The relationship between age, acceptable noise level, and listening effort in middle-aged and older-aged individuals.

Objective: The purpose of the study was to evaluate listening effort in adults who experience varied annoyance towards noise. Materials and methods: Fifty native Kannada-speaking adults aged 41-68 years participated. We evaluated the participant's acceptable noise level while listening to speech. Further, a sentence-final word-identification and recall test at 0 dB SNR (less favorable condition) and 4 dB SNR (relatively favorable condition) was used to assess listening effort. The repeat and recall scores were obtained for each condition. Results: The regression model revealed that the listening effort increased by 0.6% at 0 dB SNR and by 0.5% at 4 dB SNR with every one-year advancement in age. Listening effort increased by 0.9% at 0 dB SNR and by 0.7% at 4 dB SNR with every one dB change in the value of Acceptable Noise Level (ANL). At 0 dB SNR and 4 dB SNR, a moderate and mild negative correlation was noted respectively between listening effort and annoyance towards noise when the factor age was controlled. Conclusion: Listening effort increases with age, and its effect is more in less favorable than in relatively favorable conditions. However, if the annoyance towards noise was controlled, the impact of age on listening effort was reduced. Listening effort correlated with the level of annoyance once the age effect was controlled. Furthermore, the listening effort was predicted from the ANL to a moderate degree.

Objective Measure of Listening Effort in HearingImpaired Individuals With and Without Tinnitus.

BACKGROUND: Tinnitus is a perception of sound in the brain without any external stimulus. Tinnitus patients often complain of more efforts required in listening. They may be ineffective in inhibiting their attention, driven to irrelevant ringing sounds in their ear rather than attending to the relevant target speech stimulus. The study's objective was to evaluate an allocation of cognitive resources among tinnitus patients for concurrent tasks required for understanding speech using an objective dual-task paradigm to assess listening effort. METHODS: We recruited 40 participants with mild to moderately severe sloping sensorineural hearing loss within 60-70 years. They were subgrouped into control and clinical groups. The clinical group had a severe degree of tonal tinnitus bilaterally. The objective listening task used listening effort, and a subjective questionnaire to assess the effort in listening was assessed by each study participant. RESULTS: The results indicated poorer recognition and reduced recall scores in a clinical group than the control group in each signal-to-noise ratio. The recall score in objective listening effort measurement was strongly correlated with subjective questions assessed effort in listening among the clinical group at each signal-to-noise ratio. However, in the control group, the correlation was to a mild degree at 0 dB signal-to-noise ratio only. CONCLUSION: Annoyance caused by tinnitus disrupts attention, thereby limiting the effective use of cognitive resources for concurrent speech processing and recalling reflected in the listening effort task.

Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss

Abstract Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss.

Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene. Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss. Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids. Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used. Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.

Determining attributed factors of hearing handicap in individuals with auditory sensory and neural pathology

Abstract Introduction: There is a modest relationship between speech perception skills and perceived hearing handicap in individuals with hearing loss. In this study, an attempt is made at linking psychoacoustic results and speech perception skills to understand the subjective handicap and quality of life. Objective: To investigate how speech perception in noise (signal to noise ratio-50), difference limen frequency, temporal modulation transfer function, hearing handicap inventory for adults, and quality of life in auditory neuropathy spectrum disorder differs from sensorineural hearing loss. Further we attempt to discern attributed factors of hearing handicap in auditory neuropathy spectrum disorder and sensorineural hearing loss. Methods: A cross-sectional study with comparative and correlational research designs were utilized. Eighty-four participants were grouped into sensorineural hearing loss (n = 49), and auditory neuropathy spectrum disorder (n = 35) was sub-grouped into mild, moderately severe, and severe. We evaluated signal to noise ratio-50, difference limen frequency, and temporal modulation transfer function. In addition, hearing handicap inventory for adults, and quality of life questionnaires were administered. Results: Mild auditory neuropathy spectrum disorder showed impairment in speech perception and discriminating frequency, which were similar to the severe sensory neural hearing loss. Temporal resolution impairment in auditory neuropathy spectrum disorder mild was significantly higher than in each sub-groups of sensorineural hearing loss. The severity of the hearing handicap in was similar to severe sensorineural hearing loss, quality of life was equally affected in sensorineural hearing loss and auditory neuropathy spectrum disorder. In sensorineural hearing loss, signal to noise ratio-50 was positively related, and quality of life was negatively related to hearing handicap. In auditory neuropathy spectrum disorder, no contributory factors were related to hearing handicap. Conclusion: Mild auditory neural pathology demonstrates impairment in speech recognition and psychoacoustic skills similar to severe cochlear pathology. In sensorineural hearing loss, hearing handicap is predicted from quality of life and speech perception, but none of the contributory factors predicted hearing handicap in auditory neuropathy spectrum disorder.

Determining attributed factors of hearing handicap in individuals with auditory sensory and neural pathology.

INTRODUCTION: There is a modest relationship between speech perception skills and perceived hearing handicap in individuals with hearing loss. In this study, an attempt is made at linking psychoacoustic results and speech perception skills to understand the subjective handicap and quality of life. OBJECTIVE: To investigate how speech perception in noise (signal to noise ratio-50), difference limen frequency, temporal modulation transfer function, hearing handicap inventory for adults, and quality of life in auditory neuropathy spectrum disorder differs from sensorineural hearing loss. Further we attempt to discern attributed factors of hearing handicap in auditory neuropathy spectrum disorder and sensorineural hearing loss. METHODS: A cross-sectional study with comparative and correlational research designs were utilized. Eighty-four participants were grouped into sensorineural hearing loss (n = 49), and auditory neuropathy spectrum disorder (n = 35) was sub-grouped into mild, moderately severe, and severe. We evaluated signal to noise ratio-50, difference limen frequency, and temporal modulation transfer function. In addition, hearing handicap inventory for adults, and quality of life questionnaires were administered. RESULTS: Mild auditory neuropathy spectrum disorder showed impairment in speech perception and discriminating frequency, which were similar to the severe sensory neural hearing loss. Temporal resolution impairment in auditory neuropathy spectrum disorder mild was significantly higher than in each sub-groups of sensorineural hearing loss. The severity of the hearing handicap in was similar to severe sensorineural hearing loss, quality of life was equally affected in sensorineural hearing loss and auditory neuropathy spectrum disorder. In sensorineural hearing loss, signal to noise ratio-50 was positively related, and quality of life was negatively related to hearing handicap. In auditory neuropathy spectrum disorder, no contributory factors were related to hearing handicap. CONCLUSION: Mild auditory neural pathology demonstrates impairment in speech recognition and psychoacoustic skills similar to severe cochlear pathology. In sensorineural hearing loss, hearing handicap is predicted from quality of life and speech perception, but none of the contributory factors predicted hearing handicap in auditory neuropathy spectrum disorder.

Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin?

The study aimed to investigate the working memory and speech recognition in noise from individuals with Sensori Neural Hearing Loss (SNHL) with and without auditory neuropathy spectrum disorder (ANSD). The purpose of assessing working memory recommends for a potential intervention program to perceive speech. Twenty participants in the age range of 16-44 years, diagnosed as having mild to moderate SNHL were recruited for the study. The participants were divided into two groups based on the presence and absence of ANSD (10 in each group). The visual working memory was assessed in all the participants using the Operation Span Test, Reading Span Test and Visual Backward Test. Speech perception ability was assessed using the SNR 50 test. There was no significant difference between the scores of Operation Span, Reading Span, and Visual Backward Span for individuals with SNHL with and without ANSD. There was a significant difference between the scores of SNR 50 for individuals with SNHL with and without ANSD. The visual working memory in individuals with and without ANSD is similar. Speech perception in noise is significantly affected in ANSD than SNHL without ANSD. Thus, it is recommended to use speech reading, which utilizes visual working memory to interpret the message, as previous studies have reported that individuals with ANSD show limited benefit in auditory mode of rehabilitation alone.

Perception of temporally enhanced and hearing aid processed speech in children with late-onset Auditory Neuropathy Spectrum Disorder.

OBJECTIVE: To investigate phrase perception and subjective quality preference of temporal enhancement-based speech processing strategies: Deep-band modulation and Stretching, and hearing aid processed speech in adolescents with late-onset Auditory Neuropathy. METHODS: 15 participants with Auditory Neuropathy Spectrum Disorder were involved. Speech perception was assessed using unprocessed, deep-band modulated, stretched, and hearing aid processed conditions. Subjective preference was also assessed using the pair-wise comparison technique. Gap detection test was done using broadband noise to investigate the possible correlation with benefit from processing strategies. RESULTS: As a group, no significant benefits were found with processed speech. Clinically relevant trends emerged on subdividing the group into good and poor performers. Deep-band modulation processing was significantly better than unprocessed speech in those with poorer speech recognition abilities. There was a trend for those with poorer temporal processing abilities to benefit more with deep-band modulation processing. In those with relatively better speech recognition abilities, processing showed no benefit, and hearing aid processed speech was inferior to unprocessed speech. Quality-wise, the unprocessed speech was preferred by all the participants. Among the processed conditions, deep-band modulation was preferred by most, followed by stretching and hearing aid processed speech. CONCLUSION: Results indicate that temporal enhancement strategies may be beneficial for a subset of individuals with ANSD with poorer temporal processing and speech perception abilities. However, processing strategies need to take into account the quality aspect and not just intelligibility.

Manipulation of Hearing Aid Gain and Tinnitus Relief: A Paired Comparison Study.

OBJECTIVES: The objective of the study is to compare amplification strategies on tinnitus relief. A repeated measure research design was used to determine the best strategy that provides a significant relief on tinnitus and improvements in speech perception. METHODS: We recruited 20 participants in the age range of 30-60 years (mean age = 47.95 years) having mild to moderately severe sloping sensorineural hearing loss with continuous tonal tinnitus. We grouped the participants into mild and severe, based on the scores obtained in the Tinnitus Handicap Inventory. We evaluated tinnitus pitch and loudness using the adaptive method. Besides, we assessed signal to noise ratio 50 (SNR 50) from each of the programs. We carried out a paired comparison method to determine the best strategy among the 3 in which the maximum preference score was obtained on tinnitus relief by a test hearing aid programmed with 3 programs. RESULTS: Each group of participants significantly preferred the strategy for the gain in hearing aid set at tinnitus pitch on tinnitus. However, there was no significant difference between the SNR 50 scores in the 3 gain settings. CONCLUSION: An additional gain set at tinnitus pitch after alleviating hearing loss by the prescriptive method was found to be the best strategy for effective masking of tinnitus and that led to tinnitus relief without compromising speech perception.

Representation of amplified speech at cortical level in good and poor hearing aid performers / Representação da fala amplificada ao nível cortical em bons e maus usuários de aparelhos auditivos

Abstract Introduction: Hearing aid users reject their own hearing aid because of annoyance with background noise. The reason for dissatisfaction is located anywhere from the hearing aid microphone to the integrity of neurons along the auditory pathway. In this preview, the output of hearing aid was recorded at the level of ear canal and at auditory cortex in good and poor hearing aid users, who were classified using acceptable noise level. Objective: To study the representation of amplified speech in good and poor hearing aid performers. Methods: A total of 60 participants (age ranged 15-65 years) with moderate bilateral sensorineural hearing impairment grouped into good (n = 35) and poor (n = 25) hearing aid performers. Gap detection test and aided SNR 50 were administered. In addition, ear canal acoustic measures and cortical auditory evoked potentials were recorded in unaided and aided conditions at 65 dB SPL. Results: Hearing aid minimally alters temporal contrast of speech reflected in envelope difference index. Although having similar temporal impairment, acoustic characteristics of amplified speech sounds and SNR 50 scores from both groups, the aided cortical auditory evoked potentials surprisingly showed significant earlier latencies and higher amplitudes in good performers than poor performers. In addition, good and poor performers classified based on annoyance level was predicted by latencies of 2N1 and 2P2 components of acoustic change complex. Further, a follow-up revealed hearing aid use has relation with acceptance towards noise. Conclusion: Participants who are willing to accept noise from those who are not willing to accept noise have subtle physiological changes evident at the auditory cortex, which supports the hearing aid usage.

Resumo Introdução: Usuários de aparelhos auditivos rejeitam seu próprio aparelho pelo incômodo relacionado ao ruído de fundo. O motivo da insatisfação varia desde o microfone do aparelho auditivo até a integridade dos neurônios ao longo da via auditiva. Nesta análise prévia, a saída da prótese auditiva foi registrada no nível do meato auditivo externo e no córtex auditivo em bons e maus usuários de prótese auditiva, que foram classificados com um nível de ruído aceitável. Objetivo: Estudar a representação da fala amplificada em bons e maus usuários de aparelhos auditivos. Método: Foram examinados 60 participantes (de 15 a 65 anos) com deficiência auditiva neurossensorial bilateral moderada divididos em bons (n = 35) e maus (n = 25) usuários de aparelhos auditivos. Teste de detecção de gap e SNR 50 assistido foi administrado. Além disso, as medidas acústicas do meato externo e os potenciais evocados auditivos corticais foram registrados em condições não assistida e assistida a 65 dB NPS. Resultados: O aparelho auditivo altera minimamente o contraste temporal da fala, refletido no envelope difference index. Embora tenham uma deficiência temporal similar, as características acústicas de sons de fala amplificados e escores do SNR 50 de ambos os grupos, os potenciais evocados auditivos corticais assistidos surpreendentemente demonstraram latências iniciais significativas e maiores amplitudes em bons do que em maus usuários. Além disso, os bons em comparação com os maus usuários, classificados com base no nível de incômodo, foram previstos pelas latências dos componentes 2N1 e 2P2 do complexo de alteração acústica. Além disso, os resultados do seguimento revelaram que o uso de aparelhos auditivos têm relação com a aceitação do ruído. Conclusão: Os participantes dispostos a aceitar o ruído, quando comparados com aqueles que não estão dispostos a aceitá-lo, apresentam evidência de sutis alterações fisiológicas no córtex auditivo, que apoiam o uso da prótese auditiva.

Representation of amplified speech at cortical level in good and poor hearing aid performers.

INTRODUCTION: Hearing aid users reject their own hearing aid because of annoyance with background noise. The reason for dissatisfaction is located anywhere from the hearing aid microphone to the integrity of neurons along the auditory pathway. In this preview, the output of hearing aid was recorded at the level of ear canal and at auditory cortex in good and poor hearing aid users, who were classified using acceptable noise level. OBJECTIVE: To study the representation of amplified speech in good and poor hearing aid performers. METHODS: A total of 60 participants (age ranged 15-65 years) with moderate bilateral sensorineural hearing impairment grouped into good (n=35) and poor (n=25) hearing aid performers. Gap detection test and aided SNR 50 were administered. In addition, ear canal acoustic measures and cortical auditory evoked potentials were recorded in unaided and aided conditions at 65dB SPL. RESULTS: Hearing aid minimally alters temporal contrast of speech reflected in envelope difference index. Although having similar temporal impairment, acoustic characteristics of amplified speech sounds and SNR 50 scores from both groups, the aided cortical auditory evoked potentials surprisingly showed significant earlier latencies and higher amplitudes in good performers than poor performers. In addition, good and poor performers classified based on annoyance level was predicted by latencies of 2N1 and 2P2 components of acoustic change complex. Further, a follow-up revealed hearing aid use has relation with acceptance towards noise. CONCLUSION: Participants who are willing to accept noise from those who are not willing to accept noise have subtle physiological changes evident at the auditory cortex, which supports the hearing aid usage.

The Effect of Digital Noise Reduction on Annoyance and Speech Perception in Low and High Acceptable Noise Level Groups

Introduction: Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives: (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method: Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results: Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion: Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value (AU)

The Effect of Digital Noise Reduction on Annoyance and Speech Perception in Low and High Acceptable Noise Level Groups.

Introduction Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value.

Effect of compression release time of a hearing aid on sentence recognition and the quality judgment of speech.

CONTEXT: The sentence recognition score and quality of speech differ when hearing aid compression is set at different release times at different signal to noise ratios (SNRs) for the normal and compressed rate of sentences. AIMS: To investigate the effect of amplitude-compression release time of a hearing aid on sentence recognition and quality judgment: (1) for normal rate and time-compressed sentences (2) in quiet and noisy conditions. SETTINGS AND DESIGN: A post-test repeated measures design. METHODS AND MATERIAL: We recruited fifteen adult participants with bilateral sensorineural hearing loss in each group, the younger (35-45 years), and the older ones (60-70 years). A gap detection test assessed temporal processing ability. We used three compression settings, fast-acting, slow-acting, and linear. Sentence recognition and quality and envelope difference index in normal and altered rates were assessed in quiet and in noise at these three compression settings. STATISTICAL ANALYSIS USED: A repeated measure ANOVA. RESULTS: We found a significant improvement in recognition of sentences at a normal rate in slow compression release time, compared to fast and linear gain settings at each SNR. Similar results were observed for sentences compressed at the rate of 35% in quiet and +10 dB SNR. Further, the participants preferred the quality of speech in quiet with the hearing aid set to slow compared to fast compression release time. The benefit from the slow compression release time was higher than either linear or fast compression release time on sentence recognition. Further, we saw that there was a negative impact on sentence recognition at 3 dB SNR (normal-rate) and in quiet (35% compression rate) in older adults. CONCLUSIONS: The slow compression release time in a hearing aid is superior to the fast one in noisy conditions and also with higher subjective ratings of speech quality in quiet.

Gain adjustment at tinnitus pitch to manage both tinnitus and speech perception in noise.

To investigate how much gain variation is required from prescription to effect tinnitus percept, and if this revised prescription affects speech recognition. Twenty participants who experienced catastrophic tinnitus even after fitted with hearing aid were included. Participants were grouped based on their tinnitus pitch and the prescriptive formula used to fit hearing aid. They were evaluated for handicap from tinnitus using Tinnitus Handicap Inventory (THI). Hearing aid was programmed using either NAL- NL2 or DSL (I/o) v5 prescriptive formula and gain at tinnitus pitch was adjusted till the tinnitus get suppressed. SNR 50 was determined soon after fitted with hearing aid and 30 days of hearing aid use. Further, THI and international outcome inventory for hearing aid (IOI-HA) were determined after 30 days of hearing aid use. A significant higher gain adjustment was needed at tinnitus pitch to reduce tinnitus precept using NAL- NL2 than DSL (I/o) v5 prescriptive formula. Further, SNR 50 was not affected by either tinnitus pitch or revised prescription formulas. However, SNR 50 improved after 30 days of hearing aid use. A 76% of the participants' experienced habituation to perception after 30 days of hearing aid use, 10% had slight, 10% had mild, and 4% had a moderate degree of tinnitus on THI. On IOA-HA, 96% (N=19) of participants have reported satisfactory, and 4% (N=1) reported moderate benefit from hearing aid. Irrespective of prescriptive formula adjusting gain at tinnitus pitch is an efficient method to reduce tinnitus symptoms and improve speech perception.

Encoding of speech sounds at auditory brainstem level in good and poor hearing aid performers / Codificação dos sons da fala no nível do tronco encefálico auditivo em bons e maususuários de aparelhos auditivos

Abstract Introduction: Hearing aids are prescribed to alleviate loss of audibility. It has been reported that about 31% of hearing aid users reject their own hearing aid because of annoyance towards background noise. The reason for dissatisfaction can be located anywhere from the hearing aid microphone till the integrity of neurons along the auditory pathway. Objectives: To measure spectra from the output of hearing aid at the ear canal level and frequency following response recorded at the auditory brainstem from individuals with hearing impairment. Methods: A total of sixty participants having moderate sensorineural hearing impairment with age range from 15 to 65 years were involved. Each participant was classified as either Good or Poor Hearing aid Performers based on acceptable noise level measure. Stimuli /da/ and /si/ were presented through loudspeaker at 65 dB SPL. At the ear canal, the spectra were measured in the unaided and aided conditions. At auditory brainstem, frequency following response were recorded to the same stimuli from the participants. Results: Spectrum measured in each condition at ear canal was same in good hearing aid performers and poor hearing aid performers. At brainstem level, better F0 encoding; F0 and F1 energies were significantly higher in good hearing aid performers than in poor hearing aid performers. Though the hearing aid spectra were almost same between good hearing aid performers and poor hearing aid performers, subtle physiological variations exist at the auditory brainstem. Conclusion: The result of the present study suggests that neural encoding of speech sound at the brainstem level might be mediated distinctly in good hearing aid performers from that of poor hearing aid performers. Thus, it can be inferred that subtle physiological changes are evident at the auditory brainstem in a person who is willing to accept noise from those who are not willing to accept noise.

Resumo Introdução: Os aparelhos auditivos são prescritos para aliviar a perda de audibilidade. Tem sido relatado que 31% dos usuários rejeitam seu aparelho auditivo devido ao desconforto com o ruído de fundo. A razão para a insatisfação pode estar situada em qualquer local desde o microfone do aparelho auditivo até a integridade de neurônios ao longo da via auditiva. Objetivos: Medir espectros desde a saída do aparelho auditivo no nível do meato acústico externo e frequência de resposta (FFR) registrada no tronco encefálico de indivíduos com deficiência auditiva. Método: Foram selecionados 60 participantes com deficiência auditiva neurossensorial moderada, de 15 a 65 anos. Cada participante foi classificado como usuário bom ou mau de prótese auditiva (GHP ou PHP) com base na medida de nível de ruído aceitável (ANL). Estímulos/da/e/si/foram apresentados em alto-falante a 65 dB SPL. No meato acústico externo, os espectros foram medidos nas condições sem aparelho e com aparelho. No tronco encefálico auditivo, FFR foram registradas para os mesmos estímulos dos participantes. Resultados: Os espectros medidos em cada condição no meato acústico externo foram os mesmos em GHP e PHP. No nível do tronco cerebral, melhor codificação F0; energias de F0 e F1 foram significativamente maiores em GHP do que em PHP. Embora os espectros do aparelho auditivo fossem quase os mesmos entre GHP e PHP, existem variações fisiológicas sutis no tronco encefálico auditivo. Conclusão: O resultado do presente estudo sugere que a codificação neural do som da fala no nível do tronco encefálico pode ser mediada distintamente em GHP em comparação com PHP. Assim, pode-se inferir que mudanças fisiológicas sutis são evidentes no tronco encefálico em uma pessoa que está disposta a aceitar o ruído em comparação com aqueles que não estão dispostos a aceitar o ruído.

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

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

Encoding of speech sounds at auditory brainstem level in good and poor hearing aid performers.

INTRODUCTION: Hearing aids are prescribed to alleviate loss of audibility. It has been reported that about 31% of hearing aid users reject their own hearing aid because of annoyance towards background noise. The reason for dissatisfaction can be located anywhere from the hearing aid microphone till the integrity of neurons along the auditory pathway. OBJECTIVES: To measure spectra from the output of hearing aid at the ear canal level and frequency following response recorded at the auditory brainstem from individuals with hearing impairment. METHODS: A total of sixty participants having moderate sensorineural hearing impairment with age range from 15 to 65 years were involved. Each participant was classified as either Good or Poor Hearing aid Performers based on acceptable noise level measure. Stimuli /da/ and /si/ were presented through loudspeaker at 65dB SPL. At the ear canal, the spectra were measured in the unaided and aided conditions. At auditory brainstem, frequency following response were recorded to the same stimuli from the participants. RESULTS: Spectrum measured in each condition at ear canal was same in good hearing aid performers and poor hearing aid performers. At brainstem level, better F0 encoding; F0 and F1 energies were significantly higher in good hearing aid performers than in poor hearing aid performers. Though the hearing aid spectra were almost same between good hearing aid performers and poor hearing aid performers, subtle physiological variations exist at the auditory brainstem. CONCLUSION: The result of the present study suggests that neural encoding of speech sound at the brainstem level might be mediated distinctly in good hearing aid performers from that of poor hearing aid performers. Thus, it can be inferred that subtle physiological changes are evident at the auditory brainstem in a person who is willing to accept noise from those who are not willing to accept noise.

Recognition of Deep Band Modulated Consonants in Quiet and Noise in Older Individuals with and Without Hearing Loss.

OBJECTIVE: The purpose of the present study was to investigate the effects of temporal envelope enhancement using deep band modulation (DBM) on consonant identification scores (CIS) and transfer of features such as place of articulation, manner of articulation, and voicing. MATERIALS AND METHODS: Data were collected from four groups of ten participants each. These were grouped into younger (YNH) and older adult (ONH) individuals with normal hearing and younger (YHI) and older adult (OHI) individuals with hearing impairment who had mild to moderate sensorineural hearing loss. The CIS and transfer features for 21 vowel-consonant-vowel (VCV) syllables in unprocessed and DBM conditions with quiet and noise were obtained from each participant. RESULTS: The results showed that consonant identification scores (CIS) in DBM conditions was significantly better than in unprocessed conditions in quiet and at 5 dB and 10 dB signal-to-noise ratios (SNRs). This was true in each group. Voicing was transmitted better than other features in each condition for all the groups except for the YHI group, for whom place of articulation was conveyed best in unprocessed conditions and manner of articulation was transmitted best in DBM conditions. Furthermore, in the YHI, ONH, and OHI groups, manner of articulation was conveyed better than place of articulation in both unprocessed and DBM conditions. CONCLUSION: At reduced SNRs, cues from DBM enabled the listener to repeat the heard VCV syllables. The effect of aging and the combined effects of aging and hearing loss are partly lessened by DBM through enhancement of the manner of articulation in VCV syllables.

Sensory deprivation due to otitis media episodes in early childhood and its effect at later age: A psychoacoustic and speech perception measure.

BACKGROUND: Past research has reported that children with repeated occurrences of otitis media at an early age have a negative impact on speech perception at a later age. The present study necessitates documenting the temporal and spectral processing on speech perception in noise from normal and atypical groups. OBJECTIVES: The present study evaluated the relation between speech perception in noise and temporal; and spectral processing abilities in children with normal and atypical groups. METHODS: The study included two experiments. In the first experiment, temporal resolution and frequency discrimination of listeners with normal group and three subgroups of atypical groups (had a history of OM) a) less than four episodes b) four to nine episodes and c) More than nine episodes during their chronological age of 6 months to 2 years) were evaluated using measures of temporal modulation transfer function and frequency discrimination test. In the second experiment, SNR 50 was evaluated on each group of study participants. All participants had normal hearing and middle ear status during the course of testing. RESULTS: Demonstrated that children with atypical group had significantly poorer modulation detection threshold, peak sensitivity and bandwidth; and frequency discrimination to each F0 than normal hearing listeners. Furthermore, there was a significant correlation seen between measures of temporal resolution; frequency discrimination and speech perception in noise. It infers atypical groups have significant impairment in extracting envelope as well as fine structure cues from the signal. CONCLUSION: The results supported the idea that episodes of OM before 2 years of agecan produce periods of sensory deprivation that alters the temporal and spectral skills which in turn has negative consequences on speech perception in noise.