Breaking Down Listening Barriers for Students with Hearing Difficulties

A special issue of Audiology Research (ISSN 2039-4349).

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 4971

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Department of Otorhinolaryngology and Cervico-Facial Surgery, Madonna delle Grazie Hospital, 75100 Matera, Italy
Interests: tumors; neurotology; ear; otology; human balance; hearing
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Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
Interests: audiology; dizziness; ear; hearing loss and vertigo
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
NPO Associazione Italiana Liberi di Sentire, Varese, Italy
Interests: auditory electrophysiology; surgery of the ear; cochlear implants; hearing aids

Special Issue Information

Dear Colleagues,

Hearing problems can affect academic performance among adolescents and college students. If not addressed comprehensively and promptly, hearing loss and other barriers to listening in classrooms can slow academic progress, increase the risk of dropping out of school, and reduce the likelihood of students applying for higher education.

These are some aspects that have been addressed within the A.BA.CO project (Abbattimento delle BArriere COmunicative; breaking down communication barriers), conceived and coordinated by the Audiology Department at the Burlo Garofolo Institute of Trieste, Italy, with support and funding from the Friuli Venezia Giulia Region in Italy and the Disability Office of the Italian Presidency of the Council of Ministers. The working group included the Otolaryngology department of University of Perugia, the F.I.A.D.D.A. Umbria Onlus (Association for the rights of deaf people and families of the Umbria region, Italy) and the National Deaf Organization of Friuli Venezia Giulia, Italy.

The A.BA.CO. project was developed based on the belief that it was essential to guarantee accessibility to public services for all hearing-impaired people, but also, above all, that it was critical to promote and support the communicative autonomy of students and individuals with hearing impairments. This objective could be achieved through the implementation of technological adaptations together with actions that guaranteed complete access to communication and information at school, respecting the choices, hearing needs, and characteristics of each individual from a "universal design for hearing" perspective.

This Special Issue will include strategic analyses, reviews, and proposals for the implementation of the good practices and technological solutions that were conceived and designed within the A.BA.CO project, but we also welcome other contributions on this topic.

Dr. Giacinto Asprella Libonati
Dr. Giuseppe Chiarella
Prof. Dr. Sandro Burdo
Guest Editors

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Keywords

  • hearing loss
  • listening barriers
  • classroom acoustics
  • hearing aids
  • cochlear implants
  • lipreading
  • subtitles

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Published Papers (7 papers)

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Research

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12 pages, 493 KB  
Article
Teachers’ Voice-Related Quality of Life in Relation to Environmental Noise in Schools: A Multidimensional Study Using VHI Test and Listen Responsibly App
by Jessica Frangipane, Pasquale Viola, Roberto Minici, Alfonso Scarpa, Alessia Astorina, Teodoro Aragona, Emilio Avallone, Federico Maria Gioacchini, Pietro De Luca, Giampietro Ricci, Valeria Gambacorta, Eva Orzan and Giuseppe Chiarella
Audiol. Res. 2025, 15(5), 138; https://doi.org/10.3390/audiolres15050138 - 13 Oct 2025
Viewed by 255
Abstract
Background/Objectives: The voice is often perceived as a natural and spontaneous means of communication, but it involves complex interactions among physiological, psychological, and environmental factors. For teachers, whose profession relies heavily on vocal use, understanding and managing vocal strain is crucial. This [...] Read more.
Background/Objectives: The voice is often perceived as a natural and spontaneous means of communication, but it involves complex interactions among physiological, psychological, and environmental factors. For teachers, whose profession relies heavily on vocal use, understanding and managing vocal strain is crucial. This study investigates the correlation between ambient noise levels in classrooms and teachers’ self-assessed voice-related quality of life, as measured by the Voice Handicap Index (VHI). The focus is on how classroom acoustics affect vocal health, considering the high incidence of vocal fatigue among educators. Methods: A pilot exploratory study was conducted from September 2022 to November 2022 involving four primary school teachers (two language and two science) from an Italian primary school. Classroom noise levels were recorded using the “Listen Responsibly” app at intervals during lessons. Following each lesson, teachers completed the VHI questionnaire to evaluate their voice-related quality of life. Statistical analyses included simple and multiple linear regressions, logistic regression, and Spearman’s correlation to assess the relationships between noise levels and VHI scores. Results: The study yielded 60 observations categorized into VHI Grade 1 (0–30) and Grade 2 (31–60). Significant differences were observed in average noise levels between these groups, with Grade 2 exhibiting higher noise levels (p < 0.0001). Simple and multiple linear regression analyses confirmed a positive correlation between average recorded noise and VHI scores, with each unit increase in noise associated with a 0.72 unit increase in VHI score (p < 0.0001). Logistic regression identified average recorded noise > 59.5 dB as a significant predictor of higher VHI grades (p < 0.0001). Spearman’s correlation confirmed a strong positive correlation (ρ = 0.77, p < 0.01). Conclusions: The study demonstrates a significant relationship between increased classroom noise levels and worse voice-related quality of life among teachers. These findings highlight the need for improved acoustic management in schools to reduce vocal strain. Implementing noise reduction strategies and enhancing classroom acoustics can help mitigate vocal health issues among educators, ultimately improving their professional and personal well-being. Full article
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15 pages, 2966 KB  
Article
Time Delay and Frequency Analysis of Remote Microphones
by Elena Andreatta, Igor Caregnato, Antonio Selmo, Andrea Gulli, Marius George Onofrei and Eva Orzan
Audiol. Res. 2025, 15(5), 123; https://doi.org/10.3390/audiolres15050123 - 25 Sep 2025
Viewed by 310
Abstract
Background/Objectives: A.BA.CO. is a speech-to-text captioning system developed for school classrooms. The system uses remote microphones to capture the teacher’s speech without background noise. Under this setup, an issue of signal latency arises for students wearing hearing aids (HAs) or cochlear implants (CIs), [...] Read more.
Background/Objectives: A.BA.CO. is a speech-to-text captioning system developed for school classrooms. The system uses remote microphones to capture the teacher’s speech without background noise. Under this setup, an issue of signal latency arises for students wearing hearing aids (HAs) or cochlear implants (CIs), whose latency is different from that of the remote microphones and may require the development of a temporal coupling solution. This study establishes the foundation for such a solution by determining the latency of two RMs (Remote Microphones) compatible with both HA and CI systems. The frequency response of the systems is analyzed independently and combined. Methods: The RMs combined with two Behind-The-Ear HAs, for which transparency was verified, were tested with two different compression ratios in a laboratory specializing in electroacoustic measurements using the comparison method to assess performance. Results: The time measurements revealed that the RMs differ by 10–12 ms (23–24 ms and 33–35 ms) and that the two HAs have time delays that differ by 1–2 ms (6–7 ms and 5–7 ms). The frequency responses showed that when HA and RM have similar gains, they exhibit comb-filter distortions. This effect could alter the acoustic output of devices in the ear canal and vary according to the mix ratio and mutual positions of HA and RM, potentially necessitating greater commitment from the wearer. Conclusions: The communication system will have to foresee different delays based on the model and brand of RM because similar transmission systems do not have the same time delays. RMs were originally designed for HA and are most effective if they represent the only or major acoustic stimulation that reaches the eardrum. These limits must be considered when estimating the effectiveness of A.BA.CO. with RM. Full article
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15 pages, 272 KB  
Article
Speech-to-Text Captioning and Subtitling in Schools: The Results of a SWOT Analysis
by Ambra Fastelli, Giulia Clignon, Daniele Corasaniti and Eva Orzan
Audiol. Res. 2025, 15(4), 105; https://doi.org/10.3390/audiolres15040105 - 12 Aug 2025
Viewed by 768
Abstract
Background/Objectives: Poor classroom acoustics and inadequate digital environments in educational settings can pose an additional barrier for students, especially those with special needs, such as students with hearing difficulties. These challenges can hinder communication, academic achievement, and social inclusion. Speech-to-text captioning systems offer [...] Read more.
Background/Objectives: Poor classroom acoustics and inadequate digital environments in educational settings can pose an additional barrier for students, especially those with special needs, such as students with hearing difficulties. These challenges can hinder communication, academic achievement, and social inclusion. Speech-to-text captioning systems offer a promising assistive tool to support education. This study aimed to evaluate the strengths and limitations of implementing such systems in schools through a structured strategic analysis. Methods: The analysis method consisted of two phases. A SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis was performed on data from a survey compiled by an interdisciplinary team. A subsequent TOWS analysis was used to develop strategic recommendations by cross-referencing internal and external factors. Results: The analysis highlighted key strengths, including improved communication, support for inclusive practices, and adaptability to diverse learning needs. Identified weaknesses included cognitive load, synchronization delays, and variability in student profiles. Opportunities included educational innovation, access to funding programs, and interdisciplinary collaboration. Threats included inadequate classroom technology, poor acoustics, and the risks of social stigma. The analysis yielded 17 recommendations to improve the usability and customization of the tool. Conclusions: Speech-to-text captioning systems have significant potential to promote accessibility and inclusion in education. This strategic analysis provides a structured, interdisciplinary approach to strategic planning and the successful implementation of assistive technology in schools. By combining multidisciplinary expertise with structured evaluation, it identified key design, training, and policy priorities. This approach offers a replicable model for user-centered planning and the development of assistive tools and can inform wider efforts to reduce communication barriers in inclusive education. Full article
18 pages, 4559 KB  
Article
Evaluating Auditory Localization Capabilities in Young Patients with Single-Side Deafness
by Alessandro Aruffo, Giovanni Nicoli, Marta Fantoni, Raffaella Marchi, Edoardo Carini and Eva Orzan
Audiol. Res. 2025, 15(4), 85; https://doi.org/10.3390/audiolres15040085 - 9 Jul 2025
Viewed by 615
Abstract
Background/Objectives: Unilateral hearing loss (UHL), particularly single-sided deafness (SSD), disrupts spatial hearing in children, leading to academic and social challenges. This study aimed to (1) compare azimuthal sound-localization accuracy and compensatory strategies between children with single-sided deafness (SSD) and their normal-hearing (NH) peers [...] Read more.
Background/Objectives: Unilateral hearing loss (UHL), particularly single-sided deafness (SSD), disrupts spatial hearing in children, leading to academic and social challenges. This study aimed to (1) compare azimuthal sound-localization accuracy and compensatory strategies between children with single-sided deafness (SSD) and their normal-hearing (NH) peers within a virtual reality environment, and (2) investigate sound-localization performance across various azimuths by contrasting left-SSD (L-SSD) and right-SSD (R-SSD) groups. Methods: A cohort of 44 participants (20 NH, 24 SSD) performed sound localization tasks in a 3D virtual environment. Unsigned azimuth error (UAE), unsigned elevation error (UEE), and head movement distance were analyzed across six azimuthal angles (−75° to 75°) at 0°elevation. Non-parametric statistics (Mann–Whitney U tests, Holm–Bonferroni correction) compared performance between NH and SSD groups and within SSD subgroups (L-SSD vs. R-SSD). Results: The SSD group exhibited significantly higher UAE (mean: 22.4° vs. 3.69°, p < 0.0001), UEE (mean: 5.95° vs. 3.77°, p < 0.0001) and head movement distance (mean: 0.35° vs. 0.12°, p < 0.0001) compared with NH peers, indicating persistent localization deficits and compensatory effort. Within the SSD group, elevation performance was superior to azimuthal accuracy (mean UEE: 3.77° vs. mean UAE: 22.4°). Participants with R-SSD exhibited greater azimuthal errors at rightward angles (45°and 75°) and at −15°, as well as increased elevation errors at 75°. Hemifield-specific advantages were strongest at extreme lateral angles (75°). Conclusions: Children with SSD rely on insufficient compensatory head movements to resolve monaural spatial ambiguity in order to localize sounds. Localization deficits and the effort associated with localization task call for action in addressing these issues in dynamic environments such as the classroom. L-SSD subjects outperformed R-SSD peers, highlighting hemispheric specialization in spatial hearing and the need to study its neural basis to develop targeted rehabilitation and classroom support. The hemifield advantages described in this study call for further data collection and research on the topic. Full article
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11 pages, 230 KB  
Article
Hearing and Listening Difficulties in High Schools and Universities: The Results of an Exploratory Survey of a Large Number of Students and Teachers in the Friuli-Venezia Giulia and Umbria Regions, Italy
by Valeria Gambacorta, Davide Stivalini, Niccolò Granieri, Raffaella Marchi, Alessia Fabbri, Pasquale Viola, Alessia Astorina, Ambra Fastelli, Giampietro Ricci and Eva Orzan
Audiol. Res. 2025, 15(3), 66; https://doi.org/10.3390/audiolres15030066 - 6 Jun 2025
Viewed by 855
Abstract
Background/Objectives: with the aim of describing how students and their teachers perceive and define their hearing and auditory experience in the classroom, we present the results of a questionnaire that examined the listening challenges faced by students and teachers at the University of [...] Read more.
Background/Objectives: with the aim of describing how students and their teachers perceive and define their hearing and auditory experience in the classroom, we present the results of a questionnaire that examined the listening challenges faced by students and teachers at the University of Perugia and in four secondary schools in Friuli-Venezia Giulia, Italy. Methods: A survey was developed as part of the A.Ba.Co. project (Overcoming Communication Barriers). Closed or open-ended questions were used to analyze the responses of students and teachers regarding diagnosed or only perceived hearing difficulties in daily life and the quality of listening in school classes. Results: Hearing difficulties, either clinically diagnosed or only perceived, were reported by 8–9% of students. Between teachers, the reported hearing difficulties were 27.1% in high school and 12% at university (p < 0.001). The most frequent reason for less-than-optimal ease of listening in class differed between the two educational levels; 45.8% of high school students blamed it on the noise in the room compared to 18.2% of university students (p < 0.001). Inversely, 40.9% of university students connected listening difficulty with their place in class compared to 9.5% (101/1065) of high school students (p < 0.001). Conclusions: Although the minimum acoustic requirements for educational facilities have been established by the UNI 11532-2 standard, it is speculated that the majority of high school and university classrooms in Italy do not meet optimal listening conditions. Furthermore, the reasons for students’ poor listening quality appear to not be fully understood, neither by students nor by teachers. In addition to the need for greater attention to physical learning spaces (advocating the universal design principles), effective change will also need to involve a greater awareness of what the barriers to listening are and how much they influence both teaching and learning quality and effectiveness. Full article

Review

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18 pages, 697 KB  
Review
Lip-Reading: Advances and Unresolved Questions in a Key Communication Skill
by Martina Battista, Francesca Collesei, Eva Orzan, Marta Fantoni and Davide Bottari
Audiol. Res. 2025, 15(4), 89; https://doi.org/10.3390/audiolres15040089 - 21 Jul 2025
Viewed by 1201
Abstract
Lip-reading, i.e., the ability to recognize speech using only visual cues, plays a fundamental role in audio-visual speech processing, intelligibility, and comprehension. This capacity is integral to language development and functioning; it emerges in early development, and it slowly evolves. By linking psycholinguistics, [...] Read more.
Lip-reading, i.e., the ability to recognize speech using only visual cues, plays a fundamental role in audio-visual speech processing, intelligibility, and comprehension. This capacity is integral to language development and functioning; it emerges in early development, and it slowly evolves. By linking psycholinguistics, psychophysics, and neurophysiology, the present narrative review explores the development and significance of lip-reading across different stages of life, highlighting its role in human communication in both typical and atypical development, e.g., in the presence of hearing or language impairments. We examined how relying on lip-reading becomes crucial when communication occurs in noisy environments and, on the contrary, the impacts that visual barriers can have on speech perception. Finally, this review highlights individual differences and the role of cultural and social contexts for a better understanding of the visual counterpart of speech. Full article
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Other

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12 pages, 205 KB  
Project Report
The A.BA.CO. Project and Efforts to Optimize Access to the Sounds of Learning
by Eva Orzan, Valeria Gambacorta and Giampietro Ricci
Audiol. Res. 2025, 15(4), 92; https://doi.org/10.3390/audiolres15040092 - 25 Jul 2025
Viewed by 406
Abstract
Background/Objectives: Despite its significant impact on learning, classroom acoustics and students’ hearing difficulties are often overlooked compared with more visible issues like lighting. Hearing loss—frequently underestimated and invisible—affects both students and teachers, potentially leading to fatigue, reduced participation, and academic challenges. The [...] Read more.
Background/Objectives: Despite its significant impact on learning, classroom acoustics and students’ hearing difficulties are often overlooked compared with more visible issues like lighting. Hearing loss—frequently underestimated and invisible—affects both students and teachers, potentially leading to fatigue, reduced participation, and academic challenges. The A.BA.CO. project in Italy was developed to address these issues by promoting improved classroom design, technological solutions, and better auditory communication accessibility in schools. Objective: This article presents the A.BA.CO. project, offering context and an overview of the preliminary analyses conducted by its multidisciplinary team. The goal is to share insights and propose organizational frameworks, technical solutions, and best practices concerning the hearing, communication, and auditory learning challenges experienced by students with hearing impairments. Results: The A.BA.CO. team’s analyses identified key barriers to inclusion for students with (or without) hearing impairments, such as poor classroom acoustics, excessive noise, and suboptimal seating arrangements. The project underscores the importance of improved acoustic environments and the integration of assistive technologies, including speech-to-text systems. The findings highlight the need for interdisciplinary collaboration to design accessible and inclusive educational settings for all learners. Conclusions: Embedding educational audiology within school systems—alongside enhancements in classroom acoustics and the use of assistive technologies and other technological solutions—is essential to ensure that all students, regardless of hearing ability, have equitable access to learning and full participation in educational life. Full article
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