ObjectivesAs cochlear implant (CI) criteria widen, more candidates with usable residual hearing are being considered for a CI. Unlike children, adults mostly receive only one implant. The aim of this survey was to determine bimodal-hearing and bilateral CI service provision for adults around the world. This survey offers the backdrop against which future clinical practice and service delivery can be considered.MethodsCI professionals from across the world were invited to participate in an international multicentre survey. The online questionnaire was circulated to CI professionals in 75 countries. There were 64 respondents, representing 25 countries across five world regions.ResultsIn this sample, adult CI users most had unilateral CI (74.5%) and only 25.5% were bilateral CI users. Some 54% of unilateral CI users used a hearing aid (HA) in the non-implanted ear. Funding for a second implant or HA was not well supported for adult unilateral CI users, and there was no clear practice guidance for fitting and maintaining the contralateral HA in most regions.ConclusionsCI professionals recognised the value of fitting contralateral HAs at CI services, with audiology departments and private HA dispensers playing an ongoing role in general maintenance and support.

PURPOSE Unaddressed hearing loss can adversely affect employment and day-to-day work-life. Efficient and effective audiology support can help optimise hearing in the workplace. This study explores the audiological rehabilitation experiences of workers with hearing loss (WHL). MATERIALS AND METHODS Twenty-four WHL with experience of a wide range of audiology services across the UK participated in semi-structured interviews. Interviews were analysed using inductive thematic analysis. RESULTS Three main themes were generated: Theme 1: mixed experiences with audiology services (subdivided into two subthemes and four sub-subthemes). Theme 2: audiology role in work support (subdivided into three subthemes). Theme 3: "I think support could be improved if…" (subdivided into two subthemes). CONCLUSION The audiological rehabilitation for working-age adults with hearing loss needs improvements to deliver sufficient support and quality care. Some of the barriers to having better-functioning hearing healthcare require fundamental standards in healthcare quality, such as access to services, staff (including audiologists) deaf awareness, information and technology support, and personalised care that considers work-life needs. Further research is required to evaluate the feasibility and cost-effectiveness of improvements, such as support that extends beyond hearing aid care, whether from audiology or non-audiology services.

Objective: The goal is to implement the developed speech material in a hearing test to assess auditory fitness for duty (AFFD), specifically in areas where the intelligibility of spoken commands is essential. Design: In study 1, a speech corpus with equal intelligibility was constructed using constant stimuli to test each target word’s psychometric functions. Study 2 used an adaptive interleaving procedure to maximize equalized terms. Study 3 used Monte Carlo simulations to determine speech test accuracy. Study sample: Study 1 (n = 24) and study 2 (n = 20) were completed by civilians with normal hearing. Study 3 ran 10,000 simulations per condition across various conditions varying in slopes and speech recognition thresholds (SRTs). Results: Studies 1 and 2 produced three 8-word wordlists. The mean, standard deviation in dB SNR is −13.1 1.2 for wordlist 1, −13.7 1.6 for wordlist 2, and −13.7 1.3 for wordlist 3, with word SRTs within 3.4 dB SNR. Study 3 revealed that a 6 dB SNR range is appropriate for equally understandable speech using a closed-set adaptive technique. Conclusion: The developed speech corpus may be used in an AFFD measure. Concerning the homogeneity of the speech in noise test material, care should be taken when generalizing and using ranges and standard deviations from multiple tests.

Purpose This study explored audiologists' perspectives regarding their interactions with workers with hearing loss (WHL).Materials and methods Semi-structured interviews were conducted with twenty-five audiologists working in the National Health Service (NHS) and independent companies (IC) in the UK and were thematically analysed.Results The developed themes and sub-themes (shown in parenthesis) are (1) Current practices and routines (Same approach for most patients; Variations between hearing care services; Audiologists' personal experience of hearing loss) (2) Perceived challenges (Non-routine and challenging cases; The role of hearing technology; Concerns about lack of awareness and knowledge; Communication difficulties between services, Limited funding and resources) (3) Scope for better support (Would like to be informed; Other potential service improvements).Conclusions This study revealed that audiologists' perceived deficiencies in the hearing rehabilitation for WHL and identified ways to improve it. Key priorities for improvement were found to include addressing audiologists' informational and training needs, facilitating WHLs' access to appointments, improving communication between services, raising awareness in the workplace, developing relevant resources and extending funding for provision of longer appointments and hearing technologies. This is the first time this information has been reported in the literature. Opportunities for conducting further research in this area are suggested.Implications for rehabilitationWorkers with hearing loss face many challenges in work life and have the option of audiologic rehabilitation to alleviate their difficulties and improve their wellbeing; however, this study suggests that workers' audiological care needs improvements.Audiologists should assess and consider patients' work needs and psychosocial concerns in consultations to provide personalised care.Audiology educational programmes, services, and the healthcare system can assist audiologists in helping workers with hearing loss by providing updated knowledge, continuous training and improved interprofessional communication and patients' access to useful resources.

Objectives: To identify the average age of identification (AOI) and characteristics of Saudi children with sensorineural hearing loss (SNHL). Methods: Two cross-sectional studies were undertaken. Study A: the medical records of 1166 children aged 0-10 years old who visited the audiology clinics in four hospitals in Riyadh and Dammam during 2015 were reviewed. Study B: 174 carers of children aged 0-12 years who visited the audiology clinics in four hospitals in Riyadh during a three-month period were surveyed. Results: The mean AOI with SNHL in children was 3.2 years (SD = 2.5 years) and 3.1 years (SD = 2.6 years) with 14% and 16% not identified until after primary school age for Studies A and B, respectively. The presence of SNHL was positively associated with parental consanguinity, positive family history of SNHL, history of chemotherapy treatment, brain pathology and prior parental concern regarding their child's hearing. Conclusion: AOI of SNHL among Saudi children is deemed high in relation to the likely age of onset, with about 15 in 100 children identified after school age. Childhood hearing screening programmes (at birth and at school entry) should be considered in order to intervene earlier.

It is not well understood whether background speech affects the initial processing of words during reading or only the later processes of sentence integration. Additionally, it is not clear how eye movements support text comprehension in the face of distraction by background speech and noise. In the present research, participants read single sentences (Experiment 1) and short paragraphs (Experiments 2-3) in 4 sound conditions: silence, speech-spectrum Gaussian noise, English speech (intelligible to participants), and Mandarin speech (unintelligible to participants). Intelligible speech did not affect the lexical access of words and had a limited effect on the first-pass fixations of words. However, it led to more regressions and more rereading fixations compared with both unintelligible speech and silence. The results suggested that the distraction is mostly semantic in nature, and there was only limited evidence for a contribution of phonology. Finally, intelligible speech disrupted comprehension only when participants were prevented from rereading previous words. These findings suggest that the semantic properties of irrelevant speech can disrupt the ongoing reading process, but that this disruption occurs in the postlexical stages of reading when participants need to integrate words to form the sentence context and to construct a coherent discourse of the text. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Abstract Objective: The studies described in this article outline the design and development of a British English version of the coordinate response measure (CRM) speech-in-noise (SiN) test. Our interest in the CRM is as a SiN test with high face validity for occupational auditory fitness for duty (AFFD) assessment. Design: Study 1 used the method of constant stimuli to measure and adjust the psychometric functions of each target word, producing a speech corpus with equal intelligibility. After ensuring all the target words had similar intelligibility, for Studies 2 and 3, the CRM was presented in an adaptive procedure in stationary speech-spectrum noise to measure speech reception thresholds and evaluate the test–retest reliability of the CRM SiN test. Study sample: Studies 1 (n = 20) and 2 (n = 30) were completed by normal-hearing civilians. Study 3 (n = 22) was completed by hearing impaired military personnel. Results: The results display good test–retest reliability (95% confidence interval (CI) < 2.1 dB) and concurrent validity when compared to the triple-digit test (r ≤ 0.65), and the CRM is sensitive to hearing impairment. Conclusion: The British English CRM using stationary speech-spectrum noise is a “ready to use” SiN test, suitable for investigation as an AFFD assessment tool for military personnel.

Some blind people use echoes to detect discrete, silent objects to support their spatial orientation/navigation, independence, safety and wellbeing. The acoustical features that people use for this are not well understood. Listening to changes in spectral shape due to the presence of an object could be important for object detection and avoidance, especially at short range, although it is currently not known whether it is possible with echolocation-related sounds. Bands of noise were convolved with recordings of binaural impulse responses of objects in an anechoic chamber to create ‘virtual objects’, which were analysed and played to sighted and blind listeners inexperienced in echolocation. The sounds were also manipulated to remove cues unrelated to spectral shape. Most listeners could accurately detect hard flat objects using changes in spectral shape. The useful spectral changes for object detection occurred above approximately 3 kHz, as with object localisation. However, energy in the sounds below 3 kHz was required to exploit changes in spectral shape for object detection, whereas energy below 3 kHz impaired object localisation. Further recordings showed that the spectral changes were diminished by room reverberation. While good high-frequency hearing is generally important for echolocation, the optimal echo-generating stimulus will probably depend on the task.

Under certain conditions, sighted and blind humans can use echoes to discern characteristics of otherwise silent objects. Previous research concluded that robust horizontal-plane object localisation ability, without using head movement, depends on information above 2 kHz. While a strong interaural level difference (ILD) cue is available, it was not clear if listeners were using that or the monaural level cue that necessarily accompanies ILD. In this experiment, 13 sighted and normal-hearing listeners were asked to identify the right-vs.-left position of an object in virtual auditory space. Sounds were manipulated to remove binaural cues (binaural vs. diotic presentation) and prevent the use of monaural level cues (using level roving). With low- (<2 kHz) and high- (>2 kHz) frequency bands of noise, performance with binaural presentation and level rove exceeded that expected from use of monaural level cues and that with diotic presentation. It is argued that a high-frequency binaural cue (most likely ILD), and not a monaural level cue, is crucial for robust object localisation without head movement.

The ability to listen to commands in noisy environments and understand acoustic signals, while maintaining situational awareness, is an important skill for military personnel and can be critical for mission success. Seventeen auditory tasks carried out by British infantry and combat-support personnel were identified through a series of focus groups conducted by Bevis et al. For military personnel, these auditory tasks are termed mission-critical auditory tasks (MCATs) if they are carried in out in a military-specific environment and have a negative consequence when performed below a specified level. A questionnaire study was conducted to find out which of the auditory tasks identified by Bevis et al. satisfy the characteristics of an MCAT. Seventy-nine British infantry and combat-support personnel from four regiments across the South of England participated. For each auditory task participants indicated: 1) the consequences of poor performance on the task, 2) who performs the task, and 3) how frequently the task is carried out. The data were analysed to determine which tasks are carried out by which personnel, which have the most negative consequences when performed poorly, and which are performed the most frequently. This resulted in a list of 9 MCATs (7 speech communication tasks, 1 sound localization task, and 1 sound detection task) that should be prioritised for representation in a measure of auditory fitness for duty (AFFD) for these personnel. Incorporating MCATs in AFFD measures will help to ensure that personnel have the necessary auditory skills for safe and effective deployment on operational duties.

In order to preserve their operational effectiveness and ultimately their survival, military personnel must be able to detect important acoustic signals and maintain situational awareness. The possession of sufficient hearing ability to perform job-specific auditory tasks is defined as auditory fitness for duty (AFFD). Pure tone audiometry (PTA) is used to assess AFFD in the UK military; however, it is unclear whether PTA is able to accurately predict performance on job-specific auditory tasks. The aim of the current study was to gather information about auditory tasks carried out by infantry personnel on the frontline and the environment these tasks are performed in. The study consisted of 16 focus group interviews with an average of five participants per group. Eighty British army personnel were recruited from five infantry regiments. The focus group guideline included seven open-ended questions designed to elicit information about the auditory tasks performed on operational duty. Content analysis of the data resulted in two main themes: (1) the auditory tasks personnel are expected to perform and (2) situations where personnel felt their hearing ability was reduced. Auditory tasks were divided into subthemes of sound detection, speech communication and sound localization. Reasons for reduced performance included background noise, hearing protection and attention difficulties. The current study provided an important and novel insight to the complex auditory environment experienced by British infantry personnel and identified 17 auditory tasks carried out by personnel on operational duties. These auditory tasks will be used to inform the development of a functional AFFD test for infantry personnel.