Displaying all 13 publications

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  1. Maamor N, Billings CJ
    Neurosci Lett, 2017 01 01;636:258-264.
    PMID: 27838448 DOI: 10.1016/j.neulet.2016.11.020
    The purpose of this study was to determine the effects of noise type, signal-to-noise ratio (SNR), age, and hearing status on cortical auditory evoked potentials (CAEPs) to speech sounds. This helps to explain the hearing-in-noise difficulties often seen in the aging and hearing impaired population. Continuous, modulated, and babble noise types were presented at varying SNRs to 30 individuals divided into three groups according to age and hearing status. Significant main effects of noise type, SNR, and group were found. Interaction effects revealed that the SNR effect varies as a function of noise type and is most systematic for continuous noise. Effects of age and hearing loss were limited to CAEP latency and were differentially modulated by energetic and informational-like masking. It is clear that the spectrotemporal characteristics of signals and noises play an important role in determining the morphology of neural responses. Participant factors such as age and hearing status, also play an important role in determining the brain's response to complex auditory stimuli and contribute to the ability to listen in noise.
  2. Billings CJ, Grush LD, Maamor N
    Physiol Rep, 2017 Nov;5(20).
    PMID: 29051305 DOI: 10.14814/phy2.13464
    The effects of background noise on speech-evoked cortical auditory evoked potentials (CAEPs) can provide insight into the physiology of the auditory system. The purpose of this study was to determine background noise effects on neural coding of different phonemes within a syllable. CAEPs were recorded from 15 young normal-hearing adults in response to speech signals /s/, /ɑ/, and /sɑ/. Signals were presented at varying signal-to-noise ratios (SNRs). The effects of SNR and context (in isolation or within syllable) were analyzed for both phonemes. For all three stimuli, latencies generally decreased and amplitudes generally increased as SNR improved, and context effects were not present; however, the amplitude of the /ɑ/ response was the exception, showing no SNR effect and a significant context effect. Differential coding of /s/ and /ɑ/ likely result from level and timing differences. Neural refractoriness may result in the lack of a robust SNR effect on amplitude in the syllable context. The stable amplitude across SNRs in response to the vowel in /sɑ/ suggests the combined effects of (1) acoustic characteristics of the syllable and noise at poor SNRs and (2) refractory effects resulting from phoneme timing at good SNRs. Results provide insights into the coding of multiple-onset speech syllables in varying levels of background noise and, together with behavioral measures, may help to improve our understanding of speech-perception-in-noise difficulties.
  3. Zakaria NA, Maamor N, Abdul Wahat NH
    Int J Audiol, 2021 12;60(12):1009-1015.
    PMID: 33752568 DOI: 10.1080/14992027.2021.1896791
    OBJECTIVE: This study aimed to examine hearing-related information in public school textbooks in Malaysia to gain insight into the country's hearing health education.

    DESIGN: Qualitative content analysis on all textbooks used in Malaysian public schools in the year 2019 were conducted to identify the content and structure of information delivery through 11 years of formal education. Information related to hearing health was extracted and categorised according to the themes that emerged. Further analysis was done to characterise the usefulness of the information in promoting active hearing care based on the type of information delivered.

    STUDY SAMPLE: A total of 148 elementary and secondary school textbooks were reviewed.

    RESULTS: Fourteen textbooks (4 elementary and 10 secondary levels) were found to have relevant hearing health information covering topics of sound, ear and hearing, noise and hearing loss. The contents were mostly theoretical and lacked information about noise-induced hearing loss and proper hearing care.

    CONCLUSION: Minimal hearing health information was present in the Malaysian school curriculum. The content was inadequate for teaching students about hearing loss prevention. Areas of improvement and research are recommended to improve school-based hearing health education in Malaysia.

  4. Jean YQ, Mazlan R, Ahmad M, Maamor N
    Am J Audiol, 2018 Sep 12;27(3):260-271.
    PMID: 30007031 DOI: 10.1044/2018_AJA-17-0093
    Purpose: The aim of this study was to develop a substantive theory that explains parenting stress among mothers of deaf or hard-of-hearing (D/HH) children.

    Method: Fifteen hearing mothers of children with severe-to-profound sensorineural hearing loss were interviewed. Interviews were transcribed verbatim, and a grounded theory approach was used to inductively analyze parental stress in mothers of D/HH children. Theory generation was achieved through triangulation of data sources and systematic organization of data into codes. The coding process identified salient themes that were constantly cross-checked and compared across data to further develop categories, properties, and tentative hypotheses.

    Results: In general, two main themes emerged from the interviews: the contextual stressors and stress-reducing resources. The contextual stressors were labeled as distress over audiology-related needs, pressure to acquire new knowledge and skills, apprehension about the child's future, and demoralizing negative social attitudes. The stress-reducing resources that moderated parenting stress were identified to be the child's progress, mother's characteristics, professional support, and social support. The interaction between the identified stressors and adjustment process uncovered a central theme termed maternal coherence.

    Conclusion: The substantive theory suggests that mothers of D/HH children can effectively manage parenting stress and increase well-being by capitalizing on relevant stress-reducing resources to achieve maternal coherence.

  5. Hamzaid H, Talib RA, Azizi NH, Maamor N, Reilly JJ, Wafa SW
    Int J Pediatr Obes, 2011 Oct;6(5-6):450-4.
    PMID: 21767214 DOI: 10.3109/17477166.2011.590206
    BACKGROUND:Quality of life (QoL) is impaired in childhood obesity, but the literature on this is all from Western countries. Aim. To test for impairment of QoL in obese children in Malaysia, using parent-reported and child-reported QoL.
    METHODS:Health-related Quality of Life was measured using the Paediatric Quality of Life Inventory version 4.0. Comparison of QoL between a community sample of 90 obese children (as defined by US CDC and Cole-IOTF definitions), median age 9.5 y (interquartile range [IQR] 8.6, 10.5 y) and 90 control children of healthy weight (BMI less than the 85th centile of US reference data), median age 10.0 y (IQR 9.6, 10.5 y). Children were matched pair-wise for age, gender, and ethnic group, and controls were recruited from schools in the same area as obese participants.
    RESULTS:For child self-report, the healthy weight group had significantly higher QoL for the physical (median 82.9, IQR 65.7, 90.6), and psychosocial domains (median, 73.3, IQR 64.4, 83.3), and total QoL (median 76.1, IQR 64.1, 84.8) compared to the obese group (median 67.2, IQR 59.4, 81.3; median 62.5, IQR 53.3, 75.4; median 60.9, IQR 50.8, 73.9; all p < 0.001). There were no significant differences between the obese and healthy weight group for parent-reported physical health, psychosocial health, or total QoL.
    CONCLUSION:Obese children in Malaysia have markedly poorer QoL than their peers, but this is not evident when parent reports of QoL are used.
    Study name: Malaysian Childhood Obesity Treatment Trial (MASCOT)
    Study site: Two primary schools, Kuala Lumpur, Malaysia
  6. Quar TK, Mukari SZ, Abdul Wahab NA, Abdul Razak R, Omar M, Maamor N
    Int J Audiol, 2008 Jun;47(6):379-80.
    PMID: 18569117 DOI: 10.1080/14992020801886796
  7. Mukari SZMS, Yusof Y, Ishak WS, Maamor N, Chellapan K, Dzulkifli MA
    Braz J Otorhinolaryngol, 2018 12 10;86(2):149-156.
    PMID: 30558985 DOI: 10.1016/j.bjorl.2018.10.010
    INTRODUCTION: Hearing acuity, central auditory processing and cognition contribute to the speech recognition difficulty experienced by older adults. Therefore, quantifying the contribution of these factors on speech recognition problem is important in order to formulate a holistic and effective rehabilitation.

    OBJECTIVE: To examine the relative contributions of auditory functioning and cognition status to speech recognition in quiet and in noise.

    METHODS: We measured speech recognition in quiet and in composite noise using the Malay Hearing in noise test on 72 native Malay speakers (60-82 years) older adults with normal to mild hearing loss. Auditory function included pure tone audiogram, gaps-in-noise, and dichotic digit tests. Cognitive function was assessed using the Malay Montreal cognitive assessment.

    RESULTS: Linear regression analyses using backward elimination technique revealed that had the better ear four frequency average (0.5-4kHz) (4FA), high frequency average and Malay Montreal cognitive assessment attributed to speech perception in quiet (total r2=0.499). On the other hand, high frequency average, Malay Montreal cognitive assessment and dichotic digit tests contributed significantly to speech recognition in noise (total r2=0.307). Whereas the better ear high frequency average primarily measured the speech recognition in quiet, the speech recognition in noise was mainly measured by cognitive function.

    CONCLUSIONS: These findings highlight the fact that besides hearing sensitivity, cognition plays an important role in speech recognition ability among older adults, especially in noisy environments. Therefore, in addition to hearing aids, rehabilitation, which trains cognition, may have a role in improving speech recognition in noise ability of older adults.

  8. Yusof Y, Mukari SZS, Dzulkifli MA, Chellapan K, Ahmad K, Ishak I, et al.
    Geriatr Gerontol Int, 2019 Aug;19(8):768-773.
    PMID: 31237107 DOI: 10.1111/ggi.13710
    AIM: To evaluate the efficacy of a newly developed auditory-cognitive training system on speech recognition, central auditory processing and cognition among older adults with normal cognition (NC) and with neurocognitive impairment (NCI).

    METHODS: A double-blind quasi-experiment was carried out on NC (n = 43) and NCI (n = 33) groups. Participants in each group were randomly assigned into treatment and control programs groups. The treatment group underwent auditory-cognitive training, whereas the control group was assigned to watch documentary videos, three times per week, for 8 consecutive weeks. Study outcomes that included Montreal Cognitive Assessment, Malay Hearing in Noise Test, Dichotic Digit Test, Gaps in Noise Test and Pitch Pattern Sequence Test were measured at 4-week intervals at baseline, and weeks 4, 8 and 12.

    RESULTS: Mixed design anova showed significant training effects in total Montreal Cognitive Assessment and Dichotic Digit Test in both groups, NC (P 

  9. Mukari SZS, Umat C, Chan SC, Ali A, Maamor N, Zakaria MN
    J Audiol Otol, 2020 Jan;24(1):35-39.
    PMID: 31914504 DOI: 10.7874/jao.2019.00262
    BACKGROUND AND OBJECTIVES: The cortical auditory evoked potential (CAEP) is a useful objective test for diagnosing hearing loss and auditory disorders. Prior to its clinical applications in the pediatric population, the possible influences of fundamental variables on the CAEP should be studied. The aim of the present study was to determine the effects of age and type of stimulus on the CAEP waveforms.

    Subjects and METHODS: Thirty-five healthy Malaysian children aged 4 to 12 years participated in this repeated-measures study. The CAEP waveforms were recorded from each child using a 1 kHz tone burst and the speech syllable /ba/. Latencies and amplitudes of P1, N1, and P2 peaks were analyzed accordingly.

    RESULTS: Significant negative correlations were found between age and speech-evoked CAEP latency for each peak (p< 0.05). However, no significant correlations were found between age and tone-evoked CAEP amplitudes and latencies (p>0.05). The speech syllable /ba/ produced a higher mean P1 amplitude than the 1 kHz tone burst (p=0.001).

    CONCLUSIONS: The CAEP latencies recorded with the speech syllable became shorter with age. While both tone-burst and speech stimuli were appropriate for recording the CAEP, significantly bigger amplitudes were found in speech-evoked CAEP. The preliminary normative CAEP data provided in the present study may be beneficial for clinical and research applications in Malaysian children.

  10. Amirullah NA, Rahmat S, Dzulkarnain AAA, Maamor N, Jamaludin MKA, Che Azemin MZ
    Med J Malaysia, 2022 Jan;77(1):12-19.
    PMID: 35086989
    INTRODUCTION: Sound therapy is one of the complementary or alternative interventions for various populations. The intensity of the sounds for sound therapy needs to be properly calibrated to ensure their accuracy and effectiveness. This paper aims to provide a general guideline for calibrating sound files using free software, specifically Audacity®.

    MATERIALS AND METHODS: Six sounds (broadband noise, rain, ocean, waterfall, Quranic chapters Al-Fatihah, and Yasin recitations) were calibrated at the intensity levels of 45, 50, 55, 60, 65, 70, 75, and 80dBA. The sounds were delivered through a pair of Sennheiser HD 280 Pro headphones connected to the Sound Blaster X-Fi Surround 5.1 Pro sound card. The long-term average of the sound pressure level over the time of recording (LAseq) was recorded using the 3M SoundPro Class 1 1/3 Octave RTA sound level meter (SLM). The desired intensity levels were obtained by making adjustments to the sound files via the Audacity® software.

    RESULTS: All sound files were calibrated at the targeted levels as verified by the value of LAseq.

    CONCLUSIONS: Calibration of audio files can be done using a free/open-source software, as all six sound files were successfully calibrated at the targeted levels of 45, 50, 55, 60, 65, 70, 75, and 80dBA. The calibration steps provided in this paper can be easily applied by other researchers for similar purposes, with precautions when calibrating at low levels.

  11. Mukari SZS, Ishak WS, Maamor N, Wan Hashim WF
    Ann Otol Rhinol Laryngol, 2017 Oct;126(10):697-705.
    PMID: 28845678 DOI: 10.1177/0003489417727547
    OBJECTIVES: Studies in cognitive aging demonstrated inconsistent association between hearing and cognition in older adults. Furthermore, it is still unclear if hearing loss at high frequencies, which is the earliest to be affected, is associated with cognitive functioning. This study aimed to determine the association between global cognitive status and pure tone average (PTA) at 0.5, 1, and 2 kHz (PTA low) and PTA at 4 and 8 kHz (PTA high).

    METHODS: This study involved 307 adults aged 60 years and older. Participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively.

    RESULTS: Pure tone average (low) accounted for significant but minimal amount of variance in measure of MMSE. Multiple regression analyses were also performed on normal and impaired hearing cohorts and cohorts with younger (60-69 years) and older (≥70 years) groups. The results revealed a significant relationship between PTA (low) and MMSE only in the younger age group. In contrast, no significant relationship was found between PTA (high) and cognition in any of the cohorts.

    CONCLUSION: Pure tone average (low) is significantly but minimally related to measure of general cognitive status. Similar relationship is not observed between high-frequency hearing and cognition. Further research using a more comprehensive cognitive test battery is needed to confirm the lack of association between high-frequency hearing and cognition.

  12. Abdullah R, Maamor N, Zakaria MN, Nik Othman NA, Othman BF, Abdul Wahab NA
    PMID: 39572413 DOI: 10.1007/s00405-024-09080-3
    PURPOSE: To compare the intersubject reliability of cortical auditory evoked potential (CAEP) elicited by acoustic and electrical stimulations in pediatric cochlear implant (CI) recipients.

    METHODS: Twenty-two MED-EL CI recipients (aged 13-93 months) participated in this study. The acoustic CAEP (aCAEP) waveforms were elicited using four speech stimuli (/ba/, /m/, /g/, and /t/) presented at 65 dB SPL in a free-field condition. The electrical CAEP (eCAEP) responses were obtained by presenting electrical pulses through apical, medial, and basal electrodes. The aCAEP and eCAEP data (n = 28 ears) were analyzed using coefficient of variation (CV) and other appropriate statistics.

    RESULTS: P1, N1, and P2 peaks were observed in most of the children (92.9% response rate). The CV values were smaller for the latency metric (13.6-34.2%) relative to the amplitude metric (51.3-92.4%), and the differences were statistically significant (p 

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