Trends in Hearing

Several types of cues contribute to speech recognition in multi-talker environments. In this study, we investigated how talker head-orientation related (THOR) cues and extended high- frequency (EHF; >8kHz) cues affect speech-in-speech recognition for both female and male speech. We examined the THOR benefit associated with a non-facing masker talker head orientation (relative to a facing orientation) as a function of masker talker facing angle. The target talker always faced the listener, whereas co-located maskers were tested with eight different masker head angles, ranging from 0{degrees} (facing the listener) to facing 180{degrees} away. Two filtering conditions were tested: full- band and low-pass filtered at 8 kHz. A THOR benefit was observed at masker head angles greater than 45{degrees}, increasing from 2 dB to 8 dB between angles of 67.5{degrees} and 180{degrees}. This benefit was reduced for low-pass filtered speech. Access to EHF cues improved performance, but only for masker head angles >22.5{degrees}. There was no significant relationship between 16-kHz pure-tone thresholds and performance for young, normal-hearing listeners with good EHF hearing. These findings indicate that listeners benefit from non-facing masker talker head orientations >45{degrees} when the target talker is facing the listener, with greater benefit for larger head angles.

Intelligible speech disrupts selective auditory attention more than an unintelligible stream. However, low-level acoustic features of intelligible speech are relatively similar to target speech, confounding results. While controlling acoustic similarity and limiting energetic masking, we examined how masker intelligibility affects behavior and electroencephalography (EEG). Normal hearing listeners detected color words within a target stream of randomly timed words while ignoring an ongoing masker. Maskers were either spoken by the same or a different talker and comprised either isochronous sequences of intelligible words or temporally scrambled versions. Scrambled maskers either lacked broadband energy changes over time (Experiment 1) or were amplitude modulated to have the same energy profiles as intelligible, isochronous maskers (Experiment 2). In both experiments, scrambled maskers yielded better performance than intelligible maskers. For intelligible maskers, performance was better for different compared to identical talkers. EEG responses paralleled behavior: target-evoked onset responses were larger for scrambled than for intelligible maskers, particularly for identical talkers. Later target recognition responses were larger for color than other target words but unaffected by masker type or talker. Even when low-level acoustic features were carefully matched, intelligible maskers impaired auditory attention and reduced target-evoked neural responses more than scrambled maskers, implicating early sensory filtering.

Difficulties understanding speech in noise remain a common complaint even among listeners with normal hearing sensitivity, highlighting the need for objective, more effective measures of real-world listening. The goal of this study was to validate the use of a novel, chirped-speech (Cheech) stimulus - continuous, naturally-spoken speech fused with chirps designed to elicit robust auditory evoked potentials - to characterize relationships between speech recognition, listening effort, and auditory neural encoding. Twenty-five normal-hearing adults completed a sentence-recognition task using both original (unmodified) and Cheech-modified AzBio sentence lists in quiet, +3 dB, and -3 dB signal-to-noise ratio (SNR) conditions while neural responses from the brainstem through cortex were recorded simultaneously. Speech recognition remained near ceiling in quiet but declined with decreasing SNR for both original and Cheech stimuli. Compared with clean speech, Cheech-modified speech showed slightly poorer recognition performance as SNR decreased and somewhat higher perceived effort overall. Yet, Cheech was highly effective at evoking auditory responses from the brainstem (auditory brainstem response, ABR) through the cortex (including middle- and late-latency responses, MLR and LLR) even with <5 minutes listening time per condition. Neural responses showed reduced amplitudes and prolonged latencies as SNR decreased. In general, ABR latencies and wave I amplitudes were associated with speech-in-noise recognition performance, whereas cortical responses (MLR Na, Nb, and LLR P1) were associated with subjective workload. These findings show that Cheech-modified speech preserves intelligibility while yielding robust, multilevel neural recordings during sentence perception, offering a promising approach to examine hierarchical auditory processing under ecologically relevant speech-in-noise conditions.

Introduction Deafness is the most common human sensory deficit. Cochlear implantation is the primary intervention for severe-to-profound deafness. Currently, over 7000 people have bilateral cochlear implants (CIs) in the United Kingdom (UK), most of whom are children. Patient feedback suggests that for children with bilateral CIs, everyday communication is challenging and tiring, with extra effort required to integrate information from two ears, especially in noise, and that current rehabilitation techniques are not engaging, or appropriate to their lifestyles. To address these issues, researchers developed the Both EARS (BEARS) training package comprised of three virtual reality games to improve sound localization and listening in noise. Objectives This protocol describes the design and methodology of a multi-center phase III randomized controlled trial (RCT) to evaluate whether use of the BEARS training package alongside usual care compared to only receiving usual care improves speech-in-noise perception, hearing experiences, vocabulary and quality of life and reduces listening effort in children and young people (aged 8 -16 years (inclusive) with bilateral CIs. Methods This RCT is currently underway in 16 clinical CI departments in National Health Service or university hospitals across the UK. The intervention involves 3 months of spatial-listening training delivered via the BEARS training package in addition to any routine rehabilitation. The control is usual care (routine rehabilitation clinical care pathway). The primary outcome is the difference between the intervention groups in speech-in-noise perception score at 3 months derived from the spatial speech in noise (SSiN-VA) test. Recruitment closes at the end of the day on 31st July 2026, and end of data collection is 31st October 2026. Data analyses will be reported by 31st March 2026. Significance This is the largest known trial of children and young people with bilateral CIs. It will generate high-quality evidence on speech-in-noise outcomes and inform training interventions to improve spatial listening. Trial registration ClinicalTrials.gov registration: NCT05808543; UKs clinical study registry (ISRCTN92454702)

Natural-sound research requires stimulus sets that combine acoustic standardization with detailed behavioural characterization. We present 1,377 two-second sounds representing 240 expert-defined source--action classes. We call this database "MaMa Sounds", as it resulted from the collaborative effort of two academic teams in Maastricht and Marseille. The sounds were manually curated, segmented, sampled at 16 kHz, and labelled with a noun identifying the source and a verb identifying the action. We release deidentified trial-level identification and familiarity data together with multiple per-sound norms (e.g., identification accuracy, confidence and agreement; familiarity), along with overall norms derived with principal component analysis. Noun, verb, and joint noun--verb norms are provided as direct means and medians with the number of contributing observations. This battery preserves process-specific information, while two principal-component scores provide compact overall behavioural-identifiability measures derived from response ease, semantic correspondence, agreement, and familiarity. The repository also contains deterministic response-cleaning code, participant and reference Word2Vec representations, and code reproducing the public sound-level tables. The resource supports stimulus selection, matching, and continuous modelling in auditory cognition and neuroscience.

Noise exposure can produce lasting auditory dysfunction in the absence of permanent threshold shifts or hair cell loss, yet the functional consequences of temporary threshold shift (TTS) remain poorly defined in translational models. We assessed auditory brainstem responses (ABRs) and distortion product otoacoustic emissions (DPOAEs) in rhesus macaques (n = 13) at 2 and 9-10 months following a single moderate noise exposure that induced TTS. Previous histological analyses of these macaques showed no significant loss of hair cells or ribbon synapses but revealed persistent broadening of inner and outer hair cell ribbon-volume distributions. After exposure, DPOAE amplitudes and thresholds and ABR thresholds returned to pre-exposure values and showed low-frequency enhancement at later time points. Suprathreshold click- and tone-evoked ABR amplitudes were largely preserved or enhanced after exposure, consistent with compensatory gain. In contrast, macaque-specific chirp-evoked ABRs showed modest amplitude reductions and latency prolongation across waves, indicating altered neural synchrony at standard stimulus presentation rates, but with variable time courses. More temporally demanding paradigms revealed persistent impairments. ABRs to faster click rates and shorter paired-click intervals showed reduced adaptability in response amplitude and timing after normalization, with deficits persisting through 9-10 months. Increased inner hair cell ribbon-volume variability was more consistently associated with temporal response measures, including latency, paired-click recovery, and rate adaptation, than with amplitude-based ABR measures. Together, these findings reveal a lasting dissociation between response magnitude and fidelity after TTS: suprathreshold responses may be preserved or enhanced, while neural synchrony and temporal adaptability remain impaired. Increased presynaptic ribbon volume variability may serve as a structural marker of synaptic remodeling accompanying hidden auditory dysfunction, rather than as a direct determinant of suprathreshold response magnitude. Temporally demanding ABR paradigms may supplement threshold-based diagnostics for detecting persistent noise-induced auditory dysfunction.

The availability of hearing aids that can connect wirelessly to smartphone technologies via Bluetooth has grown exponentially in recent years. However, there is limited evidence assessing the benefits of user-adjustability afforded by these devices. This study aimed to assess the benefits of smartphone-connected hearing aids and an accompanying application (or app) in new and existing hearing aid users. In this single-centre, prospective, observational study, 44 adult hearing aid users (14 new and 30 existing) were recruited. Participants were fitted bilaterally with smartphone-connected hearing aids that could be adjusted by the user via an app. Self-reported outcome measures were collected at fitting and after seven-weeks of using the device in everyday life. For both new and existing hearing aid users, significant improvements in social participation, hearing-related fatigue, and hearing aid benefit and satisfaction were found. For existing hearing aid users, all outcomes were significantly better for the smartphone-connected hearing aids plus app in comparison to their existing hearing aids that did not connect to a smartphone, all with moderate-to-large clinical effect sizes (d> .6). User-controllability via the app was identified as the key benefit, and most participants (68%) reported that the app met their needs 'extremely' or 'very well'. These results suggest that, when used in conjunction with an app, smartphone-connected hearing aids can improve hearing outcomes due to greater user-controllability to improve listening. Thus, smartphone-connected hearing aids have the potential to facilitate patient-centred care, empowering the individual to successfully manage their hearing loss.

Sensorineural hearing loss can result from different pathologies, but the primary diagnostic method is a threshold-based audiogram, which is insensitive to some forms of cochlear dysfunction. Individuals may experience difficulty understanding speech in noise despite normal audiometric thresholds. Because most cochlear insults damage both inner (IHCs) and outer hair cells (OHCs), the contribution of IHC dysfunction to auditory-nerve coding has been difficult to isolate. We used the IHC-selective ototoxicity of carboplatin in chinchillas to examine how IHC dysfunction, with preserved OHC function, affects temporal-envelope coding in auditory-nerve fibers (ANFs). Carboplatin produced 10 to 20% IHC loss with stereocilia damage in surviving IHCs, while OHC-dependent measures such as DPOAEs and ANF thresholds were unchanged. Suprathreshold ABR wave 1 was reduced, whereas wave 5 was preserved, suggesting central compensation. Both spontaneous and driven firing rates decreased following exposure. Mean vector strength to amplitude-modulated tones was unchanged, but response variability increased. Neurometric analysis and mutual information showed degraded AM detection in carboplatin-exposed fibers, an effect accounted for by reduced driven rate (i.e., normalizing spike counts across groups removed the group difference). Background noise degraded AM coding similarly in both groups. Pooled-neurometric modeling showed that population redundancy compensated for impaired fibers in quiet, but not in noise, where carboplatin-exposed pools remained worse. These findings indicate that IHC dysfunction degrades envelope coding by reducing neural output rather than by altering temporal synchrony. This study suggests IHC dysfunction is a phenotype consistent with "hidden hearing loss" (but distinct from cochlear synaptopathy), and motivates suprathreshold clinical assays.

Objective: This study investigated whether plosive consonants carry a perceptual loudness weighting that significantly exceeds that of non-plosive consonants when judged by hearing-impaired listeners. Design: A prospective loudness matching experiment utilizing the method of adjustment. Study Sample: 19 consenting native English speakers (Mean age: 61.4, SD: 16.4) with bilateral mild to moderate high-frequency sensorineural hearing loss, indicative of presbycusis. Stimuli: 13 vowel-consonant-vowel (VCV) nonsense syllables, exclusively utilizing the flanking vowel /u/. Results: Descriptive analysis revealed a strong time-order effect influencing loudness judgments for 7 of the 13 VCV test stimuli. Statistical testing showed no significant didference (P = 0.94) between the relative amplitudes corresponding to the point of equal loudness for plosive-containing versus non-plosive-containing VCV stimuli. However, 6 individual VCV stimuli, containing consonants from 4 separate manners of articulation, produced significant loudness matching data (P < 0.01). Conclusions: The results falsify the hypothesis that plosives, analyzed collectively as a class, possess a heavier perceptual loudness weighting than non-plosive consonants. While 6 individual VCV stimuli indicated potential individual consonantal loudness weightings, these findings must be interpreted cautiously due to the restriction to a single vowel context and the presence of procedural time-order biases.

Previous work showed that observers integrate audiovisual duration cues optimally when cue-conflict is small. Does causal inference lead to a breakdown of audiovisual integration when duration conflicts are large? We addressed this by testing a wide range of duration cue-conflicts. Participants compared the auditory durations of a test and a standard stimulus. Audiovisual durations were consistent in the test stimulus, but differed by seven conflict durations (up to 250 ms) in the standard. Two levels of auditory noise were tested. Auditory duration percepts shifted systematically toward the visual duration, especially with high auditory noise. The shift was proportional to cue-conflict magnitude, inconsistent with causal inference. We compared several models. A heuristic model in which the observer probabilistically switches between the visual and auditory cues was preferred for most participants, although performance differences across models were small. Within the tested conflict range, the forced fusion, causal inference, and probabilistic cue switching models produced overlapping, near-linear shifts as a function of cue-conflict. Model simulations further revealed that given the measured sensory noise, forced fusion and causal inference can be discriminated only with unreasonably large conflicts. Together, while our results suggest that observers do not rely on causal inference when judging auditory durations under our conditions, high sensory encoding noise in auditory duration limits the discriminability of competing computational models.

BackgroundHearing aids and cochlear implants (CIs) are the primary interventions for sensorineural hearing loss, restoring auditory function through amplification and intracochlear electrical stimulation, respectively. For those with residual low-frequency hearing, the combined electric-acoustic stimulation (EAS) has demonstrated superior speech perception, particularly in noisy environments, compared to either modality. However, CI surgery carries inherent risks, including postoperative hearing loss, which undermines EAS benefits and limits future rehabilitation options. To overcome these limitations, we propose a non-invasive alternative: extracochlear electric and acoustic stimulation (EEAS), delivering electrical stimulation via transcutaneous electrodes without surgery. Here, we present a first systematic investigation of non-invasive extracochlear electrical stimulation using ear canal electrode montages, evaluating its feasibility, perceptual effects, and key parameters across diverse hearing statuses. MethodsWe conducted a controlled, within-subject study with 15 participants: 5 with normal hearing (NH), 5 with high-frequency hearing loss (HI), and 5 with severe-to-profound deafness (PL). We used charge-balanced sinusoidal stimuli (125-4000 Hz) applied via an ear canal electrode and four return electrode montages, including contralateral ear canal, contralateral mastoid, ipsilateral mastoid, and forehead electrodes. Participants rated auditory sensations, including loudness, sound quality, and lateralization, as well as side effects on separate 0-10 scales, with current intensity increased up to 2 mA/cm{superscript 2}. Thresholds and perceptual responses were analyzed across frequencies, electrode configurations, and hearing groups. ResultsReliable auditory percepts were elicited across all groups. NH participants reported pure-tone sensations, whereas HI and PL participants perceived broadband, noise-like sounds. Loudness decreased with increasing frequency, particularly for HI and PL, with minimal responses in the high-frequency range. The current threshold increased with stimulation frequency, whereas the threshold expressed as charge per phase remained constant, suggesting that charge per phase primarily determines neural activation, whereas current amplitude is more closely associated with the intensity of auditory and side effect perception. Contralateral montages produced significantly higher loudness ratings than ipsilateral or forehead configurations. The forehead montage was poorly tolerated, leading to early termination due to discomforting side effects. Sound lateralization was predominantly central or bilateral with contralateral setups, while ipsilateral and forehead configurations yielded ipsilateral perceptions. ConclusionsNon-invasive extracochlear electrical stimulation via ear canal electrodes is feasible and perceptually effective across a spectrum of hearing statuses. Perceptive outcomes are strongly influenced by electrode montage and residual hearing, with evidence of electrophonic excitation in NH individuals and electroneural activation in HI and PL participants. Contralateral mastoid electrode configurations offer the optimal balance of perceptual strength, tolerability, and spatial localization. These findings establish a critical foundation for the development of EEAS devices, demonstrating that non-invasive electrical stimulation can generate meaningful auditory percepts, paving the way for safe, accessible, and integrated hearing rehabilitation solutions. This work informs future EEAS developments and advances the path toward clinically viable, non-invasive cochlear stimulation.

Background: Internationally, workforce planning models are focussed on balancing supply and demand, rarely addressing factors such as demographic shifts and evolving health needs. There is a clear imperative for improved workforce planning to ensure adequate staff numbers to deliver audiology safely and effectively but there is still no consensus on safe minimum staffing levels or the optimal skill mix for high-quality audiology services. Methods: This research aimed to establish markers of quality in audiology service provision and estimate the audiology workforce requirements to meet current and projected demand for services, based on population changes and anticipated changes in demand. Following stakeholder engagement, a needs-based model was developed by (1) analysing NHS England's national Audiology stocktake dataset to determine current workforce, (2) creating an epidemiological model to predict changes in service population over next 5 and 10 yrs (3) use of BAA endorsed estimates delivered in East of England on staff grade required per activity. [SR1.1] Results: The estimates for 10-year adult and paediatric audiology whole time equivalent (WTE) safe minimum staffing levels for England (bands 2-7, current waiting times maintained) based on a population change model (Model 1), and two further models for paediatrics specifically (Model 2 and Model 3) were as follows: for adult audiology Model 1 estimates a 7.40% increase by 2035 (to 1125.18 WTE). For paediatric audiology Model 1 estimates a -6.3% (to 593.47 WTE) decrease due to underlying paediatric population decline in England, whereas the case complexities considered in Model 2 (1072.33 WTE) and Model 3 estimate a 10-year increase of 71.23% ( to 1072.33 WTE) and 59.17% (to 996.82 WTE) respectively. Conclusions: This is the first study to conduct a needs-based assessment of workforce requirements for audiology services. Given the substantial need for audiology staff, investment in workforce recruitment and training is essential to ensure that future activity levels meet population needs. Consideration of changing demographics is required for planning future workforce specialisation. Further analysis to address workforce equity, the impact of changes in skill mix and service delivery models and local area demographics/prevalence variation is required alongside potential efficiencies.

As part of cochlear innate immunity, cochlear resident macrophages regulate different aspects of tissue maturation, cochlear homeostasis, and injury response. Cochlear resident macrophages exhibit dynamic changes in morphology, distribution, and abundance after cochlear injury. However, in the absence of pathology, regulation of cochlear innate immunity is poorly understood. Since loss of cochlear outer hair cells (OHCs) are indicators of cochlear pathology, we hypothesize that cochlear innate immunity might be sensitive to changes in OHC function. Calcium homeostasis in OHCs is necessary for auditory function, and its dysregulation is associated with hearing loss. However, it is unknown if changes in OHC Ca2+ homeostasis are sufficient to alter cochlear innate immunity. Here, we investigate alterations in cochlear innate immunity in a mouse model lacking oncomodulin (OCM), an OHC-specific calcium buffer. Our study focused on the osseous spiral lamina (OSL), a region adjacent to cochlear hair cells. At 1 month, wild-type (WT) mice and Ocm knockout (KO) mice have similar hearing thresholds and no evidence of cochlear damage. However, in KO mice, OSL resident macrophages show increased density, altered morphology, and increased spatial segregation closer to the sensory epithelium. Despite these changes in OSL resident macrophages, cytokine profiling revealed no remarkable differences. At 5 months, Ocm KO mice show a progressive hearing loss with a frequency dependent loss of OHCs and inner hair cell ribbon synapses, but the density of OSL macrophages remained unchanged. Prior to hearing onset, there was no significant difference in immune cell numbers between Ocm WT and KO mice. These findings suggest that cochlear innate immunity is sensitive to OHC calcium buffering following hearing onset.

PurposeThe neural representation of pitch and timbre in complex sounds has previously been studied using synthetic, controlled stimuli to investigate underlying encoding mechanisms. These studies provide information about how single attributes of sound are represented in the inferior colliculus (IC), a critical hub of the auditory pathway where neurons are sensitive to stimulus periodicity and spectral shape, giving rise to representations of pitch and timbre, respectively. However, there is a gap in understanding how natural sounds with both pitch and timbre attributes, such as instrument sounds, are represented in the IC. MethodsIn this study, extracellular recordings were made in the IC of awake rabbits in response to natural instrument stimuli varying in fundamental frequency (F0) to determine how instrument identity (timbre) and F0 (pitch) are represented in IC neurons. ResultsUsing decoding models for instrument identification, we found that instrument identity was redundantly encoded in a population of neurons with diverse rate and timing characteristics. F0 identification using decoding models trained on single-neuron rate responses was poor, but the population of rate responses contained enough information to identify F0 reliably. F0 information was also encoded in single-neuron temporal responses up to 196 Hz. F0 identification from a population of temporal responses was accurate up to approximately 900 Hz, but accuracy decreased at high F0s. For the task in which F0 was identified based on responses to both oboe and bassoon stimuli that had overlapping F0s, performance decreased compared to F0 identification based on responses to a single instrument. ConclusionThis result supports the hypothesis that pitch and timbre information are encoded jointly in the IC.

Perceptual experiments show that listeners recognize female speakers with lower accuracy than male speakers. Automatic speaker recognition systems may also show performance bias against female speakers even when training data sets are gender balanced. The underlying reasons for this discrepancy are unclear. Here, we apply geometric morphometrics to quantify sex-related morphological vocal tract disparity -- the extent of shape variation -- across both resting and articulatory configurations. We find that male speakers exhibit greater disparity in both resting and articulatory configurations. This morphological idiosyncrasy may in turn generate more discriminable acoustic signatures and offer a biological explanation for higher recognition accuracies for male voices by humans and machines. Our results suggest that innate variation in vocal tract morphology may contribute to performance bias in voice technology and voice perception by human listeners.

Despite its high prevalence and socioeconomic costs, the condition of tinnitus shares with related neuropsychiatric disorders the characteristic that, to this day, it cannot be cured. Two contradictory views of the origin of tinnitus (peripheral hyperexcitability and central brain oscillation changes linked to prediction error) are currently discussed without any regard for one another. We now firstly used a compact 64 sensor optically pumped magnetometer (OPM)-MEG system to study a group of tinnitus subjects without co-morbidity of hyperacusis. This new technology provided an unprecedented opportunity for analyzing hemisphere-specific brain activity changes with high spatial resolution in response to pure-tones with a pitch within or outside the tinnitus frequency. We observed in tinnitus smaller ABR amplitudes (reflecting reduced cochlear output synchrony) linked with reduced alpha and enhanced gamma activity at rest (reflecting elevated excitement of intracortical circuits). In tinnitus, reduced alpha and enhanced gamma brain activity at rest were associated with reduced evoked alpha, beta, and gamma in response to pure-tones within tinnitus frequencies (reflecting low signal-to-noise ratios in auditory target regions). Furthermore, elevated gamma activity in key regions in the brain involved in attention control was observed in tinnitus subjects: hypergamma activity was seen in posterior/frontal regions, that -when hyperactive - are predicted to trigger excessive attention to irrelevant stimuli. Weakened cochlear output synchrony, possibly through lowering tonic inhibitory strength in the ascending auditory pathway, can thus reduce alpha activity (default-mode network) and unleash cortical regions that control attention to irrelevant stimuli -- tracing tinnitus to perception.

Objective: Impaired understanding of noisy or degraded speech is a central feature of listening difficulties (LiD), but the possible causes of these symptoms are wide-ranging. Accordingly, recent research underscores the need to study these deficits using a test battery approach. Event-related potentials are useful objective metrics for studying LiD, but probing function across the speech processing hierarchy using traditional protocols is sequential and unrealistic in clinical settings. The novel chirped speech (Cheech) method combines natural speech with acoustic chirps to overcome these limitations. This study examines its utility for profiling childhood LiD. Methods: Twenty-eight children (15 typically developing, 13 with LiD), aged 8-17 years old, listened to a 17-minute Cheech story and detected a target word within the story via button press while EEG data were collected from 53 scalp sites. Results: Cheech successfully evoked responses from the auditory brainstem response through to the brain's language centers, as reflected by the N400 effect. Unlike TD children, those with LiD demonstrated N400 effects with atypical distributions that favored frontal rather than the typical parietal sites. A trend towards a delayed and reduced amplitude Wave V was also observed. Conclusions: Hierarchical examination of speech processing using Cheech primarily implicates altered language processing as a contributing factor to LiD, with the frontal topography of the N400 effect for those with LiD potentially suggesting a greater reliance on deliberate memory retrieval during the speech perception task. Significance: LiD could arise due to auditory and/or cognitive factors. The present results demonstrate the feasibility of objective, parallel measurement across this hierarchy and point to impaired language processing as a possible mechanism.

Children and adolescents with hearing loss frequently encounter reduced auditory access and delayed language development, factors that may influence the maturation of executive functions. This study examined developmental differences in planning, a core executive function, in 98 children and adolescents with hearing loss or normal hearing aged 7 to18 years using the Tower of London task. Compared to normal hearing peers, participants with hearing loss made more unnecessary moves and rule violations and initiated problem-solving more rapidly, suggesting reduced preplanning efficiency and increased impulsivity. These group differences were most pronounced in adolescents, who showed faster initiation and greater movement inefficiency than age-matched normal hearing participants. Within the hearing loss group, adolescents displayed higher accuracy and longer initiation times than children, reflecting developmental improvements despite persistent gaps relative to hearing peers. Language development age did not alter the main effects. Findings indicate that reduced early auditory and language access may contribute to differences in planning development, highlighting the need for targeted executive functions support in educational and clinical settings for youth with hearing loss.

PurposeSpeech perception is a fundamental part of everyday communication that relies on more than simple identification of words and sentences. Attention and listening engagement both contribute to speech perception, while representing distinct aspects of the listening experience. Attention is typically associated with cognitive focus, whereas listening engagement additionally involves cognitive and affective immersion in sound. Despite their importance, these states remain difficult to disentangle, behaviorally and physiologically. Both have been linked to interpersonal synchronization (the synchronization of biobehavioral signals across individuals), raising questions about what this synchronization actually reflects. MethodIn this study, we disentangled attention and listening engagement by independently manipulating both factors within a single experiment. Thirty participants listened to two simultaneously presented streams of meaningful speech and were instructed to focus on only one. Both attended and unattended stimuli were designed to be either engaging or non-engaging. Neural activity was recorded using EEG, while physiological responses were measured using heart rate and electrodermal activity. ResultsInterpersonal synchronization was computed from neural and bodily signals, alongside a self- report measure of listening engagement and auditory attention decoding (AAD), a neural measure of selective attention. Interpersonal synchronization of all three modalities significantly predicted listening engagement, whereas neural interpersonal synchronization was the only measure that significantly predicted attention. These findings suggest that attention is primarily driven by cognitive processes represented in the brain, while listening engagement additionally involves affective processes that are more strongly reflected in bodily responses. ConclusionsOverall, this study demonstrates that different forms of interpersonal synchronization reflect distinct dimensions of the listening experience and supports interpersonal synchronization as a potential objective marker of listening engagement.

Purpose: Otoacoustic emissions (OAEs) are used to assess outer hair cell (OHC) function. Clinical interpretation of OAE responses, however, is often limited to a present/absent binary since both physiological factors and measurement variability affect the measured OAE amplitude. Prior work showed elevated OAE responses in sedated compared to awake chinchillas, pointing to the potential influence of the medial olivocochlear (MOC) efferents on amplitudes, but this finding is inconsistent across species and OAE type. Here, we aimed to further investigate the effect of anesthesia on distortion- and reflection-type emissions in chinchillas using swept stimuli and more reliable calibration methods. Methods: Swept distortion-product (DP) and stimulus-frequency (SF) OAEs were measured in chinchillas with and without ketamine/xylazine sedation. Stimuli were presented using in-ear forward pressure level calibrations. DPOAE and SFOAE amplitudes and estimated Qerb from SFOAE group delays were compared across the two conditions. Results: We found that low-frequency DPOAE amplitudes were elevated when animals were sedated. The difference in SFOAE amplitudes was more variable across animals but appeared mildly reduced in sedated animals. Qerb estimates were slightly higher in sedated animals at some frequencies. The effect of sedation was not different across sexes. Conclusion: Taken together, these findings suggest that sedation impacts OAE measurements in chinchillas. MOC modulation could account for the present findings and differences across species. For diagnostic precision, OAE responses should be considered in the context of not only intrinsic OHC function but also extrinsic physiological processes that can modulate OHCs.