Acceptable Noise Level Test Research Articles

The Effect of Root-Mean-Square and Loudness-Based Calibration Approach on the Acceptable Noise Level

environment contains many background noises in everyday conversations, it is necessary to evaluate the noise tolerance. The Acceptable Noise Level (ANL) provides an approach to quantifying the maximum amount of background noise a listener is willing to put up with while listening to a target story without becoming tense. Exploring noise tolerance in speech perception, the study investigates how different calibration methods impact normal hearing participants’ monotic and dichotic ANL results. Methods: This investigation utilizes a pared-sample t-test for statistical analysis, adopting a comparative observational approach. This study applied the Persian version of the typical ANL test. Two approaches have equalized the target and background stimuli: Root Mean Squared (RMS) and loudness match calibration via Adobe Audition. Using these modified materials the Most Comfortable Level (MCL), the Background Noise Level (BNL), and ANL were compared in terms of RMS and loudness match calibration. Fifty normal persons aged (18–39), under the conditions of monotic and dichotic listening, participated in this study. Results: The statistical analysis using a paired-sample t-test revealed no significant differences in the outcomes of the ANL test between the calibrations of RMS and loudness matching under both monotic and dichotic listening conditions (p=0.31 and p=0.67, respectively). Conclusion: The study suggests that calibration procedures, namely RMS and Loudness matching, do not affect ANL in either monotic or dichotic conditions. Keywords: Loudness; calibration; acceptable noise level; root mean square

Prediction of Hearing Aid Use Success in Adults with Sensorineural Hearing Loss Using Acceptable Noise Level Test and Self-Assessment Questionnaire

Prediction of Hearing Aid Use Success in Adults with Sensorineural Hearing Loss Using Acceptable Noise Level Test and Self-Assessment Questionnaire

Acceptable Noise Level in Children with Unilateral Cochlear Implant and Bimodal Hearing

Background and Aim: Difficulty in perception of speech in noise is one of the main complaints of hearing-impaired people. Due to profound hearing loss in cochlear implant (CI) users, they need higher signal-to-noise ratio for a better perception. Bimodal fitting is a preferred way for CI users because it prevents auditory nerve degeneration, is a complement of frequency range at the opposite ear, an is less invasive to provide binaural hearing. Acceptable noise level (ANL), as a reliable test to assess noise tolerance, has not yet been used in comparing children with bimodal hearing and CI. This study aimed to determine whether bimodal fitting can help CI children tolerate more noise.
 Methods: This descriptive-analytical study was conducted on 13 children with unilateral CI and bimodal hearing. Audiometry test was performed at aided and non-aided conditions. Then, their noise tolerance was assessed by the Persian version of ANL test.
 Results: Bimodal hearing resulted in statistically significant increase in ANL. The mean of ANL at unilateral CI and bimodal hearing conditions were 6.15±2.90 and 4.77±1.70, respectively.
 Conclusion: Bimodal fitting lead to more noise tolerance in unilateral CI children due to the combination of binaural summation and binaural release from masking.
 Keywords: Acceptable noise level; cochlear implant; hearing aid; bimodal hearing; profound hearing loss; binaural hearing

Long-Term Effect of Caffeine Intake on Speech and Sound Perception in People with Normal Hearing

Background and Aim: Caffeine intake enhances concentration through affecting brain functions. It also improves attention to the signal which is believed to be associated with increased noise tolerance and improved speech perception. This study aimed to evaluate the long-term effects of caffeine intake on simultaneous speech and sound perception in people with normal hearing.
 Methods: This double-blind study was conducted on 90 people aged 18-34 years (45 males and 45 females), randomly assigned to two intervention groups (receiving 3 and 5 mg/kg caffeine) and a control group (receiving placebo). The acceptable noise level (ANL) test was conducted before and five hours after intervention.
 Results: Comparison of ANL scores before and after intervention showed a significant difference in the 3 mg/kg caffeine group (p=0.002), but not in the placebo (p=0.497) and 5 mg/kg caffeine (p=0.146) groups. Between-group analysis showed a significant difference between the placebo and 3 mg/kg caffeine groups in the ANL five hours after (p=0.005), while the difference was not significant between the placebo and the 5 mg/kg caffeine groups (p=0.139). Moreover, there was no significant difference in the ANL between the 3 and 5 mg/ kg caffeine groups (p=0.148).
 Conclusion: Caffeine intake affects noise tolerance, depending on the dose of caffeine. The ANL and speech tolerance improve five hours after consuming 3 mg/kg of caffeine.
 Keywords: Caffeine; noise perception; normal hearing; acceptable noise level test

Acceptable Noise Level in Unilateral Ménière’s Disease

Background and Aim: Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere’s disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears. Methods: This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32–60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated. Results: The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of 250, 500, and 1000 Hz. Conclusion: MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise.

The effects of noise exposure and work-related fatigue on the acceptable noise level test in normal-hearing people

Background and Aim: The acceptable noise level (ANL) assesses the noise that a person can tolerate during a running speech. Although it is a strong test, it has not yet become popular in clinical practice. One of the reasons is its contradictory results. Since it is a psychoacoustic test, psychological factors can affect its output. Investigation of these factors can provide more accurate results. This study aims to investigate the effects of noise and work-related fatigue on the ANL in normal-hearing people. Methods: Participants were the male workers in the administration (n = 26) and production (n = 26) departments of an automotive manufacturing industry in Iran. They were evaluated before and after leaving the workplace in order to determine the effects of noise exposure, fatigue as well as their simultaneous effects on the ANL. Results: In both groups, the ANL showed a significant increase after work compared to its level before work, and the background noise level (BNL) was significantly decreased. There was no significant difference in the BNL between administration and production groups before work. The most comfortable level (MCL) showed no significant increase. Moreover, the MCL changes were not significantly different in the production group compared to administration group, but the BNL and ANL changes were significantly higher. Conclusion: Noise exposure and work-related fatigue affect the ANL. During the ANL test, earlier exposure to noise and the amount of fatigue should be controlled. Keywords: Exposure to noise; fatigue; acceptable noise level

Predicting Hearing Aid Satisfaction in Adults: A Systematic Review of Speech-in-noise Tests and Other Behavioral Measures.

Adults with hearing loss report a wide range of hearing aid satisfaction that does not significantly correlate to degree of hearing loss. It is not clear which auditory behavioral factors do contribute to hearing aid satisfaction. While poor speech understanding in noise is known to contribute to dissatisfaction, there are many categories of this type of assessment. The purpose of this systematic review is to answer the question, "Are behavioral pre-fitting measures using speech and nonspeech materials related to hearing aid satisfaction among adults?" Six electronic databases were searched to find peer-reviewed studies published before June 2020. The included studies reported on the relationship between auditory behavioral measures and hearing aid satisfaction alone or globally with other outcome domains among adults with hearing loss. Six types of behavioral prefitting measures were evaluated: speech recognition in quiet (% correct), speech recognition in noise (% correct), reception thresholds for speech-in-noise, speech-based subjective ratings, dichotic speech tests, and tests using nonspeech material. Each relevant study was independently reviewed by two reviewers. Methodological quality was evaluated in each included study using the American Speech-Language-Hearing Association's level of evidence ratings. There were 1342 articles identified in the systematic review process. After duplicates were removed and specific inclusion criteria were applied, 21 studies were included. All studies included had a 0 to 4 methodological quality rating indicating weak to moderate internal validity. The tests that showed potential for clinical application due to significant correlations with satisfaction were the QuickSIN, the synthetic sentence identification, the hearing in noise test, and the acceptable noise level test. Audibility, as measured by degree of hearing loss, was not significantly correlated to hearing aid satisfaction in the 13 studies that reported on this measure. Based on this review, results indicated that speech-in-noise tests had the highest associations to hearing aid satisfaction, suggesting a greater role for assessment of speech-in-noise perception in auditory rehabilitation. This is an important finding for clinical practice, given that audibility was not a significant factor in predicting satisfaction. Overall, the results from this review show a need for well-designed, high-quality, prospective studies assessing the predictive value of prefitting measures on hearing aid satisfaction with current hearing aid models.

Relationship Between Auditory and Visual Noise Acceptance in Normal-Hearing Listeners.

Research has shown that hearing aid acceptance is closely related to how well an individual tolerates background noise, regardless of improved speech understanding in background noise. The acceptable noise level (ANL) test was developed to quantify background noise acceptance. The ANL test measures a listener's willingness to listen to speech in noise rather than their ability to understand speech in noise, and is clinically valuable as a predictor of hearing aid success. Noise acceptance is thought to be mediated by central regions of the nervous system, but the underlying mechanism of noise acceptance is not well understood. Higher order central efferent mechanisms may be weaker and/or central afferent mechanisms are more active in listeners with large versus small ANLs. Noise acceptance, therefore, may not be limited to the auditory modality but observable across modalities. We designed a visual-ANL test, as a parallel of the auditory-ANL test, to examine the relations between auditory and visual noise acceptance. A correlational design. Thirty-seven adults between the ages of 21 and 30 years with normal hearing participated in this study. All participants completed the standard auditory-ANL task, the visual-ANL task developed for this study, reception thresholds for sentences using the hearing in noise test, and visual sentence recognition in noise using the text reception threshold test. Correlational analyses were performed to evaluate the relations between and among the ANL and perception tasks. Auditory- and Visual-ANLs were correlated; those who accepted more auditory noise were also those who accepted more visual noise. Auditory and visual perceptual measures were also correlated, demonstrating that both measures reflect common processes underlying the ability to recognize speech in noise. Finally, as expected, noise acceptance levels were unrelated to perception in noise across modalities. The results of this study support our hypothesis that noise acceptance may not be unique to the auditory modality, specifically, that the common variance shared between the two ANL tasks, may reflect a shared general perceptual or cognitive mechanism that is not specific to the auditory or visual domains. These findings also support that noise acceptance and speech recognition reflect different aspects of auditory and visual perception. Future work will relate these ANL measures with central tasks of inhibition and include hearing-impaired individuals to explore the mechanisms underlying noise acceptance.

Acceptable noise levels in Arabic-Persian bilinguals

Background and Aim: Acceptable noise level (ANL) test is a reliable measure of people’s abi­lity to tolerate background noise. Central ner­vous system is one of the determinant factors in subject’s tolerance of noise. Bilinguals’ diffe­rent central activity pattern may yield different ANL test results from monolinguals. This study aims to compare noise tolerance function in Arabic-Persian bilinguals with Persian monolin­guals via Persian version of ANL. Methods: In the present study, the Persian ver­sion of ANL was administered on 115 cases with normal hearing (56 male, 59 female) aged 18–37 years in three groups of the Persian mon­olingual, sequential Arabic-Persian bilinguals, and simultaneous Arabic-Persian bilinguals. Results: The statistical analysis revealed sig­nificant difference in most comfortable level (p = 0.002) and background noise level (p = 0.011) among three groups, i.e. between Persian monolinguals and sequential Arabic-Persian bil­inguals and between Persian monolinguals and simultaneous Arabic-Persian bilinguals. In other words, mean scores of bilingual were higher than monolingual scores. There was no signifi­cant difference among three groups with regard to ANL scores (p = 0.114). * Corresponding author: Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Piche-Shemiran, Enghelab Ave., Tehran, 1148965141, Iran. Tel: 009821-77530636, E-mail: ageshani@tums.ac.ir Conclusion: Despite the difference between Persian monolinguals and Arabic-Persian bilin­guals in most comfortable level and background noise level, there is no significance difference in ANL results. Therefore, auditory central proce­ssing acts similarly in normal hearing monolin­gual and bilingual subjects. As a result, Persian version of ANL can be used for Arabic-Persian bilinguals, too.

Effects of short-term caffeine consumption on speech and sound reception in individuals with normal hearing

Background and Aim: Caffeine consumes targeted attention to the signal, which is expected to lead to increased noise tolerance and ultimately improved speech perception. In the current study, the effect of short-term caffeine consumption on speech and noise simultaneous reception function was evaluated using acceptable noise level (ANL) test.Methods: In this interventional double-blind study, 90 cases (45 male, 45 female) aged 18−34 years were randomly assigned into three groups: the test groups, 3 and 5 mg/kg caffeine, and the control group, just placebo. The ANL test was recorded before and one hour after intervention. The results were compared before and after taking caffeine in three groups.Results: The statistical analysis revealed that there was significant difference in ANL result in dose 3 mg/kg caffeine before and one hour after intervention (p=0.043) and there was a significant difference in ANL result in dose 5 mg/kg caffeine before and one hour after intervention (p=0.001). Also, there was a significant difference in ANL before and one hour after taking caffeine between the group receiving 3 mg/kg dose of caffeine and the 5 mg/kg dose of caffeine (p=0.015).Conclusion: According to the findings of the study, after an hour of caffeine consumption, the ANL decreases. In other words, the individuals tolerate higher levels of speech noise. This is also dependent on the dose of caffeine.

Effects of a transient noise reduction algorithm on speech intelligibility in noise, noise tolerance and perceived annoyance in cochlear implant users

Objective: To evaluate the validity and efficacy of a transient noise reduction algorithm (TNR) in cochlear implant processing and the interaction of TNR with a continuous noise reduction algorithm (CNR). Design: We studied the effects of TNR and CNR on the perception of realistic sound samples with transients, using subjective ratings of annoyance, a speech-in-noise test and a noise tolerance test. Study sample: Participants were 16 experienced cochlear implant recipients wearing an Advanced Bionics Naida Q70 processor. Results: CI users rated sounds with transients as moderately annoying. Annoyance was slightly, but significantly reduced by TNR. Transients caused a large decrease in speech intelligibility in noise and a moderate decrease in noise tolerance, measured on the Acceptable Noise Level test. The TNR had no significant effect on noise tolerance or on speech intelligibility in noise. The combined application of TNR and CNR did not result in interactions. Conclusions: The TNR algorithm was effective in reducing annoyance from transient sounds, but was not able to prevent a decreasing effect of transients on speech understanding in noise and noise tolerance. TNR did not reduce the beneficial effect of CNR on speech intelligibility in noise, but no cumulated improvement was found either.

Comparison of Acceptable Noise Levels Using Korean and Non-Semantic Speech Signals in Normal Hearing Subjects

Background and Objectives The acceptable noise level (ANL) test measures the maximum noise level that a subject can tolerate while following speech. Given the limited investigation of ANL across different languages, this study aimed to compare ANLs using both Korean semantic speech and non-semantic speech signals (reversed Korean speech and international speech test signal, ISTS) in normal-hearing subjects. Subjects and Method Twenty-five subjects with normal hearing (9 males, 16 females, with the mean age of 28.5±3.15 years) were included in the study. ANLs were obtained using three speech materials (Korean speech, reversed Korean speech, and ISTS) as the target speech material and an eight-talker babble noise as the competing background noise. Results Generally, the inter-subject variability was large. The ANLs did not differ statistically regardless of the type of speech signal. Conclusion The ANLs seemed to be unaffected by the meaningfulness or semantic contents of the target speech, at least in normal-hearing adults. Thus, non-meaningful speech signals or non-semantic material can be considered as the target signal for the implementation of ANL test. Key words: Acceptable noise level ㆍ Most comfortable level

Speech Intelligibility as a Cue for Acceptable Noise Levels.

The goal of this study was to examine whether individuals are using speech intelligibility to determine how much noise they are willing to accept while listening to running speech. Previous research has shown that the amount of background noise that an individual is willing to accept while listening to speech is predictive of his or her likelihood of success with hearing aids. If it were possible to determine the criterion by which individuals make this judgment, then it may be possible to alter this cue, especially for those who are unlikely to be successful with hearing aids, and thereby improve their chances of success with hearing aids. Twenty-one individuals with normal hearing and 21 with sensorineural hearing loss participated in this study. In each group, there were 7 with a low, moderate, and high acceptance of background noise, as determined by the Acceptable Noise Level (ANL) test. (During the ANL test, listeners adjusted speech to their most comfortable listening level, then background noise was added, and they adjusted it to the maximum level that they were "willing to put up with" while listening to the speech.) Participants also performed a modified version of the ANL test in which the speech was fixed at four different levels (50, 63, 75, and 88 dBA), and they adjusted only the level of the background noise. The authors calculated speech intelligibility index (SII) scores for each participant and test level. SII scores ranged from 0 (no speech information is present) to 1 (100% of the speech information is present). The authors considered a participant's results to be consistent with a speech intelligibility-based listening criterion if his or her SIIs remained constant across all of the test conditions. For all but one of the participants with normal hearing, their SIIs remained constant across the entire 38-dB range of speech levels. For all participants with hearing loss, the SII increased with speech level. For most listeners with normal hearing, their ANLs were consistent with the use of speech intelligibility as a listening cue; for listeners with hearing impairment, they were not. Future studies should determine what cues these individuals are using when selecting an ANL. Having a better understanding of these cues may help audiologists design and optimize treatment options for their patients.

Monotic and dichotic acceptable noise levels in typically developing children and adolescents

Introduction: Ability to tolerate noise and speech perception in noise (SPIN) are important auditory skills for adults and children, with and without hearing loss. Acceptable noise level (ANL) and SPIN are tests used for the evaluation of these processes. The present study aimed to develop normative data on ANL test (monotic and dichotic) in typically developing children and adolescents using Marathi versions of the test. Methods: Thirty typically developing Marathi-speaking children and adolescents in the age range of 8–16 years were tested using Marathi versions of ANL and SPIN tests. Results: Median scores and interquartile ranges were developed. The scores were in agreement with those obtained in adults. More than 90% of children had low ANL scores of ≤3 dB showing excellent ability to tolerate noise and none showed high ANL. The dichotic ANL was significantly lower than the monotic scores, implying the advantage offered by spatial separation of speech and noise on the ability to tolerate noise. However, the scores obtained in monotic versus dichotic conditions were not correlated. There was a negative correlation between monotic ANL scores and SPIN scores (weak correlation in the left ear and moderate correlation in the right ear). Further, the ANL scores in dichotic condition did not correlate with SPIN scores. Conclusions: Children show ANL scores similar to adults. The processes underlying ANL and SPIN tests are not completely independent in children. The study does not support the role of binaural processing at higher auditory centers in the ability to tolerate background noise in children and adolescents.

The Normative Value of Acceptable Noise Level Test for Korean Young Listeners with Normal Hearing and Its Relationship with Auditory Brainstem Response Latency

Background and Objectives Acceptable noise level (ANL) test has been developed as a method to measure the background noise acceptance when listening to speech presented at the most comfortable level. The study was aimed to investigate normal-hearing in young subjects’ performance on ANL test and to evaluate the relationship between ANL and auditory evoked potentials. Subjects and Method Fifty-three young adults (23 male and 30 female; aged 21 to 39 years) with normal hearing participated in this study. ANL and auditory brainstem response (ABR) tests were administered to subjects who were certified by pure tone audiometry that they had normal hearing threshold. Results The ANL test showed a large inter-subject variability in the acceptance of background noise, ranging from -5 to 15 dB with the mean of ANL of 5.0±4.1 dB (4.5±4.5 dB in male and 5.4±3.8 dB in female). The mean most comfortable listening level was 35.2±5.3 dB, and the mean background noise level was 30.2±6.1 dB. There were no significant differences between male and female in the parameters of ANL test. There were no differences between the subjects with low versus high ANLs and ABR latencies. Conclusion We obtained the normative data of the ANL test administered to Korean young adults with normal hearing. There is no relationship between ANL and the latency of ABR in this study population. Key words: Auditory brainstem response ㆍ Hearing ㆍ Noise

The Acceptable Noise Level and the Pure-Tone Audiogram.

The vast majority of previous studies suggest that there is no relationship between the acceptable noise level (ANL) and pure-tone hearing thresholds reported as the average pure-tone hearing thresholds (pure-tone average). This study aims to explore (a) the relationship between hearing thresholds at individual frequencies and the ANL and (b) a measure of the slope of the audiogram and ANL. Sixty-three Danish adult hearing aid users participated. Assessments were pure-tone audiogram and 3 different versions of the ANL test made monaurally at 2 different sessions. The findings show that low-frequency hearing thresholds and the slope of the audiogram are significantly related to all versions of the ANL. It is possible that previous studies have failed to discover a relationship between ANL and hearing thresholds due to the use of the broad 4-frequency pure-tone average. This has implications for our understanding of the ANL test.

Clinical evaluation of an over-the-counter hearing aid (TEO First®) in elderly patients suffering of mild to moderate hearing loss.

BackgroundPresbycusis has a direct influence on autonomy of the elderly but hearing aids lack of affordability. Moreover a recent review demonstrate that electroacoustic characteristics of OTC hearing aids were generally not suitable for the elderly people. In our study, we assessed the clinical value of a new over-the-counter (OTC) hearing aid device (TEO First®) in the elderly.MethodThis prospective monocentric open label study included patients over 60 years of age with a mild to moderate presbycusis. Patients were assessed with acceptable noise level test (ANL), pure tone (PTA) and speech (SA) audiometry in silent and noisy environment, with and without TEO First®. A Glasgow Hearing Aid Benefit Profile, acceptability and satisfaction surveys were completed after one month of using the device.ResultsThirty one patients were included. There was an improvement of hearing with TEO First® in silence (SA: +39.2 %, p < 0.01; PTA: -9.04 dB, p < 0.01) or in noise (SA +47.7 %, p < 0.01; PTA: -5.23 dB, p < 0.05). After one month of use of the device, quality of life has improved with regards to the following parameters: decrease of perceived hearing difficulties during conversation without background noise (-9.6 % p = 0.018), in conversation with several people (-16.2 % p = 0.0076), decrease of negative emotions while watching TV (-18.5 % p = 0.011), during conversation without background noise (-16.5 % p = 0.0024), during conversation in noisy background (-17.1 % p = 0.027) and during conversation with several people (-20 % p = 0.014). The acceptability of the device was low to moderate.ConclusionTEO First® is an effective OTC hearing aid that improves the patient’s quality of life.Trial registrationCurrent Controlled Trials NCT01815788

Acceptability of background noise amongst children diagnosed with an auditory processing disorder

Objectives: Children with an Auditory Processing Disorder (APD) have difficulty hearing in background noise despite normal-hearing thresholds. The acceptable noise level (ANL) test assesses an individual's acceptance to background noise while listening to running speech. It was hypothesized that children with APD would have larger than normal ANL scores (poorer acceptance of background noise).Methods: This is a comparative study with a control group. Thirty-two children were tested for APD and placed into 1 of 3 groups according to their history of suspected APD, their test results and normative data, ‘APD’ (n = 14) ‘pass-APD’ (n = 10) and a group of children for whom no hearing problems had been reported by teachers or caregivers ‘norm’ (n = 8). Each child was assessed using the ANL test as well as a comprehensive behavioral APD test battery.Results: Children diagnosed with APD had significantly larger ANL scores than other children (P < 0.05). The ANL was significantly correlated with scores on a Frequency Pattern Test (FPT) and Random Gap Detection Task (RGDT). Significant interactions of group by age and group by memory were found for the ANL.Conclusion: The results demonstrate a strong relationship between low acceptance of background noise and some APD tests. We suggest that determination of sound acceptance at time of entry to school using a simple test such as the ANL would assist in early discovery of childrens’ listening needs.

Type of Speech Material Affects Acceptable Noise Level Test Outcome.

The acceptable noise level (ANL) test, in which individuals indicate what level of noise they are willing to put up with while following speech, has been used to guide hearing aid fitting decisions and has been found to relate to prospective hearing aid use. Unlike objective measures of speech perception ability, ANL outcome is not related to individual hearing loss or age, but rather reflects an individual’s inherent acceptance of competing noise while listening to speech. As such, the measure may predict aspects of hearing aid success. Crucially, however, recent studies have questioned its repeatability (test–retest reliability). The first question for this study was whether the inconsistent results regarding the repeatability of the ANL test may be due to differences in speech material types used in previous studies. Second, it is unclear whether meaningfulness and semantic coherence of the speech modify ANL outcome. To investigate these questions, we compared ANLs obtained with three types of materials: the International Speech Test Signal (ISTS), which is non-meaningful and semantically non-coherent by definition, passages consisting of concatenated meaningful standard audiology sentences, and longer fragments taken from conversational speech. We included conversational speech as this type of speech material is most representative of everyday listening. Additionally, we investigated whether ANL outcomes, obtained with these three different speech materials, were associated with self-reported limitations due to hearing problems and listening effort in everyday life, as assessed by a questionnaire. ANL data were collected for 57 relatively good-hearing adult participants with an age range representative for hearing aid users. Results showed that meaningfulness, but not semantic coherence of the speech material affected ANL. Less noise was accepted for the non-meaningful ISTS signal than for the meaningful speech materials. ANL repeatability was comparable across the speech materials. Furthermore, ANL was found to be associated with the outcome of a hearing-related questionnaire. This suggests that ANL may predict activity limitations for listening to speech-in-noise in everyday situations. In conclusion, more natural speech materials can be used in a clinical setting as their repeatability is not reduced compared to more standard materials.

The relationship between hearing aid frequency response and acceptable noise level in patients with sensorineural hearing loss.

Background:When fitting hearing aid as a compensatory device for an impaired cochlea in a patient with sensorineural hearing loss (HL), it is needed to the effective and efficient frequency response would be selected regarding providing the patient's perfect speech perception. There is not any research about the effects of frequency modifications on speech perception in patients with HL regarding the cochlear desensitization. The effect (s) of modifications in frequency response of hearing aid amplification on the results of acceptable noise level (ANL) test is the main aim of this study.Materials and Methods:The amounts of ANL in two conditions of linear amplification (high frequency emphasis [HFE] and mid frequency emphasis [MFE]) were measured. Thirty-two male subjects who participated in this study had the moderate to severe sensorineural HL.Results:There was not any significant difference between ANL in linear amplification of hearing aid with HFE frequency response and ANL in linear amplification of hearing aid with MFE frequency response.Conclusion:The gain modification of frequency response not only does not affect the patient's performance of speech intelligibility in ANL test. This indicates that we need to note to the cochlear desensitization phenomenon when fitting hearing aid as a compensatory device for an impaired cochlea in a patient. The cochlear desensitization has not been considered properly in hearing aid fitting formula which is needed to be explored more about the bio-mechanisms of impaired cochlea.