Normal-hearing Participants Research Articles

Needs of Deaf People Using Elevators: Identification of Accessibility and Safety Requirements

As urbanization and population growth continue, cities concentrate an increasing amount of people, energy, and economy. Multi-story buildings enable densification, requiring vertical transport for access to upper floors. This is crucial for people with disabilities, who may face barriers in the built environment. Elevators are essential for accessibility, allowing everyone, including people with disabilities, to comfortably access multi-story buildings. However, barriers to inclusivity remain, often subtle and hard to define. This paper highlights one such example, focusing on elevator use by individuals with varying degrees of hearing loss. Currently, they cannot establish one-to-one communication with the outside world if trapped in an elevator. Under EN standards, this issue stems from alarm system requirements that lack effective alternatives to voice communication. Based on this evidence, the research was carried out in two steps, with the aim of understanding the needs of deaf individuals when using elevators by directly involving them in the study. First, a questionnaire conducted in Italy collected information regarding the safety and usability of elevators. Second, a test campaign involving both deaf and normal-hearing participants was carried out to quantify the severity of the issue and evaluate potential solutions to address the identified challenges. The conclusions indicate that current alarm systems in elevators are inadequate for individuals with hearing impairments, and effective alternatives must be implemented.

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

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

Hearing Impairment: Reduced Pupil Dilation Response and Frontal Activation During Degraded Speech Perception.

A relevant aspect of listening is the effort required during speech processing, which can be assessed by pupillometry. Here, we assessed the pupil dilation response of normal-hearing (NH) and hard of hearing (HH) individuals during listening to clear sentences and masked or degraded sentences. We combined this assessment with functional magnetic resonance imaging (fMRI) to investigate the neural correlates of the pupil dilation response. Seventeen NH participants (Mage = 46 years) were compared to 17 HH participants (Mage = 45 years) who were individually matched in age and educational level. Participants repeated sentences that were presented clearly, that were distorted, or that were masked. The sentence intelligibility level of masked and distorted sentences was 50% correct. Silent baseline trials were presented as well. Performance measures, pupil dilation responses, and fMRI data were acquired. HH individuals had overall poorer speech reception than the NH participants, but not for noise-vocoded speech. In addition, an interaction effect was observed with smaller pupil dilation responses in HH than in NH listeners for the degraded speech conditions. Hearing impairment was associated with higher activation across conditions in the left superior temporal gyrus, as compared to the silent baseline. However, the region of interest analysis indicated lower activation during degraded speech relative to clear speech in bilateral frontal regions and the insular cortex, for HH compared to NH listeners. Hearing impairment was also associated with a weaker relation between the pupil response and activation in the right inferior frontal gyrus. Overall, degraded speech evoked higher frontal activation than clear speech. Brain areas associated with attentional and cognitive-control processes may be increasingly recruited when speech is degraded and are related to the pupil dilation response, but this relationship is weaker in HH listeners. https://doi.org/10.23641/asha.27162135.

Spectral weighting functions for localization of complex sound. III. The effect of sensorineural hearing lossa).

Spectral weighting functions for sound localization were measured in participants with bilateral mild sloping to moderately severe, high-frequency sensorineural hearing loss (SNHL) and compared to normal hearing (NH) participants with and without simulated SNHL. Each participant group localized three types of complex tones, comprised of seven frequency components spatially jittered and presented from the horizontal frontal field. A threshold-elevating noise masker was implemented in the free field to simulate SNHL for participants with NH. On average, participants with SNHL and NH (in quiet and simulated SNHL) placed the greatest perceptual weight on components within the interaural time difference "dominance region," found previously to peak around 800 Hz [Folkerts and Stecker, J. Acoust. Soc. Am. 151, 3409-3425 (2022)]. In addition to the peak at 800 Hz, both participant groups (including NH participants in quiet) placed near equal weight on 400 Hz, resulting in a broadened "peak" in the dominance region, most likely due to the reduction of audibility to higher frequency components. However, individual weighting strategies were more variable across participants with SNHL than participants with NH. Localization performance was reduced for participants with SNHL but not for NH participants with simulated hearing loss when compared to NH participants in quiet.

Temporal fine structure sensitivity measured with pulse-spreading harmonic complexes.

Two experiments investigated sensitivity to temporal fine structure (TFS) in a group of normal hearing participants. The stimuli were bandpass filtered pulse-spreading harmonic complexes (PSHCs) with a regular envelope repetition rate and a phase adjusted so that the TFS peaks were progressively shifted across envelope periods. For up-PSHCs, the TFS peaks were advanced, yielding a rising pitch percept, while for down-PSHCs, the peaks were delayed, yielding a falling pitch percept. Experiment 1 showed that in a fixed frequency region, there was a range of rates for which the direction of the pitch change could be identified. Cochlear model simulations suggested that participants may use either place-of-excitation and/or temporal cues to perform this task. Experiment 2 showed that there was an envelope rate below which down-PSHCs and up-PSHCs could not be discriminated. This lower envelope rate limit of TFS sensitivity significantly increased with increases in frequency region and was similar to the lower rate limit of melodic pitch. The results in high frequency regions suggest that TFS cues are available up to 10 kHz when the rank of the lowest component present in the passband is 18, and all harmonics are presumably unresolved.

ICF-based hearing and functioning assessment: validation and research outcomes of utilizing the HEAR-COMMAND tool for patients with mild to moderately severe hearing loss and individuals with normal hearing.

Current clinical assessments for Hearing Loss (HL) are often limited to controlled laboratory settings in which a narrow spectrum of hearing difficulties can be assessed. A majority of the daily life challenges caused by HL cannot be measured in clinical methodologies. To screen the individuals' needs and limitations, a questionnaire named the HEAR-COMMAND tool was developed and qualitatively validated through an international collaboration, aligning with the World Health Organization's International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss. The tool empowers healthcare professionals (HCPs) to integrate the ICF framework into patient assessments and patient-reported outcomes (PRO) in clinical and non-clinical settings. The aim is to provide a general foundation and starting point for future applications in various areas including ENT and hearing acoustics. The outcome can be employed to define and support rehabilitation in an evidence-based manner. This article presents the validation and research outcomes of using the tool for individuals with mild to moderately severe HL in contrast to normal-hearing individuals. Using a cross-sectional multicenter study, the tool was distributed among 215 participants in Germany, the USA, and Egypt, filled in German, English, or Arabic. Three outcome scores and the corresponding disability degree were defined: hearing-related, non-hearing-related, and speech-perception scores. The content and construct validation were conducted, and the tool's internal consistency was assessed. The extracted constructs included "Auditory processing functionality", "Sound quality compatibility", "Listening and communication functionality", "Interpersonal interaction functionality and infrastructure accessibility", "Social determinants and infrastructure compatibility", "Other sensory integration functionality", and "Cognitive functionality". Regarding content validity, it was demonstrated that normal-hearing participants differed significantly from individuals with HL in the hearing-related and speech-perception scores. The reliability assessment showed a high internal consistency (Cronbach's alpha = 0.9). The outcome demonstrated the HEAR-COMMAND tool's high content and construct validity. The tool can effectively represent the patient's perspective of HL and hearing-related functioning and enhance the effectiveness of the treatment plans and rehabilitation. The broad range of targeted concepts provides a unique overview of daily life hearing difficulties and their impact on the patient's functioning and quality of life.

Quantification of Automatic Speech Recognition System Performance on d/Deaf and Hard of Hearing Speech.

To evaluate the performance of commercial automatic speech recognition (ASR) systems on d/Deaf and hard-of-hearing (d/Dhh) speech. A corpus containing 850 audio files of d/Dhh and normal hearing (NH) speech from the University of Memphis Speech Perception Assessment Laboratory was tested on four speech-to-text application program interfaces (APIs): Amazon Web Services, Microsoft Azure, Google Chirp, and OpenAI Whisper. We quantified the Word Error Rate (WER) of API transcriptions for 24 d/Dhh and nine NH participants and performed subgroup analysis by speech intelligibility classification (SIC), hearing loss (HL) onset, and primary communication mode. Mean WER averaged across APIs was 10 times higher for the d/Dhh group (52.6%) than the NH group (5.0%). APIs performed significantly worse for "low" and "medium" SIC (85.9% and 46.6% WER, respectively) as compared to "high" SIC group (9.5% WER, comparable to NH group). APIs performed significantly worse for speakers with prelingual HL relative to postlingual HL (80.5% and 37.1% WER, respectively). APIs performed significantly worse for speakers primarily communicating with sign language (70.2% WER) relative to speakers with both oral and sign language communication (51.5%) or oral communication only (19.7%). Commercial ASR systems underperform for d/Dhh individuals, especially those with "low" and "medium" SIC, prelingual onset of HL, and sign language as primary communication mode. This contrasts with Big Tech companies' promises of accessibility, indicating the need for ASR systems ethically trained on heterogeneous d/Dhh speech data. 3 Laryngoscope, 2024.

Acoustic scene complexity affects motion behavior during speech perception in audio-visual multi-talker virtual environments

In real-world listening situations, individuals typically utilize head and eye movements to receive and enhance sensory information while exploring acoustic scenes. However, the specific patterns of such movements have not yet been fully characterized. Here, we studied how movement behavior is influenced by scene complexity, varied in terms of reverberation and the number of concurrent talkers. Thirteen normal-hearing participants engaged in a speech comprehension and localization task, requiring them to indicate the spatial location of a spoken story in the presence of other stories in virtual audio-visual scenes. We observed delayed initial head movements when more simultaneous talkers were present in the scene. Both reverberation and a higher number of talkers extended the search period, increased the number of fixated source locations, and resulted in more gaze jumps. The period preceding the participants’ responses was prolonged when more concurrent talkers were present, and listeners continued to move their eyes in the proximity of the target talker. In scenes with more reverberation, the final head position when making the decision was farther away from the target. These findings demonstrate that the complexity of the acoustic scene influences listener behavior during speech comprehension and localization in audio-visual scenes.

The Audible Contrast Threshold (ACT) test: A clinical spectro-temporal modulation detection test

Over the last decade, multiple studies have shown that hearing-impaired listeners’ speech-in-noise reception ability, measured with audibility compensation, is closely associated with performance in spectro-temporal modulation (STM) detection tests. STM tests thus have the potential to provide highly relevant beyond-the-audiogram information in the clinic, but the available STM tests have not been optimized for clinical use in terms of test duration, required equipment, and procedural standardization. The present study introduces a quick-and-simple clinically viable STM test, named the Audible Contrast Threshold (ACT™) test. First, an experimenter-controlled STM measurement paradigm was developed, in which the patient is presented bilaterally with a continuous audibility-corrected noise via headphones and asked to press a pushbutton whenever they hear an STM target sound in the noise. The patient's threshold is established using a Hughson-Westlake tracking procedure with a three-out-of-five criterion and then refined by post-processing the collected data using a logistic function. Different stimulation paradigms were tested in 28 hearing-impaired participants and compared to data previously measured in the same participants with an established STM test paradigm. The best stimulation paradigm showed excellent test-retest reliability and good agreement with the established laboratory version. Second, the best stimulation paradigm with 1-second noise “waves” (windowed noise) was chosen, further optimized with respect to step size and logistic-function fitting, and tested in a population of 25 young normal-hearing participants using various types of transducers to obtain normative data. Based on these normative data, the “normalized Contrast Level” (in dB nCL) scale was defined, where 0 ± 4 dB nCL corresponds to normal performance and elevated dB nCL values indicate the degree of audible contrast loss. Overall, the results of the present study suggest that the ACT test may be considered a reliable, quick-and-simple (and thus clinically viable) test of STM sensitivity. The ACT can be measured directly after the audiogram using the same set up, adding only a few minutes to the process.

Effects of age and hearing loss on speech emotion discrimination

Better communication with older people requires not only improving speech intelligibility but also understanding how well emotions can be conveyed and the effect of age and hearing loss (HL) on emotion perception. In this paper, emotion discrimination experiments were conducted using a vocal morphing method and an HL simulator in young normal hearing (YNH) and older participants. Speech sounds were morphed to represent intermediate emotions between all combinations of happiness, sadness, and anger. Discrimination performance was compared when the YNH listened to normal sounds, when the same YNH listened to HL simulated sounds, and when older people listened to the same normal sounds. The results showed that there was no significant difference between discrimination with and without HL simulation, suggesting that peripheral HL may not affect emotion perception. The discrimination performance of the older participants was significantly worse only for the anger-happiness pair than for the other emotion pairs and for the YNH. It was also found that the difficulty increases with age, not just with hearing level.

Remote self-testing for adult cochlear implant users: the effect of wireless streaming on speech recognition in noise

Objectives Wireless sound transfer methods for cochlear implant sound processors have become popular for remote self-assessed hearing tests. The aim of this study was to determine (1) spectral differences in stimuli between different wireless sound transfer options and (2) the effect on outcomes of speech recognition tests in noise. Design In study 1, the frequency response of different streaming options (Phonak Roger Select, Cochlear Mini Mic 2+, telecoil and Bluetooth connection) was measured by connecting headphones to CI sound processors. Study 2 followed a repeated measures design in which digits-in-noise (DIN) tests were performed using wireless streaming to sound processors from Cochlear, Advanced Bionics, and MED-EL. Study Sample 20 normal hearing participants. Results Differences in frequency response between loudspeaker and wireless streaming conditions were minimal. We did not find significant difference in DIN outcome (F4,194 = 1.062, p = 0.376) between the wireless transfer options with the Cochlear Nucleus 7 processor. No significant difference in DIN outcomes was found between Bluetooth streaming and the loudspeaker condition for all of the three tested brands. The mean standard error of measurement was 0.72 dB. Conclusions No significant differences in DIN test outcomes between wireless sound transfer and the reference method were found.

Auditory Steady-State Responses: Multiplexed Amplitude Modulation Frequencies to Reduce Recording Time.

This study investigated the efficiency of a multiplexed amplitude-modulated (AM) stimulus in eliciting auditory steady-state responses. The multiplexed AM stimulus was created by simultaneously modulating speech-shaped noise with three frequencies chosen to elicit different neural generators: 3.1, 40.1, and 102.1 Hz. For comparison, a single AM stimulus was created for each of these frequencies, resulting in three single AM conditions and one multiplex AM condition. Twenty-two bilaterally normal-hearing participants (18 females) listened for 8 minutes to each type of stimuli. The analysis compared the signal to noise ratios (SNRs) and amplitudes of the evoked responses to the single and multiplexed conditions. The results revealed that the SNRs elicited by single AM conditions were, on average, 1.61 dB higher than those evoked by the multiplexed AM condition ( p < 0.05). The single conditions consistently produced a significantly higher SNR when examining various stimulus durations ranging from 1 to 8 minutes. Despite these SNR differences, the frequency spectrum was very similar across and within subjects. In addition, the sensor space patterns across the scalp demonstrated similar trends between the single and multiplexed stimuli for both SNR and amplitudes. Both the single and multiplexed conditions evoked significant auditory steady-state responses within subjects. On average, the multiplexed AM stimulus took 31 minutes for the lower bound of the 95% prediction interval to cross the significance threshold across all three frequencies. In contrast, the single AM stimuli took 45 minutes and 42 seconds. These findings show that the multiplexed AM stimulus is a promising method to reduce the recording time when simultaneously obtaining information from various neural generators.

Investigating individual, loudness-dependent equalization preferences in different driving sound conditions

In automotive audio playback systems, dynamically increasing driving sounds are typically taken into account by applying a generic, i.e., non-individualized, increase in overall level and low-frequency amplification to compensate increased masking. This study investigated the degree of individuality regarding the preferences of noise-dependent level and equalizer settings. A user study with 18 normal-hearing participants was conducted in which individually preferred level-dependent and frequency-dependent amplification parameters were determined using a music-based procedure in quiet and in nine different driving noise conditions. The comparison of self-adjusted parameters suggested that, on average, participants adjusted higher overall levels and more low-frequency amplification in noise than in quiet. However, preferred self-adjusted levels differedmarkedly between participants for the same listening conditions but were quite similar in a re-test session for each participant, indicating that individual preferences were stable and could be reproducibly measured with the employed personalization scheme. Furthermore, the impact of driving noise on individually preferred settings revealed strong interindividual differences, indicating that listeners can differ widely with respect to their individual optimum of how equalizer and level settings should be dynamically adapted to changes in driving conditions.

The vestigial pinna-orienting system in humans briefly suppresses superior auricular muscle activity during reflexive orienting toward auditory stimuli.

The vestigial pinna-orienting system in humans is capable of increasing the activity of several auricular muscles in response to lateralized transient auditory stimuli. For example, transient increases in electromyographic activity in the posterior auricular muscle (PAM) to an attention-capturing stimulus have been documented. For the current study, surface electromyograms (EMGs) were recorded from the PAMs and superior auricular muscles (SAMs) of 10 normal-hearing participants. During the experiments, lateralized transient auditory stimuli, such as a crying baby, a shattering vase, or the participant's first names, were presented. These transient stimuli were either presented in silence or when participants actively listened to a podcast. Although ipsilateral PAM activity increased in response to transient stimuli, the SAM displayed the opposite behavior, i.e., a brief, ipsilateral suppression of activity. This suppression of ipsilateral SAM activity was more frequent on the right (75%) than left side (35%), whereas an ipsilateral PAM increase was roughly equal in prevalence on the two sides (left: 90%, right: 95%). During the active listening task, SAM suppression on the right ear was significantly larger in response to ipsilateral stimuli, compared with contralateral ones (P = 0.002), whereas PAM activity increased significantly (P = 0.002). Overall, this study provides evidence of a systematic transient suppression of the SAM during exogenous attention. This could suggest a more complex system than previously assumed, as the presence of synchronized excitatory and inhibitory components in different auricular muscles points toward a coordinated attempt at reflexively orienting the pinna toward a sound.NEW & NOTEWORTHY This study provides evidence that two auricular muscles in humans, the posterior and superior auricular muscles (PAM, SAM), react fundamentally different to lateralized transient auditory stimuli, especially during active listening. Although the PAM reacts with a transient increase in ipsilateral activity, ongoing ipsilateral SAM activity is briefly suppressed at the same time. This indicates the presence of a more complex and nuanced pinna-orienting system, with synchronized excitatory and inhibitory components in humans, than previously suspected.

Evaluating benefits of remote microphone technology for adults with hearing loss using behavioural and predictive metrics

Objective To investigate the benefit of remote-microphone (RM) systems for adults with sensory hearing loss. Design Speech recognition in quiet and in background noise was assessed. Participants with hearing loss underwent testing in two device conditions: hearing aids (HAs) alone and HAs with a RM. Normal hearing participants completed testing in the unaided condition. Predictive speech intelligibility modelling using the Hearing-Aid Speech Perception Index (HASPI) was also performed on recordings of HA processed test material. Study Sample Twenty adults with sensory hearing loss and 10 adults with normal hearing participated. Results Speech recognition for participants with hearing loss improved significantly when using the RM compared to HAs alone fit to Phonak’s proprietary prescription. Largest benefits were observed in the most challenging conditions. At the lowest signal-to-noise ratio, participants with hearing loss using a RM outperformed normal hearing listeners. Predicted intelligibility scores produced by HASPI were strongly correlated to behavioural results. Conclusions Adults using HAs who have significant difficulties understanding speech in noise will experience considerable benefits with the addition of a RM. Improvements in speech recognition were observed for all participants using RM systems, including those with relatively mild hearing loss. HASPI modelling reliably predicted the speech perception difficulties experienced.

Chinese Emotional Speech Audiometry Project (CESAP): Establishment and Validation of a New Material Set With Emotionally Neutral Disyllabic Words.

The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody. In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (-1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes. First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%-80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%-80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%-80% slope (12%). Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments. https://doi.org/10.23641/asha.25742814.

Effect of music integrated phonological awareness program on preschool cochlear implant users

ObjectivesChildren with cochlear implants exhibit lower phonological awareness and sound discrimination skills compared to their normal-hearing peers. However, music training has been shown to have a positive effect on speech discrimination and awareness skills. MethodsOur study included 23 cochlear implant users and 23 normal hearing participants aged 5–6 years with language skills. The aim was to observe the effect of a music-integrated phonological awareness program on cochlear implant users and to compare the phonological awareness skills of children with cochlear implants before and after online training with their normal hearing peers. ResultsResults showed that the trained study group scored higher on the Scale of Early Childhood Phonological Awareness (PASECP) after training than the control group (p < 0.05). In addition, SMRT scores increased between before and after training in the study group, and Mismatch Negativity (MMN) amplitudes increased and latencies decreased as a result of training (p < 0.05). ConclusionsThe study suggests that phonological awareness training integrated with music can effectively improve the phonological awareness skills of children with cochlear implants and has the potential to enable them to achieve phonological awareness levels similar to or even better than their normal hearing peers.

Subcortical auditory system in tinnitus with normal hearing: insights from electrophysiological perspective

PurposeThe mechanism of tinnitus remains poorly understood; however, studies have underscored the significance of the subcortical auditory system in tinnitus perception. In this study, our aim was to investigate the subcortical auditory system using electrophysiological measurements in individuals with tinnitus and normal hearing. Additionally, we aimed to assess speech-in-noise (SiN) perception to determine whether individuals with tinnitus exhibit SiN deficits despite having normal-hearing thresholds.MethodsA total 42 normal-hearing participants, including 22 individuals with chronic subjective tinnitus and 20 normal individuals, participated in the study. We recorded auditory brainstem response (ABR) and speech-evoked frequency following response (sFFR) from the participants. SiN perception was also assessed using the Matrix test.ResultsOur results revealed a significant prolongation of the O peak, which encodes sound offset in sFFR, for the tinnitus group (p < 0.01). The greater non-stimulus-evoked activity was also found in individuals with tinnitus (p < 0.01). In ABR, the tinnitus group showed reduced wave I amplitude and prolonged absolute wave I, III, and V latencies (p ≤ 0.02). Our findings suggested that individuals with tinnitus had poorer SiN perception compared to normal participants (p < 0.05).ConclusionThe deficit in encoding sound offset may indicate an impaired inhibitory mechanism in tinnitus. The greater non-stimulus-evoked activity observed in the tinnitus group suggests increased neural noise at the subcortical level. Additionally, individuals with tinnitus may experience speech-in-noise deficits despite having a normal audiogram. Taken together, these findings suggest that the lack of inhibition and increased neural noise may be associated with tinnitus perception.

The Cambridge aided loudness profile (CALP): item choices and data for unaided listening by young and older normal-hearing listeners and older hearing-impaired listeners

Objective To develop an improved version of the profile of aided loudness (PAL), intended for assessment of the appropriateness of the loudness of everyday sounds. Design Initially, 16 participants with a range of ages and degrees of hearing loss indicated whether they encountered each situation described in the PAL and how specific they considered the description to be. Based on the responses, most situations from the PAL were eliminated and new situations were introduced, giving the Cambridge Aided Loudness Profile (CALP). The CALP was administered to 80 young and 22 older participants with normal hearing, who rated the loudness of each situation and satisfaction with this loudness (as for the original PAL). Satisfaction was strongly negatively correlated with loudness, suggesting that satisfaction was largely based on loudness. The CALP was then administered to 32 new young normal-hearing participants and 49 older participants with hearing loss, most of whom used hearing aids, who rated loudness and the appropriateness of loudness. Results Some situations were rated as loud but appropriate in loudness, indicating that the CALP can distinguish these aspects. Conclusions The CALP questions were understood by all participants. The CALP may be useful for assessing the appropriateness of loudness.

Development of Digit in Noise Test in Hindi.

The digit in the noise test is a simple hearing screening tool that can identify hearing loss at the early stage. This screening tool takes less time than traditional pure-tone audiometry. There is a scarcity of hearing health professionals with few resources for carrying out hearing screening on a large scale in India. Hence, a hearing screening tool for the Hindi-speaking population is needed. The study aimed to develop and validate the Digit in Noise test in Hindi (DIN-H). A native Hindi female speaker recorded single digits from 1 to 9 made into triplet combinations, which were binaurally presented to 20 normal hearing subjects having hearing thresholds less than 25 dBHL from 250 to 8000Hz in the presence of broadband speech-shaped noise. The digit triplets were homogenized using speech intelligibility function for similar difficulty levels across stimuli. The homogenized stimuli were evaluated by obtaining the Speech Recognition Threshold (SRT) of 20 normal hearing subjects. The Mean SRT was - 10.4 and - 11.3 dB before and after homogenization. A strong positive correlation existed between test and retest SRTs (0.78). Mean SRT and slope obtained before and after optimization were comparable to other languages like Korean and English. This test can act as a reliable screening tool for assessing individuals. The test was administered to 106 normal hearing participants. The 95th percentile of the SRT value obtained was - 5.6 dB, which was kept as a cut-off score for the screening test. DIN-H can be used as a screening tool for assessing the integrity of the auditory system on a large scale in less time for the Hindi-speaking population.