Seminars in Hearing

The past decade has been characterized by significant changes in the distribution and sale of hearing aids. Alternatives to the clinical technology, clinical channel, clinical service (i.e., traditional) hearing healthcare delivery model have been driven by growth in hearing aid dispensaries housed in large retail establishments and direct-to-consumer hearing aid sales by internet-based companies unaffiliated with major hearing aid manufacturers (e.g., Eargo). These developments have been accompanied by acceleration in the growth of teleaudiology services as a direct result of the COVID-19 pandemic...

Audiology is experiencing exponential growth in technology, service, and provision options. These advancements give hearing care professionals the opportunity to revise, potentially improve, and adapt to the modern hearing care landscape to better serve the modern consumer. Consumer needs guide care planning and delivery, with the goal of achieving outcomes that are important to both the consumer and the clinician. The changes available to the hearing care industry can also enable consumers' needs to be identified and served in a more holistic and personalized manner than has previously been possible...

New technologies and developments in hearing healthcare are rapidly transforming service models, delivery channels, and available solutions. These advances are reshaping the ways in which care is provided, leading to greater personalization, service efficiencies, and improved access to care, to name a few benefits. Connected hearing care is one model with the potential to embrace this "customized" hearing experience by forging a hybrid of health-technology connections, as well as traditional face-to-face interactions between clients, providers, and persons integral to the care journey...

Listening amidst competing noise taxes one's limited cognitive resources, leading to increased listening effort. As such, there is interest in incorporating a reliable test of listening effort into the clinical test battery. One clinically promising method for measuring listening effort is verbal response time (VRT) because it can be obtained using already-established clinical tasks. In order for widespread implementation of the VRT paradigm, a better understanding of the psychometric properties is needed. The purpose of this work was to improve the understanding of the reliability and sensitivity of the VRT listening task...

Listening effort is a long-standing area of interest in auditory cognitive neuroscience. Prior research has used multiple techniques to shed light on the neurophysiological mechanisms underlying listening during challenging conditions. Functional near-infrared spectroscopy (fNIRS) is growing in popularity as a tool for cognitive neuroscience research, and its recent advances offer many potential advantages over other neuroimaging modalities for research related to listening effort. This review introduces the basic science of fNIRS and its uses for auditory cognitive neuroscience...

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About one-third of all recently published studies on listening effort have used at least one physiological measure, providing evidence of the popularity of such measures in listening effort research. However, the specific measures employed, as well as the rationales used to justify their inclusion, vary greatly between studies, leading to a literature that is fragmented and difficult to integrate. A unified approach that assesses multiple psychophysiological measures justified by a single rationale would be preferable because it would advance our understanding of listening effort...

This article offers a collection of observations that highlight the value of time course data in pupillometry and points out ways in which these observations create deeper understanding of listening effort. The main message is that listening effort should be considered on a moment-to-moment basis rather than as a singular amount. A review of various studies and the reanalysis of data reveal distinct signatures of effort before a stimulus, during a stimulus, in the moments after a stimulus, and changes over whole experimental testing sessions...

Response time-based dual-task paradigms are commonly adopted to measure behavioral listening effort. Most extant studies used an all-response approach that included secondary task responses under both correct and incorrect primary task responses during analysis. However, evidence supporting this strategy is limited. Therefore, the current study investigated the potential differences between including all responses versus only including correct responses. Data from two previous studies were reanalyzed. Experiment 1 included 16 listeners and used a dual-task paradigm to examine the effect of introducing background noise on listening effort...

The goal of this study was to examine the effect of hearing loss on theta and alpha electroencephalography (EEG) frequency power measures of performance monitoring and cognitive inhibition, respectively, during a speech-in-noise task. It was hypothesized that hearing loss would be associated with an increase in the peak power of theta and alpha frequencies toward easier conditions compared to normal hearing adults. The shift would reflect how hearing loss modulates the recruitment of listening effort to easier listening conditions...

Knowledge about listening difficulty experienced during a task can be used to better understand speech perception processes, to guide amplification outcomes, and can be used by individuals to decide whether to participate in communication. Another factor affecting these decisions is individuals' emotional response which has not been measured objectively previously. In this study, we describe a novel method of measuring listening difficulty and affect of individuals in adverse listening situations using automatic facial expression algorithm...

We review the literature related to Patricia Stelmachowicz's research in pediatric audiology, specifically focusing on the influence of audibility in language development and acquisition of linguistic rules. Pat Stelmachowicz spent her career increasing our awareness and understanding of children with mild to severe hearing loss who use hearing aids. Using a variety of novel experiments and stimuli, Pat and her colleagues produced a robust body of evidence to support the hypothesis that development moderates the role of frequency bandwidth on speech perception, particularly for fricative sounds...

Recent work has demonstrated that high-frequency (>6 kHz) and extended high-frequency (EHF; >8 kHz) hearing is valuable for speech-in-noise recognition. Several studies also indicate that EHF pure-tone thresholds predict speech-in-noise performance. These findings contradict the broadly accepted "speech bandwidth" that has historically been limited to below 8 kHz. This growing body of work is a tribute to the work of Pat Stelmachowicz, whose research was instrumental in revealing the limitations of the prior speech bandwidth work, particularly for female talkers and child listeners...

Basic research investigating auditory development often has implications for clinical diagnosis and treatment of hearing loss in children, but it can be challenging to translate those findings into practice. Meeting that challenge was a guiding principle of Pat Stelmachowicz's research and mentorship. Her example inspired many of us to pursue translational research and motivated the recent development of the Children's English/Spanish Speech Recognition Test (ChEgSS). This test evaluates word recognition in noise or two-talker speech, with target and masker speech produced in either English or Spanish...

Numerous studies have shown that children with mild bilateral (MBHL) or unilateral hearing loss (UHL) experience speech perception difficulties in poor acoustics. Much of the research in this area has been conducted via laboratory studies using speech-recognition tasks with a single talker and presentation via earphones and/or from a loudspeaker located directly in front of the listener. Real-world speech understanding is more complex, however, and these children may need to exert greater effort than their peers with normal hearing to understand speech, potentially impacting progress in a number of developmental areas...

This article reviews the research of Pat Stelmachowicz on traditional and novel measures for quantifying speech audibility (i.e., pure-tone average [PTA], the articulation/audibility index [AI], the speech intelligibility index, and auditory dosage) as predictors of speech perception and language outcomes in children. We discuss the limitations of using audiometric PTA as a predictor of perceptual outcomes in children and how Pat's research shed light on the importance of measures that characterize high-frequency audibility...

A counseling tool routinely used by pediatric audiologists and early intervention-specialists is the often-named "common sounds audiogram" (CSA). Typically, a child's hearing detection thresholds are plotted on the CSA to indicate that child's audibility of speech and environmental sounds. Importantly, the CSA may be the first item that parents see when their child's hearing loss is explained. Thus, the accuracy of the CSA and its associated counseling information are integral to the parents' understanding of what their child can hear and to the parents' role in the child's future hearing care and interventions...

[This corrects the article DOI: 10.1055/s-0043-1764139.].

As wideband absorbance (WBA) gains popularity, it is essential to understand the impact of different middle ear pathologies on the absorbance patterns as a function of frequency in children with various middle ear pathologies. More recently, the use of wideband tympanometry has enabled clinicians to conduct WBA at ambient pressure (WBA amb ) as well as the pressurized mode (WBA TPP ). This article reviews evidence for the ability of WBA measurements to accurately characterize the normal middle ear function across a wide range of frequencies and to aid in differential diagnosis of common middle ear disorders in children...

Acoustic reflex thresholds (ART) obtained using pure-tone probe stimuli as part of a traditional immittance test battery can be used to evaluate site of lesion and provide a cross-check with behavioral results. ARTs obtained as part of a wideband acoustic immittance (WAI) test battery using a click as the probe stimulus can be used in the same way with the added benefit that they may provide lower ARTs than those obtained using a pure-tone probe. Another benefit of the WAI ART test is that it can be completed without requiring a hermetic seal or pressurizing the ear canal...