Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing scale (SSQ)

Abstract

The Speech, Spatial and Qualities of Hearing Scale (Gatehouse & Noble, ) was applied to three independent clinical groups: 144 people prior to being fitted with amplification; 118 people with six months experience with unilateral amplification; and 42 people with six months experience with bilateral amplification. For traditional speech hearing contexts (one-on-one, in groups, in quiet, in noise) there was benefit with one aid, and no further benefit with two. By contrast, hearing speech in demanding contexts (divided or rapidly switching attention) showed benefit with one aid and further benefit with two. In the spatial domain, directional hearing showed some benefit with one hearing aid, and particular further benefit in distance and movement discrimination from fitting with two. There was some benefit from unilateral fitting for elements of the qualities domains (clarity, naturalness, recognisability, segregation of sounds), with no consistent sign of further benefit from two. Bilateral fitting added benefit with respect to listening effort. Two hearing aids offer advantage in demanding and dynamic contexts; these contexts are argued as significant in the maintenance of social competence and emotional wellbeing. The present results go toward establishing the real-world advantages of bilateral hearing aid fitting and suggest that previous, inconclusive clinical findings reflect inquiry limited to more traditional areas of hearing function.

Sumario

Se aplicó la escala de cualidades auditiva, espacial y del lenguaje (Gatehouse & Noble, ) a tres grupos clínicos independientes: 144 personas, antes de adaptarles auxiliares auditivos; 118 personas con 6 meses de experiencia con amplificación unilateral y 42 personas con 6 meses de experiencia con amplificación bilateral. Se encontró beneficio de la amplificación unilateral en el contexto de habla tradicional (uno a uno, en grupo, en silencio y en ruido) y no hubo beneficio posterior en el modo bilateral. En contraste, bajo condiciones de discriminación del lenguaje en contexto demandante (atención dividida o cambio de rápido de atención) hubo beneficio con un solo un auxiliar, y mayor beneficio con dos. En el dominio espacial, hubo cierto beneficio en la audición direccional con un solo auxiliar auditivo y particularmente resultó benéfica la condición bilateral en la discriminación de distancia y movimiento. Hubo cierto beneficio de la condición unilateral para elementos de cualidad (claridad, naturalidad, fácil discriminación, segregación de sonidos) sin signos consistentes de beneficio con amplificación bilateral. La amplificación bilateral benefició el menor esfuerzo para escuchar. Hay ventajas con dos auxiliares auditivos en contexto demandante o dinámico; estos contextos son considerados como significativos en el mantenimiento de la competencia social y el bienestar emocional. Estos resultados se encaminan a establecer las ventajas de la amplificación bilateral en el mundo real y sugieren que los hallazgos clínicos previos e inconclusos, reflejan información limitada a áreas más tradicionales de la función auditiva.

• Hearing aid fitting
• Impairment
• Disability
• Handicap
• Self-assessment

Notes

1. It makes sense to consider this item and the related one (ignoring an interfering voice of similar pitch) together. That related item happens to fall into the fourth category (benefit from one aid, additional benefit from two). See Table 6. The present item nearly qualifies to be in the same set. It is noted that the wording of these two items in the original published version of the SSQ is in error. The actual wording of these items is: ‘Can you have a conversation with someone and ignore another (third) person whose interfering voice is the same pitch as that of the person you're talking with?’, and ‘Can you have a conversation with someone and ignore another (third) person whose interfering voice is a different pitch from that of the person you're talking with?’

2.This was the only item on which substantial numbers of respondents said the situation was not applicable to them. Otherwise, all respondents were able to rate their ability on almost every item.