Providing low- and mid-frequency speech information to listeners with sensorineural hearing loss.

The present study examined the benefits of providing amplified speech to the low- and mid-frequency regions of listeners with various degrees of sensorineural hearing loss. Nonsense syllables were low-pass filtered at various cutoff frequencies and consonant recognition was measured as the bandwidth of the signal was increased. In addition, error patterns were analyzed to determine the types of speech cues that were, or were not, transmitted to the listeners. For speech frequencies of 2800 Hz and below, a positive benefit of amplified speech was observed in every case, although the benefit provided was very often less than that observed in normal-hearing listeners who received the same increase in speech audibility. There was no dependence of this benefit upon the degree of hearing loss. Error patterns suggested that the primary difficulty that hearing-impaired individuals have in using amplified speech is due to their poor ability to perceive the place of articulation of consonants, followed by a reduced ability to perceive manner information.     

The effects of hearing loss on the contribution of high- and low-frequency speech information to speech understanding

The speech understanding of persons with "flat" hearing loss (HI) was compared to a normal-hearing (NH) control group to examine how hearing loss affects the contribution of speech information in various frequency regions. Speech understanding in noise was assessed at multiple low- and high-pass filter cutoff frequencies. Noise levels were chosen to ensure that the noise, rather than quiet thresholds, determined audibility. The performance of HI subjects was compared to a NH group listening at the same signal-to-noise ratio and a comparable presentation level. Although absolute speech scores for the HI group were reduced, performance improvements as the speech and noise bandwidth increased were comparable between groups. These data suggest that the presence of hearing loss results in a uniform, rather than frequency-specific, deficit in the contribution of speech information. Measures of auditory thresholds in noise and speech intelligibility index (SII) calculations were also performed. These data suggest that differences in performance between the HI and NH groups are due primarily to audibility differences between groups. Measures of auditory thresholds in noise showed the "effective masking spectrum" of the noise was greater for the HI than the NH subjects.     

Stop-consonant recognition for normal-hearing listeners and listeners with high-frequency hearing loss. II: Articulation index predictions

Articulation index (AI) theory was used to evaluate stop-consonant recognition of normal-hearing listeners and listeners with high-frequency hearing loss. From results reported in a companion article [Dubno et al., J. Acoust. Soc. Am. 85, 347-354 (1989)], a transfer function relating the AI to stop-consonant recognition was established, and a frequency importance function was determined for the nine stop-consonant-vowel syllables used as test stimuli. The calculations included the rms and peak levels of the speech that had been measured in 1/3 octave bands; the internal noise was estimated from the thresholds for each subject. The AI model was then used to predict performance for the hearing-impaired listeners. A majority of the AI predictions for the hearing-impaired subjects fell within +/- 2 standard deviations of the normal-hearing listeners' results. However, as observed in previous data, the AI tended to overestimate performance of the hearing-impaired listeners. The accuracy of the predictions decreased with the magnitude of high-frequency hearing loss. Thus, with the exception of performance for listeners with severe high-frequency hearing loss, the results suggest that poorer speech recognition among hearing-impaired listeners results from reduced audibility within critical spectral regions of the speech stimuli.     

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.     

Auditory filter characteristics and consonant recognition for hearing-impaired listeners

To examine the association between frequency resolution and speech recognition, auditory filter parameters and stop-consonant recognition were determined for 9 normal-hearing and 24 hearing-impaired subjects. In an earlier investigation, the relationship between stop-consonant recognition and the articulation index (AI) had been established on normal-hearing listeners. Based on AI predictions, speech-presentation levels for each subject in this experiment were selected to obtain a wide range of recognition scores. This strategy provides a method of interpreting speech-recognition performance among listeners who vary in magnitude and configuration of hearing loss by assuming that conditions which yield equal audible spectra will result in equivalent performance. It was reasoned that an association between frequency resolution and consonant recognition may be more appropriately estimated if hearing-impaired listeners' performance was measured under conditions that assured equivalent audibility of the speech stimuli. Derived auditory filter parameters indicated that filter widths and dynamic ranges were strongly associated with threshold. Stop-consonant recognition scores for most hearing-impaired listeners were not significantly poorer than predicted by the AI model. Furthermore, differences between observed recognition scores and those predicted by the AI were not associated with auditory filter characteristics, suggesting that frequency resolution and speech recognition may appear to be associated primarily because both are degraded by threshold elevation.     

Intelligibility of speech in noise at high presentation levels: effects of hearing loss and frequency region

These experiments examined how high presentation levels influence speech recognition for high- and low-frequency stimuli in noise. Normally hearing (NH) and hearing-impaired (HI) listeners were tested. In Experiment 1, high- and low-frequency bandwidths yielding 70%-correct word recognition in quiet were determined at levels associated with broadband speech at 75 dB SPL. In Experiment 2, broadband and band-limited sentences (based on passbands measured in Experiment 1) were presented at this level in speech-shaped noise filtered to the same frequency bandwidths as targets. Noise levels were adjusted to produce approximately 30%-correct word recognition. Frequency bandwidths and signal-to-noise ratios supporting criterion performance in Experiment 2 were tested at 75, 87.5, and 100 dB SPL in Experiment 3. Performance tended to decrease as levels increased. For NH listeners, this "rollover" effect was greater for high-frequency and broadband materials than for low-frequency stimuli. For HI listeners, the 75- to 87.5-dB increase improved signal audibility for high-frequency stimuli and rollover was not observed. However, the 87.5- to 100-dB increase produced qualitatively similar results for both groups: scores decreased most for high-frequency stimuli and least for low-frequency materials. Predictions of speech intelligibility by quantitative methods such as the Speech Intelligibility Index may be improved if rollover effects are modeled as frequency dependent.     

The effects of hearing loss on the contribution of high- and low-frequency speech information to speech understanding. II. Sloping hearing loss

The speech understanding of persons with sloping high-frequency (HF) hearing impairment (HI) was compared to normal hearing (NH) controls and previous research on persons with "flat" losses [Hornsby and Ricketts (2003). J. Acoust. Soc. Am. 113, 1706-1717] to examine how hearing loss configuration affects the contribution of speech information in various frequency regions. Speech understanding was assessed at multiple low- and high-pass filter cutoff frequencies. Crossover frequencies, defined as the cutoff frequencies at which low- and high-pass filtering yielded equivalent performance, were significantly lower for the sloping HI, compared to NH, group suggesting that HF HI limits the utility of HF speech information. Speech intelligibility index calculations suggest this limited utility was not due simply to reduced audibility but also to the negative effects of high presentation levels and a poorer-than-normal use of speech information in the frequency region with the greatest hearing loss (the HF regions). This deficit was comparable, however, to that seen in low-frequency regions of persons with similar HF thresholds and "flat" hearing losses suggesting that sensorineural HI results in a "uniform," rather than frequency-specific, deficit in speech understanding, at least for persons with HF thresholds up to 60-80 dB HL.     

Proportional frequency compression of speech for listeners with sensorineural hearing loss.

This study examined proportional frequency compression as a strategy for improving speech recognition in listeners with high-frequency sensorineural hearing loss. This method of frequency compression preserved the ratios between the frequencies of the components of natural speech, as well as the temporal envelope of the unprocessed speech stimuli. Nonsense syllables spoken by a female and a male talker were used as the speech materials. Both frequency-compressed speech and the control condition of unprocessed speech were presented with high-pass amplification. For the materials spoken by the female talker, significant increases in speech recognition were observed in slightly less than one-half of the listeners with hearing impairment. For the male-talker materials, one-fifth of the hearing-impaired listeners showed significant recognition improvements. The increases in speech recognition due solely to frequency compression were generally smaller than those solely due to high-pass amplification. The results indicate that while high-pass amplification is still the most effective approach for improving speech recognition of listeners with high-frequency hearing loss, proportional frequency compression can offer significant improvements in addition to those provided by amplification for some patients.     

Audibility-based predictions of speech recognition for children and adults with normal hearing

This study investigated the relationship between audibility and predictions of speech recognition for children and adults with normal hearing. The Speech Intelligibility Index (SII) is used to quantify the audibility of speech signals and can be applied to transfer functions to predict speech recognition scores. Although the SII is used clinically with children, relatively few studies have evaluated SII predictions of children's speech recognition directly. Children have required more audibility than adults to reach maximum levels of speech understanding in previous studies. Furthermore, children may require greater bandwidth than adults for optimal speech understanding, which could influence frequency-importance functions used to calculate the SII. Speech recognition was measured for 116 children and 19 adults with normal hearing. Stimulus bandwidth and background noise level were varied systematically in order to evaluate speech recognition as predicted by the SII and derive frequency-importance functions for children and adults. Results suggested that children required greater audibility to reach the same level of speech understanding as adults. However, differences in performance between adults and children did not vary across frequency bands.     

Intensity discrimination as a function of level and frequency and its relation to high-frequency hearing

This paper examines how intensity discrimination depends on the test frequency, the level, and the subjects's high-frequency hearing. Three experiments were performed. In the first experiment, intensity discrimination of pulsed tones was measured as a function of level at 1 and 14 kHz in five listeners. Results show less deviation from Weber's law at 14 kHz than at 1 kHz. In the second experiment, intensity discrimination was measured for a 1-kHz tone at 90-dB SPL as a function of the cutoff frequency of a high-pass masking noise in two listeners. Results show that the audibility of very high frequencies is important for frequency discrimination at 1 kHz. The DL increased by a factor between 1.5 and 2.0 as the cutoff frequency of the noise was lowered from 19 to 6 kHz. In the third experiment, thresholds from 6 to 20 kHz and intensity discrimination for a 1-kHz tone was measured in 12 listeners. Results show that the DLs at 80-dB SPL are correlated with the ability to hear very high frequencies. Results of all three experiments are consistent with the multiband version of the excitation-pattern model for intensity discrimination [Florentine and Buus, J. Acoust. Soc. Am. 70, 1646-1654 (1981)].     

Effects of fluctuating noise and interfering speech on the speech-reception threshold for impaired and normal hearing

The speech-reception threshold (SRT) for sentences presented in a fluctuating interfering background sound of 80 dBA SPL is measured for 20 normal-hearing listeners and 20 listeners with sensorineural hearing impairment. The interfering sounds range from steady-state noise, via modulated noise, to a single competing voice. Two voices are used, one male and one female, and the spectrum of the masker is shaped according to these voices. For both voices, the SRT is measured as well in noise spectrally shaped according to the target voice as shaped according to the other voice. The results show that, for normal-hearing listeners, the SRT for sentences in modulated noise is 4-6 dB lower than for steady-state noise; for sentences masked by a competing voice, this difference is 6-8 dB. For listeners with moderate sensorineural hearing loss, elevated thresholds are obtained without an appreciable effect of masker fluctuations. The implications of these results for estimating a hearing handicap in everyday conditions are discussed. By using the articulation index (AI), it is shown that hearing-impaired individuals perform poorer than suggested by the loss of audibility for some parts of the speech signal. Finally, three mechanisms are discussed that contribute to the absence of unmasking by masker fluctuations in hearing-impaired listeners. The low sensation level at which the impaired listeners receive the masker seems a major determinant. The second and third factors are: reduced temporal resolution and a reduction in comodulation masking release, respectively.     

Factors affecting masking release for speech in modulated noise for normal-hearing and hearing-impaired listeners

The Speech Reception Threshold for sentences in stationary noise and in several amplitude-modulated noises was measured for 8 normal-hearing listeners, 29 sensorineural hearing-impaired listeners, and 16 normal-hearing listeners with simulated hearing loss. This approach makes it possible to determine whether the reduced benefit from masker modulations, as often observed for hearing-impaired listeners, is due to a loss of signal audibility, or due to suprathreshold deficits, such as reduced spectral and temporal resolution, which were measured in four separate psychophysical tasks. Results show that the reduced masking release can only partly be accounted for by reduced audibility, and that, when considering suprathreshold deficits, the normal effects associated with a raised presentation level should be taken into account. In this perspective, reduced spectral resolution does not appear to qualify as an actual suprathreshold deficit, while reduced temporal resolution does. Temporal resolution and age are shown to be the main factors governing masking release for speech in modulated noise, accounting for more than half of the intersubject variance. Their influence appears to be related to the processing of mainly the higher stimulus frequencies. Results based on calculations of the Speech Intelligibility Index in modulated noise confirm these conclusions.     

Word recognition in noise at higher-than-normal levels: decreases in scores and increases in masking

Under certain conditions, speech recognition in noise decreases above conversational levels when signal-to-noise ratio is held constant. The current study was undertaken to determine if nonlinear growth of masking and the subsequent reduction in "effective" signal-to-noise ratio accounts for this decline. Nine young adults with normal hearing listened to monosyllabic words at three levels in each of three levels of a masker shaped to match the speech spectrum. An additional low-level noise equated audibility by producing equivalent masked thresholds for all subjects. If word recognition was determined entirely by signal-to-noise ratio and was independent of overall speech and masker levels, scores at a given signal-to-noise ratio should remain constant with increasing level. Masked pure-tone thresholds measured in the speech-shaped maskers increased linearly with increasing masker level at lower frequencies but nonlinearly at higher frequencies, consistent with nonlinear growth of upward spread of masking that followed the peaks in the spectrum of the speech-shaped masker. Word recognition declined significantly with increasing level when signal-to-noise ratio was held constant which was attributed to nonlinear growth of masking and reduced "effective" signal-to-noise ratio at high speech-shaped masker levels, as indicated by audibility estimates based on the Articulation Index.     

Recognition of accented English in quiet and noise by younger and older listeners

This study investigated the effects of age and hearing loss on perception of accented speech presented in quiet and noise. The relative importance of alterations in phonetic segments vs. temporal patterns in a carrier phrase with accented speech also was examined. English sentences recorded by a native English speaker and a native Spanish speaker, together with hybrid sentences that varied the native language of the speaker of the carrier phrase and the final target word of the sentence were presented to younger and older listeners with normal hearing and older listeners with hearing loss in quiet and noise. Effects of age and hearing loss were observed in both listening environments, but varied with speaker accent. All groups exhibited lower recognition performance for the final target word spoken by the accented speaker compared to that spoken by the native speaker, indicating that alterations in segmental cues due to accent play a prominent role in intelligibility. Effects of the carrier phrase were minimal. The findings indicate that recognition of accented speech, especially in noise, is a particularly challenging communication task for older people.     

Temporal modulation transfer functions for listeners with real and simulated hearing loss

A functional simulation of hearing loss was evaluated in its ability to reproduce the temporal modulation transfer functions (TMTFs) for nine listeners with mild to profound sensorineural hearing loss. Each hearing loss was simulated in a group of three age-matched normal-hearing listeners through spectrally shaped masking noise or a combination of masking noise and multiband expansion. TMTFs were measured for both groups of listeners using a broadband noise carrier as a function of modulation rate in the range 2 to 1024 Hz. The TMTFs were fit with a lowpass filter function that provided estimates of overall modulation-depth sensitivity and modulation cutoff frequency. Although the simulations were capable of accurately reproducing the threshold elevations of the hearing-impaired listeners, they were not successful in reproducing the TMTFs. On average, the simulations resulted in lower sensitivity and higher cutoff frequency than were observed in the TMTFs of the hearing-impaired listeners. Discrepancies in performance between listeners with real and simulated hearing loss are possibly related to inaccuracies in the simulation of recruitment.     

Effect of stimulation rate on phoneme recognition by nucleus-22 cochlear implant listeners

This study investigated the effect of pulsatile stimulation rate on medial vowel and consonant recognition in cochlear implant listeners. Experiment 1 measured phoneme recognition as a function of stimulation rate in six Nucleus-22 cochlear implant listeners using an experimental four-channel continuous interleaved sampler (CIS) speech processing strategy. Results showed that all stimulation rates from 150 to 500 pulses/s/electrode produced equally good performance, while stimulation rates lower than 150 pulses/s/electrode produced significantly poorer performance. Experiment 2 measured phoneme recognition by implant listeners and normal-hearing listeners as a function of the low-pass cutoff frequency for envelope information. Results from both acoustic and electric hearing showed no significant difference in performance for all cutoff frequencies higher than 20 Hz. Both vowel and consonant scores dropped significantly when the cutoff frequency was reduced from 20 Hz to 2 Hz. The results of these two experiments suggest that temporal envelope information can be conveyed by relatively low stimulation rates. The pattern of results for both electrical and acoustic hearing is consistent with a simple model of temporal integration with an equivalent rectangular duration (ERD) of the temporal integrator of about 7 ms.     

Effects of background noise level on behavioral estimates of basilar-membrane compression

Hearing-impaired (HI) listeners often show poorer performance on psychoacoustic tasks than do normal-hearing (NH) listeners. Although some such deficits may reflect changes in suprathreshold sound processing, others may be due to stimulus audibility and the elevated absolute thresholds associated with hearing loss. Masking noise can be used to raise the thresholds of NH to equal the thresholds in quiet of HI listeners. However, such noise may have other effects, including changing peripheral response characteristics, such as the compressive input-output function of the basilar membrane in the normal cochlea. This study estimated compression behaviorally across a range of background noise levels in NH listeners at a 4 kHz signal frequency, using a growth of forward masking paradigm. For signals 5 dB or more above threshold in noise, no significant effect of broadband noise level was found on estimates of compression. This finding suggests that broadband noise does not significantly alter the compressive response of the basilar membrane to sounds that are presented well above their threshold in the noise. Similarities between the performance of HI listeners and NH listeners in threshold-equalizing noise are therefore unlikely to be due to a linearization of basilar-membrane responses to suprathreshold stimuli in the NH listeners.     

Temporal and spectral masking release in low- and mid-frequency regions for normal-hearing and hearing-impaired listeners

"Masking release" (MR), the improvement of speech intelligibility in modulated compared with unmodulated maskers, is typically smaller than normal for hearing-impaired listeners. The extent to which this is due to reduced audibility or to suprathreshold processing deficits is unclear. Here, the effects of audibility were controlled by using stimuli restricted to the low- (≤1.5 kHz) or mid-frequency (1-3 kHz) region for normal-hearing listeners and hearing-impaired listeners with near-normal hearing in the tested region. Previous work suggests that the latter may have suprathreshold deficits. Both spectral and temporal MR were measured. Consonant identification was measured in quiet and in the presence of unmodulated, amplitude-modulated, and spectrally modulated noise at three signal-to-noise ratios (the same ratios for the two groups). For both frequency regions, consonant identification was poorer for the hearing-impaired than for the normal-hearing listeners in all conditions. The results suggest the presence of suprathreshold deficits for the hearing-impaired listeners, despite near-normal audiometric thresholds over the tested frequency regions. However, spectral MR and temporal MR were similar for the two groups. Thus, the suprathreshold deficits for the hearing-impaired group did not lead to reduced MR.     

Audibility and recognition of stop consonants in normal and hearing-impaired subjects

The purpose of this study was to examine the effect of spectral-cue audibility on the recognition of stop consonants in normal-hearing and hearing-impaired adults. Subjects identified six synthetic CV speech tokens in a closed-set response task. Each syllable differed only in the initial 40-ms consonant portion of the stimulus. In order to relate performance to spectral-cue audibility, the initial 40 ms of each CV were analyzed via FFT and the resulting spectral array was passed through a sliding-filter model of the human auditory system to account for logarithmic representation of frequency and the summation of stimulus energy within critical bands. This allowed the spectral data to be displayed in comparison to a subject's sensitivity thresholds. For normal-hearing subjects, an orderly function relating the percentage of audible stimulus to recognition performance was found, with perfect discrimination performance occurring when the bulk of the stimulus spectrum was presented at suprathreshold levels. For the hearing-impaired subjects, however, it was found in many instances that suprathreshold presentation of stop-consonant spectral cues did not yield recognition equivalent to that found for the normal-hearing subjects. These results demonstrate that while the audibility of individual stop consonants is an important factor influencing recognition performance in hearing-impaired subjects, it is not always sufficient to explain the effects of sensorineural hearing loss.     

Monosyllabic word recognition at higher-than-normal speech and noise levels

The effects of intensity on monosyllabic word recognition were studied in adults with normal hearing and mild-to-moderate sensorineural hearing loss. The stimuli were bandlimited NU#6 word lists presented in quiet and talker-spectrum-matched noise. Speech levels ranged from 64 to 99 dB SPL and S/N ratios from 28 to -4 dB. In quiet, the performance of normal-hearing subjects remained essentially constant in noise, at a fixed S/N ratio, it decreased as a linear function of speech level. Hearing-impaired subjects performed like normal-hearing subjects tested in noise when the data were corrected for the effects of audibility loss. From these and other results, it was concluded that: (1) speech intelligibility in noise decreases when speech levels exceed 69 dB SPL and the S/N ratio remains constant; (2) the effects of speech and noise level are synergistic; (3) the deterioration in intelligibility can be modeled as a relative increase in the effective masking level; (4) normal-hearing and hearing-impaired subjects are affected similarly by increased signal level when differences in speech audibility are considered; (5) the negative effects of increasing speech and noise levels on speech recognition are similar for all adult subjects, at least up to 80 years; and (6) the effective dynamic range of speech may be larger than the commonly assumed value of 30 dB.