Remediation of spatial processing deficits in hearing-impaired children and adults.

Helen Glyde, Sharon Cameron, Harvey Dillon, Louise Hickson

Research output: Contribution to journalArticlepeer-review


Background: The ability to use interaural cues to seg regate target speech from competing signals allowspeople with normal hearing to understand speech at significantly poorer signal-to-noise ratios. This ability,referred to as spatial processing ability or spatial release from masking, has been shown to be deficientin people with a sensorineural hearing loss even after amplification is applied. Spatial processingdeficits in a population of children with auditory processing deficits have been found to be remediablethrough the use of a deficit-specific auditory training program called the LiSN & Learn.Purpose: The aim of the present study was to determine whether LiSN and Learn auditory training couldimprove the spatial processing ability of hearing-impaired adults and children. In addition, the researchinvestigated whether the age of the participant would affect the efficacy of the training program.Research Design: In a repeated-measures design, participants' spatial processing ability was assessedpretraining and posttraining using the Listening in Spatialized Noise-Sentences Test (LiSN-S). Questionnaireresponses were also collected from participants pretraining and posttraining to provide a subjectivemeasure of real-life listening difficulty. Between the two assessment periods, participants were asked totrain with the LiSN and Learn for 15 min per day, 5 days per week for 60 training sessions.Study Sample: Participants were five children (aged 6-11 yr) and five adults (aged 60-74 yr) with up to amoderate sensorineural hearing loss.Data Collection and Analysis: The LiSN and Learn auditory training software incorporates five computergames in which target sentences, processed with head-related transfer functions, are perceived as comingfrom 0-azimuth, and simultaneous distracting speech streams are perceived as coming from 690-azimuth. Participants are tasked with identifying a word from the target sentence and selecting thecorresponding picture from a selection of four images displayed on the screen. The signal-to-noise ratiois adapted based on whether the response given is correct or incorrect.Results: Despite an average improvement of 10 dB on the LiSN and Learn training program, no significant improvements were seen posttraining in either of the spatially separated conditions of the LiSN-S( p ranging 0.47-0.75). A 1.2 dB improvement was found in the baseline condition of the LiSN-S, whichincorporates no spatial separation between distracter and target stimuli ( p , 0.01). Age did not significantlyaffect training outcomes ( p 5 0.21). No significant improvements were found posttraining on theself-report questionnaires ( p 5 0.84 and p 5 0.20).Conclusions: This study has demonstrated that LiSN and Learn training does not significantly improvespatial processing deficits in adults or children with a sensorineural hearing loss. As auditory trainingdid not prove to be effective, further research should be directed toward the development of hearingaid processing schemes that will compensate for the degraded interaural time difference and interaurallevel difference cues which underpin spatial processing.
Original languageEnglish
Pages (from-to)605-623
Number of pages19
JournalJournal of the American Academy of Audiology
Issue number6
Publication statusPublished - 1 Jun 2014


  • Auditory training
  • Hearing impairment
  • Learn
  • LiSN &
  • Spatial processing
  • Spatial release from masking


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