(PP1304) Auditory-Visual Speech-in-Noise Recognition with Visual Distractors in Normal Hearing Adults

This study evaluated the auditory-visual Connected Speech Test (CST) in a novel condition with a visual distractor in a group of normal hearing adults. This novel condition aims to increase ecological validity of the CST by more realistically mimicking a real-world communication scenario. Thirty young adult participants with normal hearing completed the CST both with and without the visual distractor. Results revealed significantly poorer recognition performance with the visual distractor versus without the visual distractor. Results suggest that the addition of visual distraction to this auditory-visual speech understanding task has a negative impact on performance, even in young, normal-hearing individuals.

Summary: 

Speech-in-noise assessments (e.g., RSPIN, QSIN) are clinically useful for approximating one of the most common issues that brings patients to the audiologist’s door: difficulty understanding speech in background noise. Clinically implemented speech-in-noise assessments evaluate the auditory system in isolation by removing visual and sometimes lexical cues from speech. These assessments are useful in determining the contribution of auditory system function to speech understanding; however, they do not replicate the listener’s real-world experiences. In most communication situations, a listener has access to visual and semantic information. For example, a listener sitting in a busy sports bar across a table from their communication partner would have access to the visual cues of their partner’s face as well as lexical cues from knowledge of the conversational topic. In addition to these cues which benefit speech understanding, the listener would likely also be exposed to background noise (e.g., music, other conversations) and visual distractions from their partner’s face (e.g., televisions and movement of servers). Therefore, a speech-in-noise task which includes both auditory and visual information provides a more ecologically valid representation of an individual’s real-world communication performance. Auditory visual assessments of speech-in-noise understanding exist (e.g., the Connected Speech Test [Cox et al., 1989]). However, to date, no auditory-visual speech-in-noise assessments consider the possible influence of visual distraction on speech understanding in complex listening environments. As such, the present study aimed to establish normative data for an auditory-visual speech-in-noise task with a visual distractor in a young, normal-hearing population.

Thirty participants 18-34 years of age were recruited for the present study. All participants had normal hearing sensitivity, no subjective hearing difficulties as determined by the Adult Auditory Performance Scale, and vision or corrected vision of 20/40 or better.

Participants completed 6 passages of the auditory-visual condition of the Connected Speech Test (CST) binaurally both with and without the visual distractor condition. In the non-distractor condition, only the target speaker’s face was visible. In the visual distractor condition, in addition to the target speaker’s face, the faces of two men talking were visible behind the target. Stimuli were presented at 50 dB HL at a -5 dB SNR with TDH-39 earphones.

There was a significant difference between mean performance on the CST without visual distraction and the CST with visual distraction (t₂₈= 6.21, p < .001). On average, CST performance without visual distraction (M= 84.87 Rau, SD= 9.84 Rau) was 7.32 Rau higher than CST with visual distraction (M= 77.55 Rau, SD= 12.34 Rau) (95% CI [4.9, 9.7]). Neither age nor PTA accounted for variance in performance in either condition (R²< .12).

The addition of visual distractor to an auditory-visual speech understanding task decreases performance, even in a young normal hearing population. Auditory-visual speech in noise tasks more closely approximates a listener’s real-world communication environments. Ecologically valid assessments are powerful counseling tools for patients as they more closely approximate real-world performance. As such, the CST with visual distraction condition could be used as an assessment of adults with hearing impairment and of hearing aid benefit.