Speech-in-noise performance in hearing-impaired listeners assessed using evoked responses and enhanced using tactile stimulation

Abstract

Hearing aid and cochlear implant users struggle to understand speech in noisy places, such as classrooms and busy workplaces, with their performance typically being significantly worse than for normal-hearing listeners. This thesis details development of two new methods for improvement of speech-in-noise performance outcomes. The first addresses shortcomings in current techniques for assessing speech-in-noise performance and the second proposes a new intervention to improve performance. Chapters 3 and 4 present modifications to a new electrophysiological assessment method, using the temporal response function (TRF), for prediction of speech-in-noise performance. The TRF offers information not provided by behavioural speech-in-noise measures (the gold standard for speech-in-noise research and clinical assessment), which may be used for automated intervention fitting and further analysis of the mechanisms of speech-in-noise performance. Alterations to methodology for applying the TRF are proposed, which may provide the groundwork for further development of the TRF as a method for assessing speech-in-noise performance. Chapters 5 and 6 investigate the efficacy of a new intervention to improve speech-in-noise performance in cochlear implant users by providing missing sound-information through tactile stimulation on the wrists. This section focuses on developing and testing initial prototype devices that could rapidly be adapted for real-world use. These prototypes represent the first step towards the realisation of a wearable device, with accompanying results demonstrating the potential for their use in improving speech-in-noise performance. This thesis highlights two techniques that could be further developed for assessing and enhancing speech-in-noise performance, and outlines future steps to be taken for the realisation and combination of these techniques for improved treatment of the hearing impaired.

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ORCID for Samuel William Perry: orcid.org/0000-0001-5925-6332

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