To meet the need for an objective self-test for hearing screening. a new Dutch speech-in-noise test was developed. Digit triplets were used as speech material. The test was made fully automatic, was controlled by a computer, and can be done by telephone. It measures the speech reception threshold (triplet SRT(n)) using an adaptive procedure, in about 3 min. Our experiments showed no significant influence of telephone type or listening environment. Measurement errors were within 1 dB. which makes the test accurate. In additional experiments with hearing-impaired subjects (76 ears of 38 listeners), the new test was compared to the existing sentence SRT(n) test of Plomp and Mimpen, which is considered to be the standard. The correlation between both SRT(n)s was 0.866. As expected, correlations between the triplet SRT(n) test by telephone and average pure-tone thresholds are somewhat lower: 0.732 for PTA(0,5,1,2), and 0.770 for PTA(0,5,2,4). When proper SRT(n) values were chosen for distinguishing between normal-hearing and hearing-impaired subjects, the triplet SRT(n) test was found to have a sensitivity of 0.91 and a specificity of 0.93.

The findings emphasize the negative effect of hearing impairment on quality of life.

This study compares the occupational performance of employees with and without hearing impairment, and aims to identify occupational difficulties specifically related to hearing loss. The Amsterdam Checklist for Hearing and Work was administered to 150 hearing-impaired employees and 60 normally-hearing colleagues. A multivariate analysis of variance was performed to test group effects, and to examine differences between means. Factors predicting sick-leave were identified by regression analyses. A significant group effect (p < 0.01) was found. Hearing-impaired employees differed from normally-hearing colleagues in their perception of 'environmental noise', 'job control' and the 'necessity to use hearing activities' at work. Also, sick-leave due to distress occurred significantly more often in the hearing impaired group (p < 0.05). 'Hearing impairment', 'job demand', and the requirement to 'recognize/distinguish between sounds' were the strongest risk-factors for stress related sick-leave. The importance of hearing functions besides speech communication is discussed. Implications for rehabilitation are suggested. In future research, hearing loss should be considered as a risk factor for fatigue and mental distress which may lead to sick-leave.

This paper addresses the development and effectiveness of a home education program. The program, designed for hearing-impaired elders and their significant others (SO), deals with communication strategies and speech reading. Participants were randomly assigned to a training group (hearing aid fitting+home education program) or a control group (hearing aid fitting). The training group included 24 hearing-impaired subjects and 24 SO's. Controls were 24 affected individuals and 22 SO's. Questionnaires addressing emotional response, communication strategies and the IOI-HA, IOI-AI and IOI-SO were used. A repeated measures analysis of variance was applied to test group differences between pre, post, and 6-months follow-up measures. Increased awareness of benefits of speech reading and improved interaction with the SO were observed in the training group only (p < 0.05). No group difference on 'emotional response' was found. IOI-AI and IOI-SO demonstrated favorable attitudes towards the program. Follow-up measures showed improved quality of life and satisfaction in the training group, while a decrease was observed among the controls (p < 0.05). Some effects differed between first-time and experienced hearing aid users. Addition of services to amplification and involvement of the SO are relevant in aural rehabilitation.

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