HEARING aids accepted by the Council on Physical Medicine of the American Medical Association. As of April 1, 1950.
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American Medical Association↗
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HEARING aids accepted by the Council on Physical Medicine of the American Medical Association.
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American Medical Association↗
[Practical hearing compensation and an assessment of hearing effect in patients with profound hearing loss using hearing aids].
This investigation was carried out to study practical hearing compensation with hearing aids and the correlation between subjective evaluation (questionnaire survey) and objective evaluation (speech perception test) as an assessment of hearing aid effect in patients with profound hearing loss. 1. Forty-nine patients with hearing levels of 90dB or more (23 men and 26 women) were examined. Their mean and median hearing levels were 105.9dB (standard deviation: 10.4dB) and 106.3dB, respectively. The patients ranged in age from 18 to 74, with a mean age of 47.4. 2. Subjective evaluation was carried out by a questionnaire survey in which the patients chose one of 4 or 5 graded categories in 10 different hearing conditions, and three items of "satisfactory", "uneasiness" and "effectiveness". Speech sound discrimination ability for vowels and monosyllables, and speech intelligibility of words and sentences, were evaluated in audition only (A), vision only (V) and a combination of both (A + V), totaling 12 conditions with hearing aids as the objective evaluation using video tapes materials. 3. The subjective evaluation revealed that 60% of patients with hearing loss of 90-110dB understood "one to one conversation in a quiet place". Speech perception was poorer in "conversation in a noisy place" than in "conversation in a quiet place". Speech perception became poorer in the order of "one to one", "to a few people", and "to many people". For subjective feeling, 56.4% answered "satisfactory", and for hearing aid effectiveness, 78.7% answered "effective". 4. In the objective evaluation, the rates of correct answers were 19.6% in A and 46.3% in A + V for monosyllables, 19.8% in A and 43.4% in A + V for words, and 29.5% in A and 60.0% in A+V for sentences. 5. There were significant correlations (p < 0.001) between subjective evaluation of "in a quiet place and one to one conversation" (among other conditions) and objective evaluations of monosyllables, and word and sentence recognition, mostly in A and A + V. These results suggest that hearing compensation by hearing aids can be evaluated objectively in patients with profound hearing loss when word and sentence recognition tests are performed in addition to the monosyllable recognition test, and it is more practical if vision is examined in addition to hearing for speech perception in patients with profound hearing loss.
Adolescent↗
The New York State universal newborn hearing screening demonstration project: ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention.
OBJECTIVE: To determine the ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention through a multi-center, state-wide universal newborn hearing screening project. DESIGN: Universal newborn hearing screening was conducted at eight hospitals across New York State. All infants who did not bilaterally pass hearing screening before discharge were recalled for outpatient retesting. Inpatient screening and outpatient rescreening were done with transient evoked otoacoustic emissions and/or auditory brain stem response testing. Diagnostic testing was performed with age appropriate tests, auditory brain stem response and/or visual reinforcement audiometry. Infants diagnosed with permanent hearing loss were considered for hearing aids and early intervention. Ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention were investigated regarding nursery type, risk status, unilateral versus bilateral hearing loss, loss type, loss severity, and state regions. RESULTS: The prevalence of infants diagnosed with permanent hearing loss was 2.0/1000 (85 of 43,311). Of the 85 infants with hearing loss, 61% were from neonatal intensive care units (NICUs) and 67% were at risk for hearing loss. Of the 36 infants fitted with hearing aids, 58% were from NICUs and 78% were at risk for hearing loss. The median age at identification and enrollment in early intervention was 3 mo. Median age at hearing aid fitting was 7.5 mo. Median ages at identification were less for infants from the well-baby nurseries (WBNs) than for the NICU infants and for infants with severe/profound than for infants with mild/moderate hearing loss, but were similar for not-at-risk and at-risk infants. Median ages at hearing aid fitting were less for well babies than for NICU infants, for not-at-risk infants than for at-risk infants, and for infants with severe/ profound hearing loss than for infants with mild/ moderate hearing loss. However, median ages at early intervention enrollment were similar for nursery types, risk status, and severity of hearing loss. CONCLUSIONS: Early ages of hearing loss identification, hearing aid fitting, and enrollment in early intervention can be achieved for infants from NICUs and WBNs and for infants at risk and not at risk for hearing loss in a large multi-center universal newborn hearing screening program.
Age Factors↗
Low prevalence of hearing aid use among older adults with hearing loss: the Epidemiology of Hearing Loss Study.
OBJECTIVES: To measure the prevalence of hearing aid use among older adults with hearing loss and to identify factors associated with those currently using hearing aids. DESIGN: Population-based cohort study. SETTING: The south-central Wisconsin community of Beaver Dam. PARTICIPANTS: A total of 1629 adults, aged 48 to 92 years, who have hearing loss and are participating in the Epidemiology of Hearing Loss Study and the Beaver Dam Eye Study. MEASUREMENTS: A hearing-related risk factor and medical history questionnaire, the Hearing Handicap Inventory for the Elderly (screening version), screening tympanometry, pure-tone air- and bone-conduction audiometry, and word recognition tests were administered by trained examiners using standard protocols. RESULTS: The prevalence of current hearing aid use among those with a hearing loss (pure-tone average > 25 decibels hearing level over 500, 1000, 2000, and 4000 Hertz, worse ear) was 14.6%. The prevalence was 55% in a subset of the most severely affected participants. In univariate analyses, current hearing aid use was associated with age, severity of loss, word recognition scores, self-reported hearing loss, self-perceived hearing handicap, and history of noise exposure. Factors associated with current hearing aid use in multivariate logistic regression models were age, severity of loss, education, word recognition scores, Hearing Handicap Inventory for the Elderly (screening version) score, and self-report of a hearing loss. CONCLUSIONS: Few older adults with hearing loss are currently utilizing hearing aids. Improved screening and intervention programs to identify older adults who would benefit from amplification are needed to improve hearing-related quality of life for this large segment of the population.
Age Factors↗
Hearing loss- and hearing aid-related stigma: perceptions of women with age-normal hearing.
Impaired hearing and the use of hearing aids are often perceived negatively. Many adults deny hearing loss and reject amplification, in part due to such stigma. Women and men differ in how they age and adjust to impaired hearing, yet little is known specifically about women's perceptions of stigma related to hearing loss and hearing aid use. The purpose of this study was to examine the degree of stigma associated with hearing loss and hearing aid use among women in three age groups (35-45 years, 55-65 years, and 75-85 years). Participants were 191 women with hearing within normal limits based on age-related norms. Using pairs of descriptors (i.e., semantic differentials), participants completed statements related to hearing loss and hearing aid use. Results suggest that negative perceptions associated with hearing loss and hearing aid use are affected by age. Younger women perceive greater stigma than older women. Less stigma is associated with hearing aid use than hearing loss, suggesting a positive effect of hearing loss management. Implications for clinical practice and marketing of hearing instruments are discussed.
Adult↗
Hearing aid use in nursing homes. Part 1: Prevalence rates of hearing impairment and hearing aid use.
UNLABELLED: Although hearing impairment is among the most common chronic ailments of older persons, the problem is even greater among those in nursing homes. It is estimated that 70% to 90% of elderly residents in long-term care facilities have some degree of hearing impairment. Despite this high prevalence, significant underuse of hearing aids or other assistive devices exists, especially among those with dementia. OBJECTIVES: The current study assessed rates of hearing impairment and hearing aid use among residents in a large, mid-Atlantic nursing home. SETTING AND DESIGN: In a cross-sectional survey, interviews were conducted at a large, mid-Atlantic nonprofit nursing home. PARTICIPANTS: Reports were obtained from 279 resident-caregiver dyads, as well as from the Minimum Data Set (MDS) and research assistants performing the structured interviews. MEASUREMENTS: Measures included the MDS and the Barriers to Hearing Aid Use Questionnaire, which was developed for this study. RESULTS: Results show an inconsistency in reports of both hearing impairment and hearing aid use by multiple sources, as well as the underuse of hearing aids. These inconsistencies suggest that gross hearing impairment is undetected in clinical practice in over half of the residents. CONCLUSION: The findings highlight the need for regular hearing assessments in the nursing home population. They also suggest the need for evaluation of institutional-level policies regarding screening and hearing aid management, as well as the need for further information regarding potential barriers to effective hearing aid use. These issues are addressed in part 2 of this study following this report.
Activities of Daily Living↗
HEARING aids accepted by the council on Physical Medicine of the American Medical Association, October 1, 1952.
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American Medical Association↗
Males lose hearing earlier in mouse models of late-onset age-related hearing loss; females lose hearing earlier in mouse models of early-onset hearing loss.
Gender-related differences in human hearing have been attributed to genetic, environmental, and/or genetic x environmental interactive factors. These differences tend to increase with age, with males showing greater high frequency threshold elevations. An appropriate animal model could aid in prediction, treatment, and prevention of some of these losses. This paper examines inbred strains of mice that are widely used as models of late- (CBA/J and CBA/CaJ) and early- (C57BL/6J) onset age-related hearing loss. In the former two genotypes, the thresholds to high frequency stimuli of the auditory brainstem response (ABR) are higher in the male than in the female. This gender difference was less pronounced in thresholds to the cochlear nerve envelope response of the CBA/CaJ, although this response was more sensitive to the influence of age than was the ABR. In contrast, the male C57BL/6J had more sensitive thresholds than the female, with both measures showing massive loss of sensitivity with increasing age. The data are discussed in terms of the applicability of these animals as tools for examining factors that degrade cochlear function.
Aging↗
Year 2000 position statement: principles and guidelines for early hearing detection and intervention programs. Joint Committee on Infant Hearing, American Academy of Audiology, American Academy of Pediatrics, American Speech-Language-Hearing Association, and Directors of Speech and Hearing Programs in State Health and Welfare Agencies.
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Benchmarking↗
[Rehabilitation of patients with hearing disorders using hearing aids and tactical hearing measures].
After a brief summary of the problems of rehabilitation of hearing-impaired subjects, the optimal conditions for rehabilitation with hearing aids are presented: a) The right timing is crucial. b) Optimal provision of hearing aids must be carried out in close co-operation between the patient, the hearing aid technician and the otolaryngologist. c) Easy handling of the hearing aid and the use of attachments must be guaranteed. d) The hearing-impaired person must be fully informed as to the extent and type of hearing loss. He/she must accept the affliction and know about the possibilities of rehabilitation. The patient's motivation is a pre-requisite for all further steps. e) The patients must learn tactical measures to make optimal use of their hearing ability in relation to their environment. Hearing tactics consist of hearing training and a change in the attitude of the hearing-impaired patients themselves and their attitude towards their surroundings.
Auditory Perception↗
A cross-sectional study of speech- and language-abilities of children with normal hearing, mild fluctuating conductive hearing loss, or moderate to profound sensoneurinal hearing loss.
A total of 1528 pre-school children (mean age 4 years and 9 months), being identified as speech or language delayed, were evaluated with respect to micro-otoscopy, nose and throat pathology, hearing function, and speech-language abilities. Subjects were classified into groups of (I) constant normal hearing, (II) fluctuating conductive hearing loss and (III) bilateral moderate to profound sensorineural hearing loss requiring hearing aids. In groups II and III, severe speech and language pathologies were found more frequently than in group I. Additionally, auditory perception skills were less in group II, even if peripheral hearing function was normalized. Group III was affected more than group II, but not significantly. The results indicate that in children having speech or language delay for severals reasons, mild fluctuating hearing loss can additionally alter language acquisition, but less than in cases of moderate or profound sensoneurinal hearing loss. The need of early detection of sensoneurinal hearing loss appears widely accepted; this study demonstrates also the necessity of early diagnosis of mild fluctuating hearing loss, especially in children with speech-language delay.
Acoustic Impedance Tests↗
[Universal hearing screening in newborns. Recommendations for organizing and conducting universal hearing screening for congenital hearing loss in Germany].
The Interdisciplinary Consensus Conference for Newborn Hearing Screening (IKKNHS) has worked out joint recommendations for universal hearing screening of newborns. In the consensus paper, 11 professional associations and scientific societies in the fields of gynecology and obstetrics, ENT, pediatrics, and phoniatrics and pedaudiology came to an agreement on how to implement newborn hearing screening in Germany. The paper deals with the following topics: goals of universal newborn hearing screening, target group of hearing screening, schedule for screening, personnel involved in the screening program, technologies and framework conditions of hearing screening, documentation, continuous quality control of screening, confirmation diagnostics for conspicuous test subjects, motivation to take part in screening, information on newborn hearing screening, tracking, various infrastructural situations in urban and rural regions, follow-up care, in-patient vs. out-patient screening, cost factors of screening, reporting children with permanent hearing loss to the German Central Registry for hearing loss in children.
Genetic Testing↗
[Hearing aid prescription in ENT practice. II. Forms of hearing aid construction and prescription of bilateral hearing aids].
The fundamental constructional types of hearing aids are box or pocket hearing aids, behind-the-ear devices and in-the-ear devices. Other special forms include hearing aid spectacles. The indications for prescription of the various constructional types are described with consideration of their advantages and disadvantages, supplemented by a comment on the legal aspects of prescription of in-the-ear aids. In binaural deafness, provision of hearing aids for both ears is to be regarded as the normal approach with careful observation of the limits of the indications. The advantages of hearing in both ears compared with monaural hearing, and the contra-indications to binaural provision of hearing aids are described in detail. The legal basis of binaural hearing aid provision is explained.
Auditory Threshold↗
[Directional hearing of unilaterally hearing impaired--especially sense of sound direction in monaural hearing impairment and monaural deafness].
I. OBJECTIVE. The present study was undertaken in order to determine the onset of monaural deafness, especially whether it is congenital or acquired, making an investigation into the sense of sound direction in monaural hearing impairment and monaural deafness and comparing them between hearing-impaired patients and normal hearers. II. SUBJECTS. This study was carried out on 26 patients with monaural hearing impairment, 22 patients with monaural deafness and 10 normal hearers. III. METHODS. A circle with a radius of 1.3m was drawn around a fixed patient's position in a sound proof room, and the circle was divided into 16 directions at an equal angle of 22.5 degrees. A blindfolded hearer was instructed to listen to a speaker for white noise of 60dB (A) for one second and verbally answer in which direction he heard the noise. The normal hearers were tested in 4-, 8-, and 16-directions, and the hearing-impaired patients were tested in only 8-directions. IV. RESULTS. 1. Normal Hearers The rate of correct answers decreased with increasing directions of sound. The incorrect answers in 4-direction testing were only confusion between forward and backward directions, and similar incorrect answers were made in 8- and 16-direction testing. All other incorrect answers were errors of less than 45 degrees. 2. Monaurally Hearing-impaired Patients The rate of correct answers on the whole was low. There was such a relationship between the rate of correct answers and the mean hearing level of patients that the total rate of correct answers decreased with increasing hearing impairment. This correlation was statistically significant, and there was a still more significant correlation between the degree of hearing impairment and the rate of correct answers as to the right and left directions. Incorrect answers were errors of 90 degrees or less on the healthy side, while errors were made for all directions on the affected side. 3. Monaurally Deaf Patients The rate of correct answers was by far lower on the affected side. Whereas many errors were within 45 degrees on the healthy side, errors were made for all directions on the affected side. Judging from the onset of hearing loss, the monaurally deaf patients were divided into a group of 8 patients who obviously had sudden acquired deafness and a group of 9 patients who were presumed to have congenital monaural deafness. The mean rate of correct answers of the former group was superior to the latter group's, particularly on the effected side.
Adolescent↗
Perception of hearing loss and hearing handicap on hearing aid use by nursing home residents.
The purpose of this study was to examine the perception of hearing loss and self-assessed hearing handicap on hearing aid use by nursing home residents. Sixty elderly individuals who had a hearing loss and wore hearing aids were given the Nursing Home Hearing Handicap Index and were asked specific questions related to hearing aid use. The overall results indicated that there was a moderate correlation among all three variables. It was determined that nursing home residents consistently use their hearing aids. However, amplification does not address all the communication needs of the nursing home resident. Assistive listening devices and environmental modification would improve communication ability and the quality of life of the nursing home resident.
Aged↗
Hearing performance in noise of cochlear implant patients versus severely-profoundly hearing-impaired patients with hearing aids.
It is possible for most post-lingually deaf patients to attain significant open speech recognition following cochlear implantation. In contrast, many severely-profoundly sensorineural hearing-impaired patients receive no benefit from their hearing aids, especially in situations with background noise. The aim of the study was to evaluate the speech recognition ability in quiet and in noise of post-lingually deaf adults implanted with Combi 40/40+ cochlear implants versus severely-profoundly sensorineural hearing-impaired patients fitted with hearing aids. For this purpose, we tested two groups of patients: one that had received cochlear implants (n=22) and a group of subjects with severe-profound sensorineural hearing impairment, fitted with hearing aids (n = 15). All of the patients were tested using the Hochmaier, Schultz, and Moser Discrimination Test in quiet and noise. The results of the study demonstrate that most of our cochlear implant patients received a substantial benefit from their implant, achieving scores of 70 to 100 per cent (mean, 90 per cent) for the numbers test and 10 to 72 per cent (mean, 43 per cent) for the monosyllable test 1 year after implantation. Even in situations with background noise, scores of 1 to 99 per cent (mean, 45.65 per cent) for a signal to noise ratio (SNR) of +15 dB 1 year following the implantation improved to 7 to 95 per cent (mean, 50.7 per cent) at 2 years and 8 to 99 per cent (mean, 60 per cent) at 3 years after implantation. These results are significantly (p<0.04) superior to the hearing aid patients' scores of 1 to 64.2 per cent (mean, 26.7 per cent) for a SNR of 15 dB. The results of the present study may have clinical implications in regard to selection of candidates for cochlear implantation.
Adult↗
Speech understanding and directional hearing for hearing-impaired subjects with in-the-ear and behind-the-ear hearing aids.
With respect to acoustical properties, in-the-ear (ITE) aids should give better understanding and directional hearing than behind-the-ear (BTE) aids. Also hearing-impaired subjects often prefer ITEs. A study was performed to assess objectively the improvement in speech understanding and directional hearing afforded by ITE aids versus BTEs. In 28 hearing-impaired subjects, who visited our Centre for a check-up of their ITEs, the following parameters were measured: (a) thresholds for third-octave bandpass noises between 0.25 and 4 kHz, (b) speech reception thresholds for short Dutch sentences in quiet and with background noise, (c) directional hearing. All three experiments were done binaurally with the subjects wearing their ITEs, BTEs, and no hearing aid. With the 2-cc coupler, the gain used by the subject was measured. The SRT values for the ITE were significantly lower than those for BTE. More gain at 2 and 4 kHz in the ITE proved to be a responsible factor for this improvement. Directional hearing was not improved by wearing an ITE. Large interindividual differences were found between functional gain and the 2-cc coupler measurements. The mean functional gain at 4 kHz for an ITE is higher than the gain measured in a 2-cc coupler. For a BTE, the functional gain at 2 and 4 kHz is lower than the 2-cc coupler gain.
Adult↗