Two effects of reverberation on the identification of consonants were evaluated for ten normal-hearing subjects: (1) the overlap of energy of a preceding consonant on the following consonant, called "overlap-masking"; and (2) the internal temporal smearing of energy within each consonant, called "self-masking." The stimuli were eight consonants/p,t,k,f,m,n,l,w/. The consonants were spoken in /s-at/context (experiment 1) and generated by a speech synthesizer in /s-at/ and/-at/contexts (experiment 2). In both experiments, identification of consonants was tested in four conditions: (1) quiet, without degradations; (2) with a babble of voices; (3) with noise that was shaped like either natural or synthetic/s/ for the two experiments, respectively; and (4) with room reverberation. The results for the natural and synthetic syllables indicated that the effect of reverberation on identification of consonants following/s/ was not comparable to masking by either the /s/ -spectrum-shaped noise or the babble. In addition, the results for the synthetic syllables indicated that most of the errors in reverberation for the /s-at/context were similar to a sum of errors in two conditions: (1) with /s/-shaped noise causing overlap masking; and (2) with reverberation causing self-masking within each consonant.

One of the frequently quoted reasons for the rejection of hearing aids is amplification of background noise. The relationship between hearing aid use and toleration of background noise was assessed. Four groups of elderly subjects (at least 65 years old) and one group of young subjects with normal hearing participated in the study. Each group consisted of 15 subjects. The young subjects and elderly subjects in one group with relatively good hearing were tested for comparison with the hearing-impaired subjects. Elderly subjects in the three remaining groups had acquired hearing losses and had been fitted with hearing aids. The subjects were assigned to three groups on the basis of hearing aid use: full-time users, part-time users, and nonusers. The amount of background noise tolerated when listening to speech was tested. The speech stimulus was a story read by a woman and set at an individually chosen most comfortable level. The maskers were a babble of voices, speech-spectrum noise, traffic noise, music, and the noise of a pneumatic drill. There was a significant interaction between groups and noises. The full-time users tolerated significantly higher levels of music and speech-spectrum noise than part-time users and nonusers. In addition, the full-time users, but not the part-time users, assessed themselves as less handicapped in everyday functions when they wore hearing aids than when they did not wear their hearing aids

Mild traumatic brain injury (MTBI) and postconcussive syndrome can result in difficult to document complaints regarding subtle language use. Narrative discourse production has been shown to be a sensitive index of linguistic and cognitive deficits in the more severe TBI population. The narrative discourse production of MTBI subjects was investigated to determine whether cognitive changes were reflected in linguistic production. Eight MTBI, five moderate TBI, and five neurologically normal subjects were matched for age, education, and gender. The TBI subjects were matched on a number of neuropsychological measures. The subjects produced narratives about their correct picture sequences on five items from the Wechsler Adult Intelligence Scale-Revised picture arrangement subtest. The narratives were scored for correct arrangement, content essential information, correct story, and implied meaning. Significant differences were found between the normal control group and both the TBI groups on accuracy of narrative description of the correct picture sequences. Although differences in generation of implied meaning failed to reach significance, a trend was noted for both the TBI groups to produce fewer implied meanings than the control group. The results suggest that cognitive disruptions associated with MTBI may affect the quality of narrative discourse.

OBJECTIVE. The goal for this study was to determine methods to modify outcome measures for people with aphasia and to provide beginning support for the efficacy of these suggested modifications.METHOD. Twenty-nine community-dwelling people with aphasia participated. Modified outcome measures included the Stroke Impact Scale, the 36-item short form Medical Outcomes Study, Reintegration to Normal Living Scale, and Activity Card Sort. Participants were supported in their responses by systematically applying a hierarchy of support. An Independence Scale score was determined for each measure for each participant. RESULTS.Data from an examiner-rated Independence Scale, internal consistency of participants' responses, correlations among subscale scores across measures, and correlations between aphasia severity and reported outcome provide evidence that people with aphasia are able to understand and respond with these supports.

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