The Cambridge aided loudness profile (CALP): item choices and data for unaided listening by young and older normal-hearing listeners and older hearing-impaired listeners.

OBJECTIVE: To develop an improved version of the profile of aided loudness (PAL), intended for assessment of the appropriateness of the loudness of everyday sounds. DESIGN: Initially, 16 participants with a range of ages and degrees of hearing loss indicated whether they encountered each situation described in the PAL and how specific they considered the description to be. Based on the responses, most situations from the PAL were eliminated and new situations were introduced, giving the Cambridge Aided Loudness Profile (CALP). The CALP was administered to 80 young and 22 older participants with normal hearing, who rated the loudness of each situation and satisfaction with this loudness (as for the original PAL). Satisfaction was strongly negatively correlated with loudness, suggesting that satisfaction was largely based on loudness. The CALP was then administered to 32 new young normal-hearing participants and 49 older participants with hearing loss, most of whom used hearing aids, who rated loudness and the appropriateness of loudness. RESULTS: Some situations were rated as loud but appropriate in loudness, indicating that the CALP can distinguish these aspects. CONCLUSIONS: The CALP questions were understood by all participants. The CALP may be useful for assessing the appropriateness of loudness.

Effects of hearing loss, age, noise exposure, and listening skills on envelope regularity discrimination.

The envelope regularity discrimination (ERD) test assesses the ability to discriminate irregular from regular amplitude modulation (AM). The measured threshold is called the irregularity index (II). It was hypothesized that the II at threshold should be almost unaffected by the loudness recruitment that is associated with cochlear hearing loss because the effect of recruitment is similar to multiplying the AM depth by a certain factor, and II values depend on the amount of envelope irregularity relative to the baseline modulation depth. To test this hypothesis, the ERD test was administered to 60 older adults with varying degrees of hearing loss, using carrier frequencies of 1 and 4 kHz. The II values for the two carrier frequencies were highly correlated, indicating that the ERD test was measuring a consistent characteristic of each subject. The II values at 1 and 4 kHz were not significantly correlated with the audiometric thresholds at the corresponding frequencies, consistent with the hypothesis. The II values at 4 kHz were significantly positively correlated with age. There was an unexpected negative correlation between II values and a measure of noise exposure. This is argued to reflect the confounding effects of listening skills.

Forward masking of amplitude modulation across ears and its tuning in the modulation domain.

Frequency selectivity in the amplitude modulation (AM) domain has been demonstrated using both simultaneous AM masking and forward AM masking. This has been explained using the concept of a modulation filter bank (MFB). Here, we assessed whether the MFB occurs before or after the point of binaural interaction in the auditory pathway by using forward masking in the AM domain in an ipsilateral condition (masker AM and signal AM applied to the left ear with an unmodulated carrier in the right ear) and a contralateral condition (masker AM applied to the right ear and signal AM applied to the left ear). The carrier frequency was 8 kHz, the signal AM frequency, fs, was 40 or 80 Hz, and the masker AM frequency ranged from 0.25 to 4 times fs. Contralateral forward AM masking did occur, but it was smaller than ipsilateral AM masking. Tuning in the AM domain was slightly sharper for ipsilateral than for contralateral masking, perhaps reflecting confusion of the signal and masker AM in the ipsilateral condition when their AM frequencies were the same. The results suggest that there might be an MFB both before and after the point in the auditory pathway where binaural interaction occurs.

Improving hearing-aid gains based on automatic speech recognition.

This study provides proof of concept that automatic speech recognition (ASR) can be used to improve hearing aid (HA) fitting. A signal-processing chain consisting of a HA simulator, a hearing-loss simulator, and an ASR system normalizing the intensity of input signals was used to find HA-gain functions yielding the highest ASR intelligibility scores for individual audiometric profiles of 24 listeners with age-related hearing loss. Significantly higher aided speech intelligibility scores and subjective ratings of speech pleasantness were observed when the participants were fitted with ASR-established gains than when fitted with the gains recommended by the CAM2 fitting rule.

No evidence for a link between noise exposure and auditory temporal processing for young adults with normal audiograms.

The link between lifetime noise exposure and temporal processing abilities was investigated for 45 normal-hearing participants, recruited from a population of undergraduate students, aged 18 to 23 years. A self-report instrument was employed to assess the amount of neuropathic noise (here defined as sounds with levels exceeding approximately 80 dBA) each participant had been exposed to and sensitivity to temporal-fine-structure and temporal-envelope information was determined using frequency discrimination and envelope irregularity detection tasks, respectively. Despite sizable individual variability in all measures, correlations between noise exposure and the ability to process temporal cues were small and non-significant.

Envelope regularity discrimination.

The ability to discriminate irregular from regular amplitude modulation was assessed using the "envelope regularity discrimination" test. The amount of irregularity was parametrically varied and quantified by an "irregularity index." Normative data were gathered for young subjects with normal audiometric thresholds. Parameters varied were the carrier and modulation frequencies, fc and fm, and the baseline modulation index, m. All tests were performed using a background threshold-equalizing noise. The main findings were (1) using fc = 4000 Hz, fm = 8 Hz, and m = 0.3, performance improved over the first two threshold runs and then remained roughly stable, and there was a high correlation between thresholds obtained at 80 dB sound pressure level (SPL) and at 20 dB sensation level; (2) using fm = 8 Hz and m = 0.3 with a level of 80 dB SPL, thresholds did not vary significantly across fc = 1000, 2000, and 4000 Hz; (3) using fm = 8 Hz and fc = 4000 Hz with a level of 80 dB SPL, thresholds did not vary significantly for m from 0.2 to 0.5; and (4) using m = 0.3 and fc = 4000 Hz with a level of 80 dB SPL, thresholds improved with increasing fm from 2 to 16 Hz. For all conditions, there was substantial individual variability, probably resulting from differences in "processing efficiency."

Development of a method for determining binaural sensitivity to temporal fine structure.

OBJECTIVE: To develop and evaluate a test of the ability to process binaural temporal-fine-structure (TFS) information. The test was intended to provide a graded measure of TFS sensitivity for all listeners. DESIGN: Sensitivity to TFS was assessed at a sensation level of 30 dB using the established TFS-LF test at centre frequencies of 250, 500 and 750 Hz, and using the new TFS-AF test, in which the interaural phase difference (IPD) was fixed and the frequency was adaptively varied. IPDs varied from 30 to 180°. STUDY SAMPLE: Nine young (19-25 years) and 23 older (47-84 years) listeners with normal hearing over the tested frequency range. RESULTS: For the young listeners, thresholds on the TFS-AF test did not improve significantly with repeated testing. The rank-ordering of performance across listeners was independent of the size of the IPD, and moderate-to-strong correlations were observed between scores for the TFS-LF and TFS-AF tests. Older listeners who were unable to complete the TFS-LF test were all able to complete the TFS-AF test. CONCLUSIONS: No practice effects and strong correlations with an established test of binaural TFS sensitivity make the TFS-AF test a good candidate for the assessment of supra-threshold binaural processing.

Investigating the Role of Working Memory in Speech-in-noise Identification for Listeners with Normal Hearing.

With the advent of cognitive hearing science, increased attention has been given to individual differences in cognitive functioning and their explanatory power in accounting for inter-listener variability in understanding speech in noise (SiN). The psychological construct that has received most interest is working memory (WM), representing the ability to simultaneously store and process information. Common lore and theoretical models assume that WM-based processes subtend speech processing in adverse perceptual conditions, such as those associated with hearing loss or background noise. Empirical evidence confirms the association between WM capacity (WMC) and SiN identification in older hearing-impaired listeners. To assess whether WMC also plays a role when listeners without hearing loss process speech in acoustically adverse conditions, we surveyed published and unpublished studies in which the Reading-Span test (a widely used measure of WMC) was administered in conjunction with a measure of SiN identification. The survey revealed little or no evidence for an association between WMC and SiN performance. We also analysed new data from 132 normal-hearing participants sampled from across the adult lifespan (18-91 years), for a relationship between Reading-Span scores and identification of matrix sentences in noise. Performance on both tasks declined with age, and correlated weakly even after controlling for the effects of age and audibility (r = 0.39, p ≤ 0.001, one-tailed). However, separate analyses for different age groups revealed that the correlation was only significant for middle-aged and older groups but not for the young (< 40 years) participants.

Effects of age and hearing loss on stream segregation based on interaural time differences.

The effect of interaural time differences (ITDs) on obligatory stream segregation for successive tone bursts was investigated for older listeners with normal hearing (ONH) and hearing loss (OHL), by measuring the threshold for detecting a rhythmic irregularity in an otherwise isochronous sequence of interleaved "A" and "B" tones. The A and B tones had equal but opposite ITDs from 0 to 0.5 ms. For some of the ONH listeners, the threshold increased with increasing ITD, but no OHL listener showed an effect of ITD. It is concluded that hearing loss reduces the potency of ITDs in inducing obligatory stream segregation.

Neurometric amplitude-modulation detection threshold in the guinea-pig ventral cochlear nucleus.

Amplitude modulation (AM) is a pervasive feature of natural sounds. Neural detection and processing of modulation cues is behaviourally important across species. Although most ecologically relevant sounds are not fully modulated, physiological studies have usually concentrated on fully modulated (100% modulation depth) signals. Psychoacoustic experiments mainly operate at low modulation depths, around detection threshold (∼5% AM). We presented sinusoidal amplitude-modulated tones, systematically varying modulation depth between zero and 100%, at a range of modulation frequencies, to anaesthetised guinea-pigs while recording spikes from neurons in the ventral cochlear nucleus (VCN). The cochlear nucleus is the site of the first synapse in the central auditory system. At this locus significant signal processing occurs with respect to representation of AM signals. Spike trains were analysed in terms of the vector strength of spike synchrony to the amplitude envelope. Neurons showed either low-pass or band-pass temporal modulation transfer functions, with the proportion of band-pass responses increasing with increasing sound level. The proportion of units showing a band-pass response varies with unit type: sustained chopper (CS) > transient chopper (CT) > primary-like (PL). Spike synchrony increased with increasing modulation depth. At the lowest modulation depth (6%), significant spike synchrony was only observed near to the unit's best modulation frequency for all unit types tested. Modulation tuning therefore became sharper with decreasing modulation depth. AM detection threshold was calculated for each individual unit as a function of modulation frequency. Chopper units have significantly better AM detection thresholds than do primary-like units. AM detection threshold is significantly worse at 40 dB vs. 10 dB above pure-tone spike rate threshold. Mean modulation detection thresholds for sounds 10 dB above pure-tone spike rate threshold at best modulation frequency are (95% CI) 11.6% (10.0-13.1) for PL units, 9.8% (8.2-11.5) for CT units, and 10.8% (8.4-13.2) for CS units. The most sensitive guinea-pig VCN single unit AM detection thresholds are similar to human psychophysical performance (∼3% AM), while the mean neurometric thresholds approach whole animal behavioural performance (∼10% AM).

Auditory Biases in Cognitive Assessment: Insights from a Hearing-Loss Simulation for the Screening of Dementia due to Alzheimer's Disease.

Cognitive-screening tests are used to detect pathological changes in mental abilities. Many use orally presented instructions and test items. Hence, hearing loss (HL), whose prevalence increases with age, may bias cognitive-test performance in the target population for the screening of dementia due to Alzheimer's disease. To study the effect of the auditory test format, an impairment-simulation approach was used in normal-hearing listeners to compare performance on the Hopkins Verbal Learning Test, a memory task employed in dementia screening and research, when test items were unprocessed and processed to simulate age-related HL. Immediate verbal recall declined with simulated HL, suggesting that auditory factors are confounding variables in cognitive assessment and result in the underestimation of cognitive functioning.

Notionally steady background noise acts primarily as a modulation masker of speech.

Stone et al. [J. Acoust. Soc Am. 130, 2874-2881 (2011)], using vocoder processing, showed that the envelope modulations of a notionally steady noise were more effective than the envelope energy as a masker of speech. Here the same effect is demonstrated using non-vocoded signals. Speech was filtered into 28 channels. A masker centered on each channel was added to the channel signal at a target-to-background ratio of -5 or -10 dB. Maskers were sinusoids or noise bands with bandwidth 1/3 or 1 ERB(N) (ERB(N) being the bandwidth of "normal" auditory filters), synthesized with Gaussian (GN) or low-noise (LNN) statistics. To minimize peripheral interactions between maskers, odd-numbered channels were presented to one ear and even to the other. Speech intelligibility was assessed in the presence of each "steady" masker and that masker 100% sinusoidally amplitude modulated (SAM) at 8 Hz. Intelligibility decreased with increasing envelope fluctuation of the maskers. Masking release, the difference in intelligibility between the SAM and its "steady" counterpart, increased with bandwidth from near-zero to around 50 percentage points for the 1-ERB(N) GN. It is concluded that the sinusoidal and GN maskers behaved primarily as energetic and modulation maskers, respectively.

The influence of age and high-frequency hearing loss on sensitivity to temporal fine structure at low frequencies (L).

Sensitivity to temporal fine structure (TFS) at low frequencies may be adversely affected by hearing loss at high frequencies even when absolute thresholds at low frequencies are within the normal range. However, in several studies suggesting this, the effects of hearing loss and age were confounded. Here, interaural phase discrimination (IPD) thresholds for pure tones at 500 and 750 Hz were measured for 39 subjects with ages from 61 to 83 yr. All subjects had near-normal audiometric thresholds at low frequencies, but thresholds varied across subjects at high frequencies. IPD thresholds were correlated with age. IPD thresholds for the test frequency of 750 Hz were weakly correlated with absolute thresholds at high frequencies, but these correlations became non-significant when the effect of age was partialed out. The results do not confirm that sensitivity to TFS at low frequencies is influenced by hearing loss at high frequencies, independently of age.

Immediate Effects of (Simulated) Age-Related Hearing Loss on Cognitive Processing and Performance for the Backward-Digit-Span Task.

The recall of auditorily presented sequences of digits in reverse order (also known as the Backward Digit Span, BDS) is considered to reflect a person's information storage and processing abilities which have been linked to speech-in-noise intelligibility. However, especially in aging research and audiology, persons who are administered the BDS task are often affected by hearing loss (HL). If uncorrected, HL can have immediate assessment-format-related effects on cognitive-test performance and can result, in the long term, in neuroplastic changes impacting cognitive functioning. In the present study, an impairment-simulation approach, mimicking mild-to-moderate age-related HLs typical for persons aged 65, 75, and 85 years, was used in 19 young normal-hearing participants to evaluate the impact of HL on cognitive performance and the cognitive processes probed by the BDS task. Participants completed the BDS task in several listening conditions, as well as several commonly used visual tests of short-term and working memory. The results indicated that BDS performance was impaired by a simulated HL representing that of persons aged 75 years and above. In the normal-hearing condition, BDS performance correlated positively with both performance on tests of short-term memory and performance on tests of working memory. In the listening condition simulating moderate HL (as experienced by the average 85-year-old person), BDS performance only correlated with performance on working-memory tests. In conclusion, simulated (and, by extrapolation, actual) age-related HL negatively affects cognitive-test performance and may change the composition of the cognitive processes associated with the completion of a cognitive task.

Using Automatic Speech Recognition to Optimize Hearing-Aid Time Constants.

Automatic speech recognition (ASR), when combined with hearing-aid (HA) and hearing-loss (HL) simulations, can predict aided speech-identification performances of persons with age-related hearing loss. ASR can thus be used to evaluate different HA configurations, such as combinations of insertion-gain functions and compression thresholds, in order to optimize HA fitting for a given person. The present study investigated whether, after fixing compression thresholds and insertion gains, a random-search algorithm could be used to optimize time constants (i.e., attack and release times) for 12 audiometric profiles. The insertion gains were either those recommended by the CAM2 prescription rule or those optimized using ASR, while compression thresholds were always optimized using ASR. For each audiometric profile, the random-search algorithm was used to vary time constants with the aim to maximize ASR performance. A HA simulator and a HL simulator simulator were used, respectively, to amplify and to degrade speech stimuli according to the input audiogram. The resulting speech signals were fed to an ASR system for recognition. For each audiogram, 1,000 iterations of the random-search algorithm were used to find the time-constant configuration yielding the highest ASR score. To assess the reproducibility of the results, the random search algorithm was run twice. Optimizing the time constants significantly improved the ASR scores when CAM2 insertion gains were used, but not when using ASR-based gains. Repeating the random search yielded similar ASR scores, but different time-constant configurations.

OPRA-RS: A Hearing-Aid Fitting Method Based on Automatic Speech Recognition and Random Search.

Hearing-aid (HA) prescription rules (such as NAL-NL2, DSL-v5, and CAM2) are used by HA audiologists to define initial HA settings (e.g., insertion gains, IGs) for patients. This initial fitting is later individually adjusted for each patient to improve clinical outcomes in terms of speech intelligibility and listening comfort. During this fine-tuning stage, speech-intelligibility tests are often carried out with the patient to assess the benefits associated with different HA settings. As these tests tend to be time-consuming and performance on them depends on the patient's level of fatigue and familiarity with the test material, only a limited number of HA settings can be explored. Consequently, it is likely that a suboptimal fitting is used for the patient. Recent studies have shown that automatic speech recognition (ASR) can be used to predict the effects of IGs on speech intelligibility for patients with age-related hearing loss (ARHL). The aim of the present study was to extend this approach by optimizing, in addition to IGs, compression thresholds (CTs). However, increasing the number of parameters to be fitted increases exponentially the number of configurations to be assessed. To limit the number of HA settings to be tested, three random-search (RS) genetic algorithms were used. The resulting new HA fitting method, combining ASR and RS, is referred to as "objective prescription rule based on ASR and random search" (OPRA-RS). Optimal HA settings were computed for 12 audiograms, representing average and individual audiometric profiles typical for various levels of ARHL severity, and associated ASR performances were compared to those obtained with the settings recommended by CAM2. Each RS algorithm was run twice to assess its reliability. For all RS algorithms, ASR scores obtained with OPRA-RS were significantly higher than those associated with CAM2. Each RS algorithm converged on similar optimal HA settings across repetitions. However, significant differences were observed between RS algorithms in terms of maximum ASR performance and processing costs. These promising results open the way to the use of ASR and RS algorithms for the fine-tuning of HAs with potential speech-intelligibility benefits for the patient.

Determination of preferred parameters for multichannel compression using individually fitted simulated hearing AIDS and paired comparisons.

OBJECTIVE: To determine preferred parameters of multichannel compression using individually fitted simulated hearing aids and a method of paired comparisons. DESIGN: Fourteen participants with mild to moderate hearing loss listened via a simulated five-channel compression hearing aid fitted using the CAMEQ2-HF method to pairs of speech sounds (a male talker and a female talker) and musical sounds (a percussion instrument, orchestral classical music, and a jazz trio) presented sequentially and indicated which sound of the pair was preferred and by how much. The sounds in each pair were derived from the same token and differed along a single dimension in the type of processing applied. For the speech sounds, participants judged either pleasantness or clarity; in the latter case, the speech was presented in noise at a 2-dB signal-to-noise ratio. For musical sounds, they judged pleasantness. The parameters explored were time delay of the audio signal relative to the gain control signal (the alignment delay), compression speed (attack and release times), bandwidth (5, 7.5, or 10 kHz), and gain at high frequencies relative to that prescribed by CAMEQ2-HF. RESULTS: Pleasantness increased with increasing alignment delay only for the percussive musical sound. Clarity was not affected by alignment delay. There was a trend for pleasantness to decrease slightly with increasing bandwidth, but this was significant only for female speech with fast compression. Judged clarity was significantly higher for the 7.5- and 10-kHz bandwidths than for the 5-kHz bandwidth for both slow and fast compression and for both talker genders. Compression speed had little effect on pleasantness for 50- or 65-dB SPL input levels, but slow compression was generally judged as slightly more pleasant than fast compression for an 80-dB SPL input level. Clarity was higher for slow than for fast compression for input levels of 80 and 65 dB SPL but not for a level of 50 dB SPL. Preferences for pleasantness were approximately equal with CAMEQ2-HF gains and with gains slightly reduced at high frequencies and were lower when gains were slightly increased at high frequencies. Speech clarity was not affected by changing the gain at high frequencies. CONCLUSIONS: Effects of alignment delay were small except for the percussive sound. A wider bandwidth was slightly preferred for speech clarity. Speech clarity was slightly greater with slow compression, especially at high levels. Preferred high-frequency gains were close to or a little below those prescribed by CAMEQ2-HF.

The dynamic range of useful temporal fine structure cues for speech in the presence of a competing talker.

Within an auditory channel, the speech waveform contains both temporal envelope (E(O)) and temporal fine structure (TFS) information. Vocoder processing extracts a modified version of the temporal envelope (E') within each channel and uses it to modulate a channel carrier. The resulting signal, E'(Carr), has reduced information content compared to the original "E(O) + TFS" signal. The dynamic range over which listeners make additional use of E(O) + TFS over E'(Carr) cues was investigated in a competing-speech task. The target-and-background mixture was processed using a 30-channel vocoder. In each channel, E(O) + TFS replaced E'(Carr) at either the peaks or the valleys of the signal. The replacement decision was based on comparing the short-term channel level to a parametrically varied "switching threshold," expressed relative to the long-term channel level. Intelligibility was measured as a function of switching threshold, carrier type, target-to-background ratio, and replacement method. Scores showed a dependence on all four parameters. Derived intensity-importance functions (IIFs) showed that E(O) + TFS information from 8-13 dB below to 10 dB above the channel long-term level was important. When E(O) + TFS information was added at the peaks, IIFs peaked around -2 dB, but when E(O) + TFS information was added at the valleys, the peaks lay around +1 dB.

Sequential streaming due to manipulation of interaural time differences.

The effect of apparent spatial location on sequential streaming was investigated by manipulating interaural time differences (ITDs). The degree of obligatory stream segregation was inferred indirectly from the threshold for detecting a rhythmic irregularity in an otherwise isochronous sequence of interleaved "A" and "B" tones. Stimuli were bandpass-filtered harmonic complexes with a 100-Hz fundamental. The A and B tones had equal but opposite ITDs of 0, 0.25, 0.5, 1, or 2 ms and had the same or different passbands. The passband ranges were 1250-2500 Hz and 1768-3536 Hz in experiment 1, and 353-707 Hz and 500-1000 Hz in experiment 2. In both experiments, increases in ITD led to increases in threshold, mainly when the passbands of A and B were the same. The effects were largest for ITDs above 0.5 ms, for which rhythmic irregularities in the timing of the A or B tones alone may have disrupted performance. It is concluded that the differences in apparent spatial location produced by ITD have only weak effects on obligatory streaming.