different evaluations for different kinds of hearing matthew b. winn au.d., ph.d. waisman center,...
TRANSCRIPT
![Page 1: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/1.jpg)
Different evaluationsfor different kinds of hearingMatthew B. Winn Au.D., Ph.D.
Waisman Center,
UW-Madison Dept. of Surgery
![Page 2: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/2.jpg)
Different kinds of hearing?• Using both ears together
• Listening for information / listening for clarity
• The ears as part of the brain & part of the whole person
![Page 3: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/3.jpg)
The challenge of using a cochlear implant•Sound distortion•Pitch shifting•Abnormal loudness•Neural atrophy
![Page 4: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/4.jpg)
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
![Page 5: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/5.jpg)
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
![Page 6: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/6.jpg)
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
![Page 7: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/7.jpg)
Imagine the inner ear as a piano…
Low notes High notesMiddle notes
![Page 8: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/8.jpg)
In real life…
![Page 9: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/9.jpg)
Listening for information,listening for clarity
![Page 10: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/10.jpg)
Listening for information,listening for clarity
Restaurant
Restaurant
Restaurant
Restaurant
![Page 11: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/11.jpg)
Testing for clarity in hearing
![Page 12: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/12.jpg)
Testing for clarity in hearing• Speech sounds are morphed from one sound to another• Listeners label each sound as it is heard• Labeling consistency and confidence is modeled statistically
![Page 13: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/13.jpg)
Different listeners have different levels of clarity in their hearing
(clarity)
![Page 14: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/14.jpg)
Context and adaptation
14
![Page 15: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/15.jpg)
Context and adaptation
15
![Page 16: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/16.jpg)
Some voices have predictable patterns of differences• Pitch, duration, voice quality, articulation, etc.
• We can form categories• High / low pitch • Creaky / smooth voice quality• “eee” / “ooo”• “sss” “sh”
![Page 17: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/17.jpg)
Some voices have predictable patterns of differences
A “low” pitch for one voice may be higher than a “high” pitch for another voice
![Page 18: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/18.jpg)
Testing adjustment to different voices• Low pitch / High pitch
“sh” “ss”
• The difference between low “sh” and high “ss” depends on whether the voice is female or male.
male voicesh ss
female voice
boundary
![Page 19: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/19.jpg)
Testing for a boundaryFocus on a region of interest
Label the sounds
“sh” “ss”
![Page 20: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/20.jpg)
Accommodation to talker voice
20(CI Listener data)
![Page 21: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/21.jpg)
Accommodation to talker FACE
21(CI Listener data)
![Page 22: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/22.jpg)
Accommodation to talker voice with face
22(CI Listener data)
![Page 23: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/23.jpg)
A change of [this context]is worth [this much change]in auditory frequency boundary
23
Bou
ndar
y sh
ift (
Hz)
![Page 24: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/24.jpg)
Listeners with normal hearing adjust to the talker’s voice
![Page 25: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/25.jpg)
Listeners with cochlear implants adjust to the talker’s voice and face
![Page 26: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/26.jpg)
Adjusting on the fly
• Listeners with normal hearing can adjust to the speech of various talkers on-the-fly using their ears
• Listeners with cochlear implants can adjust using their ears AND their eyes,• So they may benefit from learning some audio+visual
associations between faces and vocal styles
![Page 27: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/27.jpg)
Binaural and Bilateral• People with normal hearing enjoy binaural hearing,
which means the two ears work together and compare inputs.
• This lets us do many things, including locate a sound in space and separate speech from background noise
![Page 28: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/28.jpg)
Using two cochlear implants
• Two cochlear implants are independent systems that may or may not work well together
![Page 29: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/29.jpg)
Binaural and Bilateral
• People with bilateral cochlear implants generally report benefit from the second device• Better sound localization• Better hearing in noise
![Page 30: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/30.jpg)
Some abilities are easily quantifiable…• Word recognition over the first two years
• Sound localization
![Page 31: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/31.jpg)
Other abilities are not-so-easily quantifiable.(From the Cochlear Corp. website)
Benefits of bilateral implantation:• More connected• More confident• More balanced and relaxed• Peace of mind
Bilateral implants make it “easier to hear everyday sounds… without the constant strain associated with a hearing loss.”
![Page 32: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/32.jpg)
Listening fatigue and hearing loss:why it matters
• Individuals with hearing loss (HL) have to "work harder" cognitively to process sounds compared to people without hearing loss
• Increased reports of stress, tension & fatigue [1]
• Higher "need for recovery" from work [2]
• Individuals with HL are more likely to miss work due to "fatigue, strain or burnout" than individuals without HL working at a similar or the same job [3]
![Page 33: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/33.jpg)
Effort Pupil dilation • Task-evoked pupil dilation corresponds to cognitive effort
33
![Page 34: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/34.jpg)
Listening effort test
• Listen to sentences with the right implant only
• Listen to sentences with the left implant only
• Listen to sentences with both implants
• Hear the sentence, wait a moment, then repeat
• We measure pupil size as the sentence ends, and during the time before you repeat it back
![Page 35: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/35.jpg)
Right ear CI only
![Page 36: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/36.jpg)
Right and Left CIs
![Page 37: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/37.jpg)
Bilateral CIs
![Page 38: Different evaluations for different kinds of hearing Matthew B. Winn Au.D., Ph.D. Waisman Center, UW-Madison Dept. of Surgery](https://reader035.vdocument.in/reader035/viewer/2022062407/56649da75503460f94a93184/html5/thumbnails/38.jpg)
New directions• Technology exists to improve sound clarity
• Efforts can be made to synchronize both ears
• CI recipients undergo auditory training
• We can evaluate the effects of these efforts on the listener’s experience of mental effort required to listen