The importance of interaural time differences and level differences in spatial release from masking

Effect of inter-aural temporal envelope differences on inter-aural time difference thresholds for amplitude modulated noise

PURPOSE

The inter-aural time difference (ITD) and inter-aural level difference (ILD) are important acoustic cues for horizontal localization and spatial release from masking. These cues are encoded based on inter-aural comparisons of tonotopically matched binaural inputs. Therefore, binaural coherence or the interaural spectro-temporal similarity is a pre-requisite for encoding ITD and ILD. The modulation depth of envelope is an important envelope characteristic that helps in encoding the envelope-ITD. However, inter-aural difference in modulation depth can result in reduced binaural coherence and poor representation of binaural cues as in the case with reverberation, noise and compression in cochlear implants and hearing aids. This study investigated the effect of inter-aural modulation depth difference on the ITD thresholds for an amplitude-modulated noise in normal hearing young adults.

METHODS

An amplitude modulated high pass filtered noise with varying modulation depth differences was presented sequentially through headphones. In one ear, the modulation depth was retained at 90% and in the other ear it varied from 90% to 50%. The ITD thresholds for modulation frequencies of 8 Hz and 16 Hz were estimated as a function of the inter-aural modulation depth difference.

RESULTS

The Friedman test findings revealed a statistically significant increase in the ITD threshold with an increase in the inter-aural modulation depth difference for 8 Hz and 16 Hz.

CONCLUSION

The results indicate that the inter-aural differences in the modulation depth negatively impact ITD perception for an amplitude-modulated high pass filtered noise.

Effect of a processing delay between direct and delayed sound in simulated open fit hearing aids on speech intelligibility in noise

Introduction

Subjects with mild to moderate hearing loss today often receive hearing aids (HA) with open-fitting (OF). In OF, direct sound reaches the eardrums with minimal damping. Due to the required processing delay in digital HA, the amplified HA sound follows some milliseconds later. This process occurs in both ears symmetrically in bilateral HA provision and is likely to have no or minor detrimental effect on binaural hearing. However, the delayed and amplified sound are only present in one ear in cases of unilateral hearing loss provided with one HA. This processing alters interaural timing differences in the resulting ear signals.

Methods

In the present study, an experiment with normal-hearing subjects to investigate speech intelligibility in noise with direct and delayed sound was performed to mimic unilateral and bilateral HA provision with OF.

Results

The outcomes reveal that these delays affect speech reception thresholds (SRT) in the unilateral OF simulation when presenting speech and noise from different spatial directions. A significant decrease in the median SRT from -18.1 to -14.7 dB SNR is observed when typical HA processing delays are applied. On the other hand, SRT was independent of the delay between direct and delayed sound in the bilateral OF simulation.

Discussion

The significant effect emphasizes the development of rapid processing algorithms for unilateral HA provision.

Spatial Release From Masking With Bilateral Bone Conduction Stimulation at Mastoid for Normal Hearing Subjects

This study investigates the effect of spatial release from masking (SRM) in bilateral bone conduction (BC) stimulation at the mastoid. Nine adults with normal hearing were tested to determine SRM based on speech recognition thresholds (SRTs) in simulated spatial configurations ranging from 0 to 180 degrees. These configurations were based on nonindividualized head-related transfer functions. The participants were subjected to sound stimulation through either air conduction (AC) via headphones or BC. The results indicated that both the angular separation between the target and the masker, and the modality of sound stimulation, significantly influenced speech recognition performance. As the angular separation between the target and the masker increased up to 150°, both BC and AC SRTs decreased, indicating improved performance. However, performance slightly deteriorated when the angular separation exceeded 150°. For spatial separations less than 75°, BC stimulation provided greater spatial benefits than AC, although this difference was not statistically significant. For separations greater than 75°, AC stimulation offered significantly more spatial benefits than BC. When speech and noise originated from the same side of the head, the "better ear effect" did not significantly contribute to SRM. However, when speech and noise were located on opposite sides of the head, this effect became dominant in SRM.

Cochlear Implant Facilitates the Use of Talker Sex and Spatial Cues to Segregate Competing Speech in Unilaterally Deaf Listeners

OBJECTIVES

Talker sex and spatial cues can facilitate segregation of competing speech. However, the spectrotemporal degradation associated with cochlear implants (CIs) can limit the benefit of talker sex and spatial cues. Acoustic hearing in the nonimplanted ear can improve access to talker sex cues in CI users. However, it's unclear whether the CI can improve segregation of competing speech when maskers are symmetrically placed around the target (i.e., when spatial cues are available), compared with acoustic hearing alone. The aim of this study was to investigate whether a CI can improve segregation of competing speech by individuals with unilateral hearing loss.

DESIGN

Speech recognition thresholds (SRTs) for competing speech were measured in 16 normal-hearing (NH) adults and 16 unilaterally deaf CI users. All participants were native speakers of Mandarin Chinese. CI users were divided into two groups according to thresholds in the nonimplanted ear: (1) single-sided deaf (SSD); pure-tone thresholds <25 dB HL at all audiometric frequencies, and (2) Asymmetric hearing loss (AHL; one or more thresholds > 25 dB HL). SRTs were measured for target sentences produced by a male talker in the presence of two masker talkers (different male or female talkers). The target sentence was always presented via loudspeaker directly in front of the listener (0°), and the maskers were either colocated with the target (0°) or spatially separated from the target at ±90°. Three segregation cue conditions were tested to measure masking release (MR) relative to the baseline condition: (1) Talker sex, (2) Spatial, and (3) Talker sex + Spatial. For CI users, SRTs were measured with the CI on or off.

RESULTS

Binaural MR was significantly better for the NH group than for the AHL or SSD groups ( P < 0.001 in all cases). For the NH group, mean MR was largest with the Talker sex + spatial cues (18.8 dB) and smallest for the Talker sex cues (10.7 dB). In contrast, mean MR for the SSD group was largest with the Talker sex + spatial cues (14.7 dB), and smallest with the Spatial cues (4.8 dB). For the AHL group, mean MR was largest with the Talker sex + spatial cues (7.8 dB) and smallest with the Talker sex (4.8 dB) and the Spatial cues (4.8 dB). MR was significantly better with the CI on than off for both the AHL ( P = 0.014) and SSD groups ( P < 0.001). Across all unilaterally deaf CI users, monaural (acoustic ear alone) and binaural MR were significantly correlated with unaided pure-tone average thresholds in the nonimplanted ear for the Talker sex and Talker sex + spatial conditions ( P < 0.001 in both cases) but not for the Spatial condition.

CONCLUSION

Although the CI benefitted unilaterally deaf listeners' segregation of competing speech, MR was much poorer than that observed in NH listeners. Different from previous findings with steady noise maskers, the CI benefit for segregation of competing speech from a different talker sex was greater in the SSD group than in the AHL group.

The Relationship Between Interaural Insertion-Depth Differences, Scalar Location, and Interaural Time-Difference Processing in Adult Bilateral Cochlear-Implant Listeners

Sensitivity to interaural time differences (ITDs) in acoustic hearing involves comparison of interaurally frequency-matched inputs. Bilateral cochlear-implant arrays are, however, only approximately aligned in angular insertion depth and scalar location across the cochleae. Interaural place-of-stimulation mismatch therefore has the potential to impact binaural perception. ITD left-right discrimination thresholds were examined in 23 postlingually-deafened adult bilateral cochlear-implant listeners, using low-rate constant-amplitude pulse trains presented via direct stimulation to single electrodes in each ear. Angular insertion depth and scalar location measured from computed-tomography (CT) scans were used to quantify interaural mismatch, and their association with binaural performance was assessed. Number-matched electrodes displayed a median interaural insertion-depth mismatch of 18° and generally yielded best or near-best ITD discrimination thresholds. Two listeners whose discrimination thresholds did not show this pattern were confirmed via CT to have atypical array placement. Listeners with more number-matched electrode pairs located in the scala tympani displayed better thresholds than listeners with fewer such pairs. ITD tuning curves as a function of interaural electrode separation were broad; bandwidths at twice the threshold minimum averaged 10.5 electrodes (equivalent to 5.9 mm for a Cochlear-brand pre-curved array). Larger angular insertion-depth differences were associated with wider bandwidths. Wide ITD tuning curve bandwidths appear to be a product of both monopolar stimulation and angular insertion-depth mismatch. Cases of good ITD sensitivity with very wide bandwidths suggest that precise matching of insertion depth is not critical for discrimination thresholds. Further prioritizing scala tympani location at implantation should, however, benefit ITD sensitivity.

Differing Bilateral Benefits for Spatial Release From Masking and Sound Localization Accuracy Using Bone Conduction Devices

OBJECTIVES

Normal binaural hearing facilitates spatial hearing and therefore many everyday listening tasks, such as understanding speech against a backdrop of competing sounds originating from various locations, and localization of sounds. For stimulation with bone conduction hearing devices (BCD), used to alleviate conductive hearing losses, limited transcranial attenuation results in cross-stimulation so that both cochleae are stimulated from the position of the bone conduction transducer. As such, interaural time and level differences, hallmarks of binaural hearing, are unpredictable at the level of the inner ears. The aim of this study was to compare spatial hearing by unilateral and bilateral BCD stimulation in normal-hearing listeners with simulated bilateral conductive hearing loss.

DESIGN

Bilateral conductive hearing loss was reversibly induced in 25 subjects (mean age = 28.5 years) with air conduction and bone conduction (BC) pure-tone averages across 0.5, 1, 2, and 4 kHz (PTA 4 ) <5 dB HL. The mean (SD) PTA 4 for the simulated conductive hearing loss was 48.2 dB (3.8 dB). Subjects participated in a speech-in-speech task and a horizontal sound localization task in a within-subject repeated measures design (unilateral and bilateral bone conduction stimulation) using Baha 5 clinical sound processors on a softband. For the speech-in-speech task, the main outcome measure was the threshold for 40% correct speech recognition when masking speech and target speech were both colocated (0°) and spatially and symmetrically separated (target 0°, maskers ±30° and ±150°). Spatial release from masking was quantified as the difference between colocated and separated masking and target speech thresholds. For the localization task, the main outcome measure was the overall variance in localization accuracy quantified as an error index (0.0 = perfect performance; 1.0 = random performance). Four stimuli providing various spatial cues were used in the sound localization task.

RESULTS

The bilateral BCD benefit for recognition thresholds of speech in competing speech was statistically significant but small regardless if the masking speech signals were colocated with, or spatially and symmetrically separated from, the target speech. Spatial release from masking was identical for unilateral and bilateral conditions, and significantly different from zero. A distinct bilateral BCD sound localization benefit existed but varied in magnitude across stimuli. The smallest benefit occurred for a low-frequency stimulus (octave-filtered noise, CF = 0.5 kHz), and the largest benefit occurred for unmodulated broadband and narrowband (octave-filtered noise, CF = 4.0 kHz) stimuli. Sound localization by unilateral BCD was poor across stimuli.

CONCLUSIONS

Results suggest that the well-known transcranial transmission of BC sound affects bilateral BCD benefits for spatial processing of sound in differing ways. Results further suggest that patients with bilateral conductive hearing loss and BC thresholds within the normal range may benefit from a bilateral fitting of BCD, particularly for horizontal localization of sounds.

A system for spatial hearing research

The spatial hearing experiments can be simulated using high-fidelity headphones. But these simulated experiments do not account for individual variations and are difficult to investigate when the listener is wearing hearing devices. Hence, the free-field systems are ideal for spatial hearing experiments. However, these systems are not readily available and must be customized based on experimental needs. This paper provides a brief overview of a spatial hearing research facility that is customized to perform experiments on individuals with normal hearing and hearing aid users. •

This setup enables the assessment of spatial acuity with 10⁰ precision in the horizontal plane.

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The laboratory's universal design enables modifications based on experimental needs with minimum effort.

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The signal processing and response acquisition systems are custom designed using MATLAB.

Can visual capture of sound separate auditory streams?

In noisy contexts, sound discrimination improves when the auditory sources are separated in space. This phenomenon, named Spatial Release from Masking (SRM), arises from the interaction between the auditory information reaching the ear and spatial attention resources. To examine the relative contribution of these two factors, we exploited an audio-visual illusion in a hearing-in-noise task to create conditions in which the initial stimulation to the ears is held constant, while the perceived separation between speech and masker is changed illusorily (visual capture of sound). In two experiments, we asked participants to identify a string of five digits pronounced by a female voice, embedded in either energetic (Experiment 1) or informational (Experiment 2) noise, before reporting the perceived location of the heard digits. Critically, the distance between target digits and masking noise was manipulated both physically (from 22.5 to 75.0 degrees) and illusorily, by pairing target sounds with visual stimuli either at same (audio-visual congruent) or different positions (15 degrees offset, leftward or rightward: audio-visual incongruent). The proportion of correctly reported digits increased with the physical separation between the target and masker, as expected from SRM. However, despite effective visual capture of sounds, performance was not modulated by illusory changes of target sound position. Our results are compatible with a limited role of central factors in the SRM phenomenon, at least in our experimental setting. Moreover, they add to the controversial literature on the limited effects of audio-visual capture in auditory stream separation.

Measuring and Modeling Cue Dependent Spatial Release from Masking in the Presence of Typical Delays in the Treatment of Hearing Loss

In asymmetric treatment of hearing loss, processing latencies of the modalities typically differ. This often alters the reference interaural time difference (ITD) (i.e., the ITD at 0° azimuth) by several milliseconds. Such changes in reference ITD have shown to influence sound source localization in bimodal listeners provided with a hearing aid (HA) in one and a cochlear implant (CI) in the contralateral ear. In this study, the effect of changes in reference ITD on speech understanding, especially spatial release from masking (SRM) in normal-hearing subjects was explored. Speech reception thresholds (SRT) were measured in ten normal-hearing subjects for reference ITDs of 0, 1.75, 3.5, 5.25 and 7 ms with spatially collocated (S₀N₀) and spatially separated (S₀N₉₀) sound sources. Further, the cues for separation of target and masker were manipulated to measure the effect of a reference ITD on unmasking by A) ITDs and interaural level differences (ILDs), B) ITDs only and C) ILDs only. A blind equalization-cancellation (EC) model was applied to simulate all measured conditions. SRM decreased significantly in conditions A) and B) when the reference ITD was increased: In condition A) from 8.8 dB SNR on average at 0 ms reference ITD to 4.6 dB at 7 ms, in condition B) from 5.5 dB to 1.1 dB. In condition C) no significant effect was found. These results were accurately predicted by the applied EC-model. The outcomes show that interaural processing latency differences should be considered in asymmetric treatment of hearing loss.

Effects of Simulated and Profound Unilateral Sensorineural Hearing Loss on Recognition of Speech in Competing Speech

OBJECTIVES

Unilateral hearing loss (UHL) is a condition as common as bilateral hearing loss in adults. Because of the unilaterally reduced audibility associated with UHL, binaural processing of sounds may be disrupted. As a consequence, daily tasks such as listening to speech in a background of spatially distinct competing sounds may be challenging. A growing body of subjective and objective data suggests that spatial hearing is negatively affected by UHL. However, the type and degree of UHL vary considerably in previous studies. The aim here was to determine the effect of a profound sensorineural UHL, and of a simulated UHL, on recognition of speech in competing speech, and the binaural and monaural contributions to spatial release from masking, in a demanding multisource listening environment.

DESIGN

Nine subjects (25 to 61 years) with profound sensorineural UHL [mean pure-tone average (PTA) across 0.5, 1, 2, and 4 kHz = 105 dB HL] and normal contralateral hearing (mean PTA = 7.2 dB HL) were included based on the criterion that the target and competing speech were inaudible in the ear with hearing loss. Thirteen subjects with normal hearing (19 to 60 years; mean left PTA = 4.1 dB HL; mean right PTA = 5.5 dB HL) contributed data in normal and simulated "mild-to-moderate" UHL conditions (PTA = 38.6 dB HL). The main outcome measure was the threshold for 40% correct speech recognition in colocated (0°) and spatially and symmetrically separated (±30° and ±150°) competing speech conditions. Spatial release from masking was quantified as the threshold difference between colocated and separated conditions.

RESULTS

Thresholds in profound UHL were higher (worse) than normal hearing in separated and colocated conditions, and comparable to simulated UHL. Monaural spatial release from masking, that is, the spatial release achieved by subjects with profound UHL, was significantly different from zero and 49% of the magnitude of the spatial release from masking achieved by subjects with normal hearing. There were subjects with profound UHL who showed negative spatial release, whereas subjects with normal hearing consistently showed positive spatial release from masking in the normal condition. The simulated UHL had a larger effect on the speech recognition threshold for separated than for colocated conditions, resulting in decreased spatial release from masking. The difference in spatial release between normal-hearing and simulated UHL conditions increased with age.

CONCLUSIONS

The results demonstrate that while recognition of speech in colocated and separated competing speech is impaired for profound sensorineural UHL, spatial release from masking may be possible when competing speech is symmetrically distributed around the listener. A "mild-to-moderate" simulated UHL decreases spatial release from masking compared with normal-hearing conditions and interacts with age, indicating that small amounts of residual hearing in the UHL ear may be more beneficial for separated than for colocated interferer conditions for young listeners.

Factor Analysis on Multiple Auditory Processing Assessment-2 and Listening in Spatialized Noise-Sentences Test in Children

Introduction There is need for greater understanding of tests used in assessing all aspects of auditory processing disorder (APD). This is important so that specific deficits can be identified and later remediated with the smallest possible test battery. The American Speech-Language-Hearing Association (ASHA) recommends five areas/domains for behavioral assessment: (a) temporal, (b) binaural (dichotic) separation/integration, (c) monaural low redundancy, (d) binaural interaction/localization/lateralization, and (e) auditory discrimination. Multiple-factor studies support the first three domains, which are most often used for APD assessment and which can be measured in a test battery normed within the United States (Multiple Auditory Processing Assessment-2 [MAPA-2]). This study was designed to determine if factored results from children would clarify whether a behavioral test (Listening in Spatialized Noise-Sentences Test [LiSN-S]) would factor within one of the first three domains or be separate, possibly within the fourth domain, binaural interaction. Method Fifty-one 8- and 9-year-olds with normal development and normal otoscopy and hearing responses bilaterally from 500 to 4000 Hz at 20 dB HL were recruited. Two sets of APD tests were administered: MAPA-2 and LiSN-S. Results Results verified the expected three-factor structure for MAPA-2. LiSN-S did not factor within one of those three, suggesting that some processes involved in the LiSN-S tasks require interactions between the two ears different from those involved in dichotic perception and thus better belong in the ASHA binaural interaction/lateralization domain. Conclusions Auditory processing abilities are sufficiently independent of each other that test batteries spanning the first three ASHA domains are not sensitive to at least some abilities in the fourth domain. This additional factor evidence is helpful. Future research should examine the utility of measuring additional factors within APD in order to achieve the most efficient and comprehensive test battery.

Listening Difficulties in Children: Behavior and Brain Activation Produced by Dichotic Listening of CV Syllables

Listening difficulties (LiD) are common in children with and without hearing loss. Impaired interactions between the two ears have been proposed as an important component of LiD when there is no hearing loss, also known as auditory processing disorder (APD). We examined the ability of 6-13 year old (y.o.) children with normal audiometric thresholds to identify and selectively attend to dichotically presented CV syllables using the Bergen Dichotic Listening Test (BDLT; www.dichoticlistening.com). Children were recruited as typically developing (TD; n = 39) or having LiD (n = 35) based primarily on composite score of the ECLiPS caregiver report. Different single syllables (ba, da, ga, pa, ta, ka) were presented simultaneously to each ear (6 × 36 trials). Children reported the syllable heard most clearly (non-forced, NF) or the syllable presented to the right [forced right (FR)] or left [forced left (FL)] ear. Interaural level differences (ILDs) manipulated bottom-up perceptual salience. Dichotic listening (DL) data [correct responses, laterality index (LI)] were analyzed initially by group (LiD, TD), age, report method (NF, FR, FL), and ILD (0, ± 15 dB) and compared with speech-in-noise thresholds (LiSN-S) and cognitive performance (NIH Toolbox). fMRI measured brain activation produced by a receptive speech task that segregated speech, phonetic, and intelligibility components. Some activated areas [planum temporale (PT), inferior frontal gyrus (IFG), and orbitofrontal cortex (OFC)] were correlated with dichotic results in TD children only. Neither group, age, nor report method affected the LI of right/left recall. However, a significant interaction was found between ear, group, and ILD. Laterality indices were small and tended to increase with age, as previously reported. Children with LiD had significantly larger mean LIs than TD children for stimuli with ILDs, especially those favoring the left ear. Neural activity associated with Speech, Phonetic, and Intelligibility sentence cues did not differ significantly between groups. Significant correlations between brain activity level and BDLT were found in several frontal and temporal locations for the TD but not for the LiD group. Overall, the children with LiD had only subtle differences from TD children in the BDLT, and correspondingly minor changes in brain activation.

A New Speech-in-Noise Test for Measuring Informational Masking in Speech Perception Among Elderly Listeners

Introduction Elderly listeners have reported concerns about speech perception in noisy environments. This partly occurs because of their increased informational masking (IM). This study aimed to develop a Persian coordinate response measure (CRM) corpus and a novel speech-in-noise test for measuring IM. Material and methods A cross-sectional validation study was conducted in two parts. Part one was the determination of the validity and reliability of the Persian CRM corpus. Part two consisted of measuring the IM at five signal-to-noise ratio (SNR; -6,-3, 0, +3, and +6) in two conditions: one with the target and masker speaker of the same sex and one with the target and masker speaker of different sexes. In each condition, the IM measurements were performed at a 45° separation angle of target and maskers and as a co-location of the speakers. A group of young listeners aged 20 to 40 years and a group of elderly listeners aged 60 to 75 years were recruited (50 study participants in part one and 47 in part two). The study was conducted from July 2018 to March 2019 at the Iran University Medical Sciences audiology clinic. Content validity ratio, content validity index, impact score, Spearman's test, and Mann-Whitney's test were used for statistical analysis. Results The Persian CRM corpus showed acceptable validity and reliability in each group (p < 0.001). The results suggested that in both azimuth locations and at SNRs of 0, -3, and -6, the IM amount in the elderly group was significantly higher (p < 0.003) than in the young group at conditions of target and masker speakers of opposite-sex. However, in cases where both target and masker speakers were of the same sex, a significant difference was observed at an SNR of 0 in angular separation and SNRs of +3 and 0 at co-located situations (p < 0.001). Conclusion A validated Persian CRM corpus has been collected for use in IM measurement studies. Overall, the IM of elderly listeners was higher than younger listeners in low-cue situations such as lower SNR. Therefore, a novel speech-in-noise test for measuring IM was validated to use in speech perception studies in the elderly population.

Binaural sensitivity and release from speech-on-speech masking in listeners with and without hearing loss

Listeners with sensorineural hearing loss routinely experience less spatial release from masking (SRM) in speech mixtures than listeners with normal hearing. Hearing-impaired listeners have also been shown to have degraded temporal fine structure (TFS) sensitivity, a consequence of which is degraded access to interaural time differences (ITDs) contained in the TFS. Since these "binaural TFS" cues are critical for spatial hearing, it has been hypothesized that degraded binaural TFS sensitivity accounts for the limited SRM experienced by hearing-impaired listeners. In this study, speech stimuli were noise-vocoded using carriers that were systematically decorrelated across the left and right ears, thus simulating degraded binaural TFS sensitivity. Both (1) ITD sensitivity in quiet and (2) SRM in speech mixtures spatialized using ITDs (or binaural release from masking; BRM) were measured as a function of TFS interaural decorrelation in young normal-hearing and hearing-impaired listeners. This allowed for the examination of the relationship between ITD sensitivity and BRM over a wide range of ITD thresholds. This paper found that, for a given ITD sensitivity, hearing-impaired listeners experienced less BRM than normal-hearing listeners, suggesting that binaural TFS sensitivity can account for only a modest portion of the BRM deficit in hearing-impaired listeners. However, substantial individual variability was observed.

Direct-to-Consumer Hearing Devices: Capabilities, Costs, and Cosmetics

Direct-to-consumer (DTC) hearing devices can be purchased without consulting a hearing health professional. This project aims to compare 28 DTC devices with the most popular hearing aid supplied by the U.K. National Health Service (NHS). The comparison was based on technical performance, cosmetic acceptability, and the ability to match commonly used gain and slope targets. Electroacoustic performance was evaluated in a 2-cc coupler. Match to prescription target for both gain and slope was measured on a Knowles Electronic Manikin for Acoustic Research using a mild and also a moderate sloping hearing loss. Using an online blinded paired comparison of each DTC and the NHS reference device, 126 participants (50 were hearing aid users and 76 were nonhearing aid users) assessed the cosmetic appearance and rated their willingness-to-wear the DTC devices. The results revealed that higher purchase prices were generally associated with a better match to prescribed gain–frequency response shapes, lower distortion, wider bandwidth, better cosmetic acceptability, and higher willingness-to-wear. On every parameter measured, there were devices that performed worse than the NHS device. Most of the devices were rated lower in terms of aesthetic design than the NHS device and provided gain–frequency responses and maximum output levels that were markedly different from those prescribed for commonly encountered audiograms. Because of the absence or inflexibility of most of the devices, they have the potential to deliver poor sound quality and uncomfortably loud sounds. The challenge for manufacturers is to develop low-cost products with cosmetic appeal and appropriate electroacoustic characteristics.

Spatial Release From Masking Under Different Reverberant Conditions in Young and Elderly Subjects: Effect of Moving or Stationary Maskers at Circular and Radial Conditions

Purpose Normal-hearing and hard-of-hearing listeners suffer from reduced speech intelligibility in noisy and reverberant environments. Although daily listening environments are in constant motion, most researchers have only studied speech-in-noise perception for stationary masker locations. The aim of this study was to investigate the spatial release from masking (SRM) of circularly and radially moving maskers under different room acoustic conditions for young and elderly subjects. Method Twelve young subjects with normal hearing and 12 elderly subjects with normal hearing or mild hearing loss were tested. Several different room acoustic conditions were simulated and reproduced via headphones using binaural synthesis. The target speech stream consisted of German digit triplets, and masker stream consisted of quasistationary noise with matched long-term averaged speech spectra. During the experiment, the position of the masker was changed to be in different stationary positions, or varied continuously. In the latter case, it was moved either on a circular trajectory spanning a 90° azimuth angle or on a radial trajectory linearly increasing the distance to the receiver from 0.5 m to 1.8 m. Absorption characteristics of the virtual room's surfaces were changed, recreating an anechoic room, a treated room with mean reverberation times (RT60) = 0.48 s, and an untreated room with mean RT60 = 1.26 s. Results For the circular condition, a significant difference was found between moving and stationary maskers, F(4, 44) = 20.91, p < .001, with a bigger SRM for stationary maskers than moving masker conditions. Also, both age groups displayed a significant decrease in SRM over the reverberation conditions: F(2, 22) = 12.24, p < .001. For the radial condition, both age groups showed a significant decrease in SRM over the reverberation conditions, F(2, 22) = 13.62, p < .001, as well as the moving and stationary masker conditions, F(8, 88) = 29.23, p < .001. In general, the SRM of a moving masker decreased when the reverberation increased, especially for elderly subjects. Conclusions A radially moving masker led to improved SRM in an anechoic environment for both age groups, whereas a circularly moving masker caused degraded SRM, especially for elderly subjects in the highly reverberant environment. Supplemental Material https://doi.org/10.23641/asha.9795371.

Impoverished auditory cues limit engagement of brain networks controlling spatial selective attention

Spatial selective attention enables listeners to process a signal of interest in natural settings. However, most past studies on auditory spatial attention used impoverished spatial cues: presenting competing sounds to different ears, using only interaural differences in time (ITDs) and/or intensity (IIDs), or using non-individualized head-related transfer functions (HRTFs). Here we tested the hypothesis that impoverished spatial cues impair spatial auditory attention by only weakly engaging relevant cortical networks. Eighteen normal-hearing listeners reported the content of one of two competing syllable streams simulated at roughly +30° and -30° azimuth. The competing streams consisted of syllables from two different-sex talkers. Spatialization was based on natural spatial cues (individualized HRTFs), individualized IIDs, or generic ITDs. We measured behavioral performance as well as electroencephalographic markers of selective attention. Behaviorally, subjects recalled target streams most accurately with natural cues. Neurally, spatial attention significantly modulated early evoked sensory response magnitudes only for natural cues, not in conditions using only ITDs or IIDs. Consistent with this, parietal oscillatory power in the alpha band (8-14 ​Hz; associated with filtering out distracting events from unattended directions) showed significantly less attentional modulation with isolated spatial cues than with natural cues. Our findings support the hypothesis that spatial selective attention networks are only partially engaged by impoverished spatial auditory cues. These results not only suggest that studies using unnatural spatial cues underestimate the neural effects of spatial auditory attention, they also illustrate the importance of preserving natural spatial cues in assistive listening devices to support robust attentional control.

British children's performance on the listening in spatialised noise-sentences test (LISN-S)

Objective: To investigate whether British children's performance is equivalent to North American norms on the listening in spatialised noise-sentences test (LiSN-S). Design: Prospective study comparing the performance of a single British group of children to North-American norms on the LiSN-S (North American version). Study sample: The British group was composed of 46 typically developing children, aged 6-11 years 11 months, from a mainstream primary school in London. Results: No significant difference was observed between the British's group performance and the North-American norms for Low-cue, High-cue, Spatial Advantage and Total Advantage measure. The British group presented a significantly lower performance only for Talker Advantage measure (z-score: 0.35, 95% confidence interval -0.12 to -0.59). Age was significantly correlated with all unstandardised measures. Conclusion: Our results indicate that, when assessing British children, it would be appropriate to add a corrective factor of 0.35 to the z-score value obtained for the Talker Advantage in order to compare it to the North-American norms. This strategy would enable the use of LiSN-S in the UK to assess auditory stream segregation based on spatial cues.

The effects of auditory spatial training on informational masking release in elderly listeners: a study protocol for a randomized clinical trial

Background: Regarding the strong auditory spatial plasticity capability of the central auditory system and the effect of short-term and long-term rehabilitation programs in elderly people, it seems that an auditory spatial training can help this population in informational masking release and better track speech in noisy environments. The main purposes of this study are developing an informational masking measurement test and an auditory spatial training program. Protocol: This study will be conducted in two parts. Part 1: develop and determine the validity of an informational masking measurement test by recruiting two groups of young (n=50) and old (n=50) participants with normal hearing who have no difficulty in understanding speech in noisy environments. Part 2 (clinical trial): two groups of 60-75-year-olds with normal hearing, who complain about difficulty in speech perception in noisy environments, will participate as control and intervention groups to examine the effect of auditory spatial training. Intervention: 8 sessions of auditory spatial training. The informational masking measurement test and Speech, Spatial and Qualities of Hearing Scale will be compared before intervention, immediately after intervention, and one month after intervention between the two groups. Discussion: Since auditory training programs do not deal with informational masking release, an auditory spatial training will be designed, aiming to improve hearing in noisy environments for elderly populations. Trial registration: Iranian Registry of Clinical Trials ( IRCT20190118042404N1) on 25 th February 2019.

The effects of auditory spatial training on informational masking release in elderly listeners: a study protocol for a randomized clinical trial

Background: Regarding the strong auditory spatial plasticity capability of the central auditory system and the effect of short-term and long-term rehabilitation programs in elderly people, it seems that an auditory spatial training can help this population in informational masking release and better track speech in noisy environments. The main purposes of this study are developing an informational masking measurement test and an auditory spatial training program. Protocol: This study will be conducted in two parts. Part 1: develop and determine the validity of an informational masking measurement test by recruiting two groups of young (n=50) and old (n=50) participants with normal hearing who have no difficulty in understanding speech in noisy environments. Part 2 (clinical trial): two groups of 60-75-year-olds with normal hearing, who complain about difficulty in speech perception in noisy environments, will participate as control and intervention groups to examine the effect of auditory spatial training. Intervention: 15 sessions of auditory spatial training. The informational masking measurement test and Speech, Spatial and Qualities of Hearing Scale will be compared before intervention, immediately after intervention, and five weeks after intervention between the two groups. Discussion: Since auditory training programs do not deal with informational masking release, an auditory spatial training will be designed, aiming to improve hearing in noisy environments for elderly populations. Trial registration: Iranian Registry of Clinical Trials ( IRCT20190118042404N1) on 25 th February 2019.

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.

Listening through hearing aids affects spatial perception and speech intelligibility in normal-hearing listeners

Cubick and Dau [(2016). Acta Acust. Acust. 102, 547-557] showed that speech reception thresholds (SRTs) in noise, obtained with normal-hearing listeners, were significantly higher with hearing aids (HAs) than without. Some listeners reported a change in their spatial perception of the stimuli due to the HA processing, with auditory images often being broader and closer to the head or even internalized. The current study investigated whether worse speech intelligibility with HAs might be explained by distorted spatial perception and the resulting reduced ability to spatially segregate the target speech from the interferers. SRTs were measured in normal-hearing listeners with or without HAs in the presence of three interfering talkers or speech-shaped noises. Furthermore, listeners were asked to sketch their spatial perception of the acoustic scene. Consistent with the previous study, SRTs increased with HAs. Spatial release from masking was lower with HAs than without. The effects were similar for noise and speech maskers and appeared to be accounted for by changes to energetic masking. This interpretation was supported by results from a binaural speech intelligibility model. Even though the sketches indicated a change of spatial perception with HAs, no direct link between spatial perception and segregation of talkers could be shown.

How aging impacts the encoding of binaural cues and the perception of auditory space

Over the years, the effect of aging on auditory function has been investigated in animal models and humans in an effort to characterize age-related changes in both perception and physiology. Here, we review how aging may impact neural encoding and processing of binaural and spatial cues in human listeners with a focus on recent work by the authors as well as others. Age-related declines in monaural temporal processing, as estimated from measures of gap detection and temporal fine structure discrimination, have been associated with poorer performance on binaural tasks that require precise temporal processing. In lateralization and localization tasks, as well as in the detection of signals in noise, marked age-related changes have been demonstrated in both behavioral and electrophysiological measures and have been attributed to declines in neural synchrony and reduced central inhibition with advancing age. Evidence for such mechanisms, however, are influenced by the task (passive vs. attending) and the stimulus paradigm (e.g., static vs. continuous with dynamic change). That is, cortical auditory evoked potentials (CAEP) measured in response to static interaural time differences (ITDs) are larger in older versus younger listeners, consistent with reduced inhibition, while continuous stimuli with dynamic ITD changes lead to smaller responses in older compared to younger adults, suggestive of poorer neural synchrony. Additionally, the distribution of cortical activity is broader and less asymmetric in older than younger adults, consistent with the hemispheric asymmetry reduction in older adults model of cognitive aging. When older listeners attend to selected target locations in the free field, their CAEP components (N1, P2, P3) are again consistently smaller relative to younger listeners, and the reduced asymmetry in the distribution of cortical activity is maintained. As this research matures, proper neural biomarkers for changes in spatial hearing can provide objective evidence of impairment and targets for remediation. Future research should focus on the development and evaluation of effective approaches for remediating these spatial processing deficits associated with aging and hearing loss.

Bilateral Versus Unilateral Cochlear Implantation in Adult Listeners: Speech-On-Speech Masking and Multitalker Localization

Binaural hearing helps normal-hearing listeners localize sound sources and understand speech in noise. However, it is not fully understood how far this is the case for bilateral cochlear implant (CI) users. To determine the potential benefits of bilateral over unilateral CIs, speech comprehension thresholds (SCTs) were measured in seven Japanese bilateral CI recipients using Helen test sentences (translated into Japanese) in a two-talker speech interferer presented from the front (co-located with the target speech), ipsilateral to the first-implanted ear (at +90° or -90°), and spatially symmetric at ±90°. Spatial release from masking was calculated as the difference between co-located and spatially separated SCTs. Localization was assessed in the horizontal plane by presenting either male or female speech or both simultaneously. All measurements were performed bilaterally and unilaterally (with the first implanted ear) inside a loudspeaker array. Both SCTs and spatial release from masking were improved with bilateral CIs, demonstrating mean bilateral benefits of 7.5 dB in spatially asymmetric and 3 dB in spatially symmetric speech mixture. Localization performance varied strongly between subjects but was clearly improved with bilateral over unilateral CIs with the mean localization error reduced by 27°. Surprisingly, adding a second talker had only a negligible effect on localization.

Effect of audibility on better-ear glimpsing as a function of frequency in normal-hearing and hearing-impaired listeners

Better-ear glimpsing (BEG) is an auditory phenomenon that helps understanding speech in noise by utilizing interaural level differences (ILDs). The benefit provided by BEG is limited in hearing-impaired (HI) listeners by reduced audibility at high frequencies. Rana and Buchholz [(2016). J. Acoust. Soc. Am. 140(2), 1192-1205] have shown that artificially enhancing ILDs at low and mid frequencies can help HI listeners understanding speech in noise, but the achieved benefit is smaller than in normal-hearing (NH) listeners. To understand how far this difference is explained by differences in audibility, audibility was carefully controlled here in ten NH and ten HI listeners and speech reception thresholds (SRTs) in noise were measured in a spatially separated and co-located condition as a function of frequency and sensation level. Maskers were realized by noise-vocoded speech and signals were spatialized using artificially generated broadband ILDs. The spatial benefit provided by BEG and SRTs improved consistently with increasing sensation level, but was limited in the HI listeners by loudness discomfort. Further, the HI listeners performed similar to NH listeners when differences in audibility were compensated. The results help to understand the hearing aid gain that is required to maximize the spatial benefit provided by ILDs as a function of frequency.

The Benefits of Increased Sensation Level and Bandwidth for Spatial Release From Masking

OBJECTIVE

Spatial release from masking (SRM) can increase speech intelligibility in complex listening environments. The goal of the present study was to document how speech-in-speech stimuli could be best processed to encourage optimum SRM for listeners who represent a range of ages and amounts of hearing loss. We examined the effects of equating stimulus audibility among listeners, presenting stimuli at uniform sensation levels (SLs), and filtering stimuli at two separate bandwidths.

DESIGN

Seventy-one participants completed two speech intelligibility experiments (36 listeners in experiment 1; all 71 in experiment 2) in which a target phrase from the coordinate response measure (CRM) and two masking phrases from the CRM were presented simultaneously via earphones using a virtual spatial array, such that the target sentence was always at 0 degree azimuth angle and the maskers were either colocated or positioned at ±45 degrees. Experiments 1 and 2 examined the impacts of SL, age, and hearing loss on SRM. Experiment 2 also assessed the effects of stimulus bandwidth on SRM.

RESULTS

Overall, listeners' ability to achieve SRM improved with increased SL. Younger listeners with less hearing loss achieved more SRM than older or hearing-impaired listeners. It was hypothesized that SL and bandwidth would result in dissociable effects on SRM. However, acoustical analysis revealed that effective audible bandwidth, defined as the highest frequency at which the stimulus was audible at both ears, was the best predictor of performance. Thus, increasing SL seemed to improve SRM by increasing the effective bandwidth rather than increasing the level of already audible components.

CONCLUSIONS

Performance for all listeners, regardless of age or hearing loss, improved with an increase in overall SL and/or bandwidth, but the improvement was small relative to the benefits of spatial separation.

Spatial Release From Informational Masking: Evidence From Functional Near Infrared Spectroscopy

Informational masking (IM) can greatly reduce speech intelligibility, but the neural mechanisms underlying IM are not understood. Binaural differences between target and masker can improve speech perception. In general, improvement in masked speech intelligibility due to provision of spatial cues is called spatial release from masking. Here, we focused on an aspect of spatial release from masking, specifically, the role of spatial attention. We hypothesized that in a situation with IM background sound (a) attention to speech recruits lateral frontal cortex (LFCx) and (b) LFCx activity varies with direction of spatial attention. Using functional near infrared spectroscopy, we assessed LFCx activity bilaterally in normal-hearing listeners. In Experiment 1, two talkers were simultaneously presented. Listeners either attended to the target talker (speech task) or they listened passively to an unintelligible, scrambled version of the acoustic mixture (control task). Target and masker differed in pitch and interaural time difference (ITD). Relative to the passive control, LFCx activity increased during attentive listening. Experiment 2 measured how LFCx activity varied with ITD, by testing listeners on the speech task in Experiment 1, except that talkers either were spatially separated by ITD or colocated. Results show that directing of auditory attention activates LFCx bilaterally. Moreover, right LFCx is recruited more strongly in the spatially separated as compared with colocated configurations. Findings hint that LFCx function contributes to spatial release from masking in situations with IM.

Validating a Rapid, Automated Test of Spatial Release From Masking

PURPOSE

To evaluate the test-retest reliability of a headphone-based spatial release from a masking task with two maskers (referred to here as the SR2) and to describe its relationship to the same test done over loudspeakers in an anechoic chamber (the SR2A). We explore what thresholds tell us about certain populations (such as older individuals or individuals with hearing impairment) and discuss how the SR2 might be useful in the clinic.

METHOD

Fifty-four participants completed speech intelligibility tests in which a target phrase and two masking phrases from the Coordinate Response Measure corpus (Bolia, Nelson, Ericson, & Simpson, 2000) were presented either via earphones using a virtual spatial array or via loudspeakers in an anechoic chamber. For the SR2, the target sentence was always at 0° azimuth angle, and the maskers were either colocated at 0° or positioned at ± 45°. For the SR2A, the target was located at 0°, and the maskers were colocated or located at ± 15°, ± 30°, ± 45°, ± 90°, or ± 135°. Spatial release from masking was determined as the difference between thresholds in the colocated condition and each spatially separated condition. All participants completed the SR2 at least twice, and 29 of the individuals who completed the SR2 at least twice also participated in the SR2A. In a second experiment, 40 participants completed the SR2 8 times, and the changes in performance were evaluated as a function of test repetition.

RESULTS

Mean thresholds were slightly better on the SR2 after the first repetition but were consistent across 8 subsequent testing sessions. Performance was consistent for the SR2A, regardless of the number of times testing was repeated. The SR2, which simulates 45° separations of target and maskers, produced spatially separated thresholds that were similar to thresholds obtained with 30° of separation in the anechoic chamber. Over headphones and in the anechoic chamber, pure-tone average was a strong predictor of spatial release, whereas age only reached significance for colocated conditions.

CONCLUSIONS

The SR2 is a reliable and effective method of testing spatial release from masking, suitable for screening abnormal listening abilities and for tracking rehabilitation over time. Future work should focus on developing and validating rapid, automated testing to identify the ability of listeners to benefit from high-frequency amplification, smaller spatial separations, and larger spectral differences among talkers.

The effect of simulated unilateral hearing loss on horizontal sound localization accuracy and recognition of speech in spatially separate competing speech

Unilateral hearing loss (UHL) occurs in 25% of cases of congenital sensorineural hearing loss. Due to the unilaterally reduced audibility associated with UHL, everyday demanding listening situations may be disrupted despite normal hearing in one ear. The aim of this study was to quantify acute changes in recognition of speech in spatially separate competing speech and sound localization accuracy, and relate those changes to two levels of temporary induced UHL (UHL₃₀ and UHL₄₃; suffixes denote the average hearing threshold across 0.5, 1, 2, and 4 kHz) for 8 normal-hearing adults. A within-subject repeated-measures design was used (normal binaural conditions, UHL₃₀ and UHL₄₃). The main outcome measures were the threshold for 40% correct speech recognition and the overall variance in sound localization accuracy quantified by an Error Index (0 = perfect performance, 1.0 = random performance). Distinct and statistically significant deterioration in speech recognition (2.0 dB increase in threshold, p < 0.01) and sound localization (Error Index increase of 0.16, p < 0.001) occurred in the UHL₃₀ condition. Speech recognition did not significantly deteriorate further in the UHL₄₃ condition (1.0 dB increase in speech recognition threshold, p > 0.05), while sound localization was additionally impaired (Error Index increase of 0.33, p < 0.01) with an associated large increase in individual variability. Qualitative analyses on a subject-by-subject basis showed that high-frequency audibility was important for speech recognition, while low-frequency audibility was important for horizontal sound localization accuracy. While the data might not be entirely applicable to individuals with long-standing UHL, the results suggest a need for intervention for mild-to-moderate UHL.

Binaural masking release in symmetric listening conditions with spectro-temporally modulated maskers

Speech reception thresholds (SRTs) decrease as target and maskers are spatially separated (spatial release from masking, SRM). The current study systematically assessed how SRTs and SRM for a frontal target in a spatially symmetric masker configuration depend on spectro-temporal masker properties, the availability of short-time interaural level difference (ILD) and interaural time difference (ITD), and informational masking. Maskers ranged from stationary noise to single, interfering talkers and were modified by head-related transfer functions to provide: (i) different binaural cues (ILD, ITD, or both) and (ii) independent maskers in each ear ("infinite ILD"). Additionally, a condition was tested in which only information from short-time spectro-temporal segments of the ear with a favorable signal-to-noise ratio (better-ear glimpses) was presented. For noise-based maskers, ILD, ITD, and spectral changes related to masker location contributed similarly to SRM, while ILD cues played a larger role if temporal modulation was introduced. For speech maskers, glimpsing and perceived location contributed roughly equally and ITD contributed less. The "infinite ILD" condition might suggest better-ear glimpsing limitations resulting in a maximal SRM of 12 dB for maskers with low or absent informational masking. Comparison to binaural model predictions highlighted the importance of short-time processing and helped to clarify the contribution of the different binaural cues and mechanisms.

The role of interaural differences on speech intelligibility in complex multi-talker environments

Interaural differences in time (ITDs) and interaural differences in level (ILDs) contribute to a listener's ability to achieve spatial release from masking (SRM), and help to improve speech intelligibility in noisy environments. In this study, the extent to which ITDs and ILDs contribute to SRM and the relationships with aging and hearing loss were examined. SRM was greatest when stimuli were presented with consistent ITD and ILD, relative to ITD or ILD alone, all of which produced greater SRM than when ITD and ILD cues were in conflict with each other. This pattern was independent of age and hearing loss.

Temporal Fine-Structure Coding and Lateralized Speech Perception in Normal-Hearing and Hearing-Impaired Listeners

This study investigated the relationship between speech perception performance in spatially complex, lateralized listening scenarios and temporal fine-structure (TFS) coding at low frequencies. Young normal-hearing (NH) and two groups of elderly hearing-impaired (HI) listeners with mild or moderate hearing loss above 1.5 kHz participated in the study. Speech reception thresholds (SRTs) were estimated in the presence of either speech-shaped noise, two-, four-, or eight-talker babble played reversed, or a nonreversed two-talker masker. Target audibility was ensured by applying individualized linear gains to the stimuli, which were presented over headphones. The target and masker streams were lateralized to the same or to opposite sides of the head by introducing 0.7-ms interaural time differences between the ears. TFS coding was assessed by measuring frequency discrimination thresholds and interaural phase difference thresholds at 250 Hz. NH listeners had clearly better SRTs than the HI listeners. However, when maskers were spatially separated from the target, the amount of SRT benefit due to binaural unmasking differed only slightly between the groups. Neither the frequency discrimination threshold nor the interaural phase difference threshold tasks showed a correlation with the SRTs or with the amount of masking release due to binaural unmasking, respectively. The results suggest that, although HI listeners with normal hearing thresholds below 1.5 kHz experienced difficulties with speech understanding in spatially complex environments, these limitations were unrelated to TFS coding abilities and were only weakly associated with a reduction in binaural-unmasking benefit for spatially separated competing sources.

Better-ear glimpsing at low frequencies in normal-hearing and hearing-impaired listeners

Better-ear glimpsing is an auditory process that takes advantage of short-term interaural level differences (ILDs) to improve the understanding of speech in spatial fluctuating noise. Since ILDs are mainly present at high frequencies, where most hearing-impaired (HI) listeners have the strongest hearing loss, HI individuals cannot fully utilize ILDs for better-ear glimpsing, which may lead to poorer understanding of speech in noise. This problem may be alleviated by hearing aids that artificially generate ILDs at low frequencies where hearing is typically less impaired. The present study therefore investigated the spatial benefit in speech intelligibility that is provided by better-ear glimpsing with low-frequency extended ILDs in a symmetric two-distractor speech background. Speech reception thresholds were measured in a spatially co-located and separated condition as a function of frequency region in ten normal-hearing (NH) and ten mild-to-moderate sensorineural HI subjects. In both groups the extended ILDs provided a substantial spatial advantage on top of the advantage already provided by natural ILDs. Moreover, the spatial advantage was largely independent of frequency region, suggesting that both NH and HI subjects can utilize low-frequency ILDs for improving speech understanding in noise. Overall performance as well as spatial advantage was reduced in the HI group.

Effect of audibility on spatial release from speech-on-speech masking

This study investigated to what extent spatial release from masking (SRM) deficits in hearing-impaired adults may be related to reduced audibility of the test stimuli. Sixteen adults with sensorineural hearing loss and 28 adults with normal hearing were assessed on the Listening in Spatialized Noise-Sentences test, which measures SRM using a symmetric speech-on-speech masking task. Stimuli for the hearing-impaired listeners were delivered using three amplification levels (National Acoustic Laboratories - Revised Profound prescription (NAL-RP) +25%, and NAL-RP +50%), while stimuli for the normal-hearing group were filtered to achieve matched audibility. SRM increased as audibility increased for all participants. Thus, it is concluded that reduced audibility of stimuli may be a significant factor in hearing-impaired adults' reduced SRM even when hearing loss is compensated for with linear gain. However, the SRM achieved by the normal hearers with simulated audibility loss was still significantly greater than that achieved by hearing-impaired listeners, suggesting other factors besides audibility may still play a role.

Sources of pathology underlying listening disorders in children

Some children referred to audiology and developmental disability services have listening difficulties, despite normal audiograms. These children may be tested for 'auditory processing disorder' (APD), a controversial construct suggesting that neural dysfunction in the central auditory system leads to impaired auditory perception. An important question, not currently tested in clinical evaluation, is whether listening difficulties result from problems with bottom-up auditory sensory processing or top-down modulating cognition. Perceptual variability and poor performance on standardized tests suggest that listening difficulties are primarily cognitive in origin. However, evidence for impaired olivocochlear function and temporal processing deficits may implicate peripheral or central auditory dysfunction in some cases. Wide-spread, top-down modulation of auditory cortical, brainstem and ear function suggests that afferent and efferent control systems may not be simple to segregate. During normal maturation, hearing appears to develop in proportion to the complexity of both stimuli and tasks. But some younger individuals have mature hearing, highlighting individual differences that suggest APD may be due to a generalized developmental delay. Recent studies have investigated specific hypotheses showing, for example, that spatial hearing and executive function are compromised in some children with listening difficulties. Using speech stimuli (e.g. consonant-vowel syllables) to examine auditory brainstem responses, and psychophysiological relations between dichotic hearing and cortical physiology, various effects of auditory experience and development point the way to promising approaches for further studies of APD. Newer technology, from genetic sequencing to MRI, may have the sensitivity to test whether and how frequently APD is associated with impaired processing in the auditory system.