Achieved Gain and Subjective Outcomes for a Wide-Bandwidth Contact Hearing Aid Fitted Using CAM2.

OBJECTIVES: The objective of this study was to test the ability to achieve, maintain, and subjectively benefit from extended high-frequency amplification in a real-world use scenario, with a device that restores audibility for frequencies up to 10 kHz. DESIGN: A total of 78 participants (149 ears) with mild to moderately-severe sensorineural hearing loss completed one of two studies conducted across eight clinical sites. Participants were fitted with a light-driven contact hearing aid (the Earlens system) that directly drives the tympanic membrane, allowing extended high-frequency output and amplification with minimal acoustic feedback. Cambridge Method for Loudness Equalization 2 - High Frequency (CAM2)-prescribed gains for experienced users were used for initial fitting, and adjustments were made when required according to participant preferences for loudness and comfort or when measures of functional gain (FG) indicated that more or less gain was needed. Participants wore the devices for an extended period. Prescribed versus adjusted output and gain, frequency-specific FG, and self-perceived benefit assessed with the Abbreviated Profile of Hearing Aid Benefit, and a custom questionnaire were documented. Self-perceived benefit results were compared with those for unaided listening and to ratings with participants' own acoustic hearing aids. RESULTS: The prescribed low-level insertion gain from 6 to 10 kHz averaged 53 dB across all ears, with a range from 26 to 86 dB. After adjustment, the gain from 6 to 10 kHz decreased to an average of 45 dB with a range from 16 to 86 dB. Measured FG averaged 39 dB from 6 to 10 kHz with a range from 11 to 62 dB. Abbreviated Profile of Hearing Aid Benefit results revealed a significant improvement in communication relative to unaided listening, averaging 28 to 32 percentage points for the background noise, reverberation, and ease of communication subscales. Relative to participants' own hearing aids, the subscales ease of communication and aversiveness showed small but significant improvements for Earlens ranging from 6 to 7 percentage points. For the custom satisfaction questionnaire, most participants rated the Earlens system as better than their own hearing aids in most situations. CONCLUSIONS: Participants used and reported subjective benefit from the Earlens system. Most participants preferred slightly less gain at 6 to 10 kHz than prescribed for experienced users by CAM2, preferring similar gains to those prescribed for inexperienced users, but gains over the extended high frequencies were high relative to those that are currently available with acoustic hearing aids.

The effect of spatial separation on informational masking of speech in normal-hearing and hearing-impaired listeners.

The ability to understand speech in a multi-source environment containing informational masking may depend on the perceptual arrangement of signal and masker objects in space. In normal-hearing listeners, Arbogast et al. [J. Acoust. Soc. Am. 112, 2086-2098 (2002)] found an 18-dB spatial release from a primarily informational masker, compared to 7 dB for a primarily energetic masker. This article extends the earlier work to include the study of listeners with sensorineural hearing loss. Listeners performed closed-set speech recognition in two spatial conditions: 0 degrees and 90 degrees separation between signal and masker. Three maskers were tested: (1) the different-band sentence masker was designed to be primarily informational; (2) the different-band noise masker was a control for the different-band sentence; and (3) the same-band noise masker was designed to be primarily energetic. The spatial release from the different-band sentence was larger than for the other maskers, but was smaller (10 dB) for the hearing-impaired group than for the normal-hearing group (15 dB). The smaller benefit for the hearing-impaired listeners can be partially explained by masker sensation level. However, the results suggest that hearing-impaired listeners can use the perceptual effect of spatial separation to improve speech recognition in the presence of a primarily informational masker.

Across-ear interference from parametrically degraded synthetic speech signals in a dichotic cocktail-party listening task.

Recent results have shown that listeners attending to the quieter of two speech signals in one ear (the target ear) are highly susceptible to interference from normal or time-reversed speech signals presented in the unattended ear. However, speech-shaped noise signals have little impact on the segregation of speech in the opposite ear. This suggests that there is a fundamental difference between the across-ear interference effects of speech and nonspeech signals. In this experiment, the intelligibility and contralateral-ear masking characteristics of three synthetic speech signals with parametrically adjustable speech-like properties were examined: (1) a modulated noise-band (MNB) speech signal composed of fixed-frequency bands of envelope-modulated noise; (2) a modulated sine-band (MSB) speech signal composed of fixed-frequency amplitude-modulated sinewaves; and (3) a "sinewave speech" signal composed of sine waves tracking the first four formants of speech. In all three cases, a systematic decrease in performance in the two-talker target-ear listening task was found as the number of bands in the contralateral speech-like masker increased. These results suggest that speech-like fluctuations in the spectral envelope of a signal play an important role in determining the amount of across-ear interference that a signal will produce in a dichotic cocktail-party listening task.

The advantage of knowing where to listen.

This study examined the role of focused attention along the spatial (azimuthal) dimension in a highly uncertain multitalker listening situation. The task of the listener was to identify key words from a target talker in the presence of two other talkers simultaneously uttering similar sentences. When the listener had no a priori knowledge about target location, or which of the three sentences was the target sentence, performance was relatively poor-near the value expected simply from choosing to focus attention on only one of the three locations. When the target sentence was cued before the trial, but location was uncertain, performance improved significantly relative to the uncued case. When spatial location information was provided before the trial, performance improved significantly for both cued and uncued conditions. If the location of the target was certain, proportion correct identification performance was higher than 0.9 independent of whether the target was cued beforehand. In contrast to studies in which known versus unknown spatial locations were compared for relatively simple stimuli and tasks, the results of the current experiments suggest that the focus of attention along the spatial dimension can play a very significant role in solving the "cocktail party" problem.

Informational masking: counteracting the effects of stimulus uncertainty by decreasing target-masker similarity.

Previous work has indicated that target-masker similarity, as well as stimulus uncertainty, influences the amount of informational masking that occurs in detection, discrimination, and recognition tasks. In each of five experiments reported in this paper, the detection threshold for a tonal target in random multitone maskers presented simultaneously with the target tone was measured for two conditions using the same set of five listeners. In one condition, the target was constructed to be "similar" (S) to the masker; in the other condition, it was constructed to be "dissimilar" (D) to the masker. The specific masker varied across experiments, but was constant for the two conditions. Target-masker similarity varied in dimensions such as duration, perceived location, direction of frequency glide, and spectro-temporal coherence. Group-mean results show large decreases in the amount of masking for the D condition relative to the S condition. In addition, individual differences (a hallmark of informational masking) are found to be much greater in the S condition than in the D condition. Furthermore, listener vulnerability to informational masking is found to be consistent to at least a moderate degree across experiments.

Informational masking caused by contralateral stimulation.

Although informational masking is thought to reflect central mechanisms, the effects are generally much stronger when the target and masker are presented to the same ear than when they are presented to different ears. However, the results of a recent study by Brungart and Simpson [J. Acoust. Soc. Am. 112, 2985-2995 (2002)] indicated that a speech masker that is presented contralateral to a speech signal can produce substantial amounts of informational masking when a second speech masker is played simultaneously in the same ear as the signal. In this study, we conducted a series of experiments that paralleled those of Brungart and Simpson but used a pure-tone signal and multitone informational maskers in a detection task. Both the signal and the maskers were played as sequences of short bursts in each observation interval. The maskers were arranged in two types of spectrotemporal patterns. One type of pattern, called "multiple-bursts same" (MBS), has previously been shown to produce very large amounts of informational masking while the other type of pattern, called "multiple-bursts different" (MBD), has been shown to produce very small amounts of informational masking. Several conditions of ipsilateral, contralateral, and combined presentation of these maskers were tested. The results showed that presentation of the MBS masker in the contralateral ear produced a substantial amount of informational masking when the MBD masker was simultaneously presented to the ipsilateral ear. The results supported the earlier findings of Brungart and Simpson indicating that listeners are unable to selectively focus their attention on a single ear in some complex dichotic listening conditions. These results suggest that this contralateral masking effect is not restricted to speech and may reflect more general limitations on processing capacity. Further, it was concluded that the magnitude of the contralateral masking effect was related both to the informational masking value of the contralateral masker and the complexity of the stimulus and/or task in the ear in which the signal was presented.

The effect of spatial separation on informational and energetic masking of speech.

The effect of spatial separation of sources on the masking of a speech signal was investigated for three types of maskers, ranging from energetic to informational. Normal-hearing listeners performed a closed-set speech identification task in the presence of a masker at various signal-to-noise ratios. Stimuli were presented in a quiet sound field. The signal was played from 0 degrees azimuth and a masker was played either from the same location or from 90 degrees to the right. Signals and maskers were derived from sentences that were preprocessed by a modified cochlear-implant simulation program that filtered each sentence into 15 frequency bands, extracted the envelopes from each band, and used these envelopes to modulate pure tones at the center frequencies of the bands. In each trial, the signal was generated by summing together eight randomly selected frequency bands from the preprocessed signal sentence. Three maskers were derived from the preprocessed masker sentences: (1) different-band sentence, which was generated by summing together six randomly selected frequency bands out of the seven bands not present in the signal (resulting in primarily informational masking); (2) different-band noise, which was generated by convolving the different-band sentence with Gaussian noise; and (3) same-band noise, which was generated by summing the same eight bands from the preprocessed masker sentence that were used in the signal sentence and convolving the result with Gaussian noise (resulting in primarily energetic masking). Results revealed that in the different-band sentence masker, the effect of spatial separation averaged 18 dB (at 51% correct), while in the different-band and same-band noise maskers the effect was less than 10 dB. These results suggest that, in these conditions, the advantage due to spatial separation of sources is greater for informational masking than for energetic masking.

Informational masking in listeners with sensorineural hearing loss.

Measures of energetic and informational masking were obtained from 46 listeners with sensorineural hearing loss. The task was to detect the presence of a sequence of eight contiguous 60-ms bursts of a pure tone embedded in masker bursts that were played synchronously with the signal. The masker was either a sequence of Gaussian noise bursts (energetic masker) or a sequence of random-frequency 2-tone bursts (informational masker). The 2-tone maskers were of two types: one type that normally tends to produce large amounts of informational masking and a second type that normally tends to produce very little informational masking. The two informational maskers are called "multiple-bursts same" (MBS), because the same frequency components are present in each burst of a sequence, and "multiple-bursts different" (MBD), because different frequency components are presented in each burst of a sequence. The difference in masking observed for these two maskers is thought to occur because the signal perceptually segregates from the masker in the MBD condition but fuses with the masker in MBS. In the present study, the effectiveness of the MBD masker, measured as the signal-to-masker ratio at masked threshold, increased with increasing hearing loss. In contrast, the signal-to-masker ratio at masked threshold for the MBS masker changed much less as a function of hearing loss. These results suggest that sensorineural hearing loss interferes with the ability of the listener to perceptually segregate individual components of complex sounds. The results from the energetic masking condition, which included critical ratio estimates for all listeners and auditory filter characteristics for a subset of the listeners, indicated that increasing hearing loss also reduced frequency selectivity at the signal frequency. Overall, these results suggest that the increased susceptibility to masking observed in listeners with sensorineural hearing loss is a consequence of both peripheral and central processes.

Similarity, uncertainty, and masking in the identification of nonspeech auditory patterns.

This study examined whether increasing the similarity between informational maskers and signals would increase the amount of masking obtained in a nonspeech pattern identification task. The signals were contiguous sequences of pure-tone bursts arranged in six narrow-band spectro-temporal patterns. The informational maskers were sequences of multitone bursts played synchronously with the signal tones. The listener's task was to identify the patterns in a 1-interval 6-alternative forced-choice procedure. Three types of multitone maskers were generated according to different randomization rules. For the least signal-like informational masker, the components in each multitone burst were chosen at random within the frequency range of 200-6500 Hz, excluding a "protected region" around the signal frequencies. For the intermediate masker, the frequency components in the first burst were chosen quasirandomly, but the components in successive bursts were constrained to fall in narrow frequency bands around the frequencies of the components in the initial burst. Within the narrow bands the frequencies were randomized. This masker was considered to be more similar to the signal patterns because it consisted of a set of narrow-band sequences any one of which might be mistaken for a signal pattern. The most signal-like masker was similar to the intermediate masker in that it consisted of a set of synchronously played narrow-band sequences, but the variation in frequency within each sequence was sinusoidal, completing roughly one period in a sequence. This masker consisted of discernible patterns but not patterns that were part of the set of signals. In addition, masking produced by Gaussian noise bursts--thought to produce primarily peripherally based "energetic masking"--was measured and compared to the informational masking results. For the three informational maskers, more masking was produced by the maskers comprised of narrow-band sequences than for the masker in which the frequencies were not constrained to narrow bands. Also, the slopes of the performance-level functions for the three informational maskers were much shallower than for the Gaussian noise masker or for no masker. The findings provided qualified support for the hypothesis that increasing the similarity between signals and maskers, or parts of the maskers, causes greater informational masking. However, it is also possible that the greater masking was a consequence of increasing the number of perceptual "streams" that had to be evaluated by the listener.