Quality ratings of frequency-compressed speech by participants with extensive high-frequency dead regions in the cochlea.

OBJECTIVE: The objective was to assess the degradation of speech sound quality produced by frequency compression for listeners with extensive high-frequency dead regions (DRs). DESIGN: Quality ratings were obtained using values of the starting frequency (Sf) of the frequency compression both below and above the estimated edge frequency, fe, of each DR. Thus, the value of Sf often fell below the lowest value currently used in clinical practice. Several compression ratios were used for each value of Sf. Stimuli were sentences processed via a prototype hearing aid based on Phonak Exélia Art P. STUDY SAMPLE: Five participants (eight ears) with extensive high-frequency DRs were tested. RESULTS: Reductions of sound-quality produced by frequency compression were small to moderate. Ratings decreased significantly with decreasing Sf and increasing CR. The mean ratings were lowest for the lowest Sf and highest CR. Ratings varied across participants, with one participant rating frequency compression lower than no frequency compression even when Sf was above fe. CONCLUSIONS: Frequency compression degraded sound quality somewhat for this small group of participants with extensive high-frequency DRs. The degradation was greater for lower values of Sf relative to fe, and for greater values of CR. Results varied across participants.Action on Hearing Loss, Phonak AG, H.B. Allen Trust, Medical Research CouncilThis is the final version of the article. It first appeared from Taylor & Francis via http://dx.doi.org/10.1080/14992027.2016.123407

Evaluation of a Frequency-Lowering Algorithm for Adults With High-Frequency Hearing Loss.

The objective was to determine the effects of a frequency-lowering algorithm (frequency composition, Fcomp) on consonant identification, word-final /s, z/ detection, the intelligibility of sentences in noise, and subjective benefit, for people with high-frequency hearing loss, including people with dead regions (DRs) in the cochlea. A single-blind randomized crossover design was used. Performance with Bernafon Acriva 9 hearing aids was compared with Fcomp off and Fcomp on. Participants wore the hearing aids in each condition in a counterbalanced order. Data were collected after at least 8 weeks of experience with a condition. Outcome measures were audibility, scores from the speech perception tests, and scores from a questionnaire comparing self-perceived hearing ability with Fcomp off and Fcomp on. Ten adults with mild to severe high-frequency hearing loss (seven with extensive DRs, one with patchy or restricted DRs, and two with no DR) were tested. Fcomp improved the audibility of high-frequency sounds for 6 out of 10 participants. There was no overall effect of Fcomp on consonant identification, but the pattern of consonant confusions varied across conditions and participants. For word-final /s, z/ detection, performance was significantly better with Fcomp on than with Fcomp off. Questionnaire scores showed no differences between conditions. In summary, Fcomp improved word-final /s, z/ detection. No benefit was found for the other measures.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The first author was supported by Bernafon AG and received funding from Phonak in the past

Effect of the number of amplitude-compression channels and compression speed on speech recognition by listeners with mild to moderate sensorineural hearing loss.

The use of a large number of amplitude-compression channels in hearing aids has potential advantages, such as the ability to compensate for variations in loudness recruitment across frequency and provide appropriate frequency-response shaping. However, sound quality and speech intelligibility could be adversely affected due to reduction of spectro-temporal contrast and distortion, especially when fast-acting compression is used. This study assessed the effect of the number of channels and compression speed on speech recognition when the multichannel processing was used solely to implement amplitude compression, and not for frequency-response shaping. Computer-simulated hearing aids were used. The frequency-dependent insertion gains for speech with a level of 65 dB sound pressure level were applied using a single filter before the signal was filtered into compression channels. Fast-acting (attack, 10 ms; release, 100 ms) or slow-acting (attack, 50 ms; release, 3000 ms) compression using 3, 6, 12, and 22 channels was applied subsequently. Using a sentence recognition task with speech in two- and eight-talker babble at three different signal-to-babble ratios (SBRs), 20 adults with sensorineural hearing loss were tested. The number of channels and compression speed had no significant effect on speech recognition, regardless of babble type or SBR.This work was supported by the H. B. Allen Trust and the Engineering and Physical Sciences Research Council (UK; Grant No. RG78536). M.A.S. was co-funded by the National Institute of Health Research Manchester Biomedical Research Centre and Trust Charitable funds of the Central Manchester University Hospitals National Health Service Foundation Trust

Using a Bone-Conduction Headset to Improve Speech Discrimination in Children With Otitis Media With Effusion.

The recommended management for children with otitis media with effusion (OME) is 'watchful waiting' before considering grommet surgery. During this time speech and language, listening skills, quality of life, social skills, and outcomes of education can be jeopardized. Air-conduction (AC) hearing aids are problematic due to fluctuating AC hearing loss. Bone-conduction (BC) hearing is stable, but BC hearing aids can be uncomfortable. Both types of hearing aids are costly. Given the high prevalence of OME and the transitory nature of the accompanying hearing loss, cost-effective solutions are needed. The leisure industry has developed relatively inexpensive, comfortable, high-quality BC headsets for transmission of speech or music. This study assessed whether these headsets, paired with a remote microphone, improve speech discrimination for children with OME. Nineteen children aged 3 to 6 years receiving recommended management in the United Kingdom for children with OME participated. Word-discrimination thresholds were measured in a sound-treated room in quiet and with 65 dB(A) speech-shaped noise, with and without a headset. The median threshold in quiet (N = 17) was 39 dB(A) (range: 23-59) without a headset and 23 dB(A) (range: 9-35) with a headset (Z = -3.519, p < .001). The median threshold in noise (N = 19) was 59 dB(A) (range: 50-63) without a headset and 45 dB(A) (range: 32-50) with a headset (Z = -3.825, p < .001). Thus, the use of a BC headset paired with a remote microphone significantly improved speech discrimination in quiet and in noise for children with OME.The main source of funding for this study was the Cambridge Hearing Trust. T. H. B. was awarded the British Association of Paediatricians in Audiology Prize in 2017, and J. E. M. and M. S.-C. were jointly granted the Stuart Gatehouse Applied Research Grant 2015 by the British Society of Audiology, both toward the Bone conduction In Glue ear study

Evaluation of a Frequency-Lowering Algorithm for Adults With High-Frequency Hearing Loss.

The objective was to determine the effects of a frequency-lowering algorithm (frequency composition, Fcomp) on consonant identification, word-final /s, z/ detection, the intelligibility of sentences in noise, and subjective benefit, for people with high-frequency hearing loss, including people with dead regions (DRs) in the cochlea. A single-blind randomized crossover design was used. Performance with Bernafon Acriva 9 hearing aids was compared with Fcomp off and Fcomp on. Participants wore the hearing aids in each condition in a counterbalanced order. Data were collected after at least 8 weeks of experience with a condition. Outcome measures were audibility, scores from the speech perception tests, and scores from a questionnaire comparing self-perceived hearing ability with Fcomp off and Fcomp on. Ten adults with mild to severe high-frequency hearing loss (seven with extensive DRs, one with patchy or restricted DRs, and two with no DR) were tested. Fcomp improved the audibility of high-frequency sounds for 6 out of 10 participants. There was no overall effect of Fcomp on consonant identification, but the pattern of consonant confusions varied across conditions and participants. For word-final /s, z/ detection, performance was significantly better with Fcomp on than with Fcomp off. Questionnaire scores showed no differences between conditions. In summary, Fcomp improved word-final /s, z/ detection. No benefit was found for the other measures.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The first author was supported by Bernafon AG and received funding from Phonak in the past

Comparison of Frequency Transposition and Frequency Compression for People With Extensive Dead Regions in the Cochlea.

The objective was to determine the effects of two frequency-lowering algorithms (frequency transposition, FT, and frequency compression, FC) on audibility, speech identification, and subjective benefit, for people with high-frequency hearing loss and extensive dead regions (DRs) in the cochlea. A single-blind randomized crossover design was used. FT and FC were compared with each other and with a control condition (denoted 'Control') without frequency lowering, using hearing aids that were otherwise identical. Data were collected after at least 6 weeks of experience with a condition. Outcome measures were audibility, scores for consonant identification, scores for word-final /s, z/ detection ( S test), sentence-in-noise intelligibility, and a questionnaire assessing self-perceived benefit (Spatial and Qualities of Hearing Scale). Ten adults with steeply sloping high-frequency hearing loss and extensive DRs were tested. FT and FC improved the audibility of some high-frequency sounds for 7 and 9 participants out of 10, respectively. At the group level, performance for FT and FC did not differ significantly from that for Control for any of the outcome measures. However, the pattern of consonant confusions varied across conditions. Bayesian analysis of the confusion matrices revealed a trend for FT to lead to more consistent error patterns than FC and Control. Thus, FT may have the potential to give greater benefit than Control or FC following extended experience or training.MSC was supported by an Action on Hearing Loss PhD studentship, Phonak AG, and the H. B. Allen Trust. BCJM and TB were supported by grants from the Medical Research Council (UK) grant and the Engineering and Physical Sciences Research Council, UK (RG78536). Hearing aids and technical support were provided by Phonak AG

Evaluating Spatial Hearing Using a Dual-Task Approach in a Virtual-Acoustics Environment.

Spatial hearing is critical for communication in everyday sound-rich environments. It is important to gain an understanding of how well users of bilateral hearing devices function in these conditions. The purpose of this work was to evaluate a Virtual Acoustics (VA) version of the Spatial Speech in Noise (SSiN) test, the SSiN-VA. This implementation uses relatively inexpensive equipment and can be performed outside the clinic, allowing for regular monitoring of spatial-hearing performance. The SSiN-VA simultaneously assesses speech discrimination and relative localization with changing source locations in the presence of noise. The use of simultaneous tasks increases the cognitive load to better represent the difficulties faced by listeners in noisy real-world environments. Current clinical assessments may require costly equipment which has a large footprint. Consequently, spatial-hearing assessments may not be conducted at all. Additionally, as patients take greater control of their healthcare outcomes and a greater number of clinical appointments are conducted remotely, outcome measures that allow patients to carry out assessments at home are becoming more relevant. The SSiN-VA was implemented using the 3D Tune-In Toolkit, simulating seven loudspeaker locations spaced at 30° intervals with azimuths between -90° and +90°, and rendered for headphone playback using the binaural spatialization technique. Twelve normal-hearing participants were assessed to evaluate if SSiN-VA produced patterns of responses for relative localization and speech discrimination as a function of azimuth similar to those previously obtained using loudspeaker arrays. Additionally, the effect of the signal-to-noise ratio (SNR), the direction of the shift from target to reference, and the target phonetic contrast on performance were investigated. SSiN-VA led to similar patterns of performance as a function of spatial location compared to loudspeaker setups for both relative localization and speech discrimination. Performance for relative localization was significantly better at the highest SNR than at the lowest SNR tested, and a target shift to the right was associated with an increased likelihood of a correct response. For word discrimination, there was an interaction between SNR and word group. Overall, these outcomes support the use of virtual audio for speech discrimination and relative localization testing in noise

SSiN-VA outcomes for twelve normal-hearing participants

Spatial hearing is critical for communication in everyday multi-talker, sound-rich environments. To gain an understanding of how well users of bilateral hearing devices function in complex sound environments, and to be able to regularly monitor their performance outside of the clinics, we have implemented a Virtual Acoustics (VA) version of the Spatial Speech in Noise (SSiN) test (1), named the SSiN-VA. The SSiN-VA allows for simultaneous assessment of speech discrimination and relative localisation with changing source locations in the presence of noise. The use of this dual-task paradigm increases the cognitive load to better represent the difficulties faced by listeners in noisy real-world environments. For many current speech assessments, patients need to visit a clinic and undergo testing using a multi loudspeaker array. This is time consuming for the patient and clinician. The equipment is costly and has a large footprint, taking up vital clinical space. In reality this often means that spatial hearing assessments are not conducted at all. As we move towards a clinical model where patients take greater control of their healthcare outcomes and a greater number of clinical appointments are conducted remotely, outcome measures that allow patients to carry out assessments at home are becoming more relevant. The SSiN-VA was implemented using the 3D Tune-In Toolkit (2) to simulate seven loudspeaker locations, spaced at 30° intervals with azimuths between +90° and –90°, and rendered for headphone playback using the binaural spatialisation technique. Twelve normal-hearing participants were assessed to evaluate if the virtual implementation of the test produced similar results to using a loudspeaker array. They were tested at three different individually selected speech-to-noise ratios (SNRs). 1. Bizley JK, Elliott N, Wood KC, Vickers DA. Simultaneous assessment of speech identification and spatial discrimination: A potential testing approach for bilateral cochlear implant users? Trends in Hearing. 2015 Dec 1;19:2331216515619573. 2. Cuevas-Rodríguez M, Picinali L, González-Toledo D, Garre C, de la Rubia-Cuestas E, Molina-Tanco L, et al. 3D Tune-In Toolkit: An open-source library for real-time binaural spatialisation. PloS one. 2019;14(3):1–37.MSC was funded by Imperial Confidence in Concept, Imperial Biomedical Research Centre (BRC). DAV and MSC were funded by a Programme Grant for Applied Research (NIHR201608). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. MSC, BW, and DAV were funded by the Medical Research Council (MRC) UK, Grant code MR/S002537/1

Development of New Open-Set Speech Material for Use in Clinical Audiology with Speakers of British English.

Peer reviewed: TrueAcknowledgements: We thank Michael Stone for assistance in recording the COPT materials. We also thank three reviewers for helpful comments on an earlier version of this paper.Publication status: PublishedFunder: ChearBACKGROUND: The Chear open-set performance test (COPT), which uses a carrier phrase followed by a monosyllabic test word, is intended for clinical assessment of speech recognition, evaluation of hearing-device performance, and the fine-tuning of hearing devices for speakers of British English. This paper assesses practice effects, test-retest reliability, and the variability across lists of the COPT. METHOD: In experiment 1, 16 normal-hearing participants were tested using an initial version of the COPT, at three speech-to-noise ratios (SNRs). Experiment 2 used revised COPT lists, with items swapped between lists to reduce differences in difficulty across lists. In experiment 3, test-retest repeatability was assessed for stimuli presented in quiet, using 15 participants with sensorineural hearing loss. RESULTS: After administration of a single practice list, no practice effects were evident. The critical difference between scores for two lists was about 2 words (out of 15) or 5 phonemes (out of 50). The mean estimated SNR required for 74% words correct was -0.56 dB, with a standard deviation across lists of 0.16 dB. For the participants with hearing loss tested in quiet, the critical difference between scores for two lists was about 3 words (out of 15) or 6 phonemes (out of 50)