Here is the “Have You Heard?” column from Dr. Oden as it appeared in the April 2017 Senior Savvy.
Springtime always brings excitement into the world of audiology. This month’s annual American Academy of Audiology convention is in Indianapolis. I try to attend each year to reconnect with my friend Laurie, who attended the University of Iowa with me and is an audiologist with 3M Corporation, as well as my friend Maria from the University of Denver, who is an audiologist for the Los Angeles school district. Equally important, the convention is a great time for discovering the new equipment and technology that is available. I will share with you what I learned at the convention in the May issue of Senior Savvy, when we celebrate Better Hearing Month.
The recent buzz, in the audiology journals, is the role cognition plays in processing auditory information. We have talked in the past about the direct correlation between untreated age related hearing loss and mild cognitive decline. To reiterate, in case you missed those articles; we now have research based information, using brain imaging studies, that support our theory that individuals with hearing loss have a greater likelihood of developing dementia and Alzheimer type diseases. The literature also supports the role that amplification has in slowing that decline.
So let’s talk about the role cognitive ability plays in understanding speech. Imagine you are at a party or busy restaurant and are trying to follow a conversation. Despite the music, background noise of other conversations and dishes clanging, you are able to understand most of what is being said. We make use of contextual information (knowledge of what we are talking about) to fill in the gaps of conversation you may have missed, due to inference of the background noise.
For individuals with hearing loss, cognitive processing is even more important than for individuals with normal hearing, because auditory information is further affected as a result of the hearing loss. To compensate for degraded input signals, a listener will need to rely more on cognitive processes to reconstruct the message and fill in the gaps of anything they may have missed.
Just as our patients vary in terms of their hearing abilities, they differ in terms of the cognitive abilities. I am hoping to learn more about the various tests that can be used in the clinic to measure cognitive abilities at the Audiology conference. Jane and I routinely complete speech and noise testing as part of our diagnostic test battery. The ability to measure cognitive ability will shed more light on the needed hearing rehabilitation process. Keep in mind that amplification (hearing aids) is only one part of the treatment plan.
Let’s review the cognitive abilities that are involved in the processing of speech.
- Working Memory: Holding information in memory while processing the same or new information at the same time. This process is integral to speech recognition because it allows the listener to retain stored information while processing incoming information. (This is how we can follow a story as it is being told.)
- Processing Speech: During speech recognition, the listener processes speech sounds constantly, extract syllables/words out of the continuous acoustical stream, temporarily storing them in memory, and putting new information into context to understand spoken sentences. (How many times have we heard that the grandchildren talk too fast!)
- Selective Attention: In this context, attention refers primarily to the ability to selectively focus on the talker of interest while ignoring any competing sounds, as well as switching attention among multiple talkers in a conversation. (This is why my boys always heard me when I said it was time for ice cream, even when the TV was on.)
- Lexical Knowledge: Understanding the correct meaning for a word. Unlike other cognitive abilities, which show age-related declines, lexical knowledge is preserved with age.
Remember – hearing aids are only part of the hearing rehabilitative process. Beth, Jane and I hope to work with you to develop your own, individual hearing treatment plan. Give Beth a call at 704-633-0023 to schedule an appointment. We look forward to seeing you soon.