Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark.
Trends Hear. 2024 Jan-Dec;28:23312165231224597. doi: 10.1177/23312165231224597.
Hearing aids provide nonlinear amplification to improve speech audibility and loudness perception. While more audibility typically increases speech intelligibility at low levels, the same is not true for above-conversational levels, where decreases in intelligibility ("rollover") can occur. In a previous study, we found rollover in speech intelligibility measurements made in quiet for 35 out of 74 test ears with a hearing loss. Furthermore, we found rollover occurrence in quiet to be associated with poorer speech intelligibility in noise as measured with linear amplification. Here, we retested 16 participants with rollover with three amplitude-compression settings. Two were designed to prevent rollover by applying slow- or fast-acting compression with a 5:1 compression ratio around the "sweet spot," that is, the area in an individual performance-intensity function with high intelligibility and listening comfort. The third, reference setting used gains and compression ratios prescribed by the "National Acoustic Laboratories Non-Linear 1" rule. Speech intelligibility was assessed in quiet and in noise. Pairwise preference judgments were also collected. For speech levels of 70 dB SPL and above, slow-acting sweet-spot compression gave better intelligibility in quiet and noise than the reference setting. Additionally, the participants clearly preferred slow-acting sweet-spot compression over the other settings. At lower levels, the three settings gave comparable speech intelligibility, and the participants preferred the reference setting over both sweet-spot settings. Overall, these results suggest that, for listeners with rollover, slow-acting sweet-spot compression is beneficial at 70 dB SPL and above, while at lower levels clinically established gain targets are more suited.
助听器提供非线性放大以提高语音可听度和响度感知。虽然在较低水平上,更多的可听度通常会提高语音可懂度,但在高于会话水平的情况下则并非如此,此时可懂度会下降(“滚降”)。在之前的研究中,我们发现 74 只测试耳中有 35 只在安静环境下的语音可懂度测量中出现了滚降。此外,我们发现安静环境下的滚降与使用线性放大测量的噪声下语音可懂度较差有关。在这里,我们对 16 名有滚降的参与者进行了三次幅度压缩设置的重新测试。两种设置旨在通过在“最佳点”(即个体表现强度函数中具有高可懂度和聆听舒适度的区域)周围应用具有 5:1 压缩比的慢或快作用压缩来防止滚降,最佳点。第三种,参考设置使用“国家声学实验室非线性 1”规则规定的增益和压缩比。在安静和噪声环境下评估了语音可懂度。还收集了成对的偏好判断。对于 70 dB SPL 及以上的语音水平,慢作用最佳点压缩在安静和噪声环境下的语音可懂度优于参考设置。此外,参与者明显更喜欢慢作用最佳点压缩而非其他设置。在较低的水平上,三种设置给出了可比的语音可懂度,并且参与者更喜欢参考设置而不是最佳点设置。总体而言,这些结果表明,对于有滚降的听众,在 70 dB SPL 及以上时,慢作用最佳点压缩是有益的,而在较低水平时,临床既定的增益目标更适合。