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Hearing01:31

Hearing

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When we hear a sound, our nervous system is detecting sound waves—pressure waves of mechanical energy traveling through a medium. The frequency of the wave is perceived as pitch, while the amplitude is perceived as loudness.
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Auditory Perception01:17

Auditory Perception

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The auditory system is essential for sound perception, utilizing various critical structures. When sound waves enter the outer ear, they travel through the ear canal and cause the eardrum to vibrate. These vibrations are then transmitted to the middle ear, where three tiny bones – the malleus, incus, and stapes – amplify the sound. This amplification is crucial, as it ensures that the sound vibrations are strong enough to be conveyed to the inner ear. These vibrations then reach the...
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Auditory Pathway01:15

Auditory Pathway

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Auditory pathways constitute the complex neural circuits responsible for transmitting and interpreting auditory information from the peripheral auditory system to the brain. Sound waves are initially captured by the outer ear, funneled through the ear canal, and reach the tympanic membrane (eardrum). These vibrations are transmitted via the middle ear's ossicles to the inner ear's cochlea.
When viewed cross-sectionally, the cochlea reveals the scala vestibuli and scala tympani flanking...
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Perception of Sound Waves01:01

Perception of Sound Waves

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The human ear is not equally sensitive to all frequencies in the audible range. It may perceive sound waves with the same pressure but different frequencies as having different loudness. Moreover, the perception of sound waves depends on the health of an individual's ears, which decays with age. The health of one's ears may also be affected by regular exposure to loud noises.
The pitch of a sound depends on the frequency and the pressure amplitude of the source. Two sounds of the same...
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Perceiving Loudness, Pitch, and Location01:21

Perceiving Loudness, Pitch, and Location

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The human brain perceives pitch through two primary mechanisms reflected in place theory and frequency theory. Each mechanism describes how sound waves are interpreted as specific pitches by the brain, offering insights into the intricate processes of auditory perception.
Place theory, or place coding, suggests that different pitches are heard because various sound waves activate specific locations along the cochlea's basilar membrane. The brain determines the pitch of a sound by...
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Anatomy of the Ear01:16

Anatomy of the Ear

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Auditory sensation, commonly called hearing, involves the transformation of sonic waves into neural impulses facilitated by the structures of the auditory organ. The prominent, flesh-like structure on the side of the head, called the auricle, directs sound waves towards the auditory canal. The auricle is often mislabeled as the pinna, a term more aligned with mobile structures like a feline's external ear. The auditory canal penetrates the cranium via the external auditory meatus of the...
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Related Experiment Video

Updated: Dec 31, 2025

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses

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Can Differences in Early Hearing Development Be Distinguished by the LittlEARs Auditory Questionnaire?

Hillary Ganek1,2, Adrian James3,4, Vicky Papaioannou4,5

  • 1Archie's Cochlear Implant Laboratory, The Hospital for Sick Children, Toronto, Ontario, Canada.

Ear and Hearing
|January 11, 2020
PubMed
Summary
This summary is machine-generated.

The LittlEARs Auditory Questionnaire (LEAQ) effectively tracks early auditory development in children using cochlear implants (CIs) or hearing aids (HAs). It helps identify developmental progress and informs early treatment decisions for hearing loss.

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Area of Science:

  • Pediatric Audiology
  • Developmental Pediatrics
  • Hearing Technology Research

Background:

  • The LittlEARs Auditory Questionnaire (LEAQ) is a caregiver-reported measure of auditory development.
  • Previous studies show LEAQ is sensitive to impaired auditory development.
  • LEAQ has not been used to compare auditory development across different hearing technologies (cochlear implants [CIs] vs. hearing aids [HAs]) or hearing loss types (Auditory Neuropathy Spectrum Disorder [ANSD]).

Purpose of the Study:

  • To determine if the LEAQ can differentiate early auditory development in children with bilateral CIs, bilateral HAs, or ANSD.
  • To assess the LEAQ's utility in monitoring auditory progress in young children with varying hearing loss and assistive devices.

Main Methods:

  • Retrospective longitudinal LEAQ data were collected from 43 children with HAs, 43 with CIs, and 18 with ANSD (all using hearing technology).
  • Linear mixed-effects analysis examined the influence of age, hearing type (HA, CI, ANSD), and comorbidities on LEAQ scores.
  • Secondary analyses included device audibility (Speech Intelligibility Index/Articulation Index) and consistency of device use.

Main Results:

  • Children with CIs showed faster LEAQ progression than those with HAs or ANSD.
  • However, hearing technology type did not significantly influence LEAQ improvement rate when device use consistency and audibility were considered.
  • Children with developmental delays exhibited significantly slower LEAQ score improvement across all groups.

Conclusions:

  • The LEAQ is a valuable tool for monitoring the initial auditory development of very young children.
  • LEAQ results can inform early treatment decisions for children with hearing loss and those using hearing assistive devices.