Graduation Year

2022

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Communication Sciences and Disorders

Major Professor

David A. Eddins, Ph.D., CCC-A

Committee Member

Erol J. Ozmeral, Ph.D.

Committee Member

Jungmee Lee, Ph.D.

Committee Member

Hannah W. Siburt, Au.D., Ph.D., CCC-A

Keywords

auditory perception, auditory profile, individual differences, rapid testing

Abstract

Living in a sonic world, a person with hearing loss experiences difficulty in communicating with others. One of the reasons why some people with hearing loss do not wear hearing aids (HAs) is limited perceived benefit, which may result from HAs that are not fit using “best practices” or because the best practices fail to address individual difficulties experienced by the listener. The typical audiogram provides information regarding audibility as a function of frequency and is used to establish degree, type, and configuration of hearing loss, but does not measure the ability of an individual to process various components of sounds and speech. Those perceptual abilities are not well predicted by the audiogram yet form the basis for everyday communication. Moreover, there is still limited information in determining how HA benefit may be related to specific perceptual and cognitive abilities or how such benefit may be maximized by including knowledge of perceptual and cognitive deficits in HA design and fitting.

Hence, this dissertation project focused on the identification of individualized auditory perceptual profiles in a manner that can be feasibly implemented in the clinic and that go beyond clinical audiometric measures. Candidate measures included the perception of frequency selectivity, temporal envelope, spectro-temporal envelope, temporal fine structure, frequency selectivity, spatial processing as well as working memory and fluid intelligence. Automated measures were self-administered using a tablet-based platform. The goal of Chapter 2 was to use auditory perceptual and cognitive measures to develop auditory perceptual profiles for younger and older normal hearing adults, and age-related auditory perceptual deficits manifested despite clinically “normal” pure-tone thresholds. Three distinct auditory perceptual profiles within the ONH population were identified. The perceptual and cognitive abilities that mostly contributed to the separation of profiles were spatial release from masking and working memory, followed by temporal fine structure processing, and hearing in background noise abilities. The goal of Chapter 3 was to develop auditory perceptual profiles of individuals with hearing loss. Three distinct auditory perceptual profiles were also identified in this population. Listener abilities that mostly contributed to the identification of profiles were spatial release from masking and frequency selectivity, followed by working memory and spectro-temporal cue processing. In Chapter 4, these same individuals with hearing loss were fit with hearing aids in the laboratory, and aided communication benefit was assessed for each identified profile. HA benefit was evaluated based on standardized tools including an objective speech-in-noise test, subjective questionnaires, and real-time day-to-day measures of communication. Results indicated that the profile with the poorer auditory perceptual thresholds perceived the least benefit as opposed to the other two profiles with better perceptual or cognitive abilities. Moreover, real-time measures revealed more communication benefit than standardized questionnaires. The goal of Chapter 5 was to evaluate the usability of the tablet-based testing platform in noisy settings (Experiment 1) and bring the platform to the clinic to assess its usability from patients (Experiment 2). Measures on the tablet-testing platform were unaffected by external noise, increasing its potential to be used in a clinic waiting area. Usability assessment surveys showed that participants in the laboratory and patients in the clinic were overall satisfied with the ease of use of the platform.

The long-term goal of this project was to introduce more efficient clinical measures that target auditory perceptual and cognitive abilities instead of basic audiometric and speech testing that do not represent an auditory perceptual profile. Such profiles for individual patients may provide targets for precision intervention, including informing individualized hearing aid fittings that can improve aided benefit.

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