Development of the Everyday Conversational Sentences in Noise test

The impact of tinnitus on speech perception in noise: a systematic review and meta-analysis

PURPOSE

Tinnitus is a condition that causes people to hear sounds without an external source. One significant issue arising from this condition is the difficulty in communicating, especially in the presence of noisy backgrounds. The process of understanding speech in challenging situations requires both cognitive and auditory abilities. Since tinnitus presents unique challenges, it is important to investigate how it affects speech perception in noise.

METHOD

In this review, 32 articles were investigated to determine the effect of tinnitus on the effect of speech in noise perception performance. Based on the meta-analysis performed using a random-effects model, meta-regression was used to explore the moderating effects of age and hearing acuity.

RESULTS

A total of 32 studies were reviewed, and the results of the meta-analysis revealed that tinnitus significantly impacts speech in terms of noise perception performance. Additionally, the regression analysis revealed that age and hearing acuity are not significant predictors of speech in noise perception.

CONCLUSION

Our findings suggest that tinnitus affects speech perception in noisy environments due to cognitive impairments and central auditory processing deficits. Hearing loss and aging also contribute to reduced speech in noise performance. Interventions and further research are necessary to address individual challenges associated with continuous subjective tinnitus.

Hearing help-seeking, hearing device uptake and hearing health outcomes in individuals with subclinical hearing loss: a systematic review

OBJECTIVE

This systematic review aims to examine the current literature on help-seeking, hearing device uptake, and hearing health outcomes in individuals with subclinical hearing loss.

DESIGN

Systematic review.

STUDY SAMPLE

Searches of three databases (CINAHL, MEDLINE (PubMed), and Scopus) yielded nine studies meeting the inclusion criteria. The quality of the included studies was determined using the National Institute of Health quality assessment tool. The studies' level of evidence was determined according to the Centre for Evidence-Based Medicine.

RESULTS

All included studies involved adult participants. Three studies examined help-seeking. Self-reported difficulty, poor speech-in-noise performance, and emotional responses to the hearing difficulty were identified as factors influencing help-seeking. Six studies examined the use of hearing devices as an intervention, including hearing aids (n = 4), hearables (n = 1), and FM systems (n = 1). Using hearing devices improved self-perceived hearing difficulty, speech-in-noise understanding, and motivation to address hearing difficulties. No studies focused on hearing device uptake. The quality assessment indicated limited methodological rigour across the studies, with varying levels of evidence.

CONCLUSIONS

Current evidence supports the use of hearing devices as an intervention for individuals with subclinical hearing loss. However, more research is essential, particularly focusing on help-seeking, diagnosis, treatment, and long-term outcomes using well-controlled study designs.

Feasibility of an Adaptive Version of the Everyday Conversational Sentences in Noise Test

PURPOSE

To investigate potential reasons for the mismatch between laboratory/clinic-based sentence-in-noise performance and real-world listening abilities, we recently developed a corpus of natural, spontaneously spoken speech with three vocal effort levels (Everyday Conversational Sentences in Noise [ECO-SiN]). Here, we examined the feasibility of using the ECO-SiN corpus for adaptive speech-in-noise testing, which might be a desirable format in certain situations (e.g., during a clinical visit).

METHOD

Ten young, normal-hearing adults, along with 20 older adults with hearing loss participated in the study. Speech reception thresholds (SRTs) were obtained using ECO-SiN sentences, which were systematically compared to the SRTs obtained using traditional Bamford-Kowal-Bench-like sentences.

RESULTS

Results demonstrated the properties of the test compared favorably with those of a standard test based on scripted and clearly spoken sentences. Moreover, whereas normal-hearing listeners received a benefit from an increase in vocal effort, the participants with hearing loss showed a disbenefit that increased with increasing hearing loss.

CONCLUSION

The adaptive version of the ECO-SiN test is feasible for research and clinical testing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25146338.

Visual Speech Improves Older and Younger Adults' Response Time and Accuracy for Speech Comprehension in Noise

Past research suggests that older adults expend more cognitive resources when processing visual speech than younger adults. If so, given resource limitations, older adults may not get as large a visual speech benefit as younger ones on a resource-demanding speech processing task. We tested this using a speech comprehension task that required attention across two talkers and a simple response (i.e., the question-and-answer task) and measured response time and accuracy. Specifically, we compared the size of visual speech benefit for older and younger adults. We also examined whether the presence of a visual distractor would reduce the visual speech benefit more for older than younger adults. Twenty-five older adults (12 females, MAge = 72) and 25 younger adults (17 females, MAge = 22) completed the question-and-answer task under time pressure. The task included the following conditions: auditory and visual (AV) speech; AV speech plus visual distractor; and auditory speech with static face images. Both age groups showed a visual speech benefit regardless of whether a visual distractor was also presented. Likewise, the size of the visual speech benefit did not significantly interact with age group for accuracy or the potentially more sensitive response time measure.

Developing a Real-Time Test to Investigate Conversational Speech Understanding

PURPOSE

This study aimed to develop and test a measure of real-time continuous speech understanding to be used with natural dialogues.

METHOD

The measure was based on a category monitoring paradigm and employed five existing recordings of natural dialogues from which the different test categories and associated target words were derived. For each dialogue, a listener was first given a semantic category and asked to press a button as quickly as possible whenever they heard an instance of the category. We tested 63 younger adults, using five semantic categories (family, media, season, temperature, and travel) at three noise levels (in quiet, 0 dB, and -5 dB signal-to-noise ratio [SNR]). Performance was measured in terms of accuracy and response time.

RESULTS

The results showed clear differences between the three noise conditions regardless of the semantic category. The peak of the response distribution was highest and earliest for the quiet condition and was reduced with decreasing SNR. The responses varied across categories, reflecting differences in the complexity of a given category or the typicality of the association between target words and their category. Broad categories and/or target words that were less directly associated with their category had decreased hit rates and increased response times.

CONCLUSION

The results were discussed in terms of the sensitivity (hit rate) of the performance measure, as well as whether it picked up higher level semantic, context, and discourse properties of the dialogues.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21561681.

The Effect of Age, Type of Noise, and Cochlear Implants on Adaptive Sentence-in-Noise Task

Adaptive tests of sentences in noise mimic the challenge of daily listening situations. The aims of the present study were to validate an adaptive version of the HeBio sentence test on normal hearing (NH) adults; to evaluate the effect of age and type of noise on speech reception threshold in noise (SRTn); and to test it on prelingual adults with cochlear implants (CI). In Experiment 1, 45 NH young adults listened to two lists accompanied by four-talker babble noise (4TBN). Experiment 2 presented the sentences amidst 4TBN or speech-shaped noise (SSN) to 80 participants in four age groups. In Experiment 3, 18 CI adult users with prelingual bilateral profound hearing loss performed the test amidst SSN, along with HeBio sentences and monosyllabic words in quiet and forward digits span. The main findings were as follows: SRTn for NH participants was normally distributed and had high test–retest reliability; SRTn was lower among adolescents and young adults than middle-aged and older adults, and were better for SSN than 4TBN; SRTn for CI users was higher and more variant than for NH and correlated with speech perception tests in quiet, digits span, and age at first CI. This suggests that the adaptive HeBio can be implemented in clinical and research settings with various populations.

Measuring Speech Intelligibility and Hearing-Aid Benefit Using Everyday Conversational Sentences in Real-World Environments

Laboratory and clinical-based assessments of speech intelligibility must evolve to better predict real-world speech intelligibility. One way of approaching this goal is to develop speech intelligibility tasks that are more representative of everyday speech communication outside the laboratory. Here, we evaluate speech intelligibility using both a standard sentence recall task based on clear, read speech (BKB sentences), and a sentence recall task consisting of spontaneously produced speech excised from conversations which took place in realistic background noises (ECO-SiN sentences). The sentences were embedded at natural speaking levels in six realistic background noises that differed in their overall level, which resulted in a range of fixed signal-to-noise ratios. Ten young, normal hearing participants took part in the study, along with 20 older participants with a range of levels of hearing loss who were tested with and without hearing-aid amplification. We found that scores were driven by hearing loss and the characteristics of the background noise, as expected, but also strongly by the speech materials. Scores obtained with the more realistic sentences were generally lower than those obtained with the standard sentences, which reduced ceiling effects for the majority of environments/listeners (but introduced floor effects in some cases). Because ceiling and floor effects limit the potential for observing changes in performance, benefits of amplification were highly dependent on the speech materials for a given background noise and participant group. Overall, the more realistic speech task offered a better dynamic range for capturing individual performance and hearing-aid benefit across the range of real-world environments we examined.

Spatial Resolution of Late Reverberation in Virtual Acoustic Environments

Late reverberation involves the superposition of many sound reflections, approaching the properties of a diffuse sound field. Since the spatially resolved perception of individual late reflections is impossible, simplifications can potentially be made for modelling late reverberation in room acoustics simulations with reduced spatial resolution. Such simplifications are desired for interactive, real-time virtual acoustic environments with applications in hearing research and for the evaluation of hearing supportive devices. In this context, the number and spatial arrangement of loudspeakers used for playback additionally affect spatial resolution. The current study assessed the minimum number of spatially evenly distributed virtual late reverberation sources required to perceptually approximate spatially highly resolved isotropic and anisotropic late reverberation and to technically approximate a spherically isotropic sound field. The spatial resolution of the rendering was systematically reduced by using subsets of the loudspeakers of an 86-channel spherical loudspeaker array in an anechoic chamber, onto which virtual reverberation sources were mapped using vector base amplitude panning. It was tested whether listeners can distinguish lower spatial resolutions of reproduction of late reverberation from the highest achievable spatial resolution in different simulated rooms. The rendering of early reflections remained unchanged. The coherence of the sound field across a pair of microphones at ear and behind-the-ear hearing device distance was assessed to separate the effects of number of virtual sources and loudspeaker array geometry. Results show that between 12 and 24 reverberation sources are required for the rendering of late reverberation in virtual acoustic environments.

Effect of Test Realism on Speech-in-noise Outcomes in Bilateral Cochlear Implant Users

OBJECTIVES

First, to evaluate the effect of laboratory-based test realism on speech intelligibility outcomes of cochlear implant users. Second, to conduct an exploratory investigation of speech intelligibility of cochlear implant users, including bilateral benefit, under realistic laboratory conditions.

DESIGN

For the first goal, the authors measured speech intelligibility scores of 15 bilateral cochlear implant recipients under three different test realism levels at two different signal-to-noise ratios (SNRs). The levels included (1) standard Bamford-Kowal-Bench-like sentences with spatially separated standard babble noise; (2) standard Bamford-Kowal-Bench-like sentences with three-dimensional recordings of actual situations; and (3) a variation of the second realism level where the sentences were obtained from natural effortful conversations. For the second goal, speech intelligibility of the realistic speech material was measured in six different acoustic scenes with realistic signal-to-noise ratios ranging from -5.8 dB to 3.2 dB.

RESULTS

Speech intelligibility was consistently highest in the most artificial (standard) test and lowest in the most realistic test. The effect of the realistic noise and that of the realistic speech material resulted in distinct SNR-dependent performance shifts with respect to their baselines. Speech intelligibility in realistic laboratory conditions was in general low, with mean scores around 60% at the highest SNR. Bilateral benefit provided on average a 7% benefit over unilateral speech understanding in the better-performing ear.

CONCLUSIONS

The results obtained here suggest that standard speech-in-noise tests overestimate the performance of cochlear implant recipients in the real world. To address this limitation, future assessments need to improve the realism over current tests by considering the realism of both, the speech and the noise materials. Likewise, speech intelligibility data under realistic conditions suggest that, insofar as these results can be considered representative of real-life performance, conversational speech and noise levels common to cochlear implant recipients are challenging in terms of speech intelligibility, with average scores around 60%. The findings and limitations are discussed alongside the factors affecting speech intelligibility.

Conversational distance adaptation in noise and its effect on signal-to-noise ratio in realistic listening environments

Everyday environments impose acoustical conditions on speech communication that require interlocutors to adapt their behavior to be able to hear and to be heard. Past research has focused mainly on the adaptation of speech level, while few studies investigated how interlocutors adapt their conversational distance as a function of noise level. Similarly, no study tested the interaction between distance and speech level adaptation in noise. In the present study, participant pairs held natural conversations while binaurally listening to identical noise recordings of different realistic environments (range of 53-92 dB sound pressure level), using acoustically transparent headphones. Conversations were in standing or sitting (at a table) conditions. Interlocutor distances were tracked using wireless motion-capture equipment, which allowed subjects to move closer or farther from each other. The results show that talkers adapt their voices mainly according to the noise conditions and much less according to distance. Distance adaptation was highest in the standing condition. Consequently, mainly in the loudest environments, listeners were able to improve the signal-to-noise ratio (SNR) at the receiver location in the standing condition compared to the sitting condition, which became less negative. Analytical approximations are provided for the conversational distance as well as the receiver-related speech and SNR.