Informational masking in young and elderly listeners for speech masked by simultaneous speech and noise.

Three experiments measured the effects of age on informational masking of speech by competing speech. The experiments were designed to minimize the energetic contributions of the competing speech so that informational masking could be measured with no large corrections for energetic masking. Experiment 1 used a "speech-in-speech-in-noise" design, in which the competing speech was presented in noise at a signal-to-noise ratio (SNR) of -4 dB.

The effects of cueing temporal and spatial attention on word recognition in a complex listening task in hearing-impaired listeners.

In a complex listening situation such as a multiperson conversation, the demands on an individual's attention are considerable: There will often be many sounds occurring simultaneously, with continual changes in source and direction. A laboratory analog of this was designed to measure the benefit that helping attention (by visual cueing) would have on word identification. These words were presented unpredictably but were sometimes cued with a temporal cue or a temporal-and-spatial cue.

The design of a project to assess bilateral versus unilateral hearing aid fitting.

Binaural hearing provides advantages over monaural in several ways, particularly in difficult listening situations. For a person with bilateral hearing loss, the bilateral fitting of hearing aids thus seems like a natural choice. However, surprisingly few studies have been reported in which the additional benefit of bilateral versus unilateral hearing aid use has been investigated based on real-life experiences.

Discrimination of release time constants in hearing-aid compressors.

We examined the ability of twenty-five hearing-impaired and eight normal-hearing listeners to discriminate between release time constants used for compression in hearing aids. The compressor was a standard three-channel system. The stimuli were normal and 'vocoded' sentences from a male and female database.

Spatial hearing disability after acoustic neuroma removal.

Objectives/hypothesis: Previous studies on hearing loss (HL) after acoustic neuroma removal concentrate mainly on pure-tone hearing results rather than hearing disability. Our objectives were to use the Speech, Spatial and Qualities of Hearing scale (SSQ), a comprehensively validated questionnaire, to characterize and quantify the auditory disabilities that patients experience with a profound unilateral HL after acoustic neuroma removal.

Study Design: Forty-four patients with profound unilateral HL after acoustic neuroma surgery completed the SSQ.

The detection of differences in the cues to distance by elderly hearing-impaired listeners.

This experiment measured the capability of hearing-impaired individuals to discriminate differences in the cues to the distance of spoken sentences. The stimuli were generated synthetically, using a room-image procedure to calculate the direct sound and first 74 reflections for a source placed in a 7 x 9 m room, and then presenting each of those sounds individually through a circular array of 24 loudspeakers. Seventy-seven listeners participated, aged 22-83 years and with hearing levels from -5 to 59 dB HL.

The binaural performance of a cross-talk cancellation system with matched or mismatched setup and playback acoustics.

Cross-talk cancellation is a method for synthesizing virtual auditory space using loudspeakers. One implementation is the "Optimal Source Distribution" technique [T. Takeuchi and P.

Two-eared listening in dynamic situations.

Reports of hearing disabilities, particularly those acoustically and perceptually dynamic circumstances, are associated with compromised binaural capacities. Those disabilities that are compromised largely correspond to the areas where benefits of bilateral fitting over unilateral fitting emerge. The singular exception is for disabilities in "Sound quality and naturalness".

Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing Scale (SSQ).

The Speech, Spatial and Qualities of Hearing Scale (Gatehouse & Noble, 2004) was applied to three independent clinical groups: 144 people prior to being fitted with amplification; 118 people with six months experience with unilateral amplification; and 42 people with six months experience with bilateral amplification. For traditional speech hearing contexts (one-on-one, in groups, in quiet, in noise) there was benefit with one aid, and no further benefit with two. By contrast, hearing speech in demanding contexts (divided or rapidly switching attention) showed benefit with one aid and further benefit with two.

Linear and nonlinear hearing aid fittings--2. Patterns of candidature.

We studied candidature for linear, slow-acting AVC hearing aids, and fast-acting WDRC hearing aids in a within-subject within-device crossover design of 50 listeners with SNHL. Candidature dimensions include HTLs, ULLs, spectro-temporal and masking abnormalities, cognitive capacity, and self-reports and acoustic measures of auditory ecology. Better performance with linear fittings is associated with flatter audiograms, wider dynamic range, and smaller differences in dynamic range between low and high frequencies, and also with more restricted auditory lifestyles.

Linear and nonlinear hearing aid fittings--1. Patterns of benefit.

We evaluated the benefits of fast-acting WDRC, slow-acting AVC, and linear reference fittings for speech intelligibility and reported disability, in a within-subject within-device masked crossover design on 50 listeners with SNHL. Five hearing aid fittings were implemented having two compression channels and seven frequency bands. Each listener sequentially experienced each fitting for a 10-week period.

Does patient-perceived handicap correspond to the modified clinical test for the sensory interaction on balance?

Objective: To determine whether patient self-reported handicap correlates with scores obtained from the modified Clinical Test for the Sensory Interaction on Balance as assessed by the Neurocom VSR Balance Master platform.

Study Design: Prospective observational.

Setting: Balance clinic in tertiary referral center.

Localization and speech-identification ability of hearing-impaired listeners using phase-preserving amplification.

Objective: The purpose of these experiments was to determine the ability of hearing-impaired listeners to localize and to identify speech in noise using phase-preserving and non-phase-preserving amplification.

Design: These abilities were measured 4 times over each of two 16-week periods, using a randomized, single-blinded, within-subject crossover design. Listeners were fitted bilaterally, using the National Acoustic Laboratories linear frequency-gain characteristic with a digital hearing aid programmed in one of two ways: (1) with a linear-phase filter and (2) with filters designed to compensate for the magnitude and phase anomalies caused by the hearing aid fitting, thus preserving interaural phase.

Measuring quality of life in preschool children with sore throats and otitis media using the TAPQOL questionnaire.

Objectives: TNO-AZL Preschool Quality of Life Questionnaire (TAPQOL) is one of the few instruments designed to assess health-related quality of life in preschool children but its applicability to otolaryngology is unknown.

Study Design And Setting: We studied a consecutive series of children aged 1 to 5 years referred to hospital with recurrent sore throats, recurrent acute otitis media, or otitis media with effusion.

Results: TAPQOL domain scores were not influenced by age, sex, or socio-economic class, but correlated with markers of disease severity (frequency of sore throat or pyrexia, time off school), ear-related handicap (assessed with the OM6 questionnaire), and other measures of health-related quality of life (visual analogue scale, 5-point rating scale and the Health Utilities Index mark III).

The Glasgow Children's Benefit Inventory: a new instrument for assessing health-related benefit after an intervention.

Most health-related quality-of-life measures make an assessment at a single point in time. Comparing results before and after an intervention is often difficult, because the difference measured is usually small compared with the variation between individuals. A retrospectively applied measure specifically worded to assess benefit would be very useful for clinical research.

How appropriate is the OM6 as a discriminative instrument in children with otitis media?

Background: The OM6 is a 6-item condition-specific handicap measure developed in the United States for children with recurrent acute otitis media and otitis media with effusion. Easy and quick to use, it has high test-retest repeatability and is sensitive to change after ventilation tube insertion.

Objectives: To explore aspects of the validity of OM6 in a United Kingdom population and to specifically address the instrument's ability to discriminate between children with different burdens of disease.

Interaural asymmetry of hearing loss, Speech, Spatial and Qualities of Hearing Scale (SSQ) disabilities, and handicap.

A series of comparative analyses is presented between a group with relatively similar degrees of hearing loss in each ear (n = 103: symmetry group) and one with dissimilar losses (n = 50: asymmetry group). Asymmetry was defined as an interaural difference of more than 10dB in hearing levels averaged over 0.5.

The Speech, Spatial and Qualities of Hearing Scale (SSQ).

The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world.

Perceptual segregation of competing speech sounds: the role of spatial location.

Culling and Summerfield [J. Acoust Soc. Am.

Rehabilitation: identification of needs, priorities and expectations, and the evaluation of benefit.

Audiology services evolved from technical disciplines with emphasis on assessment of hearing impairments rather than the experiences of disabilities and handicaps. This article argues for a comprehensive, though structured, framework for the assessment of listening needs (disabilities) which, via sets of personal and societal contexts, lead to handicaps. Rehabilitative and instrumental interventions should be selected on the basis of disabilities and handicaps as modulated by individuals' expectations and attitudes, and configured as part of an overall management plan aimed at alleviating the consequences of impaired hearing.

Benefits from hearing aids in relation to the interaction between the user and the environment.

It is becoming increasingly recognized that, in addition to the influence of audiometric variables and associated psychoacoustic abilities, the benefits from and candidature for various signal-processing schemes in hearing aids are strongly influenced by listeners' characteristics (such as motivations, expectations, and personality), and also the auditory environments in which those listeners are required to function (i.e. their auditory ecology).

Electronic aids to hearing.

Despite many scientific developments in the biology of hearing, there remain no wide-spread medical or surgical interventions for listeners with sensorineural hearing impairments. In addition to describing technical advances, this chapter identifies important aspects of candidature for hearing aids and some issues of service delivery.