Tobias Neher

Benefit from spatial separation of multiple talkers in bilateral hearing-aid users: Effects of hearing loss, age, and cognition

Abstract To study the spatial hearing abilities of bilateral hearing-aid users in multi-talker situations, 20 subjects received fittings configured to preserve acoustic cues salient for spatial hearing. Following acclimatization, speech reception thresholds (SRTs) were measured for three competing talkers that were either co-located or spatially separated along the front-back or left-right dimension. In addition, the subjects’ working memory and attentional abilities were measured. Left-right SRTs varied over more than 14 dB, while front-back SRTs varied over more than 8 dB. Furthermore, significant correlations were observed between left-right SRTs, age, and low-frequency hearing loss, and also between front-back SRTs, age, and high-frequency aided thresholds. Concerning cognitive effects, left-right performance was most strongly related to attentional abilities, while front-back performance showed a relation to working memory abilities. Altogether, these results suggest that, due to raised hearing thresholds and aging, hearing-aid users have reduced access to interaural and monaural spatial cues as well as a diminished ability to ‘enhance’ a target signal by means of top-down processing. These deficits, in turn, lead to impaired functioning in complex listening environments. Sumario Para estudiar las habilidades auditivas espaciales de usuarios de audífonos bilaterales en situaciones de hablantes múltiples, 20 sujetos recibieron auxiliares configurados para preservar las más destacadas claves acústicas de la audición espacial. Después de un período de adaptación, se midieron los umbrales de recepción del habla (SRTs) con tres hablantes en competencia que fueron colocados cerca o espacialmente separados en las dimensiones frente-atrás o izquierda-derecha. Además, se midieron las habilidades de memoria activa y atención. Los SRTs izquierda-derecha variaron más de 14 dB mientras que los SRTs frente-atrás, variaron más de 8 dB. Más aún, se observaron correlaciones significativas entre SRTs frente-atrás, edad y pérdida auditiva en las frecuencias graves y también entre SRTs frente-atrás, edad y umbrales con auxiliares auditivos en las frecuencias agudas. En relación con los efectos cognitivos, el rendimiento izquierda-derecha se relacionó más firmemente con habilidades de atención, mientras que el rendimiento frente-atrás, mostró relación con habilidades de memoria activa. En general, estos resultados sugieren que, debido a la elevación de los umbrales auditivos y el envejecimiento, los usuarios de auxiliares auditivos tienen un acceso reducido a las claves espaciales interaurales y monoaurales así como una habilidad disminuida para “mejorar” una señal blanco por medio del procesamiento arriba-abajo. Estos déficits, a su vez, conducen a un funcionamiento disminuido en ambientes de escucha complejos.

Do hearing loss and cognitive function modulate benefit from different binaural noise-reduction settings?

Objectives: Although previous research indicates that cognitive skills influence benefit from different types of hearing aid algorithms, comparatively little is known about the role of, and potential interaction with, hearing loss. This holds true especially for noise reduction (NR) processing. The purpose of the present study was thus to explore whether degree of hearing loss and cognitive function modulate benefit from different binaural NR settings based on measures of speech intelligibility, listening effort, and overall preference. Design: Forty elderly listeners with symmetrical sensorineural hearing losses in the mild to severe range participated. They were stratified into four age-matched groups (with n = 10 per group) based on their pure-tone average hearing losses and their performance on a visual measure of working memory (WM) capacity. The algorithm under consideration was a binaural coherence-based NR scheme that suppressed reverberant signal components as well as diffuse background noise at mid to high frequencies. The strength of the applied processing was varied from inactive to strong, and testing was carried out across a range of fixed signal-to-noise ratios (SNRs). Potential benefit was assessed using a dual-task paradigm combining speech recognition with a visual reaction time (VRT) task indexing listening effort. Pairwise preference judgments were also collected. All measurements were made using headphone simulations of a frontal speech target in a busy cafeteria. Test–retest data were gathered for all outcome measures. Results: Analysis of the test–retest data showed all data sets to be reliable. Analysis of the speech scores showed that, for all groups, speech recognition was unaffected by moderate NR processing, whereas strong NR processing reduced intelligibility by about 5%. Analysis of the VRT scores revealed a similar data pattern. That is, while moderate NR did not affect VRT performance, strong NR impaired the performance of all groups slightly. Analysis of the preference scores collapsed across SNR showed that all groups preferred some over no NR processing. Furthermore, the two groups with smaller WM capacity preferred strong over moderate NR processing; for the two groups with larger WM capacity, preference did not differ significantly between the moderate and strong settings. Conclusions: The present study demonstrates that, for the algorithm and the measures of speech recognition and listening effort used here, the effects of different NR settings interact with neither degree of hearing loss nor WM capacity. However, preferred NR strength was found to be associated with smaller WM capacity, suggesting that hearing aid users with poorer cognitive function may prefer greater noise attenuation even at the expense of poorer speech intelligibility. Further research is required to enable a more detailed (SNR-dependent) analysis of this effect and to test its wider applicability.

Working Memory and Hearing Aid Processing: Literature Findings, Future Directions, and Clinical Applications

Working memory—the ability to process and store information—has been identified as an important aspect of speech perception in difficult listening environments. Working memory can be envisioned as a limited-capacity system which is engaged when an input signal cannot be readily matched to a stored representation or template. This “mismatch” is expected to occur more frequently when the signal is degraded. Because working memory capacity varies among individuals, those with smaller capacity are expected to demonstrate poorer speech understanding when speech is degraded, such as in background noise. However, it is less clear whether (and how) working memory should influence practical decisions, such as hearing treatment. Here, we consider the relationship between working memory capacity and response to specific hearing aid processing strategies. Three types of signal processing are considered, each of which will alter the acoustic signal: fast-acting wide-dynamic range compression, which smooths the amplitude envelope of the input signal; digital noise reduction, which may inadvertently remove speech signal components as it suppresses noise; and frequency compression, which alters the relationship between spectral peaks. For fast-acting wide-dynamic range compression, a growing body of data suggests that individuals with smaller working memory capacity may be more susceptible to such signal alterations, and may receive greater amplification benefit with “low alteration” processing. While the evidence for a relationship between wide-dynamic range compression and working memory appears robust, the effects of working memory on perceptual response to other forms of hearing aid signal processing are less clear cut. We conclude our review with a discussion of the opportunities (and challenges) in translating information on individual working memory into clinical treatment, including clinically feasible measures of working memory.

Perceptual consequences of different signal changes due to binaural noise reduction: do hearing loss and working memory capacity play a role?

Objectives: In a previous study, Neher et al. (2013) investigated whether pure-tone average (PTA) hearing loss and working memory capacity (WMC) modulate benefit from different binaural noise reduction (NR) settings. Results showed that listeners with smaller WMC preferred strong over moderate NR even at the expense of poorer speech recognition due to greater speech distortion (SD), whereas listeners with larger WMC did not. To enable a better understanding of these findings, the main aims of the present study were (1) to explore the perceptual consequences of changes to the signal mixture, target speech, and background noise caused by binaural NR, and (2) to determine whether response to these changes varies with WMC and PTA. Design: As in the previous study, four age-matched groups of elderly listeners (with N = 10 per group) characterized by either mild or moderate PTAs and either better or worse performance on a visual measure of WMC participated. Five processing conditions were tested, which were based on the previously used (binaural coherence-based) NR scheme designed to attenuate diffuse signal components at mid to high frequencies. The five conditions differed in terms of the type of processing that was applied (no NR, strong NR, or strong NR with restoration of the long-term stimulus spectrum) and in terms of whether the target speech and background noise were processed in the same manner or whether one signal was left unprocessed while the other signal was processed with the gains computed for the signal mixture. Comparison across these conditions allowed assessing the effects of changes in high-frequency audibility (HFA), SD, and noise attenuation and distortion (NAD). Outcome measures included a dual-task paradigm combining speech recognition with a visual reaction time (VRT) task as well as ratings of perceived effort and overall preference. All measurements were carried out using headphone simulations of a frontal target speaker in a busy cafeteria. Results: Relative to no NR, strong NR was found to impair speech recognition and VRT performance slightly and to improve perceived effort and overall preference markedly. Relative to strong NR, strong NR with restoration of the long-term stimulus spectrum and thus HFA did not affect speech recognition, restored VRT performance to that achievable with no NR, and increased perceived effort and reduced overall preference markedly. SD had negative effects on speech recognition and perceived effort, particularly when both speech and noise were processed with the gains computed for the signal mixture. NAD had positive effects on speech recognition, perceived effort, and overall preference, particularly when the target speech was left unprocessed. VRT performance was unaffected by SD and NAD. None of the datasets exhibited any clear signs that response to the different signal changes varies with PTA or WMC. Conclusions: For the outcome measures and stimuli applied here, the present study provides little evidence that PTA or WMC affect response to changes in HFA, SD, and NAD caused by binaural NR. However, statistical power restrictions suggest further research is needed. This research should also investigate whether partial HFA restoration combined with some pre-processing that reduces co-modulation distortion results in a more favorable balance of the effects of binaural NR across outcome dimensions and whether NR strength has any influence on these results.

Relating hearing loss and executive functions to hearing aid users' preference for, and speech recognition with, different combinations of binaural noise reduction and microphone directionality

Knowledge of how executive functions relate to preferred hearing aid (HA) processing is sparse and seemingly inconsistent with related knowledge for speech recognition outcomes. This study thus aimed to find out if (1) performance on a measure of reading span (RS) is related to preferred binaural noise reduction (NR) strength, (2) similar relations exist for two different, non-verbal measures of executive function, (3) pure-tone average hearing loss (PTA), signal-to-noise ratio (SNR), and microphone directionality (DIR) also influence preferred NR strength, and (4) preference and speech recognition outcomes are similar. Sixty elderly HA users took part. Six HA conditions consisting of omnidirectional or cardioid microphones followed by inactive, moderate, or strong binaural NR as well as linear amplification were tested. Outcome was assessed at fixed SNRs using headphone simulations of a frontal target talker in a busy cafeteria. Analyses showed positive effects of active NR and DIR on preference, and negative and positive effects of, respectively, strong NR and DIR on speech recognition. Also, while moderate NR was the most preferred NR setting overall, preference for strong NR increased with SNR. No relation between RS and preference was found. However, larger PTA was related to weaker preference for inactive NR and stronger preference for strong NR for both microphone modes. Equivalent (but weaker) relations between worse performance on one non-verbal measure of executive function and the HA conditions without DIR were found. For speech recognition, there were relations between HA condition, PTA, and RS, but their pattern differed from that for preference. Altogether, these results indicate that, while moderate NR works well in general, a notable proportion of HA users prefer stronger NR. Furthermore, PTA and executive functions can account for some of the variability in preference for, and speech recognition with, different binaural NR and DIR settings.

Laboratory and Field Study of the Potential Benefits of Pinna Cue-Preserving Hearing Aids

The potential benefits of preserving high-frequency spectral cues created by the pinna in hearing-aid fittings were investigated in a combined laboratory and field test. In a single-blind crossover design, two settings of an experimental hearing aid were compared. One setting was characterized by a pinna cue-preserving microphone position, whereas the other was characterized by a microphone position not preserving pinna cues. Participants were allowed 1 month of acclimatization to each setting before measurements of localization and spatial release from speech-on-speech masking were completed in the laboratory. Real-world experience with the two settings was assessed by means of questionnaires. Seventeen participants with mild to moderate sensorineural hearing impairments completed the study. An inconsistent pinna cue benefit pattern was observed across the outcome measures. In the localization test, the pinna cue-preserving setting provided a significant mean reduction of 22° in the root mean square (RMS) error in the front–back dimension, with 13 of the 17 participants showing a reduction of at least 15°. No significant mean difference in RMS error between settings was observed in the left–right dimension. No significant differences between settings were observed in the spatial-unmasking test conditions. The questionnaire data indicated a small, but nonsignificant, benefit of the pinna cue-preserving setting in certain real-life situations, which corresponded with a general preference for that setting. No significant real-life localization benefit was observed. The results suggest that preserving pinna cues can offer benefit in some conditions for individual hearing-aid users with mild to moderate hearing loss and is unlikely to harm performances for the rest.

Speech reception with different bilateral directional processing schemes: Influence of binaural hearing, audiometric asymmetry, and acoustic scenario

ABSTRACT Hearing aid (HA) users can differ markedly in their benefit from directional processing (or beamforming) algorithms. The current study therefore investigated candidacy for different bilateral directional processing schemes. Groups of elderly listeners with symmetric (N = 20) or asymmetric (N = 19) hearing thresholds for frequencies below 2 kHz, a large spread in the binaural intelligibility level difference (BILD), and no difference in age, overall degree of hearing loss, or performance on a measure of selective attention took part. Aided speech reception was measured using virtual acoustics together with a simulation of a linked pair of completely occluding behind‐the‐ear HAs. Five processing schemes and three acoustic scenarios were used. The processing schemes differed in the tradeoff between signal‐to‐noise ratio (SNR) improvement and binaural cue preservation. The acoustic scenarios consisted of a frontal target talker presented against two speech maskers from ±60° azimuth or spatially diffuse cafeteria noise. For both groups, a significant interaction between BILD, processing scheme, and acoustic scenario was found. This interaction implied that, in situations with lateral speech maskers, HA users with BILDs larger than about 2 dB profited more from preserved low‐frequency binaural cues than from greater SNR improvement, whereas for smaller BILDs the opposite was true. Audiometric asymmetry reduced the influence of binaural hearing. In spatially diffuse noise, the maximal SNR improvement was generally beneficial. N0S&pgr; detection performance at 500 Hz predicted the benefit from low‐frequency binaural cues. Together, these findings provide a basis for adapting bilateral directional processing to individual and situational influences. Further research is needed to investigate their generalizability to more realistic HA conditions (e.g., with low‐frequency vent‐transmitted sound). HIGHLIGHTSBinaural hearing, audiometric asymmetry, and acoustic scenario influence speech reception with bilateral directional processing.For lateral speech maskers, binaural hearing modulates benefit from preserved low‐frequency binaural cues.For spatially diffuse noise, maximal signal‐to‐noise ratio improvement is beneficial.Audiometric asymmetry <2 kHz reduces the influence of binaural hearing.N0S&pgr; detection at 500 Hz predicts benefit from low‐frequency binaural cues.

A Danish open-set speech corpus for competing-speech studies

Studies investigating speech-on-speech masking effects commonly use closed-set speech materials such as the coordinate response measure [Bolia et al. (2000). J. Acoust. Soc. Am. 107, 1065-1066]. However, these studies typically result in very low (i.e., negative) speech recognition thresholds (SRTs) when the competing speech signals are spatially separated. To achieve higher SRTs that correspond more closely to natural communication situations, an open-set, low-context, multi-talker speech corpus was developed. Three sets of 268 unique Danish sentences were created, and each set was recorded with one of three professional female talkers. The intelligibility of each sentence in the presence of speech-shaped noise was measured. For each talker, 200 approximately equally intelligible sentences were then selected and systematically distributed into 10 test lists. Test list homogeneity was assessed in a setup with a frontal target sentence and two concurrent masker sentences at ±50° azimuth. For a group of 16 normal-hearing listeners and a group of 15 elderly (linearly aided) hearing-impaired listeners, overall SRTs of, respectively, +1.3 dB and +6.3 dB target-to-masker ratio were obtained. The new corpus was found to be very sensitive to inter-individual differences and produced consistent results across test lists. The corpus is publicly available.

Characterizing the binaural contribution to speech-in-noise reception in elderly hearing-impaired listeners

To scrutinize the binaural contribution to speech-in-noise reception, four groups of elderly participants with or without audiometric asymmetry <2 kHz and with or without near-normal binaural intelligibility level difference (BILD) completed tests of monaural and binaural phase sensitivity as well as cognitive function. Groups did not differ in age, overall degree of hearing loss, or cognitive function. Analyses revealed an influence of BILD status but not audiometric asymmetry on monaural phase sensitivity, strong correlations between monaural and binaural detection thresholds, and monaural and binaural but not cognitive BILD contributions. Furthermore, the N0Sπ threshold at 500 Hz predicted BILD performance effectively.

Are Experienced Hearing Aid Users Faster at Grasping the Meaning of a Sentence Than Inexperienced Users? An Eye-Tracking Study.

This study assessed the effects of hearing aid (HA) experience on how quickly a participant can grasp the meaning of an acoustic sentence-in-noise stimulus presented together with two similar pictures that either correctly (target) or incorrectly (competitor) depict the meaning conveyed by the sentence. Using an eye tracker, the time taken by the participant to start fixating the target (the processing time) was measured for two levels of linguistic complexity (low vs. high) and three HA conditions: clinical linear amplification (National Acoustic Laboratories-Revised), single-microphone noise reduction with National Acoustic Laboratories-Revised, and linear amplification ensuring a sensation level of ≥ 15 dB up to at least 4 kHz for the speech material used here. Timed button presses to the target stimuli after the end of the sentences (offline reaction times) were also collected. Groups of experienced (eHA) and inexperienced (iHA) HA users matched in terms of age, hearing loss, and working memory capacity took part (N = 15 each). For the offline reaction times, no effects were found. In contrast, processing times increased with linguistic complexity. Furthermore, for all HA conditions, processing times were longer (poorer) for the iHA group than for the eHA group, despite comparable speech recognition performance. Taken together, these results indicate that processing times are more sensitive to speech processing-related factors than offline reaction times. Furthermore, they support the idea that HA experience positively impacts the ability to process noisy speech quickly, irrespective of the precise gain characteristics.