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1.
Hear Res ; 426: 108608, 2022 12.
Article in English | MEDLINE | ID: mdl-36137862

ABSTRACT

Alterations of the speech signal, including additive noise and nonlinear distortion, can reduce speech intelligibility and quality. Hearing aids present an especially complicated situation since these devices may implement nonlinear processing designed to compensate for the hearing loss. Hearing-aid processing is often realized as time-varying multichannel gain adjustments, and may also include frequency reassignment. The challenge in designing metrics for hearing aids and hearing-impaired listeners is to accurately model the perceptual trade-offs between speech audibility and the nonlinear distortion introduced by hearing-aid processing. This paper focuses on the Hearing Aid Speech Perception Index (HASPI) and the Hearing Aid Speech Quality Index (HASQI) as representative metrics for predicting intelligibility and quality. These indices start with a model of the auditory periphery that can be adjusted to represent hearing loss. The peripheral model, the speech features computed from the model outputs, and the procedures used to fit the features to subject data are described. Examples are then presented for using the metrics to measure the effects of additive noise, evaluate noise-suppression processing, and to measure the differences among commercial hearing aids. Open questions and considerations in using these and related metrics are then discussed.


Subject(s)
Deafness , Hearing Aids , Hearing Loss, Sensorineural , Hearing Loss , Speech Perception , Humans , Speech Intelligibility , Benchmarking , Hearing Loss/diagnosis , Hearing , Hearing Loss, Sensorineural/rehabilitation
2.
Int J Audiol ; 61(1): 46-58, 2022 Jan.
Article in English | MEDLINE | ID: mdl-33913795

ABSTRACT

OBJECTIVE: This study characterised the relationship between speech intelligibility and quality in listeners with hearing loss for a range of hearing-aid processing settings and acoustic conditions. DESIGN: Binaural speech intelligibility scores and quality ratings were measured for sentences presented in babble noise and processed through a hearing-aid simulation. The intelligibility-quality relationship was investigated by (1) assessing the effects of experimental conditions on each task; (2) directly comparing intelligibility scores and quality ratings for each participant across the range of conditions; and (3) comparing the association between signal envelope fidelity (represented by a cepstral correlation metric) and intelligibility and quality. STUDY SAMPLE: Participants were 15 adults (7 females; age range 59-81 years) with mild to moderately severe sensorineural hearing loss. RESULTS: Intelligibility and quality showed a positive association both with each other and with changes to signal fidelity introduced by the entire acoustic and signal-processing system including the additive noise and the hearing-aid output. As signal fidelity decreased, quality ratings changed at a slower rate than intelligibility scores. Individual psychometric functions were more variable for quality compared to intelligibility. CONCLUSIONS: Variability in the intelligibility-quality relationship reinforces the importance of measuring both intelligibility and quality in clinical hearing-aid fittings.


Subject(s)
Deafness , Hearing Aids , Hearing Loss, Sensorineural , Hearing Loss , Speech Perception , Aged , Aged, 80 and over , Female , Hearing , Hearing Loss, Sensorineural/diagnosis , Humans , Male , Middle Aged , Speech Intelligibility
3.
J Speech Lang Hear Res ; 63(12): 4300-4313, 2020 12 14.
Article in English | MEDLINE | ID: mdl-33253602

ABSTRACT

Purpose The overall goal of the current study was to determine whether noise type plays a role in perceptual quality ratings. We compared quality ratings using various noise types and signal-to-noise ratio (SNR) ranges using hearing aid simulations to consider the effects of hearing aid processing features. Method Ten older adults with bilateral mild to moderately severe sensorineural hearing loss rated the sound quality of sentences processed through a hearing aid simulation and presented in the presence of five different noise types (six-talker babble, three-talker conversation, street traffic, kitchen, and fast-food restaurant) at four SNRs (3, 8, 12, and 20 dB). Results Everyday noise types differentially affected sound quality ratings even when presented at the same SNR: Kitchen and three-talker noises were rated significantly higher than restaurant, traffic, and multitalker babble, which were not different from each other. The effects of noise type were most pronounced at poorer SNRs. Conclusions The findings of this study showed that noise types differentially affected sound quality ratings. The differences we observed were consistent with the acoustic characteristics of the noise types. Noise types having lower envelope fluctuations yielded lower quality ratings than noise types characterized by sporadic high-intensity events at the same SNR.


Subject(s)
Hearing Aids , Hearing Loss, Sensorineural , Speech Perception , Aged , Humans , Noise , Speech
4.
Ear Hear ; 41(2): 433-441, 2020.
Article in English | MEDLINE | ID: mdl-31408045

ABSTRACT

OBJECTIVES: Hearing aids provide various signal processing techniques with a range of parameters to improve the listening experience for a hearing-impaired individual. In previous studies, we reported significant differences in signal modification for mild versus strong signal processing in commercially available hearing aids. In this study, the authors extend this work to clinically prescribed hearing aid fittings based on best-practice guidelines. The goals of this project are to determine the range of cumulative signal modification in clinically fit hearing aids across manufacturers and technology levels and the effects of listening conditions including signal to noise ratio (SNR) and presentation level on these signal modifications. DESIGN: We identified a subset of hearing aids that were representative of a typical clinical setting. Deidentified hearing aid fitting data were obtained from three audiology clinics for adult hearing aid users with sensorineural hearing loss for a range of hearing sensitivities. Matching laboratory hearing aids were programmed with the deidentified fitting data. Output from these hearing aids was recorded at four SNRs and three presentation levels. The resulting signal modification was quantified using the cepstral correlation component of the Hearing Aid Speech Quality Index which measures the speech envelope changes in the context of a model of the listener's hearing loss. These metric values represent the hearing aid processed signal as it is heard by the hearing aid user. Audiometric information was used to determine the nature of any possible association with the distribution of signal modification in these clinically fit hearing aids. RESULTS: In general, signal modification increased as SNR decreased and presentation level increased. Differences across manufacturers were significant such that the effect of presentation level varied differently at each SNR, for each manufacturer. This result suggests that there may be variations across manufacturers in processing various listening conditions. There was no significant effect of technology level. There was a small effect of pure-tone average on signal modification for one manufacturer, but no effect of audiogram slope. Finally, there was a broad range of measured signal modification for a given hearing loss, for the same manufacturer and listening condition. CONCLUSIONS: The signal modification values in this study are representative of commonly fit hearing aids in clinics today. The results of this study provide insights into how the range of signal modifications obtained in real clinical fittings compares with a previous study. Future studies will focus on the behavioral implications of signal modifications in clinically fit hearing aids.


Subject(s)
Hearing Aids , Hearing Loss, Sensorineural , Speech Perception , Adult , Hearing Tests , Humans , Signal-To-Noise Ratio
5.
J Acoust Soc Am ; 145(6): 3551, 2019 06.
Article in English | MEDLINE | ID: mdl-31255148

ABSTRACT

A remote microphone (RM) links a talker's microphone to a listener's hearing aids (HAs). The RM improves intelligibility in noise and reverberation, but the binaural cues necessary for externalization are lost. Augmenting the RM signal with synthesized binaural cues and early reflections enhances externalization, but interactions of the RM signal with the HA processing could reduce its effectiveness. These potential interactions were evaluated using RM plus HA processing in a realistic listening simulation. The HA input was the RM alone, the augmented RM signal, the acoustic inputs at the HA microphones, including reverberation measured using a dummy head, or a mixture of the augmented RM and acoustic input signals. The HA simulation implemented linear amplification or independent dynamic-range compression at the two ears and incorporated the acoustic effects of vented earmolds. Hearing-impaired listeners scored sentence stimuli for intelligibility and rated clarity, overall quality, externalization, and apparent source width. Using the RM improved intelligibility but reduced the spatial impression. Increasing the vent diameter reduced clarity and increased the spatial impression. Listener ratings reflect a trade-off between the attributes of clarity and overall quality and the attributes of externalization and source width that can be explained using the interaural cross correlation.


Subject(s)
Hearing Aids , Hearing Loss/physiopathology , Sound Localization/physiology , Speech Perception/physiology , Auditory Threshold/physiology , Female , Hearing Loss, Sensorineural/physiopathology , Humans , Male , Noise
6.
Ear Hear ; 40(6): 1280-1292, 2019.
Article in English | MEDLINE | ID: mdl-30998547

ABSTRACT

OBJECTIVES: Previous work has suggested that individual characteristics, including amount of hearing loss, age, and working memory ability, may affect response to hearing aid signal processing. The present study aims to extend work using metrics to quantify cumulative signal modifications under simulated conditions to real hearing aids worn in everyday listening environments. Specifically, the goal was to determine whether individual factors such as working memory, age, and degree of hearing loss play a role in explaining how listeners respond to signal modifications caused by signal processing in real hearing aids, worn in the listener's everyday environment, over a period of time. DESIGN: Participants were older adults (age range 54-90 years) with symmetrical mild-to-moderate sensorineural hearing loss. We contrasted two distinct hearing aid fittings: one designated as mild signal processing and one as strong signal processing. Forty-nine older adults were enrolled in the study and 35 participants had valid outcome data for both hearing aid fittings. The difference between the two settings related to the wide dynamic range compression and frequency compression features. Order of fittings was randomly assigned for each participant. Each fitting was worn in the listener's everyday environments for approximately 5 weeks before outcome measurements. The trial was double blind, with neither the participant nor the tester aware of the specific fitting at the time of the outcome testing. Baseline measures included a full audiometric evaluation as well as working memory and spectral and temporal resolution. The outcome was aided speech recognition in noise. RESULTS: The two hearing aid fittings resulted in different amounts of signal modification, with significantly less modification for the mild signal processing fitting. The effect of signal processing on speech intelligibility depended on an individual's age, working memory capacity, and degree of hearing loss. Speech recognition with the strong signal processing decreased with increasing age. Working memory interacted with signal processing, with individuals with lower working memory demonstrating low speech intelligibility in noise with both processing conditions, and individuals with higher working memory demonstrating better speech intelligibility in noise with the mild signal processing fitting. Amount of hearing loss interacted with signal processing, but the effects were small. Individual spectral and temporal resolution did not contribute significantly to the variance in the speech intelligibility score. CONCLUSIONS: When the consequences of a specific set of hearing aid signal processing characteristics were quantified in terms of overall signal modification, there was a relationship between participant characteristics and recognition of speech at different levels of signal modification. Because the hearing aid fittings used were constrained to specific fitting parameters that represent the extremes of the signal modification that might occur in clinical fittings, future work should focus on similar relationships with more diverse types of signal processing parameters.


Subject(s)
Hearing Aids , Hearing Loss, Sensorineural/rehabilitation , Signal Processing, Computer-Assisted , Age Factors , Aged , Aged, 80 and over , Cross-Over Studies , Data Compression , Double-Blind Method , Female , Humans , Male , Memory, Short-Term , Middle Aged , Noise , Severity of Illness Index , Speech Perception
7.
Int J Audiol ; 57(11): 809-815, 2018 11.
Article in English | MEDLINE | ID: mdl-30052097

ABSTRACT

Clinicians have long used self-report methods to assess hearing aid benefit. However, there are fewer data as to whether self-report instruments can be used to compare differences between signal processing settings. This study examined how self-perceived performance varied as a function of modifications in signal processing using two self-report measures. Data were collected as part of a double-blind randomised crossover clinical trial. Participants were fit with two fittings: mild processing (slow time constants, disabled frequency lowering) and strong processing (fast time constants, frequency lowering enabled). The speech, spatial, and qualities of hearing (SSQ) questionnaire and the Effectiveness of Auditory Rehabilitation (EAR) questionnaire were collected at multiple time points. Older adults with sensorineural hearing loss who had not used hearing aids within the previous year participated (49 older adults were consented; 40 were included in the final data analyses). Findings show that listeners report a difference in perceived performance when hearing aid features are modified. Both self-report measures were able to capture this change in perceived performance. Self-report measures provide a tool for capturing changes in perceived performance when hearing aid processing features are modified and may enhance provision of an evidence-based hearing aid fitting.


Subject(s)
Auditory Perception , Correction of Hearing Impairment/instrumentation , Hearing Aids , Hearing Loss, Sensorineural/rehabilitation , Patient Satisfaction , Persons With Hearing Impairments/rehabilitation , Self Report , Signal Processing, Computer-Assisted , Acoustic Stimulation , Aged , Aged, 80 and over , Auditory Threshold , Chicago , Colorado , Cross-Over Studies , Double-Blind Method , Equipment Design , Female , Hearing , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/physiopathology , Hearing Loss, Sensorineural/psychology , Humans , Male , Middle Aged , Persons With Hearing Impairments/psychology , Sound Localization , Speech Perception
8.
J Acoust Soc Am ; 143(5): 2666, 2018 05.
Article in English | MEDLINE | ID: mdl-29857749

ABSTRACT

In a remote microphone (RM) system, a talker speaks into a microphone and the signal is transmitted to the hearing aids worn by the hearing-impaired listener. A difficulty with remote microphones, however, is that the signal received at the hearing aid bypasses the head and pinna, so the acoustic cues needed to externalize the sound source are missing. The objective of this paper is to process the RM signal to improve externalization when listening through earphones. The processing is based on a structural binaural model, which uses a cascade of processing modules to simulate the interaural level difference, interaural time difference, pinna reflections, ear-canal resonance, and early room reflections. The externalization results for the structural binaural model are compared to a left-right signal blend, the listener's own anechoic head-related impulse response (HRIR), and the listener's own HRIR with room reverberation. The azimuth is varied from straight ahead to 90° to one side. The results show that the structural binaural model is as effective as the listener's own HRIR plus reverberation in producing an externalized acoustic image, and that there is no significant difference in externalization between hearing-impaired and normal-hearing listeners.


Subject(s)
Acoustic Stimulation/methods , Ear Auricle/physiology , Models, Biological , Speech Perception/physiology , Acoustic Stimulation/instrumentation , Adult , Aged , Aged, 80 and over , Ear Auricle/anatomy & histology , Female , Head/anatomy & histology , Head/physiology , Hearing Loss/diagnosis , Hearing Loss/physiopathology , Humans , Male , Middle Aged , Young Adult
9.
Ear Hear ; 39(6): 1165-1175, 2018.
Article in English | MEDLINE | ID: mdl-29554034

ABSTRACT

OBJECTIVES: The performance of hearing aids is generally characterized by a small set of standardized measurements. The primary goals of these procedures are to measure basic aspects of the hearing aid performance and to ascertain that the device is operating properly. A more general need exists for objective metrics that can predict hearing aid outcomes. Such metrics must consider the interaction of all the signal processing operating in the hearing aid and must do so while also accounting for the hearing loss for which the hearing aid has been prescribed. This article represents a first step in determining the clinical applicability of the hearing aid speech perception index (HASPI) intelligibility and hearing aid speech quality index (HASQI) speech quality metrics. The goals of this article are to demonstrate the feasibility of applying these metrics to commercial hearing aids and to illustrate the anticipated range of measured values and identify implementation concerns that may not be present for conventional measurements. DESIGN: This article uses the HASPI intelligibility and HASQI speech quality metrics to measure the performance of commercial hearing aids. These metrics measure several aspects of the processed signal, including envelope fidelity, modifications of the temporal fine structure, and changes in the long-term frequency response, all in the context of an auditory model that reproduces the salient aspects of the peripheral hearing loss. The metrics are used to measure the performance of basic and premium hearing aids from three different manufacturers. Test conditions include the environmental factors of signal to noise ratio and presentation level, and the fitting configurations were varied to provide different degrees of processing from linear to aggressive nonlinear processing for two different audiograms. RESULTS: The results show that the metrics are capable of measuring statistically significant differences across devices and processing settings. HASPI and HASQI measure both audibility and nonlinear distortion in the devices, and conditions are identified where predicted intelligibility is high but predicted speech quality is substantially reduced. The external signal properties of signal to noise ratio and presentation level are both statistically significant. Hearing loss is significant for HASPI but not for HASQI, and degree of processing is significant for both metrics. A quadratic model for manufacturer showed large effect sizes for HASPI and HASQI, but basic versus premium hearing aid model is not significant. CONCLUSIONS: The results presented in this article represent a first step in applying the HASPI and HASQI metrics to commercial hearing aids. Modern hearing aids often use several different processing strategies operating simultaneously. The proposed metrics provide a way to predict the total effect of this processing, including algorithm interactions that may be missed by conventional measurement procedures. The measurements in this article show significant differences between manufacturers, processing settings, and adjustment for different hearing losses. No significant differences were found between basic and premium hearing aid models. Further research will be needed to determine the clinical relevance of these measurements and to provide target values appropriate for successful fittings.


Subject(s)
Hearing Aids/standards , Hearing Tests , Speech Intelligibility , Analysis of Variance , Auditory Perception , Equipment Design , Feasibility Studies , Humans , Linear Models , Reference Standards , Signal-To-Noise Ratio
10.
J Am Acad Audiol ; 29(2): 118-124, 2018 02.
Article in English | MEDLINE | ID: mdl-29401059

ABSTRACT

BACKGROUND: Current guidelines for adult hearing aid fittings recommend the use of a prescriptive fitting rationale with real-ear verification that considers the audiogram for the determination of frequency-specific gain and ratios for wide dynamic range compression. However, the guidelines lack recommendations for how other common signal-processing features (e.g., noise reduction, frequency lowering, directional microphones) should be considered during the provision of hearing aid fittings and fine-tunings for adult patients. PURPOSE: The purpose of this survey was to identify how audiologists make clinical decisions regarding common signal-processing features for hearing aid provision in adults. RESEARCH DESIGN: An online survey was sent to audiologists across the United States. The 22 survey questions addressed four primary topics including demographics of the responding audiologists, factors affecting selection of hearing aid devices, the approaches used in the fitting of signal-processing features, and the strategies used in the fine-tuning of these features. STUDY SAMPLE: A total of 251 audiologists who provide hearing aid fittings to adults completed the electronically distributed survey. The respondents worked in a variety of settings including private practice, physician offices, university clinics, and hospitals/medical centers. DATA COLLECTION AND ANALYSIS: Data analysis was based on a qualitative analysis of the question responses. The survey results for each of the four topic areas (demographics, device selection, hearing aid fitting, and hearing aid fine-tuning) are summarized descriptively. RESULTS: Survey responses indicate that audiologists vary in the procedures they use in fitting and fine-tuning based on the specific feature, such that the approaches used for the fitting of frequency-specific gain differ from other types of features (i.e., compression time constants, frequency lowering parameters, noise reduction strength, directional microphones, feedback management). Audiologists commonly rely on prescriptive fitting formulas and probe microphone measures for the fitting of frequency-specific gain and rely on manufacturers' default settings and recommendations for both the initial fitting and the fine-tuning of signal-processing features other than frequency-specific gain. CONCLUSIONS: The survey results are consistent with a lack of published protocols and guidelines for fitting and adjusting signal-processing features beyond frequency-specific gain. To streamline current practice, a transparent evidence-based tool that enables clinicians to prescribe the setting of other features from individual patient characteristics would be desirable.


Subject(s)
Hearing Aids , Hearing Loss/therapy , Practice Patterns, Physicians' , Prosthesis Fitting , Signal Processing, Computer-Assisted , Adult , Hearing Loss/diagnosis , Hearing Loss/physiopathology , Humans , Surveys and Questionnaires
11.
J Speech Lang Hear Res ; 61(1): 189-190, 2018 01 22.
Article in English | MEDLINE | ID: mdl-29305596

ABSTRACT

Purpose: The purpose of this letter is to refute the comments written by Smits, Goverts, and Versfeld (2018). Method: Refutations to each issue including the fixed mathematical relationship between dynamic range (DR) and a fitting constant (Q value), deviating results for small DRs, and determination of Speech Intelligibility Index (SII) model parameters are described. Results: Although Smits et al. (2018) correctly identified several issues, those comments do not diminish the results of the original article (Jin, Kates, & Arehart, 2017) in providing new insights for the SII. Conclusions: Jin et al. (2017) clearly provided the impact of languages and DR on the SII, which was the main result of the study.


Subject(s)
Speech Intelligibility , Speech Perception , Humans , Language
12.
J Speech Lang Hear Res ; 60(6): 1674-1680, 2017 06 10.
Article in English | MEDLINE | ID: mdl-28586909

ABSTRACT

Purpose: This study aims to evaluate the sensitivity of the speech intelligibility index (SII) to the assumed speech dynamic range (DR) in different languages and with different types of stimuli. Method: Intelligibility prediction uses the absolute transfer function (ATF) to map the SII value to the predicted intelligibility for a given stimuli. To evaluate the sensitivity of the predicted intelligibility to the assumed DR, ATF-transformed SII scores for English (words), Korean (sentences), and Mandarin (sentences) were derived for DRs ranging from 10 dB to 60 dB. Results: Increasing the assumed DR caused steeper ATFs for all languages. However, high correlation coefficients between predicted and measured intelligibility scores were observed for DRs from 20 dB to 60 dB for ATFs in English, Korean, and Mandarin. Conclusions: Results of the present study indicate that the intelligibility computed from the SII is not sensitive to the assumed DR. The 30-dB DR commonly used in computing the SII is thus a reasonable assumption that produces accurate predictions for different languages and different types of stimuli.


Subject(s)
Language , Models, Biological , Speech Intelligibility , Humans , Speech Acoustics
13.
J Acoust Soc Am ; 141(5): EL482, 2017 05.
Article in English | MEDLINE | ID: mdl-28599537

ABSTRACT

A single reflection is the simplest simulation of reverberation and provides insights into more complex scenarios of listening in rooms. This paper presents an analysis of the effects of a single reflection as its delay and intensity are systematically varied. The changes to the envelope modulations are analyzed using not only the traditional within-auditory-band analysis approach but also an across-band spectro-temporal analysis using cepstral correlation coefficients. The use of an auditory model allowed the extension of the simulations to include sensorineural hearing loss. Short delays did not interfere with the envelope modulations at low modulation rates (<16 Hz) and impact predicted intelligibility, while longer delays caused substantial distortion at these rates. The patterns of envelope modulation distortions caused by a single reflection were shown to be similar in models of normal hearing and hearing impairment.


Subject(s)
Acoustics , Cues , Signal Processing, Computer-Assisted , Speech Acoustics , Speech Intelligibility , Speech Perception , Voice Quality , Humans , Models, Theoretical , Motion , Persons With Hearing Impairments/psychology , Sound , Sound Spectrography , Time Factors , Vibration
14.
J Am Acad Audiol ; 28(2): 119-126, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28240979

ABSTRACT

BACKGROUND: Graphical methods for calculating the speech intelligibility index (SII), such as the count-the-dot audiogram, are useful tools in quantifying how much weighted audibility is restored when amplification is used for individuals with hearing loss. The band-importance function (BIF), which is an important component of the SII, depends on the language. Thus, language may affect the prediction of weighted audibility using the graphical SII. PURPOSE: The purpose of this study was to apply language-specific BIFs to develop and compare graphical SIIs for English, Korean, and Mandarin. RESEARCH DESIGN: The graphical SIIs were developed and compared using a research design that applied and analyzed existing datasets. DATA COLLECTION AND ANALYSIS: Language-specific BIFs and dynamic ranges were used to derive graphical SIIs for English, Korean, and Mandarin. SII predictions were compared by calculating the language-specific predictions for the same audiometric configurations. RESULTS: The graphical SIIs for English, Korean, and Mandarin yielded different unaided and aided predictions for the same audiogram configurations. CONCLUSIONS: A graphical SII helps patients easily understand their weighted audibility for unaided and aided conditions; thus, it is a useful counseling tool in the clinic. The most accurate graphical SII's will, however, be based on a patient's spoken language.


Subject(s)
Computer Graphics , Diagnosis, Computer-Assisted , Hearing Loss, Sensorineural/rehabilitation , Language , Speech Intelligibility/physiology , Audiometry, Pure-Tone/methods , Auditory Threshold , Cohort Studies , Female , Hearing Loss, Sensorineural/diagnosis , Humans , Male , Severity of Illness Index
15.
Am J Audiol ; 25(4): 319-331, 2016 Dec 01.
Article in English | MEDLINE | ID: mdl-27788277

ABSTRACT

PURPOSE: The population of the United States is aging. Those older adults are living longer than ever and have an increased desire for social participation. As a result, audiologists are likely to see an increased demand for service by older clients whose communication difficulty is caused by a combination of hearing loss and cognitive impairment. For these individuals, early detection of mild cognitive impairment is critical for providing timely medical intervention and social support. METHOD: This tutorial provides information about cognition of older adults, mild cognitive impairment, and cognitive screening tests, with the purpose of assisting audiologists in identifying and appropriately referring potential cases of cognitive impairment. RESULTS: Topics addressed also include how to administer cognitive screening tests on individuals with hearing loss, how to use test results in audiology practice, and the potential of using cognitive screening tests for evaluating the benefit of clinical interventions. CONCLUSIONS: As health care professionals who serve the aging population, audiologists are likely to encounter cases of undiagnosed cognitive impairment. In order to provide timely referral for medical assistance as well as an optimized individual outcome of audiologic interventions, audiologists should be trained to recognize an abnormality in older clients' cognitive status.


Subject(s)
Cognitive Aging/psychology , Cognitive Dysfunction/diagnosis , Hearing Loss/diagnosis , Aged , Aged, 80 and over , Audiology , Cognitive Dysfunction/complications , Cognitive Dysfunction/psychology , Hearing Loss/complications , Hearing Loss/psychology , Humans , Mass Screening , Referral and Consultation
16.
Am J Audiol ; 25(3): 161-6, 2016 Sep 01.
Article in English | MEDLINE | ID: mdl-27669061

ABSTRACT

PURPOSE: The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions. METHOD: The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane. RESULTS: For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs. CONCLUSION: By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.


Subject(s)
Choice Behavior , Hearing Aids , Hearing Loss, Sensorineural/rehabilitation , Music , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Loudness Perception , Male , Middle Aged , Young Adult
17.
IEEE/ACM Trans Audio Speech Lang Process ; 24(2): 354-365, 2016 Feb.
Article in English | MEDLINE | ID: mdl-27135042

ABSTRACT

This paper presents an index designed to predict music quality for individuals listening through hearing aids. The index is "intrusive", that is, it compares the degraded signal being evaluated to a reference signal. The index is based on a model of the auditory periphery that includes the effects of hearing loss. Outputs from the auditory model are used to measure changes in the signal time-frequency envelope modulation, temporal fine structure, and long-term spectrum caused by the hearing aid processing. The index is constructed by combining a term sensitive to noise and nonlinear distortion with a second term sensitive to changes in the long-term spectrum. The index is fitted to an existing database of music quality judgments made by listeners having normal or impaired hearing. The data comprise ratings for three music excerpts (classical orchestra, jazz trio, and jazz singer), each processed through 100 conditions representative of hearing-aid processing and listening situations. The overall accuracy of the index is high, with a correlation coefficient of 0.970 when computed over all of the processing conditions and averaged over the combined groups of listeners having normal and impaired hearing.

18.
J Acoust Soc Am ; 138(4): 2470-82, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26520329

ABSTRACT

This paper uses mutual information to quantify the relationship between envelope modulation fidelity and perceptual responses. Data from several previous experiments that measured speech intelligibility, speech quality, and music quality are evaluated for normal-hearing and hearing-impaired listeners. A model of the auditory periphery is used to generate envelope signals, and envelope modulation fidelity is calculated using the normalized cross-covariance of the degraded signal envelope with that of a reference signal. Two procedures are used to describe the envelope modulation: (1) modulation within each auditory frequency band and (2) spectro-temporal processing that analyzes the modulation of spectral ripple components fit to successive short-time spectra. The results indicate that low modulation rates provide the highest information for intelligibility, while high modulation rates provide the highest information for speech and music quality. The low-to-mid auditory frequencies are most important for intelligibility, while mid frequencies are most important for speech quality and high frequencies are most important for music quality. Differences between the spectral ripple components used for the spectro-temporal analysis were not significant in five of the six experimental conditions evaluated. The results indicate that different modulation-rate and auditory-frequency weights may be appropriate for indices designed to predict different types of perceptual relationships.


Subject(s)
Acoustics , Auditory Perception , Hearing Loss, Sensorineural/psychology , Music , Speech Intelligibility , Speech Perception , Algorithms , Datasets as Topic , Hearing Loss, Sensorineural/physiopathology , Humans , Judgment , Sound Spectrography , Voice Quality
19.
J Acoust Soc Am ; 138(2): 938-41, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26328709

ABSTRACT

The purpose of this study was to compare band-importance functions (BIFs) derived by two different procedures. Intelligibility data from native speakers of Korean were used. BIFs were derived using an established procedure reported by Studebaker and Sherbecoe [J. Speech Lang. Hear. Res. 34, 427-438 (1991)] and by a recently published method reported by Kates [J. Acoust. Soc. Am. 134(5), EL459-EL464 (2013)]. The BIFs produced by the two different procedures were similar. These results indicate that the BIF calculation procedure by Kates is accurate for sentences as well as for the monosyllables used in its derivation.


Subject(s)
Algorithms , Speech Acoustics , Speech Intelligibility , Adolescent , Adult , Cues , Female , Humans , Language , Male , Young Adult
20.
IEEE Signal Process Mag ; 32(2): 114-124, 2015 Mar.
Article in English | MEDLINE | ID: mdl-26052190

ABSTRACT

This article presents an overview of twelve existing objective speech quality and intelligibility prediction tools. Two classes of algorithms are presented, namely intrusive and non-intrusive, with the former requiring the use of a reference signal, while the latter does not. Investigated metrics include both those developed for normal hearing listeners, as well as those tailored particularly for hearing impaired (HI) listeners who are users of assistive listening devices (i.e., hearing aids, HAs, and cochlear implants, CIs). Representative examples of those optimized for HI listeners include the speech-to-reverberation modulation energy ratio, tailored to hearing aids (SRMR-HA) and to cochlear implants (SRMR-CI); the modulation spectrum area (ModA); the hearing aid speech quality (HASQI) and perception indices (HASPI); and the PErception MOdel - hearing impairment quality (PEMO-Q-HI). The objective metrics are tested on three subjectively-rated speech datasets covering reverberation-alone, noise-alone, and reverberation-plus-noise degradation conditions, as well as degradations resultant from nonlinear frequency compression and different speech enhancement strategies. The advantages and limitations of each measure are highlighted and recommendations are given for suggested uses of the different tools under specific environmental and processing conditions.

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