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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC011828-03
Application #
8662745
Study Section
Auditory System Study Section (AUD)
Program Officer
Miller, Roger
Project Start
2012-06-01
Project End
2017-05-31
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
3
Fiscal Year
2014
Total Cost
$283,500
Indirect Cost
$58,500
Name
Oregon Health and Science University
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Jakien, Kasey M; Gallun, Frederick J (2018) Normative Data for a Rapid, Automated Test of Spatial Release From Masking. Am J Audiol 27:529-538
Diedesch, Anna C; Gallun, Frederick J (2018) Letter to the Editor: Johnson, J. A., Xu, J., Cox, R. M. (2017). Impact of Hearing Aid Technology on Outcomes in Daily Life III: Localization, Ear Hear, 38, 746-759. Ear Hear 39:398-399
Jakien, Kasey M; Kampel, Sean D; Stansell, Meghan M et al. (2017) Validating a Rapid, Automated Test of Spatial Release From Masking. Am J Audiol 26:507-518
Jakien, Kasey M; Kampel, Sean D; Gordon, Samuel Y et al. (2017) The Benefits of Increased Sensation Level and Bandwidth for Spatial Release From Masking. Ear Hear 38:e13-e21
Ellinger, Rachel L; Jakien, Kasey M; Gallun, Frederick J (2017) The role of interaural differences on speech intelligibility in complex multi-talker environments. J Acoust Soc Am 141:EL170
Srinivasan, Nirmal Kumar; Stansell, Meghan; Gallun, Frederick J (2017) The role of early and late reflections on spatial release from masking: Effects of age and hearing loss. J Acoust Soc Am 141:EL185
Srinivasan, Nirmal Kumar; Tobey, Emily A; Loizou, Philipos C (2016) Prior exposure to a reverberant listening environment improves speech intelligibility in adult cochlear implant listeners. Cochlear Implants Int 17:98-104
Reinhart, Paul N; Souza, Pamela E; Srinivasan, Nirmal K et al. (2016) Effects of Reverberation and Compression on Consonant Identification in Individuals with Hearing Impairment. Ear Hear 37:144-52
Srinivasan, Nirmal Kumar; Jakien, Kasey M; Gallun, Frederick J (2016) Release from masking for small spatial separations: Effects of age and hearing loss. J Acoust Soc Am 140:EL73
Best, Virginia; Mason, Christine R; Swaminathan, Jayaganesh et al. (2016) On the Contribution of Target Audibility to Performance in Spatialized Speech Mixtures. Adv Exp Med Biol 894:83-91

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