Binaural Speech Intelligibility in a Real Elementary Classroom

Since the fundamental phases of the learning process take place in elementary classrooms, it is necessary to guarantee a proper acoustic environment for the listening activity to children immersed in them. In this framework, speech intelligibility is especially important. In order to better understand and objectively quantify the effect of background noise and reverberation on speech intelligibility various models have been developed. Here, a binaural speech intelligibility model (BSIM) is investigated for speech intelligibility predictions in a real classroom considering the effect of talker-to-listener distance and binaural unmasking due to the spatial separation of noise and speech source. BSIM predictions are compared to the well-established room acoustic measures as reverberation time (T30), clarity or definition. Objective acoustical measurements were carried out in one Italian primary school classroom before (T30= 1.43s±0.03 s) and after (T30= 0.45±0.02 s) the acoustical treatment. Speech reception thresholds (SRTs) corresponding to signal-to-noise ratio yielding 80% of speech intelligibility will be obtained through the BSIM simulations using the measured binaural room impulse responses (BRIRs). A focus on the effect of different speech and noise source spatial positions on the SRT values will aim to show the importance of a model able to deal with the binaural aspects of the auditory system. In particular, it will be observed how the position of the noise source influences speech intelligibility when the target speech source lies always in the same position.

Auditory Training for Spatial Hearing Loss: Two Case Reports of the Older Adults Who Wear Hearing Aids

The elderly with hearing loss have often experienced spatial hearing deficits when only wearing hearing aids. This case study aimed to investigate whether auditory training for spatial hearing loss could improve the spatial hearing ability of the elderly who wear hearing aids. Two older adults (males, aged 75 years and 78 years) who were wearing bilateral hearing aids participated. They had symmetric sensorineural hearing loss. A total of 16 auditory-training sessions (40 minutes, twice per week) for auditory training for spatial hearing ability provided. For outcome measurements, we assessed speech reception thresholds (SRTs) and spatial release from masking (SRM), using two types of noise, steady-state noise and speech-like noise at pre- and post-auditory training. Both subjects increased SRTs after the auditory training, but the SRM of only one participant improved. Also, there were no masking effects for SRM in terms of noise types. Both subjects reported that their trained hearing skills helped in communication with their families and friends. These results suggested that audiologists can consider auditory training for focusing on the spatial hearing loss for the elderly hearing aids users.

Optimization of the Speech Test Material in a Group of Hearing Impaired Subjects: A Feasibility Study for Multilingual Digit Triplet Test Development

Background: The development of the global digit-in-noise test requires optimization of each language version on a group of normal-hearing native-speakers. An alternative solution may be an adaptive optimization during ongoing tests in a group of subjects with unknown hearing impairments. The objective of the research was to compare the optimization results between these groups. Methods: Digit triplets consisting of three pseudo-randomly selected digits were presented in speech-shaped noise at various signal-to-noise ratios (SNRs), according to the protocol of the final speech test. Digit-specific and position-specific speech reception thresholds (SRTs) were determined and compared between groups. Results: The study sample consisted of 82 subjects, 26 normal-hearing subjects and 56 patients with diverse hearing disorders. Statistically significant differences in digit-specific SRTs between the control and the investigated group were obtained for three digits in continuous noise (digits 0, 4, 6; p-value of 0.04, 0.03, 0.05) and two in modulated noise (digits 1 and 6; p-value of 0.05 and 0.01). An analysis including only ears with SRTs within the range of the normal hearing control group showed no statistically significant differences between digits. Conclusion: Optimization of speech material can be carried out in a group of subjects with unknown hearing impairments, provided the ears with scores outside normal range are rejected.

Older Listeners' Perception of Speech With Strengthened and Weakened Dynamic Pitch Cues in Background Noise

Purpose Dynamic pitch, which is defined as the variation in fundamental frequency, is an acoustic cue that aids speech perception in noise. This study examined the effects of strengthened and weakened dynamic pitch cues on older listeners' speech perception in noise, as well as how these effects were modulated by individual factors including spectral perception ability. Method The experiment measured speech reception thresholds in noise in both younger listeners with normal hearing and older listeners whose hearing status ranged from near-normal hearing to mild-to-moderate sensorineural hearing loss. The pitch contours of the target speech were manipulated to create four levels of dynamic pitch strength: weakened, original, mildly strengthened, and strengthened. Listeners' spectral perception ability was measured using tests of spectral ripple and frequency modulation discrimination. Results Both younger and older listeners performed worse with manipulated dynamic pitch cues than with original dynamic pitch. The effects of dynamic pitch on older listeners' speech recognition were associated with their age but not with their perception of spectral information. Those older listeners who were relatively younger were more negatively affected by dynamic pitch manipulations. Conclusions The findings suggest the current pitch manipulation strategy is detrimental for older listeners to perceive speech in noise, as compared to original dynamic pitch. While the influence of age on the effects of dynamic pitch is likely due to age-related declines in pitch perception, the spectral measures used in this study were not strong predictors for dynamic pitch effects. Taken together, these results indicate next steps in this line of work should be focused on how to manipulate acoustic cues in speech in order to improve speech perception in noise for older listeners.

Binaural (pre)processing for contralateral sound field attenuation and improved speech-in-noise recognition

ABSTRACTUnderstanding speech presented in competition with other sound sources can be challenging. Here, we reason that this task can be facilitated by improving the signal-to-noise ratio (SNR) in either of the two ears and that in free-field listening scenarios, this can be achieved by attenuating contralateral sounds. We present a binaural (pre)processing algorithm that improves the SNR in the ear ipsilateral to the target sound source by linear subtraction of the weighted contralateral stimulus. Although the weight is regarded as a free parameter, we justify setting it equal to the ratio of ipsilateral to contralateral head-related transfer functions averaged over an appropriate azimuth range. The algorithm is implemented in the frequency domain and evaluated technically and experimentally for normal-hearing listeners in simulated free-field conditions. Results show that (1) it can substantially improve the SNR (up to 20 dB) and the short-term intelligibility metric in the ear ipsilateral to the target source, particularly for speech-like maskers; (2) it can improve speech reception thresholds for sentences in competition with speech-shaped noise by up to 8.5 dB in bilateral listening and 10.0 dB in unilateral listening; (3) it hardly affects sound-source localization; and (4) the improvements, and the algorithm’s directivity pattern depend on the weights. The algorithm accounts qualitatively for binaural unmasking for speech in competition with multiple maskers and for multiple target-masker spatial arrangements, an unexpected property that can inspire binaural intelligibility models.

Can Dual Compression Offer Better Mandarin Speech Intelligibility and Sound Quality Than Fast-Acting Compression?

The aim of this study was to evaluate the efficacy of dual compression for Mandarin-speaking hearing aid users. Dual compression combines fast and slow compressors operating simultaneously across all frequency channels. The study participants were 31 hearing aid users with symmetrical moderate-to-severe hearing loss, with a mean age of 67 years. A new pair of 20-channel behind-the-ear hearing aids (i.e., Phonak Bolero B90-P) was used during the testing. The results revealed a significant improvement in speech reception thresholds in noise when switching from fast-acting compression to dual compression. The sound quality ratings revealed that most listeners preferred dual compression to fast-acting compression for listening effort, listening comfort, speech clarity, and overall sound quality at +4 dB signal-to-noise ratio. These results are consistent with predictions based on the theoretical understanding of dual and fast-acting compression. However, whether these results can be generalized to other languages or other dual compression systems should be verified by future studies.

Independent and Combined Effects of Fundamental Frequency and Vocal Tract Length Differences for School-Age Children's Sentence Recognition in a Two-Talker Masker

Purpose The purpose of this study was to examine the independent and combined contributions of fundamental frequency (F0) and vocal tract length (VTL) differences on children's speech-in-speech recognition in the presence of a competing two-talker masker. Method Participants were 64 children (5–17 years old) and 25 adults (18–39 years old). Sentence recognition thresholds were measured in a two-talker masker. Target sentences had either the same mean F0 and VTL of the masker or were digitally altered so that the target and masker differed in F0 (Experiment 1), differed in VTL (Experiment 2), or differed in both F0 and VTL (Experiment 3). To determine the benefit, masking release was computed by subtracting thresholds in each shifted condition from the threshold in the unshifted condition. Results Results demonstrate that children's ability to benefit from either F0 or VTL differences (Experiments 1 and 2) depended on listener age, with younger children showing less improvement in speech reception thresholds compared to older children and adults. Age effects were also evident in the combined-cue conditions (Experiment 3), but children showed greater improvements compared to F0-only or VTL-only manipulations. Conclusions There was a prolonged pattern of development in children's ability to benefit from F0 or VTL differences between target and masker speech. Young children failed to capitalize on F0 and VTL differences to the same extent as older children and adults but did show a robust benefit when the cues were combined, supporting the hypothesis that younger children rely more heavily on redundant cues compared to older children and adults.

Immune-mediated ototoxicity associated with immune checkpoint inhibitors in patients with melanoma

Immune checkpoint inhibitors (ICIs) are associated with a range of organ-specific toxicities known as immune-related adverse events (irAEs). Immune-mediated ototoxicity from ICIs is poorly described. Herein, we describe the clinical presentation, diagnostic evaluation and management of six ICI-treated patients who developed immune-mediated ototoxicity, identified by a multidisciplinary immune-related toxicity team. This is the largest case series to date and identifies bilateral high-frequency hearing loss and tinnitus as the most common reported symptoms and can be associated with abnormal speech reception thresholds and word recognition ability on audiogram in select patients. We propose multidisciplinary evaluation of patients with suspected otologic irAEs including referral to otolaryngology, audiometry evaluation±magnetic resonance imaging for evaluation of suspected immune-mediated ototoxicity.