Relationship Between Auditory and Visual Noise Acceptance in Normal-Hearing Listeners.

ABSTRACT

BACKGROUND: Research has shown that hearing aid acceptance is closely related to how well an individual tolerates background noise, regardless of improved speech understanding in background noise. The acceptable noise level (ANL) test was developed to quantify background noise acceptance. The ANL test measures a listener's willingness to listen to speech in noise rather than their ability to understand speech in noise, and is clinically valuable as a predictor of hearing aid success. PURPOSE: Noise acceptance is thought to be mediated by central regions of the nervous system, but the underlying mechanism of noise acceptance is not well understood. Higher order central efferent mechanisms may be weaker and/or central afferent mechanisms are more active in listeners with large versus small ANLs. Noise acceptance, therefore, may not be limited to the auditory modality but observable across modalities. We designed a visual-ANL test, as a parallel of the auditory-ANL test, to examine the relations between auditory and visual noise acceptance. RESEARCH DESIGN: A correlational design. STUDY SAMPLE Thirty-seven adults between the ages of 21 and 30 years with normal hearing participated in this study. DATA COLLECTION AND ANALYSIS: All participants completed the standard auditory-ANL task, the visual-ANL task developed for this study, reception thresholds for sentences using the hearing in noise test, and visual sentence recognition in noise using the text reception threshold test. Correlational analyses were performed to evaluate the relations between and among the ANL and perception tasks. RESULTS: Auditory- and Visual-ANLs were correlated; those who accepted more auditory noise were also those who accepted more visual noise. Auditory and visual perceptual measures were also correlated, demonstrating that both measures reflect common processes underlying the ability to recognize speech in noise. Finally, as expected, noise acceptance levels were unrelated to perception in noise across modalities. CONCLUSIONS: The results of this study support our hypothesis that noise acceptance may not be unique to the auditory modality, specifically, that the common variance shared between the two ANL tasks, may reflect a shared general perceptual or cognitive mechanism that is not specific to the auditory or visual domains. These findings also support that noise acceptance and speech recognition reflect different aspects of auditory and visual perception. Future work will relate these ANL measures with central tasks of inhibition and include hearing-impaired individuals to explore the mechanisms underlying noise acceptance.