Optimised adaptive procedures and analysis methods for conducting speech-in-noise tests.

OBJECTIVE: Speech-in-noise testing is a valuable part of audiological test batteries. Test standardisation using precise methods is desirable for ease of administration. This study investigated the accuracy and reliability of different Bayesian and non-Bayesian adaptive procedures and analysis methods for conducting speech-in-noise testing. DESIGN: Matrix sentence tests using different numbers of sentences (10, 20, 30 and 50) and target intelligibilities (50 and 75%) were simulated for modelled listeners with various characteristics. The accuracy and reliability of seven different measurement procedures and three different data analysis methods were assessed. RESULTS: The estimation of 50% intelligibility was accurate and showed excellent reliability across the majority of methods tested, even with relatively few stimuli. Estimating 75% intelligibility resulted in decreased accuracy. For this target, more stimuli were required for sufficient accuracy and selected Bayesian procedures surpassed the performance of others. Some Bayesian procedures were also superior in the estimation of psychometric function width. CONCLUSIONS: A single standardised procedure could improve the consistency of the matrix sentence test across a range of target intelligibilities. Candidate adaptive procedures and analysis methods are discussed. These could also be applicable for other speech materials. Further testing with human participants is required.

Associations between speech recognition at high levels, the middle ear muscle reflex and noise exposure in individuals with normal audiograms.

It has been hypothesized that noise-induced cochlear synaptopathy in humans may result in functional deficits such as a weakened middle ear muscle reflex (MEMR) and degraded speech perception in complex environments. Although relationships between noise-induced synaptic loss and the MEMR have been demonstrated in animals, effects of noise exposure on the MEMR have not been observed in humans. The hypothesized relationship between noise exposure and speech perception has also been difficult to demonstrate conclusively. Given that the MEMR is engaged at high sound levels, relationships between speech recognition in complex listening environments and noise exposure might be more evident at high speech presentation levels. In this exploratory study with 41 audiometrically normal listeners, a combination of behavioral and physiologic measures thought to be sensitive to synaptopathy were used to determine potential links with speech recognition at high presentation levels. We found decreasing speech recognition as a function of presentation level (from 74 to 104 dBA), which was associated with reduced MEMR magnitude. We also found that reduced MEMR magnitude was associated with higher estimated lifetime noise exposure. Together, these results suggest that the MEMR may be sensitive to noise-induced synaptopathy in humans, and this may underlie functional speech recognition deficits at high sound levels.

Sensitivity to Interaural Phase in Older Hearing-Impaired Listeners Correlates With Nonauditory Trail Making Scores and With a Spatial Auditory Task of Unrelated Peripheral Origin.

Interaural phase difference (IPD) discrimination upper frequency limits and just-noticeable differences (JNDs), interaural level difference (ILD) JNDs, and diotic intensity JNDs were measured for 20 older hearing-impaired listeners with matched moderate sloping to severe sensorineural hearing losses. The JNDs were measured using tone stimuli at 500 Hz. In addition to these auditory tests, the participants completed a cognitive test (Trail Making Test). Significant performance improvements in IPD discrimination were observed across test sessions. Strong correlations were found between IPD and ILD discrimination performance. Very strong correlations were observed between IPD discrimination and Trail Making performance as well as strong correlations between ILD discrimination and Trail Making performance. These relationships indicate that interindividual variability in IPD discrimination performance did not exclusively reflect deficits specific to any auditory processing, including early auditory processing of temporal information. The observed relationships between spatial audition and cognition may instead be attributable to a modality-general spatial processing deficit and/or individual differences in global processing speed.

Effects of Slow- and Fast-Acting Compression on Hearing-Impaired Listeners' Consonant-Vowel Identification in Interrupted Noise.

There is conflicting evidence about the relative benefit of slow- and fast-acting compression for speech intelligibility. It has been hypothesized that fast-acting compression improves audibility at low signal-to-noise ratios (SNRs) but may distort the speech envelope at higher SNRs. The present study investigated the effects of compression with a nearly instantaneous attack time but either fast (10 ms) or slow (500 ms) release times on consonant identification in hearing-impaired listeners. Consonant-vowel speech tokens were presented at a range of presentation levels in two conditions: in the presence of interrupted noise and in quiet (with the compressor "shadow-controlled" by the corresponding mixture of speech and noise). These conditions were chosen to disentangle the effects of consonant audibility and noise-induced forward masking on speech intelligibility. A small but systematic intelligibility benefit of fast-acting compression was found in both the quiet and the noisy conditions for the lower speech levels. No detrimental effects of fast-acting compression were observed when the speech level exceeded the level of the noise. These findings suggest that fast-acting compression provides an audibility benefit in fluctuating interferers when compared with slow-acting compression while not substantially affecting the perception of consonants at higher SNRs.

TV listening and hearing aids.

TV listening plays a large role in the lives of hearing-impaired (HI) individuals. Yet, few studies have examined TV listening in this group. In this paper, we report the findings of an online survey on TV listening conducted among HI individuals with and without hearing aids (HAs) in the United States in 2015. The research investigated if and in what form TV listening experiences of unaided and aided HI individuals might differ with regard to their viewing habits, difficulties they experience, and compensation strategies they employ. 515 HI people of ages 50+ years participated, 260 of whom owned HAs. HA users reported that they watched TV or video on average for 6 hours 10 min per day, 57 minutes longer than the duration reported by non-HA owners. Furthermore, HA users indicated fewer difficulties when watching TV than non-HA owners, suggesting that HA usage alleviated difficulties with TV listening. Nevertheless, the most frequent problems were still encountered by more than 39% of the HA users. Difficulties increased with greater self-reported unaided hearing disability, and female participants indicated more problems than male participants. Finally, those with carpeted floors reported fewer difficulties than those without carpets. The most frequently used compensation strategies were changing TV or HA volumes and using closed captioning. Only few HA users used audio streaming accessories. Given the exploratory nature of this study, further research is needed to inform interventions and improve the TV listening experiences of HI viewers.

Effect of age and hearing loss on auditory stream segregation of speech sounds.

Segregating and understanding speech in complex environments is a major challenge for hearing-impaired (HI) listeners. It remains unclear to what extent these difficulties are dominated by direct interference, such as simultaneous masking, or by a failure of the mechanisms of stream segregation. This study compared older HI listeners' performance with that of young and older normal-hearing (NH) listeners in stream segregation tasks involving speech sounds. Listeners were presented with sequences of speech tokens, each consisting of a fricative consonant and a voiced vowel (CV). The CV tokens were concatenated into interleaved sequences that alternated in fundamental frequency (F0) and/or simulated vocal tract length (VTL). Each pair of interleaved sequences was preceded by a "word" consisting of two random tokens. The listeners were asked to indicate whether the word was present in the following interleaved sequences. The word, if present, occurred within one of the interleaved sequences, so that performance improved if the listeners were able to perceptually segregate the two sequences. Although HI listeners' identification of the speech tokens in isolation was poorer than that of the NH listeners, HI listeners were generally able to use both F0 and VTL cues to segregate the interleaved sequences. The results suggest that the difficulties experienced by HI listeners in complex acoustic environments cannot be explained by a loss of basic stream segregation abilities.

Effects of noise reduction on AM perception for hearing-impaired listeners.

Noise reduction (NR) systems are commonplace in modern digital hearing aids. Though not improving speech intelligibility, NR helps the hearing-aid user in terms of lowering noise annoyance, reducing cognitive load and improving ease of listening. Previous psychophysical work has shown that NR does in fact improve the ability of normal-hearing (NH) listeners to discriminate the slow amplitude-modulation (AM) cues representative of those found in speech. The goal of this study was to assess whether this improvement of AM discrimination with NR can also be observed for hearing-impaired (HI) listeners. AM discrimination was measured at two audio frequencies of 500 Hz and 2 kHz in a background noise with a signal-to-noise ratio of 12 dB. Discrimination was measured for ten HI and ten NH listeners with and without NR processing. The HI listeners had a moderate sensorineural hearing loss of about 50 dB HL at 2 kHz and normal hearing (≤ 20 dB HL) at 500 Hz. The results showed that most of the HI listeners tended to benefit from NR at 500 Hz but not at 2 kHz. However, statistical analyses showed that HI listeners did not benefit significantly from NR at any frequency region. In comparison, the NH listeners showed a significant benefit from NR at both frequencies. For each condition, the fidelity of AM transmission was quantified by a computational model of early auditory processing. The parameters of the model were adjusted separately for the two groups (NH and HI) of listeners. The AM discrimination performance of the HI group (with and without NR) was best captured by a model simulating the loss of the fast-acting amplitude compression applied by the normal cochlea. This suggests that the lack of benefit from NR for HI listeners results from loudness recruitment.

Effects of interferer facing orientation on speech perception by normal-hearing and hearing-impaired listeners.

There exist perceptible differences between sound emanating from a talker who faces and a talker who does not face a listener: Sound from a non-facing talker is attenuated and acquires a spectral tilt. The present study assessed the role that these facing-orientation cues play for speech perception. Digit identification for a frontal target talker in the presence of two spatially separated interfering talkers was measured for 10 normal-hearing (NH) and 11 hearing-impaired (HI) listeners. Overall-level differences and spectral tilts were reproduced by means of digital filtering and playback via loudspeakers. Both NH and HI listeners performed significantly better when the interfering talkers were simulated not to be facing them. Spectral tilts and level differences across talkers reduced target-interferer confusions. They enabled the NH listeners to sequentially stream the digits. This was not the case for the HI listeners, who showed smaller benefits, irrespective of whether they were aided by their own hearing aids or not. While hearing-aid amplification increased audibility, it may not have aided target-interferer segregation or target selection. The present results suggest that facing orientation cannot be neglected in the exploration of speech perception in multitalker situations.

Multichannel compression hearing aids: effect of channel bandwidth on consonant and vowel identification by hearing-impaired listeners.

Aided consonant and vowel identification was measured in 13 listeners with high-frequency sloping hearing losses. To investigate the influence of compression-channel analysis bandwidth on identification performance independent of the number of channels, performance was compared for three 17-channel compression systems that differed only in terms of their channel bandwidths. One compressor had narrow channels, one had widely overlapping channels, and the third had level-dependent channels. Measurements were done in quiet, in speech-shaped noise, and in a three-talker background. The results showed no effect of channel bandwidth, neither on consonant nor on vowel identification scores. This suggests that channel bandwidth per se has little influence on speech intelligibility when individually prescribed, frequency-varying compressive gain is provided.

Effects of noise reduction on AM and FM perception.

The goal of noise reduction (NR) algorithms in digital hearing aid devices is to reduce background noise whilst preserving as much of the original signal as possible. These algorithms may increase the signal-to-noise ratio (SNR) in an ideal case, but they generally fail to improve speech intelligibility. However, due to the complex nature of speech, it is difficult to disentangle the numerous low- and high-level effects of NR that may underlie the lack of speech perception benefits. The goal of this study was to better understand why NR algorithms do not improve speech intelligibility by investigating the effects of NR on the ability to discriminate two basic acoustic features, namely amplitude modulation (AM) and frequency modulation (FM) cues, known to be crucial for speech identification in quiet and in noise. Here, discrimination of complex, non-linguistic AM and FM patterns was measured for normal hearing listeners using a same/different task. The stimuli were generated by modulating 1-kHz pure tones by either a two-component AM or FM modulator with patterns changed by manipulating component phases. Modulation rates were centered on 3 Hz. Discrimination of AM and FM patterns was measured in quiet and in the presence of a white noise that had been passed through a gammatone filter centered on 1 kHz. The noise was presented at SNRs ranging from -6 to +12 dB. Stimuli were left as such or processed via an NR algorithm based on the spectral subtraction method. NR was found to yield small but systematic improvements in discrimination for the AM conditions at favorable SNRs but had little effect, if any, on FM discrimination. A computational model of early auditory processing was developed to quantify the fidelity of AM and FM transmission. The model captured the improvement in discrimination performance for AM stimuli at high SNRs with NR. However, the model also predicted a relatively small detrimental effect of NR for FM stimuli in contrast with the average psychophysical data. Overall, these results suggest that the lack of benefits of NR on speech intelligibility is partly caused by the limited effect of NR on the transmission of narrowband speech modulation cues.

Restoration of loudness summation and differential loudness growth in hearing-impaired listeners.

When normal-hearing (NH) listeners compare the loudness of narrowband and wideband sounds presented at identical sound pressure levels, the wideband sound will most often be perceived as louder than the narrowband sound, a phenomenon referred to as loudness summation. Hearing-impaired (HI) listeners typically show less-than-normal loudness summation, due to reduced cochlear compressive gain and degraded frequency selectivity. In the present study, loudness summation at 1 and 3 kHz was estimated monaurally for five NH and eight HI listeners by matching the loudness of narrowband and wideband noise stimuli. The loudness summation was measured as a function both of noise bandwidth and level. The HI listeners were tested unaided and aided using three different compression systems to investigate the possibility of restoring loudness summation in these listeners. A compression system employing level-dependent compression channels yielded the most promising outcome. The present results inform the development of future loudness models and advanced compensation strategies for the hearing impaired.

Relations between perceptual measures of temporal processing, auditory-evoked brainstem responses and speech intelligibility in noise.

This study investigates behavioural and objective measures of temporal auditory processing and their relation to the ability to understand speech in noise. The experiments were carried out on a homogeneous group of seven hearing-impaired listeners with normal sensitivity at low frequencies (up to 1 kHz) and steeply sloping hearing losses above 1 kHz. For comparison, data were also collected for five normal-hearing listeners. Temporal processing was addressed at low frequencies by means of psychoacoustical frequency discrimination, binaural masked detection and amplitude modulation (AM) detection. In addition, auditory brainstem responses (ABRs) to clicks and broadband rising chirps were recorded. Furthermore, speech reception thresholds (SRTs) were determined for Danish sentences in speech-shaped noise. The main findings were: (1) SRTs were neither correlated with hearing sensitivity as reflected in the audiogram nor with the AM detection thresholds which represent an envelope-based measure of temporal resolution; (2) SRTs were correlated with frequency discrimination and binaural masked detection which are associated with temporal fine-structure coding; (3) The wave-V thresholds for the chirp-evoked ABRs indicated a relation to SRTs and the ability to process temporal fine structure. Overall, the results demonstrate the importance of low-frequency temporal processing for speech reception which can be affected even if pure-tone sensitivity is close to normal.

Relation between derived-band auditory brainstem response latencies and behavioral frequency selectivity.

Derived-band click-evoked auditory brainstem responses (ABRs) were obtained for normal-hearing (NH) and sensorineurally hearing-impaired (HI) listeners. The latencies extracted from these responses, as a function of derived-band center frequency and click level, served as objective estimates of cochlear response times. For the same listeners, auditory-filter bandwidths at 2 kHz were estimated using a behavioral notched-noise masking paradigm. Generally, shorter derived-band latencies were observed for the HI than for the NH listeners. Only at low click sensation levels, prolonged latencies were obtained for some of the HI listeners. The behavioral auditory-filter bandwidths accounted for the across-listener variability in the ABR latencies: Cochlear response time decreased with increasing filter bandwidth, consistent with linear-system theory. The results link cochlear response time and frequency selectivity in human listeners and offer a window to better understand how hearing impairment affects the spatiotemporal cochlear response pattern.

Estimation of cochlear response times using lateralization of frequency-mismatched tones.

Behavioral and objective estimates of cochlear response times (CRTs) and traveling-wave (TW) velocity were compared for three normal-hearing listeners. Differences between frequency-specific CRTs were estimated via lateralization of pulsed tones that were interaurally mismatched in frequency, similar to a paradigm proposed by Zerlin [(1969). J. Acoust. Soc. Am. 46, 1011-1015]. In addition, derived-band auditory brainstem responses were obtained as a function of derived-band center frequency. The latencies extracted from these responses served as objective estimates of CRTs. Estimates of TW velocity were calculated from the obtained CRTs. The correspondence between behavioral and objective estimates of CRT and TW velocity was examined. For frequencies up to 1.5 kHz, the behavioral method yielded reproducible results, which were consistent with the objective estimates. For higher frequencies, CRT differences could not be estimated with the behavioral method due to limitations of the lateralization paradigm. The method might be useful for studying the spatiotemporal cochlear response pattern in human listeners.

Relations between frequency selectivity, temporal fine-structure processing, and speech reception in impaired hearing.

Frequency selectivity, temporal fine-structure (TFS) processing, and speech reception were assessed for six normal-hearing (NH) listeners, ten sensorineurally hearing-impaired (HI) listeners with similar high-frequency losses, and two listeners with an obscure dysfunction (OD). TFS processing was investigated at low frequencies in regions of normal hearing, through measurements of binaural masked detection, tone lateralization, and monaural frequency modulation (FM) detection. Lateralization and FM detection thresholds were measured in quiet and in background noise. Speech reception thresholds were obtained for full-spectrum and lowpass-filtered sentences with different interferers. Both the HI listeners and the OD listeners showed poorer performance than the NH listeners in terms of frequency selectivity, TFS processing, and speech reception. While a correlation was observed between the monaural and binaural TFS-processing deficits in the HI listeners, no relation was found between TFS processing and frequency selectivity. The effect of noise on TFS processing was not larger for the HI listeners than for the NH listeners. Finally, TFS-processing performance was correlated with speech reception in a two-talker background and lateralized noise, but not in amplitude-modulated noise. The results provide constraints for future models of impaired auditory signal processing.