Speech In Background Noise Research Articles

Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework.

Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. https://doi.org/10.23641/asha.26237060.

Degradation in Binaural and Spatial Hearing and Auditory Temporal Processing Abilities as a Function of Aging.

Sensorineural hearing loss is common with advancing age, but even with normal or near normal hearing in older persons, performance deficits are often seen for suprathreshold listening tasks such as understanding speech in background noise or localizing sound direction. This suggests there is also a more central source of the problem. Objectives of this study were to examine as a function of age (young adult to septuagenarian) performance on: 1) a spatial acuity task examining lateralization ability, and a spatial speech-in-noise (SSIN) recognition task, both measured in a hemi-anechoic sound field using a circular horizontal-plane loudspeaker array, and 2) a suprathreshold auditory temporal processing task and a spectro-temporal processing task, both measured under headphones. Further, we examined any correlations between the measures.DesignSubjects were 48 adults, aged 21 to 78, with either normal hearing or only a mild sensorineural hearing loss through 4000 Hz. The lateralization task measured minimum audible angle (MAA) for 500 and 4000 Hz narrowband noise (NBN) bursts in diffuse background noise for both an on-axis (subject facing 0°) and off-axis (facing 45°) listening condition at signal-to-noise ratios (SNRs) of -3, -6, -9, and -12 dB. For 42 of the subjects, SSIN testing was also completed for key word recognition in sentences in multi-talker babble noise; specifically, the separation between speech and noise loudspeakers was adaptively varied to determine the difference needed for 40% and 80% correct performance levels. Finally, auditory temporal processing ability was examined using the Temporal Fine Structure test (44 subjects), and the Spectro-Temporal Modulation test (46 subjects). Mean lateralization performances were poorer (larger MAAs) in older compared to younger subjects, particularly in the more adverse listening conditions (4000 Hz, off-axis, and poorer SNRs). Performance variability was notably higher for older subjects than for young adults. The 4000 Hz NBN bursts produced larger MAAs than did 500 Hz NBN bursts. The SSIN data also showed declining mean performance with age at both criterion levels, with greater variability again found for older subjects. Spearman rho analyses revealed some low to moderate, but significant correlation coefficients for age versus MAA and age versus SSIN results. A low but significant correlation was also observed between the most adverse MAA and SSIN conditions. Results from both the TFS and STM assessments showed decreased mean performance with aging, and revealed moderate, significant correlations, with the strongest relationship shown with the TFS test. Finally, of note, extended-high-frequency (EHF) hearing loss (measured between 9000 and 16,000 Hz) was found in older but not young subjects, and correlated with decreasing performance on several tasks. Particularly for more adverse listening conditions, age-related deficits were found on both of the spatial hearing tasks and in temporal and spectro-temporal processing abilities. It may be that deficits in temporal processing ability contribute to poorer spatial hearing performance in older subjects due to inaccurate coding of binaural/interaural timing information sent from the periphery to the brainstem. In addition, EHF hearing loss may be a coexisting factor in the reduced performance in older subjects.

Neural Delays in Processing Speech in Background Noise Minimized after Short-Term Auditory Training.

Background noise disrupts the neural processing of sound, resulting in delayed and diminished far-field auditory-evoked responses. In young adults, we previously provided evidence that cognitively based short-term auditory training can ameliorate the impact of background noise on the frequency-following response (FFR), leading to greater neural synchrony to the speech fundamental frequency(F0) in noisy listening conditions. In this same dataset (55 healthy young adults), we now examine whether training-related changes extend to the latency of the FFR, with the prediction of faster neural timing after training. FFRs were measured on two days separated by ~8 weeks. FFRs were elicited by the syllable "da" presented at a signal-to-noise ratio (SNR) of +10 dB SPL relative to a background of multi-talker noise. Half of the participants participated in 20 sessions of computerized training (Listening and Communication Enhancement Program, LACE) between test sessions, while the other half served as Controls. In both groups, half of the participants were non-native speakers of English. In the Control Group, response latencies were unchanged at retest, but for the training group, response latencies were earlier. Findings suggest that auditory training can improve how the adult nervous system responds in noisy listening conditions, as demonstrated by decreased response latencies.

Intelligibility of Natively and Nonnatively Produced English Speech Presented in Noise to a Large Cohort of United States Service Members.

A corpus of English matrix sentences produced by 60 native and nonnative speakers of English was developed as part of a multinational coalition task group. This corpus was tested on a large cohort of U.S. Service members in order to examine the effects of talker nativeness, listener nativeness, masker type, and hearing sensitivity on speech recognition performance in this population. A total of 1,939 U.S. Service members (ages 18-68 years) completed this closed-set listening task, including 430 women and 110 nonnative English speakers. Stimuli were produced by native and nonnative speakers of English and were presented in speech-shaped noise and multitalker babble. Keyword recognition accuracy and response times were analyzed. General(ized) linear mixed-effects regression models found that, on the whole, speech recognition performance was lower for listeners who identified as nonnative speakers of English and when listening to speech produced by nonnative speakers of English. Talker and listener effects were more pronounced when listening in a babble masker than in a speech-shaped noise masker. Response times varied as a function of recognition score, with longest response times found for intermediate levels of performance. This study found additive effects of talker and listener nonnativeness when listening to speech in background noise. These effects were present in both accuracy and response time measures. No multiplicative effects of talker and listener language background were found. There was little evidence of a negative interaction between talker nonnativeness and hearing impairment, suggesting that these factors may have redundant effects on speech recognition. https://doi.org/10.23641/asha.26060191.

Age and masking effects on acoustic cues for vowel categorizationa).

Age-related changes in auditory processing may reduce physiological coding of acoustic cues, contributing to older adults' difficulty perceiving speech in background noise. This study investigated whether older adults differed from young adults in patterns of acoustic cue weighting for categorizing vowels in quiet and in noise. All participants relied primarily on spectral quality to categorize /ɛ/ and /æ/ sounds under both listening conditions. However, relative to young adults, older adults exhibited greater reliance on duration and less reliance on spectral quality. These results suggest that aging alters patterns of perceptual cue weights that may influence speech recognition abilities.

Effect of Digital Noise Reduction in Hearing Aids on Speech Intelligibility in Both Quiet and Noisy Environments.

Digital noise reduction (DNR) minimizes the effect of noise on speech signals by continuously monitoring frequency bands in the presence of noise. In the present study, we explored the effect of DNR technology on speech intelligibility in individuals using hearing aids (HAs) and investigated implications for daily use. Eighteen participants with bilateral moderate sensorineural hearing loss (aged 16-45 years) were included. Bilateral receiver-in-the-ear HAs were fitted in the participants. The adaptive and nonadaptive (with a signal-to-noise ratio (SNR) of +5 and -5 dB, respectively) Turkish matrix sentence test (TURMatrix) in noise and free-field hearing assessments, including hearing thresholds with hearing aids, speech recognition thresholds (SRT), and speech discrimination scores, were conducted in two different conditions: HA in the DNR-on and DNR-off conditions. No significant difference was observed between free-field hearing assessments with the HA in the DNR-off and DNR-on conditions (P > 0.05). Furthermore, the adaptive and nonadaptive TURMatrix revealed significant differences between the scores under the DNR-on and DNR-off conditions (P < 0.05). Nevertheless, under the DNR-on condition, there was no correlation between free-field hearing assessments with HA and TURMatrix results (P > 0.05). However, a significant correlation was observed between SRT scores with HA and TURMatrix scores (adaptive and nonadaptive, +5 and -5 dB SNR, respectively) under the DNR-off condition (P < 0.05). Our study findings suggest that DNR can improve speech intelligibility in noisy environments. Therefore, DNR can enhance an individual's auditory comfort by improving their capacity to grasp speech in background noise.

Sound insights: The potential of hearables for early detection and continuous monitoring of Alzheimer’s disease

Early identification using non-invasive biological markers is crucial for detecting and treating Alzheimer's disease (AD). Hearables are intra-aural wearable devices equipped with in-ear microphones capable of capturing inner body signals, including heartbeat, breathing, and blinking. These non-verbal audio events give valuable insight into the individual's physiological state, offering a unique method to detect and monitor subtle changes in the body, which holds the potential for early disease detection. Central auditory (CA) tests, such as understanding speech in background noise, have shown promise in tracking AD’s effects on the central nervous system. They also provide sensitive, quantitative, and repeatable assessments over time. Therefore, this study will assess physiological signals captured by a hearable during central auditory assessment. Thirty-five participants with AD and mild cognitive impairment will be recruited, in addition to age-matched control participants. Hearables will be used to capture physiological data and perform CA tests such as hearing in noise test, triple digits test, dichotic digits test, and dichotic sentence identification test. Moreover, a picture description task, where participants will have to produce coherent speech that holds potential for tracking the decline in cognitive abilities, will be administered. The data collected will be used to build an open-access database serving as the foundation of future research on early detection and monitoring of AD using hearables.

Effects of linguistic context and noise type on speech comprehension.

Understanding speech in background noise is an effortful endeavor. When acoustic challenges arise, linguistic context may help us fill in perceptual gaps. However, more knowledge is needed regarding how different types of background noise affect our ability to construct meaning from perceptually complex speech input. Additionally, there is limited evidence regarding whether perceptual complexity (e.g., informational masking) and linguistic complexity (e.g., occurrence of contextually incongruous words) interact during processing of speech material that is longer and more complex than a single sentence. Our first research objective was to determine whether comprehension of spoken sentence pairs is impacted by the informational masking from a speech masker. Our second objective was to identify whether there is an interaction between perceptual and linguistic complexity during speech processing. We used multiple measures including comprehension accuracy, reaction time, and processing effort (as indicated by task-evoked pupil response), making comparisons across three different levels of linguistic complexity in two different noise conditions. Context conditions varied by final word, with each sentence pair ending with an expected exemplar (EE), within-category violation (WV), or between-category violation (BV). Forty young adults with typical hearing performed a speech comprehension in noise task over three visits. Each participant heard sentence pairs presented in either multi-talker babble or spectrally shaped steady-state noise (SSN), with the same noise condition across all three visits. We observed an effect of context but not noise on accuracy. Further, we observed an interaction of noise and context in peak pupil dilation data. Specifically, the context effect was modulated by noise type: context facilitated processing only in the more perceptually complex babble noise condition. These findings suggest that when perceptual complexity arises, listeners make use of the linguistic context to facilitate comprehension of speech obscured by background noise. Our results extend existing accounts of speech processing in noise by demonstrating how perceptual and linguistic complexity affect our ability to engage in higher-level processes, such as construction of meaning from speech segments that are longer than a single sentence.

Many but not all deep neural network audio models capture brain responses and exhibit correspondence between model stages and brain regions.

Models that predict brain responses to stimuli provide one measure of understanding of a sensory system and have many potential applications in science and engineering. Deep artificial neural networks have emerged as the leading such predictive models of the visual system but are less explored in audition. Prior work provided examples of audio-trained neural networks that produced good predictions of auditory cortical fMRI responses and exhibited correspondence between model stages and brain regions, but left it unclear whether these results generalize to other neural network models and, thus, how to further improve models in this domain. We evaluated model-brain correspondence for publicly available audio neural network models along with in-house models trained on 4 different tasks. Most tested models outpredicted standard spectromporal filter-bank models of auditory cortex and exhibited systematic model-brain correspondence: Middle stages best predicted primary auditory cortex, while deep stages best predicted non-primary cortex. However, some state-of-the-art models produced substantially worse brain predictions. Models trained to recognize speech in background noise produced better brain predictions than models trained to recognize speech in quiet, potentially because hearing in noise imposes constraints on biological auditory representations. The training task influenced the prediction quality for specific cortical tuning properties, with best overall predictions resulting from models trained on multiple tasks. The results generally support the promise of deep neural networks as models of audition, though they also indicate that current models do not explain auditory cortical responses in their entirety.

Visual speech benefit provided by realistic sentences in noise

Understanding speech in background noise presents a significant challenge to listeners with hearing loss. Even though hearing aids are very successful in restoring listening in quieter conditions, current devices provide only limited benefit in noise. While seeing a talker can improve intelligibility, visual benefit has typically been quantified using rather unrealistic audio-visual speech materials. Here, we investigated visual benefit using realistic effortful speech from the ECO-SiN corpus. Audio-only, audio-visual, and visual-only sentences were presented in three simulated real-world environments at their realistic sound levels in a 3-D loudspeaker array equipped with integrated high-resolution video projectors. Ten young normal-hearing (NH) listeners as well as 18 older listeners with sensorineural hearing loss participated in the experiment with and without their own hearing aids. While the NH listeners rapidly hit ceiling, listeners with hearing loss struggled to understand the audio-only sentences in the louder background noise—even when aided. There was, however, demonstrable visual benefit of up to 16% in the audio-visual condition for both groups, which is significantly less than commonly reported. Future research will explore if the individual outcomes of the audio-visual ECO-SIN test better reflects real-world hearing experience and how far this is maintained when using virtual reality glasses.

The Application of Time-Frequency Masking To Improve Intelligibility of Dysarthric Speech in Background Noise.

Background noise reduces speech intelligibility. Time-frequency (T-F) masking is an established signal processing technique that improves intelligibility of neurotypical speech in background noise. Here, we investigated a novel application of T-F masking, assessing its potential to improve intelligibility of neurologically degraded speech in background noise. Listener participants (N = 422) completed an intelligibility task either in the laboratory or online, listening to and transcribing audio recordings of neurotypical (control) and neurologically degraded (dysarthria) speech under three different processing types: speech in quiet (quiet), speech mixed with cafeteria noise (noise), and speech mixed with cafeteria noise and then subsequently processed by an ideal quantized mask (IQM) to remove the noise. We observed significant reductions in intelligibility of dysarthric speech, even at highly favorable signal-to-noise ratios (+11 to +23 dB) that did not impact neurotypical speech. We also observed significant intelligibility improvements from speech in noise to IQM-processed speech for both control and dysarthric speech across a wide range of noise levels. Furthermore, the overall benefit of IQM processing for dysarthric speech was comparable with that of the control speech in background noise, as was the intelligibility data collected in the laboratory versus online. This study demonstrates proof of concept, validating the application of T-F masks to a neurologically degraded speech signal. Given that intelligibility challenges greatly impact communication, and thus the lives of people with dysarthria and their communication partners, the development of clinical tools to enhance intelligibility in this clinical population is critical.

Verification of Estimated Output Signal-to-Noise Ratios From a Phase Inversion Technique Using a Simulated Hearing Aid.

The signal-to-noise ratio (SNR) for speech presented in background noise may vary after being processed by digital hearing aids with nonlinear signal processing algorithms, such as wide dynamic range compression (WDRC). A phase inversion technique has been previously developed to assess the output SNR of hearing aids. However, systematic validations of this technique have not been conducted. This study aims to validate the phase inversion technique. A simulated hearing aid with multichannel WDRC was implemented, from which the output SNRs, computed via shadow filtering, for connected speech in background noise were directly computed. The agreement between the shadow filter output SNRs and those estimated using the phase inversion technique for the same stimuli was utilized to validate the phase inversion technique. The background noise was 2- or 20-talker babble noise, and the speech stimuli were presented at SNRs of -10 to +10 dB at the input of the simulated hearing aid. The simulated hearing aid was configured to provide amplification for four representative audiograms, and the WDRC was set to be fast or slow acting. To investigate the effects of additive noise, independent of the presented noise stimulus, on the phase inversion estimated output SNR, the same simulated hearing aid was implemented with an additive Gaussian noise at its input (45 and 60 dB SPL). Results showed that the phase inversion technique could either overestimate or underestimate output SNR, depending on the test condition; the estimation errors tended to coincide with temporal landmarks, such as natural pauses between consecutive sentences or fricatives; and increasing the simulated noise led to poorer estimates of output SNR. Results imply that the accuracy of the phase inversion technique is dependent on the test conditions. Thus, the phase inversion technique should be used with caution, and its validity should be evaluated further.

Hearing and Ageing.

Age-related hearing loss (ARHL), or presbycusis, occurs in most mammals, humans included, with a different age of onset and magnitude of loss. It is associated with two major symptoms: loss of sensitivity to sound, especially for high pitches, and a reduced ability to understand speech in background noise. This phenomenon involves both the peripheral structures of the inner ear and the central acoustic pathways. Several mechanisms have been identified as pro-ageing in the human cochlea. The main one is the oxidative stress. The inner ear physiological degeneration can be affected by both intrinsic conditions, such as genetic predisposition, and extrinsic ones, such as noise exposure. The magnitude of neuronal loss precedes and exceeds that of inner hair cell loss, which is also less important than the loss of outer hair cells. Patients with HL often develop atrophy of the temporal lobe (auditory cortex) and brain gliosis can contribute to the development of a central hearing loss. The presence of white matter hyperintensities (WMHs) on the MRI, which is radiologic representation of brain gliosis, can justify a central HL due to demyelination in the superior auditory pathways. Recently, the presence of WMHs has been correlated with the inability to correctly understand words in elderly with normal auditory thresholds.

Cross-modal functional connectivity supports speech understanding in cochlear implant users.

Sensory deprivation can lead to cross-modal cortical changes, whereby sensory brain regions deprived of input may be recruited to perform atypical function. Enhanced cross-modal responses to visual stimuli observed in auditory cortex of postlingually deaf cochlear implant (CI) users are hypothesized to reflect increased activation of cortical language regions, but it is unclear if this cross-modal activity is "adaptive" or "mal-adaptive" for speech understanding. To determine if increased activation of language regions is correlated with better speech understanding in CI users, we assessed task-related activation and functional connectivity of auditory and visual cortices to auditory and visual speech and non-speech stimuli in CI users (n = 14) and normal-hearing listeners (n = 17) and used functional near-infrared spectroscopy to measure hemodynamic responses. We used visually presented speech and non-speech to investigate neural processes related to linguistic content and observed that CI users show beneficial cross-modal effects. Specifically, an increase in connectivity between the left auditory and visual cortices-presumed primary sites of cortical language processing-was positively correlated with CI users' abilities to understand speech in background noise. Cross-modal activity in auditory cortex of postlingually deaf CI users may reflect adaptive activity of a distributed, multimodal speech network, recruited to enhance speech understanding.

Adult Normative Data for the Adaptation of the Hearing in Noise Test in European French (HINT-5 Min).

Decreased speech-in-noise (SpIN) understanding is an early marker not only of presbycusis but also of auditory processing disorder. Previous research has shown a strong relationship between hearing disorders and cognitive limitations. It is therefore crucial to allow SpIN testing in subjects who cannot sustain prolonged diagnostic procedures. The objectives of this study were to develop a rapid and reproducible version of the Hearing in Noise Test (HINT-5 min), and to determine its adult normative values in free-field and monaural or binaural headphone conditions. Following an adaptive signal-to-noise ratio (SNR) protocol, the test used a fixed noise level, while the signal level varied to reach the 50% speech reception threshold (SRT50). The speech material consisted of five lists of 20 sentences each, all recorded in European French. The whole semi-automated procedure lasted 5 min and was administered to 83 subjects aged 19 to 49 years with no reported listening difficulties. Fifty-two subjects were retested between 7 and 8 days later. For the binaural free-field condition, the mean SRT50 was −1.0 dB SNR with a standard deviation of 1.3 dB SNR. There was no significant difference between the results obtained at test and retest, nor was there any effect of listening condition, sex, or age on SRT50. The results indicate that the procedure is robust and not affected by any learning phenomenon. The HINT-5 min was found to be both a fast and reliable marker of the ability to understand speech in background noise.

Assistive Technology for Adults with Hearing Aids.

Although there is a strong trend of satisfaction with hearing aids, recent consumer surveys indicate that there are still challenges with understanding speech in background noise and low penetration of wireless technologies using many modern-day communication and audio devices, such as smartphones, tablets, and computers. For some listening and communication settings, many patients could benefit from assistive technology that exceeds the capabilities of their hearing aids. When patients are not wearing their hearing aids, such as during sleep, concerns about environmental awareness and safety begin to arise. This article describes some current assistive technologies and accessories that facilitate accessibility to other devices and to satisfy the patient's listening and communication needs.

Enhancement of speech-in-noise comprehension through vibrotactile stimulation at the syllabic rate

SignificanceSyllables are important building blocks of speech. They occur at a rate between 4 and 8 Hz, corresponding to the theta frequency range of neural activity in the cerebral cortex. When listening to speech, the theta activity becomes aligned to the syllabic rhythm, presumably aiding in parsing a speech signal into distinct syllables. However, this neural activity cannot only be influenced by sound, but also by somatosensory information. Here, we show that the presentation of vibrotactile signals at the syllabic rate can enhance the comprehension of speech in background noise. We further provide evidence that this multisensory enhancement of speech comprehension reflects the multisensory integration of auditory and tactile information in the auditory cortex.

Effects of training and using an audio-tactile sensory substitution device on speech-in-noise understanding

Understanding speech in background noise is challenging. Wearing face-masks, imposed by the COVID19-pandemics, makes it even harder. We developed a multi-sensory setup, including a sensory substitution device (SSD) that can deliver speech simultaneously through audition and as vibrations on the fingertips. The vibrations correspond to low frequencies extracted from the speech input. We trained two groups of non-native English speakers in understanding distorted speech in noise. After a short session (30–45 min) of repeating sentences, with or without concurrent matching vibrations, we showed comparable mean group improvement of 14–16 dB in Speech Reception Threshold (SRT) in two test conditions, i.e., when the participants were asked to repeat sentences only from hearing and also when matching vibrations on fingertips were present. This is a very strong effect, if one considers that a 10 dB difference corresponds to doubling of the perceived loudness. The number of sentence repetitions needed for both types of training to complete the task was comparable. Meanwhile, the mean group SNR for the audio-tactile training (14.7 ± 8.7) was significantly lower (harder) than for the auditory training (23.9 ± 11.8), which indicates a potential facilitating effect of the added vibrations. In addition, both before and after training most of the participants (70–80%) showed better performance (by mean 4–6 dB) in speech-in-noise understanding when the audio sentences were accompanied with matching vibrations. This is the same magnitude of multisensory benefit that we reported, with no training at all, in our previous study using the same experimental procedures. After training, performance in this test condition was also best in both groups (SRT ~ 2 dB). The least significant effect of both training types was found in the third test condition, i.e. when participants were repeating sentences accompanied with non-matching tactile vibrations and the performance in this condition was also poorest after training. The results indicate that both types of training may remove some level of difficulty in sound perception, which might enable a more proper use of speech inputs delivered via vibrotactile stimulation. We discuss the implications of these novel findings with respect to basic science. In particular, we show that even in adulthood, i.e. long after the classical “critical periods” of development have passed, a new pairing between a certain computation (here, speech processing) and an atypical sensory modality (here, touch) can be established and trained, and that this process can be rapid and intuitive. We further present possible applications of our training program and the SSD for auditory rehabilitation in patients with hearing (and sight) deficits, as well as healthy individuals in suboptimal acoustic situations.

A Clinical Paradigm for Listening Effort Assessment in Middle-Aged Listeners.

Listening effort (LE) has been known to characterize speech recognition in noise regardless of hearing sensitivity and age. Whereas the behavioral measure of dual-task paradigm effectively manifests the cognitive cost that listeners exert when processing speech in background noise, there is no consensus as to a clinical procedure that might best express LE. In order to assess the cognitive load underlying speech recognition in noise and promote counselling for coping strategies, a feasible clinical paradigm is warranted. The ecological validity of such a paradigm might best be demonstrated in middle-aged adults, exhibiting intact hearing sensitivity on one hand, however, experiencing difficulties in degraded listening conditions, unaware of the implicated cognitive cost of speech recognition in noise. To this end, we constructed a dual-task paradigm that consists of a primary task of sentences-in-noise recognition and a secondary task of simple visual colored-shape matching. Research objective was to develop a clinical paradigm for the assessment of LE in middle-aged adults. Participants were 17 middle-aged adults (mean age of 52.81 years) and 23 young adults (mean age of 24.90 years). All participants had normal hearing according to age. Speech stimuli consisted of the Hebrew Matrix sentences in noise test. SRTn was obtained for 80% correct identification. Visual stimuli were colored geometric shapes. Outcome measures were obtained initially for each task separately, to establish performance ability, and then obtained simultaneously. Reaction time and accuracy in the secondary task were the defined metrics for LE. Results: LE was indicated for both groups, however, was more pronounced in the middle-aged, manifested in the visual accuracy and reaction time metrics. Both groups maintained the 80% correct recognition-in-noise in the dual-task, however, the middle-aged group necessitated a better SNR of 1.4dB than the normal hearing group. Moreover, the middle-aged group was taxed in a greater prolongation of reaction time, in order to uphold the correct recognition. Conclusion: a dual-task paradigm consisting of sentences-in-noise primary task combined with a simple secondary task successfully showed different manifestations of LE in middle-aged adults compared to young adults, thus approximating the use of such a paradigm in a clinical setting.

The effect of hearing aid dynamic range compression on speech intelligibility in a realistic virtual sound environment.

Measures of "aided" speech intelligibility (SI) for listeners wearing hearing aids (HAs) are commonly obtained using rather artificial acoustic stimuli and spatial configurations compared to those encountered in everyday complex listening scenarios. In the present study, the effect of hearing aid dynamic range compression (DRC) on SI was investigated in simulated real-world acoustic conditions. A spatialized version of the Danish Hearing In Noise Test was employed inside a loudspeaker-based virtual sound environment to present spatialized target speech in background noise consisting of either spatial recordings of two real-world sound scenarios or quadraphonic, artificial speech-shaped noise (SSN). Unaided performance was compared with results obtained with a basic HA simulator employing fast-acting DRC. Speech reception thresholds (SRTs) with and without DRC were found to be significantly higher in the conditions with real-world background noise than in the condition with artificial SSN. Improvements in SRTs caused by the HA were only significant in conditions with real-world background noise and were related to differences in the output signal-to-noise ratio of the HA signal processing between the real-world versus artificial conditions. The results may be valuable for the design, development, and evaluation of HA signal processing strategies in realistic, but controlled, acoustic settings.