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
