed to investigate the relationship between tone decay (TD) and WRS in a group of HA users with corresponding pure-tone hearing loss. The study population included 22 patients with hearing loss between 50 and 80 dB HL. Aided WRS, unaided WRS and TD were assessed for both ears. TD was found to be frequency-dependent. TD and WRS were correlated, with up to R = −0.66. The TD test was revealed to be a feasible method for explaining variability in WRS among HA users with hearing loss below 80 dB. This may contribute to improved differential diagnostics. The TD test may thus offer a better understanding of the limitations of HA use in the context of cochlear implant candidacy assessment for HA users. [ABSTRACT FROM AUTHOR]

(1) Background: For successful hearing aid (HA) use during daily life, an objective parameter reflecting the subjective satisfaction is required. We explored the aided hearing status, hearing in noise test (HINT) scores, and subjective outcomes to predict performance improvements in everyday living. (2) Methods: A total of 406 patients with hearing loss (HL) who were prescribed HAs were included and were divided into two groups according to the symmetricity of HL. The relationship between audiometric data and subjective questionnaires under unaided and aided (3 months) conditions were investigated. (3) Results: Patients with symmetric HL showed a significant HINT signal-to-noise ratio (SNR) change and significant increase in their subjective satisfaction questionnaire score under the bilateral HA condition. On the other hand, the HINT SNR change and subjective questionnaire score showed various significances according to the side of HA (better or worse hearing) in asymmetric HL HINT SNR and was significantly correlated with the subjective questionnaire score in symmetric HL patients and AHL patients with unilateral HA in their better ear. (4) Conclusions: The HINT SNR improvement after long-term HA use could be an effective tool for predicting the subjective satisfaction of HA use and HA validation. [ABSTRACT FROM AUTHOR]

The development of language, memory and intellectual functions is linked to normal hearing and correct sounds interpretation. Hearing loss (HL), especially in its severe form, negatively affects the development of these functions. This prospective study aimed at comparing the Intelligent Quotients (IQ) of children with cochlear implants (CI) with the ones of people wearing hearing aids (HA) after one year of hearing rehabilitation. 21 subjects with severe/profound bilateral hearing loss (deafness) were included in this study. Eleven children with congenital profound HL underwent CI and ten children with moderate to severe HL (congenital and acquired) were rehabilitated by HA. Children's IQs were assessed at enrolment (T0) and 12 months after hearing aids/CI use plus speech therapy. Statistical analyses were performed to analyze the data within and between groups. Comparison of IQs showed no statistically significant differences between CI and HA none at T0 and T1. The subtests showed lower scores in verbal comprehension and process speed index in patients treated with HA when compared to CI. This study showed that auditory rehabilitation can support the normal development of cognitive function in children between six and eight years of age. The use of the correct hearing aids based on the patient's hearing thresholds is important to maximize the rehabilitation outcomes. Due to the small sample size, although stratified for age, our results must be considered preliminary and further analyses on larger samples are needed to confirm our data. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is a significant public problem affecting 466 million people worldwide. Hearing-impaired persons benefit from the use of hearing aids, but the need is unmet in 85% of the global population. For the Russian population, no data have been found on this issue. The purpose of this study is to estimate the prevalence of hearing aid use in the Russian adult population. Methods: data on hearing aid use and self-reported trouble with hearing were obtained from the open access database of the Russia Longitudinal Monitoring Survey—Higher School of Economics (RLMS-HSE) for the years 1994–2021. Results: the prevalence of hearing aid use in Russian adults ranged from 4.3 per 1000 (95% CI 3.2–5.9) to 8.8 per 1000 (95% CI 7.5–10.2). The mean rate of self-reported trouble with hearing was 22.2% (SD 0.8); of them, 2.2% (SD 0.2) used hearing aids, and it strongly correlated with older age (r = 0.889) and more severe hearing issues (r = 0.938). Conclusions: The overall prevalence of hearing aid use in Russian adults is very low with unmet needs in 98% of the cases of self-reported trouble with hearing, which is worse than in other populational studies and global estimates. The RLMS-HSE can be used for the monitoring of the national hearing health care system. [ABSTRACT FROM AUTHOR]

The objective of this work was to develop a temperature sensor system that accurately measures core body temperature from an ear-worn device. Two digital temperature sensors were embedded in a hearing aid shell along the thermal gradient of the ear canal to form a linear heat balance relationship. This relationship was used to determine best fit parameters for estimating body temperature. The predicted body temperatures resulted in intersubject limits of agreement (LOA) of ±0.49 °C over a range of physiologic and ambient temperatures without calibration. The newly developed hearing aid-based temperature sensor system can estimate core body temperature at an accuracy level equal to or better than many devices currently on the market. An accurate, continuously worn, temperature monitoring and tracking device may help provide early detection of illnesses, which could prove especially beneficial during pandemics and in the elderly demographic of hearing aid wearers. [ABSTRACT FROM AUTHOR]

(1) Background: Several types of hearing aids are available for the rehabilitation of vestibular-schwannoma (VS)-related hearing loss. There is a lack of recently published papers regarding this theme. The aim of the present work is to organize current knowledge. (2) Methods: A review of the literature regarding the topics "vestibular schwannoma", "hearing loss", and "hearing aid" was performed. Nineteen studies were thus considered. (3) Results: Conventional hearing aids, contralateral routing of signal (CROS) aids, bone anchored hearing aids (BAHA), and others are available options for hearing rehabilitation in VS patients. The speech discrimination score (SDS) is considered the best measure to assess candidacy for rehabilitation with hearing aids. The best hearing rehabilitative conditions in VS patients when using conventional hearing aid devices are a mild−moderate hearing loss degree with good word recognition (more than 50% SDS). CROS-Aid and BAHA are reported to be beneficial. CROS-Aid expands on the area of receiving hearing. BAHA aids use direct bone-conduction stimulation. Unfortunately, there are no available studies focused specifically on VS patients that compare CROS and BAHA technologies. (4) Conclusions: Hearing aids, CROS, and BAHA are viable options for rehabilitating hearing impairment in VS, but require an accurate case-by-case audiological evaluation for rehabilitating hearing impairment in VS. Further studies are needed to prove if what is currently known about similar hearing illnesses can be confirmed, particularly in the case of VS. [ABSTRACT FROM AUTHOR]

Background: Few studies have reported on the etiology, severity, or device usage of unilateral sensorineural hearing loss (UHL) compared to bilateral hearing loss. Therefore, this study investigated the characteristics of UHL in adults and children. Methods: We performed a survey using questionnaires for secondary and tertiary otolaryngology institutions. Results: We included 15,981 patients (1549 children and 14,432 adults) from 196 institutions with otolaryngology residency programs and 2844 patients (336 children and 2508 adults) from 27 institutions with board members of the Japan Audiology Society. The latter submitted audiological data. Among children, most diagnoses were made at age 0. Approximately half of them had profound hearing loss, and 37 children (2.2%) used hearing devices. Among adults, the number of cases increased with age, but decreased when people reached their 80s and 90s. More than half of them had moderate hearing loss. Sudden sensorineural hearing loss was the most common cause of UHL of all ages; 4.4% of UHL patients used hearing devices, and most of the device users (98.6%) selected a conventional hearing aid. Conclusions: Hearing aid use is limited in children and adults with UHL in Japan. There could be many candidates with UHL for intervention such as a cochlear implant. [ABSTRACT FROM AUTHOR]

The cartilage-conduction hearing aid (CC-HA) is a new hearing device that is suitable for use in patients with conductive hearing loss. It has been 5 years since the introduction of the CC-HA. Although the number of users has increased, the CC-HA is not yet widely known. This study examines the effects of CC-HA on patients with conductive hearing loss and investigates factors that affect the willingness to use the device by comparing purchasers and non-purchasers of CC-HA in patients with unilateral conductive hearing loss. Eight patients had bilateral conductive hearing loss, and 35 had unilateral conductive hearing loss. Each patient underwent sound field tests and speech audiometry, and the effects of the CC-HA were compared with those of conventional bone conduction hearing aids (BC-HA). In patients with bilateral conductive hearing loss, the CC-HA was non-inferior to BC-HA. The CC-HA improved the hearing thresholds and speech recognition in patients with unilateral conductive hearing loss. Moreover, in patients with unilateral conductive hearing loss, experiencing the effect of wearing the CC-HA under conditions such as putting noise in the better ear could affect patients' willingness to use the CC-HA. [ABSTRACT FROM AUTHOR]

The ear molds and shells of hearing devices are generally designed using ear impressions. Computed tomography (CT) can provide information concerning ear structure, which can be utilized in computer-aided design to create hearing devices. This study aimed to compare the differences in hearing devices designed using either ear impressions or CT images. The ear chip of a cartilage conduction (CC) hearing device was designed based on the ear impression and CT images of patients with aural atresia. Three patients with bilateral (n = 1) or unilateral (n = 2) aural atresia participated in this study. The aided thresholds and subjective evaluations were compared. There were no serious problems with the use of either device, and no remarkable differences were observed regarding their respective audiological and subjective benefits. Regarding the subjective patient preferences, the hearing aid with the device designed via CT imaging was better in three ears of two patients, whereas the wearing comfort of the transducer was better for the device designed via the ear impression. The subjective evaluation of appearance varied among the cases. Finally, a device that was designed using CT findings was purchased for one patient. CT images can be utilized in computer-aided design to create CC hearing devices. [ABSTRACT FROM AUTHOR]

The retrospective reporting of users' hearing aid (HA) usage can provide insight into individualized HA usage patterns. Understanding these HA usage patterns can help to provide a tailored solution to meet the usage needs of HA users. This study aims to understand the HA usage pattern in daily-life situations from self-reported data and to examine its relationship to self-reported outcomes. A total of 1537 participants who responded to questions related to situations where they always took off or put on the HAs were included in the study. A latent class analysis was performed to stratify the HA users according to their HA usage pattern. The results showed distinct usage patterns in the latent classes derived for both scenarios. The demographics, socio-economic indicators, hearing loss, and user-related factors were found to impact HA usage. The results showed that the HA users who reported using the HAs all the time (regular users) had better self-reported HA outcomes than situational users, situational non-users, and non-users. The study explained the underlying distinct HA usage pattern from self-reported questionnaires using latent class analysis. The results emphasized the importance of regular use of HAs for a better self-reported HA outcome. [ABSTRACT FROM AUTHOR]

Virtual Reality (VR) technologies have the potential to be applied in a clinical context to improve training and rehabilitation for individuals with hearing impairment. The introduction of such technologies in clinical audiology is in its infancy and requires devices that can be taken out of laboratory settings as well as a solid collaboration between researchers and clinicians. In this paper, we discuss the state of the art of VR in audiology with applications to measurement and monitoring of hearing loss, rehabilitation, and training, as well as the development of assistive technologies. We review papers that utilize VR delivered through a head-mounted display (HMD) and used individuals with hearing impairment as test subjects, or presented solutions targeted at individuals with hearing impairments, discussing their goals and results, and analyzing how VR can be a useful tool in hearing research. The review shows the potential of VR in testing and training individuals with hearing impairment, as well as the need for more research and applications in this domain. [ABSTRACT FROM AUTHOR]

Although hearing devices based on cartilage conduction have become more widely used in Japan, methods for evaluating the output volume of such devices have not yet been established. Although the output of air-conduction-based sound-generating devices (e.g., earphones and hearing aids) can be standardized via the head and torso simulator (HATS), this is not applicable to cartilage conduction devices because the simulated pinna is too soft (hardness: A5) compared with human aural cartilage. In this study, we developed polyurethane pinna that had the same shape but different degrees of hardness (A40, A20, and A10). We then compared the HATS results for the new pinna simulators with data from human ears. We found that the spectral shapes of the outputs increasingly approximated those of human ears as the simulated pinna hardness decreased. When a durometer was pressed against the ear tragus of a human ear, the hardness value ranged from A10 to A20. Accordingly, cartilage-conduction-based sound information could be obtained using a HATS that had a simulated pinna with a similar hardness value. [ABSTRACT FROM AUTHOR]

Noisy environments, changes and variations in the volume of speech, and non-face-to-face conversations impair the user experience with hearing aids. Generally, a hearing aid amplifies sounds so that a hearing-impaired person can listen, converse, and actively engage in daily activities. Presently, there are some sophisticated hearing aid algorithms available that operate on numerous frequency bands to not only amplify but also provide tuning and noise filtering to minimize background distractions. One of those is the BioAid assistive hearing system, which is an open-source, freely available downloadable app with twenty-four tuning settings. Critically, with this device, a person suffering with hearing loss must manually alter the settings/tuning of their hearing device when their surroundings and scene changes in order to attain a comfortable level of hearing. However, this manual switching among multiple tuning settings is inconvenient and cumbersome since the user is forced to switch to the state that best matches the scene every time the auditory environment changes. The goal of this study is to eliminate this manual switching and automate the BioAid with a scene classification algorithm so that the system automatically identifies the user-selected preferences based on adequate training. The aim of acoustic scene classification is to recognize the audio signature of one of the predefined scene classes that best represent the environment in which it was recorded. BioAid, an open-source biological inspired hearing aid algorithm, is used after conversion to Python. The proposed method consists of two main parts: classification of auditory scenes and selection of hearing aid tuning settings based on user experiences. The DCASE2017 dataset is utilized for scene classification. Among the many classifiers that were trained and tested, random forests have the highest accuracy of 99.7%. In the second part, clean speech audios from the LJ speech dataset are combined with scenes, and the user is asked to listen to the resulting audios and adjust the presets and subsets. A CSV file stores the selection of presets and subsets at which the user can hear clearly against the scenes. Various classifiers are trained on the dataset of user preferences. After training, clean speech audio was convolved with the scene and fed as input to the scene classifier that predicts the scene. The predicted scene was then fed as input to the preset classifier that predicts the user's choice for preset and subset. The BioAid is automatically tuned to the predicted selection. The accuracy of random forest in the prediction of presets and subsets was 100%. This proposed approach has great potential to eliminate the tedious manual switching of hearing assistive device parameters by allowing hearing-impaired individuals to actively participate in daily life by automatically adjusting hearing aid settings based on the acoustic scene. [ABSTRACT FROM AUTHOR]

(1) Background: To improve hearing-aid rehabilitation, the Danish 'Better hEAring Rehabilitation' (BEAR) project recently developed methods for individual hearing loss characterization and hearing-aid fitting. Four auditory profiles differing in terms of audiometric hearing loss and supra-threshold hearing abilities were identified. To enable auditory profile-based hearing-aid treatment, a fitting rationale leveraging differences in gain prescription and signal-to-noise (SNR) improvement was developed. This report describes the translation of this rationale to clinical devices supplied by three industrial partners. (2) Methods: Regarding the SNR improvement, advanced feature settings were proposed and verified based on free-field measurements made with an acoustic mannikin fitted with the different hearing aids. Regarding the gain prescription, a clinically feasible fitting tool and procedure based on real-ear gain adjustments were developed. (3) Results: Analyses of the collected real-ear gain and SNR improvement data confirmed the feasibility of the clinical implementation. Differences between the auditory profile-based fitting strategy and a current 'best practice' procedure based on the NAL-NL2 fitting rule were verified and are discussed in terms of limitations and future perspectives. (4) Conclusion: Based on a joint effort from academic and industrial partners, the BEAR fitting rationale was transferred to commercially available hearing aids. [ABSTRACT FROM AUTHOR]

Severe-to-profound hearing loss (STPHL) can affect a person negatively in many ways. Audiological rehabilitation is important for these patients. Patients receiving cochlear implants make up less than 10% of this group but have been studied extensively. In 2005, a national registry for adult patients with STPHL was introduced in Sweden. Its purpose was to evaluate and improve rehabilitation for all patients with STPHL. Data from the Swedish registry for adult patients with STPHL were used to evaluate variables affecting the audiological rehabilitation. Previous published data from the registry were reviewed, and new data from the follow-up questionnaire were presented. More than 90% of patients rehabilitated with hearing aids experienced a good or very good benefit of audiological rehabilitation. Tinnitus and vertigo affected quality of life negatively and were reported by many patients with STPHL (41% and 31%) at follow-up. To maintain the high number of patients who find audiological rehabilitation beneficial, individualized treatment plans and timely re-evaluations are crucial. Tinnitus and vertigo need to be addressed repeatedly in the rehabilitation process. [ABSTRACT FROM AUTHOR]

Older adults with hearing loss have difficulties during conversation with others because an elevated auditory threshold reduces speech intelligibility, especially in noisy environments. Listening and comprehension often become exhausting tasks for hearing-impaired elders, resulting in social isolation and depression. The aim of the present study was to investigate the advantages of hearing aid use in relation to relief from listening-related fatigue, which is still controversial. Participants included a sample of 49 hearing-impaired elders affected by presbycusis for whom hearing aids were prescribed. The Modified Fatigue Impact Scale was used to assess cognitive, physical and psychosocial fatigue. The vitality subscale of the Short Form Health Survey 36 and a single item of the multi-dimensional Speech, Spatial and Quality Hearing Scale ("Do you have to put a lot of effort to hear what is being said in conversation with others?") were also used. The Cognitive Failures Questionnaire was used to investigate daily errors related to lack of memory and reduced mindedness. Hearing aids rehabilitation resulted in improved speech intelligibility in competing noise, and a significant reduction in cognitive and psychosocial fatigue and listening effort in conversation. Vitality was also improved and a significant reduction in the Cognitive Failures Questionnaire scores was observed. Findings from the study indicate that the use of hearing aids in older impaired-listeners provide them not only with an increased auditory function but also with a reduction in listening-related fatigue and mindedness. [ABSTRACT FROM AUTHOR]

Background: For hearing-impaired individuals, hearing aids are clinically fit according to subjective measures of threshold and loudness. The goal of this study was to evaluate objective measures of loudness perception that might benefit hearing aid fitting. Method: Seventeen adult hearing aid users and 17 normal-hearing adults participated in the study. Outcome measures including categorical loudness scaling, cortical auditory evoked potentials (CAEPs), and pupillometry. Stimuli were 1-kHz tone bursts presented at 40, 60, and 80 dBA. Results: Categorical loudness scaling showed that loudness significantly increased with intensity for all participants (p < 0.05). For CAEPs, high intensity was associated with greater P1, N1, and P2 peak amplitude for all listeners (p < 0.05); a significant but small effect of hearing aid amplification was observed. For all participants, pupillometry showed significant effects of high intensity on pupil dilation (p < 0.05); there was no significant effect of hearing aid amplification. A Focused Principal Component analysis revealed significant correlations between subjective loudness and some of the objective measures. Conclusion: The present data suggest that intensity had a significant impact on loudness perception, CAEPs, and pupil response. The correlations suggest that pupillometry and/or CAEPs may be useful in determining comfortable amplification for hearing aids. [ABSTRACT FROM AUTHOR]

The present study is a systematic review on the effectiveness of Parent Training (PT) and coaching in deaf and hard of hearing (DHH) rehabilitation programs which reviews and synthesizes the existing body of evidence to assess the benefits of these programs in enhancing parents' sensitivity, responsivity and promoting language development in DHH children during the first years after HA fitting or CI activation. Five published studies met the Population, Intervention, Comparison and Outcomes (PICO) inclusion criteria and were eligible to be included, but heterogeneity in terms of the study design, interventions and outcomes did not allow for performing a meta-analysis. All included studies shared the view that a parent's learning is a circular (rather than frontal) process, and the results appear promising in terms of enhancing parents' responsiveness and promoting DHH child language development. Nevertheless, the available evidence was judged to not be robust enough due to limitations in the studies' designs. Further high-quality evidence is needed to evaluate the true degree of clinical value and the cost effectiveness of PT programs aimed at increasing parents' responsiveness to their DHH children. [ABSTRACT FROM AUTHOR]

Because cartilage conduction--the transmission of sound via the aural cartilage--has different auditory pathways from well-known air and bone conduction, how the output volume in the external auditory canal is stimulated remains unknown. To develop a simulator approximating the conduction of sound in ear cartilage, the vibrations of the pinna and sound in the external auditory canal were measured using pinna simulators made of silicon rubbers of different hardness (A40, A20, A10, A5, A0) as measured by a durometer. The same procedure, as well as a current calibration method for air conduction devices, was applied to an existing pinna simulator, the Head and Torso Simulator (hardness A5). The levels for vibration acceleration and sound pressure from these pinna simulators show spectral peaks at dominant frequencies (below 1.5 kHz) for the conduction of sound in cartilage. These peaks were likely to move to lower frequencies as hardness decreases. On approaching the hardness of actual aural cartilage (A10 to A20), the simulated levels for vibration acceleration and sound pressure approximated the measurements of human ears. The adjustment of the hardness used in pinna simulators is an important factor in simulating accurately the conduction of sound in cartilage. [ABSTRACT FROM AUTHOR]

Cartilage conduction (CC) is a form of conduction that allows a relatively loud sound to be audible when a transducer is placed on the aural cartilage. The CC transmission mechanism has gradually been elucidated, allowing for the development of CC hearing aids (CC-HAs), which are clinically available in Japan. However, CC is still not fully understood. This review summarizes previous CC reports to facilitate its understanding. Concerning the transmission mechanism, the sound pressure level in the ear canal was found to increase when the transducer was attached to the aural cartilage, compared to an unattached condition. Further, inserting an earplug and injecting water into the ear canal shifted the CC threshold, indicating the considerable influence of cartilage-air conduction on the transmission. In CC, the aural cartilage resembles the movable plate of a vibration speaker. This unique transduction mechanism is responsible for the CC characteristics. In terms of clinical applications, CC-HAs are a good option for patients with aural atresia, despite inferior signal transmission compared to bone conduction in bony atretic ears. The advantages of CC, namely comfort, stable fixation, esthetics, and non-invasiveness, facilitate its clinical use. [ABSTRACT FROM AUTHOR]

(1) Background: The application of machine learning techniques in the speech recognition literature has become a large field of study. Here, we aim to (1) expand the available evidence for the use of machine learning techniques for voice classification and (2) discuss the implications of such approaches towards the development of novel hearing aid features (i.e., voice familiarity detection). To do this, we built and tested a Convolutional Neural Network (CNN) Model for the identification and classification of a series of voices, namely the 10 cast members of the popular television show "Modern Family". (2) Methods: Representative voice samples were selected from Season 1 of Modern Family (N = 300; 30 samples for each of the classes of the classification in this model, namely Phil, Claire, Hailey, Alex, Luke, Gloria, Jay, Manny, Mitch, Cameron). The audio samples were then cleaned and normalized. Feature extraction was then implemented and used as the input to train a basic CNN model and an advanced CNN model. (3) Results: Accuracy of voice classification for the basic model was 89%. Accuracy of the voice classification for the advanced model was 99%. (4) Conclusions: Greater familiarity with a voice is known to be beneficial for speech recognition. If a hearing aid can eventually be programmed to recognize voices that are familiar or not, perhaps it can also apply familiar voice features to improve hearing performance. Here we discuss how such machine learning, when applied to voice recognition, is a potential technological solution in the coming years. [ABSTRACT FROM AUTHOR]

This paper proposes a technique for improving statistical-model-based voice activity detection (VAD) in noisy environments to be applied in an auditory hearing aid. The proposed method is implemented for a uniform polyphase discrete Fourier transform filter bank satisfying an auditory device time latency of 8 ms. The proposed VAD technique provides an online unified framework to overcome the frequent false rejection of the statistical-model-based likelihood-ratio test (LRT) in noisy environments. The method is based on the observation that the sparseness of speech and background noise cause high false-rejection error rates in statistical LRT-based VAD—the false rejection rate increases as the sparseness increases. We demonstrate that the false-rejection error rate can be reduced by incorporating likelihood-ratio order statistics into a conventional LRT VAD. We confirm experimentally that the proposed method relatively reduces the average detection error rate by 15.8% compared to a conventional VAD with only minimal change in the false acceptance probability for three different noise conditions whose signal-to-noise ratio ranges from 0 to 20 dB. [ABSTRACT FROM AUTHOR]

The traditional hearing aid fitting method, which mainly relies on the audiologist, is time-consuming and messy. To improve this situation, a self-fitting algorithm based on an improved interactive evolutionary computation (IEC) algorithm and expert system, which enables the patients to fit the hearing aid by themselves, is proposed. The algorithm takes the band gain as the fitting target and uses the patient's subjective evaluation to iteratively update the algorithm parameters based on the improved IEC algorithm. In addition, a real-time updated expert system is constructed to assist in the optimization of the initial and iterative parameters of the fitting based on the patient's audiogram and personal information. To verify the performance of the algorithm, a self-fitting software for the hearing aid is designed. Through this software, the test signal is generated for the patient to evaluate the audio quality on a five-level scale. Based on the evaluation results, the algorithm iteratively optimizes the algorithm parameters until the patient is satisfied with the generated audio. Compared with the fitting algorithm based on Gaussian processes algorithm or the interactive evolutionary algorithm, the average subjective speech recognition rate of the proposed algorithm increase at least 11%. The average recognition rate for environmental sound is also improved by at least 2.9%. In addition, the fitting time of the proposed algorithm is shortened by at least 10 min compared to others two algorithms. [ABSTRACT FROM AUTHOR]

This paper presents the configuration and digital signal processing details of a tablet-based hearing aid transmitting wirelessly to standard earphones, whereby the tablet performs full sound processing rather than solely providing a means of setting adjustment by streaming to conventional digital hearing aids. The presented device confirms the recognized advantages of this tablet-based approach (e.g., in relation to cost, frequency domain processing, amplification range, versatility of functionality, component battery rechargeability), and flags the future wider-spread availability of such hearing solutions within mainstream healthcare. The use of a relatively high sampling frequency was found to be beneficial for device performance, while the use of optional off-the-shelf add-on components (e.g., data acquisition device, high fidelity microphone, compact wireless transmitter/ receiver, wired headphones) are also discussed in relation to performance optimization. The easy-to-follow configuration utilized is well suited to student learning/research instrumentation projects within the health and biomedical sciences. In this latter regard, the presented device was pedagogically integrated into a flipped classroom approach for the teaching of bioinstrumentation within an Allied Health Sciences School, with the subsequent establishment of positive student engagement outcomes. [ABSTRACT FROM AUTHOR]

Implantable assembly components that are biocompatible and highly miniaturized are an important objective for hearing aid development. We introduce a mechanical transducer, which could be suitable as part of a prospective fully-implantable hearing aid. The transducer comprises a sensor and an actuator unit in one housing, located in the joint gap between the middle ear ossicles, the incus and stapes. The setup offers the advantage of a minimally invasive and reversible surgical solution. However, feedback between actuator and sensor due to mechanical coupling limits the available stable gain. We show that the system can be stabilized by digital control algorithms. The transducer is tested both in a finite elements method simulation of the middle ear and a physical model of a human middle ear. First, we characterize the sensor and actuator elements separately. Then, the maximum stable gain (MSG) of the whole transducer is experimentally determined in the middle ear model. With digital feedback control (using a least mean squares algorithm) in place, the total signal gain is greater than 30 dB for frequencies of 1 kHz and above. This shows the potential of the transducer as a high frequency hearing aid. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of and satisfaction with hearing aids as a treatment option for tinnitus with hearing loss. Methods: This retrospective study used the tinnitus handicap inventory (THI), the satisfaction with amplification in daily life (SADL) questionnaire, and a medical chart review. A total of 116 patients treated between August 2018 and December 2020 were included. All patients with tinnitus and hearing loss underwent the same counseling sessions. Sixty patients chose to have hearing aids fitted (aided group), whereas 56 patients chose not to (non-aided group). Both the groups had similar audiometric configurations, durations of tinnitus, and ages. Structured interviews were performed, with various measures evaluated using the visual analog scale (VAS) and the THI questionnaire, before and six months after fitting the hearing aids. The SADL questionnaire was administered 6 months after fitting the hearing aids. Results: The patients' THI scores reduced 6 months after the counseling, but the improvement in the THI scores was only significant in the group that received hearing aids. There were significant differences between the VAS scores of the two groups, and the changes in the VAS scores in the groups were statistically different. Subjective satisfaction with a hearing aid increased with improvements to tinnitus-related discomfort. Conclusion: The study's results indicated that patients with hearing loss and tinnitus can be treated with hearing aids and counseling. [ABSTRACT FROM AUTHOR]

Electromagnetic field emissions of modern power systems have increased in complexity if the many power conversion forms by means of power electronics and static converters are considered. In addition, the installed electric power has grown in many everyday applications such as wireless charging of vehicles, home integrated photovoltaic systems, high-performance electrified transportation systems, and so on. Attention must then be shifted to include harmonics and commutation components on one side, as well as closer interaction with humans, that concretizes in impact on physiological functions and interference to implantable medical devices and hearing aids. The panorama is complex in that standards and regulations have also increased significantly or underwent extensive revisions in the last 10 years or so. For assessment, the straightforward application of the limits of exposure is hindered by measurement problems (time or frequency domain methods, positioning errors, impact of uncertainty) and complex scenarios of exposure (multiple sources, large field gradient, time-varying emissions). This work considers thus both the clarification of the principles of interaction for each affected system (including humans) and the discussion of the large set of related normative and technical documents, deriving a picture of requirements and constraints. The methods of assessment are discussed in a metrological perspective using a range of examples. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing research interest in the correlation between hearing impairment and cognitive decline, two conditions that have demonstrated a strong association. Hearing loss appears as a risk factor for cognitive impairment, especially among certain populations, notably nursing home residents. Furthermore, hearing loss has been identified as a modifiable age-related condition linked to dementia, and it has been estimated that midlife hearing loss, if eliminated, might decrease the risk of dementia in the general population. Several mechanisms have been suggested to explain the pathologic connections between hearing loss and dementia; however, clear evidence is missing, and the common pathophysiological basis is still unclear. In this review, we discussed current knowledge about the relationship between hearing loss and dementia, and future perspectives in terms of the effects of hearing rehabilitation for early prevention of cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. Methods: eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. Results: all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. Conclusions: the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance. [ABSTRACT FROM AUTHOR]

Cochlear implants (CIs) recover hearing in severely to profoundly hearing-impaired people by electrically stimulating the cochlea. While they are extremely effective, spatial hearing is typically severely limited. Recent studies have shown that haptic stimulation can supplement the electrical CI signal (electro-haptic stimulation) and substantially improve sound localization. In haptic sound-localization studies, the signal is extracted from the audio received by behind-the-ear devices and delivered to each wrist. Localization is achieved using tactile intensity differences (TIDs) across the wrists, which match sound intensity differences across the ears (a key sound localization cue). The current study established sensitivity to across-limb TIDs at three candidate locations for a wearable haptic device, namely: the lower tricep and the palmar and dorsal wrist. At all locations, TID sensitivity was similar to the sensitivity to across-ear intensity differences for normal-hearing listeners. This suggests that greater haptic sound-localization accuracy than previously shown can be achieved. The dynamic range was also measured and far exceeded that available through electrical CI stimulation for all of the locations, suggesting that haptic stimulation could provide additional sound-intensity information. These results indicate that an effective haptic aid could be deployed for any of the candidate locations, and could offer a low-cost, non-invasive means of improving outcomes for hearing-impaired listeners. [ABSTRACT FROM AUTHOR]

As society ages, wireless body area networks (WBANs) are expected to increasingly improve the quality of life of the elderly and disabled. One promising WBAN technology is human body communication (HBC), which utilizes part of the human body as a transmission medium. Communication between head-mounted wearable devices, such as hearing aids, is a potential HBC application. To clarify the HBC transmission mechanism between head-mounted wearable devices, this study analyzes the input impedance characteristics of the transceiver electrodes, transmission characteristics, and electric field distributions around and through a detailed head model. The investigation was performed via an electromagnetic field simulation. The signal frequency had less effect on the transmission characteristics and electric field distributions at 10, 20, and 30 MHz. However, the transmission mechanism between the head-mounted wearable devices was influenced by the number of electrodes in the transceiver. Moreover, the transmission characteristics between two-electrode transceivers were improved by impedance matching. Finally, the availability of the proposed system was evaluated from power consumption and human safety perspectives. [ABSTRACT FROM AUTHOR]

This paper proposes a novel technique to improve a spectral statistical filter for speech enhancement, to be applied in wearable hearing devices such as hearing aids. The proposed method is implemented considering a 32-channel uniform polyphase discrete Fourier transform filter bank, for which the overall algorithm processing delay is 8 ms in accordance with the hearing device requirements. The proposed speech enhancement technique, which exploits the concepts of both non-negative sparse coding (NNSC) and spectral statistical filtering, provides an online unified framework to overcome the problem of residual noise in spectral statistical filters under noisy environments. First, the spectral gain attenuator of the statistical Wiener filter is obtained using the a priori signal-to-noise ratio (SNR) estimated through a decision-directed approach. Next, the spectrum estimated using the Wiener spectral gain attenuator is decomposed by applying the NNSC technique to the target speech and residual noise components. These components are used to develop an NNSC-based Wiener spectral gain attenuator to achieve enhanced speech. The performance of the proposed NNSC–Wiener filter was evaluated through a perceptual evaluation of the speech quality scores under various noise conditions with SNRs ranging from -5 to 20 dB. The results indicated that the proposed NNSC–Wiener filter can outperform the conventional Wiener filter and NNSC-based speech enhancement methods at all SNRs. [ABSTRACT FROM AUTHOR]

In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in the acoustically stimulated ear. This multicenter retrospective study examined pre- to postoperative changes in speech perception in the nonimplanted ear, the implanted ear, and both together. Results in the latter two conditions showed the expected increases, but speech perception in the nonimplanted ear showed a modest yet meaningful decrease that could not be completely explained by changes in unaided thresholds, hearing aid malfunction, or several other demographic variables. Decreases in speech perception in the nonimplanted ear were more likely in individuals who had better levels of speech perception in the implanted ear, and in those who had better speech perception in the implanted than in the nonimplanted ear. This raises the possibility that, in some cases, bimodal listeners may rely on the higher quality signal provided by the implant and may disregard or even neglect the input provided by the nonimplanted ear. [ABSTRACT FROM AUTHOR]

Hearing loss is the third most prevalent health condition in older age. In recent years, research has consistently reported an association between hearing loss and mental health outcomes, including poorer cognitive performances. Whether treating hearing loss in elders improves cognition has been directly or indirectly addressed by several studies. This review aims at providing a synthesis of those results. Regarding the literature on hearing aids' use and cognition, although the lack of interventional studies has to be underlined, observational data suggest that hearing aids positively impact long-term cognition, even though more research is necessary to ascertain this statement and provide information on the length or frequency of use required in order to observe benefits. Regarding cochlear implants in elders experiencing more severe auditory deprivation, the literature is scarcer. The available studies have many limitations and do not allow the drawing of clear conclusions. Taken together, the results are encouraging. Nevertheless, because hearing loss is suspected to account for 9% of dementia cases, and also because hearing loss is one of the few potentially modifiable factors from a dementia prevention perspective, the need to stimulate research to have clearer knowledge of the benefits of treating hearing loss on cognitive outcomes is urgent. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether emotional and behavioral difficulties (EBD) differ between children with cochlear implants (CIs) or hearing aids (HAs), according to multi-informant ratings. Methods: A battery of psychological measures (e.g., Strengths and Difficulties Questionnaire (SDQ), Illinois Test of Psycholinguistic Abilities (ITPA), Peabody Image Vocabulary Test (PPVT), and Raven Progressive Matrices Test (RPM), was administered to children with CIs or HAs. The study involved 187 children with CIs, 113 children with HAs, 176 fathers and mothers, and 300 schoolteachers. Results: Significant disagreements were found between children, parents, and schoolteachers with regard to SDQ ratings. Total SDQ difficulties score correlated poorly with other outcomes (e.g., total ITPA, final PPVT, and final RPM). Regression linear analyses showed six socio-demographic and linguistic covariates that significantly predicted children's total SDQ difficulties score. Conclusion: Several independent variables were found to be associated with children's total EBD scores. This article highlights the importance of providing professionals with sufficient training so that they are knowledgeable about the procedures they are to use to support children with EBD (e.g., developing and implementing instructional approaches for school students with EBD). [ABSTRACT FROM AUTHOR]

This paper presents a new structure for hearing aids. Normally, the power consumption and user experience are contradictory. The proposed hearing aid structure mainly consists of three parts: the earpieces, the mobile computing platform, and the real-time speech-enhancement application. It can run complex algorithms without carrying out heavy calculations on the processors in the hearing aid. Thus, the binaural algorithm is utilized without being limited by complexity and power consumption to improve the user experience. Moreover, the speech-enhancement algorithm can be updated much more easily than in traditional built-in digital signal process hearing aids. A good level of user experience is achieved by combining the hearing aid and mobile computing platform with a 400-MHz transceiver; furthermore, the 400-MHz transceiver can reduce path loss around the body. The concept verification process showed that the overall usage of the central processing unit in the smartphone is around 16%, the signal-to-noise ratios show at least a 30% improvement in some environments, and the whole system delay is 8.8 ms. The presented objective and subjective results show significant improvements regarding user experience and usability brought about by the proposed structure. [ABSTRACT FROM AUTHOR]

Cortical auditory evoked potentials (CAEPs) are an emerging tool for hearing aid fitting evaluation in young children who cannot provide reliable behavioral feedback. It is therefore useful to determine the relationship between the sensation level of speech sounds and the detection sensitivity of CAEPs, which is the ratio between the number of detections and the sum of detections and non-detections. Twenty-five sensorineurally hearing impaired infants with an age range of 8 to 30 months were tested once, 18 aided and 7 unaided. First, behavioral thresholds of speech stimuli /m/, /g/, and /t/ were determined using visual reinforcement orientation audiometry. Afterwards, the same speech stimuli were presented at 55, 65, and 75 dB sound pressure level, and CAEPs were recorded. An automatic statistical detection paradigm was used for CAEP detection. For sensation levels above 0, 10, and 20 dB respectively, detection sensitivities were equal to 72±10, 75±10, and 78±12%. In 79% of the cases, automatic detection P-values became smaller when the sensation level was increased by 10 dB. The results of this study suggest that the presence or absence of CAEPs can provide some indication of the audibility of a speech sound for infants with sensorineural hearing loss. The detection of a CAEP might provide confidence, to a degree commensurate with the detection probability, that the infant is detecting that sound at the level presented. When testing infants where the audibility of speech sounds has not been established behaviorally, the lack of a cortical response indicates the possibility, but by no means a certainty, that the sensation level is 10 dB or less.