PubMed · 2103550
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[Hearing aids].. https://pubmed.ncbi.nlm.nih.gov/2103550/
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Harvey Dillon discusses the effect of compression on understanding speech in noise in terms of the effect on the signal to noise ratio. The most common noise with which hearing-impaired persons must contend is competing speech, and the only practical computer smart enough to separate such interference from the target speech is the human brain, using its capacity for "selective listening." Hearing aids with full-dynamic-range compression and frequency-response shaping, by restoring redundant speech cues that the hearing-impaired person no longer hears because of recruitment and high-frequency loss, can empower the user's ability to listen selectively, at the expense of degrading the signal to noise ratio under some conditions.
State-of-the-art hearing aids incorporate advances in signal processing, miniaturization, and programmability. This technological progress has been accompanied by parallel enhancements in evaluating and fitting strategies. In addition, in the past several years, knowledge has increased about the influences of amplification on hearing ability and about the influences of hearing ability on benefit from amplification.
In a series of experiments, we introduced peaks of 10, 20, and 30 dB, in various combinations, onto a smooth reference frequency response. For each of the conditions, we evaluated speech intelligibility in noise, using a test as developed by Plomp and Mimpen (1979), and sound quality (for both speech and music), using a rating-scale procedure. We performed the experiments with 26 listeners with sensorineurally impaired hearing and 10 listeners with normal hearing. Signal processing was accomplished digitally; for each listener, the stimuli were filtered and subsequently amplified so that the average speech spectrum was well above the threshold of hearing at all frequencies. The results show that, as a result of the introduction of peaks onto the frequency response, speech intelligibility is affected more for the listeners with impaired hearing than for those with normal hearing. Sound-quality judgments tend to be less different between the listener groups. Conditions with 30-dB peaks especially show serious effects on both speech intelligibility and sound quality.