The role of auditory ecology in disability and hearing aid benefit

Stuart Gatehouse

MRC Institute of Hearing Research, UK

Recent years have seen an expansion of interest in factors outwith simple aspects of audibility as potential determinants of experienced disability following a hearing impairment and the benefits that accrue following hearing aid provision. Variables of interest include the distortions which are an almost inevitable accompaniment of sensorineural hearing loss (aspects of frequency, temporal and binaural processing) and the ways in which client-centred attributes such as personality and motivation are influential. This paper puts forward the thesis that an additional important consideration revolves around the auditory lifestyles of listeners in terms of the types of listening circumstances that they experience, the frequency of their occurrence, and their importance to that individual in everyday existence. We propose the term "auditory ecology" for this concept. This paper presents results from listeners with sensorineural hearing loss who are established users of various forms of linear and non-linear amplification and documents the extent to which aspects of auditory lifestyle act as significant predictors of experienced disability and handicap after control for audibility and other relevant factors. Furthermore, the data shows that perceived benefits of and preference for aspects of non-linear processing (amplitude compression of various types) over and above well-fitted linear amplification is also significantly influenced by auditory ecology as indexed by structured questionnaires and portable environmental monitors.