Effectiveness of computer-based auditory training in improving the perception of noise-vocoded speech

Generalization of auditory expertise in audio engineers and instrumental musicians

From auditory perception to general cognition, the ability to play a musical instrument has been associated with skills both related and unrelated to music. However, it is unclear if these effects are bound to the specific characteristics of musical instrument training, as little attention has been paid to other populations such as audio engineers and designers whose auditory expertise may match or surpass that of musicians in specific auditory tasks or more naturalistic acoustic scenarios. We explored this possibility by comparing students of audio engineering (n = 20) to matched conservatory-trained instrumentalists (n = 24) and to naive controls (n = 20) on measures of auditory discrimination, auditory scene analysis, and speech in noise perception. We found that audio engineers and performing musicians had generally lower psychophysical thresholds than controls, with pitch perception showing the largest effect size. Compared to controls, audio engineers could better memorise and recall auditory scenes composed of non-musical sounds, whereas instrumental musicians performed best in a sustained selective attention task with two competing streams of tones. Finally, in a diotic speech-in-babble task, musicians showed lower signal-to-noise-ratio thresholds than both controls and engineers; however, a follow-up online study did not replicate this musician advantage. We also observed differences in personality that might account for group-based self-selection biases. Overall, we showed that investigating a wider range of forms of auditory expertise can help us corroborate (or challenge) the specificity of the advantages previously associated with musical instrument training.

Effects of training length on adaptation to noise-vocoded speech

Listeners show rapid perceptual learning of acoustically degraded speech, though the amount of exposure required to maximize speech adaptation is unspecified. The current work used a single-session design to examine the length of auditory training on perceptual learning for normal hearing listeners exposed to eight-channel noise-vocoded speech. Participants completed short, medium, or long training using a two-alternative forced choice sentence identification task with feedback. To assess learning and generalization, a 40-trial pre-test and post-test transcription task was administered using trained and novel sentences. Training results showed all groups performed near ceiling with no reliable differences. For test data, we evaluated changes in transcription accuracy using separate linear mixed models for trained or novel sentences. In both models, we observed a significant improvement in transcription at post-test relative to pre-test. Critically, the three training groups did not differ in the magnitude of improvement following training. Subsequent Bayes factors analysis evaluating the test by group interaction provided strong evidence in support of the null hypothesis. For these stimuli and procedure, results suggest increased training does not necessarily maximize learning outcomes; both passive and trained experience likely supported adaptation. Findings may contribute to rehabilitation recommendations for listeners adapting to degraded speech signals.

Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies

PURPOSE

Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions.

METHOD

We explored relevant literature to inform the treatment of auditory processing dysfunction in adults, with emphasis on findings involving active or former military personnel. We were able to identify a limited number of studies, pertaining primarily to the treatment of auditory processing deficits through the use of assistive technologies and training strategies. We assessed the current state of the science for knowledge gaps that warrant additional study.

CONCLUSIONS

Auditory processing deficits often co-occur with other military injuries and may pose significant risk in military operational and occupational settings. Research is needed to advance clinical diagnostic and rehabilitative capabilities, guide treatment planning, support effective multidisciplinary management, and inform fitness-for-duty standards. We emphasize the need for an inclusive approach to the assessment and treatment of auditory processing concerns in Service members and Veterans and for evidence-based solutions to address complex military risk factors and injuries.

Translational Applications of Machine Learning in Auditory Electrophysiology

Machine learning (ML) is transforming nearly every aspect of modern life including medicine and its subfields, such as hearing science. This article presents a brief conceptual overview of selected ML approaches and describes how these techniques are being applied to outstanding problems in hearing science, with a particular focus on auditory evoked potentials (AEPs). Two vignettes are presented in which ML is used to analyze subcortical AEP data. The first vignette demonstrates how ML can be used to determine if auditory learning has influenced auditory neurophysiologic function. The second vignette demonstrates how ML analysis of AEPs may be useful in determining whether hearing devices are optimized for discriminating speech sounds.

Rapid but specific perceptual learning partially explains individual differences in the recognition of challenging speech

Perceptual learning for speech, defined as long-lasting changes in speech recognition following exposure or practice occurs under many challenging listening conditions. However, this learning is also highly specific to the conditions in which it occurred, such that its function in adult speech recognition is not clear. We used a time-compressed speech task to assess learning following either brief exposure (rapid learning) or additional training (training-induced learning). Both types of learning were robust and long-lasting. Individual differences in rapid learning explained unique variance in recognizing natural-fast speech and speech-in-noise with no additional contribution for training-induced learning (Experiment 1). Rapid learning was stimulus specific (Experiment 2), as in previous studies on training-induced learning. We suggest that rapid learning is key for understanding the role of perceptual learning in online speech recognition whereas longer training could provide additional opportunities to consolidate and stabilize learning.

Effects of experience on recognition of speech produced with a face mask

Over the past two years, face masks have been a critical tool for preventing the spread of COVID-19. While previous studies have examined the effects of masks on speech recognition, much of this work was conducted early in the pandemic. Given that human listeners are able to adapt to a wide variety of novel contexts in speech perception, an open question concerns the extent to which listeners have adapted to masked speech during the pandemic. In order to evaluate this, we replicated Toscano and Toscano (PLOS ONE 16(2):e0246842, 2021), looking at the effects of several types of face masks on speech recognition in different levels of multi-talker babble noise. We also examined the effects of listeners' self-reported frequency of encounters with masked speech and the effects of the implementation of public mask mandates on speech recognition. Overall, we found that listeners' performance in the current experiment (with data collected in 2021) was similar to that of listeners in Toscano and Toscano (with data collected in 2020) and that performance did not differ based on mask experience. These findings suggest that listeners may have already adapted to masked speech by the time data were collected in 2020, are unable to adapt to masked speech, require additional context to be able to adapt, or that talkers also changed their productions over time. Implications for theories of perceptual learning in speech are discussed.

Synchrony as a measure of conversation difficulty: Movement coherence increases with background noise level and complexity in dyads and triads

When people interact, they fall into synchrony. This synchrony has been demonstrated in a range of contexts, from walking or playing music together to holding a conversation, and has been linked to prosocial outcomes such as development of rapport and efficiency of cooperation. While the basis of synchrony remains unclear, several studies have found synchrony to increase when an interaction is made challenging, potentially providing a means of facilitating interaction. Here we focus on head movement during free conversation. As verbal information is obscured when conversing over background noise, we investigate whether synchrony is greater in high vs low levels of noise, as well as addressing the effect of background noise complexity. Participants held a series of conversations with unfamiliar interlocutors while seated in a lab, and the background noise level changed every 15-30s between 54, 60, 66, 72, and 78 dB. We report measures of head movement synchrony recorded via high-resolution motion tracking at the extreme noise levels (i.e., 54 vs 78 dB) in dyads (n = 15) and triads (n = 11). In both the dyads and the triads, we report increased movement coherence in high compared to low level speech-shaped noise. Furthermore, in triads we compare behaviour in speech-shaped noise vs multi-talker babble, and find greater movement coherence in the more complex babble condition. Key synchrony differences fall in the 0.2-0.5 Hz frequency bands, and are discussed in terms of their correspondence to talkers' average utterance durations. Additional synchrony differences occur at higher frequencies in the triads only (i.e., >5 Hz), which may relate to synchrony of backchannel cues (as multiple individuals were listening and responding to the same talker). Not only do these studies replicate prior work indicating interlocutors' increased reliance on behavioural synchrony as task difficulty increases, but they demonstrate these effects using multiple difficulty manipulations and across different sized interaction groups.

Further simulations of the effect of cochlear-implant pre-processing and head movement on interaural level differences

We simulated the effect of several automatic gain control (AGC) and AGC-like systems and head movement on the output levels, and resulting interaural level differences (ILDs) produced by bilateral cochlear-implant (CI) processors. The simulated AGC systems included unlinked AGCs with a range of parameter settings, linked AGCs, and two proprietary multi-channel systems used in contemporary CIs. The results show that over the range of values used clinically, the parameters that most strongly affect dynamic ILDs are the release time and compression ratio. Linking AGCs preserves ILDs at the expense of monaural level changes and, possibly, comfortable listening level. Multichannel AGCs can whiten output spectra, and/or distort the dynamic changes in ILD that occur during and after head movement. We propose that an unlinked compressor with a ratio of approximately 3:1 and a release time of 300-500 ms can preserve the shape of dynamic ILDs, without causing large spectral distortions or sacrificing listening comfort.

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.

Processing of Degraded Speech in Brain Disorders

The speech we hear every day is typically "degraded" by competing sounds and the idiosyncratic vocal characteristics of individual speakers. While the comprehension of "degraded" speech is normally automatic, it depends on dynamic and adaptive processing across distributed neural networks. This presents the brain with an immense computational challenge, making degraded speech processing vulnerable to a range of brain disorders. Therefore, it is likely to be a sensitive marker of neural circuit dysfunction and an index of retained neural plasticity. Considering experimental methods for studying degraded speech and factors that affect its processing in healthy individuals, we review the evidence for altered degraded speech processing in major neurodegenerative diseases, traumatic brain injury and stroke. We develop a predictive coding framework for understanding deficits of degraded speech processing in these disorders, focussing on the "language-led dementias"-the primary progressive aphasias. We conclude by considering prospects for using degraded speech as a probe of language network pathophysiology, a diagnostic tool and a target for therapeutic intervention.

Conversation in small groups: Speaking and listening strategies depend on the complexities of the environment and group

Many conversations in our day-to-day lives are held in noisy environments – impeding comprehension, and in groups – taxing auditory attention-switching processes. These situations are particularly challenging for older adults in cognitive and sensory decline. In noisy environments, a variety of extra-linguistic strategies are available to speakers and listeners to facilitate communication, but while models of language account for the impact of context on word choice, there has been little consideration of the impact of context on extra-linguistic behaviour. To address this issue, we investigate how the complexity of the acoustic environment and interaction situation impacts extra-linguistic conversation behaviour of older adults during face-to-face conversations. Specifically, we test whether the use of intelligibility-optimising strategies increases with complexity of the background noise (from quiet to loud, and in speech-shaped vs. babble noise), and with complexity of the conversing group (dyad vs. triad). While some communication strategies are enhanced in more complex background noise, with listeners orienting to talkers more optimally and moving closer to their partner in babble than speech-shaped noise, this is not the case with all strategies, as we find greater vocal level increases in the less complex speech-shaped noise condition. Other behaviours are enhanced in the more complex interaction situation, with listeners using more optimal head orientations, and taking longer turns when gaining the floor in triads compared to dyads. This study elucidates how different features of the conversation context impact individuals’ communication strategies, which is necessary to both develop a comprehensive cognitive model of multimodal conversation behaviour, and effectively support individuals that struggle conversing.

Does training with amplitude modulated tones affect tone-vocoded speech perception?

Temporal-envelope cues are essential for successful speech perception. We asked here whether training on stimuli containing temporal-envelope cues without speech content can improve the perception of spectrally-degraded (vocoded) speech in which the temporal-envelope (but not the temporal fine structure) is mainly preserved. Two groups of listeners were trained on different amplitude-modulation (AM) based tasks, either AM detection or AM-rate discrimination (21 blocks of 60 trials during two days, 1260 trials; frequency range: 4Hz, 8Hz, and 16Hz), while an additional control group did not undertake any training. Consonant identification in vocoded vowel-consonant-vowel stimuli was tested before and after training on the AM tasks (or at an equivalent time interval for the control group). Following training, only the trained groups showed a significant improvement in the perception of vocoded speech, but the improvement did not significantly differ from that observed for controls. Thus, we do not find convincing evidence that this amount of training with temporal-envelope cues without speech content provide significant benefit for vocoded speech intelligibility. Alternative training regimens using vocoded speech along the linguistic hierarchy should be explored.

Comparison of Two Music Training Approaches on Music and Speech Perception in Cochlear Implant Users

In normal-hearing (NH) adults, long-term music training may benefit music and speech perception, even when listening to spectro-temporally degraded signals as experienced by cochlear implant (CI) users. In this study, we compared two different music training approaches in CI users and their effects on speech and music perception, as it remains unclear which approach to music training might be best. The approaches differed in terms of music exercises and social interaction. For the pitch/timbre group, melodic contour identification (MCI) training was performed using computer software. For the music therapy group, training involved face-to-face group exercises (rhythm perception, musical speech perception, music perception, singing, vocal emotion identification, and music improvisation). For the control group, training involved group nonmusic activities (e.g., writing, cooking, and woodworking). Training consisted of weekly 2-hr sessions over a 6-week period. Speech intelligibility in quiet and noise, vocal emotion identification, MCI, and quality of life (QoL) were measured before and after training. The different training approaches appeared to offer different benefits for music and speech perception. Training effects were observed within-domain (better MCI performance for the pitch/timbre group), with little cross-domain transfer of music training (emotion identification significantly improved for the music therapy group). While training had no significant effect on QoL, the music therapy group reported better perceptual skills across training sessions. These results suggest that more extensive and intensive training approaches that combine pitch training with the social aspects of music therapy may further benefit CI users.

Simulations of the effect of unlinked cochlear-implant automatic gain control and head movement on interaural level differences

This study simulated the effect of unlinked automatic gain control (AGC) and head movement on the output levels and resulting inter-aural level differences (ILDs) produced by bilateral cochlear implant (CI) processors. The angular extent and velocity of the head movements were varied in order to observe the interaction between unlinked AGC and head movement. Static, broadband input ILDs were greatly reduced by the high-ratio, slow-time-constant AGC used. The size of head-movement-induced dynamic ILDs depended more on the velocity and angular extent of the head movement than on the angular position of the source. The profiles of the dynamic, broadband output ILDs were very different from the dynamic, broadband input ILD profiles. Short-duration, high-velocity head movements resulted in dynamic output ILDs that continued to change after head movement had stopped. Analysis of narrowband, single-channel ILDs showed that static output ILDs were reduced across all frequencies, producing low-frequency ILDs of the opposite sign to the high-frequency ILDs. During head movements, low- and high-frequency ILDs also changed with opposite sign. The results showed that the ILDs presented to bilateral CI listeners during head turns were highly distorted by the interaction of the bilateral, unlinked AGC and the level changes induced by head movement.

Effects of Training on Lateralization for Simulations of Cochlear Implants and Single-Sided Deafness

While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears-temporal fine structure (TFS) information with acoustic hearing vs. coarse spectro-temporal envelope information with electric hearing-may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22) and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22 and UN+SID19). After completing baseline measurements, subjects completed six lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p < 0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing.

Integration of acoustic and electric hearing is better in the same ear than across ears

Advances in cochlear implant (CI) technology allow for acoustic and electric hearing to be combined within the same ear (electric-acoustic stimulation, or EAS) and/or across ears (bimodal listening). Integration efficiency (IE; the ratio between observed and predicted performance for acoustic-electric hearing) can be used to estimate how well acoustic and electric hearing are combined. The goal of this study was to evaluate factors that affect IE in EAS and bimodal listening. Vowel recognition was measured in normal-hearing subjects listening to simulations of unimodal, EAS, and bimodal listening. The input/output frequency range for acoustic hearing was 0.1–0.6 kHz. For CI simulations, the output frequency range was 1.2–8.0 kHz to simulate a shallow insertion depth and the input frequency range was varied to provide increasing amounts of speech information and tonotopic mismatch. Performance was best when acoustic and electric hearing was combined in the same ear. IE was significantly better for EAS than for bimodal listening; IE was sensitive to tonotopic mismatch for EAS, but not for bimodal listening. These simulation results suggest acoustic and electric hearing may be more effectively and efficiently combined within rather than across ears, and that tonotopic mismatch should be minimized to maximize the benefit of acoustic-electric hearing, especially for EAS.

The Contribution of Cognitive Factors to Individual Differences in Understanding Noise-Vocoded Speech in Young and Older Adults

Noise-vocoded speech is commonly used to simulate the sensation after cochlear implantation as it consists of spectrally degraded speech. High individual variability exists in learning to understand both noise-vocoded speech and speech perceived through a cochlear implant (CI). This variability is partly ascribed to differing cognitive abilities like working memory, verbal skills or attention. Although clinically highly relevant, up to now, no consensus has been achieved about which cognitive factors exactly predict the intelligibility of speech in noise-vocoded situations in healthy subjects or in patients after cochlear implantation. We aimed to establish a test battery that can be used to predict speech understanding in patients prior to receiving a CI. Young and old healthy listeners completed a noise-vocoded speech test in addition to cognitive tests tapping on verbal memory, working memory, lexicon and retrieval skills as well as cognitive flexibility and attention. Partial-least-squares analysis revealed that six variables were important to significantly predict vocoded-speech performance. These were the ability to perceive visually degraded speech tested by the Text Reception Threshold, vocabulary size assessed with the Multiple Choice Word Test, working memory gauged with the Operation Span Test, verbal learning and recall of the Verbal Learning and Retention Test and task switching abilities tested by the Comprehensive Trail-Making Test. Thus, these cognitive abilities explain individual differences in noise-vocoded speech understanding and should be considered when aiming to predict hearing-aid outcome.

Auditory Training With Multiple Talkers and Passage-Based Semantic Cohesion

PURPOSE

Current auditory training methods typically result in improvements to speech recognition abilities in quiet, but learner gains may not extend to other domains in speech (e.g., recognition in noise) or self-assessed benefit. This study examined the potential of training involving multiple talkers and training emphasizing discourse-level top-down processing to produce more generalized learning.

METHOD

Normal-hearing participants (N = 64) were randomly assigned to 1 of 4 auditory training protocols using noise-vocoded speech simulating the processing of an 8-channel cochlear implant: sentence-based single-talker training, training with 24 different talkers, passage-based transcription training, and a control (transcribing unvocoded sentence materials). In all cases, participants completed 2 pretests under cochlear implant simulation, 1 hr of training, and 5 posttests to assess perceptual learning and cross-context generalization.

RESULTS

Performance above the control was seen in all 3 experimental groups for sentence recognition in quiet. In addition, the multitalker training method generalized to a context word-recognition task, and the passage training method caused gains in sentence recognition in noise.

CONCLUSION

The gains of the multitalker and passage training groups over the control suggest that, with relatively small modifications, improvements to the generalized outcomes of auditory training protocols may be possible.

Options for Auditory Training for Adults with Hearing Loss

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

Biomimetic direction of arrival estimation for resolving front-back confusions in hearing aids

Sound sources at the same angle in front or behind a two-microphone array (e.g., bilateral hearing aids) produce the same time delay and two estimates for the direction of arrival: A front-back confusion. The auditory system can resolve this issue using head movements. To resolve front-back confusion for hearing-aid algorithms, head movement was measured using an inertial sensor. Successive time-delay estimates between the microphones are shifted clockwise and counterclockwise by the head movement between estimates and aggregated in two histograms. The histogram with the largest peak after multiple estimates predicted the correct hemifield for the source, eliminating the front-back confusions.

Cognitive predictors of perceptual adaptation to accented speech

The present study investigated the effects of inhibition, vocabulary knowledge, and working memory on perceptual adaptation to accented speech. One hundred young, normal-hearing adults listened to sentences spoken in a constructed, unfamiliar accent presented in speech-shaped background noise. Speech Reception Thresholds (SRTs) corresponding to 50% speech recognition accuracy provided a measurement of adaptation to the accented speech. Stroop, vocabulary knowledge, and working memory tests were performed to measure cognitive ability. Participants adapted to the unfamiliar accent as revealed by a decrease in SRTs over time. Better inhibition (lower Stroop scores) predicted greater and faster adaptation to the unfamiliar accent. Vocabulary knowledge predicted better recognition of the unfamiliar accent, while working memory had a smaller, indirect effect on speech recognition mediated by vocabulary score. Results support a top-down model for successful adaptation to, and recognition of, accented speech; they add to recent theories that allocate a prominent role for executive function to effective speech comprehension in adverse listening conditions.

Computer-based auditory phoneme discrimination training improves speech recognition in noise in experienced adult cochlear implant listeners

OBJECTIVE

Specific computer-based auditory training may be a useful completion in the rehabilitation process for cochlear implant (CI) listeners to achieve sufficient speech intelligibility. This study evaluated the effectiveness of a computerized, phoneme-discrimination training programme.

DESIGN

The study employed a pretest-post-test design; participants were randomly assigned to the training or control group. Over a period of three weeks, the training group was instructed to train in phoneme discrimination via computer, twice a week. Sentence recognition in different noise conditions (moderate to difficult) was tested pre- and post-training, and six months after the training was completed. The control group was tested and retested within one month.

STUDY SAMPLE

Twenty-seven adult CI listeners who had been using cochlear implants for more than two years participated in the programme; 15 adults in the training group, 12 adults in the control group.

RESULTS

Besides significant improvements for the trained phoneme-identification task, a generalized training effect was noted via significantly improved sentence recognition in moderate noise. No significant changes were noted in the difficult noise conditions. Improved performance was maintained over an extended period.

CONCLUSIONS

Phoneme-discrimination training improves experienced CI listeners' speech perception in noise. Additional research is needed to optimize auditory training for individual benefit.

Overlapping frequency coverage and simulated spatial cue effects on bimodal (electrical and acoustical) sentence recognition in noise

Sentence recognition in 20-talker babble was measured in eight Nucleus cochlear implant (CI) users with contralateral residual acoustic hearing. Speech reception thresholds (SRTs) were measured both in standard configurations, with some frequency regions presented both acoustically and electrically, and in configurations with no spectral overlap. In both cases a continuous interleaved sampling strategy was used. Mean SRTs were around 3 dB better with bimodal presentation than with CI alone in overlap configurations. A spherical head model was used to simulate azimuthal separation of speech and noise and provided no evidence of a contribution of spatial cues to bimodal benefit. There was no effect on bimodal performance of whether spectral overlap was present or was eliminated by switching off electrodes assigned to frequencies below the upper limit of acoustic hearing. In a subsequent experiment the CI was acutely re-mapped so that all available electrodes were used to cover frequencies not presented acoustically. This gave increased spectral resolution via the CI as assessed by formant frequency discrimination, but no improvement in bimodal performance compared to the configuration with overlap.

Left temporal alpha-band activity reflects single word intelligibility

The electroencephalographic (EEG) correlates of degraded speech perception have been explored in a number of recent studies. However, such investigations have often been inconclusive as to whether observed differences in brain responses between conditions result from different acoustic properties of more or less intelligible stimuli or whether they relate to cognitive processes implicated in comprehending challenging stimuli. In this study we used noise vocoding to spectrally degrade monosyllabic words in order to manipulate their intelligibility. We used spectral rotation to generate incomprehensible control conditions matched in terms of spectral detail. We recorded EEG from 14 volunteers who listened to a series of noise vocoded (NV) and noise-vocoded spectrally-rotated (rNV) words, while they carried out a detection task. We specifically sought components of the EEG response that showed an interaction between spectral rotation and spectral degradation. This reflects those aspects of the brain electrical response that are related to the intelligibility of acoustically degraded monosyllabic words, while controlling for spectral detail. An interaction between spectral complexity and rotation was apparent in both evoked and induced activity. Analyses of event-related potentials showed an interaction effect for a P300-like component at several centro-parietal electrodes. Time-frequency analysis of the EEG signal in the alpha-band revealed a monotonic increase in event-related desynchronization (ERD) for the NV but not the rNV stimuli in the alpha band at a left temporo-central electrode cluster from 420-560 ms reflecting a direct relationship between the strength of alpha-band ERD and intelligibility. By matching NV words with their incomprehensible rNV homologues, we reveal the spatiotemporal pattern of evoked and induced processes involved in degraded speech perception, largely uncontaminated by purely acoustic effects.

Simulating the effect of interaural mismatch in the insertion depth of bilateral cochlear implants on speech perception

A bilateral advantage for diotically presented stimuli has been observed for cochlear implant (CI) users and is suggested to be dependent on symmetrical implant performance. Studies using CI simulations have not shown a true "bilateral" advantage, but a "better ear" effect and have demonstrated that performance decreases with increasing basalward shift in insertion depth. This study aimed to determine whether there is a bilateral advantage for CI simulations with interaurally matched insertions and the extent to which performance is affected by interaural insertion depth mismatch. Speech perception in noise and self-reported ease of listening were measured using matched bilateral, mismatched bilateral and unilateral CI simulations over four insertion depths for seventeen normal hearing listeners. Speech scores and ease of listening reduced with increasing basalward shift in (interaurally matched) insertion depth. A bilateral advantage for speech perception was only observed when the insertion depths were interaurally matched and deep. No advantage was observed for small to moderate interaural insertion-depth mismatches, consistent with a better ear effect. Finally, both measures were poorer than expected for a better ear effect for large mismatches, suggesting that misalignment of the electrode arrays may prevent a bilateral advantage and detrimentally affect perception of diotically presented speech.

Adaptation to spectrally-rotated speech

Much recent interest surrounds listeners' abilities to adapt to various transformations that distort speech. An extreme example is spectral rotation, in which the spectrum of low-pass filtered speech is inverted around a center frequency (2 kHz here). Spectral shape and its dynamics are completely altered, rendering speech virtually unintelligible initially. However, intonation, rhythm, and contrasts in periodicity and aperiodicity are largely unaffected. Four normal hearing adults underwent 6 h of training with spectrally-rotated speech using Continuous Discourse Tracking. They and an untrained control group completed pre- and post-training speech perception tests, for which talkers differed from the training talker. Significantly improved recognition of spectrally-rotated sentences was observed for trained, but not untrained, participants. However, there were no significant improvements in the identification of medial vowels in /bVd/ syllables or intervocalic consonants. Additional tests were performed with speech materials manipulated so as to isolate the contribution of various speech features. These showed that preserving intonational contrasts did not contribute to the comprehension of spectrally-rotated speech after training, and suggested that improvements involved adaptation to altered spectral shape and dynamics, rather than just learning to focus on speech features relatively unaffected by the transformation.

Top-down influences of written text on perceived clarity of degraded speech

An unresolved question is how the reported clarity of degraded speech is enhanced when listeners have prior knowledge of speech content. One account of this phenomenon proposes top-down modulation of early acoustic processing by higher-level linguistic knowledge. Alternative, strictly bottom-up accounts argue that acoustic information and higher-level knowledge are combined at a late decision stage without modulating early acoustic processing. Here we tested top-down and bottom-up accounts using written text to manipulate listeners’ knowledge of speech content. The effect of written text on the reported clarity of noise-vocoded speech was most pronounced when text was presented before (rather than after) speech (Experiment 1). Fine-grained manipulation of the onset asynchrony between text and speech revealed that this effect declined when text was presented more than 120 ms after speech onset (Experiment 2). Finally, the influence of written text was found to arise from phonological (rather than lexical) correspondence between text and speech (Experiment 3). These results suggest that prior knowledge effects are time-limited by the duration of auditory echoic memory for degraded speech, consistent with top-down modulation of early acoustic processing by linguistic knowledge.

Advantages from bilateral hearing in speech perception in noise with simulated cochlear implants and residual acoustic hearing

Acoustic simulations were used to study the contributions of spatial hearing that may arise from combining a cochlear implant with either a second implant or contralateral residual low-frequency acoustic hearing. Speech reception thresholds (SRTs) were measured in twenty-talker babble. Spatial separation of speech and noise was simulated using a spherical head model. While low-frequency acoustic information contralateral to the implant simulation produced substantially better SRTs there was no effect of spatial cues on SRT, even when interaural differences were artificially enhanced. Simulated bilateral implants showed a significant head shadow effect, but no binaural unmasking based on interaural time differences, and weak, inconsistent overall spatial release from masking. There was also a small but significant non-spatial summation effect. It appears that typical cochlear implant speech processing strategies may substantially reduce the utility of spatial cues, even in the absence of degraded neural processing arising from auditory deprivation.

Linking dynamic-range compression across the ears can improve speech intelligibility in spatially separated noise

Recently introduced hearing devices allow dynamic-range compression to be coordinated at the two ears through a wireless link. This study investigates how linking compression across the ears might improve speech intelligibility in the presence of a spatially separated steady noise. An analysis of the compressors' behavior shows how linked compression can preserve interaural level differences (ILDs) and, compared to compression operating independently at each ear, improve the long-term apparent speech-to-noise ratio (SNR) at the ear with the better SNR. Speech intelligibility for normal-hearing listeners was significantly better with linked than with unlinked compression. The performance with linked compression was similar to that without any compression. The benefit of linked over unlinked compression was the same for binaural listening and for monaural listening to the ear with the better SNR, indicating that the benefit was due to changes to the signal at this ear and not to the preservation of ILDs. Differences in performance across experimental conditions were qualitatively consistent with changes in apparent SNR at the better ear. Predictions made using a speech intelligibility model suggest that linked compression could potentially provide a user of bilateral hearing aids with an improvement in intelligibility of up to approximately ten percentage points.

Comparing live to recorded speech in training the perception of spectrally shifted noise-vocoded speech

Two experimental groups were trained for 2 h with live or recorded speech that was noise-vocoded and spectrally shifted and was from the same text and talker. These two groups showed equivalent improvements in performance for vocoded and shifted sentences, and the group trained with recorded speech showed consistently greater improvements than untrained controls. Another group trained with unshifted noise-vocoded speech improved no more than untrained controls. Computer-based training thus appears at least as effective as labor-intensive live-voice training for improving the perception of spectrally shifted noise-vocoded speech, and by implication, for training of users of cochlear implants.

Auditory externalization in hearing-impaired listeners: the effect of pinna cues and number of talkers

Hearing-aid wearers have reported sound source locations as being perceptually internalized (i.e., inside their head). The contribution of hearing-aid design to internalization has, however, received little attention. This experiment compared the sensitivity of hearing-impaired (HI) and normal-hearing listeners to externalization cues when listening with their own ears and simulated behind-the-ear hearing-aids in increasingly complex listening situations and reduced pinna cues. Participants rated the degree of externalization using a multiple-stimulus listening test for mixes of internalized and externalized speech stimuli presented over headphones. The results showed that HI listeners had a contracted perception of externalization correlated with high-frequency hearing loss.

Perceptual learning of dysarthric speech: a review of experimental studies

PURPOSE

This review article provides a theoretical overview of the characteristics of perceptual learning, reviews perceptual learning studies that pertain to dysarthric populations, and identifies directions for future research that consider the application of perceptual learning to the management of dysarthria.

METHOD

A critical review of the literature was conducted that summarized and synthesized previously published research in the area of perceptual learning with atypical speech. Literature related to perceptual learning of neurologically degraded speech was emphasized with the aim of identifying key directions for future research with this population.

CONCLUSIONS

Familiarization with unfamiliar or ambiguous speech signals can facilitate perceptual learning of that same speech signal. There is a small but growing body of evidence that perceptual learning also occurs for listeners familiarized with dysarthric speech. Perceptual learning of the dysarthric signal is both theoretically and clinically significant. In order to establish the efficacy of exploiting perceptual learning paradigms for rehabilitative gain in dysarthria management, research is required to build on existing empirical evidence and develop a theoretical framework for learning to better recognize neurologically degraded speech.

Stimulus uncertainty in auditory perceptual learning

Stimulus uncertainty produced by variations in a target stimulus to be detected or discriminated, impedes perceptual learning under some, but not all experimental conditions. To account for those discrepancies, it has been proposed that uncertainty is detrimental to learning when the interleaved stimuli or tasks are similar to each other but not when they are sufficiently distinct, or when it obstructs the downstream search required to gain access to fine-grained sensory information, as suggested by the Reverse Hierarchy Theory (RHT). The focus of the current review is on the effects of uncertainty on the perceptual learning of speech and non-speech auditory signals. Taken together, the findings from the auditory modality suggest that in addition to the accounts already described, uncertainty may contribute to learning when categorization of stimuli to phonological or acoustic categories is involved. Therefore, it appears that the differences reported between the learning of non-speech and speech-related parameters are not an outcome of inherent differences between those two domains, but rather due to the nature of the tasks often associated with those different stimuli.

Digit training in noise can improve cochlear implant users' speech understanding in noise

OBJECTIVE

While auditory training in quiet has been shown to improve cochlear implant (CI) users' speech understanding in quiet, it is unclear whether training in noise will benefit speech understanding in noise. The present study investigated whether auditory training could improve CI users' speech recognition in noise and whether training with familiar stimuli in an easy listening task (closed-set digit recognition) would improve recognition of unfamiliar stimuli in a more difficult task (open-set sentence recognition).

DESIGN

CI users' speech understanding in noise was assessed before, during, and after auditory training with a closed-set recognition task (digits identification) in speech babble. Before training was begun, recognition of digits, Hearing in Noise Test (HINT) sentences, and IEEE sentences presented in steady speech-shaped noise or multitalker speech babble was repeatedly measured to establish a stable estimate of baseline performance. After completing baseline measures, participants trained at home on their personal computers using custom software for approximately 30 mins/day, 5 days/wk, for 4 wks, for a total of 10 hrs of training. Participants were trained only to identify random sequences of three digits presented in speech babble, using a closed-set task. During training, the signal-to-noise ratio was adjusted according to subject performance; auditory and visual feedback was provided. Recognition of digits, HINT sentences, and IEEE sentences in steady noise and speech babble was remeasured after the second and fourth week of training. Training was stopped after the fourth week, and subjects returned to the laboratory 1 mo later for follow-up testing to see whether any training benefits had been retained.

RESULTS

Mean results showed that the digit training in babble significantly improved digit recognition in babble (which was trained) and in steady noise (which was not trained). The training benefit generalized to improved HINT and IEEE sentence recognition in both types of noise. Training benefits were largely retained in follow-up measures made 1 mo after training was stopped.

CONCLUSIONS

The results demonstrated that auditory training in noise significantly improved CI users' speech performance in noise, and that training with simple stimuli using an easy closed-set listening task improved performance with difficult stimuli and a difficult open-set listening task.

Audiovisual cues and perceptual learning of spectrally distorted speech

Two experiments investigate the effectiveness of audiovisual (AV) speech cues (cues derived from both seeing and hearing a talker speak) in facilitating perceptual learning of spectrally distorted speech. Speech was distorted through an eight channel noise-vocoder which shifted the spectral envelope of the speech signal to simulate the properties of a cochlear implant with a 6 mm place mismatch: Experiment I found that participants showed significantly greater improvement in perceiving noise-vocoded speech when training gave AV cues than when it gave auditory cues alone. Experiment 2 compared training with AV cues with training which gave written feedback. These two methods did not significantly differ in the pattern of training they produced. Suggestions are made about the types of circumstances in which the two training methods might be found to differ in facilitating auditory perceptual learning of speech.

Cochlear reimplantation with same device: surgical and audiologic results

OBJECTIVES/HYPOTHESIS

To study to what extent it is possible to achieve identical insertion depths and to maintain the same performance after cochlear reimplantation.

STUDY DESIGN

Outcome research on a retrospective case series in a tertiary university referral center.

METHODS

Data were collected for 12 adults and three children who underwent reimplantation during the last 3 years with a new HiRes90K device with HiFocus 1J electrode owing to failure of the feed-through seal. Multislice computed tomography scans were used to compare positions of the original and newly placed electrode arrays. The speech-perception scores on a consonant-vowel-consonant word test before and after reimplantation were compared.

RESULTS

All reimplantations were successfully performed by two experienced cochlear implantation surgeons, and no complications were observed. Postoperative imaging showed that the average displacement of the new implant was only 0.59 mm. Reactivation of the implant gave immediate open set speech understanding in all patients, and speech perception rapidly returned to the previous level obtained with the original implant within weeks; it was even significantly better at the 3-month follow-up. No relation was found between changes in performance and the amount of displacement of the electrode array.

CONCLUSIONS

After cochlear reimplantation with the same device, electrode-array position can be accurately replicated and speech perception can be regained or even improved within weeks.

Interactions between unsupervised learning and the degree of spectral mismatch on short-term perceptual adaptation to spectrally shifted speech

OBJECTIVES

Cochlear implant listeners are able to at least partially adapt to the spectral mismatch associated with the implant device and speech processor via daily exposure and/or explicit training. The overall goal of this study was to investigate interactions between short-term unsupervised learning (i.e., passive adaptation) and the degree of spectral mismatch in normal-hearing listeners' adaptation to spectrally shifted vowels.

DESIGN

Normal-hearing subjects were tested while listening to acoustic cochlear implant simulations. Unsupervised learning was measured by testing vowel recognition repeatedly over a 5 day period; no feedback or explicit training was provided. In experiment 1, subjects listened to 8-channel, sine-wave vocoded speech. The spectral envelope was compressed to simulate a 16 mm cochlear implant electrode array. The analysis bands were fixed and the compressed spectral envelope was linearly shifted toward the base by 3.6, 6, or 8.3 mm to simulate different insertion depths of the electrode array, resulting in a slight, moderate, or severe spectral shift. In experiment 2, half the subjects were exclusively exposed to a severe shift with 8 or 16 channels (exclusive groups), and half the subjects were exposed to 8-channel severely shifted speech, 16-channel severely shifted speech, and 8-channel moderately shifted speech, alternately presented within each test session (mixed group). The region of stimulation in the cochlea was fixed (16 mm in extent and 15 mm from the apex) and the analysis bands were manipulated to create the spectral shift conditions. To determine whether increased spectral resolution would improve adaptation, subjects were exposed to 8- or 16-channel severely shifted speech.

RESULTS

In experiment 1, at the end of the adaptation period, there was no significant difference between 8-channel speech that was spectrally matched and that shifted by 3.6 mm. There was a significant, but less-complete, adaptation to the 6 mm shift and no adaptation to the 8.3 mm shift. In experiment 2, for the mixed exposure group, there was significant adaptation to severely shifted speech with 8 channels and even greater adaptation with 16 channels. For the exclusive exposure group, there was no significant adaptation to severely shifted speech with either 8 or 16 channels.

CONCLUSIONS

These findings suggest that listeners are able to passively adapt to spectral shifts up to 6 mm. For spectral shifts beyond 6 mm, some passive adaptation was observed with mixed exposure to a smaller spectral shift, even at the expense of some low frequency information. Mixed exposure to the smaller shift may have enhanced listeners' access to spectral envelope details that were not accessible when listening exclusively to severely shifted speech. The results suggest that the range of spectral mismatch that can support passive adaptation may be larger than previously reported. Some amount of passive adaptation may be possible with severely shifted speech by exposing listeners to a relatively small mismatch in conjunction with the severe mismatch.

Inferior frontal gyrus activation predicts individual differences in perceptual learning of cochlear-implant simulations

This study investigated the neural plasticity associated with perceptual learning of a cochlear implant (CI) simulation. Normal-hearing listeners were trained with vocoded and spectrally shifted speech simulating a CI while cortical responses were measured with functional magnetic resonance imaging (fMRI). A condition in which the vocoded speech was spectrally inverted provided a control for learnability and adaptation. Behavioral measures showed considerable individual variability both in the ability to learn to understand the degraded speech, and in phonological working memory capacity. Neurally, left-lateralized regions in superior temporal sulcus and inferior frontal gyrus (IFG) were sensitive to the learnability of the simulations, but only the activity in prefrontal cortex correlated with interindividual variation in intelligibility scores and phonological working memory. A region in left angular gyrus (AG) showed an activation pattern that reflected learning over the course of the experiment, and covariation of activity in AG and IFG was modulated by the learnability of the stimuli. These results suggest that variation in listeners' ability to adjust to vocoded and spectrally shifted speech is partly reflected in differences in the recruitment of higher-level language processes in prefrontal cortex, and that this variability may further depend on functional links between the left inferior frontal gyrus and angular gyrus. Differences in the engagement of left inferior prefrontal cortex, and its covariation with posterior parietal areas, may thus underlie some of the variation in speech perception skills that have been observed in clinical populations of CI users.

Resistance to learning binaurally mismatched frequency-to-place maps: implications for bilateral stimulation with cochlear implants

Simulations of monaural cochlear implants in normal hearing listeners have shown that the deleterious effects of upward spectral shifting on speech perception can be overcome with training. This study simulates bilateral stimulation with a unilateral spectral shift to investigate whether listeners can adapt to upward-shifted speech information presented together with contralateral unshifted information. A six-channel, dichotic, interleaved sine-carrier vocoder simulated a binaurally mismatched frequency-to-place map. Odd channels were presented to one ear with an upward frequency shift equivalent to 6 mm on the basilar membrane, while even channels were presented to the contralateral ear unshifted. In Experiment 1, listeners were trained for 5.3 h with either the binaurally mismatched processor or with just the shifted monaural bands. In Experiment 2, the duration of training was 10 h, and the trained condition alternated between those of Experiment 1. While listeners showed learning in both experiments, intelligibility with the binaurally mismatched processor never exceeded, intelligibility with just the three unshifted bands, suggesting that listeners did not benefit from combining the mismatched maps, even though there was clear scope to do so. Frequency-place map alignment may thus be of importance when optimizing bilateral devices of the type studied here.

Perceptual learning for speech

Adult language users have an enormous amount of experience with speech in their native language. As a result, they have very well-developed processes for categorizing the sounds of speech that they hear. Despite this very high level of experience, recent research has shown that listeners are capable of redeveloping their speech categorization to bring it into alignment with new variation in their speech input. This reorganization of phonetic space is a type of perceptual learning, or recalibration, of speech processes. In this article, we review several recent lines of research on perceptual learning for speech.

Comparison of word-, sentence-, and phoneme-based training strategies in improving the perception of spectrally distorted speech

PURPOSE

To compare the effectiveness of 3 self-administered strategies for auditory training that might improve speech perception by adult users of cochlear implants. The strategies are based, respectively, on discriminating isolated words, words in sentences, and phonemes in nonsense syllables.

METHOD

Participants were 18 normal-hearing adults who listened to speech processed by a noise-excited vocoder to simulate the information provided by a cochlear implant. They were assigned randomly to word-, sentence-, or phoneme-based training and underwent 9 training sessions (20 min each) on separate days over a 2- to 3-week period. The effectiveness of training was assessed as the improvement in accuracy of discriminating vowels and consonants, as well as identifying words in sentences, relative to participants' best performance in repeated tests prior to training.

RESULTS

Word- and sentence-based training led to significant improvements in the ability to identify words in sentences that were significantly larger than the improvements produced by phoneme-based training. There were no significant differences between the effectiveness of word- and sentence-based training. No significant improvements in consonant or vowel discrimination were found for the sentence- or phoneme-based training groups, but some improvements were found for the word-based training group.

CONCLUSION

The word- and sentence-based training strategies were more effective than the phoneme-based strategy at improving the perception of spectrally distorted speech.