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Proc Natl Acad Sci U S A. 2019 Nov 19;116(47):23753-23759. doi: 10.1073/pnas.1903315116. Epub 2019 Nov 4.

Extended high-frequency hearing enhances speech perception in noise.

Author information

Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229;
Department of Communication Sciences & Disorders, University of Cincinnati, Cincinnati, OH 45267.
Communication Sciences Research Center, Cincinnati Children's Hospital, Cincinnati, OH 45229.
Department of Speech-Language Pathology and Audiology, University of Pretoria, 0002 Pretoria, Republic of South Africa.
Department of Otolaryngology, College of Medicine, University of Cincinnati, Cincinnati, OH 45267.
Manchester Centre for Audiology and Deafness, University of Manchester, M13 9PL Manchester, United Kingdom.


Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 "normally hearing," mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (≤8 kHz), DIN hearing thresholds were significantly better (P < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with "normal hearing" frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss.


digits-in-noise test; high-frequency hearing; listening in noise; pure-tone audiometry; self-report

[Available on 2020-05-04]

Conflict of interest statement

Conflict of interest statement: D.W.S. is cofounder, lead inventor, and shareholder, and D.R.M. is a scientific advisor and shareholder of the hearX Group. No author has any other financial or nonfinancial interest in relation to the work described.

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