Objective: The objective of this study was to compare speech recognition across a sampling of amplification choices available for listeners with severe loss. This includes conventional options (linear with peak clipping and linear with compression limiting) and newer strategies (multichannel wide-dynamic range compression [WDRC]) theorized to better accommodate reduced dynamic range. A second objective was to compare speech quality across the same conditions using a paired-comparison test.
Design: Participants were 13 adults with severe sensorineural hearing loss and a control group of seven adults with normal hearing. Test materials included consonant-vowel syllables (speech recognition) and sentences (speech quality). Four amplification conditions were included: peak clipping; compression limiting; two-channel WDRC; and three-channel WDRC, with overall audibility similar across conditions. In the WDRC conditions, the compression ratio was fixed at 3:1 in each channel. Consonant recognition was measured using a closed-set task, and speech quality was measured using a paired-comparison test.
Results: For the listeners with severe loss, recognition and preference were lower for a three-channel WDRC system than for a compression limiting system. Specific errors were consistent with poorer transmission of amplitude envelope information by the multichannel WDRC systems.
Conclusions: Under some conditions, the benefit of fast-acting, multichannel WDRC systems relative to more linear amplification strategies may be reduced in listeners with severe loss. Performance decrements with these systems are consistent with consequences of broader auditory filters.