Speech Manipulation for Hearing Loss

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen by Christian Stilp, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of Louisville

Disqualifiers: Cognitive disabilities, others

No Placebo Group

Trial Summary

What is the purpose of this trial?

Recognition of speech sounds is accomplished through the use of adjacent sounds in time, in what is termed acoustic context. The frequency and temporal properties of these contextual sounds play a large role in recognition of human speech. Historically, most research on both speech perception and sound perception in general examine sounds out-of-context, or presented individually. Further, these studies have been conducted independently of each other with little connection across labs, across sounds, etc. These approaches slow the progress in understanding how listeners with hearing difficulties use context to recognize speech and how their hearing aids and/or cochlear implants might be modified to improve their perception. This research has three main goals. First, the investigators predict that performance in speech sound recognition experiments will be related when testing the same speech frequencies or the same moments in time, but that performance will not be related in further comparisons across speech frequencies or at different moments in time. Second, the investigators predict that adding background noise will make this contextual speech perception more difficult, and that these difficulties will be more severe for listeners with hearing loss. Third, the investigators predict that cochlear implant users will also use surrounding sounds in their speech recognition, but with key differences than healthy-hearing listeners owing to the sound processing done by their implants. In tandem with these goals, the investigators will use computer models to simulate how neurons respond to speech sounds individually and when surrounded by other sounds.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Speech Manipulation for hearing loss?

Research shows that training people to speak clearly can significantly improve speech understanding for those with hearing loss. When communication partners receive clear speech training, individuals with hearing loss can understand speech as well as those with normal hearing. ^{1 2 3 4 5}

Is Speech Manipulation for Hearing Loss safe for humans?

There is no specific safety data available for Speech Manipulation for Hearing Loss, but general safety studies in auditory function suggest that any new treatment should be carefully evaluated for potential hearing impacts. Safety pharmacology studies are important to identify any undesirable effects on hearing. ^{6 7 8 9 10}

How does the Speech Manipulation treatment differ from other treatments for hearing loss?

Speech Manipulation is unique because it enhances speech intelligibility by increasing the contrast of speech sounds against background noise, using a process that adjusts the auditory excitation pattern of speech signals. This approach focuses on improving the clarity of speech for hearing-impaired listeners, which is different from traditional hearing aids that primarily amplify sound. ^{11 12 13 14 15}

Research Team

Christian Stilp, PhD

Principal Investigator

University of Louisville

Eligibility Criteria

This trial is for individuals with varying degrees of hearing loss, including those who use hearing aids or cochlear implants. It aims to understand how they perceive speech in different acoustic contexts and the impact of background noise on their recognition abilities.

Inclusion Criteria

Be able to recognize spoken words in English

Have normal audiometric thresholds below 25 dB HL at frequencies between 250 and 8000 Hz OR have audiometric thresholds not exceeding 40 dB HL at frequencies between 250 and 8000 Hz OR have audiometric thresholds not exceeding 55 dB HL at frequencies between 250 and 8000 Hz OR use a cochlear implant

I am fluent in North American English.

Exclusion Criteria

Not a competent speaker of North American English

I am under 18 years old.

I am older than 65.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Baseline

Audiometric threshold testing to determine the lowest sound intensity detectable by participants

1 week

1 visit (in-person)

Treatment

Participants undergo systematic manipulation of speech sounds to evaluate speech categorization and recognition

1 year

Multiple sessions (in-person)

Follow-up

Participants are monitored for outcomes and data is reported through study completion

4 weeks

Treatment Details

Interventions

• Speech Manipulation (Behavioural Intervention)

Trial Overview The study investigates how people with healthy and impaired hearing recognize speech sounds within context. It will explore the role of adjacent sounds and examine if modifications to hearing devices can improve perception.

Participant Groups

Group I: Speech perception experiments Experimental Treatment 1 Intervention

This arm involves experiments wherein participants listen to speech played at comfortable volumes and respond by indicating what they heard either in open-ended form or by choosing among a set of options displayed on a computer.

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

University of Minnesota Minneapolis, MN

University of Louisville Louisville, KY

Who Is Running the Clinical Trial?

University of Louisville

Lead Sponsor

Trials

353

Recruited

76,400+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Findings from Research

A study involving hearing aid users aged 16-89 in Nigeria found that aural rehabilitation significantly improves self-reported outcomes across various domains, including daily use and satisfaction, with mean scores comparable to those in developed countries.

The results indicate that aural rehabilitation is both feasible and effective in enhancing the quality of life for hearing-impaired individuals in a developing country, with most respondents reporting favorable outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-reported outcomes of aural rehabilitation in a developing country. Olusanya, B.[2019]

A study involving eight hearing-impaired adults showed that communication therapy can effectively change how individuals use repair strategies when they misinterpret spoken sentences, leading to a more diverse approach in communication.

After therapy, participants reduced their reliance on the 'repeat' strategy and began using other strategies, such as asking for simplification or key words, indicating improved communication skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Repair strategy usage by hearing-impaired adults and changes following communication therapy. Tye-Murray, N.[2019]

In a review of 1,835 articles from major otolaryngology journals, only 31% provided therapeutic recommendations, and 65% mentioned harms or adverse events, indicating a significant underreporting issue.

Studies that reported beneficial effects of therapy were more likely to omit details about adverse events, suggesting a potential bias in reporting, while surgical studies were more likely to document harms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting of harms and adverse events in otolaryngology journals. Bibawy, H., Cossu, A., Cogan, S., et al.[2009]

Safety pharmacology studies are essential in drug development to evaluate the potential effects of new drugs on auditory functions, ensuring that they do not cause hearing loss at therapeutic doses.

The chapter emphasizes the importance of identifying the specific mechanisms behind any observed hearing loss, as well as adhering to FDA standards when designing ototoxicity studies to assess drug interactions with the auditory system.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Safety Pharmacology of Auditory Function. Abernathy, MM.[2015]

The speech-enhancement process developed for hearing-impaired listeners significantly improved speech intelligibility in noisy environments, particularly at speech-to-noise ratios between -3 and 6 dB.

This enhancement technique, which modifies the auditory excitation pattern of speech signals, showed small but meaningful improvements for subjects with moderate to severe sensorineural hearing loss, indicating its potential effectiveness in real-world listening situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Spectral Enhancement to Improve the Intelligibility of Speech in Noise for Hearing-impaired Listeners. Simpson, AM., Moore, BCJ., Glasberg, BR.[2020]

The speech-enhancement process developed for hearing-impaired listeners significantly improved speech intelligibility in noisy environments, particularly at speech-to-noise ratios between -3 and 6 dB.

This enhancement technique, which modifies the auditory excitation pattern of speech signals, showed small but meaningful improvements for subjects with moderate to severe sensorineural hearing loss, indicating its potential effectiveness in real-world listening situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Spectral enhancement to improve the intelligibility of speech in noise for hearing-impaired listeners. Simpson, AM., Moore, BC., Glasberg, BR.[2008]

Advancements in speech-recognition and processing technology could significantly help people with hearing impairments by automatically enhancing important speech sounds, making them easier to hear.

The study outlines methods for determining which speech sounds need enhancement and how much amplification is necessary, as well as the potential training required for hearing-impaired individuals to effectively use these enhancements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Some rehabilitative considerations for future speech-processing hearing aids. Revoile, SG., Holden-Pitt, LD., Edward, DM., et al.[2012]

Enhancing specific acoustic features of consonants significantly improved speech perception in hearing-impaired individuals, with 75% of participants achieving at least 90% accuracy in identifying stop voicing sounds after the enhancements.

A single training session using these enhanced consonant sounds was effective in maximizing performance improvements, indicating that targeted acoustic modifications can be a practical intervention for improving speech perception in those with severe to profound hearing loss.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech-cue enhancement for the hearing impaired: amplification of burst/murmur cues for improved perception of final stop voicing. Revoile, SG., Holden-Pitt, L., Edward, D., et al.[2007]

In a study of four profoundly deafened adults, simplified feedback on voice fundamental frequency (Fx) led to better control of voice pitch compared to traditional amplified speech feedback, particularly for those with impaired control.

The results suggest that using simplified Fx feedback could enhance speech-processing strategies in hearing aids and cochlear implants, as it showed improved or maintained Fx control in subjects who struggled with traditional feedback methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of two different speech-coding strategies on voice fundamental frequency control in deafened adults. Ball, V., Faulkner, A., Fourcin, A.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Self-reported outcomes of aural rehabilitation in a developing country. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Clear speech for adults with a hearing loss: does intervention with communication partners make a difference? [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Repair strategy usage by hearing-impaired adults and changes following communication therapy. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Intelligibility of clear and conversational speech of young and elderly talkers. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Measuring outcomes of a communication program for older people with hearing impairment using the International Outcome Inventory. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Reporting of harms and adverse events in otolaryngology journals. [2009]

7. United States pubmed.ncbi.nlm.nih.gov

Distortion Product Otoacoustic Emission Test is Not the Test to Use in Nonclinical Safety Assessment. [2022]

8. Germany pubmed.ncbi.nlm.nih.gov

The Safety Pharmacology of Auditory Function. [2015]

9. United States pubmed.ncbi.nlm.nih.gov

United States multicenter clinical trial of the cochlear nucleus hybrid implant system. [2021]

10. Germany pubmed.ncbi.nlm.nih.gov

[Hearing loss following the use of topical otitis therapeutics in dogs]. [2022]

11. England pubmed.ncbi.nlm.nih.gov

Spectral Enhancement to Improve the Intelligibility of Speech in Noise for Hearing-impaired Listeners. [2020]

12. Norway pubmed.ncbi.nlm.nih.gov

Spectral enhancement to improve the intelligibility of speech in noise for hearing-impaired listeners. [2008]

13. United States pubmed.ncbi.nlm.nih.gov

Some rehabilitative considerations for future speech-processing hearing aids. [2012]

14. United States pubmed.ncbi.nlm.nih.gov

Speech-cue enhancement for the hearing impaired: amplification of burst/murmur cues for improved perception of final stop voicing. [2007]

15. England pubmed.ncbi.nlm.nih.gov

The effects of two different speech-coding strategies on voice fundamental frequency control in deafened adults. [2019]