Acceptable noise level: Repeatability with Danish and non-semantic speech materials for adults with normal hearing

Objective: The acceptable noise level (ANL) is used to quantify the amount of background noise that subjects can accept while listening to speech, and is suggested for prediction of individual hearing-aid use. The aim of this study was to assess the repeatability of the ANL measured in normal-hearing subjects using running Danish and non-semantic speech materials as stimuli and modulated speech-spectrum and multi-talker babble noises as competing stimuli. Design: ANL was measured in both ears at two test sessions separated by a period ranging from 12 to 77 days. At each session the measurements at the first and the second ear were separated in time by 15–30 minutes. Bland-Altman plots and calculation of the coefficient of repeatability (CR) were used to estimate the repeatability. Study sample: Thirty nine normal-hearing subjects. Results: The ANL CR was 6.0–8.9 dB for repeated tests separated by about 15–30 minutes and 7.2–10.2 dB for repeated tests separated by 12 days or more. Conclusions: The ANL test has poor repeatability when assessed with Danish and non-semantic speech materials on normal-hearing subjects. The same CR among hearing-impaired subjects would imply too poor repeatability to predict individual patterns of future hearing-aid use.     

Acceptable noise level (ANL) and real-world hearing-aid success in Taiwanese listeners

Abstract

Objective: The objective of this prospective study was to investigate the relationship between acceptable noise level (ANL), which was measured using Taiwanese and the international speech test signal (ISTS), and real-world hearing-aid success for listeners who were representative of the population commonly seen in clinics. Design: Unaided ANLs were measured pre-hearing-aid fitting. Hearing-aid success was assessed three months post-fitting using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Study sample: Eighty adults with hearing impairment completed the study. Results: Both Taiwanese and ISTS ANLs were significantly associated with hearing-aid success, with higher ANLs suggesting poorer outcomes. However, the ANL's prediction accuracy for the probability of hearing-aid success was either much lower than that suggested by some literature, or was not much different from that of simply predicting all listeners as successful users. Conclusions: The current study suggested the possibility of using ANL to predict hearing-aid success. However, the usefulness of ANL as a clinical tool is unlikely to be as great as indicated by the literature.     

Acceptable noise level (ANL) with Danish and non-semantic speech materials in adult hearing-aid users

Abstract Objective: The acceptable noise level (ANL) test is used for quantification of the amount of background noise subjects accept when listening to speech. This study investigates Danish hearing-aid users' ANL performance using Danish and non-semantic speech signals, the repeatability of ANL, and the association between ANL and outcome of the international outcome inventory for hearing aids (IOI-HA). Design: ANL was measured in three conditions in both ears at two test sessions. Subjects completed the IOI-HA and the ANL questionnaire. Study sample: Sixty-three Danish hearing-aid users; fifty-seven subjects were full time users and 6 were part time/non users of hearing aids according to the ANL questionnaire. Results: ANLs were similar to results with American English speech material. The coefficient of repeatability (CR) was 6.5-8.8 dB. IOI-HA scores were not associated to ANL. Conclusions: Danish and non-semantic ANL versions yield results similar to the American English version. The magnitude of the CR indicates that ANL with Danish and non-semantic speech materials is not suitable for prediction of individual patterns of future hearing-aid use or evaluation of individual benefit from hearing-aid features. The ANL with Danish and non-semantic speech materials is not related to IOI-HA outcome.     

Predicting three-month and 12-month post-fitting real-world hearing-aid outcome using pre-fitting acceptable noise level (ANL)

Objective: Determine the extent to which pre-fitting acceptable noise level (ANL), with or without other predictors such as hearing-aid experience, can predict real-world hearing-aid outcomes at three and 12 months post-fitting. Design: ANLs were measured before hearing-aid fitting. Post-fitting outcome was assessed using the international outcome inventory for hearing aids (IOI-HA) and a hearing-aid use questionnaire. Models that predicted outcomes (successful vs. unsuccessful) were built using logistic regression and several machine learning algorithms, and were evaluated using the cross-validation technique. Study sample: A total of 132 adults with hearing impairment. Results: The prediction accuracy of the models ranged from 61% to 68% (IOI-HA) and from 55% to 61% (hearing-aid use questionnaire). The models performed more poorly in predicting 12-month than three-month outcomes. The ANL cutoff between successful and unsuccessful users was higher for experienced (～18 dB) than first-time hearing-aid users (～10 dB), indicating that most experienced users will be predicted as successful users regardless of their ANLs. Conclusions: Pre-fitting ANL is more useful in predicting short-term (three months) hearing-aid outcomes for first-time users, as measured by the IOI-HA. The prediction accuracy was lower than the accuracy reported by some previous research that used a cross-sectional design.     

Development and evaluation of the Mandarin speech signal content on the acceptable noise level test in listeners with normal hearing in mainland China

Abstract

Objective: To develop and evaluate the Mandarin speech signal content on the acceptable noise level (ANL) test in listeners with normal hearing in mainland China. Design: The Mandarin ANL tests were conducted using three different sets of Mandarin running speech materials which were chosen from textbooks for primary school, secondary school, and high school, respectively. For each discourse, two ANL measurements were obtained and averaged for each experimental condition using ANL test procedures. Study sample: Thirty-one normal-hearing listeners participated in this study. Results: There were significant differences for ANLs among the normal-hearing listeners, but no differences were found for MCLs and ANLs for the three sets of test materials. The Pearson correlations suggested significant correlations between MCL and ANL among the three test materials; also the results showed that the correlation coefficient between MCL-ANL of the primary material was much better than other two materials. Conclusions: (1) The contents of different Mandarin running speeches may not affect the acceptable noise level in Mandarin normal-hearing listeners; (2) The running speech selected from the primary school ought to be used as the Mandarin acceptable noise level test material to evaluate the outcomes of hearing aid fitting.

Sumario

Objetivo: Desarrollar y evaluar el contenido de la señal de lenguaje en mandarín con la Prueba de Nivel de Ruido Aceptable (ANL), en sujetos con audición normal de China continental. Diseño: Las pruebas de ANL en mandarín fueron conducidas usando tres diferentes tipos de contenidos provenientes de materiales de lenguaje en mandarín escogidos de libros de texto para la escuela primaria, secundaria y preparatoria, respectivamente. Para cada discurso, se obtuvieron dos mediciones de ANL y se promediaron para cada condición experimental, usando los procedimientos de la prueba de ANL. Muestra del Estudio: Participaron en el estudio treinta y un sujetos con audición normal. Resultados: Existieron diferencias significativas de ANL entre los sujetos con audición normal, pero no se encontraron diferencias en el MCL y ANL de los tres materiales. Las correlaciones de Pearson sugirieron correlaciones significativas entre el MCL y ANL de los tres materiales; también los resultados mostraron que el coeficiente de correlación entre MCL-ANL del material de primaria fue mucho mejor que con los otros dos materiales. Conclusiones: (1) el contenido de los diferentes discursos en mandarín puede no afectar el nivel aceptable de ruido en oyentes de mandarín con audición normal; (2) el discurso seleccionado de la escuela primaria debería ser utilizado como el material de prueba en mandarín con un nivel aceptable de ruido, para evaluar los resultados de la adaptación de auxiliares auditivos.     

Assessing speech recognition abilities with digits in noise in cochlear implant and hearing aid users

Objective: The primary objective of the study was to investigate the feasibility, reliability, and validity of the Dutch digits in noise (DIN) test for measuring speech recognition in hearing aid and cochlear implant users and compare results to the standard sentences-in-noise (SIN) test. Design: The relation between speech reception thresholds for DIN test and SIN test was analysed to determine the validity of the DIN test. As linguistic skills were expected to make different contributions in these tests, their influence was analysed. Study sample: Participants were 12 normal-hearing listeners, 24 hearing aid users, and 24 cochlear implant users. Results: The DIN test was feasible for more participants than the SIN test. Intraclass correlation coefficients showed high reliability. The standard error of measurement was smaller for the DIN test than for the SIN test. DIN test and SIN test were highly correlated (r = 0.95 and r = 0.56 for NH+ HA and CI users respectively). In the regression analysis no significant contribution of basic linguistic skills or personal factors was found. Conclusion: In the assessment of speech recognition in noise of aided hearing-impaired listeners with hearing aids or cochlear implants, the DIN test is a feasible, reliable and valid test.     

An Australian version of the acceptable noise level test and its predictive value for successful hearing aid use in an older population

Abstract

Objective: The acceptable noise level (ANL), a measure of noise tolerance, has been proposed as a predictor for successful hearing aid use. The aims of this study were to obtain normative data, and to evaluate the clinical feasibility and predictive value of an Australian version of the ANL test in an older population. Design: Repeated ANL measurements were presented diotically using earphones. All participants provided demographic information and hearing aid owners were asked about their aid use. Study sample: A total of 290 older adults were assessed; 166 participants had a hearing impairment and 96 owned a hearing aid. Results: The mean ANL was lower than previously reported. While age and gender had no effect on ANL, a significant, but weak, correlation was found between ANL and hearing loss. The test-retest reliability showed the results were clinically unreliable. In addition, the ANL did not predict hours or pattern of hearing aid use. Conclusions: While the Australian ANL test showed several similar characteristics to previous versions of the test, low test-retest reliability raised questions about its clinical value as a predictor for long-term hearing aid use.     

Effects of speech signal content and speaker gender on acceptance of noise in listeners with normal hearing

Abstract

Objective: The purpose of this research was to determine if the content and/or speaker gender of a running speech sample affected the acceptance of background noise within a participant. Design: A male and a female recording of the Arizona Travelogue (Cosmos Inc.) and the ipsilateral competing message (ICM) from the synthetic sentence identification with ICM were created and used as the experimental speech signals. Two acceptable noise level measurements were obtained and averaged for each condition. Twenty-one participants rated interest level in the speech sample for each condition. Study Sample: Forty-three listeners with normal hearing participated. Results: Interest level was significantly greater for the ICM than the Arizona Travelogue speech samples, and was significantly greater for female samples. Neither the content of the sample nor the gender of the speaker significantly affected the most comfortable level or the acceptable noise level. Conclusions: Findings suggest that the acceptable noise level can be measured using various types of speech signals for normal-hearing listeners.

Sumario

Objetivo: El propósito de esta investigación fue determinar si el contenido y/o el género del locutor en una muestra de lenguaje corrido afectaba la aceptación del ruido de fondo en un mismo participante. Diseño: Se realizóuna grabación con la participación de un hombre y una mujer del Arizona Travelogue (Cosmos Inc.) y del Mensaje Competitivo Ipsilateral (ICM) de la prueba de identificación de Frases Sintéticas con ICM, y se creó una material que fue utilizado como señal lingûstica experimental. Se obtuvieron dos mediciones de niveles de ruido aceptables y se promediaron para cada condición. Veintiún participantes calificaron el nivel de interés de la muestra de lenguaje para cada condición. Muestra del Estudio: Participaron cuarenta y tres sujetos con audición normal. Resultados: El nivel de interés fue significativamente mayor para las muestras de lenguaje del ICM que para las del Arizona Travelogue y estas fueron significativamente mayores para muestras grabadas por mujeres. Ni el contenido de la muestra ni el género del locutor afectó significativamente el nivel más confortable o el nivel aceptable de ruido. Conclusiones: Los hallazgos sugieren que el nivel aceptable de ruido puede medirse usando varios tipos de señales de lenguaje para oyentes con audición normal.     

Effects of a transient noise reduction algorithm on speech intelligibility in noise,noise tolerance and perceived annoyance in cochlear implant users

Objective: To evaluate the validity and efficacy of a transient noise reduction algorithm (TNR) in cochlear implant processing and the interaction of TNR with a continuous noise reduction algorithm (CNR). Design: We studied the effects of TNR and CNR on the perception of realistic sound samples with transients, using subjective ratings of annoyance, a speech-in-noise test and a noise tolerance test. Study sample: Participants were 16 experienced cochlear implant recipients wearing an Advanced Bionics Naida Q70 processor. Results: CI users rated sounds with transients as moderately annoying. Annoyance was slightly, but significantly reduced by TNR. Transients caused a large decrease in speech intelligibility in noise and a moderate decrease in noise tolerance, measured on the Acceptable Noise Level test. The TNR had no significant effect on noise tolerance or on speech intelligibility in noise. The combined application of TNR and CNR did not result in interactions. Conclusions: The TNR algorithm was effective in reducing annoyance from transient sounds, but was not able to prevent a decreasing effect of transients on speech understanding in noise and noise tolerance. TNR did not reduce the beneficial effect of CNR on speech intelligibility in noise, but no cumulated improvement was found either.     

普通话可接受噪声级测试材料的开发与等价性评估

目的 开发普通话版可接受噪声级(acceptable noise level,ANL)测试材料.方法 从小学、初中和高中语文教材中选取3篇难易程度不同的短文材料;选取31例听力言语正常人分别进行3种材料的ANL测试,获得3种材料下的最舒适响度级(most comfortable loudness,MCL)、最大背景噪声...     

Construction and evaluation of the Mandarin Chinese matrix (CMNmatrix) sentence test for the assessment of speech recognition in noise

Abstract

Objective: Development of the Mandarin Chinese matrix (CMNmatrix) sentence test for speech intelligibility measurements in noise according to the international standard procedure.

Design: A 50-word base matrix representing the distribution of phonemes and lexical tones of spoken Mandarin was established. Hundred sentences capturing all the co-articulations of two consecutive words were recorded. Word-specific speech recognition functions, speech reception thresholds (SRT: signal-to-noise ratio (SNR), that provides 50% speech intelligibility) and slopes were obtained from measurements at fixed SNRs. The speech material was homogenised in intelligibility by applying level corrections up to ± 2?dB. Subsequently, the CMNmatrix test was evaluated, the comparability of test lists was measured at two fixed SNRs. To investigate the training effect and establish the reference data, speech recognition was measured adaptively.

Study sample: Overall, the study sample contained 80 normal-hearing native Mandarin-speaking listeners.

Results: Multi-centre evaluation measurements confirmed that test lists are equivalent in intelligibility, with a mean SRT of ?10.1?±?0.1?dB SNR and a slope of 13.1?±?0.9 %/dB. The reference SRT is ?9.3?±?0.8 and ?11.2?±?1.2?dB SNR for the open- and closed-set response format, respectively.

Conclusion: The CMNmatrix test is suitable for accurate and internationally comparable speech recognition measurements in noise.     

Implementation and evaluation of a Danish test battery for auditory processing disorder in children

Objective: This study presents a Danish test battery for auditory processing disorder (APD). The tests were evaluated as to normative cut-off values (pass-fail criteria) and their test–retest reliability. Design: The battery consists of four behavioural tests: the filtered words (FW) test, the dichotic digits (DD) test, the gap detection (GD) test and the binaural masking level difference (BMLD) test. The tests were evaluated through listening experiments on children with no known history of auditory problems. Study sample: The normative cut-off values were obtained from 158 children (75 boys and 83 girls, aged 6–16 years), whereas the test–retest reliability was obtained from 20 children (10 boys and 10 girls, aged 6–11 years). Results: For each of the four tests one to four different cut-off values were determined depending on whether the scores from the two ears and the different age groups could be pooled. For each of the four tests the test–retest reliability was found to be satisfactory. The test–retest reliability was highest for the FW and the DD test. Conclusions: A Danish APD test battery is now available for clinical use with normative data.     

Investigation of a matrix sentence test in noise: Reproducibility and discrimination function in cochlear implant patients

Abstract

Objective: The aim of this study was to describe common properties (reproducibility, discrimination function, and its steepness) of matrix tests used for cochlear implant (CI) users and to obtain data for the German-language version matrix test, the Oldenburg sentence test (OLSA), presented in noise. Design: The speech reception thresholds (SRT) in noise were measured by means of an adaptive test procedure, and by measurement at various signal-to-noise ratios to determine the course of the entire discrimination function per subject. Study sample: The measurements were performed on 38 CI users fitted with a Cochlear^? Freedom^® or a Cochlear^? Nucleus^® 5 CI system. Results: The test–retest reproducibility showed a significant dependence on the SRT in noise. For the better performers, the test-retest difference was found to be smaller, while for the poorer performers the difference increased. For the better performers, the slope of the discrimination function at SRT (s50) was comparable to that for individuals with normal hearing, while for the poorer performers the s50 tended to be significantly reduced. Conclusions: As the CI users differed significantly in their SRT and their s50, a unified discrimination function for CI users must not be used. Further tailoring of the procedure may be required, especially for poorer CI performers.     

Effect of signal processing strategy and stimulation type on speech and auditory perception in adult cochlear implant users

Objective: The objective of this study was to investigate the effects of signal processing strategy on speech understanding and auditory function for adult cochlear implant (CI) users with a focus on the effects of sequential versus paired stimulation.

Design: Within-subjects, repeated measures design was utilised to compare performance between processing strategies and stimulation type on various measures of auditory function and subjective sound quality. Testing with subsequent strategies was completed after a total familiarisation time of two weeks.

Study Sample: Ten post-lingually deafened adult CI users were recruited from a clinical population. Participants had a minimum of 13?months CI experience. Ages ranged from 25–78?years. All participants had long-term experience with the optima strategy; eight with sequential stimulation and two with paired stimulation.

Results: We found no statistically significant effect of processing strategy. We observed an effect of stimulation type with sequential stimulation yielding significantly higher performance than paired stimulation for speech understanding in quiet and in noise, and subjective estimates of sound quality. No significant differences were noted across strategy or stimulation for music perception, spectral resolution or temporal resolution.

Conclusions: Many patients utilise paired stimulation – the default stimulation type in the clinical software; however, sequential stimulation yielded significantly higher outcomes on multiple measures.