The performance of an experimental frequency compression hearing device was evaluated using tests of speech understanding in quiet. The device compressed frequencies above a programmable cut-off, resulting in those parts of the input signal being shifted to lower frequencies. Below the cut-off, signals were amplified without frequency shifting. Subjects were experienced hearing aid users with moderate-to-severe sensorineural hearing loss and sloping audiograms. Their recognition of monosyllabic words was tested using the experimental device in comparison with conventional hearing aids. Of the 17 subjects, eight showed a significant score improvement (p < 0.05), whereas one subject showed a significant score decrease. Some of the improvements may have resulted from the better audibility provided in the high frequencies by the experimental device in comparison with the conventional aids. However, a subsequent study found that increasing the high-frequency gain in the conventional aids did not produce equivalent perceptual benefits.

Previous investigation of an experimental, wearable frequency-compression hearing aid revealed improvements in speech perception for a group of listeners with moderately sloping audiograms (Simpson et al, 2005). In the frequency-compression hearing aid, high frequencies (above 1600 Hz) were amplified in addition to being lowered in frequency. Lower frequencies were amplified without frequency shifting. In the present study, an identical frequency-compression scheme was evaluated in a group of seven subjects, all of whom had steeply sloping hearing losses. No significant differences in group mean scores were found between the frequency-compression device and a conventional hearing instrument for understanding speech in quiet. Testing in noise showed improvements for the frequency-compression scheme for only one of the five subjects tested. Subjectively, all but one of the subjects preferred the sound quality of the conventional hearing instruments. In conclusion, the experimental frequency-compression scheme provided only limited benefit to these listeners with steeply sloping hearing losses.

Frequency-lowering technology has been around for decades. The primary aim—namely, that of providing high-frequency information to those with severe high-frequency hearing loss—addresses a clinical need most conventional hearing devices are still unable to provide. Early studies with frequency-lowering technology reported mostly unfavorable results, and the devices never gained clinical popularity. However, as hearing aid (HA) technology becomes ever more sophisticated, it is appropriate to reconsider whether frequency-lowering HAs should be an amplification choice in those with high-frequency hearing loss. Recent research is yielding promise with people who wear frequency-lowering devices showing improved speech perception. Questions remain regarding patient candidacy and whether auditory training may result in better outcomes. The author also discusses future clinical directions and research needs for frequency lowering.