Dataset Information

Speech perception in older hearing impaired listeners: benefits of perceptual training.

ABSTRACT: Hearing aids (HAs) only partially restore the ability of older hearing impaired (OHI) listeners to understand speech in noise, due in large part to persistent deficits in consonant identification. Here, we investigated whether adaptive perceptual training would improve consonant-identification in noise in sixteen aided OHI listeners who underwent 40 hours of computer-based training in their homes. Listeners identified 20 onset and 20 coda consonants in 9,600 consonant-vowel-consonant (CVC) syllables containing different vowels (/?/, /i/, or /u/) and spoken by four different talkers. Consonants were presented at three consonant-specific signal-to-noise ratios (SNRs) spanning a 12 dB range. Noise levels were adjusted over training sessions based on d' measures. Listeners were tested before and after training to measure (1) changes in consonant-identification thresholds using syllables spoken by familiar and unfamiliar talkers, and (2) sentence reception thresholds (SeRTs) using two different sentence tests. Consonant-identification thresholds improved gradually during training. Laboratory tests of d' thresholds showed an average improvement of 9.1 dB, with 94% of listeners showing statistically significant training benefit. Training normalized consonant confusions and improved the thresholds of some consonants into the normal range. Benefits were equivalent for onset and coda consonants, syllables containing different vowels, and syllables presented at different SNRs. Greater training benefits were found for hard-to-identify consonants and for consonants spoken by familiar than unfamiliar talkers. SeRTs, tested with simple sentences, showed less elevation than consonant-identification thresholds prior to training and failed to show significant training benefit, although SeRT improvements did correlate with improvements in consonant thresholds. We argue that the lack of SeRT improvement reflects the dominant role of top-down semantic processing in processing simple sentences and that greater transfer of benefit would be evident in the comprehension of more unpredictable speech material.

SUBMITTER: Woods DL

PROVIDER: S-EPMC4346400 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Speech perception in older hearing impaired listeners: benefits of perceptual training.

Woods David L DL Doss Zoe Z Herron Timothy J TJ Arbogast Tanya T Younus Masood M Ettlinger Marc M Yund E William EW

PloS one 20150302 3

Hearing aids (HAs) only partially restore the ability of older hearing impaired (OHI) listeners to understand speech in noise, due in large part to persistent deficits in consonant identification. Here, we investigated whether adaptive perceptual training would improve consonant-identification in noise in sixteen aided OHI listeners who underwent 40 hours of computer-based training in their homes. Listeners identified 20 onset and 20 coda consonants in 9,600 consonant-vowel-consonant (CVC) sylla ...[more]

PMID: 25730330

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Project description:The most common complaint of older hearing impaired (OHI) listeners is difficulty understanding speech in the presence of noise. However, tests of consonant-identification and sentence reception threshold (SeRT) provide different perspectives on the magnitude of impairment. Here we quantified speech perception difficulties in 24 OHI listeners in unaided and aided conditions by analyzing (1) consonant-identification thresholds and consonant confusions for 20 onset and 20 coda consonants in consonant-vowel-consonant (CVC) syllables presented at consonant-specific signal-to-noise (SNR) levels, and (2) SeRTs obtained with the Quick Speech in Noise Test (QSIN) and the Hearing in Noise Test (HINT). Compared to older normal hearing (ONH) listeners, nearly all unaided OHI listeners showed abnormal consonant-identification thresholds, abnormal consonant confusions, and reduced psychometric function slopes. Average elevations in consonant-identification thresholds exceeded 35 dB, correlated strongly with impairments in mid-frequency hearing, and were greater for hard-to-identify consonants. Advanced digital hearing aids (HAs) improved average consonant-identification thresholds by more than 17 dB, with significant HA benefit seen in 83% of OHI listeners. HAs partially normalized consonant-identification thresholds, reduced abnormal consonant confusions, and increased the slope of psychometric functions. Unaided OHI listeners showed much smaller elevations in SeRTs (mean 6.9 dB) than in consonant-identification thresholds and SeRTs in unaided listening conditions correlated strongly (r = 0.91) with identification thresholds of easily identified consonants. HAs produced minimal SeRT benefit (2.0 dB), with only 38% of OHI listeners showing significant improvement. HA benefit on SeRTs was accurately predicted (r = 0.86) by HA benefit on easily identified consonants. Consonant-identification tests can accurately predict sentence processing deficits and HA benefit in OHI listeners.

Project description:Speech perception in background noise is difficult for many individuals, and there is considerable performance variability across listeners. The combination of physiological and behavioral measures may help to understand sources of this variability for individuals and groups and prove useful clinically with hard-to-test populations. The purpose of this study was threefold: (1) determine the effect of signal-to-noise ratio (SNR) and signal level on cortical auditory evoked potentials (CAEPs) and sentence-level perception in older normal-hearing (ONH) and older hearing-impaired (OHI) individuals, (2) determine the effects of hearing impairment and age on CAEPs and perception, and (3) explore how well CAEPs correlate with and predict speech perception in noise.Two groups of older participants (15 ONH and 15 OHI) were tested using speech-in-noise stimuli to measure CAEPs and sentence-level perception of speech. The syllable /ba/, used to evoke CAEPs, and sentences were presented in speech-spectrum background noise at four signal levels (50, 60, 70, and 80 dB SPL) and up to seven SNRs (-10, -5, 0, 5, 15, 25, and 35 dB). These data were compared between groups to reveal the hearing impairment effect and then combined with previously published data for 15 young normal-hearing individuals to determine the aging effect.Robust effects of SNR were found for perception and CAEPs. Small but significant effects of signal level were found for perception, primarily at poor SNRs and high signal levels, and in some limited instances for CAEPs. Significant effects of age were seen for both CAEPs and perception, while hearing impairment effects were only found with perception measures. CAEPs correlate well with perception and can predict SNR50s to within 2 dB for ONH. However, prediction error is much larger for OHI and varies widely (from 6 to 12 dB) depending on the model that was used for prediction.When background noise is present, SNR dominates both perception-in-noise testing and cortical electrophysiological testing, with smaller and sometimes significant contributions from signal level. A mismatch between behavioral and electrophysiological results was found (hearing impairment effects were primarily only seen for behavioral data), illustrating the possible contributions of higher order cognitive processes on behavior. It is interesting that the hearing impairment effect size was more than five times larger than the aging effect size for CAEPs and perception. Sentence-level perception can be predicted well in normal-hearing individuals; however, additional research is needed to explore improved prediction methods for older individuals with hearing impairment.

Dataset Information

Speech perception in older hearing impaired listeners: benefits of perceptual training.

Publications

Speech perception in older hearing impaired listeners: benefits of perceptual training.

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