The effect of hearing loss on source-distance dependent speech intelligibility in rooms

Assessing a Video-Based Intervention to Promote Parent Communication Strategies with a Deaf Infant: A Feasibility and Acceptability Study

Infant–parent interaction forms the foundation for language learning. For the majority of deaf infants, hearing loss can impact access to, and the quality of communicative interactions, placing language development at risk. Support for families to meet the challenges faced during interaction is highly variable in the United Kingdom. In a step towards more standardized but tailorable family support, we co-produced an instructional, video-based intervention, testing for feasibility in terms of behavior change in seven communicative strategies and acceptability with 9 parents, forming study 1. Parents increased their use of the majority of behaviors and found content and delivery acceptable. However, further development was required to: (a) support use of semantically contingent talk and attention getting strategies to elicit infant attention, and (b) ensure the information was provided in a bite-size format that could be tailored to individual families. In study 2, the intervention was refined based on findings from study 1 and assessed for acceptability with 9 parents and 17 professionals, who reported similar high acceptability scores. Final refinements and modifications could be addressed in future interventions. The current studies provide a positive early step towards a standardized intervention to support communication that could be used in routine practice.

Listening in 2020: A Survey of Adults' Experiences With Pandemic-Related Disruptions

PURPOSE

The COVID-19 pandemic has introduced lifestyle changes that may negatively impact communication, including the pervasive use of face masks and videoconferencing technology. Here, we examine the effects of age and self-rated hearing on subjective measures of speech understanding via a survey accessed by adults residing in the United States.

METHOD

Responses to an online survey were obtained from adults (21 years of age and older) during the summer and fall of 2020. The survey included questions about hearing and speech understanding in a variety of scenarios and different listening conditions, including when communicating with people using face masks in quiet and noisy environments and when using videoconferencing.

RESULTS

Data from 1,703 surveys were analyzed. In general, the use of face masks led to the perception of poorer speech understanding and greater need for concentration, especially in noisy environments. When responses from all participants were considered, poorer self-rated communication ability was noted as age increased. However, among people who categorized their overall hearing as "Excellent" or "Good," younger adults rated their speech understanding ability in noisy situations as poorer than middle-age or older adults. Among people who rated their overall hearing as "Fair" or "Poor," middle-age adults indicated having more difficulty communicating with people using face masks, as compared with older adults. Examination of open-ended responses suggested that the strategies individuals use when communicating with people wearing face masks vary by age and self-rated hearing. Notably, middle-age and older adults were more likely to report using strategies that could put them at risk (e.g., asking others to remove their face masks).

CONCLUSIONS

Even younger adults with self-perceived good hearing are not immune to communication challenges brought about by face masks. Among individuals with similar degrees of self-rated hearing, the expected increase in communication difficulty with age was not noted among our respondents.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.16528431.

Changes in Orientation Behavior due to Extended High-Frequency (5 to 10 kHz) Spatial Cues

OBJECTIVES

Current hearing aids have a limited bandwidth, which limits the intelligibility and quality of their output, and inhibits their uptake. Recent advances in signal processing, as well as novel methods of transduction, allow for a greater useable frequency range. Previous studies have shown a benefit for this extended bandwidth in consonant recognition, talker-sex identification, and separating sound sources. To explore whether there would be any direct spatial benefits to extending bandwidth, we used a dynamic localization method in a realistic situation.

DESIGN

Twenty-eight adult participants with minimal hearing loss reoriented themselves as quickly and accurately as comfortable to a new, off-axis near-field talker continuing a story in a background of far-field talkers of the same overall level in a simulated large room with common building materials. All stimuli were low-pass filtered at either 5 or 10 kHz on each trial. To further simulate current hearing aids, participants wore microphones above the pinnae and insert earphones adjusted to provide a linear, zero-gain response.

RESULTS

Each individual trajectory was recorded with infra-red motion-tracking and analyzed for accuracy, duration, start time, peak velocity, peak velocity time, complexity, reversals, and misorientations. Results across listeners showed a significant increase in peak velocity and significant decrease in start and peak velocity time with greater (10 kHz) bandwidth.

CONCLUSIONS

These earlier, swifter orientations demonstrate spatial benefits beyond static localization accuracy in plausible conditions; extended bandwidth without pinna cues provided more salient cues in a realistic mixture of talkers.

Relational Factors in Pragmatic Skill Development: Deaf and Hard of Hearing Infants and Toddlers

In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one's own or others' thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children's development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children's pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.

Binaural speech transmission index with spatialized virtual speaker in near field: Distance and direction dependence

As well as background noise and reverberation, speaker-to-listener relative location affects the binaural speech transmission index (BSTI) considerably, especially in the near field. To highlight how speaker location influences the BSTI, binaural room impulse responses measured in a low-reverberation listening room are used to obtain the BSTI indirectly and analyze its near-field dependence on distance and direction. The results show that the BSTI based on the better-ear rule is higher when the virtual speaker is located laterally rather than in the anterior or posterior. When the distance-dependent intensity factor is introduced, the distance is the dominant factor, not the azimuth.

Listening through hearing aids affects spatial perception and speech intelligibility in normal-hearing listeners

Cubick and Dau [(2016). Acta Acust. Acust. 102, 547-557] showed that speech reception thresholds (SRTs) in noise, obtained with normal-hearing listeners, were significantly higher with hearing aids (HAs) than without. Some listeners reported a change in their spatial perception of the stimuli due to the HA processing, with auditory images often being broader and closer to the head or even internalized. The current study investigated whether worse speech intelligibility with HAs might be explained by distorted spatial perception and the resulting reduced ability to spatially segregate the target speech from the interferers. SRTs were measured in normal-hearing listeners with or without HAs in the presence of three interfering talkers or speech-shaped noises. Furthermore, listeners were asked to sketch their spatial perception of the acoustic scene. Consistent with the previous study, SRTs increased with HAs. Spatial release from masking was lower with HAs than without. The effects were similar for noise and speech maskers and appeared to be accounted for by changes to energetic masking. This interpretation was supported by results from a binaural speech intelligibility model. Even though the sketches indicated a change of spatial perception with HAs, no direct link between spatial perception and segregation of talkers could be shown.

The effect of nearby maskers on speech intelligibility in reverberant, multi-talker environments

The extent to which informational masking (IM) is involved in real-world listening is not well understood. In the literature, IM effects of more than 8 dB are reported, but these experiments typically used simplified spatial configurations and speech materials with exaggerated confusions. Westermann and Buchholz [(2015b). J. Acoust. Soc. Am. 138, 584-593] considered a simulated cafeteria and found only substantial IM effects when the target and maskers were colocated and the same talker. The present study further investigates the relevance of IM in real-world environments, specifically distractions by nearby maskers and the effect of hearing impairment. Speech reception thresholds (SRTs) were measured with normal hearing (NH) and sensorineural hearing impaired (HI) listeners in a simulated cafeteria environment. Three different masker configurations were considered: (1) seven dialogues distributed in the cafeteria, (2) two monologues presented close to the listener with varying angular separation, and (3) a combination of (1) and (2). The contribution of IM was measured as the difference in SRTs between speech maskers and unintelligible vocoded maskers. No significant IM was found with the seven dialogues alone. Including nearby maskers resulted in substantial IM for both NH and HI listeners, suggesting that such maskers might result in IM in real-world environments.