The Impact of the COVID-19 Pandemic on Newborn Hearing Screening Programs in Western States

The primary objective of this study was to determine the impact of the COVID-19 pandemic on newborn hearing screening guideline adherence and the respective rates of screening, diagnosis, and intervention. This was a review of newborn hearing screening data compiled from the Departments of Health of six states for the time periods of March-September 2019 and March-September 2020. Endpoints included the numbers of live births as well as the numbers and timeframes of screening, diagnostic, and intervention events. Two-tailed paired t-tests were performed to determine statistical significance. 181,662 births in six states were assessed. Compared to March-September 2019, March-September 2020 had a significantly lower mean rate of screening before 1 month of age (97.3% vs. 96.2%, p \u3c 0.001) and mean screen rate overall (98.9% vs. 98.0%, p \u3c 0.001). Additionally, the 2020 time period had a significantly higher mean rate of patients lost to follow up for referral to early intervention (14.7% vs. 28.9%, p = 0.005). The COVID-19 pandemic has had a significant impact on the newborn hearing screening programs of several states in the Western US. This information holds significant implications for the current evaluation of these newborn hearing screening programs

Detection and discrimination of brief increments

The ability to detect a brief increment in intensity in a longer duration stimulus is often used as a measure of the intensity resolution of the auditory system, but it is unclear how listeners actually perform the task. Early investigators suggested that the decision as to the presence or absence of an increment was based on the overall energy within the critical band centered on the signal frequency. The use of signal energy falling outside of the critical band is often limited by introducing a noise masker. However, facets of the noise may impact increment detection beyond this intended purpose. Recent findings indicate that performance in increment detection can be impaired by envelope fluctuations in a masker. This interaction suggests an alternate decision process to energy detection based on detection or discrimination of envelope modulation. An energy-based decision device can be evaluated by comparing performance in a task where a listener is asked to detect a change in intensity to performance in a task where the listener is asked to identify the direction of the change. An energy-based decision process would predict better performance in identification than in detection. A modulation-based decision device can be evaluated by adding irregularity to the envelope through addition of a noise masker of varying bandwidth. The purpose of the current study was to evaluate the decision process underlying increment detection by comparing performance for detection and identification, and by evaluating the effect of noise on detection. Results indicate that listeners are better able to detect a change in intensity than to identify the direction of that change, where performance is virtually at chance. Thresholds for increment detection increase with increasing bandwidth for an on-frequency noise masker. While an off-frequency noise masker can produce masking at certain signal frequencies, there is no effect of bandwidth. A decision device based on energy detection cannot account for these results. A model that includes a modulation filter bank analysis of envelope modulation can account for observed data, but a model based on discrimination of spectral patterns does equally well

Cochlear Implantation for Children and Adults with Severe-to-Profound Hearing Loss

Cochlear implants (CIs) have proven to be a useful treatment option for individuals with severe-to-profound hearing loss by providing improved access to one\u27s surrounding auditory environment. CIs differ from traditional acoustic amplification by providing information to the auditory system via electrical stimulation. Both postlingually deafened adults and prelingually deafened children can benefit from a CI; however, outcomes with a CI can vary. Numerous factors can impact performance outcomes with a CI. It is important for the audiologist to understand what factors might play a role and impact performance outcomes with a CI so that they can effectively counsel the recipient and their family, as well as establish appropriate and realistic expectations with a CI. This review article will discuss the CI candidacy process, CI programming and postoperative follow-up care, as well as considerations across the lifespan that may affect performance outcomes with a CI

The effect of narrow-band noise maskers on increment detection1

It is often assumed that listeners detect an increment in the intensity of a pure tone by detecting an increase in the energy falling within the critical band centered on the signal frequency. A noise masker can be used to limit the use of signal energy falling outside of the critical band, but facets of the noise may impact increment detection beyond this intended purpose. The current study evaluated the impact of envelope fluctuation in a noise masker on thresholds for detection of an increment. Thresholds were obtained for detection of an increment in the intensity of a 0.25- or 4-kHz pedestal in quiet and in the presence of noise of varying bandwidth. Results indicate that thresholds for detection of an increment in the intensity of a pure tone increase with increasing bandwidth for an on-frequency noise masker, but are unchanged by an off-frequency noise masker. Neither a model that includes a modulation-filter-bank analysis of envelope modulation nor a model based on discrimination of spectral patterns can account for all aspects of the observed data