Auditory Evaluation & Training

Hans H. Stassen Ph.D.

About this app

The App provides (1) a high-resolution auditory evaluation for 56 frequencies in the range between 55–7,040 Hz that can be carried out in the users’ home environment; and (2) individually organized, hearing-loss specific training sessions that help to improve auditory thresholds and speech intelligibility (supported languages: English, French, German, Spanish).

Single Tests
«Single Tests» are used to determine the users’ hearing threshold for a given frequency (tone) for either the left ear, the right ear, or both ears together. Single Tests are carried out by presenting the tone of the chosen frequency several times while successively adjusting intensity (loudness). The standard approach starts with the user-defined initial loudness (e.g., -25.5db) and reduces loudness in steps of -1.5db until the user is unable to detect any sound.

Full Tests
«Full Tests» are used to determine the users’ hearing thresholds for 56 frequencies in the range between 55–7,040 Hz (7 octaves; 8 tones per octave), beginning with the left ear and, upon completion, continuing with the right ear. For each single frequency, intensity (loudness) is successively increased in steps of +1.5db (starting with the user-defined minimum value) until the user acknowledges the tone’s audibility. The outcome is displayed in form of bar charts “hearing loss as a function of frequency”.

Training 1: Working on auditory thresholds
«Training1» loops through 56 frequencies between 55–7,040 Hz (7 octaves; 8 tones per octave); the tone duration is 8 seconds with pre-specified intensity (loudness) and for the selected ear(s). Please note that any auditory training will show the desired effect only if the training sessions are repeated on a regular basis (e.g., twice per day for 15 minutes).

Training 2: Working on speech intelligibility
«Training 2» presents a standard text of 60 seconds duration at a pre-specified intensity (loudness) and for the selected ear(s). Focus is laid on speech intelligibility: users begin with a comfortable intensity and concentrate themselves on understanding each single word. Subsequently, users may reduce intensity and repeat the training twice a day for 15 minutes, noting down the training time and the intensities used. Languages are English, French, German, and Spanish.

Scientific Background
Hearing loss: Hearing loss is a common health condition among older adults with a prevalence of >50% in people aged 60 years or older. It causes the sufferers to lose the ability to efficiently communicate with family, peer group, and work place. It leads to chronic stress and is associated with significant psychological and medical co-morbidity, such as social isolation, cognitive decline, and depression.

Etiology: Hearing loss is a complex, etiologically diverse medical condition where multiple genetic and environmental factors are involved. Environmental factors include noise exposure, ototoxin exposure, infections, smoking, and comorbidities like hypertension or diabetes. There are distinct between-subject differences regarding onset, pathology, and form of impairment. Critically important for speech intelligibility are the frequencies affected in the range between 55–7,040 Hz (7 octaves).

Hearing aids: Patients typically report improved quality of life with use of hearing aids but commonly complain that they cannot understand speech, especially in the presence of background noise. Despite implementation of noise-reduction strategies and directional-microphones, everyday communication through hearing aids has still really frustrating limits at present.

What you can do about it: For adults with hearing loss, specific auditory training can facilitate communication in noisy situations as it almost always improves speech intelligibility. Moreover, regular auditory training counteracts inactivity and cognitive decline very efficiently — getting involved and doing something about it is the most important step to successfully cope with hearing loss.