title: Perception of Hearing Aid-Processed Speech in Individuals with Late-Onset Auditory Neuropathy Spectrum Disorder.
abstract: BACKGROUND
  Auditory neuropathy spectrum disorder (ANSD) is a form of sensorineural hearing loss, causing severe deficits in speech perception. The perceptual problems of individuals with ANSD were attributed to their temporal processing impairment rather than to reduced audibility. This rendered their rehabilitation difficult using hearing aids. Although hearing aids can restore audibility, compression circuits in a hearing aid might distort the temporal modulations of speech, causing poor aided performance. Therefore, hearing aid settings that preserve the temporal modulations of speech might be an effective way to improve speech perception in ANSD.
  
  
  OBJECTIVE
  The purpose of the study was to investigate the perception of hearing aid-processed speech in individuals with late-onset ANSD.
  
  
  METHODS
  A repeated measures design was used to study the effect of various compression time settings on speech perception and perceived quality.
  
  
  METHODS
  Seventeen individuals with late-onset ANSD within the age range of 20-35 yr participated in the study.
  
  
  METHODS
  The word recognition scores (WRSs) and quality judgment of phonemically balanced words, processed using four different compression settings of a hearing aid (slow, medium, fast, and linear), were evaluated. The modulation spectra of hearing aid-processed stimuli were estimated to probe the effect of amplification on the temporal envelope of speech. Repeated measures analysis of variance and post hoc Bonferroni's pairwise comparisons were used to analyze the word recognition performance and quality judgment.
  
  
  RESULTS
  The comparison between unprocessed and all four hearing aid-processed stimuli showed significantly higher perception using the former stimuli. Even though perception of words processed using slow compression time settings of the hearing aids were significantly higher than the fast one, their difference was only 4%. In addition, there were no significant differences in perception between any other hearing aid-processed stimuli. Analysis of the temporal envelope of hearing aid-processed stimuli revealed minimal changes in the temporal envelope across the four hearing aid settings. In terms of quality, the highest number of individuals preferred stimuli processed using slow compression time settings. Individuals who preferred medium ones followed this. However, none of the individuals preferred fast compression time settings. Analysis of quality judgment showed that slow, medium, and linear settings presented significantly higher preference scores than the fast compression setting.
  
  
  CONCLUSIONS
  Individuals with ANSD showed no marked difference in perception of speech that was processed using the four different hearing aid settings. However, significantly higher preference, in terms of quality, was found for stimuli processed using slow, medium, and linear settings over the fast one. Therefore, whenever hearing aids are recommended for ANSD, those having slow compression time settings or linear amplification may be chosen over the fast (syllabic compression) one. In addition, WRSs obtained using hearing aid-processed stimuli were remarkably poorer than unprocessed stimuli. This shows that processing of speech through hearing aids might have caused a large reduction of performance in individuals with ANSD. However, further evaluation is needed using individually programmed hearing aids rather than hearing aid-processed stimuli.
authors.affiliation: All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.
authors.forename: Jijo Pottackal
authors.initials: JP
authors.lastname: Mathai
authors.affiliation: All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.
authors.forename: Sabarish
authors.initials: S
authors.lastname: Appu
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006310:Hearing Aids; D006313:Hearing Loss, Central / Q000503:physiopathology*; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology; D006320:Hearing Tests; D006801:Humans; D007600:Judgment; D008297:Male; D013067:Speech Perception / Q000502:physiology*; D055815:Young Adult