The Contribution of a Frequency-Compression Hearing Aid to Contralateral Cochlear Implant Performance

2013 ◽  
Vol 24 (02) ◽  
pp. 105-120 ◽  
Author(s):  
Ann E. Perreau ◽  
Ruth A. Bentler ◽  
Richard S. Tyler
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Self Report ◽  
Vowel Perception ◽  
Frequency Compression ◽  
Significant Difference ◽  
The Impact

Background: Frequency-lowering signal processing in hearing aids has re-emerged as an option to improve audibility of the high frequencies by expanding the input bandwidth. Few studies have investigated the usefulness of the scheme as an option for bimodal users (i.e., combined use of a cochlear implant and a contralateral hearing aid). In this study, that question was posed. Purpose: The purposes of this study were (1) to determine if frequency compression was a better bimodal option than conventional amplification and (2) to determine the impact of a frequency-compression hearing aid on speech recognition abilities. Research Design: There were two separate experiments in this study. The first experiment investigated the contribution of a frequency-compression hearing aid to contralateral cochlear implant (CI) performance for localization and speech perception in noise. The second experiment assessed monaural consonant and vowel perception in quiet using the frequency-compression and conventional hearing aid without the use of a contralateral CI or hearing aid. Study Sample: Ten subjects fitted with a cochlear implant and hearing aid participated in the first experiment. Seventeen adult subjects with a cochlear implant and hearing aid or two hearing aids participated in the second experiment. To be included, subjects had to have a history of postlingual deafness, a moderate or moderate-to-severe hearing loss, and have not worn this type of frequency-lowering hearing aid previously. Data Collection and Analysis: In the first experiment, performance using the frequency-compression and conventional hearing aids was assessed on tests of sound localization, speech perception in a background of noise, and two self-report questionnaires. In the second experiment, consonant and vowel perception in quiet was assessed monaurally for the two conditions. In both experiments, subjects alternated daily between a frequency-compression and conventional hearing aid for 2 mo. The parameters of frequency compression were set individually for each subject, and audibility was measured for the frequency compression and conventional hearing aid programs by comparing estimations of the Speech Intelligibility Index (SII) using a modified algorithm (Bentler et al, 2011). In both experiments, the outcome measures were administered following the hearing aid fitting to assess performance at baseline and after 2 mo of use. Results: For this group of subjects, the results revealed no significant difference between the frequency-compression and conventional hearing aid on tests of localization and consonant recognition. Spondee-in-noise and vowel perception scores were significantly higher with the conventional hearing aid compared to the frequency-compression hearing aid after 2 mo of use. Conclusions: These results suggest that, for the subjects in this study, frequency compression is not a better bimodal option than conventional amplification. In addition, speech perception may be negatively influenced by frequency compression because formant frequencies are too severely compressed and can no longer be distinguished.

scholarly journals Benefits of Localization and Speech Perception with Multiple Noise Sources in Listeners with a Short-Electrode Cochlear Implant

2010 ◽  
Vol 21 (01) ◽  
pp. 044-051 ◽  
Author(s):  
Camille C. Dunn ◽  
Ann Perreau ◽  
Bruce Gantz ◽  
Richard S. Tyler
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Low Frequency ◽  
Noise Sources ◽  
Speech Perception In Noise ◽  
Hearing Aid Use ◽  
Significant Difference ◽  
Array Performance

Background: Research suggests that for individuals with significant low-frequency hearing, implantation of a short-electrode cochlear implant may provide benefits of improved speech perception abilities. Because this strategy combines acoustic and electrical hearing within the same ear while at the same time preserving low-frequency residual acoustic hearing in both ears, localization abilities may also be improved. However, very little research has focused on the localization and spatial hearing abilities of users with a short-electrode cochlear implant. Purpose: The purpose of this study was to evaluate localization abilities for listeners with a short-electrode cochlear implant who continue to wear hearing aids in both ears. A secondary purpose was to document speech perception abilities using a speech-in-noise test with spatially separate noise sources. Research Design: Eleven subjects that utilized a short-electrode cochlear implant and bilateral hearing aids were tested on localization and speech perception with multiple noise locations using an eight-loudspeaker array. Performance was assessed across four listening conditions using various combinations of cochlear implant and/or hearing aid use. Results: Results for localization showed no significant difference between using bilateral hearing aids and bilateral hearing aids plus the cochlear implant. However, there was a significant difference between the bilateral hearing aid condition and the implant plus use of a contralateral hearing aid for all 11 subjects. Results for speech perception showed a significant benefit when using bilateral hearing aids plus the cochlear implant over use of the implant plus only one hearing aid. Conclusion: Combined use of both hearing aids and the cochlear implant show significant benefits for both localization and speech perception in noise for users with a short-electrode cochlear implant. These results emphasize the importance of low-frequency information in two ears for the purpose of localization and speech perception in noise.

scholarly journals The Effects of Manufacturer’s Prefit and Real-Ear Fitting on the Predicted Speech Perception of Children with Severe to Profound Hearing Loss

2019 ◽  
Vol 30 (05) ◽  
pp. 346-356 ◽  
Author(s):  
Tian Kar Quar ◽  
Cila Umat ◽  
Yong Yee Chew
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
High Input ◽  
Profound Hearing Loss ◽  
High Frequency Region ◽  
Cross Sectional ◽  
Significant Difference

AbstractThe use of probe microphone measures in hearing aid verification is often neglected or not fully used by practitioners. Some practitioners rely on simulated gain and output provided by manufacturer's fitting software to verify hearing aids.This study aims to evaluate the effectiveness of manufacturer’s prefit procedure in matching the prescribed real-ear targets. It also aims to study its correlated impact on the predicted speech perception in children with severe and profound hearing loss.This cross-sectional experiment was carried out by measuring the output of hearing aids based on prefit versus real-ear at low-, moderate-, and high-input levels. The predicted speech perception for different hearing aid fittings was determined based on the Speech Intelligibility Index (SII).Sixteen children (28 ears) aged between 4 and 7 yr, with severe to profound sensorineural hearing loss took part in the study.Two different types of hearing aids (Phonak and Unitron) were programmed based on their respective manufacturers’ Desired Sensation Levels (DSL) v5 Child procedure. The hearing aids were then verified using coupler-based measurements and individual real-ear-to-coupler differences. The prefit outputs were compared with the DSL v5 Child–prescribed outputs at low-, moderate-, and high-input levels. The hearing aids were then adjusted to closely match the prescribed output. The SIIs were calculated for the fittings before and after adjustment.Sixty four percent of fittings that were based on the prefit procedure achieved the optimal fit-to-targets, with less than 5-dB RMS deviations from the DSL v5 Child targets. After adjusting the hearing aids to attempt to meet the DSL v5 Child targets, 75% of the ears tested achieved the optimal fit-to-targets. On average, hearing aid outputs generated by the manufacturer’s prefit procedure had good and reasonable agreement with the DSL v5 Child–prescribed outputs at low- and mid-frequencies. Nonetheless, at 4000 Hz, the hearing aid output mostly fell below the DSL v5 Child–prescribed outputs. This was still the case even after the hearing aid was adjusted to attempt to match with the targets. At low input level, some prefit outputs were found to be higher than the prescribed outputs. The deviations of prefit outputs from the prescribed outputs were dependent on the type of hearing aid and input levels. There was no significant difference between the SII calculated for fittings based on the prefit and adjusted fit.Prefit procedure tends to produce outputs that were below the DSL v5 Child–prescribed outputs, with the largest mean difference at 4000 Hz. Even though the hearing aid gains were adjusted to attempt to match with the targets, the outputs were still below the targets. The limitations of hearing aids to match the DSL v5 Child targets at high-frequency region have resulted in no improvement in the children’s predicted speech perception.

Comparing NAL-NL1 and DSL v5 in Hearing Aids Fit to Children with Severe or Profound Hearing Loss: Goodness of Fit-to-Targets, Impacts on Predicted Loudness and Speech Intelligibility

2015 ◽  
Vol 26 (03) ◽  
pp. 260-274 ◽  
Author(s):  
Teresa Y.C. Ching ◽  
Tian Kar Quar ◽  
Earl E. Johnson ◽  
Philip Newall ◽  
Mridula Sharma
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Goodness Of Fit ◽  
Hearing Aid ◽  
High Input ◽  
Profound Hearing Loss ◽  
Significant Difference ◽  
The Impact ◽  
Input Level

Background: An important goal of providing amplification to children with hearing loss is to ensure that hearing aids are adjusted to match targets of prescriptive procedures as closely as possible. The Desired Sensation Level (DSL) v5 and the National Acoustic Laboratories’ prescription for nonlinear hearing aids, version 1 (NAL-NL1) procedures are widely used in fitting hearing aids to children. Little is known about hearing aid fitting outcomes for children with severe or profound hearing loss. Purpose: The purpose of this study was to investigate the prescribed and measured gain of hearing aids fit according to the NAL-NL1 and the DSL v5 procedure for children with moderately severe to profound hearing loss; and to examine the impact of choice of prescription on predicted speech intelligibility and loudness. Research Design: Participants were fit with Phonak Naida V SP hearing aids according to the NAL-NL1 and DSL v5 procedures. The Speech Intelligibility Index (SII) and estimated loudness were calculated using published models. Study Sample: The sample consisted of 16 children (30 ears) aged between 7 and 17 yr old. Data Collection and Analysis: The measured hearing aid gains were compared with the prescribed gains at 50 (low), 65 (medium), and 80 dB SPL (high) input levels. The goodness of fit-to-targets was quantified by calculating the average root-mean-square (RMS) error of the measured gain compared with prescriptive gain targets for 0.5, 1, 2, and 4 kHz. The significance of difference between prescriptions for hearing aid gains, SII, and loudness was examined by performing analyses of variance. Correlation analyses were used to examine the relationship between measures. Results: The DSL v5 prescribed significantly higher overall gain than the NAL-NL1 procedure for the same audiograms. For low and medium input levels, the hearing aids of all children fit with NAL-NL1 were within 5 dB RMS of prescribed targets, but 33% (10 ears) deviated from the DSL v5 targets by more than 5 dB RMS on average. For high input level, the hearing aid fittings of 60% and 43% of ears deviated by more than 5 dB RMS from targets of NAL-NL1 and DSL v5, respectively. Greater deviations from targets were associated with more severe hearing loss. On average, the SII was higher for DSL v5 than for NAL-NL1 at low input level. No significant difference in SII was found between prescriptions at medium or high input level, despite greater loudness for DSL v5 than for NAL-NL1. Conclusions: Although targets between 0.25 and 2 kHz were well matched for both prescriptions in commercial hearing aids, gain targets at 4 kHz were matched for NAL-NL1 only. Although the two prescriptions differ markedly in estimated loudness, they resulted in comparable predicted speech intelligibility for medium and high input levels.

scholarly journals Integrated Bimodal Fitting for Unilateral CI Users with Residual Contralateral Hearing

2021 ◽  
Vol 11 (2) ◽  
pp. 200-206
Author(s):  
Gennaro Auletta ◽  
Annamaria Franzè ◽  
Carla Laria ◽  
Carmine Piccolo ◽  
Carmine Papa ◽  
...  
Keyword(s):  
Cochlear Implants ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Performance Difference ◽  
Test Conditions ◽  
Significant Difference ◽  
Noisy Conditions ◽  
New Formula ◽  
Better Than

Background: The aim of this study was to compare, in users of bimodal cochlear implants, the performance obtained using their own hearing aids (adjusted with the standard NAL-NL1 fitting formula) with the performance using the Phonak Naìda Link Ultra Power hearing aid adjusted with both NAL-NL1 and a new bimodal system (Adaptive Phonak Digital Bimodal (APDB)) developed by Advanced Bionics and Phonak Corporations. Methods: Eleven bimodal users (Naìda CI Q70 + contralateral hearing aid) were enrolled in our study. The users’ own hearing aids were replaced with the Phonak Naìda Link Ultra Power and fitted following the new formula. Speech intelligibility was assessed in quiet and noisy conditions, and comparisons were made with the results obtained with the users’ previous hearing aids and with the Naída Link hearing aids fitted with the NAL-NL1 generic prescription formula. Results: Using Phonak Naìda Link Ultra Power hearing aids with the Adaptive Phonak Digital Bimodal fitting formula, performance was significantly better than that with the users’ own rehabilitation systems, especially in challenging hearing situations for all analyzed subjects. Conclusions: Speech intelligibility tests in quiet settings did not reveal a significant difference in performance between the new fitting formula and NAL-NL1 fittings (using the Naída Link hearing aids), whereas the performance difference between the two fittings was very significant in noisy test conditions.

scholarly journals The use of speech sentence audiometry in a free sound field

2020 ◽  
Vol 5 (1) ◽  
pp. 36-39
Author(s):  
Mariya Yu. Boboshko ◽  
Irina P. Berdnikova ◽  
Natalya V. Maltzeva
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Speech Intelligibility ◽  
Normative Data ◽  
Hearing Aid ◽  
Sound Field ◽  
Normal Hearing ◽  
Significant Difference ◽  
Hearing Aid Benefit

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p

scholarly journals Auditory Training Using Remembering the Order of Sentences for the Elderly Who Wear Hearing Aids: Is it Effective for Speech Perception in Noise, Working Memory and Reasoning Ability?

2020 ◽  
Vol 16 (2) ◽  
pp. 124-132
Author(s):  
Donghoon Kang ◽  
So Hyun Kim ◽  
Dajung Yun ◽  
Junghwa Bahng
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Speech Perception ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Self Report ◽  
Auditory Training ◽  
Reasoning Ability ◽  
Speech Perception In Noise ◽  
Reasoning Test

Purpose: The present study examines auditory training outcomes in terms of speech perception in noise, working memory, reasoning ability, and subjective hearing aid satisfaction. Methods: Ten older adults who wear hearing aids (mean age: 71.6) voluntarily participated in the study. For the training material, 78 sentence sets composed of 3 to 5 sentences were used. During the auditory training, participants tried to remember the order of sentences. Among the 78 sentence sets, 45 contained clues and the rest did not. Each participant underwent assessments including speech perception in noise and digit spans and reasoning test and completed a self-report hearing aid satisfaction questionnaire both pre- and post-auditory training. The participants completed eight sessions of the auditory training. Results: The results showed a statistically significant increase in speech recognition ability in noise, short-term memory, and working memory, as well as satisfaction with hearing aid use. Despite a slight increase on the reasoning test, there was no statistically significant improvement.Conclusion: The results of this study suggested that the auditory training in remembering the order of sentences improved speech perception in noise, sensory and working memory, and subjective satisfaction with hearing aids. Future research can investigate more effective auditory training tools to improve the various cognitive skills and communication ability of older adults who wear hearing aids.

The Effect of Adaptive Nonlinear Frequency Compression on Phoneme Perception

2017 ◽  
Vol 26 (4) ◽  
pp. 531-542 ◽  
Author(s):  
Danielle Glista ◽  
Marianne Hawkins ◽  
Andrea Bohnert ◽  
Julia Rehmann ◽  
Jace Wolfe ◽  
...  
Keyword(s):  
Speech Perception ◽  
Hearing Aids ◽  
Multiple Testing ◽  
Hearing Aid ◽  
Similar Amount ◽  
Nonlinear Frequency ◽  
Group Level ◽  
Frequency Compression ◽  
Individual Level ◽  
Phoneme Perception

Purpose This study implemented a fitting method, developed for use with frequency lowering hearing aids, across multiple testing sites, participants, and hearing aid conditions to evaluate speech perception with a novel type of frequency lowering. Method A total of 8 participants, including children and young adults, participated in real-world hearing aid trials. A blinded crossover design, including posttrial withdrawal testing, was used to assess aided phoneme perception. The hearing aid conditions included adaptive nonlinear frequency compression (NFC), static NFC, and conventional processing. Results Enabling either adaptive NFC or static NFC improved group-level detection and recognition results for some high-frequency phonemes, when compared with conventional processing. Mean results for the distinction component of the Phoneme Perception Test (Schmitt, Winkler, Boretzki, & Holube, 2016) were similar to those obtained with conventional processing. Conclusions Findings suggest that both types of NFC tested in this study provided a similar amount of speech perception benefit, when compared with group-level performance with conventional hearing aid technology. Individual-level results are presented with discussion around patterns of results that differ from the group average.

Investigation of Extended Bandwidth Hearing Aid Amplification on Speech Intelligibility and Sound Quality in Adults with Mild-to-Moderate Hearing Loss

2018 ◽  
Vol 29 (03) ◽  
pp. 243-254 ◽  
Author(s):  
Angeline Seeto ◽  
Grant D. Searchfield
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
High Frequency ◽  
Speech Intelligibility ◽  
Hearing Aid ◽  
Sound Quality ◽  
Significant Benefit ◽  
Band Frequency ◽  
Significant Difference ◽  
Moderate Hearing Loss

AbstractAdvances in digital signal processing have made it possible to provide a wide-band frequency response with smooth, precise spectral shaping. Several manufacturers have introduced hearing aids that are claimed to provide gain for frequencies up to 10–12 kHz. However, there is currently limited evidence and very few independent studies evaluating the performance of the extended bandwidth hearing aids that have recently become available.This study investigated an extended bandwidth hearing aid using measures of speech intelligibility and sound quality to find out whether there was a significant benefit of extended bandwidth amplification over standard amplification.Repeated measures study designed to examine the efficacy of extended bandwidth amplification compared to standard bandwidth amplification.Sixteen adult participants with mild-to-moderate sensorineural hearing loss.Participants were bilaterally fit with a pair of Widex Mind 440 behind-the-ear hearing aids programmed with a standard bandwidth fitting and an extended bandwidth fitting; the latter provided gain up to 10 kHz.For each fitting, and an unaided condition, participants completed two speech measures of aided benefit, the Quick Speech-in-Noise test (QuickSIN™) and the Phonak Phoneme Perception Test (PPT; high-frequency perception in quiet), and a measure of sound quality rating.There were no significant differences found between unaided and aided conditions for QuickSIN™ scores. For the PPT, there were statistically significantly lower (improved) detection thresholds at high frequencies (6 and 9 kHz) with the extended bandwidth fitting. Although not statistically significant, participants were able to distinguish between 6 and 9 kHz 50% better with extended bandwidth. No significant difference was found in ability to recognize phonemes in quiet between the unaided and aided conditions when phonemes only contained frequency content <6 kHz. However significant benefit was found with the extended bandwidth fitting for recognition of 9-kHz phonemes. No significant difference in sound quality preference was found between the standard bandwidth and extended bandwidth fittings.This study demonstrated that a pair of currently available extended bandwidth hearing aids was technically capable of delivering high-frequency amplification that was both audible and useable to listeners with mild-to-moderate hearing loss. This amplification was of acceptable sound quality. Further research, particularly field trials, is required to ascertain the real-world benefit of high-frequency amplification.

scholarly journals The effect of a coding strategy that removes temporally masked pulses on speech perception by cochlear implant users

2020 ◽  
Author(s):  
Wiebke Lamping ◽  
Tobias Goehring ◽  
Jeremy Marozeau ◽  
Robert P. Carlyon
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Speech Intelligibility ◽  
Average Power ◽  
Decision Criterion ◽  
Speech In Noise ◽  
Current Pulses ◽  
Temporal Integrator ◽  
Significant Difference ◽  
Temporal Masking

Speech recognition in noisy environments remains a challenge for cochlear implant (CI) recipients. Unwanted charge interactions between current pulses in the same and across different electrode channels are likely to impair performance. Here we investigate the effect of reducing the number of current pulses on speech perception. This was achieved by implementing a psychoacoustic temporal-masking model where current pulses in each channel were passed through a temporal integrator to identify and remove pulses that were less likely to be perceived by the recipient. The decision criterion of the temporal integrator was varied to control the percentage of pulses removed in each condition. In experiment 1, speech in quiet was processed with a standard Continuous Interleaved Sampling (CIS) strategy and with 25, 50 and 75% of pulses removed. In experiment 2, performance was measured for speech in noise with the CIS reference and with 50 and 75% of pulses removed. Speech intelligibility in quiet revealed no significant difference between reference and test conditions. For speech in noise, results showed a significant improvement of 2.4 dB when removing 50% of pulses. Performance both in quiet and in noise was not significantly different between the reference and when 75% of pulses were removed. Further, by reducing the overall amount of current pulses by 25, 50, and 75% but accounting for the increase in charge necessary to compensate for the decrease in loudness, estimated average power savings of 21.15, 40.95, and 63.45%, respectively, could be possible for this set of listeners. In conclusion, removing temporally masked pulses may improve speech perception in noise and result in substantial power savings.

Benefits of Nonlinear Frequency Compression in Adult Hearing Aid Users

2015 ◽  
Vol 26 (10) ◽  
pp. 838-855 ◽  
Author(s):  
Melissa Kokx-Ryan ◽  
Julie Cohen ◽  
Mary T. Cord ◽  
Therese C. Walden ◽  
Matthew J. Makashay ◽  
...  
Keyword(s):  
Speech Recognition ◽  
Hearing Aid ◽  
Nonlinear Frequency ◽  
Frequency Compression ◽  
Repeated Measures Design ◽  
Clinical Procedures ◽  
Significant Difference ◽  
The Impact ◽  
Modified Rhyme Test

Background: Frequency-lowering (FL) algorithms are an alternative method of providing access to high-frequency speech cues. There is currently a lack of independent research addressing: (1) what functional, measureable benefits FL provides; (2) which, if any, FL algorithm provides the maximum benefit, (3) how to clinically program algorithms, and (4) how to verify algorithm settings. Purpose: Two experiments were included in this study. The purpose of Experiment 1 was to (1) determine if a commercially available nonlinear frequency compression (NLFC) algorithm provides benefit as measured by improved speech recognition in noise when fit and verified using standard clinical procedures; and (2) evaluate the impact of acclimatization. The purpose of Experiment 2 was to (1) evaluate the benefit of using enhanced verification procedures to systematically determine the optimal application of a prototype NLFC algorithm, and (2) determine if the optimized prototype NLFC settings provide benefit as measured by improved speech recognition in quiet and in noise. Research Design: A single-blind, within-participant repeated measures design in which participants served as their own controls. Study Sample: Experiment 1 included 26 participants with a mean age of 68.3 yr and Experiment 2 included 37 participants with a mean age of 68.8 yr. Participants were recruited from the Audiology and Speech Pathology Center at Walter Reed National Military Medical Center in Bethesda, MD. Intervention: Participants in Experiment 1 wore bilateral commercially available hearing aids fit using standard clinical procedures and clinician expertise. Participants in Experiment 2 wore a single prototype hearing aid for which FL settings were systematically examined to determine the optimum application. In each experiment, FL-On versus FL-Off settings were examined in a variety of listening situations to determine benefit and possible implications. Data Collection and Analysis: In Experiment 1, speech recognition measures using the QuickSIN and Modified Rhyme Test stimuli were obtained at initial bilateral fitting and 3–5 weeks later during a follow-up visit. In Experiment 2, Modified Rhyme Test, /s/, /∫/ consonant discrimination task, and dual-task cognitive load speech recognition performance measures were conducted. Participants in Experiment 2 received four different systematic hearing aid programs during an initial visit and speech recognition data were collected over 2–3 follow-up sessions. Results: Some adults with hearing loss obtained small-to-moderate benefits from implementation of FL, while others maintained performance without detriment in both experiments. There was no significant difference among FL-On settings systematically obtained in Experiment 2. There was a modest but significant age effect in listeners of both experiments that indicated older listeners (>65 yr) might benefit more on average from FL than younger listeners. In addition, there were reliable improvements in the intelligibility of the phonemes /η/ and /b/ for both groups, and /ð/ for older listeners from the FL in both experiments. Conclusions: Although the optimum settings, application, and benefits of FL remain unclear at this time, there does not seem to be degradation in listener performance when FL is activated. The benefits of FL should be explored in older adult (>65 yr) listeners, as they tended to benefit more from FL applications.

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