Invisible Hearing Loss and Speech Perception in Middle Age
The fact that temporal processing issues and temporal abnormalities can negatively impact speech perception in noise has been well described in the literature and is fairly well accepted. For example, Dubno and colleagues (2002) reported that people with reduced temporal resolution (due to aging or hearing loss) demonstrate poor speech recognition in temporally modulated noise, and deficient temporal processing may be a major factor associated with age-related speech in noise difficulties.
Jin et al (2014) reported that “…one could speculate that older listeners are less effective at distinguishing speech from complex noise…(due to a)…reduced ability to process temporal varying information….” Helfer and Vargo (2009) noted that "it is tantalizing to consider that temporal processing may be an underlying cause of problems understanding speech in competing speech."
Fullgrabe et al (2015) reported that even in the absence of peripheral hearing loss (as measured by the audiogram) speech-in-noise (SIN) identification declines with age. Grose et al (2015) reported that temporal fine structure (TFS) and the temporal envelope of the acoustic waveform are of significant importance when evaluating temporal processing deficits in middle age. Further, they reported that "deficits in both temporal envelope and temporal fine structure processing are evident during middle age while audiometric (often) hearing sensitivity remains normal." Beck (2015) reported that “for many children and adults with normal hearing, invisible hearing loss may be (and often is) present in tandem with normal audiograms.”
Helfer (2015) states that “…the ability to understand speech in complex listening environments can be demonstrated in midlife….” She reports that it is not unusual for adults (middle-age) to self-refer for hearing issues due to hearing-related problems in the presence of normal thresholds. She states “suboptimal temporal processing” may be responsible for disallowing listeners to take full advantage of “fluctuations in a competing speech signal leading to reduced ability to glimpse portions of the to-be-attended message….” She reports that multiple studies have found abnormal temporal processing in middle-aged adults and she concludes there is evidence that “substantial changes in speech recognition can occur in midlife….”
For More Information, References, and Recommendations
Beck DL. (2015) BrainHearing—Maximizing Hearing And Listening. Hearing Review. March.
Dubno JR, Horwitz AR, Ahlstrom JB. (2002) Benefit of Modulated Maskers for Speech recognition by Younger and Older Adults with Normal Hearing. Journal of the Acoustical Society of America. 97(1):2897-2907.
Fullgrabe C, Moore BCJ, Stone MA. (2015) Age-group Differences in Speech Identification Despite Matched Audiometrically Normal Hearing: Contributions from Auditory Temporal Processing and Cognition. Frontiers.
Grose GH, Mamo SK, Buss E, Hall JW. (2015) Temporal Processing Deficits in Middle Age. American Journal of Audiology 24:91.
Helfer KS. (2015) Competing Speech Perception in Middle Age. American Journal of Audiology 24:80-83.
Helfer KS, Vargo M. (2009) Speech Recognition and Temporal Processing in Middle-Aged Women. Journal of the American Academy of Audiology 20(4):264-271.
Jin SH, Liu C, Sladen DP. (2014) The Effects of Aging on Speech Perception in Noise: Comparison between Normal Hearing and Cochlear-Implant Listeners. Journal of the American Academy of Audiology 26:656-665.