National Academies Press: OpenBook
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R1
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R2
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R3
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R4
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R5
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R6
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R8
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R10
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating Hearing Loss for Individuals with Cochlear Implants. Washington, DC: The National Academies Press. doi: 10.17226/26057.
×
Page R12

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Evaluating Hearing Loss for Individuals with Cochlear Implants Committee on Evaluating Hearing Loss for Individuals with Cochlear Implants Board on Health Care Services Health and Medicine Division A Consensus Study Report of PREPUBLICATION COPY: UNCORRECTED PROOFS

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and the Social Security Administration (Contract No. 28321318D00060015). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26057 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2021 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2021. Evaluating hearing loss for individuals with cochlear implants. Washington, DC: The National Academies Press. https://doi.org/10.17226/26057. PREPUBLICATION COPY: UNCORRECTED PROOFS

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private nongovernment institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public-policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY: UNCORRECTED PROOFS

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on studies’ statements of task by committees of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committees and the committees’ deliberations. Each report has been subjected to a rigorous and independent peer-review process and represents the position of the National Academies on its statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at workshops, symposia, or other events convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY: UNCORRECTED PROOFS

COMMITTEE ON EVALUATING HEARING LOSS FOR INDIVIDUALS WITH COCHLEAR IMPLANTS JUDITH GREEN-MCKENZIE (Chair), Professor and Chief, Division of Occupational and Environmental Medicine, University of Pennsylvania Perelman School of Medicine RENÉ H. GIFFORD, Professor of Hearing and Speech Sciences and Director of the Cochlear Implant Program, Vanderbilt University Medical Center FRANK R. LIN, Professor of Otolaryngology and Director of the Cochlear Center for Hearing and Public Health, Johns Hopkins University KNASHAWN H. MORALES, Associate Professor, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine SARAH F. POISSANT, Associate Professor and Acting Chair, Communication Disorders Department, University of Massachusetts Amherst NICHOLAS S. REED, Audiologist and Assistant Professor of Epidemiology, Johns Hopkins Bloomberg School of Public Health GRETA C. STAMPER, Audiology Division Chair and Assistant Professor of Audiology, Mayo Clinic Florida TERESA A. ZWOLAN, Professor of Otolaryngology and Director of the Cochlear Implant Program, University of Michigan Consultant KARL R. WHITE, Professor of Psychology and Director of the National Center for Hearing Assessment and Management, Utah State University Study Staff CAROLYN FULCO, Scholar BERNICE CHU, Program Officer BLAKE REICHMUTH, Associate Program Officer JOSEPH GOODMAN, Senior Program Assistant SHARYL NASS, Senior Director, Board on Health Care Services PREPUBLICATION COPY: UNCORRECTED PROOFS v

Reviewers This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following individuals for their review of this report: JULIE G. ARENBERG, Harvard Medical School BRUCE J. GANTZ, University of Iowa HOWARD H. GOLDMAN, University of Maryland School of Medicine SANDRA GORDON-SALANT, University of Maryland MICHAEL MERZENICH, University of California, San Francisco STEPHANIE J. SJOBLAD, University of North Carolina at Chapel Hill Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by DAN G. BLAZER, Duke University Medical Center, and BRUCE N. CALONGE, University of Colorado School of Medicine. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies. PREPUBLICATION COPY: UNCORRECTED PROOFS vii

Contents ACRONYMS AND ABBREVIATIONS xi SUMMARY S-1 1 INTRODUCTION 1-1 Statement of Task, 1-3 Approach to the Task, 1-5 Cochlear Implants, 1-6 Introduction to the Hearing in Noise Test (HINT), 1-11 Organization of the Report, 1-12 References, 1-13 2 CONSIDERATIONS FOR EVALUATING HEARING FUNCTION 2-1 Auditory Processing: Detection and Perception, 2-1 Hearing Test Characteristics, 2-3 Presentation Level and Test Setup, 2-5 Introduction to Speech Tests, 2-15 References, 2-21 3 CHARACTERISTICS AND LIMITATIONS OF THE HEARING IN NOISE TEST 3-1 Background, 3-1 Development of the HINT, 3-2 Administration of the HINT, 3-4 Salient Characteristics of the HINT, 3-5 The HINT as a Test for Individuals with Cochlear Implants, 3-7 Limitations of the HINT, 3-9 References, 3-11 4 CHARACTERISTICS OF HEARING AND SPEECH TESTS 4-1 Cross-Cutting Issues, 4-3 Sentence Tests, 4-4 Word Tests, 4-14 Considerations Beyond Auditory Testing, 4-23 Conclusions and Recommendations, 4-25 References, 4-27 5 EVALUATING HEARING ABILITY IN PERSONS WITH COCHLEAR IMPLANTS WITH SINGLE-SIDED DEAFNESS OR ASYMMETRIC HEARING LOSS 5-1 Introduction, 5-2 Special Considerations in the Testing and Treatment of Persons with Bilateral But Unequal Hearing Loss, 5-5 Correlation Between Hearing Loss in the Less Affected Ear and Recovery Time or Treatment in the More Affected Ear, 5-9 PREPUBLICATION COPY: UNCORRECTED PROOFS ix

x SSD, AHL, and Social Security Disability, 5-11 Testing Hearing Ability in Persons with SSD or AHL Receiving a Cochlear Implant, 5-14 Proxies for the HINT for Individuals with SSD or AHL, 5-14 References, 5-15 6 TEST COMPARISONS AND RECOMMENDATIONS 6-1 Test Comparisons, 6-2 Alternative Measures for HINT Equivalence, 6-5 Summary and Recommendations, 6-7 References, 6-10 PREPUBLICATION COPY: UNCORRECTED PROOFS

Acronyms and Abbreviations 0º azimuth angle in relation to the listener that is directly in front of the listener AHL asymmetric hearing loss AzBio Arizona Biomedical Sentences Test BI CROS bilateral contralateral routing of signal BKB Bamford, Kowal, and Bench BKB-SIN Bamford-Kowal-Bench Speech-in-Noise Test CHILDES Child Language Data Exchange System CI cochlear implant CID Central Institute for the Deaf CNC consonant–nucleus–consonant (refers to the Maryland CNC word test) CPT current procedural terminology CROS contralateral routing of signal CUNY City University of New York dB decibel, a unit of measure for sound level dB A decibels with A-weighted sound levels (designed to mimic the spectral range and audibility curves, in dB SPL, of human hearing) dB HL decibels hearing level (the decibel measure displayed on an audiometer, normalized so that 0 dB HL = average normal for all frequencies) dB SPL decibels sound pressure level (the decibel measure that most people are familiar with and, referencing the pressure of the measured displacement of air molecules relative to the surrounding or ambient air pressure) EPA U.S. Environmental Protection Agency EXT A or B external or auxiliary input setting for an audiometer FDA U.S. Food and Drug Administration HINT Hearing in Noise Test HINT-C Hearing in Noise Test-Children Hz Hertz, a measure of frequency (pitch), describing number of cycles per second IA interaural attenuation IEEE Institute of Electrical and Electronics Engineers LNT Lexical Neighborhood Test PREPUBLICATION COPY: UNCORRECTED PROOFS xi

xii MLNT Multisyllabic Neighborhood Test MLV monitored live voice MSTB Minimum Speech Test Battery NU-6 Northwestern University Test Number 6 OR odds ratio PBK Phonetically Balanced Kindergarten (a word test) PTA pure tone average QuickSIN Quick Speech in Noise Test S/B signal-to-babble ratio SIN Speech in Noise Test SLM sound level meter SNR signal-to-noise ratio SOT statement of task SPL sound pressure level SRM spatial release from masking SRT speech recognition threshold SSA U.S. Social Security Administration SSD single-sided deafness SSDI Social Security Disability Insurance SSI Supplemental Security Income T Levels threshold levels UHL unilateral hearing loss VU meter volume unit meter (a device that displays a representation of the signal level) WIN Words in Noise Test PREPUBLICATION COPY: UNCORRECTED PROOFS

Next: Summary »
Evaluating Hearing Loss for Individuals with Cochlear Implants Get This Book
×
Buy Paperback | $50.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The U.S. Social Security Administration (SSA) administers programs that provide disability benefits. Once SSA establishes the presence of a severe impairment, it determines whether the impairment meets the criteria in the Listing of Impairments (Listings) that qualify a candidate for disability benefits.

The current Listings that address hearing loss treated with cochlear implantation contain criteria that evaluate hearing ability through a speech recognition test called the Hearing in Noise Test (HINT). Since its development in 1994, the HINT has been widely used to measure cochlear implant candidacy and postoperative outcomes. However, the test characteristics, the state of cochlear implant technology, and the environment that made the HINT a common choice of assessment in 1994 are different in 2021. The HINT has several limitations in its characteristics and deviation from its intended use.

At the request of SSA, the National Academies of Sciences, Engineering, and Medicine convened a consensus study committee to identify and recommend generalized testing procedures and criteria for evaluating the level of functional hearing ability needed to make a disability determination in adults and children after cochlear implantation. The committee's report, Evaluating Hearing Loss for Individuals with Cochlear Implants, details and supports its findings, conclusions, and recommendations based on published evidence and professional judgment.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!