Suprathreshold Auditory Processing Research Articles

Relating self-reported auditory difficulties, suprathreshold auditory processing, and cognition after brain injury

The Portable Automated Rapid Testing (PART) app increases access to psychophysical tasks that are not typically available outside of specialized laboratory settings. PART contains a wide array of suprathreshold auditory and cognitive processing measures that can be completed in a short amount of time, making it attractive to audiologists who are interested in clinically assessing different aspects of auditory function. This may be particularly useful for testing normal-hearing patients with auditory complaints that are not well predicted by standard audiometric tests, such as those with a history of mild traumatic brain injury (mTBI). To begin exploring this possibility, this study aimed to identify whether performance on a battery of PART tests is predictive of auditory complaints in participants with (n = 27) and without (n = 28) a history of mTBI. Regression modeling was used to determine relationships between self-reported auditory difficulties and performance on measures of spectrotemporal modulation detection, frequency modulation detection, spatial release from masking, as well as memory and attention. Findings contribute to our understanding of the effects of mTBI on auditory processing. The importance of integrating remote testing platforms into research on understudied patient populations and of interdisciplinary collaboration with clinicians will also be discussed.

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.

Predicting self-reported hearing problems using suprathreshold auditory processing and cognitive measures

Measures typically included in standard audiometric test batteries often fail to correlate with self-reported auditory complaints. This is especially common for patients with normal- or near-normal-hearing sensitivity, like those who are aging or have a history of traumatic brain injury (TBI). This discrepancy likely stems from the use of measures that are not sensitive to auditory or cognitive processing deficits underlying patient complaints, which limits effective clinical assessment and management. Recent work has focused on making common laboratory-based measures more clinically accessible using a tablet-based app called PART. The goal of the current study was to identify PART measures that better reflect patient complaints. Data was collected from adults with (n = 37) or without (n = 36) a history of TBI that were matched in age and hearing sensitivity. Regression modeling was used to determine relationships between self-reported auditory difficulties and measures of auditory processing and cognition, including spectrotemporal modulation detection, frequency modulation detection, spatial release from masking, and the Auditory Visual Divided Attention Task (AVDAT). Items from the Concussion Symptom Subtype Inventory were used to measure self-reported auditory complaints. Results contribute to a better understanding of processing difficulties that underly auditory complaints in those with and without TBI.

The role of suprathreshold auditory processing abilities in children with specific learning disorder.

To assess the suprathreshold auditory processing and speech recognition abilities in noise in children with specific learning disorder (SLD). A group of twenty-five children diagnosed with SLD and a control group of twenty-five neuro-typical children were included in the study. All the participants were between 6-11 years old. To evaluate suprathreshold auditory processing abilities, the participants were given the Temporal Fine Structure (TFS) Sensitivity Test and the Temporal Envelope (TE) Sensitivity Test, as well as the Consonant Identification Test, was administered to evaluate speech recognition ability in noise. In addition, the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) intelligence test was applied to children with SLD, and the relationship between WISC-IV intelligence test scores in different skills and suprathreshold auditory processing and speech recognition abilities in noise was investigated. Significant differences were found between children diagnosed with SLD and neuro-typical children in terms of suprathreshold auditory processing tasks and speech recognition in noise. Additionally, no correlation was found between suprathreshold auditory processing tasks, speech recognition in noise, and intelligence tests. Suprathreshold auditory processing and speech recognition abilities in noise were found to be affected in children with SLD. A holistic evaluation including a multidisciplinary approach that includes suprathreshold auditory processing abilities is required for children diagnosed with SLD.

Noise-Vocoded Sentence Recognition and the Use of Context in Older and Younger Adult Listeners.

When listening to speech under adverse conditions, older adults, even with "age-normal" hearing, face challenges that may lead to poorer speech recognition than their younger peers. Older listeners generally demonstrate poorer suprathreshold auditory processing along with aging-related declines in neurocognitive functioning that may impair their ability to compensate using "top-down" cognitive-linguistic functions. This study explored top-down processing in older and younger adult listeners, specifically the use of semantic context during noise-vocoded sentence recognition. Eighty-four adults with age-normal hearing (45 young normal-hearing [YNH] and 39 older normal-hearing [ONH] adults) participated. Participants were tested for recognition accuracy for two sets of noise-vocoded sentence materials: one that was semantically meaningful and the other that was syntactically appropriate but semantically anomalous. Participants were also tested for hearing ability and for neurocognitive functioning to assess working memory capacity, speed of lexical access, inhibitory control, and nonverbal fluid reasoning, as well as vocabulary knowledge. The ONH and YNH listeners made use of semantic context to a similar extent. Nonverbal reasoning predicted recognition of both meaningful and anomalous sentences, whereas pure-tone average contributed additionally to anomalous sentence recognition. None of the hearing, neurocognitive, or language measures significantly predicted the amount of context gain, computed as the difference score between meaningful and anomalous sentence recognition. However, exploratory cluster analyses demonstrated four listener profiles and suggested that individuals may vary in the strategies used to recognize speech under adverse listening conditions. Older and younger listeners made use of sentence context to similar degrees. Nonverbal reasoning was found to be a contributor to noise-vocoded sentence recognition. However, different listeners may approach the problem of recognizing meaningful speech under adverse conditions using different strategies based on their hearing, neurocognitive, and language profiles. These findings provide support for the complexity of bottom-up and top-down interactions during speech recognition under adverse listening conditions.

Remote auditory assessment using Portable Automated Rapid Testing (PART) and participant-owned devices.

Remote testing of auditory function can be transformative to both basic research and hearing healthcare; however, historically, many obstacles have limited remote collection of reliable and valid auditory psychometric data. Here, we report performance on a battery of auditory processing tests using a remotely administered system, Portable Automatic Rapid Testing. We compare a previously reported dataset collected in a laboratory setting with the same measures using uncalibrated, participant-owned devices in remote settings (experiment 1, n = 40) remote with and without calibrated hardware (experiment 2, n = 36) and laboratory with and without calibrated hardware (experiment 3, n = 58). Results were well-matched across datasets and had similar reliability, but overall performance was slightly worse than published norms. Analyses of potential nuisance factors such as environmental noise, distraction, or lack of calibration failed to provide reliable evidence that these factors contributed to the observed variance in performance. These data indicate feasibility of remote testing of suprathreshold auditory processing using participants' own devices. Although the current investigation was limited to young participants without hearing difficulties, its outcomes demonstrate the potential for large-scale, remote hearing testing of more hearing-diverse populations both to advance basic science and to establish the clinical viability of auditory remote testing.

Relating Suprathreshold Auditory Processing Abilities to Speech Understanding in Competition.

(1) Background: Difficulty hearing in noise is exacerbated in older adults. Older adults are more likely to have audiometric hearing loss, although some individuals with normal pure-tone audiograms also have difficulty perceiving speech in noise. Additional variables also likely account for speech understanding in noise. It has been suggested that one important class of variables is the ability to process auditory information once it has been detected. Here, we tested a set of these “suprathreshold” auditory processing abilities and related them to performance on a two-part test of speech understanding in competition with and without spatial separation of the target and masking speech. Testing was administered in the Portable Automated Rapid Testing (PART) application developed by our team; PART facilitates psychoacoustic assessments of auditory processing. (2) Methods: Forty-one individuals (average age 51 years), completed assessments of sensitivity to temporal fine structure (TFS) and spectrotemporal modulation (STM) detection via an iPad running the PART application. Statistical models were used to evaluate the strength of associations between performance on the auditory processing tasks and speech understanding in competition. Age and pure-tone-average (PTA) were also included as potential predictors. (3) Results: The model providing the best fit also included age and a measure of diotic frequency modulation (FM) detection but none of the other potential predictors. However, even the best fitting models accounted for 31% or less of the variance, supporting work suggesting that other variables (e.g., cognitive processing abilities) also contribute significantly to speech understanding in noise. (4) Conclusions: The results of the current study do not provide strong support for previous suggestions that suprathreshold processing abilities alone can be used to explain difficulties in speech understanding in competition among older adults. This discrepancy could be due to the speech tests used, the listeners tested, or the suprathreshold tests chosen. Future work with larger numbers of participants is warranted, including a range of cognitive tests and additional assessments of suprathreshold auditory processing abilities.

Speech Perception and Dichotic Listening Are Associated With Hearing Thresholds and Cognition, Respectively, in Unaided Presbycusis.

Presbycusis or age-related hearing loss is a prevalent condition in the elderly population, which affects oral communication, especially in background noise, and has been associated with social isolation, depression, and cognitive decline. However, the mechanisms that relate hearing loss with cognition are complex and still elusive. Importantly, recent studies show that the use of hearing aids in presbycusis, which is its standard management, can induce neuroplasticity and modify performance in cognitive tests. As the majority of the previous studies on audition and cognition obtained their results from a mixed sample of subjects, including presbycusis individuals fitted and not fitted with hearing aids, here, we revisited the associations between hearing loss and cognition in a controlled sample of unaided presbycusis. We performed a cross-sectional study in 116 non-demented Chilean volunteers aged ≥65 years from the Auditory and Dementia study cohort. Specifically, we explored associations between bilateral sensorineural hearing loss, suprathreshold auditory brain stem responses, auditory processing (AP), and cognition with a comprehensive neuropsychological examination. The AP assessment included speech perception in noise (SIN), dichotic listening (dichotic digits and staggered spondaic words), and temporal processing [frequency pattern (FP) and gap-in-noise detection]. The neuropsychological evaluations included attention, memory, language, processing speed, executive function, and visuospatial abilities. We performed an exploratory factor analysis that yielded four composite factors, namely, hearing loss, auditory nerve, midbrain, and cognition. These four factors were used for generalized multiple linear regression models. We found significant models showing that hearing loss is associated with bilateral SIN performance, while dichotic listening was associated with cognition. We concluded that the comprehension of the auditory message in unaided presbycusis is a complex process that relies on audition and cognition. In unaided presbycusis with mild hearing loss (<40 dB HL), speech perception of monosyllabic words in background noise is associated with hearing levels, while cognition is associated with dichotic listening and FP.

Training with an auditory perceptual learning game transfers to speech in competition

Understanding speech in the presence of acoustical competition is a major complaint of those with hearing difficulties. Here, a novel perceptual learning game was tested for its effectiveness in reducing difficulties with hearing speech in competition. The game was designed to train a mixture of auditory processing skills thought to underlie speech in competition, such as spectral-temporal processing, sound localization, and auditory working memory. Training on these skills occurred both in quiet and in competition with noise. Thirty college-aged participants without any known hearing difficulties were assigned either to this mixed-training condition or an active control consisting of frequency discrimination training within the same gamified setting. To assess training effectiveness, tests of speech in competition (primary outcome), as well as basic supra-threshold auditory processing and cognitive processing abilities (secondary outcomes) were administered before and after training. Results suggest modest improvements on speech in competition tests in the mixed-training compared to the frequency-discrimination control condition (Cohen’s d = 0.68). While the sample is small, and in normally hearing individuals, these data suggest promise of future study in populations with hearing difficulties.

Compression and amplification algorithms in hearing aids impair the selectivity of neural responses to speech.

In quiet environments, hearing aids improve the perception of low-intensity sounds. However, for high-intensity sounds in background noise, the aids often fail to provide a benefit to the wearer. Here, by using large-scale single-neuron recordings from hearing-impaired gerbils — an established animal model of human hearing — we show that hearing aids restore the sensitivity of neural responses to speech, but not their selectivity. Rather than reflecting a deficit in supra-threshold auditory processing, the low selectivity is a consequence of hearing-aid compression (which decreases the spectral and temporal contrasts of incoming sound) and of amplification (which distorts neural responses, regardless of whether hearing is impaired). Processing strategies that avoid the trade-off between neural sensitivity and selectivity should improve the performance of hearing aids.

A comparison of temporal processing and spectral processing abilities of monolingual, bilingual and multilingual children

Objective: This study examined the effects of bilingualism and multilingualism on supra-threshold auditory processing abilities in children.Design: Cross-sectional study.Study sample: Ninety children participated in the study, based on the number of languages they know children were assigned into three groups, i.e. monolingual, bilingual and multilingual. Amplitude modulation detection threshold, gap detection threshold, pitch discrimination threshold and spectral ripple discrimination threshold were measured.Results: Results showed superior supra-threshold auditory processing abilities among multilingual and bilingual children than monolingual children. The results further showed that, the supra-threshold auditory processing of multilingual children was better than bilingual children.Conclusion: This finding suggests that knowledge of multiple languages improves supra-threshold auditory processing abilities. This study adds to the growing body of literature supporting the superior supra-threshold auditory processing abilities among bilingual and multilingual individuals.

Combining psychophysics and modeling to probe suprathreshold auditory processing efficiently

The ability to understand speech in noise differs considerably among people. Even “normal-hearing” individuals, i.e., with normal audiograms, exhibit a variety of performances in speech-in-noise listening tests. The number of studies investigating the underlying causes of this variability, not captured by current audiological measures, has exploded over the last few years. However, we still lack an overall computational account of suprathreshold auditory processing that would incorporate enough flexibility to capture these idiosyncratic differences. We propose to uncover the psychophysical mechanisms of suprathreshold processing trough its variability among individuals, by combining noise-based psychophysical methods and computational tools. This approach is illustrated in the case of spectrotemporal modulation processing in normal and impaired hearing. Experimental results collected show how listeners modulate their tuning characteristics depending on the task and reveal that hearing-impaired listeners with similar audiometric losses exhibit a large variety of computational strategies for such tasks, which our modeling approach have the potential to connect with specific computational elements. Overall, this shows how a signal-detection theory framework combined with efficient experimental methods and modeling tools should be considered as a powerful approach to further understand the respective contributions of sensory coding and read-out inefficiencies in human suprathreshold processing.

Categorization of sentence recognition for older adults under noisy and time-altered conditions.

PurposeWhile evaluating the speech recognition ability of older adults, the present study aimed to analyze their error types in parts of speech and find error patterns under various conditions of background noise level and speed of speech.MethodsTwenty older adults with normal hearing for their age (NHiA) and 20 older adults with sensorineural hearing loss (SNHL) participated. Their cognitive function was screened as within the normal range (mini-mental state examination scores >25). The SNHL listeners were divided into high performers (SNHL-H; n=12) and low performers (SNHL-L; n=8), based on their achieving word recognition scores above or below 70%, respectively. A sentence recognition test was conducted at four levels of signal-to-noise ratio (SNR; eg, no noise, +6, +3, 0 dB) and four conditions of time alteration (eg, 30% and 15% of compression and expansion) at the most comfortable level for each participant.ResultsAs expected, the three groups showed that the error percentage increased in sentence recognition as either the SNR decreased or the speech rate became faster. Interestingly, a larger performance difference was found between the SNHL-H and SNHL-L groups in the condition of time alteration than in that of background noise. Among the parts of speech, nouns presented the highest error scores for all participants regardless of degree of listening difficulty. The noun errors of the three groups mainly consisted of no response and fail patterns, but substitution and omission were identified as the third pattern of noun error for background noise and fast speech, respectively.ConclusionDeterioration of speech recognition from the hearing threshold and supra-threshold auditory processing was seen in the elderly in difficult listening environments such as background noise and time alteration. Although different group performance ran across the eight experimental conditions, the robustness of noun errors and the error patterns were very similar, which might be extended to a possible clinical application of aural rehabilitation for the elderly population.

Exploring the Link Between Cognitive Abilities and Speech Recognition in the Elderly Under Different Listening Conditions.

Elderly listeners are known to differ considerably in their ability to understand speech in noise. Several studies have addressed the underlying factors that contribute to these differences. These factors include audibility, and age-related changes in supra-threshold auditory processing abilities, and it has been suggested that differences in cognitive abilities may also be important. The objective of this study was to investigate associations between performance in cognitive tasks and speech recognition under different listening conditions in older adults with either age appropriate hearing or hearing-impairment. To that end, speech recognition threshold (SRT) measurements were performed under several masking conditions that varied along the perceptual dimensions of dip listening, spatial separation, and informational masking. In addition, a neuropsychological test battery was administered, which included measures of verbal working and short-term memory, executive functioning, selective and divided attention, and lexical and semantic abilities. Age-matched groups of older adults with either age-appropriate hearing (ENH, n = 20) or aided hearing impairment (EHI, n = 21) participated. In repeated linear regression analyses, composite scores of cognitive test outcomes (evaluated using PCA) were included to predict SRTs. These associations were different for the two groups. When hearing thresholds were controlled for, composed cognitive factors were significantly associated with the SRTs for the ENH listeners. Whereas better lexical and semantic abilities were associated with lower (better) SRTs in this group, there was a negative association between attentional abilities and speech recognition in the presence of spatially separated speech-like maskers. For the EHI group, the pure-tone thresholds (averaged across 0.5, 1, 2, and 4 kHz) were significantly associated with the SRTs, despite the fact that all signals were amplified and therefore in principle audible.

Designing rehabilitative experiences for virtual, mixed, and augmented reality environments

It is rapidly becoming possible to conduct nearly all of the diagnostic testing necessary for understanding suprathreshold auditory and visual processing abilities using consumer-grade electronics. It is also the case that all of the psychometric methods used are consistent with a game-based structure, which will encourage engagement and increase reliability of the testing. The obvious next step is to integrate diagnosis and rehabilitation into a single game-based framework, for which virtual, augmented, and mixed reality are an ideal platform. The possibilities include auditory, visual, and memory training and diagnostic games, as well as guided interactions to improve skills in real-life scenarios. Essential to effective design, however, is optimizing interfaces to facilitate universal access. Universal design is essential for rehabilitation because it is necessarily the case that those in need of services cannot be assumed to have optimal auditory, visual, tactile, and balance capabilities. The most exciting challenge for the future will involve designing environments that scale appropriately to engage, challenge, and improve all of the senses and cognitive systems of the participant while being flexible enough to provide engaging experiences for those who can most benefit from the experience.

Complementary metrics of human auditory nerve function derived from compound action potentials.

Declines in auditory nerve (AN) function contribute to suprathreshold auditory processing and communication deficits in individuals with normal hearing, hearing loss, hyperacusis, and tinnitus. Procedures to characterize AN loss or dysfunction in humans are limited. We report several novel complementary metrics using the compound action potential (CAP), a direct measure of summated AN activity. Together, these metrics may be used to characterize AN function noninvasively in humans. We examined how these metrics change with stimulus intensity and interpreted these changes within a framework of known physiological properties of the basilar membrane and AN. Our results reveal how neural synchrony and the recruitment of AN fibers with longer first-spike latencies likely contribute to the CAP, affect auditory processing, and differ with noise exposure history in younger adults with normal pure-tone thresholds. Moving forward, this new battery of metrics provides a crucial step toward new diagnostics of AN function in humans. NEW & NOTEWORTHY Loss or inactivity of auditory nerve (AN) fibers is thought to contribute to suprathreshold auditory processing deficits, but evidence-based methods to assess these effects are not available. We describe several novel metrics that together may be used to quantify neural synchrony and characterize AN function in humans.

The effects of noise exposure and musical training on suprathreshold auditory processing and speech perception in noise

Recent animal research has shown that exposure to single episodes of intense noise causes cochlear synaptopathy without affecting hearing thresholds. It has been suggested that the same may occur in humans. If so, it is hypothesized that this would result in impaired encoding of sound and lead to difficulties hearing at suprathreshold levels, particularly in challenging listening environments. The primary aim of this study was to investigate the effect of noise exposure on auditory processing, including the perception of speech in noise, in adult humans. A secondary aim was to explore whether musical training might improve some aspects of auditory processing and thus counteract or ameliorate any negative impacts of noise exposure. In a sample of 122 participants (63 female) aged 30–57 years with normal or near-normal hearing thresholds, we conducted audiometric tests, including tympanometry, audiometry, acoustic reflexes, otoacoustic emissions and medial olivocochlear responses. We also assessed temporal and spectral processing, by determining thresholds for detection of amplitude modulation and temporal fine structure. We assessed speech-in-noise perception, and conducted tests of attention, memory and sentence closure. We also calculated participants' accumulated lifetime noise exposure and administered questionnaires to assess self-reported listening difficulty and musical training. The results showed no clear link between participants' lifetime noise exposure and performance on any of the auditory processing or speech-in-noise tasks. Musical training was associated with better performance on the auditory processing tasks, but not the on the speech-in-noise perception tasks. The results indicate that sentence closure skills, working memory, attention, extended high frequency hearing thresholds and medial olivocochlear suppression strength are important factors that are related to the ability to process speech in noise.

Masked speech perception across the adult lifespan: Impact of age and hearing impairment

As people grow older, speech perception difficulties become highly prevalent, especially in noisy listening situations. Moreover, it is assumed that speech intelligibility is more affected in the event of background noises that induce a higher cognitive load, i.e., noises that result in informational versus energetic masking. There is ample evidence showing that speech perception problems in aging persons are partly due to hearing impairment and partly due to age-related declines in cognition and suprathreshold auditory processing. In order to develop effective rehabilitation strategies, it is indispensable to know how these different degrading factors act upon speech perception. This implies disentangling effects of hearing impairment versus age and examining the interplay between both factors in different background noises of everyday settings. To that end, we investigated open-set sentence identification in six participant groups: a young (20–30 years), middle-aged (50–60 years), and older cohort (70–80 years), each including persons who had normal audiometric thresholds up to at least 4 kHz, on the one hand, and persons who were diagnosed with elevated audiometric thresholds, on the other hand. All participants were screened for (mild) cognitive impairment. We applied stationary and amplitude modulated speech-weighted noise, which are two types of energetic maskers, and unintelligible speech, which causes informational masking in addition to energetic masking. By means of these different background noises, we could look into speech perception performance in listening situations with a low and high cognitive load, respectively. Our results indicate that, even when audiometric thresholds are within normal limits up to 4 kHz, irrespective of threshold elevations at higher frequencies, and there is no indication of even mild cognitive impairment, masked speech perception declines by middle age and decreases further on to older age. The impact of hearing impairment is as detrimental for young and middle-aged as it is for older adults. When the background noise becomes cognitively more demanding, there is a larger decline in speech perception, due to age or hearing impairment. Hearing impairment seems to be the main factor underlying speech perception problems in background noises that cause energetic masking. However, in the event of informational masking, which induces a higher cognitive load, age appears to explain a significant part of the communicative impairment as well. We suggest that the degrading effect of age is mediated by deficiencies in temporal processing and central executive functions. This study may contribute to the improvement of auditory rehabilitation programs aiming to prevent aging persons from missing out on conversations, which, in turn, will improve their quality of life.

Investigating the role of supra-threshold auditory processing and cognitive abilities in presbyacusis

Anecdotal evidence and experimental investigations indicate that older people experience increased speech-perception difficulties, especially in noisy environments. Since peripheral hearing sensitivity declines with age, lower speech intelligibility can often be explained by a reduction in audibility. However, aided speech-perception in hearing-impaired listeners frequently falls short of the performance level that would be expected based on the audibility of the speech signal. Given that many of these listeners are older, poor performance may be partly caused by age-related changes in supra-threshold auditory and/or cognitive processes that are not captured by an audiometric assessment. The presentation will discuss experimental evidence obtained from clinically normal-hearing adult listeners showing that auditory temporal processing, cognition, and speech-in-noise perception are indeed linked and, independently of hearing loss, decline across the adult lifespan. These findings highlight the need to take...

Suprathreshold auditory processing deficits in noise: Effects of hearing loss and age

People with sensorineural hearing loss generally suffer from a reduced ability to understand speech in complex acoustic listening situations, particularly when background noise is present. In addition to the loss of audibility, a mixture of suprathreshold processing deficits is possibly involved, like altered basilar membrane compression and related changes, as well as a reduced ability of temporal coding. A series of 6 monaural psychoacoustic experiments at 0.5, 2, and 6 kHz was conducted with 18 subjects, divided equally into groups of young normal-hearing, older normal-hearing and older hearing-impaired listeners, aiming at disentangling the effects of age and hearing loss on psychoacoustic performance in noise. Random frequency modulation detection thresholds (RFMDTs) with a low-rate modulator in wide-band noise, and discrimination of a phase-jittered Schroeder-phase from a random-phase harmonic tone complex are suggested to characterize the individual ability of temporal processing. The outcome was compared to thresholds of pure tones and narrow-band noise, loudness growth functions, auditory filter bandwidths, and tone-in-noise detection thresholds. At 500 Hz, results suggest a contribution of temporal fine structure (TFS) to pure-tone detection thresholds. Significant correlation with auditory thresholds and filter bandwidths indicated an impact of frequency selectivity on TFS usability in wide-band noise. When controlling for the effect of threshold sensitivity, the listener's age significantly correlated with tone-in-noise detection and RFMDTs in noise at 500 Hz, showing that older listeners were particularly affected by background noise at low carrier frequencies.