JRRD special issue on hearing and hearing loss

The current issue of the Journal of Rehabilitation Research and Development (JRRD) is a supplement on hearing loss, which affects 31 million Americans. This supplement addresses topics at the cutting edge of both basic and clinical hearing loss research and is edited by internationally renown experts in the field of audiology.

Advance in hearing evaluation provides rapid data on health of middle ear, pg 63
A recent advance in the evaluation of middle-ear function is described in this article. The new instrument measures acoustic power flow in the ear canal and the proportion of this power entering the middle ear. Since the middle ear is involved in almost every hearing test, determining the health status of the middle ear during an audiological evaluation is important. Within minutes, the instrument provides information on the health of the middle ear. Clinical instruments currently in use for middle-ear evaluation cannot measure many important acoustic properties of the middle ear because of the complexity of these measurements.

Prevention programs can be effective in reducing the incidence of hearing loss, pg 45
Researchers say hearing loss prevention programs that educate people on appropriate use of ear protection, ways to reduce noise exposure, and the effects of ototoxic medications can reduce the incidence of noise- and ototoxic-induced hearing loss. Hearing loss affects 31 million Americans, many of whom also receive treatment with ototoxic medications that may exacerbate preexisting hearing loss. Poor implementation of hearing protection programs and a lack of audiometric testing during medical treatment leave patients vulnerable to unrecognized and untreated hearing loss until speech communication is impaired. Ultimately, hearing loss prevention requires education to reduce occupational and recreational noise exposure, appropriate audiometric testing to identify hearing loss early, and counseling on the risks and options available.

Hearing loss and aging: New research findings and clinical implications, pg 9
An overview of recent research addressing hearing loss and auditory processing problems among elderly people is presented in this article. University of Maryland scientists investigated problems in auditory temporal processing (the ability to perceive changes in the duration of single sounds or to perceive sounds in a sequence) by older listeners. Volunteers participated in speech perception experiments using temporally altered signals and in psychoacoustic experiments of duration and rhythm discrimination for simple and complex signals. Some recent studies of perceived hearing disability are also reviewed. Research findings from this series of studies suggest that the older person's problems in processing rapid acoustic information and information with disruption in speech rhythms may be important to address in the next generation of signal processing hearing aids.

Progressive intervention approach to the clinical management of tinnitus, pg 95
A five-level "progressive intervention" approach to managing tinnitus is presented in this article. Level 1 is an interview to determine if the person requires clinical intervention. Level 2 is structured group educational counseling. If the screening determines that care is urgently required or further help is needed following the group session(s), a tinnitus intake assessment should be performed (level 3). The intake assessment, which includes educational counseling, can often meet a patient's needs. If not, then a program of continuing treatment (level 4) is indicated. If significant benefit is not achieved through consistent treatment over one to two years, long-term treatment is indicated (level 5), including alternate or multiple treatments.

Hearing aid use and satisfaction with cell phone technology, pg 145
The usability of commercially available cell phones by hearing aid wearers is evaluated in this article. Results suggest that certain transmission technologies create more interference than others and hearing aid wearers' use of microphone or telecoil coupling may influence their susceptibility to experiencing cell phone interference. Data also suggest that interference alone does not fully predict the usability of a cell phone for hearing aid wearers. These findings have implications for the standard used to rate cell phone compliance for the FCC and for the education of consumers with regard to their expectations for cell phone use.

Aging and speech recognition, pg 25
The effect of aging on central auditory mechanisms is presented in this article. Speech comprehension in noisy environments, which is often difficult for older persons, is a focus of the study. The authors use the technique of dichotic listening to examine the effect of aging on both behavioral measures of listening ability and on brain electrical activity evoked while listening. Results show that age-related deficits in the connection between the two halves of the brain may contribute to listening problems experienced by older listeners. Implications for clinical audiological rehabilitative efforts in this population are discussed.

Hair cell regeneration: Is it possible to restore hearing and balance?, pg 187
In this review, key recent findings in sensory hair cell regeneration and what they mean for audiologists and other hearing healthcare practitioners are discussed. Sensory hair cells of the inner ear are susceptible to damage from a variety of sources, including aging, genetic defects, and environmental stresses such as loud noises and/or chemotherapeutic drugs. The consequence of this hair cell damage in humans is often permanent hearing/balance problems. The discovery that hair cells can regenerate in birds and other nonmammalian vertebrates has fueled a wide range of studies that examine ways of restoring hearing and balance after such damage.

Recent advances in audiologic diagnostic and treatment techniques, pg 1
Noise-induced hearing loss, idiopathic sudden sensorineural hearing loss, otosclerosis, and Meniere's disease are discussed in this article. Sensorineural hearing loss characterizes each, but additional aspects vary with each of the conditions. This article describes the conditions, discusses their diagnoses and treatments, and outlines current and suggested rehabilitation.

Central auditory system plasticity and aural rehabilitation of adults, pg 169
Evidence of changes in the auditory cortex (portion of the brain involved with processing sound) of mature animals and humans with acquired sensorineural hearing loss is reviewed in this article. Investigators also discuss changes in the auditory cortex associated with auditory training in persons with normal hearing. The results of studies measuring psychoacoustic and speech recognition performance of persons with hearing loss, with and without hearing aids, are interpreted within the framework of the new knowledge about plasticity of the auditory system. Application of electrophysiologic techniques (which measure the electrical signals generated in the auditory system and in the brain in response to sound) in hearing aid research and clinical practice are highlighted.

Directional hearing aids: then and now, pg 133
The history, recent research, and pros and cons of directional microphone hearing aids, including the potential interaction with bilateral versus unilateral fittings, are described in this article. Recent results show that bilateral directional mode hearing aids are beneficial in many noisy environments. Other results indicated localization accuracy was similar in directional and omnidirectional modes, though significantly poorer in the aided omnidirectional microphone mode than in the unaided condition. Bilateral fittings are recommended for most hearing-aid candidates because of the advantages related to localization and speech understanding in noise. Hearing aids that can be switched between directional and omnidirectional mode are advocated for many hearing aid candidates.

Hearing aid outcomes– What to measure?, pg 157
Investigators discuss the complex nature of measuring outcomes in audiology. While outcome measurement is critical for all audiological services, recent attention has focused on outcomes of hearing aid intervention in adults. Outcomes measurement allows audiologists to demonstrate to providers, patients, and institutions the cost-to-benefit ratio of hearing aid provision. Authors state that both hearing-specific and generic measures provide important and different information. They caution that many non-hearing related factors can affect outcome measure interpretations and audiologists should consider these in their clinical practice.

Bilateral amplification and sound localization, pg 117
The history, recent research, and the pros and cons of bilateral hearing aids are described in this article. The results of unaided localization experiments with people who use either one or two hearing aids are discussed. Authors conclude that although most listeners with moderate hearing loss have good to excellent accuracy of localization, some will always have difficulty localizing sound. Decreased localization ability may be seen in the unaided situation, especially with individuals with one hearing aid. Because of the advantages of two hearing aids for sound localization and speech intelligibility, hearing aid candidates prefer bilateral fittings.

Speech audiometry from the 1800s to present, pg 79
The evolution of speech audiometry from the 1800s to present is reviewed in this article. The two-component aspect of hearing loss (audibility and distortion) is presented in the context of speech recognition. The differences between speech recognition in quiet and in background noise are discussed in relation to listeners with normal hearing and listeners with hearing loss. A discussion of the use of sentence materials versus word materials for clinic use is included, as is a discussion of the effects of presentation level on recognition performance in quiet and noise. The effects of age and hearing loss on speech recognition are also considered.

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About the Journal
JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit www.rehab.research.va.gov.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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