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Background There is an increasing need to administer hearing tests outside of sound-attenuating rooms. Maximum permissible ambient noise levels (MPANLs) from published in standards (Occupational Health and Safety Administration [OSHA] 1983; American National Standards Institute [ANSI] S3.1–1999 (R2018)) can be modified to account for the additional attenuation provided by circumaural earphones (relative to supra-aural earphones) that are used for pure-tone audiometry. Ambient noise can influence the results of pure-tone audiometry by elevating thresholds by direct masking and by producing distractions that affect the accuracy of the test. The effects of these distractions have not been studied in relation to pure-tone audiometry in adult listeners. Purpose In Part I MPANLs provided by ANSI and OSHA standards are extended to account for the greater attenuation provided by circumaural earphones. Rules (“alerts”) were developed taking into account the listeners' thresholds. In Part II effects of distracting noise on pure-tone thresholds are reported. Methods and Results In Part I MPANLs two standards were modified for circumaural earphones by adding the additional attenuation provided by three circumaural earphones (relative to supra-aural earphones). A set of rules (“alerts”) is provided for identifying masking effects from ambient noise in a variety of conditions (earphone type, threshold elevation, uncovered ear). In Part II the distracting effects of an industrial noise sample on thresholds obtained from five listeners with normal hearing are described. Pure-tone thresholds were measured in quiet and in distracting noise presented at various levels. The effects of the distracting noise on the following variables were measured: time per trial, number of trials required to measure threshold, threshold shift, and perceived distractibility of the noise. Time per trial was unaffected by distracting noise. Number of trials required for threshold, threshold shift, and perceived distractibility increased with distracting noise level. Conclusion Part I: The modified MPANLs provide more relevant determinations of the potential effects of ambient noise on pure-tone thresholds than the values in the standards. Part II: Distracting noise affects pure-tone threshold measurements in a manner that is different from direct masking. The potential contaminating effect of distracting noise can be measured and reported.

Purpose This project was undertaken to develop automated tests of speech recognition, including speech-recognition threshold (SRT) and word-recognition test, using forced-choice responses and computerized scoring of responses. Specific aims were (1) to develop an automated method for measuring SRT for spondaic words that produces scores that are in close agreement with average pure-tone thresholds and (2) to develop an automated test of word recognition that distinguishes listeners with normal hearing from those with sensorineural hearing loss and which informs the hearing aid evaluation process. Method An automated SRT protocol was designed to converge on the lowest level at which the listener responds correctly to two out of two spondees presented monaurally. A word-recognition test was conducted with monosyllabic words (female speaker) presented monaurally at a fixed level. For each word, there were three rhyming foils, displayed on a touchscreen with the test word. The listeners touched the word they thought they heard. Participants were young listeners with normal hearing and listeners with sensorineural hearing loss. Words were also presented with nonrhyming foils and in an open-set paradigm. The open-set responses were scored by a graduate student research assistant. Results The SRT results agreed closely with the pure-tone average (PTA) obtained by automated audiometry. The agreement was similar to results obtained with the conventional SRT scoring method. Word-recognition scores were highest for the closed-set, nonrhyming lists and lowest for open-set responses. For the hearing loss participants, the scores varied widely. There was a moderate correlation between word-recognition scores and pure-tone thresholds which increased as more high frequencies were brought into the PTA. Based on the findings of this study, a clinical protocol was designed that determines if a listener's performance was in the normal range and if the listener benefited from increasing the level of the stimuli. Conclusion SRTs obtained using the automated procedure are comparable to the results obtained by the conventional clinical method that is in common use. The automated closed-set word-recognition test results show clear differentiation between scores for the normal and hearing loss groups. These procedures provide clinical test results that are not dependent on the availability of an audiologist to perform the tests.

Background The amplitude and temporal asymmetry of the speech waveform are mostly associated with voiced speech utterances and are obvious in recent graphic depictions in the literature. The asymmetries are attributed to the presence and interactions of the major formants characteristic of voicing with possible contributions from the unidirectional air flow that accompanies speaking. Purpose This study investigated the amplitude symmetry/asymmetry characteristics (polarity) of speech waveforms that to our knowledge have not been quantified. Study Sample Thirty-six spondaic words spoken by two male speakers and two female speakers were selected because they were multisyllabic words providing a reasonable sampling of speech sounds and four recordings were available that were not related to the topic under study. Research Design Collectively, the words were segmented into phonemes (vowels [130], diphthongs [77], voiced consonants [258], voiceless consonants [219]), syllables (82), and blends (6). For each segment the following were analyzed separately for the positive and negative datum points: peak amplitude, the percent of the total segment datum points, the root-mean-square (rms) amplitude, and the crest factor. Data Collection and Analyses The digitized words (44,100 samples/s; 16-bit) were parsed into 144 files (36 words × 4 speakers), edited, transcribed to numeric values (±1), and stored in a spread sheet in which all analyses were performed with in-house routines. Overall approximately 85% of each waveform was analyzed, which excluded portions of silent intervals, transitions, and diminished waveform endings. Results The vowel, diphthong, and syllable segments had durations (180–220 ms) that were about twice as long as the consonant durations (∼90 ms) and peak and rms amplitudes that were 6 to 12 dB higher than the consonant peak and rms amplitudes. Vowel, diphthong, and syllable segments had 10% more positive datum points (55%) than negative points (45%), which suggested temporal asymmetries within the segments. With voiced consonants, the distribution of positive and negative datum points dropped to 52 and 48% and essentially was equal with the voiceless consonants (50.3 and 49.6%). The mean rms amplitudes of the negative datum points were higher than the rms amplitudes for the positive points by 2 dB (vowels, diphthongs, and syllables), 1 dB (voiced consonants), and 0.1 dB (voiceless consonants). The 144 waveforms and segmentations are illustrated in the Supplementary Material along with the tabularized positive and negative segment characteristics. Conclusions The temporal and amplitude waveform asymmetries were by far most notable in segments that had a voicing component, which included the voiced consonants. These asymmetries were characterized by larger envelopes and more energy in the negative side of the waveform segment than in the positive side. Interestingly, these segments had more positive datum points than negative points, which indicated temporal asymmetry. All aspects of the voiceless consonants were equally divided between the positive and negative domains. There were female/male differences but with these limited samples such differences should not be generalized beyond the speakers in this study. The influence of the temporal and amplitude asymmetries on monaural word-recognition performance is thought to be negligible.

The Auditec of St. Louis and the Department of Veterans Affairs (VA) recorded versions of the Northwestern University Auditory Test No. 6 (NU-6) are in common usage. Data on young adults with normal hearing for pure tones (YNH) demonstrate equal recognition performances on the two versions when the VA version is presented 5 dB higher but similar data on older listeners with sensorineural hearing loss (OHL) are lacking.To compare word-recognition performances on the Auditec and VA versions of NU-6 presented at six presentation levels with YNH and OHL listeners.A quasi-experimental, repeated-measures design was used.Twelve YNH (M = 24.0 years; PTA = 9.9-dB HL) and 36 OHL listeners (M = 71.6 years; PTA = 26.7-dB HL) participated in three, one-hour sessions.Each listener received 100 stimulus words that were randomized by 6 presentation levels for each of two speakers (YNH, −2 to 28-dB SL; OHL, −2 to 38-dB SL). The sessions were limited to 25 practice and 400 experimental words. Digital versions of the 16, 25-word tracks for each session were alternated between speakers.Each of the 48 listeners had higher recognition performances on the Auditec version of NU-6 than on the VA version. The respective overall recognition performances on the Auditec and VA versions were 71.4% and 64.1% (YNH) and 68.7% and 58.2% (OHL). At the highest presentation levels, recognition performances on the two versions differed by only 0.5% (YNH) and 3.3% (OHL). At the 50% correct point, performances on the Auditec version were 3.2 dB (YNH) and 6.1 dB (OHL) better than those on the VA version. The slopes at the 50% points on the mean functions for both speakers were about 4.9%/dB (YNH) and 3.0%/dB (OHL); however, the slopes evaluated from the individual listener data were steeper, 5.2 to 5.3%/dB (YNH) and 3.3 to 3.5%/dB (OHL). When the individual data were transformed from dB SL to dB HL, the differences between the two listener groups were emphasized. The four functions (2 speakers by 2 listener groups) were plotted for each of the 48 participants and each of the 200 words, which revealed the gamut of relations among the datasets. Examination of the data for each speaker across test sessions, in the traditional 50-word lists, and in the typically used 25-word lists of Randomization A revealed no differences of clinical concern. Finally, introspective reports from the listeners revealed that 91.7% and 83.3% of the YNH and OHL listeners, respectively, thought the Auditec speaker was easier to understand than the VA speaker. Recognition performances on each participant and on each word are presented.

Background English materials for speech audiometry are well established. In Spanish, speech-recognition materials are not standardized with monosyllables, bisyllables, and trisyllables used in word-recognition protocols.Purpose This study aimed to establish the psychometric characteristics of common Spanish monosyllabic, bisyllabic, and trisyllabic words for potential use in word-recognition procedures.Research Design Prospective descriptive study.Study Sample Eighteen adult Puerto Ricans (M = 25.6 years) with normal hearing [M = 7.8-dB hearing level (HL) pure-tone average] were recruited for two experiments.Data Collection and Analyses A digital recording of 575 Spanish words was created (139 monosyllables, 359 bisyllables, and 77 trisyllables), incorporating materials from a variety of Spanish word-recognition lists. Experiment 1 (n = 6) used 25 randomly selected words from each of the three syllabic categories to estimate the presentation level ranges needed to obtain recognition performances over the 10 to 90% range. In Experiment 2 (n = 12) the 575 words were presented over five 1-hour sessions using presentation levels from 0- to 30-dB HL in 5-dB steps (monosyllables), 0- to 25-dB HL in 5-dB steps (bisyllables), and −3- to 17-dB HL in 4-dB steps (trisyllables). The presentation order of both the words and the presentation levels were randomized for each listener. The functions for each listener and each word were fit with polynomial equations from which the 50% points and slopes at the 50% point were calculated.Results The mean 50% points and slopes at 50% were 8.9-dB HL, 4.0%/dB (monosyllables), 6.9-dB HL, 5.1%/dB (bisyllables), and 1.4-dB HL, 6.3%/dB (trisyllables). The Kruskal–Wallis test with Mann–Whitney U post-hoc analysis indicated that the mean 50% points and slopes at the 50% points of the individual word functions were significantly different among the syllabic categories. Although significant differences were observed among the syllabic categories, substantial overlap was noted in the individual word functions, indicating that the psychometric characteristics of the words were not dictated exclusively by the syllabic number. Influences associated with word difficulty, word familiarity, singular and plural form words, phonetic stress patterns, and gender word patterns also were evaluated.Conclusion The main finding was the direct relation between the number of syllables in a word and word-recognition performance. In general, words with more syllables were more easily recognized; there were, however, exceptions. The current data from young adults with normal hearing established the psychometric characteristics of the 575 Spanish words on which the formulation of word lists for both threshold and suprathreshold measures of word-recognition abilities in quiet and in noise and other word-recognition protocols can be based.

Background In the 1950s, with monitored live voice testing, the vu meter time constant and the short durations and amplitude modulation characteristics of monosyllabic words necessitated the use of the carrier phrase amplitude to monitor (indirectly) the presentation level of the words. This practice continues with recorded materials. To relieve the carrier phrase of this function, first the influence that the carrier phrase has on word recognition performance needs clarification, which is the topic of this study. Purpose Recordings of Northwestern University Auditory Test No. 6 by two female speakers were used to compare word recognition performances with and without the carrier phrases when the carrier phrase and test word were (1) in the same utterance stream with the words excised digitally from the carrier (VA-1 speaker) and (2) independent of one another (VA-2 speaker). The 50-msec segment of the vowel in the target word with the largest root mean square amplitude was used to equate the target word amplitudes. Research Design A quasi-experimental, repeated measures design was used. Study Sample Twenty-four young normal-hearing adults (YNH; M = 23.5 years; pure-tone average [PTA] = 1.3-dB HL) and 48 older hearing loss listeners (OHL; M = 71.4 years; PTA = 21.8-dB HL) participated in two, one-hour sessions. Data Collection and Analyses Each listener had 16 listening conditions (2 speakers × 2 carrier phrase conditions × 4 presentation levels) with 100 randomized words, 50 different words by each speaker. Each word was presented 8 times (2 carrier phrase conditions × 4 presentation levels [YNH, 0- to 24-dB SL; OHL, 6- to 30-dB SL]). The 200 recorded words for each condition were randomized as 8, 25-word tracks. In both test sessions, one practice track was followed by 16 tracks alternated between speakers and randomized by blocks of the four conditions. Central tendency and repeated measures analyses of variance statistics were used. Results With the VA-1 speaker, the overall mean recognition performances were 6.0% (YNH) and 8.3% (OHL) significantly better with the carrier phrase than without the carrier phrase. These differences were in part attributed to the distortion of some words caused by the excision of the words from the carrier phrases. With the VA-2 speaker, recognition performances on the with and without carrier phrase conditions by both listener groups were not significantly different, except for one condition (YNH listeners at 8-dB SL). The slopes of the mean functions were steeper for the YNH listeners (3.9%/dB to 4.8%/dB) than for the OHL listeners (2.4%/dB to 3.4%/dB) and were Conclusion The current data indicate that word recognition performances with and without the carrier phrase (1) were different when the carrier phrase and target word were produced in the same utterance with poorer performances when the target words were excised from their respective carrier phrases (VA-1 speaker), and (2) were the same when the carrier phrase and target word were produced as independent utterances (VA-2 speaker).

Background: In the 1950s, with monitored live voice testing, the vu meter time constant and the shortdurations and amplitude modulation characteristics of monosyllabic words necessitated the use of the carrierphrase amplitude tomonitor (indirectly) the presentation level of the words. This practice continues withrecorded materials. To relieve the carrier phrase of this function, first the influence that the carrier phrasehas on word recognition performance needs clarification, which is the topic of this study.Purpose: Recordings of Northwestern University Auditory Test No. 6 by two female speakers were usedto compare word recognition performances with and without the carrier phrases when the carrier phraseand test word were (1) in the same utterance stream with the words excised digitally from the carrier (VA-1speaker) and (2) independent of one another (VA-2 speaker). The 50-msec segment of the vowel in thetarget word with the largest root mean square amplitude was used to equate the target word amplitudes.Research Design: A quasi-experimental, repeated measures design was used.Study Sample: Twenty-four young normal-hearing adults (YNH; M = 23.5 years; pure-tone average[PTA] = 1.3-dB HL) and 48 older hearing loss listeners (OHL; M = 71.4 years; PTA = 21.8-dB HL) participatedin two, one-hour sessions.Data Collection and Analyses: Each listener had 16 listening conditions (2 speakers 3 2 carrier phraseconditions 3 4 presentation levels) with 100 randomized words, 50 different words by each speaker.Each word was presented 8 times (2 carrier phrase conditions 3 4 presentation levels [YNH, 0- to24-dB SL; OHL, 6- to 30-dB SL]). The 200 recorded words for each condition were randomized as 8,25-word tracks. In both test sessions, one practice track was followed by 16 tracks alternated betweenspeakers and randomized by blocks of the four conditions. Central tendency and repeated measuresanalyses of variance statistics were used.Results: With the VA-1 speaker, the overall mean recognition performances were 6.0% (YNH) and 8.3%(OHL) significantly better with the carrier phrase than without the carrier phrase. These differences werein part attributed to the distortion of some words caused by the excision of the words from the carrierphrases. With the VA-2 speaker, recognition performances on the with and without carrier phrase conditionsby both listener groups were not significantly different, except for one condition (YNH listeners at8-dB SL). The slopes of the mean functions were steeper for the YNH listeners (3.9%/dB to 4.8%/dB) thanfor the OHL listeners (2.4%/dB to 3.4%/dB) and were Conclusion: The current data indicate that word recognition performances with and without the carrierphrase (1) were different when the carrier phrase and target word were produced in the same utterancewith poorer performances when the target words were excised from their respective carrier phrases(VA-1 speaker), and (2) were the same when the carrier phrase and target word were produced as independentutterances (VA-2 speaker).See the Supplementary Data tab for supplementary materials.

Background: In developing the PB-50 word lists, J. P. Egan suggested five developmental principles, two of which were “equal average difficulty” and an “equal range of difficulty” among the lists (page 963). Egan was satisfied that each of the 20 PB-50 lists had equivalent ranges of recognition performances and that the lists produced the same average performances. This was accomplished in preliminary studies that measured the recognition performance of each word and eliminated words that were always or never correct. In preparing for studies of interrupted words, we needed to know the range of difficulty inherent in the speaker specific NU-6 and Maryland CNC materials we planned to use when those words were not interrupted. There were only a few studies in the literature that touched on the range of difficulty characteristic of the word-recognition materials in common usage. The paucity of this information prompted this investigation whose scope broadened to include the CID W-22, Maryland CNC, NU-6, and PB-50 materials spoken by a variety of speakers. Purpose: The purpose was to evaluate the homogeneity with respect to intelligibility of the words that comprise several of the common word-recognition materials used in audiologic evaluations. Research Design: Both retrospective (10) and prospective (3) studies were involved. Data from six of the retrospective studies were from our labs. The prospective studies involved both listeners with normal hearing for pure tones and listeners with sensorineural hearing loss. Study Sample: The sample sizes for the 13 data sets ranged from 24 to 1,030, with 24 the typical number for listeners with normal hearing. Data Collection and Analysis: The retrospective data were from published studies and archived data from our laboratories. The prospective studies involved presentation of the word-recognition materials to the listeners at a comfortable level. An item analysis was conducted on each data set with descriptive statistics used to characterize the data. Additionally, skewness coefficients were calculated on the distributions of word performances and the interquartile range was used to determine minor and major outliers within each set of 200 words and their component 50-word lists (300 words for the Maryland CNCs). Results: For listeners with normal hearing the majority of performances on the words within a 50-word list were better than the mean performance, which produced negatively skewed distributions with outlier performances in every list. For listeners with sensorineural hearing loss the performances on the words within a 50-word list were evenly distributed above and below the mean performance, which yielded essentially normal distributions with few outliers. There were a few words on which performances were better by the listeners with hearing loss. Conclusions: Every list of word-recognition materials has a few words on which recognition performances are noticeably poorer than performances on the majority of the remaining words. If the intention of an experiment is to evaluate performance at the word level, then identifying these “outliers” becomes a necessity. Although not evaluated in this report, the implications for 25-word lists are they should be based on recognition-performance data and not compiled arbitrarily.

Two previous experiments from our laboratory with 70 interrupted monosyllabic words demonstrated that recognition performance was influenced by the temporal location of the interruption pattern. The interruption pattern (10 interruptions/sec, 50% duty cycle) was always the same and referenced word onset; the only difference between the patterns was the temporal location of the on- and off-segments of the interruption cycle. In the first study, both young and older listeners obtained better recognition performances when the initial on-segment coincided with word onset than when the initial on-segment was delayed by 50 msec. The second experiment with 24 young listeners detailed recognition performance as the interruption pattern was incremented in 10-msec steps through the 0- to 90-msec onset range. Across the onset conditions, 95% of the functions were either flat or U-shaped.To define the effects that interruption pattern locations had on word recognition by older listeners with sensorineural hearing loss as the interruption pattern incremented, re: word onset, from 0 to 90 msec in 10-msec steps.A repeated-measures design with ten interruption patterns (onset conditions) and one uninterruption condition.Twenty-four older males (mean = 69.6 yr) with sensorineural hearing loss participated in two 1-hour sessions. The three-frequency pure-tone average was 24.0 dB HL and word recognition was ≥80% correct.Seventy consonant-vowel nucleus-consonant words formed the corpus of materials with 25 additional words used for practice. For each participant, the 700 interrupted stimuli (70 words by 10 onset conditions), the 70 words uninterrupted, and two practice lists each were randomized and recorded on compact disc in 33 tracks of 25 words each.The data were analyzed at the participant and word levels and compared to the results obtained earlier on 24 young listeners with normal hearing. The mean recognition performance on the 70 words uninterrupted was 91.0% with an overall mean performance on the ten interruption conditions of 63.2% (range: 57.9–69.3%), compared to 80.4% (range: 73.0–87.7%) obtained earlier on the young adults. The best performances were at the extremes of the onset conditions. Standard deviations ranged from 22.1% to 28.1% (24 participants) and from 9.2% to 12.8% (70 words). An arithmetic algorithm categorized the shapes of the psychometric functions across the ten onset conditions. With the older participants in the current study, 40% of the functions were flat, 41.4% were U-shaped, and 18.6% were inverted U-shaped, which compared favorably to the function shapes by the young listeners in the earlier study of 50.0%, 41.4%, and 8.6%, respectively. There were two words on which the older listeners had 40% better performances.Collectively, the data are orderly, but at the individual word or participant level, the data are somewhat volatile, which may reflect auditory processing differences between the participant groups. The diversity of recognition performances by the older listeners on the ten interruption conditions with each of the 70 words supports the notion that the term hearing loss is inclusive of processes well beyond the filtering produced by end-organ sensitivity deficits.

Background: The authors reviewed the evidence regarding the existence of age-related declines in central auditory processes and the consequences of any such declines for everyday communication. Purpose: This report summarizes the review process and presents its findings. Data Collection and Analysis: The authors reviewed 165 articles germane to central presbycusis. Of the 165 articles, 132 articles with a focus on human behavioral measures for either speech or nonspeech stimuli were selected for further analysis. Results: For 76 smaller-scale studies of speech understanding in older adults reviewed, the following findings emerged: (1) the three most commonly studied behavioral measures were speech in competition, temporally distorted speech, and binaural speech perception (especially dichotic listening); (2) for speech in competition and temporally degraded speech, hearing loss proved to have a significant negative effect on performance in most of the laboratory studies; (3) significant negative effects of age, unconfounded by hearing loss, were observed in most of the studies of speech in competing speech, time-compressed speech, and binaural speech perception; and (4) the influence of cognitive processing on speech understanding has been examined much less frequently, but when included, significant positive associations with speech understanding were observed.For 36 smaller-scale studies of the perception of nonspeech stimuli by older adults reviewed, the following findings emerged: (1) the three most frequently studied behavioral measures were gap detection, temporal discrimination, and temporal-order discrimination or identification; (2) hearing loss was seldom a significant factor; and (3) negative effects of age were almost always observed.For 18 studies reviewed that made use of test batteries and medium-to-large sample sizes, the following findings emerged: (1) all studies included speech-based measures of auditory processing; (2) 4 of the 18 studies included nonspeech stimuli; (3) for the speech-based measures, monaural speech in a competing-speech background, dichotic speech, and monaural time-compressed speech were investigated most frequently; (4) the most frequently used tests were the Synthetic Sentence Identification (SSI) test with Ipsilateral Competing Message (ICM), the Dichotic Sentence Identification (DSI) test, and time-compressed speech; (5) many of these studies using speech-based measures reported significant effects of age, but most of these studies were confounded by declines in hearing, cognition, or both; (6) for nonspeech auditory-processing measures, the focus was on measures of temporal processing in all four studies; (7) effects of cognition on nonspeech measures of auditory processing have been studied less frequently, with mixed results, whereas the effects of hearing loss on performance were minimal due to judicious selection of stimuli; and (8) there is a paucity of observational studies using test batteries and longitudinal designs. Conclusions: Based on this review of the scientific literature, there is insufficient evidence to confirm the existence of central presbycusis as an isolated entity. On the other hand, recent evidence has been accumulating in support of the existence of central presbycusis as a multifactorial condition that involves age- and/or disease-related changes in the auditory system and in the brain. Moreover, there is a clear need for additional research in this area.

Background: Since the 1940s, measures of pure-tone sensitivity and speech recognition in quiet have been vital components of the audiologic evaluation. Although early investigators urged that speech recognition in noise also should be a component of the audiologic evaluation, only recently has this suggestion started to become a reality. This report focuses on the Words-in-Noise (WIN) Test, which evaluates word recognition in multitalker babble at seven signal-to-noise ratios and uses the 50% correct point (in dB SNR) calculated with the Spearman-Kärber equation as the primary metric. The WIN was developed and validated in a series of 12 laboratory studies. The current study examined the effectiveness of the WIN materials for measuring the word-recognition performance of patients in a typical clinical setting. Purpose: To examine the relations among three audiometric measures including pure-tone thresholds, word-recognition performances in quiet, and word-recognition performances in multitalker babble for veterans seeking remediation for their hearing loss. Research Design: Retrospective, descriptive. Study Sample: The participants were 3430 veterans who for the most part were evaluated consecutively in the Audiology Clinic at the VA Medical Center, Mountain Home, Tennessee. The mean age was 62.3 yr (SD = 12.8 yr). Data Collection and Analysis: The data were collected in the course of a 60 min routine audiologic evaluation. A history, otoscopy, and aural-acoustic immittance measures also were included in the clinic protocol but were not evaluated in this report. Results: Overall, the 1000–8000 Hz thresholds were significantly lower (better) in the right ear (RE) than in the left ear (LE). There was a direct relation between age and the pure-tone thresholds, with greater change across age in the high frequencies than in the low frequencies. Notched audiograms at 4000 Hz were observed in at least one ear in 41% of the participants with more unilateral than bilateral notches. Normal pure-tone thresholds (≤20 dB HL) were obtained from 6% of the participants. Maximum performance on the Northwestern University Auditory Test No. 6 (NU-6) in quiet was ≥90% correct by 50% of the participants, with an additional 20% performing at ≥80% correct; the RE performed 1–3% better than the LE. Of the 3291 who completed the WIN on both ears, only 7% exhibited normal performance (50% correct point of ≤6 dB SNR). Overall, WIN performance was significantly better in the RE (mean = 13.3 dB SNR) than in the LE (mean = 13.8 dB SNR). Recognition performance on both the NU-6 and the WIN decreased as a function of both pure-tone hearing loss and age. There was a stronger relation between the high-frequency pure-tone average (1000, 2000, and 4000 Hz) and the WIN than between the pure-tone average (500, 1000, and 2000 Hz) and the WIN. Conclusions: The results on the WIN from both the previous laboratory studies and the current clinical study indicate that the WIN is an appropriate clinic instrument to assess word-recognition performance in background noise. Recognition performance on a speech-in-quiet task does not predict performance on a speech-in-noise task, as the two tasks reflect different domains of auditory function. Experience with the WIN indicates that word-in-noise tasks should be considered the “stress test” for auditory function.

Background: The most common complaint of adults with hearing loss is understanding speech in noise. One class of masker that may be particularly useful in the assessment of speech-in-noise abilities is interrupted noise. Interrupted noise usually is a continuous noise that has been multiplied by a square wave that produces alternating intervals of noise and silence. Wilson and Carhart found that spondaic word thresholds for listeners with normal hearing were 28 dB lower in an interrupted noise than in a continuous noise, whereas listeners with hearing loss experienced only an 11 dB difference. Purpose: The purpose of this series of experiments was to determine if a speech-in-interrupted-noise paradigm differentiates better (1) between listeners with normal hearing and listeners with hearing loss and (2) among listeners with hearing loss than do traditional speech-in-continuous-noise tasks. Research Design: Four descriptive/quasi-experimental studies were conducted. Study Sample: Sixty young adults with normal hearing and 144 older adults with pure-tone hearing losses participated. Data Collection and Analysis: A 4.3 sec sample of speech-spectrum noise was constructed digitally to form the 0 interruptions per second (ips; continuous) noise and the 5, 10, and 20 ips noises with 50% duty cycles. The noise samples were mixed digitally with the Northwestern University Auditory Test No. 6 words at selected signal-to-noise ratios and recorded on CD. The materials were presented through an earphone, and the responses were recorded and analyzed at the word level. Similar techniques were used for the stimuli in the remaining experiments. Results: In Experiment 1, using 0 ips as the reference condition, the listeners with normal hearing achieved 34.0, 30.2, and 28.4 dB escape from masking for 5, 10, and 20 ips, respectively. In contrast, the listeners with hearing loss only achieved 2.1 to 2.4 dB escape from masking. Experiment 2 studied the 0 and 5 ips conditions on 72 older listeners with hearing loss, who were on average 13 yr younger and more varied in their hearing loss than the listeners in Experiment 1. The mean escape from masking in Experiment 2 was 7 dB, which is 20–25 dB less than the escape achieved by listeners with normal hearing. Experiment 3 examined the effects that duty cycle (0–100% in 10% steps) had on recognition performance in the 5 and 10 ips conditions. On the 12 young listeners with normal hearing, (1) the 50% correct point increased almost linearly between the 0 and 60% duty cycles (slope = 4.2 dB per 10% increase in duty cycle), (2) the slope of the function was steeper between 60 and 80% duty cycles, and (3) about the same masking was achieved for the 80–100% duty cycles. The data from the listeners with hearing loss were inconclusive. Experiment 4 varied the interburst ratios (0, –6, –12, –24, –48, and –∞ dB) of 5 ips noise and evaluated recognition performance by 24 young adults. The 50% points were described by a linear regression (R 2 = 0.98) with a slope of 0.55 dB/dB. Conclusion: The current data indicate that interrupted noise does provide a better differentiation both between listeners with normal hearing and listeners with hearing loss and among listeners with hearing loss than is provided by continuous noise.

Purpose: To analyze the 50% correct recognition data that were from the Wilson et al (this issue) study and that were obtained from 24 listeners with normal hearing; also to examine whether acoustic, phonetic, or lexical variables can predict recognition performance for monosyllabic words presented in speech-spectrum noise. Research Design: The specific variables are as follows: (a) acoustic variables (i.e., effective root-mean-square sound pressure level, duration), (b) phonetic variables (i.e., consonant features such as manner, place, and voicing for initial and final phonemes; vowel phonemes), and (c) lexical variables (i.e., word frequency, word familiarity, neighborhood density, neighborhood frequency). Data Collection and Analysis: The descriptive, correlational study will examine the influence of acoustic, phonetic, and lexical variables on speech recognition in noise performance. Results: Regression analysis demonstrated that 45% of the variance in the 50% point was accounted for by acoustic and phonetic variables whereas only 3% of the variance was accounted for by lexical variables. These findings suggest that monosyllabic word-recognition-in-noise is more dependent on bottom-up processing than on top-down processing. Conclusions: The results suggest that when speech-in-noise testing is used in a pre- and post-hearing-aid-fitting format, the use of monosyllabic words may be sensitive to changes in audibility resulting from amplification.

Background: A previous experiment with 70 interrupted monosyllabic words demonstrated that recognition performance was influenced by the location of an interruption pattern (Wilson, 2014). The interruption paradigm (10 interruptions/sec, 50% duty cycle periodic interruption) was referenced to word onset. The words were interrupted such that alternate 50-msec segments were parsed to separate files. In the 0-msec condition the first on-segment coincided with the word onset, whereas in the 50-msec condition the first on-segment occurred 50 msec after word onset. The 0- and 50-msec conditions were complementary halves. Recognition performance by young listeners was 19% better on the 0-msec condition (86%) than on the 50-msec condition (68%); there were a minority number of words on which the results were just the opposite. A second study using the same interruption paradigm but 300 different words reported similar relations, with 63% correct recognition on the 0-msec condition and 48% on the 50-msec condition (Wilson and Irish, 2015). Both studies suggest the importance that the first 50 msec of the target word has on intelligibility. Purpose: To define in detail the effects that interruption patterns have on word recognition as the interruption pattern was incremented with reference to word onset from 0 to 90 msec in 10-msec steps. Research Design: A repeated-measures design with ten interruption patterns (onset conditions). Study Sample: Twenty-four young listeners (19–29 yr) with normal hearing for pure tones participated in this study. Data Collection and Analyses: Seventy consonant-nucleus-consonant words formed the corpus of materials with 25 additional words used for practice. For each participant, the 700 stimuli (70 words by ten onset conditions) were interrupted (10 interruptions/sec; 50% duty cycle), randomized, and recorded on compact disc in 28, 25-word tracks. Results: The overall mean recognition performance was 80.4% with mean performances for the ten conditions ranging from 73.0% (50-msec condition) to 87.7% (90-msec condition). The mean recognition performances changed systematically, decreasing from the 0-msec condition to the 50-msec condition and then increasing to the 90-msec condition, which formed a U-shaped function of the means. Of the 45 mean paired comparisons (post hoc t-tests with Bonferroni corrections), there were 17 significant differences at the p ≤ 0.001 level, increasing to 31 significant differences when the significance level was increased to the p ≤ 0.01 level. Visual inspection of the 70-word performance functions revealed that 32 words had flat functions, 34 words had U-shaped functions, two functions were rising, one was an inverted V-shape, and one was irregular. Conclusions: First, some words (utterances of those words) were immune to any differential effects of the ten interruption patterns. These words with flat performance functions constituted 46% of the word corpus. Second, 49% of the words exhibited U-shaped performance functions that were always systematic, going from maximum to minimum and back to maximum. These words were thought to be more dependent on the initial consonant to attain maximum performance. The conclusion is that some words are not affected by the location of the interruption pattern (those with flat functions) whereas other words are substantially affected (those with U-shaped functions).

Dichotic word recognition was evaluated in free-recall, directed-attention right, and directed-attention left response conditions. All participants were right-handed and included a group of young adults with normal hearing and two groups of older adults with sensorineural hearing loss. Dichotic word recognition performance was best for young adults and decreased for each older group. A right-ear advantage (REA) was observed for all groups. REAs observed in the older groups were larger than those for the young adults, resulting from a greater deficit in dichotic word recognition performance for words presented to the left ear. A subset of older adults exhibited few to no responses (≤3/100) for the left ear for all response conditions, which may relate to a compromise in auditory processing. The results support an age-related disadvantage in recognition performance for dichotic stimuli presented to the left ear not entirely accounted for by differences in hearing sensitivity between subject groups.

The purpose of this study was to determine the list equivalency of the 18 QuickSIN™ (Quick Speech in Noise test) lists. Individuals with normal hearing (n = 24) and with sensorineural hearing loss (n = 72) were studied. Mean recognition performances on the 18 lists by the listeners with normal hearing were 2.8 to 4.3 dB SNR (signal-to-noise ratio), whereas the range was 10.0 to 14.3 dB SNR for the listeners with hearing loss. The psychometric functions for each list showed high performance variability across lists for listeners with hearing loss but not for listeners with normal hearing. For listeners with hearing loss, Lists 4, 5, 13, and 16 fell outside of the critical difference. The data from this study suggest nine lists that provide homogenous results for listeners with and without hearing loss. Finally, there was an 8.7 dB difference in performances between the two groups indicating a more favorable signal-to-noise ratio required by the listeners with hearing loss to obtain equal performance.

Background: Several European countries have demonstrated successful use of telephone screening tests for auditory function. The screening test consists of spoken three-digit sequences presented in a noise background. The speech-to-noise ratios of the stimuli are determined by an adaptive tracking method that converges on the level required to achieve 50% correct recognition. Purpose: A version of the three-digit telephone screening protocol for the United States was developed: the US National Hearing Test (NHT). The objective of the current study was to determine the sensitivity and specificity as well as the feasibility of the NHT for use within the Department of Veterans Affairs (VA). Research Design and Study Sample: Using a multisite study design with convenience sampling, we used the NHT to collect data from 693 participants (1379 ears) from three geographical areas of the United States (Florida, Tennessee, and California). Data Collection and Analysis: The NHT procedures were as follows: the participants (1) called a toll-free telephone number, (2) entered their assigned ear-specific identification code, (3) listened to 40-sets of digit triplets presented in speech-spectrum background noise, and (4) entered in the numbers that they heard on the telephone key pad. The NHT was performed on each ear, either at home or in a VA clinic. In addition to collecting data from the experimental task, we gathered demographic data and the data from other standard-of-care tests (i.e., audiometric thresholds and speech recognition tests in quiet and in noise). Results: A total of 505 participants completed the NHT at a VA clinic, whereas 188 completed the test at home. Although the ear-specific NHT and mean pure-tone threshold all correlated significantly (p < 0.001), there were more modest correlations in the low- and high-frequency ranges with the highest correlation seen with the 2000 Hz mean pure-tone threshold. When the NHT 50% point or threshold was compared with the three-frequency PTA at 500, 1000, and 2000 Hz, the sensitivity was 0.87 and specificity was 0.54. When comparing the NHT with the four-frequency PTA at 500, 1000, 2000, and 4000 Hz, the sensitivity was 0.81 and specificity increased to 0.65. The NHT also correlated strongly with other speech-in-noise measures. Conclusions: The NHT was found to correlate with other audiometric measures, including pure-tone thresholds and speech recognition tests in noise, at sufficiently high correlation values to support its use as a screening test of auditory function.

The purpose of this study was to determine if performances on a 500 Hz MLD task and a word-recognition task in multitalker babble covaried or varied independently for listeners with normal hearing and for listeners with hearing loss. Young listeners with normal hearing (n = 25) and older listeners (25 per decade from 40–80 years, n = 125) with sensorineural hearing loss were studied. Thresholds at 500 and 1000 Hz were ≤30 dB HL and ≤40 dB HL, respectively, with thresholds above 1000 Hz

A simple word-recognition task in multitalker babble for clinic use was developed in the course of four experiments involving listeners with normal hearing and listeners with hearing loss. In Experiments 1 and 2, psychometric functions for the individual NU No. 6 words from Lists 2, 3, and 4 were obtained with each word in a unique segment of multitalker babble. The test paradigm that emerged involved ten words at each of seven signal-to-babble ratios (S/B) from 0 to 24 dB. Experiment 3 examined the effect that babble presentation level (70, 80, and 90 dB SPL) had on recognition performance in babble, whereas Experiment 4 studied the effect that monaural and binaural listening had on recognition performance. For listeners with normal hearing, the 90th percentile was 6 dB S/B. In comparison to the listeners with normal hearing, the 50% correct points on the functions for listeners with hearing loss were at 5 to 15 dB higher signal-to-babble ratios.

The purpose of this series of experiments was to develop a simple, 500-Hz masking-level difference (MLD) protocol that could be implemented easily in the clinic to assess auditory perceptual abilities using an audio compact disc. Five, 300-ms tones with 250-ms intertone intervals were embedded in 3-s bursts of 200-800 Hz noise presented at 42.2-dB pressure-spectrum level with 4-5 s inter-stimulus intervals. The homophasic and antiphasic conditions were interleaved with the signal-to-noise ratios decreasing in 2-dB steps. A single-interval, "yes/no" response task was used. Three experiments were performed on 24-28 listeners with normal hearing. The mean SoNo thresholds (58.1- to 59.5-dB SPL) and the mean SπNo thresholds (45.1- to 46.0-dB SPL) produced ˜13-dB MLDs. Experiment 3 included a SoNπ condition that had a mean threshold of 48.8-dB SPL and a 10.0-dB MLD. The mean test, retest ot the SoNo and SπNo thresholds on 15 listeners was

Background: The abrupt transition of a signal from off to on and vice versa typically produces spectral splatter that can mask other signals that are spectrally removed from the nominal signal frequency. Both the Miller and Licklider (1950) and Cherry (1953) studies of interrupted speech and alternated speech, respectively, acknowledged the generation of extraneous noise by the rapid on and off characteristics of their unshaped signals but noted for slower interruption rates (e.g., 10 interruptions per second); the masking effects were minimal. Recent studies of interrupted speech have avoided this issue by shaping the rise-fall times with a digital algorithm (e.g., Jin and Nelson, 2010; Wang and Humes, 2010). A second variable in the interrupted speech paradigm is the temporal location or placement of the interruptions (i.e., where in the waveform the interruptions occur). Here the issue is this: what parts of an utterance are necessary to enable intelligibility (e.g., Fogerty and Kewley-Port, 2009)? Interruptions may or may not disturb these necessary cues. Purpose: Here is the prompting question: do shaped and unshaped rise-fall characteristics of the on-segments of interrupted speech produce the same or different recognition performances? A second question arises: are recognition performances on complementary halves of an interrupted signal the same or different? Research Design: This study used a mixed-model design with two within-subject variables (unshaped and shaped rise-fall characteristic, complementary halves) and one between-subjects variable (listener group). Study Sample: A total of 12 young listeners (age range: 19–29 yr) with normal hearing and 12 older listeners (age range: 53–80 yr) with hearing loss for pure tones participated. Data Collection and Analysis: A total of 95 consonant-vowel nucleus-consonant words were interrupted (10 interruptions per second; 50% duty cycle) by parsing alternate 50 msec segments to separate files, which provided complementary temporal halves of the target word referenced to word onset; the first on-segment of the 0 msec condition started at word onset, whereas the first on-segment of the 50 msec condition started 50 msec after word onset. The interruption routine either applied no shaping of the 4 msec rise-fall times or a cos2 shape. Each listener received 25 practice words then a unique randomization of 280 interrupted words (70 words, 2 rise-fall shapes, and 2 interrupt onset conditions). Results: The listeners with normal hearing performed 8–16% better on the various comparable conditions than did the older listeners with hearing loss. The mean performance differences between shaped and unshaped rise-fall characteristics ranged from Conclusions: The rise-fall shape of the onset and offset of the on-segment of the interruption cycle does not affect recognition performance of words. The location of the interruptions in a word can have a significant effect on recognition performance.

Background: For the past 50+ years, audiologists have been taught to measure the pure-tone thresholds at the interoctave frequencies when the thresholds at adjacent octave frequencies differ by 20 dB or more. Although this so-called 20 dB rule is logical when enhanced audiometric resolution is required, the origin of the rule is elusive, and a thorough literature search failed to find supporting scientific data. Purpose: This study purposed to examine whether a 20 dB difference between thresholds at adjacent octave frequencies is the critical value for whether the threshold of the interoctave frequency should be measured. Along this same line of questioning is whether interoctave thresholds can be predicted from the thresholds of the adjacent or bounding octave frequencies instead of measured, thereby saving valuable time. Research Design: Retrospective, descriptive, correlational, and cross-sectional. Study Sample: Audiograms from over a million veterans provided the data, which were archived at the Department of Veterans Affairs, Denver Acquisition and Logistics Center. Data Collection and Analysis: Data from the left and right ears were independently evaluated. For each ear three interoctave frequencies (1500, 3000, and 6000 Hz) were studied. For inclusion, thresholds at the interoctave frequency and the two bounding octave frequencies had to be measurable, which produced unequal numbers of participants in each of the six conditions (2 ears by 3 interoctave frequencies). Age tags were maintained with each of the six conditions. Results: Three areas of analyses were considered. First, relations among the octave-frequency thresholds were examined. About 62% of the 1000–2000 Hz threshold differences were ≥20 dB, whereas about 74% of the 4000–8000 Hz threshold differences were 20 dB. There was an inverse relation between frequency and the percent of negative slopes between octave-frequency thresholds, ranging from 89% at 1500 Hz to 54% at 6000 Hz. The majority of octave-frequency pairs demonstrated poorer thresholds for the higher frequency of the pair. Second, interoctave frequency thresholds were evaluated using the median metric. As the interoctave frequency increased from 1500 to 6000 Hz, the percent of thresholds at the interoctave frequencies that were not equal to the median threshold increased from ˜9.5% (1500 Hz) to 15.6% (3000 Hz) to 28.2% (6000 Hz). Bivariate plots of the interoctave thresholds and the mean octave-frequency thresholds produced 0.85–0.91 R2 values and 0.79–0.92 dB/dB slopes. Third, the predictability of the interoctave thresholds from the mean thresholds of the bounding octave frequencies was evaluated. As expected, as the disparity between octave-frequency thresholds increased, the predictability of the interoctave threshold decreased; for example, using a ±5 dB criterion at 1500 Hz, 53% of the thresholds were ±5 dB when the octave thresholds differed by ≥20 dB, whereas 77% were ±5 dB when the octave thresholds differed by Conclusions: The current findings support the 20 dB rule for testing interoctave frequency thresholds and suggest the rule could be increased to 25 dB or more with little adverse effect.

The sentence stimuli developed in this project combined aspects from several traditional approaches to speech audiometry. Sentences varied with respect to frequency of word use and phonetic confusability. Familiar consonant-vowel-consonant words, nouns and modifiers, were used to form 500 sentences of seven to nine syllables. Based on concepts from the Neighborhood Activation Model for spoken word recognition, each sentence contained three key words that were all characterized as high- or low-use frequency and high or low lexical confusability. Use frequency was determined by published indices of word use, and lexical confusability was defined by a metric based on the number of other words that were similar to a given word using a single phoneme substitution algorithm. Thirty-two subjects with normal hearing were randomly assigned to one of seven presentation levels in quiet, and an additional 32 listeners were randomly assigned to a fixed-level noise background at one of six signal-to-noise ratios. The results indicated that in both quiet and noise listening conditions, high-use words were more intelligible than low-use words, and there was an advantage for phonetically unique words; the position of the key word in the sentence was also a significant factor. These data formed the basis for a sequence of experiments that isolated significant nonacoustic sources of variation in spoken word recognition. Abbreviations: CVC = consonant-vowel-consonant, HD = high frequency of use word from a dense neighborhood, HS = high frequency of use word from a sparse neighborhood, LD = low frequency of use word from a dense neighborhood, LS = low frequency of use word from a sparse neighborhood, NAM = Neighborhood Activation Model, SIN = Speech in Noise, SNR = signal-to-noise ratio

An option for estimating the word-recognition performance of patients who do not speak English as a first language involves using auditory materials, presented in the patient’s native language, in conjunction with a closed-set response mode incorporating pictures or written words. The advantage of this auditory/visual paradigm is that the audiologist is not required to know the foreign language and is therefore not required to judge the accuracy of an oral response to speech stimuli in a foreign language. Spanish auditory/visual materials, known as the Spanish Picture-Identification Task, were developed to be used in a computer- driven multimedia administration and scoring format. Performance data, both in open- (word-recognition) and closed-set (word-identification) response modes, were established for the Spanish Picture-Identification Task using subjects whose first language was Spanish. The results from the open-set paradigm indicate that the Spanish Picture-Identification Task word lists are essentially equivalent to conventional Spanish and English materials used for word recognition. Findings from the closed-set conditions indicate that the Spanish Picture- Identification Task materials are appropriate for estimating the word-identification abilities of Spanish-speaking adult listeners.

Four patients who preferred monaural as compared with binaural amplification were evaluated. For these patients, audiometric data, recognition performance on a dichotic digit task, and monaural and binaural hearing aid performance using four amplification strategies (National Acoustic Laboratories-Revised, a speech in noise algorithm, multiple-microphone arrays, and frequency modulated [FM]) are described. The results of dichotic testing using a one-, two-, and three-pair dichotic digit task in free- and directed-recall conditions indicated a left-ear deficit for all subjects that could not be explained by peripheral auditory findings or by a cognitive-based deficit. The results of soundfield testing using a speech in multitalker babble paradigm indicated that when listening in noise, there was little difference between aided and unaided word-recognition performance, suggesting that the binaural hearing aids originally fit for each patient were not providing substantial benefit when listening in a competing babble background. Word-recognition performance when aided monaurally in the right ear was superior to performance when aided monaurally in the left ear and when aided bin- aurally. The only successful binaural amplification strategy was the FM system. The results indicate that listeners with an auditory-based deficit in dichotic listening may function better with a monaural hearing aid fitting or with an assistive listening device such as an FM system. The findings also suggest that a test of dichotic listening is an important component in the evaluation of patients being considered for amplification. Abbreviations: ALD = assistive listening device, BTE = behind the ear, DM = directional microphone, FM = frequency modulated, ITE = in the ear, NAL-R = National Acoustic Laboratories-Revised, NU-6 = Northwestern University Auditory Test No. 6, S/B = signal-to-babble ratio, S/N - signal-to-noise ratio

Dichotic listening was evaluated using monosyllabic word pairs that differed in lexical difficulty as defined by the Neighborhood Activation Model of spoken word recognition. Four combinations of lexically EASY and lexically HARD words were evaluated (same pair: EASY-EASY, HARD-HARD; or mixed pair: EASY-HARD, HARD-EASY) in young adult listeners with normal hearing and older adult listeners with mild-to-moderate hearing loss. The same-pair data indicated that for all subjects, EASY words were identified correctly more often than HARD words, and recognition performance on words presented to the right ear was better than performance on words presented to the left ear. Overall performance was lower and the right-ear advantage was larger for the older group. The mixed-pair data for the young group revealed that EASY words were recognized more accurately than HARD words, regardless of the ear to which they were presented. For the older adults, the words presented to the right ear were recognized more accurately than were the words presented to the left ear, regardless of the type of word. The efficiency of the processing of stimuli from the left ear is discussed as an explanation of the results for the mixed-pair conditions. Abbreviations: ANCOVA = analysis of covariance, ANOVA = analysis of variance, CV = consonant-vowel, NAM = Neighborhood Activation Model

This tutorial paper examines the relation between the slope of a mean word recognition function and the homogeneity or variability (with respect to recognition) of the individual stimulus items that compose the test materials. This was studied in terms of both the location (Cartesian) and slope of the psychometric functions of the individual words that compose the materials. Word recognition performances were measured for 100 CID W-22 (Hirsh) words and 100 PB-50 (Rush Hughes) words in quiet (0 to 56 dB HL in 8-dB steps) on 12 subjects with normal hearing. The functions for the individual W-22 words were more homogeneous (less variable) than were the functions for the individual PB-50 words. The mean function for the W-22 words was steeper (3.1%/dB) than the function for the PB-50 words (1.9%/dB). This evaluation of the individual words demonstrates the direct relation between variability of the test items and the slope of the mean psychometric function. The more homogeneous performance is on the individual test items with respect to both location and slope, the steeper the slope of the mean psychometric function. Abbreviations: ANOVA = analysis of variance, CD = compact disc

A one-, two-, and three-pair dichotic digit test was administered to 180 subjects (20-79 years) with varying degrees of hearing sensitivity. The test was carried out under free- and directed-recall response conditions. The results indicated that recognition performance decreased as a function of increasing age. Statistical analysis using analysis of covariance indicated that differences in performance between age groups were not owing to differences in hearing sensitivity. Thus, with the effects of hearing sensitivity removed, age alone accounted for a significant portion of the variability in the data among age groups. Normative data for the free-recall condition are reported for the two lists of randomly interleaved one-, two-, and three-pair digits included on the Tonal and Speech Materials for Auditory Perceptual Assessment, Disc 2.0 (1998) compact disc. A comparison of performance in free- and directed-recall conditions indicated three patterns of results. First, 58 percent of the subjects had normal recognition performance for one-, two-, and three-pair digits under both recall conditions. Second, 39 percent of the subjects had a deficit in the free-recall condition, with normal performance in the directed-recall condition, which was interpreted as representing primarily a cognitive problem. Third, the remaining 3 percent of the subjects showed a deficit in both free- and directed-recall conditions, which was attributed primarily to an auditory problem. Abbreviations: ANCOVA = analysis of covariance, ANOVA = analysis of variance, CD = compact disc, rau = rationalized arcsine unit

Word recognition norms were determined for the Northwestern University Auditory Test No. 6 (NU-6) released on the Department of Veterans Affairs (VA) Disc 1.1. Word recognition performance (in quiet and in competing message) was measured at 12 presentation levels for 24 young adults with normal hearing. Test-retest reliability also was evaluated. Word recognition scores for VA Disc 1.1 were generally higher than those reported for VA Disc 1.0. The differences in NU-6 scores across disc versions, however, were small and unlikely to affect clinical decisions based on word recognition tests. Score differences on test-retest for the VA Disc 1.1 version of the NU-6 with a competing message background also were small and unlikely to affect clinical outcomes. Overall, based on comparisons of scores for the disc versions of the NU-6, it appears that the two different recordings can be used interchangeably for clinical applications. Abbreviations: CD = compact disc, NU-6 = Northwestern University Auditory Test No. 6, VA = Department of Veterans Affairs, W/CML = word to competing message level

Dichotic digit listening was made more difficult by interleaving one-, two-, three-, and four-pair digits within a test list in which the subjects did not know a priori the number of digit pairs presented on a given trial, thereby introducing listener uncertainty. Twenty right-handed (mean age = 26.8 years) and 20 left-handed adults (mean age = 24.0) with normal hearing and 40 right-handed adults in the 60- to 75-years age range (mean age = 67.2) with mild-to-moderate sensorineural hearing loss were evaluated. Compared to traditional paradigms, the uncertainty of stimulus length (one, two, three, or four pairs) reduced overall recognition performance on stimuli presented to both ears of all groups, but the reduction was more pronounced for the left ear than for the right ear. The recognition performance of the right-handed subjects was more homogeneous than the performance of the left-handed subjects. In comparison to the young subjects, the 60- to 75-year-old group had substantially reduced recognition performance. Abbreviations: ANOVA = analysis of variance, CD = compact disc, CV = consonant-vowel

Background: In certain masking paradigms, the masker can have two components, energetic and informational. Energetic masking is the traditional peripheral masking, whereas informational masking involves confusions (uncertainty) between the signal and masker that originate more centrally in the auditory system. Sperry et al (1997) used Northwestern University Auditory Test No. 6 (NU-6) words in multitalker babble to study the differential effects of energetic and informational masking using babble played temporally forward (FB) and backward (BB). The FB and BB are the same except BB is void of the contextual and semantic content cues that are available in FB. It is these informational cues that are thought to fuel informational masking. Sperry et al found 15% better recognition performance (˜3 dB) on BB than on FB, which can be interpreted as the presence of informational masking in the FB condition and not in the BB condition (Dirks and Bower, 1969). The Words-in-Noise Test (WIN) (Wilson, 2003; Wilson and McArdle, 2007) uses NU-6 words as the signal and multitalker babble as the masker, which is a combination of stimuli that potentially could produce informational masking. The WIN presents 5 or 10 words at each of seven signal-to-noise ratios (S/N, SNR) from 24 to 0 dB in 4 dB decrements with the 50% correct point being the metric of interest. The same recordings of the NU-6 words and multitalker babble used by Sperry et al are used in the WIN. Purpose: To determine whether informational masking was involved with the WIN. Research Design: Descriptive, quasi-experimental designs were conducted in three experiments using FB and BB in various paradigms in which FB and BB varied from 4.3 sec concatenated segments to essentially continuous. Study Sample: Eighty young adults with normal hearing and 64 older adults with sensorineural hearing losses participated in a series of three experiments. Data Collection and Analysis: Experiment 1 compared performance on the normal WIN (FB) with performance on the WIN in which the babble segment with each word was reversed temporally (BB). Experiment 2 examined the effects of continuous FB and BB segments on WIN performance. Experiment 3 replicated the Sperry et al (1997) experiment at 4 and 0 dB S/N using NU-6 words in the FB and BB conditions. Results: Experiment 1—with the WIN paradigm, recognition performances on FB and BB were the same for listeners with normal hearing and listeners with hearing loss, except at the 0 dB S/N with the listeners with normal hearing at which performance was significantly better on BB than FB. Experiment 2—recognition performances on FB and BB were the same at all SNRs for listeners with normal hearing using a slightly modified WIN paradigm. Experiment 3—there was no difference in performances on the FB and BB conditions with either of the two SNRs. Conclusions: Informational masking was not involved in the WIN paradigm. The Sperry et al results were not replicated, which is thought to be related to the way in which the Sperry et al BB condition was produced.

Background: The Revised Speech Perception in Noise Test (R-SPIN; Bilger, 1984b) is composed of 200 target words distributed as the last words in 200 low-predictability (LP) and 200 high-predictability (HP) sentences. Four list pairs, each consisting of two 50-sentence lists, were constructed with the target word in a LP and HP sentence. Traditionally the R-SPIN is presented at a signal-to-noise ratio (SNR, S/N) of 8 dB with the listener task to repeat the last word in the sentence. Purpose: The purpose was to determine the practicality of altering the R-SPIN format from a single SNR paradigm into a multiple SNR paradigm from which the 50% points for the HP and LP sentences can be calculated. Research Design: Three repeated measures experiments were conducted. Study Sample: Forty listeners with normal hearing and 184 older listeners with pure-tone hearing loss participated in the sequence of experiments. Data Collection and Analysis: The R-SPIN sentences were edited digitally (1) to maintain the temporal relation between the sentences and babble, (2) to establish the SNRs, and (3) to mix the speech and noise signals to obtain SNRs between –1 and 23 dB. All materials were recorded on CD and were presented through an earphone with the responses recorded and analyzed at the token level. For reference purposes the Words-in-Noise Test (WIN) was included in the first experiment. Results: In Experiment 1, recognition performances by listeners with normal hearing were better than performances by listeners with hearing loss. For both groups, performances on the HP materials were better than performances on the LP materials. Performances on the LP materials and on the WIN were similar. Performances at 8 dB S/N were the same with the traditional fixed level presentation and the descending presentation level paradigms. The results from Experiment 2 demonstrated that the four list pairs of R-SPIN materials produced good first approximation psychometric functions over the –4 to 23 dB S/N range, but there were irregularities. The data from Experiment 2 were used in Experiment 3 to guide the selection of the words to be used at the various SNRs that would provide homogeneous performances at each SNR and would produce systematic psychometric functions. In Experiment 3, the 50% points were in good agreement for the LP and HP conditions within both groups of listeners. The psychometric functions for List Pairs 1 and 2, 3 and 4, and 5 and 6 had similar characteristics and maintained reasonable separations between the HP and LP functions, whereas the HP and LP functions for List Pair 7 and 8 bisected one another at the lower SNRs. Conclusions: This study indicates that the R-SPIN can be configured into a multiple SNR paradigm. A more in-depth study with the R-SPIN materials is needed to develop lists that are systematic and reasonably equivalent for use on listeners with hearing loss. The approach should be based on the psychometric characteristics of the 200 HP and 200 LP sentences with the current R-SPIN lists discarded. Of importance is maintaining the synchrony between the sentences and their accompanying babble.

Background: The Words-in-Noise Test (WIN) was developed as an instrument to quantify the ability of listeners to understand monosyllabic words in background noise using multitalker babble (Wilson, 2003). The 50% point, which is calculated with the Spearman-Kärber equation (Finney, 1952), is used as the evaluative metric with the WIN materials. Initially, the WIN was designed as a 70-word instrument that presented ten unique words at each of seven signal-to-noise ratios from 24 to 0 dB in 4 dB decrements. Subsequently, the 70-word list was parsed into two 35-word lists that achieved equivalent recognition performances (Wilson and Burks, 2005). This report involves the development of a third list (WIN List 3) that was developed to serve as a practice list to familiarize the participant with listening to words presented in background babble. Purpose: To determine—on young listeners with normal hearing and on older listeners with sensorineural hearing loss—the psychometric properties of the WIN List 3 materials. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 21.6 yr) with normal pure-tone thresholds (≤20 dB HL at 250 to 8000 Hz) and 24 older listeners (M = 65.9 yr) with sensorineural hearing loss participated. Data Collection and Analysis: The level of the babble was fixed at 80 dB SPL with the level of the words varied from 104 to 80 dB SPL in 4 dB decrements. Results: For listeners with normal hearing, the 50% points for Lists 1 and 2 were similar (4.3 and 5.1 dB S/N, respectively), both of which were lower than the 50% point for List 3 (7.4 dB S/N). A similar relation was observed with the listeners with hearing loss, 50% points for Lists 1 and 2 of 12.2 and 12.4 dB S/N, respectively, compared to 15.8 dB S/N for List 3. The differences between Lists 1 and 2 and List 3 were significant. The relations among the psychometric functions and the relations among the individual data both reflected these differences. Conclusions: The significant ˜3 dB difference between performances on WIN Lists 1 and 2 and on WIN List 3 by the listeners with normal hearing and the listeners with hearing loss dictates caution with the use of List 3. The use of WIN List 3 should be reserved for ancillary purposes in which equivalent recognition performances are not required, for example, as a practice list or a stand alone measure.

Background: This is a case study of an 18-year-old female who suffered a bilateral idiopathic sensorineural hearing loss that was coincident with the removal of four impacted wisdom teeth. Throughout childhood the patient had normal hearing for pure tones bilaterally as measured at the pediatrician's office. One month prior to dental surgery (May) the patient volunteered to participate in an auditory experiment at which time her pure-tone audiogram was normal. Immediately following surgery (June), the patient had substantial swelling of the face and complained of some hearing loss with no other auditory/vestibular complaints. The following month (July) during the course of a routine physical examination a pure-tone audiogram revealed bilateral, air-conduction thresholds of 30–35 dB HL (500–4000 Hz) and 20 dB HL (8000 Hz). Because bone conduction was not tested, it is impossible to know whether the hearing loss was conductive, mixed, or sensorineural. The pediatrician thought that the hearing loss was conductive and would resolve as the edema subsided. A month later (August) the subject again volunteered for an auditory experiment at which time her hearing again was tested. Purpose: The purpose of this report is to detail the dental procedures involved in the extraction of the wisdom teeth, to report the results of a variety and series of post-op hearing tests, and to discuss the possible mechanisms that might be involved in the “idiopathic” bilateral sensorineural hearing loss. Research Design: Case report. Results: During the August visit to the laboratory, hearing for pure tones bilaterally was 0 to 5 dB HL at 250–1000 Hz with a 40–45 dB HL notch at 2000 Hz with a return to 10 dB HL at 8000 Hz. Air conduction and bone conduction thresholds were equivalent. Word recognition in quiet was ≥92 percent correct for both ears, whereas the signal-to-noise ratio (SNR) hearing loss measured with the Words-in-Noise test was high normal in the left ear with a mild SNR hearing loss in the right ear. Tympanometry and acoustic reflex thresholds were normal. Distortion product otoacoustic emissions were reduced in the 1000–3000 Hz region for both ears, which is consistent with cochlear hearing loss. The hearing loss has remained unchanged for the past 19 months. Conclusions: The possible etiologies, including insults to the cochleae by vibration trauma and through alterations in the blood supply to the cochleae, are considered.

Purpose: To establish normative data for children and to characterize developmental differences in performance with the free recall version of the Randomized Dichotic Digits Test. Research Design: Group comparison of behavioral data derived from administration of the Randomized Dichotic Digits Test. Study Sample: Children from 10 to 18 years of age (167) and young adults from 19 to 28 years of age (50). Results: Performance improved with age across all types of digit pairs, especially in the left ear, leading to smaller interaural asymmetries among older participants. A left-ear advantage was produced by 39 subjects (18%), only two of whom were left-handed. Normative data are reported for right and left ear scores and for interaural asymmetry (percent correct difference between the two ears) under one-, two-, and three-pair conditions of the test and for interaural asymmetry across the entire test. A unilateral deficit was identified in children (15.5%) and young adults (12%) for the left ear and in children (11.3%) and young adults (6%) for the right ear. A bilateral deficit was also identified in children (6.5%) and young adults (6%). Conclusions: This test may be useful as part of the clinical battery for identifying binaural integration weaknesses and referring individuals for auditory rehabilitation for interaural asymmetry (ARIA).

Background: So that portions of the classic Miller, Heise, and Lichten (1951) study could be replicated, new recorded versions of the words and digits were made because none of the three common monosyllabic word lists (PAL PB-50, CID W-22, and NU–6) contained the 9 monosyllabic digits (1–10, excluding 7) that were used by Miller et al. It is well established that different psychometric characteristics have been observed for different lists and even for the same materials spoken by different speakers. The decision was made to record four lists of each of the three monosyllabic word sets, the monosyllabic digits not included in the three sets of word lists, and the CID W-1 spondaic words. A professional female speaker with a General American dialect recorded the materials during four recording sessions within a 2-week interval. The recording order of the 582 words was random. Purpose: To determine—on listeners with normal hearing—the psychometric properties of the five speech materials presented in speech-spectrum noise. Research Design: A quasi-experimental, repeated-measures design was used. Study Sample: Twenty-four young adult listeners (M = 23 years) with normal pure-tone thresholds (≤20-dB HL at 250 to 8000 Hz) participated. The participants were university students who were unfamiliar with the test materials. Data Collection and Analysis: The 582 words were presented at four signal-to-noise ratios (SNRs; −7-, −2-, 3-, and 8-dB) in speech-spectrum noise fixed at 72-dB SPL. Although the main metric of interest was the 50% point on the function for each word established with the Spearman-Kärber equation (Finney, 1952), the percentage correct on each word at each SNR was evaluated. The psychometric characteristics of the PB-50, CID W-22, and NU–6 monosyllabic word lists were compared with one another, with the CID W-1 spondaic words, and with the 9 monosyllabic digits. Results: Recognition performance on the four lists within each of the three monosyllabic word materials were equivalent, ±0.4 dB. Likewise, word-recognition performance on the PB-50, W-22, and NU–6 word lists were equivalent, ±0.2 dB. The mean recognition performance at the 50% point with the 36 W-1 spondaic words was ˜6.2 dB lower than the 50% point with the monosyllabic words. Recognition performance on the monosyllabic digits was 1–2 dB better than mean performance on the monosyllabic words. Conclusions: Word-recognition performances on the three sets of materials (PB-50, CID W-22, and NU–6) were equivalent, as were the performances on the four lists that make up each of the three materials. Phonetic/phonemic balance does not appear to be an important consideration in the compilation of word-recognition lists used to evaluate the ability of listeners to understand speech.A companion paper examines the acoustic, phonetic/phonological, and lexical variables that may predict the relative ease or difficulty for which these monosyllable words were recognized in noise (McArdle and Wilson, this issue).

Background: The Speech Recognition in Noise Test (SPRINT) is a word-recognition instrument that presents the 200 Northwestern University Auditory Test No. 6 (NU-6) words binaurally at 50 dB HL in a multitalker babble at a 9 dB signal-to-noise ratio (S/N) (Cord et al, 1992). The SPRINT was developed by and used by the Army as a more valid predictor of communication abilities (than pure-tone thresholds or word-recognition in quiet) for issues involving fitness for duty from a hearing perspective of Army personnel. The Words-in-Noise test (WIN) is a slightly different word-recognition task in a fixed level multitalker babble with 10 NU-6 words presented at each of 7 S/N from 24 to 0 dB S/N in 4 dB decrements (Wilson, 2003; Wilson and McArdle, 2007). For the two instruments, both the babble and the speakers of the words are different. The SPRINT uses all 200 NU-6 words, whereas the WIN uses a maximum of 70 words. Purpose: The purpose was to compare recognition performances by 24 young listeners with normal hearing and 48 older listeners with sensorineural hearing on the SPRINT and WIN protocols. Research Design: A quasi-experimental, mixed model design was used. Study Sample: The 24 young listeners with normal hearing (19 to 29 years, mean = 23.3 years) were from the local university and had normal hearing (≤20 dB HL; American National Standards Institute, 2004) at the 250–8000 Hz octave intervals. The 48 older listeners with sensorineural hearing loss (60 to 82 years, mean = 69.9 years) had the following inclusion criteria: (1) a threshold at 500 Hz between 15 and 30 dB HL, (2) a threshold at 1000 Hz between 20 and 40 dB HL, (3) a three-frequency pure-tone average (500, 1000, and 2000 Hz) of ≤40 dB HL, (4) word-recognition scores in quiet ≥40%, and (5) no history of middle ear or retrocochlear pathology as determined by an audiologic evaluation. Data Collection and Analysis: The speech materials were presented bilaterally in the following order: (1) the SPRINT at 50 dB HL, (2) two half lists of NU-6 words in quiet at 60 dB HL and 80 dB HL, and (3) the two 35-word lists of the WIN materials with the multitalker babble fixed at 60 dB HL. Data collection occurred during a 40–60 minute session. Recognition performances on each stimulus word were analyzed. Results: The listeners with normal hearing obtained 92.5% correct on the SPRINT with a 50% point on the WIN of 2.7 dB S/N. The listeners with hearing loss obtained 65.3% correct on the SPRINT and a WIN 50% point at 12.0 dB S/N. The SPRINT and WIN were significantly correlated (r = −0.81, p < .01), indicating that the SPRINT had good concurrent validity. The high-frequency, pure-tone average (1000, 2000, 4000 Hz) had higher correlations with the SPRINT, WIN, and NU-6 in quiet than did the traditional three-frequency pure-tone average (500, 1000, 2000 Hz). Conclusions: Graphically and numerically the SPRINT and WIN were highly related, which is indicative of good concurrent validity of the SPRINT.

Retest stability and retest reliability were assessed for the Words-in-Noise Test (WIN) in two experiments involving older listeners with sensorineural hearing loss. In Experiment 1, the 70-item WIN protocol was administered during two sessions 12 months apart to examine retest stability on a sample of 315 veterans from four VA Medical Centers. The mean 50% points on the WIN were 12.5- and 12.8-dB S/N for the two sessions with a critical difference of 3.5 dB and an intra-class correlation coefficient of 0.88. [Normal recognition performance on the WIN (50% point) is ≤6-dB S/N.] In Experiment 2, intra- and inter-session retest reliability was examined for the two 35-word WIN protocols on 96 veterans, 48 of whom had mild-to-severe hearing loss (Group 1) and 48 of whom had a moderate-to-severe hearing loss (Group 2). The mean 50% points on the WIN during the two sessions (separated by 40 days) were 13.0- and 13.4-dB S/N (Group 1) and 15.3- and 15.8-dB S/N (Group 2) with no significant intra-session differences. A 3.1-dB critical difference was calculated for the groups combined with intra-class correlations of 0.89 and 0.91 for Group 1 and Group 2, respectively. La estabilidad y la confiabilidad para el re-test se evaluaron para la Prueba de Palabras en Ruido (WIN) en dos experimentos que involucraron sujetos con hipoacusia sensorineural. En el experimento 1, se administró el protocolo WIN de 70 ítems en dos sesiones con 12 meses de separación, para examinar la estabilidad del re-test en una muestra de 315 veteranos de nuestros Centros Médicos del VA. Los puntos medios 50% del WIN fueron 12.5 y 12.8 dB S/N para las dos sesiones, con una diferencia crítica de 3.5 dB y un coeficiente de correlación de intra-clase de 0.88. [El desempeño normal de reconocimiento en el WIN (punto 50%) es ≤ 6-dB S/N.] En el experimento 2, se examinó la confiabilidad del re-test tanto intra- como intersesiones para los 2 protocolos de 35 palabras del WIN, en 96 veteranos, 48 de los cuáles tenían una hipoacusia leve a severa (Grupo 1), y 48 tenían una hipoacusia moderada a severa (Grupo 2). Los puntos medios 50% del WIN durante las dos sesiones (separadas por 40 días) fueron de 13.0 y 13.4 dB S/N (Grupo 1) y 15.3 y 15.8 dB S/N (Grupo 2) sin diferencias significativas intra-sesión. Se calculó una diferencia crítica de 3.1 dB para los grupos, combinada con correlaciones intra-clase de 0.89 y 0.91 para el Grupo 1 y para el Grupo 2, respectivamente.

Larson et al (2000) reported the findings of a multicenter, NIDCD/VA clinical trial that compared hearing aid performance for three output limiting circuits in 360 adults with symmetrical sensorineural hearing loss. The current study was undertaken to examine long-term hearing aid benefit in this same group of participants following five to six years of hearing aid use. The speech-recognition portion of the follow-up study enrolled 108 participants from the original study, 85% of whom were current hearing aid users and 15% of whom had not worn hearing aids during the past month (nonusers). Recognition performance in sound field on the NU-6 (quiet at 62 dB SPL) and the CST (quiet at 74 dB SPL and with -3 and 3 dB signal-to-babble ratios [S/B] at 62 and 74 dB SPL) was measured unaided and aided whenever possible. Speech-recognition abilities decreased significantly since the original study. Speech-recognition decrements were observed regardless of the speech materials (NU-6 and CST), test condition (quiet and noise), S/B (-3 and 3 dB), or stimulus level (62 and 74 dB SPL). Despite decreases in speech recognition, hearing aid benefit remained largely unchanged since the original study; aided performance exceeded unaided performance regardless of presentation level or noise condition. As in the original study, the relations among stimulus level, S/B, and speech-recognition performance were complex. Larson y col. (2000) reportaron los hallazgos de un estudio clínicos multicéntrico del NIDCD/VA que comparó el desempeño en el uso de auxiliares auditivos (AA) con tres circuitos de limitación de la salida, en 360 adultos con pérdida auditiva sensorineural simétrica. El estudio actual fue conducido para examinar el beneficio a largo plazo del AA en el mismo grupo de participantes, luego de cinco a seis años de utilización del AA. La porción de reconocimiento de lenguaje del estudio de seguimiento involucró a 108 participantes del estudio original, 85% de los cuáles eran actuales usuarios de AA y 15% que no habían usado AA durante el mes anterior (no usuarios). El desempeño en reconocimiento del lenguaje en campo sonoro con el NU-6 (en silencio a 62 dB SPL) y con el CST (en silencio a 74 dB SPL, y con tasas de señal/balbuceo de -3 y +3 dB [S&B] a 62 y 74 dB SPL), fue medido con y sin amplificación cuando resultó posible. Las habilidades de reconocimiento del lenguaje habían disminuido significativamente desde el estudio original. Se observó reducción en el reconocimiento del lenguaje independientemente del material logoaudiométrico (NU-6 y CST), las condiciones de la prueba (en silencio o en ruido), S/B (-3 y +3 dB), o la intensidad del estímulo (62 y 74 dB SPL). A pesar de la disminución en el reconocimiento del lenguaje, el beneficio del AA permaneció sin cambios en relación al estudio original; el desempeño con amplificación superó el desempeño sin amplificación sin importar la intensidad de la presentación o las condiciones de ruido. Al igual que en el estudio original, las relaciones entre el nivel de estímulo, la S/B y el desempeño en el reconocimiento de lenguaje fueron complejas.

The purpose of this mixed model design was to examine recognition performance differences when measuring speech recognition in multitalker babble on listeners with normal hearing (n = 36) and listeners with hearing loss (n = 72) utilizing stimulus of varying linguistic complexity (digits, words, and sentence materials). All listeners were administered two trials of two lists of each material in a descending speech-to-babble ratio. For each of the materials, recognition performances by the listeners with normal hearing were significantly better than the performances by the listeners with hearing loss. The mean separation between groups at the 50% point in signal-to-babble ratio on each of the three materials was ~8 dB. The 50% points for digits were obtained at a significantly lower signal-to-babble ratio than for sentences or words that were equivalent. There were no interlist differences between the two lists for the digits and words, but there was a significant disparity between QuickSIN™ lists for the listeners with hearing loss. A two-item questionnaire was used to obtain a subjective measurement of speech recognition, which showed moderate correlations with objective measures of speech recognition in noise using digits (r = .641), sentences (r = .572), and words (r = .673).

The purpose of this experiment was to determine the relationship between psychometric functions for words presented in multitalker babble using a descending presentation level protocol and a random presentation level protocol. Forty veterans (mean = 63.5 years) with mild-to-moderate sensorineural hearing losses were enrolled. Seventy of the Northwestern University Auditory Test No. 6 words spoken by the VA female speaker were presented at seven signal-to-babble ratios from 24 to 0 dB (10 words/step). Although the random procedure required 69 sec longer to administer than the descending protocol, there was no significant difference between the results obtained with the two psychophysical methods. There was almost no relation between the perceived ability of the listeners to understand speech in background noise and their measured ability to understand speech in multitalker babble. Likewise, there was a tenuous relation between pure-tone thresholds and performance on the words in babble and between recognition performance in quiet and performance on the words in babble.

A simple word-recognition task in multitalker babble for clinic use was developed in the course of four experiments involving listeners with normal hearing and listeners with hearing loss. In Experiments 1 and 2, psychometric functions for the individual NU No. 6 words from Lists 2, 3, and 4 were obtained with each word in a unique segment of multitalker babble. The test paradigm that emerged involved ten words at each of seven signal-to-babble ratios (S/B) from 0 to 24 dB. Experiment 3 examined the effect that babble presentation level (70, 80, and 90 dB SPL) had on recognition performance in babble, whereas Experiment 4 studied the effect that monaural and binaural listening had on recognition performance. For listeners with normal hearing, the 90th percentile was 6 dB S/B. In comparison to the listeners with normal hearing, the 50% correct points on the functions for listeners with hearing loss were at 5 to 15 dB higher signal-to-babble ratios.