Auditory Dynamic Range Research Articles

Perceived auditory dynamic range is enhanced with wrist-based tactile stimulation.

Tactile stimulation has been shown to increase auditory loudness judgments in listeners. This bias could be utilized to enhance perception for people with deficiencies in auditory intensity perception, such as cochlear implant users. However, several aspects of this enhancement remain uncertain. For instance, does the tactile stimulation need to be applied to the hand or body, or can it be applied to the wrist? Furthermore, can the tactile stimulation both amplify and attenuate the perceived auditory loudness? To address these questions, two loudness-matching experiments were conducted. Participants matched a comparison auditory stimulus with an auditory reference, either with or without spectro-temporally identical tactile stimulation. In the first experiment, fixed-level tactile stimulation was administered to the wrist during the comparison stimulus to assess whether perceived auditory loudness increased. The second experiment replicated the same conditions but introduced tactile stimulation to both the reference and comparison, aiming to investigate the potential decrease in perceived auditory loudness when the two tactile accompaniments were incongruent between the reference and comparison. The results provide evidence supporting the existence of the tactile loudness bias in each experiment and are a step towards wrist-based haptic devices that modulate the auditory dynamic range for a user.

Longitudinal Investigation of Auditory Dynamic Range Deficits in Early Psychosis and its Relationship to Negative Symptoms.

Despite accounting for significant disease morbidity in schizophrenia, the neuropathological basis of negative symptoms remains poorly understood and options for treatment limited. Our recent study identified robust associations between diminished auditory cortex (AC) dynamic range and social functioning impairments and negative symptoms in first episode psychosis (FESz). The current investigation examined the progression of these relationships 4-8 months from baseline testing. Twenty-six FESz and 38 healthy controls (HC) were tested at baseline and follow-up. Magnetoencephalography (MEG) was recorded during binaural presentation of tones (75, 80, and 85 dB). Assessments included the MATRICS cognitive consensus battery (MCCB) and Global Functioning: Role and Social scales (GFR/GFS) and the Positive and Negative Syndrome Scale. Overall, FESz exhibited a blunted response to increasing tone intensity relative to HC. While this deficit did not change over time at the group level, recovery of right hemisphere AC dynamic range (85-75 dB response) among FESz individuals was associated with reductions in negative symptoms (ρ = -0.50). Diminished dynamic range was also associated with impaired GFS (ρ = 0.65), GFR (ρ = 0.51), and MCCB (ρ = 0.49) at baseline and increased negative symptoms at baseline (ρ = -0.53) and follow-up (ρ = -0.51). Despite persistent dynamic range impairment in FESz as a group, individual recovery of this AC response property was associated with significant reduction in negative symptoms. Identification of a functional neural deficit that tracts progression of negative symptoms during a critical period for disease modification is essential to the management of these devastating and historically treatment refractory symptoms.

146. Longitudinal Progression of Auditory Dynamic Range Deficits and Associated Disease Morbidity in Early Psychosis

146. Longitudinal Progression of Auditory Dynamic Range Deficits and Associated Disease Morbidity in Early Psychosis

Local acoustic habitat relative to hearing sensitivities in beluga whales (Delphinapterus leucas)

Background noise can have a substantial effect on communication signals, however far less is known about how natural soundscapes may influence hearing sensitivity. Here we compare the audiograms of 26 wild beluga whales measured in their natural environment to a series of ecoacoustic measurements within a primary portion of their Bristol Bay summer habitat, the Nushagak Estuary in Bristol Bay, AK, USA. Environmental acoustic measurements were made during 2012 and 2016 using two different methods: a moored recorder and drifter buoys. Environmental noise curves varied substantially. Drifter recordings from the middle of Nushgak Estuary had the highest spectrum levels during ebb tides with acoustic energy from sediment transport extending well into higher frequencies (ca. 60 kHz), likely due to rapidly moving tidal flow and shifting sediment in that location. Drifter recordings near the estuary mouth and shallow tidal flats were lower amplitude. Noise levels generally varied during drifts (in one case up to ca. 6 dB) reflecting acoustic cues available to the local belugas. The moored recorder showed a substantially different spectral profile, especially at lower frequencies, perhaps due to its attachment to a pier piling and subsequent pier noise. Hearing sensitivity varied by individual and thresholds often fell above 1/3 octave-band noise levels, but not overall noise spectral density. Audiograms of the most sensitive animals closely paralleled the lowest ambient noise power spectral density curves, suggesting that an animal’s auditory dynamic range may extend to include its habitat’s quietest conditions. These data suggest a cautious approach is necessary when estimating the sound-sensitivity of odontocetes found in quiet environments as they may have sensitive auditory abilities that allow for hearing within the lowest noise-level conditions. Further, lower level ambient noise conditions could provide a conservative estimate of the maximal sensitivity of some cetacean populations within specific environments.

Structured Counseling for Auditory Dynamic Range Expansion.

A structured counseling protocol is described that, when combined with low-level broadband sound therapy from bilateral sound generators, offers audiologists a new tool for facilitating the expansion of the auditory dynamic range (DR) for loudness. The protocol and its content are specifically designed to address and treat problems that impact hearing-impaired persons who, due to their reduced DRs, may be limited in the use and benefit of amplified sound from hearing aids. The reduced DRs may result from elevated audiometric thresholds and/or reduced sound tolerance as documented by lower-than-normal loudness discomfort levels (LDLs). Accordingly, the counseling protocol is appropriate for challenging and difficult-to-fit persons with sensorineural hearing losses who experience loudness recruitment or hyperacusis. Positive treatment outcomes for individuals with the former and latter conditions are highlighted in this issue by incremental shifts (improvements) in LDL and/or categorical loudness judgments, associated reduced complaints of sound intolerance, and functional improvements in daily communication, speech understanding, and quality of life leading to improved hearing aid benefit, satisfaction, and aided sound quality, posttreatment.

A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: Case Evidence Showcasing Treatment Efficacy.

Case evidence is presented that highlights the clinical relevance and significance of a novel sound therapy-based treatment. This intervention has been shown to be efficacious in a randomized controlled trial for promoting expansion of the dynamic range for loudness and increased sound tolerance among persons with sensorineural hearing losses. Prior to treatment, these individuals were unable to use aided sound effectively because of their limited dynamic ranges. These promising treatment effects are shown in this article to be functionally significant, giving rise to improved speech understanding and enhanced hearing aid benefit and satisfaction, and, in turn, to enhanced quality of life posttreatment. These posttreatment sound therapy effects also are shown to be sustained, in whole or part, with aided environmental sound and to be dependent on specialized counseling to maximize treatment benefit. Importantly, the treatment appears to be efficacious for hearing-impaired persons with primary hyperacusis (i.e., abnormally reduced loudness discomfort levels [LDLs]) and for persons with loudness recruitment (i.e., LDLs within the typical range), which suggests the intervention should generalize across most individuals with reduced dynamic ranges owing to sensorineural hearing loss. An exception presented in this article is for a person describing the perceptual experience of pronounced loudness adaptation, which apparently rendered the sound therapy inaudible and ineffectual for this individual. Ultimately, these case examples showcase the enormous potential of a surprisingly simple sound therapy intervention, which has utility for virtually all audiologists to master and empower the adaptive plasticity of the auditory system to achieve remarkable treatment benefits for large numbers of individuals with sensorineural hearing losses.

A Sound Therapy-Based Intervention to Expand the Auditory Dynamic Range for Loudness among Persons with Sensorineural Hearing Losses: A Randomized Placebo-Controlled Clinical Trial.

The primary aim of this research was to evaluate the validity, efficacy, and generalization of principles underlying a sound therapy-based treatment for promoting expansion of the auditory dynamic range (DR) for loudness. The basic sound therapy principles, originally devised for treatment of hyperacusis among patients with tinnitus, were evaluated in this study in a target sample of unsuccessfully fit and/or problematic prospective hearing aid users with diminished DRs (owing to their elevated audiometric thresholds and reduced sound tolerance). Secondary aims included: (1) delineation of the treatment contributions from the counseling and sound therapy components to the full-treatment protocol and, in turn, the isolated treatment effects from each of these individual components to intervention success; and (2) characterization of the respective dynamics for full, partial, and control treatments. Thirty-six participants with bilateral sensorineural hearing losses and reduced DRs, which affected their actual or perceived ability to use hearing aids, were enrolled in and completed a placebo-controlled (for sound therapy) randomized clinical trial. The 2 × 2 factorial trial design was implemented with or without various assignments of counseling and sound therapy. Specifically, participants were assigned randomly to one of four treatment groups (nine participants per group), including: (1) group 1-full treatment achieved with scripted counseling plus sound therapy implemented with binaural sound generators; (2) group 2-partial treatment achieved with counseling and placebo sound generators (PSGs); (3) group 3-partial treatment achieved with binaural sound generators alone; and (4) group 4-a neutral control treatment implemented with the PSGs alone. Repeated measurements of categorical loudness judgments served as the primary outcome measure. The full-treatment categorical-loudness judgments for group 1, measured at treatment termination, were significantly greater than the corresponding pretreatment judgments measured at baseline at 500, 2,000, and 4,000 Hz. Moreover, increases in their "uncomfortably loud" judgments (∼12 dB over the range from 500 to 4,000 Hz) were superior to those measured for either of the partial-treatment groups 2 and 3 or for control group 4. Efficacy, assessed by treatment-related criterion increases ≥ 10 dB for judgments of uncomfortable loudness, was superior for full treatment (82% efficacy) compared with that for either of the partial treatments (25% and 40% for counseling combined with the placebo sound therapy and sound therapy alone, respectively) or for the control treatment (50%). The majority of the group 1 participants achieved their criterion improvements within 3 months of beginning treatment. The treatment effect from sound therapy was much greater than that for counseling, which was statistically indistinguishable in most of our analyses from the control treatment. The basic principles underlying the full-treatment protocol are valid and have general applicability for expanding the DR among individuals with sensorineural hearing losses, who may often report aided loudness problems. The positive full-treatment effects were superior to those achieved for either counseling or sound therapy in virtual or actual isolation, respectively; however, the delivery of both components in the full-treatment approach was essential for an optimum treatment outcome.

Sound Therapy-Based Treatment to Expand the Auditory Dynamic Range.

I am excited to introduce you to this unique edition of Seminars in Hearing. Rather than a group of articles on a topic, you will find a comprehensive article outlining a recently completed study by Dr. Formby and his colleagues. This is the first study to be produced that provides a randomized placebo-controlled clinical trial investigating sound therapy–based intervention to expand the auditory dynamic range. At a time when we continue to see very few randomized controlled trials in audiology, we are pleased to be able to provide you with this comprehensive report. Dr. Formby and his colleagues have used the Seminars in Hearing format so they can provide extensive details about the study including how the placebo sound generator was envisioned and created. There is an entire appendix devoted to the specifics of the placebo condition for those interested or in a position to replicate or continue this important work.

ATP-gated ion channels mediate adaptation to elevated sound levels

The sense of hearing is remarkable for its auditory dynamic range, which spans more than 10(12) in acoustic intensity. The mechanisms that enable the cochlea to transduce high sound levels without damage are of key interest, particularly with regard to the broad impact of industrial, military, and recreational auditory overstimulation on hearing disability. We show that ATP-gated ion channels assembled from P2X2 receptor subunits in the cochlea are necessary for the development of temporary threshold shift (TTS), evident in auditory brainstem response recordings as sound levels rise. In mice null for the P2RX2 gene (encoding the P2X2 receptor subunit), sustained 85-dB noise failed to elicit the TTS that wild-type (WT) mice developed. ATP released from the tissues of the cochlear partition with elevation of sound levels likely activates the broadly distributed P2X2 receptors on epithelial cells lining the endolymphatic compartment. This purinergic signaling is supported by significantly greater noise-induced suppression of distortion product otoacoustic emissions derived from outer hair cell transduction and decreased suprathreshold auditory brainstem response input/output gain in WT mice compared with P2RX2-null mice. At higher sound levels (≥95 dB), additional processes dominated TTS, and P2RX2-null mice were more vulnerable than WT mice to permanent hearing loss due to hair cell synapse disruption. P2RX2-null mice lacked ATP-gated conductance across the cochlear partition, including loss of ATP-gated inward current in hair cells. These data indicate that a significant component of TTS represents P2X2 receptor-dependent purinergic hearing adaptation that underpins the upper physiological range of hearing.

Gravity Receptor Aging in the CBA/CaJ Strain: A Comparison to Auditory Aging

The CBA/CaJ mouse strain is commonly used as a control as it has no known genetic mutations affecting the inner ear, maintains hearing sensitivity throughout life, and serves as a background for creating new genetic strains. The purpose of the present study was to characterize the effects of age and gender on gravity receptor function and compare functional changes between auditory and vestibular modalities. Vestibular-evoked potentials (VsEPs), auditory brainstem responses (ABRs), and distortion product otoacoustic emissions were measured in 131 mice. VsEP thresholds deteriorated an average of 0.39dB re: 1.0g/ms per month and at the oldest ages (18-23months old) showed an average loss of 49% of VsEP dynamic range. No significant gender differences were found for VsEPs. ABR thresholds increased by an average of 1.35, 1.38, and 1.15dB pe SPL per month for ABR stimulus frequencies of 8, 16, and 32kHz, respectively, demonstrating an average decrease in auditory dynamic range of 25-35% at advanced ages. Both modalities declined with age. Age-related decreases in gravity receptor sensitivity should be considered when using the CBA/CaJ strain for vestibular studies.

Auditory intensity discrimination as a function of level-rove and tone duration in normal-hearing and impaired subjects: The “mid-level hump” revisited

The just-noticeable difference (ΔI) in the intensity (I) of sound is typically reported to be a constant or a slightly decreasing ratio of the baseline intensity (known as Weber’s law, and the “near-miss to Weber’s law”, respectively). However, in the relatively few studies on the intensity discrimination of very brief sounds, ΔI/I is usually found to be non-monotonic, with poorest discrimination in the middle of the auditory dynamic range. Here, it is demonstrated that this “severe departure from Weber’s law” or “mid-level hump” is not merely a phenomenon of short-duration sounds. In normal-hearing subjects ( n = 8), the near-miss to Weber’s law that is observed with the discrimination of 300 ms-long, 4 kHz tones, gives way to a significant mid-level hump if tone intensities are not fixed over a great many trials (as is standard practice) but are instead randomly roved, trial-to-trial, over a wide intensity range. This was not the case in subjects with mild to moderate hearing impairment ( n = 4). Furthermore, in the discrimination of widely-roved, 4 ms-long, 4 kHz tone bursts, the performance of normal-hearing subjects did not significantly worsen at mid-levels compared to the unroved condition, unlike what was found with the 300 ms-long tones. It is suggested that mid-level humps could simply be the product of the well-known mid-level compressive nonlinearity in cochlear mechanics. We further suggest that the hump is eliminated, and the near-miss to Weber’s law is produced, by a more central mechanism such as the recently reported “adaptation to sound-level statistics”, which is bypassed during wide-range roving and possibly when sound durations are brief.

Secondary Benefits from Tinnitus Retraining Therapy: Clinically Significant Increases in Loudness Discomfort Level and Expansion of the Auditory Dynamic Range

In this report, the authors highlight clinically significant improvements in sound tolerance observed over the past decade among patients who were enrolled in tinnitus retraining therapy (TRT) at the University of Maryland Tinnitus and Hyperacusis Center. Pretreatment and TRT follow-up audiometric threshold, loudness discomfort level (LDL), and dynamic-range (DR) data are documented for (1) a group of 68 tinnitus patients who presented with primary complaints of sound intolerance, and (2) a second group of 70 patients who reported only tinnitus (and no sound tolerance problems). TRT-related increases in sound tolerance are (1) due to increases in LDLs and occur independently of changes in audiometric threshold, which were invariant with treatment; (2) statistically significant in tinnitus patients with and without sound tolerance problems, and with and without hearing loss; (3) observed among 81% of the patients with sound tolerance complaints and 44% of the patients who reported primary tinnitus; (4) independent of audiometric frequency over the range 1000 to 8000 Hz; and (5) seemingly independent of TRT treatment duration, which is consistent with recent experimental evidence of a rapid treatment effect (within the first month of TRT). The TRT treatment effects were clinically meaningful, offering new opportunities for expanding the auditory DR and improving sound tolerance in the general hearing-impaired population. The mechanism responsible for the plasticity underlying these treatment effects is uncertain, but appears consistent with a centrally mediated auditory gain control process. Sound tolerance problems were overpredicted among the authors' sample of tinnitus-only patients when existing objective audiometric criteria were used. This finding promoted the development of a new predictive model for sound tolerance problems, which is described in a companion report.

Secondary Treatment Benefits Achieved by Hearing-Impaired Tinnitus Patients Using Aided Environmental Sound Therapy for Tinnitus Retraining Therapy: Comparisons with Matched Groups of Tinnitus Patients Using Noise Generators for Sound Therapy

Tinnitus patients with hearing loss may use amplified environmental sound from hearing aids (HAs) for the sound therapy (ST) component of tinnitus retraining therapy (TRT). Sizable secondary treatment benefits, namely, incremental shifts in loudness discomfort levels (LDLs) and expansion of the auditory dynamic range (DR) for loudness, have been reported for tinnitus patients who use noise generators (NGs) for ST in TRT. The primary questions addressed in this study are (1) Then hearing-impaired tinnitus patients using amplified environmental sound for their ST also achieve significant secondary treatment benefits and, if so, (2) are these secondary effects of similar magnitude to those measured for tinnitus patients using NGs for their ST? An analysis of patient records in the University of Maryland Tinnitus and Hyperacusis Center (UMTHC) revealed TRT treatment-related changes in the LDL averaged 2.70 dB for a group of 25 aided hearing-impaired tinnitus patients. Corresponding treatment effects for four matched groups of tinnitus patients, who used NGs for their ST, ranged from 5.91 to 10.10 dB. The associated incremental changes in the DR averaged 0.60 dB for the aided tinnitus patients and from 4.10 to 9.23 dB for the matched groups of tinnitus patients who used NGs for their ST. These findings indicate that hearing-impaired tinnitus patients using aided environmental sound for TRT achieve smaller secondary treatment benefits than do tinnitus patients who use NGs for their ST.

Effect of Slow-Acting Wide Dynamic Range Compression on Measures of Intelligibility and Ratings of Speech Quality in Simulated-Loss Listeners

The purpose of this study was twofold: (a) to determine the extent to which 4-channel, slow-acting wide dynamic range amplitude compression (WDRC) can counteract the perceptual effects of reduced auditory dynamic range and (b) to examine the relation between objective measures of speech intelligibility and categorical ratings of speech quality for sentences processed with slow-acting WDRC. Multiband expansion was used to simulate the effects of elevated thresholds and loudness recruitment in normal hearing listeners. While some previous studies have shown that WDRC can improve both speech intelligibility and quality, others have found no benefit. The current experiment shows that moderate amounts of compression can provide a small but significant improvement in speech intelligibility, relative to linear amplification, for simulated-loss listeners with small dynamic ranges (i.e., flat, moderate hearing loss). This benefit was found for speech at conversational levels, both in quiet and in a background of babble. Simulated-loss listeners with large dynamic ranges (i.e., sloping, mild-to-moderate hearing loss) did not show any improvement. Comparison of speech intelligibility scores and subjective ratings of intelligibility showed that listeners with simulated hearing loss could accurately judge the overall intelligibility of speech. However, in all listeners, ratings of pleasantness decreased as the compression ratio increased. These findings suggest that subjective measures of speech quality should be used in conjunction with either objective or subjective measures of speech intelligibility to ensure that participant-selected hearing aid parameters optimize both comfort and intelligibility.

Estimates of Loudness, Loudness Discomfort, and the Auditory Dynamic Range: Normative Estimates, Comparison of Procedures, and Test-Retest Reliability

The purpose of this series of experiments was to establish normative reference values for absolute and relative judgements of loudness discomfort and for the auditory dynamic range (DR), and to evaluate intersubject variability and intra-subject test-retest reliability for the respective measures of loudness discomfort. To establish the normal auditory DR, audiometric thresholds and loudness discomfort levels (LDLs) were measured from a group of 59 normal-hearing adults without sound tolerance problems. The resulting estimates of the LDL and DR were on the order of 100 dB HL and 95 dB, respectively. A subset (n = 18) of this larger group participated in further studies in which loudness growth functions and the upper limit of the auditory DR were measured by categorical scaling judgments. The findings revealed no significant differences between the test methods for absolute (LDL) and relative (categorical scaling) judgements of loudness discomfort, intersubject variability, or intrasubject test-retest reliability, and suggest that the simple LDL estimate of loudness discomfort is an efficient and valid clinical measure for characterizing the "threshold of discomfort."

Increased perception of loudness in autism

Clinical reports on autism describe abnormal responses to auditory stimuli such as intolerance to sounds. The present study assessed subjective perception of loudness in subjects with autism compared to healthy controls, using two psychoacoustic tests. First, the auditory dynamic range was evaluated at six different tone frequencies. Secondly, loudness growth as a function of the intensity level of a 1 kHz tone was estimated. Verbal responses from a group of 11 children and adolescents with autism were compared to responses of 11 age- and gender- matched healthy controls. Smaller auditory dynamic ranges were found in the autistic group than in the control group, as well as increased perception of loudness, indicating hyperacusis in subjects with autism.

An adaptive procedure for categorical loudness scaling.

In this study, an adaptive procedure for categorical loudness scaling is introduced and evaluated. The procedure adjusts the presentation levels to the subject's individual auditory dynamic range without employing any premeasurement and presents levels in randomized order. The procedure has been named "Oldenburg-ACALOS" (Oldenburg-Adaptive CAtegorical LOudness Scaling). It was evaluated using repeated measurements with ten subjects with normal hearing and ten subjects with sensorineural hearing impairment. The results of this investigation revealed that the adaptive procedure provides greater reliability, while being more time efficient than a reference procedure that uses constant stimuli.

Non-linear signal processing in digital hearing aids.

Three different non-linear digital signal processing algorithms were developed; LinEar, DynEar and RangeEar. All three provided individual frequency shaping via a seven-band low-power filterbank and compression in two channels. RangeEar and DynEar used wide dynamic range syllabic compression in the low-frequency (LF) channel, while LinEar used compression limiting. In the high-frequency (HF) channel, RangeEar used a slow-acting automatic volume control, while DynEar and LinEar used compression limiting. Wearable digital signal processing-based experimental instruments were used to evaluate the fitting algorithms under real world conditions with experienced hearing aid users. Evaluation included laboratory testing of speech recognition in noise and questionnaires on sound quality ratings. Results did not indicate one general good-for-all algorithm, but different algorithms resulting in preference and performance depending on the hearing loss configuration. Preference for any of the new algorithms could be predicted based on auditory dynamic range measurements. It was hypothesized that the different preferences were affected by different susceptibility to masking of HF sounds by amplified LF sounds.

Auditory dynamic range derived from the mean rate-intensity function in the cat.

Loudness change is perceived over a far greater range than the discrimination range of single afferents-the "dynamic range problem" [1]. However, earlier neural count models have not fully considered how variability in the dynamic ranges, thresholds, spontaneous rates, and saturation rates of these afferents may affect overall dynamic range. In the present model, all four of these characteristics appear in a logistic rate-intensity function that fits well with sigmoidally firing cat neurons (a double logistic fits well with sloping-saturating units). These equations were averaged statistically over parameter distributions for each of three spontaneous rate groups. An average over these groups (weighted by relative group size) was used to compute discriminability for a patch of basilar membrane. The upper limit on dynamic range for a patch one critical band wide at 8 kHz was 89 dB SPL, less than implied by psychophysics [2]. A two-channel model extended the upper limit by only 3 dB, and splitting the population into four channels did not improve this limit. Seven channels, optimally combined, provided a dynamic range nearly equal to that of an ideal observer that treats each fiber as a separate channel. Moreover, the contribution of sloping-saturating units to discriminability was not as great as popularly expected. Changing the variances of fiber dynamic ranges did not strongly affect overall dynamic range in any of these computations. In sum, when the distributions of neural parameters are taken into account, local pooling can greatly mitigate the "dynamic range problem."

A digital filterbank hearing aid: predicting user preference and performance for two signal processing algorithms.

In a series of experiments with a wearable binaural digital hearing aid, two hearing aid processing algorithms were compared. Both algorithms provided individual frequency shaping via a seven-band filterbank with compression limiting in the high-frequency channel. They differed in the processing of the low-frequency channel, using dynamic range compression for one (DynEar) and linear processing with compression limiting for the other (LinEar). In a pilot field test we found that LinEar/ DynEar preference based on use time could be predicted from auditory dynamic range data. For the subjects who preferred DynEar, the mean dynamic range was broader for low and mid frequencies and narrower for high frequencies, as compared with the LinEar preference subjects. These groupings were tested as predictors of user preference and performance in a main field test. The main study included 26 hearing aid users with symmetrical sensorineural losses. The algorithms were compared in a one-mo-long blind field test. A data logger function was included for objective recording of the total time each algorithm was used and how the volume controls were used. The preference was based on the time used for each algorithm and on subjective statements. Threshold signal-to-noise ratio (S/N-threshold) for speech was tested, and sound quality ratings were obtained through a questionnaire. We also tested the S/N-thresholds for the subjects' conventional (own) aids. The preference was correctly predicted by the dynamic range data on 12 out of 15 new cases. S/N-thresholds were lower for the preferred fittings compared with the nonpreferred fittings and with the subjects' own aids. In the questionnaire the preferred fittings were rated significantly higher in terms of overall impression and clearness. Because of the systematic way the DynEar-preference subjects adjusted the high-frequency DynEar gain, we speculate that upward spread of masking may have been a factor in preference and performance. Additionally, LinEar-preference subjects' preference and performance might have been influenced by excessive compression ratios with the DynEar processing in these cases. 1. Preference for DynEar versus LinEar depends on the auditory dynamic range. 2. S/N-thresholds for speech were better for the preferred fittings, which also were rated higher in terms of overall impression of sound quality and clearness.