Hearing loss and auditory processing ability in people with aphasia

Abstract

Background: Hearing loss can add to the linguistic deficits present in aphasia to make comprehension of speech difficult. Although some studies document a relatively high prevalence of hearing loss in adults with aphasia, many people with aphasia do not have their hearing tested. Self-reported disability measures offer a possible alternative to pure-tone audiometry when this service is not readily available. Aims: This study aims to investigate the prevalence of hearing loss in a group of people with aphasia and to determine the usefulness of self-reported measures to screen for hearing impairment. Methods & Procedures: Hearing ability was measured using pure tone audiometry and five measures of auditory processing, which looked at speech perception in quiet and noise, for 21 individuals with aphasia recruited from a community clinic and 21 age-matched individuals without aphasia. The Speech, Spatial and Qualities of Hearing Scale (SSQ) and a brief questionnaire exploring whether they had experienced hearing difficulties, were used to measure self-perception of hearing acuity. Differences in scores between the groups were analyzed. Correlations and regressions were used to establish the relationship between selfperception of hearing and measures of hearing ability. Outcomes & Results: Despite minimal impairment and a non-significant difference between performance on pure tone audiometry for participants with and without aphasia, participants with aphasia performed significantly worse on measures of speech perception in noise than participants without aphasia. They also had a significantly greater degree of perceived hearing disability. Although SSQ scores were correlated with some behavioural measures for the participants with aphasia, the SSQ only predicted the hearing status and speech in noise performance of control participants. Conclusions: The results suggest that the prevalence of hearing loss for people with aphasia (at least for this group) is no greater than the general population. However, they are significantly more affected in their recognition of speech in noise and experience greater disability in listening situations than people without aphasia. The latter problems were not predicted by pure tone audiograms or sound-in-noise performance. The brief questionnaire was not effective in identifying hearing impairment, indicating the need for a regular hearing screen to ensure provision of the most effective rehabilitation. Ideally, the screen should include disability and behavioural measures, as our results suggest they cannot replace each other. These findings should assist clinicians in setting realistic goals and delivering interventions in the most effective way for people with aphasia.

Prosodic processing post traumatic brain injury - a systematic review

“…These issues eventually lead to functional impairments and overall reduction in quality of life [63, 64]. Considering that prosodic processing impairments, communication deficits and emotion recognition deficits are also associated with psychosocial problems [53, 65], it raises the importance of identifying prosodic processing issues at early stages of the injury to reduce medical burden and improve outcomes for survivors of TBI.…”

“…Furthermore, most of the studies included examined prosodic impairment post-TBI despite the initial literature search terms that included a large and comprehensive list of language disorders. It is alarming that none of the studies reporting post-TBI aphasia have concurrently assessed for prosodic processing, despite prosodic processing deficits being common among aphasic patients [65–67]. This is especially important for patients who experience communication difficulties post-TBI despite scoring above cut-offs for typical standardized language tests, as the real issue may be prosodic processing impairments that are scarcely assessed in these tests.…”

Effects of Acquired Aphasia on the Recognition of Speech Under Energetic and Informational Masking Conditions

“…One early study compared the performance of PWA and age-and hearingmatched controls on a task requiring attention to speech in the presence of steady-state noise maskers, that is, a condition presumably involving high EM but relatively little IM, and found that PWA performance was poorer than that of controls (Winchester & Hartman, 1955). A more recent study examined the ability of PWA to identify and selectively attend to target speech while ignoring different types of competing auditory information, including both speech maskers and noise maskers (Rankin et al, 2014). The results from this second study indicated that PWA demonstrated a poorer ability to receptively process speech under masked conditions than did controls of similar age and hearing status and that this difference was present when either speech or noise maskers were used.…”

Assessing the benefit of acoustic beamforming for listeners with aphasia using modified psychoacoustic methods

“…(2017) for a series of recent reviews], has high relevance for everyday communication, as real-world conversations often take place in settings that are acoustically complex. While the majority of past research on receptive speech processing in persons with aphasia (PWA) has focused on auditory language comprehension in quiet settings, several recent studies have directly investigated the ability of persons with aphasia (PWA) to selectively attend to and understand speech in the presence of auditory maskers [e.g., Rankin et al (2014) and Villard and Kidd (2019) ]. These studies have provided evidence that PWA—even, in some cases, PWA with milder aphasia types thought to be characterized primarily by expressive language deficits—require higher target-to-masker ratios (TMRs) than do age-matched controls in order to successfully understand target speech.…”