Quote:TSI: Focused Attention: An Efficacy Study for Adults

Problems with auditory figure-ground processing�understanding speech in background noise�is a common complaint of adults. The problem appears to increase as we age. As part of its TSI-Targeted Sound Intervention�, NACD created the TSI: Focused Attention program in 2009 to help address figure-ground problems in children. An initial field study (TSI � Focused Attention Field Study Report) and an analysis of our initial data as our clients used the program (TSI Report of Data) supported the program�s effectiveness in increasing attention and focus in children, especially as it relates to the auditory environment and being in the presence of distracting sounds.

The current study was intended to look at the effectiveness of using TSI: Focused Attention with adults whose main complaint was difficulty hearing and understanding when there is background noise.
Method

Fifteen participants completed the study. NACD client families were contacted about the study, so participants were either parents or grandparents of children involved with NACD. Criteria for inclusion into the study included:

Age 40 or older
Complaint of figure-ground processing problems, with or without a documented hearing loss

Figure-ground processing problems were explained to potential candidates as concerns related to processing, hearing or listening when there is background noise.

Participants were provided with a TSI: Focused Attention program and headphones. They were instructed to listen twice per day, 5 days/week, for a total of 24 weeks. Pre- and post-testing included a speech-in-noise test and rating scales.

Participants were divided into two groups:

Hearing loss�either documented or suspected but never tested (N=9)
No hearing loss (N=6)

Regardless of grouping, all participants used the program the same way and received the same instruction and testing. The speech-in-noise test administered was an informal assessment created by NACD. It consisted of a CD of 20 words spoken in quiet (to serve as a comparison), randomly alternated with 20 words spoken in noise. Listeners were asked to repeat each word they heard. In addition, participants were asked to rate eight listening/processing skills 0-10, with 0 meaning they had no difficulty with that task and 10 meaning they had the greatest difficulty. Skills on the rating scale are listed in Table 1.


Table 1: Functional Rating Questionnaire Items
1) Do you have problems hearing and/or understanding speech if the speaker is turned away from you?
2) Do you have problems hearing and/or understanding speech on the phone?
3) Do you have problems hearing and/or understanding speech in a noisy environment?
4) Do you have trouble blocking out background noise?
5) Does it take more effort to pay attention to someone talking to you than it used to?
6) Do you feel like you lose information because you can�t tell what people are saying to you?
7) Do you feel fatigued after participating in extended conversation in environments with competing background sound?
8) Are you distracted by competing background conversations in public settings in which people are seated close to you?


Results

Results are reported in Tables 2 and 3 and are reported separately for the Hearing Loss group and No Hearing Loss group. Results are shown as percentages correct for the speech-in-noise test. For the rating scales, results are shown as the mean score for each question.

Quote:Width: 1280 pixels
Height: 720 pixels
Format: AVC
Codec: AVC
Duration: 00:44:06
Bit rate: 1064 Kbps
Frame rate: 23.976 fps
Aspect ratio: 16:9
Bit depth: 8 bits
Color space: YUV
Subtitles: N/A

Quote:Audio track: 1
Language: N/A
Codec: AAC LC
Channels: 2
Bit rate: 128 Kbps
Compression: Lossy
Sampling rate: 48 Khz