Predicting the benefits of spatial and spectrotemporal cues

描述（由申请人提供）：在3600万听力受损的美国人中，2100万人年龄超过45岁，65岁以上的人中有35-40%是听力受损的。随着人口老龄化，美国老年人和听力受损的人数只会增加。尽管对噪声中的言语理解进行了数十年的研究，但与年轻人相比，老年听力受损的听者在多人环境中的困难增加并没有理论上的解释。我们知识上的这一根本性差距使我们无法在临床上解决在餐馆、工作场所和许多零售环境等社交环境中无法沟通的破坏性影响。这些影响包括增加残疾和社会退缩的自我感觉。这项研究计划将寻求确定是否可以通过测量对空间，频谱，广告时间信息的敏感性来预测在多人情况下的言语感知能力。这项研究的临床意义直接关系到 尽管有证据表明双耳听力、对时间信息的敏感性和对时间信息的敏感性， 在听力受损的听众中，频谱信息受损，并且已经为临床开发了旨在对这些能力敏感的测试，但是很少有临床听力学家常规地测试这些能力作为其听力测定检查的一部分。如果可以证明这些临床测试的哪个子集是多人背景下语音识别的准确预测因子，则所获得的知识将允许临床医生更准确地预测特定听力设备在各种环境中对特定用户的预期临床益处。这将允许临床医生选择和适应 助听器更成功，更有效地咨询患者在各种环境中应该期望的益处。通过将这些信息提供给助听器技术和康复训练计划的开发人员，他们可以开发特定的设备和技术来解决最常见的缺陷，从而获得类似的患者护理益处。 公共卫生相关性：拟议的研究将测试个体对空间，频谱和/或时间信息的敏感性是否可以预测复杂环境中的语音理解。基于一组快速可靠的测量方法，准确预测多人背景下的语音识别，将允许临床医生设计康复计划，目标不仅仅是恢复听力，这是目前与一组简单的测试相关的唯一目标：听力图。更准确地了解对各种线索的敏感性与预期受益之间的关系，将使临床医生能够更成功地选择和安装助听器，以更有针对性的方式进行康复听觉训练，并更有效地为患者提供他们应该期望的受益。

DESCRIPTION (provided by applicant): Of the 36 million hearing-impaired Americans, 21 million are over 45 years of age, and 35-40% of persons over 65 years of age are hearing-impaired. As the population ages, the number of Americans who are both older and hearing-impaired will only increase. Despite decades of research on speech understanding in noise, there is no theoretical explanation for the increased difficulties older hearing- impaired listener have in multitalker environments as compared to their younger counterparts. This fundamental gap in our knowledge makes it impossible to address clinically the devastating effects of an inability to communicate in social environments such as restaurants, the workplace, and many retail environments. These effects include increased self-perception of handicap and social withdrawal. This research program will seek to determine whether or not speech perception ability in multitalker situations can be predicted by measuring sensitivity to spatial, spectral, ad temporal information. The clinical significance of the research proposed is related directly to the ability to predict how successful an individual listener will be in a given multitalker environment Despite the evidence that binaural hearing, sensitivity to temporal information, and sensitivity to spectral information are impaired in listeners with hearing impairment, and the fact that tests have been developed for the clinic that are intended to be sensitive to these abilities, there are very few clinical audiologists who routinely test these abilities as part of their audiometric examination. If it can be demonstrated which subset of these clinical tests are accurate predictors of speech recognition in a multitalker background, the knowledge gained will allow the clinician to more accurately predict the expected clinical benefit of a particular hearing device for a specific user in various environments. This will allow the clinician to choose and fit hearing aids more successfully and to counsel patients more effectively in terms of the benefit they should expect in various environments. Similar benefits to patient care will be obtained by providing this information to the developers of hearing aid technology and rehabilitative training programs, who could then develop specific devices and techniques to address those deficits that occur most often. PUBLIC HEALTH RELEVANCE: The proposed research will test whether or not individual sensitivity to spatial, spectral, and/or temporal information can predict speech understanding in complex environments. Accurately predicting speech recognition in a multitalker background on the basis of a set of rapid and reliable measures would allow the clinician to design rehabilitatio programs targeting more than simply restoring audibility, which is the only goal currently associated with a simple set of tests: the audiogram. Knowing more precisely the relationship between sensitivity to various cues and predicted benefit would allow the clinician to choose and fit hearing aids more successfully, prescribe rehabilitative auditory training in a more targeted manner, and to counsel patients more effectively in terms of the benefit they should expect.