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Author: admin | 22.01.2015 | Category: Relieve Tinnitus

Are the consequences of neonatal hearing loss serious enough that we need to be concerned about them in the first place? Slide #47 shows data from an annual survey done each year by Gallaudet University showing that children with severe profound bilateral losses suffer from substantial deficits in reading comprehension. Although virtually everyone agrees that severe profound bilateral hearing loss has substantial negative consequences for all aspects of academic performance, the consequences of mild bilateral or unilateral hearing loss are less well known.
The data in slide #50 come from the Greater Boston Otitis Media Study Group, where 194 children were followed prospectively for 7 years. The hearing industry is constantly striving to develop hearing instruments that improve listening for people with hearing impairment. Though patient comfort has definitely been enhanced with some of the techniques listed above, the jury is still out on whether speech understanding is consistently improved across all listening conditions with these techniques (FM being the exception).
Hearing instruments manipulate the amplitude of a signal, making sound louder across frequencies.
One signal processing strategy that addresses the limitations of amplification, and unusable hearing, is proportional frequency compression. The use of proportional frequency compression as a method to tap into useable hearing has been mentioned in several publications over the past few years.7-8 Though various proportional frequency compression algorithms exist7-9, to date, AVR Communications is the only company producing ear-level proportional frequency compression hearing instruments with their ImpaCt and Logicom-20 hearing instruments. The proportional frequency compression technology described above functions in a selective manner.
For this reason, the frequency compression component in ImpaCt and Logicom-20 hearing instruments is programmable. The programmable and digital hearing instrument provided detection, but the proportional frequency compression instrument provided the high frequency cues required for discrimination. Case 2: 24-year-old with moderately severe to profound bilateral sensorineural hearing loss. Though the aided thresholds with the WDRC instrument were good, aided thresholds with the proportional frequency compression aid were significantly better from 1-6 kHz.
Conclusion The above case studies underline the need for hearing care professionals to consider carefully all available options when treating high frequency hearing loss. Acknowledgements The author thanks Danelle Knowlton, MA, Oakland Children’s Hospital, Oakland, CA, and Claudia Hawley, MA, West Metro Audiological Services, Minnetonka, MN, for providing the case studies in this article, and Barak Dar, Victoria Miskowiec and Joel Skoog for their input.
Sensorineural Hearing Loss is a hearing loss due to impairment or degeneration of the cochlear (inner ear) resulting in an irreversible hearing loss. Bilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in both ears.
Unilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in one ear only.
At the age of 9, I was diagnosed with severe to profound sensorineural hearing loss in both ears. At 27 and as a first time mom, Shanna began loosing her hearing.  "Hearing aid wearing mom? I went back to the doctor. Gael Hannan is a writer, actor and public speaker who grew up with a progressive hearing loss that is now severe-to-profound. Read her blog. Deafness Chronicles is a blog by Brazilian, Paula Pfeifer, who chronicles her hearing loss and how she is in the world of sounds after her cochlear implants.
The blog, In My Head, is about a freelance journalist, mom, voracious reader, pop culture and sugar junkie who happens to be deaf. The author has a cochlear implant, reads lips, speaks, types fast, and has a lot to say.


Fortunately, there is a wealth of data on this question, and only three very brief examples will be given related to children with severe profound bilateral losses, children with mild bilateral and unilateral losses, and children with fluctuating conductive losses (slide #46). There are, however, a number of studies demonstrating that even mild or unilateral sensorineural hearing loss has substantial negative consequences. Although virtually all newborn hearing screening programs focus only on identifying children with permanent congenital hearing loss, some children with fluctuating conductive losses are often identified. Each time the child visited his or her primary- care physician, data were collected about episodes of otitis media (there were an average of 7 visits per year during the birth to 3-year-old period). The technological advances confronting dispensing professionals and consumers are mind-boggling: digital signal processing hearing instruments, hearing instruments with multiple microphones, FM receivers integrated into hearing instruments, disposable hearing aids and much more.
With all the sophisticated technology being introduced, why is improving speech understanding still such a challenge and why is measuring client benefit so difficult? A process called Dynamic Speech Re-Coding first identifies specific characteristics in speech to determine if that speech sound needs to be frequency compressed.
If we draw a line at 2 kHz, the information below this line is what the patient hears to discriminate the sentence.
2b shows the original recording played through a hearing instrument with proportional frequency compression enabled. The child is being mainstreamed in an oral program and receives auditory-oral therapy weekly.
The client achieved 68% discrimination with the WDRC hearing instrument and 92% with the frequency compression hearing instrument. The results of these cases support changing conventional amplification to amplification with proportional frequency compression. Sensorineural hearing loss can be caused by aging, noise exposure, birth defects, medication and viral or bacterial infections. This can be caused by impacted cerumen (wax), punctured eardrum, birth defects or otosclerosis.
Hearing Sparks is a way for me to share my story of hearing loss, as well as news about accessibility, and other geeky stuff about deafness.When I was four years old I was diagnosed with a bilateral sensorineural hearing loss. Kirsteen is a working mum in Scotland writing about her cochlear implant and experiences of deafness. That gap continues to widen over time, with the average deaf child or youth never exceeding a grade equivalent of 3 years, in spite of the fact that most of them are enrolled in educational programs specifically designed for deaf students. Slide #48 summarizes information about five different students in which a sample of children with unilateral hearing loss were compared to similar children with normal hearing, and measures were taken about their performance in math, language, and social functioning. The reason for presenting this information is to emphasize the point that even mild fluctuating hearing losses have an important negative effect on developmental outcomes. Data were also collected periodically on a wide variety of measures related to intellectual ability, cognitive functioning, and language competency by trained diagnosticians who were uninformed about the purposes of the study.
And, given the time constraints of a busy practice, how can one quickly assess the benefits of hearing instruments in light of the diverse populations served? The selective proportional frequency compression process is designed to ensure that only desired sounds are moved lower in frequency while other sounds are not modified.
The test results associated with each case were obtained during the same session a frequency compression hearing aid was fit.
Three hearing instruments were considered: a power programmable hearing aid, a power digital hearing aid, and the ImpaCt DSR675 power hearing aid (Fig.


At 4 kHz, a significant separation in performance between the hearing instruments can be observed. The correlation between the aided thresholds, Ling Test and NU-6 results once again support the use of the Ling Test to predict speech discrimination ability. There is no cure for this type of hearing ,loss; however, most patients with sensorineural hearing loss can be helped with hearing aids. Surgery or medication can be an appropriate therapy for conductive hearing loss in some cases.
In fact, for 22 years I often pretended to hear when I couldn't. This is my cochlear implant journey. As shown in slide #49, children with unilateral hearing loss lagged substantially behind their peers regardless of the measure used, whether math, language, or social functioning.
Results at 7 years of age for two groups of children are reported here: those with less than 30 days of otitis media over the 3-year period compared to those with 130 or more days of otitis media over the same period. The proportional frequency compression aid provided 15 dB better thresholds (sound is approximately five times louder) than the programmable and the digital hearing instruments.
The clients will now be able to hear plurals, possessives, third person singular, contractions, etc. Proportional frequency compression is designed to provide dispensing professionals with a tool to tap into the high frequency speech cues clients need to improve speech recognition, and the Ling Test can serve as a quick, accurate test to assess hearing instrument benefit.
My left ear is my good ear - my right ear hears barely anything. There's more info right this way! Even though the sample sizes are quite small in each of the studies, matching was generally done quite well and the results are very consistent.
After statistically adjusting the results for a variety of demographic and socio-economic status variables, children with fewer episodes of otitis media did substantially better than their peers on all measures. 1b, proportional Frequency Compression for Voiceless Sounds (FCVL) is applied at a factor of 2.25. The client achieved 64% wearing the programmable hearing instrument, 52% with the DSP instrument and 80% wearing the frequency compression instrument. The addition of this single phoneme is significant for speech and language development, speech understanding and speech production. The difference averaged about one-half standard deviation, which is equivalent to more than a year's worth of development in reading or math achievement. The correlation between the aided thresholds, Ling Test and WIPI results support the use of the Ling Test to predict speech discrimination ability. Audibility and discrimination of high frequency voiceless sounds are made possible because relationships of the energy peaks within a sound and between sounds has been maintained. Because the degree of useable hearing will vary from patient to patient, the prescribed amount of frequency compression will vary accordingly.
The amplified signal is compressed to the frequency band where the acoustic response of the hearing instrument (shaded area) provides effective gain and the client has better residual hearing.



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