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Results for “Speech Reception Threshold Test”

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PubMed1996

Effects of pulse separation on detection thresholds for electrical stimulation of the human cochlea.

Effects of pulse separation on detection of electrical stimulation of the cochlea were studied in 12 profoundly deaf human subjects with Nucleus 22 cochlear implants. Biphasic symmetric pulses were used. Pulse separation is the time from offset of one biphasic pulse to the onset of the next biphasic pulse in the train. Effects of pulse separation were studied in the context of different covariables in four stages of the experiment. Effects of pulse separation seen in the different stages were similar, despite the different covariables. Both pulse separation and the total number of pulses per stimulus seem to be important variables affecting stimulus detection. For 0.5 ms/phase pulses, thresholds were lowest at the shortest pulse separations tested (0.2-1.1 ms) and increased as a function of pulse separation. For 2 ms/phase pulses, detection thresholds were lowest at pulse separations around 7.5 ms, in most cases, and higher at both longer and shorter pulse separations. These results suggest that interactions among adjacent pulses can either hinder or facilitate detection of the signal depending on the magnitudes of pulse separation and phase duration. Pulse separations at which thresholds measured for 2 ms/phase pulses were minimum were fairly consistent across subjects and did not correlate well with speech recognition scores. However, significant variation in this measure across species has been seen.

Adult↗

PubMed1997

Speech recognition at simulated soft, conversational, and raised-to-loud vocal efforts by adults with cochlear implants.

Ten postlinguistically deaf adults who used the Nucleus Cochlear Implant System and SPEAK speech coding strategy responded to vowels, consonants, words, and sentences presented sound-only at 70, 60, and 50 dB sound-pressure level. Highest group mean scores were at a raised-to-loud level of 70 dB for consonants (73%), words (44%), and sentences (87%); the highest score for vowels (70%) was at a conversational level of 60 dB. Lowest group mean scores were at a soft level of 50 dB for vowels (56%), consonants (47%), words (10%), and sentences (29%); all except subject 7 had some open-set speech recognition at this level. For the conversational level (60 dB), group mean scores for sentences and words were 72% and 29%, respectively. With this performance and sound-pressure level, it was observed that these subjects communicated successfully in a variety of listening situations. Given these subjects' speech recognition scores at 60 dB and the fact that 70 dB does not simulate the vocal effort used in everyday speaking situations, it is suggested that cochlear implant candidates and implantees be evaluated with speech tests presented at 60 dB instead of the customary 70 dB sound-pressure level to simulate benefit provided by implants in everyday life. Analysis of individuals' scores at the three levels for the four speech materials revealed different patterns of speech recognition among subjects (e.g., subjects 1 and 5). Future research on the relation between stimuli, sound processing, and subjects' responses associated with these different patterns may provide guidelines to select parameter values with which to map incoming sound onto an individual's electrical dynamic range between threshold and maximum acceptable loudness level to improve speech recognition.

Adult↗

PubMed1999

Advantages of a new miniature hearing aid for mild to moderate hearing loss.

OBJECTIVES/HYPOTHESIS: To evaluate the performance of a new, miniature, behind-the-ear hearing aid designed for individuals with mild to moderate high-frequency hearing loss who need an aid but are reluctant to try one. The aid is essentially invisible, leaves the ear canal open, and can be fit in less than 30 minutes without an ear impression. The cost is less than $500. STUDY DESIGN: A 4-week trial of the aid in 63 ears (62 subjects) with mild to moderate bilateral hearing loss. METHODS: A questionnaire was completed at the end of the study by each subject asking them to evaluate several features of the aid (cosmesis, comfort, understanding speech, amplification, and so forth) and to compare their unaided performance in quiet and in noise with the test hearing aid. A rating scale of 1 to 10 was used, with 10 being excellent and 1 poor. RESULTS: Subjective improvement in understanding speech in both quiet (5.8-->7.3) and noise (4.6-->5.9) occurred with the aid. Cosmesis, comfort, and appearance were highly rated (mean scores, > 8). CONCLUSIONS: This aid appears to have several features (comfort, cost, performance, and cosmesis) that make it ideal as a first aid for patients with mild to moderate losses.

Adult↗

PubMed2001

Benefit of a digital feedback suppression system for acoustical telephone communication.

Because hearing instruments have traditionally performed poorly during acoustical telephone use, the benefit of using a Digital Feedback Suppression (DFS) system for acoustical telephone communication was evaluated. For this purpose a special speech test based on the method and material of the Oldenburg Sentence Test was developed, presenting the speech signal via a telephone receiver. The correct coupling of the receiver and the hearing aid was monitored by means of a probe microphone. The word score was determined for two different settings of the hearing aid: (1) DFS activated (2) DFS deactivated. The difference in word score between these two conditions is an indication of the benefit provided by the DFS system. For almost all subjects, speech recognition at the telephone could be improved using the DFS system. This is a significant contribution in increasing end-user overall satisfaction with hearing aids.

Acoustic Stimulation↗

PubMed2002

Middle ear electromagnetic semi-implantable hearing device: results of the phase II SOUNDTEC direct system clinical trial.

OBJECTIVE: To assess the safety and efficacy of the SOUNDTEC Direct System, a partially implantable electromagnetic middle ear hearing device. STUDY DESIGN: Food and Drug Administration Phase II clinical trial of 103 patients at 10 sites across the United States. SETTING: Tertiary referral medical centers. PATIENTS: Individuals with bilateral moderate to moderately severe sensorineural hearing impairment who had worn optimally fit hearing aids for at least 45 days. INTERVENTIONS: Therapeutic intervention included implantation of a 27-mg neodymium iron boron magnet encased in a laser-welded titanium canister onto the incudostapedial joint, followed, after a 10-week healing period, by fitting with a deep earmold coil assembly and activation of the sound processor. MAIN OUTCOME MEASURES: Functional gain, speech recognition in quiet and noise, articulation index scores, perceived aided benefit, sound quality judgments, satisfaction, and presence of feedback and occlusion with the Direct System were compared with those of the patients' optimally fit hearing aid. RESULTS: The results of this multicenter clinical trial were submitted to the Food and Drug Administration on April 13, 2001, and are presented here. The results with the use of the SOUNDTEC Direct System compared with an optimally fit hearing aid provided an average 7.9-dB increase in functional gain in the speech frequencies (500-4,000 Hz) and a 9.6 dB gain in high frequencies (2,000, 3,000, and 4,000 Hz). There was a statistically significant average increase of 5.3% in speech discrimination. The mean speech perception in noise test score was improved, but the improvement was not statistically significant. Subjective tests using abbreviated profile of hearing aid benefit and the Hough Ear Institute Profile demonstrated scores statistically improved over the hearing aid condition. These subjective tests measured areas such as the presence of occlusion and feedback, speech quality judgments, device preference, and perceived aided benefit. CONCLUSIONS: The results of this Phase II clinical trial demonstrate that the SOUNDTEC Direct System provided statistically significant reduction in feedback and occlusive effect as well as a statistically significant improvement in all the following categories: functional gain, articulation index scores, speech discrimination in quiet, perceived aided benefit, patient satisfaction and device preference over the patient's optimally fit hearing aid.

Adult↗

PubMed1991

Cochlear versus retrocochlear presbyacusis: clinical correlates.

This study reviews audiologic findings on cases of hearing-impaired elderly adults who were matched on the basis of peripheral hearing loss and who were divided into cochlear and retrocochlear groups on the basis of auditory brain stem response (ABR) test results. ABR test results were compared to other audiologic test results that included: (1) word-recognition scores and performance-intensity functions of phonetically balanced word lists; and (2) performance-intensity functions of Synthetic Sentence Identification lists with ipsilateral competing messages. The results of this study indicate that the retrocochlear group performed less favorably than the cochlear group on speech measures known to be sensitive to a retrocochlear site of disorder. This study further emphasizes the complexity of presbyacusis by demonstrating that peripheral hearing loss, alone, cannot account for the totality of the auditory problems that are encountered by elderly listeners.

Aged↗

PubMed1998

Adjustment to hearing impairment II: audiological and demographic correlates.

To study adjustment to hearing impairment, clinical records from a five-center consortium (N = 1,008) were used to create a heterogeneous clinical database with results of audiometric tests, demographic and case history information, and responses to the Communication Profile for the Hearing Impaired (CPHI; Demorest & Erdman, 1986, 1987). Normative findings have been described previously (Erdman & Demorest, 1998). Hierarchical regression analyses revealed that audiometric variables were moderately correlated with communication performance, behavioral strategies, and personal adjustment. With hearing impairment controlled statistically, age and education effects were evident in many areas of adjustment; correlations between adjustment and gender were relatively weak; and marital status, employment status, and race/ethnicity were rarely significant correlates.

Adolescent↗

PubMed2003

Acoustic hemifields in the spatial release from masking of speech by noise.

The Hearing-in-Noise Test (HINT) is able to measure the benefit to speech intelligibility in noise conferred when the noise masker is displaced 90 degrees in eccentricity from a speech source located at zero degrees azimuth. Both psychoacoustic and neurophysiological data suggest that the perceptual benefit of the 90-degree azimuth separation would be greatest if the speech and noise were presented in different acoustic hemifields, and would be smallest if the two sources were in the same acoustic hemifield. The present study tested this hypothesis directly in ten normal-hearing adult listeners. Using the HINT stimuli, we confirmed the hypothesis. Release from masking scores averaged 8.61 dB for "between-hemifield" conditions, 6.05 dB for HINT conditions, and 1.27 dB for "within-hemifield" conditions, even though all stimulus configurations retained a 90-degree angular separation of speech and noise. These data indicate that absolute separation of speech and noise alone is insufficient to guarantee a significant release from masking, and they suggest that what matters is the location of the stimulus elements relative to the left and right spatial perceptual channels.

Adult↗

PubMed1998

Performance with the 20 + 2L lateral wall cochlear implant.

OBJECTIVE: The purpose of this study was to investigate the operating characteristics of the Nucleus 20 + 2L lateral wall cochlear implant including speech recognition results. STUDY DESIGN: This was a prospective randomized study involving five different modes of stimulation. SETTING: This study was carried out in an academic, tertiary referral center. PATIENTS: The patients included in this study were adult cochlear implant candidates ages 44-74 years. Length of deafness ranged from 1 to 58 years with a variety of etiologies. INTERVENTIONS: All patients were implanted with a 20 + 2L implant, which includes an intrascalar electrode array and an apically placed extracochlear, titanium encased ball electrode in contact with the endosteum of the apical turn. All patients underwent psychophysical and speech recognition testing in five different modes of electrode configuration. MAIN OUTCOME MEASURE(S): The main outcome measures included thresholds, comfort levels, dynamic ranges, and speech recognition results obtained in five electrode configuration modes. RESULTS: Thresholds were significantly lower (repeated measures ANOVA) in both monopolar conditions when compared to bipolar mode of stimulation. A binomial statistical analysis indicated that in five of nine patients activated in all five modes of stimulation, the monopolar modes of stimulation resulted in improved speech recognition scores. CONCLUSIONS: The results of the study demonstrate the feasibility of the use of an apical lateral cochlear wall electrode in conjunction with an intrascalar electrode array. It further demonstrated the superiority of monopolar stimulation in selected patients.

Adult↗

PubMed2003

Forward masking in different cochlear implant systems.

The goal of this study was to evaluate, from a psychophysical standpoint, the neural spread of excitation produced by the stimulation of different types of intracochlear electrode arrays: the Ineraid, the Clarion S-Series on its own or with the Electrode Positioning System (EPS), and the Clarion HiFocus-I with the EPS. The EPS is an independent silicone part designed to bring the electrode array close to the modiolus. Forward masking was evaluated in 12 adult subjects (3 Ineraid, 4 Clarion S-Series, 3 Clarion S-Series+EPS, 3 HiFocus-I+EPS) by psychophysical experiments conducted using trains of biphasic stimuli (813 pulses per second, 307.6 micros/phase). Masker signals (+8 dB re: threshold, 300 ms) were applied to the most apical electrode. Probe signals (30 ms, 10-ms postmasker) were delivered to more basal electrodes. Masked and unmasked detection thresholds of probe signals were measured. For both Clarion HiFocus-I subjects, measurements were conducted in both monopolar and bipolar stimulus configurations. No major differences were found in forward masking between the different intracochlear electrode arrays tested in the monopolar configuration at suprathreshold levels equivalent to those used in speech-coding strategies, but significant differences were found between subjects. A significant negative correlation also was found between the level of forward masking and the consonant identification performance. These measurements showed that the neural spread of excitation was more restricted in the bipolar configuration than in the monopolar configuration for HiFocus-I subjects. It was found that CIS strategies implemented without using apical electrodes, which showed high levels of masking, could improve consonant identification.

Adult↗

PubMed2005

Can central auditory processing tests resist supramodal influences?

For the past 10 years, Cacace and McFarland have contended that current central auditory processing tests are invalid because they cannot disassociate central auditory processing disorder (CAPD) from language, attention, and other problems. Over this period of time, they have not developed a battery of tests to compare with the current procedures, so the question cannot be resolved in a proper scientific fashion. Also, we disagree with their contention and demonstrate that an experienced audiologist, under double-blind research conditions, can reliably evaluate individuals with attention-deficit/hyperactivity disorder for CAPD, whether therapeutically controlled for attention with Ritalin or taking a placebo. Further, we show how intra- and intertest comparisons, as well as a team approach, disassociate CAPD from potential contamination from supramodal factors.

Adult↗

PubMed2005

Binaural-bimodal hearing: concomitant use of a unilateral cochlear implant and a contralateral hearing aid.

CONCLUSION: The benefit obtained with a contralateral hearing aid (HA) in unilateral cochlear implantees improves over time, at least during the first year after implantation. OBJECTIVE: To evaluate binaural-bimodal auditory ability and its early changes over time after unilateral cochlear implantation in patients with residual hearing in the non-implanted ear, in which they use an HA. MATERIAL AND METHODS: Sentence identification in background noise was tested in 12 patients (3 post-lingual adults and 9 pre-lingual adults and older children) under 3 listening conditions: cochlear implant (CI) alone, HA alone and CI+HA. The presentation level was 55 dB HL with a signal-to-noise ratio of +10 dB. Subjects were tested after 1-6 months of concomitant use of both devices and again after a further 7-12 months. RESULTS: At the first testing session, the mean score in background noise was 34.9% with CI alone (range 0-90%) and 41.1% with both devices (range 0-100%). Seven patients could recognize sentences in noise with CI alone, and four of them showed further improvement with added amplification. At the second session, at which all subjects could recognize sentences in noise with the CI alone, seven showed further improvement with added amplification. The mean score was 60.6% with CI alone (range 10-99%) and 75.5% with both devices (range 52-100%).

Adolescent↗

PubMed1996

Audiometric findings in children with chronic suppurative otitis media without cholesteatoma.

Chronic suppurative otitis media without cholesteatoma (CSOMWC) is usually associated with an increase in air conduction thresholds. However, only a few investigations reported on loss of cochlear function in the pediatric population. We undertook a prospective study in order to further delineate air and bone conduction levels in children with CSOMWC and the possible relationship between sensorineural hearing loss (SNHL) and other clinical characteristics that might reflect the extent of disease. Eighty-seven children were enrolled, 40 of which had bilateral disease. Hence, the total number of diseased ears tested was 127. Audiometric studies were performed three days after achieving a 'dry' ear following medical treatment. We found no statistically significant differences between the bone conduction threshold tested in ears with CSOMWC and control ears. This was also the case in 47 children with unilateral disease when cochlear function was investigated in the diseased and uninvolved ear in the same patient. Clinical correlation showed no association between age, sex, duration of otorrhea and presence of granulation or polyps and the degree of cochlear loss. Our study shows that CSOMWC in children has little effect on cochlear function.

Adolescent↗

PubMedDate not supplied

Northwestern University Auditory Test No. 6 in multi-talker babble: a preliminary report.

The purpose of this project was to develop a spoken word-recognition task that could be used clinically to evaluate recognition performance of individuals with hearing loss in a background noise. The test instrument incorporated monosyllabic words at seven levels over a 35-dB range presented in a background of "multi-talker" babble that was fixed in level. In Experiment 1, we established normative data on 24 young adult listeners with normal hearing and on 50 older adult listeners with high-frequency hearing loss. In Experiment 2, we examined the effects that age and hearing loss have on understanding speech in multi-talker babble by studying 15 subjects in each decade interval from 20 to 79 years.

Adult↗

PubMed2005

Using multichannel wide-dynamic range compression in severely hearing-impaired listeners: effects on speech recognition and quality.

OBJECTIVE: The objective of this study was to compare speech recognition across a sampling of amplification choices available for listeners with severe loss. This includes conventional options (linear with peak clipping and linear with compression limiting) and newer strategies (multichannel wide-dynamic range compression [WDRC]) theorized to better accommodate reduced dynamic range. A second objective was to compare speech quality across the same conditions using a paired-comparison test. DESIGN: Participants were 13 adults with severe sensorineural hearing loss and a control group of seven adults with normal hearing. Test materials included consonant-vowel syllables (speech recognition) and sentences (speech quality). Four amplification conditions were included: peak clipping; compression limiting; two-channel WDRC; and three-channel WDRC, with overall audibility similar across conditions. In the WDRC conditions, the compression ratio was fixed at 3:1 in each channel. Consonant recognition was measured using a closed-set task, and speech quality was measured using a paired-comparison test. RESULTS: For the listeners with severe loss, recognition and preference were lower for a three-channel WDRC system than for a compression limiting system. Specific errors were consistent with poorer transmission of amplitude envelope information by the multichannel WDRC systems. CONCLUSIONS: Under some conditions, the benefit of fast-acting, multichannel WDRC systems relative to more linear amplification strategies may be reduced in listeners with severe loss. Performance decrements with these systems are consistent with consequences of broader auditory filters.

Acoustic Stimulation↗

PubMed2002

Evaluation of an adaptive, directional-microphone hearing aid.

The effectiveness of adaptive directional processing for improvement of speech recognition in comparison to non-adaptive directional and omni-directional processing was examined across four listening environments intended to simulate those found in the real world. The test environment was a single, moderately reverberant room with four loudspeaker configurations: three with fixed discrete noise source positions and one with a single panning noise source. Sentence materials from the Hearing in Noise Test (HINT) and Connected Speech Test (CST) were selected as test materials. Speech recognition across all listening conditions was evaluated for 20 listeners fitted binaurally with Phonak Claro behind-the-ear (BTE) style hearing aids. Results indicated improved speech recognition performance with adaptive and non-adaptive directional processing over that measured with the omnidirectional processing across all four listening conditions. While the magnitudes of directional benefit provided to subjects listening in adaptive and fixed directional modes were similar in some listening environments, a significant speech recognition advantage was measured for the adaptive mode in specific conditions. The advantage for adaptive over fixed directional processing was most prominent when a competing noise was presented from the listener's sides (both fixed and panning noise conditions), and was partially predictable from electroacoustically measured directional pattern data.

Audiometry, Pure-Tone↗

PubMed1996

[The Clarion cochlear implant--technical principles, initial clinical experiences and results].

BACKGROUND: Certain design characteristics of the Clarion device (Advanced Bionics Corp.) make it significantly different from other cochlear implant systems. It has a preformed electrode array to be placed closer to the modiolus, thus providing a more efficient coupling of the electrical signal to the auditory nerve; a telemetric function which permits the evaluation of the implant electronics; and two different speech processing strategies. The strategies are continuous interleaved sampling (CIS) and compressed analog (CA); both can be programmed into the same speech processor and alternatively selected by the patients, as they desire. The surgical procedure is only slightly different from the procedure familiar from the Nucleus system with the exception of a significantly larger cochleostomy. PATIENTS: The results of a series of speech tests designed to evaluate benefit in terms of speech understanding were administered to the first ten Clarion patients and compared to the results of a similar group of patients using the Nucleus system and the M Peak method. From a data-base of more than 300 Nucleus users, it was possible to select ten subjects who had near-equivalent data for onset of deafness, duration of deafness, and age at implantation (so-called matched pairs). In the majority of cases, etiology and course of deafness (progressive or sudden) could also be matched. RESULTS: It was found that the Clarion patients had higher test scores than the Nucleus patients after two weeks, three months, and six months after implantation. This positive experience with the Clarion device encouraged us to continue implanting this system in patients. As of September 1995, 106 patients (including 35 children between the ages of two and fourteen) are currently enrolled in the study. CONCLUSIONS: A final assessment of results with the Clarion implant is not possible because of the short follow-up. In any case, it appears that the patients with this implant system achieve faster open-set speech understanding and that it is accomplished with less effort in programming and shorter rehabilitation time.

Adolescent↗

PubMed1988

A closed- versus open-set measure of speech discrimination in normally hearing young and elderly adults.

This investigation sought to determine whether the pattern of performance differed between young and elderly normally hearing adults on a closed v. open-set discrimination task. The California Consonant Test was administered at 32 dB SL (re:SRT) to 20 young and 20 elderly normally hearing subjects under two conditions: one which required subjects to mark their response on a multiple choice answer form; and a second which required subjects to provide a one-word written response on a blank answer form. The only significant difference occurred within the young group between conditions (closed-set, open-set). The young group's speech discrimination was significantly better in the closed-set condition then in the open-set condition. No other differences were significant. The results question the concept of phonemic regression as a concomitant of ageing.

Adult↗