Remote Microphone Hearing Aid Use Improves Classroom Listening, Without Adverse Effects on Spatial Listening and Attention Skills, in Children With Auditory Processing Disorder: A Randomised Controlled Trial

Abstract

Background: Children with Auditory Processing Disorder (APD) often have poor auditory processing skills in the presence of normal peripheral hearing. These children have worse listening-in-noise skills compared to typically developing peers, while other commonly reported symptoms include poor attention and distractibility. One of the management strategies for children with APD is the use of Remote Microphone Hearing Aids (RMHAs), which can help improve the signal-to-noise ratio in the child's ears. The aim of this randomised controlled trial was to examine whether RMHAs improved classroom listening in children with APD, and to further test their effects on children's listening-in-noise and attention skills following a 6-month intervention. Methods: Twenty-six children diagnosed with APD, aged 7-12, in primary mainstream education, were randomised into the intervention (N = 13) and control group (N = 13). The primary outcome measure was the Listening Inventory for Education-Revised questionnaire, completed by children to assess their listening using RMHAs under several acoustically challenging situations in the classroom. Secondary outcome measures included the Listening in Spatialised Noise-Sentences test, assessing speech-in-noise perception and spatial listening, and the Test of Everyday Attention for Children, assessing different types of attention skills. Tests were conducted in unaided conditions. Mixed analysis of variance was used to analyse the data. The clinical trial was registered at clinicaltrials.gov (unique identifier: NCT02353091). Results: The questionnaire scores of self-reported listening skills in the classroom significantly improved in the intervention group after 3, MD = 7.31, SE = 2.113,

The Assistive Benefits of Remote Microphone Technology for Normal Hearing Children With Listening Difficulties

“…Contrasting Rosenberg (2002), broader practice guidelines put forward by American Academy of Audiology (2008) indicate candidacy may be appropriate for any child with hearing, listening, or learning problems. More recently, studies have investigated amplification in children who meet the diagnostic criteria for APD (American Speech-Language-Hearing Association 2005), without considering the specific deficits in each participant (Johnston et al 2009; Smart et al 2018; Stavrinos et al 2020). The present study did not recruit based on this arbitrary criterion but instead considered any child with at least one listening-related deficit as eligible.…”

“…Although we believe this to be the first study to test attention of children when aided with RMT, others have attempted to behaviorally measure a therapeutic effect on unaided ability over time (Smart et al 2018; Stavrinos et al 2020). No significant changes in auditory attention or sustained auditory attention were found after 5 and 6 months of wearing RMT in the classroom, suggesting the passive nature of device use is unlikely to produce lasting changes to higher order function.…”

“…RMT use during laboratory-based measures has also been found to reduce the negative impacts of noise on cortical auditory-evoked potential amplitudes and latencies (Smart et al 2018), indicating an advantage in adverse listening conditions can be measured both behaviorally and electrophysiologically. In addition to clinical findings, questionnaire results from teachers, parents, and students indicate positive outcomes regarding classroom engagement and academic performance (Friederichs & Friederichs 2008; Johnston et al 2009; Smart et al 2018; Stavrinos et al 2020). Notable improvements have related to perceived listening ability, on-task behaviors, following instructions, contributions to class discussion, appropriateness of answers to questions, and learning outcomes.…”

Temporal and Directional Cue Effects on the Cocktail Party Problem for Patients With Listening Difficulties Without Clinical Hearing Loss

“…There were many methodological differences between the two measurements, so it is difficult to determine exactly which factors caused the difference in intelligibility due to the different measurement methods. However, given that the ability of spatial hearing, which uses auditory cues from both ears to help spatially separate sounds arriving from different directions (Arbogast et al 2002; Culling et al 2004; Cameron and Dillon 2008; Stavrinos et al 2020), has been reported to be poorer in patients with listening difficulties compared with healthy controls (Cameron et al 2006; Cameron and Dillon 2008), the spatial separation of sound sources in the present cocktail party conditions, but not in the speech in noise assessed under headphones, may be a key factor in explaining the difference. Moreover, the fact that we randomly changed the presentation direction of the target stimuli in the present study may have been one of the factors that caused the different results between the two measurements.…”

Development and Psychometric Evaluation of Persian Dynamic Spatial Quick Speech-in-Noise Test in Adults with Normal Hearing

“…Difficulty in understanding speech should be considered one of the most incapacitating elements of hearing impairment, given its potential to cause feelings of isolation and relationships in adults [2]. Also, children with this kind of problem could have symptoms like distractibility or insufficient attention, which cause severe problems in their communication and education [9].…”