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Hearing Loss, Hearing Aids, and the Business of LearningAndrea Pittman, PhD CCC-AArizona State University
http://pedamp.asu.edu/presentations
© 2019 Pittman All Rights Reserved
Disclosures
This work was supportedby grants from:
Arizona CommunityFoundation
Hearing Industry Research Consortium
Research Assistants (The Pitt Crew):Elizabeth Stewart Ian OdgearLauren Meadows Amanda WillmanNicole Marzan Madalyn RashBeatriz Lazaro Brittany SchuettElizabeth Rainy Ashley WrightAmy Stahl Jacelyn Olson
(and many more)
© 2019 Pittman All Rights Reserved
Learning New Words
That’s a
kitten.
kitten
© 2019 Pittman All Rights Reserved
Learning New Words
That’s the
manubrium of
the malleus.
Manubrium of
the malleus
The
what?
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A word isn’t really learned until it can be retrieved.
© 2019 Pittman All Rights Reserved
Learning New Words
Kitty!!
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That’s why we make university students take tests.
Manulleus of
the malibrium
Nasopharyngeal
uvula?
© 2019 Pittman All Rights Reserved
185 Normal Hearing159 Hearing Loss 5-17 years of age
Vocabulary Learning and Hearing Loss
Latto (2013) Vocabulary constraints in children with hearing loss. Honors thesis.
-20
0
20
40
60
80
100
120
0.25 0.5 1 2 4 8
Leve
l (d
B H
L)
Frequency (kHz)
NHHL
0
2
4
6
8
10
12
14
16
18
20
22
24
0 2 4 6 8 10 12 14 16 18
PP
VT
Vo
cab
ula
ry A
ge (
Year
s)
Chronological Age (Years)
NH
HL
© 2019 Pittman All Rights Reserved
Hearing Loss and Vocabulary Knowledge
College Students
97 Normal Hearing
93 Mild to Profound Hearing Loss
106
82
0
20
40
60
80
100
120
NH HL
PP
VT
Stan
dar
d S
core
7.7
15.5
0
5
10
15
20
25
30
NH HL
PP
VT
Ove
rest
imat
e (1
20
item
s)
Actual Vocabulary Knowledge
Estimate of Knowledge
of Vocabulary
Sarchet et al (2014), Vocabulary Knowledge of Deaf and Hearing Postsecondary Students, J Postsecond Educ Disabil, 27(2), 161-178.
© 2019 Pittman All Rights Reserved
Hearing Loss and Vocabulary Knowledge
College Students
89 Normal Hearing
25 w/Cochlear Implants <3.5 yrs
68 w/Cochlear Implants >3.5 yrs
104
7884
0
20
40
60
80
100
120
NH CI<3.5yrs
CI>3.5yrs
PP
VT
Stan
dar
d S
core
Actual Vocabulary Knowledge
World Knowledge
(History)
Covertino et al (2014) Word and World Knowledge Among Deaf Learners With and Without Cochlear Implants, J Deaf Studies and Deaf Ed, 19;4
27
15 14
0
10
20
30
40
50
NH CI<3.5yrs
CI>3.5yrs
His
tory
Sco
re (
% c
orr
ect)
© 2019 Pittman All Rights Reserved
How many words do children need to learn?
The average college student knows between 15,000 and 200,000 words (D’Anna et al 1991)
50,000 words
Learned over 18 years (3 to 22 years)
= 7 new words everyday
1,000 new words every year
= 3 new words every day
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How is Word Learning Tested?
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Incidental Word-Learning Paradigms
We’re looking
for a blag.
Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.© 2019 Pittman All Rights Reserved
Incidental Word-Learning Paradigms
Which one is the blag?
Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.© 2019 Pittman All Rights Reserved
0
20
40
60
80
100
Word
Learn
ing (
% c
orr
ect)
4 kHz
9 kHz
Incidental Word-Learning Paradigms
4 kHz9 kHz
Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.
NormalHearing
HearingLoss
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Incidental Word-Learning Paradigms
0
20
40
60
80
100
0 10 20 30 40 50 60 70 80
Word
Learn
ing (
% c
orr
ect)
# of Exposures
4 kHz9 kHz
4 kHz9 kHz
Pittman et al (2005) Rapid word-learning in normal-hearing and hearing-impaired children… Ear & Hearing, 26(6), 619-629.
Rapid
© 2019 Pittman All Rights Reserved
stomun
doztulhomtul
sothnud
fosnush
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0
10
20
30
40
50
60
70
80
90
100
51
52
53
54
55
56
57
58
59
51
05
11
51
25
13
51
45
Perf
orm
ance
(%
Co
rrec
t)
Trials
𝑃𝑐 = 1 − 0.80𝑒−𝑛/𝑐
Learning Speed:3 = 1 trial (perfect learning)2 = 10 trials1 = 100 trials0 = 1000 trials (no learning)
© 2019 Pittman All Rights Reserved
What Affects Word Learning?
© 2019 Pittman All Rights Reserved
Musical Training?
Group n Training
Musicians 20 19 yrs
Non-Musicians 20 <1 yr
0
1
2
3
Quiet Babble
Lear
nin
g Sp
eed
Listening Condition
Mu
sici
ans
No
n-M
usi
cian
s
Stewart (2017) Learning and Retention of Novel Words in Musicians and Non-Musicians: The Impact of Enriched Auditory Experience on Behavioral and Electro-physiologic Outcomes, Dissertation.
Mu
sici
ans
No
n-M
usi
cian
s
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Lear
nin
g Sp
eed
0
0.5
1
1.5
Engl
ish
Span
ish
Ara
bic
Monolingual Bilingual
Bilingual?
de Diego Lazaro (2019) Novel-Word Learning in Bilingual Children with Hearing Loss. Dissertation.
Language Hearing Age n
Monolingual NH 8-12 20
Bilingual NH 8-12 20
Engl
ish
Span
ish
Ara
bic
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18
363
12
3980
1
2
3
NH HL
Lear
nin
g Sp
eed
(lo
g 1
00
0/n
)
Hearing Loss?
Pittman et al (2017) Detecting and Learning New Words: The Impact of Advancing Age and Hearing Loss, AJA, 26, 318-327.
Group Age (yrs) n
Children w/NH 8-12 20
Children w/HL 8-12 21
Adults w/NH 50-67 15
Adults w/HL 52-78 17
Aids
Normal Hearing Hearing Loss
Ch
ildre
n
Ad
ult
s
© 2019 Pittman All Rights Reserved
18 1612
47
0
1
2
3
NH HL
Lear
nin
g Sp
eed
(lo
g 1
00
0/n
)
Hearing Loss?
Pittman et al (2017) Detecting and Learning New Words: The Impact of Advancing Age and Hearing Loss, AJA, 26, 318-327.
Group Age (yrs) n
Children w/NH 8-12 20
Children w/HL 8-12 21
Adults w/NH 50-67 15
Adults w/HL 52-78 17
Aids
Normal Hearing Hearing Loss
Ch
ildre
n
Ad
ult
s
Ch
ildre
n
Ad
ult
s
© 2019 Pittman All Rights Reserved
Lear
nin
g Sp
eed
0
0.5
1
1.5
Engl
ish
Span
ish
Ara
bic
Monolingual Bilingual
Bilingual with Hearing Loss and Hearing Aids?
de Diego Lazaro (2019) Novel-Word Learning in Bilingual Children with Hearing Loss. Dissertation.
Engl
ish
Span
ish
Ara
bic
-20
0
20
40
60
80
100
120
0.25 0.5 1 2 4 8
Hea
rin
g Le
vel (
dB
HL)
Frequency
0.25 0.5 1 2 4 8
(kHz)
BilingualMonolingual
Language Hearing Age n
Monolingual HL 8-12 20
Bilingual HL 8-12 13
© 2019 Pittman All Rights Reserved
Unilateral Loss?
de Diego Lazaro (2019) Novel-Word Learning in Bilingual Children with Hearing Loss. Dissertation.
Group Age n
Unilateral 8-12 12
Bilateral 8-12 21
0
0.5
1
1.5
Lear
nin
g Sp
eed
Listening Condition
Span
ish
Ara
bic
BilateralUnilateral
Normal Hearing
BilateralLoss
UnilateralLoss
Span
ish
Ara
bic
Span
ish
Ara
bic
© 2019 Pittman All Rights Reserved
Listening in Noise?
0
20
40
60
80
100
5 15 25 35 45 55 65 75 85 95
Perf
orm
ance
(%
)
Trials
8-9 Year Olds
0
20
40
60
80
100
5 15 25 35 45 55 65 75 85 95
Trials
QUIET
NOISE
11-12 Year Olds
Normal-HearingChildren
Pittman (2011) Age-related benefits of digital noise reduction for short-term word learning in children with hearing loss, JSLHR, 54, 1448-1463.
© 2019 Pittman All Rights Reserved
0
20
40
60
80
100
5 15 25 35 45 55 65 75 85 95
Trial
QUIET
NOISE0
20
40
60
80
100
5 15 25 35 45 55 65 75 85 95
Perf
orm
ance
(%
)
Trial
Listening in Noise?
8-9 Year Olds 11-12 Year Olds
Hearing-ImpairedChildren
Pittman (2011) Age-related benefits of digital noise reduction for short-term word learning in children with hearing loss, JSLHR, 54, 1448-1463.
© 2019 Pittman All Rights Reserved
Digital Noise Reduction?
Group Age (yrs) n
Children w/HL 8-12 13
Adults w/HL 52-78 13
0
1
2
3
0 1 2 3
DN
R O
n (
Lear
nin
g Sp
eed
)
DNR Off (Learning Speed)
HIC
HIA
Pittman et al (2017) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.
© 2019 Pittman All Rights Reserved
High-Frequency Amplification?
0
1
2
3
0 1 2 3
Wid
eb
and
Am
p (
log
10
00
/n)
Narrowband Amp (log 1000/n)
Children
Adults
Group Age (yrs) n
Children w/HL 8-12 21
Adults w/HL 52-78 17
Pittman et al (2017) Word Recognition and Learning: Effects of Hearing Loss and Amplification Feature, Trends in Hearing, 21, 1-13.
© 2019 Pittman All Rights Reserved
Is rapid word-learning durable?
Retention Posttest
Name Name Name
Learning
Pittman, Wright, Latto, Wright (in process) © 2019 Pittman All Rights Reserved
Is rapid word-learning durable?
Children
8-15 years33 Normal Hearing22 Hearing Loss
0.0
0.2
0.4
0.6
0.8
1.0
7 8 9 10 11 12 13 14 15 16
Perf
orm
ance
Age (Years)
NHHL
0.0
0.2
0.4
0.6
0.8
1.0
7 8 9 10 11 12 13 14 15 16
Perf
orm
ance
Age (Years)
Rapid Word LearningDay 1
Word RecallDay 2
Pittman, Wright, Latto, Wright (in process) © 2019 Pittman All Rights Reserved
What Have We’ve Learned?
Learning is a fundamental skill acquired early and maintained throughout life.
Specific aspects of learning can be measured.
Uncorrected hearing loss impedes learning.
Corrected hearing loss (amplification) significantly improves learning for both children and adults.
But, there is more work to do because children with hearing loss have difficulty retaining rapidly learned words as well as their normally hearing peers.
© 2019 Pittman All Rights Reserved
The End
http://pedamp.asu.edu/presentations
© 2019 Pittman All Rights Reserved