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PubMed1997

Audiological correlates of speech understanding deficits in elderly listeners with mild-to-moderate hearing loss. III. Factor representation.

OBJECTIVE: The objective of the study was to determine the major factors that underlie auditory/audiological performance measures in an elderly population, with particular emphasis on finding those factors responsible for speech understanding under specific conditions of interference. DESIGN: Audiological status and auditory performance of a group of elderly (60- to 81-yr-old) and normal-hearing young (18- to 30-yr-old) individuals was determined through a test battery. When present, the hearing loss of elderly subjects was symmetrical in the two ears and, at most, moderate. The battery included tests of speech intelligibility on the word and sentence levels, with and without the presence of interfering speech. In addition to pure-tone and speech reception thresholds, perception of spectrally or temporally distorted speech as well as auditory resolution of frequency, time, and space were tested. Two tests received special consideration: the Speech Perception In Noise Test and the Modified Rhyme Reverberation Test. Taking the overall results as well as various subsets of the results, principal component analyses were conducted to identify major factors underlying auditory performance. RESULTS: The factors extracted by the principal component analyses present a portrayal of the auditory performance profile in which effects of interference, high-frequency hearing, and basic auditory function play a major role. Interference factors include general susceptibility to noise as well as segregation of concurrent speech sounds on the basis of temporal dissimilarities and spatial separation. Comparison of factors extracted from various subsets of tests indicate that factors underlying the decline of the "cocktail party effect" in the elderly are addressed mostly by tests specifically designed to assess speech understanding in spatially distributed babble or in a reverberant environment. CONCLUSIONS: Factor analysis of test measures obtained from a group of elderly individuals with normal hearing or mild-to-moderate hearing loss led to two main findings. First, it portrayed hearing loss as a component of different factors rather than as a factor on its own. Second, the independence of measures of speech understanding in babble or reverberation from other measures suggests that such tests should become an integral part of audiological test batteries designed to assess auditory functions in aging.

Adolescent↗

PubMed1989

Speech audiometry using an adaptive method.

A curve-fitting method is described whereby the results of an adaptive speech test can be used to obtain an accurate value for the speech reception threshold and an estimate of the slope of the psychometric function in the neighbourhood of this threshold.

Audiometry, Speech↗

PubMed2003

[The Oldenburg children's rhyme test during speech simulating noise disturbance (Regensburg variant). Modification of the test and normal values for the ages 7-10 years].

OBJECTIVE: Of the German language speech audiometry tests used for children, only the Oldenburg children's rhyme test is constructed to allow measurements in noise. Unfortunately, no reference values exist for such measurements. Many of children admitted to test speech discrimination in noise are suspected of suffering from central auditory processing disorders and/or attention deficits. Thus, the objective of the present study is the development of a speech-in-noise test that focuses the children's attention on the target words. DESIGN: A speech-simulating noise was added to the Oldenburg children's rhyme test and the discrimination function was estimated. First, the total power of all target words was equalised and the total power of the noise adjusted to obtain a constant signal-to-noise ratio (SNR) for all target words. Second, speech and noise were presented binaurally with headphones. Speech was presented at 65 dB SPL and the noise level varied to obtain SNRs of 0, -5 and -10 dB SN. A total of 55 normal children, 7-10 years of age, were also tested. RESULTS: Mean speech discrimination was 91+/-7% at 0 dB SN, 75+/-11% at -5 dB SN and 55+/-14% at -10 dB SN. The discrimination function results in a speech reception threshold (SRT) of -10.9 dB SN and a maximum slope of 4.95%/dB SN. CONCLUSION: The "Regensburg" variation of the "Oldenburg children's rhyme test" was easily feasible in all tested children. The results can be used as normative data for children between 7 and 10 years.

Age Factors↗

PubMed1987

Speech reception thresholds for digits.

Of every 10 Canadians, 4 do not speak English as a first language. With non-native speakers of English, SRT testing using spondaic words lists, after the fashion in the U.S.A., may be difficult or invalid. This study examined the viability of using a closed set of English digits (1, 2, 4, 5, 9) for SRT testing in a Canadian setting. Ss were 130 consecutive patients referred for audiologic assessment in an English hospital in Montreal. Approximately 1/3 were native English, 1/3 native French, and 1/3 with other ethnic languages. Digit SRTs by a 10-db-down and 5-db-up procedure correlated very highly with both the standard 3-frequency (.5, 1, 2 kc/s) pure-tone average HTL (r = .94) and the Fletcher average of the 2 best speech-frequency pure-tone HTLs (r = .96). This study concluded that serial digits are viable SRT testing material for Canadian speech audiometry and should be studied for application to other multilingual populations.

Adolescent↗

PubMed2006

Cochlear implantation in patients with neurofibromatosis type 2 and bilateral vestibular schwannoma.

OBJECTIVE: To investigate the results of cochlear implantation in patients with neurofibromatosis Type 2 (NF2) and bilateral vestibular schwannoma. STUDY DESIGN: Retrospective case review. SETTING: Three academic tertiary referral centers. PATIENTS: Seven patients with NF2 and bilateral vestibular schwannoma who lost hearing in at least one ear after treatment of their tumor (surgery or radiation therapy). INTERVENTION: Cochlear implantation after treatment of their vestibular schwannoma. MAIN OUTCOME MEASURE: Postimplantation audiometric scores (pure-tone average thresholds, consonant-nucleus-consonant (CNC) words/phonemes, Central Institute for the Deaf (CID) sentences, Hearing in Noise Test (HINT) quiet/noise, and Monosyllable, Trochee, Spondee (MTS) recognition/category tests), patient satisfaction, and device use patterns. RESULTS: The average age at implantation was 40 years (range, 16-57 yr). Follow-up ranged from 6 to 88 months after implantation. Three patients were implanted with residual useful hearing in the contralateral ear, whereas four patients had no hearing in the contralateral ear. Hearing loss was due to surgical excision of tumor (n=5) or gamma-knife radiotherapy (n=2). Postactivation pure-tone average thresholds in the implanted ear ranged from 30 to 55 dB (average, 32.5 dB), although speech reception testing varied considerably among subjects. Despite this variability, all patients continue to use the device on a daily basis. CONCLUSION: In selected cases of deafness in patients with NF2 where there has been anatomic preservation of the auditory nerve after acoustic neuroma resection or radiation therapy, cochlear implantation may offer some improvement in communication skills, including the possibility of open-set speech communication in some patients. These results compare favorably to the auditory brainstem implant offering an alternative for hearing rehabilitation in patients with NF2.

Adolescent↗

PubMed1978

Auditory changes associated with moderate blood salicylate levels.

Thirty patients with rheumatoid arthritis were randomly assigned to two groups: aspirin and placebo. Aspirin group subjects received five grain ASA capsules and placebo group subjects received lactose placebo for seven days. Blood salicylate level (BSL) and audiological evaluations were performed on Days 0, 3 and 7. BSLs never exceeded 21 mg/100 ml. BSLs during the seven days varied only slightly among aspirin group subjects but dropped consistently in the placebo group. Intra-subject comparison of scores on low versus high BSL days indicated significant differences between mean speech reception thresholds (SRT) scores and pure-tone air-conduction thresholds at all test frequencies for both groups, except at 2000 Hz for the aspirin group. Inter-group differences occurred on SRT and high-frequency pure-tone thresholds. The results indicate that moderate BSLs adversely affect hearing ability. These adverse effects appear to be temporary.

Adult↗

PubMed1990

Administering audiometric speech tests via bone conduction: a comparison of transducers.

This study compared the intelligibility of speech delivered via three transducers: a TDH-39 earphone, a Pracitronic KH 70 bone vibrator, and a Radioear B-72 bone vibrator. CID W-1 spondees were presented to normal-hearing listeners via each transducer over a range of intensity levels. Functions relating the percentage of spondees correctly identified to stimulus level were similar for the three transducers, and notably, their slopes were comparable. This suggests that it is appropriate to use the W-1 word lists to determine speech reception thresholds (SRTs) with the KH 70 and B-72 bone vibrators, even though these word lists were originally developed for testing by air conduction. Our subjects also identified NU-6 monosyllabic words equally well for each transducer when the words were delivered at 40 dB above SRT. This result suggests that it is also valid to deliver the NU 6 speech test via the two types of bone vibrators.

Adolescent↗

PubMed1987

Consonant reception in noise by listeners with mild and moderate sensorineural hearing impairment.

The goal of this study was to determine the extent to which the difficulty experienced by impaired listeners in understanding noisy speech can be explained on the basis of elevated tone-detection thresholds. Twenty-one impaired ears of 15 subjects, spanning a variety of audiometric configurations with average hearing losses to 75 dB, were tested for reception of consonants in a speech-spectrum noise. Speech level, noise level, and frequency-gain characteristic were varied to generate a range of listening conditions. Results for impaired listeners were compared to those of normal-hearing listeners tested under the same conditions with extra noise added to approximate the impaired listeners' detection thresholds. Results for impaired and normal listeners were also compared on the basis of articulation indices. Consonant recognition by this sample of impaired listeners was generally comparable to that of normal-hearing listeners with similar threshold shifts listening under the same conditions. When listening conditions were equated for articulation index, there was no clear dependence of consonant recognition on average hearing loss. Assuming that the primary consequence of the threshold simulation in normals is loss of audibility (as opposed to suprathreshold discrimination or resolution deficits), it is concluded that the primary source of difficulty in listening in noise for listeners with moderate or milder hearing impairments, aside from the noise itself, is the loss of audibility.

Acoustic Stimulation↗

PubMed1998

Does chronic otitis media cause sensorineural hearing loss?

OBJECTIVE: The purpose of this study was to determine whether chronic middle ear infection is associated with sensorineural hearing loss. METHOD: Audiometric data from 123 patients with unilateral chronic otitis media were compared using the non-involved ear as a control. The average bone threshold at 500, 1000, and 2000 Hz, the speech reception threshold, and the extent of the disease was compared using the t-test, linear regression, and MANOVA techniques. RESULTS: A highly significant association was found between the presence of chronic otitis media and sensorineural hearing loss. The great variability in our data imply that some individuals are particularly susceptible to chronic otitis media. We offer one suggestion as to why this may occur. CONCLUSION: Sensorineural hearing loss is associated with chronic ear infection with some persons being particularly vulnerable.

Adolescent↗

PubMed2001

Speech recognition in noise for cochlear implantees with a two-microphone monaural adaptive noise reduction system.

OBJECTIVE: In this study the performance of a noise reduction strategy applied to cochlear implants is evaluated. The noise reduction strategy is based on a 2-channel adaptive filtering strategy using two microphones in a single behind-the-ear hearing aid. DESIGN: Four adult LAURA cochlear implant users (Peeters et al., 1993) took part in the experiments. The tests included identification of monosyllabic CVC (consonant-vowel-consonant) words and measurements of the speech reception threshold (SRT) of lists of numbers, in background noise presented at 90 degrees relative to the 0 degrees frontal direction of the speech. Percent correct phoneme scores for the CVC words at signal to noise ratios (SNRs) of -5, 0, and +5 dB in steady speech-weighted noise at 60 dB SPL and SRTs for numbers in speech-weighted steady and nonsteady ICRA noise were both obtained in conditions with and without the noise reduction pre-processing. Physical SNR improvements of the noise reduction system are evaluated as well, as a function of the direction of the noise source. RESULTS: Highly significant improvements in speech understanding, corresponding on average to an SNR improvement of about 10 dB, were observed with this 2-channel adaptive filtering noise reduction strategy using both types of speech-noise test materials. These perceptual evaluations agree with physical evaluations and simulations of this noise reduction strategy. Taken together, these data demonstrate that cochlear implantees may increase their speech intelligibility in noisy environments with the use of multimicrophone noise reduction systems.

Adult↗

PubMed1993

Directional hearing aid based on array technology.

The hearing impaired often have great difficulty understanding speech in surroundings with background noise or reverberation. A directional hearing aid might be beneficial in reducing background noise in relation to the desired speech signal. To this end microphone systems were developed with strongly directional characteristics, using array techniques. Considerable attention was paid to optimization and stability. Free-field simulations of several robust models showed that a directivity index of 9 dB can be obtained. Simulations were verified with a laboratory model. Based on simulations and measurements, two portable prototypes were developed and tested using a KEMAR-manikin. The KEMAR-measurements showed that the two prototypes gave an improvement of the signal to noise ratio of 7 dB in a fully diffuse sound field. The benefit of these microphone arrays for the hearing impaired was tested in a sound insulated room. One loudspeaker was placed in front of the listener simulating the partner in a discussion, and a diffuse background noise was produced by eight loudspeakers placed on the corners of a cube. The hearing impaired subject was seated in the centre of the cube. The speech-reception threshold in noise for simple Dutch sentences was determined with a normal single omni-directional microphone and with one of the prototypes. The results of the listening tests with 45 hearing impaired subjects showed an average improvement of the S/N-ratio of 7.0 dB for monaural fitting.

Acoustic Stimulation↗

PubMed1991

Correlations between self-assessed hearing handicap and standard audiometric tests in elderly persons.

The relationship between self-assessed hearing handicap and audiometric measures using pure-tone and speech audiometry was studied in a group of elderly persons representative of an urban Swedish population. The study population consisted of two cohorts, one of which was followed longitudinally. Significant correlations between measured and self-assessed hearing were found. Speech discrimination scores showed lower correlations with the self-estimated hearing than pure-tone averages and speech reception threshold. Questions concerning conversation with one person and concerning difficulty in hearing the doorbell showed lower correlations with measured hearing than the other questions. The discrimination score test is an inadequate tool for measuring hearing handicap.

Aged↗

PubMed2004

Noise reduction results of an adaptive filtering technique for dual-microphone behind-the-ear hearing aids.

OBJECTIVE: The performance of an adaptive beam-former in a 2-microphone, behind-the-ear hearing aid for speech understanding in noisy environments was evaluated. Physical and perceptual evaluations were carried out. This was the first large-scale test of a wearable real-time implementation of this algorithm. The main perceptual research questions of this study were related to the influence on the noise reduction performance of (1) the spectro-temporal character of the jammer sound, (2) the jammer sound scene, (3) hearing impairment, and (4) the basic microphone configuration in the hearing aid. Four different speech materials were used for the perceptual evaluations. All tests were carried out in an acoustical environment comparable to living room reverberation. DESIGN: The adaptive beamformer was implemented in Audallion, a small, body-worn processor, linked to a Danasound 2-microphone behind-the-ear aid. The strategy was evaluated physically in different acoustical environments. Using speech reception threshold (SRT) measurements, the processing was evaluated perceptually and the different research questions addressed with three groups of subjects. Groups I, II, and III consisted of 10 normal-hearing, 5 hearing-impaired, and 7 normal-hearing persons, respectively. The tests were carried out in three spectro-temporally different jammer sounds (unmodulated and modulated speech weighted noise, multitalker babble) and in three different noise scenarios (single noise source at 90 degrees, noise sources at 90 degrees and 270 degrees relative to speaker position, diffuse noise scene). Two microphone configurations were compared: a device equipped with two omnidirectional microphones and a device equipped with one hardware directional and one omnidirectional microphone. In each of these conditions, the adaptive beamformer and the directional and omnidirectional microphone configurations were tested. RESULTS: The improvement in signal-to-noise ratio from the use of the adaptive beamformer did not depend on the spectro-temporal character of the jammer sounds and the speech materials used, although the absolute levels of the SRTs varied appreciably for different speech-noise combinations. The performance of the adaptive noise reduction depended on the jammer sound scene. CONCLUSIONS: No difference in signal-to-noise ratio improvement was observed between hearing-impaired and normal-hearing listeners, although individual SRT levels may differ. On average, an SRT improvement of 7.7 and 3.9 dB for a single noise source at 90 degrees and 5.9 and 3.4 dB for two noise sources at 90 degrees and 270 degrees was obtained for both normal-hearing and hearing-impaired listeners, using the adaptive beamformer and the directional microphone, respectively, relative to the omnidirectional microphone signal. In diffuse noise, only small improvements were obtained.

Adult↗

PubMed2005

Development of the Cantonese Hearing In Noise Test (CHINT).

OBJECTIVE: To develop a Cantonese version of the Hearing In Noise Test (CHINT) with the same features as the English Hearing In Noise Test (HINT) (Nilsson, Soli, & Sullivan, 1994). DESIGN: The CHINT was developed in five separate studies: (1) evaluation of initial materials; (2) creation of sentence materials; (3) equalization of sentence difficulty; (4) creation of sentence lists; and (5) evaluation of response variability, inter-list reliability, and establishment of norms. Using the CHINT material, reception thresholds for sentences were measured under four headphone test conditions: Quiet, and in noise with noise simulated as originating from 0 degrees (noise front), 90 degrees (noise right), and 270 degrees (noise left). The speech source was located at 0 degrees in all conditions. The locations of the speech and noise sources were simulated using virtual audio processing, as with the English HINT. The noise conditions consisted of listening with noise fixed at 65 dBA with the level of speech varied in an adaptive procedure. A total of 142 subjects with normal hearing thresholds participated in the five studies. RESULTS: Two versions of the test materials, twenty-four 10-sentence lists and twelve 20-sentence lists, were created from a single set of 240 sentences containing 10 syllables per sentence. Using the twenty-four 10-sentence lists, mean thresholds under earphones in quiet were measured at 19.4 dBA and reception thresholds for sentences of -3.9 dB for noise front, -10.6 dB for noise right, and -10.5 dB for noise left. Similar results were obtained using the 20-sentence lists (19.4, -4.0, -10.9, and -11.0 dB, respectively, for quiet, noise front, noise right, and noise left conditions). There was low response variability within each list. High inter-list reliability suggests that consistent results could be obtained using any list. Confidence intervals are reported. The CHINT norms for listening in quiet and noise conditions were comparable to those for the English HINT. CONCLUSIONS: The CHINT is the first standardized Cantonese sentence speech intelligibility test. The CHINT was developed using the same rationale as the English HINT, allowing norm reference results from the two tests to be compared directly across languages. Results showed the CHINT is a reliable test. The CHINT would benefit from further evaluation of validity.

Acoustic Stimulation↗

PubMed1986

Perceptual features from normal-hearing and hearing-impaired children's errors on the NST.

Perceptual features for consonants contained in the nonsense syllable test, were evaluated from normal-hearing and hearing-impaired children's errors. One group consisted of 30 normal-hearing children between 6:0 and 12:8 years of age; the other group consisted of 7 hearing-impaired children between 8:0 and 14:8. The subjects provided verbal responses to list A of the nonsense syllable test which was presented at 25, 35, 45, and 55 dB sensation levels regarding each subject's speech reception threshold. Responses were phonetically transcribed, pooled across sensation levels, converted to confusion matrices, and submitted to Symmetric Individual Differences Scaling. Consonants were analyzed for pre- and inter-vocalic positions. Results revealed that features differed across subject groups and consonant positions. Salient features related to place of articulation, voicing, nasality, sonorancy, and sibilancy.

Adolescent↗

PubMed2000

Audiovestibular findings and location of an acoustic neuroma.

Forty-one patients with unilateral acoustic neuroma (AN) were diagnosed by magnetic resonance imaging (MRI) between 1992 and 1997. All cases were analyzed with respect to tumor location and the results of audiometric examinations, auditory brainstem response (ABR) testing, and electronystagmography (ENG). Tumor location was determined by MRI and cases were divided into intracanalicular and extracanalicular sites. Intracanalicular tumors were significantly smaller than the extracanalicular ones The pure-tone hearing thresholds were better in ears with intracanalicular lesions than in those with extracanalicular ones. Respectively, speech reception thresholds were 33 dB and 45 dB, and speech discrimination scores 79% and 65%. ABR was abnormal in 98% of ANs, but was insufficient for determining tumor location. The ENG pursuit test was more frequently normal and the caloric side difference was smaller in ears with intracanalicular than extracanalicular AN. These findings show that the results of pure-tone and speech audiometry and ENG are better in ears with intracanalicular AN, while ABR results are similar regardless of tumor location.

Audiometry, Evoked Response↗

PubMedDate not supplied

Hearing abilities of Down syndrome and other mentally handicapped adolescents.

Down syndrome (DS) individuals are prone to auditory processing difficulties in a variety of audiological, short-term memory, and language tasks. The present study explored: (a) the hearing capabilities of DS adolescents and young adults relative to a sample of non-DS mentally handicapped (MH) individuals, and (b) the relationship between hearing ability and performance on several cognitive tasks. Samples of 26 DS and 26 MH trainable mentally handicapped individuals were matched on IQ and chronological age (CA). Audiometric data revealed greater hearing losses in DS than in MH individuals at five of the six tested frequencies, more DS conductive and mixed hearing losses, and particularly high DS losses in the high-frequency range. Measurement of the speech reception threshold revealed poorer reception of speech by the DS than the MH group. Classification of tympanograms indicated fewer normal ears and twice as many DS ears with middle ear problems reflecting no mobility or retraction of the tympanic membrane. Presence of DS middle ear difficulties was also confirmed by poorer elicitation of the acoustic (stapedius) reflex in DS subjects. Correlation of hearing variables with seven cognitive tasks administered on the same day revealed only one significant relationship after the statistical removal of the effects of CA and IQ: DS subjects with poorer hearing identified fewer words in a task in which a masking noise quickly followed a spoken word. This result suggests that group findings of DS auditory-verbal processing difficulties stem, in part, from subjects with hearing difficulties needing more time to identify spoken words.

Adolescent↗

PubMed1998

Factors governing speech reception benefits of adaptive linear filtering for listeners with sensorineural hearing loss.

Adaptive linear filtering can improve effective speech-to-noise ratios by attenuating spectral regions with intense noise components to reduce the noise's spread of masking onto speech in neighboring regions. This mechanism was examined in static listening conditions for seven individuals with sensorineural hearing loss. Subjects were presented with nonsense syllables in an intense octave-band noise centered on 0.5, 1, or 2 kHz. The nonsense syllables were amplified to maximize. the articulation index; the noises were the same for all subjects. The processing consisted of applying frequency-selective attenuation to the speech-plus-noise with the goal of attenuating the frequency region containing the noise by various amounts. Consonant recognition scores and noise masking patterns were collected in all listening conditions. When compared with masking patterns obtained from normal-hearing subjects, all hearing-impaired subjects had higher masked thresholds at frequencies below, within, and above the masker band except for one subject who demonstrated additional masking above the masker only. Frequency-selective attenuation resulted in both increases and decreases in consonant recognition scores. Increases were associated with a release from upward spread of masking. Decreases were associated with applying too much attenuation such that speech energy within the masker band that was audible before processing was partially below threshold after processing. Fletcher's [Speech and Hearing in Communication (Van Nostrand, New York, 1953)] version of articulation theory (without modification) accounted for individual subject differences within the range of variability associated with the consonant recognition test in almost every instance. Hence, primary factors influencing speech reception benefits are characterized by articulation theory. Fletcher's theory appears well-suited to guide the design of control algorithms that will maximize speech recognition for individual listeners.

Adult↗