Auditory Training With Multiple Talkers and Passage-Based Semantic Cohesion

Involving Children and Teenagers With Bilateral Cochlear Implants in the Design of the BEARS (Both EARS) Virtual Reality Training Suite Improves Personalization

Older children and teenagers with bilateral cochlear implants often have poor spatial hearing because they cannot fuse sounds from the two ears. This deficit jeopardizes speech and language development, education, and social well-being. The lack of protocols for fitting bilateral cochlear implants and resources for spatial-hearing training contribute to these difficulties. Spatial hearing develops with bilateral experience. A large body of research demonstrates that sound localisation can improve with training, underpinned by plasticity-driven changes in the auditory pathways. Generalizing training to non-trained auditory skills is best achieved by using a multi-modal (audio-visual) implementation and multi-domain training tasks (localisation, speech-in-noise, and spatial music). The goal of this work was to develop a package of virtual-reality games (BEARS, Both EARS) to train spatial hearing in young people (8–16 years) with bilateral cochlear implants using an action-research protocol. The action research protocol used formalized cycles for participants to trial aspects of the BEARS suite, reflect on their experiences, and in turn inform changes in the game implementations. This participatory design used the stakeholder participants as co-creators. The cycles for each of the three domains (localisation, spatial speech-in-noise, and spatial music) were customized to focus on the elements that the stakeholder participants considered important. The participants agreed that the final games were appropriate and ready to be used by patients. The main areas of modification were: the variety of immersive scenarios to cover age range and interests, the number of levels of complexity to ensure small improvements were measurable, feedback, and reward schemes to ensure positive reinforcement, and an additional implementation on an iPad for those who had difficulties with the headsets due to age or balance issues. The effectiveness of the BEARS training suite will be evaluated in a large-scale clinical trial to determine if using the games lead to improvements in speech-in-noise, quality of life, perceived benefit, and cost utility. Such interventions allow patients to take control of their own management reducing the reliance on outpatient-based rehabilitation. For young people, a virtual-reality implementation is more engaging than traditional rehabilitation methods, and the participatory design used here has ensured that the BEARS games are relevant.

The Influence of the Type of Background Noise on Perceptual Learning of Speech in Noise

OBJECTIVES

Auditory perceptual learning studies tend to focus on the nature of the target stimuli. However, features of the background noise can also have a significant impact on the amount of benefit that participants obtain from training. This study explores whether perceptual learning of speech in background babble noise generalizes to other, real-life environmental background noises (car and rain), and if the benefits are sustained over time.

DESIGN

Normal-hearing native English speakers were randomly assigned to a training (n = 12) or control group (n = 12). Both groups completed a pre- and post-test session in which they identified Bamford-Kowal-Bench (BKB) target words in babble, car, or rain noise. The training group completed speech-in-babble noise training on three consecutive days between the pre- and post-tests. A follow up session was conducted between 8 and 18 weeks after the post-test session (training group: n = 9; control group: n = 7).

RESULTS

Participants who received training had significantly higher post-test word identification accuracy than control participants for all three types of noise, although benefits were greatest for the babble noise condition and weaker for the car- and rain-noise conditions. Both training and control groups maintained their pre- to post-test improvement over a period of several weeks for speech in babble noise, but returned to pre-test accuracy for speech in car and rain noise.

CONCLUSION

The findings show that training benefits can show some generalization from speech-in-babble noise to speech in other types of environmental noise. Both groups sustained their learning over a period of several weeks for speech-in-babble noise. As the control group received equal exposure to all three noise types, the sustained learning with babble noise, but not other noises, implies that a structural feature of babble noise was conducive to the sustained improvement. These findings emphasize the importance of considering the background noise as well as the target stimuli in auditory perceptual learning studies.

The Viability of Media Interviews as Materials for Auditory Training

Purpose Rehabilitative auditory training for people with hearing loss faces 2 primary challenges: generalization of learning to novel contexts and user adherence to training goals. We hypothesized that using interview excerpts from popular media as training materials would have the potential to positively influence both of these areas. Interviews contain predictable, structured complexity that promotes perceptual generalization and are also designed to be engaging for consumers. This study tested the viability of such popular media interviews as training materials, comparing their effectiveness to that obtained with sentence transcription training. Method Young adults with normal hearing ( N = 60) completed 1 hr of transcription training using noise-vocoded materials, simulating acoustic perception through an 8-channel cochlear implant. Participants completed pre- and posttraining assessments of vocoded speech perception in quiet and in noise, along with posttraining high-variability sentence recognition and cued isolated word recognition. Scores on all tests were compared across 4 randomly assigned groups differing in training materials: audiovisual interviews, audio-only interviews, isolated sentences, and undegraded isolated sentences (providing an untrained control comparison group). Results Recognition in quiet and in noise improved with both types of interview-based training, and interview training groups outperformed the control group on all generalization tests. Participants in the audiovisual interview group also reported significantly higher, more sustained engagement in a retrospective survey. Conclusions Media interviews appear to be at least as effective as isolated sentences for transcription-based auditory training in simulated hearing loss settings with young adults and may improve engagement and generalization of benefit in auditory training applications.