Klein Kelsey E, Wu Yu-Hsiang, Stangl Elizabeth, Bentler Ruth A
Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA.
J Am Acad Audiol. 2018 Apr;29(4):279-291. doi: 10.3766/jaaa.16114.
Auditory environments can influence the communication function of individuals with hearing loss and the effects of hearing aids. Therefore, a tool that can objectively characterize a patient's real-world auditory environments is needed.
To use the Language Environment Analysis (LENA) system to quantify the auditory environments of adults with hearing loss, to examine if the use of hearing aids changes a user's auditory environment, and to determine the association between LENA variables and self-report hearing aid outcome measures.
This study used a crossover design.
Participants included 22 adults with mild-to-moderate hearing loss, age 64-82 yr.
Participants were fitted with bilateral behind-the-ear hearing aids from a major manufacturer.
The LENA system consists of a digital language processor (DLP) that is worn by an individual and records up to 16 hr of the individual's auditory environment. The recording is then automatically categorized according to time spent in different types of auditory environments (e.g., meaningful speech and TV/electronic sound) by the LENA algorithms. The LENA system also characterizes the user's auditory environment by providing the sound levels of different auditory categories. Participants in the present study wore a LENA DLP in an unaided condition and aided condition, which each lasted six to eight days. Participants wore bilateral hearing aids in the aided condition. Percentage of time spent in each auditory environment, as well as median levels of TV/electronic sounds and speech, were compared between subjects' unaided and aided conditions using paired sample t tests. LENA data were also compared to self-report measures of hearing disability and hearing aid benefit using Pearson correlations.
Overall, participants spent the greatest percentage of time in silence (∼40%), relative to other auditory environments. Participants spent ∼12% and 26% of their time in meaningful speech and TV/electronic sound environments, respectively. No significant differences were found between mean percentage of time spent in each auditory environment in the unaided and aided conditions. Median TV/electronic sound levels were on average 2.4 dB lower in the aided condition than in the unaided condition; speech levels were not significantly different between the two conditions. TV/electronic sound and speech levels did not significantly correlate with self-report data.
The LENA system can provide rich data to characterize the everyday auditory environments of older adults with hearing loss. Although TV/electronic sound level was significantly lower in the aided than unaided condition, the use of hearing aids seemed not to substantially change users' auditory environments. Because there is no significant association between objective LENA variables and self-report questionnaire outcomes, these two types of measures may assess different aspects of communication function. The feasibility of using LENA in clinical settings is discussed.
听觉环境会影响听力损失患者的交流功能以及助听器的效果。因此，需要一种能够客观描述患者现实世界听觉环境的工具。
使用语言环境分析（LENA）系统量化成年听力损失患者的听觉环境，研究使用助听器是否会改变用户的听觉环境，并确定LENA变量与自我报告的助听器效果测量指标之间的关联。
本研究采用交叉设计。
参与者包括22名年龄在64 - 82岁之间的轻至中度听力损失成年人。
为参与者佩戴一家主要制造商生产的双侧耳背式助听器。
LENA系统由一个数字语言处理器（DLP）组成，个体佩戴该处理器可记录长达16小时的个人听觉环境。然后，LENA算法会根据在不同类型听觉环境（如，有意义的言语和电视/电子声音）中所花费的时间对录音进行自动分类。LENA系统还通过提供不同听觉类别的声级来描述用户的听觉环境。本研究中的参与者在未佩戴助听器和佩戴助听器的情况下各佩戴一个LENA DLP，每种情况持续六至八天。在佩戴助听器的情况下，参与者佩戴双侧助听器。使用配对样本t检验比较受试者在未佩戴助听器和佩戴助听器情况下在每个听觉环境中所花费时间的百分比，以及电视/电子声音和言语的中位水平。还使用Pearson相关性将LENA数据与听力残疾和助听器益处的自我报告测量指标进行比较。
总体而言，相对于其他听觉环境，参与者在安静环境中所花费的时间百分比最高（约40%）。参与者分别在有意义的言语和电视/电子声音环境中花费约12%和26%的时间。在未佩戴助听器和佩戴助听器的情况下，每个听觉环境中所花费时间的平均百分比没有显著差异。佩戴助听器情况下电视/电子声音的中位水平平均比未佩戴助听器时低2.4 dB；两种情况下言语水平没有显著差异。电视/电子声音和言语水平与自我报告数据没有显著相关性。
LENA系统可以提供丰富的数据来描述老年听力损失患者的日常听觉环境。尽管佩戴助听器时电视/电子声音水平显著低于未佩戴时，但使用助听器似乎并没有实质性改变用户的听觉环境。由于客观的LENA变量与自我报告问卷结果之间没有显著关联，这两种测量方法可能评估了交流功能的不同方面。本文讨论了在临床环境中使用LENA的可行性。
