Hearing Loss, Hearing Aids, and the Business of...

Hearing Loss, Hearing Aids, and the Business of LearningAndrea Pittman, PhD CCC-AArizona State University

http://pedamp.asu.edu/presentations

© 2019 Pittman All Rights Reserved

Disclosures

This work was supportedby grants from:

Arizona CommunityFoundation

Hearing Industry Research Consortium

Research Assistants (The Pitt Crew):Elizabeth Stewart Ian OdgearLauren Meadows Amanda WillmanNicole Marzan Madalyn RashBeatriz Lazaro Brittany SchuettElizabeth Rainy Ashley WrightAmy Stahl Jacelyn Olson

(and many more)


Learning New Words

That’s a

kitten.

kitten


Learning New Words

That’s the

manubrium of

the malleus.

Manubrium of

the malleus

The

what?


A word isn’t really learned until it can be retrieved.


Learning New Words

Kitty!!


That’s why we make university students take tests.

Manulleus of

the malibrium

Nasopharyngeal

uvula?


185 Normal Hearing159 Hearing Loss 5-17 years of age

Vocabulary Learning and Hearing Loss

Latto (2013) Vocabulary constraints in children with hearing loss. Honors thesis.

-20

0

20

40

60

80

100

120

0.25 0.5 1 2 4 8

Leve

l (d

B H

L)

Frequency (kHz)

NHHL

0

2

4

6

8

10

12

14

16

18

20

22

24

0 2 4 6 8 10 12 14 16 18

PP

VT

Vo

cab

ula

ry A

ge (

Year

s)

Chronological Age (Years)

NH

HL


Hearing Loss and Vocabulary Knowledge

College Students

97 Normal Hearing

93 Mild to Profound Hearing Loss

106

82

0

20

40

60

80

100

120

NH HL

PP

VT

Stan

dar

d S

core

7.7

15.5

0

5

10

15

20

25

30

NH HL

PP

VT

Ove

rest

imat

e (1

20

item

s)

Actual Vocabulary Knowledge

Estimate of Knowledge

of Vocabulary

Sarchet et al (2014), Vocabulary Knowledge of Deaf and Hearing Postsecondary Students, J Postsecond Educ Disabil, 27(2), 161-178.


Hearing Loss and Vocabulary Knowledge

College Students

89 Normal Hearing

25 w/Cochlear Implants <3.5 yrs

68 w/Cochlear Implants >3.5 yrs

104

7884

0

20

40

60

80

100

120

NH CI<3.5yrs

CI>3.5yrs

PP

VT

Stan

dar

d S

core

Actual Vocabulary Knowledge

World Knowledge

(History)

Covertino et al (2014) Word and World Knowledge Among Deaf Learners With and Without Cochlear Implants, J Deaf Studies and Deaf Ed, 19;4

27

15 14

0

10

20

30

40

50

NH CI<3.5yrs

CI>3.5yrs

His

tory

Sco

re (

% c

orr

ect)


How many words do children need to learn?

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

50,000 words

Learned over 18 years (3 to 22 years)

= 7 new words everyday

1,000 new words every year

= 3 new words every day


How is Word Learning Tested?


Incidental Word-Learning Paradigms

We’re looking

for a blag.

Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.© 2019 Pittman All Rights Reserved


Which one is the blag?

Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.© 2019 Pittman All Rights Reserved

0

20

40

60

80

100

Word

Learn

ing (

% c

orr

ect)

4 kHz

9 kHz


4 kHz9 kHz

Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.

NormalHearing

HearingLoss



0

20

40

60

80

100

0 10 20 30 40 50 60 70 80

Word

Learn

ing (

% c

orr

ect)

# of Exposures

4 kHz9 kHz

4 kHz9 kHz

Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.

Rapid


stomun

doztulhomtul

sothnud

fosnush


0

10

20

30

40

50

60

70

80

90

100

51

52

53

54

55

56

57

58

59

51

05

11

51

25

13

51

45

Perf

orm

ance

(%

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)


What Affects Word Learning?


Musical Training?

Group n Training

Musicians 20 19 yrs

Non-Musicians 20 <1 yr

0

1

2

3

Quiet Babble

Lear

nin

g Sp

eed

Listening Condition

Mu

sici

ans

No

n-M

usi

cian

s

Stewart (2017) Learning and Retention of Novel Words in Musicians and Non-Musicians: The Impact of Enriched Auditory Experience on Behavioral and Electro-physiologic Outcomes, Dissertation.

Mu

sici

ans

No

n-M

usi

cian

s


Lear

nin

g Sp

eed

0

0.5

1

1.5

Engl

ish

Span

ish

Ara

bic

Monolingual Bilingual

Bilingual?

de Diego Lazaro (2019) Novel-Word Learning in Bilingual Children with Hearing Loss. Dissertation.

Language Hearing Age n

Monolingual NH 8-12 20

Bilingual NH 8-12 20

Engl

ish

Span

ish

Ara

bic


18

363

12

3980

1

2

3

NH HL

Lear

nin

g Sp

eed

(lo

g 1

00

0/n

)

Hearing Loss?

Pittman et al (2017) Detecting and Learning New Words: The Impact of Advancing Age and Hearing Loss, AJA, 26, 318-327.

Group Age (yrs) n

Children w/NH 8-12 20

Children w/HL 8-12 21

Adults w/NH 50-67 15

Adults w/HL 52-78 17

Aids

Normal Hearing Hearing Loss

Ch

ildre

n

Ad

ult

s


18 1612

47

0

1

2

3

NH HL

Lear

nin

g Sp

eed

(lo

g 1

00

0/n

)

Hearing Loss?

Pittman et al (2017) Detecting and Learning New Words: The Impact of Advancing Age and Hearing Loss, AJA, 26, 318-327.

Group Age (yrs) n

Children w/NH 8-12 20


Adults w/NH 50-67 15


Aids

Normal Hearing Hearing Loss

Ch

ildre

n

Ad

ult

s

Ch

ildre

n

Ad

ult

s


Lear

nin

g Sp

eed

0

0.5

1

1.5

Engl

ish

Span

ish

Ara

bic

Monolingual Bilingual

Bilingual with Hearing Loss and Hearing Aids?


Engl

ish

Span

ish

Ara

bic

-20

0

20

40

60

80

100

120

0.25 0.5 1 2 4 8

Hea

rin

g Le

vel (

dB

HL)

Frequency

0.25 0.5 1 2 4 8

(kHz)

BilingualMonolingual

Language Hearing Age n

Monolingual HL 8-12 20

Bilingual HL 8-12 13


Unilateral Loss?


Group Age n

Unilateral 8-12 12

Bilateral 8-12 21

0

0.5

1

1.5

Lear

nin

g Sp

eed

Listening Condition

Span

ish

Ara

bic

BilateralUnilateral

Normal Hearing

BilateralLoss

UnilateralLoss

Span

ish

Ara

bic

Span

ish

Ara

bic


Listening in Noise?

0

20

40

60

80

100

5 15 25 35 45 55 65 75 85 95

Perf

orm

ance

(%

)

Trials

8-9 Year Olds

0

20

40

60

80

100

5 15 25 35 45 55 65 75 85 95

Trials

QUIET

NOISE

11-12 Year Olds

Normal-HearingChildren

Pittman (2011) Age-related benefits of digital noise reduction for short-term word learning in children with hearing loss, JSLHR, 54, 1448-1463.


0

20

40

60

80

100

5 15 25 35 45 55 65 75 85 95

Trial

QUIET

NOISE0

20

40

60

80

100

5 15 25 35 45 55 65 75 85 95

Perf

orm

ance

(%

)

Trial

Listening in Noise?

8-9 Year Olds 11-12 Year Olds

Hearing-ImpairedChildren

Pittman (2011) Age-related benefits of digital noise reduction for short-term word learning in children with hearing loss, JSLHR, 54, 1448-1463.


Digital Noise Reduction?

Group Age (yrs) n



0

1

2

3

0 1 2 3

DN

R O

n (

Lear

nin

g Sp

eed

)

DNR Off (Learning Speed)

HIC

HIA

Pittman et al (2017) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.


High-Frequency Amplification?

0

1

2

3

0 1 2 3

Wid

eb

and

Am

p (

log

10

00

/n)

Narrowband Amp (log 1000/n)

Children

Adults

Group Age (yrs) n



Pittman et al (2017) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.


Is rapid word-learning durable?

Children

8-15 years33 Normal Hearing22 Hearing Loss

0.0

0.2

0.4

0.6

0.8

1.0

7 8 9 10 11 12 13 14 15 16

Perf

orm

ance

Age (Years)

NHHL

0.0

0.2

0.4

0.6

0.8

1.0

7 8 9 10 11 12 13 14 15 16

Perf

orm

ance

Age (Years)

Rapid Word LearningDay 1

Word RecallDay 2

Pittman, Wright, Latto, Wright (in process) © 2019 Pittman All Rights Reserved

What Have We’ve Learned?

Learning is a fundamental skill acquired early and maintained throughout life.

Specific aspects of learning can be measured.

Uncorrected hearing loss impedes learning.

Corrected hearing loss (amplification) significantly improves learning for both children and adults.

But, there is more work to do because children with hearing loss have difficulty retaining rapidly learned words as well as their normally hearing peers.


The End

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