Hearing Loss, Hearing Devices, and the Business of Childhood

Andrea Pittman, PhD CCC-AArizona State University Pediatric Amplification Labpedamp.asu.edu/presentations We Give Kids Volume

DisclosuresAnd the help of research assistants (The Pitt Crew):Current: Previous:Elizabeth Rainy Ian Odgear Elizabeth StewartLauren Meadows Amanda Willman Ashley WrightNicole Marzan Madalyn Rash Amy Stahl Beatriz Lazaro Brittany Schuett (and many more)

This work was supported by grants from:

And collaborators:

Rachel Krupa – Mesa Public Schools, AZJudy Attaway – Casa Colina Hospital, CADan Duran – Valley Children’s Hospital, CAKari Morgenstein – Miami Univ Hospital, FLKristy Winters – Michigan Univ Hospital, MI

Arizona CommunityFoundation

Hearing Industry Research Consortium

Leadership Fund

The kids we’re talking about

The kids we’re talking about

Profound

Mild

AGE (years)

HEA

RIN

G L

OSS

(d

egr

ee)

0 5 10 15 18

The business of childhood

Vocabulary Development

2

4

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18

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24

4 6 8 10 12 14 16

PP

VT

Vo

cab

ula

ry A

ge (

Yrs)

Chronological Age (Yrs)

NHC

HIC

AGE (years)

HEA

RIN

G L

OSS

(d

egre

e)

81 HI Children 110 NH Children

Pittman & Latto (1998-2008)

Secretly Awesome

Vocabulary Development

AGE (years)

HEA

RIN

G L

OSS

(d

egre

e)

40 HA Children 47 CI Children

Blamey et al (2001) Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing, JSLRH, 44, 264-285.

Secretly Awesome

Vocabulary Knowledge - College Students

106

82

0

20

40

60

80

100

120

NH HL

PP

VT

Stan

dar

d S

core

7.7

15.5

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25

30

NH HL

PP

VT

Ove

rest

imat

e (1

20

item

s)

Vocabulary Knowledge

Overestimate of Vocabulary

Knowledge

Sarchet et al (2014), Vocabulary knowledge of deaf and hearing postsecondary students, J Postsecond Educ Disabil, 27(2), 161-178.

93 Hearing loss97 Normal hearing

AGE (years)

HEA

RIN

G L

OSS

(d

egre

e)

What does it take to learn a new word?

To learn a new word a child needs to be able to:

1) Perceive speech

2) Detect that a word is new (unknown)

3) Learn what the new word means

4) Remember the new word

Auditory Lexical Decision Task

“Swim”Repeat Categorize

Swim Real

Swim Not Real

Srim Real

Srim Not Real

Whim Real

Whim Not Real

pedamp1.asu.edu/presentations

Repeat Categorize

Glat Not Real

Glat Real

Glad Not Real

Glad Real

Grat Not Real

Grat Real

“Glat”

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AIDED

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eban

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rrec

t)

Narrowband (Prop. Correct)

Wideband

NLFC

Amplification Bandwidth (Wide vs Narrow)

Pittman, Stewart, Odgear & Willman (2017) Detecting and learning new words: The impact of advancing age and hearing loss. American Journal of Audiology.

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Digital Noise Reduction (On vs Off)

Pittman, Stewart, Willman & Odgear (2017) Word recognition and learning: Effects of hearing loss and amplification feature, Trends in Hearing.

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BINAURAL FF UNAIDEDBINAURAL FF OFFBINAURAL FF ON

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Bone Conduction (Softband vs Direct)

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N)

SoftbandDirect

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Pittman (in progress)

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Softband Coupling (Prop Correct)

Non-Word Detection 2.0

# of

nonsense

words

Example phrase

0 Clocks tick on time.

1 Birds rike long worms

2 Dats catch slow bice.

3 -

4 -

0 1 2 42 31 NEXT

Amplification (Unaided vs Aided)

Pittman & Daliri (in progress)

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RealNonsense

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Real

Nonsense

Bone Conduction (Softband vs Direct)

Pittman (in progress)

Rapid Word Learning

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5 25 45 65 85 105 125 145

PER

FOR

MA

NC

E (%

Co

rrec

t)

TRIALS

𝑃𝑐 = 1 − 0.80𝑒−𝑛/𝑐

Learning Speed:3 = 1 trial (perfect learning)2 = 10 trials1 = 100 trials0 = 1000 trials (no learning)

Rapid Word Learning

115 correct/150 trials

=77%

High-Frequency AmplificationNLFC

WB

Pittman, Stewart, Odgear & Willman (2017) Detecting and learning new words: The impact of advancing age and hearing loss. American Journal of Audiology.

0

1

2

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0 1 2 3

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eb

and

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arn

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spee

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Digital Noise Reduction (on vs off)

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BINAURAL FF UNAIDEDBINAURAL FF OFFBINAURAL FF ON

Pittman, Stewart, Willman & Odgear (2017) Word recognition and learning: Effects of hearing loss and amplification feature, Trends in Hearing.

0.0

0.5

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ect

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up

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(lea

rnin

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eed

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Softband Coupling (learning speed)

Bone Conduction (direct vs softband)

pedamp1.asu.edu/presentationsPittman (in progress)

.59

.66

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.84

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.87

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1.0NB

WB

.89

1.79

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Group Results – Amplification Bandwidth

NWD 1.0 WORD LEARNINGLEXICAL DECISIONWORD RECOGNITION

PER

FOR

MA

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RO

P. C

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PER

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T)

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E (P

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T)

LEA

RN

ING

SP

EED

(LO

G N

/10

00

)

Pittman, Stewart, Willman & Odgear (2017) Word recognition and learning: Effects of hearing loss and amplification feature, Trends in Hearing.

.46 .46

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.46 .46

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Group Results – Digital Noise Reduction

NWD 1.0 WORD LEARNINGLEXICAL DECISIONWORD RECOGNITION

PER

FOR

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PER

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RN

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SP

EED

(LO

G N

/10

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)

Pittman, Stewart, Willman & Odgear (2017) Word recognition and learning: Effects of hearing loss and amplification feature, Trends in Hearing.

Group Results – Bone Conduction

0.74 0.76

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1.0

PER

FOR

MA

NC

E (P

RO

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SoftbandDirect

0.61

0.71

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FOR

MA

NC

E (P

RO

P. C

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T)1.18

1.44

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SEN

SITI

VIT

Y (D

-PR

IME)

0.84

1.19

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NWD 2.0 WORD LEARNINGLEXICAL DECISIONWORD RECOGNITION

Pittman (in progress)

Are the new words remembered?Retention Posttest

Name Name Name

Learning

Pittman, Wright, Latto, Wright (in process)

Are the new words remembered?

0

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50 100 150 200

Perf

orm

ance

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rrec

t)

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TrainingRetention

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orm

ance

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NORMAL HEARING

HEARING LOSS

Pittman, Wright, Latto, Wright (in process)

If given enough trials, children with hearing loss can learn as quickly as children with normal hearing but they need more training than children with normal hearing to remember what they’ve learned.

Catching up

Vocabulary Size

The average undergraduate student knows between 15,000 and 200,000 words (D’Anna et al, 1991).

Oxford Dictionary of American English:

1000+ new entries each year

1. new words

2. new definitions to existing words

D’Anna, Zechmeister, and Hall (1991) Toward a meaningful definition of vocabulary size. Journal of Reading Behavior 23.1: 109–22.

Let’s do a little math…

Children:

50,000 word vocabulary

learned over 18 years (3 to 22 years)

= 7 new words everyday

Adults:

1,000 new words per year

= 3 new words every day

Vocabulary Knowledge - Adults

Older adults outperform younger adults on standardized vocabulary tests (Verhaeghen, 2003).

Flynn Effect: Scores increase with age due to a cohort effect that favors the earlier born (Flynn, 1987).

Verhaeghen (2003) Aging and Vocabulary Scores: A Meta- Analysis. Psychology and Aging, 18(2), 332–339.Flynn (1987) Massive IQ gains in 14 nations: What IQ tests really measure. Psychological Bulletin, 101, 171–191.

VocabTest

1960 1970 1980 1990 2000 2010 2020

70 yrs20 yrs

20-50

Word Type # Example

Old Words 15 Aghast: Filled with horror or shock

Old words with a new definition

15Ship: The desire of a fan for two fictional characters to be in a romantic relationship

New words 15Geotag: An electronic tag that assigns a geographical location to a photograph

Nonsense words 5 Desill

Vocabulary Knowledge - Adults

Pittman, Stahl & Marzan (in process)

Vocabulary Knowledge - Adults

0.0

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Overall Old Words New Words Nonsense Words

Perf

orm

ance

20-30 yrs

40-50 yrs

60-70 yrs

n=48

n=50

n=16

Pittman, Stahl & Marzan (in process)

Vocabulary Knowledge - Adults

21 Adults 19-88 years

Pittman, Stahl & Marzan (in process)

Old Words: r = -.17, p=.51Partial correlations controlling for age

New Words: r= -.83, p<.001*Partial correlations controlling for age

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Perf

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ance

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rop

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Degree of Hearing Loss (4FPTA, dB HL)

Old Words

New Words

What have we learned today?

We’ve learned that…Perceiving words we already know is easy,

but learning new words is more challenging.

Learning new words is directly related to:

1) the quality of the auditory signal

2) the opportunities to learning

When we optimize amplification for children (and adults), we optimize their opportunities to learn.

pedamp1.asu.edu/presentations

pedamp.asu.edu/presentations

Thank you!