Categories of Auditory Performance (CAP) describes a scale used to rate outcomes from paediatric cochlear implantation in everyday life. It differs from more technical measures by being readily applied and easily understood by non-specialist professionals and by parents. Being based on subjective assessments, there is a need to establish whether ratings by different persons are comparable. Therefore, an analysis of inter-user reliability was undertaken using ratings from 23 children followed up at various intervals after implantation. Analysis relating scores by local teachers of the deaf and the teachers of the deaf at the implant centre revealed very high inter-user reliability (correlation coefficient 0.97). This result establishes the reliability of CAP as an outcome measure for use in cochlear implant programmes.

These guidelines aim to assist in the diagnosis of noise-induced hearing loss (NIHL) in medicolegal settings. The task is to distinguish between possibility and probability, the legal criterion being 'more probable than not'. It is argued that the amount of NIHL needed to qualify for that diagnosis is that which is reliably measurable and identifiable on the audiogram. The three main requirements for the diagnosis of NIHL are defined: R1, high-frequency hearing impairment; R2, potentially hazardous amount of noise exposure; R3, identifiable high-frequency audiometric notch or bulge. Four modifying factors also need consideration: MF1, the clinical picture; MF2, compatibility with age and noise exposure; MF3, Robinson's criteria for other causation; MF4, complications such as asymmetry, mixed disorder and conductive hearing impairment.

The present study supports the use of generic QOL measures to assess outcome and to draw comparisons between different populations.

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Bilateral cochlear implantation with the Nucleus 24 device provides marked improvement in horizontal plane localization abilities compared with unilateral CI use for a range of stimuli having different spectral and temporal characteristics. Benefit was obtained by all subjects, for all stimulus types, and for all sound directions. However, binaural performance was still worse than that obtained by normal hearing listeners and hearing aid users with the same methodology. Monaural localization performance was at chance. There is no benefit for localization with dual microphones.

Objective To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of UK adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. Design The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure as well as demographic variables were collected. Results Overall, 10.7% of adults (95%CI 10.5–10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6–17.1%) and hearing aid use was 2.0% (95%CI 1.9–2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Conclusion Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underutilization of hearing aids has altered little since the 1980s, and is a major cause for concern.

One of the putative functions of the medial olivocochlear (MOC) system is to enhance signal detection in noise. The objective of this study was to elucidate the role of the MOC system in speech perception in noise. In normal-hearing human listeners, we examined (1) the association between magnitude of MOC inhibition and speech-in-noise performance, and (2) the association between MOC inhibition and the amount of contralateral acoustic stimulation (CAS)-induced shift in speech-in-noise acuity. MOC reflex measurements in this study considered critical measurement issues overlooked in past work by: recording relatively low-level, linear click-evoked otoacoustic emissions (CEOAEs), adopting 6 dB signal-to-noise ratio (SNR) criteria, and computing normalized CEOAE differences. We found normalized index to be a stable measure of MOC inhibition (mean = 17.21%). MOC inhibition was not related to speech-in-noise performance measured without CAS. However, CAS in a speech-in-noise task caused an SNRSP enhancement (mean = 2.45 dB), and this improvement in speech-in-noise acuity was directly related to their MOC reflex assayed by CEOAEs. Individuals do not necessarily use the available MOC-unmasking characteristic while listening to speech in noise, or do not utilize unmasking to the extent that can be shown by artificial MOC activation. It may be the case that the MOC is not actually used under natural listening conditions and the higher auditory centers recruit MOC-mediated mechanisms only in specific listening conditions–those conditions remain to be investigated.

A systematic improvement in auditory performance over time, following a change in the acoustic information available to the listener (that cannot be attributed to task, procedural or training effects) is known as auditory acclimatization. However, there is conflicting evidence concerning the existence of auditory acclimatization; some studies show an improvement in performance over time while other studies show no change. In an attempt to resolve this conflict, speech recognition abilities of 16 subjects with bilateral sensorineural hearing impairments were measured over a 12-week period following provision of a monaural hearing instrument for the first time. The not-fitted ear was used as the control. Three presentation levels were used representing quiet, normal, and raised speech. The results confirm the presence of acclimatization. In addition, the results show that acclimatization is evident at the higher presentation levels but not at the lowest.