Benefits of phoneme discrimination training in a randomized controlled trial of 50- to 74-year-olds with mild hearing loss.
Benefits of phoneme discrimination training in a randomized controlled trial of 50- to 74-year-olds with mild hearing loss.
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DOI：
10.1097/aud.0000000000000020
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发表时间：
2014-07
期刊：
影响因子：
3.7
通讯作者：
Moore DR
中科院分区：
文献类型：
--
作者：
Ferguson MA;Henshaw H;Clark DP;Moore DR
本研究的目的是（i）评估音素辨别训练对年龄在50至74岁之间的轻度感音神经性听力损失成年人（未使用助听器）的听力和认知能力的有效性，以及（ii）确定参与者对自我管理，计算机提供，基于家庭和游戏的听觉训练计划的依从性。本研究为重复测量、交叉设计的随机对照试验。参与者接受了8至12周的培训和测试。一组（立即训练）在第1周和第4周进行训练。第二个等待组（延迟训练）在第1周和第4周没有训练，但在第5周和第8周训练。在第0、4和8周获得了两组的任务（音素辨别）和可转移的结果测量（言语感知、认知、听力残疾的自我报告），而延迟训练组仅在第12周获得。两组都发现了强大的音素辨别学习，初始阈值最差的人的阈值改善最大。在第1周和第4周之间，即时训练组在听力残疾、注意力分散和工作记忆的自我报告方面表现出中度、显著的改善，特别是在更复杂、更具挑战性的条件或情况下。训练并没有导致噪音中言语感知的持续改善。延迟训练组在第1周和第4周之间没有任何重测效应的证据。在训练后4周，音素辨别、分散注意力、工作记忆和听力残疾的自我报告显示出益处的保留。注意力分散的改善和自我报告的听力困难的减少高度相关。据观察，音素辨别训练有益于一些但不是所有轻度听力损失的人。这里提出的证据，连同其他研究，使用不同的训练刺激，表明听觉训练可能有助于认知技能，索引执行功能和自我感知的听力困难，在具有挑战性的情况下。对于改善日常生活中的沟通和言语感知，认知技能的发展可能比感官技能的发展更重要。然而，改进幅度不大。结果测量需要具有适当的挑战性，以便对相对少量的培训效果敏感。在一个典型的助听前人群中，评价了音素辨别训练对增强听力和相关认知能力的功效。显著和强大的任务学习被证明。培训的好处是减少听力残疾，特别是在复杂的听力环境中，并改善注意力和工作记忆。这些益处在训练后至少保留4周。在家接受培训的情况很好。因此，听觉训练为与现实环境中的听力相关的复杂和具有挑战性的技能提供了适度的益处。
The aims of this study were to (i) evaluate the efficacy of phoneme discrimination training for hearing and cognitive abilities of adults aged 50 to 74 years with mild sensorineural hearing loss who were not users of hearing aids, and to (ii) determine participant compliance with a self-administered, computer-delivered, home- and game-based auditory training program. This study was a randomized controlled trial with repeated measures and crossover design. Participants were trained and tested over an 8- to 12-week period. One group (Immediate Training) trained during weeks 1 and 4. A second waitlist group (Delayed Training) did no training during weeks 1 and 4, but then trained during weeks 5 and 8. On-task (phoneme discrimination) and transferable outcome measures (speech perception, cognition, self-report of hearing disability) for both groups were obtained during weeks 0, 4, and 8, and for the Delayed Training group only at week 12. Robust phoneme discrimination learning was found for both groups, with the largest improvements in threshold shown for those with the poorest initial thresholds. Between weeks 1 and 4, the Immediate Training group showed moderate, significant improvements on self-report of hearing disability, divided attention, and working memory, specifically for conditions or situations that were more complex and therefore more challenging. Training did not result in consistent improvements in speech perception in noise. There was no evidence of any test-retest effects between weeks 1 and 4 for the Delayed Training group. Retention of benefit at 4 weeks post-training was shown for phoneme discrimination, divided attention, working memory, and self-report of hearing disability. Improved divided attention and reduced self-reported hearing difficulties were highly correlated. It was observed that phoneme discrimination training benefits some but not all people with mild hearing loss. Evidence presented here, together with that of other studies that used different training stimuli, suggests that auditory training may facilitate cognitive skills that index executive function and the self-perception of hearing difficulty in challenging situations. The development of cognitive skills may be more important than the development of sensory skills for improving communication and speech perception in everyday life. However, improvements were modest. Outcome measures need to be appropriately challenging to be sensitive to the effects of the relatively small amount of training performed. The efficacy of phoneme discrimination training for enhancing hearing and related cognitive abilities in a typical, pre–hearing aid population was evaluated. Significant and robust on-task learning was demonstrated. Benefits of training were seen in reduced hearing disability, particularly in complex listening environments, and in improved attention and working memory. These benefits were retained for at least 4 weeks posttraining. Compliance with home-delivered training was high. Auditory training thus provided modest benefit for complex and challenging skills that are relevant for listening in realistic environments.