RESEARCH ARTICLE Aided and Unaided Speech Perception by Older Hearing Impaired Listeners

The most common complaint of older hearing impaired (OHI) listeners is difficulty under-standing speech in the presence of noise. However, tests of consonant-identification and sentence reception threshold (SeRT) provide different perspectives on the magnitude of im-pairment. Here we quantified speech perception difficulties in 24 OHI listeners in unaided and aided conditions by analyzing (1) consonant-identification thresholds and consonant confusions for 20 onset and 20 coda consonants in consonant-vowel-consonant (CVC) syl-lables presented at consonant-specific signal-to-noise (SNR) levels, and (2) SeRTs ob-tained with the Quick Speech in Noise Test (QSIN) and the Hearing in Noise Test (HINT). Compared to older normal hearing (ONH) listeners, nearly all unaided OHI listeners showed abnormal consonant-identification thresholds, abnormal consonant confusions, and re-duced psychometric function slopes. Average elevations in consonant-identification thresh-olds exceeded 35 dB, correlated strongly with impairments in mid-frequency hearing, and were greater for hard-to-identify consonants. Advanced digital hearing aids (HAs) improved average consonant-identification thresholds by more than 17 dB, with significant HA benefi