Speech perception in individuals with auditory neuropathy.

PURPOSE Speech perception in participants with auditory neuropathy (AN) was systematically studied to answer the following 2 questions: Does noise present a particular problem for people with AN? Can clear speech and cochlear implants alleviate this problem? METHOD The researchers evaluated the advantage in intelligibility of clear speech over conversational speech in 13 participants with AN. Of these participants, 7 had received a cochlear implant. Eight sentence-recognition experiments were conducted to examine the clear speech advantage in 2 listening conditions (quiet and noise) using 4 stimulation modes (monaural acoustic, diotic acoustic, monaural electric, and binaurally combined acoustic and electric stimulation). RESULTS Participants with AN performed more poorly in speech recognition in noise than did the normal-hearing, cochlear-impaired, and cochlear implant controls. A significant clear speech advantage was observed, ranging from 9 to 23 percentage points in intelligibility for all listening conditions and stimulation modes. Electric stimulation via a cochlear implant produced significantly higher intelligibility than acoustic stimulation in both quiet and in noise. Binaural hearing with either diotic acoustic stimulation or combined acoustic and electric stimulation produced significantly higher intelligibility than monaural stimulation in quiet but not in noise. CONCLUSIONS Participants with AN most likely derive the clear speech advantage from enhanced temporal properties in clear speech and improved neural synchrony with electric stimulation. Although the present result supports cochlear implantation as one treatment choice for people with AN, it suggests that the use of innovative hearing aids may be another viable option to improve speech perception in noise.