Auditory Distraction and Acclimatization to Hearing Aids

Objective: It is widely recognized by hearing aid users and audiologists that a period of auditory acclimatization and adjustment is needed for new users to become accustomed to their devices. The aim of the present study was to test the idea that auditory acclimatization and adjustment to hearing aids involves a process of learning to "tune out" newly audible but undesirable sounds, which are described by new hearing aid users as annoying and distracting. It was hypothesized that (1) speech recognition thresholds in noise would improve over time for new hearing aid users, (2) distractibility to noise would reduce over time for new hearing aid users, (3) there would be a correlation between improved speech recognition in noise and reduced distractibility to background sounds, (4) improvements in speech recognition and distraction would be accompanied by self-report of reduced annoyance, and (5) improvements in speech recognition and distraction would be associated with higher general cognitive ability and more hearing aid use. Design: New adult hearing aid users (n = 35) completed a test of aided speech recognition in noise (SIN) and a test of auditory distraction by background sound amplified by hearing aids on the day of fitting and 1, 7, 14, and 30 days post fitting. At day 30, participants completed self-ratings of the annoyance of amplified sounds. Daily hearing aid use was measured via hearing aid data logging, and cognitive ability was measured with the Wechsler Abbreviated Scale of Intelligence block design test. A control group of experienced hearing aid users (n = 20) completed the tests over a similar time frame. Results: At day 30, there was no statistically significant improvement in SIN among new users versus experienced users. However, levels of hearing loss and hearing aid use varied widely among new users. A subset of new users with moderate hearing loss who wore their hearing aids at least 6 hr/day (n = 10) had significantly improved SIN (by ~3-dB signal to noise ratio), compared with a control group of experienced hearing aid users. Improvements in SIN were associated with more consistent HA use and more severe hearing loss. No improvements in the test of auditory distraction by background sound were observed. Improvements in SIN were associated with self-report of background sound being less distracting and greater self-reported hearing aid benefit. There was no association between improvements in SIN and cognitive ability or between SIN and auditory distraction. Conclusions: Improvements in SIN were accompanied by self-report of background sounds being less intrusive, consistent with auditory acclimatization involving a process of learning to "tune out" newly audible unwanted sounds. More severe hearing loss may afford the room for improvement required to show better SIN performance with time. Consistent hearing aid use may facilitate acclimatization to hearing aids and better SIN performance.

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