Modeling sensorineural hearing loss. I. Model and retrospective evaluation

The present article describes an approach to the evaluation of psychoacoustic data from the hearing impaired. The results obtained from the hearing impaired in several studies of frequency resolution, temporal resolution, and speech recognition are compared to the results expected for noise-masked normal listeners. It is presumed in this approach that the hypothetical noise-masked normal listeners have masked thresholds that agree perfectly with the quiet thresholds of the hearing-impaired subjects. Using this approach, most of the results obtained from impaired ears on spectral-resolution and speech-recognition tasks could be accurately predicted, an exception being results from spectral-resolution paradigms using fixed-level signals. Some of the data from hearing-impaired listeners on temporal-resolution tasks, on the other hand, could not be adequately described with this approach. The latter data, however, were much more limited. Additional data are needed to better evaluate the adequacy of this approach in describing the performance of the hearing impaired on temporal-resolution tasks.     

Relations among temporal acuity, hearing loss, and the perception of speech distorted by noise and reverberation

Eight normal listeners and eight listeners with sensorineural hearing losses were compared on a gap-detection task and on a speech perception task. The minimum detectable gap (71% correct) was determined as a function of noise level, and a time constant was computed from these data for each listener. The time constants of the hearing-impaired listeners were significantly longer than those of the normal listeners. The speech consisted of sentences that were mixed with two levels of noise and subjected to two kinds of reverberation (real or simulated). The speech thresholds (minimum signal-to-noise ratio for 50% correct) were significantly higher for the hearing-impaired listeners than for the normal listeners for both kinds of reverberation. The longer reverberation times produced significantly higher thresholds than the shorter times. The time constant was significantly correlated with all the speech threshold measures (r = -0.58 to -0.74) and a measure of hearing threshold loss also correlated significantly with all the speech thresholds (r = 0.53 to 0.95). A principal components analysis yielded two factors that accounted for the intercorrelations. The factor loadings for the time constant were similar to those on the speech thresholds for real reverberation and the loadings for hearing loss were similar to those of the thresholds for simulated reverberation.     

Application of the articulation index to the speech recognition of normal and impaired listeners wearing hearing protection

The present study examined the application of the articulation index (AI) as a predictor of the speech-recognition performance of normal and hearing-impaired listeners with and without hearing protection. The speech-recognition scores of 12 normal and 12 hearing-impaired subjects were measured for a wide range of conditions designed to be representative of those in the workplace. Conditions included testing in quiet, in two types of background noise (white versus speech spectrum), at three signal-to-noise ratios (+ 5, 0, - 5 dB), and in three conditions of protection (unprotected, earplugs, earmuffs). The mean results for all 21 listening conditions and both groups of subjects were accurately described by the AI. Moreover, a single transfer-function relating performance to the AI could describe all the data from both groups.     

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.     

Upward spread of masking, hearing loss, and speech recognition in young and elderly listeners

Upward spreading of masking, measured in terms of absolute masked threshold, is greater in hearing-impaired listeners than in listeners with normal hearing. The purpose of this study was to make further observations on upward-masked thresholds and speech recognition in noise in elderly listeners. Two age groups were used: One group consisted of listeners who were more than 60 years old, and the second group consisted of listeners who were less than 36 years old. Both groups had listeners with normal hearing as well as listeners with mild to moderate sensorineural loss. The masking paradigm consisted of a continuous low-pass-filtered (1000-Hz) noise, which was mixed with the output of a self-tracking, sweep-frequency Bekesy audiometer. Thresholds were measured in quiet and with maskers at 70 and 90 dB SPL. The upward-masked thresholds were similar for young and elderly hearing-impaired listeners. A few elderly listeners had lower upward-masked thresholds compared with the young control group; however, their on-frequency masked thresholds were nearly identical to the control group. A significant correlation was found between upward-masked thresholds and the Speech Perception in Noise (SPIN) test in elderly listeners.     

Effect of multiple speechlike maskers on binaural speech recognition in normal and impaired hearing.

Speech-reception thresholds (SRT) were measured for 17 normal-hearing and 17 hearing-impaired listeners in conditions simulating free-field situations with between one and six interfering talkers. The stimuli, speech and noise with identical long-term average spectra, were recorded with a KEMAR manikin in an anechoic room and presented to the subjects through headphones. The noise was modulated using the envelope fluctuations of the speech. Several conditions were simulated with the speaker always in front of the listener and the maskers either also in front, or positioned in a symmetrical or asymmetrical configuration around the listener. Results show that the hearing impaired have significantly poorer performance than the normal hearing in all conditions. The mean SRT differences between the groups range from 4.2-10 dB. It appears that the modulations in the masker act as an important cue for the normal-hearing listeners, who experience up to 5-dB release from masking, while being hardly beneficial for the hearing impaired listeners. The gain occurring when maskers are moved from the frontal position to positions around the listener varies from 1.5 to 8 dB for the normal hearing, and from 1 to 6.5 dB for the hearing impaired. It depends strongly on the number of maskers and their positions, but less on hearing impairment. The difference between the SRTs for binaural and best-ear listening (the "cocktail party effect") is approximately 3 dB in all conditions for both the normal-hearing and the hearing-impaired listeners.     

Relations among some psychoacoustic parameters in normal and cochlearly impaired listeners

Frequency resolution (viz., masking by low-pass-filtered noise and broadband noise) and temporal resolution (viz., masking by interrupted noise) were compared with hearing thresholds and acoustic reflex thresholds for four normally hearing and 13 cochlearly impaired subjects. Two models, one for frequency resolution (model I) and one for temporal resolution (model II), were introduced, and these provided a means of predicting individual frequency and temporal resolution from hearing thresholds for both normal-hearing and hearing-impaired listeners. Model I is based on the assumption that the upward spread of masking increases in cochlearly impaired hearing with an amount proportional to the hearing threshold in dB HL. Model II is based on the assumption that the poststimulatory masked thresholds return to the level of the hearing threshold within a duration of 200 ms, independent of the level of the masker and the amount of cochlear hearing loss. Model parameters were determined from results from other studies. Although some discrepancies between measured and predicted values were observed, the model predictions generally agree with measurements. Thus, to a first-order approximation, it seems possible to predict individual frequency and temporal resolution of cochlearly hearing-impaired listeners solely on the basis of their hearing thresholds.     

Discrimination of interaural temporal disparities by normal-hearing listeners and listeners with high-frequency sensorineural hearing loss

Thresholds of ongoing interaural time difference (ITD) were obtained from normal-hearing and hearing-impaired listeners who had high-frequency, sensorineural hearing loss. Several stimuli (a 500-Hz sinusoid, a narrow-band noise centered at 500 Hz, a sinusoidally amplitude-modulated 4000-Hz tone, and a narrow-band noise centered at 4000 Hz) and two criteria [equal sound-pressure level (Eq SPL) and equal sensation level (Eq SL)] for determining the level of stimuli presented to each listener were employed. The ITD thresholds and slopes of the psychometric functions were elevated for hearing-impaired listeners for the two high-frequency stimuli in comparison to: the listener's own low-frequency thresholds; and data obtained from normal-hearing listeners for stimuli presented with Eq SPL interaurally. The two groups of listeners required similar ITDs to reach threshold when stimuli were presented at Eq SLs to each ear. For low-frequency stimuli, the ITD thresholds of the hearing-impaired listener were generally slightly greater than those obtained from the normal-hearing listeners. Whether these stimuli were presented at either Eq SPL or Eq SL did not differentially affect the ITD thresholds across groups.     

Effects of age and mild hearing loss on speech recognition in noise

Using an adaptive strategy, the effects of mild sensorineural hearing loss and adult listeners' chronological age on speech recognition in babble were evaluated. The signal-to-babble ratio required to achieve 50% recognition was measured for three speech materials presented at soft to loud conversational speech levels. Four groups of subjects were tested: (1) normal-hearing listeners less than 44 years of age, (2) subjects less than 44 years old with mild sensorineural hearing loss and excellent speech recognition in quiet, (3) normal-hearing listeners greater than 65 with normal hearing, and (4) subjects greater than 65 years old with mild hearing loss and excellent performance in quiet. Groups 1 and 3, and groups 2 and 4 were matched on the basis of pure-tone thresholds, and thresholds for each of the three speech materials presented in quiet. In addition, groups 1 and 2 were similar in terms of mean age and age range, as were groups 3 and 4. Differences in performance in noise as a function of age were observed for both normal-hearing and hearing-impaired listeners despite equivalent performance in quiet. Subjects with mild hearing loss performed significantly worse than their normal-hearing counterparts. These results and their implications are discussed.     

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.     

Benefit of modulated maskers for speech recognition by younger and older adults with normal hearing

To assess age-related differences in benefit from masker modulation, younger and older adults with normal hearing but not identical audiograms listened to nonsense syllables in each of two maskers: (1) a steady-state noise shaped to match the long-term spectrum of the speech, and (2) this same noise modulated by a 10-Hz square wave, resulting in an interrupted noise. An additional low-level broadband noise was always present which was shaped to produce equivalent masked thresholds for all subjects. This minimized differences in speech audibility due to differences in quiet thresholds among subjects. An additional goal was to determine if age-related differences in benefit from modulation could be explained by differences in thresholds measured in simultaneous and forward maskers. Accordingly, thresholds for 350-ms pure tones were measured in quiet and in each masker; thresholds for 20-ms signals in forward and simultaneous masking were also measured at selected signal frequencies. To determine if benefit from modulated maskers varied with masker spectrum and to provide a comparison with previous studies, a subgroup of younger subjects also listened in steady-state and interrupted noise that was not spectrally shaped. Articulation index (AI) values were computed and speech-recognition scores were predicted for steady-state and interrupted noise; predicted benefit from modulation was also determined. Masked thresholds of older subjects were slightly higher than those of younger subjects; larger age-related threshold differences were observed for short-duration than for long-duration signals. In steady-state noise, speech recognition for older subjects was poorer than for younger subjects, which was partially attributable to older subjects' slightly higher thresholds in these maskers. In interrupted noise, although predicted benefit was larger for older than younger subjects, scores improved more for younger than for older subjects, particularly at the higher noise level. This may be related to age-related increases in thresholds in steady-state noise and in forward masking, especially at higher frequencies. Benefit of interrupted maskers was larger for unshaped than for speech-shaped noise, consistent with AI predictions.     

Vowel perception by noise masked normal-hearing young adults

This study examined vowel perception by young normal-hearing (YNH) adults, in various listening conditions designed to simulate mild-to-moderate sloping sensorineural hearing loss. YNH listeners were individually age- and gender-matched to young hearing-impaired (YHI) listeners tested in a previous study [Richie et al., J. Acoust. Soc. Am. 114, 2923-2933 (2003)]. YNH listeners were tested in three conditions designed to create equal audibility with the YHI listeners; a low signal level with and without a simulated hearing loss, and a high signal level with a simulated hearing loss. Listeners discriminated changes in synthetic vowel tokens /I e epsilon alpha ae/ when Fl or F2 varied in frequency. Comparison of YNH with YHI results failed to reveal significant differences between groups in terms of performance on vowel discrimination, in conditions of similar audibility by using both noise masking to elevate the hearing thresholds of the YNH and applying frequency-specific gain to the YHI listeners. Further, analysis of learning curves suggests that while the YHI listeners completed an average of 46% more test blocks than YNH listeners, the YHI achieved a level of discrimination similar to that of the YNH within the same number of blocks. Apparently, when age and gender are closely matched between young hearing-impaired and normal-hearing adults, performance on vowel tasks may be explained by audibility alone.     

Excess masking among listeners with a sensorineural hearing loss

Three experiments were conducted to determine whether listeners with a sensorineural hearing loss exhibited greater than normal amounts of masking at frequencies above the frequency of the masker. Excess masking was defined as the difference (in dB) between the masked thresholds actually obtained from a hearing-impaired listener and the expected thresholds calculated for the same individual. The expected thresholds were the power sum of the listener's thresholds in quiet and the average masked thresholds obtained from a group of normal-hearing subjects at the test frequency. Hearing-impaired listeners, with thresholds in quiet ranging from approximately 35-70 dB SPL (at test frequencies between 500-3000 Hz), displayed approximately 12-15 dB of maximum excess masking. The maximum amount of excess masking occurred in the region where the threshold in quiet of the hearing-impaired listener and the average normal masked threshold were equal. These findings indicate that listeners with a sensorineural hearing loss display one form of reduced frequency selectivity (i.e., abnormal upward spread of masking) even when their thresholds in quiet are taken into account.     

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.     

Sound localization in noise in hearing-impaired listeners.

The present study assesses the ability of four listeners with high-frequency, bilateral symmetrical sensorineural hearing loss to localize and detect a broadband click train in the frontal-horizontal plane, in quiet and in the presence of a white noise. The speaker array and stimuli are identical to those described by Lorenzi et al. (in press). The results show that: (1) localization performance is only slightly poorer in hearing-impaired listeners than in normal-hearing listeners when noise is at 0 deg azimuth, (2) localization performance begins to decrease at higher signal-to-noise ratios for hearing-impaired listeners than for normal-hearing listeners when noise is at +/- 90 deg azimuth, and (3) the performance of hearing-impaired listeners is less consistent when noise is at +/- 90 deg azimuth than at 0 deg azimuth. The effects of a high-frequency hearing loss were also studied by measuring the ability of normal-hearing listeners to localize the low-pass filtered version of the clicks. The data reproduce the effects of noise on three out of the four hearing-impaired listeners when noise is at 0 deg azimuth. They reproduce the effects of noise on only two out of the four hearing-impaired listeners when noise is at +/- 90 deg azimuth. The additional effects of a low-frequency hearing loss were investigated by attenuating the low-pass filtered clicks and the noise by 20 dB. The results show that attenuation does not strongly affect localization accuracy for normal-hearing listeners. Measurements of the clicks' detectability indicate that the hearing-impaired listeners who show the poorest localization accuracy also show the poorest ability to detect the clicks. The inaudibility of high frequencies, "distortions," and reduced detectability of the signal are assumed to have caused the poorer-than-normal localization accuracy for hearing-impaired listeners.     

Detection of a temporal gap in low-frequency narrow-band signals by normal-hearing and hearing-impaired listeners

Temporal processing ability in the hearing impaired was investigated in a 2IFC gap-detection paradigm. The stimuli were digitally constructed 50-Hz-wide bands of noise centered at 250, 500, and 1000 Hz. On each trial, two 400-ms noise samples were paired, shaped at onset and offset, filtered, and presented in the quiet with and without a temporal gap. A modified up-down procedure with trial-by-trial feedback was used to establish threshold of detection of the gap. Approximately 4 h of practice preceded data collection; final estimate of threshold was the average of six listening blocks. There were 10 listeners, 19-25 years old. Five had normal hearing; five had a moderate congenital sensorineural hearing loss with relatively flat audiometric configuration. Near threshold (5 dB SL), all listeners performed similarly. At 15 and 25 dB SL, the normal-hearing group performed better than the hearing-impaired group. At 78 dB SPL, equal to the average intensity of the 5-dB SL condition for the hearing impaired, the normal-hearing group continued to improve and demonstrated a frequency effect not seen in the other conditions. Substantial individual differences were found in both groups, though intralistener variability was as small as expected for these narrow-bandwidth signals.     

Late-onset auditory deprivation: effects of monaural versus binaural hearing aids

Performance on tests of pure-tone thresholds, speech-recognition thresholds, and speech-recognition scores for the two ears of each subject were evaluated in two groups of adults with bilateral hearing losses. One group was composed of individuals fitted with binaural hearing aids, and the other group included persons with monaural hearing aids. Performance prior to the use of hearing aids was compared to performance after 4-5 years of hearing aid use in order to determine whether the unaided ear would show effects of auditory deprivation. There were no differences over time for pure-tone thresholds or speech-recognition thresholds for both ears of both groups. Nevertheless, the results revealed that the speech-recognition difference scores of the binaurally fitted subjects remained stable over time whereas they increased for the monaurally fitted subjects. The findings reveal an auditory deprivation effect for the unfitted ears of the subjects with monaural hearing aids.     

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.     

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.     

Phonetic identification by elderly normal and hearing-impaired listeners

Young normal-hearing listeners, elderly normal-hearing listeners, and elderly hearing-impaired listeners were tested on a variety of phonetic identification tasks. Where identity was cued by stimulus duration, the elderly hearing-impaired listeners evidenced normal identification functions. On a task in which there were multiple cues to vowel identity, performance was also normal. On a/b d g/identification task in which the starting frequency of the second formant was varied, performance was abnormal for both the elderly hearing-impaired listeners and the elderly normal-hearing listeners. We conclude that errors in phonetic identification among elderly hearing-impaired listeners with mild to moderate, sloping hearing impairment do not stem from abnormalities in processing stimulus duration. The results with the /b d g/continuum suggest that one factor underlying errors may be an inability to base identification on dynamic spectral information when relatively static information, which is normally characteristic of a phonetic segment, is unavailable.