Effects of audibility and multichannel wide dynamic range compression on consonant recognition for listeners with severe hearing loss

Verification of EasyGain Settings in the Roger Remote Microphone System

PURPOSE

The purpose of this study was to evaluate how the EasyGain settings on a wireless receiver used with a remote microphone (RM) affected output as a function of hearing loss and receiver type.

METHOD

To assess the effects of the EasyGain setting on a Roger receiver, a Phonak Naida V90 superpower hearing aid (HA), two universal Roger X (02) receivers, two Roger 18 integrated receivers, and a Roger Inspiro transmitter were used. An electroacoustic evaluation was performed for five degrees of hearing loss ranging from a flat 40 to 80 dB HL, and for nine EasyGain settings from +8 to -8 dB with each Roger receiver.

RESULTS

A three-way analysis of variance indicated significant main effects of hearing loss, receiver type and EasyGain settings, as well as their two-way interactions (p < .05). Overall, the output of the integrated receiver was 2.77 dB higher than that of the universal receiver. The change in output with 2-dB changes in EasyGain setting varied with the degree of hearing loss. For mild hearing loss (40 and 50 dB), every 2-dB change in EasyGain produced an average of 1.93 dB (SD = 0.17) change in the root-mean-square (RMS) output. For the higher degrees of hearing loss (60, 70, and 80 dB HL), the change in RMS varied depending on the range of EasyGain setting as follows: when EasyGain was > 0 dB, every 2-dB change in EasyGain setting produced an average change in RMS output of 1.32 dB (SD = 0.41); however, when EasyGain was ≤ 0 dB, every 2-dB change resulted in a mean 1.95 dB (SD = 0.16) change.

CONCLUSIONS

The benefits of EasyGain technology on the RMS output are dependent on the interaction of the receiver type, degree of hearing loss, and EasyGain settings. The results highlight the importance of electroacoustic verification to determine appropriate settings for optimal audibility when using an RM system.

Preference for Combinations of Hearing Aid Signal Processing

PURPOSE

The purpose of this study was to determine how multiple types of signal processing activated together influence listeners' preferences.

METHOD

Participants were adults with mild to moderately severe sensorineural hearing loss. Stimuli were spatialized low-context sentences mixed with six-talker babble at 3 and 8 dB signal-to-noise ratios (SNRs). Stimuli were processed with three common hearing aid processing algorithms: wide dynamic range compression (WDRC), frequency compression (FC), and digital noise reduction (DNR). A full-factorial design with two levels for each algorithm (WDRC & DNR: mild versus strong; FC: ON versus OFF; clinically relevant ranges) was evaluated. Preference was measured using a paired-comparison task within a choice-based conjoint analysis framework. Remote data collection methods were used. A signal fidelity metric quantified the acoustic effects across conditions.

RESULTS

At 3 dB SNR, participants preferred a combination of Slow WDRC and Mild DNR, although the mean preference was small (odds ratio close to 1). At both SNRs when Strong DNR was used, Fast WDRC was preferred over Slow WDRC. This may be related to signal fidelity, which was lower for the combination of Fast WDRC and Mild DNR and higher for the combination of Slow WDRC and either Mild DNR or Strong DNR. There was no effect of FC on preference or signal fidelity.

CONCLUSIONS

WDRC and DNR together influenced both listeners' preferences and signal fidelity in the investigated listening conditions. On average, the small effect sizes suggest that minor fine-tuning adjustments to hearing aid algorithms may not result in a substantial change in clinical outcomes.

Influence of Audibility and Distortion on Recognition of Reverberant Speech for Children and Adults with Hearing Aid Amplification

BACKGROUND

Adults and children with sensorineural hearing loss (SNHL) have trouble understanding speech in rooms with reverberation when using hearing aid amplification. While the use of amplitude compression signal processing in hearing aids may contribute to this difficulty, there is conflicting evidence on the effects of amplitude compression settings on speech recognition. Less clear is the effect of a fast release time for adults and children with SNHL when using compression ratios derived from a prescriptive procedure.

PURPOSE

The aim of the study is to determine whether release time impacts speech recognition in reverberation for children and adults with SNHL and to determine if these effects of release time and reverberation can be predicted using indices of audibility or temporal and spectral distortion.

RESEARCH DESIGN

This is a quasi-experimental cohort study. Participants used a hearing aid simulator set to the Desired Sensation Level algorithm m[i/o] for three different amplitude compression release times. Reverberation was simulated using three different reverberation times.

PARTICIPANTS

Participants were 20 children and 16 adults with SNHL.

DATA COLLECTION AND ANALYSES

Participants were seated in a sound-attenuating booth and then nonsense syllable recognition was measured. Predictions of speech recognition were made using indices of audibility, temporal distortion, and spectral distortion and the effects of release time and reverberation were analyzed using linear mixed models.

RESULTS

While nonsense syllable recognition decreased in reverberation release time did not significantly affect nonsense syllable recognition. Participants with lower audibility were more susceptible to the negative effect of reverberation on nonsense syllable recognition.

CONCLUSION

We have extended previous work on the effects of reverberation on aided speech recognition to children with SNHL. Variations in release time did not impact the understanding of speech. An index of audibility best predicted nonsense syllable recognition in reverberation and, clinically, these results suggest that patients with less audibility are more susceptible to nonsense syllable recognition in reverberation.

Influence of Compression Thresholds and Maximum Power Output on Speech Understanding with Bone-Anchored Hearing Systems

Bone-anchored hearing systems (BAHS) transmit sound via osseointegrated implants behind the ear. They are used to treat patients with conductive or mixed hearing loss, but speech understanding may be limited especially in users with substantial additional cochlear hearing losses. In recent years, BAHS with higher maximum power output (MPO) and more advanced digital processing including loudness compression have become available. These features may be useful to increase speech understanding in users with mixed hearing loss. We have tested the effect of 4 combinations of two different MPO levels (highest level available and level reduced by 12 dB) and two different compression thresholds (CT) levels (50 dB and 65 dB sound pressure level) in 12 adult BAHS users on speech understanding in quiet and in noise. We have found that speech understanding in quiet was not influenced significantly by any of the changes in these two fitting parameters. In contrast, in users with average bone-conduction (BC) threshold of 25 dB or more, speech understanding in noise was improved by +0.8 dB to +1.1 dB (p < 0.03) when using the higher MPO level. In this user group, there may be an additional, but very small benefit of +0.1 dB to +0.4 dB when using the lower rather than the higher CT value, but the difference was not statistically significant (p > 0.27). In users with better average BC thresholds than 25 dB, none of the improvement was statistically significant. Higher MPOs and possibly, to a lesser degree, lower CTs seem to be able to improve speech understanding in noise in users with higher BC thresholds, but even their combined effect seems to be limited.

Does the Speech Cue Profile Affect Response to Amplitude Envelope Distortion?

Purpose A broad area of interest to our group is to understand the consequences of the "cue profile" (a measure of how well a listener can utilize audible temporal and/or spectral cues for listening scenarios in which a subset of cues is distorted. The study goal was to determine if listeners whose cue profile indicated that they primarily used temporal cues for recognition would respond differently to speech-envelope distortion than listeners who utilized both spectral and temporal cues. Method Twenty-five adults with sensorineural hearing loss participated in the study. The listener's cue profile was measured by analyzing identification patterns for a set of synthetic syllables in which envelope rise time and formant transitions were varied. A linear discriminant analysis quantified the relative contributions of spectral and temporal cues to identification patterns. Low-context sentences in noise were processed with time compression, wide-dynamic range compression, or a combination of time compression and wide-dynamic range compression to create a range of speech-envelope distortions. An acoustic metric, a modified version of the Spectral Correlation Index, was calculated to quantify envelope distortion. Results A binomial generalized linear mixed-effects model indicated that envelope distortion, the cue profile, the interaction between envelope distortion and the cue profile, and the pure-tone average were significant predictors of sentence recognition. Conclusions The listeners with good perception of spectro-temporal contrasts were more resilient to the detrimental effects of envelope compression than listeners who used temporal cues to a greater extent. The cue profile may provide information about individual listening that can direct choice of hearing aid parameters, especially those parameters that affect the speech envelope.

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

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

Can Dual Compression Offer Better Mandarin Speech Intelligibility and Sound Quality Than Fast-Acting Compression?

The aim of this study was to evaluate the efficacy of dual compression for Mandarin-speaking hearing aid users. Dual compression combines fast and slow compressors operating simultaneously across all frequency channels. The study participants were 31 hearing aid users with symmetrical moderate-to-severe hearing loss, with a mean age of 67 years. A new pair of 20-channel behind-the-ear hearing aids (i.e., Phonak Bolero B90-P) was used during the testing. The results revealed a significant improvement in speech reception thresholds in noise when switching from fast-acting compression to dual compression. The sound quality ratings revealed that most listeners preferred dual compression to fast-acting compression for listening effort, listening comfort, speech clarity, and overall sound quality at +4 dB signal-to-noise ratio. These results are consistent with predictions based on the theoretical understanding of dual and fast-acting compression. However, whether these results can be generalized to other languages or other dual compression systems should be verified by future studies.

Effects of Directionality, Compression, and Working Memory on Speech Recognition

OBJECTIVES

Previous research has shown that the association between hearing aid-processed speech recognition and individual working memory ability becomes stronger in more challenging conditions (e.g., higher background noise levels) and with stronger hearing aid processing (e.g., fast-acting wide dynamic range compression, WDRC). To date, studies have assumed omnidirectional microphone settings and collocated speech and noise conditions to study such relationships. Such conditions fail to recognize that most hearing aids are fit with directional processing that may improve the signal to noise ratio (SNR) and speech recognition in spatially separated speech and noise conditions. Here, we considered the possibility that directional processing may reduce the signal distortion arising from fast-acting WDRC and in turn influence the relationship between working memory ability and speech recognition with WDRC processing. The combined effects of hearing aid processing (WDRC and directionality) and SNR were quantified using a signal modification metric (cepstral correlation), which measures temporal envelope changes in the processed signal with respect to a linearly amplified reference. It was hypothesized that there will be a weaker association between working memory ability and speech recognition for hearing aid processing conditions that result in overall less signal modification (i.e., fewer changes to the processed envelope).

DESIGN

Twenty-three individuals with bilateral, mild to moderately severe sensorineural hearing loss participated in the study. Participants were fit with a commercially available hearing aid, and signal processing was varied in two dimensions: (1) Directionality (omnidirectional [OMNI] versus fixed-directional [DIR]), and (2) WDRC speed (fast-acting [FAST] versus slow-acting [SLOW]). Sentence recognition in spatially separated multi-talker babble was measured across a range of SNRs: 0 dB, 5 dB, 10 dB, and quiet. Cumulative signal modification was measured with individualized hearing aid settings, for all experimental conditions. A linear mixed-effects model was used to determine the relationship between speech recognition, working memory ability, and cumulative signal modification.

RESULTS

Signal modification results showed a complex relationship between directionality and WDRC speed, which varied by SNR. At 0 and 5 dB SNRs, signal modification was lower for SLOW than FAST regardless of directionality. However, at 10 dB SNR and in the DIR listening condition, there was no signal modification difference between FAST and SLOW. Consistent with previous studies, the association of speech recognition in noise with working memory ability depended on the level of signal modification. Contrary to the hypothesis above, however, there was a significant association of speech recognition with working memory only at lower levels of signal modification, and speech recognition increased at a faster rate for individuals with better working memory as signal modification decreased with DIR and SLOW.

CONCLUSIONS

This research suggests that working memory ability remains a significant predictor of speech recognition when WDRC and directionality are applied. Our findings revealed that directional processing can reduce the detrimental effect of fast-acting WDRC on speech cues at higher SNRs, which affects speech recognition ability. Contrary to some previous research, this study showed that individuals with better working memory ability benefitted more from a decrease in signal modification than individuals with poorer working memory ability.

Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss

Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.

Perceptual Evaluation of Signal-to-Noise-Ratio-Aware Dynamic Range Compression in Hearing Aids

Dynamic range compression is a compensation strategy commonly used in modern hearing aids. Fast-acting systems respond relatively quickly to the fluctuations in the input level. This allows for more effective compression of the dynamic range of speech and hence enhanced the audibility of its low-intensity components. However, such processing also amplifies the background noise, distorts the modulation spectra of both the speech and the background, and can reduce the output signal-to-noise ratio (SNR). Recently, May et al. proposed a novel SNR-aware compression strategy, in which the compression speed is adapted depending on whether speech is present or absent. Fast-acting compression is applied to speech-dominated time–frequency (T-F) units, while noise-dominated T-F units are processed using slow-acting compression. It has been shown that this strategy provides a similar effective compression of the speech dynamic range as conventional fast-acting compression, while introducing fewer distortions of the modulation spectrum of the background and providing an improved output SNR. In this study, this SNR-aware compression strategy was compared with conventional fast- and slow-acting compression in terms of speech intelligibility and subjective preference in a group of 17 hearing-impaired listeners with varying degree of hearing loss. The results show a speech intelligibility benefit of the SNR-aware compression strategy over the conventional slow-acting system. Furthermore, the SNR-aware approach demonstrates an increased subjective preference compared with both conventional fast- and slow-acting systems.

Effects of Reverberation on the Relation Between Compression Speed and Working Memory for Speech-in-Noise Perception

OBJECTIVES

Previous study has suggested that when listening in modulated noise, individuals benefit from different wide dynamic range compression (WDRC) speeds depending on their working memory ability. Reverberation reduces the modulation depth of signals and may impact the relation between WDRC speed and working memory. The purpose of this study was to examine this relation across a range of reverberant conditions.

DESIGN

Twenty-eight older listeners with mild-to-moderate sensorineural hearing impairment were recruited in the present study. Individual working memory was measured using a Reading Span test. Sentences were combined with noise at two signal to noise ratios (2 and 5 dB SNR), and reverberation was simulated at a range of reverberation times (0.00, 0.75, 1.50, and 3.00 sec). Speech intelligibility was measured in listeners when listening to the sentences processed with simulated fast-acting and slow-acting WDRC conditions.

RESULTS

There was a significant relation between WDRC speed and working memory with minimal or no reverberation. Consistent with previous research, this relation was such that individuals with high working memory had higher speech intelligibility with fast-acting WDRC, and individuals with low working memory performed better with slow-acting WDRC. However, at longer reverberation times, there was no relation between WDRC speed and working memory.

CONCLUSIONS

Consistent with previous studies, results suggest that there is an advantage of tailoring WDRC speed based on an individual's working memory under anechoic conditions. However, the present results further suggest that there may not be such a benefit in reverberant listening environments due to reduction in signal modulation.

Quantifying the Range of Signal Modification in Clinically Fit Hearing Aids

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.

Frequency-based multi-band adaptive compression for hearing aid application

Multi-band Dynamic Range (MBDR) Compression is a key part of the signal processing operation in hearing aid devices (HADs). Operating speed of the MBDR compressor plays an important role in preserving the quality and intelligibility of the output signal. Traditional fast-acting compressor preserves the audible cues in quiet speech but, in presence of surrounding noise, it can degrade the sound quality by introducing pumping and breathing effects. Alternatively, slow-acting compressor maintains the temporal cues and the listening comfort but may provide inadequate gain for soft inputs that come right after loud inputs. HADs may operate in a variable acoustic environment. Therefore, a fixed speed in compression might affect the performance of the hearing aids. In this study, we propose a frequency(FFT) based nine-band adaptive MBDR compression which uses spectral flux as a measure of the intensity change in input level to adapt the speed of the compressor in each band. Gain, threshold and compression ratio of the compressor for nine bands are adjusted based on the audiogram of the hearing impaired patient. The proposed frequency-based adaptive MBDR compression method is implemented on smartphone. The objective and subjective test results demonstrate the performance of proposed method compared to fixed compression approaches.

The Characteristics of Adults with Severe Hearing Loss

BACKGROUND

Severe hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices.

PURPOSE

The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use.

RESEARCH DESIGN

A within-subjects design was used.

STUDY SAMPLE

Participants included 36 adults aged 54-93 yr with unilateral or bilateral severe hearing loss.

DATA COLLECTION AND ANALYSIS

Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition.

RESULTS

For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids.

CONCLUSIONS

The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.

Effects of noise and reverberation on speech recognition with variants of a multichannel adaptive dynamic range compression scheme

Objective: Adaptive compression methods in hearing aids have been developed to maximise audibility while preserving temporal envelope modulations. Increasing the number of channels may improve listening comfort for loud sounds. However, the effects of this on speech recognition in different environmental conditions are unknown. This study evaluated the effects of different channel architectures and adaptive compression properties on speech recognition in noise and reverberation. Design: Sentences were mixed with steady or modulated noise at three signal-to-noise ratios (SNRs). These were processed with and without reverberation and amplified with four proprietary adaptive compression methods or linear amplification. Study sample: 36 listeners with mild to moderately-severe hearing loss. Results: Adaptive compression improved speech recognition over linear amplification to a small extent, with no significant differences among methods using 4 or 24 channels or a combination thereof. These effects remained across the different background noise and reverberation conditions. Conclusions: Increasing the number of channels does not negatively affect speech recognition in noise and reverberation when adaptive compression is used. If future research shows that increasing the number of channels improves listening comfort for loud sounds, these results indicate that adaptive compression methods with as many as 24 channels are viable options for hearing aids.

Effect of improving audibility on better-ear glimpsing using non-linear amplification

Better-ear glimpsing (BEG) utilizes interaural level differences (ILDs) to improve speech intelligibility in noise. This spatial benefit is reduced in most hearing-impaired (HI) listeners due to their increased hearing loss at high frequencies. Even though this benefit can be improved by providing increased amplification, the improvement is limited by loudness discomfort. An alternative solution therefore extends ILDs to low frequencies, which has been shown to provide a substantial benefit from BEG. In contrast to previous studies, which only applied linear stimulus manipulations, wide dynamic range compression was applied here to improve the audibility of soft sounds while ensuring loudness comfort for loud sounds. Performance in both speech intelligibility and BEG was measured in 13 HI listeners at three different masker levels and for different interaural stimulus manipulations. The results revealed that at low signal levels, performance substantially improved with increasing masker level, but this improvement was reduced by the compressive behaviour at higher levels. Moreover, artificially extending ILDs by applying infinite (broadband) ILDs provided an extra spatial benefit in speech reception thresholds of up to 5 dB on top of that already provided by natural ILDs and interaural time differences, which increased with increasing signal level.

Signal-to-Noise-Ratio-Aware Dynamic Range Compression in Hearing Aids

Fast-acting dynamic range compression is a level-dependent amplification scheme which aims to restore audibility for hearing-impaired listeners. However, when being applied to noisy speech at positive signal-to-noise ratios (SNRs), the gain function typically changes rapidly over time as it is driven by the short-term fluctuations of the speech signal. This leads to an amplification of the noise components in the speech gaps, which reduces the output SNR and distorts the acoustic properties of the background noise. An adaptive compression scheme is proposed here which utilizes information about the SNR in different frequency channels to adaptively change the characteristics of the compressor. Specifically, fast-acting compression is applied to speech-dominated time-frequency (T-F) units where the SNR is high, while slow-acting compression is used to effectively linearize the processing for noise-dominated T-F units where the SNR is low. A systematic evaluation of this SNR-aware compression scheme showed that the effective compression of speech components embedded in noise was similar to that of a conventional fast-acting system, whereas natural fluctuations in the background noise were preserved in a similar way as when a slow-acting compressor was applied.

The role of spectral resolution, working memory, and audibility in explaining variance in susceptibility to temporal envelope distortion

BACKGROUND

Several studies have shown that hearing thresholds alone cannot adequately predict listeners' success with hearing-aid amplification. Furthermore, previous studies have shown marked differences in listeners' susceptibility to distortions introduced by certain nonlinear amplification parameters.

PURPOSE

The purpose of this study was to examine the role of spectral resolution, working memory, and audibility in explaining perceptual susceptibility to temporal envelope and other hearing-aid compression-induced distortions for listeners with mild to moderate and moderate to severe hearing loss.

RESEARCH DESIGN

A between-subjects repeated-measures design was used to compare speech recognition scores with linear versus compression amplification, for listeners with mild to moderate and moderate to severe hearing loss.

STUDY SAMPLE

The study included 15 adult listeners with mild to moderate hearing loss and 13 adults with moderate to severe hearing loss.

DATA COLLECTION/ANALYSIS

Speech recognition scores were measured for vowel-consonant-vowel syllables processed with linear, moderate compression, and extreme compression amplification. Perceptual susceptibility to compression-induced temporal envelope distortion was defined as the difference in scores between linear and compression amplification. Both overall scores and consonant feature scores (i.e., place, manner, and voicing) were analyzed. Narrowband spectral resolution was measured using individual measures of auditory filter bandwidth at 2000 Hz. Working memory was measured using the reading span test. Signal audibility was quantified using the Aided Audibility Index. Multiple linear regression was used to determine the predictive role of spectral resolution, working memory, and audibility benefit on listeners' susceptibility to compression-induced distortions.

RESULTS

For all listeners, spectral resolution, working memory, and audibility benefit were significant predictors of overall distortion scores. For listeners with moderate to severe hearing loss, spectral resolution and audibility benefit predicted distortion scores for consonant place and manner of articulation features, and audibility benefit predicted distortion scores for consonant voicing features. For listeners with mild to moderate hearing loss, the model did not predict distortion scores for overall or consonant feature scores.

CONCLUSIONS

The results from this study suggest that when audibility is adequately controlled, measures of spectral resolution may identify the listeners who are most susceptible to compression-induced distortions. Working memory appears to modulate the negative effect of these distortions for listeners with moderate to severe hearing loss.

Optimal gain control step sizes for bimodal stimulation

OBJECTIVE

Cochlear implants (CI) and hearing aids (HA) have a gain control that allows the bimodal user to change the loudness. Due to differences in dynamic range between CI and HA, an equal change of the gains of the two devices results in different changes in loudness. The objective was to relate and individualise the step sizes of the loudness controls to obtain a similar perceptual effect in the two ears.

DESIGN

We used loudness models parametrised for individual users to find a relation between the controls of the CI and the HA such that each step resulted in an equal change in loudness. We conducted loudness balancing experiments to validate the results.

STUDY SAMPLE

Eleven bimodal users of whom six were tested in a prior study.

RESULTS

The difference between the optimal gain from the loudness balancing procedure and actual gain was 3.3 dB when the new relation was applied. In contrast, the difference was 8 dB if equal step sized were applied at both sides.

CONCLUSION

We can relate the controls such that each step results in a similar loudness difference.

Effects of WDRC release time and number of channels on output SNR and speech recognition

OBJECTIVES

The purpose of this study was to investigate the joint effects that wide dynamic range compression (WDRC) release time (RT) and number of channels have on recognition of sentences in the presence of steady and modulated maskers at different signal-to-noise ratios (SNRs). How the different combinations of WDRC parameters affect output SNR and the role this plays in the observed findings were also investigated.

DESIGN

Twenty-four listeners with mild to moderate sensorineural hearing loss identified sentences mixed with steady or modulated maskers at three SNRs (-5, 0, and +5 dB) that had been processed using a hearing aid simulator with six combinations of RT (40 and 640 msec) and number of channels (4, 8, and 16). Compression parameters were set using the Desired Sensation Level v5.0a prescriptive fitting method. For each condition, amplified speech and masker levels and the resultant long-term output SNR were measured.

RESULTS

Speech recognition with WDRC depended on the combination of RT and number of channels, with the greatest effects observed at 0 dB input SNR, in which mean speech recognition scores varied by 10 to 12% across WDRC manipulations. Overall, effect sizes were generally small. Across both masker types and the three SNRs tested, the best speech recognition was obtained with eight channels, regardless of RT. Increased speech levels, which favor audibility, were associated with the short RT and with an increase in the number of channels. These same conditions also increased masker levels by an even greater amount, for a net decrease in the long-term output SNR. Changes in long-term SNR across WDRC conditions were found to be strongly associated with changes in the temporal envelope shape as quantified by the Envelope Difference Index; however, neither of these factors fully explained the observed differences in speech recognition.

CONCLUSIONS

A primary finding of this study was that the number of channels had a modest effect when analyzed at each level of RT, with results suggesting that selecting eight channels for a given RT might be the safest choice. Effects were smaller for RT, with results suggesting that short RT was slightly better when only 4 channels were used and that long RT was better when 16 channels were used. Individual differences in how listeners were influenced by audibility, output SNR, temporal distortion, and spectral distortion may have contributed to the size of the effects found in this study. Because only general suppositions could made for how each of these factors may have influenced the overall results of this study, future research would benefit from exploring the predictive value of these and other factors in selecting the processing parameters that maximize speech recognition for individuals.

Reference-Free Assessment of Speech Intelligibility Using Bispectrum of an Auditory Neurogram

Sensorineural hearing loss occurs due to damage to the inner and outer hair cells of the peripheral auditory system. Hearing loss can cause decreases in audibility, dynamic range, frequency and temporal resolution of the auditory system, and all of these effects are known to affect speech intelligibility. In this study, a new reference-free speech intelligibility metric is proposed using 2-D neurograms constructed from the output of a computational model of the auditory periphery. The responses of the auditory-nerve fibers with a wide range of characteristic frequencies were simulated to construct neurograms. The features of the neurograms were extracted using third-order statistics referred to as bispectrum. The phase coupling of neurogram bispectrum provides a unique insight for the presence (or deficit) of supra-threshold nonlinearities beyond audibility for listeners with normal hearing (or hearing loss). The speech intelligibility scores predicted by the proposed method were compared to the behavioral scores for listeners with normal hearing and hearing loss both in quiet and under noisy background conditions. The results were also compared to the performance of some existing methods. The predicted results showed a good fit with a small error suggesting that the subjective scores can be estimated reliably using the proposed neural-response-based metric. The proposed metric also had a wide dynamic range, and the predicted scores were well-separated as a function of hearing loss. The proposed metric successfully captures the effects of hearing loss and supra-threshold nonlinearities on speech intelligibility. This metric could be applied to evaluate the performance of various speech-processing algorithms designed for hearing aids and cochlear implants.

Individual sensitivity to spectral and temporal cues in listeners with hearing impairment

PURPOSE

The present study was designed to evaluate use of spectral and temporal cues under conditions in which both types of cues were available.

METHOD

Participants included adults with normal hearing and hearing loss. We focused on 3 categories of speech cues: static spectral (spectral shape), dynamic spectral (formant change), and temporal (amplitude envelope). Spectral and/or temporal dimensions of synthetic speech were systematically manipulated along a continuum, and recognition was measured using the manipulated stimuli. Level was controlled to ensure cue audibility. Discriminant function analysis was used to determine to what degree spectral and temporal information contributed to the identification of each stimulus.

RESULTS

Listeners with normal hearing were influenced to a greater extent by spectral cues for all stimuli. Listeners with hearing impairment generally utilized spectral cues when the information was static (spectral shape) but used temporal cues when the information was dynamic (formant transition). The relative use of spectral and temporal dimensions varied among individuals, especially among listeners with hearing loss.

CONCLUSION

Information about spectral and temporal cue use may aid in identifying listeners who rely to a greater extent on particular acoustic cues and applying that information toward therapeutic interventions.

Working memory, age, and hearing loss: susceptibility to hearing aid distortion

OBJECTIVES

Hearing aids use complex processing intended to improve speech recognition. Although many listeners benefit from such processing, it can also introduce distortion that offsets or cancels intended benefits for some individuals. The purpose of the present study was to determine the effects of cognitive ability (working memory) on individual listeners' responses to distortion caused by frequency compression applied to noisy speech.

DESIGN

The present study analyzed a large data set of intelligibility scores for frequency-compressed speech presented in quiet and at a range of signal-to-babble ratios. The intelligibility data set was based on scores from 26 adults with hearing loss with ages ranging from 62 to 92 years. The listeners were grouped based on working memory ability. The amount of signal modification (distortion) caused by frequency compression and noise was measured using a sound quality metric. Analysis of variance and hierarchical linear modeling were used to identify meaningful differences between subject groups as a function of signal distortion caused by frequency compression and noise.

RESULTS

Working memory was a significant factor in listeners' intelligibility of sentences presented in babble noise and processed with frequency compression based on sinusoidal modeling. At maximum signal modification (caused by both frequency compression and babble noise), the factor of working memory (when controlling for age and hearing loss) accounted for 29.3% of the variance in intelligibility scores. Combining working memory, age, and hearing loss accounted for a total of 47.5% of the variability in intelligibility scores. Furthermore, as the total amount of signal distortion increased, listeners with higher working memory performed better on the intelligibility task than listeners with lower working memory did.

CONCLUSIONS

Working memory is a significant factor in listeners' responses to total signal distortion caused by cumulative effects of babble noise and frequency compression implemented with sinusoidal modeling. These results, together with other studies focused on wide-dynamic range compression, suggest that older listeners with hearing loss and poor working memory are more susceptible to distortions caused by at least some types of hearing aid signal-processing algorithms and by noise, and that this increased susceptibility should be considered in the hearing aid fitting process.

An evidence-based systematic review of amplitude compression in hearing aids for school-age children with hearing loss

PURPOSE

Two clinical questions were developed: one addressing the comparison of linear amplification with compression limiting to linear amplification with peak clipping, and the second comparing wide dynamic range compression with linear amplification for outcomes of audibility, speech recognition, speech and language, and self- or parent report in children with hearing loss.

METHOD

Twenty-six databases were systematically searched for studies addressing a clinical question and meeting all inclusion criteria. Studies were evaluated for methodological quality, and effect sizes were reported or calculated when possible.

RESULTS

The literature search resulted in the inclusion of 8 studies. All 8 studies included comparisons of wide dynamic range compression to linear amplification, and 2 of the 8 studies provided comparisons of compression limiting versus peak clipping.

CONCLUSIONS

Moderate evidence from the included studies demonstrated that audibility was improved and speech recognition was either maintained or improved with wide dynamic range compression as compared with linear amplification. No significant differences were observed between compression limiting and peak clipping on outcomes (i.e., speech recognition and self-/parent report) reported across the 2 studies. Preference ratings appear to be influenced by participant characteristics and environmental factors. Further research is needed before conclusions can confidently be drawn.