The Contour Test of Loudness Perception

Cox, Robyn M.; Alexander, Genevieve C.; Taylor, Izel M.; Gray, Ginger A.

doi:10.1097/00003446-199710000-00004

Cited by 157 publications

(154 citation statements)

References 24 publications

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“…The highest tolerable level of broadband noise, the stimulus used during imaging, was determined for each subject as follows (Cox et al 1997). The noise was presented over headphones (TDH-39P) for ϳ1 s at a time at progressively higher levels beginning with 35 dB SPL.…”

Section: Measuring Loudness Discomfort Levelmentioning

confidence: 99%

Tinnitus, Diminished Sound-Level Tolerance, and Elevated Auditory Activity in Humans With Clinically Normal Hearing Sensitivity

Halpin

Nam

et al. 2010

Journal of Neurophysiology

273

247

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Gu JW, Halpin CF, Nam E-C, Levine RA, Melcher JR. Tinnitus, diminished sound-level tolerance, and elevated auditory activity in humans with clinically normal hearing sensitivity. J Neurophysiol 104: 3361-3370, 2010. First published September 29, 2010 doi:10.1152/jn.00226.2010. Phantom sensations and sensory hypersensitivity are disordered perceptions that characterize a variety of intractable conditions involving the somatosensory, visual, and auditory modalities. We report physiological correlates of two perceptual abnormalities in the auditory domain: tinnitus, the phantom perception of sound, and hyperacusis, a decreased tolerance of sound based on loudness. Here, subjects with and without tinnitus, all with clinically normal hearing thresholds, underwent 1) behavioral testing to assess sound-level tolerance and 2) functional MRI to measure soundevoked activation of central auditory centers. Despite receiving identical sound stimulation levels, subjects with diminished sound-level tolerance (i.e., hyperacusis) showed elevated activation in the auditory midbrain, thalamus, and primary auditory cortex compared with subjects with normal tolerance. Primary auditory cortex, but not subcortical centers, showed elevated activation specifically related to tinnitus. The results directly link hyperacusis and tinnitus to hyperactivity within the central auditory system. We hypothesize that the tinnitus-related elevations in cortical activation may reflect undue attention drawn to the auditory domain, an interpretation consistent with the lack of tinnitus-related effects subcortically where activation is less potently modulated by attentional state. The data strengthen, at a mechanistic level, analogies drawn previously between tinnitus/ hyperacusis and other, nonauditory disordered perceptions thought to arise from neural hyperactivity such as chronic neuropathic pain and photophobia.

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Section: Measuring Loudness Discomfort Levelmentioning

confidence: 99%

Tinnitus, Diminished Sound-Level Tolerance, and Elevated Auditory Activity in Humans With Clinically Normal Hearing Sensitivity

Halpin

Nam

et al. 2010

Journal of Neurophysiology

273

247

View full text Add to dashboard Cite

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“…The classification of hearing loss into mild, moderate, and severe/profound is determined by the 4FA HTL being less than or equal to 40 dB HL, between 40 and 60 dB HL, and greater than 60 dB HL, respectively. Cox, Alexander, Taylor, and Grey (1997) cite two studies reporting that female listeners with normal hearing rate a particular level significantly louder than normally hearing male listeners in loudness scaling tests using narrow-band stimuli (Kiessling, Steffens, & Wagner, 1993;Nielsen, 1995). In both studies the difference between loudness functions was about 6 dB.…”

Section: Gender Effectmentioning

confidence: 99%

NAL-NL2 Empirical Adjustments

Keidser

Dillon

Carter

et al. 2012

Trends in Amplification

101

102

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NAL-NL1, the first procedure from the National Acoustic Laboratories (NAL) for prescribing nonlinear gain, was a purely theoretically derived formula aimed at maximizing speech intelligibility for any input level of speech while keeping the overall loudness of speech at or below normal loudness. The formula was obtained through an optimization process in which speech intelligibility and loudness were predicted from selected models. Using updated models and applying some revisions to the derivation process, a theoretically derived NAL-NL2 formula was obtained in a similar way. Further adjustments, directed by empirical data collected in studies using NAL-NL1 as the baseline response, have been made to the theoretically derived formula. Specifically, empirical data have demonstrated that (a) female hearing aid users prefer lower overall gain than male users; (b) new hearing aid users with more than a mild hearing loss prefer increasingly less gain with increasing degree of hearing loss than experienced hearing aid users, and require up to 2 years to adapt to gain levels selected by experienced hearing aid users; (c) unilaterally and bilaterally fitted hearing aid users prefer overall gain levels that vary less than estimated by the bilateral correction factor; (d) adults prefer lower overall gain than children; and (e) people with severe/profound hearing loss prefer lower compression ratios than predicted when fitted with fast-acting compression. The literature and data leading to these conclusions are summarized and discussed in this article, and the procedure for implementing the adjustments to the theoretically derived NAL-NL2 formula is described.

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“…Separate target gain curves are provided for low ("soft"), conversational, and high ("loud") input levels, with decreasing target gain at higher input levels. As part of the IHAFF protocol, a standardized test of loudness perception called the Contour test (Cox et al, 1997) is administered to the patient. In this test, the listener rates the loudness of a series of pulsed tones presented at different levels.…”

Section: Prescriptive Procedures For Compression Amplificationmentioning

confidence: 99%

Effects of Compression on Speech Acoustics, Intelligibility, and Sound Quality

Souza

2002

Trends in Amplification

151

125

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time, use of compression hearing aids has increased dramatically, from half of hearing aids dispensed only 5 years ago to four out of five hearing aids dispensed today (Strom, 2002b). Most of today's digital and digitally programmable hearing aids are compression devices (Strom, 2002a). It is probable that within a few years, very few patients will be fit with linear hearing aids. Furthermore, compression has increased in complexity, with greater numbers of parameters under the clinician's control. Ideally, these changes will translate to greater flexibility and precision in fitting and selection. However, they also increase the need for information about the effects of compression amplification on speech perception and speech quality. As evidenced by the large number of sessions at professional conferences on fitting compression hearing aids, clinicians continue to have questions about compression technology and when and how it should be used. How does compression work? Who are the best candidates for this technology? How should adjustable parameters be set to provide optimal speech recognition? What effect will compression have on speech quality? These and other questions continue to drive our interest in this technology. This article reviews the effects of compression on the speech signal and the implications for speech intelligibility, quality, and design of clinical procedures.Categorizing Compression tensity vowels such as /i/, and from whispered speech to shouting, the benefit of a linear hearing With a linear hearing aid, a constant gain is ap-aid is restricted when the amplification needed to plied to all input levels until the hearing aid's sat-make low-intensity sounds audible amplifies uration limit is reached. Because daily speech in-high-intensity sounds to the point of discomfort. cludes such a wide range of intensity levels, from In other words, linear hearing aids have a limited low-intensity consonants such as /f/ to high-in-capacity to maximize audibility across a range of 131 From the

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The Contour Test of Loudness Perception

Cited by 157 publications

References 24 publications

Tinnitus, Diminished Sound-Level Tolerance, and Elevated Auditory Activity in Humans With Clinically Normal Hearing Sensitivity

Tinnitus, Diminished Sound-Level Tolerance, and Elevated Auditory Activity in Humans With Clinically Normal Hearing Sensitivity

NAL-NL2 Empirical Adjustments

Effects of Compression on Speech Acoustics, Intelligibility, and Sound Quality

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