Kevin Munro

The University of Manchester · School of Psychological Sciences

Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicia...

Background The National Institute of Health and Social Care Research (NIHR) Health Informatics Collaborative (HIC) for Hearing Health has been established in the UK to curate routinely collected hearing health data to address research questions. This study defines priority research areas, outlines its aims, governance structure and demonstrates how...

Objective: Hearing aid use is lowest in 0-3-year-olds with hearing loss, placing spoken language development at risk. Existing interventions lack effectiveness and are typically not based on a theoretically driven, comprehensive understanding of the factors influencing infant hearing aid use. The present study is the first to address this gap in u...

Objective Listening effort (LE) varies as a function of listening demands, motivation and resource availability, among other things. Motivation is posited to have a greater influence on listening effort under high, compared to low, listening demands. Methods To test this prediction, we manipulated the listening demands of a speech recognition task...

Background This study identified and explored how National Health Service (NHS) hearing aid clinics address cultural competence concerning Deaf British Sign Language (BSL) users. This was approached by (i) investigating how organisational processes meet the needs of Deaf signers from a hospital and hearing aid clinic perspective, (ii) analysing pol...

Hearing aid verification with real-ear measurement (REM) is recommended in clinical practice. Improvements, over time, in accuracy of manufacturers’ initial fit mean the benefit of routine REM for new adult users is unclear. This registered, double-blinded, randomized, mixed-methods clinical trial aimed to (i) determine whether new adult hearing ai...

Objective: Several viruses are known to have a negative impact on hearing health. The global prevalence of COVID-19 means that it is crucial to understand whether and how SARS-CoV2 affects hearing. Evidence to date is mixed, with studies frequently exhibiting limitations in the methodological approaches used or the populations sampled, leading to...

Objective The aim was to use a battery of clinic-based auditory assessment procedures to compare participants with and without self-reported hearing difficulties following a confirmed COVID-19 infection. A further aim was to compare the groups on self-reported measures of listening effort and fatigue. Methods There were 25 participants in each gro...

Objectives: The cortical auditory evoked potential (CAEP) test is a candidate for supplementing clinical practice for infant hearing aid users and others who are not developmentally ready for behavioral testing. Sensitivity of the test for given sensation levels (SLs) has been reported to some degree, but further data are needed from large numbers...

Objective: The capabilities (C), opportunities (O) and motivations (M) model of behavior (B) change (COM-B) is designed to capture the key features of numerous models of behavior change, but little is known about its predictive validity. The present study tests the predictive validity of COM-B prospectively in the domain of attending hearing scree...

Sensorineural hearing loss is the most common type of hearing loss in adults and occurs due to damage of the inner ear caused by a range of factors including ageing, excessive noise, toxins, and cancer. Auto-inflammatory disease is also a cause of hearing loss and there is evidence that inflammation could contribute to hearing loss in other conditi...

Objective: The clinical audiology test battery often involves playing physically simple sounds with questionable ecological value to the listener. In this technical report, we revisit how valid this approach is using an automated, involuntary auditory response; the acoustic reflex threshold (ART). Design: The ART was estimated four times in each...

Objective: Consistent symptom reporting for conditions like tinnitus that do not have an associated sign is critical for evaluating severity and intervention effectiveness, and for interpreting research findings. There is little research examining reporting of tinnitus and hearing difficulty over time. We address this here by comparing reported hea...

Background Evidence on hearing outcome measures when assessing hearing preservation following stereotactic radiosurgery (SRS) for adults with vestibular schwannoma (VS) has not previously been collated in a structured review. Objective The objective of the present study was to perform a scoping review of the evidence regarding the choice of hearing...

Objective Patient and public involvement (PPI) in research improves relevance to end users and improves processes including recruitment participants. PPI in our research has gone from being non-existent to ubiquitous over a few years. We provide critical reflections on the benefits and challenges of PPI. Design Case studies are reported according...

Objective: The aim was to establish the reliability and the validity of Arabic translated versions of the Fatigue Assessment Scale (FAS) and the Effort Assessment Scale (EAS). Design: The FAS and the EAS were translated from the original English following a recommended six-step approach for translating hearing-related questionnaires for differen...

Objective: Remote hearing screening and assessment may improve access to, and uptake of, hearing care. This review, the most comprehensive to date, aimed to (i) identify and assess functionality of remote hearing assessment tools on smartphones and online platforms, (ii) determine if assessed tools were also evaluated in peer-reviewed publications...

Objective: Hearing aids are typically programmed using the individual's audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the individual's audiometric thresholds. This review aimed to identify whether prog...

There are reports of associations between SARS-CoV2, COVID-19, COVID-19 vaccines, and auditory symptoms (hearing difficulty, tinnitus). However, most studies have relied on self-report and lack baseline and/or non-COVID control groups. This makes it problematic to differentiate if symptoms are associated with SARS-CoV2, COVID-19, the vaccine, psych...

Motivation influences the amount of listening effort (LE) exerted or experienced under challenging conditions, such as in high-noise environments. This systematic review and meta-analysis is the first to quantify the effects of motivation on LE. The review was pre-registered in PROSPERO, and performed in accordance with PRISMA guidelines. Eligible...

Objective: Provision of information is already part of standard care and may not be sufficient to promote hearing aid use. The I-PLAN is a behavior change intervention that is designed to promote hearing aid use in adults. It consists of a prompt, an action plan and provision of information. The objective was to test the effectiveness of the I-PLA...

Coronavirus pandemics increase the incidence of posttraumatic stress disorder (PTSD), which requires intensive treatment and is related to several long-term psychiatric disorders. Older adults are particularly vulnerable to COVID-19 and hence trauma symptoms. It is not known what is the prevalence of trauma symptoms relating to COVID-19 specificall...

Purpose Visual cues from a speaker's face may benefit perceptual adaptation to degraded speech, but current evidence is limited. We aimed to replicate results from previous studies to establish the extent to which visual speech cues can lead to greater adaptation over time, extending existing results to a real-time adaptation paradigm (i.e., withou...

Objective To determine if a positive test for COVID-19 is associated with self-reported audio-vestibular symptoms. Design Self-reported changes in hearing, tinnitus, hyperacusis, and dizziness/rotatory vertigo were assessed in hospitalised and non-hospitalised COVID-19 patients during and after the acute phase of the disease and compared to non-CO...

Introduction: Hearing aids are typically programmed using the individual's audiometric thresholds. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not programmed using the individual's audiometric thresholds. This review aims to identify whether programming hearing aids using the individual's aud...

Suboptimal hearing aid use negatively impacts health and well-being. The aim of this study was to conduct a controlled trial of a behavior change intervention to promote hearing aid use. This study was a quasi-randomized controlled trial with two arms. A total of 160 first-time hearing aid users were recruited at their hearing aid fitting appointme...

Motivation influences the amount of listening effort (LE) exerted or experienced under challenging conditions, such as in high-noise environments. This systematic review and meta-analysis is the first to quantify the effects of motivation on LE. The review was pre-registered in PROSPERO, and performed in accordance with PRISMA guidelines. Eligible...

This systematic review, the first on this topic, aimed to investigate if probe-tube verification of real-ear hearing aid amplification characteristics improves outcomes in adults. The review was preregistered in the Prospective Register of Systematic Reviews and performed in accordance with the guidelines of the Preferred Reporting Items for System...

Objective To evaluate uptake of the internet-based hearing test, with respect to the 11% of UK adults that have hearing loss but do not use hearing aids. Design Feasibility study in a primary care practice in the North of England. Study Sample Adults aged 50–74 years were sent postal invitations to complete an internet hearing test (N = 600). Tho...

Objective Baseline electroencephalography (EEG) alpha power, i.e. that measured prior to stimulus presentation, is a potential objective predictor of task performance. Here we assessed the predictive power of EEG alpha on performance accuracy in a digits-in-noise recognition task, factoring in hearing thresholds and age. Design EEG alpha power, re...

Objective: The aim was to systematically review the literature to December 2020, in order to provide a timely summary of evidence on SARS-CoV-2, COVID-19 and audio-vestibular symptoms. Design: The protocol was registered in the International Prospective Register of Systematic Reviews. The methods were developed in accordance with the Preferred Repo...

Objectives The aim of this study was to assess people’s perceptions of their personal risk, population prevalence and perceived severity in relation to three key health conditions (cancer, heart disease and hearing loss), gauge the size of any misperceptions, and identify correlates of such misperceptions. Design This study was a cross-sectional s...

Objectives: To investigate the effects of listening demands and motivation on listening effort (LE) in a novel speech recognition task. Design: We manipulated listening demands and motivation using vocoded speech and financial reward, respectively, and measured task performance (correct response rate) and indices of LE (response times (RTs), sub...

The acoustic reflex (AR) shows promise as an objective test for the presence of cochlear synaptopathy in rodents. The AR has also been shown to be reduced in humans with tinnitus compared to those without. The aim of the present study was twofold: (a) to determine if AR strength (quantified as both threshold and growth) varied with lifetime noise e...

Objective Pupillometry is sensitive to cognitive resource allocation and has been used as a potential measure of listening-related effort and fatigue. We investigated associations between peak pupil diameter, pre-stimulus pupil diameter, performance on a listening task, and the dimensionality of self-reported outcomes (task-related listening effort...

Objectives: To determine population-based risks of adverse effects on hearing and well-being outcomes associated with unilateral hearing impairment. Design: A group of 40- to 69-year-old adults (n = 861) who reported being able to hear only in one ear and having speech reception thresholds (SRTs) in noise indicating normal hearing in that ear (S...

Background: Hearing loss is prevalent and disabling, yet little is known about the extent of recreational noise exposure and hearing protection use. The aim of the present research was to estimate the extent of recreational noise exposure and hearing protection use in a sample representative of the UK adult population. Methods: We conducted a cr...

Visual cues from a speaker’s face may improve perceptual adaptation to degraded speech over time, but current evidence is limited. We aimed to replicate results from previous studies and extend them to more demanding speech stimuli (sentences), to better represent real-life, challenging speech comprehension. In addition, we investigated whether par...

Introduction Using a probe-tube microphone to measure and adjust the real-ear performance of the hearing aid to match the prescription target is recommended and widely used in clinical practice. Hearing aid fitting software can approximately match the amplification characteristics of the hearing aid to the prescription without real-ear measurements...

Objective: To report a robust measure of the proportion of adults who do not use their hearing aids. Design: Data on hearing aid use was extracted from national household survey data, from 2004 to 2018 in Wales, UK. Study sample: A representative sample of 10,000 to 16,000 adults per year. Results: Self-reported hearing difficulty increased smoothl...

Objective: This rapid systematic review investigated audio-vestibular symptoms associated with coronavirus. Design: The protocol for the rapid review was registered in the International Prospective Register of Systematic Reviews and the review methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-An...

Extended high frequencies (EHF), above 8 kHz, represent a region of the human hearing spectrum that is generally ignored by clinicians and researchers alike. This article is a compilation of contributions that, together, make the case for an essential role of EHF in both normal hearing and auditory dysfunction. We start with the fundamentals of bio...

Objectives: Approximately 10 to 35% of people with a hearing impairment own a hearing aid. The present study aims to identify barriers to obtaining a hearing aid and inform future interventions by examining the biopsychosocial characteristics of adults aged 50+ according to 7 categories: (i) Did not report hearing difficulties, (ii) Reported heari...

Short-duration speech-like stimuli, for example, excised from running speech, can be used in the clinical setting to assess the integrity of the human auditory pathway at the level of the cortex. Modeling of the cochlear response to these stimuli demonstrated an imprecision in the location of the spectrotemporal energy, giving rise to uncertainty a...

In 2019, the Manchester Centre for Audiology and Deafness celebrates its 100th anniversary. To mark the centenary, this special issue is a collection of papers that showcases current research in Manchester Centre for Audiology and Deafness. The Editorial provides a brief history and description of the Centre and an overview of the special issue.

Pure-tone threshold audiometry is currently the standard test of hearing. However, in everyday life, we are more concerned with listening to speech of moderate loudness and, specifically, listening to a particular talker against a background of other talkers. FreeHear delivers strings of three spoken digits (0–9, not 7) against a background babble...

Age-related hearing impairment (ARHI) is the most common sensory impairment in the aging population; a third of individuals are affected by disabling hearing loss by the age of 65. It causes social isolation and depression and has recently been identified as a risk factor for dementia. The genetic risk factors and underlying pathology of ARHI are l...

Objectives: With the advent of newborn hearing screening and early intervention, there is a growing interest in using supra-threshold obligatory cortical auditory evoked potentials (CAEPs) to complement established pediatric clinical test procedures. The aim of this study was to assess the feasibility, and parent acceptability, of recording infant...

Although there is strong histological evidence for age-related synaptopathy in humans, evidence for the existence of noise-induced cochlear synaptopathy in humans is inconclusive. Here, we sought to evaluate the relative contributions of age and noise exposure to cochlear synaptopathy using a series of electrophysiological and behavioral measures....

Objectives: Hearing impairment is ranked fifth globally for years lived with disability, yet hearing aid use is low among individuals with a hearing impairment. Identifying correlates of hearing aid use would be helpful in developing interventions to promote use. To date, however, no studies have investigated a wide range of variables, this has li...

Direct-to-consumer (DTC) hearing devices can be purchased without consulting a hearing health professional. This project aims to compare 28 DTC devices with the most popular hearing aid supplied by the U.K. National Health Service (NHS). The comparison was based on technical performance, cosmetic acceptability, and the ability to match commonly use...

https://www.entandaudiologynews.com/features/audiology-features/post/direct-to-consumer-hearing-devices-a-need-to-combine-cosmetic-appeal-with-device-capabilities

Objectives: Diet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large populatio...

Objective: This systematic review investigated if hearing aid use was associated with acute improvements in cognitive function in hearing-impaired adults. Design: The review question and inclusion/exclusion criteria were designed using the Population, Intervention, Control, Outcomes, and Study design (PICOS) mnemonic. The review was pre-registered...

Investigations of cochlear synaptopathy in living humans rely on proxy measures of auditory nerve function. Numerous procedures have been developed, typically based on the auditory brainstem response (ABR), envelope-following response (EFR), or middle-ear-muscle reflex (MEMR). Validation is challenging, due to the absence of a gold-standard measure...

The occurrence of tinnitus is associated with hearing loss and neuroplastic changes in the brain, but disentangling correlation and causation has remained difficult in both human and animal studies. Here we use earplugs to cause a period of monaural deprivation to induce a temporary, fully reversible tinnitus sensation, to test whether differences...

Age-related hearing impairment (ARHI) is the most common sensory impairment in the aging population; a third of individuals are affected by disabling hearing loss by the age of 65. ARHI is a multifactorial condition caused by both genetic and environmental factors, with estimates of heritability between 35% and 55%. The genetic risk factors and und...

Objectives: Listening effort can be defined as the cognitive resources required to perform a listening task. The literature on listening effort is as confusing as it is voluminous: measures of listening effort rarely correlate with each other and sometimes result in contradictory findings. Here, we directly compared simultaneously recorded multimod...

Objectives: Listening effort can be defined as the cognitive resources required to perform a listening task. The literature on listening effort is as confusing as it is voluminous: measures of listening effort rarely correlate with each other and sometimes result in contradictory findings. Here, we directly compared simultaneously recorded multimo...

Objective: To conduct a systematic review of the evidence in relation to what hearing healthcare professionals do during hearing aid consultations and identifying which behaviours promote hearing aid use and benefit among adult patients. Design: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMe...

Objective: The present study investigated: (a) how motivated patients are to use their hearing aid, and (b) whether post-motivational variables (e.g. action planning, coping planning) have anything to offer in terms of developing interventions to boost hearing aid use. Design: participants completed a questionnaire designed to tap Health Action Pro...

The acoustic middle-ear-muscle reflex (MEMR) has been suggested as a sensitive non-invasive measure of cochlear synaptopathy, the loss of synapses between inner hair cells and auditory nerve fibers. In the present study, clinical MEMR thresholds were measured for 1-, 2-, and 4-kHz tonal elicitors, using a procedure shown to produce thresholds with...

Objective: Electrically evoked auditory brainstem responses (eABRs) can be recorded before cochlear implant (CI) surgery to verify auditory nerve function, and is particularly helpful in to assess the function of the auditory nerve in cases of auditory nerve hypoplasia. This is the first study to compare three preimplant eABRs recording techniques...