Improvements in speech intelligibility in quiet and in noise produced by two-channel compression hearing aids

Eight subjects suffering from bilateral sensorineural hearing losses with recruitment were fitted binaurally with two-channel compression hearing aids, worn behind the ear. After they had worn the aids for some time, measures of speech intelligibility were compared for two conditions: listening unaided, and listening aided. the dynamic range for speech, defined as the difference in level between the speech reception threshold in quiet and the highest comfortable level for speech, was substantially increased in the aided condition for seven of the eight subjects (the exception was a subject with almost normal low-frequency hearing). Speech reception thresholds were also measured in two levels of background noise ('babble'), 60 and 75 dB SPL. Seven of the eight subjects showed a reduced speech reception threshold (i.e. an improvement) in the aided condition for at least one of the two noise levels, although the size of the improvement differed considerably from one subject to another. The subjects were also given a battery of psycho-acoustical tests in an attempt to better characterise their hearing loss, and to gain more insight into individual differences. Results of measurements of frequency selectivity, frequency discrimination, temporal acuity and temporal masking are described and related to the measures of speech intelligibility.     

Internationally comparable screening tests for listening in noise in several European languages: The German digit triplet test as an optimization prototype

Abstract

Objective: A review is given of internationally comparable speech-in-noise tests for hearing screening purposes that were part of the European HearCom project. This report describes the development, optimization, and evaluation of such tests for headphone and telephone presentation, using the example of the German digit triplet test. In order to achieve the highest possible comparability, language- and speaker-dependent factors in speech intelligibility should be compensated for. Materials and methods: The tests comprise spoken numbers in background noise and estimate the speech reception threshold (SRT), i.e. the signal-to-noise ratio (SNR) yielding 50% speech intelligibility. Results: The respective reference speech intelligibility functions for headphone and telephone presentation of the German version for 15 and 10 normal-hearing listeners are described by a SRT of ?9.3?±?0.2 and ?6.5?±?0.4 dB SNR, and slopes of 19.6 and 17.9%/dB, respectively. Reference speech intelligibility functions of all digit triplet tests optimized within the HearCom project allow for investigation of the comparability due to language specificities. Conclusions: The optimization criteria established here should be used for similar screening tests in other languages.     

Talker- and language-specific effects on speech intelligibility in noise assessed with bilingual talkers: Which language is more robust against noise and reverberation?

Objective: Investigate talker- and language-specific aspects of speech intelligibility in noise and reverberation using highly comparable matrix sentence tests across languages. Design: Matrix sentences spoken by German/Russian and German/Spanish bilingual talkers were recorded. These sentences were used to measure speech reception thresholds (SRTs) with native listeners in the respective languages in different listening conditions (stationary and fluctuating noise, multi-talker babble, reverberated speech-in-noise condition). Study sample: Four German/Russian and four German/Spanish bilingual talkers; 20 native German-speaking, 10 native Russian-speaking, and 10 native Spanish-speaking listeners. Results: Across-talker SRT differences of up to 6 dB were found for both groups of bilinguals. SRTs of German/Russian bilingual talkers were the same in both languages. SRTs of German/Spanish bilingual talkers were higher when they talked in Spanish than when they talked in German. The benefit from listening in the gaps was similar across all languages. The detrimental effect of reverberation was larger for Spanish than for German and Russian. Conclusions: Within the limitations set by the number and slight accentedness of talkers and other possible confounding factors, talker- and test-condition-dependent differences were isolated from the language effect: Russian and German exhibited similar intelligibility in noise and reverberation, whereas Spanish was more impaired in these situations.     

Development and evaluation of the British English coordinate response measure speech-in-noise test as an occupational hearing assessment tool

Objective: The studies described in this article outline the design and development of a British English version of the coordinate response measure (CRM) speech-in-noise (SiN) test. Our interest in the CRM is as a SiN test with high face validity for occupational auditory fitness for duty (AFFD) assessment. Design: Study 1 used the method of constant stimuli to measure and adjust the psychometric functions of each target word, producing a speech corpus with equal intelligibility. After ensuring all the target words had similar intelligibility, for Studies 2 and 3, the CRM was presented in an adaptive procedure in stationary speech-spectrum noise to measure speech reception thresholds and evaluate the test–retest reliability of the CRM SiN test. Study sample: Studies 1 (n?=?20) and 2 (n?=?30) were completed by normal-hearing civilians. Study 3 (n?=?22) was completed by hearing impaired military personnel. Results: The results display good test–retest reliability (95% confidence interval (CI)?r?≤?0.65), and the CRM is sensitive to hearing impairment. Conclusion: The British English CRM using stationary speech-spectrum noise is a “ready to use” SiN test, suitable for investigation as an AFFD assessment tool for military personnel.     

Do you hear the noise? The German matrix sentence test with a fixed noise level in subjects with normal hearing and hearing impairment

Objective: The aim of this study was to determine the relationship between hearing loss and speech reception threshold (SRT) in a fixed noise condition using the German Oldenburg sentence test (OLSA). Design: After training with two easily-audible lists of the OLSA, SRTs were determined monaurally with headphones at a fixed noise level of 65 dB SPL using a standard adaptive procedure, converging to 50% speech intelligibility. Study sample: Data was obtained from 315 ears of 177 subjects with hearing losses ranging from ? 5 to 90 dB HL pure-tone average (PTA, 0.5, 1, 2, 3 kHz). Results: Two domains were identified with a linear dependence of SRT on PTA. The SRT increased with a slope of 0.094 ± 0.006 dB SNR/dB HL (standard deviation (SD) of residuals = 1.17 dB) for PTAs < 47 dB HL and with a slope of 0.811 ± 0.049 dB SNR/dB HL (SD of residuals = 5.54 dB) for higher PTAs. Conclusion: The OLSA can be applied to subjects with a wide range of hearing losses. With 65 dB SPL fixed noise presentation level the SRT is determined by listening in noise for PTAs < ～47 dB HL, and above it is determined by listening in quiet.     

Influence of noise type on speech reception thresholds across four languages measured with matrix sentence tests

Objective: To compare speech reception thresholds (SRTs) in noise using matrix sentence tests in four languages: German, Spanish, Russian, Polish. Design: The four tests were composed of equivalent five-word sentences and were all designed and optimized using the same principles. Six stationary speech-shaped noises and three non-stationary noises were used as maskers. Study sample: Forty native listeners with normal hearing: 10 for each language. Results: SRTs were about 3 dB higher for the German and Spanish tests than for the Russian and Polish tests when stationary noise was used that matched the long-term frequency spectrum of the respective speech test materials. This general SRT difference was also observed for the other stationary noises. The within-test variability across noise conditions differed between languages. About 56% of the observed variance was predicted by the speech intelligibility index. The observed SRT benefit in fluctuating noise was similar for all tests, with a slightly smaller benefit for the Spanish test. Conclusions: Of the stationary noises employed, noise with the same spectrum as the speech yielded the best masking. SRT differences across languages and noises could be attributed in part to spectral differences. These findings provide the feasibility and limits of comparing audiological results across languages.     

Matrix sentence intelligibility prediction using an automatic speech recognition system

Objective: The feasibility of predicting the outcome of the German matrix sentence test for different types of stationary background noise using an automatic speech recognition (ASR) system was studied. Design: Speech reception thresholds (SRT) of 50% intelligibility were predicted in seven noise conditions. The ASR system used Mel-frequency cepstral coefficients as a front-end and employed whole-word Hidden Markov models on the back-end side. The ASR system was trained and tested with noisy matrix sentences on a broad range of signal-to-noise ratios. Study sample: The ASR-based predictions were compared to data from the literature (Hochmuth et al, 2015 Hochmuth S., Jürgens T., Brand T. & Kollmeier B. 2015. Influence of noise type on speech reception thresholds across four languages measured with matrix sentence tests. Int J Audiol., 54, doi: 10.3109/14992027.2015.1046502. [22 June 2015][Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) obtained with 10 native German listeners with normal hearing and predictions of the speech intelligibility index (SII). Results: The ASR-based predictions showed a high and significant correlation (R² = 0.95, p < 0.001) with the empirical data across different noise conditions, outperforming the SII-based predictions which showed no correlation with the empirical data (R² = 0.00, p = 0.987). Conclusions: The SRTs for the German matrix test for listeners with normal hearing in different stationary noise conditions could well be predicted based on the acoustical properties of the speech and noise signals. Minimum assumptions were made about human speech processing already incorporated in a reference-free ordinary ASR system.     

普通话语句理解能力分割评分法的比较研究

目的确定普通话噪声下言语测试（Mandarin hearing in noise test，MHINT）的最佳分割评分法，建立评估受试者言语能力的测试规则。方法使用MHINT测试材料对30名听力正常受试者进行测试，采用不同的适应性得分规则，分别将短句按单字和词组分割，进行评分。对使用两种分割评分法得到的测试结果进行比较。结果两组受试者采用不同分割评分法测试，按单字分割组和按词组分割组所得到的各适应性得分规则下的语句接受阈之间差异均无统计学意义（P〉0．05）；言语识别率之间差异无统计学意义（P〉0．05）。同一受试者采用不同分割评分法的测试，按单字分割和按词组分割得到的各适应性得分规则下的语句接受阈之间差异无统计学意义（P〉0．05）；言语识别率之间差异无统计学意义（P〉0．05）。结论两种分割评分法均可用于正常听力者和听障人群的言语理解能力评估。     

An examination of speech reception thresholds measured in a simulated reverberant cafeteria environment

Objective: There is increasing demand in the hearing research community for the creation of laboratory environments that better simulate challenging real-world listening environments. The hope is that the use of such environments for testing will lead to more meaningful assessments of listening ability, and better predictions about the performance of hearing devices. Here we present one approach for simulating a complex acoustic environment in the laboratory, and investigate the effect of transplanting a speech test into such an environment. Design: Speech reception thresholds were measured in a simulated reverberant cafeteria, and in a more typical anechoic laboratory environment containing background speech babble. Study sample: The participants were 46 listeners varying in age and hearing levels, including 25 hearing-aid wearers who were tested with and without their hearing aids. Results: Reliable SRTs were obtained in the complex environment, but led to different estimates of performance and hearing-aid benefit from those measured in the standard environment. Conclusions: The findings provide a starting point for future efforts to increase the real-world relevance of laboratory-based speech tests.     

Semantic context improves speech intelligibility and reduces listening effort for listeners with hearing impairment

Objective: We investigated whether speech intelligibility and listening effort for hearing-aid users is affected by semantic context and hearing-aid setting. Design: Participants heard target sentences spoken in a reverberant background of cafeteria noise and competing speech. Participants reported each sentence verbally. Eight participants also rated listening effort after each sentence. Sentence topic was either the same as, or different from, the previous target sentence. Study sample: Twenty participants with sensorineural hearing loss were fit binaurally with Signia receiver-in-the-canal hearing aids. Participants performed the task twice: once using the hearing aid’s omnidirectional setting and once using the “Reverberant Room” setting, designed to aid listening in reverberant environments. Results: Participants achieved better speech intelligibility for same-topic than different-topic sentences, and when they used the “Reverberant Room” than the omnidirectional hearing-aid setting. Participants who rated effort showed a reliable reduction in listening effort for same-topic sentences and for the “Reverberant Room” hearing-aid setting. The improvement in speech intelligibility from semantic context (i.e. same-topic compared to different-topic sentences) was greater than the improvement gained from changing hearing-aid setting. Conclusions: These findings highlight the enormous potential of cognitive (specifically, semantic) factors for improving speech intelligibility and reducing perceived listening effort in noise for hearing-aid users.     

Evaluation of the NAL Dynamic Conversations Test in older listeners with hearing loss

Objective: The National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT) is a new test of speech comprehension that incorporates a realistic environment and dynamic speech materials that capture certain features of everyday conversations. The goal of this study was to assess the suitability of the test for studying the consequences of hearing loss and amplification in older listeners. Design: Unaided and aided comprehension scores were measured for single-, two- and three-talker passages, along with unaided and aided sentence recall. To characterise the relevant cognitive abilities of the group, measures of short-term working memory, verbal information-processing speed and reading comprehension speed were collected. Study sample: Participants were 41 older listeners with varying degrees of hearing loss. Results: Performance on both the NAL-DCT and the sentence test was strongly driven by hearing loss, but performance on the NAL-DCT was additionally related to a composite cognitive deficit score. Benefits of amplification were measurable but influenced by individual test SNRs. Conclusions: The NAL-DCT is sensitive to the same factors as a traditional sentence recall test, but in addition is sensitive to the cognitive factors required for speech processing. The test shows promise as a tool for research concerned with real-world listening.     

Speech intelligibility of virtual humans

Abstract

The speech intelligibility benefit of visual speech cues during oral communication is well-established. Therefore, an ecologically valid approach of auditory assessment should include the processing of both auditory and visual speech cues. This study describes the development and evaluation of a virtual human speaker designed to present speech auditory-visually. A male and female virtual human speaker were created and evaluated in two experiments: a visual-only speech reading test of words and sentences and an auditory-visual speech intelligibility sentence test. A group of five hearing, skilled speech reading adults participated in the speech reading test whereas a group of young normal-hearing participants (N?=?35) was recruited for the intelligibility test. Skilled speech readers correctly identified 57 to 67% of the words and sentences uttered by the virtual speakers. The presence of the virtual speaker improved the speech intelligibility of sentences in noise by 1.5 to 2?dB. These results demonstrate the potential applicability of virtual humans in future auditory-visual speech assessment paradigms.     

To measure the impact of hearing protectors on the perception of speech in noise

Abstract

Objective: To propose and evaluate a new method for assessing the potential impact on speech intelligibility when wearing a hearing protection device (HPD) in a noisy environment. Design: The method is based on a self adaptive method for finding the speech reception threshold (SRT) using speech material from the Callsign acquisition test (CAT) presented at a constant level while adjusting the level of a background noise. A key point is to primarily examine the impact of the HPD; i.e. the difference between occluded and unoccluded SRTs, presented as the speech intelligibility impact level. Study sample: A total of 31 test subjects. Results: The method is shown to be stable, with a minimum amount of learning effect, and capable of detecting differences between hearing protection devices. It is also shown that low-attenuation passive HPDs are likely to have a very small effect on speech intelligibility in noise, and that an electronic HPD with a level-dependant function has the potential to improve intelligibility. Conclusions: The results are encouraging regarding the precision, repeatability, and applicability of the proposed method.     

Perceived listening effort and speech intelligibility in reverberation and noise for hearing-impaired listeners

Objective: The purpose of this study was to assess perceived listening effort and speech intelligibility in reverberant and noisy conditions for hearing-impaired listeners for conditions that are similar according to the speech transmission index (STI). Design: Scaled listening effort was measured in four different conditions at five different STI generated using various relative contributions of noise and reverberant interferences. Intelligibility was measured for a subset of conditions. Study sample: Twenty mildly to moderately hearing-impaired listeners. Results: In general, listening effort decreased and speech intelligibility increased with increasing STI. For simulated impulse responses consisting of white Gaussian noise exponentially decaying in time, a good agreement between conditions of different relative contributions of noise and reverberation was found. For real impulse responses, the STI slightly overestimated the effect of reverberation on the perceived listening effort and underestimated its effect on speech intelligibility. Including the average hearing loss in the calculation of the STI led to a better agreement between STI predictions and subjective data. Conclusion: Speech intelligibility and listening effort provide complementary tools to evaluate speech perception over a broad range of acoustic scenarios. In addition, when incorporating hearing loss information the STI provides a rough prediction of listening effort in these acoustic scenarios.     

Speech intelligibility with and without noise in individuals exposed to electronic music

Audiometry is the main way with which hearing is evaluated, because it is a universal and standardized test. Speech tests are difficult to standardize due to the variables involved, their performance in the presence of competitive noise is of great importance.Aim: To characterize speech intelligibility in silence and in competitive noise from individuals exposed to electronically amplified music.Material and Method: It was performed with 20 university students who presented normal hearing thresholds. The speech recognition rate (SRR) was performed after fourteen hours of sound rest after the exposure to electronically amplified music and once again after sound rest, being studied in three stages: without competitive noise, in the presence of Babble-type competitive noise, in monotic listening, in signal/noise ratio of +5 dB and with the signal/noise ratio of 5 dB.Results: There was greater damage in the SRR after exposure to the music and with competitive noise, and as the signal/noise ratio decreases, the performance of individuals in the test also decreased.Conclusion: The inclusion of competitive noise in the speech tests in the audiological routine is important, because it represents the real disadvantage experienced by individuals in daily listening.     

Noise-induced hearing loss in young adults: The role of personal listening devices and other sources of leisure noise

Concept: No consensus exists regarding the magnitude of the risk of noise-induced hearing loss (NIHL) associated with leisure noise, in particular, personal listening devices in young adults. Objective: Examine the magnitude of hearing loss associated with personal listening devices and other sources of leisure noise in causing NIHL in young adults. Study Design: Prospective auditory testing of college student volunteers with retrospective history exposure to home stereos, personal listening devices, firearms, and other sources of recreational noise. Methods: Subjects underwent audiologic examination consisting of estimation of pure-tone thresholds, speech reception thresholds, and word recognition at 45 dB HL. Results: Fifty subjects aged 18 to 30 years were tested. All hearing thresholds of all subjects (save one—a unilateral 30 dB HL threshold at 6 kHz) were normal, (i.e., 25 dB HL or better). A 10 dB threshold elevation (notch) in either ear at 3 to 6 kHz as compared with neighboring frequencies was noted in 11 (22%) subjects and an unequivocal notch (15 dB or greater) in either ear was noted in 14 (28%) of subjects. The presence or absence of any notch (small or large) did not correlate with any single or cumulative source of noise exposure. No difference in pure-tone threshold, speech reception threshold, or speech discrimination was found among subjects when segregated by noise exposure level. Conclusion: The majority of young users of personal listening devices are at low risk for substantive NIHL. Interpretation of the significance of these findings in relation to noise exposure must be made with caution. NIHL is an additive process and even subtle deficits may contribute to unequivocal hearing loss with continued exposure. The low prevalence of measurable deficits in this study group may not exclude more substantive deficits in other popu lations with greater exposures. Continued education of young people about the risk to hearing from recreational noise exposure is warranted.     

Internationally comparable screening tests for listening in noise in several European languages: The German digit triplet test as an optimization prototype

Abstract Objective: A review is given of internationally comparable speech-in-noise tests for hearing screening purposes that were part of the European HearCom project. This report describes the development, optimization, and evaluation of such tests for headphone and telephone presentation, using the example of the German digit triplet test. In order to achieve the highest possible comparability, language- and speaker-dependent factors in speech intelligibility should be compensated for. Materials and methods: The tests comprise spoken numbers in background noise and estimate the speech reception threshold (SRT), i.e. the signal-to-noise ratio (SNR) yielding 50% speech intelligibility. Results: The respective reference speech intelligibility functions for headphone and telephone presentation of the German version for 15 and 10 normal-hearing listeners are described by a SRT of -9.3?±?0.2 and -6.5?±?0.4 dB SNR, and slopes of 19.6 and 17.9%/dB, respectively. Reference speech intelligibility functions of all digit triplet tests optimized within the HearCom project allow for investigation of the comparability due to language specificities. Conclusions: The optimization criteria established here should be used for similar screening tests in other languages.     

Development and evaluation of the Turkish matrix sentence test

Objectives: The Turkish matrix sentence test, TURMatrix, was developed for precise, internationally comparable speech intelligibility testing. Design: The TURMatrix comprises a base matrix of ten well-known Turkish names, numbers, adjectives, objects, verbs, from which syntactically fixed sentences were randomly composed. Test conduction may be in an open-set (standard), or closed-set response format. Homogeneity in intelligibility of the test material was optimized by applying level adaptations (maximal ± 3 dB) based on word-specific speech reception thresholds (SRTs). Test list equivalence was verified and reference values were determined. Study sample: Thirty-eight native listeners of Turkish with normal hearing. Results: After training, mean SRT and slope of the final test lists were ? 8.3 ± 0.2 dB SNR and 14.1 ± 1.0%/dB, respectively (fixed SNR measurements; inter-list variability). For adaptive measurements, average across listeners was ? 7.2 ± 0.7 dB SNR in the open-set and ? 7.9 ± 0.7 dB SNR in the closed-set response format. Mean SRT for adaptive measurements in the open-set response format in quiet was 20.3 ± 4.1 dB. Individual SRTs in quiet correlated more closely with audiograms than with SRTs in noise. Conclusions: The TURMatrix was developed according to European standards and provides reliable speech intelligibility measurements in noise and quiet.     

Evaluation of a wireless remote microphone in bimodal cochlear implant recipients

Objective: To evaluate the benefit of a wireless remote microphone (MM) for speech recognition in noise in bimodal adult cochlear implant (CI) users both in a test setting and in daily life. Design: This prospective study measured speech reception thresholds in noise in a repeated measures design with factors including bimodal hearing and MM use. The participants also had a 3-week trial period at home with the MM. Study sample: Thirteen post-lingually deafened adult bimodal CI users. Results: A significant improvement in SRT of 5.4?dB was found between the use of the CI with the MM and the use of the CI without the MM. By also pairing the MM to the hearing aid (HA) another improvement in SRT of 2.2?dB was found compared to the situation with the MM paired to the CI alone. In daily life, participants reported better speech perception for various challenging listening situations, when using the MM in the bimodal condition. Conclusion: There is a clear advantage of bimodal listening (CI and HA) compared to CI alone when applying advanced wireless remote microphone techniques to improve speech understanding in adult bimodal CI users.     

Development of the Cantonese Hearing In Noise Test (CHINT)

OBJECTIVE: To develop a Cantonese version of the Hearing In Noise Test (CHINT) with the same features as the English Hearing In Noise Test (HINT) (Nilsson, Soli, & Sullivan, 1994). DESIGN: The CHINT was developed in five separate studies: (1) evaluation of initial materials; (2) creation of sentence materials; (3) equalization of sentence difficulty; (4) creation of sentence lists; and (5) evaluation of response variability, inter-list reliability, and establishment of norms. Using the CHINT material, reception thresholds for sentences were measured under four headphone test conditions: Quiet, and in noise with noise simulated as originating from 0 degrees (noise front), 90 degrees (noise right), and 270 degrees (noise left). The speech source was located at 0 degrees in all conditions. The locations of the speech and noise sources were simulated using virtual audio processing, as with the English HINT. The noise conditions consisted of listening with noise fixed at 65 dBA with the level of speech varied in an adaptive procedure. A total of 142 subjects with normal hearing thresholds participated in the five studies. RESULTS: Two versions of the test materials, twenty-four 10-sentence lists and twelve 20-sentence lists, were created from a single set of 240 sentences containing 10 syllables per sentence. Using the twenty-four 10-sentence lists, mean thresholds under earphones in quiet were measured at 19.4 dBA and reception thresholds for sentences of -3.9 dB for noise front, -10.6 dB for noise right, and -10.5 dB for noise left. Similar results were obtained using the 20-sentence lists (19.4, -4.0, -10.9, and -11.0 dB, respectively, for quiet, noise front, noise right, and noise left conditions). There was low response variability within each list. High inter-list reliability suggests that consistent results could be obtained using any list. Confidence intervals are reported. The CHINT norms for listening in quiet and noise conditions were comparable to those for the English HINT. CONCLUSIONS: The CHINT is the first standardized Cantonese sentence speech intelligibility test. The CHINT was developed using the same rationale as the English HINT, allowing norm reference results from the two tests to be compared directly across languages. Results showed the CHINT is a reliable test. The CHINT would benefit from further evaluation of validity.