This study aimed to compare performance between unilateral and bilateral bone conduction hearing device (BCHD) use for speech understanding and subjective listening difficulty. This study involved prospective investigation of bilateral BCHD with human subjects at an academic medical center. Twelve individuals (five children, seven adults) with BCHD were recruited (eight unilateral BCHDs, four bilateral BCHDs). Speech recognition was assessed in colocated noise (Bamford-Kowal-Bench Speech in Noise), diffuse noise (AzBio/BabyBio), and roving speech in diffuse noise (Basic English Lexicon sentences) as well as patient-reported outcomes of listening difficulty and Speech, Spatial and Qualities of Hearing Scale. Statistically significant bilateral BCHD benefit was noted for roving speech. Bilateral BCHDs resulted in speech understanding scores that were not significantly different across speech location, whereas unilateral BCHD revealed significantly poorer performance with speech directed to the unaided ear. However, bilateral BCHD benefit may not be easily quantified in clinical settings, as we observed no significant bilateral benefit for the clinical assessments of speech in colocated noise. Significant bilateral BCHD benefit was noted for roving speech in diffuse noise, similar to group conversations in noisy restaurants. Significant benefits were not observed for a fixed sound source in colocated noise making clinical assessment of the potential benefit of a second BCHD challenging; however, performance in the bilateral BCHD condition was either similar to or better than the best single ear alone thereby consistent with clinical benefits observed in complex noise. Overall, the study provides evidence in support of bilateral BCHD, but further investigation with larger samples is warranted.

An Adult Cochlear Implant Aural Rehabilitation Special Interest Group was formed in 2023. Members represent interdisciplinary collaborators, including audiologists, speech-language pathologists, surgeons, nonclinical administrators, manufacturer/industry representatives, and researchers. Current perspectives of adult cochlear implant (CI) recipients regarding aural rehabilitation (AR) remain unknown and understudied. The aim of this study is to survey adult CI recipients to determine their perspectives on the AR process. A web-based national survey was sent to adult CI recipients through multiple channels. The survey asked recipients about their demographics, state of residence, hearing loss history, and device configuration. Questions probed recipients' experiences of learning about AR options, services used, definitions of AR, and perceived value of services received. Questions were also asked about barriers to AR services, preoperative counseling, and satisfaction with their decision to pursue a CI. A total of 115 CI recipients responded to the survey. Results revealed a relative lack of information provided to many CI recipients regarding AR services. Many CI recipients reported wishing they had received additional resources in the areas of music training and equipment troubleshooting. Most participants reported that both one-on-one clinician-guided AR and independent listening practice were effective methods of AR. Findings shed light on current gaps in providing the most effective AR services, which will need to be addressed to optimize hearing health care and outcomes for adult CI recipients. Future work should include outreach to a broader representation of CI users to expand our understanding of AR resources, education, and limitations.

Misophonia and hyperacusis are distinct sound sensitivity conditions that can co-occur and are linked to heightened emotional distress and impaired functioning. This study investigated the convergence between audiometric-based and self-reported indicators of hyperacusis and examined how each related to misophonia severity and psychological outcomes in adults with misophonia. Participants (N = 60) completed self-report measures and underwent loudness discomfort level (LDL) testing. Analyses revealed discrepancies between self-reported and LDL-defined hyperacusis, with no significant associations between LDL-based classifications and psychological or misophonia-related outcomes. In contrast, hyperacusis identified via a standardized self-report measure was significantly associated with heightened emotional and behavioral reactivity in misophonia, as well as greater severity and elevated internalizing symptoms, including depression, anxiety, and stress. Findings raise concerns about the clinical utility of LDLs as standalone indicators in misophonia populations. They highlight the value of subjective assessments for identifying clinically relevant variables associated with hyperacusis and misophonia comorbidity. Our results support that self-report tools may better capture the lived experience and psychological features associated with co-occurring hyperacusis and misophonia. However, until more research is established, we recommend employing audiometric and self-report metrics to assess for hyperacusis in this population. Future research should focus on identifying psychometric measures that can accurately distinguish between the two conditions and on developing standardized protocols for assessing hyperacusis in individuals with misophonia.

Although age-related auditory changes are well recognized, limited studies have examined how aging affects middle ear mechanics, which can be assessed using wideband tympanometry (WBT). Unlike conventional tympanometry, WBT offers frequency-specific insights into middle ear acoustic transfer function. Ethnic differences in the anatomy of the external and middle ear such as canal length, ossicular dimensions, and stapes configuration may influence acoustic transmission. This study aimed to investigate the effect of aging on middle ear absorbance across frequencies using WBT. A nonexperimental, standard group comparison design was used to test 60 ears from older adults (50-70 years of age) and young adults (20-30 years of age) with clinically normal hearing. Wideband absorbance was measured using click stimuli (0.2-8 kHz) at 100 dB peSPL under both ambient and peak pressure. Data were analyzed using mixed repeated-measures analysis of variance to assess the main and interaction effects of group, gender, frequency, and pressure condition; independent t test for between-group comparisons at each frequency; and paired t test between pressure within-group comparisons. Both groups showed a similar wideband absorbance pattern. However, older adults exhibited a significantly higher absorbance at low frequencies (250-600 Hz) and a lower absorbance at high frequencies (2000-8000 Hz) compared to young adults. These differences indicate age-related alterations in middle ear mechanics, likely due to ossicular joint loosening and tissue degeneration. Pressure-related absorbance changes were more pronounced in younger adults at low to mid frequencies, suggesting that middle ear function in this group is more sensitive to pressure variations. Moreover, gender did not show a significant main effect on absorbance across frequencies. WBT appears to be a sensitive tool to detect subtle age-related changes that may not be evident with conventional tympanometry. The findings offer insights into age-related middle ear changes and suggest possible modification that might be considered during hearing aid fitting in older adults. Additionally, it also suggests that gender may not be a significant factor in assessing middle ear transfer function.

Narrowband (NB) chirps have recently been of great interest in audiology for the electrophysiological assessment of hearing in infants, but clinicians have little information about these new stimuli and how they compare to more standard stimuli, such as 2-1-2-cycle tones. The current study examined the frequency specificity of NB chirps by comparing the spectral characteristics of 500-, 1000-, 2000-, and 4000-Hz NB CE-Chirp LS ("level-specific" version) stimuli with those of the 2-1-2 tones. Spectral characteristics, including center frequency (CF), bandwidth, and stimulus energy changes after stopband filtering, were compared. Bandwidth was computed as the difference between the upper and lower frequencies at the -20 and -3 dB cutoff points of the main lobe; CF was determined as the geometric mean of the upper and lower frequencies at the -20 and -3 dB cutoff points. At 100 dB peSPL, the bandwidths of the 500-, 1000-, and 2000-Hz NB CE-Chirp LS acoustic spectra were 1.8-1.9 times wider than those of the acoustic spectra for the 2-1-2 tones; the 4000-Hz NB CE-Chirp LS bandwidths were 1.4-1.5 times wider than those of the 2-1-2 tones. The energy of the NB CE-Chirp LS stimuli was concentrated within ±0.75 octave of the CF, compared to ±0.5 octave for 2-1-2 tones. These spectral characteristics did not change with stimulus intensity. The NB CE-Chirp LS stimuli demonstrated poorer frequency specificity compared with that of the 2-1-2 tones. NB-chirp thresholds may therefore underestimate true thresholds, especially in steeply sloping hearing loss. Further studies are needed to investigate the cochlear place specificity of auditory brainstem responses to the NB CE-Chirp LS stimuli before recommending them for clinical use.

The main objective of this study was to examine the effect of a classifier-based noise management algorithm (AutoSense Sky OS 3.0) on speech perception in noise in pediatric cochlear implant (CI) recipients and to compare the speech perception outcomes with typically hearing peers. This prospective observational study included nine children (ages 9-15 years) with bilateral CIs and nine age-matched, typically hearing peers. Speech perception outcomes were measured in noise using Pediatric AzBio sentences to compare performance in the omnidirectional microphone mode with the classifier-based automatic noise management mode at four signal-to-noise ratios. Ratings of listening ease and speech clarity were recorded to obtain subjective measures of benefit. Results from the bilateral CI recipients were compared to a group of typically hearing children. Paired t tests were used to evaluate outcomes. Classifier-based noise management improved speech perception in noise compared to listening in the omnidirectional microphone mode. CI group averages revealed a 21.4 percentage point and 47.1 percentage point improvement in speech perception when using the Sky OS 3.0 algorithm at 0 and -5 dB SNR, respectively. Listening ease and speech clarity were improved when using the classifier-based noise management algorithm. Pediatric CI recipients can benefit from classifier-based noise management. Given the difficult listening environments children face, especially in typical classroom settings while listening for learning, audiologists should consider activating classifier-based noise management in this population.

Cognitive decline may affect how older listeners tolerate noise. Our purpose was to determine which cognitive variables are associated with older adults' acceptance of background noise, as measured by the acceptable noise level (ANL). Fifteen adults with hearing within normal limits, aged 50-72 years, were administered the following tests: the ANL, the digit span and letter-number sequencing subtests of the Wechsler Adult Intelligence Scale-Fourth Edition, the auditory attention subtest from the Woodcock-Johnson Tests of Cognitive Abilities, the Hearing in Noise Test (HINT), and the operation span test. We then compared data from the older adults with an earlier data set obtained from younger adults with normal hearing, aged 20-29 years. Older adults had significantly larger ANL values (were less tolerant of noise) than younger adults, and older adults scored significantly lower on auditory attention than the younger adults. There was no significant relation between scores on the HINT test and the ANL scores. Older adults' reduced attention control may make them less tolerant of noise than younger adults. Older adults who are not yet hearing aid candidates may still be more adversely affected by noise and may benefit from auditory rehabilitation-related tools to address noise.

This study aims to investigate how visual acuity resulting from head motions in three planes (roll, yaw, and pitch) may affect the intensity of symptoms that follow exposure to virtual reality (VR) in healthy people. Static visual acuity and dynamic visual acuity (DVA) values of all participants were measured within the DVA test battery. After that, they were instructed to be exposed to VR tools for 20 min. Last, the Turkish version of the Virtual Reality Sickness Questionnaire (VRSQ) was used to evaluate the intensity of symptoms following VR. The associations among age, symptoms, and the DVA test parameters were investigated using multiple regression models. Of all participants, 32 were female (53.33%) and 28 were male (46.67%). According to multiple regression models, there was no significant model in which the static visual acuity and age (the independent variables) had a statistically significant effect on all three scores of the VRSQ (the dependent variable). The impact of gaze stabilization on spatial learning and spatial memory in the horizontal, vertical, and sagittal planes was not statistically significant (p > .05). In contrast, the effects of DVA on these parameters were statistically significant in all planes (p < .05). The study emphasized the link between DVA and post-VR symptoms. Addressing vestibular-visual functions and individual differences is vital for improving user experiences and reducing adverse effects in VR. Future advancements and case-control studies involving vestibular disorders are needed to enhance inclusivity and comfort for diverse users.

High rates of hearing loss are observed for individuals with Down syndrome, and regular hearing assessment is recommended for children and adults. Unknown variability of threshold estimates for repeated auditory assessments for individuals with diverse intellectual abilities, such as individuals with Down syndrome, confounds the ability to determine true threshold changes between assessments. This study evaluated variability of pure-tone thresholds measured within and across test sessions for individuals with Down syndrome. Participants included 27 individuals with Down syndrome, ages 5.1-46.5 years (average = 22.7, SD = 11.8). A group of 11 neurotypical individuals, ages 15.9-48.6 years (average = 24.5, SD = 10.3) was included in intrasession variability assessment. Pure-tone thresholds in quiet were measured at 1, 4, 8, and 11.2 kHz during a single session or during repeated audiograms separated by 2.7-11.2 months (average = 5.8, SD = 2.4) and 3.0-3.9 years (average = 3.4, SD = 0.4). Intrasession variability was ≤ 10 dB for 94.3%-100% of thresholds for participants with Down syndrome, with similar variability observed for neurotypical participants. Threshold differences were ≤ 10 dB for 63.2%-85% of responses from audiograms separated by an average of 5.8 months and 37.5%-62.5% of responses separated by an average of 3.4 years. Intrasession variability for participants with Down syndrome aligns with current clinical standards accepting variability of ≤ 10 dB between repeated threshold estimates. Differences in repeated audiometric thresholds greater than 10 dB likely reflect true changes in hearing sensitivity. https://doi.org/10.23641/asha.30052885.