Speech intelligibility benefits of hearing AIDS at various input levels.

Although the benefits of hearing aids are generally recognized for soft- and conversational-level sounds, most studies have reported negative benefits (i.e., poorer aided than unaided performance) at high noise inputs. Advances in digital signal processing such as compression, noise reduction, and directional microphone could improve speech perception at high input levels. This could alter our view on the efficacy of hearing aids in loud, noisy situations. The current study compared the aided versus the unaided speech intelligibility performance of hearing-impaired (HI) listeners at various input levels (from 50-100 dB SPL) and signal-to-noise ratios (SNRs; quiet, +6, +3, and -3 dB) in order to document the benefits of modern hearing aids. In addition, subjective preference between aided and unaided sounds (speech and music) at various input levels was also compared. The experiment used a factorial repeated-measures design. A total of 10 HI adults with symmetrical moderate to severe hearing losses served as test participants. In addition, speech intelligibility scores of five normal-hearing (NH) listeners were also measured for comparison. Speech perception was studied at 50 and 65 dB SPL input levels in quiet and also in noise at levels of 65, 85, and 100 dB SPL with SNRs of +6, +3, and -3 dB. This was done for all participants (HI and NH). In addition, the HI participants compared subjective preference between the aided and unaided presentations of speech and music stimuli at 50, 65, 85, and 100 dB SPL in quiet. The data were analyzed with repeated-measures analysis of variance. The results showed a decrease in aided benefits as input levels increased. However, even at the two highest input levels (i.e., 85 and 100 dB SPL), aided speech scores were still higher than the unaided speech scores. Furthermore, NH listeners and HI listeners in the aided condition showed stable speech-in-noise performance between 65 and 100 dB SPL input levels, except that the absolute performance of the NH listeners was higher than that of the HI listeners. Subjective preference for the unaided sounds versus the aided sounds increased as input level increased, with a crossover intensity at approximately 75 dB SPL for speech and 80 dB SPL for music. The results supported the hypothesis that the study hearing aid can provide aided speech-in-noise benefit at very high noise inputs in a controlled environment.

Kuk F ，Lau CC ，Korhonen P ，Crose B ... -  《-》

Subjective Speech Intelligibility Drives Noise-Tolerance Domain Use During the Tracking of Noise-Tolerance Test.

Recently, the Noise-Tolerance Domains Test (NTDT) was applied to study the noise-tolerance domains used by young normal-hearing (NH) listeners during noise acceptance decisions. In this study, we examined how subjective speech intelligibility may drive noise acceptance decisions by applying the NTDT on NH and hearing-impaired (HI) listeners at the signal to noise ratios (SNRs) around the Tracking of Noise-Tolerance (TNT) thresholds. A single-blind, within-subjects design with 22 NH and 17 HI older adults was followed. Listeners completed the TNT to determine the average noise acceptance threshold (TNT Ave ). Then, listeners completed the NTDT at the SNRs of 0, ±3 dB (re: TNT Ave ) to estimate the weighted noise-tolerance domain ratings (WNTDRs) for each domain criterion. Listeners also completed the Objective and Subjective Intelligibility Difference (OSID) Test to establish the individual intelligibility performance-intensity (P-I) functions of the TNT materials. All test measures were conducted at 75 and 82 dB SPL speech input levels. NH and HI listeners were tested in the unaided mode. The HI listeners were also tested using a study hearing aid. The WNTDRs were plotted against subjective speech intelligibilities extrapolated from individual P-I of the OSID at the SNRs corresponding to NTDT test conditions. Listeners were grouped according to their most heavily weighed domain and a regression analysis was performed against listener demographics as well as TNT and OSID performances to determine which variable(s) affected listener grouping. Three linear mixed effects (LMEs) models were used to examine whether WNTDRs changed with subjective speech intelligibility. All three LMEs found significant fixed effects of domain criteria, subjective intelligibility, and speech input level on WNTDRs. In general, heavier weights were assigned to speech interference and loudness domains at poorer intelligibility levels (<50%) with reversals to distraction and annoyance at higher intelligibility levels (>80%). The comparison between NH and HI-unaided showed that NH listeners assigned greater weights to loudness than the HI-unaided listeners. The comparison between NH and HI-aided groups showed similar weights between groups. The comparison between HI-unaided and HI-aided found that HI listeners assigned lower weights to speech interference and greater weights to loudness when tested in aided compared with unaided modes. In all comparisons, loudness was weighed heavier at the 82 dB SPL input level than at the 75 dB SPL input level with greater weights to annoyance in the NH versus HI-unaided comparison and lower weights to distraction in the HI-aided versus HI-unaided comparison. A generalized linear model determined that listener grouping was best accounted for by subjective speech intelligibility estimated at TNT Ave . The domain criteria used by listeners were driven by their subjective speech intelligibility regardless of their hearing status (i.e., NH versus HI). In general, when subjective intelligibility was poor, the domains of speech interference and loudness were weighed the heaviest. As subjective intelligibility improved, the weightings on annoyance and distraction increased. Furthermore, a listener's criterion for >90% subjective speech understanding at the TNT Ave may allow one to profile the listener.

Kuk F ，Slugocki C ，Korhonen P 《-》

Speech recognition performance of patients with sensorineural hearing loss under unaided and aided conditions using linear and compression hearing AIDS.

Shanks JE ，Wilson RH ，Larson V ，Williams D ... -  《EAR AND HEARING》

Evaluation of the sparse coding shrinkage noise reduction algorithm in normal hearing and hearing impaired listeners.

Although there are numerous single-channel noise reduction strategies to improve speech perception in noise, most of them improve speech quality but do not improve speech intelligibility, in circumstances where the noise and speech have similar frequency spectra. Current exceptions that may improve speech intelligibility are those that require a priori knowledge of the speech or noise statistics, which limits practical application. Hearing impaired (HI) listeners suffer more in speech intelligibility than normal hearing listeners (NH) in the same noisy environment, so developing better single-channel noise reduction algorithms for HI listeners is justified. Our model-based "sparse coding shrinkage" (SCS) algorithm extracts key speech information in noisy speech. We evaluate it by comparison with a state-of-the-art Wiener filtering approach using speech intelligibility tests with NH and HI listeners. The model-based SCS algorithm relies only on statistical signal information without prior information. Results show that the SCS algorithm improves speech intelligibility in stationary noise and is comparable to the Wiener filtering algorithm. Both algorithms improve intelligibility for HI listeners but not for NH listeners. Improvement is less in fluctuating (babble) noise than in stationary noise. Both noise reduction algorithms perform better at higher input signal-to-noise ratios (SNR) where HI listeners can benefit but where NH listeners have already reached ceiling performance. The difference between NH and HI subjects in intelligibility gain depends fundamentally on the input SNR rather than the hearing loss level. We conclude that HI listeners need different signal processing algorithms from NH subjects and that the SCS algorithm offers a promising alternative to Wiener filtering. Performance of all noise reduction algorithms is likely to vary according to extent of hearing loss and algorithms that show little benefit for listeners with moderate hearing loss may be more beneficial for listeners with more severe hearing loss.

Sang J ，Hu H ，Zheng C ，Li G ，Lutman ME ，Bleeck S ... -  《-》

Tracking of Noise Tolerance to Measure Hearing Aid Benefit.

The benefits offered by noise reduction (NR) features on a hearing aid had been studied traditionally using test conditions that set the hearing aids into a stable state of performance. While adequate, this approach does not allow the differentiation of two NR algorithms that differ in their timing characteristics (i.e., activation and stabilization time). The current study investigated a new method of measuring noise tolerance (Tracking of Noise Tolerance [TNT]) as a means to differentiate hearing aid technologies. The study determined the within-session and between-session reliability of the procedure. The benefits provided by various hearing aid conditions (aided, two NR algorithms, and a directional microphone algorithm) were measured using this procedure. Performance on normal-hearing listeners was also measured for referencing. A single-blinded, repeated-measures design was used. Thirteen experienced hearing aid wearers with a bilaterally symmetrical (≤10 dB) mild-to-moderate sensorineural hearing loss participated in the study. In addition, seven normal-hearing listeners were tested in the unaided condition. Participants tracked the noise level that met the criterion of tolerable noise level (TNL) in the presence of an 85 dB SPL continuous discourse passage. The test conditions included an unaided condition and an aided condition with combinations of NR and microphone modes within the UNIQUE hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR; directional microphone, no NR; and directional microphone, NR) and the DREAM hearing aid (omnidirectional microphone, no NR; omnidirectional microphone, NR). Each tracking trial lasted 2 min for each hearing aid condition. Normal-hearing listeners tracked in the unaided condition only. Nine of the 13 hearing-impaired listeners returned after 3 mo for retesting in the unaided and aided conditions with the UNIQUE hearing aid. The individual TNL was estimated for each participant for all test conditions. The TNT index was calculated as the difference between 85 dB SPL and the TNL. The TNT index varied from 2.2 dB in the omnidirectional microphone, no NR condition to -4.4 dB in the directional microphone, NR on condition. Normal-hearing listeners reported a TNT index of -5.7 dB using this procedure. The averaged improvement in TNT offered by the NR algorithm on the UNIQUE varied from 2.1 dB when used with a directional microphone to 3.0 dB when used with the omnidirectional microphone. The time course of the NR algorithm was different between the UNIQUE and the DREAM hearing aids, with the UNIQUE reaching a stable TNL sooner than the DREAM. The averaged improvement in TNT index from the UNIQUE directional microphone was 3.6 dB when NR was activated and 4.4 dB when NR was deactivated. Together, directional microphone and NR resulted in a total TNT improvement of 6.5 dB. The test-retest reliability of the procedure was high, with an intrasession 95% confidence interval (CI) of 2.2 dB and an intersession 95% CI of 4.2 dB. The effect of the NR and directional microphone algorithms was measured to be 2-3 and 3.6-4.4 dB, respectively, using the TNT procedure. Because of its tracking property and reliability, this procedure may hold promise in differentiating among some hearing aid features that also differ in their time course of action.

Kuk F ，Seper E ，Lau CC ，Korhonen P ... -  《-》