Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants

Ching, Teresa Y. C.; Zhang, Vicky W.; Ibrahim, Ronny; Bardy, Fabrice; Rance, Gary; Dun, Bram Van; Sharma, Mridula; Chisari, Donella; Dillon, Harvey

doi:10.1016/j.clinph.2023.02.172

Cited by 8 publications

(4 citation statements)

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“…Therefore, alternative methodologies must be considered. These may involve novel methods of measuring infants' ability to hear [e.g., objective assessments which measure speech discrimination in infants (35,36)], and analysing outcomes data of aided and unaided infants with mild hearing loss from large observational studies, such as the proposed National Health and Medical Research Council (NHMRC) funded Australian National Child Hearing Health Outcomes Registry (ANCHOR), which aims to link data from child hearing health services in Australia to track child hearing outcomes. 1 In conclusion, our attempted trial highlighted many barriers and challenges around trial recruitment involving randomisation for families at a very vulnerable and stressful time of their children's lives, shortly after their hearing loss diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss

et al. 2023

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IntroductionEarly identification of mild hearing loss has resulted in early hearing amplification without adequate evidence of effectiveness. This paper describes learnings from a pilot trial, combined with a qualitative study, to highlight the importance of community engagement in designing research studies to determine whether early amplification benefits young children with bilateral mild hearing loss.MethodsPART 1 of the study is a proof-of-concept non-blinded multi-centre randomised controlled trial (RCT) of hearing device fitting vs. no fitting aimed to gather preliminary data and determine its acceptability/feasibility in children <2 years old with bilateral mild hearing loss.ResultsPART 2 is a qualitative study to understand the barriers/enablers to RCT participation. Of 40 potentially eligible families, nine (23%) declined, three were uncontactable (7%), 26 (65%) ineligible: of these, nine (35%) did not meet hearing threshold inclusion criteria, 11 (42%) were already fitted or had made decisions on fitting hearing device, two (7%) had conductive loss and four (16%) were ineligible for other reasons. Two of 11 (18%) eligible families were randomised. With the limited sample size, outcome measures were not compared between groups. Both participants completed the trial, reported the RCT to be acceptable, and neither changed group post-enrolment.DiscussionWhilst recruitment uptake could potentially be increased by altering the eligibility criteria, better communication with and reimbursement of clinicians as recruiters, and improving awareness of the study amongst external stakeholders, the RCT methodology does not conform to family-centred practice, and potentially raises ethical concerns regarding potential adverse consequences of not offering early amplification. Parental perception of losing control over choice of management due to randomisation is not an easily modifiable factor. Alternative methodological approaches without randomisation are required to determine whether hearing amplification benefits infants with mild hearing loss.Clinical Trial Registration: identifier [ACTRN12618001608257].

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Section: Discussionmentioning

confidence: 99%

Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss

et al. 2023

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“…Cortical processing of sounds is also thought to relate to behavioural speech perception, mostly in quiet. In 4-month old children with TH or HL, components of the LAER relate to parents' reports of auditory functional performance 65 . In adults, the MMN is thought to relate to perceptual speech discrimination, at least at the group level (for a review, see 66 ).…”

Section: Relationship Between Speech Processing and Perception Of Speechmentioning

confidence: 99%

“…This contrasts with numerous studies that report small to medium correlations between subcortical responses and speech intelligibility, especially in noise 57-61, 63, 64 . Some correlations have also been observed between cortical responses and speech discrimination 65,66 , although the nature of this relationship remains unclear [67][68][69] . Again, our sample size might be too small to adequately investigate such possible correlations.…”

Section: Relationship Between Speech Processing and Perceptionmentioning

confidence: 99%

Effects of childhood hearing loss on the subcortical and cortical representation of speech

Calcus,

Rosen

2024

Preprint

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Little is known about the effects of childhood mild-to-moderate sensorineural hearing loss (MM HL) on the function of the auditory pathway. We aimed to examine the effect of childhood MM HL and the benefit of frequency-specific amplification on both subcortical and cortical auditory processing, and to relate it to speech-perceptual abilities. We recorded subcortical and cortical responses to speech syllables in nineteen children with congenital MM HL (unamplified and amplified), and sixteen children with normal hearing (unamplified sounds only). Speech perception was measured behaviourally. Congenital HL led to smaller subcortical and cortical responses to unamplified speech sounds. There was a significant benefit of amplification on subcortical and early, but not late, cortical responses, with some effects differing across age. No relationship was found between the neural and behavioural measures. Childhood MM HL affects both subcortical and cortical processing of speech. Amplification mostly benefits subcortical processing of speech in younger children. Childhood HL leads to functional changes in the processing of sounds, with amplification differentially affecting subcortical and cortical levels of the auditory pathway.

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“…ACC is a cortical auditoryevoked potential (CAEP) evoked in response to a change in an ongoing sound [5]. Several studies have shown that the ACC can be recorded in children with normal hearing, CI users, and H.As using gap-in-tone stimuli [6][7][8], and the authors of the studies examined the effects of amplification on the ACC. The results indicated that the ACC can be recorded reliably in individuals using HAs.…”

Section: Introductionmentioning

confidence: 99%

Acoustic change complex (ACC) as a new tool in assessment of hearing aid performance in children

Shalaby,

El-Kholy,

El-kabarity

et al. 2024

Egypt J Otolaryngol

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Objective To evaluate the clinical use of acoustic change complex (ACC) as an objective tool in children who use hearing aids (H.As) and explore how far ACC threshold could be correlated to behavioral measures. Study design Sixty Arabic-speaking children (34 boys & 26 girls) using binaural H.As participated in the present study. Their age ranged from 6 to 12 years. The short stimulus used in the present study to elicit ACC response was “gap in tone.” Evaluation of H.As of children was performed in the form of questionnaire, aided sound field thresholds, central auditory tests, and aided/unaided cortical ACC recordings. The replicated ACC waveforms were collected and analyzed, and the aided ACC responses were compared with unaided ACC in addition to correlation of ACC-GDT to behavioral thresholds/scores. Results The highest percent of ACC detectability achieved with gap in tone with 50-ms duration. Percent detectability reached 65% in aided condition and decreased to 25% in unaided test condition. The aided ACC wave morphology showed no significant difference when compared with unaided condition; however, a significant decrease in ACC latency was observed in the aided condition. The ACC response was elicited easily at 40-dB sensation levels or at MCL in both conditions. The ACC-GDT showed correlation to questionnaire scores rather than behavioral test (AFT). Conclusions ACC to relatively short duration stimulus can be successfully recorded in hearing-impaired children in aided and unaided conditions. ACC response parameters (detectability and P1 latency) can reflect the benefit from H.As as an objective measure in evaluation of young children and difficult to test subjects with the usual subjective measures, and finally, ACC-GDT may add a predictive value to questionnaire scores which may help in case of inability of parents or caregivers to fulfill the entire questionnaire items.

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Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants

Cited by 8 publications

References 58 publications

Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss

Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss

Effects of childhood hearing loss on the subcortical and cortical representation of speech

Acoustic change complex (ACC) as a new tool in assessment of hearing aid performance in children

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