Sound Localization of Listeners With Normal Hearing, Impaired Hearing, Hearing Aids, Bone-Anchored Hearing Instruments, and Cochlear Implants: A Review.

PURPOSE: This review article reviews the contemporary studies of localization ability for different populations in different listening environments and provides possible future research directions. CONCLUSIONS: The ability to accurately localize a sound source relying on three cues (interaural time difference, interaural level difference, and spectral cues) is important for communication, learning, and safety. Confounding effects including noise and reverberation, which exist in common listening environments, mask or alter localization cues and negatively affect localization performance. Hearing loss, a common public health issue, also affects localization accuracy. Although hearing devices have been developed to provide excellent audibility of speech signals, less attention has been paid to preserving and replicating crucial localization cues. Unique challenges are faced by users of various hearing devices, including hearing aids, bone-anchored hearing instruments, and cochlear implants. Hearing aids have failed to consistently improve localization performance and, in some cases, significantly impair sound localization. Bone-conduction hearing instruments show little to no benefit for sound localization performance in most cases, although some improvement is seen in binaural users. Although cochlear implants provide great hearing benefit to individuals with severe-to-profound sensorineural hearing loss, cochlear implant users have significant difficulty localizing sound, even with two implants. However, technologies in each of these areas are advancing to reduce interference with desired sound signals and preserve localization cues to help users achieve better hearing and sound localization in real-life environments.

Effects of noise and reverberation on virtual sound localization for listeners with bilateral cochlear implants.

OBJECTIVE: This study investigated the effects of both noise and reverberation on the ability of listeners with bilateral cochlear implants (BCIs) to localize and the feasibility of using a virtual localization test to evaluate BCI users. DESIGN: Seven adults with normal hearing (NH) and two adults with BCIs participated. All subjects completed the virtual localization test in quiet and at 0, -4, -8 dB signal-to-noise ratio in simulated anechoic and reverberant environments. BCI users were also tested at +4 dB signal-to-noise ratio. The noise source was at 0°. A three-word phrase was presented at 70 dB SPL from nine simulated locations in the frontal horizontal plane (±90°). RESULTS: Results revealed significantly poorer localization accuracy for BCI users than NH listeners in all conditions. Significant reverberation effects were observed for BCI users but not listeners with NH. CONCLUSION: Noise and reverberation have a significant effect on BCI users, and their localization ability can be evaluated using these virtual tests.

The effects of reverberation on a listener's ability to recognize target sentences in the presence of up to three synchronized masking sentences.

OBJECTIVE: To determine the effects of room reverberation on target sentence recognition in the presence of 0-to-3 synchronous masking sentences. DESIGN: Target and masker sentences were presented through four loudspeakers (± 90° and ± 45° azimuth; 1m from the listener) in rooms having reverberation times (RT) of 0.2, 0.4, 0.6, and 1.1 s. STUDY SAMPLE: Four groups of 13 listeners each participated in the study (N = 52). RESULTS: In rooms with RTs of 0.2, 0.4, and 0.6 s, mean speech recognition scores (SRSs) were similar, with scores ranging from 96-100%, 90-95%, 75-80%, and 53-60%, when 0, 1, 2, and 3 competing sentences were present, respectively. However, in the room with a RT = 1.1 s, SRSs deteriorated significantly faster as the number of competing sentences increased; mean scores were 93%, 73%, 26%, and 10%, in the 0, 1, 2, 3, competing sentence condition, respectively. The majority of errors in SRSs (98%) resulted from listeners reporting words presented in masking sentences along with those in target sentences (mixing errors). CONCLUSIONS: Results indicate that reverberation has a similar influence on SRSs measured in multi-talker environments, when room reverberation is ≤ 0.6 s. However, SRSs are dramatically reduced in the room with a RT = 1.1 s, even when only one competing talker is present.

Neural indices of spoken word processing in background multi-talker babble.

OBJECTIVE: To evaluate the impact of multi-talker babble on cortical event-related potentials (ERPs), specifically the N400, in a spoken semantic priming paradigm. DESIGN: Participants listened in quiet and with background babble to word triplets, evaluating whether the third word was related to the preceding words. A temporo-spatial principal component analysis was conducted on ERPs to the first and second words (S1 and S2), processed without an overt behavioral response. One factor corresponded to the N400 and revealed greater processing negativity for unrelated as compared to related S2s in quiet and in babble. STUDY SAMPLE: Twelve young adults with normal hearing. RESULTS: Background babble had no significant impact on the N400 in the posterior region but increased neural processing negativity at anterior and central regions during the same timeframe. This differential processing negativity in babble occurred in response to S2 but not S1. Furthermore, background babble impacted processing negativity for related S2s more than unrelated S2s. CONCLUSIONS: Results suggest that speech processing in a modestly degraded listening environment alters neural activity associated with auditory working memory, attention, and semantic processing in anterior and central scalp regions.

Processing interaural cues in sound segregation by young and middle-aged brains.

BACKGROUND: When listening to one speaker while another conversation is occurring simultaneously, we separate the competing sounds by processing physical cues such as common onset time, intensity, frequency harmonicity, and spatial location of the sound sources. Spatial location is determined in large part by differences in arrival of a sound at one ear versus the other ear, otherwise known as interaural time difference (ITD) or interaural phase difference (IPD). There is ample anecdotal evidence that middle-aged adults experience greater difficulty listening to speech in noise, even when their audiological evaluation does not reveal abnormal results. Furthermore, it has been shown that the frequency range for IPD processing is reduced in middle-aged adults compared to young adults, even though morphological changes in the auditory evoked potential (AEP) response were only observed in older adults. PURPOSE: The purpose of the current study was to examine early aging effects (< 60 years) on IPD processing in concurrent sound segregation. RESEARCH DESIGN: We examined the change AEP evoked by detection of a mistuned and/or phase-shifted second harmonic during the last 1500 msec of a 3000 msec amplitude-modulated harmonic complex. A passive listening paradigm was used. STUDY SAMPLE: Ten young (21-35 years) and 11 middle-aged (48-57 years) adults with normal hearing were included in the study. DATA COLLECTION AND ANALYSIS: Scalp electroencephalographic activity was recorded from 63 electrodes. A temporospatial principal component analysis was conducted. Spatial factor scores of individual spatial factors were the dependent variable in separate mixed-design ANOVAs for each temporal factor of interest. Stimulus type was the within-subject independent variable, and age group was the between-subject independent variable. RESULTS: Results indicated a delay in the upward P2 slope and the P2 peak latency to a sudden phase shift in the second harmonic of a harmonic complex in middle-aged adults compared to young adults. This AEP difference increased as mistuning (as a second grouping cue) decreased and remained evident when the IPD was the only grouping cue. CONCLUSIONS: We conclude that our findings reflect neurophysiologic differences between young and middle-aged adults for IPD processing in concurrent sound segregation.

Combined Effects of Noise and Reverberation on Sound Localization for Listeners With Normal Hearing and Bilateral Cochlear Implants.

PURPOSE: This study examined the individual and combined effects of noise and reverberation on the ability of listeners with normal hearing (NH) and with bilateral cochlear implants (BCIs) to localize speech. METHOD: Six adults with BCIs and 10 with NH participated. All subjects completed a virtual localization test in quiet and at 0-, -4-, and -8-dB signal-to-noise ratios (SNRs) in simulated anechoic and reverberant (0.2-, 0.6-, and 0.9-s RT60) environments. BCI users were also tested at +8- and +4-dB SNR. A 3-word phrase was presented at 70 dB SPL from 9 simulated locations in the frontal horizontal plane (±90°), with the noise source at 0°. RESULTS: BCIs users had significantly poorer localization than listeners with NH in all conditions. BCI users' performance started to decrease at a higher SNR (+4 dB) and shorter RT60 (0.2 s) than listeners with NH (-4 dB and 0.6 s). The combination of noise and reverberation began to degrade localization of BCI users at a higher SNR and a shorter RT60 than listeners with NH. CONCLUSION: The clear effect of noise and reverberation on the performance of BCI users provides information that should be useful for refining cochlear implant processing strategies and developing cochlear implant rehabilitation plans to optimize binaural benefit for BCI users in everyday listening situations.

The effect of background babble on working memory in young and middle-aged adults.

BACKGROUND: Background noise has been found to negatively affect working memory. Numerous studies have also found that older adults perform more poorly on working memory tasks than young adults (YA). Hearing status has often been a confounding factor in older individuals. Therefore, it would be beneficial to investigate working memory functions in adverse listening conditions early in the aging process (i.e., middle-age), when hearing function is relatively unaffected. PURPOSE: The focus of this study was to determine the influence of background babble on working memory in YA and middle-aged adults (MA) with normal hearing. RESEARCH DESIGN: Before testing was begun, we established that all participants could correctly identify words in a degraded experimental testing environment with 100% accuracy. Then, the participants listened to lists composed of five pairs of words in quiet and in 20-talker babble. After the final word pair, the participants were cued with the first word of one of the previous five word pairs. The participants were required to write down the second word of the pair. The percent correct scores for each of the five serial positions were analyzed comparing the two listening conditions for YA and MA. Ten YA and ten MA with normal hearing between 250-8000 Hz and a score of at least 26/30 on the Mini-Mental State Examination participated in the study. As different cognitive processes are used for initial, middle, and final serial positions, averaged scores were obtained for Positions 2 and 3 and for Positions 4 and 5. Subsequently, repeated-measures analyses of variance (ANOVAs) were conducted on mean scores of correctly recalled word pairs with serial positions (initial, middle, and final) and listening condition (quiet, babble) as the within-participant variables and age group (YA, MA) as the between-participant independent variable. This OMNIBUS repeated-measures ANOVA was then followed up with separate repeated-measures ANOVAS for the initial, middle, and final positions. RESULTS: Correct recall scores were lower for early positions compared with the latter positions, irrespective of listening condition. For Position 1, YA-but not MA-performed significantly better in babble than in quiet. For the middle positions (Positions 2 and 3), MA performed significantly more poorly than the YA irrespective of listening condition. For the final positions (Positions 4 and 5), no age differences or effects of listening condition were found. CONCLUSIONS: The results indicate that both YA and MA have trouble recalling earlier pieces of information in quiet and in babble. However, MA exhibited significantly poorer recall scores than YA in babble for Position 1, which suggest that cognitive processes related to memory encoding and retrieval are different in background babble for MA and YA.

Effects of reverberation on fusion of lead and lag noise burst stimuli.

The purpose of this investigation was to determine the effects of reverberation on the precedence effect by obtaining thresholds for perception of leading and lagging noise burst stimuli as separate auditory events. In Experiment 1, lag burst thresholds for 4-ms noise bursts were measured in a simulated reverberant and anechoic environment for nine subjects with normal hearing at presentation levels of 10, 20, and 30 dB SL. Results indicated that lag burst thresholds obtained in the reverberant environment were higher than those obtained in the anechoic environment, with no effect of sensation level. In Experiment 2, three new stimulus conditions, two monaural and one binaural control, were employed. For one monaural condition, the stimuli were equal in level and for the other, the leading stimulus was more intense than the lagging stimulus. For the binaural control condition, the stimuli were presented from a perceived spatial location of 0 degrees azimuth. In the monaural and binaural control conditions, lag burst thresholds were lower than those obtained in the reverberant environment of Experiment 1. There was no difference between lag burst thresholds obtained in either environment for the monaural and binaural control conditions compared to the anechoic condition of Experiment 1. Results of Experiment 2 indicate that the higher lag burst thresholds observed in Experiment 1 are not fully explained by a peripheral masking effect.

Effects of noise and reverberation on the precedence effect in listeners with normal hearing and impaired hearing.

The purpose of this study was to determine the effects of reverberation and noise on the precedence effect in listeners with hearing loss. Lag burst thresholds (LBTs) for 4-ms noise bursts were obtained for 2 groups of participants: impaired hearing and normal hearing. Data were collected in reverberant and anechoic environments in quiet and noise, at sensation levels of 10, 20, 30, 40, and 50 dB. Results indicated a significant effect of reverberation on LBTs for both participant groups. LBTs increased with sensation level in the reverberant environment and decreased with increasing sensation level in the anechoic environment. There was no effect of hearing loss on LBTs. When the change in LBT due to noise was compared, the effect of noise depended on group and environment, with a greater effect of noise on the performance of listeners with impaired hearing. It is likely that the ability to fuse direct sounds and early reflections is degraded in listeners with impaired hearing and that this contributes to the difficulties experienced by these listeners in reverberation and noise.

Interference and enhancement effects on interaural time discrimination and level discrimination in listeners with normal hearing and those with hearing loss.

It is known that many listeners with sensorineural hearing loss (SNHL) have difficulty performing binaural tasks. In this study, interference and enhancement effects on interaural time discrimination and level discrimination were investigated in 4 listeners with normal hearing (NH) and 7 listeners with SNHL. Just-noticeable differences were measured using 1/3-octave narrowband noises centered at 0.5 and 4 kHz. Noises were presented in isolation and together at equivalent sound pressure level (EqSPL) and equivalent sensation level (EqSL). Each noise served as target and distractor in the dual-band conditions. Congruent conditions included interaural differences in both noises that varied together, and incongruent conditions included an interaural difference in one noise with the second noise diotic. No significant enhancement effects were observed for either group in either task. Interference effects for the NH group were limited to the interaural level discrimination task in the 0.5-kHz target and 4-kHz distractor condition. Performance of participants with SNHL was similar to that of the NH group for interaural time discrimination with noises at EqSL but not EqSPL. In interaural level discrimination, listeners with SNHL demonstrated interference with a 4-kHz target and 0.5-kHz distractor. Results indicated that the relative levels of low- and high-frequency targets and distractors could affect binaural performance of individuals with SNHL but that in some conditions listeners with SNHL performed similarly to those with normal hearing. Implications of these results for binaural clinical tests and hearing aid fitting strategies are discussed.

Seton Hall university doctor of science degree program: clinical doctorate in audiology.

This article provides an overview of the clinical doctoral program in audiology at Seton Hall University. It is a full-time, 4-year program that includes academic course work, clinical practica, and research experience. In concert with the university mission, the program is designed to enable students to develop the skills they need to be leaders in the field of audiology, providing assessment and intervention to individuals with hearing problems and enhancing the knowledge base of the profession. As part of the School of Graduate Medical Education, students in the program have access to a wealth of resources in related health professions. The close proximity to New York City provides many opportunities for outstanding clinical education with a diverse population.

Auditory evoked potentials in the detection of interaural intensity differences in children and adults.

OBJECTIVE: The goal of the current study was to identify neurophysiological indices of binaural processing in children with no history of hearing loss or listening problems. The results will guide our efforts to diagnose children for whom impaired binaural processing may contribute to difficulty understanding speech in adverse listening environments. Our main aim was to document the cortical auditory evoked potentials (AEPs) in response to interaural intensity differences (IIDs) in children. It is well known, however, that the morphology of AEPs is substantially different in children and adults. Comparison of AEPs in response to IIDs between children and adults allowed us to evaluate age-related differences in the AEP waveform of binaural processing. DESIGN: Nine children (ages 7 yr 0 mo to 9 yr 4 mo) and 11 adults (23 to 34 yr) with normal hearing and no known or suspected neurological or academic problems listened to click stimuli under earphones. Click trains consisted of broadband noise of 1-msec duration with a click rate of 100 Hz. In the experimental condition (IID-present) 50-msec intervals containing an interaural intensity difference of 20 dB were introduced periodically in the continuous stream of otherwise diotic click trains. The diotic trains alternated in intensity between 50 and 70 dB peSPL. In the baseline condition (IID-absent), the same continuous diotic click stream utilized in the IID-present condition was presented with no IID. Finally, for comparison with existing literature on AEPs in children and adults, we presented monaural click trains of 50-msec duration, like those used in the IID stimulus (but with no continuous stream) to the left ear at 70 dB peSPL, with an interstimulus interval of 750 msec. Stimuli were presented in separate blocks for each stimulus type and AEPs were recorded in a passive listening condition. RESULTS: A prominent AEP activation was present in both age groups for the IID-present condition; the IID-absent condition did not evoke substantial AEPs. Adult waveform characteristics of the AEPs to monaural clicks and IID-present around 100 and 200 msec were comparable to previous reports. The children demonstrated the expected AEP activation patterns in response to monaural clicks (i.e., positivity around 100 msec, followed by prominent negativity around 250 msec); however their AEP waveforms to IIDs were mainly comprised of a prolonged positivity around 200 to 250 msec after stimulus onset. A two-step temporal-spatial Principal Component Analysis (PCA) was used to evaluate the temporal (time) and spatial (electrode location) composition of the AEP waveforms in children and adults in response to IID-present and IID-absent conditions. Separate repeated-measures ANOVAs with factor scores as the dependent variable were conducted for each temporal factor (TF) representing the waveform deflections around 100, 200 and 250 msec (i.e., TF110, TF200, and TF255) at the frontocentral spatial factor (SF1). Significantly greater negative activation was observed in adults than in children in response to IID-present for TF110. The IID-present condition evoked a significantly greater waveform inflection for TF200 in both age groups than IID-absent. A positive going activation for TF255 was observed in the IID-present condition in children but not in adults. CONCLUSIONS: This study compared obligatory AEPs in response to binaural processing of IIDs in children and adults with normal hearing. The morphology of the AEP waveform in children was different for monaural clicks and IID-present stimuli. The difference between AEPs for monaural clicks and IID-present did not occur in adults. It is likely that polarity reversal of the AEPs in response to the IID accounts for the observed AEP morphology in children.

Effects of age and frequency disparity on gap discrimination.

Temporal discrimination was measured using a gap discrimination paradigm for three groups of listeners with normal hearing: (1) ages 18-30, (2) ages 40-52, and (3) ages 62-74 years. Normal hearing was defined as pure-tone thresholds < or = 25 dB HL from 250 to 6000 Hz and < or = 30 dB HL at 8000 Hz. Silent gaps were placed between 1/4-octave bands of noise centered at one of six frequencies. The noise band markers were paired so that the center frequency of the leading marker was fixed at 2000 Hz, and the center frequency of the trailing marker varied randomly across experimental runs. Gap duration discrimination was significantly poorer for older listeners than for young and middle-aged listeners, and the performance of the young and middle-aged listeners did not differ significantly. Age group differences were more apparent for the more frequency-disparate stimuli (2000-Hz leading marker followed by a 500-Hz trailing marker) than for the fixed-frequency stimuli (2000-Hz lead and 2000-Hz trail). The gap duration difference limens of the older listeners increased more rapidly with frequency disparity than those of the other listeners. Because age effects were more apparent for the more frequency-disparate conditions, and gap discrimination was not affected by differences in hearing sensitivity among listeners, it is suggested that gap discrimination depends upon temporal mechanisms that deteriorate with age and stimulus complexity but are unaffected by hearing loss.

Effects of hearing loss on echo thresholds.

OBJECTIVE: The purpose of this investigation was to determine the effects of hearing loss on the perception of echoes. DESIGN: Echo thresholds were measured for eight listeners with normal hearing and nine listeners with impaired hearing. Pairs of 4-msec noise bursts were presented to each listener with onset-to-onset delays ranging from 2 to 16 msec. Echo thresholds were obtained at signal presentation levels of 10, 20, 30, 40, and 50 dB SL. RESULTS: Results revealed differences between the psychometric functions of the two subject groups. Psychometric functions of the subjects with impaired hearing indicated higher echo thresholds than for the subjects with normal hearing. In addition, echo thresholds at 10 dB SL were significantly higher than echo thresholds measured at 40 dB SL for both subject groups. CONCLUSION: Listeners with impaired hearing exhibit higher echo thresholds than listeners with normal hearing. The higher echo thresholds for listeners with impaired hearing may account, at least in part, for difficulty on tasks such as localization in everyday listening environments.