OBJECTIVE: Hearing aid users have recently been reported to experience problems with electromagnetic interference when using digital cellular phones. This study was undertaken to investigate the possible benefit of an induction loop system developed for use with some cellular phone models, and also to compare the possible benefit in two languages (Finnish and American English) as well as the benefit with two hearing aid technologies (analog versus digital). DESIGN: The study was performed in controlled laboratory conditions at two tertiary care hearing health care centers, one in Oulu, Finland and the other in Dallas, in the United States. The subjects were experienced users of behind-the-ear hearing aids and served as their own controls in three different listening conditions. Thirty-two eligible subjects (20 in Oulu and 12 in Dallas) participated in three test conditions: 1. call with a landline phone, 2. call with a digital cellular phone alone and 3. call with a digital cellular phone coupled to an induction loop. RESULTS: Sentence recognition scores and subjective judgments using a visual analog scale revealed the poorest results with the digital cellular phone alone. When the induction loop was used with the digital cellular phones, sentence recognition scores and the visual analog scale scores were comparable to the scores obtained with a landline phone. The mean sentence recognition score for analog hearing aids was 62.4% (95% confidence interval 50.2 to 74.6) with the landline phone, 12.6% (-1.6 to 26.9) with the digital cellular phone alone, and 63.3% (44.2 to 82.3) when using the digital cellular phone with the induction loop. For digital hearing aids, the sentence recognition scores were 62.4% (51.9 to 72.9), 37.4% (18.0 to 56.8) and 57.6% (39.0 to 76.2), respectively. There was no significant difference in performance between the two centers. However, when using the digital cellular phone alone, there was no drop in the sentence recognition scores with the few (N = 5) digital hearing aids in Dallas. The subjects ranked the digital cellular phone alone as the poorest test condition and the digital cellular phone with an induction loop as the best. CONCLUSIONS: Induction loops appear to offer one possible solution for the incompatibility problem between hearing aids and digital cellular phones. However, the generalizability of the results must be viewed cautiously, because testing included only one induction loop and two digital cellular phone models.
OBJECTIVE: In the assessment of speech intelligibility, procedures that are easy to use, but also valid and reliable, are needed. The aim of this study was to explore the reliability and concurrent validity of two scaling methods for assessing the speech intelligibility of children with impaired hearing. MATERIAL AND METHODS: A total of 51 children aged 4-17 years with a mild to profound hearing impairment performed a naming task comprising 62 single words. Altogether, 85 inexperienced listeners, divided into 17 panels, assessed the speech production of the children. A percent correct score (for identification of the words) was obtained from every listener. The listeners were also asked to judge the overall intelligibility of each child using a visual analogue scale (VAS) and a four-point ordinal level rating scale with verbal descriptors. RESULTS: The percent correct score correlated significantly both with the VAS and the rating scale with verbal descriptors (Pearsons' coefficient 0.90 and Spearman's coefficient 0.78, respectively). Also, the VAS and the scale with verbal descriptors were significantly intercorrelated (Spearman's rho 0.85). Moderate to high correlations were usually obtained for all grades of hearing impairment, both sexes, different age groups and main communication modes. CONCLUSIONS: Especially for assessing the need for remediation of speech and in monitoring its effectiveness, a quick overall estimate of speech intelligibility can be obtained quite reliably using the above rating scales. Item identification is more time-consuming but is often needed in research and therapy planning, where acoustic and linguistic phenomena that reduce intelligibility need to be traced.
Our aim was to obtain versatile information on the communication and socioemotional development of implanted children in their everyday environment. We studied 18 children implanted unilaterally at the mean age of 3 years 4 months. All had normal nonverbal intelligence, but 8 (44%) had concomitant problems. Their parents filled out semistructured questionnaires at 6 months and then annually 1-5 years after activation. Parents reported a change from use of signs to speech, and changes in the children's vocal behavior and spoken language development. They also reported that children had calmed down and showed an increased sense of self-confidence and safety with an expanded social life. The greatest changes started to take place 1 year after implantation. Five years after implantation, two thirds of children were judged to be as independent as their age peers. We conclude that changes in communication pave the way to benefits in psychosocial development after implantation.
During the process of implantation, parents may have rather heterogeneous expectations and concerns about their child's development and the functioning of habilitation and education services. Their views on habilitation and education are important for building family-centred practices.
We explored the perceptions of parents and speech and language therapists (SLTs) on the effects of implantation on the child and the family and on the quality of services provided. Their views were also compared.
Parents and SLTs of 18 children filled out questionnaires containing open- and closed-ended questions at 6 months and annually 1-5 years after activation of the implant. Their responses were analysed mainly using data-based inductive content analysis.
Positive experiences outnumbered negative ones in the responses of both the parents and the SLTs surveyed. The parents were particularly satisfied with the improvement in communication and expanded social life in the family. These were the most prevalent themes also raised by the SLTs. The parents were also satisfied with the organization and content of habilitation. Most of the negative experiences were related to arrangement of hospital visits and the usability and maintenance of speech processor technology. Some children did not receive enough speech and language therapy, and some of the parents were dissatisfied with educational services. The habilitation process had generally required parental efforts at an expected level. However, parents with a child with at least one concomitant problem experienced habilitation as more stressful than did other parents.
Parents and SLTs had more positive than negative experiences with implantation. As the usability and maintenance of speech processor technology were often compromised, we urge implant centres to ensure sufficient personnel for technical maintenance. It is also important to promote services by providing enough information and parental support.
We explored variation in the linguistic environments of hearing children of Deaf parents and how it was associated with their early bilingual language development. For that purpose we followed up the children's productive vocabulary (measured with the MCDI; MacArthur Communicative Development Inventory) and syntactic complexity (measured with the MLU10; mean length of the 10 longest utterances the child produced during videorecorded play sessions) in both Finnish Sign Language and spoken Finnish between the ages of 12 and 30 months. Additionally, we developed new methodology for describing the linguistic environments of the children (N = 10). Large variation was uncovered in both the amount and type of language input and language acquisition among the children. Language exposure and increases in productive vocabulary and syntactic complexity were interconnected. Language acquisition was found to be more dependent on the amount of exposure in sign language than in spoken language. This was judged to be related to the status of sign language as a minority language. The results are discussed in terms of parents' language choices, family dynamics in Deaf-parented families and optimal conditions for bilingual development.