We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This research aims to assess the prevalence, severity and underlying causes of hearing impairments.
Methods
This cross-sectional study used multistage stratified sampling to select 2148 individuals from Salyan and Surkhet, following the World Health Organization’s Ear and Hearing Survey Handbook.
Results
Among 1946 participants, 38.9 per cent had hearing impairments, including 15.9 per cent with disabling hearing loss, with severity increasing with age. Ear diseases affected 34.3 per cent, including dull or retracted tympanic membranes (18 per cent), impacted wax (8 per cent), perforated tympanic membrane (6.1 per cent), and abnormal tympanometry (23.1 per cent). The major causes were age-related hearing loss (50.5 per cent), Eustachian tube dysfunction (23 per cent), chronic suppurative otitis media (10.8 per cent), and otitis media with effusion (4.7 per cent). Higher education and immunisation were associated with reduced risk, while chronic conditions, earaches, drainage and tinnitus increased the risk.
Conclusion
The high prevalence of hearing impairment, primarily from preventable causes, underscores the importance of early screening and strengthened primary health care.
Cochlear Implants (CIs) enhance linguistic skills in deaf or hard of hearing children (D/HH). However, the benefits of CIs have not been sufficiently studied, especially with regard to communicative-pragmatics, i.e., the ability to communicate appropriately in a specific context using different expressive means, such as language and extralinguistic or paralinguistic cues. The study aimed to assess the development of communicative-pragmatic ability, through the Assessment Battery for Communication (ABaCo), in school-aged children with CIs, to compare their performance to a group of children with typical auditory development (TA), and to investigate if CI received under the age of 24 months promotes the typical development of such ability. Results show that children with CIs performed significantly worse than TA on the paralinguistic and contextual scales of the ABaCo. Finally, the age of first implantation had a significant role in the development of communicative-pragmatic ability.
This chapter addresses the bidirectional interface between phonetics and speech-language therapy/pathology, focusing on the application of phonetic principles and methods within the clinical domain. The history of clinical phonetics as a phonetic subdomain is charted, including the birth of the extensions to the IPA for disordered speech (extIPA). Three critical issues are touched on: the complexities of the phonetics/phonology interface in discussing disordered speech; the related clinical application of different levels of transcription; and how advancing technologies are enabling clinical phoneticians to better understand the implications of clinical conditions for speech perception and production. In discussing a range of clinical populations and affected speech subsystems, it highlights some of the salient phonetic features explored in recent years and insights gained from different instrumental methods. Best practice for teaching and learning is described in the context of the professional training objective of most clinical phonetics programmes, and future directions of clinical phonetics are hypothesised in terms of the evolving technological and clinical landscapes.
The speech perception ability of people with hearing loss can be efficiently measured using phonemic-level scoring. We aimed to develop linguistic stimuli suitable for a closed-set phonemic discrimination test in the Swedish language called the Situated Phoneme (SiP) test. The SiP test stimuli that we developed consisted of real monosyllabic words with minimal phonemic contrast, realised by phonetically similar phones. The lexical and sublexical factors of word frequency, phonological neighbourhood density, phonotactic probability, and orthographic transparency were similar between all contrasting words. Each test word was recorded five times by two different speakers, including one male and one female. The accuracy of the test-word recordings was evaluated by 28 normal-hearing subjects in a listening experiment with a silent background using a closed-set design. With a few exceptions, all test words could be correctly discriminated. We discuss the results in terms of content- and construct-validity implications for the Swedish SiP test.
Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.
When parents discover that their child has hearing loss, a new reality presents itself with frustration, a huge amount of work as special care, therapies, exams, etc. Adapting to this new situation is a huge challenge to the development of both parents and children who receive this diagnosis.
Objectives
This study investigated how Brazilian parents of children diagnosed with hearing loss dealt with this situation from diagnosis to the present day.
Methods
In this study it was used the Bioecological Theory of Human Development, which considers the development of both parents and children over time. Two meetings were conducted using a focal group technique, with questions related to the diagnosis and how they faced the situation, prejudice, care of other siblings, etc.
Results
Most parents discovered the diagnosis of hearing loss of their children right after birth. Only one mother said she did not care about the diagnosis of hearing loss while most reported having suffered a lot and glimpsed a life of difficulties. Even knowing the limitations imposed by the condition of the children, no one considered hearing loss as a sickness. Parents reported that the child suffered bullying because of difficulties in speaking and most parents say they worry about their children’s school life.
Conclusions
Parenting kids with hearing impairment is challenging, and involves dealing with prejudice, fear of future, long-term therapies and high costs. Nevertheless parents make great efforts to provide a good environment minimizing the risks of having such condition.
Previous literature has identified several cognitive abilities as predictors of individual differences in speech perception. Working memory was chief among them, but effects have also been found for processing speed. Most research has been conducted on speech in noise, but fast and unclear articulation also makes listening challenging, particularly for older listeners. As a first step toward specifying the cognitive mechanisms underlying spoken word recognition, we set up this study to determine which factors explain unique variation in word identification accuracy in fast speech, and the extent to which this was affected by further degradation of the speech signal. To that end, 105 older adults were tested on identification accuracy of fast words in unaltered and degraded conditions in which the speech stimuli were low-pass filtered. They were also tested on processing speed, memory, vocabulary knowledge, and hearing sensitivity. A structural equation analysis showed that only memory and hearing sensitivity explained unique variance in word recognition in both listening conditions. Working memory was more strongly associated with performance in the unfiltered than in the filtered condition. These results suggest that memory skills, rather than speed, facilitate the mapping of single words onto stored lexical representations, particularly in conditions of medium difficulty.
Age-related hearing and vision problems are common among people with dementia and are associated with poorer function, reduced quality of life and increased caregiver burden. Addressing sensory impairments may offer an opportunity to improve various aspects of life for people with dementia.
Methods:
Electronic databases were searched using key terms dementia, hearing impairment, vision impairment, intervention, and management. Database searches were supplemented by hand searching bibliographies of papers and via consultation with a network of health professional experts. Studies were eligible for inclusion if they included adults aged over 50 with dementia with adult-onset hearing or vision impairment who had received a hearing or vision intervention in relation to cognitive function, rate of decline, psychiatric symptoms, hearing/vision-related disability, quality of life, and/or caregiver burden outcomes. A range of study designs were included. Results were summarized descriptively according to level of evidence and effect sizes calculated where possible. Risk of bias was assessed using Downs and Black's (1998) checklist. The development of the intervention was summarized according to the CReDECI2 scheme. PROSPERO review registration number 2016:CRD42016039737.
Results:
Twelve papers describing hearing interventions and five papers describing vision interventions were included. Most were of low to moderate quality. One high quality randomized controlled trial of a hearing aid intervention was identified. Hearing interventions included provision of hearing aids, assistive listening devices, communication strategies, hearing aid trouble shooting, and cochlear implantation. Vision interventions included prism lenses, rehabilitation training, and cataract surgery. There was no consistent evidence for the positive impact of hearing/vision interventions on cognitive function, rate of cognitive decline, quality of life, or caregiver burden.
Conclusion:
Sensory interventions may promote better outcomes, but there is a need for properly powered, controlled trials of hearing and vision interventions on outcomes relevant to people living with dementia.
To examine the longitudinal risk of vision loss (VL) or hearing loss (HL) for experiencing suicidal ideation in older adults.
Design:
The Three-City study, examining data from three waves of follow-up (2006–2008, 2008–2010, and 2010–2012).
Setting:
Community-dwelling older French adults.
Participants:
N = 5,438 adults aged 73 years and over.
Measurements:
Suicidality was assessed by the Mini-International Neuropsychiatric Interview, Major Depressive Disorder module. Mild VL was defined as Parinaud of 3 or 4 and severe VL as Parinaud >4. Mild HL was self-reported as difficulty understanding a conversation and severe HL as inability to understand a conversation.
Results:
Severe VL was associated with an increased risk of suicidal ideation at baseline (OR = 1.59, 95% CIs = 1.06–2.38) and over five years (OR = 1.65, 95% CIs = 1.05–2.59). Mild and severe HL were associated with an increased risk of suicidal ideation, both at baseline (OR = 1.29, 95% CIs = 1.03–1.63; OR = 1.78, 95% CIs = 1.32–2.40) and over five years (OR = 1.47, 95% CIs = 1.17–1.85; OR = 1.97, 95% CIs = 1.44–2.70).
Conclusion:
Sensory losses in late life pose a risk for suicidal ideation. Suicidality requires better assessment and intervention in this population.
Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment.
Methods
Hallucination presence was determined in 1007 subjects aged 18–92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands. The presence and severity of hearing impairment were calculated using mean air conduction thresholds from the most recent pure tone audiometry.
Results
Out of 829 participants with hearing impairment, 16.2% (n = 134) had experienced auditory hallucinations in the past 4 weeks; significantly more than the non-impaired group [5.8%; n = 10/173; p < 0.001, odds ratio 3.2 (95% confidence interval 1.6–6.2)]. Prevalence of auditory hallucinations significantly increased with categorized severity of impairment, with rates up to 24% in the most profoundly impaired group (p < 0.001). The corrected odds of hallucination presence increased 1.02 times for each dB of impairment in the best ear. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%).
Conclusions
Our findings reveal that auditory hallucinations are common among patients with hearing impairment, and increase with impairment severity. Although more research on potential confounding factors is necessary, clinicians should be aware of this phenomenon, by inquiring after hallucinations in hearing-impaired patients and, conversely, assessing hearing impairment in patients with auditory hallucinations, since it may be a treatable factor.
To investigate the differential associations between sensory loss and neuropsychiatric symptoms among older adults with and without diagnosed neurocognitive disorder.
Methods:
The sample comprised 1,393 adults (52.3% men) aged between 72 and 79 years from a community-based cohort study. There were 213 cases of mild and 64 cases of major neurocognitive disorders. The main outcome was number of informant reported symptoms on the Neuropsychiatric Inventory (NPI). Sensory loss was defined by visual acuity worse the 0.3 logMAR (6/12 or 20/40) and self-reported hearing problems.
Results:
Clinically relevant NPI symptoms were reported in 182 (13.1%) participants, but no individual symptom occurred in more than 5% of the total sample. Among participants diagnosed with a major neurocognitive disorder, those with any sensory loss had over three times (95%CI: 1.72–11.78) greater rates of NPI symptoms than those with unimpaired levels of sensory functioning. There were no differences in the number of neuropsychiatric symptoms by type of sensory loss, and no additional risk associated with a dual sensory loss compared to a single sensory loss. There was no evidence of an association between sensory loss and number of neuropsychiatric symptoms among cognitively healthy adults.
Conclusions:
The extent to which this association is the result of underlying neuropathology, unmet need, or interpersonal factors is unclear. These findings have significant implications for dementia care settings, including hospitals and respite care, as patients with sensory loss are at increased risk of neuropsychiatric symptoms and may require additional psychosocial support. Interventions to manage sensory loss and reduce the impact of sensory limitations on neuropsychiatric symptoms are needed.
Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment.
Method:
Electronic databases were searched using subject terms “hearing disorders” OR “vision disorders” AND “cognitive assessment,” supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature.
Results:
1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment; 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test.
Conclusions:
While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.
This study aimed to determine the prevalence of hearing impairment in Bangladeshi people of all ages.
Methods:
A nationally representative cross-sectional survey was carried out in 2013. A total of 4260 subjects (1774 males and 2486 females), with a mean age of 32 years, participated. Hearing impairment was determined by pure tone audiometry and otoacoustic emissions testing.
Results:
Disabling hearing loss (greater than 40 dB loss in adults, and greater than 30 dB loss in children younger than 15 years, in their better hearing ears) was present in 9.6 per cent (95 per cent confidence interval, 8.5–10.8 per cent) of the respondents. Hearing loss was more prevalent in socio-economically deprived people and in those older than 60 years. Multiple logistic regression analysis identified age, socio-economic deprivation, family history, impacted ear wax, chronic suppurative otitis media, otitis media with effusion, and otitis externa as the significant predictors of disabling hearing loss.
Conclusion:
Deafness prevention should focus mainly on chronic suppurative otitis media, otitis media with effusion, and impacted ear wax prevention, integrated within the primary healthcare system and addressing the equity issue.
Minor stresses measured in daily life have repeatedly been associated with increased momentary psychotic experiences, both in individuals with psychotic disorders and in persons who are genetically at an increased risk for these disorders. Severe hearing impairment (SHI) is an environmental risk factor for psychotic disorder, possibly due to the experience of social exclusion. The aim of the current study is to investigate whether people with SHI exhibit higher levels of psychotic reactivity to social stressors in daily life than normal-hearing controls and whether this reactivity is associated with decreased baseline dopamine (DA) D2/3 receptor availability and/or elevated DA release following a dexamphetamine challenge.
Method.
We conducted an experience sampling study in 15 young adults with SHI and 19 matched normal-hearing controls who had previously participated in a single photon emission computed tomography study measuring DA D2/3 receptor availability and DA release in response to dexamphetamine.
Results.
The association between social stress and momentary psychotic experiences in daily life was stronger among SHI participants than among normal-hearing controls. Interactions between social stress and baseline striatal DA D2/3 receptor availability or DA release were not significant in multilevel models of momentary psychotic experiences including age, sex and tobacco use.
Conclusions.
While both elevated striatal DA release and elevated psychotic stress reactivity have been found in the same population defined by an environmental risk factor, SHI, their inter-relationship cannot be established. Further research is warranted to clarify the association between biological and psychological endophenotypes and psychosis risk.
Many different conditions cause hearing impairment including inflammation, trauma, aging (presbyacusis), ototoxic drugs, genetic disorders, and stroke. As the blood supply to the auditory system originates from the vertebrobasilar system, hearing loss and tinnitus are common with vertebrobasilar territory ischemic stroke. This chapter reviews the clinical spectrum of hearing impairment associated with stroke. Central hearing impairment results from lesions central to the cochlear nucleus from the brainstem auditory nuclei to the auditory cortex in the temporal lobe. Central hearing abnormalities characterized by difficulty understanding spoken communication usually result from lesions of the central auditory pathways rostral to the cochlear nucleus. Brainstem stroke can cause auditory symptoms such as hearing loss, phantom auditory perceptions (tinnitus and hallucinations), and hyperacusis. Cortical deafness, pure word deafness, auditory agnosia for environmental sounds, and amusia are well-known central auditory disorders associated with hemispheric stroke.
A previous study examined the ‘patient journey’ of adults with gradual-onset acquired hearing impairment. This study examined the same for adults with sudden-onset acquired hearing impairment, and assessed differences.
Study design:
Data were collected from 16 audiologists, using the Ida Institute template, and from four adults with sudden-onset acquired hearing impairment, through semi-structured interviews. Data were analysed using thematic analysis and presented using a process mapping model.
Results:
A patient journey template for sudden-onset acquired hearing impairment was developed based on the professionals' and patients' perspectives. The main difference between these two groups' perspectives was seen in the self-evaluation phase: some stages within this phase were recognised by the patients but not by the professionals. The main difference between the current and the previous study was the absence of a pre-awareness phase in the journey described by patients with sudden-onset acquired hearing impairment, compared with that described by patients with gradual-onset acquired hearing impairment.
Conclusion:
Patient journey templates could be useful counselling tools for ear and hearing healthcare specialists. However, such templates should be used only as a baseline; it is important to take a detailed case history to understand each patient's unique experience, including the psychosocial impact of hearing impairment.
It has long been acknowledged that hearing impairment may increase the risk for psychotic experiences. Recent work suggests that young people in particular may be at risk, indicating a possible developmental mechanism.
Method
The hypothesis that individuals exposed to hearing impairment in early adolescence would display the highest risk for psychotic symptoms was examined in a prospective cohort study of a population sample of originally 3021 adolescents and young adults aged 14–24 years at baseline, in Munich, Germany (Early Developmental Stages of Psychopathology Study). The expression of psychosis was assessed at multiple time points over a period of up to 10 years, using a diagnostic interview (Munich Composite International Diagnostic Interview; CIDI) administered by clinical psychologists.
Results
Hearing impairment was associated with CIDI psychotic symptoms [odds ratio (OR) 2.04, 95% confidence interval (CI) 1.10–3.81], particularly more severe psychotic symptoms (OR 5.66, 95% CI 1.64–19.49). The association between hearing impairment and CIDI psychotic symptoms was much stronger in the youngest group aged 14–17 years at baseline (OR 3.28, 95% CI 1.54–7.01) than in the older group aged 18–24 years at baseline (OR 0.82, 95% CI 0.24–2.84).
Conclusions
The finding of an age-specific association between hearing impairment and psychotic experiences suggests that disruption of development at a critical adolescent phase, in interaction with other personal and social vulnerabilities, may increase the risk for psychotic symptoms.