Currently, standard measures used in audiology clinics to assess hearing aid (HA) outcome and performance in background noise include behavioral word or sentence tests (e.g., Bench, Kowal, & Bamford, 1979 Boothroyd, 1968 Nilsson, Soli, & Sullivan, 1994) or self-report questionnaires (e.g., Cox & Alexander, 1995 Gatehouse & Noble, 2004). However, objective measures to assess the outcome of an intervention (e.g., hearing aids) or to assess performance in background noise have yet to be applied in clinical audiology. These measures include the auditory brainstem response (ABR) to clicks and tone bursts and the auditory steady-state response (ASSR Hall, 2015). Objective measures to evaluate hearing in infants and in patients who cannot be assessed using behavioral measures are standard clinical audiological practice. However, our results suggest that speech-ABRs may have potential for clinical application as an objective measure of speech detection with hearing aids. These results show that speech-ABR F0 encoding is not a good predictor of speech-in-noise recognition or self-reported speech understanding with hearing aids. Results showed that (a) aided speech-ABRs had earlier peak latencies, larger peak amplitudes, and larger F0 encoding amplitudes compared to unaided speech-ABRs (b) the addition of background noise resulted in later F0 encoding latencies but did not have an effect on peak latencies and amplitudes or on F0 encoding amplitudes and (c) speech-ABRs were not a significant predictor of any of the behavioral or self-report measures. In addition, we evaluated whether speech-ABR F0 encoding (obtained from the complex cross-correlation with the 40 ms fundamental waveform) predicted aided behavioral speech recognition in noise or aided self-reported speech understanding. We compared aided and unaided speech-ABRs, and speech-ABRs in quiet and in noise. Here, we investigated the potential application of speech-ABRs as an objective clinical outcome measure of speech detection, speech-in-noise detection and recognition, and self-reported speech understanding in 98 adults with sensorineural hearing loss.
Brainstem responses to short consonant-vowel stimuli (speech-auditory brainstem responses ) have been proposed as a measure of subcortical encoding of speech, speech detection, and speech-in-noise performance in individuals with normal hearing. Evaluation of patients who are unable to provide behavioral responses on standard clinical measures is challenging due to the lack of standard objective (non-behavioral) clinical audiological measures that assess the outcome of an intervention (e.g., hearing aids).