Speech Perception in Noise and Listening Effort of Older Adults With Nonlinear Frequency Compression Hearing Aids.
Speech Perception in Noise and Listening Effort of Older Adults With Nonlinear Frequency Compression Hearing Aids.
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使用非线性频率压缩助听器的老年人对噪声的言语感知和听力努力。
DOI：
10.1097/aud.0000000000000481
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Muller,Thomas
中科院分区：
文献类型：
--
作者：
Shehorn,James;Marrone,Nicole;Muller,Thomas
目的：这项以实验室为基础的研究的目的是比较两种助听器配件在有和没有非线性频率压缩的情况下的效果，这两种配件是在商用助听器中实施的。以前关于非线性频率压缩的效用的研究已经揭示了语音识别的相互矛盾的结果，其标志是高度的个体变异性。听觉功能和认知能力的个体差异，特别是听力损失斜率和工作记忆，可能有助于辅助表现。这项研究的第一个目的是使用双重任务测试范式来确定非线性频率压缩对噪声和听力努力中的辅助语音识别的影响。基于语言理解简易度模型的假设是，非线性频率压缩可以改善噪声中的语音识别，降低听力努力。研究的第二个目的是确定听力损失斜率、工作记忆容量和年龄等听者变量是否可以预测在非线性频率压缩下的表现。设计：使用助听器Fit to Target(NAL-NL2)在声场中对17名对称性感音神经性听力损失的成年人(年龄57-85岁)进行测试。参与者被招募到一系列听力损失严重程度和斜率的情况下。受试者内部的单盲设计被用来比较在有和没有非线性频率压缩的情况下的性能。噪声中的语音识别和听力努力是通过将修订的噪声中的语音修改为双重任务范式来测量的。参与者被要求逐一复述演讲中出现的每个句子的最后一个单词，然后在每六个句子块之后回忆结束句子的单词。一半的句子具有丰富的语境以识别每个句子的最后一个词，另一半的句子在语境中是中性的。实验采用了句子语境和非线性频率压缩的外在因素，并测量了听力损失斜率、工作记忆容量和年龄等内在因素，以确定哪些参与因素与非线性频率压缩的益处有关。结果：平均而言，使用非线性频率压缩可以显著提高噪声环境下的语音识别成绩。陡坡听力损失的人获得了更多的认可好处。回想成绩在群体层面也有显著改善，非线性频率压缩显示听力努力减少。研究队列中年龄较大的参与者比年轻参与者获得的回忆益处较少。非线性频率压缩对语音识别和听力工作的好处并不相互关联，这表明这些结果测量的益处来源是分开的。结论：噪声中语音识别的改善和听力工作量的减少表明，成人助听器用户可以在噪声环境中从非线性频率压缩中获得好处，受益程度因个体和结果测量而异。有证据支持对非线性频率压缩的个性化选择，结果表明，对于听力急剧下降的人来说，语音识别有益于他们，而对于年轻人来说，他们的听力努力也更好。未来的研究表明，关于双重任务范式的更大数据集是一种潜在的认知结果衡量标准。
Objectives:The purpose of this laboratory-based study was to compare the efficacy of two hearing aid fittings with and without nonlinear frequency compression, implemented within commercially available hearing aids. Previous research regarding the utility of nonlinear frequency compression has revealed conflicting results for speech recognition, marked by high individual variability. Individual differences in auditory function and cognitive abilities, specifically hearing loss slope and working memory, may contribute to aided performance. The first aim of the study was to determine the effect of nonlinear frequency compression on aided speech recognition in noise and listening effort using a dual-task test paradigm. The hypothesis, based on the Ease of Language Understanding model, was that nonlinear frequency compression would improve speech recognition in noise and decrease listening effort. The second aim of the study was to determine if listener variables of hearing loss slope, working memory capacity, and age would predict performance with nonlinear frequency compression.Design:A total of 17 adults (age, 57–85 years) with symmetrical sensorineural hearing loss were tested in the sound field using hearing aids fit to target (NAL-NL2). Participants were recruited with a range of hearing loss severities and slopes. A within-subjects, single-blinded design was used to compare performance with and without nonlinear frequency compression. Speech recognition in noise and listening effort were measured by adapting the Revised Speech in Noise Test into a dual-task paradigm. Participants were required trial-by-trial to repeat the last word of each sentence presented in speech babble and then recall the sentence-ending words after every block of six sentences. Half of the sentences were rich in context for the recognition of the final word of each sentence, and half were neutral in context. Extrinsic factors of sentence context and nonlinear frequency compression were manipulated, and intrinsic factors of hearing loss slope, working memory capacity, and age were measured to determine which participant factors were associated with benefit from nonlinear frequency compression.Results:On average, speech recognition in noise performance significantly improved with the use of nonlinear frequency compression. Individuals with steeply sloping hearing loss received more recognition benefit. Recall performance also significantly improved at the group level, with nonlinear frequency compression revealing reduced listening effort. The older participants within the study cohort received less recall benefit than the younger participants. The benefits of nonlinear frequency compression for speech recognition and listening effort did not correlate with each other, suggesting separable sources of benefit for these outcome measures.Conclusions:Improvements of speech recognition in noise and reduced listening effort indicate that adult hearing aid users can receive benefit from nonlinear frequency compression in a noisy environment, with the amount of benefit varying across individuals and across outcome measures. Evidence supports individualized selection of nonlinear frequency compression, with results suggesting benefits in speech recognition for individuals with steeply sloping hearing losses and in listening effort for younger individuals. Future research is indicated with a larger data set on the dual-task paradigm as a potential cognitive outcome measure.
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