Role of Cortical Auditory Evoked Potentials in Reducing the Age at Hearing Aid Fitting in Children With Hearing Loss Identified by Newborn Hearing Screening.

Recording of free-field cortical auditory evoked potential (CAEP) responses to speech tokens was introduced into the audiology management for infants with a permanent childhood hearing impairment (PCHI) during 2011-2015 at a U.K. service. Children with bilateral PCHI were studied from two sequential cohorts. Thirty-four children had followed an audiology pathway prior to CAEP introduction, and 44 children followed a pathway after the introduction of CAEP and were tested with unaided and aided CAEP responses. Data analysis explored the age of diagnosis, hearing aid fitting, and referral for cochlear implant (CI) assessment for each of these groups. CAEP offered a novel educative process for the parents and audiologists supporting decision-making for hearing aid fitting and CI referral. Delays in hearing aid fitting and CI referral were categorized as being due to the audiologist's recommendation or parental choice. Results showed that the median age of hearing aid fitting prior to CAEP introduction was 9.2 months. After the inclusion of CAEP recording in the infant pathways, it was 3.9 months. This reduction was attributable to earlier fitting of hearing aids for children with mild and moderate hearing losses, for which the median age fell from 19 to 5 months. Children with profound hearing loss were referred for CI assessment at a significantly earlier age following the introduction of CAEP. Although there has also been a national trend for earlier hearing aid fitting in children, the current study demonstrates that the inclusion of CAEP recording in the pathway facilitated earlier hearing aid fitting for milder impairments

Using a Bone-Conduction Headset to Improve Speech Discrimination in Children With Otitis Media With Effusion.

The recommended management for children with otitis media with effusion (OME) is 'watchful waiting' before considering grommet surgery. During this time speech and language, listening skills, quality of life, social skills, and outcomes of education can be jeopardized. Air-conduction (AC) hearing aids are problematic due to fluctuating AC hearing loss. Bone-conduction (BC) hearing is stable, but BC hearing aids can be uncomfortable. Both types of hearing aids are costly. Given the high prevalence of OME and the transitory nature of the accompanying hearing loss, cost-effective solutions are needed. The leisure industry has developed relatively inexpensive, comfortable, high-quality BC headsets for transmission of speech or music. This study assessed whether these headsets, paired with a remote microphone, improve speech discrimination for children with OME. Nineteen children aged 3 to 6 years receiving recommended management in the United Kingdom for children with OME participated. Word-discrimination thresholds were measured in a sound-treated room in quiet and with 65 dB(A) speech-shaped noise, with and without a headset. The median threshold in quiet (N = 17) was 39 dB(A) (range: 23-59) without a headset and 23 dB(A) (range: 9-35) with a headset (Z = -3.519, p < .001). The median threshold in noise (N = 19) was 59 dB(A) (range: 50-63) without a headset and 45 dB(A) (range: 32-50) with a headset (Z = -3.825, p < .001). Thus, the use of a BC headset paired with a remote microphone significantly improved speech discrimination in quiet and in noise for children with OME.The main source of funding for this study was the Cambridge Hearing Trust. T. H. B. was awarded the British Association of Paediatricians in Audiology Prize in 2017, and J. E. M. and M. S.-C. were jointly granted the Stuart Gatehouse Applied Research Grant 2015 by the British Society of Audiology, both toward the Bone conduction In Glue ear study

Identifying and prioritising unanswered research questions for people with hyperacusis: James Lind Alliance Hyperacusis Priority Setting Partnership

Objective To determine research priorities in hyperacusis that key stakeholders agree are the most important. Design/setting A priority setting partnership using two international surveys, and a UK prioritisation workshop, adhering to the six-staged methodology outlined by the James Lind Alliance. Participants People with lived experience of hyperacusis, parents/carers, family and friends, educational professionals and healthcare professionals who support and/or treat adults and children who experience hyperacusis, including but not limited to surgeons, audiologists, psychologists and hearing therapists. Methods The priority setting partnership was conducted from August 2017 to July 2018. An international identification survey asked respondents to submit any questions/uncertainties about hyperacusis. Uncertainties were categorised, refined and rephrased into representative indicative questions using thematic analysis techniques. These questions were verified as ‘unanswered’ through searches of current evidence. A second international survey asked respondents to vote for their top 10 priority questions. A shortlist of questions that represented votes from all stakeholder groups was prioritised into a top 10 at the final prioritisation workshop (UK). Results In the identification survey, 312 respondents submitted 2730 uncertainties. Of those uncertainties, 593 were removed as out of scope, and the remaining were refined into 85 indicative questions. None of the indicative questions had already been answered in research. The second survey collected votes from 327 respondents, which resulted in a shortlist of 28 representative questions for the final workshop. Consensus was reached on the top 10 priorities for future research, including identifying causes and underlying mechanisms, effective management and training for healthcare professionals. Conclusions These priorities were identified and shaped by people with lived experience, parents/carers and healthcare professionals, and as such are an essential resource for directing future research in hyperacusis. Researchers and funders should focus on addressing these priorities.Additional co-authors: Tracey Pollard, Helen Henshaw, Toto A Gronlund, Derek J Hoar

Development of New Open-Set Speech Material for Use in Clinical Audiology with Speakers of British English.

Peer reviewed: TrueAcknowledgements: We thank Michael Stone for assistance in recording the COPT materials. We also thank three reviewers for helpful comments on an earlier version of this paper.Publication status: PublishedFunder: ChearBACKGROUND: The Chear open-set performance test (COPT), which uses a carrier phrase followed by a monosyllabic test word, is intended for clinical assessment of speech recognition, evaluation of hearing-device performance, and the fine-tuning of hearing devices for speakers of British English. This paper assesses practice effects, test-retest reliability, and the variability across lists of the COPT. METHOD: In experiment 1, 16 normal-hearing participants were tested using an initial version of the COPT, at three speech-to-noise ratios (SNRs). Experiment 2 used revised COPT lists, with items swapped between lists to reduce differences in difficulty across lists. In experiment 3, test-retest repeatability was assessed for stimuli presented in quiet, using 15 participants with sensorineural hearing loss. RESULTS: After administration of a single practice list, no practice effects were evident. The critical difference between scores for two lists was about 2 words (out of 15) or 5 phonemes (out of 50). The mean estimated SNR required for 74% words correct was -0.56 dB, with a standard deviation across lists of 0.16 dB. For the participants with hearing loss tested in quiet, the critical difference between scores for two lists was about 3 words (out of 15) or 6 phonemes (out of 50)