1
|
Hisagi M, Barragan B, Diaz A, White K, Winter M. Auditory discrimination in aging bilinguals vs. monolinguals with and without hearing loss. FRONTIERS IN AGING 2024; 4:1302050. [PMID: 38274287 PMCID: PMC10808419 DOI: 10.3389/fragi.2023.1302050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
Demands for effective assessments of speech perception specific to the aging brain are increasing, as the impacts of hearing loss on an individual's functional health, socialization, and cognition have become more widely recognized. Understanding the mechanisms behind the optimal function of the aging brain in relation to speech and language is challenging, especially in the bilingual population where the language learning and language interference processes could be mistaken for perceptual difficulty. Age-related presbycusis is unavoidable, and the contributions of this sensorineural hearing loss (SNHL) process on impaired speech recognition are not completely understood. This lack of understanding of the effects of aging and bilingual language competency on speech perception can act as a barrier to successful auditory rehabilitation. The present study investigated the effects of aging on vowel sound discrimination in adult listeners (age 50+) with the following characteristics: American English (AE) monolinguals with normal hearing, simultaneous or early sequential Spanish-English (SE) bilinguals with normal hearing, and AE monolinguals with SNHL (AE-SNHL). The goal was to identify the differences in vowel sound discrimination performance between the monolingual and bilingual aging populations to guide future language assessments and intervention processes. English vowel discrimination was assessed using an AXB discrimination task in quiet and using the Quick Speech in Noise (QuickSIN) test. SE bilinguals were outperformed by AE and AE-SNHL monolinguals, suggesting SE bilinguals primarily use their L1 acoustic properties to discriminate speech segments. No significant difference was found in QuickSIN performance between the bilingual and the monolingual groups, but there was a significant difference between AE and AE-SNHL. In conclusion, vowel discrimination was affected by interference with the native language, while performance in the noise condition was affected by hearing loss. The results of this study contribute to our understanding of the age-related speech processing deficits from three different aging groups regarding the cognitive control system.
Collapse
Affiliation(s)
- Miwako Hisagi
- Department of Communication Disorders, Doctor of Audiology Program, California State University-Los Angeles, Los Angeles, CA, United States
| | - Beatriz Barragan
- Department of Audiology and Speech-Language Pathology, AT Still University, Mesa, AZ, United States
| | - Arlene Diaz
- Department of Communication Disorders, Doctor of Audiology Program, California State University-Los Angeles, Los Angeles, CA, United States
| | - Kai White
- Department of Communication Disorders, Doctor of Audiology Program, California State University-Los Angeles, Los Angeles, CA, United States
| | - Margaret Winter
- Department of Communication Disorders, Doctor of Audiology Program, California State University-Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
2
|
Rallapalli V, Schauer J, Souza P. Preference for Combinations of Hearing Aid Signal Processing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3100-3116. [PMID: 35881878 DOI: 10.1044/2022_jslhr-22-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to determine how multiple types of signal processing activated together influence listeners' preferences. METHOD Participants were adults with mild to moderately severe sensorineural hearing loss. Stimuli were spatialized low-context sentences mixed with six-talker babble at 3 and 8 dB signal-to-noise ratios (SNRs). Stimuli were processed with three common hearing aid processing algorithms: wide dynamic range compression (WDRC), frequency compression (FC), and digital noise reduction (DNR). A full-factorial design with two levels for each algorithm (WDRC & DNR: mild versus strong; FC: ON versus OFF; clinically relevant ranges) was evaluated. Preference was measured using a paired-comparison task within a choice-based conjoint analysis framework. Remote data collection methods were used. A signal fidelity metric quantified the acoustic effects across conditions. RESULTS At 3 dB SNR, participants preferred a combination of Slow WDRC and Mild DNR, although the mean preference was small (odds ratio close to 1). At both SNRs when Strong DNR was used, Fast WDRC was preferred over Slow WDRC. This may be related to signal fidelity, which was lower for the combination of Fast WDRC and Mild DNR and higher for the combination of Slow WDRC and either Mild DNR or Strong DNR. There was no effect of FC on preference or signal fidelity. CONCLUSIONS WDRC and DNR together influenced both listeners' preferences and signal fidelity in the investigated listening conditions. On average, the small effect sizes suggest that minor fine-tuning adjustments to hearing aid algorithms may not result in a substantial change in clinical outcomes.
Collapse
Affiliation(s)
- Varsha Rallapalli
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jacob Schauer
- Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Pamela Souza
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
- Knowles Hearing Center, Northwestern University, Evanston, IL
| |
Collapse
|
3
|
Souza PE, Ellis G, Marks K, Wright R, Gallun F. Does the Speech Cue Profile Affect Response to Amplitude Envelope Distortion? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2053-2069. [PMID: 34019777 PMCID: PMC8740712 DOI: 10.1044/2021_jslhr-20-00481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/13/2020] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
Purpose A broad area of interest to our group is to understand the consequences of the "cue profile" (a measure of how well a listener can utilize audible temporal and/or spectral cues for listening scenarios in which a subset of cues is distorted. The study goal was to determine if listeners whose cue profile indicated that they primarily used temporal cues for recognition would respond differently to speech-envelope distortion than listeners who utilized both spectral and temporal cues. Method Twenty-five adults with sensorineural hearing loss participated in the study. The listener's cue profile was measured by analyzing identification patterns for a set of synthetic syllables in which envelope rise time and formant transitions were varied. A linear discriminant analysis quantified the relative contributions of spectral and temporal cues to identification patterns. Low-context sentences in noise were processed with time compression, wide-dynamic range compression, or a combination of time compression and wide-dynamic range compression to create a range of speech-envelope distortions. An acoustic metric, a modified version of the Spectral Correlation Index, was calculated to quantify envelope distortion. Results A binomial generalized linear mixed-effects model indicated that envelope distortion, the cue profile, the interaction between envelope distortion and the cue profile, and the pure-tone average were significant predictors of sentence recognition. Conclusions The listeners with good perception of spectro-temporal contrasts were more resilient to the detrimental effects of envelope compression than listeners who used temporal cues to a greater extent. The cue profile may provide information about individual listening that can direct choice of hearing aid parameters, especially those parameters that affect the speech envelope.
Collapse
|
4
|
Abstract
OBJECTIVES Previous research has shown that the association between hearing aid-processed speech recognition and individual working memory ability becomes stronger in more challenging conditions (e.g., higher background noise levels) and with stronger hearing aid processing (e.g., fast-acting wide dynamic range compression, WDRC). To date, studies have assumed omnidirectional microphone settings and collocated speech and noise conditions to study such relationships. Such conditions fail to recognize that most hearing aids are fit with directional processing that may improve the signal to noise ratio (SNR) and speech recognition in spatially separated speech and noise conditions. Here, we considered the possibility that directional processing may reduce the signal distortion arising from fast-acting WDRC and in turn influence the relationship between working memory ability and speech recognition with WDRC processing. The combined effects of hearing aid processing (WDRC and directionality) and SNR were quantified using a signal modification metric (cepstral correlation), which measures temporal envelope changes in the processed signal with respect to a linearly amplified reference. It was hypothesized that there will be a weaker association between working memory ability and speech recognition for hearing aid processing conditions that result in overall less signal modification (i.e., fewer changes to the processed envelope). DESIGN Twenty-three individuals with bilateral, mild to moderately severe sensorineural hearing loss participated in the study. Participants were fit with a commercially available hearing aid, and signal processing was varied in two dimensions: (1) Directionality (omnidirectional [OMNI] versus fixed-directional [DIR]), and (2) WDRC speed (fast-acting [FAST] versus slow-acting [SLOW]). Sentence recognition in spatially separated multi-talker babble was measured across a range of SNRs: 0 dB, 5 dB, 10 dB, and quiet. Cumulative signal modification was measured with individualized hearing aid settings, for all experimental conditions. A linear mixed-effects model was used to determine the relationship between speech recognition, working memory ability, and cumulative signal modification. RESULTS Signal modification results showed a complex relationship between directionality and WDRC speed, which varied by SNR. At 0 and 5 dB SNRs, signal modification was lower for SLOW than FAST regardless of directionality. However, at 10 dB SNR and in the DIR listening condition, there was no signal modification difference between FAST and SLOW. Consistent with previous studies, the association of speech recognition in noise with working memory ability depended on the level of signal modification. Contrary to the hypothesis above, however, there was a significant association of speech recognition with working memory only at lower levels of signal modification, and speech recognition increased at a faster rate for individuals with better working memory as signal modification decreased with DIR and SLOW. CONCLUSIONS This research suggests that working memory ability remains a significant predictor of speech recognition when WDRC and directionality are applied. Our findings revealed that directional processing can reduce the detrimental effect of fast-acting WDRC on speech cues at higher SNRs, which affects speech recognition ability. Contrary to some previous research, this study showed that individuals with better working memory ability benefitted more from a decrease in signal modification than individuals with poorer working memory ability.
Collapse
|
5
|
Turton L, Souza P, Thibodeau L, Hickson L, Gifford R, Bird J, Stropahl M, Gailey L, Fulton B, Scarinci N, Ekberg K, Timmer B. Guidelines for Best Practice in the Audiological Management of Adults with Severe and Profound Hearing Loss. Semin Hear 2020; 41:141-246. [PMID: 33364673 PMCID: PMC7744249 DOI: 10.1055/s-0040-1714744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Individuals with severe to profound hearing loss are likely to present with complex listening needs that require evidence-based solutions. This document is intended to inform the practice of hearing care professionals who are involved in the audiological management of adults with a severe to profound degree of hearing loss and will highlight the special considerations and practices required to optimize outcomes for these individuals.
Collapse
Affiliation(s)
- Laura Turton
- Department of Audiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom
| | - Pamela Souza
- Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, Illinois
| | - Linda Thibodeau
- University of Texas at Dallas, Callier Center for Communication Disorders, Dallas, Texas
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Judith Bird
- Cambridge University Hospital NHS Foundation Trust, United Kingdom
| | - Maren Stropahl
- Department of Science and Technology, Sonova AG, Stäfa, Switzerland
| | | | | | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Katie Ekberg
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| | - Barbra Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia
| |
Collapse
|
6
|
Micula A, Ning Ng EH, El-Azm F, Rönnberg J. The effects of task difficulty, background noise and noise reduction on recall. Int J Audiol 2020; 59:792-800. [PMID: 32564633 DOI: 10.1080/14992027.2020.1771441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE In the present study, we investigated whether varying the task difficulty of the Sentence-Final Word Identification and Recall (SWIR) Test has an effect on the benefit of noise reduction, as well as whether task difficulty predictability affects recall. The relationship between working memory and recall was examined. DESIGN Task difficulty was manipulated by varying the list length with noise reduction on and off in competing speech and speech-shaped noise. Half of the participants were informed about list length in advance. Working memory capacity was measured using the Reading Span. STUDY SAMPLE Thirty-two experienced hearing aid users with moderate sensorineural hearing loss. RESULTS Task difficulty did not affect the noise reduction benefit and task difficulty predictability did not affect recall. Participants may have employed a different recall strategy when task difficulty was unpredictable and noise reduction off. Reading Span scores positively correlated with the SWIR test. Noise reduction improved recall in competing speech. CONCLUSIONS The SWIR test with varying list length is suitable for detecting the benefit of noise reduction. The correlation with working memory suggests that the SWIR test could be modified to be adaptive to individual cognitive capacity. The results on noise and noise reduction replicate previous findings.
Collapse
Affiliation(s)
- Andreea Micula
- Oticon A/S, Smørum, Denmark.,Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Elaine Hoi Ning Ng
- Oticon A/S, Smørum, Denmark.,Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | | | - Jerker Rönnberg
- Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| |
Collapse
|
7
|
Souza P, Arehart K, Schoof T, Anderson M, Strori D, Balmert L. Understanding Variability in Individual Response to Hearing Aid Signal Processing in Wearable Hearing Aids. Ear Hear 2020; 40:1280-1292. [PMID: 30998547 PMCID: PMC6786927 DOI: 10.1097/aud.0000000000000717] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Previous work has suggested that individual characteristics, including amount of hearing loss, age, and working memory ability, may affect response to hearing aid signal processing. The present study aims to extend work using metrics to quantify cumulative signal modifications under simulated conditions to real hearing aids worn in everyday listening environments. Specifically, the goal was to determine whether individual factors such as working memory, age, and degree of hearing loss play a role in explaining how listeners respond to signal modifications caused by signal processing in real hearing aids, worn in the listener's everyday environment, over a period of time. DESIGN Participants were older adults (age range 54-90 years) with symmetrical mild-to-moderate sensorineural hearing loss. We contrasted two distinct hearing aid fittings: one designated as mild signal processing and one as strong signal processing. Forty-nine older adults were enrolled in the study and 35 participants had valid outcome data for both hearing aid fittings. The difference between the two settings related to the wide dynamic range compression and frequency compression features. Order of fittings was randomly assigned for each participant. Each fitting was worn in the listener's everyday environments for approximately 5 weeks before outcome measurements. The trial was double blind, with neither the participant nor the tester aware of the specific fitting at the time of the outcome testing. Baseline measures included a full audiometric evaluation as well as working memory and spectral and temporal resolution. The outcome was aided speech recognition in noise. RESULTS The two hearing aid fittings resulted in different amounts of signal modification, with significantly less modification for the mild signal processing fitting. The effect of signal processing on speech intelligibility depended on an individual's age, working memory capacity, and degree of hearing loss. Speech recognition with the strong signal processing decreased with increasing age. Working memory interacted with signal processing, with individuals with lower working memory demonstrating low speech intelligibility in noise with both processing conditions, and individuals with higher working memory demonstrating better speech intelligibility in noise with the mild signal processing fitting. Amount of hearing loss interacted with signal processing, but the effects were small. Individual spectral and temporal resolution did not contribute significantly to the variance in the speech intelligibility score. CONCLUSIONS When the consequences of a specific set of hearing aid signal processing characteristics were quantified in terms of overall signal modification, there was a relationship between participant characteristics and recognition of speech at different levels of signal modification. Because the hearing aid fittings used were constrained to specific fitting parameters that represent the extremes of the signal modification that might occur in clinical fittings, future work should focus on similar relationships with more diverse types of signal processing parameters.
Collapse
Affiliation(s)
- Pamela Souza
- Department of Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, Illinois, USA
| | - Kathryn Arehart
- Department of Speech Language Hearing Sciences, University of Colorado at Boulder
| | - Tim Schoof
- Department of Speech, Hearing and Phonetic Sciences, Division of Psychology and Language Sciences, University College London
| | - Melinda Anderson
- Department of Otolaryngology, University of Colorado School of Medicine
| | - Dorina Strori
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
- Department of Linguistics, Northwestern University, Evanston, Illinois, USA
| | - Lauren Balmert
- Department of Preventive Medicine, Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University
| |
Collapse
|
8
|
Souza P, Hoover E, Blackburn M, Gallun F. The Characteristics of Adults with Severe Hearing Loss. J Am Acad Audiol 2019; 29:764-779. [PMID: 30222545 DOI: 10.3766/jaaa.17050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Severe hearing loss impairs communication in a wide range of listening environments. However, we lack data as to the specific objective and subjective abilities of listeners with severe hearing loss. Insight into those abilities may inform treatment choices. PURPOSE The primary goal was to describe the audiometric profiles, spectral resolution ability, and objective and subjective speech perception of a sample of adult listeners with severe hearing loss, and to consider the relationships among those measures. We also considered the typical fitting received by individuals with severe loss, in terms of hearing aid style, electroacoustic characteristics, and features, as well as supplementary device use. RESEARCH DESIGN A within-subjects design was used. STUDY SAMPLE Participants included 36 adults aged 54-93 yr with unilateral or bilateral severe hearing loss. DATA COLLECTION AND ANALYSIS Testing included a full hearing and hearing aid history; audiometric evaluation; loudness growth and dynamic range; spectral resolution; assessment of cochlear dead regions; objective and subjective assessment of speech recognition; and electroacoustic evaluation of current hearing aids. Regression models were used to analyze relationships between hearing loss, spectral resolution, and speech recognition. RESULTS For speech in quiet, 60% of the variance was approximately equally accounted for by amount of hearing loss, spectral resolution, and number of dead regions. For speech in noise, only a modest proportion of performance variance was explained by amount of hearing loss. In general, participants were wearing amplification of appropriate style and technology for their hearing loss, but the extent of assistive technology use was low. Subjective communication ratings depended on the listening situation, but in general, were similar to previously published data for adults with mild-to-moderate loss who did not wear hearing aids. CONCLUSIONS The present data suggest that the range of abilities of an individual can be more fully captured with comprehensive testing. Such testing also offers an opportunity for informed counseling regarding realistic expectations for hearing aid use and the availability of hearing assistive technology.
Collapse
Affiliation(s)
- Pamela Souza
- Department of Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, Evanston, IL
| | - Eric Hoover
- Auditory & Speech Sciences Laboratory, University of South Florida, Tampa, FL
| | | | - Frederick Gallun
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center and Oregon Health Sciences University, Portland, OR
| |
Collapse
|
9
|
Souza P, Hoover E. The Physiologic and Psychophysical Consequences of Severe-to-Profound Hearing Loss. Semin Hear 2018; 39:349-363. [PMID: 30443103 DOI: 10.1055/s-0038-1670698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Substantial loss of cochlear function is required to elevate pure-tone thresholds to the severe hearing loss range; yet, individuals with severe or profound hearing loss continue to rely on hearing for communication. Despite the impairment, sufficient information is encoded at the periphery to make acoustic hearing a viable option. However, the probability of significant cochlear and/or neural damage associated with the loss has consequences for sound perception and speech recognition. These consequences include degraded frequency selectivity, which can be assessed with tests including psychoacoustic tuning curves and broadband rippled stimuli. Because speech recognition depends on the ability to resolve frequency detail, a listener with severe hearing loss is likely to have impaired communication in both quiet and noisy environments. However, the extent of the impairment varies widely among individuals. A better understanding of the fundamental abilities of listeners with severe and profound hearing loss and the consequences of those abilities for communication can support directed treatment options in this population.
Collapse
Affiliation(s)
- Pamela Souza
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Eric Hoover
- Department of Hearing and Speech Sciences, University of Maryland, Baltimore, Maryland
| |
Collapse
|
10
|
Shen J, Anderson MC, Arehart KH, Souza PE. Using Cognitive Screening Tests in Audiology. Am J Audiol 2016; 25:319-331. [PMID: 27788277 DOI: 10.1044/2016_aja-16-0032] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/03/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The population of the United States is aging. Those older adults are living longer than ever and have an increased desire for social participation. As a result, audiologists are likely to see an increased demand for service by older clients whose communication difficulty is caused by a combination of hearing loss and cognitive impairment. For these individuals, early detection of mild cognitive impairment is critical for providing timely medical intervention and social support. METHOD This tutorial provides information about cognition of older adults, mild cognitive impairment, and cognitive screening tests, with the purpose of assisting audiologists in identifying and appropriately referring potential cases of cognitive impairment. RESULTS Topics addressed also include how to administer cognitive screening tests on individuals with hearing loss, how to use test results in audiology practice, and the potential of using cognitive screening tests for evaluating the benefit of clinical interventions. CONCLUSIONS As health care professionals who serve the aging population, audiologists are likely to encounter cases of undiagnosed cognitive impairment. In order to provide timely referral for medical assistance as well as an optimized individual outcome of audiologic interventions, audiologists should be trained to recognize an abnormality in older clients' cognitive status.
Collapse
Affiliation(s)
- Jing Shen
- Northwestern University, Evanston, IL
| | | | | | | |
Collapse
|
11
|
Wayne RV, Hamilton C, Jones Huyck J, Johnsrude IS. Working Memory Training and Speech in Noise Comprehension in Older Adults. Front Aging Neurosci 2016; 8:49. [PMID: 27047370 PMCID: PMC4801856 DOI: 10.3389/fnagi.2016.00049] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/22/2016] [Indexed: 11/16/2022] Open
Abstract
Understanding speech in the presence of background sound can be challenging for older adults. Speech comprehension in noise appears to depend on working memory and executive-control processes (e.g., Heald and Nusbaum, 2014), and their augmentation through training may have rehabilitative potential for age-related hearing loss. We examined the efficacy of adaptive working-memory training (Cogmed; Klingberg et al., 2002) in 24 older adults, assessing generalization to other working-memory tasks (near-transfer) and to other cognitive domains (far-transfer) using a cognitive test battery, including the Reading Span test, sensitive to working memory (e.g., Daneman and Carpenter, 1980). We also assessed far transfer to speech-in-noise performance, including a closed-set sentence task (Kidd et al., 2008). To examine the effect of cognitive training on benefit obtained from semantic context, we also assessed transfer to open-set sentences; half were semantically coherent (high-context) and half were semantically anomalous (low-context). Subjects completed 25 sessions (0.5–1 h each; 5 sessions/week) of both adaptive working memory training and placebo training over 10 weeks in a crossover design. Subjects' scores on the adaptive working-memory training tasks improved as a result of training. However, training did not transfer to other working memory tasks, nor to tasks recruiting other cognitive domains. We did not observe any training-related improvement in speech-in-noise performance. Measures of working memory correlated with the intelligibility of low-context, but not high-context, sentences, suggesting that sentence context may reduce the load on working memory. The Reading Span test significantly correlated only with a test of visual episodic memory, suggesting that the Reading Span test is not a pure-test of working memory, as is commonly assumed.
Collapse
Affiliation(s)
- Rachel V Wayne
- Department of Psychology, Queen's University Kingston, ON, Canada
| | - Cheryl Hamilton
- Department of Psychology, Queen's University Kingston, ON, Canada
| | | | - Ingrid S Johnsrude
- Department of Psychology, Queen's UniversityKingston, ON, Canada; Department of Psychology, School of Communication Sciences and Disorders, The Brain and Mind Institute, University of Western OntarioLondon, ON, Canada
| |
Collapse
|
12
|
Souza P, Arehart K, Neher T. Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications. Front Psychol 2015; 6:1894. [PMID: 26733899 PMCID: PMC4679849 DOI: 10.3389/fpsyg.2015.01894] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/23/2015] [Indexed: 11/13/2022] Open
Abstract
Working memory—the ability to process and store information—has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This “mismatch” is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with “low alteration” processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory.
Collapse
Affiliation(s)
- Pamela Souza
- Communication Sciences and Disorders, Knowles Hearing Center, Northwestern University, Evanston IL, USA
| | - Kathryn Arehart
- Speech, Language and Hearing Sciences, University of Colorado Boulder, Boulder CO, USA
| | - Tobias Neher
- Medizinische Physik and Cluster of Excellence Hearing4all, Carl von Ossietzky University of Oldenburg Oldenburg, Germany
| |
Collapse
|
13
|
Davies-Venn E, Nelson P, Souza P. Comparing auditory filter bandwidths, spectral ripple modulation detection, spectral ripple discrimination, and speech recognition: Normal and impaired hearing. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 138:492-503. [PMID: 26233047 PMCID: PMC4514721 DOI: 10.1121/1.4922700] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Some listeners with hearing loss show poor speech recognition scores in spite of using amplification that optimizes audibility. Beyond audibility, studies have suggested that suprathreshold abilities such as spectral and temporal processing may explain differences in amplified speech recognition scores. A variety of different methods has been used to measure spectral processing. However, the relationship between spectral processing and speech recognition is still inconclusive. This study evaluated the relationship between spectral processing and speech recognition in listeners with normal hearing and with hearing loss. Narrowband spectral resolution was assessed using auditory filter bandwidths estimated from simultaneous notched-noise masking. Broadband spectral processing was measured using the spectral ripple discrimination (SRD) task and the spectral ripple depth detection (SMD) task. Three different measures were used to assess unamplified and amplified speech recognition in quiet and noise. Stepwise multiple linear regression revealed that SMD at 2.0 cycles per octave (cpo) significantly predicted speech scores for amplified and unamplified speech in quiet and noise. Commonality analyses revealed that SMD at 2.0 cpo combined with SRD and equivalent rectangular bandwidth measures to explain most of the variance captured by the regression model. Results suggest that SMD and SRD may be promising clinical tools for diagnostic evaluation and predicting amplification outcomes.
Collapse
Affiliation(s)
- Evelyn Davies-Venn
- Department of Speech-Language-Hearing Sciences, University of Minnesota, 164 Pillsbury Drive Southeast, Minneapolis, Minnesota 55455, USA
| | - Peggy Nelson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, 164 Pillsbury Drive Southeast, Minneapolis, Minnesota 55455, USA
| | - Pamela Souza
- Department of Communication Sciences and Disorders and Knowles Hearing Center, Northwestern University, 2240 Campus Drive, Evanston, Illinois 60208, USA
| |
Collapse
|
14
|
Souza PE, Arehart KH, Shen J, Anderson M, Kates JM. Working memory and intelligibility of hearing-aid processed speech. Front Psychol 2015; 6:526. [PMID: 25999874 PMCID: PMC4423473 DOI: 10.3389/fpsyg.2015.00526] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/13/2015] [Indexed: 11/23/2022] Open
Abstract
Previous work suggested that individuals with low working memory capacity may be at a disadvantage in adverse listening environments, including situations with background noise or substantial modification of the acoustic signal. This study explored the relationship between patient factors (including working memory capacity) and intelligibility and quality of modified speech for older individuals with sensorineural hearing loss. The modification was created using a combination of hearing aid processing [wide-dynamic range compression (WDRC) and frequency compression (FC)] applied to sentences in multitalker babble. The extent of signal modification was quantified via an envelope fidelity index. We also explored the contribution of components of working memory by including measures of processing speed and executive function. We hypothesized that listeners with low working memory capacity would perform more poorly than those with high working memory capacity across all situations, and would also be differentially affected by high amounts of signal modification. Results showed a significant effect of working memory capacity for speech intelligibility, and an interaction between working memory, amount of hearing loss and signal modification. Signal modification was the major predictor of quality ratings. These data add to the literature on hearing-aid processing and working memory by suggesting that the working memory-intelligibility effects may be related to aggregate signal fidelity, rather than to the specific signal manipulation. They also suggest that for individuals with low working memory capacity, sensorineural loss may be most appropriately addressed with WDRC and/or FC parameters that maintain the fidelity of the signal envelope.
Collapse
Affiliation(s)
- Pamela E. Souza
- Department of Communication Sciences and Disorders, Northwestern UniversityEvanston, IL, USA
- Knowles Hearing Center, Northwestern UniversityEvanston, IL, USA
| | - Kathryn H. Arehart
- Department of Speech, Language and Hearing Sciences, University of Colorado at BoulderBoulder, CO, USA
| | - Jing Shen
- Department of Communication Sciences and Disorders, Northwestern UniversityEvanston, IL, USA
| | - Melinda Anderson
- Department of Speech, Language and Hearing Sciences, University of Colorado at BoulderBoulder, CO, USA
| | - James M. Kates
- Department of Speech, Language and Hearing Sciences, University of Colorado at BoulderBoulder, CO, USA
| |
Collapse
|
15
|
Souza PE, Wright RA, Blackburn MC, Tatman R, Gallun FJ. Individual sensitivity to spectral and temporal cues in listeners with hearing impairment. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:520-34. [PMID: 25629388 PMCID: PMC4462137 DOI: 10.1044/2015_jslhr-h-14-0138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 10/14/2014] [Accepted: 12/18/2014] [Indexed: 05/26/2023]
Abstract
PURPOSE The present study was designed to evaluate use of spectral and temporal cues under conditions in which both types of cues were available. METHOD Participants included adults with normal hearing and hearing loss. We focused on 3 categories of speech cues: static spectral (spectral shape), dynamic spectral (formant change), and temporal (amplitude envelope). Spectral and/or temporal dimensions of synthetic speech were systematically manipulated along a continuum, and recognition was measured using the manipulated stimuli. Level was controlled to ensure cue audibility. Discriminant function analysis was used to determine to what degree spectral and temporal information contributed to the identification of each stimulus. RESULTS Listeners with normal hearing were influenced to a greater extent by spectral cues for all stimuli. Listeners with hearing impairment generally utilized spectral cues when the information was static (spectral shape) but used temporal cues when the information was dynamic (formant transition). The relative use of spectral and temporal dimensions varied among individuals, especially among listeners with hearing loss. CONCLUSION Information about spectral and temporal cue use may aid in identifying listeners who rely to a greater extent on particular acoustic cues and applying that information toward therapeutic interventions.
Collapse
Affiliation(s)
- Pamela E. Souza
- Northwestern University, Evanston, IL
- Knowles Hearing Center, Northwestern University, Evanston, IL
| | | | | | | | - Frederick J. Gallun
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center, OR
- Oregon Health & Science University, Portland
| |
Collapse
|