ABSTRACT
Synaptic connections in the auditory system change throughout life in response to
the changing acoustic environment. These changes help to compensate for sensorineural
hearing loss (SNHL) and the consequent impairment of high-frequency hearing by enhancing
the efficiency of synaptic transmission of low-frequency signals. They also help to
compensate for the inevitable deterioration in the central auditory system that occurs
with normal aging even without clinically significant hearing loss. However, in many
cases the neuroplastic changes are insufficient to maintain optimal speech comprehension.
Indeed, the enhanced transmission of low-frequency phonetic cues that occurs with
longstanding SNHL may interfere with a patient's ability to use the high-frequency
phonetic cues that are restored by hearing aids. Adaptive perceptual training using
tasks that require high-frequency phonetic cue processing can drive neuroplastic change
in auditory cortex to improve speech discrimination. The authors tested the benefits
of at-home personal computer-based phoneme identification training in new hearing
aid (HA) users and found that it produced significant benefit in phoneme identification
by reducing phonetic confusions and enhancing the patient's abilities to identify
previously difficult syllables. Perceptual training is a promising and cost-effective
tool for enhancing speech perception in HA users who have difficulty in understanding
everyday speech.
KEYWORDS
Computer-based training - hearing aids - speech perception - phonemes - neuroplasticity
- adaptive learning
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David Woods
Neurology Service (127E), Building R4, VANCHCS
150 Muir Rd., Martinez, CA 94553
Email: dlwoods@ucdavis.edu
