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      Effect of Vowel Auditory Training on the Speech-In-Noise Perception among Older Adults with Normal Hearing

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          Abstract

          Introduction:

          Aging reduces the ability to understand speech in noise. Hearing rehabilitation is one of the ways to help older people communicate effectively. This study aimed to investigate the effect of vowel auditory training on the improvement of speech-in-noise (SIN) perception among elderly listeners.

          Materials and Methods:

          This study was conducted on 36 elderly listeners (17 males and 15 females) with the mean±SD of 67.6±6.33. They had the normal peripheral auditory ability but had difficulties in SIN perception. The samples were randomly divided into two groups of intervention and control. The intervention group underwent vowel auditory training; however, the control group received no training.

          Results:

          After vowel auditory training, the intervention group showed significant changes in the results of the SIN test at two signal-to-noise ratios of 0 and -10 and the Iranian version of the Speech, Spatial, and Qualities of Hearing Scale, compared to the control group (P<0.001). Regarding the Speech Auditory Brainstem Response test, the F 0 magnitude was higher in the intervention group (8.42±2.26), compared to the control group (6.68±1.87) (P<0.011).

          Conclusion:

          This study investigated the effect of vowel auditory training on the improvement of SIN perception which could be probably due to better F 0 encoding and receiving. This ability enhancement resulted in the easier perception of speech and its more proper separation from background noise which in turn enhanced the ability of the old people to follow the speech of a specific person and track the discussion.

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          Most cited references 33

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          Brainstem responses to speech syllables.

          To establish reliable procedures and normative values to quantify brainstem encoding of speech sounds. Auditory brainstem responses to speech syllables presented in quiet and in background noise were obtained from 38 normal children. Brainstem responses consist of transient and sustained, periodic components-much like the speech signal itself. Transient peak responses were analyzed with measures of latency, amplitude, area, and slope. Magnitude of sustained, periodic frequency-following responses was assessed with root mean square, fundamental frequency, and first formant amplitudes; timing was assessed by stimulus-to-response and quiet-to-noise inter-response correlations. Measures of transient and sustained components of the brainstem response to speech syllables were reliably obtained with high test-retest stability and low variability across subjects. All components of the brainstem response were robust in quiet. Background noise disrupted the transient responses whereas the sustained response was more resistant to the deleterious effects of noise. The speech-evoked brainstem response faithfully reflects many acoustic properties of the speech signal. Procedures to quantitatively describe it have been developed. Accurate and precise manifestation of stimulus timing at the auditory brainstem is a hallmark of the normal perceptual system. The brainstem response to speech sounds provides a mechanism for understanding the neural bases of normal and deficient attention-independent auditory function.
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            Auditory training improves neural timing in the human brainstem.

            The auditory brainstem response reflects neural encoding of the acoustic characteristic of a speech syllable with remarkable precision. Some children with learning impairments demonstrate abnormalities in this preconscious measure of neural encoding especially in background noise. This study investigated whether auditory training targeted to remediate perceptually-based learning problems would alter the neural brainstem encoding of the acoustic sound structure of speech in such children. Nine subjects, clinically diagnosed with a language-based learning problem (e.g., dyslexia), worked with auditory perceptual training software. Prior to beginning and within three months after completing the training program, brainstem responses to the syllable /da/ were recorded in quiet and background noise. Subjects underwent additional auditory neurophysiological, perceptual, and cognitive testing. Ten control subjects, who did not participate in any remediation program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Transient and sustained (frequency-following response) components of the brainstem response were evaluated. The primary pathway afferent volley -- neural events occurring earlier than 11 ms after stimulus onset -- did not demonstrate plasticity. However, quiet-to-noise inter-response correlations of the sustained response ( approximately 11-50 ms) increased significantly in the trained children, reflecting improved stimulus encoding precision, whereas control subjects did not exhibit this change. Thus, auditory training can alter the preconscious neural encoding of complex sounds by improving neural synchrony in the auditory brainstem. Additionally, several measures of brainstem response timing were related to changes in cortical physiology, as well as perceptual, academic, and cognitive measures from pre- to post-training.
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              Neural timing is linked to speech perception in noise.

              Understanding speech in background noise is challenging for every listener, including those with normal peripheral hearing. This difficulty is attributable in part to the disruptive effects of noise on neural synchrony, resulting in degraded representation of speech at cortical and subcortical levels as reflected by electrophysiological responses. These problems are especially pronounced in clinical populations such as children with learning impairments. Given the established effects of noise on evoked responses, we hypothesized that listening-in-noise problems are associated with degraded processing of timing information at the brainstem level. Participants (66 children; ages, 8-14 years; 22 females) were divided into groups based on their performance on clinical measures of speech-in-noise (SIN) perception and reading. We compared brainstem responses to speech syllables between top and bottom SIN and reading groups in the presence and absence of competing multitalker babble. In the quiet condition, neural response timing was equivalent between groups. In noise, however, the bottom groups exhibited greater neural delays relative to the top groups. Group-specific timing delays occurred exclusively in response to the noise-vulnerable formant transition, not to the more perceptually robust, steady-state portion of the stimulus. These results demonstrate that neural timing is disrupted by background noise and that greater disruptions are associated with the inability to perceive speech in challenging listening conditions.
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                Author and article information

                Journal
                Iran J Otorhinolaryngol
                Iran J Otorhinolaryngol
                IJO
                Iranian Journal of Otorhinolaryngology
                Mashhad University of Medical Sciences (Mashhad, Iran )
                2251-7251
                2251-726X
                July 2020
                : 32
                : 111
                : 229-236
                Affiliations
                [1 ] Department of Audiology, Faculty of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran.
                [2 ] Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
                [3 ] Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
                [4 ] Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
                [5 ] Department of Audiology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
                Author notes
                [* ]Corresponding Author: Department of Audiology, Faculty of Rehabilitation, Hamadan University of Medical Sciences, Hamadan, Iran. E-mail: atta.heidari@gmail.com
                Article
                10.22038/ijorl.2019.33433.2110
                7423087

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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