Decreased Speech Intelligibility Research Articles

Psychophysical and Electrophysiological Parameters of the Auditory Analyzer as Indicators of the Effectiveness of Cochlear Implantation in Children with Bilateral Deafness

Background. The results of rehabilitation of patients with deafness after cochlear implantation (CI) depends on many factors related on both the individual characteristics of the patient and the technical parameters of auditory nerve stimulation — fitting of the CI system processor. Article presents the results of a study of the relationship between psychophysical (subjective) auditory sensations and electrophysiological (objective) responses of the structures of the auditory analyzer to electrical stimulation. Aims — to evaluate the relationship between the electrophysiological responses of the auditory analyzer and the psychophysical parameters of the thresholds of sound perception and speech intelligibility in patients with deafness after CI. Methods. The study involved 88 patients with IV bilateral sensorineural hearing loss, borderline with deafness, aged 6 to 17 years 11 months, among whom 54.5% (n = 48) of girls and 45.5% (n = 40) of boys. Of the patients included in the follow-up, 40% (n = 35) underwent unilateral CI; 60% (n = 53) of children underwent bilateral sequential CI. In our study, slightly more than half of the patients (51.1%) had experience using the CI system for more than 5 years. At the first stage of the study, we studied the relationship between sound perception thresholds (tonal audiometry in a free field) and registered ASSR (auditory steady state response) thresholds in patients with deafness receiving rehabilitation after CI surgery. The relationship between behavioral and electrophysiological (objective) thresholds was assessed by comparing the results of tonal threshold audiometry and the responses received during ASSR registration to acoustic stimulation in a free field. At the second stage, patients with indications for processor fitting (decreased speech intelligibility, uncomfortable sensations) underwent speech audiometry, evoked compound action potentials (ECAP) registration, according to the results of which the parameters of the CI processor were changed. Results. Research data showed the effectiveness of the approach of including the ECAP registration test, followed by the creation of a fitting card and correction of the level of auditory nerve stimulation under the control of speech audiometry in the protocol of fitting the CI processor. Conclusions. The results of the conducted studies allow us to recommend the use of the developed method of objective recording of sound perception thresholds in patients with CI as one of the indicators of the effectiveness of CI in the early period of auditory-speech rehabilitation in patients with undeveloped speech skills and when it is impossible to conduct objective tests accompanied by supra-threshold stimulation of the auditory nerve.

Multisensory effects of mask wearing on speech intelligibility and the benefit of multilingualism.

Due to the pandemic of the Covid-19 disease, it became common to wear masks on some public spaces. By covering mouth and nose, visual-related speech cues are greatly reduced, while the auditory signal is both distorted and attenuated. The present study aimed to analyze the multisensory effects of mask wearing on speech intelligibility and the differences in these effects between participants who spoke 1, 2 and 3 languages. The study consisted of the presentation of sentences from the SPIN test to 40 participants. Participants were asked to report the perceived sentences. There were four conditions: auditory with mask; audiovisual with mask; auditory without mask; audiovisual without mask. Two sessions were conducted, one week apart, each with the same stimuli but with a different signal-to-noise ratio. Results demonstrated that the use of the mask decreased speech intelligibility, both due to a decrease in the quality of auditory stimuli and due to the loss of visual information. Signal-to-noise ratio largely affects speech intelligibility and higher ratios are needed in mask-wearing conditions to obtain any degree of intelligibility. Those who speak more than one language are less affected by mask wearing, as are younger listeners. Wearing a facial mask reduces speech intelligibility, both due to visual and auditory factors. Older people and people who only speak one language are affected the most.

The Effect of the Frequency and Energetic Content of Broadband Noise on the Lombard Effect and Speech Intelligibility

The Lombard effect is an unconscious reflex of speakers to increase vocal effort when disturbed by noise, aiming to enhance speech intelligibility. This study aims to evaluate the effect of noise with different energetic content and levels at various frequencies on the Lombard effect, communication disturbance, vocal comfort, and speech intelligibility. Twenty university students participated in the study, reading a six-sentence excerpt and performing an intelligibility test under 12 randomized noise conditions. These conditions included noises at low (20–500 Hz), medium (500–4000 Hz), and high frequencies (4000–20,000 Hz), at four levels (45 dB, 55 dB, 65 dB, 75 dB). After each condition, participants rated their perceived communication disturbance and vocal discomfort. The results indicated that noise with energetic content at medium frequencies produced the highest Lombard effect, produced the most detrimental effect on communication disturbance and vocal comfort, and caused the strongest decrease in speech intelligibility, whereas it was minimally affected by low- and high-frequency noise. In conclusion, this study highlights that medium-frequency noise has the greatest impact on vocal effort, communication disturbance, and vocal comfort, while low- and high-frequency noise has minimal effect on speech intelligibility.

A Transparent Mask and Clear Speech Benefit Speech Intelligibility in Individuals With Hearing Loss.

The purpose of the study is to investigate the impacts of a surgical mask and a transparent mask on audio-only and audiovisual speech intelligibility in noise (i.e., 0 dB signal-to-noise ratio) in individuals with mild-to-profound hearing loss. The study also examined if individuals with hearing loss can benefit from using a transparent mask and clear speech for speech understanding in noise. Thirty-one individuals with hearing loss (from 22 to 74 years old) completed keyword identification tasks to measure face-masked speech intelligibility in noise. A mixed-effects logistic regression model was used to examine the effects of face masks (no mask, transparent mask, surgical mask), presentation modes (audio only, audiovisual), speaking styles (conversational, clear), noise type (speech-shaped noise [SSN], four-talker babble [4-T babble]), hearing groups (mild hearing loss [MHL], greater than MHL: GHL), and their interactions on binary accuracy of keyword identification. In the audio-only mode, the GHL group showed reduced speech intelligibility regardless of other factors, whereas the MHL group showed decreased speech intelligibility for the transparent mask more than for the surgical mask. The use of a transparent mask was advantageous for both hearing loss groups. Clear speech remediated the detrimental effects of face masks on speech intelligibility in noise. Both groups tended to perform better in SSN versus 4-T babble. The findings indicate that, when using face masks, either a transparent mask or a surgical mask negatively affects speech understanding in noise for individuals with hearing loss. Using a transparent mask and clear speech could be a potential solution to improve speech intelligibility in communication with face masks in noise.

Hearing perception by cochlear implantation

Cochlear implantation is a unique development in the field of prosthetics of human sensory systems. Due to the electrical stimulation of the auditory nerve, auditory sensations close to natural occur. Despite significant progress in the engineering design of cochlear implants (CI), the quality of auditory perception when used is significantly limited. CI users experience the greatest difficulties in communication tasks such as understanding speech in noise or in multi-talkers environment. There are many factors, both technical and physiological, to reduce speech intelligibility in CI users. Speech perception in CI users is limited due to low frequency resolution, perceptual distortion of pitch, and compression of dynamic range. Low frequency resolution is the reason a decrease in speech intelligibility and the ability to perceive music. To realize these ability the question about the state of central hearing mechanisms, especially for children with congenital deafness, is crucial Neuroplasticity with ages decreases and the central auditory processing deficiency develops, therefore, it is desirable to carry out cochlear implantation as early as possible after hearing loss identification. Analysis of the auditory perception features in case of the auditory nerve is electrically excited allows not only to propose innovative approaches to improve the auditory abilities of CI users, but also to study auditory processing disorders.

The effects of speech masking on neural tracking of acoustic and semantic features of natural speech

Listening environments contain background sounds that mask speech and lead to communication challenges. Sensitivity to slow acoustic fluctuations in speech can help segregate speech from background noise. Semantic context can also facilitate speech perception in noise, for example, by enabling prediction of upcoming words. However, not much is known about how different degrees of background masking affect the neural processing of acoustic and semantic features during naturalistic speech listening. In the current electroencephalography (EEG) study, participants listened to engaging, spoken stories masked at different levels of multi-talker babble to investigate how neural activity in response to acoustic and semantic features changes with acoustic challenges, and how such effects relate to speech intelligibility. The pattern of neural response amplitudes associated with both acoustic and semantic speech features across masking levels was U-shaped, such that amplitudes were largest for moderate masking levels. This U-shape may be due to increased attentional focus when speech comprehension is challenging, but manageable. The latency of the neural responses increased linearly with increasing background masking, and neural latency change associated with acoustic processing most closely mirrored the changes in speech intelligibility. Finally, tracking responses related to semantic dissimilarity remained robust until severe speech masking (−3 dB SNR). The current study reveals that neural responses to acoustic features are highly sensitive to background masking and decreasing speech intelligibility, whereas neural responses to semantic features are relatively robust, suggesting that individuals track the meaning of the story well even in moderate background sound.

The effect of wearing face masks on voice and intelligibility of speech during the COVID-19 pandemic

BackgroundThe study aims at evaluating the effect of wearing face masks on voice and intelligibility of speech in Egyptian working individuals during the COVID-19 pandemic to identify if there are any adverse effects of wearing face masks in the working environment.Materials and methodsA cross-section analytical study was conducted on 153 participants. Personal data and data about the nature of their workplaces were collected. The evaluation included a subjective assessment of voice and intelligibility of speech using a specifically designed questionnaire addressing self-perception of voice fatigue, speech unintelligibility, received auditory feedback and breathing difficulty, and objective voice assessment by Computerized Speech Lab, while objective speech unintelligibility assessment by the Arabic Speech Intelligibility Test.ResultsThe study revealed poor workplace acoustics and increased their self-perception of voice fatigue, speech unintelligibility, auditory feedback, and breathing difficulty while wearing masks. Medical professionals showed increased self-perception of speech unintelligibility and the received auditory feedback. No significant difference was found in absolute jitter with and without a face mask. Increasing shimmer and mean fundamental frequency and decreasing noise to harmonic ratio and maximum phonation time were found. The study revealed decreased speech intelligibility especially with the N95 mask.ConclusionWearing face masks negatively affects communication in the workplace, with poor room acoustics. It affects both speech intelligibility and voice subjectively and objectively. It caused increased self-perception of voice fatigue and changes in objective voice parameters.

The dynamic effect of speaking fast on speech prosody

Speaking fast causes several changes in speech prosody. In addition, it can be associated with a decrease in speech intelligibility. In this study, prosodic changes in fast speech were investigated using common prosodic measurements and syllabic prosody index (SPI), a novel prominence measure that combines f0, energy and duration features. Dynamic changes in long-term prosodic prominence were investigated using functional data analysis (FDA), in which the SPI is transformed into a functional form. The possibly decreasing effect of speaking fast on speech intelligibility was evaluated using automatic speech recognition. Phonetic analyses of syllabic units showed that speaking fast decreases duration, f0 and SPI, and increases articulation rate and proportional acoustic energy in the frequency range of 0–1 kHz. FDA supported the aforementioned results by revealing dynamically decreased overall prominence in fast speech. Furthermore, in comparison to regular speech, speech intelligibility was found to be significantly lower in fast speech: word error rate (WER) for regular speech was 0.27, whereas for fast speech it was 0.86.

Predictors of Adverse Outcomes Following Cleft Palate Repair: An Analysis of Over 2500 Patients Using International Smile Train Data.

The objective of this study was to use data from Smile Train's global partner hospital network to identify patient characteristics that increase odds of fistula and postoperative speech outcomes. Multi-institution, retrospective review of Smile Train Express database. 1110 Smile Train partner hospitals. 2560 patients. N/A. Fistula occurrence, nasal emission, audible nasal emission with amplification (through a straw or tube) only, nasal rustle/turbulence, consistent nasal emission, consistent nasal emission due to velopharyngeal dysfunction, rating of resonance, rating of intelligibility, recommendation for further velopharyngeal dysfunction assessment, and follow-up velopharyngeal dysfunction surgery. The patients were 46.6% female and 27.5% underweight by WHO standards. Average age at palatoplasty was 24.7 ± 0.5 months and at speech assessment was 6.8 ± 0.1 years. Underweight patients had higher incidence of hypernasality and decreased speech intelligibility. Palatoplasty when under 6 months or over 18 months of age had higher rates of affected nasality, intelligibility, and fistula formation. The same findings were seen in Central/South American and African patients, in addition to increased velopharyngeal dysfunction and fistula surgery compared to Asian patients. Palatoplasty technique primarily involved one-stage midline repair. Age and nutrition status were significant predictors of speech outcomes and fistula occurrence following palatoplasty. Outcomes were also significantly impacted by location, demonstrating the need to cultivate longitudinal initiatives to reduce regional disparities. These results underscore the importance of Smile Train's continual expansion of accessible surgical intervention, nutritional support, and speech-language care.

The effect of SpeechVive device on speech intelligibility in Parkinson’s Disease patients: Randomized Clinical Trial Protocol

Background: Hypokinetic dysarthria -with hypophonia as its main symptom- is a common feature of Parkinson’s disease, affecting approximately 90% of patients. Hypophonia, characterized by reduced speech volume, leads to difficulties in communication with others due to decreased speech intelligibility. Current treatments involve intensive and cognitively demanding behavioral therapies such as the Lee Silverman Voice Treatment (LSVT). The SpeechVive is a wearable device that produces noise to elicit increased vocal intensity utilizing a natural reflex through the Lombard effect.Methods: We propose a multicenter, phase III, two-armed, parallel, open-label, randomized controlled trial comparing the effectiveness of LSVT with SpeechVive. We seek to assign 238 patients to either LSVT or SpeechVive device in a 1:1 ratio through a stratified permuted block randomization. Patients ages 50 to 80 years, diagnosed with idiopathic Parkinson's Disease based on MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) criteria, a Hoehn and Yahr stage 2 and 3, on stable dopaminergic doses for the past 3 months, with perceived communication difficulties will be included in the trial. Patients will be excluded if they present additional neurodegenerative diseases, prior stroke, laryngeal pathologies, hearing or a severe visual impairment, or who underwent speech therapy or have a deep brain stimulation electrode implanted. The primary outcome is speech intelligibility measured through the Speech Intelligibility Test (SIT) for windows. Secondary outcomes include adherence, the vocal intensity measured with Sound Pressure Level (SPL), Vocal Handicap Index (VIH), and Parkinson's Disease Questionary-39. We will measure each outcome at baseline and after eight weeks of treatment. Our principal statistical analysis is multiple linear regression analysis, with age, gender, site, and PD severity as covariates.Discussion: We present a protocol for a randomized controlled trial addressing an important issue that hampers the ability of Parkinson's Disease patients to communicate effectively. We aim at exploring SpeechVive as an alternative, more accessible treatment for hypophonia in patients with Parkinson’s Disease. Keywords: SpeechVive device, Lee Silverman Speech Therapy (LSVT), hypophonia, Parkinson's Disease, the Lombard effect, Speech intelligibility.

52. THE EFFECT OF PREOPERATIVE PATIENT CHARACTERISTICS ON POSTOPERATIVE OUTCOMES OF CLEFT PALATE REPAIR: AN ANALYSIS OF GLOBAL SMILE TRAIN DATA

PURPOSE: The aim of this study was to identify patient characteristics that contribute to fistula and postoperative speech outcomes using global Smile Train data. METHODS: Analysis of palatoplasty outcomes was performed for 1,110 Smile Train partner hospitals. Patient factors following palatoplasty, including age, weight, and region, were correlated with fistula occurrence and speech outcomes. RESULTS: 2,560 patients were analyzed. The patients were 46.6% female and 27.5% underweight by WHO standards. Average age at palatoplasty was 24.7 + 0.5 months and at speech assessment was 6.8 ± 0.1 years. Underweight patients had higher incidence of hypernasality and decreased speech intelligibility. Palatoplasty when under 6 months or over 18 months of age had higher rates of affected nasality, intelligibility, and fistula formation. The same findings were seen in Central/South American and African patients, in addition to increased VPD and fistula surgery compared to Asian patients. Central/South American patients were also more likely to require VPD assessment. CONCLUSION: In the largest global cleft outcomes study to date, age and nutrition status were significant predictors of speech outcomes and fistula occurrence following palatoplasty. Outcomes were also significantly impacted by location, demonstrating the need to cultivate longitudinal initiatives to reduce regional disparities. These results underscore the importance of Smile Train’s continual expansion of accessible surgical intervention, nutritional support, and speech-language care.

Cluttering in a School-Aged Child: Tackling the Challenges Step by Step.

The purpose of this article is to highlight and provide solutions for the complexities of the communication disorder of cluttering. The article includes a 12-part case study of a school-aged child who is referred for an evaluation due to decreased speech intelligibility. The case is woven throughout the article to illustrate all aspects of client management: initial referral, evaluation and differential diagnosis, treatment, and discharge. The case reflects the challenges of increasing client awareness and the importance of advocating for client's needs throughout the process. This article provides background on myths about cluttering and current research findings to debunk these myths. Additionally, methods for evaluation, differential diagnosis, and treatment of cluttering are presented. An indirect approach to increasing client awareness and family and client education is included. The overall focus is to help the clinician better understand how to evaluate, treat, discharge, and advocate for clients with cluttering in ways that meet clients where they are.

The Influence of Face Masks on Verbal Communication in Persian in the Presence of Background Noise in Healthcare Staff.

Wearing face masks has resulted in verbal communication being more challenging during the COVID-19 pandemic. This study aimed to investigate the effect of face masks on the speech comprehensibility of Persian nurses in healthcare settings. Twenty female nurses from the governmental hospitals randomly participated in an experiment on seven typical commercial face masks at two background noise levels. Nurses' speech intelligibility from a human talker when wearing each face mask was determined based on the speech discrimination score. The vocal effort of nurses wearing each face mask was determined based on the Borg CR10 scale. Based on the linear mixed model, the speech intelligibility of nurses from a human speaker wearing surgical masks, N95 masks, and a shield with face masks were approximately 10%, 20%, and 40–50% lower, respectively, than no-mask conditions (p < 0.01). The background noise decreased the speech intelligibility of nurses by approximately 22% (p < 0.01). The use of a face shield further decreased speech intelligibility up to 30% compared to using a face mask alone (p < 0.01). The vocal efforts of nurses when wearing surgical masks were not significant compared with the baseline vocal efforts (p > 0.05); however, vocal efforts of nurses when wearing N95 and N99 respirators were at an unacceptable level. The face masks had no considerable effect on the speech spectrum below 2.5 kHz; however, they reduced high frequencies by different values. Wearing face masks has a considerable impact on the verbal communication of nurses in Persian. The level of background noise in the healthcare setting can aggravate the effect sizes of face masks on speech comprehensibility.

Public Speaking Coaching for Adult Special Olympics Athletes

Purpose Individuals with intellectual disabilities often face communication challenges that can impact verbal communication, social interactions, and public speaking effectiveness. These challenges include decreased speech intelligibility, eye contact, and storytelling organization. The purpose of this study was to investigate the benefit of a 4.5-month public speaking coaching program for adult Special Olympics athletes with intellectual disabilities. Method Using a pre–post design, four athletes and their parents or caregivers completed questionnaires that rated the athletes' public speaking skills in 10 areas relevant for effective public speaking before and after the 4.5-month program. Graduate students in communication sciences and disorders worked with the adults on individualized goals identified from a preliminary speech and the self-report questionnaires. Differences in pre- and post-program response ratings and pre- and post-program speech behaviors were evaluated. Results Participation in the program resulted in positive changes in the athletes' public speaking ratings and behaviors, as measured by the athletes' and familiar-listeners' pre- and post-program questionnaires and the athletes' observed public speaking performance. Conclusions The results support the benefit of individualized coaching in public speaking programs. Because public speaking skills are important for communicating effectively in community interactions more broadly, the program also has potential relevance for use in clinical settings and education programs for adults and adolescents with and without intellectual disabilities.

Assessment of speech intelligibility in university lecture rooms of different sizes using objective and subjective methods

The scores of speech intelligibility, obtained using objective and subjective methods for three university lecture rooms of the small, medium, and large sizes with different degrees of filling, were presented. The problem of achieving high speech intelligibility is relevant for both students and university administration, and for architects designing or reconstructing lecture rooms. Speech intelligibility was assessed using binaural room impulse responses which applied an artificial head and non-professional quality audio equipment for measuring. The Speech Transmission Index was an objective measure of speech intelligibility, while the subjective evaluation of speech intelligibility was carried out using the articulation method. Comparative analysis of the effectiveness of parameters of impulse response as a measure of speech intelligibility showed that Early Decay Time exceeded the score of the T30 reverberation time but was ineffective in a small lecture room. The C50 clarity index for all the considered lecture rooms was the most informative. Several patterns determined by the influence of early sound reflections on speech intelligibility were detected. Specifically, it was shown that an increase in the ratio of the energy of early reflections to the energy of direct sound leads to a decrease in speech intelligibility. The exceptions are small, up to 30‒40 cm, distances from the back wall of the room, where speech intelligibility is usually slightly higher than in the middle of the room. At a distance of 0.7–1.7 m from the side walls of the room, speech intelligibility is usually worse for the ear, which is closer to the wall. The usefulness of the obtained results lies in refining the quantitative characteristics of the influence of early reflections of sound on speech intelligibility at different points of lecture rooms.

Effect of Noise on Speech Intelligibility and Perceived Listening Effort in Head and Neck Cancer.

Purpose This study (a) examined the effect of different levels of background noise on speech intelligibility and perceived listening effort in speakers with impaired and intact speech following treatment for head and neck cancer (HNC) and (b) determined the relative contribution of speech intelligibility, speaker group, and background noise to a measure of perceived listening effort. Method Ten speakers diagnosed with nasal, oral, or oropharyngeal HNC provided audio recordings of six sentences from the Sentence Intelligibility Test. All speakers were 100% intelligible in quiet: Five speakers with HNC exhibited mild speech imprecisions (speech impairment group), and five speakers with HNC demonstrated intact speech (HNC control group). Speech recordings were presented to 30 inexperienced listeners, who transcribed the sentences and rated perceived listening effort in quiet and two levels (+7 and +5 dB SNR) of background noise. Results Significant Group × Noise interactions were found for speech intelligibility and perceived listening effort. While no differences in speech intelligibility were found between the speaker groups in quiet, the results showed that, as the signal-to-noise ratio decreased, speakers with intact speech (HNC control) performed significantly better (greater intelligibility, less perceived listening effort) than those with speech imprecisions in the two noise conditions. Perceived listening effort was also shown to be associated with decreased speech intelligibility, imprecise speech, and increased background noise. Conclusions Speakers with HNC who are 100% intelligible in quiet but who exhibit some degree of imprecise speech are particularly vulnerable to the effects of increased background noise in comparison to those with intact speech. Results have implications for speech evaluations, counseling, and rehabilitation.

The Influence of Aging, Hearing, and Tinnitus on the Morphology of Cortical Gray Matter, Amygdala, and Hippocampus.

Age related hearing loss (presbycusis) is a natural process represented by elevated auditory thresholds and decreased speech intelligibility, especially in noisy conditions. Tinnitus is a phantom sound that also potentially leads to cortical changes, with its highest occurrence coinciding with the clinical onset of presbycusis. The aim of our project was to identify age, hearing loss and tinnitus related structural changes, within the auditory system and associated structures. Groups of subjects with presbycusis and tinnitus (22 subjects), with only presbycusis (24 subjects), young tinnitus patients with normal hearing (10 subjects) and young controls (17 subjects), underwent an audiological examination to characterize hearing loss and tinnitus. In addition, MRI (3T MR system, analysis in Freesurfer software) scans were used to identify changes in the cortical and subcortical structures. The following areas of the brain were analyzed: Heschl gyrus (HG), planum temporale (PT), primary visual cortex (V1), gyrus parahippocampus (PH), anterior insula (Ins), amygdala (Amg), and hippocampus (HP). A statistical analysis was performed in R framework using linear mixed-effects models with explanatory variables: age, tinnitus, laterality and hearing. In all of the cortical structures, the gray matter thickness decreased significantly with aging without having an effect on laterality (differences between the left and right hemispheres). The decrease in the gray matter thickness was faster in the HG, PT and Ins in comparison with the PH and V1. Aging did not influence the surface of the cortical areas, however there were differences between the surface size of the reported regions in the left and right hemispheres. Hearing loss caused only a borderline decrease of the cortical surface in the HG. Tinnitus was accompanied by a borderline decrease of the Ins surface and led to an increase in the volume of Amy and HP. In summary, aging is accompanied by a decrease in the cortical gray matter thickness; hearing loss only has a limited effect on the structure of the investigated cortical areas and tinnitus causes structural changes which are predominantly within the limbic system and insula, with the structure of the auditory system only being minimally affected.

Acoustic characteristics in relation to intelligibility reduction in noise for speakers with Parkinson’s disease

ABSTRACT Decreased speech intelligibility in noisy environments is frequently observed in speakers with Parkinson’s disease (PD). This study investigated which acoustic characteristics across the speech subsystems contributed to poor intelligibility in noise for speakers with PD. Speech samples were obtained from 13 speakers with PD and five healthy controls reading 56 sentences. Intelligibility analysis was conducted in quiet and noisy listening conditions. Seventy-two young listeners transcribed the recorded sentences in quiet and another 72 listeners transcribed in noise. The acoustic characteristics of the speakers with PD who experienced large intelligibility reduction from quiet to noise were compared to those with smaller intelligibility reduction in noise and healthy controls. The acoustic measures in the study included second formant transitions, cepstral and spectral measures of voice (cepstral peak prominence and low/high spectral ratio), pitch variation, and articulation rate to represent speech components across speech subsystems of articulation, phonation, and prosody. The results show that speakers with PD who had larger intelligibility reduction in noise exhibited decreased second formant transition, limited cepstral and spectral variations, and faster articulation rate. These findings suggest that the adverse effect of noise on speech intelligibility in PD is related to speech changes in the articulatory and phonatory systems.

Diagnostic significance of subjective techniques for the study of the acoustic organ in patients with primary arterial hypertension

Objectives - to evaluate the diagnostic significance of subjective techniques for the study of the acoustic organ in patients with primary arterial hypertension (HT) Material and methods. 40 patients (n = 40) were divided into 2 groups: Group 1 included patients with HT, group 2 - conditionally healthy patients, examined at the Republican Center for Research and Practice in Otorhinolaryngology, in 2018-2019. The mathematical statistics, Student t-test were used. Results. The patients in the group 1 presented the following complaints: the decrease in speech intelligibility 80% (n=16), difficulty in recognizing the speech in polyphony 70% (n=14), tinnitus 60% (n=12), hearing loss 15% (n=3). Otoscopy in both groups was within normal. Whisper test result was 6 m in the conditionally healthy patients. In patients with HT, the whisper test with familiar multi-syllable words resulted as 6±0.5 m. However, the mono-syllable word hearing in all patients was reduced to 4±0.5 m. Type A tympanogram was registered in patients of both groups (n=40) with bilateral acoustic reflex. High-frequency audiometry showed changes in 1/3 of the patients in HT group (n=6). Monoaural speech intelligibility (multi-syllable words) at the comfortable hearing threshold was not significantly different in both study groups. The binaural speech intelligibility tested by alternating binaural speech at the comfortable auditory threshold reached 80±5% (t&gt;0,95), along with extremely low pass percentage (35%) in digital dichotic tests in patients with HT, that can suggest the feasible central mechanism of the auditory analyzer lesion. Conclusion. HT is a systemic disease that causes an impairment of the acoustic organ at the central and peripheral levels. In addition to the standard batch of hearing tests, it is recommended to use the superthreshold speech intelligibility tests in patients with arterial hypertension.

Interactions Between Digital Noise Reduction and Reverberation: Acoustic and Behavioral Effects.

Digital noise reduction (DNR) processing is used in hearing aids to enhance perception in noise by classifying and suppressing the noise acoustics. However, the efficacy of DNR processing is not known under reverberant conditions where the speech-in-noise acoustics are further degraded by reverberation. The purpose of this study was to investigate acoustic and perceptual effects of DNR processing across a range of reverberant conditions for individuals with hearing impairment. This study used an experimental design to investigate the effects of varying reverberation on speech-in-noise processed with DNR. Twenty-six listeners with mild-to-moderate sensorineural hearing impairment participated in the study. Speech stimuli were combined with unmodulated broadband noise at several signal-to-noise ratios (SNRs). A range of reverberant conditions with realistic parameters were simulated, as well as an anechoic control condition without reverberation. Reverberant speech-in-noise signals were processed using a spectral subtraction DNR simulation. Signals were acoustically analyzed using a phase inversion technique to quantify improvement in SNR as a result of DNR processing. Sentence intelligibility and subjective ratings of listening effort, speech naturalness, and background noise comfort were examined with and without DNR processing across the conditions. Improvement in SNR was greatest in the anechoic control condition and decreased as the ratio of direct to reverberant energy decreased. There was no significant effect of DNR processing on speech intelligibility in the anechoic control condition, but there was a significant decrease in speech intelligibility with DNR processing in all of the reverberant conditions. Subjectively, listeners reported greater listening effort and lower speech naturalness with DNR processing in some of the reverberant conditions. Listeners reported higher background noise comfort with DNR processing only in the anechoic control condition. Results suggest that reverberation affects DNR processing using a spectral subtraction algorithm in such a way that decreases the ability of DNR to reduce noise without distorting the speech acoustics. Overall, DNR processing may be most beneficial in environments with little reverberation and that the use of DNR processing in highly reverberant environments may actually produce adverse perceptual effects. Further research is warranted using commercial hearing aids in realistic reverberant environments.