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PubMed2005

Adaptation of the HINT (hearing in noise test) for adult Canadian Francophone populations.

The HINT provides an efficient and reliable method of assessing speech intelligibility in quiet and in noise by using an adaptive strategy to measure speech reception thresholds for sentences, thus avoiding ceiling and floor effects that plague traditional measures performed at fixed presentation levels A strong need for such a test within the Canadian Francophone population, led us to develop a French version of the HINT. Here we describe the development of this test. The Canadian French version is composed of 240-recorded sentences, equated for intelligibility, and cast into 12 phonemically balanced 20-sentence lists. Average headphone SRTs, measured with 36 adult Canadian Francophone native speakers with normal hearing, were 16.4 dBA in quiet, -3.0 dBA SNR in a 65 dBA noise front condition and -11.4 dBA SNR in a 65 dBA noise side condition. Reliability was established by means of within-subjects standard deviation of repeated SRT measurements over different lists and yielded values of 2.2 and 1.1 dB for the quiet and noise conditions, respectively.

Acoustic Stimulation↗
PubMed2005

Learning effect when using the Danish Hagerman sentences (Dantale II) to determine speech reception threshold.

The objective of the present study was to examine the learning effect found when using the Danish sentence test, Dantale II, in our daily clinical work. Specifically, the aim was to determine the within-visit and the inter-visit learning effects when the Dantale II is presented to aided hearing-impaired listeners who have not previously completed the task. Nineteen subjects participated in the study. The within-visit learning effect after listening to 160 sentences was found to be 3.2 dB, and the inter-visit learning effect was 1.6 dB with an inter-visit period range of 14-43 days. For research evaluation of algorithms or hearing aid settings, where the differences are expected to be small, it is recommended that a pool of test subjects are regularly tested using the Dantale II speech material. Moreover, a limitation of the number of signal processing test conditions is suggested.

Adult↗
PubMed2004

The performance-perceptual test and its relationship to unaided reported handicap.

OBJECTIVE: Measurement of hearing aid outcomes is necessary for demonstration of treatment efficacy, third-party payment, and cost-benefit analysis. Outcomes are usually measured with hearing-related questionnaires and/or tests of speech recognition. However, results from these two types of test often conflict. In this paper, we provide data from a new test measure, known as the Performance-Perceptual Test (PPT), in which subjective and performance aspects of hearing in noise are measured using the same test materials and procedures. A Performance Speech Reception Threshold (SRTN) and a Perceptual SRTN are measured using the Hearing In Noise Test materials and adaptive procedure. A third variable, the discrepancy between these two SRTNs, is also computed. It measures the accuracy with which subjects assess their own hearing ability and is referred to as the Performance-Perceptual Discrepancy (PPDIS). DESIGN: One hundred seven subjects between 24 and 83 yr of age took part. Thirty-three subjects had normal hearing, while the remaining seventy-four had symmetrical sensorineural hearing loss. Of the subjects with impaired hearing, 24 wore hearing aids and 50 did not. All subjects underwent routine audiological examination and completed the PPT and the Hearing Handicap Inventory for the Elderly/Adults on two occasions, between 1 and 2 wk apart. The PPT was conducted for unaided listening with the masker level set to 50, 65, and 80 dB SPL. RESULTS: PPT data show that the subjects with normal hearing have significantly better Performance and Perceptual SRTNs at each test level than the subjects with impaired hearing but that PPDIS values do not differ between the groups. Test-retest reliability for the PPT is excellent (r-values > 0.93 for all conditions). Stepwise multiple regression analysis showed that the Performance SRTN, the PPDIS, and age explain 40% of the variance in reported handicap (Hearing Handicap Inventory for the Elderly/Adults scores). More specifically, poorer performance, underestimation of hearing ability and younger age result in greater reported handicap, and vice versa. CONCLUSION: Reported handicap consists of a performance component and a (mis)perception component, as measured by the Performance SRTN and the PPDIS respectively. The PPT should thus prove to be a valuable tool for better understanding why some individuals complain of hearing difficulties but have only a mild hearing loss or conversely report few difficulties in the presence of substantial impairment. The measure would thus seem to provide both an explanation and a counseling tool for patients for whom there is a mismatch between reported and measured hearing difficulties.

Adult↗
PubMed2005

The viability of speech-in-noise audiometric screening using domestic audio equipment.

Speech-in-noise audiometry has potential application as a low-cost, self-screening test for sensorineural hearing loss. To realize this potential, the influence of variations in audio equipment and listening environment need assessment. The present study assessed: 1) the frequency response and distortion produced by a wide range of commercially available audio equipment; 2) the effects of such variations upon test results with normally hearing subjects using a simple, open-set, word-identification test; 3) the effect of distortion on the speech reception threshold using digitally applied distortion; and 4) the reliability of the test in listening environments with different levels of reverberation. In addition, preliminary tests were conducted with elderly listeners. The results indicate that variations in equipment have negligible effects on speech-in-noise audiometry. The only factor that substantially elevated normally hearing listeners' thresholds was high levels of room reverberation when using loudspeaker presentation. Variations in equipment and environment thus present no significant obstacle to the development of a self-administered audiometric screening test based on speech in noise.

Acoustic Stimulation↗
PubMed1993

Development and assessment of two fixed-array microphones for use with hearing aids.

Hearing-impaired listeners often have great difficulty understanding speech in situations with background noise (e.g., meetings, parties). Conventional hearing aids offer insufficient directivity to significantly reduce background noise relative to the desired speech signal. Based on array techniques, microphone prototypes have been developed with strongly directional characteristics to be incorporated into the frame and the "temples" of a pair of eyeglasses. Particular emphasis was on optimization and electronic stability. Computer simulations show that a directivity index of more than 10 dB can be obtained at the higher frequencies. Simulations were verified with free-field measurements. To investigate the influence of the human head on directivity, two portable models were also tested with a KEMAR manikin. The measurements show that the two models give an improvement of the signal-to-noise ratio of approximately 7 dB in a diffuse background noise field compared with an omnidirectional microphone. For the clinical assessment of these microphone arrays in the diffuse noise field (simulating a cocktail party situation), the speech-reception threshold in noise for simple Dutch sentences was determined with a normal single omnidirectional microphone and with one of the microphone arrays. The results of monaural listening tests of 30 subjects with normal hearing and 45 subjects with hearing impairment show that the microphone arrays give a mean improvement of the speech reception threshold in noise of about 7 dB compared with an omnidirectional microphone.

Adult↗
PubMed2004

Development and validation of an automatic speech-in-noise screening test by telephone.

To meet the need for an objective self-test for hearing screening. a new Dutch speech-in-noise test was developed. Digit triplets were used as speech material. The test was made fully automatic, was controlled by a computer, and can be done by telephone. It measures the speech reception threshold (triplet SRT(n)) using an adaptive procedure, in about 3 min. Our experiments showed no significant influence of telephone type or listening environment. Measurement errors were within 1 dB. which makes the test accurate. In additional experiments with hearing-impaired subjects (76 ears of 38 listeners), the new test was compared to the existing sentence SRT(n) test of Plomp and Mimpen, which is considered to be the standard. The correlation between both SRT(n)s was 0.866. As expected, correlations between the triplet SRT(n) test by telephone and average pure-tone thresholds are somewhat lower: 0.732 for PTA(0,5,1,2), and 0.770 for PTA(0,5,2,4). When proper SRT(n) values were chosen for distinguishing between normal-hearing and hearing-impaired subjects, the triplet SRT(n) test was found to have a sensitivity of 0.91 and a specificity of 0.93.

Acoustic Stimulation↗
PubMed2004

The effect of mild hearing impairment on auditory processing tests.

The application of auditory processing tests to patients with sensorineural hearing loss is controversial. Several studies have shown that it is difficult to separate peripheral from central hearing processes. In the present study, a Dutch auditory processing test battery was administered to 24 subjects with mild, relatively flat, symmetrical sensorineural hearing loss. Tests were administered twice; the second time, the presentation level in four out of the six tests was adjusted according to the speech reception threshold. The scores of the hearing-impaired subjects were significantly poorer than those of the subjects with normal hearing on five out of the six tests, even with the adjusted presentation level. Significant correlations were found between test scores and PTA (pure-tone average); scores on words-in-noise, filtered-speech and binaural-fusion tests were additionally corrected according to PTA. In contrast to previous studies in the literature, the present dichotic-digit and pattern-recognition tests were greatly influenced by mild hearing loss. Therefore, this auditory processing test battery cannot readily be used to diagnose central auditory processing disorders in patients with flat sensorineural hearing loss. At least, both adjustment of presentation level and additional correction are needed.

Adult↗
PubMed1979

Comparison of tangibly reinforced speech-reception and pure-tone thresholds of mentally retarded children.

Sixteen mentally retarded children who had normal hearing were examined with two tests of auditory sensitivity. One procedure employed a tangibly reinforced operant-conditioning paradigm for pure tones, and the other test was based on a modification of operant conditioning for obtaining speech-reception thresholds. The speech procedure, utilizing an attractive mechanical device in the form of a clown, proved to be effective and efficient for use with retarded children.

Acoustic Stimulation↗
PubMed1978

Telecommunication performance of persons with hearing handicap in relation to speech reception threshold.

This study is concerned with the ability of hearing-impaired persons to perceive speech via the telephone and in particular with the possible benefit gained by the use of different kinds of auxiliary equipment (receiver amplifier, extra watch receiver, hearing aid in telemagnetic or microphone position, so-called combined amplifier, and combinations of these). In 203 hard-of-hearing subjects, grouped according to the speech reception threshold (SRT) of the better ear, the efficiency of the devices under test was investigated at two different line attenuations, one representing a good telephone connection and one representing a rather poor connection. It is concluded that persons with a slight hearing impairment (SRT:0--25 dB in the better ear) are able to use the telephone without special devices. The same applies to the majority of those with moderate hearing impairment (SRT:30--45 dB). For persons having a more severe hearing loss, a telephone with a receiving amplifier, or the individual hearing aid combined with the ordinary telephone set, can largely compensate for difficulties experienced when using the telephone. To complete the experiments, the audibility of a number of telephone bells was assessed. The bell in the standard set had low audibility for all the investigated groups of persons. Some of the other sound sources offered somewhat less difficulty.

Adult↗
PubMed1977

A comparison of the Auditec of St. Louis cassette recordings of NU-6 and CID W-22 on a normal-hearing population.

Articulation functions were generated on a normal-hearing population with the Auditec of St. Louis cassette recordings of the NU-6 and CID W-22 speech discrimination tests. Both tests were similar and yielded slopes of about 4.4%/dB. Each gave a speech discrimination score of approximately 95% at 32 dB SL. Speech reception thresholds were obtained with monitored live voice and yielded good test-retest consistency. Speech thresholds were about 9 dB better than the ANSI (1969) specifications.

Adult↗
PubMed1981

Noise and hearing loss.

Audiology is an essential aid to diagnosis of hearing loss, including loss due to exposure to excessive noise. Patients who complain of hearing difficulty should be examined and their hearing tested to determine hearing acuity, speech reception threshold, and speech discrimination as well as whether amplification is warranted.

Aged↗
PubMed2004

Head shadow, squelch, and summation effects in bilateral users of the MED-EL COMBI 40/40+ cochlear implant.

OBJECTIVE: The aim of the study was to investigate the impact of bilateral cochlear implant use on speech perception in noise in bilateral users of the MED-EL COMBI 40/40+ cochlear implants. DESIGN: Speech reception thresholds were measured in 21 subjects using the Oldenburg sentence test. Speech was always presented from the front. Noise was either presented from the front, from the left side, or from the right side. Each condition was measured for unilateral and bilateral implant use. RESULTS: For three subjects, the test was too difficult to be administered. The 18 subjects from whom a complete data set could be obtained showed a significant head shadow effect and summation effect for all test conditions, whereas the squelch effect was significant for noise from the left side only. Average effect sizes were significant for all effects and amounted to 6.8 dB for the head shadow effect, 0.9 dB for the squelch effect, and 2.1 dB for the summation effect. Effect sizes were not correlated with duration of deafness. CONCLUSIONS: Bilateral cochlear implant users can at least qualitatively benefit from the effects that are known from normal-hearing subjects, that is, head shadow, summation, and squelch effect. Bilateral cochlear implantation also reduces the performance gap between cochlear implant users and normal-hearing subjects.

Adolescent↗
PubMed1999

[Hearing status after stapedectomy with preservation or cutting of stapedius tendon].

The authors analysed the influence of preservation or cutting of stapedius tendon during stapedotomy on postoperative hearing improvement. The material analysed was 110 operated ears, which were divided into two egual groups considering preservation or cutting of stapedius tendon. All operations were performed by the same surgeon using stapedotomy with tarflen prothesis. In all cases before and after operation there was performed tonal audiometry within a range from 0.5 to 4.0 kHz, speech audiometry with indication of speech reception threshold using mono-syllable test. The comparison of operation results did not show significant statistical differences between the studied groups of operated ears.

Adult↗
PubMed1979

[Psychogenic hearing loss (author's transl)].

The possible causes of psychogenic hearing loss and aggravating deafness are compared. The evaluation of anamnesis, speech reception thresholds, hearing threshold levels and recuitment tests, Békésy audiometry and simulation tests for the differential diagnosis is discussed. Therapeutical consequences are talked about. A case report will demonstrate in-debth how a minor noise-induced hearing loss due to having worked in a noisy environment for 25 years, was dominated by psychogenic hearing disorders of a considerable degree.

Audiometry↗
PubMed2004

Better speech perception in noise with an assistive multimicrophone array for hearing AIDS.

OBJECTIVE: To evaluate the improvement in speech intelligibility in noise obtained with an assistive real-time fixed endfire array of bidirectional microphones in comparison with an omnidirectional hearing aid microphone in a realistic environment. DESIGN: The microphone array was evaluated physically in anechoic and reverberant conditions. Perceptual tests of speech intelligibility in noise were carried out in a reverberant room, with two types of noise and six different noise scenarios with single and multiple noise sources. Ten normal-hearing subjects and 10 hearing aid users participated. The speech reception threshold for sentences was measured in each test setting for the omnidirectional microphone of the hearing aid and for the hearing aid in combination with the array with one and three active microphones. In addition, the extra improvement of five active array microphones, relative to three, was determined in another group of 10 normal-hearing listeners. RESULTS: Improvements in speech intelligibility in noise obtained with the array relative to an omnidirectional microphone depend on noise scenario and subject group. Improvements up to 12 dB for normal-hearing and 9 dB for hearing-impaired listeners were obtained with three active array microphones relative to an omnidirectional microphone for one noise source at 90 degrees . For three uncorrelated noise sources at 90 degrees, 180 degrees, and 270 degrees, improvements of approximately 9 dB and 6 dB were obtained for normal-hearing and hearing-impaired listeners, respectively. Even with a single noise source at 45 degrees, benefits of 4 dB were achieved in both subject groups. Five active microphones in the array can provide an additional improvement at 45 degrees of approximately 1 dB, relative to the three-microphone configuration for normal-hearing listeners. CONCLUSIONS: These improvements in signal-to-noise ratio can be of great benefit for hearing aid users, who have difficulties with speech understanding in noisy environments.

Adolescent↗
PubMed2003

Development of materials for the clinical assessment of speech recognition: the speech sound pattern discrimination test.

The purpose of this investigation was to evaluate the validity and reliability of materials designed for an assessment procedure capable of making meaningful distinctions in speech recognition ability among individuals having mild-to-moderate hearing losses. Sets of phonetic contrasts were presented within sentence contexts to 53 listeners (22 normal hearing, 31 hearing impaired) in 4 listening conditions (quiet and with background competition at signal-to-noise ratios of +5, 0, and -5 dB). The listeners were asked to discriminate pairs of sentences (e.g., "The man hid the dog" and "The man hit the dog") using same-different judgments. Their performances were analyzed in a manner enabling comparisons among items in terms of the classification of phonetic contrasts. Listener performance was also compared to performance on a set of independent variables, including the W-22 and QuickSIN speech tests, high-frequency hearing loss, speech reception threshold, listener age, and others. Results indicated that the new materials distinguished the normal-hearing from the hearing-impaired group and that listener performance (a) declined about 17% for each 5 dB decrement in SNR and (b) was influenced by the phonetic content of items in a manner similar to that reported by G. A. Miller and P. E. Nicely (1955). The performances of the hearing-impaired listeners were much more strongly related to high-frequency hearing loss, listener age, and other variables than were their performances on either the W-22 or QuickSIN tests. These findings are discussed with specific reference to the use of a mathematical model (i.e., the Rasch model for person measurement) for scaling items along a continuum of difficulty. The mathematical model and associated item difficulty values will serve as the basis for construction of a clinically useful computerized, adaptive test of speech recognition ability known as the Speech Sound Pattern Discrimination Test (Bochner, J., Garrison, W., Palmer, L., MacKenzie, D., & Braveman, A., 1997).

Adult↗
PubMed1985

Improvements in speech intelligibility in quiet and in noise produced by two-channel compression hearing aids.

Eight subjects suffering from bilateral sensorineural hearing losses with recruitment were fitted binaurally with two-channel compression hearing aids, worn behind the ear. After they had worn the aids for some time, measures of speech intelligibility were compared for two conditions: listening unaided, and listening aided. the dynamic range for speech, defined as the difference in level between the speech reception threshold in quiet and the highest comfortable level for speech, was substantially increased in the aided condition for seven of the eight subjects (the exception was a subject with almost normal low-frequency hearing). Speech reception thresholds were also measured in two levels of background noise ('babble'), 60 and 75 dB SPL. Seven of the eight subjects showed a reduced speech reception threshold (i.e. an improvement) in the aided condition for at least one of the two noise levels, although the size of the improvement differed considerably from one subject to another. The subjects were also given a battery of psycho-acoustical tests in an attempt to better characterise their hearing loss, and to gain more insight into individual differences. Results of measurements of frequency selectivity, frequency discrimination, temporal acuity and temporal masking are described and related to the measures of speech intelligibility.

Aged↗