title: The effect of presentation level on normal-hearing and hearing-impaired listeners' acceptable speech and noise levels.
abstract: BACKGROUND
  Acceptable noise level (ANL) is a measure of the maximum amount of background noise that a listener is willing to "put up with" while listening to running speech. This test is unique in that it can predict with a high degree of accuracy who will be a successful hearing-aid wearer. Individuals who tolerate high levels of background noise are generally successful hearing-aid wearers, whereas individuals who do not tolerate background noise well are generally unsuccessful hearing-aid wearers.
  
  
  OBJECTIVE
  Various studies have been unsuccessful in trying to relate ANLs to listener characteristics or other test results. Presumably, understanding the perceptual mechanism by which listeners determine their ANLs could provide an understanding of the ANL's unique predictive abilities and our current inability to correlate these results with other listener attributes or test results. As a first step in investigating this problem, the relationships between ANLs and other threshold measures where listeners adjust the signal-to-noise ratio (SNR) according to some criterion in a way similar to the ANL measure were examined. RESEARCH DESIGN AND STUDY SAMPLE: Ten normal-hearing and 10 hearing-impaired individuals participated in a laboratory experiment that followed a within-subjects, repeated-measures design.
  
  
  METHODS
  Participants were seated in a sound booth. Running speech and noise (eight-talker babble) were presented from a loudspeaker at 0°, 3 ft in front of the participant. Individuals adjusted either the level of the speech or the level of the background noise. Specifically, with the speech fixed at different levels (50, 63, 75, or 88 dBA), participants performed the ANL task, in which they adjusted the level of the background noise to the maximum level at which they were willing to listen while following the speech. With the noise fixed at different levels (50, 60, 70, or 80 dBA), participants adjusted the level of the speech to the minimum, preferred, or maximum levels at which they were willing to listen while following the speech. Additionally, for the minimum acceptable speech level task, each participant was tested at four participant-specific noise levels, based on his/her ANL results. To emphasize that the speech level was adjusted in these measurements, three new terms were coined: "minimum acceptable speech level" (MinASL), "preferred speech level" (PSL), and "maximum acceptable speech level" (MaxASL). Each condition was presented twice, and the results were averaged. Test order and presentation level were randomized. Hearing-impaired participants were tested in the aided condition only.
  
  
  RESULTS
  For most participants, as the presentation level increased, SNRs increased for the ANL test but decreased for the MinASL, PSL, and MaxASL tests. For a few participants, ANLs were similar to MinASLs. For most test conditions, the normal-hearing results were not significantly different from those of the hearing-impaired participants.
  
  
  CONCLUSIONS
  For most participants, stimulus level affected the SNRs at which they were willing to listen. However, a subset of listeners was willing to listen at a constant SNR for the ANL and MinASL tests. Furthermore, for these individuals, ANLs and MinASLs were roughly equal, suggesting that these individuals may have used the same perceptual criterion for both tests.
authors.affiliation: Starkey Hearing Technologies. karrie_recker@starkey.com
authors.forename: Karrie L
authors.initials: KL
authors.lastname: Recker
authors.forename: Brent W
authors.initials: BW
authors.lastname: Edwards
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology; D005260:Female; D006309:Hearing / Q000502:physiology*; D006310:Hearing Aids / Q000523:psychology*; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008144:Loudness Perception / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D013067:Speech Perception / Q000502:physiology*; D055815:Young Adult