Auditory Brain Development in Children With Hearing Loss – Part One
There auditory Brain Development in Children With Hearing Loss – Part One a variety of prevention strategies available to avoid or reduce hearing loss. Lowering the volume of sound at its source, limiting the time of exposure, and physical protection can reduce the impact of excessive noise. If not prevented, hearing loss can be managed through assistive devices and cognitive therapies. The first symptom of NIHL may be difficulty hearing a conversation against a noisy background.
The effect of hearing loss on speech perception has two components. The first component is the loss of audibility, which may be perceived as an overall decrease in volume. Modern hearing aids compensate this loss with amplification. TTS is also measured in decibels.
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TTS imperceptibly gives way to PTS. Tinnitus is described as hearing sound when an external sound is not present. 16 million of them have symptoms serious enough for them to see a doctor or hearing specialist. Tinnitus is the largest single category for disability claims in the military, with hearing loss a close second. The third largest category is post-traumatic stress disorder, which itself may be accompanied by tinnitus and may exacerbate it. The symptoms mentioned above are the external signs of the physiological response to cochlear overstimulation. Those noxious conditions worsen the damaged hair-cells degeneration.
Noise overstimulation causes an excessive release of glutamate, causing the postsynaptic bouton to swell and burst. NIHL has implications on quality of life that extend beyond related symptoms and the ability to hear. DALYs represent the number of healthy years lost due to a disease or other health condition. The negative impacts of NIHL on one’s ability to reciprocate communication, socialize and interact with society are largely invisible. 80 dB can cause permanent hearing loss. NIHL caused by acute acoustic trauma refers to permanent cochlear damage from a one-time exposure to excessive sound pressure. This form of NIHL commonly results from exposure to high-intensity sounds such as explosions, gunfire, a large drum hit loudly, and firecrackers.
The discomfort threshold is the loudness level from which a sound starts to be felt as “too loud” and thus painful by an individual. Gradually developing NIHL refers to permanent cochlear damage from repeated exposure to loud sounds over a period of time. Unlike acoustic trauma, this form of NIHL does not occur from a single exposure to a high-intensity sound pressure level. About 22 million workers are exposed to hazardous noise, with additional millions exposed to solvents and metals that could put them at increased risk for hearing loss. Occupational hearing loss is one of the most common occupational diseases.
Musicians, from classical orchestras to rock groups, are exposed to high decibel ranges. Music-induced hearing loss is still a controversial topic for hearing researchers. While some population studies have shown that the risk for hearing loss increases as music exposure increases, other studies found little to no correlation between the two. Determining which individuals or groups are at risk for such exposures may be a difficult task. In 2018, a musician named Chris Goldscheider won a case against Royal Opera House for damaging his hearing in a rehearsal of Wagner’s thunderous opera Die Walkure.
If subsequent monitoring shows that 85 dB is not surpassed for an eight-hour TWA, the employee is no longer required to wear hearing protection. Both values are based on 8 hours per day, with a 3 dB exchange rate. A 2012 Cochrane review found low-quality evidence that legislation to reduce noise in the workplace was successful in reducing exposure both immediately and long-term. Several sports stadiums pride themselves in having louder stadiums than their opponents because it may create a more difficult environment for opposing teams to play in. While there is no agency that currently monitors sports stadium noise exposure, organizations such as NIOSH or OSHA use occupational standards for industrial settings that some experts feel could be applied for those working at sporting events. Workers often will not exceed OSHA standards of 90dBA, but NIOSH, whose focus is on best practice, has stricter standards which say that when exposed to noise at or exceeding 85dBA workers need to be put on a hearing conservation program. Studies are still being done on fan exposure, but some preliminary findings show that there are often noises that can be at or exceed 120 dB which, unprotected, can cause damage to the ears in seconds.
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NIHL occurs when too much sound intensity is transmitted into and through the auditory system. When the ear is exposed to excessive sound levels or loud sounds over time, the overstimulation of the hair cells leads to heavy production of reactive oxygen species, leading to oxidative cell death. In animal experiments, antioxidant vitamins have been found to reduce hearing loss even when administered the day after noise exposure. The potassium rich fluid is toxic to the neuronal endings and can damage hearing of the entire ear.
Recent studies have investigated additional mechanisms of NIHL involving delayed or disabled electrochemical transmission of nerve impulses from the hair cell to and along the auditory nerve. Acoustic over-exposure can also result in decreased myelination at specific points on the auditory nerve. Myelin, an insulating sheath surrounding nerve axons, expedites electrical impulses along nerves throughout the nervous system. There appear to be large differences in individual susceptibility to NIHL.
Example audiogram of a notch-shaped high frequency hearing loss. Both NIHL caused by acoustic trauma and gradually-developed-NIHL can often be characterized by a specific pattern presented in audiological findings. NIHL is generally observed to affect a person’s hearing sensitivity in the higher frequencies, especially at 4000 Hz. This typical 4000 Hz notch is due to the transfer function of the ear. However, not all audiological results from people with NIHL match this typical notch. Variations arise from differences in people’s ear canal resonance, the frequency of the harmful acoustic signal, and the length of exposure. NIHL can be prevented through the use of simple, widely available, and economical tools.
Personal noise reduction devices can be passive, active or a combination. Passive ear protection includes earplugs or earmuffs which can block noise up to a specific frequency. Earplugs and earmuffs can provide the wearer with 10 dB to 40 dB of attenuation. Before hearing protective actions will take place, a person must understand they are at risk for NIHL and know their options for prevention. Hearing protection programs have been hindered by people not wearing the protection for various reasons, including the desire to converse, uncomfortable devices, lack of concern about the need for protection, and social pressure against wearing protection. A systematic review of the effectiveness of interventions to promote the use of hearing protection devices such as earplugs and earmuffs among workers found that tailored interventions improve the average use of such devices when compared with no intervention. Although research is limited, it suggests that increased exposure to loud noise through personal listening devices is a risk factor for noise induced hearing loss.
More than half of people are exposed to sound through music exposure on personal devices greater than recommended levels. However, it is understood that HCPs are designed to change behavior, which is known to be a complex issue that requires a multi-faceted approach. 2015 study of such programming, they cite the necessary attitude change towards the susceptibility of risk and degree of severity of hearing loss. Interventions to prevent noise-induced hearing loss often have many components.
A 2017 Cochrane review found that hearing loss prevention programs revealed that stricter legislation might reduce noise levels. Giving workers information on their noise exposure levels by itself was not shown to decrease exposure to noise. There are a variety of public awareness programs as well as available curricula to teach awareness messages becoming available. There is evidence that hearing loss can be minimized by taking high doses of magnesium for a few days, starting as soon as possible after exposure to the loud noise. Despite different people having different thresholds for what noises are painful, this pain threshold had no correlation with which noises cause hearing damage. The ear can not get more resistant to noise harmfulness by training it to noise. The cochlea is partially protected by the acoustic reflex, but being frequently exposed to noise does not lower the reflex threshold.
The inner hair cells are connected to afferent nerve fibers, and the outer hair cells are connected to efferent nerve fibers. However, a 2006 study revealed a different protective mechanism for stress conditioning. The effects of glucocorticoid thus mitigate the inflammation from an acoustic trauma that can lead to hearing loss. It does not make the ear more resistant to noise. It reduces the inflammation caused by the acoustic trauma, which would cause subsequent damages to hair cells.
NIHL are under research and development. Currently there are no commonly used cures, but rather assistive devices and therapies to try and manage the symptoms of NIHL. Several clinical trials have been conducted to treat temporary NIHL occurring after a traumatic noise event, such as a gunshot or firework. In 2007, individuals with acute acoustic trauma after firecracker exposure were injected intratympanically with a cell permeable ligand, AM-111.
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The trial found AM-111 to have a therapeutic effect on at least 2 cases of those with acute trauma. Additionally, clinical trials using antioxidants after a traumatic noise event to reduce reactive oxygen species have displayed promising results. Antibiotic injections with allopurinol, lazaroids, α-D-tocopherol, and mannitol were found to reduce the threshold shift after noise exposure. Another antioxidant, Ebselen, has been shown to have promising results for both TTS and PTS. At the present time, no established clinical treatments exist to reverse the effects of permanent NIHL. However, current research for the possible use of drug and genetic therapies look hopeful.
In addition, management options such as hearing aids and counseling exist. Many studies have been conducted looking at regeneration of hair cells in the inner ear. While hair cells are generally not replaced through cell regeneration, mechanisms are being studied to induce replacement of these important cells. For people living with NIHL, there are several management options that can improve the ability to communicate. A systematic-review conducted by the American Academy of Audiology Task Force On the Health-Related Quality of Life Benefits of Amplification in Adults found the use of hearing aids to increase quality of life. The review pertained to adults who experienced sensorineural hearing loss, which can be caused by excessive, loud noise.
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The World Health Organization estimates that nearly 360 million people have moderate to profound hearing loss from all causes. Rates of hearing loss has traditionally been attributed to occupational or firearm-related exposure, as well as recreational exposure. 20-69 in the United States has an audiometric notch, suggesting high levels of noise exposure as of 2011. Occupational noise exposure is a risk factor for noise induced hearing loss. 65 who had a higher occupational noise exposure than the average worker.
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The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults”. Disclosure statement Assal Habibi does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. University of Southern California — Dornsife College of Letters, Arts and Sciences provides funding as a member of The Conversation US. The Conversation UK receives funding from Hefce, Hefcw, SAGE, SFC, RCUK, The Nuffield Foundation, The Ogden Trust, The Royal Society, The Wellcome Trust, Esmée Fairbairn Foundation and The Alliance for Useful Evidence, as well as sixty five university members. How does music training in early childhood help the developing brain?
As a researcher of neuroscience and a pianist myself, I understand that the mastering of this skill not only takes practice, but also requires complex coordination of many different brain regions. It takes coordinating both hands and communicating emotionally with other players and listeners to produce the magical effect. The combination of such demands is likely to influence brain structures and their functions. In our lab, we want to understand whether music training during childhood improves brain functions for processing sound more generally. These functions are important for the development of language and reading skills. Music training and brain Over the past two decades, several investigators have reported differences in the brain and behavior of musicians compared to nonmusicians.
Music training has been found to be related to better language and mathematical skills, higher IQ and overall greater academic achievement. Music training helps develop many other skills. However, the interpretation of the findings remains unclear. For example, the differences reported between adult musicians and nonmusicians might be due to long-term intensive training or might result primarily from inherent biological factors, such as genetic makeup. Or, as with many aspects of the nature-versus-nurture debate, the differences may well result from contributions of both environmental and biological factors.
One way to better understand the effects of music training on child development would be to study children before they start any music training and follow them systematically after, to see how their brain and behavior change in relation to their training. It would involve including a comparison group, as all children change with age. The ideal comparison group would be children who participate in equally socially interactive but nonmusical training, such as sports. Follow-up assessments after their training would reveal how each group changes over time. Impact of music training on child development In 2012, our research group at the Brain and Creativity Institute at University of Southern California began a five-year study that did just that. We began to investigate the effects of group-based music training in 80 children between ages six and seven.
We have continued to follow them, to explore the effects of such training on their brain, cognitive, social and emotional development. We started the study when one group of children were about to begin music training through the Youth Orchestra Los Angeles program. What is the impact of group-based music training? The second group of children were about to begin a sports training program with a community-based soccer program. They were not engaged in music training.
A third group of children were from public schools and community centers in the same areas of Los Angeles. All three groups of children were from equally underprivileged and ethnic minority communities of Los Angeles. Each year, we meet every participant and their families at our institute for a testing period over the course of two to three days. During this visit, we measure language and memory abilities, capacity to process music and speech, and brain development of each child. We also conduct a detailed interview with their families. At the beginning of the study, when children did not have any music or sports training, we found that the children in the music training group were not different from the children in the other two groups.