Hearing Science and Hearing Disorders (eBook)

M.E. Lutman (Herausgeber)

eBook Download: PDF | EPUB

2014 | 1. Auflage
338 Seiten
Elsevier Science (Verlag)
978-1-4832-9516-9 (ISBN)

Infos

Hearing Science and Hearing Disorders focuses on the nature of the processes in the inner ear and the nervous system that mediate hearing. Organized into eight chapters, this book first discusses the nature of speech communication, the extent of hearing problems, and the pathophysiology of hearing. Four core chapters follow, in which four areas of central importance to understanding hearing disorders and their effects are covered. These areas are assessment of auditory function, the scope for technological solutions, the nature of audio-visual speech perception, and the effects of deafness upon speech production. This book will be valuable to students; to academic and professional workers concerned with hearing, speech, and their disorders; and to scientifically or medically literate people in general.

Inhalt

Front Cover 1
Hearing Science and Hearing Disorders 4
Copyright Page 5
Table of Contents 12
Preface 6
Editorial Note 10
List of Contributors 11
Chapter 1. Hearing for Speech: the Information Transmitted in Normal and Impaired Hearing 16
I. INTRODUCTION 16
II. WHAT FORMS CAN LINGUISTICALLY RELEVANT INFORMATION TAKE? 19
III. ARTICULATORY AND ACOUSTIC BASES FOR PHONETIC CONTRASTS 23
IV. REPRESENTATIONS OF ACOUSTIC AND AUDITORY SPEECH PATTERNS 30
V. PROPERTIES OF HEARING IMPAIRMENT RELEVANT TO SPEECH PERCEPTION 33
VI. DIVISION OF LABOUR BETWEEN PERCEPTION AND PRODUCTION FOR EFFICIENT SPEECH COMMUNICATION 36
VII. SPEECH PERCEPTION IN HEARING IMPAIRED LISTENERS 38
VIII. CONCLUDING SUMMARY 46
ACKNOWLEDGEMENT 46
REFERENCES 46
FURTHER READING 49
Chapter 2. Hearing Disorders in the Population: First Phase Findings of the MRC National Study of Hearing 50
I. INTRODUCTION AND AIMS 50
II. DESIGN OF THE NATIONAL STUDY OF HEARING 56
III. PREVALENCE OF REPORTED AUDITORY IMPAIRMENT AND DISABILITY 57
IV. RELATIONSHIP BETWEEN MEASURED AUDIOLOGICAL IMPAIRMENT AND SELF REPORTED IMPAIRMENT AND DISABILITY 63
V. PREVALENCE OF TYPES AND DEGREES OF AUDITORY IMPAIRMENT 66
VI. THE VARIATION OF AUDITORY IMPAIRMENT AND DISABILITY WITH AGE, SEX AND SOCIO-ECONOMIC GROUP (SEG) 67
VII. HEARING AID POSSESSION 71
VIII. CONCLUDING SUMMARY 73
ACKNOWLEDGEMENTS 73
REFERENCES 74
Chapter 3. Pathophysiology of the Peripheral Hearing Mechanism 76
I. INTRODUCTION 76
II. HOW ARE SOUNDS ANALYSED BY THE EAR? 78
III. THE EAR AS A BANK OF FILTERS 81
IV. ANIMAL MODELS OF DEAFNESS 83
V. RELEVANCE TO UNDERSTANDING HEARING LOSS IN PATIENTS 85
VI. CAN WE PUT THIS NEW UNDERSTANDING OF THE PATHOPHYSIOLOGY OF HEARING TO PRACTICAL USE? 88
VII. OTHER ASPECTS OF HEARING IMPAIRMENT: ANIMAL MODELS OF TINNITUS 90
VIII. CONCLUDING SUMMARY 91
REFERENCES 92
FURTHER READING 95
Chapter 4. The Scientific Basis for the Assessment of Hearing 96
I. INTRODUCTION 96
II. CLASSIFICATION OF HEARING DISORDERS INTO CLINICAL TYPES 98
III. HISTORICAL DEVELOPMENT OF HEARING ASSESSMENT 100
IV. BASIC SUBJECTIVE METHODS OF ASSESSMENT 101
V. BASIC OBJECTIVE METHODS OF HEARING ASSESSMENT 122
VI. DIAGNOSTIC DETERMINANTS 135
VII. ASSESSMENT FOR REHABILITATION 137
VIII. DIAGNOSIS VERSUS REHABILITATION 138
IX. CONCLUDING SUMMARY 139
REFERENCES 140
FURTHER READING 143
Chapter 5. Audio-visual Speech Perception, Lipreading and Artificial Stimulation 146
I. POSSIBILITIES AND LIMITATIONS OF LIPREADING 147
II. LIPREADING CONSONANTS 149
III. LIPREADING VOWELS 161
IV. LIPREADING FLUENT SPEECH 166
V. SHOULD "LIPREADING" BE TAUGHT? 177
VI. SENSORY SUBSTITUTION AND HEARING "BIONIC EARS" OR AIDS TO LIPREADING?
VII. CONCLUDING SUMMARY 191
ACKNOWLEDGEMENTS 192
REFERENCES 192
FURTHER READING 197
Chapter 6. Speech Production in Profound Postlingual Deafness 198
I. INTRODUCTION - RECOGNITION OF THE PROBLEM 198
II. THE SEVERITY OF THE PROBLEM 201
III. THE NATURE OF SPEECH DETERIORATION 212
IV. THEORETICAL ISSUES 233
V. CONCLUDING SUMMARY 240
REFERENCES 241
Chapter 7. New and Old Conceptions of Hearing Aids 246
I. INTRODUCTION 247
II. THE DISABLING ASPECTS OF IMPAIRMENT 248
III. EFFECTS OF THE INTENSITY OF SPEECH 253
IV. SIGNAL PROCESSING TO ENHANCE SPEECH PERCEPTION 265
V. BEHAVIOURAL FACTORS IN RELATION TO AID CHARACTERISTICS 283
VI. CONCLUDING SUMMARY 292
REFERENCES 293
FURTHER READING 297
Chapter 8. Rehabilitation and Service Needs 298
I. INTRODUCTION 298
II. GENERAL DESCRIPTION OF AN IDEAL SERVICE 299
III. REHABILITATION SERVICES IN DIFFERENT COUNTRIES 322
IV. COST EFFECTIVENESS 330
V. POSSIBLE SHORT-TERM IMPROVEMENTS 333
Acknowledgements 335
Appendix 336
REFERENCES 336
FURTHER READING 339
Glossary of Audiological, Acoustical and Phonetic Terms 340
Subject Index 352

Textauszug

2

Hearing Disorders in the Population: First Phase Findings of the MRC National Study of Hearing

Adrian C. Davis

Publisher Summary

Hearing disorders are a major community health problem in industrialized countries. Hearing impairments are the most common source of disability in the USA. Despite the extent of hearing impairments and their socio-economic impact, there is a paucity of precise population-based data on these. Population studies of hearing have given neither precise indications of the prevalence of various categories, severities and forms of hearing disorders, nor information on the relative importance of causal factors. A large population study, the national study of hearing (NSH) is under way to fill this gap. It has been designed to answer a diverse set number of questions on the causes, forms, correlates, and distributions of hearing disorders. The examination of the role of age, sex, socio-economic group, and noise exposure in population hearing impairment is important.

Contents

I INTRODUCTION AND AIMS

A Rationale for the population study

i. Extent of hearing disorders

ii. Understanding of hearing disorders

iii. Schema for hearing dysfunction

iv. The importance of disability

II THE DESIGN OF THE NATIONAL STUDY OF HEARING

III PREVALENCE OF REPORTED AUDITORY IMPAIRMENT AND DISABILITY

A Self-reported hearing problems

B Prevalence of tinnitus

C Reported noise exposure

IV RELATIONSHIP BETWEEN MEASURED AUDIOLOGICAL IMPAIRMENT AND SELF-REPORTED IMPAIRMENT

V PREVALENCE OF TYPES AND DEGREES OF AUDITORY IMPAIRMENT

VI THE VARIATION OF AUDITORY IMPAIRMENT AND DISABILITY WITH AGE, SEX AND SOCIO-ECONOMIC GROUP

VII HEARING AID POSSESSION

VIII CONCLUDING SUMMARY

I INTRODUCTION AND AIMS

A Rationale for the population study

Hearing disorders, including tinnitus, are a major community health problem in industrialised countries (Roberts, 1979; NCHS, 1980). Leske (1981), has claimed that hearing impairments are the most common source of disability in the USA. Yet, despite the extent of hearing impairments and their obvious socio-economic impact there is a paucity of precise population-based data on these. Not only is it necessary to document the extent of these impairments (Shepherd, 1978), but it is essential that we extend our understanding of hearing disorders in order that appropriate preventative and remedial services may be organised.

In this chapter I hope to achieve four limited objectives. Firstly, I wish to emphasise a rationale for conducting population studies of hearing, which goes beyond the primary aim of accumulation of gross prevalence figures. This entails developing a better understanding of hearing disorders using several aspects of the impairment, disability and handicap that are a consequence of disease; the discussion of these aspects provides my second objective. Thirdly, having developed the rationale and schema used by a major study, the National Study of Hearing (NSH) I report some early results from this study. They are concerned mainly with the distribution of hearing impairment in Great Britain and its breakdown by age and socio-economic group. Finally, I will show that for any reasonable criterion of impairment requiring remedial action, we have to conclude that much need in the population is not being met.

i Extent of hearing disorders

Many of the estimates for population prevalence and clinical incidence of hearing disorders in the UK (e.g. Shepherd, 1978) cannot be usefully interpreted because either the assumptions on which they are based are untenable or because imprecise definitions of hearing disorders have been used. Even where available, service statistics such as patient attendances are difficult to interpret even as estimates of incidence because they are based on purely otological diagnosis (at best upon the WHO International Classification of Diseases) and are hence totally inadequate for assessing the auditory status of patients. Also those who do present for treatment may be considered not to be representative of the population (Davis, in press). In particular, those with a mild to moderate hearing loss do not come forward for assistance unless their hearing loss is compounded by limitations in their central information processing capacity (Hayes and Jerger, 1977) which, if anything, limits the extent to which they can then be helped.

Estimates of prevalence based on service statistics face similar problems. In particular local differences in the system for the treatment of hearing disorders makes a unified account of health care statistics relating to those disorders impossible. Furthermore, it is often the case that hearing disorders are secondary to respiratory, infective or neoplastic disease (Patrick et al., 1981; MacLean, in press; Leske, 1981) and consequently both in clinical records and in surveys, a hearing disorder may not be recorded. This is especially the case in surveys of general health (e.g. in the General Household Survey) and in some surveys of disability, where the questions are often imprecise about the nature and extent of hearing losses.

In the UK, the last major survey of hearing disorders in the population was the model study of Wilkins (1948), which is now rather dated; it did not use any audiological measurements but used a questionnaire “calibrated” in a different population to assess hearing loss. The MRC Institute of Hearing Research (IHR) is coducting the NSH to overcome the above drawbacks; it ensures adequate measurement by being able to call on the services of scientific and technical audiological personnel as well as medical (otological) screening and cover. This means we can document precisely the otological and audiological status of specified samples from the population as well as the demographic and possible causal factors involved in the hearing disorders. This will enable us to generalise the broader implications of our results, and some of the finer associations within them, beyond the population of immediate concern in the UK. For example the factors influencing hearing disorders such as age have value for generalising from one population to another once key variables such as the age structures are known.

ii Understanding of hearing disorders

Although the population audiometric profile is of practical value, it has a rather limited scientific interest. At present it appears possible to enhance the understanding of hearing disorders in three main ways. We may extend our appreciation of their causes, we may improve their description in physiological or communication-science terms, or we may appreciate the differential consequences they may have. Any improvements in legislation, in either preventive or responsive medical services and in overall rehabilitative provision (or possibly detailed procedures) must follow from the appraisal of knowledge in each of these domains, rather than from an increase in one alone. Because knowledge is best applied societally in such a multi-domain fashion it is necessary for the knowledge itself to be acquired and structured within a framework that acknowledges the separate domains. Such a framework is outlined in Section IAiii and Fig. 1. It follows from this framework that it is important to assess individuals in domains other than those tapped by their hearing sensitivity (see also Lutman, 1982; this volume).

FIG. 1 Domains of auditory dysfunction.

iii Schema for hearing dysfunction

There is a need for audiologists to learn from and align themselves with those who deal with impairment, disability and handicap in other specialties e.g. vision and mobility. To facilitate such alignment the World Health Organisation has recommended a standard terminology, which we have adopted. This is particularly necessary as medical terminology largely presupposes that the underlying disorder is, in some anatomical and patho-physiological sense, known; this is often not the case in auditory dysfunction. Much of the work leading to the adopted terminology was undertaken by Wood (WHO, 1980; Wood, 1980). I have expressed the terminology as a schema for auditory dysfunction in Fig. 1 urged by Duckworth (in press) closely following the schema of Colenbrander (1977) for dimensions of visual performance. An array of concrete examples in each domain is provided plus the type of remedial action currently appropriate to alleviate or minimise dysfunction. It is obvious from Fig. 1 that any particular measurement taken or report received from a patient...

Produkt-Details

• Erscheint lt. Verlag: 28.6.2014
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe ► Logopädie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► HNO-Heilkunde
• ISBN-10: 1-4832-9516-8 / 1483295168
• ISBN-13: 978-1-4832-9516-9 / 9781483295169