Perceptual training of phoneme identification for hearing loss

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.