Turn an Ear to Hear: How Hearing-Impaired Listeners Can Exploit Head Orientation to Enhance Their Speech Intelligibility in Noisy Social Settings.

Turning an ear toward the talker can enhance spatial release from masking. Here, with their head free, listeners attended to speech at a gradually diminishing signal-to-noise ratio and with the noise source azimuthally separated from the speech source by 180° or 90°. Young normal-hearing adult listeners spontaneously turned an ear toward the speech source in 64% of audio-only trials, but a visible talker's face or cochlear implant (CI) use significantly reduced this head-turn behavior. All listener groups made more head movements once instructed to explore the potential benefit of head turns and followed the speech to lower signal-to-noise ratios. Unilateral CI users improved the most. In a virtual restaurant simulation with nine interfering noises or voices, hearing-impaired listeners and simulated bilateral CI users typically obtained a 1 to 3 dB head-orientation benefit from a 30° head turn away from the talker. In diffuse interference environments, the advice to U.K. CI users from many CI professionals and the communication guidance available on the Internet most often advise the CI user to face the talker head on. However, CI users would benefit from guidelines that recommend they look sidelong at the talker with their better hearing or implanted ear oriented toward the talker.