The Effect of Hearing Aid Signal-Processing Schemes on Acceptable Noise Levels: Perception and Prediction

Objectives: The acceptable noise level (ANL) test determines the maximum noise level that an individual is willing to accept while listening to speech. The first objective of the present study was to systematically investigate the effect of wide dynamic range compression processing (WDRC), and its combined effect with digital noise reduction (DNR) and directional processing (DIR), on ANL. Because ANL represents the lowest signal-to-noise ratio (SNR) that a listener is willing to accept, the second objective was to examine whether the hearing aid output SNR could predict aided ANL across different combinations of hearing aid signal-processing schemes. Design: Twenty-five adults with sensorineural hearing loss participated in the study. ANL was measured monaurally in two unaided and seven aided conditions, in which the status of the hearing aid processing schemes (enabled or disabled) and the location of noise (front or rear) were manipulated. The hearing aid output SNR was measured for each listener in each condition using a phase-inversion technique. The aided ANL was predicted by unaided ANL and hearing aid output SNR, under the assumption that the lowest acceptable SNR at the listener's eardrum is a constant across different ANL test conditions. Results: Study results revealed that, on average, WDRC increased (worsened) ANL by 1.5 dB, while DNR and DIR decreased (improved) ANL by 1.1 and 2.8 dB, respectively. Because the effects of WDRC and DNR on ANL were opposite in direction but similar in magnitude, the ANL of linear/DNR-off was not significantly different from that of WDRC/DNR-on. The results further indicated that the pattern of ANL change across different aided conditions was consistent with the pattern of hearing aid output SNR change created by processing schemes. Conclusions: Compared with linear processing, WDRC creates a noisier sound image and makes listeners less willing to accept noise. However, this negative effect on noise acceptance can be offset by DNR, regardless of microphone mode. The hearing aid output SNR derived using the phase-inversion technique can predict aided ANL across different combinations of signal-processing schemes. These results suggest a close relationship between aided ANL, signal-processing scheme, and hearing aid output SNR. (Ear & Hearing 2013;34;333-341)