Threshold Estimation and Speech Perception Under Hearing Loss Simulation: Examination of the Immersive Hearing Loss and Prosthesis Simulator

Purpose: Hearing loss simulation (HLS) has been recommended for clinical teaching and counseling of patients and their families, so that they can experience hearing impairment. However, few validated procedures for simulating hearing loss are available to instructors and practicing clinicians. The aim of this study was to assess the accuracy of the Immersive Hearing Loss and Prosthesis Simulator (I-HeLPS) on reducing hearing sensitivity and word recognition to determine its adequacy for educational and clinical use. Method: Thirty-seven young adults with normal hearing completed hearing threshold and word recognition testing under normal and simulated hearing losses. The accuracy of the nominal hearing threshold settings within the I-HeLPS software was assessed with behavioral detection of frequency-modulated pure tones presented in a calibrated sound field, while listeners wore I-HeLPS headphones. The impact of the HLSs on speech perception was measured using the California Consonant Test. Hearing thresholds, word identification accuracy, and sound confusions were compared across listening conditions. Results: Hearing thresholds increased systematically with worse simulated hearing loss. Performance on the California Consonant Test worsened, and the number of phoneme confusions increased with simulated hearing loss severity. Most of the confusions were place confusions with near neighbors and manner confusions increased as a function of increasing severity of simulated hearing loss. Conclusions: The I-HeLPS accurately elevated hearing thresholds with increasing HLS severity and impacted word recognition in a manner consistent with sensorineural hearing loss. The simulations were considered reasonable for educational and clinical purposes. Supplemental Material: https://doi.org/10.23641/asha.24520966