Factors Affecting Sentence-in-Noise Recognition for Normal Hearing Listeners and Listeners with Hearing Loss

Background and objectives: Despite amplified speech, listeners with hearing loss often report more difficulties understanding speech in background noise compared to normalhearing listeners. Various factors such as deteriorated hearing sensitivity, age, suprathreshold temporal resolution, and reduced capacity of working memory and attention can attribute to their sentence-in-noise problems. The present study aims to determine a primary explanatory factor for sentence-in-noise recognition difficulties in adults with or without hearing loss.

Subjects and methods: Forty normal-hearing (NH) listeners (23-73 years) and thirty-four hearing-impaired (HI) listeners (24-80 years) participated for experimental testing. For both NH and HI group, the younger, middle-aged, older listeners were included. The sentence recognition score in noise was measured at 0 dB signal-to-noise ratio. The ability of temporal resolution was evaluated by gap detection performance using the Gaps-In-Noise test. Listeners' short-term auditory working memory span was measured by forward and backward digit spans.

Results: Overall, the HI listeners' sentence-in-noise recognition, temporal resolution abilities, and digit forward and backward spans were poorer compared to the NH listeners. Both NH and HI listeners had a substantial variability in performance. For NH listeners, only the digit backward span explained a small proportion of the variance in their sentence-in-noise performance. For the HI listeners, all the performance was influenced by age, and their sentence-in-noise difficulties were associated with various factors such as high-frequency hearing sensitivity, suprathreshold temporal resolution abilities, and working memory span. For the HI listeners, the critical predictors of the sentence-in-noise performance were composite measures of peripheral hearing sensitivity and suprathreshold temporal resolution abilities.

Conclusions: The primary explanatory factors for the sentence-in-noise recognition performance differ between NH and HI listeners. Factors affecting sentence-in-noise recognition performance differed between NH and HI listeners. The working memory was the primary predictor of the sentence-in-noise scores for the NH individuals. In contrast, a combination of factors seemed to contributed to speech-in-noise understanding for the HI listeners. Given this, we must be careful not to generalize findings from the NH listeners to the HI individuals.