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      Scientifically speaking

      A project based at Cincinnati Children’s Hospital in the US is using virtual reality technology to assess children’s hearing. Dr Hannah Stewart tells us how.

      By: Dr Hannah Stewart | 11 October 2018

      Sitting still in a sound-booth wearing headphones, or looking at some speakers, is a very alien environment for children. By using virtual reality (VR), I hope we can make hearing assessments more enjoyable and relatable. Adding in a visual element, so the children can turn their heads and look at the source of the sounds, is really important in helping us understand how they process auditory information in everyday life. Currently, hearing and vision are looked at separately, but in reality we experience them in tandem. With VR, we’ll be able to examine how children process sound with simple to complex visual scenes and maintain control over every element of their environment.

      Instead of using an expensive and space-intensive speaker ring in an echo-free room (typically costing around $1m), we’re going to trial a $200 VR headset that doesn’t need an external computer to run the software. I’m interested to see if we can get similar results on this cheaper headset, compared to the more expensive and complicated tech set-up options. If so, this could make realistic hearing and listening assessments possible in even the most remote areas.

      At the moment, we’re developing the graphics to be attractive to children. However, using VR as an assessment technique can easily work with adults too. In the near future, we may be able to assess hearing skills in a VR ‘coffee shop’, with the sounds of a milk steamer and other customers chatting, for example, to create a difficult listening environment. This would make results much more applicable to how someone hears in real life, rather than the traditional audiogram of pure tones.

      Since I was a teenager, I’ve worked with children with developmental difficulties and disorders. My specific interest in hearing has developed from my own personal frustration. I’ve experienced listening difficulties in noisy environments my entire life – and I’ve been annoyed by the typical reaction from others when I say that I can’t hear them. Instead of shouting at me, and simplifying what they’ve said, I ask people to turn and look at me so that I can lipread them. However, this request is often met with surprise and misunderstanding.

      I actually started out with a degree in artificial intelligence (AI) and mathematics but fell for the psychology side of AI. Studying cognition and the brain merged with my love of working with children with developmental difficulties and disorders. I continued my psychology career with a PhD at the University of Nottingham, based at the Medical Research Council Institute of Hearing Research. I then won a grant to visit the Rotman Research Institute in Toronto, Canada for nine months, where I started learning brain-imaging techniques. This led to my current postdoc at Cincinnati Children’s Hospital, where I lead the Magnetic Resonance Imaging (MRI) side of our hearing and listening projects. I’m still surprised that I’ve almost gone full circle back to the ‘tech side’, and I love bringing new techniques into how we explore children’s hearing – through imaging, apps and devices.

      It’s always hard to find start-up funding for a project that explores a new area. Action on Hearing Loss is funding the day-to-day running of our VR project – from recruitment through to testing. The next stage for the project is to finalise the programming so we can get the children in to see how the VR experience compares to the traditional sound-booth experience.

      When you’re working in the field of hearing research, I think it’s really important to get a holistic view of hearing – from assessment to assistive devices to how the ears and brain interact. I also think an understanding of how research, industry and the clinical sides all work is vital, as they’re often very disconnected from each other.

      New technology is rapidly changing hearing research and potential treatments. Traditionally, an audiogram would provide a diagnosis on whether an individual could be helped by hearing aids. However, we now know that audiograms provide an incomplete assessment of hearing and are complemented by more complex tests to provide additional information (such as speech in noise, attention and memory). The use of mobile devices means that a range of appropriate tests can now be run in even the most remote of areas. The development of auditory devices to boost the volume of a listener’s surroundings, and the use of digital technology to reduce background noise and make it easier to listen, mean that hearing aids are no longer the only treatment. While this technology is the most accessible it’s ever been, I believe there’s more change to come that will make hearing assessments better reflect everyday life.

      Find out more

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      Dr Hannah Stewart, from the Cincinnati Children’s Hospital Medical Center, USA
      Dr Hannah Stewart, from the Cincinnati Children’s Hospital Medical Center, USA

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