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An investigation was conducted to examine the effects of lexical difficulty on spoken word recognition among young normal-hearing and middle-aged and older listeners with hearing loss. Two word lists, based on the lexical characteristics of word frequency and neighborhood density and frequency (Neighborhood Activation Model [NAM]), were developed: (1) lexically "easy" words with high word frequency and a low number and frequency of words phonemically similar to the target word and (2) lexically "hard" words with low word frequency and a high number and frequency of words phonemically similar to the target word. Simple and transformed up-down adaptive strategies were used to estimate performance levels at several locations on the performance-intensity functions of the words. The results verified predictions of the NAM and showed that easy words produced more favorable performance levels than hard words at an equal intelligibility. Although the slopes of the performance-intensity function for the hearing-impaired listeners were less steep than those of normal-hearing listeners, the effects of lexical difficulty on performance were similar for both groups.

The purpose of this investigation was to determine whether subjective judgments of clarity or intelligibility would be rated equally among conditions in which speech was equated for predicted intelligibility (using the Speech Intelligibility Index, SII) but varied in bandwidth. Twenty listeners with normal hearing rated clarity and intelligibility for sentence material (Hearing In Noise Test) in speech-shaped noise at six paired low- and high-pass filtered conditions in which SII was equated for each pair. For three paired conditions, predicted intelligibility increased as SII increased monotonically (0.3, 0.4, 0.5). In the remaining paired conditions, SII continued to increase monotonically (0.6, 0.7, 0.8) but predicted intelligibility was held at a maximal level (> or = 95%). Predicted intelligibility was estimated from the transfer function relating SII to speech recognition scores determined in preliminary experiments. Differences in ratings between paired low- and high-pass filtered sentences did not reach statistical significance for either clarity or intelligibility, indicating that the spectral differences at equivalent SIIs did not influence the judgments for either of the two dimensions. For conditions in which predicted intelligibility increased, both clarity and intelligibility ratings increased in a similar manner. For conditions in which predicted intelligibility was maximized, intelligibility ratings remained the same statistically across conditions while clarity ratings changed modestly. Although high correlations were observed between clarity and intelligibility ratings, intelligibility ratings were consistently higher than clarity ratings for comparable conditions. The results indicated that listeners with normal hearing produced clarity and intelligibility ratings for the same speech material and experimental conditions that were highly related but differed in magnitude. Caution is required when substituting clarity for intelligibility.

Real-ear sound pressure levels (SPLs) were compared among three methods used for positioning a probe microphone in the ear canal. The probe insertion techniques included (1) an acoustic method that incorporates use of the quarter-wave anti-resonance property of the ear to determine acoustically the location of the probe tube relative to the eardrum; (2) a constant insertion depth method (25 mm from the intratragal notch); and (3) the earmold +5-mm method, which places the probe 5 mm beyond the tip of the earmold, thereby avoiding problems associated with the transition region where sound exits from the bore of the earmold into the larger ear canal. Measurements were obtained at 32 test frequencies in 24 adults with normal middle ear impedance. Results indicated that the SPLs measured by the acoustic method were modestly higher than those measured by the other two methods. This result was most evident in subjects with long ear canals (> 25 mm) and at high test frequencies (3.0 to 6.3 kHz).

Children's subjective judgments of speech clarity using the methods of paired comparisons and category rating were evaluated in this investigation. Eighty children with normal hearing between the ages of 4 and 8 years judged the clarity of sentences that were systematically bandpass-filtered using conditions that increased intelligibility as estimated by the Articulation Index. Subjects were classified into four age groups (4-, 5-, 6-, and 7-8-year age groups) with 20 subjects per group. With use of materials and training methods suitable for children, judgments were obtained via the two psychophysical procedures (10 subjects per age group for each procedure). Results indicated that children 5 years of age and older were able to make reliable clarity judgments using either procedure; however, the method of paired comparisons was more sensitive than category rating in detecting differences between the bandpass-filtered conditions.

The effect of amplitude-modulated (AM) noise on speech recognition in listeners with normal and impaired hearing was investigated in two experiments. In the first experiment nonsense syllables were presented in high-pass steady-state or AM noise to determine whether the release from masking in AM noise relative to steady-state noise was significantly different between normal-hearing and hearing-impaired subjects when the two groups listened under equivalent masker conditions. The normal-hearing subjects were tested in the experimental noise under two conditions: (a) in a spectrally shaped broadband noise that produced pure tone thresholds equivalent to those of the hearing-impaired subjects, and (b) without the spectrally shaped broadband noise. The release from masking in AM noise was significantly greater for the normal-hearing group than for either the hearing-impaired or masked normal-hearing groups. In the second experiment, normal-hearing and hearing-impaired subjects identified nonsense syllables in isolation and target words in sentences in steady-state or AM noise adjusted to approximate the spectral shape and gain of a hearing aid prescription. The release from masking was significantly less for the subjects with impaired hearing. These data suggest that hearing-impaired listeners obtain less release from masking in AM noise than do normal-hearing listeners even when both the speech and noise are presented at levels that are above threshold over much of the speech frequency range.

The purpose of this article is to provide an overall summary of the role probe insertion depth has on real ear measurements, and to compare the real ear sound pressure level measured by a probe microphone system, using three methods for positioning the probe in an ear canal. The probe insertion techniques that were compared included: (1) an acoustic method that incorporates use of the quarter-wave antiresonance property of the ear to determine acoustically the location of the probe tube relative to the eardrum in an individual ear; (2) a constant insertion depth method (25 mm from the intratragal notch); and (3) the earmold +5 mm method, which places the probe 5 mm beyond the tip of the individual's earmold in the canal, thereby avoiding problems associated with the transition region, where sound exits from the bore of the earmold into the larger ear canal. Measurements were obtained for each method at 32 frequencies in the unoccluded ears of 17 subjects. Results indicated that the sound pressure levels measured by the acoustic method were significantly larger than those measured by the other two methods. This result was most evident in subjects with long ear canals (> 25 mm) and at high test frequencies (4.0 to 6.3 kHz). For subjects with short or average length ear canals, the three methods provided essentially equivalent results.

The purpose of these investigations was to compare the preferred frequency-gain responses obtained from two- and three-channel amplification systems. The current experiments were limited to a linear system in which the crossover frequency dividing the channels was systematically varied. The subjects for the experiment were nine individuals with mild to moderately severe sensorineural hearing loss with various audiometric configurations. The subjects listened to continuous discourse, in noise, via a computer-controlled digital master hearing aid containing two real-time data acquisition processors. Initially, a modified simplex procedure was used to obtain preferred frequency-gain responses using several different crossover frequencies. A round-robin procedure was then conducted in which each preferred response from the simplex was compared with every other preferred response. The frequency-gain responses chosen most often for the two- and three-channel systems were compared. The results showed no significant differences between the preferred frequency-gain response for the two- versus the three-channel system. In addition, the preferred response chosen most often was not consistently observed at the same crossover frequency for all subjects, with the exception of those with steeply sloping hearing loss who chose 1,120 Hz as the first or second preference for the two-channel system. The round-robin results were rank-ordered according to the number of times each frequency-gain response was chosen. In general, subjects chose several frequency-gain responses at various crossover frequencies, which were not significantly different from each other statistically. The results of a final experiment suggested that physical similarities in the preferred responses chosen at the various crossover frequencies played a role in the rank-ordering of the preference judgments obtained in the original investigation.

The relative importance and absolute contributions of various spectral regions to speech intelligibility under conditions of either neutral or predictable sentential context were examined. Specifically, the frequency-importance functions for a set of monosyllabic words embedded in a highly predictive sentence context versus a sentence with little predictive information were developed using Articulation Index (AI) methods. Forty-two young normal-hearing adults heard sentences presented at signal-to-noise ratios from -8 to +14 dB in a noise shaped to conform to the peak spectrum of the speech. Results indicated only slight differences in 1/3-octave importance functions due to differences in semantic context, although the crossovers differed by a constant 180 Hz. Methodological and theoretical aspects of parameter estimation in the AI model are discussed. The results suggest that semantic context, as defined by these conditions, may alter frequency-importance relationships in addition to the dynamic range over which intelligibility rises.

To examine the association between frequency and temporal resolution and speech recognition, auditory filter parameters, rates of masking decay, and stop-consonant recognition were determined for 9 normal-hearing and 24 hearing-impaired subjects. Speech-presentation levels were selected for each subject based on articulation index (AI) predictions. Results suggest that auditory filter widths and dynamic ranges were strongly correlated with pure-tone threshold, while time constants were not. Stop-consonant recognition scores for most hearing-impaired listeners were not significantly poorer than predicted by the AI model. Furthermore, differences between observed recognition scores and those predicted by the AI were poorly correlated with derived psychophysical parameter values, suggesting that measures of frequency and temporal resolution and speech recognition may appear to be associated primarily because of their dependence on auditory threshold.

This paper describes the results of two experiments in which speech recognition performance was determined for listeners with sensorineural hearing loss, while listening in babble. Adaptive strategies were used in both experiments to measure the signal-to-babble ratio required to achieve a preselected level of performance at several speech presentation levels encountered in normal conversation or when listening through an amplification system. The results suggest that the proposed adaptive strategy may provide a practical method by which the relative effects of competition on speech recognition may be quantified in an individual listener.

The purpose of this experiment was to determine the applicability of the Articulation Index (AI) model for characterizing the speech recognition performance of listeners with mild-to-moderate hearing loss. Performance-intensity functions were obtained from five normal-hearing listeners and 11 hearing-impaired listeners using a closed-set nonsense syllable test for two frequency responses (uniform and high-frequency emphasis). For each listener, the fitting constant Q of the nonlinear transfer function relating AI and speech recognition was estimated. Results indicated that the function mapping AI onto performance was approximately the same for normal and hearing-impaired listeners with mild-to-moderate hearing loss and high speech recognition scores. For a hearing-impaired listener with poor speech recognition ability, the AI procedure was a poor predictor of performance. The AI procedure as presently used is inadequate for predicting performance of individuals with reduced speech recognition ability and should be used conservatively in applications predicting optimal or acceptable frequency response characteristics for hearing-aid amplification systems.

Confusion patterns among English consonants were examined using log-linear modeling techniques to assess the influence of low-pass filtering, shaped noise, presentation level, and consonant position. Ten normal-hearing listeners were presented consonant-vowel (CV) and vowel-consonant (VC) syllables containing the vowel /a/. Stimuli were presented in quiet and in noise, and were either filtered or broadband. The noise was shaped such that the effective signal level in each 1/3 octave band was equivalent in quiet and noise listening conditions. Three presentation levels were analyzed corresponding to the overall rms level of the combined speech stimuli. Error patterns were affected significantly by presentation level, filtering, and consonant position as a complex interaction. The effect of filtering was dependent on presentation level and consonant position. The effects stemming from the noise were less pronounced. Specific confusions responsible for these effects were isolated, and an acoustical interaction is suggested, stressing the spectral characteristics of the signals and their modification by presentation level and filtering.

Articulation index (AI) theory was used to evaluate stop-consonant recognition of normal-hearing listeners and listeners with high-frequency hearing loss. From results reported in a companion article [Dubno et al., J. Acoust. Soc. Am. 85, 347-354 (1989)], a transfer function relating the AI to stop-consonant recognition was established, and a frequency importance function was determined for the nine stop-consonant-vowel syllables used as test stimuli. The calculations included the rms and peak levels of the speech that had been measured in 1/3 octave bands; the internal noise was estimated from the thresholds for each subject. The AI model was then used to predict performance for the hearing-impaired listeners. A majority of the AI predictions for the hearing-impaired subjects fell within +/- 2 standard deviations of the normal-hearing listeners' results. However, as observed in previous data, the AI tended to overestimate performance of the hearing-impaired listeners. The accuracy of the predictions decreased with the magnitude of high-frequency hearing loss. Thus, with the exception of performance for listeners with severe high-frequency hearing loss, the results suggest that poorer speech recognition among hearing-impaired listeners results from reduced audibility within critical spectral regions of the speech stimuli.

Log-linear models, in conjunction with the G2 statistic, were developed and applied to several existing sets of consonant confusion data. Significant interactions of consonant error patterns were found with signal-to-noise ratio (S/N), presentation level, vowel context, and low-pass and high-pass filtering. These variables also showed significant interactions with error patterns when categorized on the basis of feature classifications. Patterns of errors were significantly altered by S/N for place of articulation (front, middle, back), voicing, frication, and nasality. Low-pass filtering significantly affected error patterns when categorized by place of articulation, duration, or nasality; whereas, high-pass filtering only affected voicing and frication error patterns. This paper also demonstrates the utility of log-linear modeling techniques in applications to confusion matrix analysis: specific effects can be tested; variant cells in a matrix can be isolated with respect to a particular model of interest; diagonal cells can be eliminated from the analysis; and the matrix can be collapsed across levels of variables, with no violation of independence. Finally, log-linear techniques are suggested for development of parsimonious and predictive models of speech perception.

To examine the association between frequency resolution and speech recognition, auditory filter parameters and stop-consonant recognition were determined for 9 normal-hearing and 24 hearing-impaired subjects. In an earlier investigation, the relationship between stop-consonant recognition and the articulation index (AI) had been established on normal-hearing listeners. Based on AI predictions, speech-presentation levels for each subject in this experiment were selected to obtain a wide range of recognition scores. This strategy provides a method of interpreting speech-recognition performance among listeners who vary in magnitude and configuration of hearing loss by assuming that conditions which yield equal audible spectra will result in equivalent performance. It was reasoned that an association between frequency resolution and consonant recognition may be more appropriately estimated if hearing-impaired listeners' performance was measured under conditions that assured equivalent audibility of the speech stimuli. Derived auditory filter parameters indicated that filter widths and dynamic ranges were strongly associated with threshold. Stop-consonant recognition scores for most hearing-impaired listeners were not significantly poorer than predicted by the AI model. Furthermore, differences between observed recognition scores and those predicted by the AI were not associated with auditory filter characteristics, suggesting that frequency resolution and speech recognition may appear to be associated primarily because both are degraded by threshold elevation.

Invariance of error patterns in confusion matrices of varying dimensions were examined. Normal-hearing young adults were presented closed-set arrangements of digitized syllable tokens, spoken by 1 male and 1 female talker, and selected from a set of 14 consonants (stops and fricatives). Each consonant was paired with the vowel/a/ in a vowel-consonant format and presented at three intensity levels. Patterns of errors among voiceless stops and among voiced fricatives were dependent on the set of alternatives. Voiceless fricatives and voiced stops were not significantly affected by the number of response alternatives. Speaker differences, individual differences among listeners, and implications relating to the generalization of confusion data collected in small closed-set arrangements are discussed.

Syllable recognition ability and consonant confusion patterns were evaluated for 38 listeners with mild-to-moderate sensorineural hearing loss using the closed-set Nonsense-Syllable Test (NST). Performance for these materials varies as a function of consonant voicing, the position of the consonant in the syllable, and the accompanying vowel. Scores for listeners with steeply sloping audiometric configurations were consistently poorer than those for listeners with gradually sloping or flat audiograms. Consonant confusion analyses revealed place of articulation errors to be the most frequent, regardless of the listener's audiometric configuration. Analysis of consonant confusion patterns indicates the existence of a systematic relationship between consonant confusions and audiometric configuration. The NST findings are discussed in terms of the test's potential use and are compared to the results of existing confusion analyses.

Attempts to specify normal threshold sensitivity by bone conduction have been unsuccessful because of problems in obtaining reliable measurements from commercially available artificial mastoids. Recent design modifications incorporated in the Bruel and Kjaer 4930 artificial mastoids have resulted in greater uniformity among these units. However, the new design has resulted in impedances that are higher than those recommended in current standards. Bone-conduction thresholds referenced to measurements made on B & K 4930 artificial mastoids with the new design were performed on 60 normal listeners by three participating laboratories. The results are reported for consideration in the development of a reference threshold for hearing by bone conduction.

The effects of spectral shaping on speech recognition were investigated for hearing-impaired listeners with flat and steep audiometric configuration. Three frequency responses were tested: uniform frequency gain, high pass filtering, and a response shaped relative to each subject's loudness discomfort level curve. Speech-recognition performance was measured at four levels (from 80 to 95 dB SPL) using nonsense syllable (NST) and synthetic sentence (SSI) tests, presented against a background of "cafeteria noise." No significant differences in performance on the NST were observed between the two subject groups across all spectral shapes (frequency response) and presentation levels. On the SSI, performance of subjects with flat audiometric configuration was highest using the uniform frequency response, while performance of listeners with steep configuration was poorest for the uniform response. The recognition data were compared with predictions of relative performance using a modification of the Articulation index (AI). The AIs provided accurate estimates of relative performance across spectral shapes but were not consistent with relative performance as a function of presentation level. The results indicate that the selection of spectral shape for optimal performance is influenced by the particular speech task used to test recognition and also suggest that, with further validation, the AI may provide an objective technique for selecting optimal spectral shape.

Performance-intensity (PI) functions for phonetically balanced (PB) word lists were obtained for a group of normal listeners (27 ears), and for two groups of patients with cochlear (89 ears) and retrocochlear disorders (eight ears). Listeners with normal hearing or cochlear disorders exhibited mild to moderate reductions in discrimination score as the speech level was raised above the PB maximum. In contrast, patients with retrocochlear disorders showed a pronounced rollover phenomenon, characterized by a rapid decline in performance as the speech level was raised above the maximum discrimination score.

The reliability of the Synthetic Sentence Identification (SSI) test was determined for a group of 33 listeners with mild-to-moderate sensorineural hearing loss. Randomizations of the 10-item test were administered 12 times (six trials on each of two days) under identical listening conditions. Lists were presented monaurally, under earphones, at 90 dB SPL with a cafeteria background noise set at a signal-to-noise ratio (S/N) estimated (by adaptive procedure for each subject) to obtain 50% performance. Average scores ranged from 48.8% for Trial 1 to 67.9% for Trial 9. Reliability of the 12 measurements was determined by Pearson correlation, analyses of variance, and by testing individual differences in scores against a theoretical statistical distribution. Results evidenced large intra-subject variability, especially for the initial trials conducted in each testing session. However, if sufficient practice trials are presented each day under relatively difficult listening conditions, the scores on subsequent lists tend to remain relatively stable. Suggested procedures to optimize reliability are included.

In the present study, speech-recognition performance was measured in four hearing-impaired subjects and twelve normal hearers. The normal hearers were divided into four groups of three subjects each. Speech-recognition testing for the normal hearers was accomplished in a background of spectrally shaped noise in which the noise was shaped to produce masked thresholds identical to the quiet thresholds of one of the hearing-impaired subjects. The question addressed in this study is whether normal hearers with a hearing loss simulated through a shaped masking noise demonstrate speech-recognition difficulties similar to those of listeners with actual hearing impairment. Regarding overall percent-correct scores, the results indicated that two of the four hearing-impaired subjects performed better than their corresponding subgroup of noise-masked normal hearers, whereas the other two impaired listeners performed like the noise-masked normal listeners. A gross analysis of the types of errors made suggested that subjects with actual and simulated losses frequently made different types of errors.

Several investigations were perfomed with normal hearing subjects to determine the effects of presentation level and signal-to-babble ratio on the speech perception in noise (SPIN) test. The SPIN test contains sentences that simulate a range of contextual situations encountered in everyday speech communication. Findings from several representative patients with sensorineural hearing loss demonstrate the possible clinical utility of the test to measure the effects of context on speech discrimination.

The effect of standing waves on the ear canal measurement of eardrum sound pressure level (SPL) was determined by both calculation and measurement. Transmission line calculations of the standing wave were made using the dimensions of the ANSI S3.25-1979 ear simulator and three different eardrum impedances. Standing wave curves have been obtained for the standard eardrum impedance at 1-kHz intervals in the range of 1-8 kHz. The changes in standing wave position due to each of the three eardrum impedances and their effects on ear canal measurements of SPL were computed for each of the eardrum impedances. Ear canal SPL measurements conducted on simulators modified to correspond to the eardrum impedances used in the calculations were compared to the computed values. Differences between eardrum SPLs and those measured at different locations in the ear canal approached a standing wave ratio (SWR) of 10-12 dB as the position of the measuring probe approached the standing wave minimum at each frequency. These maximum differences compared favorably with data developed by other investigators from real ears. Differences due to the eardrum impedance were found to be significant only in the frequency region of 2-5 kHz. Calibration of probes in a standard or modified ANSI simulator at the same distance from the eardrum as in the real ear reduces the eardrum SPL measurement errors to those resulting from differences in eardrum impedance.

The purpose of the investigation was to determine the effect of eardrum and earmold impedance on eardrum sound pressure level (SPL) produced by a hearing aid receiver. Acoustic interactions between receivers and ears occurring at receiver resonances were explored and analyzed. Results with ear simulators showed that the effect of simulator eardrum impedance was increased in regions where ear and receiver impedance approached each other during resonances. Earmold acoustics were also significant factors at frequencies where their impedance were comparable to ear impedances. Resonant frequency shifts of 540 Hz in the region between 800 and 1500 Hz were observed for the range of simulator eardrum and earmold impedances employed, with SPL changes of 10 dB occurring at some frequencies. Results were different for each of the five receivers tested confirming the effect of the receiver characteristics on the eardrum SPL. A subsequent test was performed using real ears with results that agreed substantially with those obtained with the simulators.

The reliability of a closed-set Nonsense-Syllable Test was determined on a group of 38 listeners with mold-to-moderate sensorineural hearing loss. Eight randomizations of the 91-item test (four trials on each of two days) were presented monaurally, under earphones, at 90 dB SPL with a cafeteria background noise set at a +20-dB S/N ratio. Performance under these conditions ranged from 21.4 to 91.2%, reflecting the wide range of syllable-recognition ability of these subjects. Reliability of the eight measurements was determined by analysis of variance and analysis of covariance structure (parallel-test modelling) for the entire test and each of 11 subtests. Overall and individual subject results failed to show any systematic differences in scores over eight trials. Likewise, no significant differences were found in performance on individual syllables, nor were changes in the relative occurrence of specific syllable confusions noted. The test is highly reliable when evaluating hearing-impaired subjects, and thus is appropriate for use in investigations where identical items are administered under multiple experimental conditions.

Three investigations were conducted to determine the application of the articulation index (AI) to the prediction of speech performance of hearing-impaired subjects as well as of normal-hearing listeners. Speech performance was measured in quiet and in the presence of two interfering signals for items from the Speech Perception in Noise test in which target words are either highly predictable from contextual cues in the sentence or essentially contextually neutral. As expected, transfer functions relating the AI to speech performance were different depending on the type of contextual speech material. The AI transfer function for probability-high items rises steeply, much as for sentence materials, while the function for probability-low items rises more slowly, as for monosyllabic words. Different transfer functions were also found for tests conducted in quiet or white noise rather than in a babble background. A majority of the AI predictions for ten individuals with moderate sensorineural loss fell within +/- 2 standard deviations of normal listener performance for both quiet and babble conditions.

Using an adaptive strategy, the effects of mild sensorineural hearing loss and adult listeners' chronological age on speech recognition in babble were evaluated. The signal-to-babble ratio required to achieve 50% recognition was measured for three speech materials presented at soft to loud conversational speech levels. Four groups of subjects were tested: (1) normal-hearing listeners less than 44 years of age, (2) subjects less than 44 years old with mild sensorineural hearing loss and excellent speech recognition in quiet, (3) normal-hearing listeners greater than 65 with normal hearing, and (4) subjects greater than 65 years old with mild hearing loss and excellent performance in quiet. Groups 1 and 3, and groups 2 and 4 were matched on the basis of pure-tone thresholds, and thresholds for each of the three speech materials presented in quiet. In addition, groups 1 and 2 were similar in terms of mean age and age range, as were groups 3 and 4. Differences in performance in noise as a function of age were observed for both normal-hearing and hearing-impaired listeners despite equivalent performance in quiet. Subjects with mild hearing loss performed significantly worse than their normal-hearing counterparts. These results and their implications are discussed.

In these experiments, the effects of sound direction on the eardrum response of an anthropometric manikin (the KEMAR manikin) were investigated. Pure tones and pink noise (analyzed in 1/3-octave bandwidths) over a wide frequency range were used as signals as the manikin rotated 360 degrees with respect to a point source in a anechoic chamber. The simulated eardrum SPL was compared with the averaged human field-to-eardrum data reported by Shaw [J. Acoust. Soc. Am. 56, 1848--1861 (1974)]. It was concluded that the KEMAR manikin can be used up to frequencies of approximately 8.0 kHz, with (1) 1/3-octave pink noise signals to measure a response equivalent to tht obtained by averaging over a number of humans, and (2) pure-tone signals to measure the response equivalent to that of a single human having average head and ear dimensions.

The purpose of these experiments was to determine the incidence of the middle ear reflex in response to several nonacoustic (tactile and air jet) stimuli among subjects with normal hearing who had an acoustic reflex and selected patients with severe hearing loss. The results demonstrate that the incidence of response to tactile stimulation increases as the facial area stimulated approaches the auricle. The response to an air jet stimulus directed toward the eye is high; however, the clinical utility of the air jet may be limited because it often results in a startle reaction and head movement, and the response appears to fatigue easily. In normal listeners the response to auricular air jet stimulation probably results from both acoustic and tactile stimulation. The presence of a reflex to tactile stimulation, together with normal tympanometry constitutes strong evidence of a normal middle ear; but the absence of a reflex to acoustic or tactile stimuli still leads to an ambiguous determination of potential stapedial muscle function.

The problems inherent in using frequency-specific stimuli in the sound field to determine threshold sensitivity are reviewed, including a discussion of some of the specific problems encountered when introducing pure tones, narrow bands of noise, and frequency-modulated (FM) tones. The results of two experiments are reported. In Experiment I, the relationship between pure tones and frequency-modulated tones is developed under earphones in an anechoic chamber, and in two sound-isolated auditory test rooms (not anechoic). Experiment I resulted in the development of a reference threshold sound pressure level for frequency-modulated signals in the sound field. In Experiment II the reference level was applied to a clinical test facility and evaluated with a group of hearing-impaired individuals. The results suggest that the sound-field reference levels accurately reflect monaural threshold under earphones, when the earphone is calibrated to the ANSI, 1969 standard, and the sound field is calibrated to the suggested standard.

The present article is divided into four major sections dealing with the application of acoustical indices to the prediction of speech recognition performance. In the first section, two acoustical indices, the Articulation Index (AI) and the Speech Transmission Index (STI), are described. In the next section, the effectiveness of the AI and the STI in describing the performance of normal-hearing and hearing-impaired subjects listening to spectrally distorted (filtered) and temporarily distorted (reverberant) speech is examined retrospectively. In the third section, the results of a prospective investigation that examined the recognition of nonsense syllables under conditions of babble competition, filtering and reverberation are described. Finally, in the fourth section, the ability of the acoustical indices to describe the performance of 10 hearing-impaired listeners, 5 listening in quiet and 5 in babble, is examined. It is concluded that both the AI and the STI have significant shortcomings. A hybrid index, designated mSTI, which takes the best features from each procedure, is described and demonstrated to be the best alternative presently available.