Ahead of maturation: Enhanced speech envelope training boosts rise time discrimination in pre-readers at cognitive risk for dyslexia.

Dyslexia has frequently been related to atypical auditory temporal processing and speech perception. Results of studies emphasizing speech onset cues and reinforcing the temporal structure of the speech envelope, that is, envelope enhancement (EE), demonstrated reduced speech perception deficits in individuals with dyslexia. The use of this strategy as auditory intervention might thus reduce some of the deficits related to dyslexia. Importantly, reading-skill interventions are most effective when they are provided during kindergarten and first grade. Hence, we provided a tablet-based 12-week auditory and phonics-based intervention to pre-readers at cognitive risk for dyslexia and investigated the effect on auditory temporal processing with a rise time discrimination (RTD) task. Ninety-one pre-readers at cognitive risk for dyslexia (aged 5-6) were assigned to two groups receiving a phonics-based intervention and playing a story listening game either with (n = 31) or without (n = 31) EE or a third group playing control games and listening to non-enhanced stories (n = 29). RTD was measured directly before, directly after and 1 year after the intervention. While the groups listening to non-enhanced stories mainly improved after the intervention during first grade, the group listening to enhanced stories improved during the intervention in kindergarten and subsequently remained stable during first grade. Hence, an EE intervention improves auditory processing skills important for the development of phonological skills. This occurred before the onset of reading instruction, preceding the maturational improvement of these skills, hence potentially giving at risk children a head start when learning to read. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=e0BfT4dGXNA.

Speech Understanding With Bimodal Stimulation Is Determined by Monaural Signal to Noise Ratios: No Binaural Cue Processing Involved.

OBJECTIVES: To investigate the mechanisms behind binaural and spatial effects in speech understanding for bimodal cochlear implant listeners. In particular, to test our hypothesis that their speech understanding can be characterized by means of monaural signal to noise ratios, rather than complex binaural cue processing such as binaural unmasking. DESIGN: We applied a semantic framework to characterize binaural and spatial effects in speech understanding on an extensive selection of the literature on bimodal listeners. In addition, we performed two experiments in which we measured speech understanding in different masker types (1) using head-related transfer functions, and (2) while adapting the broadband signal to noise ratios in both ears independently. We simulated bimodal hearing with a vocoder in one ear (the cochlear implant side) and a low-pass filter in the other ear (the hearing aid side). By design, the cochlear implant side was the main contributor to speech understanding in our simulation. RESULTS: We found that spatial release from masking can be explained as a simple trade-off between a monaural change in signal to noise at the cochlear implant side (quantified as the head shadow effect) and an opposite change in signal to noise at the hearing aid side (quantified as a change in bimodal benefit). In simulated bimodal listeners, we found that for every 1 dB increase in signal to noise ratio at the hearing aid side, the bimodal benefit improved by approximately 0.4 dB in signal to noise ratio. CONCLUSIONS: Although complex binaural cue processing is often implicated when discussing speech intelligibility in adverse listening conditions, performance can simply be explained based on monaural signal to noise ratios for bimodal listeners.

Temporal quantization deteriorates the discrimination of interaural time differences.

Cochlear implants (CIs) often replace acoustic temporal fine structure by a fixed-rate pulse train. If the pulse timing is arbitrary (that is, not based on the phase information of the acoustic signal), temporal information is quantized by the pulse period. This temporal quantization is probably imperceptible with current clinical devices. However, it could result in large temporal jitter for strategies that aim to improve bilateral and bimodal CI users' perception of interaural time differences (ITDs), such as envelope enhancement. In an experiment with 16 normal-hearing listeners, it is shown that such jitter could deteriorate ITD perception for temporal quantization that corresponds to the often-used stimulation rate of 900 pulses per second (pps): the just-noticeable difference in ITD with quantization was 177 µs as compared to 129 µs without quantization. For smaller quantization step sizes, no significant deterioration of ITD perception was found. In conclusion, the binaural system can only average out the effect of temporal quantization to some extent, such that pulse timing should be well-considered. As this psychophysical procedure was somewhat unconventional, different procedural parameters were compared by simulating a number of commonly used two-down one-up adaptive procedures in Appendix B.

Redundant Information Is Sometimes More Beneficial Than Spatial Information to Understand Speech in Noise.

OBJECTIVES: To establish a framework to unambiguously define and relate the different spatial effects in speech understanding: head shadow, redundancy, squelch, spatial release from masking (SRM), and so on. Next, to investigate the contribution of interaural time and level differences to these spatial effects in speech understanding and how this is influenced by the type of masking noise. DESIGN: In our framework, SRM is uniquely characterized as a linear combination of head shadow, binaural redundancy, and binaural squelch. The latter two terms are combined into one binaural term, which we define as binaural contrast: a benefit of interaural differences. In this way, SRM is a simple sum of a monaural and a binaural term. We used the framework to quantify these spatial effects in 10 listeners with normal hearing. The participants performed speech intelligibility tasks in different spatial setups. We used head-related transfer functions to manipulate the presence of interaural time and level differences. We used three spectrally matched masker types: stationary speech-weighted noise, a competing talker, and speech-weighted noise that was modulated with the broadband temporal envelope of the competing talker. RESULTS: We found that (1) binaural contrast was increased by interaural time differences, but reduced by interaural level differences, irrespective of masker type, and (2) large redundancy (the benefit of having identical information in two ears) could reduce binaural contrast and thus also reduce SRM. CONCLUSIONS: Our framework yielded new insights in binaural processing in speech intelligibility. First, interaural level differences disturb speech intelligibility in realistic listening conditions. Therefore, to optimize speech intelligibility in hearing aids, it is more beneficial to improve monaural signal-to-noise ratios rather than to preserve interaural level differences. Second, although redundancy is mostly ignored when considering spatial hearing, it might explain reduced SRM in some cases.

Delta-band neural envelope tracking predicts speech intelligibility in noise in preschoolers.

Behavioral tests are currently the gold standard in measuring speech intelligibility. However, these tests can be difficult to administer in young children due to factors such as motivation, linguistic knowledge and cognitive skills. It has been shown that measures of neural envelope tracking can be used to predict speech intelligibility and overcome these issues. However, its potential as an objective measure for speech intelligibility in noise remains to be investigated in preschool children. Here, we evaluated neural envelope tracking as a function of signal-to-noise ratio (SNR) in 14 5-year-old children. We examined EEG responses to natural, continuous speech presented at different SNRs ranging from -8 (very difficult) to 8 dB SNR (very easy). As expected delta band (0.5-4 Hz) tracking increased with increasing stimulus SNR. However, this increase was not strictly monotonic as neural tracking reached a plateau between 0 and 4 dB SNR, similarly to the behavioral speech intelligibility outcomes. These findings indicate that neural tracking in the delta band remains stable, as long as the acoustical degradation of the speech signal does not reflect significant changes in speech intelligibility. Theta band tracking (4-8 Hz), on the other hand, was found to be drastically reduced and more easily affected by noise in children, making it less reliable as a measure of speech intelligibility. By contrast, neural envelope tracking in the delta band was directly associated with behavioral measures of speech intelligibility. This suggests that neural envelope tracking in the delta band is a valuable tool for evaluating speech-in-noise intelligibility in preschoolers, highlighting its potential as an objective measure of speech in difficult-to-test populations.

Neural envelope tracking predicts speech intelligibility and hearing aid benefit in children with hearing loss.

Early assessment of hearing aid benefit is crucial, as the extent to which hearing aids provide audible speech information predicts speech and language outcomes. A growing body of research has proposed neural envelope tracking as an objective measure of speech intelligibility, particularly for individuals unable to provide reliable behavioral feedback. However, its potential for evaluating speech intelligibility and hearing aid benefit in children with hearing loss remains unexplored. In this study, we investigated neural envelope tracking in children with permanent hearing loss through two separate experiments. EEG data were recorded while children listened to age-appropriate stories (Experiment 1) or an animated movie (Experiment 2) under aided and unaided conditions (using personal hearing aids) at multiple stimulus intensities. Neural envelope tracking was evaluated using a linear decoder reconstructing the speech envelope from the EEG in the delta band (0.5-4 Hz). Additionally, we calculated temporal response functions (TRFs) to investigate the spatio-temporal dynamics of the response. In both experiments, neural tracking increased with increasing stimulus intensity, but only in the unaided condition. In the aided condition, neural tracking remained stable across a wide range of intensities, as long as speech intelligibility was maintained. Similarly, TRF amplitudes increased with increasing stimulus intensity in the unaided condition, while in the aided condition significant differences were found in TRF latency rather than TRF amplitude. This suggests that decreasing stimulus intensity does not necessarily impact neural tracking. Furthermore, the use of personal hearing aids significantly enhanced neural envelope tracking, particularly in challenging speech conditions that would be inaudible when unaided. Finally, we found a strong correlation between neural envelope tracking and behaviorally measured speech intelligibility for both narrated stories (Experiment 1) and movie stimuli (Experiment 2). Altogether, these findings indicate that neural envelope tracking could be a valuable tool for predicting speech intelligibility benefits derived from personal hearing aids in hearing-impaired children. Incorporating narrated stories or engaging movies expands the accessibility of these methods even in clinical settings, offering new avenues for using objective speech measures to guide pediatric audiology decision-making.

Head shadow enhancement with low-frequency beamforming improves sound localization and speech perception for simulated bimodal listeners.

Many hearing-impaired listeners struggle to localize sounds due to poor availability of binaural cues. Listeners with a cochlear implant and a contralateral hearing aid - so-called bimodal listeners - are amongst the worst performers, as both interaural time and level differences are poorly transmitted. We present a new method to enhance head shadow in the low frequencies. Head shadow enhancement is achieved with a fixed beamformer with contralateral attenuation in each ear. The method results in interaural level differences which vary monotonically with angle. It also improves low-frequency signal-to-noise ratios in conditions with spatially separated speech and noise. We validated the method in two experiments with acoustic simulations of bimodal listening. In the localization experiment, performance improved from 50.5∘ to 26.8∘ root-mean-square error compared with standard omni-directional microphones. In the speech-in-noise experiment, speech was presented from the frontal direction. Speech reception thresholds improved by 15.7 dB SNR when the noise was presented from the cochlear implant side, improved by 7.6 dB SNR when the noise was presented from the hearing aid side, and was not affected when noise was presented from all directions. Apart from bimodal listeners, the method might also be promising for bilateral cochlear implant or hearing aid users. Its low computational complexity makes the method suitable for application in current clinical devices.