Localization and Speech-Identification Ability of Hearing-Impaired Listeners Using Phase-Preserving Amplification

Objective: The purpose of these experiments was to determine the ability of hearing-impaired listeners to localize and to identify speech in noise using phase-preserving and non–phase-preserving amplification. Design: These abilities were measured 4 times over each of two 16-week periods, using a randomized, single-blinded, within-subject crossover design. Listeners were fitted bilaterally, using the National Acoustic Laboratories linear frequency-gain characteristic with a digital hearing aid programmed in one of two ways: (1) with a linear-phase filter and (2) with filters designed to compensate for the magnitude and phase anomalies caused by the hearing aid fitting, thus preserving interaural phase. Listeners identified a word and its location in background noise with a speech-shaped spectrum. Results: Immediately after fitting, both hearing aid programs reduced the listeners' ability to localize the speech in noise. The phase-preserving processing had a less detrimental effect on localization ability immediately after fitting. After 3 weeks, performance improved such that, for localization in noise, there was no detrimental effect of amplification and no difference between the two processing strategies. Over 16 weeks, speech understanding in noise improved. Speech understanding for phase-preserving processing was slightly and significantly better than linear-phase processing at 16 weeks. Conclusions: Localization ability using phase-preserving amplification does not differ from localization ability using traditional non–phase-preserving amplification after just 3 weeks of use. Listeners quickly acclimated to altered spatial cues. Phase-preserving amplification provided a 2.3% advantage for speech intelligibility in noise after 16 weeks.