Relating Suprathreshold Auditory Processing Abilities to Speech Understanding in Competition

Testing the Informativeness of Diverse Measures of Auditory Processing for Clinical Audiological Practice in Middle-Aged Adults in Mexico

PURPOSE

Standard clinical audiologic assessment is limited in its ability to capture variance in self-reported hearing difficulty. Additionally, the costs associated with clinical testing in audiology create financial barriers for hearing health care in developing countries like Mexico. This study used an open-source Spanish-language tool called PART (Portable Automated Rapid Testing) to test the hypothesis that a battery of assessments of auditory processing can complement standard clinical audiological assessment to better capture the variance of self-reported hearing difficulty.

METHOD

Forty-three adults between 40 and 69 years of age were tested in Mexico City using a traditional clinical pure-tone audiogram, cognitive screening, and a battery of PART-based auditory processing assessments including a speech-on-speech competition spatial release from masking task. Results were compared to self-reported hearing difficulty, assessed with a Spanish-language adaptation of the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S).

RESULTS

Several measures from the PART battery exhibited stronger correlations with self-reported hearing difficulties than the pure-tone audiogram. The spatial release from masking task best captured variance in HHIE-S scores and remained significant after controlling for the effects of age, audibility, and cognitive score.

CONCLUSIONS

The spatial release from masking task can complement traditional clinical measures to better account for patient's self-reported hearing difficulty. Open-source access to this test in PART supports its implementation for Spanish speakers in clinical settings around the world at low cost.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24470140.

Validation of the adaptive scan method in the quest for time-efficient methods of testing auditory processes

A major barrier to the clinical application of psychophysical testing of central auditory processes is the time required to obtain precise estimates of different listening abilities. In this study, we validate a novel adaptive scan (AS) method of threshold estimation that is designed to adapt on a range of values around threshold rather than on a single threshold value. This method has the advantage of providing the listener with greater familiarity with the stimulus characteristics near threshold while maintaining precise measurement and increasing time-efficiency. Additionally, we explore the time-efficiency of AS through comparison with two more conventional adaptive algorithms and the method of constant stimuli in two common psychophysical tasks: the detection of a gap in noise and the detection of a tone in noise. Seventy undergraduates without hearing complaints were tested using all four methods. The AS method provided similar threshold estimates with similar precision to those from the other adaptive methods and, thus, it is a valid adaptive method of psychophysical testing. We also provide an analysis of the AS method based on precision metrics to propose a shortened version of the algorithm that maximizes the time/precision tradeoff and can achieve similar thresholds to the adaptive methods tested in the validation. This work lays the foundation for using AS across a wide variety of psychophysical assessments and experimental situations where different levels of precision and/or time-efficiency may be required.

Remote auditory assessment using Portable Automated Rapid Testing (PART) and participant-owned devices

Remote testing of auditory function can be transformative to both basic research and hearing healthcare; however, historically, many obstacles have limited remote collection of reliable and valid auditory psychometric data. Here, we report performance on a battery of auditory processing tests using a remotely administered system, Portable Automatic Rapid Testing. We compare a previously reported dataset collected in a laboratory setting with the same measures using uncalibrated, participant-owned devices in remote settings (experiment 1, n = 40) remote with and without calibrated hardware (experiment 2, n = 36) and laboratory with and without calibrated hardware (experiment 3, n = 58). Results were well-matched across datasets and had similar reliability, but overall performance was slightly worse than published norms. Analyses of potential nuisance factors such as environmental noise, distraction, or lack of calibration failed to provide reliable evidence that these factors contributed to the observed variance in performance. These data indicate feasibility of remote testing of suprathreshold auditory processing using participants' own devices. Although the current investigation was limited to young participants without hearing difficulties, its outcomes demonstrate the potential for large-scale, remote hearing testing of more hearing-diverse populations both to advance basic science and to establish the clinical viability of auditory remote testing.