Erin Margaret Picou

Purpose: The purpose of this study was to evaluate the effects of loudspeaker configuration and relative dialogue-to-background sound levels on subjective ratings of speech understanding and sound quality of recorded media for listeners with and without hearing loss. Method: Three groups of 20 adults participated, including younger and older adults with normal hearing and older adults with mild sloping to moderately severe sensorineural hearing loss. Participants rated their perceived speech understanding and sound quality in response to 10-s-long recorded media clips in audio-only and audiovisual formats. Three loudspeaker configurations were used: television speakers, stereo speakers, and five-channel surround sound. The dialogue-to-background ratio was manipulated to be either approximately +7 or +12 dB. Results: Participants in all three groups rated speech understanding and sound quality as better with more favorable dialogue-to-background ratios. Older listeners with hearing loss consistently rated their speech understanding as lower than either group with normal hearing. For listeners with hearing loss, surround sound was consistently rated among the poorest, and the stereo speaker configuration was rated among the best. Furthermore, the sound quality disadvantages found for the television speakers in young listeners without hearing loss were generally not evident in older listeners with or without hearing loss. Conclusions: The results did not support the use of five-channel surround sound configuration as a method to improve perceived speech understanding in listeners with hearing loss. However, they do support individualized clinical recommendations, as the surround sound was not universally the lowest rated configuration for all participants. Supplemental Material: https://doi.org/10.23641/asha.32691750

Objectives: Task-irrelevant sounds can be distracting, impairing speech recognition and increasing listening effort. One way to measure distraction is to evaluate performance differences between trials that do and do not contain task-irrelevant sounds. Poorer performance following irrelevant sounds is interpreted as evidence of distraction. Using this general approach, previous work has demonstrated that the degree to which irrelevant non-speech sounds are distracting is related to stimulus valence. That is, unpleasant and pleasant sounds are more distracting than neutral ones. The purpose of the present study was to evaluate the effect of the presence of task-irrelevant, human vocalizations on word repetition performance and behavioral listening effort. Design: Eighteen adults with normal hearing participated in a dual-task paradigm where the primary task was word repetition, and the secondary task was word categorization speed, with speed being interpreted as a measure of behavioral listening effort. Immediately before 45% of the target words, a task-irrelevant vocalization was presented. Each list contained trials with and without irrelevant vocalizations; the difference in performance between trial types was interpreted as distraction. Conditions varied by background noise (quiet, noise) and by valence of the vocalization (pleasant, unpleasant, neutral). Conditions were blocked such that testing with each list of words was completed with a single combination of noise and valence vocalization. Data were analyzed using linear mixed-effects modeling to evaluate the effect of task-irrelevant vocalization presence, vocalization valence, and background noise on word repetition performance and behavioral listening effort. Results: As expected, background noise negatively affected word repetition performance (~6 percentage points) and increased behavioral listening effort (119 msec slowing of secondary task response times). The valence of the task-irrelevant sound within a condition did not affect word repetition performance, but did affect behavioral listening effort. Response times were longer (~40 msec longer) during the conditions with pleasant or unpleasant vocalizations than during conditions when neutral vocalizations were interleaved with target words. No distraction was noted in word recognition performance; performance was similar for trials with and without task-irrelevant vocalizations. Distraction effects were evident in behavioral listening effort; response times were ~30 msec longer in trials preceded by task-irrelevant vocalizations than in trials without task-irrelevant vocalizations. The calculated distraction effects were similar across conditions. Conclusions: Although the valence of the vocalizations generally increased listening effort, slowing secondary task times in conditions with valenced task-irrelevant vocalizations, the calculated distraction effects within a condition did not depend on valence or the presence of background noise. Moreover, the task-irrelevant vocalizations increased behavioral listening effort in quiet and in noise, despite minimal changes in word repetition performance. Future work is warranted to disentangle the methodological differences and the differences in effect sizes between the present study and previous work with non-speech sounds. The findings have implications for listening in complex, real-world environments, where distraction and valenced sounds are likely to co-occur.

The study aim was to evaluate differences in ratings of valence made for a set of nonspeech sounds varying in spectrotemporal modulation. For 17 auditory-frequency bands (from 125 to 9474 Hz), modulation index values were extracted at five rates (from 2 to 32 Hz). Higher ratings of valence were associated with lower modulation values in the frequency region below 500 Hz and higher modulation values in the 1620–4000 Hz region. Listeners with hearing loss demonstrated significantly shallower relationships between modulation index and ratings of valence compared to adults with normal hearing. This could partially explain previously demonstrated compressed valence associated with hearing loss.

Objectives: The purpose of this study was to evaluate the effects of an advanced digital noise reduction algorithm on measures in the laboratory (double-blind paired comparison testing, unblinded slider setting, sentence recognition performance) and during a field trial (unblinded slider setting). A secondary purpose was to evaluate participants’ ability and willingness to use a smartphone application for controlling the algorithm in the field. Design: Laboratory procedures included the evaluation of subjective ratings of listening ease using a double-blinded, paired comparisons approach while listening to speech in background noise. Participants were trained to use a smartphone application for manually controlling the advanced digital noise reduction algorithm and they indicated their preferred setting using the smartphone application, also in the laboratory. In addition, they completed double-blinded, behavioral sentence recognition in noise testing with a variety of advanced noise reduction settings. Finally, participants wore the hearing aids at home during a field trial, with instructions to use the smartphone application during the trial in noisy situations and to report on their experiences using a bespoke questionnaire upon their return to the laboratory. Results: Double-blind, paired comparison testing revealed that most participants (80%) preferred to have advanced digital noise reduction active in the noisy, reverberant laboratory. These participants were also likely to demonstrate a preference for the advanced digital noise reduction to be active during the unblinded preference task. Advanced digital noise reduction did not affect sentence recognition in noise performance. During the field trial, participants could use the smartphone application to adjust the advanced noise reduction strength in noisy situations but did not choose to do so frequently. In addition, on average, participants did not activate the advanced digital noise reduction algorithm when in self-identified difficult listening situations during the field trial. Conclusions: The results of the current study demonstrate robust subjective benefits of advanced digital noise activation in the laboratory, with no effects on speech intelligibility. In addition, participants were internally consistent in the laboratory; their self-adjusted settings were consistent with the program they preferred during the double-blind, paired comparisons testing. However, the findings with the smartphone application demonstrate that, in general, they did not activate the advanced digital noise reduction during their self-identified difficult listening situations in the field. This result could partially be explained by the limited reported use of the smartphone application during the field trial. Future study is warranted to reconcile the laboratory and field trial findings in this study. In the interim, a reasonable clinical approach with limited negative speech intelligibility consequences might be to activate advanced digital noise reduction by default and provide smartphone application access in case a patient discovers a preference for an alternative noise reduction strength.

Individuals with hearing loss, even when using hearing aids, often perceive pleasant environmental sounds as less pleasant than do those with normal hearing. This bias in emotional response may negatively impact well-being, leading to decreased social participation and increased loneliness. The present study examined whether the Positive Focus intervention—encouraging hearing aid users to focus on positive listening experiences—could influence emotional response to environmental sounds. Thirty participants were randomly assigned to either a Positive Focus or a Control group. At the initial laboratory visit, all participants were fitted with study hearing aids and performed affective ratings of 120 environmental sounds. Over 3 weeks, both groups wore the hearing aids; the Positive Focus group additionally reported daily positive listening experiences via a text message. At the end of the three-week period, participants completed questionnaires on hearing aid outcomes and repeated the affective ratings. The Positive Focus intervention did not alter emotional responses to environmental sounds in a laboratory setting. However, regression analyses revealed that valence ratings of typically pleasant sounds moderated the effectiveness of Positive Focus on hearing aid benefit; the intervention was more effective for individuals less naturally inclined to respond positively to such sounds. These findings suggest that valence screening may help identify individuals most likely to benefit from Positive Focus, supporting more personalized hearing care strategies.

The purpose of this study was to evaluate the effect of sound quality on ratings of mood (esteem-related affect, vigor, and fatigue), listening-related fatigue, and perceived hearing-related experiences (speech intelligibility, perceived disability, participation, concentration). Thirty adults (51–80 years old) with bilateral hearing loss and at least six months of hearing aid experience participated in this crossover study. They adjusted hearing aids based on sound quality in a laboratory setting, creating a preferred program (good sound quality) and a non-preferred program (tolerable sound quality). After a cooling-off period, they wore each hearing aid program (counterbalanced) home for approximately one week each. During the home trial, they provided ratings of hearing aid sound quality, mood, and hearing-related experiences daily. After each home trial, they rated their listening-related fatigue retrospectively. Sound quality ratings were significantly related to hearing-related experiences and mood ratings during the home trial. Nineteen of the participants preferred their “good” program during the home trial, while the remaining 11 preferred the “tolerable” program. For the participants whose program preference was consistent between the lab and home experiences, listening-related fatigue and mood were significantly better during the week with the “good” program. These results highlight the importance of sound quality for listening-related fatigue and mood for adult hearing aid users.

Purpose: This study examined the effects of reduced bandwidth and auditory-visual congruence on emotional responses to nonspeech auditory-only and auditory-visual stimuli. Auditory-visual stimuli were picture/sound pairs that were congruent or incongruent in terms of valence (e.g., pleasant picture/unpleasant sound or vice versa). Method: Twenty adults with normal hearing rated the valence (pleasant to unpleasant) and arousal (exciting to calming) of nonspeech auditory-only and auditory-visual stimuli. Auditory stimuli were presented broadband (~125–8000 Hz) or bandpass filtered (800–2000 Hz). Auditory-visual stimuli were created by combining auditory stimuli with a picture of congruent or incongruent valence. Results: Bandpass filtering of auditory-only stimuli reduced the range of valence responses (less pleasant and less unpleasant). With congruent auditory-visual stimuli, bandpass filtering did not affect valence ratings. Incongruent audiovisual stimuli were rated as less pleasant than were congruent, pleasant, auditory-visual stimuli. Arousal ratings were lower with bandpass filtering but were not affected by congruency. Conclusions: Congruent auditory-visual stimuli resulted in more extreme ratings of valence than did auditory-only stimuli. Incongruent auditory-visual stimuli were generally rated as more unpleasant than pleasant, auditory-only stimuli. Consistent with previous studies of low- and high-pass filtering, bandpass filtering (800–2000 Hz) of auditory-only stimuli resulted in more neutral responses, suggesting that frequencies below 800 Hz and above 2000 Hz are important for ratings of valence. Inconsistent with previous low- and high-pass filtering work, bandpass filtering did not affect ratings of congruent auditory-visual stimuli, suggesting a different set of frequencies are important for ratings of valence when visual cues are also available. Supplemental Material: https://doi.org/10.23641/asha.29971387

Purpose: Understanding speech in challenging environments can be fatiguing for individuals with and without hearing loss. Empirical research examining interventions to reduce such fatigue, however, is limited. Our study investigated the effects of imperfect captions, such as those created using automated speech recognition systems, on listening-related fatigue during a challenging speech task. Method: Twenty-two adults (aged 18–63 years) with essentially normal hearing completed a sustained dual task designed to induce listening-related fatigue. The primary task was audiovisual sentence recognition in quiet, with speech levels individually adjusted for ~70% correct performance (without captions). The secondary task was response time (RT) to topic words presented during the speech task. Participants completed the dual task with or without captions. Subjective fatigue ratings were obtained before, during, and after the dual task. Vigilant attention was measured via the secondary task and before and after the dual task using visual stimuli (RTs to a visual marker presented at random intervals). Results: Subjective fatigue ratings increased significantly over the course of the dual task. However, this increase was larger for the group who had captions, even though they had better sentence recognition overall. Evidence of behavioral fatigue (slowed RTs over time) was also present but only for those in the Caption group. Anecdotal reports from study participants suggest that the increased fatigue for the Caption group was related to the cognitive challenge of combining information from the time-locked audiovisual cues and the time-delayed, and imperfect, text captions. Conclusions: Even though they were time-delayed and contained inaccuracies, captions improved speech recognition. However, this benefit was accompanied by greater increases in subjective and behavioral fatigue. Therefore, in some conditions imperfect captions can have negative consequences for listening-related fatigue. Further research is needed to determine whether this pattern holds in different circumstances, such as with audio-only stimuli. Supplemental Material: https://doi.org/10.23641/asha.29646482

Recent regulatory changes in the United States created a category of hearing aids that could be purchased over-the-counter (OTC), directly by a consumer without professional dispensing. Evidence supporting the benefits of OTC hearing aids for adults with perceived mild-to-moderate hearing difficulty is somewhat mixed in the literature. The purpose of this study is to compare hearing aid benefits and satisfaction rates for OTC and traditional, provider-dispensed hearing aids within the MarkeTrak 25 survey data. Results of the survey demonstrate robust benefits and high satisfaction rates for both OTC and traditional hearing aids. However, there are some differences in trends between OTC and traditional hearing aids. Specifically, within owners of traditional hearing aids, there is remarkable stability in terms of benefits, satisfaction rates (83% of hearing aid owners are satisfied), and net promoter scores (+30 points for promoters relative to detractors). These values are essentially unchanged over the last several years, suggesting the introduction of the formal OTC hearing aid category has not affected the benefit or satisfaction rates of traditional hearing aids. The OTC hearing aids themselves have similar benefits as traditional hearing aids, although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied). Compared to owners of traditional hearing aids, owners of OTC hearing aids were less likely to be satisfied with the size and reliability of their hearing aids, although they were more likely to be satisfied with the price of the hearing aids. The current data also highlight the importance of professional services, even within the group of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately 80%) utilize some type of professional service, but those who did receive professional support were more likely to be satisfied with their hearing aids than were those who did not receive professional services. Therefore, although the OTC hearing aids are beneficial and consumers are satisfied with them, professional support continues to be an important and beneficial aspect in the OTC category of hearing aids.

The purpose of this study is to review the current state of the over-the-counter (OTC) hearing aid market, specifically focusing on adoption, affordability, accessibility, and satisfaction rates in the MarkeTrak 2025 survey. In a large-scale consumer survey, nearly 5,000 adults with perceived hearing difficulties completed a survey, which asked questions about, among other things, their hearing aids. The results of the survey suggest OTC hearing aids have had a small incremental increase (4 percentage points) in hearing device adoptions, a smaller impact than earbuds with features designed to support hearing loss. The introduction of OTC hearing aids has not affected the adoption rates of prescription hearing aids, where adoption rates (currently 39%) have been stable, or even increased, over the last decade. The data also demonstrate that most OTC hearing aid owners received some professional services, suggesting the accessibility of OTC hearing aids might not be fully successful if success means the ability to acquire hearing aids without professional support. However, OTC hearing aids have been successful in other respects. Relative to prescription hearing aids, OTC hearing aids are more affordable and have similarly high satisfaction rates. The OTC and earbud devices will be interesting to continue to monitor as the market adjusts to the widespread availability of direct-to-consumer solutions for management of hearing difficulties in adults. To date, the availability of OTC hearing aids has not disrupted the prescription hearing aid market, although they are more affordable, and most people who use them are satisfied.