Subjective ratings of the effort involved in speech recognition in noise reflect SNRs, and individual cognitive capacity seems to influence relative rating of noise type.

No abstract

To study the spatial hearing abilities of bilateral hearing-aid users in multi-talker situations, 20 subjects received fittings configured to preserve acoustic cues salient for spatial hearing. Following acclimatization, speech reception thresholds (SRTs) were measured for three competing talkers that were either co-located or spatially separated along the front-back or left-right dimension. In addition, the subjects' working memory and attentional abilities were measured. Left-right SRTs varied over more than 14 dB, while front-back SRTs varied over more than 8 dB. Furthermore, significant correlations were observed between left-right SRTs, age, and low-frequency hearing loss, and also between front-back SRTs, age, and high-frequency aided thresholds. Concerning cognitive effects, left-right performance was most strongly related to attentional abilities, while front-back performance showed a relation to working memory abilities. Altogether, these results suggest that, due to raised hearing thresholds and aging, hearing-aid users have reduced access to interaural and monaural spatial cues as well as a diminished ability to 'enhance' a target signal by means of top-down processing. These deficits, in turn, lead to impaired functioning in complex listening environments.

Prompt identification of educationally significant hearing loss is yet an unattained goal. However, there is some evidence that the ability to identify and diagnose hearing loss at an early age has been significantly improved through the use of carefully designed screening protocols such as birth certificate-based high-risk registries. To evaluate the efficiency of birth certificate-based screening programs, 70 parents and guardians of 6-to 9-yr-old children with significant sensorineural losses were surveyed regarding their child's identification history. Each of these children was born in the state during the time a birth certificate-based screening program was in full operation. Results indicate that children with at least one risk factor for hearing impairment were identified an average of 7.7 mo earlier than children with no risk history. However, only 50% of the children with sensorineural hearing losses exhibited any of the risk factors and a significant number of children with risk factors were missed by the system. Had admission to a neonatal intensive care unit been considered a risk factor, 63% of the children would have exhibited at least one risk factor. More extensive implementation of high-risk registries in conjunction with more widespread education of parents and primary care providers regarding early behavioral indicators of hearing loss, procedures for referral, and appropriate intervention and management services needs to be considered (Ear Hear 12 5312-319).