HEAL 2024 - HEaring  across the Lifespan

Below is a selection of topics that will be addressed:

Speech perception

Speech-in-noise testing with Digits-in-Noise

Epidemiology

Genetic issues

Early identification – novel techniques and methods

Auditory Processing Disorders

Listening effort

Cognitive decline

Quality of life and hearing loss

Computational Audiology

Noise exposure

Tinnitus

Amplification – technologies and strategies

Implantable devices

Auditory training

Improving Hearing Care and Services

e- and m-health solutions

Remote Care Solutions  

Intervention and Rehabilitation: strategies and methods.

Special Sessions HEAL 2024

Precision Diagnostics and Therapy Across the Lifespan - Hearing4All

Coordinators: Birger Kollmeier (Dept. of Medical Physics and Acoustics, School of Medicine and Health Sciences, Universität Oldenburg, Germany) and Thomas Lenarz (Hals-Nasen-Ohrenklinik, Medizinischen Hochschule, Hannover, Germany)

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 Symposium - Community-Delivered Hearing Care: Bringing WHO Guidance into Practice

De Wet Swanepoel (Dept. Speech-Language Pathology and Audiology, University of Pretoria, South Africa) and Carrie Nieman (Johns Hopkins Health Care and Surgery Center, Bethesda, MD, USA)

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Applications, strengths, and pitfalls of Ecological Momentary Assessment

Coordinator: EMA methods in audiology working group (Louise Burke, Klaudia Edinger Andersson, Inga Holube, Maria Iankilevitch, Lorienne Jenstad, Dina Lelic, Graham Naylor, Niels Pontoppidan, Nadja Schinkel Bielefeld, Gurjit Singh, Karolina Smeds, Barbra Timmer, Petra von Gablenz, Florian Wolters, and Yu-Hsiang Wu, Adriana Zekveld).

Ecological Momentary Assessment (EMA) is a method to evaluate feelings and perceptions in real life. It consists of repeated in-situ questionnaires which nowadays is typically administered via smart phone and often combined with the collection of objective data. While this method has been employed in other disciplines for decades, it only gained popularity in hearing sciences in recent years.
In this session we will look at different applications of EMA. Although EMA has primarily been used in research context, it has great potential for clinical application and as a tool to facilitate the communication between individuals with hearing problems and health care providers. Hearing aids make it easy to discretely collect data on the acoustic environment and currently active hearing aid algorithms. However, the dependence of hearing problems on a quickly changing hearing environment and the fact that situations with hearing problems are often not easy to report in the moment bring some challenges.
We invite talks about different applications of EMA in hearing sciences, with a focus on strengths and pitfalls of the method. The session will end with a panel discussion on the potential of EMA in clinical applications.

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Empowering healthcare professionals in supporting older adults with comorbid hearing and cognitive impairment

Coordinators: Dona Jayakody & Rob Eikelboom, Ear Science Institute Australia

The session will share data on current knowledge, attitudes and practices of healthcare professionals (hearing healthcare professionals, General Practitioners, Geriatricians, Geriatric Psychologists/Psychiatrists) in supporting older adults with comorbid hearing and cognitive impairment. The outcomes will be used to develop a training program, clinical guidelines, practices, and policies to upskill these healthcare professionals in supporting older adults with comorbid hearing and cognitive impairment. The presentation will also highlight the importance of using a design-based approach to integrating and facilitating effective communication between complex healthcare systems; hearing, cognition, general practice and aged-care systems to mediate new routines and establish potential new system structures to better support older adults with comorbid hearing and cognitive impairment.

Listening effort and affective responses: Exploring the multidimensional aspects of hearing

Session Coordinators: Alessia Paglialonga, Consiglio Nazionale delle Ricerche (CNR), Milan, Italy;  Edoardo Maria Polo, Politecnico di Milano, Italy

Listening effort, the mental exertion required to navigate challenges in auditory processing, is a pivotal aspect of the listening experience. While commonly perceived as effortful and stressful, clinical measures of listening effort in audiology are not widespread.

Self-report measures, often in the form of closed-set questionnaires or rating scales, are the conventional means to gauge listening effort. However, relying solely on self-reports may not offer a comprehensive reflection of the cognitive demands associated with comprehending auditory messages. To address this, the scientific community is exploring variables and physiological indices as potential biomarkers for this cognitive effort. In this Special Session, we will discuss recent findings in the area of listening effort and behavioral and physiological measures.

Moreover, listening effort, akin to an emotion itself, elicits a spectrum of feelings during the listening process, including frustration, confusion, and enjoyment. Noticeably, individuals perceiving a high level of listening effort are more likely to report negative emotions such as boredom or annoyance. Surprisingly, in the literature the relationship between hearing and emotions is comparatively understudied, compared for example to the extensive analysis of visual stimuli. While the role of auditory stimuli in eliciting emotions has been minimally explored, determining the comparative effectiveness of different stimulation types—audio, visual, or audio-visual—remains a challenge.

This Special Session aims to bridge this gap and stimulate discussion by exploring the less-investigated connections from auditory stimuli to listening effort and emotions. This exploration extends to the monitoring of physiological signals and machine learning methods to investigate the efficacy of various stimulation approaches.

Keynote Lectures HEAL 2024 

Keynote Lecture 

Objective measures at different stages of cochlear implantation

George Tavartkiladze, Department of Clinical Audiology, Russian medical Academy of Continuing professional Education, Moscow, Russia

Keynote Lecture 

Universal Hearing Screening and Intervention Programs for People with Intellectual Disability in their Live Environment - Implementation in Germany
Katrin Neumann (University Hospital Münster, University of Münster, Germany)

Introduction: People with intellectual disabilities (ID) suffer from hearing loss about 5-10 times more frequently than the general population which often remains undiagnosed and untreated. Recently, the Germany-wide implementation of a program for hearing screening, diagnostics and intervention in the living environment of people with disabilities (residential facilities, workshops, kindergartens, schools) was evaluated (Schwarze et al. 2023).

Methods: To investigate the feasibility of such a program, 1050 individuals with ID (all ages) received hearing screenings in their living environment. Failed screening was followed by audiometric diagnostics and, in case of hearing loss, initiation and monitoring of therapy. One-hundred-forty-one control participants were invited by their health insurer to undergo the same program in a clinic. Both cohorts performed the program one year later to assess its outcome.

Results: Screenings and diagnostics in the living environment of people with ID were feasible and reliable by hearing care professionals in most cases. Tele-monitoring by a physician was performed in about 20% of cases. Partly under COVID-19 pandemic conditions, it appeared difficult to gain access to people with ID. Of 810 facilities contacted, 19% participated, and from initial contact to hearing screening required an average of 8.0% conversations. Screenings in clinical settings were hardly taken up.

Discussion/Conclusion: Hearing screenings, on-site diagnoses and interventions, including hearing aid fittings, appear to be feasible (Prein et al. 2023), but access to people with ID in their facilities is a barrier that must be overcome for such a program to be implemented nationwide. Education of caregivers about the usefulness of regular hearing screenings for people with ID is needed.

*Funding: Germany’s Federal Joint Committee (G-BA): FKZ: 01NVF18038

References:

Schwarze K*, Mathmann P*, Schäfer K, Brannath W, Höhne PH, Altin S, Prein L, Naghipour A, Zielonkowski SM, Wasmuth S, Kanaan O, Am Zehnhoff-Dinnesen A, Schwalen AS, Schotenröhr A, Scharpenberg M, Schlierenkamp S, Stuhrmann N, Lang-Roth R, Demir M, Diekmann S, Neumann A, Gietmann C‡, Neumann K‡. Effectiveness and costs of a low-threshold hearing screening programme (HörGeist) for individuals with intellectual disabilities: protocol for a screening study. BMJ Open. 2023 May 18;13(5):e070259. doi: 10.1136/bmjopen-2022-070259. *shared first authorship, ‡shared senior authorship

Prein L, Vogt N, Neumann K. Hörgeräte-Versorgung von Menschen mit geistiger Behinderung in ihrem Lebensumfeld. [Hearing aid provision for people with intellectual disabilities in their living environment]. Hörakustik. 2023 Sep;10;8-12.

Keynote Lecture 

The Importance of Global Partnerships for Multiple Disabilities!

[30 or 45 minutes, depending on availability]

Roxanna Spruyt and Karen Keyes, DeafBlind Ontario Services, Service Provider, Newmarket, Canada

Keynote Lecture 

Auditory Situation Awareness:  the Conundrum when Your Life Depends upon your Hearing and your Hearing Depends on your Hearing Protector or Earphone

John G. Casali (Virginia Tech University, Blacksburg, VA)

Hearing protection devices (HPDs) for prevention of noise-induced hearing loss and earphones for providing music and communications to the ear are both in common use internationally. However, along with their use, concomitant preservation of the user's auditory situation awareness (ASA) is critical for safety and other objectives. The human auditory sense provides key sensory-perceptual inputs, e.g., it is: always “on” and primed for response, reactive to sounds from all directions, renders an “acoustic startle response” for arousal to dangers, and has a relatively low threshold of sensitivity even during sleep. Unfortunately, recent in-lab and in-field human subject experiments have evidenced that certain selective-sound pass-through HPDs and military-fielded Tactical-Communications-and-Protective-Systems (TCAPS) do not provide "transparency," but instead leave an imprint on incoming signals, and thus degrade ASA. Experimental stimuli have included vehicular reverse alarms and a variety of signals of broadband, low-frequency, and high-frequency content. Metrics of ASA performance have included: hearing threshold at detection, accuracy and response time in recognizing/identifying and localizing signals, and intelligibility of communications. Interactive effects of earphone design with the low-frequency interaural time difference (ITD) cues and high-frequency interaural level difference (ILD) cues that are critical to localization are covered.  In addition to device testing results, auditory training is covered, in regard to the ability of both the natural and occluded ear to be trained to achieve better performance. Using a Portable Auditory Localization Acclimation and Training System (PALAT) developed at Virginia Tech, which provides an array of directional loudspeakers and a dissonant tonal complex that is highly localizable, experiments have demonstrated that spatial localization accuracy with the open ear can be improved with training by up to about 30% over baseline in some individuals, and when wearing certain HPDs or earphones, improvements can also be obtained with training.  However, other devices have been found to be insensitive to training effects, giving rise to questions about whether they should be deployed, especially in a military or occupational setting where the user needs to maintain ASA.

Humans can hear up to 20 kHz; however, clinically, hearing is measured up to 8 kHz. Hearing in the extended high frequencies (EHFs; e.g., 10- 16 kHz) can be impaired despite a normal audiogram. Little is known about the general characteristics and perceptual consequences of EHF hearing loss. This talk will present findings from our ongoing studies on EHF hearing loss. Specifically, we will report: (1) the prevalence and risk factors associated with EHF loss in adults and children who have an otherwise normal audiogram; (2) the effects of EHF hearing loss on auditory resolution and speech-in-noise recognition; (3) the effects of EHF hearing loss on self-reported hearing ability in young adults; and (4) the predictive value of EHF hearing in determining future hearing loss among the normal-hearing adults.

Data from adults (n= 222; 19-38 years) and typically developing children (n= 542; 4-18 years) with normal hearing are reported. In a case-control design, participants were categorized into EHF-normal and EHF-impaired groups. In Experiment 1, we measured hearing thresholds from 0.25 to 16 kHz and speech recognition thresholds (SRTs) in multi-talker babble using the digit triplet test. In Experiment 2, we measured frequency change detection thresholds (FCDT) at 0.5 and 4 kHz. In Experiment 3, SRTs and self-reported hearing ability was assessed using the original version of the Speech, Spatial, and Qualities of Hearing Scale in adults. In Experiment 4, we monitored hearing thresholds over a period of 24 months.

Experiment 1: EHF hearing loss was observed in 19% of adults and 7% of children. Hearing thresholds in the standard frequencies (0.25 through 8 kHz) were higher (~3 dB), and SRTs were lower (poorer; 2 dB) for the EHF-impaired relative to the EHF-normal group after adjusting for age effects. Sex appears to have no direct effect on hearing thresholds or SRT; however, the age at which EHF hearing starts to decline was higher (later) in females than males. Experiment 2: Individuals with EHF hearing loss had higher (poorer) FCDTs for the 4 kHz but not for 0.5 kHz compared to the EHF-normal group. Experiment 3: machine learning was applied to model SRTs based on hearing thresholds. Experiment 4: SSQ ratings were significantly lower for EHF-impaired adults compared to the EHF-normal group. SRTs and SSQ ratings were significantly related. Experiment 5: Hearing thresholds were measured twice over a period of 24 months.

EHF hearing loss is associated with poor auditory resolution and speech-in-noise recognition. Individuals with EHF hearing loss report hearing-in-noise deficits regardless of a normal audiogram. Modeling results suggest that speech-in-noise recognition development is altered for children with EHF loss. In addition, adults with EHF hearing loss had a significant decline in hearing in the standard frequency range over 24-months period. Machine learning models suggest the value of EHF audiometry in predicting speech-in-noise recognition.

Last udate: 15 March 2024