Auditory brainstem responses (ABR) have been used as a powerful and the most common objective tool to evaluate hearing sensitivity and to diagnose the types of hearing loss and neurological disorders, through the auditory peripheral pathway to a central level of the brainstem, since 1971. Although bone-conduction (BC) ABR could be an alternative to air-conduction (AC) ABR, as the former overcomes some limitations of the latter, the majority of clinicians rarely utilize it due to a lack of knowledge and no routine test administration. This review presents the weaknesses of AC ABR that apply to all clinical population, and discusses the development of BC ABR. The optimal placements of bone oscillators to obtain favorable clinical outcomes in infants, children, and adults, and the appropriate stimuli for BC ABR are examined. While providing absolute thresholds and latencies of BC ABR based on previous studies compared to AC ABR, this review includes clinical data of infants and young children with both normal hearing in terms of maturation, and with pathology such as congenital external auditory canal atresia. We recommend the future clinical application of BC ABR for candidacy as well as for patients with BC hearing implants.

Objective: The present study aimed to identify the reliability and validity of a screening tool for the elderly who wish to check their level of hearing loss by themselves. Design: A total of 170 older adults with different hearing levels participated. The Self-Assessment for Hearing Screening of the Elderly-Revised (SHSE-R) consisted of 20 questions measured on a 5-point scale and developed in terms of characteristics of age-related hearing loss. For reliability, the subjects responded to SHSE-R twice with a three-week interval. They also took various subjective and objective hearing tests and a working memory test and filled out two other questionnaires for validation. Results: SHSE-R showed a high internal consistency and a high reliability when comparing test-retest scores. Its content validity was as high as 0.88-1. Convergent validity supported SHSE-R and its subcategories while showing either a positive or negative correlation with pure-tone average, word recognition scores, and otoacoustic emission tests. Construct validity was proved by a moderate negative correlation with the tests of speech in noise, speech with fast speed, and working memory. In criterion validity, a strong positive correlation existed between SHSE-R and the other questionnaires, except for a group with severe hearing loss. The factor analysis showed similar results to the original version of SHSE having three factors, although some items were interchanged. Conclusion: We confirmed that SHSE-R was well developed with both excellent internal consistency and test-retest reliability and valuable convergent, construct, and criterion validities, consequently making SHSE-R useful for self-checking hearing loss in the elderly.

Background and Objectives:Many studies have reported no benefit of sound localization, but improved speech understanding in noise after treating patients with single-sided deafness (SSD). Furthermore, their performances provided a large individual difference. The present study aimed to measure the ability of speech perception and gap detection in noise for the SSD patients to better understand their hearing nature. Subjects and Methods: Nine SSD patients with different onset and period of hearing deprivation and 20 young adults with normal hearing and simulated conductive hearing loss as the control groups conducted speech perception in noise (SPIN) and Gap-In-Noise (GIN) tests. The SPIN test asked how many presented sentences were understood at the +5 and -5 dB signal-to-noise ratio. The GIN test was asked to find the shortest gap in white noise with different lengths in the gap. Results: Compared to the groups with normal hearing and simulated instant hearing loss, the SSD group showed much poor performance in both SPIN and GIN tests while supporting central auditory plasticity of the SSD patients. Rather than a longer period of deafness, the large individual variance indicated that the congenital SSD patients showed better performance than the acquired SSD patients in two measurements. Conclusions: The results suggested that comprehensive assessments should be implemented before any treatment of the SSD patient considering their onset time and etiology, although these findings need to be generalized with a large sample size. J Audiol Otol 2019;23(4):197-203 KEY WORDS:0 Single-sided deafness · Simulated conducted hearing loss · Speech perception in noise · Gap-In-Noise.This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

PurposeWhile evaluating the speech recognition ability of older adults, the present study aimed to analyze their error types in parts of speech and find error patterns under various conditions of background noise level and speed of speech.MethodsTwenty older adults with normal hearing for their age (NHiA) and 20 older adults with sensorineural hearing loss (SNHL) participated. Their cognitive function was screened as within the normal range (mini-mental state examination scores >25). The SNHL listeners were divided into high performers (SNHL-H; n=12) and low performers (SNHL-L; n=8), based on their achieving word recognition scores above or below 70%, respectively. A sentence recognition test was conducted at four levels of signal-to-noise ratio (SNR; eg, no noise, +6, +3, 0 dB) and four conditions of time alteration (eg, 30% and 15% of compression and expansion) at the most comfortable level for each participant.ResultsAs expected, the three groups showed that the error percentage increased in sentence recognition as either the SNR decreased or the speech rate became faster. Interestingly, a larger performance difference was found between the SNHL-H and SNHL-L groups in the condition of time alteration than in that of background noise. Among the parts of speech, nouns presented the highest error scores for all participants regardless of degree of listening difficulty. The noun errors of the three groups mainly consisted of no response and fail patterns, but substitution and omission were identified as the third pattern of noun error for background noise and fast speech, respectively.ConclusionDeterioration of speech recognition from the hearing threshold and supra-threshold auditory processing was seen in the elderly in difficult listening environments such as background noise and time alteration. Although different group performance ran across the eight experimental conditions, the robustness of noun errors and the error patterns were very similar, which might be extended to a possible clinical application of aural rehabilitation for the elderly population.

The present study aimed to develop a healthcare application for the elderly who suspect or know they have a hearing loss, namely, the Hearing Rehabilitation for Older Adults (HeRO), which is available in a mobile device, and then to confirm its probability of acceptance among elderly users. Under a web server system, HeRO which had four types of tailored training for the aged auditory system (i.e., syllable, sentence, discourse, working memory) and a self-reported questionnaire to screen amount of the hearing loss was completed for the elderly. To verify whether the HeRO contents and functions were user-friendly to the elderly users, the technology acceptance model (TAM) was used. Forty-four older adults were asked to use the developed application for 10 days and then respond to a TAM questionnaire with 25 items. The Cronbach’s α coefficient of each subcategory was very high. The construct validity of all subcategories showed high eigenvalues using principal component analysis. Furthermore, our regression model statistically supported a persuasive intention to use the healthcare application because the elderly readily accept it and find it easy to manipulate. We expect the current technology to be applied to the general public as well as the elderly who want to explore digital health.