Older hearing-impaired listeners were able to significantly improve their word-recognition abilities through training with one talker and to the same degree as young normal-hearing listeners. The improved performance was maintained across talkers and across time. This might imply that training a listener using a standardized list and talker may still provide benefit when these same words are presented by novel talkers outside the clinic. However, training on isolated words was not sufficient to transfer to fluent speech for the specific sentence materials used within this study. Further investigation is needed regarding approaches to improve a hearing aid user's speech understanding in everyday communication situations.

Objectives The objective of this study was to evaluate the efficacy of a word-based auditory-training procedure for use with older adults who have impaired hearing. The emphasis during training and assessment is placed on words with a high frequency of occurrence in American English. Design A repeated-measures group design was used with each of the two groups of participants in this study to evaluate the effects of the word-based training regimen. One group was comprised of 20 young adults with normal hearing and the other consisted of 16 older adults with impaired hearing. The group of young adults was not included for the purpose of between-group comparisons. Rather, it was included to demonstrate the efficacy of the training regimen should efficacy fail to be demonstrated in the group of older adults and also to estimate the magnitude of the benefits that could be achieved in younger listeners. Result Significant improvements were observed in the group means for each of five measures of post-training assessment. Pre-training and post-training performance assessments were all based on the open-set recognition of speech in a fluctuating speech-like background noise. Assessment measures ranged from recognition of trained words and phrases produced by talkers heard during training to the recognition of untrained sentences produced by a talker not encountered during training. In addition to these group data, analysis of individual data via 95% critical differences for each assessment measure revealed that 75–80% of the older adults demonstrated significant improvements on most or all of the post-training measures. Conclusions The word-based auditory-training program examined here, one based on words having a high frequency of occurrence in American English, has been demonstrated to be efficacious in older adults with impaired hearing. Training on frequent words and frequent phrases generalized to sentences constructed from frequently occurring words whether spoken by talkers heard during training or by a novel talker.

Purpose-This study examined how repeated presentations of words in noise affected understanding of both trained and untrained words in noise (in isolation and in sentences).Method-Eight older listeners with hearing impairment completed a word-based auditory training protocol lasting approximately 12 weeks. Training materials were presented in a closedset condition with both orthographic and auditory feedback on a trial-to-trial basis. Performance on both trained and untrained lexically easy and hard words, as well as generalization to sentences, was measured. Listeners then returned for an additional 14 weeks to monitor retention of the trained materials.Results-Training listeners on 1 set of words improved both their open-and closed-set recognition of the trained materials but did not improve performance on another set of untrained words. When training switched to the other set, performance for the new set of words improved significantly, whereas significant improvements on the previously trained words were maintained. Training generalized to unfamiliar talkers but did not generalize to untrained words or untrained keywords within running speech. Listeners were able to maintain improved performance over an extended period. Conclusion-Older listeners were able to improve their word-recognition performance in noise on a set of 150 words with training. Keywords speech recognition; training; hearing impairedMany older individuals seeking help from an audiologist have a sloping sensorineural hearing loss. This type of hearing loss will often become apparent to the patient due to decreased speech understanding in noisy environments. The problem of speech understanding, particularly in noise, is twofold. There is the obvious issue of reduced audibility of the signal in the high frequencies, where the listener's hearing loss is typically most severe, as well as the interfering effects of the competing stimulus. Due to the particularly deleterious effects of background noise for older hearing-impaired (OHI) listeners relative to young normal-hearing (YNH) listeners (Frisina & Frisina, 1997;Gordon-Salant & Fitzgibbons, 1995), it is often desirable to improve the signal-to-noise ratio (SNR) for older adults. Hearing aids have been an effective means for improving the audibility of the speech signal but have been less successful at improving the SNR sufficiently. Technologies such as directional microphones and noise-reduction algorithms, designed to improve the acoustical SNR, continue to have promise. Another approach that © American Speech-Language-Hearing Association NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript might also provide benefit, however, is to train the listener to make better use of the existing SNR.Research in auditory training has a long history, with several key studies conducted in the 1970s and 1980s (Rubinstein & Boothroyd, 1987;Sweetow & Palmer, 2005;Walden, Erdman, Montgomery, Schwartz, & Prosek, 1981;Walden, Prosek, Montgomery, Scherr, & Jones, 1977). As will be...