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PubMed1982

Cost effectiveness of various spondee-threshold methods.

Spondees (N:15) chosen from the literature as having relatively homogeneous intelligibility were re-recorded to preserve this feature. ST's were collected twice from 60 normal-hearing young adults by each of 6 combinations of method (ascending, descending, bracketing) and step size (2-, 5-db). A cost-benefit analysis (test-retest reliability, time required, agreement with PTA) yielded the descending-2-db combination as superior to other combinations.

Adult↗
PubMed1982

Differentiation of types of presbycusis using the masking-level difference.

Masking-level differences in quiet at 500 Hz were used to demonstrate evidence of elevated noise levels within the auditory systems of subjects with assumed neural presbycusis. The following five groups of subjects were evaluated: normal-hearing young and old adults; and older adults with metabolic, sensory, or neural presbycusis. The group with assumed neural presbycusis--that is, bilateral high-frequency sensorineural hearing loss and poor word-recognition performance--had masking-level differences (a) in quiet that were significantly larger than those for the other groups and (b) in noise that were significantly smaller than those for the other groups. The data suggest that elevated internal noise levels accompany neural presbycusis.

Adolescent↗
PubMed2002

A speech enhancement scheme incorporating spectral expansion evaluated with simulated loss of frequency selectivity.

Hearing-impaired listeners often suffer from supra-threshold speech perception deficits. One such deficit is reduced frequency selectivity. We applied a speech enhancement scheme that incorporated spectral expansion in an attempt to reduce the effects of this deficit. The speech processing could contain up to three stages, a first in which the peak-valley ratio of the speech spectrum was enlarged to counteract the broadening of the auditory filtering, and a second in which the overall speech spectrum was modified to counteract the effects of upward-spread-of-masking, using a linear filter. The third stage was a noise suppression stage, applied before the spectral enhancement. The effectiveness of the speech processing with and without noise suppression was evaluated for various parameter settings by measuring the speech reception threshold (SRT) in noise, i.e., the signal-to-noise ratio at which listeners repeat 50% of presented sentences correctly. We used normal-hearing subjects. To simulate the loss of frequency selectivity we applied spectral smearing to the stimuli presented to the subjects. The speech material of the SRT tests was mixed with the noise before processing, and, when present, the smearing was applied last. The results indicated that for one specific parameter setting the SRT values decreased (i.e., improved) by approximately 1 dB when incorporating the spectral expansion together with the linear filtering. Employing either of these two stages separately did not improve the SRT. The application of the noise suppression stage did not further improve the SRT. A pilot study using hearing-impaired listeners showed more promising results for a female than for a male speaker.

Adult↗
PubMed1985

[Evaluation of hearing improvement due to hearing aids].

A method to assess the hearing improvement due to hearing aids is described. This method has been used routinely at a local hospital for 2 years on 200 patients. This method is based on the assessment of the speech reception threshold for sentences ("Marburger Satztest") in silence and in various noise levels (speech simulating noise). The following were used for the assessment of the hearing aid: the improvement of the speech reception threshold in silence with or without a hearing aid, the maximum tolerable noise level (i.e. the noise level at which everyday speech becomes subliminal for patients with hearing aids) and the noise level at which the speech reception threshold with the hearing aid is worse than without.

Adolescent↗
PubMedDate not supplied

Four spondee threshold procedures: a comparison.

Two ascending and two descending procedures were used to obtain spondee thresholds from normally hearing and sensorineural hearing impaired subjects. Minimal differences were found when comparisons of threshold were made among all four procedures. Results indicated slightly more sensitive thresholds when the descending procedures were used and slightly poorer pure-tone average and spondee threshold agreement. Test-retest reliability was good for all four procedures, but large differences existed among the procedures in the amount of time and in the number of words required to establish threshold. Advantages and clinical implications are discussed.

Adult↗
PubMed1978

Speech audiometry.

Two aspects of speech audiometry, namely, the speech reception threshold and the speech discrimination scores, have been discussed in the light of their development and present day administration. Evidence was presented to forego the concept of phonetic balance in discrimination test messages for the preferable attributes of familiarity and equated list difficulty. Campbell's redistribution of the W-22 word lists was proposed as an available solution to one of these parameters. Some delineation of the single "maximal" discrimination score's relation to the prediction of the hearing impaired individual's ability to understand continuous discourse was offered. Diagnostic implications of speech audiometry were not treated.

Audiometry↗
PubMed1989

The effect of varying the amplitude-frequency response on the masked speech-reception threshold of sentences for hearing-impaired listeners.

In an evaluation of frequency-dependent automatic gain-control systems in hearing aids, the effect of varying the amplitude-frequency response on the speech-reception threshold (SRT) for sentences in noise is studied for 20 hearing-impaired listeners. The noise has a spectrum identical to the long-term average spectrum of the sentences. Speech and noise are shaped by the same amplitude-frequency response; their spectra are varied relative to the bisector of the individual's dynamic range. In four experimental conditions, the effect of a steady-state amplitude-frequency response is studied. Steepening the negative spectral slope of speech and noise appears to cause an increase of masked SRT, possibly due to increased effect of upward spread of masking. The effect of a single transition of the amplitude-frequency response between 10 and -10 dB/oct halfway through the sentence seems to be related to the effect for the fixed -10-dB/oct condition. Two transition times are tested. For a transition time of 0.25 s, the SRT is only a little higher than for 1 s. The results suggest that the amplitude-frequency response may be varied in time without having a detrimental effect on the masked SRT of sentences for hearing-impaired listeners as long as strongly negatively sloping spectra are avoided.

Adult↗
PubMed1986

A signal-to-noise ratio model for the speech-reception threshold of the hearing impaired.

This paper reviews the results of a series of investigations inspired by a model of the speech-reception threshold (SRT) of hearing-impaired listeners. The model contains two parameters accounting for the SRT of normal-hearing listeners (SRT in quiet and signal-to-noise ratio corresponding to the threshold at high noise levels), two parameters describing the hearing loss (attenuation and threshold elevation in terms of signal-to-noise ratio), and three parameters describing the hearing aid (acoustic gain, threshold elevation expressed in signal-to-noise ratio, and equivalent internal noise level). Experimental data are reported for three different types of hearing impairment: presbycusis, hearing losses with a pathological origin, and noise-induced losses. The model gives an excellent description of the data. It demonstrates that for many hearing-impaired persons speech intelligibility at noise levels beyond 50 to 60 dB(A) is their main problem, whereas hearing aids are most effective below that noise level.

Auditory Threshold↗
PubMedDate not supplied

Pediatric speech intelligibility test: performance-intensity characteristics.

Performance-intensity (PI) functions for Pediatric Speech Intelligibility (PSI) test materials were obtained in 40 normal-hearing children between 3 and 6 yrs of age. PSI messages were monosyllabic words and sentences presented in quiet and in the presence of a competing speech message. The message-to-competition ratio was constant across intensity levels: +4 dB (words) and O dB (sentences). Maximum speech intelligibility scores were 100% correct in all children for all conditions. The steepness of the PSI-PI functions, defined by the intensity range yielding performance between 20 and 80%, ranged from 8 to 12 dB. Threshold levels (50% correct) ranged from 21 to 26 dB SPL. With one exception, chronological age did not significantly influence the steepness of PSI-PI functions. The exception was the increasing steepness with increasing age noted for sentences in competition. A significant chronological age developmental trend was noted for all speech threshold results.

Age Factors↗
PubMed1980

An evaluation of speech audiometry by bone conduction in hearing-impaired adults.

Pure-tone thresholds, speech reception thresholds (SRT), and speech discrimination scores (DS) were obtained by ac and bc on 20 normal-hearing and 30 hearing-impaired adults. Correlations between the SRT and pure-tone thresholds (ave. of .5, 1, and 2 kc/s) were significant by both ac and bc. Correlations between DS by ac and bc were also highly significant, indicating the value of the bc DS in specific difficult cases. The clinical observation was confirmed statistically of decreasing DS with increasing sensorineural hearing loss.

Adolescent↗
PubMedDate not supplied

The effects of sophistication on three threshold tests for subjects with simulated hearing loss.

Forty-five normal-hearing subjects were divided into three groups to determine the effects of listener sophistication on threshold estimates obtained with three commonly used tests for pseudohypacusis. A pure-tone Stenger test, speech Stenger test, and pure-tone delayed auditory feedback test were performed on each subject. The results indicate that increased sophistication levels allow subjects to simulate larger hearing losses on the two Stenger procedures. Sophistication level did not play a significant role in threshold determination with the delayed auditory feedback procedure, which was also found to be the closest indicator of true threshold.

Adult↗
PubMed1997

[Cochlear implant in patients with residual hearing].

INTRODUCTIONS: Cochlear implants are used for the rehabilitation of bilaterally deaf patients. Due to the improvements in speech processing they might be also useful for patients with residual hearing and some speech understanding. METHODS: Pre- and postoperative speech understanding scores in 26 patients receiving implants were evaluated in a retrospective study. RESULTS: The preoperative pure-tone threshold in the implanted ear was between 80 and 115 dB in the frequency range of 500 to 2000 Hz. On the contralateral side the mean threshold was 10 dB better. The mean score for the number test was 11.3%, for the monosyllables below 5%. Postoperatively speech understanding improved significantly up to 97% for numbers and 48% for monosyllables (tested with the Freiburger Speech Test). Cochlear implantation also benefits patients with residual hearing and some speech understanding with hearing aids under optimum conditions. The speech understanding scores must be below certain limits. General selection criteria cannot yet be specified. The individual decision must be based upon several criteria, especially the speech understanding scores in quiet and noise under optimum conditions. A prospective study is needed to develop generally applicable criteria.

Audiometry, Pure-Tone↗
PubMedDate not supplied

Audiological results with the cochlear implant.

Audiological test results from 135 adult, profoundly deaf, single-electrode cochlear implant subjects are presented. Unaided, aided, and cochlear implant warble-tone and speech detection thresholds have been analyzed, as well as word, word stress, and environmental sound discrimination scores. Results indicate that implant thresholds are significantly better than aided thresholds at all frequencies tested and for speech detection. Also, word, word stress, and environmental sound discrimination scores are all significantly better with the implant than with a hearing aid. Although the implant does not provide speech discrimination, subjects report that it does provide valuable speech and sound awareness, which aids in speechreading and voice monitoring. A small group of subjects has shown that an an implant in the poorer ear can also be successfully combined with a hearing aid in the better ear. The audiological test results clearly show that the implant is a viable alternative for the profoundly deaf.

Adolescent↗
PubMed1988

[Alterations of speech audiometry in presbycusis brought about by cochlear acoustic emissions].

Click-evoked oto-acoustic emissions (EOEs) and speech audiometry were recorded in a group of normally hearing subjects (n = 56 ears), and a group of patients demonstrating sensorineural hearing loss due to presbycusis (n = 39 ears). Correlations were made between detection-threshold of EOEs, speech reception threshold (i.e., lowest hearing level at which the subject can repeat 50% of a message), and discrimination score (i.e., discrimination score determined 35 dB above the speech reception threshold). EOEs have never been observed when speech reception threshold was equal to or greater than 35 dB HL. EOEs were always found when speech reception threshold was equal to or lower than 25 dB HL. Moreover, the detection-threshold of EOEs increased when increasing speech reception threshold. On the other side, there was not a good correlation between the discrimination score and the detection-threshold of EOEs. Thus, complementary information on outer hair cell degenerative changes in presbycusis could be deduced from these data.

Adolescent↗
PubMed1997

[Aspects of auditory speech perception in cochlear implant and hearing aid managed children].

Speech perception is a valuable tool for the assessment of auditory (re-)habilitation of children with hearing impairments. We tested 3 groups of prelingually deaf children. For the evaluation of speech recognition abilities the test of auditory perception of speech in children (TAPS) was used. Hearing aid fitted children of a school for hard of hearing and school of the deaf (n = 12 and n = 10, respectively) and cochlear implant users (n = 12) of the same age group were tested. A positive correlation of the speech perception abilities with the aided thresholds was found. Hearing aid fitted children of the school of hard of hearing with aided thresholds between 20 and 40 dB HL including 4000 Hz showed best results. Students of the same school with aided thresholds in the range of 45 to 70 dB HL performed comparable to the lesser cochlear implant users fitted with a single channel analogue system. Hearing aid fitted students of a school for the deaf with the same degree of hearing loss and amplification showed significantly poorer results.

Auditory Threshold↗