Posted July 19, 2019

Dr. Odile Clavier, Ph.D., Creare, LLC

Hearing loss is one of the most common health issues among active duty Service members and Veterans, as hearing ability can become compromised from prolonged and acute noise exposure in operational environments, including in training and deployment settings. Hearing loss not only impacts quality of life, but also presents a potential problem when considering whether a Service member is fit for duty when healthy hearing ability is essential to the mission. Hearing capability among Service members is often assessed with tests that measure ranges of auditory tone thresholds, but these tools may not be precise enough to identify functional impairments to specific words and phrases that are common to the mission or operational environment. For example, a Service member may be able to hear a certain tone threshold, but may not be able to correctly hear all components of a sentence in an operational setting. 

To address this gap in hearing assessment, Dr. Clavier has worked with researchers within the Department of Defense to develop novel tools, the Military Hearing In Noise Test (MHINT), and the Military Sound in Noise Test (MilSINT) to measure more operationally specific hearing ability. Rather than using a series of tone thresholds, MHINT involves presenting common military, and operationally-relevant phrases and sentences to examine functional hearing performance. The MilSINT measures both sound detection and sound recognition in a two-step process. First, a sound is presented and the user acknowledges hearing the sound; then, if the sound is recognized, the user selects the appropriate subject category to which the sound belongs, such as noise from an aircraft or gunfire. Both tests are administered on hand-held mobile tablets that connect wirelessly to a noise attenuating audiometric headset that make it possible to perform the tests outside the clinic, even in operational environments.

At the Military Health System Research Symposium, Dr. Clavier and her colleagues showed how the MHINT was created from phrases spoken during military training exercises, and then professionally recorded and normed on active duty personnel. It was also shown that MHINT can be administered efficiently among Navy and Army personnel within operational settings.  

Dr. Clavier has also collaborated with Dr. Pinata Sessoms at the Naval Health Research Center to design two return-to-duty (RTD) hearing assessments that target speech recognition while also integrating vestibular components. These RTD tasks were designed as an additional auditory component to incorporate into current fit-for-duty assessments, such as the Computer Assisted Rehabilitation Environment (CAREN). Such an addition to the CAREN assessment will offer a more complete examination for RTD in Service members who have sustained a traumatic brain injury.

Taken together, these improvements in hearing assessments have the potential to facilitate the development of official standards for measuring functional hearing ability among Service members as it relates to the mission.

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