Hearing LossNCT03604185
Effects of Short-term Choir Participation on Auditory Perception in Hearing-aided Older Adults.
A study testing Choir Singing and Music Appreciation in people with Hearing Loss and Auditory Perception, run by Toronto Metropolitan University at 1 site in Canada.
Trial summary
Hearing loss has been associated with decreased emotional wellbeing and reduced quality of life in aging adults. Although hearing aids can target aspects of peripheral hearing loss, persistent perceptual deficits are widely reported. Read more about this study
- Who is it for?
- Ages 50 years and older
- Conditions the study is for
- Hearing Loss, Auditory Perception, Music Therapy
- What is being tested?
- Choir Singing and Music Appreciation
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 81 participants
- Where
- 1 siteCanada
- Study dates
- 1 Sep 2018to 13 Mar 2020
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Older adults (50+)
- Have a hearing aid
- Hearing loss must be mild-moderate (i.e. between 25 and 60 dB HL at standard test frequencies)
- Hearing loss must be symmetrical (i.e. no more than 25 dB HL difference between ears at any standard test frequency)
Who cannot join
- Adults younger than 50
- Do not have a hearing aid
- Hearing loss exceeds mild-moderate rating (i.e. any standard test frequency measures higher than 25 - 60 dB HL)
- Hearing loss is asymmetrical (i.e. at any standard test frequency the difference between ears is larger than 25 dB HL).
Trial locations and contacts
1 site in 1 country.
About this study
Hearing loss has been associated with decreased emotional wellbeing and reduced quality of life in aging adults. Although hearing aids can target aspects of peripheral hearing loss, persistent perceptual deficits are widely reported. One prevalent example is the loss of the ability to perceive speech in a noisy environment, which severely impacts quality of life and goes relatively unremediated by hearing aids. Musicianship has been shown to improve aspects of auditory processing, but has not been studied as a short-term intervention for improving these abilities in older adults with hearing aids. The current study investigates whether short-term choir participation can improve three aspects of auditory processing: perception of speech in noise, pitch discrimination, and the neural response to brief auditory stimuli (frequency following response; FFR). Sixty hearing aided older adults (aged 50+) recruited from the Greater Toronto Area will be randomly assigned to one of three conditions: a choir singing class (n=20), a music appreciation class (n=20), and a do-nothing control group (n=20). Choir participants will take part in a singing class for 14 weeks, during which they will take part in group singing (2 hours/week) supported by individual online musical training (1 hour/week). Participants will undergo pre- and post-training assessments, conducted during the first week of the choir class and again after the last week. Participants in the music appreciation class will be involved in 14 weeks of music listening classes, and the do-nothing control group will not engaged in an active intervention. All participants will undergo the same battery of assessments, measured before and after the 14-week time frame. Auditory assessments (speech perception in noise and pitch discrimination tests) will be administered electronically, and the FFR will be obtained using electroencephalography (EEG). Each of the four assessment sessions (two pre-training, two post-training) will last approximately 1.5 hours, for a total of 6 hours of data collection. The goal of this research is to investigate whether short-term musical training will result in improved auditory outcomes for older adults with hearing aids. It is predicted that the choir singing group will demonstrate the greatest improvements across all auditory measures, and that both the choir singing and musical appreciation groups will experience greater improvements than the do-nothing control group.
Read the detailed description
The study will investigate whether choir participation and musical training can improve three aspects of auditory processing in hearing aided older adults: perception of speech in noise, pitch discrimination, and the neural response to brief auditory stimuli (frequency following response; FFR). Sixty older adults with hearing aids will be recruited from the Greater Toronto Area through flyers in Connect Hearing Clinics and Ryerson's 50+ Program Bulletin, as well as through an ad in the Toronto Star, which will provide contact information for the Science of Music, Auditory Research and Technology (SMART) Laboratory. Anyone who contacts the SMART Lab with an interest in participating will be administered a pre-screening questionnaire over the phone by a study researcher; this may also be administered by email depending on participant preference. Those who are eligible and give informed consent will be randomly assigned to one of three groups: a choir singing class (n=20), a music appreciation class (n=20), or a do-nothing control condition (n=20). Each choir participant will come into the SMART Laboratory for two pre-training assessments that will take approximately 1.5 hours each, during which time they will complete several questionnaires and assessments of auditory abilities (including pitch discrimination and speech perception in noise), and undergo an electroencephalograph (EEG) during presentation of repeated auditory stimuli (obtaining the FFR). Choir participants will then take part in weekly two-hour group choral sessions over the course of fourteen weeks, during which time they will receive pitch training and vocal direction in an open and encouraging environment. In addition to the weekly group choir sessions, participants will be offered optional individual online musical and vocal training exercises (up to one hour weekly), designed to target and improve the participants' abilities to perceive and produce small changes in pitch. After fourteen weeks of choir participation and musical training, each choir participant will return to the SMART Lab for two post-training assessments that will last approximately 1.5 hours each. During post-training data collection sessions, participants will complete different versions of the pre-training auditory assessments, and undergo a post-training EEG. Participants assigned to the music appreciation class will take part in a fourteen week course which will emphasize analytic listening to musical excerpts, which will match the choir class in terms of duration, homework demands, and instructor - both classes will be taught by the same person. The do-nothing control group will undergo the same battery of pre- and post-testing, with fourteen weeks between data collection sessions, but will not receive any active training during this time. All participants in the music appreciation class and the do-nothing control group will be offered the opportunity to take part in the choir at a later date. It is hypothesized that musical training - in particular, group singing practice - will result in improved outcomes of auditory perceptual measures in hearing-aided older adults. It is predicted that individuals who take part in 14 weeks of group choral singing will demonstrate improvements across all auditory measures, including improved pitch discrimination, enhanced ability to perceive speech in noisy environments, and higher fidelity and more consistent neural responses to brief auditory stimuli (as indexed by features of the FFR). It is predicted that participants in the music appreciation class may demonstrate auditory improvements as a result of their focus on music perception, but that these improvements will not be as significant as those of the choir participants. It is further predicted that both training groups will outperform the do-nothing control group on post-training measures.
- Conditions
- Hearing Loss, Auditory Perception, Music Therapy, Aging
- Being tested
- Choir Singing, Music Appreciation
- Keywords
- Hearing Loss, Auditory Processing, Aging, Speech Perception in Noise (SIN), Pitch Discrimination, Frequency Following Response (FFR), Choir Singing, Musical Training
- Medical subject headings
- Hearing Loss
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Choir SingingBehavioural
A weekly 2-hour group choral session over fourteen weeks. Plus an optional weekly 1-hour online musical and vocal training session.
Music AppreciationBehavioural
A fourteen week course which will emphasize analytic listening to musical excerpts, and will match the choir class in terms of duration, homework demands, and instructor.
| Study group | Role | What they receive |
|---|---|---|
| Choir Singing Group | Experimental | Choir participants will take part in weekly two-hour group choral sessions over the course of fourteen weeks, during which time they will receive pitch training and vocal direction. In addition to the weekly group choir sessions, participants will be offered optional individual online musical and vocal training exercises (up to one hour weekly). Receives: Behavioral: Choir Singing |
| Music Appreciation Group | Active comparator | Participants assigned to the music appreciation class will take part in a fourteen week course which will emphasize analytic listening to musical excerpts, which will match the choir class in terms of duration, homework demands, and instructor - both classes will be taught by the same person. Receives: Behavioral: Music Appreciation |
| Do-Nothing Control Group | No intervention | The do-nothing control group will not receive any active training. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Speech-in-noise perception: Signal-to-Noise Ratio (SNR)
Ability to track speech in a noisy environment will be assessed using the QuickSIN test (Speech-In-Noise; Etymotic Research; Killion, Niquette, Gudmundsen, Revit, \& Banerjee, 2004) and the Revised Speech Perception in Noise (R-SPIN) test (Bilger, 1984).
Measured: 14 weeks
Secondary outcomes (2)
Pitch discrimination: Frequency Difference Limens (FDL)
Participants' ability to distinguish different frequencies will be measured using a computerized assessment of frequency difference limens (FDL).
Measured: 14 weeks
Frequency Following Response (FFR)
The frequency following response (FFR) is a component of the auditory brainstem response, which represents the capacity of neurons in the auditory brainstem to track and encode changes in frequency during the solid state of a complex auditory signal (Skoe and Kraus, 2010). This is measured by obtaining an EEG during repeated presentation of brief complex auditory stimuli, and analyzing the signal for fidelity (as indexed by the FFT, a fast Fourier transform of the signal) and consistency (as indexed by the ITPC, inter-trial phase coherence).
Measured: 14 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jul 2018
- Study start1 Sep 2018
- Primary completion13 Mar 2020
- Study completion13 Mar 2020
Why it stopped: COVID-19 forced the shut down of the study
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Hearing LossStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Sixty hearing aided older adults will be randomly assigned to one of three conditions: a choir singing class (n=20), a music appreciation class (n=20), and a do-nothing control group (n=20). Choir participants will take part in a singing class for 14 weeks, during which they will take part in group singing (2 hours/week) supported by individual online musical training (1 hour/week). Participants will undergo pre- and post-training assessments, conducted during the first week of the choir class and again after the last week. The music appreciation group will consist of hearing aided older adults attending 14 weeks of music listening classes, and the do-nothing control group will not be engaged in an active intervention. All participants will undergo the same battery of assessments, measured before and after the 14-week time frame.
- Masking
- None (open label)
- Enrolment
- 81 participants (actual)
Sponsor and investigators
- Lead sponsor
- Toronto Metropolitan University
- Sponsor type
- University, hospital or other
- Collaborators
- Sonova AG, Mitacs
- Responsible party
- Principal investigator, Frank Russo, Toronto Metropolitan University
- Investigators
- Frank Russo, PhD, Principal investigator, Toronto Metropolitan UniversityElla Dubinsky, MA, Study director, Toronto Metropolitan University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03604185
- Sponsor's protocol ID
- HAC 2018-089
- Status last verified
- Apr 2025
- First submitted
- 18 Jul 2018
- Last updated
- 6 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Killion MC, Niquette PA, Gudmundsen GI, Revit LJ, Banerjee S. Development of a quick speech-in-noise test for measuring signal-to-noise ratio loss in normal-hearing and hearing-impaired listeners. J Acoust Soc Am. 2004 Oct;116(4 Pt 1):2395-405. doi: 10.1121/1.1784440.
PubMed 15532670Bilger RC. (1984b) Speech recognition test development. In: Elkins E, ed. Speech Recognition by the Hearing Impaired. ASHA Reports 14. Rockville, MD: American Speech-Language-Hearing Association.
Skoe E, Kraus N. Auditory brain stem response to complex sounds: a tutorial. Ear Hear. 2010 Jun;31(3):302-24. doi: 10.1097/AUD.0b013e3181cdb272.
PubMed 20084007
Study at a glance
From the registry record, last updated by the sponsor on 6 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Short-term Choir Participation on Auditory Perception in Hearing-aided Older Adults.
- ClinicalTrials.gov ID
- NCT03604185
- Acronym / sponsor ID
- HAC 2018-089
- Conditions
- Hearing Loss, Auditory Perception, Music Therapy, Aging
- Keywords
- Hearing Loss, Auditory Processing, Aging, Speech Perception in Noise (SIN), Pitch Discrimination, Frequency Following Response (FFR), Choir Singing, Musical Training
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: COVID-19 forced the shut down of the study
- Enrolment
- 81 participants (actual)
- Lead sponsor
- Toronto Metropolitan UniversityUniversity, hospital or other
- Collaborators
- Sonova AG, Mitacs
- Study start
- 1 Sep 2018 (actual)
- Primary completion
- 13 Mar 2020 (actual)
- Study completion
- 13 Mar 2020 (actual)
- First posted
- 27 Jul 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hearing loss has been associated with decreased emotional wellbeing and reduced quality of life in aging adults. Although hearing aids can target aspects of peripheral hearing loss, persistent perceptual deficits are widely reported. One prevalent example is the loss of the ability to perceive speech in a noisy environment, which severely impacts quality of life and goes relatively unremediated by hearing aids. Musicianship has been shown to improve aspects of auditory processing, but has not been studied as a short-term intervention for improving these abilities in older adults with hearing aids. The current study investigates whether short-term choir participation can improve three aspects of auditory processing: perception of speech in noise, pitch discrimination, and the neural response to brief auditory stimuli (frequency following response; FFR). Sixty hearing aided older adults (aged 50+) recruited from the Greater Toronto Area will be randomly assigned to one of three conditions: a choir singing class (n=20), a music appreciation class (n=20), and a do-nothing control group (n=20). Choir participants will take part in a singing class for 14 weeks, during which they will take part in group singing (2 hours/week) supported by individual online musical training (1 hour/week). Participants will undergo pre- and post-training assessments, conducted during the first week of the choir class and again after the last week. Participants in the music appreciation class will be involved in 14 weeks of music listening classes, and the do-nothing control group will not engaged in an active intervention. All participants will undergo the same battery of assessments, measured before and after the 14-week time frame. Auditory assessments (speech perception in noise and pitch discrimination tests) will be administered electronically, and the FFR will be obtained using electroencephalography (EEG). Each of the four assessment sessions (two pre-training, two post-training) will last approximately 1.5 hours, for a total of 6 hours of data collection. The goal of this research is to investigate whether short-term musical training will result in improved auditory outcomes for older adults with hearing aids. It is predicted that the choir singing group will demonstrate the greatest improvements across all auditory measures, and that both the choir singing and musical appreciation groups will experience greater improvements than the do-nothing control group.
Detailed description
The study will investigate whether choir participation and musical training can improve three aspects of auditory processing in hearing aided older adults: perception of speech in noise, pitch discrimination, and the neural response to brief auditory stimuli (frequency following response; FFR). Sixty older adults with hearing aids will be recruited from the Greater Toronto Area through flyers in Connect Hearing Clinics and Ryerson's 50+ Program Bulletin, as well as through an ad in the Toronto Star, which will provide contact information for the Science of Music, Auditory Research and Technology (SMART) Laboratory. Anyone who contacts the SMART Lab with an interest in participating will be administered a pre-screening questionnaire over the phone by a study researcher; this may also be administered by email depending on participant preference. Those who are eligible and give informed consent will be randomly assigned to one of three groups: a choir singing class (n=20), a music appreciation class (n=20), or a do-nothing control condition (n=20). Each choir participant will come into the SMART Laboratory for two pre-training assessments that will take approximately 1.5 hours each, during which time they will complete several questionnaires and assessments of auditory abilities (including pitch discrimination and speech perception in noise), and undergo an electroencephalograph (EEG) during presentation of repeated auditory stimuli (obtaining the FFR). Choir participants will then take part in weekly two-hour group choral sessions over the course of fourteen weeks, during which time they will receive pitch training and vocal direction in an open and encouraging environment. In addition to the weekly group choir sessions, participants will be offered optional individual online musical and vocal training exercises (up to one hour weekly), designed to target and improve the participants' abilities to perceive and produce small changes in pitch. After fourteen weeks of choir participation and musical training, each choir participant will return to the SMART Lab for two post-training assessments that will last approximately 1.5 hours each. During post-training data collection sessions, participants will complete different versions of the pre-training auditory assessments, and undergo a post-training EEG. Participants assigned to the music appreciation class will take part in a fourteen week course which will emphasize analytic listening to musical excerpts, which will match the choir class in terms of duration, homework demands, and instructor - both classes will be taught by the same person. The do-nothing control group will undergo the same battery of pre- and post-testing, with fourteen weeks between data collection sessions, but will not receive any active training during this time. All participants in the music appreciation class and the do-nothing control group will be offered the opportunity to take part in the choir at a later date. It is hypothesized that musical training - in particular, group singing practice - will result in improved outcomes of auditory perceptual measures in hearing-aided older adults. It is predicted that individuals who take part in 14 weeks of group choral singing will demonstrate improvements across all auditory measures, including improved pitch discrimination, enhanced ability to perceive speech in noisy environments, and higher fidelity and more consistent neural responses to brief auditory stimuli (as indexed by features of the FFR). It is predicted that participants in the music appreciation class may demonstrate auditory improvements as a result of their focus on music perception, but that these improvements will not be as significant as those of the choir participants. It is further predicted that both training groups will outperform the do-nothing control group on post-training measures.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Sixty hearing aided older adults will be randomly assigned to one of three conditions: a choir singing class (n=20), a music appreciation class (n=20), and a do-nothing control group (n=20). Choir participants will take part in a singing class for 14 weeks, during which they will take part in group singing (2 hours/week) supported by individual online musical training (1 hour/week). Participants will undergo pre- and post-training assessments, conducted during the first week of the choir class and again after the last week. The music appreciation group will consist of hearing aided older adults attending 14 weeks of music listening classes, and the do-nothing control group will not be engaged in an active intervention. All participants will undergo the same battery of assessments, measured before and after the 14-week time frame.
| Arm | Type | Receives |
|---|---|---|
| Choir Singing Group | Experimental | Behavioral: Choir SingingChoir participants will take part in weekly two-hour group choral sessions over the course of fourteen weeks, during which time they will receive pitch training and vocal direction. In addition to the weekly group choir sessions, participants will be offered optional individual online musical and vocal training exercises (up to one hour weekly). |
| Music Appreciation Group | Active comparator | Behavioral: Music AppreciationParticipants assigned to the music appreciation class will take part in a fourteen week course which will emphasize analytic listening to musical excerpts, which will match the choir class in terms of duration, homework demands, and instructor - both classes will be taught by the same person. |
| Do-Nothing Control Group | No intervention | –The do-nothing control group will not receive any active training. |
Who may qualify
- Ages
- 50 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Older adults (50+)
- Have a hearing aid
- Hearing loss must be mild-moderate (i.e. between 25 and 60 dB HL at standard test frequencies)
- Hearing loss must be symmetrical (i.e. no more than 25 dB HL difference between ears at any standard test frequency)
Key exclusion criteria (4 listed)
- Adults younger than 50
- Do not have a hearing aid
- Hearing loss exceeds mild-moderate rating (i.e. any standard test frequency measures higher than 25 - 60 dB HL)
- Hearing loss is asymmetrical (i.e. at any standard test frequency the difference between ears is larger than 25 dB HL).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Choir SingingA weekly 2-hour group choral session over fourteen weeks. Plus an optional weekly 1-hour online musical and vocal training session. | Behavioural | Choir Singing Group |
| Music AppreciationA fourteen week course which will emphasize analytic listening to musical excerpts, and will match the choir class in terms of duration, homework demands, and instructor. | Behavioural | Music Appreciation Group |
Primary outcome
Speech-in-noise perception: Signal-to-Noise Ratio (SNR)
Time frame: 14 weeks
Ability to track speech in a noisy environment will be assessed using the QuickSIN test (Speech-In-Noise; Etymotic Research; Killion, Niquette, Gudmundsen, Revit, \& Banerjee, 2004) and the Revised Speech Perception in Noise (R-SPIN) test (Bilger, 1984).
2 secondary outcomes
Pitch discrimination: Frequency Difference Limens (FDL)
Time frame: 14 weeks
Frequency Following Response (FFR)
Time frame: 14 weeks
Results and safety
The study was stopped early (reason given: COVID-19 forced the shut down of the study). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Apr 2025.
- Background: PubMed 15532670Killion MC, Niquette PA, Gudmundsen GI, Revit LJ, Banerjee S. Development of a quick speech-in-noise test for measuring signal-to-noise ratio loss in normal-hearing and hearing-impaired listeners. J Acoust Soc Am. 2004 Oct;116(4 Pt 1):2395-405. doi: 10.1121/1.1784440.
- BackgroundBilger RC. (1984b) Speech recognition test development. In: Elkins E, ed. Speech Recognition by the Hearing Impaired. ASHA Reports 14. Rockville, MD: American Speech-Language-Hearing Association.
- Background: PubMed 20084007Skoe E, Kraus N. Auditory brain stem response to complex sounds: a tutorial. Ear Hear. 2010 Jun;31(3):302-24. doi: 10.1097/AUD.0b013e3181cdb272.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Frank Russo, PhD principal investigator
Toronto Metropolitan University
Ella Dubinsky, MA study director
Toronto Metropolitan University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Choir Singing and Music Appreciation in people with Hearing Loss and Auditory Perception, run by Toronto Metropolitan University at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 6 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was stopped early (reason given: COVID-19 forced the shut down of the study). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Speech-in-noise perception: Signal-to-Noise Ratio (SNR) (time frame: 14 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03604185, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Apr 2025.