Jeffrey L. Danhauer

Perceptual features of speech for males in four perceived age decades

Spontaneous speech samples of 46 male speakers between the ages of 25 and 70 years were played to 40 untrained listeners who estimated the speakers’ ages. Samples which showed agreement among untrained listeners were played to 20 trained listeners who described the perceptual features of the given perceived ages via a closed‐response schema. Results showed characteristic perceptual features for four perceived age decades which could be classified according to pitch, rate of speech, quality, and articulation. The features were discussed in light of earlier findings. The features and their weightings by the listeners were derived from an a posteriori schema and samples of spontaneous speech. It was concluded that these features have perceptual importance and should be useful in establishing criteria for defining ’’normal’’ aging speech, planning management strategies for individuals with speech deviances, and in speaker recognition research.Subject Classification: [43]70.30, [43]70.35.

Clinical use of otoacoustic emissions in children with autism

Transient-evoked otoacoustic emissions (TEOAEs) may offer an objective way of evaluating the peripheral auditory systems of difficult-to-test patients. Children with autism are often suspected of hearing loss, but frequently will not respond on traditional behavior auditory tests. The clinical feasibility of obtaining TEOAEs on children with autism was evaluated here. The use of TEOAEs for 6 children (12 ears) with autism is described here regarding the acquisition of data, the presence of emissions, and their amplitudes and reproducibility. Emissions were recorded for 9 of the 12 ears; the lack of emissions for the remaining 3 ears was due to lack of patient cooperation. The results suggest that TEOAEs may be a valuable part of the audiologic test battery for children with autistic behavior. The ease of obtaining emissions for these children with autism is discussed.

Xylitol as a prophylaxis for acute otitis media: Systematic review

Abstract A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects. Sumario Se llevó a cabo una revisión sistemática para evaluar la(s) evidencia(s) sobre el Xylitol, un alcohol de azúcar, como profiláctico para la otitis media aguda en niños (AOM). Los autores buscaron en PubMed y en otras bases de datos para identificar las evidencias. Los criterios para incluir los estudios fueron: que apareciera en idioma inglés, en revistas revisadas por científicos de la misma disciplina con un diseño al menos quasi experimental; con uso de Xylitol y con resultados. Los autores completaron las formas de evaluación para los estudios incluidos en todas las fases de la revisión. Los autores revisaron 1479 títulos y excluyeron 1435. Se revisaron sumarios y artículos completos de los 44 restantes; cuatro ensayos clínicos aleatorios controlados cumplieron los criterios de inclusión. En general el Xylitol fue bien tolerado en la profilaxis de la AOM con pocos efectos colaterales cuando se administró en goma de mascar o sirope a dosis de 10g/día en cinco tomas. El meta-análisis reveló efectos terapéuticos significativos (tasa de riesgo de 0.68; intervalo de confianza del 95% 0.57 a 0.83) El Xiylitol puede ser una profilaxia para la AOM, pero se requieren más estudios, especialmente acerca de otros vehículos distintos a la goma de mascar para niños pequeños, y es necesaria mayor información sobre los costos, la duración requerida y los efectos esperados a largo plazo.

Hearing Aid Benefit in Patients with Mild Sensorineural Hearing Loss: A Systematic Review.

BACKGROUND Untreated sensorineural hearing loss (SNHL) is associated with chronic health-care conditions, isolation, loneliness, and reduced quality of life. Although hearing aids can minimize the negative effects of SNHL, only about one in five persons with SNHL seeks help for communication problems. Many persons wait 10 yr or more from the time they first notice a problem before pursuing amplification. Further, little information about the benefits of amplification is available for persons with mild SNHL (MSNHL), who likely defer treatment even longer. PURPOSE To conduct a systematic review to weigh the evidence regarding benefits derived from the use of amplification by adults with MSNHL. RESEARCH DESIGN Systematic review with meta-analysis. STUDY SAMPLE Adult hearing aid wearers with bilateral average pure-tone thresholds ≤45 dB HL at 500, 1000, 2000, and 4000 Hz. DATA COLLECTION AND ANALYSIS PubMed, Cumulative Index to Nursing and Allied-Health Literature, Cochrane Collaboration, and Google Scholar were searched independently by the authors during September 2013. The authors used a consensus approach to assess the quality and extract data for the meta-analysis. RESULTS Of 106 articles recovered for full-text review, only 10 met inclusion criteria (at least Level IV of evidence and involved and reported separate pre-/postfitting hearing aid outcomes for patients with MSNHL). Included studies involved mainly middle-aged to elderly patients using hearing aids of various styles and circuitry. Results from all of the studies indicated positive benefits from amplification for patients with MSNHL. Data from five studies were suitable for a meta-analysis, which produced a small-to-medium effect size of 0.85 (95% confidence intervals = 0.44-1.25) after adjusting for a small publication bias. This evidence confirmed benefits from the use of amplification in adults with MSNHL. CONCLUSIONS Evidence exists supporting the notion that adults with MSNHL benefit from hearing aids. This information is important and useful to audiologists, patients, and third-party payers, even considering that most of the studies in this systematic review were limited, somewhat dated, and used analog and early digital technology available when the studies were conducted. Clinical recommendations may be even stronger as future studies become available for patients fit with modern styles and high-technology hearing aids.

Perceptual features from normal-hearing and hearing-impaired children's errors on the NST.

Perceptual features for consonants contained in the nonsense syllable test, were evaluated from normal-hearing and hearing-impaired childrens errors. One group consisted of 30 normal-hearing children between 6:0 and 12:8 years of age; the other group consisted of 7 hearing-impaired children between 8:0 and 14:8. The subjects provided verbal responses to list A of the nonsense syllable test which was presented at 25, 35, 45, and 55 dB sensation levels regarding each subjects speech reception threshold. Responses were phonetically transcribed, pooled across sensation levels, converted to confusion matrices, and submitted to Symmetric Individual Differences Scaling. Consonants were analyzed for pre- and inter-vocalic positions. Results revealed that features differed across subject groups and consonant positions. Salient features related to place of articulation, voicing, nasality, sonorancy, and sibilancy.

Is mother-child transmission a possible vehicle for xylitol prophylaxis in acute otitis media?

Abstract Objective: Xylitol can be a prophylaxis for acute otitis media (AOM), especially when administered via chewing gum, but that vehicle has limitations for children. This review sought evidence for links of mother-child transmission of bacteria and as a vehicle for xylitol as a prophylaxis for dental caries and its translation to AOM in infants and young children. Design: Qualitative systematic review. Method: Combining output from 43 search strings used earlier and submitting 20 new strings to PubMed resulted in 14 studies (six were excluded; eight were included). Included studies had to be published in English-language, peer-reviewed journals; involve mothers using xylitol; and assess bacteria or caries in their children. Evaluation forms were completed for search, retrieval, and quality assessment of included studies. Results: The studies showed that mothers’ chewing xylitol gum was a prophylaxis against bacteria and caries in their children. A mother-child transmission model was presented as a possible vehicle for use in comprehensive prevention programs for AOM. Conclusions: Potential for xylitol use to prevent AOM warrants further study. A mother-child model may apply to AOM for transmission of bacteria and as a prophylaxis, but alternative vehicles like nasal sprays should be investigated for ease of use and effectiveness. Sumario Objetivo: El Xylitol puede ser un profiláctico para la otitis media aguda (AOM), especialmente cuando se administra en forma de goma de mascar, pero ese vehiculo tiene sus limitaciones en los niños. Esta revisión buscó evidencias sobre la conexión de la transmisión de la bacteria entre madre e hijo y el Xylitol como vehículo de profilaxis para la caries dental y su conversión a AOM en bebés y niños. Diseño: Revisión sistemática cuantitativa. Metodo: Se combinaron los resultados de 43 líneas de búsqueda utilizadas anteriormente con 20 nuevas líneas de búsqueda a PubMed; se obtuvieron 14 estudios (se excluyeron seis y se incluyeron ocho). Los estudios incluidos tenían que estar publicados en revistas en inglés, con revisión editorial; que incluyeran a madres utilizando Xylitol; y una evaluación de bacterias o caries en sus niños. Resultados: Los estudios demostraron que las madres que masticaban Xylitol eran un profiláctico contra bacterias y caries en sus niños. Se presenta un modelo de transmisión madre-hijo como posible vehículo para ser utilizado en los programas de prevención integral de la AOM. Conclusiones: El potencial del Xylitol en la prevención de la AOM requiere mayor estudio. Es posible que se pueda aplicar un modelo de transmisión de bacterias entre madre e hijo en la AOM y como profiláctico; pero un vehículo alternativo como el spray nasal debe ser investigado para facilitar su uso y efectividad.

A systematic review of the nonacoustic benefits of bone-anchored hearing aids

Objective: This study completed an evidence-based practice systematic review of the nonacoustic benefits for adult patients receiving bone-anchored hearing aid(s) (BAHAs) relative to other forms of amplification (i.e., none, bone-conduction hearing aids [BCHAs], or air-conduction hearing aids [ACHAs]). Design: Systematic review. Methods: ComDisDome and PubMed were used to perform a comprehensive search for studies that were of at least level III of evidence. Three independent reviewers completed the search, quality assessment, and data extraction. Results: Out of 28 studies, seven studies were identified, three of which were prospective and four of which were retrospective within-subject comparison designs. Nearly all of the studies were of small sample size and/or limited methodological quality, primarily because of logistics (e.g., heterogeneity of subject samples and prior experience with amplification). Conclusions: The evidence identified in this review is limited regarding the nonacoustic benefits of BAHAs compared with unaided conditions or other types of amplification. Professionals should use caution when counseling patients about the quality of life (QOL) benefits of these devices. Routine use of QOL outcome measures and standardized methods for reporting findings are critical in demonstrating the nonacoustic benefits of BAHAs.

A young meningitically deaf child with a cochlear implant, a case study

This study describes the development of the auditory, cognitive, linguistic, and social domains of a child deafened by meningitis at 20 months of age. He received a 3M/House cochlear implant at 27 months and is believed to be the youngest child to receive a cochlear implant. He was seen for intervention emphasizing audiometric conditioning and testing and language (speech and sign) stimulation for a period of 2:9 years (6 months pre-implant to 2:3 years post-implant). Videotapes of intervention; interviews with parents, teachers, and clinicians; test results; and medical and clinical reports were documented from pre-implant to two years post-implantation. The child regressed in all areas evaluated following his illness and subsequent deafness and cochlear implantation. At about one year after implantation, his social and cognitive skills began to improve. By two years after implantation (chronological age (CA) = 4:6), his abilities in all areas except auditory reception and speech had progressed to about the 4:0 age level. He communicates primarily through signs and seems to derive environmental sound and speech duration cues from the implant. Although it is difficult to separate the effects of the implant from maturational factors, he now willingly uses the implant simultaneously with his hearing aid on the non-implanted ear every day and seems to be functioning well with them. He responds inconsistently to his name when called, and consistently provides appropriate signed responses to questions. His imitative skills are improving; he can discriminate one- vs two-syllable words; and produces limited spontaneous speech. His cognitive and social abilities are at least age-appropriate and he signs 3- and 4-word combinations.

Features from normal and sensorineural listeners' nonsense syllable test errors.

Identification errors for initial consonants of consonants vowels-consonants-vowels from lists A and B of the Nonsense Syllable Test were analyzed for 10 normal-hearing and 8 sensorineural hearing-impaired listeners. The Nonsense Syllable Test stimuli were presented binaurally through earphones at 6 increasing sensation levels. Listeners verbal responses were recorded and transcribed, converted to symmetric confusion matrices, and submitted to analysis of individual differences scaling for symmetrical matrices. Results from 2- through 5-dimensional analyses revealed that voicing, place of articulation, frication, and sibilancy were the salient features used by both listener types in their perceptions of the initial consonants. Findings suggest that consideration of composition of the stimulus set is important when assessing a listeners response to specific speech discrimination tests.

Benefits from, Satisfaction with, and Self-Efficacy for Advanced Digital Hearing Aids in Users with Mild Sensorineural Hearing Loss

Little evidence is available regarding outcomes of advanced digital technology (ADT) hearing aid wearers with mild sensorineural hearing loss (MSNHL). The purpose of this article is to report the characteristics of and outcomes for this population. A cross-sectional research design was employed with 56 participants from a private practice setting. The International Outcomes Inventory for Hearing Aids (IOI-HA), Satisfaction with Amplification in Daily Life (SADL), and the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA) were completed, scored, and compared with normative data. Results revealed that ADT aids were worn 10.5 hours/day, were mostly advanced to premium (55%), had an average cost per aid of