Abstract
Speech understanding in background noise and reverberation is difficult in children and even in adolescents. Reverberation tends to destroy the temporal-modulation characteristics of speech, especially at the syllable and word level. Speech in noise is more difficult to understand than speech in quiet, especially for the hard of hearing. To better understand this, Plomp and colleagues devised a two-factor model that, besides an attenuation factor (A) represented in the audiogram, also incorporates a central distortion factor (D), which describes the additional burden of noise on the hard of hearing. Aging appears to have a disproportionally large effect on the D factor. Hearing aids only reduce the A-factor, and this explains why they are still suboptimal for improving speech understanding in noise and reverberation. Brain regions maximally activated by speech in noise are different from those maximally activated by speech in quiet, suggesting that difficult-to-understand speech requires the mobilization of different brain areas.
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