Multilevel Modeling of Gaze From Listeners With Hearing Loss Following a Realistic Conversation.

Purpose: There is a need for tools to study real-world communication abilities in people with hearing loss. We outline a potential method for this that analyzes gaze and use it to answer the question of when and how much listeners with hearing loss look toward a new talker in a conversation.

Method: Twenty-two older adults with hearing loss followed a prerecorded two-person audiovisual conversation in the presence of babble noise.

The Effects of Noise and Simulated Conductive Hearing Loss on Physiological Response Measures During Interactive Conversations.

Purpose: The purpose of this work was to study the effects of background noise and hearing attenuation associated with earplugs on three physiological measures, assumed to be markers of effort investment and arousal, during interactive communication.

Method: Twelve pairs of older people (average age of 63.2 years) with age-adjusted normal hearing took part in a face-to-face communication to solve a Diapix task.

Comparing In-ear EOG for Eye-Movement Estimation With Eye-Tracking: Accuracy, Calibration, and Speech Comprehension.

This presentation details and evaluates a method for estimating the attended speaker during a two-person conversation by means of in-ear electro-oculography (EOG). Twenty-five hearing-impaired participants were fitted with molds equipped with EOG electrodes (in-ear EOG) and wore eye-tracking glasses while watching a video of two life-size people in a dialog solving a Diapix task. The dialogue was directionally presented and together with background noise in the frontal hemisphere at 60 dB SPL.

Conversational Interaction Is the Brain in Action: Implications for the Evaluation of Hearing and Hearing Interventions.

Humans have evolved the unique capacity to efficiently communicate using the spoken word. Hearing plays a key role as a receiver in this process and dysfunction leads to difficulties in listening and communication. It is widely accepted that effective communication is not adequately captured with current behavioral speech tests that principally focus on passive sound detection and speech recognition with idealized stimuli.

Three New Outcome Measures That Tap Into Cognitive Processes Required for Real-Life Communication.

To increase the ecological validity of outcomes from laboratory evaluations of hearing and hearing devices, it is desirable to introduce more realistic outcome measures in the laboratory. This article presents and discusses three outcome measures that have been designed to go beyond traditional speech-in-noise measures to better reflect realistic everyday challenges. The outcome measures reviewed are: the Sentence-final Word Identification and Recall (SWIR) test that measures working memory performance while listening to speech in noise at ceiling performance; a neural tracking method that produces a quantitative measure of selective speech attention in noise; and pupillometry that measures changes in pupil dilation to assess listening effort while listening to speech in noise.

The Quest for Ecological Validity in Hearing Science: What It Is, Why It Matters, and How to Advance It.

Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hearing research in a consistent and productive manner.

Consistency of Hearing Aid Setting Preference in Simulated Real-World Environments: Implications for Trainable Hearing Aids.

Trainable hearing aids let users fine-tune their hearing aid settings in their own listening environment: Based on consistent user-adjustments and information about the acoustic environment, the trainable aids will change environment-specific settings to the user's preference. A requirement for effective fine-tuning is consistency of preference for similar settings in similar environments. The aim of this study was to evaluate consistency of preference for settings differing in intensity, gain-frequency slope, and directionality when listening in simulated real-world environments and to determine if participants with more consistent preferences could be identified based on profile measures.

Hearing Aid Amplification Reduces Communication Effort of People With Hearing Impairment and Their Conversation Partners.

Objectives This study investigates the hypothesis that hearing aid amplification reduces effort within conversation for both hearing aid wearers and their communication partners. Levels of effort, in the form of speech production modifications, required to maintain successful spoken communication in a range of acoustic environments are compared to earlier reported results measured in unaided conversation conditions. Design Fifteen young adult normal-hearing participants and 15 older adult hearing-impaired participants were tested in pairs.

Development of the Everyday Conversational Sentences in Noise test.

To capture the demands of real-world listening, laboratory-based speech-in-noise tasks must better reflect the types of speech and environments listeners encounter in everyday life. This article reports the development of original sentence materials that were produced spontaneously with varying vocal efforts. These sentences were extracted from conversations between a talker pair (female/male) communicating in different realistic acoustic environments to elicit normal, raised and loud vocal efforts.

Hearing Impairment Increases Communication Effort During Conversations in Noise.

Purpose This article describes patterns of speech modifications produced by talkers as a function of the degree of hearing impairment of communication partners during naturalistic conversations in noise. An explanation of observed speech modifications is proposed in terms of a generalization of the concept of effort. This account complements existing theories of listening effort by extending the concept of effort to the domain of interactive communication.

Complex Acoustic Environments: Review, Framework, and Subjective Model.

The concept of complex acoustic environments has appeared in several unrelated research areas within acoustics in different variations. Based on a review of the usage and evolution of this concept in the literature, a relevant framework was developed, which includes nine broad characteristics that are thought to drive the complexity of acoustic scenes. The framework was then used to study the most relevant characteristics for stimuli of realistic, everyday, acoustic scenes: multiple sources, source diversity, reverberation, and the listener's task.

A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies.

Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones.

The Relationship Between Hearing Loss Self-Management and Hearing Aid Benefit and Satisfaction.

Purpose Hearing loss self-management refers to the knowledge and skills people use to manage the effects of hearing loss on all aspects of their daily lives. The purpose of this study was to investigate the relationship between self-reported hearing loss self-management and hearing aid benefit and satisfaction. Method Thirty-seven adults with hearing loss, all of whom were current users of bilateral hearing aids, participated in this observational study.

Poorer Speech Reception Threshold in Noise Is Associated With Lower Brain Volume in Auditory and Cognitive Processing Regions.

Purpose Hearing loss is associated with changes in brain volume in regions supporting auditory and cognitive processing. The purpose of this study was to determine whether there is a systematic association between hearing ability and brain volume in cross-sectional data from a large nonclinical cohort of middle-aged adults available from the UK Biobank Resource ( http://www.ukbiobank.

Eliciting Naturalistic Conversations: A Method for Assessing Communication Ability, Subjective Experience, and the Impacts of Noise and Hearing Impairment.

Purpose The purpose of this study was to introduce a method of eliciting conversational behavior with many aspects of realism, which may be used to study the impacts of hearing impairment and noise on verbal communication; to describe the characteristics of speech and language participants produced during the task; and to assess participants' engagement and motivation while completing the task. Method Twenty young adults with normal hearing and 20 older adults with hearing impairment took part in face-to-face conversations while completing a referential communication puzzle task designed to elicit natural conversational speech production and language with a number of realistic characteristics. Participants rated the difficulty and relevance of acoustic scenes for communication and their engagement in conversations.

The Chronic Care Model and Chronic Condition Self-Management: An Introduction for Audiologists.

Hearing health care is biomedically focused, device-centered, and clinician-led. There is emerging evidence that these characteristics-all of which are hallmarks of a health care system designed to address acute, rather than chronic, conditions-may contribute to low rates of help-seeking and hearing rehabilitation uptake among adults with hearing loss. In this review, we introduce audiologists to the Chronic Care Model, an organizational framework that describes best-practice clinical care for chronic conditions, and suggest that it may be a viable model for hearing health care to adopt.

Factors Associated With Successful Setup of a Self-Fitting Hearing Aid and the Need for Personalized Support.

Objectives: Self-fitting hearing aids have the potential to increase the accessibility of hearing health care. The aims of this study were to (1) identify factors that are associated with the ability to successfully set up a pair of commercially available self-fitting hearing aids; 2) identify factors that are associated with the need for knowledgeable, personalized support in performing the self-fitting procedure; and (3) evaluate performance of the individual steps in the self-fitting procedure.

Design: Sixty adults with hearing loss between the ages of 51 and 85 took part in the study.

Outcomes With a Self-Fitting Hearing Aid.

Self-fitting hearing aids (SFHAs)-devices that enable self-directed threshold measurements leading to a prescribed hearing aid (HA) setting, and fine-tuning, without the need for professional support-are now commercially available. This study examined outcomes obtained with one commercial SFHA, the Companion (SoundWorld Solutions), when support was available from a clinical assistant during self-fitting. Participants consisted of 27 experienced and 25 new HA users who completed the self-fitting process, resulting in 38 user-driven and 14 clinician-driven fittings.

Predictors of hearing loss self-management in older adults.

To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores. Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment was determined by exploratory factor analysis.

Assessing hearing loss self-management in older adults.

Objective: To evaluate the capacity of a self-management assessment tool to identify unmet hearing health care (HHC) needs; to determine whether such an assessment yields novel and clinically useful information.

Design: Hearing loss self-management (HLSM) was assessed with the Partners in Health scale and the Cue and Response interview from the Flinders Chronic Condition Management Program™. The results of the scale and the interview were compared to determine the extent to which they each contributed to the assessment of HLSM.

Evaluation of the NAL Dynamic Conversations Test in older listeners with hearing loss.

Objective: The National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT) is a new test of speech comprehension that incorporates a realistic environment and dynamic speech materials that capture certain features of everyday conversations. The goal of this study was to assess the suitability of the test for studying the consequences of hearing loss and amplification in older listeners.

Design: Unaided and aided comprehension scores were measured for single-, two- and three-talker passages, along with unaided and aided sentence recall.

The Influence of Social Interaction and Physical Health on the Association Between Hearing and Depression With Age and Gender.

Recent epidemiological data suggest the relation between hearing difficulty and depression is more evident in younger and middle-aged populations than in older adults. There are also suggestions that the relation may be more evident in specific subgroups; that is, other factors may influence a relationship between hearing and depression in different subgroups. Using cross-sectional data from the UK Biobank on 134,357 community-dwelling people and structural equation modelling, this study examined the potential mediating influence of social isolation and unemployment and the confounding influence of physical illness and cardiovascular conditions on the relation between a latent hearing variable and both a latent depressive episodes variable and a latent depressive symptoms variable.