Audible Improvement Research Articles

Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss.

This study aimed to investigate the role of hearing aid (HA) usage in language outcomes among preschool children aged 3-5 years with mild bilateral hearing loss (MBHL). The data were retrieved from a total of 52 children with MBHL and 30 children with normal hearing (NH). The association between demographical, audiological factors and language outcomes was examined. Analyses of variance were conducted to compare the language abilities of HA users, non-HA users, and their NH peers. Furthermore, regression analyses were performed to identify significant predictors of language outcomes. Aided better ear pure-tone average (BEPTA) was significantly correlated with language comprehension scores. Among children with MBHL, those who used HA outperformed the ones who did not use HA across all linguistic domains. The language skills of children with MBHL were comparable to those of their peers with NH. The degree of improvement in audibility in terms of aided BEPTA was a significant predictor of language comprehension. It is noteworthy that 50% of the parents expressed reluctance regarding HA use for their children with MBHL. The findings highlight the positive impact of HA usage on language development in this population. Professionals may therefore consider HAs as a viable treatment option for children with MBHL, especially when there is a potential risk of language delay due to hearing loss. It was observed that 25% of the children with MBHL had late-onset hearing loss. Consequently, the implementation of preschool screening or a listening performance checklist is recommended to facilitate early detection.

Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases

Background Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients. Aims/objectives Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified. Material and methods Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo). Results A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC4 of ≤30 dB. A gain in AC4 of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%). Conclusion and significance Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6–12 months seems relevant.

Modelling microprosodic effects can lead to an audible improvement in articulatory synthesis.

When pitch is explicitly modelled for parametric speech synthesis, microprosodic variations of the fundamental frequency f0 are usually disregarded by current intonation models. While there are numerous studies dealing with the nature and the origin of microprosody, little research has been done on its audibility and its effect on the naturalness of synthetic speech. In this work, the influence of obstruent-related microprosodic variations on the perceived naturalness of articulatory speech synthesis was studied. A small corpus of 20 German words and sentences was re-synthesized using the state-of-the-art articulatory synthesizer VocalTractLab. The pitch contours of the real utterances were extracted and fitted with the Target-Approximation-Model. After the real microprosodic variations were removed from the obtained pitch contours, synthetic variations were applied based on a microprosody model. Subsequently, multiple stimuli with different microprosody amplitudes were synthesized and evaluated in a listening experiment. The results indicate that microprosodic variations are barely audible, but can lead to a greater perceived naturalness of the synthesized speech in certain cases.

Clinical Performance Assessment of a New Active Osseointegrated Implant System in Mixed Hearing Loss: Results From a Prospective Clinical Investigation.

Objective:Evaluation of a new active osseointegrated bone-conduction hearing implant in moderate to severe mixed-hearing loss.Study Design:Prospective observational study of a series of cases.Setting:Tertial referral center.Patients:Twenty patients with moderate mixed-hearing loss were evaluated (10 Cochlear Osia group and 10 Baha 5 Power Connect -control group).Intervention:Rehabilitative.Main Outcome Measures:Hearing performance in quiet and in noise and quality-of-life were evaluated.Results:Improvements in audibility, speech-understanding, speech-recognition, and quality-of-sound in noise and quiet were found for the Osia System compared with preoperative unaided hearing and performance was similar to that obtained with Baha 5 Power Connect.Conclusions:The new active transcutaneous bone conduction system provided a tonal improvement in free-field at middle and high frequencies. The performance in speech recognition in quiet and in noise was similar to control group outcomes.

Clinical performance of the Osia™ system, a new active osseointegrated implant system. Results from a prospective clinical investigation

Background: Bone-conduction hearing implants are standard of care devices.Aims/Objectives: Evaluation of a new active magnetic bone-conduction hearing implant: Cochlear Osia™ system.Material and methods: This device uses a transcutaneous connection between an external sound-processor and an osseointegrated implant that generates vibrations using a piezoelectricity-based internal bone-conduction system. Nine patients with conductive-hearing loss were implanted. Surgical efficacy, hearing performance and quality-of-life were evaluated. Hearing performance in quiet and in noise was compared with unaided hearing and hearing with the Baha 5 Power® Sound Processor on a softband.Results: Surgery and healing were uneventful. Statistically significant improvements in audibility, speech-understanding, speech-recognition and quality-of-sound in noise and quiet were found for the Osia™ compared to preoperative unaided hearing and aided hearing with the Baha 5 Power® Sound Processor on a softband. The active vibration system provided improvement at low and high frequencies. At 6 months postoperatively, all patients continue to use the device.Conclusions and significance: The Osia™ is safe and effective, improving speech-recognition in quiet and in noise, at low and high frequencies, thus delivering better quality-of-hearing than passive devices.

Evaluating School Improvement Efforts – Pupils as Silent Result Suppliers, or Audible Improvement Resources?

This article contributes to a perspective of school development, where pupils‟ experiences of the teaching they encounter are regarded as a result of improvement work. In a three-year research coll ...

Hearing loss and cognition: the role of hearing AIDS, social isolation and depression.

Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.

Study of the long-term effects of frequency compression by behavioral verbal tests in adults.

To verify the effect of long-term use of hearing aids with frequency compression for verbal behavior tests and daily activities. Thirty-two adults, aged between 30 and 60 years old, with moderate to severe sensorineural hearing loss at high frequencies with steeply sloping configuration were divided into two groups: 16 with hearing aids with frequency compression algorithm enabled and 16 not enabled. All participants underwent the detection tests of consonant sounds, monosyllable recognition in quiet environments, identification of fricative monosyllables, and Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire in five times throughout a 12-month trial. Detection of consonant sounds, recognition of monosyllables in quiet environments and identification of fricative monosyllables improved significantly with frequency compression enabled. Participants had their APHAB scores improved whether they were adapted to the frequency compression or not. Frequency compression provides the anticipated improvement in audibility, detection of high-frequency consonant sounds, and recognition of monosyllables.

Frequency bark cepstral coefficients extraction for speech analysis by synthesis.

The Mel scale was proposed in 1937, following a series of experiments used to establish a perceptual scale. The use of the Mel scale is almost standard for speech recognition application. The Bark scale divides the audible spectrum into 24 critical bands that try to mimic the frequency response of the human ear. This article describes the process used to extract a set of cepstral coefficients from a warped frequency space (Mel and Bark) and analyze the perceived differences in the reconstructed signal. We will try to determine if there is any audible improvement between these two most warping functions for the purpose of speech analysis by synthesis. We will use the same procedure for parameter extraction and signal reconstruction for both functions, replacing only the warping scale used, to minimize the distortion other elements might add to the results. After running the waveform through both processes and reconstructing a wave signal from the parameters, while the resulting output was somewhat different, there were slight differences between the bark and mel generated signals. Statistical tests are now running between Mel and Bark scales.

Effects of Audibility and Multichannel Wide Dynamic Range Compression on Consonant Recognition for Listeners with Severe Hearing Loss

This study examined the effects of multichannel wide-dynamic range compression (WDRC) amplification and stimulus audibility on consonant recognition and error patterns. Listeners had either severe or mild to moderate sensorineural hearing loss. Each listener was monaurally fit with a wearable hearing aid using typical clinical procedures, frequency-gain parameters, and a hybrid of clinically prescribed compression ratios for desired sensation level () and NAL-NL (). Consonant-vowel nonsense syllables were presented in soundfield at multiple input levels (50, 65, 80 dB SPL). Test conditions were four-channel fast-acting WDRC amplification and a control compression limiting (CL) amplification condition. Listeners identified the stimulus heard from choices presented on an on-screen display. A between-subject repeated measures design was used to evaluate consonant recognition and consonant confusion patterns. Fast-acting WDRC provided a considerable audibility advantage at 50 dB SPL, especially for listeners with severe hearing loss. Listeners with mild to moderate hearing loss received less audibility improvement from the fast-acting WDRC amplification, for conversational and high level speech, when compared with listeners with severe hearing loss. Analysis of WDRC benefit scores revealed that listeners had slightly lower scores with fast-acting WDRC amplification (relative to CL) when WDRC provided minimal improvement in audibility. The negative effect was greater for listeners with mild to moderate hearing loss compared with their counterparts with severe hearing loss. All listeners, but particularly the severe loss group, benefited from fast-acting WDRC amplification for low-level speech. For conversational and higher speech levels (i.e., when WDRC does not confer a significant audibility advantage), fast-acting WDRC amplification seems to slightly degrade performance. Listeners' consonant confusion patterns suggest that this negative effect may be partly due to fast-acting WDRC-induced distortions, which alter specific consonant features. In support of this view, audibility accounted for a greater percentage of the variance in listeners' performance with CL amplification compared with fast-acting WDRC amplification.

Effects of an Extended Version of the Lee Silverman Voice Treatment on Voice and Speech in Parkinson’s Disease

The present study examined vocal SPL, voice handicap, and speech characteristics in Parkinson's disease (PD) following an extended version of the Lee Silverman Voice Treatment (LSVT), to help determine whether current treatment dosages can be altered without compromising clinical outcomes. Twelve participants with idiopathic PD received the extended treatment version (LSVT-X), similar to LSVT except that it was administered twice a week in 1-hr sessions over 8 weeks and required substantially more home practice. Recordings were made in a sound-treated booth immediately before and after treatment, and again 6 months later. Vocal SPL was measured for 4 different tasks and compared with data from a previous study, in which participants with PD received traditional LSVT 4 times a week for 4 weeks. Listener ratings were conducted with audio samples from both studies, using sentence pairs from a standard passage. LSVT-X participants completed the Voice Handicap Index (VHI) before each set of recordings. Participants receiving LSVT-X significantly increased vocal SPL by 8 dB after treatment and maintained increased vocal SPL by 7.2 dB at 6 months. VHI scores improved for 25% of the LSVT-X participants following treatment, and listener ratings indicated audible improvement in speech. LSVT-X successfully increased vocal SPL (which was consistent with improvements following traditional LSVT), decreased perceived voice handicap, and improved functional speech in individuals with PD. Further large-scale research is required to truly establish LSVT-X efficacy.

Large Vestibular Aqueduct Syndrome: A Case Study

A 23-month-old female was referred for hearing aid fitting after failing newborn hearing screening and being diagnosed with significant hearing loss through subsequent diagnostic testing. Auditory brainstem response (ABR) and behavioral testing revealed a moderate-to-severe bilateral mixed hearing loss. Prior to the hearing aid evaluation, tympanostomy tubes had been placed bilaterally with little or no apparent change in hearing sensitivity. Initial testing during the hearing aid fitting confirmed earlier findings, but abnormal middle ear results were observed, requiring referral for additional otologic management. Following medical clearance, binaural digital programmable hearing aids were fit using Desired Sensation Level parameters. Behavioral testing and probe microphone measures showed significant improvements in audibility. Decrease in hearing sensitivity was observed six months following hearing aid fitting. Radiological studies, ordered due to the mixed component and decreased hearing sensitivity, revealed large vestibular aqueduct syndrome (LVAS). Based on the diagnosis of LVAS, a cochlear implant was placed on the right ear; almost immediate speech-language gains were observed.

Effects of Three Amplification Strategies on Speech Perception by Children With Severe and Profound Hearing Loss

Traditionally in the United Kingdom, children with severe and profound hearing loss have been fitted with linear, analog hearing aids. Fast-acting, wide-dynamic-range compression (WDRC) has been shown to give better discrimination of speech than linear amplification for moderately hearing-impaired young adults. For severe and profound hearing losses, higher compression ratios are needed. The resultant distortion of the temporal envelope and reduced modulation depth may offset improvements in audibility offered by WDRC. In this study, speech recognition and discrimination were assessed for severely and profoundly hearing-impaired children, using three different amplification strategies, including WDRC. Fifteen children (ages 7 to 15 yr) with severe and profound hearing loss were fitted bilaterally with high-power, multichannel compression hearing aids, incorporating one of three different amplification strategies: linear with peak clipping, linear with compression limiting, or WDRC. Output responses were matched to Desired Sensation Level (DSL i/o) targets. The children wore hearing aids programmed with each of the amplification strategies in turn, for at least 1 wk, in a counterbalanced order across children. After using a particular amplification strategy for at least 1 wk, speech perception tests were carried out. Speech scores on closed-set testing for the profound group showed significant benefit for WDRC over the other two algorithms. None of the other results showed a statistically significant effect of algorithm on speech performance. WDRC amplification sometimes led to better performance than linear amplification with peak clipping or output limiting, and it never led to poorer performance. Therefore, it appears to be safe to use well-designed WDRC for hearing-impaired children with severe or profound hearing loss.

Automated post‐hoc noise cancellation tool for audio recordings acquired in an MRI scanner

There are several types of experiment in which it is useful to have subjects speak overtly in a magnetic resonance imaging (MRI) scanner, including those studying the articulatory apparatus and the neural basis of speech production, and fMRI experiments in which speech is used as a response modality. Although it is relatively easy to record sound from the bore, it can be difficult to hear the speech over the very loud acoustic noise from the scanner. This is particularly a problem during echo-planar imaging, which is usually used for fMRI. We present a post-hoc sound cancellation algorithm, and describe a Windows-based tool that implements it. The tool is fast and operates with minimal user intervention. We evaluate cancellation performance in terms of the improvement in signal-to-noise ratio, and investigate the effect of the recording medium. A substantial improvement in audibility was obtained.

Dissonant frequency filtering technique for improving perceptual quality of noisy speech and husky voice

There have been numerous studies on the enhancement of the noisy speech signal. In this paper, we propose a completely new speech quality improvement method, that is, a dissonant frequency filtering technique (especially B and F# in each octave of the tempered scale when the reference frequency is C) based on improved fundamental frequency estimation which is developed in frequency domain. The subjective test results indicate that the proposed method provides a significant gain in audible improvement especially for a husky voice signal. Therefore if the filter is employed as a pre-filter for speech quality improvement, the output speech quality and intelligibility should be enhanced perceptually.

New speech tests reveal benefit of widedynamic-range, fast-acting compression for consonant discrimination in children with moderate-to-profound hearing loss: Una nueva prueba con lenguaje demuestra beneficios al utilizar compresión de ejecución rápida y de rango dinámico amplio, rango dinámico amplio, compresión de ejecución rápida para la discriminación de consonantes en niños con hipoacusia moderada a profunda

Fast-acting, wide-dynamic-range compression (WDRC) has been shown to give better discrimination of soft speech and shouted speech than linear amplification for moderately hearingimpaired young adults. For severe and profound hearing losses, higher compression ratios are needed. The resultant distortion of the temporal envelope and reduced modulation depth may offset improvements in audibility offered by WDRC. This study compares the effectiveness of WDRC and linear amplification for children with different degrees of hearing loss. Pre-recorded tests of closed-set consonant confusions and open-set word recognition were developed to assess performance. Three groups of subjects (aged 4–14 years) with moderate (51–70 dB), severe (71–90 dB) and profound (91–115 dB) hearing loss were fitted with hearing aids programmed with WDRC or linear amplification. The frequency response was adjusted to match each child's own hearing aid prescription. For each group, stimuli were presented both in quiet and in noise at levels chosen to avoid floor and ceiling effects. Consonant confusion scores for the profound and severe groups combined and for the moderate group were significantly better with WDRC than with linear amplification. Open-set lest results showed greater variability. Although mean scores were higher for WDRC than for linear processing, the effects were of marginal statistical significance.

Casque antibruit actif basses-fréquences et audition dans le bruit

A low-frequency active anti-noise headset has been made, and tested on human ears with regard to hearing in noise. Psychoacoustic methods are used in order to quantify the improvement in audibility and intelligibility. Under low-frequency noise, a spectacular effect of anti-noise is observed, while headset wearing brings just a very little global improvement because of negative passive effect. Besides optimization of passive acoustic attenuation, evaluation of such an apparatus is faced with interindividual hearing in noise variability

Filtering of colored noise for speech enhancement and coding

Scalar and vector Kalman filters are implemented for filtering speech contaminated by additive white noise or colored noise, and an iterative signal and parameter estimator which can be used for both noise types is presented. Particular emphasis is placed on the removal of colored noise, such as helicopter noise, by using state-of-the-art colored-noise-assumption Kalman filters. The results indicate that the colored noise Kalman filters provide a significant gain in signal-to-noise ratio (SNR), a visible improvement in the sound spectrogram, and an audible improvement in output speech quality, none of which are available with white-noise-assumption Kalman and Wiener filters. When the filter is used as a prefilter for linear predictive coding, the coded output speech quality and intelligibility are enhanced in comparison to direct coding of the noisy speech.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

Resistively damped loudspeaker system

A loudspeaker system is provided wherein the coils, capacitors, and loudspeaker drive units and combinations thereof are resistively damped to provide electrical damping of the back EMF of these components and thereby reduce ringing in the loudspeaker crossover networks. The result is a measurable and clearly audible improvement in the accuracy of the sound produced by the loudspeaker system.