AJA
Research Forum
Forum on the Brain and Hearing Aids M. Kathleen Pichora-Fullera,b
Purpose: The purpose of this article is to introduce and provide an overview of the 3 articles presented in the invited forum “The Brain and Hearing Aids.” Method: The main ideas of the articles presented by the 3 panelists are identified, and a commentary is provided to synthesize the ideas.
Conclusions: Benefits from hearing aids and auditory training entail higher-level cortical and cognitive processing involved in categorizing and remembering sound. New approaches to predicting, designing, and evaluating technological and behavioral interventions will need to consider the brain and not just the ears of listeners.
T
categorizing and remembering sound. Thomas Lunner reviewed experiments demonstrating that memory for speech can be improved by certain kinds of signal processing that reduce noise in the signal delivered to adult listeners. He proposed provocative new ideas about how electroencephalogram monitoring could possibly be used to control hearing aids, much like the brain exerts attentional control over listening. Together, this set of articles showcases research involving physiological measures of brain activity in listeners across the life span. The authors concur in emphasizing the importance of suprathreshold, higher-level auditory processing in rehabilitation. Furthermore, they highlight the importance of research and new approaches to hearing aid fitting and auditory training that take into account how listeners use top-down processing to monitor, control, and learn how to functionally use auditory signals to perceive, attend to, and remember what has been heard. Last, they concur in acknowledging that much more research will be needed to realize the usability of these physiological tools in clinical practice.
raditional measures and approaches used to fit hearing aids and to predict and validate outcomes have focused on audiometric thresholds and restoring the audibility of the signal. The set of three articles presented in the forum “The Brain and Hearing Aids” explored the potential importance of using new measures to gain information about how the neural transmission of incoming signals affects the perception of speech, the categorization of auditory objects, and attention to and memory of what has been heard in unaided and aided conditions. In her article examining the use of cortical auditory evoked potentials and the acoustic change complex to evaluate the speech perception abilities of infants, Susan Small concluded that the presence of these responses may be beneficial, especially to rule out concerns about the adequacy of neural processing when recommendations are made about amplification for infants. Considering middle-aged and older adults, Kelly Tremblay described the use of electroencephalography and magnetoencephalography measures to gain insight into how hearing aids and auditory training may interact with age-related declines in the neural processing of the precise timing information necessary for speech understanding in noise. Because hearing aid processing may distort the signal delivered to the ear, it is worthwhile to study the neural representation of amplified signals, especially in older adults who may have declines in central auditory processing. Tremblay’s general conclusion was that the weight of the evidence so far points to the importance of changes in higher-level brain mechanisms involved in
Acknowledgment The forum “The Brain and Hearing Aids” (chaired by M. K. Pichora-Fuller; panelists: S. Small, K. Tremblay, and T. Lunner) took place at the HEaring Across the Lifespan (HEAL) conference “Early Intervention: The Key to Better Hearing Care,” which took place June 5, 2014, in Lake Como, Italy.
a
University of Toronto, Ontario, Canada Linneaus Centre HEAD, Linköping University, Sweden
b
Correspondence to M. Kathleen Pichora-Fuller: [email protected] Editor and Associate Editor: Larry Humes Received November 5, 2014 Accepted November 16, 2014 DOI: 10.1044/2015_AJA-14-0067
112
Disclosure: The author has declared that no competing interests existed at the time of publication.
American Journal of Audiology • Vol. 24 • 112 • June 2015 • Copyright © 2015 American Speech-Language-Hearing Association Research Forum: The Brain and Hearing Aids
Downloaded From: http://aja.pubs.asha.org/ by a Fudan University User on 08/22/2017 Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx
Research Forum
Forum on the Brain and Hearing Aids M. Kathleen Pichora-Fullera,b
Purpose: The purpose of this article is to introduce and provide an overview of the 3 articles presented in the invited forum “The Brain and Hearing Aids.” Method: The main ideas of the articles presented by the 3 panelists are identified, and a commentary is provided to synthesize the ideas.
Conclusions: Benefits from hearing aids and auditory training entail higher-level cortical and cognitive processing involved in categorizing and remembering sound. New approaches to predicting, designing, and evaluating technological and behavioral interventions will need to consider the brain and not just the ears of listeners.
T
categorizing and remembering sound. Thomas Lunner reviewed experiments demonstrating that memory for speech can be improved by certain kinds of signal processing that reduce noise in the signal delivered to adult listeners. He proposed provocative new ideas about how electroencephalogram monitoring could possibly be used to control hearing aids, much like the brain exerts attentional control over listening. Together, this set of articles showcases research involving physiological measures of brain activity in listeners across the life span. The authors concur in emphasizing the importance of suprathreshold, higher-level auditory processing in rehabilitation. Furthermore, they highlight the importance of research and new approaches to hearing aid fitting and auditory training that take into account how listeners use top-down processing to monitor, control, and learn how to functionally use auditory signals to perceive, attend to, and remember what has been heard. Last, they concur in acknowledging that much more research will be needed to realize the usability of these physiological tools in clinical practice.
raditional measures and approaches used to fit hearing aids and to predict and validate outcomes have focused on audiometric thresholds and restoring the audibility of the signal. The set of three articles presented in the forum “The Brain and Hearing Aids” explored the potential importance of using new measures to gain information about how the neural transmission of incoming signals affects the perception of speech, the categorization of auditory objects, and attention to and memory of what has been heard in unaided and aided conditions. In her article examining the use of cortical auditory evoked potentials and the acoustic change complex to evaluate the speech perception abilities of infants, Susan Small concluded that the presence of these responses may be beneficial, especially to rule out concerns about the adequacy of neural processing when recommendations are made about amplification for infants. Considering middle-aged and older adults, Kelly Tremblay described the use of electroencephalography and magnetoencephalography measures to gain insight into how hearing aids and auditory training may interact with age-related declines in the neural processing of the precise timing information necessary for speech understanding in noise. Because hearing aid processing may distort the signal delivered to the ear, it is worthwhile to study the neural representation of amplified signals, especially in older adults who may have declines in central auditory processing. Tremblay’s general conclusion was that the weight of the evidence so far points to the importance of changes in higher-level brain mechanisms involved in
Acknowledgment The forum “The Brain and Hearing Aids” (chaired by M. K. Pichora-Fuller; panelists: S. Small, K. Tremblay, and T. Lunner) took place at the HEaring Across the Lifespan (HEAL) conference “Early Intervention: The Key to Better Hearing Care,” which took place June 5, 2014, in Lake Como, Italy.
a
University of Toronto, Ontario, Canada Linneaus Centre HEAD, Linköping University, Sweden
b
Correspondence to M. Kathleen Pichora-Fuller: [email protected] Editor and Associate Editor: Larry Humes Received November 5, 2014 Accepted November 16, 2014 DOI: 10.1044/2015_AJA-14-0067
112
Disclosure: The author has declared that no competing interests existed at the time of publication.
American Journal of Audiology • Vol. 24 • 112 • June 2015 • Copyright © 2015 American Speech-Language-Hearing Association Research Forum: The Brain and Hearing Aids
Downloaded From: http://aja.pubs.asha.org/ by a Fudan University User on 08/22/2017 Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx
