This is a critical review of two major phonological theories: linear natural phonology and the nonlinear optimality theory. Natural phonological theory asserts that phonological processes are phonetically based. Phonological error patterns help organize treatment targets and assess generalization. However, the natural phonology’s explanation of speech sound learning in children does not attain the status of a scientific theory. Process proliferation and poor definitions are other limitations. Optimality theory proposes that speech sounds may be marked (complex, more difficulty to produce, etc.) or unmarked (simple, easier to produce, etc.). Optimality replaces rules with markedness and faithfulness constraints. Constraints are common to all languages, but their ranking are unique to each language. Speakers can violate constraints ranked lower, but not those ranked higher in their language. When speech is imminent, GEN the generator generates a variety of output (response) options and EVAL the evaluator selects an optimal output that is faithful to the higher-ranked constraints. There is no independent evidence for the existence of universal and innate constraints, specific language-based rankings, and the operation of GEN or EVAL. Assumptions of universality of phonological rules and even the existence of such rules are speculative. That children have innate phonological knowledge is an untenable assumption. Most generative phonological theories have little or no empirical validity. Investigations of child-directed speech, statistical learning, implicit learning, sociolinguistics, usage- and exemplar-based phonology and behavior analysis have all supported the view that children master their speech sounds (and language structures) through social interactions.

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Purpose: The present study aimed to compare speech perception in noise and horizontal localization with and without activating digital noise reduction (DNR) in hearing aids with and without an ear-to-ear synchronization. Materials and Methods: Twenty-five listeners with mild-to-moderate bilateral sensorineural hearing loss, aged between 18 and 55 years, were the participants. Each participant’s horizontal sound-source localization performance was measured as a root-mean-square degree of error. Speech recognition in the presence of speech babble noise was measured as the signal-to-noise ratio required for 50% recognition score (SNR-50). Further, SNR-50 was measured with noise source from four different directions and was recorded in four aided conditions, with and without an independent activation of wireless link and DNR. Results: Results showed that wireless synchronization technology in hearing aids improved localization and speech perception in noise under certain conditions. Adding the activation of DNR improved the overall performance in the horizontal sound-source localization task. However, the amount of improvement in speech perception in noise with the activation of wireless synchronization and/or DNR depended on the spatial separation between the direction of speech and the noise. Conclusions: The activation of DNR and wireless synchronization in hearing aids showed a better performance in assessed parameters in the current study. However, the improvement in scores may or may not be beneficial to the listener, depending on the direction of noise and speech.

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Purpose: A review of the existing literature shows that auditory steady-state responses (ASSR) to narrow-band (NB) chirps analyzed using q sample averaging is more reliable and accurate than ASSR for modulated tones in predicting behavioral thresholds. Studies in this direction have been carried out to predict hearing sensitivity. However, there is a dearth of studies investigating ASSR for NB chirps in persons using hearing aids. The present study evaluated if ASSR for NB chirps analyzed using q sample averaging could be used to predict aided behavioral thresholds during the hearing aid selection. Specifically, the study investigated the agreement and differences between behavioral thresholds predicted from aided ASSR with aided behavioral thresholds. Materials and Methods: Retrospective analysis of clinical records of 24 ears with hearing loss were carried out. The age of the children ranged from 3 to 5 years. Aided behavioral thresholds and aided ASSR for NB chirps were recorded at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. Results: Wilcoxon signed-rank test revealed no significant difference between aided thresholds predicted through aided ASSR and measured behavioral thresholds for all four frequencies. The Bland–Altman analysis also showed that the results of the two tests are comparable for all four frequencies. Conclusions: Aided ASSR can predict aided behavioral thresholds in children who fail to provide voluntary responses to behavioral tests, but the results need to be crosschecked using other measures. ASSR can thus be added to the protocol used for hearing aid fitting and validation in young children.

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Purpose: Since the inception of the term cochlear synaptopathy, extensive research is carried out to study the effects of noise and age on suprathreshold hearing in individuals with otherwise normal hearing. Yet, there is a lack of a standard test battery. We hypothesize that this variability in the results across studies may be due to the use of “cochlear synaptopathy” or “hidden hearing loss” as a blanket term to refer to auditory deficits seen in individuals with noise exposure, aging, and tinnitus with normal hearing. The present study aimed to systematically review the literature on hidden hearing loss due to noise exposure, aging, and tinnitus. Method: Keywords were combined using Boolean operations, and an electronic search was carried out through PubMed, ScienceDirect, ResearchGate, and Google Scholar databases. Screening for abstracts, title, and full text resulted in 46 articles eligible for data extraction. Results: Among the 46 studies considered for the review, 30 studies included human participants and 16 included animal participants. The possibility of noise-induced synaptopathy was assessed in 30 studies; age-induced synaptopathy in 6 studies; and synaptopathy in normal-hearing individuals with tinnitus in 10 studies. The results revealed conclusive findings of synaptopathy in animals; however, the evidence in studies involving human participants was inconclusive. Conclusions: Auditory brainstem response (ABR), histopathology, and middle ear muscle reflex (MEMR) are the widely used measures of synaptopathy in animals. Human studies indicated that temporal processing, speech perception in the presence of background noise, and working memory are majorly affected in individuals with hidden hearing loss. Specifically, speech perception in noise (SPiN), temporal resolution, MEMR, ABR wave I amplitude growth, and electrocochleography (ECochG) are identified as the potential measures of hidden hearing loss due to noise exposure. Further, the effect of common recreational noise on these measures is less compared to high life-time noise exposure. The results of synaptopathy due to aging or tinnitus are inconclusive.

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The Covid-19 pandemic has disrupted traditional teaching-learning programs across all educational disciplines. The Speech and Hearing training program is no exception. It has provided many opportunities to incorporate online learning in the curriculum and upskilling and reskilling of new technologies. The pandemic has made us think differently. This will be a golden opportunity to have brainstorming discussions with all the stakeholders to discuss their expectations and aspirations towards professional courses like Speech and Hearing programs. This is an opinion piece; Covid-19 and various restrictions have impacted the Speech and Hearing profession, especially training programs. This article intends to initiate a dialogue among professionals that will hopefully enable us to define a strategic roadmap for the recovery of Speech and Hearing services and human resources as we emerge from the pandemic. The pandemic has given new directions towards the delivery of the education model. Various programs have received significant experience about what is doable and not doable modules in the academic program. This is a golden opportunity for all to move away from the traditional educational model and develop a flexible and student-oriented educational program. Are we ready for these challenges?

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