Adaptive Syllable Training Improves Phoneme Identification in Older Listeners with and without Hearing Loss

Schumann, Annette; Ross, Bernhard · 2022 · Crossref

DOI: 10.3390/audiolres12060063

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Summary

This study investigates whether an adaptive acoustic-phonetic training paradigm can improve phoneme identification in noise for older adults, addressing the persistent challenge of speech-in-noise (SIN) deficits associated with aging and hearing loss. While hearing aids restore audibility, they often fail to fully restore intelligibility, particularly for consonants masked by noise. The authors aimed to optimize training efficiency by applying two principles of perceptual learning: reducing stimulus variability by grouping phonetically similar consonant–vowel–consonant (CVC) syllables, and maintaining an optimal difficulty level through adaptive signal-to-noise ratio (SNR) adjustment. The study involved 52 adults aged 60–90 years, including those with normal hearing and those with moderate hearing loss. Participants underwent five training sessions over two weeks. The training utilized nonsense CVC syllables from the California Syllable Test, grouped into three sets based on phonetic similarity: voiced stops/(af)fricatives, voiceless stops/(af)fricatives, and voiced nasals/liquids. Participants identified the onset or coda consonant by matching the auditory stimulus to one of three orthographic alternatives. The procedure employed a three-up, one-down staircase algorithm to adaptively adjust the SNR based on performance, ensuring listeners operated at their individual "edge of competence." Immediate visual feedback and the option for stimulus repetition were provided to reinforce learning. Pre- and post-training assessments measured changes in identification accuracy and the SNR required for 50% correct identification. Results demonstrated that the adaptive training was feasible and effective for both normal-hearing and hearing-impaired older adults. All participants showed improved phoneme identification, quantified by increased accuracy and a decreased required SNR. Normal-hearing listeners achieved high accuracy at lower SNRs post-training, whereas participants with hearing loss improved consonant accuracy but still required higher SNRs than their normal-hearing peers. Improvements were observed across all stimulus sets, though gains were most significant for voiced and voiceless stop and (af)fricative consonants. Notably, while the training benefited difficult consonants, the easiest-to-identify consonants showed the most prominent improvements. The study also found that syllables within the same phonetic set required noticeably different SNRs, indicating that phonological similarity did not perfectly equate to perceptual difficulty. The findings suggest that adaptive syllable training can effectively remediate consonant identification deficits in older listeners by leveraging perceptual learning mechanisms. By individualizing the difficulty level, the paradigm accommodates a heterogeneous population with varying hearing abilities and cognitive statuses. This approach offers a promising avenue for auditory rehabilitation, potentially enhancing communication abilities and reducing the social burden of SIN deficits in aging populations. The study highlights that while training improves performance, the magnitude of benefit varies by hearing status and specific phonetic features, underscoring the need for tailored interventions in clinical settings.

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• age related perceptual decline