Abstract-We assessed the effects of perceptual training of syllable identification in noise on nonsense syllable test (NST) performance of new (Experiment 1) and experienced (Experiment 2) hearing aid (HA) users with sensorineural hearing loss. In Experiment 1, new HA users were randomly assigned to either immediate training (IT) or delayed training (DT) groups. IT subjects underwent 8 weeks of at-home syllable identification training and in-laboratory testing, whereas DT subjects underwent identical in-laboratory testing without training. Training produced large improvements in syllable identification in IT subjects, whereas spontaneous improvement was minimal in DT subjects. DT subjects then underwent training and showed performance improvements comparable with those of the IT group. Training-related improvement in NST scores significantly exceeded improvements due to amplification. In Experiment 2, experienced HA users received identical training and testing procedures as users in Experiment 1. The experienced users also showed significant training benefit. Trainingrelated improvements generalized to untrained voices and were maintained on retention tests. Perceptual training appears to be a promising tool for improving speech perception in new and experienced HA users.
The purpose of this study was to reexamine the Margolis and Heller (1987) normative tympanometric data (also American Speech-Language-Hearing [ASHA], 1990 interim norms) using a strict control over subject age and gender. Normative values for peak, compensated static acoustic admittance (Peak Ytm), acoustic equivalent volume (Vea), and tympanometric width (TW) were determined for 102 young adults with normal hearing. Relative to the Margolis and Heller normative values, significant differences were found for Vea and TW. Although statistically significant, these differences were small and of little clinical importance. However, significant and clinically important gender differences in young adults were observed for each of the tympanometric measures. Compared to males, females had lower Peak Ytm values, smaller Vea values, and higher TW values.
Dichotic word recognition was evaluated in free-recall, directed-attention right, and directed-attention left response conditions. All participants were right-handed and included a group of young adults with normal hearing and two groups of older adults with sensorineural hearing loss. Dichotic word recognition performance was best for young adults and decreased for each older group. A right-ear advantage (REA) was observed for all groups. REAs observed in the older groups were larger than those for the young adults, resulting from a greater deficit in dichotic word recognition performance for words presented to the left ear. A subset of older adults exhibited few to no responses (< or = 3/100) for the left ear for all response conditions, which may relate to a compromise in auditory processing. The results support an age-related disadvantage in recognition performance for dichotic stimuli presented to the left ear not entirely accounted for by differences in hearing sensitivity between subject groups.
Objectives/Hypothesis: Cochlear implants (CIs) restore auditory sensation to patients with moderate-to-profound sensorineural hearing loss. However, the benefits to speech recognition vary considerably among patients. Advancing age contributes to this variability in postlingual adult CI users. Similarly, older individuals with normal hearing (NH) perform more poorly on tasks of recognition of spectrally degraded speech. The overarching hypothesis of this study was that the detrimental effects of advancing age on speech recognition can be attributed both to declines in auditory spectral resolution as well as declines in cognitive functions. Study Design: Case-control study. Methods: Speech recognition was assessed in CI users (in the clear) and NH controls (spectrally degraded using noise-vocoding), along with auditory spectral resolution using the Spectral–Temporally Modulated Ripple Test. Cognitive skills were assessed using nonauditory visual measures of working memory, inhibitory control, speed of lexical/phonological access, nonverbal reasoning, and perceptual closure. Linear regression models were tested for mediation to explain aging effects on speech recognition performance. Results: For both groups, older age predicted poorer sentence and word recognition. The detrimental effects of advancing age on speech recognition were partially mediated by declines in spectral resolution and in some measures of cognitive function. Conclusions: Advancing age contributes to poorer recognition of degraded speech for CI users and NH controls through declines in both auditory spectral resolution and cognitive functions. Findings suggest that improvements in spectral resolution as well as cognitive improvements may serve as therapeutic targets to optimize CI speech recognition outcomes.
The results from the present study suggest that adults who present with complaints of HD even in the presence of normal hearing sensitivity represent a unique population that warrants further evaluation beyond the standard hearing test. Furthermore, results from the hearing aid trial suggest that mild-gain amplification is a viable treatment option for at least some individuals with HD.
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