High-frequency audibility: benefits for hearing-impaired listeners.

The present study was a systematic investigation of the benefit of providing hearing-impaired listeners with audible high-frequency speech information. Five normal-hearing and nine high-frequency hearing-impaired listeners identified nonsense syllables that were low-pass filtered at a number of cutoff frequencies. As a means of quantifying audibility for each condition, Articulation Index (AI) was calculated for each condition for each listener. Most hearing-impaired listeners demonstrated an improvement in speech recognition as additional audible high-frequency information was provided. In some cases for more severely impaired listeners, increasing the audibility of high-frequency speech information resulted in no further improvement in speech recognition, or even decreases in speech recognition. A new measure of how well hearing-impaired listeners used information within specific frequency bands called "efficiency" was devised. This measure compared the benefit of providing a given increase in speech audibility to a hearing-impaired listener to the benefit observed in normal-hearing listeners for the same increase in speech audibility. Efficiencies were calculated using the old AI method and the new AI method (which takes into account the effects of high speech presentation levels). There was a clear pattern in the results suggesting that as the degree of hearing loss at a given frequency increased beyond 55 dB HL, the efficacy of providing additional audibility to that frequency region was diminished, especially when this degree of hearing loss was present at frequencies of 4000 Hz and above. A comparison of analyses from the "old" and "new" AI procedures suggests that some, but not all, of the deficiencies of speech recognition in these listeners was due to high presentation levels.