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. 2009 Oct;30(5):613-27.
doi: 10.1097/AUD.0b013e3181b00d90.

Development and efficacy of a frequent-word auditory training protocol for older adults with impaired hearing

Larry E Humes  1 , Matthew H Burk, Lauren E Strauser, Dana L Kinney
Affiliations

Development and efficacy of a frequent-word auditory training protocol for older adults with impaired hearing

Larry E Humes et al. Ear Hear. 2009 Oct.

Abstract

Objectives: The objective of this study was to evaluate the efficacy of a word-based auditory-training procedure for use with older adults who have impaired hearing. The emphasis during training and assessment is placed on words with a high frequency of occurrence in American English.

Design: In this study, a repeated-measures group design was used with each of the two groups of participants to evaluate the effects of the word-based training regimen. One group comprised 20 young adults with normal hearing and the other consisted of 16 older adults with impaired hearing. The group of young adults was not included for the purpose of between-group comparisons. Rather, it was included to demonstrate the efficacy of the training regimen, should efficacy fail to be demonstrated in the group of older adults, and to estimate the magnitude of the benefits that could be achieved in younger listeners.

Results: Significant improvements were observed in the group means for each of five measures of post-training assessment. Pretraining and post-training performance assessments were all based on the open-set recognition of speech in a fluctuating speech-like background noise. Assessment measures ranged from recognition of trained words and phrases produced by talkers heard during training to the recognition of untrained sentences produced by a talker not encountered during training. In addition to these group data, analysis of individual data via 95% critical differences for each assessment measure revealed that 75 to 80% of the older adults demonstrated significant improvements on most or all of the post-training measures.

Conclusions: The word-based auditory-training program examined here, one based on words having a high frequency of occurrence in American English, has been demonstrated to be efficacious in older adults with impaired hearing. Training on frequent words and frequent phrases generalized to sentences constructed from frequently occurring words whether spoken by talkers heard during training or by a novel talker.

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Figures

Figure 1
Figure 1
Mean air-conduction pure-tone thresholds for the test ear for the two subgroups of older adults, one received training Protocol 1 (filled circles) and the other received training Protocol 2 (unfilled circles). Thin vertical lines represent one standard deviation above or below the corresponding group mean.
Figure 2
Figure 2
The long-term amplitude spectra measured in Adobe Audition for the words (top panel), phrases (middle panel) and sentences (bottom panel) produced by each of the four talkers, as well as the corresponding long-term spectra for the ICRA noise used as competition with these materials.
Figure 3
Figure 3
The 1/3-octave-band levels measured in the 2-cm3 coupler for the steady-state calibration noise shaped to match the spectrum of the two-talker ICRA noise.
Figure 4
Figure 4
Means and standard deviations are shown in rationalized arcsine units (RAU; Studebaker, 1985) for the young adults with normal hearing (top) and the older adults with impaired hearing (bottom). Black bars represent pre-training baseline performance and grey or white bars represent post-training performance. Thin vertical lines depict corresponding standard deviations.
Figure 5
Figure 5
Individual improvements from pre-training baseline to post-training evaluation, training benefit, on the set of 200 randomly selected frequent words for each of the 16 older adults with impaired hearing. The solid horizontal line illustrates the 95% critical difference in RAU for a test comprised of 200 items (Studebaker, 1985).
Figure 6
Figure 6
Individual improvements from pre-training baseline to post-training evaluation, training benefit, on for sets of speech materials: (1) CID 1 Everyday Sentences (top left); (2) CID 2 Everyday Sentences (top right); (3) modified VAST sentences (bottom left); and (4) frequent phrases (bottom right). The solid horizontal line in each panel again illustrates the 95% critical difference in RAU for each measure.
Figure 7
Figure 7
Scatterplots of the individual CID 1 training improvements (y axes) versus CID pre-training baseline score (top, x axis) and age (bottom, x axis). The data points for the four older adults who showed the least amount of generalization of training (Participants 6, 8, 9 and 10) have been circled in each scatterplot.
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