Objective: Perceived voice quality (VQ) ratings provide data with ordinal characteristics on arbitrary scales regarding the relative order of VQ disruptions ranging from mild to severe quality. The overarching goal of this research is to develop a new and rigorous method for perceptual evaluation of VQ using quantitative comparisons and facilitating standardized comparisons across time points, clinicians, and clinical sites. Our prior research developed standard ratio-level scales of breathy and rough VQ analogous to the sone scale that (a) have physical units, (b) are strongly related to psychophysical measures, and (c) can quantify not just the direction but also the magnitude of change. The current study reestablishes the standard reference points, validates the newly developed VQ scales with natural dysphonic stimuli, and evaluates the psychometric measurement properties of the novel scales for breathiness and roughness in a small clinical pilot experiment. Method: In the first experiment, a set of magnitude estimation (ME) tasks were first used to determine the perceived magnitudes of breathiness and roughness of 10 natural voice stimuli in each VQ continuum. The resulting data were compared with previously acquired magnitude estimates of the synthetic comparison stimuli to adjust the reference points. In the second experiment, a set of inexperienced listeners evaluated the same set of natural dysphonic stimuli using the new clinical scales with perceived magnitude expressed in standard VQ units. In the third experiment, two expert clinicians evaluated 12 breathy and 10 rough dysphonic voices (pre- and posttreatment) using the new VQ scales. Results: The standard reference units were identified as 15 dB SNR for breathiness and -26 dB modulation depth for roughness. The strength of the relationship between the ME data and the predicted values from the clinical scales was high for both breathiness and roughness (r > .9). Treatment outcomes measured using the newly developed scales demonstrated high intra- (r > .8) and interrater reliability (r > .8) when compared to Consensus Auditory-Perceptual Evaluation of Voice providing evidence for concurrent validity of the clinical scales. Conclusion: Such formal VQ scales support valid quantitative comparisons of perceptual judgments and represent a critical step in clinical translation.

PURPOSE:The purpose of this study was to examine objective correlates of strain by reducing the covarying effects of other voice qualities. Predominant strain was elicited in a group of typical voice individuals instructed to modulate their vocal effort. The resulting sustained vowel productions were evaluated by (a) auditory-perceptual ratings to confirm the presence of predominant strain, and (b) a series of objective acoustic and psychoacoustic measures previously reported as potentially effective in the characterization of strain. METHODS:Sustained vowel /ɑ/ productions were elicited from 37 normophonic subjects using habitual (typical) voice and intermediate and maximal levels of strained voice. Strained voice samples were elicited using specific verbal instructions, visual cues, and example voice recordings demonstrating varying levels of strain. Vowel samples were analyzed using measures of sharpness (acum), pitch strength, pitch height, cepstral measures (including cepstral peak prominence [CPP], CPP standard deviation, and CPP fo), measures of spectral tilt (low vs high spectral ratio at 2-kHz and 4-kHz cutoffs), and relative vocal intensity (dB SPL). RESULTS AND CONCLUSIONS:Auditory-perceptual analyses showed that productions of intermediate and maximal predominant strain were relatively unencumbered by the covarying effects of breathiness and roughness. The results showed that perceived strain is related to increased sharpness and spectral tilt, increased fo and fo variability, and increased SPL. While minor reductions in CPP and pitch strength may be observed with increasing strain, the presence of relatively strong periodicity and harmonic content in sustained vowel production characterized by predominant strain makes these objective measures weaker indices of increased vocal effort and strain.

OBJECTIVE:As with adult voices, the reliability of Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) appears to vary widely for pediatric voices, especially for supraglottal voice sources (SGVS). The current study compared the reliability of estimates of breathy, rough, and strained voice qualities in pediatric dysphonic voices using laboratory-based methods, such as visual sort and rank (VSR) and magnitude estimation (ME), and the clinical CAPE-V method. METHODS:A total of 124 samples (30 SGVS and 94 glottal vibratory source or GVS) from children aged 4 to 11 years were selected from the Cincinnati Children's Hospital Medical Center (CCHMC) database. Three expert listeners rated breathiness, roughness, and strain of 1000-ms /ɑ/ samples using VSR, ME, and CAPE-V. In the VSR task, experts were presented with subsets of voice samples and were encouraged to sort and rank them into a relative order by comparing each sample to another. In the ME task, experts assigned the voice quality magnitude a number between 1 and 1000. RESULTS:High intra- and inter-rater reliability was observed for each of the perceptual measurement methods. For intra-rater reliability, the ME task provided the highest reliability across the two vibratory sources and the three voice quality dimensions. For inter-rater reliability, the ME task provided higher values for SGVS samples, while VSR provided higher values for GVS samples. There was also a strong relationship between the three methods with high correlations. CONCLUSIONS:Among three expert voice clinician-scientists, inter- and intra-rater reliability was similar for the offline CAPE-V assessment and the laboratory methods of VSR and ME. However, there appears to be a slight variation in absolute reliability values between the two vibratory sources. It is unclear how this highly controlled comparison extends to typical clinical practice. High reliability among expert professionals can potentially be translated to other clinicians and inexperienced listeners using superior ratio-level scaling procedures provided by the ME task.

INTRODUCTION:The primary purpose of this study was to examine the relationship between phonation quotient (PQ) obtained using a low-cost vortex whistle system (VWS) vs phonatory airflow (PA) in sustained voicing calculated using a clinical-standard pneumotach-based system (the Phonatory Aerodynamic System [PAS]). PQ values obtained using the VWS were also compared with PQ values obtained using a "gold" standard pneumotach-based Koko Sx1000 spirometer. METHODOLOGY:Participants were 91 vocally healthy young adults (61 females and 30 males) between the ages of 18 and 30 years. Measures of vital capacity (VC) were obtained using the VWS and Koko Sx1000 spirometer, and measures of maximum phonation time (MPT) and PA during sustained phonation were obtained from the Maximum Sustained Phonation protocol on the PAS. PQs were calculated via PQ = VC (L)/MPT (s). RESULTS:Correlations of r = 0.828 and r = 0.791 were observed between PA and PQKoko and PQVWS, respectively, with no significant difference between the two correlations. Stronger correlations between both PQKoko and PQVWS and PA were observed in males vs females. Linear regressions to predict PA from either PQKoko or PQVWS resulted in residual standard errors of 0.037 L/s (37 mL/s) and 0.040 L/s (40 mL/s), respectively. PQVWS and PQKoko were highly correlated (r = 0.961). CONCLUSION:These results confirm prior research demonstrating that PQ may be used as a reasonable substitute for PA, with error values within previously reported expected ranges of intrasubject variability. In addition, a low-cost VWS can provide similarly accurate measures of PQ vs those computed using VC estimates from a "gold standard" pneumotach-based spirometer. PQ estimates of airflow via a VWS show great promise as a low-cost method that can promote the use of respiratory measures of capacity and flow to the voice assessment protocols of speech-language pathologists.

PURPOSE:Severe dysphonia in children often poses a challenge for conventional acoustic measurement methods due to the high degree of aperiodicity, which can result in invalid or unreliable measures. Signal typing can support the validity of these measures, but current methods rely on subjective inspection and do not account for multiple signal types within a voice sample. This study aimed to improve current signal typing practices by refining a manual signal typing tool for segment-level labeling and a predictive model for objective signal typing. METHOD:Sustained /ɑ/ phonations from 94 children with a glottal vibratory source and 30 children with supraglottal vibratory source (SGVS) were evaluated by three expert speech-language pathologists using the signal typing tool. Signal type labels determined through expert consensus were considered the ground truth for each segment and used to train a predictive model. Computational measures associated with periodicity and voice quality, including pitch strength, envelope standard deviation (EnvSD8), sharpness, and smoothed cepstral peak prominence (CPPS), were extracted and used in an ordinal logistic regression model. Model performance was evaluated using a held-out test set and fivefold cross-validation. RESULTS:Manual signal typing revealed that 11% of the overall samples and 20% of the samples with SGVS included two or more signal types. A predictive model incorporating EnvSD8, CPPS, and sharpness achieved good to excellent prediction accuracy (81%-96%) across signal types in both the test and cross-validation sets. CONCLUSIONS:The manual signal typing tool developed in this study shows promise for improving the precision of signal typing, which may enhance the reliability of conventional acoustic measures and enable the calculation of signal type proportions as potential outcome metrics. Automating signal typing using the measures investigated in this study could further increase the clinical utility of this tool by providing objective signal typing.

Objective While many research studies evaluate a single voice quality dimension to improve measurement precision, this approach often fails to capture the covariance among more than one voice quality. The goal of the current study was to investigate the relative utility of objective acoustic and bioinspired psychoacoustic-based measurement methods in a set of dysphonic voices that covary in severity from mild to severe along three voice quality dimensions. Methods Stimuli included 26 voices that varied across three levels of dysphonic severity (mild, moderate, and severe) in three covarying voice quality dimensions (breathy, rough, and strain) based on the dimension-specific severity rankings of all 26 stimuli by four voice experts. Subsequent analyses of the vocal acoustic signals included two computations of the cepstral peak prominence (CPP) and three psychoacoustic-based methods derived from the front end of models of auditory processing, including pitch strength (PS), temporal envelope standard deviation, and spectral sharpness. Results Analyses revealed that breathiness severity was strongly correlated with PS and CPPPRAAT, moderately correlated with CPPADSV, and not significantly correlated with the temporal envelope standard deviation measure. Roughness severity was significantly and moderately correlated with the temporal envelope standard deviation measure and CPPADSV. Both PS and sharpness were significantly correlated with strain severity. PS was the single most strongly correlated metric with overall severity. Conclusions The relative strength of acoustic and bioinspired psychoacoustic-based measures of the voice signal can substantially vary depending upon the perceptual focus of the raters that are rating/ranking a set of voice samples. While PS emerged as the single strongest correlate of ranked breathiness and strain, as well as ranked severity across breathy, rough, and strained voice types, other measures were observed to provide important contributions in marking the presence and severity of roughness (CPPADSV and temporal envelope standard deviation) and strain (sharpness).

Interaural time difference (ITD) cues are the dominant cue for sound localization in the horizontal plane. Encoding of ITD is postulated to occur via an internal binaural cross-correlation function, where the peak correlation serves as the interaural coherence (IAC) and the delay in which the peak occurs serves as the ITD. Sound sources in anechoic chambers have IAC values at or near 1. Sound sources in reverberant rooms have a wide range of frequency-dependent IAC values between 1 and 0, where ITD sensitivity decreases as IAC decreases toward 0 [Rakerd and Hartmann, J. Acoust. Soc. Am. 28, 3052–3063 (2010)]. The current work builds upon the relationships described by Rakerd and Hartmann to examine the degraded binaural temporal processing of the aging auditory system in complex (reverberant and noise-filled) rooms. Behavioral ITD thresholds were measured as a function of IAC for younger and older listeners with clinically normal hearing. Results indicate that at higher IAC values, older listeners have elevated ITD thresholds. However, at lower IAC values, ITD thresholds between listener groups converge. Following Rakerd and Hartmann, binaural analyses were made in a reverberant room, with the addition of competing noise to simulate listening scenarios older listeners often find difficult.

Listening to speech in noisy environments poses significant challenges for individuals with hearing loss, potentially due to poor representation of the temporal envelope. We explored the peripheral and central roles of temporal envelope processing using a gaps-in-noise task, computational modeling of the auditory periphery, and electrophysiology. Three behavioral experiments were conducted, using a 3-alternative-forced-choice procedure and a 3-down-1-up adaptive tracking method to estimate gap thresholds. Experiments 1 and 2 tracked gap detection (in ms) for various signal bandwidths, masker bandwidths, signal-to-noise ratios (SNRs), and gap modulation depths. Experiment 3 fixed the gap duration and tracked gap modulation depth (in dB) at various SNRs. Results showed that poorer SNRs were associated with poorer gap thresholds in all three experiments. In experiment 2, increased masker bandwidths also led to poorer gap thresholds. Modeling these results indicated that gap thresholds in noise can be attributed to mostly peripheral processes; however, the results of experiment 2 were more consistent with central factors. Participants also completed a passive EEG task using a standard acoustic change complex paradigm. The present study provides a comprehensive assessment of peripheral and central factors associated with temporal envelope processing which may have implications for amplification strategies. [Work supported by NIH.]

PURPOSE:Pediatric dysphonia can be categorized by the vibratory source used for voicing: the glottal vibratory source (GVS) and supraglottal vibratory source (SGVS). While voice quality assessment is integral to clinical voice care, there is limited research to support the direct adoption of tools developed for adult voices in the assessment of pediatric voices, particularly given the potential differences in vibratory sources. The study aimed to determine the primary voice quality dimensions in children with GVS and SGVS via multidimensional scaling. METHOD:Sustained /ɑ/ phonations from 15 children with GVS and 15 children with SGVS representing a wide range of dysphonia severity were selected. Fifteen listeners participated in a pairwise comparison task, rating the perceived similarity of voice quality between stimuli pairs. Averaged perceptual distances between stimuli were analyzed using a PROXSCAL model to determine the optimal multidimensional model. To interpret each resulting dimension, auditory-perceptual and objective measures of voice quality were obtained. RESULTS:The dominant perceptual dimension in both GVS and SGVS voices was related to signal periodicity, which was associated with perceived hoarseness and overall dysphonia severity. Other perceptual dimensions obtained were strongly correlated with breathiness, roughness, and strain, commonly assessed in adult dysphonia. Roughness and strain strongly characterized the perceptual dimension distinguishing the two vibratory sources. CONCLUSION:The perceptual organization of pediatric dysphonia shares similarities with adults, and perceptual features related to roughness and strain characterize SGVSs.

OBJECTIVE:The role of pitch perception in the assessment of pediatric dysphonia remains underexplored. Aperiodicity associated with severe dysphonia poses a vexing problem for conventional measurement methods that rely on signal periodicity, rendering them unreliable for most dysphonic voices. We tested the hypotheses that pitch height and pitch strength systematically vary with type 1, 2, and 3 signals (varying in periodicity) associated with glottal and supraglottal vibratory sources and may be used to augment signal typing classification. METHODS:Ten naive listeners judged pitch height through a single-variable matching task and pitch strength through an anchored magnitude estimation task for 42 pediatric dysphonic sustained /a/ vowels (14 per signal type). Computational estimates of pitch height and pitch strength were obtained from the auditory sawtooth waveform inspired pitch estimator prime (Aud-SWIPE') algorithm. Analyses of variance were used to determine the differences in pitch height and pitch strength across the three signal types. The relationship between perceptual and computational estimates was examined using correlation coefficients and their significance. RESULTS:Listeners were able to reliably judge pitch height even in type 3 signals, which lack clear periodicity. Aud-SWIPE' consistently generated reliable pitch height estimates, even for aperiodic type 3 signals. Pitch strength was significantly higher in type 1 signals than in type 2 or 3, both perceptually (P = 0.01) and computationally (P < 0.001). CONCLUSIONS:Pitch height and pitch strength can be successfully estimated in pediatric dysphonic voices for all signal types. These measures can also be applied to natural speech, enabling assessment using real-world communication.

Understanding the flow-induced sound represents a serious problem in many engineering applications. A wide variety of aeroacoustics problems are solved by CFD-CAA simulations, in which the time step typically cannot be too small due to the limited computational resources. This situation results in an identified aliasing error in spectral analysis. Therefore, an anti-aliasing operation prior to sampling is necessary to remove such aliasing errors from acoustic source terms. In the present study, an anti-aliasing filter in a time-domain, compact filter scheme, was designed based on the compact finite difference formulation. This filter was applied on the Navier-Stokes solver directly, prior to sampling for CAA analysis. A case of cavity flow was simulated to validate the mitigation strategy. The result shows that the artificial spectral peak induced by the aliasing error is removed while not affecting other signature peaks. The anti-aliasing filter was applied to more complicated cases with signature peaks in predicting the acoustic field of a vortex whistle. The acoustic field around the vortex whistle with constant inlet flow rates and variable flow rates was simulated and the aliasing peak was successfully removed. Although the peak magnitudes are decreased slightly by the filter, the signature frequencies are not changed. Therefore, the simulation with anti-aliasing operation can predict acoustic features without introducing the aliasing error, even if the time step is not sufficiently small, and thus reduce the simulation time significantly.

Older adults with normal hearing or with age-related hearing loss face challenges when listening to speech in noisy environments. To better serve individuals with communication difficulties, precision diagnostics are needed to characterize individuals’ auditory perceptual and cognitive abilities beyond pure tone thresholds. These abilities can be heterogenous across individuals within the same population. The goal of the present study is to consider the suprathreshold variability and develop characteristic profiles for older adults with normal hearing (ONH) and with hearing loss (OHL). Auditory perceptual and cognitive abilities were tested on ONH ( n = 20) and OHL ( n = 20) on an abbreviated test battery using portable automated rapid testing. Using cluster analyses, three main profiles were revealed for each group, showing differences in auditory perceptual and cognitive abilities despite similar audiometric thresholds. Analysis of variance showed that ONH profiles differed in spatial release from masking, speech-in-babble testing, cognition, tone-in-noise, and binaural temporal processing abilities. The OHL profiles differed in spatial release from masking, speech-in-babble testing, cognition, and tolerance to background noise performance. Correlation analyses showed significant relationships between auditory and cognitive abilities in both groups. This study showed that auditory perceptual and cognitive deficits can be present to varying degrees in the presence of audiometrically normal hearing and among listeners with similar degrees of hearing loss. The results of this study inform the need for taking individual differences into consideration and developing targeted intervention options beyond pure tone thresholds and speech testing.

Purpose: We present results from a 6-month field trial of a transitional intervention for debilitating primary hyperacusis, including a combination of structured counseling; promotion of safe, comfortable, and healthy sound exposure; and therapeutic broadband sound from sound generators. This intervention is designed to overcome barriers to successful delivery of therapeutic sound as a tool to downregulate neural hyperactivity in the central auditory pathways (i.e., the maladaptive mechanism believed to account for primary hyperacusis) and, together with the counseling, reduce the associated negative emotional and physiological reactions to debilitating hyperacusis. Method: Twelve adults with normal or near-normal audiometric thresholds, complaints consistent with their pretreatment loudness discomfort levels ≤ 75 dB HL at multiple frequencies, and hearing questionnaire scores ≥ 24 completed the sound therapy–based intervention. The low-level broadband therapeutic sound was delivered by ear-level devices fitted bilaterally with either occluding earpieces and output-limiting loudness suppression (LS; to limit exposure to offensive sound levels) or open domes to maximize comfort and exposure to sound therapy. Thresholds for LS (primary outcome) were incrementally adjusted across six monthly visits based on treatment-driven change in loudness judgments for running speech in sound field. Secondary outcomes included categorical loudness judgments, speech understanding, and questionnaires to assess the hyperacusis problem, quality of life, and depression. An exit survey assessed satisfaction with and benefit from the intervention and the counseling, therapeutic sound, and LS components. Results: The mean change in LS (34.8 dB) was highly significant (effect size = 2.045). Eleven of 12 participants achieved ≥ 16-dB change in LS, consistent with highly significant change in sound-based questionnaire scores. Exit surveys indicated satisfaction with and benefit from the intervention. Conclusion: The transitional intervention was successful in improving the hyperacusis conditions of 11 of 12 study participants while reducing their sound avoidance behaviors and reliance on sound protection.

Speech perception relies on our ability to process fast modulations in a signal. Such temporal processing often is probed using a temporal gap detection task. Because speech-in-noise listening is a common challenge for listeners with hearing loss, we investigated the role of the periphery to process temporal gaps in the presence of noise. Three experiments were conducted using a classic gap detection threshold method, including a 3-alternative-forced-choice procedure and a 3-down-1-up adaptive tracking method to estimate thresholds. Experiments 1 and 2 tracked gap detection (in ms) for various signal bandwidths, signal-to-noise ratios (SNRs), and masker modulation depths. Experiment 3 fixed the gap duration, then tracked gap modulation depth (in dB) at various SNRs. Experiments 1 to 3 showed similar effects of SNR, with poorer SNRs increasing gap thresholds. Masker bandwidth also reduced performance in Experiment 2. Current analyses with a common modulation filter bank frontend (Dau et al., 1997) performed on par as the normal hearing listeners suggesting that auditory gap detection and, by extension, temporal envelope processing, can be explained by peripheral processes. [Work supported by NIH R01 DC020514 and R01DC015051.]

Purpose: This report provides the experimental, clinical, theoretical, and historical background that motivated a patented transitional intervention and its implementation and evaluation in a field trial for mitigation of debilitating loudness-based hyperacusis (LH). Background and Rationale: Barriers for ameliorating LH, which is differentiated here from other forms of hyperacusis, are delineated, including counterproductive management and treatment strategies that may exacerbate the condition. Evidence for hyper-gain central auditory processes as the bases for LH and the associated LH-induced distress and stress responses are presented. This presentation is followed by an overview of prior efforts to use counseling and therapeutic sound as interventional tools for recalibrating the hyper-gain LH response. We also consider previous efforts to use output-limiting sound-protection devices in the management of LH. This historical background lays the foundation for our transitional intervention protocol and its implementation and evaluation in a field trial. Conclusions: The successful implementation and evaluation of a transitional intervention, which we document in the outcomes of a companion proof-of-concept field trial in this issue, build on our prior efforts and those of others to understand, manage, and treat hyperacusis. These efforts to overcome significant barriers and vexing long-standing challenges in the management and treatment of LH, as reviewed here, are the pillars of the transitional intervention and its primary components, namely, counseling combined with protective sound management and therapeutic sound, which we detail in separate reports in this issue.

Spectral resolution and spectro-temporal modulation (STM) sensitivity both show a correlation with speech reception thresholds in noise. Both are also sensitive to the difficulties resulting from sensorineural hearing loss; however, the relationship between the two is not fully understood. The present study investigated the potential relationship between spectral resolution and STM sensitivity and the impact of presentation level in young, normal hearing listeners. Four noise carriers were tested with the two broader bandwidths and two 1-octave wide bandwidths: 200–6400 Hz, 1250–5000 Hz, 1250–2500 Hz, & 2500–5000 Hz. Presentation levels were 70 dB SPL and 20 dB SL relative to the individual’s pure-tone frequency-shaped noise carrier threshold. Spectral resolution was tested using a phase reversal paradigm, also known as a spectral ripple discrimination task, with thresholds measured in cycles per octave. Spectral, temporal, and STM sensitivity were each tested using a depth detection task, with thresholds measured in dB. On a test-by-test case, results were aligned with past studies that included a single test. The results show that both sensitivities are distinct at a low presentation level close to individual hearing thresholds, and a mixed relationship between both measures indicate that spectral resolution may only be one contributor to STM sensitivity.

Introduction: This clinical focus article describes a structured counseling protocol for use with protected sound management and therapeutic sound in a transitional intervention for debilitating hyperacusis. The counseling protocol and its associated visual aids are crafted as a teaching tool to educate affected individuals about hyperacusis and encourage their acceptance of a transitional intervention. Description of Counseling Components: The counseling protocol includes five components. First, the patient's audiometric results are reviewed with the patient, and the transitional intervention is introduced. An overview of peripheral auditory structures and central neural pathways and the concept of central gain are covered in the second and third components. Maladaptive hyper-gain processes within the auditory neural pathways, which underlie the hyperacusis condition, and associated connections with nonauditory processes responsible for negative reactions to hyperacusis are covered in the fourth component. Detrimental effects from misused hearing protection devices (HPDs) and the necessity to wean the patient from overuse of HPDs are also discussed. In the fifth component, the importance of therapeutic sound is introduced as a tool to downregulate hyper-gain activity within the auditory pathways; its implementation in uncontrolled and controlled sound environments is described. It is explained that, over the course of the transitional intervention, recalibration of the hyper-gain processes will be ongoing, leading to restoration of normal homeostasis within the auditory pathways. In turn, associated activation of reactive nonauditory processes, which contribute to hyperacusis-related distress, will be reduced or eliminated. As recalibration progresses, there will be less need for protected sound management and sound therapy. Sound tolerance will improve, hyperacusis will subside, and daily activities in typical healthy sound environments will again become routine. Results and Conclusion: The combination of counseling with protected sound management and therapeutic sound is highlighted in companion reports, including a summary of the outcomes of a successful trial of the transitional intervention.

PURPOSE:Auditory perceptual and cognitive tasks can be useful as a long-term goal in guiding rehabilitation and intervention strategies in audiology clinics that mostly operate at a faster pace and on strict timelines. The rationale of this study was to assess test-retest reliability of an abbreviated test battery and evaluate age-related auditory perceptual and cognitive effects on these measures. METHOD:Experiment 1 evaluated the test-retest repeatability of an abbreviated test battery and its use in an adverse listening environment. Ten participants performed two visits, each including four conditions: quiet, background noise, external noise, and background mixed with external noise. In Experiment 2, both auditory perceptual and cognitive assessments were collected from younger adults with normal hearing and older adults with and without hearing loss. The full test battery included measures of frequency selectivity, temporal fine structure and envelope processing, spectrotemporal and spatial processing and cognition, and an external measure of tolerance to background noise. RESULTS:Results from Experiment 1 showed good test-retest repeatability and nonsignificant effects from background or external noise. In Experiment 2, effects of age and hearing loss were shown across auditory perceptual and cognitive measures, except in measures of temporal envelope perception and tolerance to background noise. CONCLUSIONS:These data support the use of an abbreviated test battery in relatively uncontrolled listening environments such as clinic waiting rooms. With an efficient test battery, perceptual and cognitive deficits can be assessed with minimal resources and little clinician involvement due to the automated nature of the test and the use of consumer-grade technology. SUPPLEMENTAL MATERIAL:https://doi.org/10.23641/asha.28021070.

Head movement plays a vital role in auditory processing by contributing to spatial awareness and the ability to identify and locate sound sources. Here we investigate head-orienting behaviors using a dual-task experimental paradigm to measure: (a) localization of a speech source; and (b) detection of meaningful speech (numbers), within a complex acoustic background. Ten younger adults with normal hearing and 20 older adults with mild-to-severe sensorineural hearing loss were evaluated in the free field on two head-movement conditions: (1) head fixed to the front and (2) head moving to a source location; and two context conditions: (1) with audio only or (2) with audio plus visual cues. Head-tracking analyses quantified the target location relative to head location, as well as the peak velocity during head movements. Evaluation of head-orienting behaviors revealed that both groups tended to undershoot the auditory target for targets beyond 60° in azimuth. Listeners with hearing loss had higher head-turn errors than the normal-hearing listeners, even when a visual location cue was provided. Digit detection accuracy was better for the normal-hearing than hearing-loss groups, with a main effect of signal-to-noise ratio (SNR). When performing the dual-task paradigm in the most difficult listening environments, participants consistently demonstrated a wait-and-listen head-movement strategy, characterized by a short pause during which they maintained their head orientation and gathered information before orienting to the target location.

Current methods of auditory-perceptual evaluation of disordered voice quality using ordinal or interval scales have limited reliability and precision to quantify the magnitude of change in response to disorder progression or treatment. Matching tasks with synthetic comparison sounds have emerged as a more effective alternative, reducing biases and providing adjustable comparative values to represent perceived magnitude of change in quality. Previous studies have focused on the individual dimensions of breathiness, roughness, and strain separately and indicate covarying voice qualities may impact listener judgments. Here we investigate a three-dimensional matching (3-DMA) task where three variables, each representing a major quality dimension, can be adjusted concurrently. The comparison sound was a low-pass filtered sawtooth waveform (f o = 151 Hz) mixed with noise. Independent variables for matching were the signal-to-noise ratio for breathiness, amplitude modulation depth for roughness, and bandpass filter gain for strain. Listeners used sliders to adjust each variable, matching all three dimensions of 26 natural voice samples, selected to contain wide variation in all three dimensions. Preliminary results from five listeners demonstrated good reliability, similar to that observed in previous single-variable matching tasks for individual voice qualities. The results support the feasibility of the 3-DMA task. [Work supported by NIH R01DC009029.]