Pichora-Fuller M Kathleen, Singh Gurjit
Department of Psychology, University of Toronto, 3359 Mississauga Road, Mississauga, Ontario, Canada L5L 1C6.
Trends Amplif. 2006 Mar;10(1):29-59. doi: 10.1177/108471380601000103.
Recent advances in research and clinical practice concerning aging and auditory communication have been driven by questions about age-related differences in peripheral hearing, central auditory processing, and cognitive processing. A "site-of-lesion'' view based on anatomic levels inspired research to test competing hypotheses about the contributions of changes at these three levels of the nervous system. A "processing'' view based on psychologic functions inspired research to test alternative hypotheses about how lower-level sensory processes and higher-level cognitive processes interact. In the present paper, we suggest that these two views can begin to be unified following the example set by the cognitive neuroscience of aging. The early pioneers of audiology anticipated such a unified view, but today, advances in science and technology make it both possible and necessary. Specifically, we argue that a synthesis of new knowledge concerning the functional neuroscience of auditory cognition is necessary to inform the design and fitting of digital signal processing in "intelligent'' hearing devices, as well as to inform best practices for resituating hearing aid fitting in a broader context of audiologic rehabilitation. Long-standing approaches to rehabilitative audiology should be revitalized to emphasize the important role that training and therapy play in promoting compensatory brain reorganization as older adults acclimatize to new technologies. The purpose of the present paper is to provide an integrated framework for understanding how auditory and cognitive processing interact when older adults listen, comprehend, and communicate in realistic situations, to review relevant models and findings, and to suggest how new knowledge about age-related changes in audition and cognition may influence future developments in hearing aid fitting and audiologic rehabilitation.
近期，关于衰老与听觉交流的研究及临床实践进展，是由外周听力、中枢听觉处理和认知处理方面与年龄相关的差异问题所推动的。基于解剖学层面的“病变部位”观点激发了研究，以检验关于神经系统这三个层面变化所起作用的相互竞争的假设。基于心理功能的“处理”观点激发了研究，以检验关于较低层次感觉过程和较高层次认知过程如何相互作用的替代假设。在本文中，我们认为，遵循衰老认知神经科学树立的范例，这两种观点可以开始统一起来。听力学的早期先驱者曾预见到这样一种统一的观点，但如今，科技的进步使其既成为可能，也变得必要。具体而言，我们认为，综合有关听觉认知功能神经科学的新知识，对于为“智能”听力设备中的数字信号处理设计和适配提供信息，以及为在更广泛的听力学康复背景下重新定位助听器适配的最佳实践提供信息而言是必要的。长期以来的康复听力学方法应予以振兴，以强调训练和治疗在促进老年人适应新技术时大脑进行代偿性重组方面所起的重要作用。本文的目的是提供一个综合框架，以理解老年人在现实情境中倾听、理解和交流时听觉与认知处理是如何相互作用的，回顾相关模型和研究结果，并提出关于听觉和认知方面与年龄相关变化的新知识可能如何影响助听器适配和听力学康复未来发展的建议。
