Binaural Listening

This can consist of Diotic or Dichotic presentations

Diotic refers to same stimulus presented to both ears

Dichotic refers to different stimuli presented to each ear

Binaural Listening Advantages- Review

Binaural summation at threshold and at suprathreshold

levels

Enhanced difference limen for intensity and frequency

Understanding speech with background interference:

@ 2-4 dB for SRT

@ 6-7 dB for interference by speech
Localization
Dichotic Speech Tests
 Dichotic Tests

Present a different stimulus to each ear simultaneously

May assess two different processes

Binaural Integration (Divided Attention)

Requires the listener to repeat everything that is heard
Can be Free Recall or by Directed Ear first

Binaural Separation (Selective Auditory Attention)

Requires the listener to direct attention to one ear and
repeat or indicate what is heard only in that ear
Kimuras Model

Kimura theorized that

the contralateral
pathways are stronger
and more numerous
than the ipsilateral
pathways.

When competing
linguistic stimuli are
presented dichotically,
the ipsilateral pathways
are suppressed by the
stronger contralateral
Dichotic Listening pathways.
Kimuras Supposition

Because language-dominant hemisphere usually is the

left hemisphere:

o Information presented in right ear has direct access to left

AR/language region

o Information presented in left ear must traverse the right

hemisphere and the corpus callosum in order to be
perceived and labeled in the Left Hemisphere language
region
 Evidence Supporting Kimuras
Theory

Studies involving surgical sectioning of Corpus Callosum (CC)

- Surgical sectioning of posterior portion of CC results

in suppression of left-ear presentations and right-ear
enhancement in dichotic tasks (i.e., no ability to
recall what heard in left ear)

** Note that sectioning of the anterior portion of the CC does

not affect abilities on Dichotic listening tasks.
 Effects of Temporal Lobe Lesions on
Dichotic Listening

Right Hemisphere temporal lobe lesion will significantly

suppress left ear performance on a dichotic listening
task

On the other hand, a Left Hemisphere temporal lobe

lesion will not only affect right ear performance but
also left ear performance.

Why?
 Effects of Temporal Lobe Lesions on
Dichotic Listening

I believe if temporal lobe lesion is extensive enough, it

impacts on the auditory association area, thus,
making it difficult to also process speech stimuli from
left ear (via CC from right Auditory Cortex)

Thus, either a CC posterior lesion or a significant Left

Temporal lobe lesion will result in poor left ear
performance.
 Right Ear Advantage (REA)

In the 1960s, several researchers documented the

existence of a cerebral dominance effect in dichotic
listening (greatest for competing sentence stimuli-
highest linguistic load, least for digits)

This REA is apparent only upon dichotic stimulation

using speech stimuli:

If, on the other hand, present speech in one ear and

non-linguistic noise in opposite ear, REA will not ensue
1 MINUTE QUESTION

WHEN CONDUCTING DICHOTIC LISTENING TASKS, WHAT

FACTORS DO YOU THINK ONE MUST CONSIDER?
 Summarizing Dichotic Listening
Tasks

May be viewed in many different ways:

Type of stimuli used
Level of difficulty
Degree of linguistic loading
Task required of the listener
 Types of Stimuli Used

CV segments

Although light linguistic load, most difficult because

of limited amount of linguistic information
combined with the close temporal alignment of the
stimuli presentation

not recommended for children

 Types of Stimuli Used- contd

Digits (Light linguistic load)

- Easiest to administer to children/2nd language learners

- Can be administered to those with relatively

symmetrical hearing loss

Monosyllabic words (fairly light linguistic load)

Used in the SCAN-3
 Types of Stimuli Used- contd

Spondaic words (fairly common usage)

o Stimuli used in Staggered Spondaic Word test

Sentences (Heavy linguistic load)

o Depending on test can consist of highly familiar
linguistic/world context or 3rd word sentence
approximations
 Dichotic Digits Test (DDT)

Digits from 1-10 (excluding 7) are presented to each ear

simultaneously (Musiek, 1983)

The listener must repeat all digits heard (not matter which
order)

Available in singles (1 digit each ear), doubles (2 digits each

ear), triples (3 digits each ear)

Recommended that Doubles be given in most instances

o Use singles for training
o Triples rely too much on memory
o Light linguistic load
 DDT- contd

Test is quick and easy to administer and score

Relatively resistant to peripheral hearing loss

The paired digits are presented, and the listener is asked

to wait until all of the pairs (one, two, or three have been
presented- depending on test) before responding

Note that administered only in divided attention condition, requiring

all digits to be recalled; a selective attention task would be too easy
DDT- contd

Test instructions for this assignment:

You will be hearing two numbers in each of your ears. Listen
carefully in both ears and repeat all of the numbers you hear.
The order doesnt matter. If you are unsure of the numbers,
please guess.
Guenette, L A (2006)- Hearing Journal 59(2), 50.

Test scored in terms of percent correct per ear:

o The total # of digits correctly recalled is divided by the total # of
digits per ear (e.g., DDT- two digit pairs have a total of 76 digits
per ear) to derive the % correct score per ear

Test seems to be of average difficulty

Dichotic Tests

Because of the way dichotic stimuli are processed by

the CANS, with younger children there is typically a right
ear advantage (REA) on these tests

Remember Kimuras Model !!

 Competing Words Test-
Subtest of the SCAN

Recall:

Monosyllabic words on this test are presented dichotically

Free Recall: Patient recalls words in any order

Directed Recall: Patient is directed as to which word to

repeat first- according to directed ear

Patient has to repeat both words

 Competing Sentences Test
Subtest of the SCAN

Simple sentences that are

presented dichotically

Patient has to repeat the target

sentence

IGNORE COMPETING SENTENCE!!!

This is a binaural separation (selective attention task)

 Competing Sentences Test-
Willeford Test Battery

Assesses the process of binaural separation of auditory

information

Consists of total of 30 sentence pairs

Each sentence consists of similar topic and @ 7-9 words in

length and aligned for @ simultaneous onset/offset

Target sentences are 35 dB SL re SRT and Competing

sentences are 50 dB SL re SRT

Client is required to selectively attend to target sentence

and ignore irrelevant sentence and recall all words heard
 Competing Sentences Test-
contd

Originally scored by whether the client processed/

retained the essential meaning of the sentence

Bellis felt this approach resulted in confusion in the part of

clinicians as well as a lack of standardization across
clinics

Consequently she developed a quartile method of

scoring (i.e., each sentence is divided into quadrants,
each worth 2.5 points) x 10 sentences = /100 points
 Competing Sentences Test- contd

As I mentioned earlier, there are 30 sentence sets

I usually present 1 set of 10 sentence pairs- target is

one ear, and the next 10 sentence sets with other ear
being targeted

Depending on the results, I either present the next 10

sentence sets:
 Competing Sentences Test- contd

In Quiet, that is, I shut off one channel and the subject
hears only one speaker diotically at the lower 35 dB SL
presentation level

Thus, I am comparing how the client does with

competing stimuli versus Quiet.

If client has trouble in Quiet, then maybe it is a

memory/language issue, but if no difficulty, then if poorer
performance with competing stimuli, then due to
selective attention difficulty
 Competing Sentences Test- contd

In a divided attention condition, the sentences are

presented at 50 dB SL (relative to each ears SRT) and
the clients are required to repeat back both
sentences

At this point in time, the only scoring mechanism in

place is to score an item correct if they recall the
essential meaning of both sentences correctly
(i.e., all key words and no substitutions that
change the effective meaning of either sentence)
 Staggered Spondaic Words
(SSW)

Complex test
o Pairs of spondaic words
o Part of the stimuli are dichotic
o Part of the stimuli are monotic
o Detailed scoring procedure

This test will be presented in an upcoming lecture.

 Dichotic Speech Tests

Difficulties with binaural integration and/or separation?

Implications
Significant ear deficit (usually left ear)

If difficulty with Binaural Separation, then difficulty listening to

one speaker when there are other speakers present
Dichotic Speech Tests

Hear better on side of better ear (if difference, usually

right is better ear)

And, as you will see later on, there are many more
implications..
Comments
For any test, if there is a lesion one can expect certain
pattern of results:

o Example: Temporal Lobe lesion, one will find poor

S/N results in ear opposite to lesioned hemisphere

o However, if Auditory Nerve or low BS lesion, poorer

S/N results is on ipsilateral side

Thus, interpretation works only in one direction (i.e., if

get significant finding, one needs to look at the rest of
the test battery results to figure out where is the lesion)
 Comments

I concur with Matkin & Hook (1983) cited on page 213

of Keiths chapter in Musiek & Chermak:

Dichotic Sentence scoring requiring the repetition of

both sentences is the most sensitive to identifying
individuals with a processing disorder than any other
single measure

This test is very difficult (i.e., because of the extrinsic

demands, it requires high intrinsic ability), thus, if there
is any underlying deficit- even mild in nature- be
breakdown in performance
Dichotic Tests: Thus??

Provides information about CC maturation

Informs us re hemispheric specialization

o That is, left-hemisphere is specialized for processing

speech (otherwise, one would get a LEA)

o Right hemisphere specialized for processing

environmental sounds and prosody
 Summary- Interpreting Dichotic
Test Results

REA within normative values indicates language is

appropriately established in left cerebral hemisphere

An atypical LEA indicates individual may have right

hemisphere/mixed dominance for language

An atypically large REA (i.e., left ear deficit) as children

approach 11-12 years, indicates possible delay in
maturation of CC
Summary- Interpreting Dichotic Test
Results

When strong LEA for all dichotic tests- regardless of

speech/environmental stimuli, evidence of a
neurologically based language disorder

When a child, test annually to determine if maturation of

CC was delayed or disordered
CLASS TASK: PLEASE ORDER THE TEST
FROM EASIEST TO MOST DIFFICULT

1. Staggered Spondaic Word Test

2. Competing Consonant Vowels Test

3. Dichotic Digits Test

4. Competing Sentences- Divided Attention

5. Competing Sentences Test- Selective Attention

 Answer to Previous Slide

1. Dichotic Digits Test

2. Competing Sentences Test- Selective Attention

3. Staggered Spondaic Word Test

4. Competing Consonant Vowels Test

5. Competing Sentences- Divided Attention

Binaural Interaction Tests
 Binaural Interaction

Definition: way your two ears work together

Present complementary but
separate information to
each ear
Listener must integrate the
information from both ears
to perceive the message
Binaural Interaction

Sample functions:
o Localization

o Lateralization

o Binaural release from masking

o Detection of signals in noise

o Binaural fusion
 Binaural Interaction
Rostral

SOC is most caudal structure to

receive & process binaural
input

o Low brainstem is CRITICAL to

binaural interaction

PERCEPTION of sound location

is in the cortex

Caudal
 Binaural Interaction
Localization & Lateralization

Effects of Unilateral Hearing Loss

Poor localization when stimulus presented below

threshold of poorer ear

Normal localization performance when stimulus is within

10 dB difference between ears
Experimental Manipulations

If normal hearing individual, completely

lateralizes to other ear at @18 dB difference

If within 1-2 dB difference between ears, still

perceive in mid-line
 Binaural Interaction:
Binaural Release from Masking

Homophasic condition
oSpeech and noise in phase (SN)
oSpeech and noise both out of phase (S N)

Antiphasic condition
oSpeech in phase and noise out of phase (SN)
oSpeech out of phase and noise in phase (SN)
 Binaural Interaction:
Binaural Release from Masking

Signal Noise
 Binaural Interaction:
Binaural Release from Masking

Licklider (1948) examined the effects of

interaural phase on intelligibility of binaural
speech stimuli:

Speech intelligibility is lower for the

homophasic noise condition than antiphasic
condition
 Binaural Interaction:
Binaural Release from Masking
Hirsh (1948) investigated pure tone frequency and
stimulus intensity

o Noise 180 out of phase to the 2 ears

Noise perceived at the ears

o Noise in phase to the 2 ears

Noise perceived in the middle of the head

 Binaural Interaction:
Binaural Release from Masking

Hirsh (1948) cont'd.

Binaural puretone thresholds

Perceived better in antiphasic condition

o Puretone heard at midline, noise at ears (SN)

o Noise heard at midline, puretone at ears (SN)

Known as release from masking

 Binaural Interaction:
Binaural Release from Masking

Difference in binaural thresholds between

homophasic and antiphasic conditions is the
Masking Level Difference or MLD

As puretone frequency increases, the amount

(size) of MLD decreases

This is because the MLD is based on temporal

coding, which best occurs in the low
frequencies
 Binaural Interaction:
Binaural Release from Masking

Lower brainstem lesions

greatly reduce size of MLD

Upper brainstem or cortical

lesions do not affect size of
MLD
 Binaural Interaction:
Binaural Fusion

Studies used simultaneous presentation of:

High-pass filtered stimuli to one ear
Low-pass filtered stimuli to opposite ear

Normal hearing
Either stimuli presented alone = poor WRS
Both stimuli presented = significant WRS improvement
 Binaural Interaction:
Binaural Fusion

Cortical lesions
Same results as those with normal hearing

Brainstem lesions (have to be fairly large in size)

Difficulty with the task

Mechanism of binaural fusion is mediated

primarily in the brainstem
 Binaural Interaction:
Effects of Pathology

Brainstem
o MLD most sensitive behavioral test for brainstem integrity
assessment
o Abnormal MLDs for:
Ponto-medullary junction lesions
M.S.
Results on tests of auditory function processing
depend on where the focal lesions are located
Auditory Neuropathy
 Listening in Spatialized Noise
Test (LISN)

Allows for the assessment of the use of the spatial

advantage to understand speech in competing babble

Designed to simulate a three-dimensional environment

under headphones

The listener is required to follow a story presented by a

target talker arriving at 00 azimuth in the face of a
competing story spoken by the same or different talker
at 00 or 900- right or left side of the speaker at midline
 LISN-contd

The talker level is adjusted to find the minimum level

where the listener can just understand the story

A revised LISN test now incorporates sentences and

sentence reception thresholds are obtained

Children/adults with suspected CAPD perform more

poorly than TD children when the competing masker
is separated by +/- 900
 1 Minute Questions

1. Which part of the Central Auditory Nervous System is most sensitive to

Binaural Interaction tests?

2. Which part of the Central Auditory Nervous System is most sensitive to

Dichotic Listening tests?
Appendix
Binaural Fusion: Ivey Adaptation

Consists of two lists of twenty spondees each

Low-pass segment is routed to one ear
High-pass segment presented to the other ear
Listener is required to repeat the words heard
Test is scored by calculating the percent correct
Binaural Fusion: NU-6 word List (VA CD)

Uses monosyllabic words rather than spondaic words

Using monosyllabic words may further reduce the
redundancy of the signal, resulting in greater sensitivity
Test should be administered at 30 dB HL in order to use
the norms
 CVC Fusion task

Carrier phrase and vowel segment of the word are

presented to one ear and consonant segments are
presented to the other ear

This presentation allows for preservation of the spectral

characteristics of the stimulus

Test was designed to be resistant to peripheral hearing

loss
Masking Level Difference (MLD)

Listeners performance depends on the type of

stimuli, masker, and specific administration
protocols used.
Test is designed to compare listeners signal
threshold for a variety of masking conditions.
MLD for pure tones may be as high as 10 to 15 dB
Depends on the frequency of the signal and the characteristics of the
masking stimulus
 Administration of Speech MLD
using the Auditec CD

Calibrate both channels to the calibration tone provided

Set audiometer to Channel 1 (Left Ear) and Channel 2
(Right Ear)
12 different spondees are used in this test
Familiarize the listener to these 12 words (in fact, they can
hold the list of the 12 words in front of them throughout
testing)
There are a total of 16 sets, 4 spondee words in each list
(i.e., total of 64 spondees)
Administration of Speech MLD using the
Auditec CD

Set audiometer to 50 dB HL in both channels

Note that after every four words presented, the
intensity level of the speech automatically decreases
by 2 dB
Therefore, do not adjust the audiometer. Because
the CD automatically decreases the speech
condition by 2 dB after every four words, the S/N
ratio automatically becomes poorer
 Administration of Speech MLD

Begin by obtaining threshold for SN condition

(i.e., condition # 1): Track # 5

The first four words presented are at 0 dB S/N

On the scoring sheet, indicate each word responded to

correctly since this is scored in determining MLD

Testing continues until listener misses all 4 four words at two

consecutive levels
 Administration of Speech MLD

Now obtain threshold for SN condition (i.e., Condition # 2;

Track # 6); that is, noise is in phase, but signal is now 1800 out
of phase

Track # 6 commences again at the beginning of the

spondee list

As before, after every four words, the channel decreases

by 2dB

Testing continues until the listener misses all 4 four words in

each list, at two consecutive levels
 Scoring & Interpretation of
Speech MLD
To determine MLD:

SN Condition: # of words responded to correctly / 2

SN condition: # of words responded to correctly / 2

MLD= SN - SN

** Example:

SN condition, scored 40 words correctly = 40/2 = 20

SN condition, scored 28 words correctly = 28/2 = 14

MLD = 20 -14 = 6 dB

For adults, MLDs less than 5.5 dB are considered abnormal

Administration of 500 Hz MLD using the
Auditec CD

Calibrate both channels to the calibration tone provided (if you did
not do the Speech MLD test first)

Set audiometer to Channel 1 (Left Ear) and Channel 2 (Right Ear)

Set the attenuators for both channels to 70 dB HL

Inform the listener that they will might hear a series of tones within
noise bursts and to respond when they hear tones present

The test consists of 33 presentations, of which some presentations

are:

a) SN b) SN c) No embedded signal (foils)

 Administration of 500 Hz MLD
On the scoring sheet, levels of the tones are listed in terms of S/NR ratio
Next to each item, indicate if listener indicated/not indicated hearing
a tone

Scoring

Total the # correct in (a) SN condition and (b) SN condition

Go to Table 1 on the scoring sheet and find the SN dB S/N threshold

for corresponding SN # of correct responses

Then find the SN dB S/N threshold for the corresponding SN # of

correct responses

In this case, the MLD = SN threshold dB S/N - SN threshold dB S/N

Example = SN threshold = - 4; SN threshold dB S/N = -16,

then -4 (16) = an MLD of 12 (and WNL)