Although new hearing aid technologies have somewhat reduced problems of music enjoyment experienced by hearing-impaired people, audiologists should be aware that some 25-30% of patients may have difficulties with listening to music and may require extra attention to minimize those problems.

This review paper provides evidence of the need to institute job-specific AFFD protocols, move beyond the pure-tone audiogram, and establish the validity of test protocols. These needs are arguably greater now than in times past.

In face-to-face speech communication, the listener extracts and integrates information from the acoustic and optic speech signals. Integration occurs within the auditory modality (i.e., across the acoustic frequency spectrum) and across sensory modalities (i.e., across the acoustic and optic signals). The difficulties experienced by some hearing-impaired listeners in understanding speech could be attributed to losses in the extraction of speech information, the integration of speech cues, or both. The present study evaluated the ability of normal-hearing and hearing-impaired listeners to integrate speech information within and across sensory modalities in order to determine the degree to which integration efficiency may be a factor in the performance of hearing-impaired listeners. Auditory-visual nonsense syllables consisting of eighteen medial consonants surrounded by the vowel [a] were processed into four nonoverlapping acoustic filter bands between 300 and 6000 Hz. A variety of one, two, three, and four filter-band combinations were presented for identification in auditory-only and auditory-visual conditions: A visual-only condition was also included. Integration efficiency was evaluated using a model of optimal integration. Results showed that normal-hearing and hearing-impaired listeners integrated information across the auditory and visual sensory modalities with a high degree of efficiency, independent of differences in auditory capabilities. However, across-frequency integration for auditory-only input was less efficient for hearing-impaired listeners. These individuals exhibited particular difficulty extracting information from the highest frequency band (4762-6000 Hz) when speech information was presented concurrently in the next lower-frequency band (1890-2381 Hz). Results suggest that integration of speech information within the auditory modality, but not across auditory and visual modalities, affects speech understanding in hearing-impaired listeners.

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People working in noisy environments often complain of difficulty communicating when they wear hearing protection. It was hypothesized that part of the workers' communication difficulties stem from changes in speech production that occur when hearing protectors are worn. To address this possibility, overall and one-third-octave-band SPL measurements were obtained for 16 men and 16 women as they produced connected speech while wearing foam, flange, or no earplugs (open ears) in quiet and in pink noise at 60, 70, 80, 90, and 100 dB SPL. The attenuation and the occlusion effect produced by the earplugs were measured. The Speech Intelligibility Index (SII) was also calculated for each condition. The talkers produced lower overall speech levels, speech-to-noise ratios, and SII values, and less high-frequency speech energy, when they wore earplugs compared with the open-ear condition. Small differences in the speech measures between the talkers wearing foam and flange earplugs were observed. Overall, the results of the study indicate that talkers wearing earplugs (and consequently their listeners) are at a disadvantage when communicating in noise.