Speech Recognition Performance In Noise Research Articles

A real-world evaluation of the clinical benefits of improved sound processor technology among Chinese cochlear implant users: A focus on Cochlear Nucleus 7.

Real-world evidence is increasingly used to support clinical and regulatory decisions globally and may be a useful tool to study the unique needs of cochlear implant users in China. The ability to recognize and understand speech in noise is critical for cochlear implant users, however, this remains a challenge in everyday settings with fluctuating competing noise levels. The Cochlear™ Sound Processor, Nucleus® 7 (CP1000), includes Forward Focus, a spatial noise algorithm aimed to improve speech-in-noise performance, and Made for iPhone/iPod/iPad functionality. We conducted a prospective, single-center, open-label, within-participant, real-world evidence investigation in participants with cochlear implants. The primary objective of this study, conducted in China, was to compare speech perception in spatially separated dynamic noise with the Nucleus 7 to the recipients' current older Cochlear Sound Processor, including the Freedom and Nucleus 5 sound processors. A follow-up study monitored participants from the initial study up to 12-months post the fitting of their Nucleus 7 and investigated hearing ability, satisfaction, and usability of the device via a questionnaire. Forty participants were included in the initial study (age-range 3 to 49 years) and 29 continued to the follow-up study (age-range 5 to 28 years). The participants were heterogeneous in terms of age, cochlear implant experience, and duration of hearing loss. Nucleus 7 significantly improved participant speech recognition performance in noise by 7.54 dB when compared with the participants' current older sound processor (p<0.0001). Overall satisfaction with Nucleus 7 was 72%. Satisfaction in different hearing contexts ranged from 93.1% for understanding a 1:1 conversation in a quiet setting, 62.1% for understanding on the phone, to 34.5% hearing in complex noisy situations. The study demonstrated the benefits of the Nucleus 7 sound processor across different hearing environments in a Chinese population and showed improved hearing ability, usability, and satisfaction in a real-world every-day environment.

Comprehensive Audiologic Analyses After Cisplatin-Based Chemotherapy

Cisplatin is highly ototoxic but widely used. Evidence is lacking regarding cisplatin-related hearing loss (CRHL) in adult-onset cancer survivors with comprehensive audiologic assessments (eg, Words-in-Noise [WIN] tests, full-spectrum audiometry, and additional otologic measures), as well as the progression of CRHL considering comorbidities, modifiable factors associated with risk, and cumulative cisplatin dose. To assess CRHL with comprehensive audiologic assessments, including the WIN, evaluate the longitudinal progression of CRHL, and identify factors associated with risk. The Platinum Study is a longitudinal study of cisplatin-treated testicular cancer survivors (TCS) enrolled from 2012 to 2018 with follow-up ongoing. Longitudinal comprehensive audiologic assessments at Indiana University and Memorial Sloan Kettering Cancer Center included 100 participants without audiometrically defined profound hearing loss (HL) at baseline and at least 3.5 years from their first audiologic assessment. Data were analyzed from December 2013 to December 2022. Factors associated with risk included cumulative cisplatin dose, hypertension, hypercholesterolemia, diabetes, tobacco use, physical inactivity, body mass index, family history of HL, cognitive dysfunction, psychosocial symptoms, and tinnitus. Main outcomes were audiometrically measured HL defined as combined-ears high-frequency pure-tone average (4-12 kHz) and speech-recognition in noise performance measured with WIN. Multivariable analyses evaluated factors associated with risk for WIN scores and progression of audiometrically defined HL. Median (range) age of 100 participants at evaluation was 48 (25-67) years; median (range) time since chemotherapy: 14 (4-31) years. At follow-up, 78 (78%) TCS had audiometrically defined HL; those self-reporting HL had 2-fold worse hearing than TCS without self-reported HL (48 vs 24 dB HL; P < .001). A total of 54 (54%) patients with self-reported HL showed clinically significant functional impairment on WIN testing. Poorer WIN performance was associated with hypercholesterolemia (β = 0.88; 95% CI, 0.08 to 1.69; P = .03), lower-education (F1 = 5.95; P = .004), and severity of audiometrically defined HL (β̂ = 0.07; 95% CI, 0.06 to 0.09; P < .001). CRHL progression was associated with hypercholesterolemia (β̂ = -4.38; 95% CI, -7.42 to -1.34; P = .01) and increasing age (β̂ = 0.33; 95% CI, 0.15 to 0.50; P < .001). Importantly, relative to age-matched male normative data, audiometrically defined CRHL progression significantly interacted with cumulative cisplatin dose (F1 = 5.98; P = .02); patients given 300 mg/m2 or less experienced significantly less progression, whereas greater temporal progression followed doses greater than 300 mg/m2. Follow-up of cisplatin-treated cancer survivors should include strict hypercholesterolemia control and regular audiological assessments. Risk stratification through validated instruments should include querying hearing concerns. CRHL progression relative to age-matched norms is likely associated with cumulative cisplatin dose; investigation over longer follow-up is warranted.

Effects of Cognitive Functions on Speech Recognition in Noise in Cochlear Implant Recipients

Introduction: There are substantial differences in speech recognition performance of adult cochlear implant (CI) recipients. This study investigated the effects of cognitive function on speech recognition in CI recipients. Methods: The verbal working memory of 36 adults with unilateral CIs was tested using digit span tests. Attention and inhibition abilities were assessed by using the Stroop test (both congruent and incongruent tasks). Speech recognition in noise was measured using the Turkish matrix test. Results: A moderate negative correlation was observed between the critical signal-to-noise ratio obtained via speech recognition in noise test and the digit span test scores (backward and digit span total scores). There was no correlation between Stroop test scores and speech recognition in noise in CI recipients. Conclusion: The findings indicated that verbal working memory correlated well with speech recognition outcomes in adult CI recipients and that higher working memory capacity led to better speech recognition performance in noise.

Hearing Thresholds, Speech Recognition, and Audibility as Indicators for Modifying Intervention in Children With Hearing Aids.

The purpose of this study was to determine if traditional audiologic measures (e.g., pure-tone average, speech recognition) and audibility-based measures predict risk for spoken language delay in children who are hard of hearing (CHH) who use hearing aids (HAs). Audibility-based measures included the Speech Intelligibility Index (SII), HA use, and auditory dosage, a measure of auditory access that weighs each child's unaided and aided audibility by the average hours of HA use per day. The authors also sought to estimate values of these measures at which CHH would be at greater risk for delayed outcomes compared with a group of children with typical hearing (CTH) matched for age and socioeconomic status, potentially signaling a need to make changes to a child's hearing technology or intervention plan. The authors compared spoken language outcomes of 182 CHH and 78 CTH and evaluated relationships between language and audiologic measures (e.g., aided SII) in CHH using generalized additive models. They used these models to identify values associated with falling below CTH (by > 1.5 SDs from the mean) on language assessments, putting CHH at risk for language delay. Risk for language delay was associated with aided speech recognition in noise performance (<59% phonemes correct, 95% confidence interval [55%, 62%]), aided Speech Intelligibility Index (SII < 0.61, 95% confidence internal [.53,.68]), and auditory dosage (dosage < 6.0, 95% confidence internal [5.3, 6.7]) in CHH. The level of speech recognition in quiet, unaided pure-tone average, and unaided SII that placed children at risk for language delay could not be determined due to imprecise estimates with broad confidence intervals. Results support using aided SII, aided speech recognition in noise measures, and auditory dosage as tools to facilitate clinical decision-making, such as deciding whether changes to a child's hearing technology are warranted. Values identified in this article can complement other metrics (e.g., unaided hearing thresholds, aided speech recognition testing, language assessment) when considering changes to intervention, such as adding language supports, making HA adjustments, or referring for cochlear implant candidacy evaluation.

Speech Recognition in Noise Performance Measured Remotely Versus In-Laboratory From Older and Younger Listeners.

This study examined the performance difference between remote and in-laboratory test modalities with a speech recognition in noise task in older and younger adults. Four groups of participants (younger remote, younger in-laboratory, older remote, and older in-laboratory) were tested on a speech recognition in noise protocol with 72 sentences. While the younger remote group performed more poorly than the younger in-laboratory group, older participants' performance was comparable between the two modality groups, particularly in the easy to moderately difficult conditions. These results persisted after controlling for demographic variables (e.g., age, gender, and education). While these findings generally support the feasibility of remote data collection with older participants for research on speech perception, they also suggest that technological proficiency is an important factor that affects performance on remote testing in the aging population.

Comparing Sound-Field Speech-Auditory Brainstem Response Components between Cochlear Implant Users with Different Speech Recognition in Noise Scores

ObjectivesMany studies have suggested that cochlear implant (CI) users vary in terms of speech recognition in noise. Studies in this field attribute this variety partly to subcortical auditory processing. Studying speech-Auditory Brainstem Response (speech-ABR) provides good information about speech processing; thus, this work was designed to compare speech-ABR components between two groups of CI users with good and poor speech recognition in noise scores. Materials & MethodsThe present study was conducted on two groups of CI users aged 8-10 years old. The first group (CI-good) consisted of 15 children with prelingual CI who had good speech recognition in noise performance. The second group (CI-poor) was matched with the first group, but they had poor speech recognition in noise performance. The speech-ABR test in a sound-field presentation was performed for all the participants. Results The speech-ABR response showed more delay in C, D, E, F, O latencies in CI-poor than CI-good users (P <0.05), meanwhile no significant difference was observed in initial wave (V(t= -0.293, p= 0.771 and A (t= -1.051, p= 0.307). Analysis in spectral-domain showed a weaker representation of fundamental frequency as well as the first formant and high-frequency component of speech stimuli in the CI users with poor auditory performance.ConclusionsResults revealed that CI users who showed poor auditory performance in noise performance had deficits in encoding the periodic portion of speech signals at the brainstem level. Also, this study could be as physiological evidence for poorer pitch processing in CI users with poor speech recognition in noise performance.

İşitme cihazı kullanan çocuklarda gürültüde konuşmayı anlama becerisinin değerlendirilmesi: Preliminer sonuçlar

Assessment of speech perception in noise in children with hearing aids: Preliminary results* Objective: Noisy environments are a part of the daily life of children, just like adults. Children with hearing loss who wear hearing aids are more susceptible to the negative effects of noise than their normal-hearing peers. This study aims to evaluate the speech recognition in noise performance of hearing aid users and compare them with their normal-hearing peers. Material and Method: Five children aged 6-12 years with bilateral moderate to severe symmetrical sensorineural hearing loss and using bilateral behind-the-ear hearing aids were included in the study. 4 different conditions of the Turkish HINT-C were applied, and a speech recognition threshold (SRT) is determined for each condition. Results: Regardless of their age, the SRT needed by children with hearing aids to achieve equal performance with their normal-hearing peers was found to be higher for all test conditions. As seen in children with normal hearing in general, the mean noise front score of the children with hearing loss was higher than the mean noise right and noise left scores. Conclusion: The results of this study revealed that children with bilaterally symmetrical moderate to severe hearing loss achieved poor speech recognition scores in environments similar to the classroom environment, compared to their normal-hearing peers. Our results guided appropriate rehabilitation and follow-up. Keywords: noise, speech recognition in noise, hearing loss, hearing aid, pediatric audiology, HINT, HINT-C

Symmetrical and asymmetrical directional benefits are present for talkers at the front and side

Objective The purpose of the study was to examine the effects of symmetrical and asymmetrical directional microphone settings on speech recognition, localisation and microphone preference in listening conditions with on- and off-axis talkers. Design A within-subjects repeated-measure evaluation of three hearing aid microphone settings (bilateral omnidirectional, bilateral directional, asymmetrical directional) was completed in a moderately reverberant laboratory. An exploratory analysis of the potential relationship between microphone preference and unaided measures was also completed. Study Sample Twenty adult listeners with mild to moderately severe bilateral hearing loss participated. Results The directional and asymmetric microphone settings resulted in equivalent benefits for sentence recognition in noise, word recall, and localisation speed regardless of the speech loudspeaker location (on- or off-axis). However, localisation accuracy was significantly worse with the asymmetric fitting than the directional setting when speech was presented from the rear hemisphere. Listeners who always preferred directional microphones had significantly poorer unaided speech recognition than those who preferred the omnidirectional setting for one or more listening condition. Conclusions Benefits from directional and asymmetric processing were small in the current study, but generally similar to each other. Unaided speech recognition in noise performance may have utility as a clinical predictor of preference for directional processing.

Development of a Revised Performance-Perceptual Test Using Quick Speech in Noise Test Material and Its Norms.

Two audiometric speech measures have been recognized to have associations with hearing aid use success: the Quick Speech in Noise (QuickSIN) test and the Performance-Perceptual Test (PPT). The PPT involves using the same speech test material (Hearing in Noise Test [HINT]) twice, to evaluate patients' objective and subjective speech recognition performance in noise and the discrepancy between the two measures (Performance-Perceptual Discrepancy [PPDIS]). Using the QuickSIN to conduct the PPT (revised-PPT) may provide clinicians two pieces of important information from one test to help predict hearing aid use success and the need for counseling. Moreover, we could achieve the desired clinical efficiency without purchasing additional test materials. This study aimed (1) to evaluate the validity and reliability of using the QuickSIN speech material to administer the PPT and (2) to establish normative data across listeners with normal hearing (NH) and hearing loss (HL). This study used a repeated measures design. Of the total 65 participants between 18 and 88 years of age, 20 (31%) had NH and 45 (69%) had sensorineural HL, ranging from mild to profound in both ears. Thirty-two of the 45 participants with HL were hearing aid users. All participants completed the original PPT using HINT and the revised-PPT using QuickSIN, via sound field. Generalized linear mixed models were used to compare the performance, perceptual, and PPDIS data between the two test materials across all participants. Normative data for the revised-PPT were established from all participants. Significant main effects for both the test material and hearing status were found for the performance and perceptual data. All interactions were nonsignificant. There were no significant PPDIS differences between the original PPT and the revised-PPT. Normative values for the revised-PPT were established and comparable to the norms for the original PPT in the present study. The test-retest results suggested that the revised-PPT has good reliability. In addition, it appeared that there was a negative association between underestimation of hearing ability and hearing aid use success. It is concluded that the QuickSIN speech material can replace HINT to measure PPT. The revised-PPT may serve as a useful and efficient clinical tool in any clinics for hearing aid fitting and counseling.

Speech recognition in noise in patients with type II diabetes

Context: The chronic diabetes is associated with damage to the sensory and cognitive regions brain. The central auditory system is susceptible to the damage caused by high glucose level. Aims: Since the healthy auditory system plays an important role in communication, this study examined speech recognition in noise performance of these people so as to better identify the harmful impacts of diabetes on the auditory processing. Settings and Design: This cross-sectional comparative study compares the speech recognition in noise performance of 30 diabetic patients and 30 normal individuals aged 30–55 years with quick speech in noise (Q-SIN) test. Subjects and Methods: All people had normal hearing and the speech recognition performance in silent, the Persian version of the Q-SIN test was used. Statistical Analysis Used: Results of signal-to-noise ratio loss (SNR loss) and recognition of words at different SNR levels were analyzed with Chi-square test and independent t-test in two groups. Results: There was a significant difference between diabetic patients and normal individuals in mean of SNR loss (P 0.05), but the performance of diabetic patients was weaker in 15, 10, 5, 0 SNR (P

Preimplant Hearing Aid Fittings and Aided Audibility for Pediatric Cochlear Implant Recipients.

Audibility of speech for children with hearing loss (HL) depends on the degree of HL and the fitting of the hearing aids (HAs) themselves. Many studies on cochlear implant (CI) users have demonstrated that preimplant hearing is associated with postimplant outcomes, but there have been very few reports on the fitting of HAs before surgery. The aims of this study were to characterize HA fittings and aided audibility of speech for pediatric HA users with severe to profound HL and to examine the relation between preimplant aided audibility and postimplant speech perception. A descriptive/observational and correlational study. Audiologic records of pediatric CI participants involved in a larger study examining the effects of early acoustic hearing were analyzed retrospectively; when available, these records included HA verification and speech recognition performance. The CI participants were enrolled in audiology centers and oral schools for the deaf across the United States. To determine whether deviations from prescribed DSL target were significantly greater than zero, 95% confidence intervals of the mean deviation were calculated for each frequency (250, 500, 1000, 2000, and 4000 Hz). Correlational analyses were used to examine the relationship between preimplant aided Speech Intelligibility Indices (SIIs) and postimplant speech perception in noise. Correlational analyses were also used to explore the relationship between preimplant aided SIIs and demographic data. T-tests were used to compare preimplant-aided SIIs of HAs of listeners who later became users of either sequential CIs, simultaneous CIs, or bimodal devices. Preimplant fittings of HAs were generally very close to prescriptive targets, except at 4000 Hz for those HAs with active frequency-lowering processing, and preimplant SIIs, albeit low, were correlated with postimplant speech recognition performance in noise. These results suggest that aided audibility should be maximized throughout the HA trial for later speech recognition purposes. It is recommended that HA fittings be optimized to support speech audibility even when considering implantation. In addition to the age at which HA use begins, the aided audibility itself is important in determining CI candidacy and decisions regarding bimodal HA use.

Development of a Revised Performance-Perceptual Test Using Quick Speech in Noise Test Material and Its Norms

Background: Two audiometric speech measures have been recognized to have associations with hearingaid use success: the Quick Speech in Noise (QuickSIN) test and the Performance-Perceptual Test(PPT). The PPT involves using the same speech test material (Hearing in Noise Test [HINT]) twice, toevaluate patients’ objective and subjective speech recognition performance in noise and the discrepancybetween the two measures (Performance-Perceptual Discrepancy [PPDIS]). Using the QuickSIN to conductthe PPT (revised-PPT) may provide clinicians two pieces of important information from one test tohelp predict hearing aid use success and the need for counseling. Moreover, we could achieve the desiredclinical efficiency without purchasing additional test materials.&lt;br /&gt;Purpose: This study aimed (1) to evaluate the validity and reliability of using the QuickSIN speech materialto administer the PPT and (2) to establish normative data across listeners with normal hearing (NH)and hearing loss (HL).&lt;br /&gt;Research Design: This study used a repeated measures design.&lt;br /&gt;Study Sample: Of the total 65 participants between 18 and 88 years of age, 20 (31%) had NH and 45(69%) had sensorineural HL, ranging from mild to profound in both ears. Thirty-two of the 45 participantswith HL were hearing aid users.Data Collection and Analysis: All participants completed the original PPT using HINT and the revised-PPT using QuickSIN, via sound field. Generalized linear mixed models were used to compare the performance,perceptual, and PPDIS data between the two test materials across all participants. Normativedata for the revised-PPT were established from all participants.&lt;br /&gt;Results: Significant main effects for both the test material and hearing status were found for the performanceand perceptual data. All interactions were nonsignificant. There were no significant PPDISdifferences between the original PPT and the revised-PPT. Normative values for the revised-PPT wereestablished and comparable to the norms for the original PPT in the present study. The test–retest resultssuggested that the revised-PPT has good reliability. In addition, it appeared that there was a negativeassociation between underestimation of hearing ability and hearing aid use success.&lt;br /&gt;Conclusions: It is concluded that the QuickSIN speech material can replace HINT to measure PPT. Therevised-PPT may serve as a useful and efficient clinical tool in any clinics for hearing aid fitting and counseling.&lt;br /&gt;

Pulse-rate discrimination deficit in cochlear implant users: is the upper limit of pitch peripheral or central?

Cochlear implant (CI) users do not reliably associate an increase in pulse rate above 300 pulses per second (pps) with an increase in pitch. The locus of this upper limit of pitch remains unknown. The present study tested the hypothesis that this deficit resides at least initially at the auditory nerve. The hypothesis was tested by comparing pulse rate discrimination in different neural excitation patterns, in which a large versus small population of auditory nerve fibers was activated. If poorer pulse rate discrimination was found under conditions where narrower spread of neural excitation (SOE) was anticipated where a relatively small neural population was activated, then it would support the hypothesis that the rate processing deficit found in CI users is related to peripheral neural degeneration. Nine listeners (12 ears) implanted with the Cochlear Americas Nucleus® devices participated in the study. Different SOE conditions were created by (1) selecting electrodes that showed narrow versus broad forward-masked psychophysical spatial tuning curves, and (2) by measuring these electrodes in monopolar (MP) and narrow bipolar (BP0) electrode configurations. Rate discrimination difference limen (DL) was measured at the selected electrodes in two electrode configurations at three base rates (200, 300 and 500 pps). Consistent with the prediction, group mean DL was better (1) at stimulation sites measured with broader tuning, and (2) in MP relative to BP stimulation. These effects were more salient at the more challenging base rates. There was a weak relationship between rate discrimination (above thresholds) and the effect of rate on detection thresholds. Finally, rate discrimination at rates above the known upper limit (i.e., 500 pps) was correlated with duration of deafness and highly predicted the subjects’ speech recognition performance in noise. These findings support that pulse rate discrimination depends, at least partially, on neural conditions at the auditory periphery and this peripheral limit predicts speech recognition outcomes with a CI.

Speech Recognition in Noise in Adults and Children Who Speak English or Chinese as Their First Language.

Speech recognition of individuals who are listening to a nonnative language is significantly degraded in the presence of background noise and may be influenced by proficiency, age of acquisition, language experience, and daily use of the nonnative language. The purpose of this study is to examine and compare speech recognition in noise performance across test conditions with varying signal-to-noise ratios (SNRs) as well as the presence of vocal and spatial cues in listeners who speak American English as a native language or Mandarin Chinese as a native language. Self-rated English proficiency and experience were collected for native Mandarin Chinese speakers to determine its relationship to performance on the test measures. A cross-sectional repeated measures design was used for the study. Four groups of participants were included in the study. The adult groups consisted of 25 adults who speak native English and 25 adults who speak native Mandarin Chinese with English as an additional language. The pediatric groups consisted of 16 children who speak native English and 16 children who speak native Mandarin Chinese with English as an additional language. Percent correct speech recognition in noise was assessed at three SNRs (-3, 0, +3 dB) using the adult or pediatric versions of the AzBio sentence test. The Listening in Spatialized Noise-Sentence (LiSN-S) test was used to determine the effect of providing spatial and vocal cues on the speech recognition in noise performance of the groups of participants. The data for each age group and test measure were analyzed with a repeated measures analysis of variance. Correlation analyses were performed to examine relationships between English proficiency and experience on performance across the speech recognition test conditions. Analysis of the data from the adult or pediatric AzBio sentence test identified a significant effect of native language for adults but no significant effect for children. The higher SNRs yielded better performance for all listeners. On the LiSN-S test, results for the adult and pediatric groups were similar and showed significantly better performance for the native English speakers in every test condition. The demographic and language characteristics that most affected speech recognition performance across the test measures included the length of time the person lived in the United States, the age of English acquisition, the number of minutes per day English was spoken by the participant, and the self-rated English proficiency. The findings in this study highlight the importance and benefit of higher SNRs as well as the provision of vocal and spatial cues for improving speech recognition performance in noise of adult and pediatric listeners who speak Mandarin Chinese as a native language.

The Relationship between Random Gap Detection and Hearing in Noise Test Performances.

Temporal acoustic cues are particularly important for speech understanding, and past research has inferred a relationship between temporal resolution and speech recognition in noise ability. A temporal resolution disorder is thought to affect speech understanding abilities because persons would not be able to accurately encode these frequency transitions, creating speech discrimination errors even in the presence of normal pure-tone hearing. The primary purpose was to investigate the relationship between temporal resolution as measured by the Random Gap Detection Test (RGDT) and speech recognition in noise performance as measured by the Hearing in Noise Test (HINT) in adults with normal audiometric thresholds. The second purpose was to examine the relationship between temporal resolution and spatial release from masking. The HINT and RGDT protocols were administered under headphones according to the guidelines specified by the developers. The HINT uses an adaptive protocol to determine the signal-to-noise ratio where the participant recognizes 50% of the sentences. For HINT conditions, the target sentences were presented at 0° and the steady-state speech-shaped noise and a four-talker babble (4TB) was presented at 0°, +90°, or -90° for noise front, noise right, and noise left conditions, respectively. The RGDT is used to evaluate temporal resolution by determining the smallest time interval between two matching stimuli that can be detected by the participant. The RGDT threshold is the shortest time interval where the participant detects a gap. Tonal (0.5, 1, 2, and 4 kHz) and click stimuli random gap subtests were presented at 60 dB HL. Tonal subtests were presented in a random order to minimize presentation order effects. Twenty-one young, native English-speaking participants with normal pure-tone thresholds (≤25 dB HL for 500-4000 Hz) participated in this study. The average age of the participants was 20.2 years (SD = 0.66). Spearman rho correlation coefficients were conducted using SPSS 22 (IBM Corp., Armonk, NY) to determine the relationships between HINT and RGDT thresholds and derived measures (spatial advantage and composite scores). Nonparametric testing was used because of the ordinal nature of RGDT data. Moderate negative correlations (p < 0.05) were found between eight RGDT and HINT threshold measures and a moderate positive correlation (p < 0.05) was found between RGDT click thresholds and HINT 4TB spatial advantage. This suggests that as temporal resolution abilities worsened, speech recognition in noise performance improved. These correlations were not statistically significant after the p value reflected the Bonferroni correction for multiple comparisons. The results of the present study imply that the RGDT and HINT use different temporal processes. Performance on the RGDT cannot be predicted from HINT thresholds or vice versa.

Speech Perception in Noise and Listening Effort of Older Adults With Nonlinear Frequency Compression Hearing Aids.

The purpose of this laboratory-based study was to compare the efficacy of two hearing aid fittings with and without nonlinear frequency compression, implemented within commercially available hearing aids. Previous research regarding the utility of nonlinear frequency compression has revealed conflicting results for speech recognition, marked by high individual variability. Individual differences in auditory function and cognitive abilities, specifically hearing loss slope and working memory, may contribute to aided performance. The first aim of the study was to determine the effect of nonlinear frequency compression on aided speech recognition in noise and listening effort using a dual-task test paradigm. The hypothesis, based on the Ease of Language Understanding model, was that nonlinear frequency compression would improve speech recognition in noise and decrease listening effort. The second aim of the study was to determine if listener variables of hearing loss slope, working memory capacity, and age would predict performance with nonlinear frequency compression. A total of 17 adults (age, 57-85 years) with symmetrical sensorineural hearing loss were tested in the sound field using hearing aids fit to target (NAL-NL2). Participants were recruited with a range of hearing loss severities and slopes. A within-subjects, single-blinded design was used to compare performance with and without nonlinear frequency compression. Speech recognition in noise and listening effort were measured by adapting the Revised Speech in Noise Test into a dual-task paradigm. Participants were required trial-by-trial to repeat the last word of each sentence presented in speech babble and then recall the sentence-ending words after every block of six sentences. Half of the sentences were rich in context for the recognition of the final word of each sentence, and half were neutral in context. Extrinsic factors of sentence context and nonlinear frequency compression were manipulated, and intrinsic factors of hearing loss slope, working memory capacity, and age were measured to determine which participant factors were associated with benefit from nonlinear frequency compression. On average, speech recognition in noise performance significantly improved with the use of nonlinear frequency compression. Individuals with steeply sloping hearing loss received more recognition benefit. Recall performance also significantly improved at the group level, with nonlinear frequency compression revealing reduced listening effort. The older participants within the study cohort received less recall benefit than the younger participants. The benefits of nonlinear frequency compression for speech recognition and listening effort did not correlate with each other, suggesting separable sources of benefit for these outcome measures. Improvements of speech recognition in noise and reduced listening effort indicate that adult hearing aid users can receive benefit from nonlinear frequency compression in a noisy environment, with the amount of benefit varying across individuals and across outcome measures. Evidence supports individualized selection of nonlinear frequency compression, with results suggesting benefits in speech recognition for individuals with steeply sloping hearing losses and in listening effort for younger individuals. Future research is indicated with a larger data set on the dual-task paradigm as a potential cognitive outcome measure.

Investigating Speech Recognition and listening effort with different device configurations in adult cochlear implant users

Objectives: The purpose of this study was to investigate speech recognition in noise and listening effort among a group of adults with cochlear implants (CIs). Two main research questions were addressed. First, what are the effects of omni versus directional microphone configuration on speech recognition and listening effort for noisy conditions? Second, what is the effect of unilateral versus bimodal or bilateral CI listening on speech recognition and listening effort in noisy conditions?Design: Sixteen adults (mean age 58 years) with CIs participated. Listening effort was measured using a dual-task paradigm and also using a self-reported rating of difficulty scale. In the dual-task measure, participants were asked to repeat monosyllabic words while at the same time press a button in response to a visual stimulus. Participants were tested in two baseline conditions (speech perception alone and visual task alone) and in the following experimental conditions: (1) quiet with an omnidirectional microphone, (2) noise with an omnidirectional microphone, (3) noise with a directional microphone, and (4) noise with a directional microphone and with a second sided CI or hearing aid. When present, the noise was fixed with a +5 dB signal-to-noise ratio. After each listening condition, the participants rated the degree of listening difficulty.Results: Changing the microphone from omni to directional mode significantly enhanced speech recognition in noise performance. There were no significant changes in speech recognition between the unilateral and bimodal/bilateral CI listening conditions. Listening effort, as measured by reaction time, increased significantly between the baseline and omnidirectional quiet listening condition though did not change significantly across the remaining listening conditions. Self-perceived listening effort revealed a greater effort for the noisy conditions, and reduced effort with the move from an omni to a directional microphone.Conclusions: Directional microphones significantly improve speech in noise recognition over omnidirectional microphones and allowed for decreased self-perceived listening effort. The dual task used in this study failed to show any differences in listening effort across the experimental conditions and may not be sensitive enough to detect changes in listening effort.

Auditory Distraction and Acclimatization to Hearing Aids.

It is widely recognized by hearing aid users and audiologists that a period of auditory acclimatization and adjustment is needed for new users to become accustomed to their devices. The aim of the present study was to test the idea that auditory acclimatization and adjustment to hearing aids involves a process of learning to "tune out" newly audible but undesirable sounds, which are described by new hearing aid users as annoying and distracting. It was hypothesized that (1) speech recognition thresholds in noise would improve over time for new hearing aid users, (2) distractibility to noise would reduce over time for new hearing aid users, (3) there would be a correlation between improved speech recognition in noise and reduced distractibility to background sounds, (4) improvements in speech recognition and distraction would be accompanied by self-report of reduced annoyance, and (5) improvements in speech recognition and distraction would be associated with higher general cognitive ability and more hearing aid use. New adult hearing aid users (n = 35) completed a test of aided speech recognition in noise (SIN) and a test of auditory distraction by background sound amplified by hearing aids on the day of fitting and 1, 7, 14, and 30 days post fitting. At day 30, participants completed self-ratings of the annoyance of amplified sounds. Daily hearing aid use was measured via hearing aid data logging, and cognitive ability was measured with the Wechsler Abbreviated Scale of Intelligence block design test. A control group of experienced hearing aid users (n = 20) completed the tests over a similar time frame. At day 30, there was no statistically significant improvement in SIN among new users versus experienced users. However, levels of hearing loss and hearing aid use varied widely among new users. A subset of new users with moderate hearing loss who wore their hearing aids at least 6 hr/day (n = 10) had significantly improved SIN (by ~3-dB signal to noise ratio), compared with a control group of experienced hearing aid users. Improvements in SIN were associated with more consistent HA use and more severe hearing loss. No improvements in the test of auditory distraction by background sound were observed. Improvements in SIN were associated with self-report of background sound being less distracting and greater self-reported hearing aid benefit. There was no association between improvements in SIN and cognitive ability or between SIN and auditory distraction. Improvements in SIN were accompanied by self-report of background sounds being less intrusive, consistent with auditory acclimatization involving a process of learning to "tune out" newly audible unwanted sounds. More severe hearing loss may afford the room for improvement required to show better SIN performance with time. Consistent hearing aid use may facilitate acclimatization to hearing aids and better SIN performance.

The Development of Remote Speech Recognition Tests for Adult Cochlear Implant Users: The Effect of Presentation Mode of the Noise and a Reliable Method to Deliver Sound in Home Environments

The number of cochlear implant (CI) users is increasing annually, resulting in an increase in the workload of implant centers in ongoing patient management and evaluation. Remote testing of speech recognition could be time-saving for both the implant centers as well as the patient. This study addresses two methodological challenges we encountered in the development of a remote speech recognition tool for adult CI users. First, we examined whether speech recognition in noise performance differed when the steady-state masking noise was presented throughout the test (i.e. continuous) instead of the standard clinical use for evaluation where the masking noise stops after each stimulus (i.e. discontinuous). A direct coupling between the audio port of a tablet computer to the accessory input of the sound processor with a personal audio cable was used. The setup was calibrated to facilitate presentation of stimuli at a predefined sound level. Finally, differences in frequency response between the audio cable and microphones were investigated.

The role of auditory working memory In the development of glimpsing skills in children

Glimpsing is a complex process involving lower-and higher level auditory skills required for speech understanding in noise. However, little is know the role of working memory as glimpsing develops in children. The present study aimed to determine the extent to which auditory working memory contributes across the continuum of auditory perception skills in children. This study investigated the role working memory plays in speech recognition and auditory comprehension task in the presences of noise. We measured working memory, speech recognition and auditory comprehension performance with noise in 20 seven-to-nine year old children with normal hearing. Backward digit recall was used to assess working memory. Speech recognition in noise performance was measure using the Hearing In Noise Test. Comprehension was measured by a child’s ability to answer five questions associated to auditorily-presented stories. Each question evaluated a different level of comprehension. In general, there are no relationships between the speech recognition in noise performance and working memory. However, the relationship between working memory and comprehension was stronger. These results suggest that working memory contributes more when the auditory task is more complex especially in the presence of noise.