Consonant reception in noise by listeners with mild and moderate sensorineural hearing impairment.

The goal of this study was to determine the extent to which the difficulty experienced by impaired listeners in understanding noisy speech can be explained on the basis of elevated tone-detection thresholds. Twenty-one impaired ears of 15 subjects, spanning a variety of audiometric configurations with average hearing losses to 75 dB, were tested for reception of consonants in a speech-spectrum noise. Speech level, noise level, and frequency-gain characteristic were varied to generate a range of listening conditions. Results for impaired listeners were compared to those of normal-hearing listeners tested under the same conditions with extra noise added to approximate the impaired listeners' detection thresholds. Results for impaired and normal listeners were also compared on the basis of articulation indices. Consonant recognition by this sample of impaired listeners was generally comparable to that of normal-hearing listeners with similar threshold shifts listening under the same conditions. When listening conditions were equated for articulation index, there was no clear dependence of consonant recognition on average hearing loss. Assuming that the primary consequence of the threshold simulation in normals is loss of audibility (as opposed to suprathreshold discrimination or resolution deficits), it is concluded that the primary source of difficulty in listening in noise for listeners with moderate or milder hearing impairments, aside from the noise itself, is the loss of audibility.