Cochlear Implant Users can Effectively Combine Place and Timing Cues for Pitch Perception.

OBJECTIVES: The study objective was to characterize cochlear implant (CI) pitch perception for pure, complex, and modulated tones for frequencies and fundamental frequencies in the ecologically essential range between 110 and 440 Hz. Stimulus manipulations were used to examine CI users' reliance on stimulation place and rate cues for pitch discrimination. DESIGN: The study was a within-subjects design with 21 CI users completing pitch discrimination measures using pure, complex, and modulated tones. Stimulus manipulations were used to test whether CI users have better pitch discrimination for low-pass compared with high-pass filtered harmonic complexes, and to test whether they have better pitch discrimination when provided a covarying place cue when listening to amplitude-modulated tones. RESULTS: Averaged across conditions, participants had better pitch discrimination for pure tones compared with either complex or amplitude-modulated tones. Participants had better pitch discrimination for low-pass compared with high-pass harmonic complexes and better pitch discrimination for amplitude-modulated tones when provided a covarying place cue. CONCLUSIONS: CI users integrate place and rate cues across the ecologically essential pitch range between 110 and 440 Hz. We interpret the observed better pitch discrimination for low-pass compared with high-pass filtered harmonics complexes, and for amplitude-modulated tones when provided a covarying place cue, as evidence for the importance of providing place-of-excitation cues for fundamental frequencies below 440 Hz. Discussion considers how such encoding could be implemented with existing devices.

FORUM: Remote testing for psychological and physiological acoustics.

Acoustics research involving human participants typically takes place in specialized laboratory settings. Listening studies, for example, may present controlled sounds using calibrated transducers in sound-attenuating or anechoic chambers. In contrast, remote testing takes place outside of the laboratory in everyday settings (e.g., participants' homes). Remote testing could provide greater access to participants, larger sample sizes, and opportunities to characterize performance in typical listening environments at the cost of reduced control of environmental conditions, less precise calibration, and inconsistency in attentional state and/or response behaviors from relatively smaller sample sizes and unintuitive experimental tasks. The Acoustical Society of America Technical Committee on Psychological and Physiological Acoustics launched the Task Force on Remote Testing (https://tcppasa.org/remotetesting/) in May 2020 with goals of surveying approaches and platforms available to support remote testing and identifying challenges and considerations for prospective investigators. The results of this task force survey were made available online in the form of a set of Wiki pages and summarized in this report. This report outlines the state-of-the-art of remote testing in auditory-related research as of August 2021, which is based on the Wiki and a literature search of papers published in this area since 2020, and provides three case studies to demonstrate feasibility during practice.

Audibility emphasis of low-level sounds improves consonant identification while preserving vowel identification for cochlear implant users.

Consonant perception is challenging for listeners with hearing loss, and transmission of speech over communication channels further deteriorates the acoustics of consonants. Part of the challenge arises from the short-term low energy spectro-temporal profile of consonants (for example, relative to vowels). We hypothesized that an audibility enhancement approach aimed at boosting the energy of low-level sounds would improve identification of consonants without diminishing vowel identification. We tested this hypothesis with 11 cochlear implant users, who completed an online listening experiment remotely using the media device and implant settings that they most commonly use when making video calls. Loudness growth and detection thresholds were measured for pure tone stimuli to characterize the relative loudness of test conditions. Consonant and vowel identification were measured in quiet and in speech-shaped noise for progressively difficult signal-to-noise ratios (+12, +6, 0, -6 dB SNR). These conditions were tested with and without an audibility-emphasis algorithm designed to enhance consonant identification at the source. The results show that the algorithm improves consonant identification in noise for cochlear implant users without diminishing vowel identification. We conclude that low-level emphasis of audio can improve speech recognition for cochlear implant users in the case of video calls or other telecommunications where the target speech can be preprocessed separately from environmental noise.

Children With Normal Hearing Are Efficient Users of Fundamental Frequency and Vocal Tract Length Cues for Voice Discrimination.

BACKGROUND: The ability to discriminate between talkers assists listeners in understanding speech in a multitalker environment. This ability has been shown to be influenced by sensory processing of vocal acoustic cues, such as fundamental frequency (F0) and formant frequencies that reflect the listener's vocal tract length (VTL), and by cognitive processes, such as attention and memory. It is, therefore, suggested that children who exhibit immature sensory and/or cognitive processing will demonstrate poor voice discrimination (VD) compared with young adults. Moreover, greater difficulties in VD may be associated with spectral degradation as in children with cochlear implants. OBJECTIVES: The aim of this study was as follows: (1) to assess the use of F0 cues, VTL cues, and the combination of both cues for VD in normal-hearing (NH) school-age children and to compare their performance with that of NH adults; (2) to assess the influence of spectral degradation by means of vocoded speech on the use of F0 and VTL cues for VD in NH children; and (3) to assess the contribution of attention, working memory, and nonverbal reasoning to performance. DESIGN: Forty-one children, 8 to 11 years of age, were tested with nonvocoded stimuli. Twenty-one of them were also tested with eight-channel, noise-vocoded stimuli. Twenty-one young adults (18 to 35 years) were tested for comparison. A three-interval, three-alternative forced-choice paradigm with an adaptive tracking procedure was used to estimate the difference limens (DLs) for VD when F0, VTL, and F0 + VTL were manipulated separately. Auditory memory, visual attention, and nonverbal reasoning were assessed for all participants. RESULTS: (a) Children' F0 and VTL discrimination abilities were comparable to those of adults, suggesting that most school-age children utilize both cues effectively for VD. (b) Children's VD was associated with trail making test scores that assessed visual attention abilities and speed of processing, possibly reflecting their need to recruit cognitive resources for the task. (c) Best DLs were achieved for the combined (F0 + VTL) manipulation for both children and adults, suggesting that children at this age are already capable of integrating spectral and temporal cues. (d) Both children and adults found the VTL manipulations more beneficial for VD compared with the F0 manipulations, suggesting that formant frequencies are more reliable for identifying a specific speaker than F0. (e) Poorer DLs were achieved with the vocoded stimuli, though the children maintained similar thresholds and pattern of performance among manipulations as the adults. CONCLUSIONS: The present study is the first to assess the contribution of F0, VTL, and the combined F0 + VTL to the discrimination of speakers in school-age children. The findings support the notion that many NH school-age children have effective spectral and temporal coding mechanisms that allow sufficient VD, even in the presence of spectrally degraded information. These results may challenge the notion that immature sensory processing underlies poor listening abilities in children, further implying that other processing mechanisms contribute to their difficulties to understand speech in a multitalker environment. These outcomes may also provide insight into VD processes of children under listening conditions that are similar to cochlear implant users.

Adaptive spatial filtering improves speech reception in noise while preserving binaural cues.

Hearing loss greatly reduces an individual's ability to comprehend speech in the presence of background noise. Over the past decades, numerous signal-processing algorithms have been developed to improve speech reception in these situations for cochlear implant and hearing aid users. One challenge is to reduce background noise while not introducing interaural distortion that would degrade binaural hearing. The present study evaluates a noise reduction algorithm, referred to as binaural Fennec, that was designed to improve speech reception in background noise while preserving binaural cues. Speech reception thresholds were measured for normal-hearing listeners in a simulated environment with target speech generated in front of the listener and background noise originating 90° to the right of the listener. Lateralization thresholds were also measured in the presence of background noise. These measures were conducted in anechoic and reverberant environments. Results indicate that the algorithm improved speech reception thresholds, even in highly reverberant environments. Results indicate that the algorithm also improved lateralization thresholds for the anechoic environment while not affecting lateralization thresholds for the reverberant environments. These results provide clear evidence that this algorithm can improve speech reception in background noise while preserving binaural cues used to lateralize sound.

Training improves cochlear implant rate discrimination on a psychophysical task.

The purpose of this study was to determine the extent to which cochlear implant (CI) rate discrimination can be improved through training. Six adult CI users took part in a study that included 32 h of training and assessment on rate discrimination measures. Rate difference limens (DLs) were measured from 110 to 3520 Hz in octave steps using 500 ms biphasic pulse trains; the target and standard stimuli were loudness-balanced with the target always at an adaptively lower rate. DLs were measured at four electrode positions corresponding to basal, mid-basal, mid-apical, and apical locations. Procedural variations were implemented to determine if rate discrimination was impacted by random variations in stimulus amplitude or by amplitude modulation. DLs improved by more than a factor of 2 across subjects, electrodes, and standard rates. Factor analysis indicated that the effect of training was comparable for all electrodes and standard rates tested. Neither level roving nor amplitude modulation had a significant effect on rate DLs. In conclusion, the results demonstrate that training can significantly improve CI rate discrimination on a psychophysical task.

Two-microphone spatial filtering provides speech reception benefits for cochlear implant users in difficult acoustic environments.

This article introduces and provides an assessment of a spatial-filtering algorithm based on two closely-spaced (∼1 cm) microphones in a behind-the-ear shell. The evaluated spatial-filtering algorithm used fast (∼10 ms) temporal-spectral analysis to determine the location of incoming sounds and to enhance sounds arriving from straight ahead of the listener. Speech reception thresholds (SRTs) were measured for eight cochlear implant (CI) users using consonant and vowel materials under three processing conditions: An omni-directional response, a dipole-directional response, and the spatial-filtering algorithm. The background noise condition used three simultaneous time-reversed speech signals as interferers located at 90°, 180°, and 270°. Results indicated that the spatial-filtering algorithm can provide speech reception benefits of 5.8 to 10.7 dB SRT compared to an omni-directional response in a reverberant room with multiple noise sources. Given the observed SRT benefits, coupled with an efficient design, the proposed algorithm is promising as a CI noise-reduction solution.

Characterizing the relationship between modulation sensitivity and pitch resolution in cochlear implant users.

Cochlear implants are medical devices that have restored hearing to approximately one million people around the world. Outcomes are impressive and most recipients attain excellent speech comprehension in quiet without relying on lip-reading cues, but pitch resolution is poor compared to normal hearing. Amplitude modulation of electrical stimulation is a primary cue for pitch perception in cochlear implant users. The experiments described in this article focus on the relationship between sensitivity to amplitude modulations and pitch resolution based on changes in the frequency of amplitude modulations. In the first experiment, modulation sensitivity and pitch resolution were measured in adults with no known hearing loss and in cochlear implant users with sounds presented to and processed by their clinical devices. Stimuli were amplitude-modulated sinusoids and amplitude-modulated narrow-band noises. Modulation detection and modulation frequency discrimination were measured for modulation frequencies centered on 110, 220, and 440 Hz. Pitch resolution based on changes in modulation frequency was measured for modulation depths of 25 %, 50 %, 100 %, and for a half-waved rectified modulator. Results revealed a strong linear relationship between modulation sensitivity and pitch resolution for cochlear implant users and peers with no known hearing loss. In the second experiment, cochlear implant users took part in analogous procedures of modulation sensitivity and pitch resolution but bypassing clinical sound processing using single-electrode stimulation. Results indicated that modulation sensitivity and pitch resolution was better conveyed by single-electrode stimulation than by clinical processors. Results at 440 Hz were worse, but also not well conveyed by clinical sound processing, so it remains unclear whether the 300 Hz perceptual limit described in the literature is a technological or biological limitation. These results highlight modulation depth and sensitivity as critical factors for pitch resolution in cochlear implant users and characterize the relationship that should inform the design of modulation enhancement algorithms for cochlear implants.

Effect of Realistic Test Conditions on Perception of Speech, Music, and Binaural Cues in Normal-Hearing Listeners.

PURPOSE: The purpose of this study was to determine the feasibility of online testing in a quiet room for three auditory perception experiments in normal-hearing listeners: speech, music, and binaural cue. METHOD: Under Experiment 1, sentence perception was measured using fixed signal-to-noise ratios (SNRs: +10 dB, 0 dB, and -10 dB) and using adaptive speech reception threshold (SRT) procedures. The correct scores were compared between quiet room and soundproof booth listening environments. Experiment 2 was designed to compare melodic contour identification between the two listening environments. Melodic contour identification was assessed with 1, 2, and 4 semitone spacings. Under Experiment 3, interaural level difference (ILD) and interaural time differences (ITD) were measured as a function of carrier frequency. For both measures, two modulated tones (400-ms duration and 100-Hz modulation rate) were sequentially presented through headphones to both ears, and subjects were asked to indicate whether the sound moved to the left or right ear. The measured ITD and ILD were then compared between the two listening environments. RESULTS: There were no significant differences in any outcome measures (SNR- and SRT-based speech perception, melodic contour identification, and ITD/ILD) between the two listening environments. CONCLUSIONS: These results suggest that normal-hearing listeners may not require a controlled listening environment in any of the three auditory assessments. As comparable data can be obtained via the online testing tool, using the online auditory experiments is recommended.

Perceptions of Vocal Performance Impairment in Singers with and without Hearing Loss.

INTRODUCTION: It is well understood that hearing plays an important role in accurate vocal production. Singers in particular rely on auditory cues and auditory feedback to reproduce specific pitch contours. Therefore, even mild hearing loss may have a detrimental effect on a singer's ability to perform. This study investigates the effect of hearing loss on self-reported vocal production in singers, specifically in the domains of pitch matching, pitch maintenance, vowel production, and dynamic control as well as the effect of hearing loss on vocal handicap. METHODS: An 18-item electronic self-report survey was distributed to the members of the National Association of Teachers of Singing and to the Voice Foundation. Data collected included demographics, the Singing Voice Handicap Index-10 (SVHI-10), and a series of closed and open-ended questions. Demographic variables, variables related to the SVHI-10, and variables related to the newly introduced survey were included in a hierarchical regression analysis to determine significant relationships. RESULTS: Among 206 eligible participants, 37 individuals reported a voice problem, 58 reported hearing loss, and 19 reported concurrent hearing loss and a voice problem. Among males, there were no significant differences between hearing impaired and normal hearing singers in reported pitch matching, pitch maintenance, dynamic control, and vowel matching when those with voice problems were excluded and included. However, in females, when singers with voice problems were excluded, there was a significant difference between hearing impaired and normal hearing singers in pitch matching (P = 0.38). Additionally, when singers with voice problems were included in the female subset, significant differences emerged between the hearing impaired and normal hearing singers in areas of pitch matching (P = 0.01) and vowel matching (P = 0.02). Further, controlling for gender, when excluding voice problems, there was a significant difference between the SVHI-10 scores of normal hearing (mean = 9.03) and hearing impaired participants (mean = 11.30, P = 0.02). This difference continued to be significant when including those with voice problems (normal hearing mean = 9.97, hearing impaired mean=14.1, P <0.0001). Additionally, individuals with hearing impairments were more likely to report higher perceived vocal handicap scores as reflected on the SVHI-10 than normal hearing respondents (P = 0.002). Other factors associated with higher likelihood of SVHI-10 score include older age (P = 0.008), having a voice problem (P <0.0001), and being paid to sing within the past six months (P = 0.001). CONCLUSION: When controlling for voice problems, singers with hearing impairments subjectively did not perceive that they performed less accurately on pitch matching, pitch maintenance, dynamic control, and vowel matching, yet they scored higher on the SVHI-10 indicating vocal handicap. Further study is needed to characterize the relationship between perceived and measured vocal accuracy in singers with hearing loss.

Computational Modeling of Synchrony in the Auditory Nerve in Response to Acoustic and Electric Stimulation.

Cochlear implants are medical devices that provide hearing to nearly one million people around the world. Outcomes are impressive with most recipients learning to understand speech through this new way of hearing. Music perception and speech reception in noise, however, are notably poor. These aspects of hearing critically depend on sensitivity to pitch, whether the musical pitch of an instrument or the vocal pitch of speech. The present article examines cues for pitch perception in the auditory nerve based on computational models. Modeled neural synchrony for pure and complex tones is examined for three different electric stimulation strategies including Continuous Interleaved Sampling (CIS), High-Fidelity CIS (HDCIS), and Peak-Derived Timing (PDT). Computational modeling of current spread and neuronal response are used to predict neural activity to electric and acoustic stimulation. It is shown that CIS does not provide neural synchrony to the frequency of pure tones nor to the fundamental component of complex tones. The newer HDCIS and PDT strategies restore synchrony to both the frequency of pure tones and to the fundamental component of complex tones. Current spread reduces spatial specificity of excitation as well as the temporal fidelity of neural synchrony, but modeled neural excitation restores precision of these cues. Overall, modeled neural excitation to electric stimulation that incorporates temporal fine structure (e.g., HDCIS and PDT) indicates neural synchrony comparable to that provided by acoustic stimulation. Discussion considers the importance of stimulation rate and long-term rehabilitation to provide temporal cues for pitch perception.

Advantages of Pulse Rate Compared to Modulation Frequency for Temporal Pitch Perception in Cochlear Implant Users.

Most cochlear implants encode the fundamental frequency of periodic sounds by amplitude modulation of constant-rate pulsatile stimulation. Pitch perception provided by such stimulation strategies is markedly poor. Two experiments are reported here that consider potential advantages of pulse rate compared to modulation frequency for providing stimulation timing cues for pitch. The first experiment examines beat frequency distortion that occurs when modulating constant-rate pulsatile stimulation. This distortion has been reported on previously, but the results presented here indicate that distortion occurs for higher stimulation rates than previously reported. The second experiment examines pitch resolution as provided by pulse rate compared to modulation frequency. The results indicate that pitch discrimination is better with pulse rate than with modulation frequency. The advantage was large for rates near what has been suggested as the upper limit of temporal pitch perception conveyed by cochlear implants. The results are relevant to sound processing design for cochlear implants particularly for algorithms that encode fundamental frequency into deep envelope modulations or into precisely timed pulsatile stimulation.

Combining Place and Rate of Stimulation Improves Frequency Discrimination in Cochlear Implant Users.

In the auditory system, frequency is represented as tonotopic and temporal response properties of the auditory nerve. While these response properties are inextricably linked in normal hearing, cochlear implants can separately excite tonotopic location and temporal synchrony using different electrodes and stimulation rates, respectively. This separation allows for the investigation of the contributions of tonotopic and temporal cues for frequency discrimination. The present study examines frequency discrimination in adult cochlear implant users as conveyed by electrode position and stimulation rate, separately and combined. The working hypothesis is that frequency discrimination is better provided by place and rate cues combined compared to either cue alone. This hypothesis was tested in two experiments. In the first experiment, frequency discrimination needed for melodic contour identification was measured for frequencies near 100, 200, and 400 Hz using frequency allocation modeled after clinical processors. In the second experiment, frequency discrimination for pitch ranking was measured for frequencies between 100 and 1600 Hz using an experimental frequency allocation designed to provide better access to place cues. The results of both experiments indicate that frequency discrimination is better with place and rate cues combined than with either cue alone. These results clarify how signal processing for cochlear implants could better encode frequency into place and rate of electrical stimulation. Further, the results provide insight into the contributions of place and rate cues for pitch.

Computer-based musical interval training program for Cochlear implant users and listeners with no known hearing loss.

A musical interval is the difference in pitch between two sounds. The way that musical intervals are used in melodies relative to the tonal center of a key can strongly affect the emotion conveyed by the melody. The present study examines musical interval identification in people with no known hearing loss and in cochlear implant users. Pitch resolution varies widely among cochlear implant users with average resolution an order of magnitude worse than in normal hearing. The present study considers the effect of training on musical interval identification and tests for correlations between low-level psychophysics and higher-level musical abilities. The overarching hypothesis is that cochlear implant users are limited in their ability to identify musical intervals both by low-level access to frequency cues for pitch as well as higher-level mapping of the novel encoding of pitch that implants provide. Participants completed a 2-week, online interval identification training. The benchmark tests considered before and after interval identification training were pure tone detection thresholds, pure tone frequency discrimination, fundamental frequency discrimination, tonal and rhythm comparisons, and interval identification. The results indicate strong correlations between measures of pitch resolution with interval identification; however, only a small effect of training on interval identification was observed for the cochlear implant users. Discussion focuses on improving access to pitch cues for cochlear implant users and on improving auditory training for musical intervals.

Pitch perception is more robust to interference and better resolved when provided by pulse rate than by modulation frequency of cochlear implant stimulation.

Cochlear implants are medical devices that have been used to restore hearing to more than half a million people worldwide. Most recipients achieve high levels of speech comprehension through these devices, but speech comprehension in background noise and music appreciation in general are markedly poor compared to normal hearing. A key aspect of hearing that is notably diminished in cochlear implant outcomes is the sense of pitch provided by these devices. Pitch perception is an important factor affecting speech comprehension in background noise and is critical for music perception. The present article summarizes two experiments that examine the robustness and resolution of pitch perception as provided by cochlear implant stimulation timing. The driving hypothesis is that pitch conveyed by stimulation timing cues is more robust and better resolved when provided by variable pulse rates than by modulation frequency of constant-rate stimulation. Experiment 1 examines the robustness for hearing a large, one-octave, pitch difference in the presence of interfering electrical stimulation. With robustness to interference characterized for an otherwise easily discernible pitch difference, Experiment 2 examines the resolution of discrimination thresholds in the presence of interference as conveyed by modulation frequency or by pulse rate. These experiments test for an advantage of stimulation with precise temporal cues. The results indicate that pitch provided by pulse rate is both more robust to interference and is better resolved compared to when provided by modulation frequency. These results should inform the development of new sound processing strategies for cochlear implants designed to encode fundamental frequency of sounds into precise temporal stimulation.

Pleasantness Ratings of Musical Dyads in Cochlear Implant Users.

Cochlear implants have been used to restore hearing to more than half a million people around the world. The restored hearing allows most recipients to understand spoken speech without relying on visual cues. While speech comprehension in quiet is generally high for recipients, many complain about the sound of music. The present study examines consonance and dissonance perception in nine cochlear implant users and eight people with no known hearing loss. Participants completed web-based assessments to characterize low-level psychophysical sensitivities to modulation and pitch, as well as higher-level measures of musical pleasantness and speech comprehension in background noise. The underlying hypothesis is that sensitivity to modulation and pitch, in addition to higher levels of musical sophistication, relate to higher-level measures of music and speech perception. This hypothesis tested true with strong correlations observed between measures of modulation and pitch with measures of consonance ratings and speech recognition. Additionally, the cochlear implant users who were the most sensitive to modulations and pitch, and who had higher musical sophistication scores, had similar pleasantness ratings as those with no known hearing loss. The implication is that better coding and focused rehabilitation for modulation and pitch sensitivity will broadly improve perception of music and speech for cochlear implant users.

Supporting Equity and Inclusion of Deaf and Hard-of-Hearing Individuals in Professional Organizations.

Disability is an important and often overlooked component of diversity. Individuals with disabilities bring a rare perspective to science, technology, engineering, mathematics, and medicine (STEMM) because of their unique experiences approaching complex issues related to health and disability, navigating the healthcare system, creatively solving problems unfamiliar to many individuals without disabilities, managing time and resources that are limited by physical or mental constraints, and advocating for themselves and others in the disabled community. Yet, individuals with disabilities are underrepresented in STEMM. Professional organizations can address this underrepresentation by recruiting individuals with disabilities for leadership opportunities, easing financial burdens, providing equal access, fostering peer-mentor groups, and establishing a culture of equity and inclusion spanning all facets of diversity. We are a group of deaf and hard-of-hearing (D/HH) engineers, scientists, and clinicians, most of whom are active in clinical practice and/or auditory research. We have worked within our professional societies to improve access and inclusion for D/HH individuals and others with disabilities. We describe how different models of disability inform our understanding of disability as a form of diversity. We address heterogeneity within disabled communities, including intersectionality between disability and other forms of diversity. We highlight how the Association for Research in Otolaryngology has supported our efforts to reduce ableism and promote access and inclusion for D/HH individuals. We also discuss future directions and challenges. The tools and approaches discussed here can be applied by other professional organizations to include individuals with all forms of diversity in STEMM.

Perceptual learning of pitch provided by cochlear implant stimulation rate.

Cochlear implant users hear pitch evoked by stimulation rate, but discrimination diminishes for rates above 300 Hz. This upper limit on rate pitch is surprising given the remarkable and specialized ability of the auditory nerve to respond synchronously to stimulation rates at least as high as 3 kHz and arguably as high as 10 kHz. Sensitivity to stimulation rate as a pitch cue varies widely across cochlear implant users and can be improved with training. The present study examines individual differences and perceptual learning of stimulation rate as a cue for pitch ranking. Adult cochlear implant users participated in electrode psychophysics that involved testing once per week for three weeks. Stimulation pulse rate discrimination was measured in bipolar and monopolar configurations for apical and basal electrodes. Base stimulation rates between 100 and 800 Hz were examined. Individual differences were quantified using psychophysically derived metrics of spatial tuning and temporal integration. This study examined distribution of measures across subjects, predictive power of psychophysically derived metrics of spatial tuning and temporal integration, and the effect of training on rate discrimination thresholds. Psychophysical metrics of spatial tuning and temporal integration were not predictive of stimulation rate discrimination, but discrimination thresholds improved at lower frequencies with training. Since most clinical devices do not use variable stimulation rates, it is unknown to what extent recipients may learn to use stimulation rate cues if provided in a clear and consistent manner.

Pediatric Hearing Loss and Speech Recognition in Quiet and in Different Types of Background Noise.

Purpose Speech recognition deteriorates with hearing loss, particularly in fluctuating background noise. This study examined how hearing loss affects speech recognition in different types of noise to clarify how characteristics of the noise interact with the benefits listeners receive when listening in fluctuating compared to steady-state noise. Method Speech reception thresholds were measured for a closed set of spondee words in children (ages 5-17 years) in quiet, speech-spectrum noise, 2-talker babble, and instrumental music. Twenty children with normal hearing and 43 children with hearing loss participated; children with hearing loss were subdivided into groups with cochlear implant (18 children) and hearing aid (25 children) groups. A cohort of adults with normal hearing was included for comparison. Results Hearing loss had a large effect on speech recognition for each condition, but the effect of hearing loss was largest in 2-talker babble and smallest in speech-spectrum noise. Children with normal hearing had better speech recognition in 2-talker babble than in speech-spectrum noise, whereas children with hearing loss had worse recognition in 2-talker babble than in speech-spectrum noise. Almost all subjects had better speech recognition in instrumental music compared to speech-spectrum noise, but with less of a difference observed for children with hearing loss. Conclusions Speech recognition is more sensitive to the effects of hearing loss when measured in fluctuating compared to steady-state noise. Speech recognition measured in fluctuating noise depends on an interaction of hearing loss with characteristics of the background noise; specifically, children with hearing loss were able to derive a substantial benefit for listening in fluctuating noise when measured in instrumental music compared to 2-talker babble.

Factors Affecting Speech Reception in Background Noise with a Vocoder Implementation of the FAST Algorithm.

Speech segregation in background noise remains a difficult task for individuals with hearing loss. Several signal processing strategies have been developed to improve the efficacy of hearing assistive technologies in complex listening environments. The present study measured speech reception thresholds in normal-hearing listeners attending to a vocoder based on the Fundamental Asynchronous Stimulus Timing algorithm (FAST: Smith et al. 2014), which triggers pulses based on the amplitudes of channel magnitudes in order to preserve envelope timing cues, with two different reconstruction bandwidths (narrowband and broadband) to control the degree of spectrotemporal resolution. Five types of background noise were used including same male talker, female talker, time-reversed male talker, time-reversed female talker, and speech-shaped noise to probe the contributions of different types of speech segregation cues and to elucidate how degradation affects speech reception across these conditions. Maskers were spatialized using head-related transfer functions in order to create co-located and spatially separated conditions. Results indicate that benefits arising from voicing and spatial cues can be preserved using the FAST algorithm but are reduced with a reduction in spectral resolution.