Speaker
Description
Clinical hearing assessment and hearing aid fitting rely mainly on the pure tone audiogram, which emphasizes audibility at low levels. However, many real-world sounds occur at moderate to high levels, where speech understanding can decline and listening discomfort may arise. Current clinical measures capture these effects only to a limited extent. The LoudSounds project aims to develop clinically feasible methods for assessing hearing at moderate to high levels and to evaluate their relation to existing procedures. Data were collected at the University of Southern Denmark and the German Institute of Hearing Aids from older adults with mild to moderate sensorineural hearing loss and young normal hearing listeners. This study focuses on loudness perception and discomfort. Pure tone audiometry included uncomfortable loudness levels as an index of high-level tolerance. Loudness growth was assessed using adaptive categorical loudness scaling with speech and speech shaped noise, yielding estimates of most comfortable levels and upper loudness categories. Speech-based measures of most comfortable and uncomfortable levels were obtained using procedures aligned with pure tone testing. Sensitivity to impulse sounds was evaluated using transient stimuli with increasing levels until discomfort or maximum output was reached. Results confirm that hearing impaired listeners show elevated thresholds while uncomfortable loudness levels remain similar to those of normal hearing listeners. Estimates of most comfortable and uncomfortable levels were consistent across methods. Hearing impaired listeners showed stronger binaural loudness summation, increasing at higher levels. Loudness recruitment was observed for sustained stimuli, while sensitivity to impulse sounds was reduced, suggesting a partly independent perceptual dimension of transient sounds.