Mathai Jijo Pottackal, Appu Sabarish
All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.
J Am Acad Audiol. 2015 Nov-Dec;26(10):815-23. doi: 10.3766/jaaa.14102.
Auditory neuropathy spectrum disorder (ANSD) is a form of sensorineural hearing loss, causing severe deficits in speech perception. The perceptual problems of individuals with ANSD were attributed to their temporal processing impairment rather than to reduced audibility. This rendered their rehabilitation difficult using hearing aids. Although hearing aids can restore audibility, compression circuits in a hearing aid might distort the temporal modulations of speech, causing poor aided performance. Therefore, hearing aid settings that preserve the temporal modulations of speech might be an effective way to improve speech perception in ANSD.
The purpose of the study was to investigate the perception of hearing aid-processed speech in individuals with late-onset ANSD.
A repeated measures design was used to study the effect of various compression time settings on speech perception and perceived quality.
Seventeen individuals with late-onset ANSD within the age range of 20-35 yr participated in the study.
The word recognition scores (WRSs) and quality judgment of phonemically balanced words, processed using four different compression settings of a hearing aid (slow, medium, fast, and linear), were evaluated. The modulation spectra of hearing aid-processed stimuli were estimated to probe the effect of amplification on the temporal envelope of speech. Repeated measures analysis of variance and post hoc Bonferroni's pairwise comparisons were used to analyze the word recognition performance and quality judgment.
The comparison between unprocessed and all four hearing aid-processed stimuli showed significantly higher perception using the former stimuli. Even though perception of words processed using slow compression time settings of the hearing aids were significantly higher than the fast one, their difference was only 4%. In addition, there were no significant differences in perception between any other hearing aid-processed stimuli. Analysis of the temporal envelope of hearing aid-processed stimuli revealed minimal changes in the temporal envelope across the four hearing aid settings. In terms of quality, the highest number of individuals preferred stimuli processed using slow compression time settings. Individuals who preferred medium ones followed this. However, none of the individuals preferred fast compression time settings. Analysis of quality judgment showed that slow, medium, and linear settings presented significantly higher preference scores than the fast compression setting.
Individuals with ANSD showed no marked difference in perception of speech that was processed using the four different hearing aid settings. However, significantly higher preference, in terms of quality, was found for stimuli processed using slow, medium, and linear settings over the fast one. Therefore, whenever hearing aids are recommended for ANSD, those having slow compression time settings or linear amplification may be chosen over the fast (syllabic compression) one. In addition, WRSs obtained using hearing aid-processed stimuli were remarkably poorer than unprocessed stimuli. This shows that processing of speech through hearing aids might have caused a large reduction of performance in individuals with ANSD. However, further evaluation is needed using individually programmed hearing aids rather than hearing aid-processed stimuli.
听觉神经病谱系障碍(ANSD)是一种感音神经性听力损失形式,会导致严重的言语感知缺陷。ANSD患者的感知问题归因于其时间处理障碍,而非可听度降低。这使得使用助听器对他们进行康复治疗变得困难。尽管助听器可以恢复可听度,但助听器中的压缩电路可能会扭曲言语的时间调制,导致助听效果不佳。因此,保留言语时间调制的助听器设置可能是改善ANSD患者言语感知的有效方法。
本研究的目的是调查迟发性ANSD患者对经助听器处理的言语的感知。
采用重复测量设计来研究不同压缩时间设置对言语感知和感知质量的影响。
17名年龄在20 - 35岁之间的迟发性ANSD患者参与了本研究。
评估了使用助听器的四种不同压缩设置(慢、中、快和线性)处理的音素平衡词的单词识别分数(WRSs)和质量判断。估计了经助听器处理的刺激的调制谱,以探究放大对言语时间包络的影响。使用重复测量方差分析和事后Bonferroni成对比较来分析单词识别性能和质量判断。
未处理的刺激与所有四种经助听器处理的刺激之间的比较显示,使用前者刺激时的感知明显更高。尽管使用助听器慢压缩时间设置处理的单词的感知明显高于快压缩时间设置处理的单词,但它们之间的差异仅为4%。此外,任何其他经助听器处理的刺激之间在感知上没有显著差异。对经助听器处理的刺激的时间包络分析表明,在四种助听器设置下,时间包络的变化最小。在质量方面,最多的个体更喜欢使用慢压缩时间设置处理的刺激。其次是喜欢中等设置的个体。然而,没有个体喜欢快压缩时间设置。质量判断分析表明,慢、中、线性设置的偏好分数明显高于快压缩设置。
ANSD患者对使用四种不同助听器设置处理的言语的感知没有明显差异。然而,在质量方面,与快压缩设置相比,慢、中、线性设置处理的刺激的偏好明显更高。因此,每当为ANSD患者推荐助听器时,可能应选择具有慢压缩时间设置或线性放大的助听器,而不是快(音节压缩)的助听器。此外,使用经助听器处理的刺激获得的WRSs明显低于未处理的刺激。这表明通过助听器处理言语可能会导致ANSD患者的表现大幅下降。然而,需要使用个性化编程的助听器而非经助听器处理的刺激进行进一步评估。