AmericanAuditorySocietyScientificandTechnologyMeetingMarch3-5,2016PODIUMPRESENTATIONS:Thursday,March3,2016PODIUMSESSIONI:HEARINGAIDSINADULTSANDCHILDRENPodiumPaperI.A.HearingAids:User-AdjustmentofOutputandSpectrumArthurBoothroyd,PhD;CarolMackersie,PhD,SanDiegoStateUniversity,SanDiego,CAThisstudywascarriedoutinpreparationforresearchintotheefficacyof,andcandidacyfor,user-fittingandreadjustmentofhearing-aids.Self-fittingsoftwarewasdevelopedtoprovideadjustmentofhigh-frequencyboost,low-frequencycut,andoveralllevel.Asampleofparticipantswithmild-to-moderatehearinglossmadetheseadjustmentswhilelisteningtoprerecordedspeech.Word-in-sentencerecognitionwasthenmeasuredusingthelistener’sadjustment(Aided1).Theprocesswasrepeated(Aided2).Finally,word-recognitionwasmeasuredatanormalconversationallevelwithoutspectraladjustment(Unaided).MeanadjustmenttimewastwominutesforAided1andoneminuteforAided2.Meanwordrecognitionrosefrom46%unaidedto88%forAided1and91%forAided2.Aninterestingfindingwasthatlistenersconsistentlyoptedforincreasedlevelandincreasedhighfrequencyboostafterthefirstword-recognitiontest.Thisfinding,thoughnotconclusive,suggeststhatself-testing,aspartofaself-fittingprocess,canincreasetheimportanceofintelligibility(relativetoquality)indeterminingalistener’sadjustmentcriteria.Thedatasupporttheconclusionthateffectiveself-fittingofamplificationisfeasiblebuttheeffectsofhearing-aidexperience,startingconditions,theinclusionofself-testing,andusercharacteristicshaveyettobedetermined.PodiumPaperI.B.EffectivenessofPremiumandBasicHearingAidTechnologiesYu-HsiangWu,PhD;ElizabethStangl,AuD,TheUniversityOfIowa,IowaCity,IAAlthoughdirectionalmicrophones(DM)andnoisereduction(NR)algorithmsareimportanthearingaidtechnologiesdesignedtoimprovelisteningexperienceinnoise,theevidenceoftheireffectivenessintherealworldislimited.Furthermore,itisunknownifmoreadvancedDM/NRcurrentlyonlyavailableonhigh-cost,premiumhearingaidswouldprovidemorebenefitthanDM/NRoflow-cost,basichearingaids.ThepurposeofthisstudywastodetermineandcomparetheeffectivenessofDM/NRtechnologiesofpremiumandbasichearingaids.Thestudyusedarepeated-measuredesignwithfourconditions,whichconsistedoffactorialcombinationsofhearingaidmodel(premiumandbasic)andDM/NRstatus(onandoff).Tomeasurereal-worldoutcomes,standardizedquestionnaireswereused.Theparticipantsalsousedsmartphonesthatdeliveredsurveysseveraltimesperdaytoreporttheirreal-timeexperiencewithhearingaids(i.e.,theecologicalmomentaryassessment;EMA).Intotal,fifty-oneadultscompleted8,592EMAsurveys.TheresultsofthequestionnairesandEMAindicatedthattheparticipantsreportedbetteroutcomesintheDM/NR-onthan-offconditions,supportingtheeffectivenessofDM/NR.TheEMAresultsfurthersuggestedthatpremiumandbasicDM/NRhadadifferentialeffectonoutcomes.Theimplicationoftheseoutcomemeasureswillbediscussed.

PodiumPaperI.C.HearingAidGainPreferencesinNoisyRoomsPeggyNelson,PhD;DianneVantasell,PhD;MelanieGregan,PhD;TrevorPerry,UniversityOfMinnesota,Minneapolis,MNNoisyrestaurantsarechallengingenvironmentsforhearing-aidusersandarethesourceofdissatisfactionformany.Self-adjustmenttechnologycanprovidecustomamplificationparameterstoaccommodatelistenerpreferencesinnoise.Previousresults(Nelsonetal,AAS2015)indicatedthatassignal-to-noiseratio(SNR)decreases,somelistenersreducehearingaidgain,withsignificantvariabilityacrosslisteners.Datawillbepresentedfrom30listenersaged52-79yearswithmildtomoderatehearinglosswhoself-adjustedamplificationparametersinsimulatedrestaurantenvironments.ParticipantslistenedusinganiPodTouchrunningareal-timesimulationofamultichannelcompressionhearingaid,withgain/compressionparametersadjustableviaasimpleuserinterface(EarMachine).Listenersadjustedamplificationparameterswhilelisteningtorunningspeechatsignallevelsof65dBCandSNRsof+25to-10dB.Listeners’self-adjustedgaininquietwasnearthatprescribedbyNAL-NL2,withslightlyhighergaininlow-frequencyregionsandslightlylowergaininhighfrequencies.Onaverage,listenersselected9dBlowergaininthelowestSNRcondition.IndividualdifferencesfromNALtargetswerenotrelatedtohearinglossorage.Intelligibilitytestingconfirmedthatalthoughlistenersreducedgainindifficultconditions,reductionsseldominterferedwithspeechunderstanding.Acknowledgements:NIDCDR01DC01309301,EarMachine.PodiumPaperI.D.ImpactofSimulatedMicrophoneDirectionalityonMonitoringComplexAuditoryScenesJulieCohen,AuD;LaguinnSherlock,AuD;DouglasBrungart,PhD,WalterReedNationalMilitaryMedicalCenter,Bethesda,MDAnecdotalresultsoftensuggestthatlistenersreceivelessbenefitfromdirectionalmicrophonetechnologyinrealworldlisteningenvironmentsthantheydoincontrolledlaboratoryexperiments.Oneexplanationforthismightbethatlaboratoryexperimentstendtofocusonselectiveattentiontasks,wherealistenerisaskedtofocusattentiononasingletalkerataknownlocation,whereasreal-worldenvironmentsoftenrequirelistenerstoperformdividedattentiontaskswheretheyattendtoatargettalkerwhilescanningtheauditorysceneforimportantevents.Thisstudywillassesshowdirectionalmicrophoneconfigurationsimpactauditoryawarenessinataskthatrequireslistenerstodetectandlocalizechangesinacomplexscene,including:1)additionofatalker;2)removalofatalker,3)changeintalkeridentity(e.g.,gender),and4)changeintopicofsentencesspokenbyatalker.Directionalhearingwillbesimulatedfornormalhearinglistenersbyadjustingthegainofeachsourceinresponsetochangesintheorientationoftheirhead.Resultswillbediscussedintermsoftheimpactofdirectionalityonspeedandaccuracyofchangedetectionineachconditionandintermsofthepatternsofexploratoryheadmovementsthatoccurineachcondition.PodiumPaperI.E.ApplicationofCROSinChildrenwithSevereUnilateralHearingLoss

MeghanWisneski,AuD;ErinChristianson,PhD;JulieKinsman,AuD;SusanNorton,PhD,SeattleChildren'sHospital,Seattle,WAThepurposeofthisstudywastodetermineifchildrenwithsingle-sideddeafness(SSD)showimprovedperformanceonspeechperceptiontasksinnoisewhileusingmoderncontralateralroutingofsignal(CROS)systemscomparedtotheunaidedcondition.WehypothesizedthatCROS-aidedspeechperceptionperformancewouldbebetterthantheunaidedcondition.Thirty-sevenchildrenwithSSDandnormalornear-normalhearingthresholdsinthebetterhearingearwereincludedinourcohort.Speechperceptiontestinginnoisewascarriedoutinasound-treatedboothsuchthatthetargetsignalwasdirected90degreestowardsthepoorerhearingearandmaskingnoisewasdirected90degreestowardsthebetterhearingear(S90ssd/N90nh),relativeto0degreesazimuth.TheresultsshowedthatCROS-aidedspeechperceptionscoresinnoiseweresignificantlybetterthantheunaidedinnoisecondition.ModernCROShearingsystemsareanappropriatetreatmentmethodforchildrenwithSSD.Thisoptionisanon-surgicalapproachandshouldbeconsideredafirststepintreatmentforSSD.WerecommendregularperformanceevaluationsforchildrenwhouseaCROSsystemandthatthistestingiscompletedinanS90ssd/N90nh,relativeto0degreesazimuth,configuration.PodiumPaperI.F.SentenceRecognitioninNoiseandReverberationforChildrenwithHearingAidsRyanMcCreery,PhD;BenjaminKirby,PhD;MeredithSpratford,AuD;MarcBrennan,PhD,BoysTownNationalResearchHospital,Omaha,NEElizabethWalker,PhD,UniversityOfIowaChildrenwithhearinglossmustlistenandunderstandspeechinclassroomsandotheracousticenvironmentswithnoiseandreverberation.Significantindividualvariabilityinperformanceacrosschildrenmayberelatedtodifferencesinauditoryexperienceandcognition.Todate,fewstudieshaveexaminedthefactorsthatsupportlisteninginnoiseandreverberationforchildrenwhowearhearingaids.Thecurrentstudyincluded48childrenwhoworehearingaidsand48age-matchedpeerswithnormalhearing.Weexaminedhowfactorsrelatedtoamplificationandcognitiveabilitiesinfluencedindividualdifferencesinsentencerecognitioninnoiseandreverberation.Wepredictedthatchildrenwithhigheraidedaudibilityandmoreconsistenthearingaidusewouldhavebetterspeechrecognitioninnoiseandreverberationthanpeerswithpooreraudibilityorlessconsistenthearingaiduse.Childrenwithstrongworkingmemoryabilitieswerealsoexpectedtohavebetterspeechrecognitioninnoiseandreverberationduetoanenhancedabilitytomaintainphonologicalrepresentationsofdegradedstimuliduringrecognition.Wefoundthatregardlessofhearingstatus,childrenwithstrongerworkingmemoryabilitieshadbetterspeechrecognitionthanpeerswithpoorerabilities.Childrenwithhearingaidswhohadhigheraidedaudibilityalsohadbetterspeechrecognitioninnoiseandreverberation. PODIUMSESSIONII:PHYSIOLOGICALMEASURESOFTHEAUDITORYSYSTEMPodiumPaperII.A.HighFrequencyTransient-EvokedOtoacousticEmissionMeasurementsinYoungAdults

DouglasKeefe,PhD;DenisFitzpatrick,PhD;MarcinWrobkewski,AuD,BoysTownNationalResearchHospital,Omaha,NEPatrickFeeney,PhD;DanielPutterman,AuD,VAPortlandHealthCareSystem,NationalCenterForRehabilitativeAuditoryResearch,Portland,ORAngelaGarinis,PhD,OregonHealth&ScienceUniversity,Portland,ORLisaHunter,PhD,CincinnatiChildren'sHospitalMedicalCenter,Cincinnati,OHTransient-evokedotoacousticemission(TEOAE)responsestoclicksandchirpsweremeasuredinalow-frequency(LF)band(0.7-8kHz)andhigh-frequency(HF)band(7.1-14.7kHz)inyoungadultswithnormalhearing.Ineachband:(1)aclickstimuluswasdesignedtohaveaflatincidentpressurelevelwithminimaltemporaldispersion,and(2)sixchirpstimulihadaninstantaneousfrequencythateitherincreasedordecreasedlinearlywithtimeatoneofthreesweeprates(317,188,or53Hz/ms).TEOAEswereacquiredforeachstimulustypetocomparebandwidth,sweep-rateandleveleffects.SignificantTEOAEsweredetectedintimeandfrequencydomainsbasedonthesignal-to-noiseratioandthecoherencesynchronymodulus.ClickTEOAEswereanalyzedintermsofgroupdelayandgroupspreadacrossfrequency,andinstantaneousfrequencyandinstantaneousbandwidthacrosstime.ChirpTEOAEsweretransformedintoequivalentclickTEOAEsandanalyzedinamannersimilartoclickTEOAEanalyses.TheseLFandHFstimuliwithvaryingphasecharacteristicsgenerateTEOAEssensitivetocochlearfunctionandspatial-temporalsuppression.BaselinenormativedatawillbeusefulinresearchtoimprovelongitudinalmonitoringprogramsthatuseHFTEOAEstopredictchangesinhearingduetoototoxicity.SupportedbyNIHR01DC010202.PodiumPaperII.B.TheFunctionalRolesofHairCellsandSpiralGanglionNeuronsinComplexListeningSituationsMarkParker,PhD,TuftsUniversitySchoolOfMedicine,Boston,MAEfoeNyatepee-coo,AuD;GiftyEasow;RichardHoben,AuD,StElizabethsMedicalCenterTheoverallaimofthisresearchistodescribethefunctionalrolesplayedbyhaircellsandspiralganglionneuronsinaudition.Severalrecentlinesofresearchhavehighlightedthecriticalfunctionalroleofthespiralganglionincomplexlisteningsituations,suchasspeechrecognitioninthepresenceofbackgroundnoise.Thisstudyextendsthisworktodeterminewhethertheouterhaircellsalsoplayaroleinspeechprocessingduringcomplexlisteningsituations.Totestthis,normalandhearingimpairedsubjects(N=25)weresubjectedtospeechrecognitiontestinginquite(NU-6)andinthepresenceofcompetingbackgroundnoise(QuickSIN),andthenouterhaircellfunction(DPOAEamplitude)andspiralganglion(ABRwaveIamplitude)functionwasmeasured.Statisticaldifferencesbetweennormalandimpairedgroupswasmeasuredbystudentst-testandANOVA,andalinearmixedregressionmodelwasusedtoidentifycorrelationsbetweenpatientage,puretoneaverage,NU-6scores,DPAOEamplitudes,andwaveIamplitudes.ThepreliminaryresultsindicatethatpoorerQuickSINscores(<5SNRloss;p=0.00),butnotNU-6scores(p=0.23),areassociatedwithbothreducedDPOAEamplitudes(mean4KHzDPOAE=>-7.7+/-2.2s.e.m.)andreducedwaveIamplitudes(meanpeak-trough>0.12V+/-0.05s.e.m.).Furthermore,thereisastrongercorrelationbetweenspeechrecognitioninnoiseandhaircellandspiralganglionfunctionasthepatientages.Thesepreliminaryresultssuggestthatbothouterhaircellsandthespiralganglionplayafunctionalroleinspeechdiscriminationinthepresenceofbackgroundnoise,butnotinquiet.

PodiumPaperII.C.PhysiologicalMeasuresofHearingAfterExposuretoInfantSleepMachinesAndrewDimitrijevic,PhD;LisaHunter,PhD;MichaelSmith;DavidMoore,PhD,CincinnatiChildren'sHospitalMedicalCenter,CommunicationSciencesResearchCenter,Cincinnati,OHInfantsleepmachines(ISMs)aredevicesthatgeneratenoise,intendedtohelpbabiessleep.ArecentstudyshowedthatISMscandeliversoundsatlevelswellaboverecommendedoccupationalhealthandhospitalnurserystandardsindicatingthatsomeparentsmightbeexposingtheirchildrenatsoundlevelscapableofcausingdamage.ThisstudysoughttodeterminewhetherISMexposureisrelatedtohearingimpairment.WequantifiedISMuseinchildrenthroughtheuseofaparent-basedquestionnaire.Additionally,soundlevelmeasurementsoftheISMwereperformed.Inbothnon-ISMexposedandISMexposedchildren,wemeasuredotoacousticemissions(OAEs),auditorybrainstemresponses(ABR),auditorysteadystateresponses(ASSRs),andcorticalresponsestospectralandtemporal‘change’responses.Preliminarydatafrom10controland7ISMexposedchildrendidnotshowsignificantdifferencesbetweenthetwogroups.NodifferencesinOAEthresholdsoramplitudeswereobserved.However,allelectrophysiologicalmeasuresshowedreduced,mean,suprathresholdevokedresponseamplitudeintheISMgroup,particularlyintheyoungestoftheISMexposedchildren.ThesepreliminaryfindingssuggestthatISMexposuredoesnotaffectouterhaircellhearingthresholdsbutmayaffectsuprathresholdhearing.Thefindingssuggestthatthesechildrenmayexperiencedifficultiesinnoisyenvironmentssuchasabusyclassroom.Moredataareneededtodeterminewhethermoresubtle,significantdifferencesarepresent.PodiumPaperII.D.Relationshipbetween20HzAuditorySteady-StateandTransientAuditoryEvokedPotentialsOzcanOzdamar,PhD;FredHolt,PhD;JorgeBohorquez,PhD,UniversityOfMiami,CoralGables,FLWhentheauditorysystemisstimulatedwithbriefsoundspresentedat20Hz,anenhancedamplitudedoublepeakedauditorysteady-stateresponse(ASSR)isobserved.Spectralanalysisshowsalargecomponentat20Hzwithasmallercontributionat40Hz.Although20HzASSRactivityhasbeenknowntobemodulatedbyattentionanddifferentlevelsofarousalandimplicatedinseveralpsychiatricdisorders,itstruenatureandrelationshipto40HzASSRsandtransientauditoryevokedresponses(AEPs)arenotknown.Inthisstudypossiblegenerationmechanismsofthe20HzASSRsarestudiedusingsyntheticallygeneratedresponsesderivedfromtransientAEPsobtainedbydeconvolutionofrecordingsataroundthesamefrequency.Simulationstudiesusingpeakremovalsshowthatwaveforminteractionsofthebrainstem,middleandearlylateresponsecomponents(V,Na,Pa,NbandP1)appeartoberesponsibleforsuchwaveformcharacteristicsandaccountfortheobservedamplitudeincreaseatthisfrequency.Thefirstlargepositivepeakofthe20HzASSRwasmostlygeneratedbyVandP1whilePawasresponsibleforthesecondsmallerpeak.ThenegativepeaksweremostlyduetoNaandNb,respectively.Magnitudeandphasespectralanalysisoftheacquiredandsyntheticwaveformscloselymatchedtheresults.PodiumPaperII.E.

NeuralCorrelatesoftheBinauralMaskingLevelDifferenceinHumansChristopherClinard,PhD;SarahHodgson,JamesMadisonUniversity,Harrisonburg,VAProcessingrelatedtobinauralmaskingleveldifferences(BMLDs)hasbeenconfirmedintheauditorybrainstemofnon-humanmammals,butattemptstofindneuralcorrelatesofBMLDhavebeenlargelyunsuccessfulwhenstudyingresponsesfromthehumanauditorybrainstem.BMLDsat500Hzwereobtainedfrom14young,normal-hearingadults(ages21-26).Behavioralandphysiologicaltestingwasperformedinthreebinauralstimulusconditions:SoNo,S-No,andSoN.Bothapproachesestimateddetectionthresholdsusingatraditionalbracketingapproachacrossarangeofstimulussignal-to-noiseratios.PhysiologicalBMLDsusedthefrequency-followingresponse(FFR),ascalp-recordedauditoryevokedpotentialdependentonsustainedphase-lockedneuralactivity.FFRBMLDsweresignificantlysmaller(poorer)thanbehavioralBMLDsanddidnotreflectaphysiologicalreleasefrommasking,onaverage.FFRamplitudewassystematicallyaffectedbystimulusphaseconditionandsignal-to-noiseratio.FFRamplitudedifferencesbetweenphaseconditions(e.g.,SoNoamplitudeS-Noamplitude)weresignificantlypredictiveofbehavioralS-NoBMLDs(R^2>0.8);individualswithlargeramplitudereductionshadlarger(better)behavioralMLDsandindividualswithsmalleramplitudereductionshadsmaller(poorer)behavioralMLDs.Thesedataindicatearoleforsustainedphase-lockedneuralactivityinBMLDsofhumans.PodiumPaperII.F.TheABRofBottlenoseDolphins:NoiseburstRisetimeandLevelRobertBurkard,PhD,UniversityAtBuffalo,Buffalo,NYJamesFinneran,PhD,USNavyMarineMammalProgram,SanDiego,CAJasonMulsow,PhD;DorianHouser,PhD,NationalMarineMammalFoundation,SanDiego,CAPhillipsetal.(2001)investigatedtheeffectsofnoiseburstrisetimeandlevelonauditorynearfieldresponsesofchinchillas.WhenplottedacrossstimulusSPL,responseamplitudewassubstantiallyreduced,andresponselatencywassubstantiallyincreased,withincreasingnoiseburstrisetime.Theeffectsofrisetimeonresponselatencyandamplitudelargelydisappearedwhenplottedacrossnoiseburstonsetslope(inPa/s).InthisstudyweobtainedABRsin5bottlenosedolphins,usingsuction-cupelectrodesplacedjustbehindtheblowhole(non-inverting),neartherightexternalauditorymeatus(non-inverting),andnearthebaseofthedorsalfin(common).Noiseburstsweredigitallyfilteredtoflattenthespectrumfrom10-160kHz.Noiseburstrisetimesvariedfrom31.24sto4ms;noiseburstlevelrangedfrom95-145dBSPL(re:1Pa).Dolphinsweretrainedtosubmergeunderwater,andremaininplaceuntilABRcollection(1024sweeps,20-Hzrate;100-3000Hzpassband)wascompleted.WhenplottedacrossstimulusSPL,therewasanincreaseinlatencyandadecreaseinamplitudewithincreasingrisetime(anddecreasinglevel).Whenplottedacrossonsetslope(inPa/s),theeffectofrisetimewassubstantiallyreducedforpeaklatencyandamplitudeforrisetimesgreaterthan0.125ms.PODIUMSESSIONIII:AUDIOLOGY/OTOLOGYANDHEARINGTESTINGTECHNOLOGYPodiumPaperIII.A.

DynamicsoftheeVORElicitedbyaVestibularProsthesisJamesPhillips;LeoLing;ChristopherPhillips;KaibaoNie;JayRubinstein,UniversityOfWashington,Seattle,WAIntroduction:Electricalstimulationfromachronicallyimplantedvestibularprosthesiscouldpotentiallyrestorelostvestibularfunction.Inordertoprovideoptimalbenefit,therelationshipbetweenstimulationpulseamplitude,orstimulationpulserate,andslowphaseeyevelocityofelectricallyelicitedVOR(eVOR)mustbeestablished.Weexaminedtherelationshipbetweenthesevariablesinrhesusmonkeysandhumanpatientsimplantedwithavestibularprosthesis.Methods:Subjectswhowereimplantedwithavestibularprosthesisunderwentbiphasicpulseelectricalstimulationthathad1)constantfrequencyandpulseamplitude,2)sinusoidallymodulatedpulsefrequency,or3)sinusoidallymodulatedpulseamplitude.Theslowphaseeyevelocitiesthatwereelicitedwerecomparedacrossstimulationtype,andacrossmodulationfrequencies.Results:Humansubjectsandmonkeysproducedqualitativelysimilarresults.Increasingslowphaseeyevelocitiesincreasedwithincreasingstimulationpulsefrequencyorcurrentamplitude.However,comparableconstantcurrentandfrequencystimulationproducedhigherslowphasevelocitiesthanthesamecurrentsandpulseratesduringmodulatedstimulation.Furthermore,highandlowmodulationfrequenciesproducedlessvelocitymodulationthanintermediatemodulationfrequencies(e.g.,5Hz).Conclusion:ThedynamicsoftheresponsetoeVORiscomplex,anddoesnotmatchtheresponsedynamicsofthenormalVOR.PodiumPaperIII.B.Type1DiabetesandHiddenHearingLossChristopherSpankovich,PhD,UniversityOfMississippiMedicalCenter,Jackson,MSColleenLePrell,PhD;EdwardLobarinas,PhD,UniversityOfTexasAtDallas,Richardson,TXLindaHood,PhD,VanderbiltUniversity,Nashville,TNThepurposeofthisstudywastoexaminetherelationshipbetweennoiseexposurebackground(NEB)andevidenceof“hiddenhearingloss”inyoungadultswithtype-1diabetescomparedtoage-sex-matchedcontrols.Forty(20type-1diabetes)“normalhearing”(i.e.,thresholds25dBHL250to8000Hz)youngadults(18-28years)withvariablenoiseexposurewererecruited.TEOAEs,DPOAEs,andABRswerecomparedbetweengroupsandasrelatedtomeasuresofnoiseexposure,includingtheNEB(Stamper&Johnson,2013),AdolescentHabitsandHearingProtectionUseQuestionnaire(Olsen&Erlandsson,2004),andreportedtemporarychangesinhearing.ANOVAandlinearregressionwereperformed.Nostatisticallysignificantdifferencesbetweengroupsfornoise,OAEs,andABRoutcomes(WavesIandVamplitude/latency)wereindicated.Inaddition,therewasnostatisticallysignificantrelationshipofreportednoiseexposureandauditoryfunctionmeasures.MalesandfemalesdidshowstatisticallysignificantdifferencesinOAEandABRoutcomes,butnotforreportednoiseexposure.Wewereunabletoidentifyarelationshipbetweenreportednoiseexposureandsensitiveauditoryfunctionoutcomesin“normalhearing”youngadultswithandwithouttype-1diabetes.Studydesignandinterpersonalvariabilityofnoiseeffectswillbediscussedasrelatedtohiddenhearingloss.PodiumPaperIII.C.IntraoperativeAssessmentofAir-BoneGapClosureDuringOssiculoplasty

KrzysztofMorawski,MD;KazimierzNiemczyk,MD;RobertBartoszewicz,MD,DepartmentOfOtolaryngology,MedicalUniversityOfWarsaw,Warsaw,PolandErdemYavuz,PhD;RafaelDelgado,PhD,IntelligentHearingSystems,Miami,FLObjective:Toassessintraoperativeair-bonegapclosure(I-ABG-Closure)duringossiculoplastyusingroundwindowelectrocochleography(RW-ECochG).MethodesandMeasures:Fortypatientswithhistoryofcholesteatomaundergoingsecondstageossicularreconstructionsurgerywereincludedtothisstudy.Duringthesecondlookprocedure,aneedleelectrodeforRW-ECochGwasplacedattheRWnicheviaposteriortympanotomy.ProsthesisplacementefficacywasevaluatedbyintraoperativelymeasuredRW-ECochG.I-ABG-Closurewasevaluatedintwooptions.Firstly,asadifferencebetweenpre-andpostossiculoplastyauditorythresholdsforclickandtone-bursts,definedasthelastintensityforwhichRW-ECochG-N1peakwaspresent.Secondly,asanautomaticestimationofpre-andpostossiculoplastyRW-ECochG-N1latencychanges.Results:SixmonthspostoperativeABG-Closurerangedbetween10to45dBandsignificantlycorrelatedwithI-ABG-Closure(r>0.5;p<0.05).AdjustmentsinprosthesisconfigurationandplacementresultedinmeasurablechangesinI-ABG-ClosureevaluatedasaRW-ECochGthresholdsandlatencyshortening.TheauthorspresenttheminisoftwareforautomaticI-ABG-Closureestimation.Conclusions:RW-ECochGwasfoundtobeaveryeffectivetoolforevaluationofI-ABG-Closureshowinggoodcorrelationwithpostoperativehearingstatusincasesofsecondstageossiculoplasty.AutomaticevaluationofRW-ECochGlatencyshorteningtopredictI-ABG-Closurewasfoundtobefast,objectiveandprecise.PodiumPaperIII.D.WidebandAcousticImmitance:Instrument,Ethnicity,andGenderSpecificNormativeDataNavidShahnaz,PhD;SukainaJaffer;AinsleyMa,UniversityOfBritishColumbia,VancouverThisstudyinvestigatedwidebandacousticimmittance(WAI)valuesinanormalhearingyoungadultpopulationbasedongender,ethnicity,andinstrumentused.Test-retestreliabilitywasalsomeasuredacrossallsystems.Eightynormalhearingyoungadults(40Caucasianand40Chineseagedbetween18-34)wererecruitedtoundergoWAItestingwithtwohand-helddevices(OtostatMimosaAcousticsandTitanInteracoustics)andtwonon-portabledevices(ReflwinInteracousticsandMimosaAcousticsHearID).Thedifferencesbetweenpowerabsorbance(PA)atambientandpeakpressure,frequencyaveragedPA(between0.38-2kHz)asafunctionofairpressure(widebandtympanometry-WBTinTitan),phaseangle,andresonantfrequencyinthesegroupsandinstrumentswereinvestigated.Bodymassindex(BMI)andequivalentearcanalvolumewasmeasuredtoinvestigatethesourceofthesedifferences.MeanPAvariedacrossfrequenciesbetweendevices,ethnicitiesandgenders.Instrumentspecificdatadidimprovetheabilitytodistinguishbetweennormalandtwenty-eightearswithsurgicallyconfirmedOtosclerosisusingreceiveroperatingcharacteristics(ROC)curveanalysis.ItisadvisedthatfutureresearchinvestigatingtheclinicalutilityofWAIinmiddleeardysfunctionincorporategender,ethnicity,andvariousinstrumentspecificnormstodeterminewhetherthesefactorsimprovesensitivityandspecificityinidentifyingvariousmiddle-earpathologies.PodiumPaperIII.E.

Forward-PressureLevelCalibrationImprovesAccuracyandReliabilityofPure-ToneAudiometryJudiA.LapsleyMiller,PhD,MimosaAcoustics,Champaign,ILSarahR.Robinson,MS;JontB.Allen,PhD,UniversityOfIllinoisAtUrbana-Champaign,Urbana,ILCharlotteM.Reed,PhD;ZacharyD.Perez,ResearchLaboratoryofElectronics,MassachusettsInstituteofTechnology,Cambridge,MAClinicalpure-toneaudiometryisconductedusingheadphonesorearphoneswithacoupler(averageear)calibration.Deviationsinindividual-earacousticsfromaverageaffecttestvalidity,andvariationsinprobeinsertionorheadphoneplacementaffecttest-retestreliability.Usingastandardotoacousticemissionsprobe,containingamicrophoneandloudspeaker,anin-the-earcalibrationmaybeperformedforeachinsertion.However,ifthestimuluslevelissetaccordingtotheprobemicrophonepressure,acousticstandingwavesintheearcanalcausestimuluslevelerrorsattheeardrumaslargeas20dBabove4kHz,dependingonprobedepth.Forwardpressurelevel(FPL)calibrationremovestheseerrors,andreducesvariationsduetoprobeangle.WecomparestandardaudiometryusingamodernclinicalaudiometertoaFPL-calibratedprototypeaudiometer.Thetestprocedurewassimilartothosecommonlyusedinhearing-conservationprograms,usingpulsed-tonetestfrequenciesat0.5,1,2,3,4,6,and8kHz,andanautomatedmodifiedHughson-Westlakeaudiometricprocedure.ResultsindicatethatreliabilityisbetterwithFPLcalibrationandthattheimprovementisclinicallymeaningful,potentiallyallowinghearing-conservationprogramstohavemoreconfidenceindeterminingsignificantthresholdshiftsat6and8kHz-keyfrequenciesforearlydetectionofnoise-inducedhearingloss.PodiumPaperIII.F.DevelopmentofaMobileAudiometricHeadsetwithHighPassiveAttenuationOdileClavier,PhD;JamesNorris,PhD;JedWilbur,MS;SandraGraveson,CreareLLC,Hanover,NHMeetingtheincreasingdemandforhearinghealthcarewillrequiretechnologiesthatenablequalityscreeninginnon-traditionalsettings.Mobiletechnologiesoffermuchpromiseintermsofreach,however,theycannotensureaquietenvironmenttoaccuratelymeasurethresholds.Wepresentontheengineeringdevelopmentofaheadsetspecificallydesignedforaudiometricapplications,withearmuffsthatprovidehighpassivesoundattenuation.Althoughsignificantattenuationcanbeobtainedwithdeeply-setinsertearphones,circumauralearmuffsareeasiertouseandprovidereliablenoiseattenuation,evenwithun-trainedusers.Designinghighattenuationearcupsrequirestrade-offsbetweenvolume,mass,earcushioncompression,comfort,andergonomics.Toenablemobiletesting,theaudiometerelectronicsweredesignedtofitentirelywithintheearcupsandcommunicatewithmobiledevicesoverBluetooth.Theaddedelectronicsaddedanotherchallengetoattenuation.Ultimately,RealEarAttenuationAtThreshold(REAT)measurementsshowsthisdesigncanachieveanaverageof30to40dBofattenuationatallfrequenciestestedbetween250Hzand8000Hz,usingtheANSIS12.6-2008,MethodAon20humansubjects.Suchhighattenuationwillallowqualityhearingscreeninginsettingsnotspecificallydesignedforaudiometry,suchasschools,industrialsites,andpoint-of-carelocations.PODIUMPRESENTATIONS:Saturday,March5,2016

PODIUMSESSIONIV:COCHLEARIMPLANTSPodiumPaperIV.A.CochlearImplantationinCasesofSingle-SidedDeafnessMargaretDillon,AuD;EmilyBuss,PhD;MeredithAnderson,AuD;KevinBrown,MD;HaroldPillsbury,MD,UniversityOfNorthCarolinaAtChapelHill,ChapelHill,NCEnglishKing,AuD;EllenDeres,AuD,UNCHealthCareSingle-sideddeafness(SSD),wherethepatienthasonepoorearandonenormalhearingear,resultsinreducedspeechperceptionabilitiesinnoise,localizationabilities,andqualityoflifeascomparedtonormalhearers.CurrentSSDtreatmentoptionsroutethesignalfromtheaffectedsidetothenormalhearingear.Theabilitytousebinauralcuesforimprovedspeechperceptioninnoiseandlocalizationhasbeenvariablewiththesetechnologies.Itisofinterestwhethercochlearimplantationoftheaffectedearwouldbenefitrecipientsonsuchtasksduetostimulationoftheauditorypathwayontheaffectedside.Theobjectiveofthisstudywastoassesssubjectivebenefit,localization,andspeechperceptionabilitiesinspatiallyseparatednoiseofcochlearimplantrecipientswithSSD.Subjectscompletedthetestbatterypreoperatively,andone,threeandsixmonthspostoperatively.Threelisteningconditionswereassessed:unaided,bone-conductiondevice,andcochlearimplant.Subjectsexperiencedanimprovementwiththeircochlearimplantonmeasuresoflocalizationandspeechperception,whichwasinlinewiththeirsubjectivereport.CochlearimplantationincasesofSSDmayprovideimprovedspeechperceptioninnoise,localization,andsubjectivebenefitascomparedtoanunaidedlisteningconditionorwithcurrentlyapprovedtreatmentoptions.PodiumPaperIV.B.PhysiologicalResponsestoAcousticStimulationinCochlearImplantUsersPaulAbbas,PhD;ViralTejani,AuD;CarolynBrown,PhD;RachelScheperle,PhD,UniversityOfIowa,IowaCity,IAWeuseneuraltelemetrysystemoftheNucleuscochlearimplantandacousticstimulationtomeasurecochlearmicrophonic(CM)andneuralresponses(neurophonicandcompoundactionpotential)fromanintracochlearelectrodeinHybridCIusers.OurgoalistobetterunderstandthepathophysiologybehindthelossofacoustichearingexperiencedbyasubsetofHybridCIusersaswellasgainingabetterunderstandhowacousticandelectricalsignalsinteract.Wehaverecordedresponsestobroadbandclicksand500-Hztoneburstsinover40individualswithhighfrequencyhearinglosstodate.ThemajorityofindividualsshowacleargrowthofbothCMandneuralresponsemeasuresandphysiologicalthresholdscorrelatewithbehavioralthresholds.Inasubsetofoursubjectpool,however,showedcleargrowthofCMbutnoneuralresponse,suggestingapathologyofhearinglossrelatedtosynapticorneuraldysfunctionasopposedtodamagetothehaircells.Wealsomaderepeatedmeasuresoverthefirstyearpostimplant.Mostsubjectsshowednochangeinthresholdbutasmallgroupexperiencedadelayedlossoftheiracoustichearing,bothbehaviorallyandinbothCMandneuralresponses,suggestingapresynapticetiologyofhearinglossinthesecases.PodiumPaperIV.C.

Low-FrequencyConductiveComponentFollowingCochlearImplantationwithMed-ElInternalDeviceJessiMiddaugh,AuD;CarrieSlough,AuD;TimothyHullar,MD;AngieGarinis,PhD;BrittanyWilson,OregonHealth&ScienceUniversity,Portland,ORLossofresidualsensoryhearingfollowingcochlearimplantationiscommonduetoinner-eartraumaassociatedwithsurgicalplacementoftheelectrodearray.Recentevidencehasshownthatpatientsdevelopapost-surgicalconductivecomponentintheirlow-frequencyresidualhearingthatdidnotexistpriortoimplantation.ThepresentstudyisaretrospectiveandprospectiveexaminationofpatientswhoreceivedtheMed-ELConcertorSynchronyinternaldevicewhichhasanelectrodearraymarketedtopreservecochlearstructureandresidualhearingfollowingimplantation.Clinicalaudiometricdataincluding,tympanometry,airandboneconductionthresholdswillbediscussedforpre-andpost-implantevaluation.Preliminaryresultsfromthreepatientssuggestthatwhenhearingispreservedintheapicalregionofthecochleaaftersurgery,alow-frequencyair-bonegaprangingbetween20dBHLand50dBHLisevident,suggestingconductivepathology..Thesefindingsindicatethatanatomicalchangesortraumaduringimplantsurgerymayproducealow-frequencyconductivecomponent.Pre-andpost-implantationevaluationsshouldincludeboneconductionthresholdtestingtomonitorforsuchchanges.Identifyingthesourceofthislosswouldbeusefulformodifyingcurrentsurgicaltechniquesordevicedevelopmentforpreservingresidualhearingpost-implantation.PodiumPaperIV.D.EvaluationofFineStructureCodingStrategiesinCochlearImplantsDouglasSladen,PhD;AnnPeterson,MA,MayoClinic,Rochester,MNChangLiu,PhD,UniversityofTexasatAustin,Austin,TXOlderimplantedadultshavemoredifficultywithspeechinnoiserecognitionthanyoungerimplantedadults.Temporalprocessingdeficitshavebeensuggestedasapossibleunderlyingreasonforage-relateddifferences.Itispossiblethattemporalfinestructureinspeechcodingstrategiesofferolderimplantedadultsadditionalbenefits,thoughthishypothesisremainsuntested.Thisstudycomparedtheperformanceofolderandyoungerimplantedadultstoexplorehowpatientsmakeuseoffinestructurecuescomparedtotraditionalenvelopecodingstrategies.Todate,fifteenadultcochlearimplantlistenershaveparticipatedinacrossoverexperiment.Participantswereaskedtousehighdefinitioncontinuousinterleavedsampling(HDCIS)andfinestructureprocessing(FS4/FS4-p);eachforathreemonthperiod.Aftereachthree-monthinterval,atestbatterycomprisedoftemporalmodulationdetectionthresholds(TMDT),consonantrecognition(CR),andspeechinnoiserecognitionwascompleted.Atstudycompletion,participantswereaskedtoindicatetheirpreferredcodingstrategy.PreliminaryresultsdemonstrateequivalentoutcomesinTMDTsandCRscoresforallageswhenusingHDCISandFS4/FS4-p,thoughspeechrecognitioninnoisetestingshowsanadvantageforfinestructureprocessing.Noage-relatedperformancedifferenceswerefound.Theseresultshaveclinicalimplicationsonselectionofappropriatesoundcodingstrategies.PodiumPaperIV.E.SpectralModulationDetectionintheNon-ImplantedEarPredictsBimodalBenefitReneGifford,PhD;LinseySunderhaus,AuD;AdrianTaylor,AuD;TimDavis,AuD;JourdanHolder;SusanReynolds,VanderbiltUniversity,Nashville,TN

TonySpahr,PhD,AdvancedBionics,Valencia,CAMichaelDorman,PhD,ArizonaStateUniversity,Tempe,AZMostcochlearimplant(CI)candidateshaveacoustichearinginoneorbothears.StudieshaveshownthatacoustichearingprovidessignificantbenefitwhenpairedwithaCIinabimodallisteningconfiguration.Thedegreeofbimodalbenefit,however,variesacrossearsandisgenerallynotcorrelatedwithaudiometricthreshold,etiology,age,orpreoperativespeechrecognition.Atpresent,thereisnoclinicalmeasureprovidingpredictiveutilityforselectinganeartobeimplanted-acriticalconsiderationwhenbilateralimplantationmayberestricted.Thequickspectralmodulationdetection(QSMD)taskisamodifiedversionofavalidatedpsychophysicalprocedureassessingspectralresolution.Wehavereplicatedapreviousstudy1examiningtheutilityoftheacousticQSMDtask(rate=1cyc/oct)asapredictorofbimodalbenefit.Inagroupof50postlinguallydeafenedadultCIusers,wefoundasignificantcorrelationbetweenQSMDandbimodalbenefitforAzBiosentencerecognitioninnoiseat+5dB.Wedidnotobserveacorrelationbetweenaudiometricthresholdsandbimodalbenefit,thoughtherewasatrendforthosewithlower(i.e.better)thresholdstoderivebimodalbenefit.TheacousticQSMDtaskcanprovideinformationregardingthepredictiveutilityofagiveneartoaddbimodalbenefit.1ZhangT,SpahrAJ,DormanMF,SaojiA.(2013).Therelationshipbetweenauditoryfunctionofnon-implantedearsandbimodalbenefit.EarHear.34(2):133-41.PodiumPaperIV.F.BinauralPitchFusionwithBilateralCochlearImplantsLinaReiss,PhD;CurtisHartling,AuD;JenniferFowler,AuD,OregonHealth&ScienceUniversity,Portland,ORRecentstudiesshowthatadultswhousehearingaidsorbimodalcochlearimplants(CIs)experienceabnormallybroadbinauralpitchfusion,suchthatsoundsdifferingbyasmuchas3-4octavesinpitcharefusedacrossears;normal-hearinglistenersonlyfusetonesdifferingbylessthan0.01-0.03octaves.ThegoalofthisstudywastodeterminewhetheradultbilateralCIusersalsoexperiencebroadbinauralpitchfusion.Stimuliwerepulsetrainsdeliveredtoindividualelectrodes.Fusionrangesweremeasuredusingsimultaneous,dichoticpresentationofreferenceandcomparisonstimuliinoppositeears,andvaryingthecomparisonstimulustofindtherangethatfusedwiththereferencestimulus.BilateralCIlistenershadbinauralpitchfusionrangesvaryingfrom0-11mm(average4.9-3.3mm),equivalentto0-18.7Cochlearelectrodesor0.5-5Med-ELelectrodesor1.2octavesinthefrequencydomain.Nocorrelationswereobservedbetweenfusionrangesandwithin-earelectrodediscriminationabilities,indicatingthatbroadfusionismorelikelyduetocentralauditoryprocessingdifferencesinhowinformationiscombinedbinaurally,ratherthanperipheralfactorssuchaspoorelectrodediscrimination.ThisbroadfusionandtheassociatedbinauralaveragingofspectralinformationmayexplainthevariabilityofbinauralbenefitsinbilateralCIusers.PodiumPaperIV.G.EnhancingStreamingandImprovingIntelligibilityinCochlearImplantSimulationFredericApoux,PhD;BrittneyCarter;EricHealy,PhD,TheOhioStateUniversityWexnerMedicalCenter,Columbus,OHThusfarmostattemptstoimprovespeechintelligibilityinnoiseforcochlearimplant(CI)usershaveconsistedoftryingtosuppressthebackgroundnoise.Thecurrentapproach

differsfundamentallyfromtheseattempts,asthegoalistoimproveintelligibilityinnoisewhilepreservingtherichnessoftheacousticenvironment.Toachievethisgoal,wehavedevelopedtwotechniquesthatenhanceexistingand/orintroducenewsegregationcues.Thefirsttechnique,referredtoasdual-carrierprocessing,consistsoftransmittingthetargetspeechandbackgroundonseparatecarriers.Thesecondtechniqueinvolvesdistinctenvelopefiltercutoffsforeachsignal.BothtechniqueswereevaluatedinCIsimulation.TheresultsofthisevaluationshowedthateachtechniquecanimprovespeechintelligibilityinnoisecomparedtotraditionalCIsimulationbyupto50%points.Combiningthetwotechniquesimprovedintelligibilitybyupto60%points.Incomparison,normal-hearing(NH)listeners’performanceonunprocessedspeechinnoisewas70%pointsabovethatoftraditionalCIsimulation,amere10%pointsabovetheperformanceachievedusingourtechniques.Inotherwords,thecombinedimprovementreportedheresuggeststhepossibilityforCIuserstonearlymatchtheperformanceofNHlistenersinnoisewhilepreservingthebackground.PodiumPaperIV.H.EffectivenessofanAutomaticDirectionalMicrophoneforCochlearImplantRecipientsSmitaAgrawal,PhD,AdvancedBionics,LLC,Valencia,CAMostcochlearimplant(CI)recipientsfacedynamicandchallenginglisteningsituationseveryday.Directionalmicrophones(DM)havebeenshowntoeffectivelyimproveface-to-facespeechunderstandinginnoise.AutomaticDMactivationinnoisewouldallowlistenerstouseandbenefitfromsuchtechnologymoreeasily.TheautoUltraZoomfeatureavailableonAdvancedBionicsNaidaCIQ90soundprocessorsusesanautomaticsceneclassifiertoanalyzethelisteningenvironmentandindependentlyactivateanomnidirectionalmicrophone(T-Mic2,processormicor50/50)inquietandaDM(UltraZoom)innoise.Theobjectiveofthepresentstudywas(1)toexaminewhetherautoUltraZoomselectsthecorrectmicrophonemodeinquietandinnoiseand(2)toevaluateitseffectonspeechunderstandinginquietandinnoiseascomparedtoitsmanualcounterparts(T-Mic2andUltraZoom).Speechunderstandingwasevaluatedin20AdvancedBionicsCIrecipientswithAzBiosentencespresentedfrom0inquietandinPhonakCantinaNoisefrom±90and180.Followingmicmodeswereevaluatedrandomlyandcompared:T-Mic2,UltraZoomandautoUltraZoom.ClearVoice(medium)wasactiveinallprograms.Resultswillbepresentedatthemeeting.PODIUMSESSIONV:PSYCHOACOUSTICS,SPEECHPERCEPTIONANDLISTENINGEFFORTPodiumPaperV.A.InfluenceofMusicalTrainingonSpectralRipplePerceptionEvelynDavies-Venn,PhD,UniversityOfMinnesota,Minneapolis,MNMusiciansoftenendurecountlesshoursoftrainingtohonetheircraft.Suchtraininginducesneuralplasticityandenhancescognitiveskills.Recentstudiesshowthatmusicaltrainingalsoenhancesperipheralauditoryprocessingabilitiessuchassensitivitytotemporalfinestructureandnarrowbandfrequencyresolution.Thisstudyevaluated

whethermusicianenhancementinfrequencyresolutioncanbegeneralizedtobroadbandspectralresolution.Spectralripplednoisesharessimilarcomplexspectraasspeech,butitisvoidofcontextandlinguisticcues,whicharestronglyinfluencedbyenhancedcognitiveskillsandmayconfoundspeechperceptionresults.Italsopredictsspeechscoresinquietandnoiseforlistenerswithnormalhearingandhearingloss.Thus,rippled-noisemightbesensitivetoperipheralmechanismsthatunderlieenhancedspeechperceptioninmusicians.Thisstudyevaluatedbroadbandspectralresolutioninmusiciansandnon-musicianswithnormalhearing.Wetestedthehypothesisthatmusicianshaveenhancedbroadbandspectralresolutionabilities.Spectralmodulationtransferfunctionsweremeasuredtodeterminewhethermusicianshadlowerspectralmodulationdetectionthresholdscomparedtoage-matchednon-musicians.Resultstodateshowslightmusicianenhancementinspectralprocessing,butthiseffectismodulatedbytheintensityofmusicaltraining.Theclinicalimplicationsofthesefindingsforauditory-rehabilitationwillbediscussed.PodiumPaperV.B.ReducedMaskingReleaseRevealedinGlideDetectionforHearing-ImpairedListenersYingjiuNie,PhD,JamesMadisonUniversity,Harrisonburg,VAEvelynDavies-venn,PhD;PeggyNelson,PhD,UniversityOfMinnesota,Minneapolis,MNAdamSvec,PhD,StarkeyHearingTechnologies,EdenPrairie,MNDetectionoffrequencychangeisimportantforformantdetectionandforunderstandingcomplexsignalssuchasspeech.Thetemporalenvelopeofnoisecaninterferewithspeechunderstandingandleadtoreversedmaskingreleaseinhearing-impaired(HI)listeners.Thisstudydemonstratessuchinterferenceondetectionoffrequencychangeforpuretones.Frequencychangedetectionthresholdsweremeasuredusing60-msupward-sweepingpuretoneglideswithinitialfrequenciesof1250and2500Hz.Glideswerepresentedinquiet,steadynoiseandgatednoisetonormal-hearing(NH)andHIlistenerscompensatedforaudibility.ResultsshowedthatNHlistenersexperiencedimprovementinglidedetectionthresholdsforgatedoversteadynoise,indicatingmaskingrelease.Theirglidethresholdsineithernoisepositivelycorrelatedwithglidethresholdsinquiet,suggestinganeffectoffrequencyselectivityonglidedetectioninbothtypesofnoise.Incontrast,HIlistenersdemonstratednoorreversedmaskingreleasefortheirglidethresholds.Theirglidethresholdsingatednoisepositivelycorrelatedwithpuretonethresholdsinsteadofglidethresholdsinquiet,suggestingothermechanisms(e.g.envelopeconfusion)ratherthanfrequencyselectivityexplainingtheno/reversedmaskingrelease.Resultshaveimplicationsforunderstandingmaskingreleaseforhearinglossandamplificationoutcomesinfluctuatingnoise.PodiumPaperV.C.Non-NativeEnglishSpeakers'SpectralIntegrationofEnglishSpeechLaurenCalandruccio,PhD,CaseWesternReserveUniversity,Cleveland,OHEmilyBuss,PhD,UniversityOfNorthCarolina,ChapelHill,NCComparedtotheirnativespeakingpeers,non-nativespeakersofEnglishoftenhavegreaterdifficultyrecognizingEnglishspeechinnoise.ThisistrueevenforhighlyproficientsequentialbilingualspeakerswhohavenearperfectEnglishperceptioninquiet.Itispossiblethattheirpoorperformanceisdue,inpart,toaninabilitytointegratesparse

spectralinformationwhenthespeechofinterestismaskedbycompetingnoise.Todeterminespectral-integrationabilitiesofnon-nativeEnglishspeakers20sequentialMandarin(nativelanguage)/English(secondlanguage)bilingualsand10monolingualEnglishlistenerswererecruited.Thefirsttwolisteningconditionsestimatedthebandwidthassociatedwith20%correctforEnglishspeechfilteredintoabandcenteredoneither500or2500Hz.Theselistenerspecificbandwidthswerethenusedtoestimatelisteners’Englishspeechrecognitionforthreeconditions:lowfrequencybandalone,highfrequencybandalone,andlowplushighfrequencybandtogether.Non-nativespeakersofEnglishneededawiderbandwidthtoperformsimilarlytonativespeakersofEnglishinboththelowandhighbandconditions.However,nativesandnon-nativeswereequallyefficientatcombiningspectralinformationacrosstwo(lowandhigh)Englishspeechbands.PodiumPaperV.D.PrevalenceandVerificationofCommunicationDeficitsinBlast-ExposedServiceMembersLeeAnnHorvat,MS,AuD;LinaKubli,PhD;LynnBielski,PhD;DouglasBrungart,PhD;JacquelineJackson,AuD;MelissaKokx-Ryan,AuD;GeneralLee,BS,BA;OlgaStakhovskaya,AuD,PhD;KennethGrant,PhD,WalterReedNationalMilitaryMedicalCenter,Bethesda,MDHectorGalloza,MS,IndependentContractorforCreare,LLCThereisbothanecdotalandobjectiveevidencetosuggestthatactive-dutyservicememberswhohavebeenexposedtohigh-explosiveblastsmayexperiencesignificantproblemsunderstandingspeechinnoisyandcomplexlisteningenvironmentsthatfarexceedwhatwouldbepredictedbasedontheiraudiogramalone.Asaresult,thereareseriousgapsinourcurrentcapabilitytoeffectivelycharacterizethefunctionalauditorydeficitsreportedbyServiceMembersorthroughyearlymonitoringofhearingthresholds.Recently,rapidscreeningtoolsconsistingofshortsurveysandbrieflisteningtestshaveprovenusefulinidentifyingindividualServiceMemberswhohavedifficultyunderstandingspeecheventhoughtheyhavenormalhearingthresholds.Preliminarydatawillbereportedfromamulti-sitestudyon1)theprevalenceofself-perceiveddifficultiesunderstandingspeechinnoisyenvironmentsbyServiceMemberswithnormaltonear-normalhearing,2)therelationshipbetweenself-perceivedspeechcommunicationdeficits,exposuretohigh-intensityblasts,andperformanceonfunctionalmeasuresofspeechandbinauralhearing,and3)centralauditoryprocessing(primarilyrelatedtotemporalandbinauralcues)andcognitive-communicationprocessingskills(primarilyrelatedtomemory,attention,andspeedofprocessing)innormal-hearing,blast-exposedlistenerswithdemonstratedfunctionalcommunicationdeficits.PodiumPaperV.E.ModalityEffectsonSensoryandCognitiveResourcesinMultitaskListeningLynnBielski,PhD;KenGrant,PhD,WalterReedNationalMilitaryMedicalCenter,Bethesda,MDEverydaylisteningsituationsarecomplex,andrequirelistenerstoallocatesensoryandcognitiveresourcesbetweenthedesiredsignal(s)andeventsinthebackground.Numerousstudieshaveshownthatinthesecomplexenvironments,listenersoftenusevisualcuestosupplementaudition,andthereisbroadconsensusthatauditory-visual(AV)speechperceptionprovidessubstantialbenefitsoverauditory-alone(AO)speechperception.

Thesebenefitsincludefaster,moreaccurate,betterrecollection,andsubjectivelylessperceptualeffortforspeechinputs.GiventhemanyadvantagesofAVoverAOspeechperception,onemightpredictthattheabilitytomonitorchangesinthebackgroundwhilecommunicatingwithaspeakerintheforegroundwouldbesignificantlybetterintheAVmode.Totestthisassumption,adividedattentiontestwithAVorAOtopic-relatedsentencesastheprimarytaskandthedetectionofsilentgapsinabackgroundnoiseasthesecondarytask.PerformanceonthetopicidentificationtaskwasevaluatedatequalperformancelevelsandequalSNR.Performanceonthegapdetectiontaskwasevaluatedforthreedifferentgapdurations.Resultswillbediscussedintermsoftheallocationofsensoryandcognitiveresources,perceptualeffortandpotentialrehabilitativestrategiesforthosewithhearinglossand/orcognitiveimpairment.PodiumPaperV.F.ChangesinAlphaPowerandPupilDilationDuringSentencesDegradedbyNoiseandChannelVocodingCatherineMcMahon,PhD;IsabelleBoisvert,PhD;PeterDelissa,PhD;LouiseGranger;RonnyIbrahim,PhD;ChiLo;MacquarieUniversity,NorthRydeListeningeffortisinfluencedbyboththeclarityoftheauditorysignalaswellasthecognitiveresourcesavailable,anditisrecognisedthatassessmentofthisinaclinicalsettingmightincreasethesensitivityofspeechperceptiontests.This,inturncouldfacilitatetargetedrehabilitationorbettercomparisonofsignalprocessingstrategies.Changesinpupildilationandalphapower(8-13Hz)havebeenshowntobeassociatedwithspeechperceptiontaskswhichvaryinintelligibility.However,therelationshipbetweentheseobjectivemeasuresandchangesinsignal-to-noiseratioorperformance(wordorsentencerecognition)isnotsimple.Further,itisnotclearwhethertheseobjectivemeasuresbehaveinthesamewayforthesamechangeinsignaldegradationorwhethertheyreflectdifferentprocesseswhichareindependentlyassociatedwithcognitiveload.Therefore,inthisstudy,wesimultaneouslymeasuredchangesinpupildilationandalphapower(electroencephalography)in18youngadultswithnormalhearingusing16-and6-channelnoisevocodedsentencesatsignal-to-noiseratiosbetween+7and-7dB.Wedemonstratetherelationshipsbetweentheobjectivecorrelates,sentencerecognitionperformanceandsignal-to-noiseratioandshowdifferencesinthebehaviourofalphapowerandpupildilationwithsignaldegradation.PodiumPaperV.G.ConcurrentProcessingofSpokenLanguageandVisualStimuliinPreschoolChildrenTinaM.Grieco-Calub,PhD;KristiM.Ward,NorthwesternUniversity,Evanston,ILChildrenareoftenexpectedtosimultaneouslyprocessauditoryandvisualstimuli.Thepurposeofthisstudywastodeterminehowspokenlanguageprocessingisinfluencedbyvisualstimulivaryingincomplexityandredundancywiththespeechstimulus.Twogroupsofthree-year-oldtypically-developingchildrenperformedawordrecognitiontaskwhilelisteningtoauditory-onlyspeechorwhileconcurrentlyviewinga(a)flashinglight;(b)staticimageofafemale;(c)femaleproducingtargetspeech;or(d)femaleproducingnon-targetspeech.Groupswereassignedtoaquietenvironmentoranenvironmentcontainingspeechmaskersat0dBsignal-to-noiseratio.Aneye-trackingparadigmquantifiedtheaccuracyandspeedofspokenlanguageprocessing.Resultsrevealedfasterandmoreaccuratelanguageprocessingduringauditory-onlytrialsthanduringtrialswithvisual

stimuliinthequietandspeechmaskerenvironments.Thissuggeststhatconcurrentvisualstimuliinterferewithlanguageprocessinginpreschool-agedchildren.Additionally,childrenexposedtothespeechmaskerwereslower,butequallyaccurate,atprocessinglanguagethanchildreninquietforallconditionsexcepttrialscontainingthefemaleproducingtargetspeech.Thissuggeststhatredundantvisualspeechpreservesthespeedoflanguageprocessinginchildreninnoisyenvironments.Implicationsforpreschoolclassroomswillbediscussed.PodiumPaperV.H.ListeningEffortMeasuredAcrossDifferentCochlearImplantProfilesAnnPerreau,PhD;DianaIrwin,AugustanaCollege,RockIsland,ILBaileyTatge;Yu-hsiangWu,PhD,UniversityOfIowa,IowaCity,IASeveralstudieshaveexaminedlisteningeffortinindividualswithhearinglosstodeterminetheextentofimpairment.Regardingcochlearimplants(CIs),resultshavefoundthatlisteningeffortisimprovedusingbilateralCIscomparedtounilateralCIs.However,fewstudieshaveinvestigatedlisteningeffortandtheshortelectrodeCI.ThepurposeofthisstudywastocomparelisteningeffortacrossfourCIgroups,andtoanormalhearingcontrolgroup.Theparticipantscompletedadual-taskparadigmwithaprimarytaskidentifyingsentencesinnoiseandasecondarytaskmeasuringreactiontimeonaStrooptest.Performancewasassessedatdifferentsignal-to-noiseratios(SNR),rangingin2-dBstepsfrom0to+10dB,whichwasindividuallyselectedbasedontheindividual’sSNR-50,orSNRrequiredtocorrectlyrepeat50%ofthesentences.Theparticipantsalsocompletedsubjectivequestionnairesandareadingspantest.ResultsrevealedasignificantdecreaseinlisteningeffortforlistenerswithnormalhearingcomparedtobilateralandunilateralCIgroups.Interestingly,therewasnosignificantdifferenceinlisteningeffortbetweenindividualswithnormalhearingandashortelectrodeCI.Finally,resultsfoundthatageandreadingspanweresignificantlycorrelatedwithlisteningeffort.PODIUMSESSIONVI:TINNITUS,HEARINGHEALTHANDEPIDEMIOLOGYPodiumPaperVI.A.TheHealthcareCostofTinnitusManagementintheUKDerekHoare,PhD,UniversityOfNottingham,Nottingham,NADavidStockdale,BritishTinntiusAssociationDonMcferran,ColchesterHospitalUniversityNHSFoundationTrustPeterBrazier,OptimityAdvisorsTonyKay,AintreeUniversityHospitalNHSFoundationTrustChristopherDowrick,UniversityofLiverpoolAshealthservicescomeunderincreasingeconomicpressurestodeployresourcesmoreeffectivelythereisaneedtodemonstratethevalueoftinnitustherapies,andhowvaluemaybecontinuouslyenhanced.TheobjectiveofthisprojectwastoquantifytheeconomicvalueoftinnitustherapiesprovidedbytheNHSdifferentiatingbetweenthecommontherapiescurrentlyavailable.Treatmentpathways,costs,andhealthoutcomesweredeterminedfromthetinnitusliterature,nationalstatistics,apatientsurvey,andexpertopinion.Thesewereusedtocreateaneconomicmodel.Wecalculatedcostoftreatmentperpatient,averagehealthoutcomeperpatient(QALYsgained),andcost-effectiveness(cost

perQALYgained).TheaveragecostoftreatmentperpatientperyearwasestimatedtobeGB£717,equatingtoanNHShealthcarebillofGB£2.7billionperyear.Acrossallpathways,tinnitustherapycosts£10,600perQALYgained.Sensitivityanalyseshadlittleeffectontheestimate.NHSprovisionsfortinnitusarethereforecost-effectiveagainsttheNationalInstituteforHealthandClinicalExcellencecost-effectivethreshold,andspendingonothercomparableconditions.Mosttherapieshelp,buteducationaloneoffersverysmallQALYgains.Themosteffectivetherapiesinthemodelweredeliveredwithinaudiology.PodiumPaperVI.B.CanweDevelopa'SilverBullet'forTinnitus'NanotheranosticPerspectiveAnthonyCacace,PhD,DepartmentOfCommunicationSciences&Disorders,WayneStateUniversity,Detroit,MIAvrilHolt,PhD,DepartmentOfAnatomy&CellBiology,WayneStateUniversitySchoolOfMedicine,Detroit,MIMagnusBergqvist,PhD;JamesCastracane,PhD,SUNYPolytechnicInstitute,CollegesofNanoscaleScience&Engineering,Albany,NYWithover50millionindividualsaffectedbytinnitusandwithapproximately3milliondisabledbythiscondition,newapproachesareurgentlyneededfordiagnosisandtreatment.Herein,wedescribeatheranosticnanoparticle-basedplatformtolocalizeandtreattinnitusbyattenuatinghyperactiveneuralactivityinaffectedbrainregions.Themulti-functionalityofthenanoparticles(NPs)isthedrivingforceunderlyingthisapproach,since:1)theirexteriorsurfacecanbedecoratedwithmultipleligandswhichallowsfortargetingspecificreceptorsinthebrainresponsiblefortinnitus-relatedhyperactivityandforcrossingtheblood-brain-barrier(BBB),2)contrastagentcanbeencapsulatedwithintheNPsallowingforspatiallocalizationoftinnitus-relatedareasinthebrainusingMRI,and3)thecentralcorecanbechargedwithapharmacologicalagent,wherebyapayloadofdrugscanbedeliveredtoaspecificbrainregionwherethereceptorsresidetoattenuateand/oreliminatethetinnitus-relatedhyperactivity.Initialexvivoandinvivoexperimentsindicatethatcapsid-basedNPsareabletobindtoHep/G2cellsinvitroandinvivoandareabletocrosstheBBB.CurrentstudiesunderwayseektooptimizeNPconcentrations,loadtherapeutics/imagingagents,andexploreoverexpressedreceptortargetsfordeliverytospecificbrainregions.PodiumPaperVI.C.ANovelInterventiontoPromoteHelpSeekingforHearingLossGabrielleSaunders,PhD;MelissaFrederick,AuD;ShienPeiSilverman,MA,NationalCenterForRehabilitativeAuditoryResearch,Portland,ORClausNielsen,PhD;ArianeLaplante-Levesque,PhD,EriksholmResearchCentre,SnekkerstenOurresearchhasshownthattheconstructsoftheTranstheoreticalModel(Prochaska&DiClemente1983)andtheHealthBeliefModel(Rosenstock1966)canbeappliedtounderstandinghearinghealthbehaviors.Thecombinationofperceivingfewerbenefitsandmorebarriers,havinglowerself-efficacy,andencounteringfewercuestoactionisassociatedwithlowerlikelihoodofseekinghelpforhearingdifficulties.Wethereforedevelopedacounseling-basedinterventiontargetingtheseattitudesthatlimitbehaviorchangewiththegoalofchangingtheseattitudesandthusincreasinghelp-seekingbehavior.Theinterventionisdesignedforusebyprimarycarephysiciansorcommunityhealthworkersandthusdoesnotrequireaudiologicalknowledge.Itisbrief(<10minutes)and

aimstochangetheindividual’sintrinsic/autonomousmotivationtoseekhelp.Datafromupto100individualssurveyedtwiceovera6-monthperiodwillbepresented,halfofwhomreceivedtheinterventionandhalfofwhomdidnot.Baselineandfollow-updatawillbepresentedalongwithoutcomesregardinghelp-seekingandhearingaiduptake.PodiumPaperVI.D.AddressingHearingHealthCareDisparitiesinaRuralHispanicCommunityNicoleMarrone,PhD;DaiseySanchez;AdrianaSanchez;StephanieAdamovich,PhD,Speech,Language,AndHearingSciences,UniversityOfArizona,Tucson,AZMaiaIngram;JillDeZapien,BA;ScottCarvajal,MelAndEnidZuckermanCollegeOfPublicHealth,UniversityOfArizona,Tucson,AZRosiePiper,MariposaHealthClinic,Nogalez,AZU.S.-Mexicobordercommunitiesfacenumerouschallengestoaccessinghealthcareserviceslimitingpreventivecareforhearinghealthandleadingtounder-diagnosedhearingloss.WedevelopedandtestedaCommunityHealthWorker(Promotora)programonhearinghealthandwellness,OyendoBien,toaddresshearinghealthdisparitiesseenwithinaruralcommunity.Herewereportoninitialanalysesofthepilotprogram.ThePromotorasleadtwo5-weekpilotinterventionprogramsthatfocusonhearinghealtheducationwithinthecontextofasupportivegroupenvironment.Promotorasrecruitedpersonswithhearinglossandtheircommunicationpartnerstoparticipate.Enrollmentinterviewswereconductedoneweekpriortotheprogram.Theprogramsessionswereobservedfortreatmentfidelity.Outcomeswereevaluatedtwoweeksafterprogramcompletionandlongitudinallyusingamixed-methodsapproach.Thepilotprogramwasbothfeasibleandwellreceived.Personswithhearinglossandcommunicationpartnerssignificantlyimprovedinenjoymentoflife,self-efficacytomanagehearingloss,andfamilycommunication.Preliminaryanalysessuggestsustainedbenefitsovertime.Theengagementofcommunityhealthworkersinaddressinghearinghealthincommunitiesthatsufferdisparitiescanbeaneffectivewaytotailorinterventionstrategiestocommunitycharacteristicsandincreaseculturalrelevance.[ResearchsupportedbyNIH/NIDCD.]PodiumPaperVI.E.RiskFactorsforHearingLossamongChildrenAged0-17YearsHowardJ.Hoffman,MA;KatalinG.Losonczy,MA;Chuan-mingLi,MD,EpidemiologyAndStatisticsProgram,NationalInstituteOnDeafnessAndOtherCommunicationDisorders(NIDCD),NIH,Bethesda,MDChristaL.Themann,MA,HearingLossPreventionTeam,NationalInstituteForOccupationalSafetyAndHealth(niosh),Cdc,Cincinnati,OHObjective:Describehearingimpairment(HI)andriskfactorsforchildren.Methods:The2014NationalHealthInterviewSurvey-ChildSupplement(NHIS-CS)isthefirstlarge-scale,nationally-representativesurveyonhearingofU.S.children(n=13,380).Parents/caregiverswereinterviewedbyCensusBureaustaffandreportedHI(‘alittletrouble’,‘moderatetrouble’,‘alotoftrouble’,or‘deaf’).Informationwascollectedonearlychildhooddevelopment,hearingscreening,specialistreferrals,communicationdifficulties,3+earinfections-pastyear,eartubeseverinserted,loudnoiseexposure,useofhearingprotectionandhearingaids.Logisticregressionmodelswerestatistically-adjustedforcovariatesusingnationalsamplingweights.Results:HIwasreportedfor1.4million,1.94%

(males,2.12%;females,1.75%).Prevalencewaslowest,1.17%,ages0-5;increasedto2.49%,ages6-11,and2.14%,ages12-17.PercentwithHIreferredtohearingspecialists(pastfiveyears)was83.26%,65.30%,and78.66%forages0-5,6-11,and12-17,respectively.For‘moderate-to-worse’HIchildren(0.4million,0.56%),32.1%werecurrentlyusinghearingaids.Inmultivariablelogisticmodels,riskfactorswere:age>6years,3+earinfections-pastyear,eartubeseverinserted,andearlydevelopmentaldelay.Conclusion:The2014NHIS-CSprovidesnationally-representativehearinghealthinformationforU.S.children.PodiumPaperVI.F.DizzinessandFallsinOlderAdults:IcelandAGES-RSLongitudinalStudyChuan-MingLi,PhD;HowardHoffman,NationalInstituteOnDeafnessAndOtherCommunicationDisorders,NIH,Bethesda,MDHannesPetersen;PalmiJonsson,UniversityofIceland,Reykjavik,IcelandCharlesDellaSantina,JohnsHopkinsUniversityGudnyEiriksdottir;VilmundurGudnason,IcelandicHeartAssociation,Kopavogur,IcelandDianaFisher,NationalEyeInstitute,NIHBackground:Olderadultshavehighriskoffallsresultinginseriousmorbidityandmortality.Objective:Identifyriskfactorsoffallingforpreventiveinterventions.Methods:FallsandassociatedriskfactorswereanalyzedusingdatafromtheAge,Gene/EnvironmentSusceptibility-ReykjavikStudy(AGES-RS),apopulation-based,longitudinalcohortof5,764adults,aged66-96yearsin2002-2006;3,411survivorswerere-interviewed/examinedfiveyearslaterinAGES-RSII.Results:Among3,411returningadults,aged72+years,falling(past12months)prevalenceinAGES-RSIwas17.6%(15.0%,males;19.5%,females),andfiveyearslaterinAGES-RSIIwas23.0%(21.2%,males;24.2%,females).Falling(past12months)wasassociatedwith:dizziness(oddsratio,OR=1.8;95%confidenceinterval,CI=1.5-2.3);hospitalization(pastfiveyears)(OR=1.4;CI=1.1-1.8);frequentdoctorvisits(past12months)(1.5;CI=1.2-1.9);recenthippain(OR=1.4;CI=1.1-1.8).AmongAGES-RSparticipantswhoreportedfallinginpast12months,65.9%fellagainwithinfiveyears.Fallingprevalence(pastfiveyears)inAGES-RSIIwas51.1%(48.0%,males;53.0%,females).Amongparticipantswhofell(pastfiveyears),41.4%reportedoneormoreassociateddizzinesssymptoms:spinning/floatingsensation,17.0%;light-headedness,7.0%;presyncope,10.9%;oscillopsia,2.5%;unsteadiness,28.3%.Conclusion:Dizzinesscontributessubstantiallytofallingriskamongolderadults.PodiumPaperVI.G.Hyperacusis:PrevalenceandRiskFactorsintheUSAdultPopulationRobertDobie,MD,Uthscsa,SanAntonio,TXHowardHoffman,MA;KatalinLosonczy,MA,NIDCDForthefirsttimein2014,theUSNationalHealthInterviewSurveyaskedrespondentsabouthyperacusis:“Somepeoplearebotheredbyeverydaysoundsornoisesthatdon’tbothermostpeople.Doeverydaysounds,suchasfromahairdryer,vacuumcleaner,lawnmower,orsiren,seemtooloudorannoyingtoyou”Responseswereweightedtoensurenationallyrepresentativeestimatesofprevalenceandriskfactors:14.1millioncivilian,non-institutionalizedUSadults(5.9%ofadults)have“hyperacusis”bythisdefinition.Whilemostconsiderthistobenoproblemorasmallproblem,about4.3millionUSadults(1.8%ofadults)consideritamoderateproblemorworse.Univariatepredictors

of“hyperacusis”includedself-reportedhearingimpairment(especiallydifficultiescommunicatinginnoise),femalesex,olderage,highereducationlevel,tinnitus(especiallytinnitusseverity),currenthearingaiduse,occupationalnoiseexposure,severeemotionalproblems,andsevereheadachesormigraine.Inmultivariatemodels,alloftheseexceptforhearingaiduseweresignificantriskfactorsfor“hyperacusis”and/or“moderateorworseproblem.”However,theageeffectwasreversed:afteraccountingforhearingimpairmentandothervariables,adultsaged40ormorewerelesslikelytohaveamoderateorworseproblemthanyoungeradults.PodiumPaperVI.H.AcousticReflexPrevalenceintheUnitedStatesGregoryFlamme,PhD;KristyDeiters,AuD;StephenTasko,PhD,WesternMichiganUniversity,Kalamazoo,MIWilliamAhroon,PhD,USArmyAeromedicalResearchLaboratory,Ft.Rucker,ALAcousticreflexesareinvokedasaprotectivemechanismbysomedamage-riskcriteria(DRC).However,acousticreflexesarenotalwaysobservedamongpeoplewithoutauditorydysfunction,andshouldnotbeincludedinDRCunlessthereis95%certaintythat95%ofthepopulationhaveacousticreflexes.Wepresenttheprevalenceofacousticreflexesamongpeople12yearsandolder(N>11,400),usingdatafromtheNationalHealthandNutritionExaminationSurvey(NHANES).TheNHANEScanbeusedtoproduceprevalenceestimatesgeneralizabletothenon-institutionalizedUSpopulation.IpsilateralreflexeswerescreenedattwoelicitorfrequenciesanddetectedusingFrequentistmethodsandviaKalmanfilteringofthereflextrace.Reflexesarepervasiveonlyamongthosewithhearingthresholdsbetterthan15dBHLatallfrequencies,andfallbelowthecriterioncertaintywithpoorersensitivityevenatlowerfrequencies.Ageandtympanometricvariablesarealsorelatedtoreflexdetection.Reflexprevalenceisgenerallyhighamongyoungpeoplewithadequatehearingsensitivityforunrestrictedmilitaryduty,buttheprevalenceisnotuniformamongaudiometricconfigurationswithinthishearingprofile.