Hearing Connectivity Solutions for OT Patients

Depression and cognitive decline has been shown to be significantly associated with hearing difficulties. Current digital technology has advanced hearing rehabilitation dramatically and provided new opportunities for improved communication and consequent well-being of the occupational therapy patient. Also, digital signal processing provides greater opportunities for enhanced speech reception in both noise and other difficult listening environments. Wireless technology including Bluetooth products now provides a significant rehabilitative asset to those with limited mobility, dexterity and cognition. The relationship between audiologic practice and occupational therapy practice becomes an active process that is transdisciplinary. It is no longer only a matter of providing amplification for hearing deficit. It is an active process, whereby the patient is provided with connectivity options for a large array of audio devices. More importantly, audio products that hearing aid wearers want to listen to are being made with digital wireless embedded technology. Audio devices are then easier to connect to hearing aids, wirelessly. Hearing aids now include a wireless receiver so that the hearing aid wearer can listen to television audio that is not subject to room reverberation and at an appropriate level for the listener. Patient benefit will produce evidence when new technology is introduced and will become more commonplace. A survey of this knowledge-base for occupational therapists in Montana has provided a view of available resources. Hearing aid technology and rehabilitation is no longer a matter only for audiologists, but is now a part of the occupational therapy rehabilitative and normalization process for the patient

Is it Hearing Loss or is it Dementia? How do you know?

Cognitive decline has recently been shown to be associated with hearing difficulties. Occupational therapists in Montana were canvassed via survey concerning their knowledge about best practice with patients who have hearing loss as well as best practice with patients who have dementia. With aging patients, many occupational therapists will encounter greater numbers of patients who exhibit either a hearing impairment and/or dementia. This presentation will focus on the differentiation between hearing loss and dementia. Oftentimes, patients with hearing loss and patients with dementia present with similar symptoms. For example, both those with hearing loss and those with dementia may need frequent repetition and reinstruction. Both those with hearing loss and those with dementia may exhibit signs of frustration, depression, and general social withdrawal. There may be increased isolation from family and friends. Despite similarities in signs and symptoms, it is critical that occupational therapists differentiate between hearing loss and dementia. This poster describes the similarities and differences between signs and symptoms of hearing loss and dementia. The survey reveals how occupational therapists in Montana differentiate, and what resources and referrals are used to help differentiate in order to implement best practice. Using these resources, occupational therapists can ultimately aid in promoting patients’ quality of life. In addition, this poster also discusses recent research revealing links between untreated hearing loss and dementia and cognitive decline. Counseling patients with suspected hearing loss and referring for appropriate hearing evaluation and remediation may help to delay or even prevent onset of dementia

Objective determination of backward masking.

Auditory processing disorders (APDs) affect a diverse range of people. These types of disorders impair auditory function, despite the outer, middle and inner ear maintaining proper function and health. APD is not necessarily related to auditory thresholds. When people with APD have difficulty discriminating sounds in connected speech, it may be due in part to an effect called Backward Masking (BM). Masking occurs when one stimulus inhibits another, which can lead to a variety of impairments. The neural locus of APDs is for the most part unknown, including the specific conditions which cause BM. A better understanding of these processes would lead to a greater ability to provide an intervention and therapy for APD. Electrophysiological responses have been well documented in a forward-masking paradigm, but not so in a backward masking paradigm. The significance of these responses is yielded through electrode signal input, a large degree of amplification and summation analyses of brain wave data. In this research a latency and amplitude deviance was detected in the early and middle stages of the auditory evoked response. Our data has revealed that the backward masking effect is observable at approximately the 90-250 msec range given the appropriate stimulus parameters. The temporal conditions of this effect lead to the conclusion that the BM effect occurs in the midbrain to the auditory cortex

Perceptual Consequences of Conductive Hearing Loss: Speech Perception in Indigenous Students Learning English as a School Language

The high incidence of ear disease and hearing loss in Australian Indigenous children is well documented. This study aims to consider the effect of hearing loss and native-language phonology on learning English by Australian Indigenous children. Twenty-one standard Australian English consonants were considered in a consonant-vowel (CV) context. Each consonant was paired with each other to yield 'same' and 'different' consonant pairs. The participants were classified into three groups: (1) English speaking, non-Indigenous children without history of hearing loss and otitis media (three males, four females, mean age 13.7 years); (2) Indigenous children speaking Tiwi as their native language, without history of hearing loss and otitis media and learning English as a second language (two males, three females, mean age 12.1 yrs) and (3) Indigenous children speaking Tiwi as their native language, with a history of hearing loss and otitis media since childhood (six females, mean age 13.1 years). The reaction time from the onset of the second word of the pair to the pressing of a 'same' or 'different' button was measured. The results demonstrated that discrimination of consonants was differentially affected by differences in language. Hearing loss further complicated the difficulties that a child was already having with English. Hearing loss tended to affect discrimination of English consonants more than those in the native language. The study suggests that amplification alone does not suffice and recommended that phonological awareness programs, with or without amplification, need to be part of a reading program from preschool with Indigenous children learning English as a 'school' language

Tonal Masking Level Differences in Aboriginal Children: Implications for Binaural Interaction, Auditory Processing Disorders and Education

The masking level difference (MLD) is a psychoacoustic measure of binaural interaction and central auditory processing related to extracting signals from noise backgrounds. It represents the improvement in threshold sensitivity under antiphasic listening conditions relative to homophasic conditions. A low frequency pure tone (500 Hz) was presented in-phase (So) binaurally to the subject in the presence of a phasic masker (No). The behavioural threshold obtained at this condition was used as a reference. The behavioural threshold was again determined with the pure tone stimulus presented antiphasically (Sπ), and the difference in thresholds was calculated to determine the MLD. The MLD was measured for a 500 Hz pure tone in 36 Aboriginal children (16 males and 20 females) from an Aboriginal community school (Nguiu, Tiwi Islands) where conductive hearing loss, due to otitis media, is endemic. The control group consisted of 62 normal-hearing children (40 males and 22 females) from a private school in Darwin. Aboriginal children showed a mean MLD of 7.76 dB whereas the control group exhibited a mean MLD of 11.21 dB. Aboriginal children showed a consistently lower MLD than non-Aboriginal normal-hearing children. Auditory processing disorders (APDs) have been shown to be related to early auditory deprivation, a common feature of chronic conductive hearing loss observed frequently in Aboriginal children. Thus, the MLD provides a metric for assessing binaural hearing abilities which may be relevant to the assessment of APD and hearing aid fitting. The MLD is a less linguistically, less culturally biased predictive measure and may be more easily administered than many speech and language test procedures used in diagnosing APD

Binaural Speech Discrimination in Noise With Bone Conduction: Applications for Hearing Loss in High-Risk Populations

The use of bone conducted signals for children with chronic otitis media may be considered when earphones or hearing aid receivers are contraindicated because of discharging or painful ears. The use of FM hearing aids in the classroom coupled to a bone conduction (BC) transducer has beneficial application even when considering improved binaural function. This study investigated speech discrimination in diotic and dichotic noise. Confusion matrices were obtained for consonant-vowel (CV) exemplars presented to normal hearing subjects through BC in both correlated and uncorrelated noise. Thirty-six university-aged listeners served as subjects. The CV exemplars were presented randomly, 20 times each, for a total presentation of 420 stimuli for each subject. The stimuli were presented to the subject at a signal level of 55 dB HL through a B-70A BC transducer worn at the forehead position. Each subject was requested to write down the consonants as they heard them. Three conditions were utilised. In condition 1, CV exemplars were presented through air conduction (earphones) in order to assess the quality of the testing apparatus, including the CV exemplars, and to provide a reference for comparison to BC. In condition 2, these exemplars were presented through the BC transducer. Condition 3 involved two separate listening tasks in which CV exemplars were presented through the BC transducer and band-limited white noise was presented binaurally, correlated and uncorrelated, through earphones. The results indicated that speech discrimination with BC was excellent and equal to air-conduction consonant identification. The confusion matrices showed higher speech discrimination scores in the uncorrelated noise condition, revealing a binaural advantage for BC hearing. Distinctive feature identification was also greater for the uncorrelated noise condition