American Journal of Audiology最新文献

{"title":"Normative Ranges for Wideband Middle Ear Muscle Reflex Magnitude: Limited Potential for Diagnosing Cochlear Deafferentation.","authors":"Naomi F Bramhall, Garnett P McMillan, Sean D Kampel, Anne E Heassler, Nicole K Whittle, Haley A Szabo","doi":"10.1044/2025_AJA-25-00241","DOIUrl":"10.1044/2025_AJA-25-00241","url":null,"abstract":"<p><strong>Purpose: </strong>Cochlear synaptopathy, the loss of the synapses between the inner hair cells and their auditory nerve fiber targets, is expected to be a common type of auditory deficit resulting from noise exposure or aging. Unfortunately, there is currently no means for diagnosing cochlear synaptopathy or other forms of cochlear deafferentation. Wideband middle ear muscle reflexes (MEMRs) have been proposed as a potential diagnostic indicator of cochlear deafferentation, but we lack normative ranges for MEMR magnitude. The objective of this study was to develop normative ranges for wideband MEMR magnitude that can be used to identify patients with abnormally weak MEMRs.</p><p><strong>Method: </strong>Normative ranges were generated for ipsilateral and contralateral wideband MEMR magnitude in a population at low risk for cochlear synaptopathy due to young age, normal hearing thresholds, and minimal noise exposure history. The normative ranges were statistically adjusted for average distortion product otoacoustic emission (DPOAE) levels to account for possible impacts of outer hair cell dysfunction. To evaluate the ability of the normative ranges to differentiate between populations at low versus high risk of synaptopathy, measurements were also collected from military Veterans with normal hearing thresholds who reported at least one of the auditory complaints predicted to result from synaptopathy-tinnitus, speech perception in noise difficulty, or decreased sound tolerance.</p><p><strong>Results: </strong>For individuals with poorer DPOAEs, it is not possible to fall below the lower bounds of the wideband MEMR normative ranges. For individuals with more robust DPOAEs, the lower bounds are very close to an MEMR magnitude indicating an absent reflex. Few individuals from the high-risk sample fell below the normative ranges, suggesting that these normative ranges do not identify significant cochlear deafferentation as expected.</p><p><strong>Conclusion: </strong>Wideband MEMR magnitude normative ranges will not be effective as a stand-alone indicator of cochlear deafferentation.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"457-471"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the Booth: A Commentary on Implementing Boothless Audiometry for Hearing Conservation Programs.","authors":"Alyssa Davidson, Victoria Bugtong, Devon Kulinski, Benjamin Sheffield, Kerri Klingseis, Michael Murphy, Douglas Brungart","doi":"10.1044/2025_AJA-25-00184","DOIUrl":"10.1044/2025_AJA-25-00184","url":null,"abstract":"<p><strong>Purpose: </strong>This commentary discusses the evolving role of boothless audiometry in hearing conservation programs. It addresses space and access limitations of traditional booth-based testing and explores how boothless solutions offer alternatives for maintaining and boosting service delivery.</p><p><strong>Method: </strong>We present a conceptual discussion on the utility of boothless audiometry for hearing conservation monitoring, followed by a real-world implementation example from Department of Defense (DOD) hearing conservation clinics.</p><p><strong>Results: </strong>DOD hearing conservation programs completed over 40,000 boothless hearing tests between 2021 and May 2025, showing progressive year-over-year adoption. Patient satisfaction surveys from over 800 service members revealed positive ratings for boothless compared to traditional booth-based testing. Implementation feedback emphasized the importance of quiet testing environments and comprehensive staff training.</p><p><strong>Conclusions: </strong>Boothless audiometry represents a viable, and often underutilized, model for conducting audiometric monitoring for hearing conservation programs. Its portability, scalability, and adaptability make it particularly suited to outreach settings, resource-limited clinics, or as a contingency during facility disruptions. This commentary encourages audiologists to explore boothless approaches as complementary, not alternative, methods for increasing access to high-quality care.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"779-784"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Benefits of Bilateral Bone Conduction Hearing Devices for Children and Adults With Conductive and Mixed Hearing Losses.","authors":"René H Gifford, Hilary Davis, Jourdan Holder","doi":"10.1044/2026_AJA-25-00123","DOIUrl":"10.1044/2026_AJA-25-00123","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare performance between unilateral and bilateral bone conduction hearing device (BCHD) use for speech understanding and subjective listening difficulty.</p><p><strong>Method: </strong>This study involved prospective investigation of bilateral BCHD with human subjects at an academic medical center. Twelve individuals (five children, seven adults) with BCHD were recruited (eight unilateral BCHDs, four bilateral BCHDs). Speech recognition was assessed in colocated noise (Bamford-Kowal-Bench Speech in Noise), diffuse noise (AzBio/BabyBio), and roving speech in diffuse noise (Basic English Lexicon sentences) as well as patient-reported outcomes of listening difficulty and Speech, Spatial and Qualities of Hearing Scale.</p><p><strong>Results: </strong>Statistically significant bilateral BCHD benefit was noted for roving speech. Bilateral BCHDs resulted in speech understanding scores that were not significantly different across speech location, whereas unilateral BCHD revealed significantly poorer performance with speech directed to the unaided ear. However, bilateral BCHD benefit may not be easily quantified in clinical settings, as we observed no significant bilateral benefit for the clinical assessments of speech in colocated noise.</p><p><strong>Conclusions: </strong>Significant bilateral BCHD benefit was noted for roving speech in diffuse noise, similar to group conversations in noisy restaurants. Significant benefits were not observed for a fixed sound source in colocated noise making clinical assessment of the potential benefit of a second BCHD challenging; however, performance in the bilateral BCHD condition was either similar to or better than the best single ear alone thereby consistent with clinical benefits observed in complex noise. Overall, the study provides evidence in support of bilateral BCHD, but further investigation with larger samples is warranted.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"734-744"},"PeriodicalIF":1.8,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Auditory Deficits in Veterans With Traumatic Brain Injury: A Principal Component Analysis Approach.","authors":"Tess K Koerner, Melissa A Papesh, Frederick J Gallun","doi":"10.1044/2026_AJA-25-00253","DOIUrl":"10.1044/2026_AJA-25-00253","url":null,"abstract":"<p><strong>Purpose: </strong>There is currently no consensus regarding an evidence-based assessment protocol for normal-hearing patients with a history of brain injury who report auditory difficulties. This work used a large test battery to identify measures that explained the most variability across participants with and without a history of head injury, to determine relationships between measures, and to explore patterns of performance across participants, with the aim of identifying measures that should be considered in future research on developing clinical assessment protocols for this unique patient population.</p><p><strong>Method: </strong>A principal component analysis was conducted on data from 22 self-report, central auditory processing, and cognitive processing measures completed by a sample of 95 participants. Participants included Veterans with a history of blast exposure, Veterans with a history of nonblast mild traumatic brain injury (mTBI), and a sample of control participants with no history of head injury.</p><p><strong>Results: </strong>Several central auditory processing and self-report measures explained variance in the data set. However, analyses revealed that performance on the behavioral auditory processing tests was not predictive of self-reported auditory and non-auditory symptom severity. A cluster analysis further revealed spread in performance across participants with a history of blast exposure or nonblast mTBI.</p><p><strong>Conclusions: </strong>Results from the current study underscore the need for a comprehensive, individualized approach to patient care for those with a history of head injury. The measures identified in the current analysis should be investigated in future studies that aim to develop an auditory assessment protocol for this patient population.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.32060232.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"680-690"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time Matters: Possible Predictors of the Number of Appointments During the First Year After Hearing Aid Fitting.","authors":"Shannon C McCabe, Kaitlyn Ramirez, Sara Dyer, David Velenovsky, Tom Muller, Megan J Kobel","doi":"10.1044/2026_AJA-25-00240","DOIUrl":"10.1044/2026_AJA-25-00240","url":null,"abstract":"<p><strong>Purpose: </strong>Follow-up care after hearing aid fitting is recommended, yet clinicians lack data on the expected number of follow-up appointments needed and which patients require more support. This study aimed to characterize follow-up service utilization during the first year after hearing aid fitting and to determine whether patient, device, or cost-related factors may predict the number of follow-up appointments.</p><p><strong>Method: </strong>A retrospective chart review was conducted on 223 adult patients who received hearing aids at a university-affiliated audiology clinic between May 2022 and April 2023. Demographic, audiological, device-specific, and cost-related data were extracted. The number of follow-up appointments over 1 year was used as the primary outcome. Negative binomial regression analyses were performed to identify predictors of follow-up service utilization.</p><p><strong>Results: </strong>Patients attended an average of 4.1 follow-up appointments (range: 1-16), with most attending three to five visits. No significant effects were observed for gender, degree of hearing loss, or language. Effects of age and prior hearing aid experience were identified with older patients and those with over 10 years of prior hearing aid use attending more appointments. Device factors, including dispensing of accessories and dispensing of standard-level technology, were associated with increased follow-up utilization. Patients with higher out-of-pocket (OOP) costs or no insurance coverage attended more appointments, though cost and technology level exhibited interdependencies.</p><p><strong>Conclusions: </strong>Overall, most adult hearing aid patients attended approximately three to five appointments over the first year, and most demographic and audiometric factors did not predict follow-up appointment attendance. However, on average, patients with higher OOP costs and those with an accessory attended more appointments. Clinicians can use these data to provide evidence-based counseling to patients and to inform clinical decision making.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"771-778"},"PeriodicalIF":1.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Competency Criteria for Real-Ear Measurement: Findings From a Modified E-Delphi Round 1.","authors":"Bavadharani Venkatesan, Marlene Bagatto, Sheila Moodie, Susan Diane Scollie","doi":"10.1044/2025_AJA-25-00012","DOIUrl":"10.1044/2025_AJA-25-00012","url":null,"abstract":"<p><strong>Background: </strong>Hearing aid verification ensures that appropriate audibility and access to the speech signal are provided to the hearing aid user. Best practice guidelines recommend evidence-based verification measures (on-ear real-ear aided response [REAR] and simulated REAR) to match the hearing aid output with prescribed targets. Skill development for measuring and interpreting REAR involves six stages: novice, advanced, beginner, competent, proficient, and expert. At the competent stage, trainees can perform entrustable professional activities independently, demonstrating sufficient competence for unsupervised practice.</p><p><strong>Purpose: </strong>The purpose of this study was to obtain consensus on key competency criteria expected for audiologists performing hearing aid verification across the lifespan to ensure effective real-ear performance evaluation.</p><p><strong>Method: </strong>A modified e-Delphi technique was used. In the preparatory stage, 54 preselected competency items were categorized into seven domains. In the first round of the survey, expert audiologists rated their level of agreement on a 7-point Likert scale ranging from <i>strongly disagree</i> to <i>strongly agree</i> for each competency. An a priori threshold of 70% was required for consensus.</p><p><strong>Results: </strong>Twenty-nine expert audiologists completed the first survey round. Consensus was achieved for 52 out of the 54 competency items. Competencies related to calibration, equipment setup, and interpretation of REAR had over 90% agreement. Items not reaching initial consensus were revised for Round 2 based on expert feedback.</p><p><strong>Conclusions: </strong>Results from Round 1 and the new consolidated items will be shared in Round 2. This study identifies key competencies for audiologists to perform on-ear and simulated REAR, forming the basis for knowledge, training, and improved clinical outcomes.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"13-30"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessibility of University Audiology Clinics.","authors":"Laura Gaeta","doi":"10.1044/2025_AJA-25-00169","DOIUrl":"10.1044/2025_AJA-25-00169","url":null,"abstract":"<p><strong>Purpose: </strong>Access to hearing health care remains a major issue for people with hearing and balance disorders across the lifespan. University audiology clinics are in a unique position to address these disparities in access, as they serve as training programs for future clinicians and health care centers. This study examined the accessibility of university audiology clinics in various domains including financial barriers, LGBTQ+-inclusive facilities, physical access, scheduling, transportation, financial assistance, and communication.</p><p><strong>Method: </strong>Data on accessibility domains were collected via structured phone calls with clinic reception staff at university audiology clinics and websites. Distances between the nearest bus stop or rail station and the university audiology clinic were calculated and categorized based on the frequency of service. Responses and public transportation data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>University audiology clinics had a range of accessibility features, including ways to schedule an appointment, services for patients with limited English proficiency, financial assistance, disability accommodations, availability of gender-neutral restrooms, and extended clinic hours. Most offered standard scheduling by phone, written visit summaries, and accessible physical facilities, but fewer clinics provided services for extended hours, disability accommodations, or language support. Gaps identified include gender-inclusive restrooms, bilingual staffing, and financial assistance options for patients. The mean distance from the university clinic to the nearest bus stop was 0.206 mi, and the mean distance from the university clinic to the nearest rail station was 0.488 mi. Clinics are located in slightly more socially disadvantaged areas compared to the national average.</p><p><strong>Conclusions: </strong>The findings provide data on the accessibility of university audiology clinics for patients from various backgrounds with differing needs (e.g., financial assistance, language support). Gaps in hearing health care access and areas for improvement of accessibility across areas such as language services, physical facilities, scheduling, and transportation for university audiology clinics are identified and discussed. Recommendations include asking about transportation options, scheduling considerations around transit schedules, installing clear signage, providing staff training, and offering tele-audiology appointments.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.31235929.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"206-217"},"PeriodicalIF":1.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Don't Assume I'm Too Old!\": Assessment of Digital Literacy in a Clinical Sample of Adults With Hearing Loss.","authors":"Melanie Ferguson, Talveen Sahota, Cathy Sucher","doi":"10.1044/2025_AJA-25-00160","DOIUrl":"10.1044/2025_AJA-25-00160","url":null,"abstract":"<p><strong>Purpose: </strong>Digital and remote technologies are commonly used in audiology, which require digital literacy skills. The study objectives were to (a) assess digital literacy in adults with hearing loss attending an audiology clinic in Australia and (b) establish the relationship of digital literacy with demographic factors.</p><p><strong>Method: </strong>A single-center, cross-sectional survey on self-report of skill and confidence with mobile technologies using two measures (a) the validated Mobile Device Proficiency Questionnaire-16 items (MDPQ-16), and (b) the short two-item Digital Literacy-2Q (DL-2Q) for clinical use asking about Mobile Skill and Mobile Confidence. The study sample was adults with primarily mild-moderate hearing loss (<i>n =</i> 110), aged 52-96 years (<i>M</i> = 73.9).</p><p><strong>Results: </strong>Age was negatively associated with MDPQ-16 scores, <i>r</i>(108) = -0.454, <i>p</i> < .001. However, in the mid-age range 65-85 years, more than twice as many participants (69.7%) had good mobile proficiency compared to those who had poorer mobile proficiency (30.3%). For the DL-2Q, the 92% who rated themselves as <i>competent</i>, and the 58.3% and 41.0% who rated themselves as <i>confident</i> or <i>depends on task</i>, respectively, had good MDPQ-16 scores. However, in 25% there was a mismatch between ratings of <i>competent</i> and <i>confident</i>. No other demographic factors were significantly associated with digital literacy.</p><p><strong>Conclusions: </strong>Although age overall was a factor in digital literacy, there were many older adults attending audiology appointments who were shown to have good digital literacy, irrespective of their age. The DL-2Q is a quick and easy measure to assess digital literacy in audiology clinics. This can help to ensure that age is not barrier to remote hearing health technologies, which should be accessible to all those who would benefit.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.30853604.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"150-160"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bimodal Neuromodulation for Tinnitus in a Clinical Practice Setting: Clinically Significant Benefit for Patients With Moderate or Worse Symptoms.","authors":"Craig A Kasper, Juliana M May, Natalie E Crossland, Hubert H Lim","doi":"10.1044/2025_AJA-25-00090","DOIUrl":"10.1044/2025_AJA-25-00090","url":null,"abstract":"<p><strong>Purpose: </strong>Controlled clinical trials demonstrate the safety and efficacy of new treatments, but real-world outcomes may vary due to patient diversity and treatment variations. Tinnitus, affecting 10%-15% of the population, is a major health concern. Lenire, a bimodal neuromodulation treatment combining sound and tongue stimulations, has shown safety and effectiveness in clinical trials. This study presents the first real-world evidence (RWE) from a U.S. cohort that investigates tinnitus subgroup severities, providing further assessment of Lenire's use in clinical practice.</p><p><strong>Method: </strong>A single-site, single-arm chart review of 140 patients treated between May 1, 2023, and January 19, 2024, was conducted. Patients were prescribed Lenire for up to 60 min daily and attended follow-ups at 6 and 12 weeks.</p><p><strong>Results: </strong>This is the first study in a U.S. cohort to show results consistent with the U.S. Food and Drug Administration (FDA) labeling of Lenire, where positive therapeutic outcomes were achieved in patients with moderate or worse tinnitus severity as measured by the Tinnitus Handicap Inventory (THI). In this bothered tinnitus group, 81.8% (95% CI [70.9%, 89.3%]) achieved a clinically significant response (THI improvement ≥ 7 points) to treatment, with a mean reduction of -23.8 ± 2.3 points after only 12 weeks of treatment. In contrast, when providing Lenire treatment to tinnitus patients with less bothersome tinnitus (i.e., slight and mild categories), nearly zero change in score, on average, was observed after treatment. Additionally, responder rates based on an alternative threshold of at least an 11-point reduction in THI score show a high response to treatment even with this stricter minimal clinically important difference criterion, with 71.2% (95% CI [59.4%, 80.7%]) of the participants meeting or exceeding the threshold. Similar results were observed when using an alternative threshold based on an intrasubject percent improvement, defined as a reduction of at least 15% from each participant's THI score at the initial assessment.</p><p><strong>Conclusions: </strong>Real-world data support Lenire's clinical benefits for patients with moderate or more severe tinnitus and demonstrate consistency with clinical trial results that led to FDA approval. These findings further confirm its successful integration into standard audiology care. Ongoing RWE collection will help identify the most responsive patients and guide tailored treatments.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.31028449.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"55-68"},"PeriodicalIF":1.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectral Degradation and Speaking Style Effects on Emotional Prosody Perception Are Largely Independent of Cross-Modal Dual-Tasking.","authors":"Zilong Xie","doi":"10.1044/2025_AJA-25-00190","DOIUrl":"10.1044/2025_AJA-25-00190","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined the extent to which spectral degradation and speaking style (child-directed vs. adult-directed speech) affect emotion recognition from prosodic cues and how these effects are modulated by concurrent tasks involving nonauditory sensory input.</p><p><strong>Method: </strong>Adults with normal hearing completed an emotion recognition task under three conditions: alone (auditory single-task), concurrently with a low-load visual memory task (four identical images), and with a high-load visual memory task (four different images). Stimuli consisted of semantically neutral sentences spoken in five emotions (angry, happy, neutral, sad, and scared) and two speaking styles (child-directed and adult-directed). All sentences were vocoded to simulate spectral degradation. Emotion recognition was assessed using a single-interval, five-alternative, forced-choice paradigm, in which the participants were asked to indicate which of five emotions was associated with each heard sentence.</p><p><strong>Results: </strong>Emotion recognition was significantly reduced for vocoded stimuli, as indicated by lower sensitivity (<i>d</i>') and prolonged reaction times (RTs). Child-directed speech led to better performance than adult-directed speech, although its facilitative effect was reduced under vocoded conditions. Dual-tasking impaired performance, with lower <i>d</i>' values in both dual-task conditions and slower RTs under high-load dual-task conditions. Crucially, dual-task effects did not significantly vary with spectral degradation or speaking style.</p><p><strong>Conclusions: </strong>Top-down cognitive demands from cross-modal dual-tasking and bottom-up stimulus factors, such as spectral degradation and speaking style, independently influence emotion recognition from prosodic cues. These findings provide insight into how cochlear implant users perceive emotional speech in complex, multimodal environments.</p>","PeriodicalId":49241,"journal":{"name":"American Journal of Audiology","volume":" ","pages":"218-230"},"PeriodicalIF":1.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}