Effects of Amplification and Hearing Aid Experience on the Contribution of Specific Frequency Bands to Loudness

OBJECTIVES: The primary aim of this study is to describe the effect of hearing aid amplification on the contribution of specific frequency bands to overall loudness in adult listeners with sensorineural hearing loss (SNHL). Results for listeners with SNHL were compared with results for listeners with normal hearing (NH) to evaluate whether amplification restores the normal perception of loudness for broadband sound. A secondary aim of this study is to determine whether the loudness perception of new hearing aid users becomes closer to normal over the first few months of hearing aid use. It was hypothesized that amplification would cause the high-frequency bands to contribute most to the perception of loudness and that this effect might decrease as new hearing aid users adapt to amplification. DESIGN: In experiment 1, 8 adult listeners with SNHL completed a two-interval forced-choice loudness task in unaided and aided conditions. A control group of 7 listeners with NH completed the task in the unaided condition only. Stimuli were composed of seven summed noise bands whose levels were independently adjusted between presentations. During a trial, two stimuli were presented, and listeners determined the louder one. The correlation between the difference in levels for a given noise band on every trial and the listener's response was calculated. The resulting measure is termed the perceptual weight because it provides an estimate of the relative contribution of a given frequency region to overall loudness. In experiment 2, a separate group of 6 new hearing aid users repeated identical procedures on 2 sessions separated by 12 weeks. RESULTS: Results for listeners with SNHL were similar in experiments 1 and 2. In the unaided condition, perceptual weights were greatest for the low-frequency bands. In the aided condition, perceptual weights were greatest for the high-frequency bands. On average, the aided perceptual weights for listeners with SNHL for high-frequency bands were greater than the unaided weights for listeners with NH. In experiment 2, hearing aid experience did not have a significant effect on perceptual weights. CONCLUSIONS: The high frequencies seem to dominate loudness perception in listeners with SNHL using hearing aids as they do in listeners with NH. However, the results suggest that amplification causes high frequencies to have a larger contribution to overall loudness compared with listeners with NH. The contribution of the high frequencies to loudness did not change after an acclimatization period for the first-time hearing aid users.