Temporal speech cue perception in listeners with cochlear implants depends on the time between those cues and previous sound energy.

Cochlear implants (CIs) provide precise temporal information that listeners use to understand speech. Other acoustic cues are not conveyed as precisely, making unambiguous temporal speech cues vital to a listener's ability to understand speech. Several speech sounds are differentiated by small differences in the timing of acoustic features. Previous studies have shown differences in the perception of these differences, depending on whether the speech sound was heard in a single word or embedded in a sentence. This study expands on previous research by exploring forward masking as a possible contributor to the mechanisms driving the effects observed when temporal cues were embedded in sentences. Listeners using CIs performed a phoneme categorization task on words from four continua that each varied mainly on a single temporal dimension. The differentiating phonemes were located at the beginning of the word in two continua and at the end of the word in two others. Silent intervals of 0, 25, 50, 75, and 100 ms between the preceding sentence and the target words were tested. Results showed an increasing effect on performance as the inter-stimulus interval duration decreased for the two word-initial phonemic contrasts, lending support to forward masking as an influence on speech understanding.

A Step Toward Precision Audiology: Individual Differences and Characteristic Profiles From Auditory Perceptual and Cognitive Abilities.

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals' auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH (n = 20) and OHL (n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.

Band importance for speech-in-speech recognition in the presence of extended high-frequency cues.

Band importance functions for speech-in-noise recognition, typically determined in the presence of steady background noise, indicate a negligible role for extended high frequencies (EHFs; 8-20 kHz). However, recent findings indicate that EHF cues support speech recognition in multi-talker environments, particularly when the masker has reduced EHF levels relative to the target. This scenario can occur in natural auditory scenes when the target talker is facing the listener, but the maskers are not. In this study, we measured the importance of five bands from 40 to 20 000 Hz for speech-in-speech recognition by notch-filtering the bands individually. Stimuli consisted of a female target talker recorded from 0° and a spatially co-located two-talker female masker recorded either from 0° or 56.25°, simulating a masker either facing the listener or facing away, respectively. Results indicated peak band importance in the 0.4-1.3 kHz band and a negligible effect of removing the EHF band in the facing-masker condition. However, in the non-facing condition, the peak was broader and EHF importance was higher and comparable to that of the 3.3-8.3 kHz band in the facing-masker condition. These findings suggest that EHFs contain important cues for speech recognition in listening conditions with mismatched talker head orientations.

Speech recognition and speech audiometry parameters in evaluation of aural rehabilitation progress in cochlear implant patients. Review paper.

<b>Introduction:</b> Speech audiometry is well established and frequently used test in audiology as well as in cochlear implant recipient's performance evaluation. Expanding indications for cochlear implantation forces use of more refined methods of both assessment and prognosis of outcome of aural rehabilitation. Variability of speech intelligibility tests and materials require standardized protocol facilitating outcome comparison.<b>Aim:</b> Aim of this review paper is analysis of usage of speech audiometry and other speech intelligibility tests and its results reporting in patients with cochlear implant in Poland and in the World.<b>Materials and methods:</b> Protocols of many different domestic and foreign health centers where compared, showing many methodological differences. Selection of literature for analysis was made according to PRISMA algorithm recommendations. Twenty research papers were chosen for review process.<b>Discussion:</b> In many papers we found lack of data regarding methodology of performed tests. Many authors indicate difficulties in comparing results, especially if publication lacks basic technical information. Despite that if right method is applied, results can be compared. In literature only one level of material presentation in test is prevalent. Speech audiometry is significant in exploring connections between multiple pre-op and post-op prognostic aspects of cochlear implantation.<b>Conclusions:</b> Because of variability in presentation and reporting of CI patients outcomes, consensus is needed in area of system facilitating comparison of research results. This may provide simple solution for accurate analysis and choosing right set of data. Schematic of presentation of audiological data in authors health center was proposed as example.

Transducer Variability in Speech-in-Noise Testing: Considerations Related to Stimulus Bandwidth.

PURPOSE: Clinical audiologists typically assume that headphones and insert phones will produce comparable results when they are used to conduct speech-in-noise or other audiological tests; however, this may not always be the case. Here, we show that there are significant differences in the scores that previous studies have reported for headphone and insert-phone transducers on the Words-in-Noise (WIN) Test, and discuss the possibility that the variations in high-frequency output that are allowable under the speech source specifications of American National Standards Institute S3.6 might be contributing to transducer-dependent differences in performance for the WIN and other tests that are presented through the auxiliary input channels of clinical audiometers. METHOD: A literature review was conducted to identify articles that reported WIN Test results for both listeners with normal hearing and with hearing impairment and specified the type of transducer (insert or TDH-50) used for the data collection. RESULTS: Among the 19 included studies, participants with normal hearing using inserts exhibited systematically worse WIN Test scores compared to those using TDH-50 headphones, while participants with hearing loss showed comparable average scores across transducer types. CONCLUSIONS: The results highlight the importance of considering transducer type when interpreting WIN Test outcomes, particularly when comparing to normative scores obtained from individuals with normal hearing. Although further research is needed to elucidate the underlying mechanisms driving differences in test performance across transducer types, these findings underscore the need for standardized test administration protocols and careful documentation of transducer type when administering speech-in-noise tests for clinical or research applications.

Spectral degradation and carrier sentences increase age-related temporal processing deficits in a cue-specific manner.

Advancing age is associated with decreased sensitivity to temporal cues in word segments, particularly when target words follow non-informative carrier sentences or are spectrally degraded (e.g., vocoded to simulate cochlear-implant stimulation). This study investigated whether age, carrier sentences, and spectral degradation interacted to cause undue difficulty in processing speech temporal cues. Younger and older adults with normal hearing performed phonemic categorization tasks on two continua: a Buy/Pie contrast with voice onset time changes for the word-initial stop and a Dish/Ditch contrast with silent interval changes preceding the word-final fricative. Target words were presented in isolation or after non-informative carrier sentences, and were unprocessed or degraded via sinewave vocoding (2, 4, and 8 channels). Older listeners exhibited reduced sensitivity to both temporal cues compared to younger listeners. For the Buy/Pie contrast, age, carrier sentence, and spectral degradation interacted such that the largest age effects were seen for unprocessed words in the carrier sentence condition. This pattern differed from the Dish/Ditch contrast, where reducing spectral resolution exaggerated age effects, but introducing carrier sentences largely left the patterns unchanged. These results suggest that certain temporal cues are particularly susceptible to aging when placed in sentences, likely contributing to the difficulties of older cochlear-implant users in everyday environments.

The role of hidden hearing loss in tinnitus: Insights from early markers of peripheral hearing damage.

Since the presence of tinnitus is not always associated with audiometric hearing loss, it has been hypothesized that hidden hearing loss may act as a potential trigger for increased central gain along the neural pathway leading to tinnitus perception. In recent years, the study of hidden hearing loss has improved with the discovery of cochlear synaptopathy and several objective diagnostic markers. This study investigated three potential markers of peripheral hidden hearing loss in subjects with tinnitus: extended high-frequency audiometric thresholds, the auditory brainstem response, and the envelope following response. In addition, speech intelligibility was measured as a functional outcome measurement of hidden hearing loss. To account for age-related hidden hearing loss, participants were grouped according to age, presence of tinnitus, and audiometric thresholds. Group comparisons were conducted to differentiate between age- and tinnitus-related effects of hidden hearing loss. All three markers revealed age-related differences, whereas no differences were observed between the tinnitus and non-tinnitus groups. However, the older tinnitus group showed improved performance on low-pass filtered speech in noise tests compared to the older non-tinnitus group. These low-pass speech in noise scores were significantly correlated with tinnitus distress, as indicated using questionnaires, and could be related to the presence of hyperacusis. Based on our observations, cochlear synaptopathy does not appear to be the underlying cause of tinnitus. The improvement in low-pass speech-in-noise could be explained by enhanced temporal fine structure encoding or hyperacusis. Therefore, we recommend that future tinnitus research takes into account age-related factors, explores low-frequency encoding, and thoroughly assesses hyperacusis.

Aging affects auditory contributions to focus perception in Jianghuai Mandarina).

Speakers can place their prosodic prominence on any locations within a sentence, generating focus prosody for listeners to perceive new information. This study aimed to investigate age-related changes in the bottom-up processing of focus perception in Jianghuai Mandarin by clarifying the perceptual cues and the auditory processing abilities involved in the identification of focus locations. Young, middle-aged, and older speakers of Jianghuai Mandarin completed a focus identification task and an auditory perception task. The results showed that increasing age led to a decrease in listeners' accuracy rate in identifying focus locations, with all participants performing the worst when dynamic pitch cues were inaccessible. Auditory processing abilities did not predict focus perception performance in young and middle-aged listeners but accounted significantly for the variance in older adults' performance. These findings suggest that age-related deteriorations in focus perception can be largely attributed to declined auditory processing of perceptual cues. Poor ability to extract frequency modulation cues may be the most important underlying psychoacoustic factor for older adults' difficulties in perceiving focus prosody in Jianghuai Mandarin. The results contribute to our understanding of the bottom-up mechanisms involved in linguistic prosody processing in aging adults, particularly in tonal languages.

Chinese Emotional Speech Audiometry Project (CESAP): Establishment and Validation of a New Material Set With Emotionally Neutral Disyllabic Words.

PURPOSE: The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody. METHOD: In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (-1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes. RESULTS: First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%-80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%-80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%-80% slope (12%). CONCLUSION: Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25742814.

Pediatric normative data for a novel and fast speech perception test in noise.

OBJECTIVES: Communicating in noisy settings can be difficult due to interference and environmental noise, which can impact intelligibility for those with hearing impairments and those with normal hearing threshold. Speech intelligibility is commonly assessed in audiology through speech audiometry in quiet environments. Nevertheless, this test may not effectively assess hearing challenges in noisy environments, as total silence is rare in daily activities. A recently patented method, known as the SRT50 FAST, has been developed for conducting speech audiometry in noise. This new method enables the acceleration and simplification of free field speech audiometry tests involving competition noise. This study aims to establish normative scores and standardize the SRT50 FAST method as a test for evaluating speech perception in noise in pediatric patients. METHODS: The study included 30 participants with normal hearing, consisting of 11 females and 19 males, ranging in age from 6 to 11 years. A series of speech audiometry tests were conducted to determine the speech reception threshold 50% (SRT50) in competing conditions. This included testing both the fast mode (SRT50 FAST) currently being studied and the traditional method (SRT50 CLASSIC). The SRT50, or Signal to Noise Ratio (SNR) at which 50% of speech recognition occurred, was investigated for both methods. RESULTS: The mean SRT50 FAST test score was -2.69 (SD = 3.15). The dataset exhibited a normal distribution with values ranging from 3.60 to -8.60. Since the scores are expressed in SRT, higher scores indicate poorer performance. We have established a threshold of 3.60 as the upper limit of the normal range, therefore, patients with scores above this threshold are considered to have abnormal results. CONCLUSIONS: This study aimed to establish normative data for the evaluation of free field speech in noise recognition using the SRT50 FAST method in the pediatric population. This method accurately investigates the necessary signal-to-noise ratio for achieving 50% recognition scores with bisyllabic words in a quick manner. The ultimate objective is to employ this test to identify the optimal configuration of hearing rehabilitation devices, particularly for pediatric patients with hearing aids and/or cochlear implants. Additionally, it can be used to assess pediatric patients with unilateral hearing loss.

Focusing on Positive Listening Experiences Improves Speech Intelligibility in Experienced Hearing Aid Users.

Negativity bias is a cognitive bias that results in negative events being perceptually more salient than positive ones. For hearing care, this means that hearing aid benefits can potentially be overshadowed by adverse experiences. Research has shown that sustaining focus on positive experiences has the potential to mitigate negativity bias. The purpose of the current study was to investigate whether a positive focus (PF) intervention can improve speech-in-noise abilities for experienced hearing aid users. Thirty participants were randomly allocated to a control or PF group (N = 2 × 15). Prior to hearing aid fitting, all participants filled out the short form of the Speech, Spatial and Qualities of Hearing scale (SSQ12) based on their own hearing aids. At the first visit, they were fitted with study hearing aids, and speech-in-noise testing was performed. Both groups then wore the study hearing aids for two weeks and sent daily text messages reporting hours of hearing aid use to an experimenter. In addition, the PF group was instructed to focus on positive listening experiences and to also report them in the daily text messages. After the 2-week trial, all participants filled out the SSQ12 questionnaire based on the study hearing aids and completed the speech-in-noise testing again. Speech-in-noise performance and SSQ12 Qualities score were improved for the PF group but not for the control group. This finding indicates that the PF intervention can improve subjective and objective hearing aid benefits.

Automated Speech Audiometry: Can It Work Using Open-Source Pre-Trained Kaldi-NL Automatic Speech Recognition?

A practical speech audiometry tool is the digits-in-noise (DIN) test for hearing screening of populations of varying ages and hearing status. The test is usually conducted by a human supervisor (e.g., clinician), who scores the responses spoken by the listener, or online, where software scores the responses entered by the listener. The test has 24-digit triplets presented in an adaptive staircase procedure, resulting in a speech reception threshold (SRT). We propose an alternative automated DIN test setup that can evaluate spoken responses whilst conducted without a human supervisor, using the open-source automatic speech recognition toolkit, Kaldi-NL. Thirty self-reported normal-hearing Dutch adults (19-64 years) completed one DIN + Kaldi-NL test. Their spoken responses were recorded and used for evaluating the transcript of decoded responses by Kaldi-NL. Study 1 evaluated the Kaldi-NL performance through its word error rate (WER), percentage of summed decoding errors regarding only digits found in the transcript compared to the total number of digits present in the spoken responses. Average WER across participants was 5.0% (range 0-48%, SD = 8.8%), with average decoding errors in three triplets per participant. Study 2 analyzed the effect that triplets with decoding errors from Kaldi-NL had on the DIN test output (SRT), using bootstrapping simulations. Previous research indicated 0.70 dB as the typical within-subject SRT variability for normal-hearing adults. Study 2 showed that up to four triplets with decoding errors produce SRT variations within this range, suggesting that our proposed setup could be feasible for clinical applications.

Functional outcomes for speech-in-noise intelligibility of NAL-NL2 and DSL v.5 prescriptive fitting rules in hearing aid users.

PURPOSE: The primary aim of this research study is to assess whether differences exist in the application of the NAL-NL2 and DSL v.5 prescription formulas in terms of speech-in-noise intelligibility. METHODS: Data from 43 patients, were retrospectively evaluated and analyzed. Inclusion criteria were patients with bilateral conductive, sensorineural, or mixed hearing loss, already using hearing aids for at least 1 year, and aged 18 years or older. Patients were categorized into two groups based on the prescriptive method employed by the hearing aid: NAL-NL2 or DSL v.5. Pure tone audiometry, speech audiometry, free field pure tone and speech audiometry with the hearing aid, and Matrix sentence test were performed. The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire was used to assess the personal audiological benefit provided by the hearing aid. RESULTS: No statistically significant differences were found comparing the free-field pure tone average (FF PTA) and the free-field Word Recognition Score (FF WRS). Comparing the Speech Reception Threshold (SRT) parameter of patients with NAL-NL2 vs DSL v.5, no statistically significant difference was found, thus highlighting a condition of comparability between the two prescription methods in terms of speech-in-noise intelligibility. Comparing the results of the APHAB questionnaire, no statistically significant differences were evident for all subscales and overall benefit. When conducting a comparison between male and female patients using the NAL-NL2 method, no differences were observed in SRT values, however, the APHAB questionnaire revealed a difference in the AV subscale score for the same subjects. CONCLUSION: Our analysis revealed no statistically significant differences in speech-in-noise intelligibility, as measured by the SRT values from the Matrix Sentence Test, when comparing the two prescriptive methods. This compelling result reinforces the notion that, functionally, both methods are comparably effective in enhancing speech intelligibility in real-world, noisy environments. However, it is crucial to underscore that the absence of differences does not diminish the importance of considering individual patient needs and preferences in the selection of a prescriptive method.

The effect of piston diameter in primary stapes surgery on surgical success.

PURPOSE: To evaluate the effect of piston diameter in patients undergoing primary stapes surgery on audiometric results and postoperative complications. METHODS: A retrospective single-center cohort study was performed. Adult patients who underwent primary stapes surgery between January 2013 and April 2022 and received a 0.4-mm-diameter piston or a 0.6-mm-diameter piston were included. The primary and secondary outcomes were pre- and postoperative pure-tone audiometry, pre- and postoperative speech audiometry, postoperative complications, intraoperative anatomical difficulties, and the need for revision stapes surgery. The pure-tone audiometry included air conduction, bone conduction, and air-bone gap averaged over 0.5, 1, 2 and 3 kHz. RESULTS: In total, 280 otosclerosis patients who underwent 321 primary stapes surgeries were included. The audiometric outcomes were significantly better in the 0.6 mm group compared to the 0.4 mm group in terms of gain in air conduction (median = 24 and 20 dB, respectively), postoperative air-bone gap (median = 7.5 and 9.4 dB, respectively), gain in air-bone gap (median = 20.0 and 18.1 dB, respectively), air-bone gap closure to 10 dB or less (75% and 59%, respectively) and 100% speech reception (median = 75 and 80 dB, respectively). We found no statistically significant difference in postoperative dizziness, postoperative complications and the need for revision stapes surgery between the 0.4 and 0.6 mm group. The incidence of anatomical difficulties was higher in the 0.4 mm group. CONCLUSION: The use of a 0.6-mm-diameter piston during stapes surgery seems to provide better audiometric results compared to a 0.4-mm-diameter piston, and should be the preferred piston size in otosclerosis surgery. We found no statistically significant difference in postoperative complications between the 0.4- and 0.6-mm-diameter piston. Based on the results, we recommend always using a 0.6-mm-diameter piston during primary stapes surgery unless anatomical difficulties do not allow it.

[Analysis of hearing aids application in elderly patients.]

The aim of the study is to evaluate the possibility to implement machine learning to create a digital auditory profile for elderly patients and to analyze the hearing aid fitting efficacy depending on involvement of the peripheral and central auditory pathways in a pathological process. Data analysis of 375 people aged 60-93 years is presented. 355 patients with chronic bilateral hearing loss (230 of them used hearing aids) were included in the main group, and 20 normal hearing elderly people were included in the control group. Audiological examination consisted of standard tests (pure tone audiometry, impedancemetry, speech audiometry in quiet) and tests to evaluate the central auditory processing (binaural fusion, dichotic digits, speech audiometry in noise, random gap detection). The Montreal Cognitive Assessment was used to detect cognitive impairment. The hearing aid fitting efficiency was evaluated with COSI questionnaire and speech audiometry in free field. Processing of the results was carried out using Pearson's correlation analysis aimed at creating a polynomial model of a patient's hearing on the basis of the limited test battery. There were close correlations between the state of cognitive functions and age, results of tests to evaluate the central auditory processing, as well as patients' satisfaction of hearing aid. The results of the work indicate the possibility of using computer technologies of data analysis to develop rehabilitation programs for elderly hearing impaired patients.

Further Evaluation of a Protocol for Integrated Speech Audiometry.

PURPOSE: When a bilateral evaluation is conducted with the integrated speech protocol described in Punch and Rakerd (2019), testing for the first ear concludes with a measurement of the uncomfortable loudness level for speech (UCL). The purpose of this study was to assess the possibility that exposure to the high speech intensities required for that UCL test might bias the subsequent measurement of a listener's most comfortable loudness level for speech (MCL) in the opposite ear. METHOD: Across 32 test runs, the left and right ear MCLs were established for 16 young adult listeners with normal hearing (five women, 11 men). The MCL assessed on each test run was measured twice. The first measurement was made at the start of the run and before a full integrated speech evaluation was conducted in the opposite ear (pretest); the second was made after that evaluation (posttest). RESULTS: The difference between the MCL means measured on the pretest (37.7 dB) and the posttest (38.5 dB) was less than 1 dB, and it did not approach statistical significance, t(15) = 0.69, p = .50. CONCLUSIONS: There was no evidence that UCL testing done in one ear on a bilateral speech test will have carryover effects that bias the subsequent measurement of a listener's MCL in the other ear. The results, therefore, support the potential clinical use of an integrated protocol when conducting bilateral speech audiometric evaluations.

[OLSA level control in monaural speech audiometry in background noise for the evaluation of the CI fitting result]. / OLSA-Pegelsteuerung bei monauraler Sprachaudiometrie im Störschall zur Evaluation des CI-Versorgungsergebnisses.

SCIENTIFIC BACKGROUND: Speech audiometry measurements under the influence of background noise are a fundamental part of evaluating the outcome of hearing care. As yet far, there are no recommendations for selecting a suitable method for adaptive speech audiometry measurements in background noise in cochlear implant (CI) care, so either the choice the adaptive level change of the speech signal (S) with constant noise (N) or the adaptive level change of N with constant S. OBJECTIVES: Do the measurement results of the monaural speechrecognition threshold in noise (SRT) with the Oldenburg Sentence Test (OLSA) depend on the choice of level control? MATERIAL AND METHODS: A total of 50 series of measurements with OLSA in noise and the Freiburg speech intelligibility test in quiet (FBE) on middle-aged CI patients from clinical routine. RESULTS: There is no significant difference in the measurement results with different level controls when the SRT is less than 5 [Formula: see text]. Below 55 % monosyllabic intelligibility in quiet, the SRT in noise becomes greater than 5 [Formula: see text]. CONCLUSION: From a clinical, audiological and methodological point of view, it is advisable to carry out the adaptive monaural speech intelligibility measurement with a constant speech signal at 65 [Formula: see text].

Clinical utility of response time in speech audiometry in elderly with mild cognitive impairment.

OBJECTIVES: This study investigated whether verbal response time (RT) as a measure of listening effort in speech audiometry could be an indicator for identifying elderly individuals with mild cognitive impairment (MCI). DESIGN: Korean sentence recognition tests were conducted in favourable (+5 dB signal-to-noise ratio [SNR]) and adverse (-5 dB SNR) conditions in the presence of noise. Sentence recognition scores (SRSs) and RTs for the two groups were measured and analysed with other demographic variables. STUDY SAMPLES: Fourteen elderly adults who were diagnosed with MCI and 14 age-matched adults with normal cognition participated in this study. RESULTS: No statistical difference was found between the SRSs of the two groups. RTs for the MCI elderly were significantly longer than the control group. We found significant correlations of RTs with SRSs, Korean Mini-Mental State Examination (K-MMSE) scores, and age at -5 dB SNR. Only the SRSs were correlated with the RTs at +5 dB SNR. CONCLUSIONS: This study found that elderly individuals with MCI need a longer time for sentence recognition in noise. These findings suggest that measuring RT in speech audiometry could potentially be a cost-effective and time-saving method that could characterise elderly with MCI at hearing-care clinics.

Associations between aided speech audiometry and subjective assessment of hearing aid outcomes.

OBJECTIVE: This study aimed to analyse outcomes with hearing aid (HA) use and to determine whether common audiological tests, including pure-tone audiometry or word recognition test, correlate with HA wearers' subjective benefit. DESIGN: A retrospective chart review. STUDY SAMPLE: A total of 129 patients who adopted new HAs between January 2011 and December 2018 were enrolled. Outcome measures including pure tone thresholds, word recognition score (WRS), and self-reported questionnaires were obtained 1, 4, and 12 months post fit. RESULTS: The mean aided threshold and WRS at each post-fit visit significantly improved from the unaided condition. Self-reported outcomes confirmed by the Hearing Handicap Inventory for the Elderly (HHIE) scores significantly improved compared to the unaided condition at 1- and 4-month follow-up. Results of the regression analysis indicated that the aided WRS score is a significant factor at all post-fit visits that explains less than 10% of the variance in HHIE scores. CONCLUSIONS: Aided WRS is the factor most associated with subjectively reported HA outcomes, both in the short- and long term. Therefore, aided WRS should be considered as a useful tool for evaluating HA benefits, even after the prolonged use of HAs.

Benefits of amplification for unaided speech discrimination in age-related hearing loss with flat type audiogram.

OBJECTIVE: The present study aimed to investigate whether hearing aid use can induce improvement as acclimatization effect in unaided speech perception in patients with age-related hearing loss. METHODS: Fifty ears in 41 patients (age range: 65-91 years) diagnosed as age-related hearing loss were enrolled in this study. They used hearing aids for more than 8 hours per day. Unaided speech audiometry using 67-S Japanese monosyllabic word list was performed one or two years after the commencement of hearing aid use. The changes in the unaided speech discrimination score before and after the commencement of hearing aid use were analyzed. To investigate factors for improvement, the patients' backgrounds in terms of age, sex, pure tone average, unaided maximum speech discrimination score, fitting period (one year/two years), fitting ear (bilateral/unilateral), audiogram type (flat-type/other-type), and the level of amplification were also analyzed. RESULTS: Significant improvement in the unaided speech discrimination score after hearing aid use was seen only in the flat-type audiogram group. More than half of older patients in the flat-type audiogram group improved their unaided maximum speech discrimination score 10 % or more. The analysis of aided hearing thresholds revealed that the flat-type audiogram group had significantly lower thresholds of 3kHz and 4kHz than the other-type audiogram group. The age, sex, pure tone average, fitting period, fitting ear, functional gain were not influential factors for improvement. On the other hand, unaided maximum speech discrimination score before using hearing aid and aided hearing threshold at 4kHz had a negative correlation with improvement. CONCLUSION: The findings suggested that older patients with age-related hearing loss whose audiogram is a flat type can benefit from amplification as means of improving their unaided speech perception since flat-type audiogram can be more easily adjusted to sufficiently amplify speech sound at high frequencies. It should be considered that the potential for experience-dependent plasticity is retained even in older adults.