Understanding and alleviating hearing disability: the contribution of natural behaviours

人们在各种情况下以各种方式使用他们的听力。我们的听觉帮助我们了解周围发生的事情，并警告我们注意看不见的危险。可能更重要的是，听力对社会交流至关重要。对于有听力损失的人来说，他们的听力残疾经历将取决于他们参加的社会活动的组合，以及他们在这些活动中取得成功的重要性。对于这种听力活动模式在人与人之间以及听力正常与受损人群之间的差异，我们所知甚少。我们也不知道使用助听器是否会改变人们参加的活动。在更“微观”的细节层面上，当人们的听觉能力面临挑战时，他们本能地以某种方式行事。例如，如果我们因为嘈杂的背景而听不到某人在说什么，我们通常会靠近他们或把一只耳朵转向他们。我们对这些行为知之甚少。听力损失的人比其他人面临更大的挑战，他们可能会使用不同的行为，或者他们可能会接受训练，使用更有效的行为。同时，助听器一般都是在假设人们保持静止和面对面的情况下设计的，无论情况如何。这意味着助听器不仅错过了利用佩戴者自然行为的机会，而且有时还会破坏这些行为的有效性。人们越来越认识到，为了使助听器更有帮助，助听器必须适应人们日常生活中随时变化的情况。此外，助听器的临床处方需要更多地考虑每个患者的个人生活方式和活动模式。我们的研究将提供新的知识和见解，为未来改进助听器技术和处方奠定基础。我们将通过建立一个数学模型来描述环境声学、听力障碍、助听器中的声音处理和身体运动如何相互作用来影响人们的听力表现。为了做到这一点，我们将进行几项实验研究，测量人们在听力受到挑战时如何移动和改变沟通策略。-确定真实世界的听力残疾（以及助听器提供的残疾缓解）是由对个人至关重要的孤立事件驱动的，还是由跨越时间的事件的“大平均值”驱动的。-设计和测试考虑到病人对声音变化不敏感的助听器安装方案。-开发原型助听器技术，利用或支持听者的自然行为，提供超越现有的好处，并在实验室和现实条件下进行评估。-检查常规临床数据是否可以支持更个性化的听力损失干预处方。我们将使用一个非常大的数据集，作为常规临床护理的一部分，这意味着数据的控制相对宽松。我们将评估已知的关系是否仍然可以再现。如果是这样，我们将寻找信息丰富的新模式，可能用于改善听力问题的个性化治疗。

People use their hearing in all sorts of ways and in all sorts of situations. Our sense of hearing helps us to understand what is going on around us, and warns us of unseen dangers. Possibly more importantly, hearing is vital to social communication. For someone with hearing loss, their experience of hearing disability will depend on the mix of social activities they take part in, and the importance they assign to success in those activities. Very little is known about how such patterns of hearing activity differ from person to person, and between people with normal versus impaired hearing. Nor do we know whether using hearing aids changes the activities people take part in.At a more 'microscopic' level of detail, people instinctively behave in certain ways when faced with challenges to their ability to hear. For example, if we cannot hear what someone is saying because of a noisy background, we typically move closer or turn one ear towards them. We know only a little about these behaviours. People with hearing loss face greater challenges than others, and they may use different behaviours, or maybe they could be trained to use more effective behaviours. Meanwhile, hearing aids are generally designed on the assumption that people remain static and face to face, regardless of the situation. This means not only that hearing aids miss out on the chance to take advantage of their wearer's natural behaviours, but that they sometimes undermine the effectiveness of those behaviours. It is becoming increasingly recognised that in order for hearing aids to be more helpful, they must adapt to the moment-to-moment changes in situation which are part of people's everyday life. Furthermore, the clinical prescribing of hearing aids needs to take more account of each patient's individual lifestyle and activity patterns.Our research will provide new knowledge and insights which can form the basis of future improved hearing aid technology and prescribing. We will do this by:- Constructing a mathematical model describing how the acoustics of the environment, hearing impairment, sound processing in hearing aids and body movements all interact to affect people's hearing performance. To do this, we will carry out several experimental studies measuring how people move and change communication tactics when their hearing is challenged.- Determining whether real-world hearing disability (and the relief from disability provided by hearing aids) is driven by isolated events which are crucial for the individual, or by a 'grand average' of events across time.- Devising and testing hearing-aid fitting protocols which account for patients' insensitivity to acoustic changes. - Developing prototype hearing aid technologies which exploit or support listeners' natural behaviour to provide benefits beyond those currently available, and evaluating them in the laboratory and in realistic conditions.- Examining whether routine clinical data can support more individualised prescription of interventions for hearing loss. We will use a very large set of data accumulated as part of routine clinical care, which means the data are relatively loosely controlled. We will evaluate whether known relations are nevertheless reproduced. If so, we will then look for informative new patterns which might be used to improve the individualisation of treatment for hearing problems.