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Different Evaluations for Varied Hearing: A Comprehensive Overview

Explore the nuances of different kinds of hearing, from using both ears to challenges with cochlear implants, testing clarity in hearing, adjusting to different voices, binaural and bilateral hearing benefits, and the impact of hearing loss on cognitive effort. Dive into various aspects of hearing assessments and the potential for improvement through advancements in technology and auditory training.

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Different Evaluations for Varied Hearing: A Comprehensive Overview

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  1. Different evaluationsfor different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery

  2. Different kinds of hearing? • Using both ears together • Listening for information / listening for clarity • The ears as part of the brain & part of the whole person

  3. The challenge of using a cochlear implant • Sound distortion • Pitch shifting • Abnormal loudness • Neural atrophy

  4. Imagine the inner ear as a piano… Low notes High notes Middle notes

  5. Imagine the inner ear as a piano… Low notes High notes Middle notes

  6. Imagine the inner ear as a piano… Low notes High notes Middle notes

  7. Imagine the inner ear as a piano… Low notes High notes Middle notes

  8. In real life…

  9. Listening for information,listening for clarity

  10. Listening for information,listening for clarity Restaurant Restaurant Restaurant Restaurant

  11. Testing for clarity in hearing

  12. Testing for clarity in hearing • Speech sounds are morphed from one sound to another • Listeners label each sound as it is heard • Labeling consistency and confidence is modeled statistically

  13. Different listeners have different levels of clarity in their hearing (clarity)

  14. Context and adaptation

  15. Context and adaptation

  16. Some voices have predictable patterns of differences • Pitch, duration, voice quality, articulation, etc. • We can form categories • High / low pitch • Creaky / smooth voice quality • “eee” / “ooo” • “sss” “sh”

  17. Some voices have predictable patterns of differences A “low” pitch for one voice may be higher than a “high” pitch for another voice

  18. Testing adjustment to different voices • Low pitch / High pitch “sh” “ss” • The difference between low “sh” and high “ss” depends on whether the voice is female or male. male voice female voice sh ss boundary

  19. Testing for a boundary “sh” “ss” Focus on a region of interest Label the sounds

  20. Accommodation to talker voice (CI Listener data)

  21. Accommodation to talker FACE (CI Listener data)

  22. Accommodation to talker voice with face (CI Listener data)

  23. A change of [this context]is worth [this much change]in auditory frequency boundary Boundary shift (Hz)

  24. Listeners with normal hearing adjust to the talker’s voice

  25. Listeners with cochlear implants adjust to the talker’s voice and face

  26. Adjusting on the fly • Listeners with normal hearing can adjust to the speech of various talkers on-the-fly using their ears • Listeners with cochlear implants can adjust using their ears AND their eyes, • So they may benefit from learning some audio+visual associations between faces and vocal styles

  27. Binaural and Bilateral • People with normal hearing enjoy binaural hearing, which means the two ears work together and compare inputs. • This lets us do many things, including locate a sound in space and separate speech from background noise

  28. Using two cochlear implants • Two cochlear implants are independent systems that may or may not work well together

  29. Binaural and Bilateral • People with bilateral cochlear implants generally report benefit from the second device • Better sound localization • Better hearing in noise

  30. Some abilities are easily quantifiable… • Word recognition over the first two years • Sound localization

  31. Other abilities are not-so-easily quantifiable. (From the Cochlear Corp. website) Benefits of bilateral implantation: • More connected • More confident • More balanced and relaxed • Peace of mind Bilateral implants make it “easier to hear everyday sounds… without the constant strain associated with a hearing loss.”

  32. Listening fatigue and hearing loss:why it matters • Individuals with hearing loss (HL) have to "work harder" cognitively to process sounds compared to people without hearing loss • Increased reports of stress, tension & fatigue [1] • Higher "need for recovery" from work [2] • Individuals with HL are more likely to miss work due to "fatigue, strain or burnout" than individuals without HL working at a similar or the same job [3]

  33. Effort  Pupil dilation • Task-evoked pupil dilation corresponds to cognitive effort

  34. Listening effort test • Listen to sentences with the rightimplant only • Listen to sentences with the leftimplant only • Listen to sentences with both implants • Hear the sentence, wait a moment, then repeat • We measure pupil size as the sentence ends, and during the time before you repeat it back

  35. Right ear CI only

  36. Right and Left CIs

  37. Bilateral CIs

  38. New directions • Technology exists to improve sound clarity • Efforts can be made to synchronize both ears • CI recipients undergo auditory training • We can evaluate the effects of these efforts on the listener’s experience of mental effort required to listen

  39. Questions and comments are welcome! • Matthew Winn • mwinn2@wisc.edu

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