Perception In Quiet Research Articles

Bimodal Hearing in Individuals with Severe-to-Profound Hearing Loss: Benefits, Challenges, and Management.

Binaural hearing offers numerous advantages over monaural hearing. While bilateral implants are a successful treatment option for some patients, many individuals choose to achieve binaural hearing by using a cochlear implant with a contralateral hearing aid. Compared with monaural hearing, benefits of bimodal hearing include improved speech perception in quiet and in noise, improved localization, and more natural sound quality. Despite the advantages, there exist disadvantages to bimodal hearing, primarily related to binaural integration. Management of these devices can be challenging in that the hearing aid and cochlear implant may be managed by different clinicians. When fitting devices, strategies are recommended to optimize the integration of input from both devices. In managing bimodal devices, recommended outcomes measures include those that would reflect bimodal benefit, such as speech understanding in noise and spatial sound quality perception.

Cognitive Performance of Severely Hearing-impaired Older Adults Before and After Cochlear Implantation: Preliminary Results of a Prospective, Longitudinal Cohort Study Using the RBANS-H.

To evaluate cognitive change in severely hearing-impaired older adults after cochlear implantation. Prospective, longitudinal cohort study with assessments before, and at 6 and 12 months after implantation. Twenty older adults (median age: 71.5 yr). Change in the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing-impaired individuals (RBANS-H) total score and subdomain scores were used to assess cognitive evolution. In addition, change in best-aided speech audiometry in quiet (monosyllabic words) and in noise (Leuven Intelligibility Sentences Test [LIST]) was examined, as well as patient-reported measures of health-related quality of life (Nijmegen Cochlear Implant Questionnaire [NCIQ]), self-perceived hearing disability (Speech, Spatial, and Qualities of hearing Scale-12 [SSQ12]), sound quality (Hearing Implant Sound Quality Index-19 [HISQUI19]), and states of anxiety and depression (Hospital Anxiety and Depression Scale [HADS]). The RBANS-H total scores improved significantly after 12 months cochlear implant (CI) usage (p < 0.001). At subdomain level, significant improvements were observed in the immediate and delayed memory domain (p = 0.005 and p = 0.002, respectively), and to a lesser extent also in the attention domain (p = 0.047). Furthermore, speech perception in quiet and in noise improved significantly after 6 months and remained stable after 12 months. Similarly, a significant improvement was observed on all patient-reported measures after 6 months of CI usage. These results remained stable after 12 months, except for the HADS. A significant improvement in overall cognition after 12 months of CI usage was established. However, future research is imperative to further disentangle possible practice effects from the effects of the cochlear implantation. The significant, positive effect of cochlear implantation on speech perception and patient-reported measures was confirmed.

Tinnitus and Auditory Perception After a History of Noise Exposure: Relationship to Auditory Brainstem Response Measures.

To determine whether auditory brainstem response (ABR) wave I amplitude is associated with measures of auditory perception in young people with normal distortion product otoacoustic emissions (DPOAEs) and varying levels of noise exposure history. Tinnitus, loudness tolerance, and speech perception ability were measured in 31 young military Veterans and 43 non-Veterans (19 to 35 years of age) with normal pure-tone thresholds and DPOAEs. Speech perception was evaluated in quiet using Northwestern University Auditory Test (NU-6) word lists and in background noise using the words in noise (WIN) test. Loudness discomfort levels were measured using 1-, 3-, 4-, and 6-kHz pulsed pure tones. DPOAEs and ABRs were collected in each participant to assess outer hair cell and auditory nerve function. The probability of reporting tinnitus in this sample increased by a factor of 2.0 per 0.1 µV decrease in ABR wave I amplitude (95% Bayesian confidence interval, 1.1 to 5.0) for males and by a factor of 2.2 (95% confidence interval, 1.0 to 6.4) for females after adjusting for sex and DPOAE levels. Similar results were obtained in an alternate model adjusted for pure-tone thresholds in addition to sex and DPOAE levels. No apparent relationship was found between wave I amplitude and either loudness tolerance or speech perception in quiet or noise. Reduced ABR wave I amplitude was associated with an increased risk of tinnitus, even after adjusting for DPOAEs and sex. In contrast, wave III and V amplitudes had little effect on tinnitus risk. This suggests that changes in peripheral input at the level of the inner hair cell or auditory nerve may lead to increases in central gain that give rise to the perception of tinnitus. Although the extent of synaptopathy in the study participants cannot be measured directly, these findings are consistent with the prediction that tinnitus may be a perceptual consequence of cochlear synaptopathy.

A Role for Acoustic Stimulation in Advanced Otosclerosis: Direct Acoustic Cochlear Implant versus Cochlear Implant

Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1–3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.

Long-Term Cognitive Prognosis of Profoundly Deaf Older Adults After Hearing Rehabilitation Using Cochlear Implants.

To analyze long-term cognitive status and function after cochlear implantation in profoundly deaf individuals. Prospective observational longitudinal study. Ten academic medical centers referent for cochlear implantation. Individuals aged 65 and older who qualified for cochlear implantation (N=70). Cognitive tests were administered before cochlear implantation and 1 and 5 or more years after cochlear implantation. Evaluation consisted of 6 tests assessing attention, memory, orientation, executive function, mental flexibility, and fluency. Cognitive status was determined as normal, mild cognitive impairment (MCI), or dementia. Speech perception in quiet and noisy conditions was assessed using disyllabic words, and quality of life was assessed using the Nijmegen Cochlear Implant Questionnaire. Mean follow-up was 6.8 years (range 5.5-8.5 years). Speech perception scores and quality of life remained stable from 1 to 7 years after cochlear implantation. Of 31 participants (45%) with MCI before cochlear implantation, 2 (6%) developed dementia during follow-up, 19 (61%) remained stable, and 10 (32%) returned to normal cognition. None of the 38 with normal cognition developed dementia during follow-up, although 12 (32%) developed MCI. MCI is highly prevalent in older adults with profound hearing loss. Nevertheless, we observed a low rate of progression to dementia, and cognitive function improved in some individuals with MCI at baseline. These results highlight that cochlear implantation should be strongly considered in profoundly deaf individuals, even those with MCI, who may have a specific subtype of MCI, with a possible positive effect of hearing rehabilitation on neurocognitive functioning.

Hidden hearing loss in patients with Charcot-Marie-Tooth disease type 1A

The aim of this study was to investigate hidden hearing loss in patients with Charcot-Marie-Tooth disease type 1 A (CMT1A), a common inherited demyelinating neuropathy. By using pure-tone audiometry, 43 patients with CMT1A and 60 healthy controls with normal sound detection abilities were enrolled. Speech perception in quiet and noisy backgrounds, spectral ripple discrimination (SRD), and temporal modulation detection (TMD) were measured. Although CMT1A patients and healthy controls had similar pure-tone thresholds and speech perception scores in a quiet background, CMT1A patients had significantly (p < 0.05) decreased speech perception ability in a noisy background compared to controls. CMT1A patients showed significantly decreased temporal and spectral resolution (both p < 0.05). Also, auditory temporal processing of CMT1A patients was correlated with speech perception in a noisy background (r = 0.447, p < 0.01) and median motor conduction velocity (r = 0.335, p < 0.05). Therefore, we assumed that demyelination of auditory nerve in CMT1A causes defective cochlear neurotransmission, which reduces temporal resolution and speech perception in a noisy background. Because the temporal resolution test was well correlated with the degree of demyelination in auditory and peripheral motor nerves, temporal resolution testing could be performed as an additional marker for CMT1A.

Hearing Loss in Children With Otitis Media With Effusion: Actual and Simulated Effects on Speech Perception.

Conductive hearing loss simulations have attempted to estimate the speech-understanding difficulties of children with otitis media with effusion (OME). However, the validity of this approach has not been evaluated. The research aim of the present study was to investigate whether a simple, frequency-specific, attenuation-based simulation of OME-related hearing loss was able to reflect the actual effects of conductive hearing loss on speech perception. Forty-one school-age children with OME-related hearing loss were recruited. Each child with OME was matched with a same sex and age counterpart with normal hearing to make a participant pair. Pure-tone threshold differences at octave frequencies from 125 to 8000 Hz for every participant pair were used as the simulation attenuation levels for the normal-hearing children. Another group of 41 school-age otologically normal children were recruited as a control group without actual or simulated hearing loss. The Mandarin Hearing in Noise Test was utilized, and sentence recall accuracy at four signal to noise ratios (SNR) considered representative of classroom-listening conditions were derived, as well as reception thresholds for sentences (RTS) in quiet and in noise using adaptive protocols. The speech perception in quiet and in noise of children with simulated OME-related hearing loss was significantly poorer than that of otologically normal children. Analysis showed that RTS in quiet of children with OME-related hearing loss and of children with simulated OME-related hearing loss was significantly correlated and comparable. A repeated-measures analysis suggested that sentence recall accuracy obtained at 5-dB SNR, 0-dB SNR, and -5-dB SNR was similar between children with actual and simulated OME-related hearing loss. However, RTS in noise in children with OME was significantly better than that for children with simulated OME-related hearing loss. The present frequency-specific, attenuation-based simulation method reflected the effects of OME-related hearing loss on speech perception impairment in quiet environments. In noisy environments, the simulation method could only approximately estimate the effects of OME-related hearing loss on speech perception in typical classroom noise levels. Children with OME-related hearing loss may develop compensatory strategies to reduce the effects of hearing loss in adverse listening environments.

Improved Speech Perception in Cochlear Implant Users With Interleaved High-Rate Pulse Trains.

Electrical stimulation with a cochlear implant (CI) elicits abnormally high neural synchrony, which poses significant challenges for speech perception. Previous investigations showed that constant-amplitude high-rate pulse trains (HRPs) desynchronize neural responses and improve stimulus encoding. The study objective was to investigate the effects of HRP on speech perception in adult CI users. Prospective, within-subject design. Tertiary CI center. Ten adult CI recipients. Sentence stimuli were created by modifying a basic continuous interleaved sampling (CIS) strategy (1,000 pulses per second; pps) with interleaved biphasic pulse trains (3,000 pps) on even electrodes. Institute of Electrical and Electronics Engineers sentences in quiet and in noise were tested without HRP, and with HRPs of various stimulation levels. Sentence perception in percent correct was calculated for all conditions. The highest speech perception score with HRP stimulation was defined as "max-HRP." Group analyses showed significantly improved sentence perception in background noise with HRPs (p < 0.001). There was no significant difference for sentence perception in quiet for the group. However, seven of 10 subjects experienced some benefit from HRP stimuli in quiet and the degree of HRP benefit showed significant relationships with baseline performance and age at implantation, indicating that HRP stimuli may be most beneficial for older patients or poorer performers. Significant improvement in speech perception in noise was observed with HRP stimuli. Some recipients may also benefit from HRP stimulation in quiet. Interleaved HRPs hold promise as a novel stimulation paradigm with clinical sound processing strategies to improve patient performance.

Bimodal benefit for cochlear implant listeners with different grades of hearing loss in the opposite ear

Objective: To determine speech perception in quiet and noise of adult cochlear implant listeners retaining a hearing aid contralaterally. Second, to investigate the influence of contralateral hearing thresholds and speech perception on bimodal hearing.Patients and methods: Sentence recognition with hearing aid alone, cochlear implant alone and bimodally at 6 months after cochlear implantation were assessed in 148 postlingually deafened adults. Data were analyzed for bimodal summation using measures of speech perception in quiet and in noise.Results: Most of the subjects showed improved sentence recognition in quiet and in noise in the bimodal condition compared to the hearing aid-only or cochlear implant-only mode. The large variability of bimodal benefit in quiet can be partially explained by the degree of pure tone loss. Also, subjects with better hearing on the acoustic side experience significant benefit from the additional electrical input.Conclusions: Bimodal summation shows different characteristics in quiet and noise. Bimodal benefit in quiet depends on hearing thresholds at higher frequencies as well as in the lower- and middle-frequency ranges. For the bimodal benefit in noise, no correlation with hearing threshold in any frequency range was found.

Bimodal neglect: When electrically- and acoustically stimulated ears do not play nice with each other

This study describes speech perception in quiet, before and after implantation, in 54 adult cochlear implant (CI) patients with usable hearing in the ear contralateral to the CI. Patients had preoperative aided CNC word scores of at least 8% as well as stable unaided hearing in the unimplanted ear throughout the analysis period. Word identification scores in quiet were analyzed for the implanted ear only (CI), acoustic hearing ear only (HA), and the bimodal condition (CI + HA) to determine changes in performance over time and to characterize bimodal benefit (difference between bimodal score and best single-ear score). On average, patients experienced 6% bimodal benefit in quiet after implantation. Not surprisingly, speech scores in the implanted ear and in the binaural condition significantly improved post-implantation. However, scores in the HA decreased unexpectedly after implantation in almost one third of the patients despite unchanged PTA. Although simple explanations like hearing aid malfunction or ...

Vowel perception in quiet and noise for native and non-native listeners: Analysis of vowel identifiability

For a number of years, research on phonetic perception has been primarily focused on the percentage correct of phonetic identification (e.g., hit rate) without considering listeners’ response (e.g., false alarm). The purpose of this study was to compute d’ of English vowel identification in quiet and noise including both hit rate and false alarm for native and non-native listeners. Both data analyses showed native listeners outperformed non-native listeners for vowel identification in quiet and noise. However, the d’ data showed that the non-naïve disadvantage became larger in long-term speech shaped (LTSS) noise than in quiet, while the percentage correct data showed an oppositely finding that the non-native disadvantage was smaller in LTSS noise than in quiet. These preliminary results suggest that false alarms should be included in the data analysis of phonetic perception and the idenitificability (e.g., d’) based on the signal detection theory may be more appropriate to evaluate listeners’ capacity to identify phonemes. [Work supported by China Natural Science Foundation 31628009 and University of Texas at Austin Research Grant].

Binaural Pitch Fusion in Bilateral Cochlear Implant Users.

Binaural pitch fusion is the fusion of stimuli that evoke different pitches between the ears into a single auditory image. Individuals who use hearing aids or bimodal cochlear implants (CIs) experience abnormally broad binaural pitch fusion, such that sounds differing in pitch by as much as 3-4 octaves are fused across ears, leading to spectral averaging and speech perception interference. The goal of this study was to determine if adult bilateral CI users also experience broad binaural pitch fusion. Stimuli were pulse trains delivered to individual electrodes. Fusion ranges were measured using simultaneous, dichotic presentation of reference and comparison stimuli in opposite ears, and varying the comparison stimulus to find the range that fused with the reference stimulus. Bilateral CI listeners had binaural pitch fusion ranges varying from 0 to 12 mm (average 6.1 ± 3.9 mm), where 12 mm indicates fusion over all electrodes in the array. No significant correlations of fusion range were observed with any subject factors related to age, hearing loss history, or hearing device history, or with any electrode factors including interaural electrode pitch mismatch, pitch match bandwidth, or within-ear electrode discrimination abilities. Bilateral CI listeners have abnormally broad fusion, similar to hearing aid and bimodal CI listeners. This broad fusion may explain the variability of binaural benefits for speech perception in quiet and in noise in bilateral CI users.

The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training

Objectives: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception. Design: A randomised, prospective crossover design. Study sample: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints. Results: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception. Conclusions: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.

Background noise interacts with spectral context effects during speech categorization

Speech perception is heavily influenced by surrounding sounds. When spectral properties differ between earlier (context) and later (target) sounds, this can produce spectral contrast effects (SCEs) that bias categorization of later sounds. For example, context sounds with a low-F1 bias produce more high-F1 responses to the target vowel and vice versa. SCEs have been studied for decades but only for speech perception in quiet. Background noise is expected to interfere with these effects, but the extent of this interference is unclear. On each trial, listeners heard a context sentence and target vowel both combined with speech-shaped noise. Sentences were filtered to add a + 20-dB spectral peak at low-F1 (100–400 Hz) or high-F1 frequencies (550–850 Hz). Target vowels varied from /ɪ/ to /ɛ/. Background noise was unmodulated or sinusoidally modulated at 2/4/8 Hz at variable SNRs. In general, SCEs were larger at better SNRs and in unmodulated noise, but all SCEs were smaller than those reported for speech in quiet. Complex patterns of results were observed at different noise modulation rates, with likely ties to modulations in F1 frequency regions in the context sentence. In sum, background noise diminishes context effects in speech perception, but the extent depends on noise characteristics.

Impact of Cochlear Implantation on Cognitive Functions of Older Adults: Pilot Test Results.

A significant relationship between hearing loss and cognitive impairment has been previously reported. Overall, improvement in speech perception in quiet and quality of life has been observed after cochlear implantation. However, the impact of hearing loss treatment using cochlear implantation on cognitive functions is yet to be fully elucidated. To investigate the impact of cochlear implantation on cognitive and psychological functions of older adults. Prospective patient-control study. A total of 39 participants took part in the study: 23 cochlear implant (CI) candidates (M = 69.04 ± 12.35 yr) and 16 CI recipients (M = 61.75 ± 15.62 yr). All participants completed an assessment of hearing (pure-tone thresholds and speech perception in quiet), and a computerised, nonverbal test battery of cognitive function assessment, as well as a depression, anxiety, and stress scale. Independent-sample t test scores for the changes between 0 and 12 months revealed that CI recipients performed significantly better on measures of simple reaction time, cognitive flexibility, paired-associate learning, working memory, and strategy use (p < 0.05) compared with implant candidates. Compared with the candidates, recipients also showed significantly lower stress scores (p < 0.05) after 1 year use of a CI. Our results indicate that even in participants with a long duration, severe to profound hearing loss, cochlear implantation has some impact on improving a number of cognitive functions. This finding warrants future longitudinal investigations with a large sample size to examine if the observed cognitive enhancement benefits are sustainable.

Effects of hearing loss on speech recognition under distracting conditions and working memory in the elderly.

PurposeThe current study aimed to evaluate hearing-related changes in terms of speech-in-noise processing, fast-rate speech processing, and working memory; and to identify which of these three factors is significantly affected by age-related hearing loss.MethodsOne hundred subjects aged 65–84 years participated in the study. They were classified into four groups ranging from normal hearing to moderate-to-severe hearing loss. All the participants were tested for speech perception in quiet and noisy conditions and for speech perception with time alteration in quiet conditions. Forward- and backward-digit span tests were also conducted to measure the participants’ working memory.Results1) As the level of background noise increased, speech perception scores systematically decreased in all the groups. This pattern was more noticeable in the three hearing-impaired groups than in the normal hearing group. 2) As the speech rate increased faster, speech perception scores decreased. A significant interaction was found between speed of speech and hearing loss. In particular, 30% of compressed sentences revealed a clear differentiation between moderate hearing loss and moderate-to-severe hearing loss. 3) Although all the groups showed a longer span on the forward-digit span test than the backward-digit span test, there was no significant difference as a function of hearing loss.ConclusionThe degree of hearing loss strongly affects the speech recognition of babble-masked and time-compressed speech in the elderly but does not affect the working memory. We expect these results to be applied to appropriate rehabilitation strategies for hearing-impaired elderly who experience difficulty in communication.

Assessing the Importance of Lexical Tone Contour to Sentence Perception in Mandarin-Speaking Children With Normal Hearing.

The aim of the present study was to evaluate the influence of lexical tone contour and age on sentence perception in quiet and in noise conditions in Mandarin-speaking children ages 7 to 11 years with normal hearing. Test materials were synthesized Mandarin sentences, each word with a manipulated lexical contour, that is, normal contour, flat contour, or a tone contour randomly selected from the four Mandarin lexical tone contours. A convenience sample of 75 Mandarin-speaking participants with normal hearing, ages 7, 9, and 11 years (25 participants in each age group), was selected. Participants were asked to repeat the synthesized speech in quiet and in speech spectrum-shaped noise at 0 dB signal-to-noise ratio. In quiet, sentence recognition by the 11-year-old children was similar to that of adults, and misrepresented lexical tone contours did not have a detrimental effect. However, the performance of children ages 9 and 7 years was significantly poorer. The performance of all three age groups, especially the younger children, declined significantly in noise. The present research suggests that lexical tone contour plays an important role in Mandarin sentence recognition, and misrepresented tone contours result in greater difficulty in sentence recognition in younger children. These results imply that maturation and/or language use experience play a role in the processing of tone contours for Mandarin speech understanding, particularly in noise.

Speech Perception in Quiet and in Noise Condition in Individuals with Auditory Neuropathy Spectrum Disorder.

The study investigated the effect of noise on syllable perception in individuals with Auditory Neuropathy Spectrum Disorder (ANSD) and compared that with the normal hearing individuals. A total of 54 participants were considered, out of which 26 individuals were diagnosed with ANSD and 28 with normal hearing sensitivity. Syllable identification and discrimination were assessed in both the groups in quiet as well as +10 dB SNR. All the individuals with ANSD performed poorer on syllable identification and syllable discrimination tasks compared to individuals with normal hearing. Information transfer and d-prime analyses revealed that noise affects the perception of voicing information in individuals with ANSD compared to place and manner information. Among the consonants tested, /pa/ was more resistant to noise. Noise had deleterious effects on speech perception in individuals with ANSD. Low-frequency information appears to be more susceptible to the effects of noise in individuals with ANSD.

Prevalence of hearing impairment in patients with rheumatoid arthritis, granulomatosis with polyangiitis (GPA, Wegener's granulomatosis), or systemic lupus erythematosus.

Hearing loss in patients with autoimmune diseases, such as systemic lupus erythematosus (SLE), granulomatosis with polyangiitis (GPA, Wegener's granulomatosis), or rheumatoid arthritis (RA), is controversial. Many studies lack measurements of bone-conduction thresholds to sufficiently differentiate between sensorineural hearing loss and conductive hearing loss. In addition, many studies lack control groups or comparisons to an age-related normal hearing threshold. This study investigates hearing performance with an extended audiological battery using psychoacoustic and objective measures. A total of 22 adults with RA, 16 with GPA, 20 with SLE, and two age- and gender-matched control groups (n=34 for GPA and RA and n=42 for SLE) were included. Pure-tone hearing thresholds, speech perception in quiet and noise, tympanometry, and high-resolution otoacoustic emissions were assessed. GPA patients exhibited impaired pure-tone hearing compared to the control group, whereas SLE and RA patients did not. In GPA patients, a larger air-bone gap indicated conductive hearing loss. In addition, speech perception was reduced exclusively in GPA patients. A significant correlation was found between hearing loss and both the cumulative steroid dose and number of organ manifestations in GPA and SLE patients. Our data indicate that GPA and SLE patients are at moderate-to-high risk of conductive hearing loss. In contrast, RA patients are at low risk of disease-associated hearing loss.

Deep band modulated phrase perception in quiet and noise in individuals with auditory neuropathy spectrum disorder and sensorineural hearing loss.

Context:Deep band modulation (DBM) improves speech perception in individuals with learning disability and older adults, who had temporal impairment in them. However, it is unclear on perception of DBM phrases at quiet and noise conditions in individuals with auditory neuropathy spectrum disorder (ANSD) and sensorineural hearing loss (SNHL), as these individuals suffer from temporal impairment.Aim:The aim is to study the effect of DBM and noise on phrase perception in individuals with normal hearing, SNHL, and ANSD.Settings and Design:A factorial design was used to study deep-band-modulated phrase perception in quiet and at noise.Materials and Methods:Twenty participants in each group (normal, SNHL, and ANSD) were included to assess phrase perception on four lists of each unprocessed (UP) and DBM phrases at different signal-to-noise ratios (SNRs) (−1, −3, and −5 dB SNR), which were presented at most comfortable level. In addition, a temporal processing was determined by gap detection threshold test.Statistical Analysis:A mixed analysis of variance was used to investigate main and interaction effects of conditions, noise, and groups. Further, a Pearson product moment correlation was used to document relationship between phrase perception and temporal processing among study participants in each experimental condition.Results:In each group, a significant improvement was observed in DBM phrase perception over UP phrase recognition in quiet and noise conditions. Although a significant improvement was observed, the benefit of recognition from DBM over UP is negligible at −5 dB SNR in both SNHL and ANSD groups. In addition, as expected, a significant improvement in phrase perception in each condition was found in normal hearing than SNHL followed by ANSD. Further, in both atypical groups, a strong negative correlation was found between phrase perception and gap detection threshold in each of the experimental condition.Conclusion:This is to conclude that temporal envelope cues from DBM were made available for phrase perception in those individuals who have temporal impairment.