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Age-related hearing loss, or presbycusis, is the slow loss of hearing that occurs as people get older. Causes Tiny hairs inside your ear help you hear. While digital TV, both broadcast and IP-delivered, offers great potential for interactivity and receiver functionality, it is all too easy to overlook the needs of those affected by sensory and physical disabilities. The World Health Organisation (WHO) states, in a 2013 Fact Sheet, that there are a billion people worldwide with some form of disability.
According to the European Disability Forum (EDF), One in four Europeans has a family member with a disability, suggesting that around 25% of households in Europe include someone with a disability. Using an audio-visual medium like digital television creates challenges for specific groups of disabled and older people. From early on, the DTG has recognised the needs of disabled television consumers and has been active in trying to harness opportunities to improve the accessibility of digital television.
DTG and its members contributed significantly to the Government's Digital Action Plan, including in the work to ensure that accessible solutions were available to older and disabled people as switchover was taking place in the UK. More recently, the DTG's focus has been on Connected TV and ensuring that access services such as subtitles and audio description are as widely available as possible. As television evolves, the DTG Accessibility Working Group continues to develop guidance, define opportunities to harness new technologies to improve services and products and raises awareness amongst key stakeholders about the need for accessible solutions and content.
The DTG's ground-breaking work on Text-to-Speech for digital television (see Text to Speech tab above), through a partnership with DigitalEurope, culminated in an International Standard IEC 62731: Text-to-speech for television - General requirements. In addition to ongoing work to keep the U-Book up to date, the Accessibility Working Group is now also preparing guidelines on the clarity of broadcast speech.
DTG U-Book: UK Digital TV Usability and Accessibility Guidelines, including Text to Speech, Version 3, December 2014. The DTG Receiver Recommendations publication gives details of the mandatory requirements for accessibility features in receivers.
The older DTG Implementation Guidelines and Recommendations for Text-to-Speech have been updated and are now included in the U-Book. Hearing loss is often categorised on the basis of degree of loss, from mild, moderate to severe and profound. A common problem for people with hearing loss is that people experience difficulty in discerning speech from background. Subtitles are essential for many people with hearing loss, while Sign Language interpretation opens up content for those for whom Sign Language is their first language. Despite common misconceptions, blind and partially sighted people do use television, just like other consumers.
Like other conditions, colour blindness comes in varying degrees from mild over moderate to severe. The term "physical disabilities" covers a quite wide ranging set of conditions and abilities.
For this group, interface accessibility (usually via alternative input devices) tends to be a high priority. Sometimes the origins are genetic, in other cases the result of injury, trauma or as a consequence of diseases such as meningitis or brain tumours.
Dyslexia is often included in the group of cognitive disabilities, being primarily a reading disability. DTG U-Book: UK Digital TV Usability and Accessibility Guidelines, including Text to Speech,Version 3, December 2014.
The DTG Accessibility Working Group maintains the U-Book, the UK Digital TV Usability and Accessibility Guidelines, including Text to Speech. Part A - Usability Guidelines: information on the best industry practices for ensuring a good, usable customer experience when using digital television products.
Part B - Accessibility Guidelines: offers guidelines to manufacturers wishing to incorporate accessibility features into their products. Part C - Connected TV Implementation Guidelines: these are currently under development by the Working Group and expected to be published later this year.
The challenges that disabled and older people face when using television can be divided between interface accessibility barriers and impediments in using the television content itself. Also, as more and more features are added to television products and services, some viewers find them more complicated to use. Connected TV also offers new prospects for improved accessibility beyond what could be done with traditional solutions. However, in addition to content accessibility, the television product itself, its User Interface (UI), also needs to be accessible to people with sight loss. Such talking features provide a spoken alternative to the visual menus and other components of the default interface. The Digital TV Group, working with organisations representing blind and partially-sighted users, has been a pioneer in this field. Later, this excellent piece of work by DTG was adopted by DigitalEurope and taken to the International Electrotechnical Commission (IEC). As a result of this work, we have seen more and more solutions with integrated text-to-speech (talking features) being introduced to the UK market. In order to make television content accessible to people with sensory disabilities and to older viewers, the UK has been a forerunner in the delivery of subtitling, signing or audio description.
Audio description and subtitles are closed services, which means the viewer can turn them on or off as they require. Subtitles are an elective service which, when turned on, provides a text representation of the dialogue or commentary. Another issue is the availability of subtitles on non-domestic TV receivers such as are found in many hotels and fed from an in-house distribution system.
Whilst subtitling is the obvious facility to assist the hard-of-hearing in accessing TV programmes, for many viewers with moderate hearing loss subtitles are intrusive in a family-viewing environment and unnecessary if the TV audio can be made available to them at a higher level than for normal viewing or in a processed form that emphasises the higher frequencies.
The provision of facilities for enabling both the main and any secondary audio outputs simultaneously is strongly encouraged.
Audio Description is an additional narrative that describes the visual elements of a programme, such as the scene, actions, body language and expressions and is intended to make the programme clear through sound. Broadcast-mix: this comes as alternative audio including both the standard programme audio and the audio description track, brought together by the broadcaster. Receiver-mix: this is where the audio description is an additional audio track that the receiver combines with the main audio. According to the 2011 Census, there are approximately 25,000 people who use British Sign Language (BSL) as their first language. Complaints from viewers about the difficulty of understanding dialogue ranks high on the list of calls to broadcasters. In 2010 BBC Vision carried out two separate surveys with its Pulse on-line panel of 20,000 viewers to identify the issues which caused problems with television sound. Clarity of speech: poor and very fast delivery, mumbling and muffled dialogue, turning away from camera, people talking over each other, trailing off at the end of sentences. Unfamiliar or strong accents: Audiences find accents other than their own harder to understand. Background noise - locations with heavy traffic, babbling streams, farmyard animals, in fact any intrusive background noise can make it difficult to hear what's being said.
Background music - particularly heavily percussive music or music with spikes that cut across dialogue. A common problem for people with hearing loss is that they experience difficulty in discerning speech from background sounds.
More than 10 million people in the UK have hearing loss—about one in six of the population. Age-related damage to the cochlea, or presbycusis, is the single biggest cause of hearing loss.
Most of the 9 million deaf and hard of hearing people have developed a hearing loss as they get older. The curves below illustrate the way in which hearing loss increases with age, both basic sensitivity and frequency-dependent loss.
A vital factor is that a majority of consonants, which are crucial to understanding, are centred in the higher frequency range, where hearing loss is most marked. While subtitles are a solution for some viewers, many of those suffering from mild hearing loss prefer not to use subtitles, particularly for news programmes, as the delay and errors can be distracting. A study carried out by the BBC in 2003 revealed that the over-55s account for nearly 40% of peak-time audiences, and that the average time spent watching all channels was, at 4hrs 21mins, about 45 minutes longer for the 55 – 65 year-old than for the population as a whole.
Considering just the over-65s, 29% of programmes posed speech audibility problems to at least 10% of their viewers.
You can hear for yourself what it's like to have impaired hearing by using software simulators. University College London's HearLoss - an interactive Windows PC program for demonstrating to normally hearing people the effects of hearing loss.
University of Cambridge Inclusive Design Kit - demonstrates some of the main effects of common types of hearing loss in the UK. Many of the difficulties affecting the clarity of speech can be reduced or removed by care taken in the production process, including pre-production planning and quality control. Whenever possible, prior to release a programme should be played through domestic quality loudspeakers to someone not involved in the post production so that any instances of unclear dialogue can be identified and rectified prior to transmission. The BBC's College of Production has made a number of useful training videos giving practical advice on, among many other things, acquiring, recording and post-producing sound for television. New York, (IANS) The death of sensory hair cells in the inner ear has long been blamed for age-related hearing loss. Studies in mice have verified an increased number of connections between certain sensory cells and nerve cells in the inner ear of ageing mice.
Because these connections normally tamp down hearing when an animal is exposed to loud sound, the scientists think these new connections could also be contributing to age-related hearing loss in the mice, and possibly in humans.

Previous research has suggested that with age, inner hair cells in mice and humans experience a decrease in outgoing nerve cell connections, while incoming nerve cell connections increase. To find out if the new connections worked, the researchers recorded electrical signals from within the inner hair cells of young and old mice. They found that the incoming nerve cells were indeed active and that their activity levels correlated with the animals' hearing abilities: The harder of hearing an animal was, the higher the activity of its incoming nerve cells.
If the same phenomenon occurs in human ears, Fuchs said there may be ways of preventing the incoming nerve cells from forming new connections with inner hair cells, a technique that could help maintain normal hearing in old age. Please note that under 66A of the IT Act, sending offensive or menacing messages through electronic communication service and sending false messages to cheat, mislead or deceive people or to cause annoyance to them is punishable. Losing your hearing is a bit like going to a foreign country where you speak only a bit of the language.
As a result, they may start to withdraw from many of the activities they used to enjoy, because certain scenarios might tire them out, or might be embarrassing or difficult. Their scores suggested their cognitive abilities aged by the equivalent of seven years compared with people with normal hearing.
So taking yourself out of daily interactions because your hearing problems make them impossible may raise the risk of memory loss and cognitive problems.Not being able to hear properly could be a recipe for disaster a€” yet most people dona€™t get a hearing aid for at least ten years after they should.
The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. The goal of this study was to examine the ability to combine temporal-envelope information across frequency channels.
Contact author: Pamela Souza, Department of Speech and Hearing Sciences, University of Washington, 1417 NE 42nd Street Seattle, WA 98105.
You will receive an email whenever this article is corrected, updated, or cited in the literature. This work was supported by the National Institutes of Health (Grants AG020360 and DC006014).
They pick up sound waves and change them into the nerve signals that the brain interprets as sound. It also confirms that the incidence of disability is increasing due to population ageing, amongst other causes.
Individuals with sight or hearing loss are particularly affected, but there are also accessibility challenges for people with physical and cognitive disabilities. DTG has also published the U-Book, which complements the DTG D-Book and provides detailed Usability and Accessibility Guidelines for manufacturers. The Working Group includes representatives of manufacturers, broadcasters, charities and organisations working for those with a wide range of disabilities, including sight and hearing loss. Nevertheless, for practical reasons it may be helpful to identify some of the key stakeholder groups for the DTG's accessibility and usability work.
People who develop hearing loss later in life usually have acquired spoken language, whereas those born deaf or with severe hearing loss from birth (or shortly thereafter) often use British Sign Language (BSL).
Even the minor hearing loss that is a natural result of ageing leads to a noticeable reduction in the ability to follow dialogue over background sound. In fact, many people with sight loss have some perception and most, of course, are able to enjoy the sound.
In most cases colour blindness is genetically inherited, while diseases such as diabetes and medication are other common causes. Nevertheless, colour blindness can occur for the whole colour spectrum and even black can be confused for dark green or dark blue in some cases. This user group includes people with motor impairments, dexterity barriers as well as wheelchair users and individuals with missing or differently formed limbs. Indeed, there exist many types of cognitive disabilities covering a wide range of difficulties and deficits involving language understanding, reading, memory, visual comprehension, problem solving, reasoning and reduced mathematical comprehension.
Sight and hearing loss, reduced dexterity and sometimes decreased cognitive faculties are all typical corollaries of getting older. This part includes guidance on remote controls, Electronic Programme Guides, User Interfaces, labelling, user documentation, etc. In addition, the DTG Receiver Recommendations give details of the mandatory requirements for accessibility features in receivers. The advent of Connected TV brings many benefits to viewers, bringing together traditional television services with Internet based content. However, the added functionality and jargon of Connected TV can create new challenges for accessibility and usability. The U-Book's Connected TV section identifies these opportunities to harness Connected TV as a means to bring innovation to accessibility-related features and content.
Where content is concerned, the DTG and the UK have been pioneers in the provision of audio description, a major feature to give this user group an equivalent experience in consuming television programmes. A talking interface can provide a substantial improvement in accessibility and usability for this group of consumers. By using text-to-speech in a television solution, a person operating the product via the spoken interface will receive the same feedback and be able to perform the same tasks as someone using the default (visual) interface.
It started work on text-to-speech in 2007, bringing together industry and other stakeholders to write a technical specification for Text to Speech (this has since been included in the U-Book). The U-Book contains best practice guidance surrounding the implementation of access services in digital television solutions. They are normally shown at the bottom of the picture and benefit from the use of different-coloured characters for different speakers, when applicable.
Whilst many receivers have an option for the audio to be processed to give an output that is more intelligible for the hard-of-hearing, this is suitable only for solitary viewing. Audio Description is used primarily by blind and partially sighted people and supplements the dialogue spoken by the cast. When activating broadcast-mix audio description, the receiver selects this alternative instead of the default audio.
The research showed that nearly 60% of viewers had some trouble hearing what was said in TV programmes.
This includes over six million people who could benefit from hearing aids (hearing loss of at least 35dB in the better ear).
With HearLoss you can replay speech, music and noise under a variety of loudness, filtering and masking conditions typical of hearing impairments. Use of a hearing-loss simulator provides a convenient way of checking the clarity of the speech element of a programme and is encouraged. However, this may not be entirely true as the role of nerve cells in hearing loss can't be ignored, says a study. Kindly do not post any personal, abusive, defamatory, infringing, obscene, indecent, discriminatory or unlawful or similar comments. It is obligatory on CANARANEWS to provide the IP address and other details of senders of such comments, to the authority concerned upon request. You struggle to understand the conversations around you, and just trying to get by leaves you exhausted.This is exactly what happens to people who suffer hearing loss.
Three areas were addressed: (a) the effects of hearing loss, (b) the effects of age and (c) whether such effects increase with the number of frequency channels. Boike is now at the Department of Speech and Hearing Science, Arizona State University, Tempe.Kumiko T. We are grateful to Chris Turner for helpful comments on the study design and to Marc Caldwell and Kerry Witherell for their assistance with data collection and analysis.
Being able to use television programmes is not just nice to have, but indeed a key part of citizenship and participation. BSL was recognised by the Government as a language in its own right in March 2003 Using the 2011 Census there are approximately 25,000 people in the UK aged three and over who use sign language as their main language. The DTG Accessibility Working Group is currently involved in a clean audio project to improve the audibility of speech in television programmes.
Nevertheless, blind people and those with significant sight loss are arguably the group that faces the biggest accessibility challenges. The use of specialised keyboards, large button remotes, single switch devices and voice control are amongst the tools used by this group. While the degree of disability in older people is generally milder compared to other groups of disabled people, it is compounded by the fact that several of these conditions, both physical and sensory, tend to co-exist amongst these consumers rather than a single disability dominating the individual's profile of abilities and preferences. Subtitles are the most used access service in the UK, with millions of viewers enjoying them. Twenty adults aged 23–80 years with hearing loss ranging from mild to severe and a control group of 6 adults with normal hearing participated.
The hair cells do not regrow, so most hearing loss is permanent. There is no known single cause for age-related hearing loss. Yet, despite the prevalence of hearing loss, it is also an often overlooked group and one that is very diverse in terms of its make-up and requirements.
It is a visual language, with its own grammar and principles, which are completely different from the grammatical structure of English. They face significant barriers both in terms of using television products (interface accessibility) as well as with regard to content (where Audio Description is a key service for this group). Prototype systems demonstrating closed signing have been developed, but there are many technical and economic barriers to their real-world deployment. Amongst the main user groups for subtitles are those with hearing loss, older people and those for whom English is not their first language.
To provide BSL interpretation for a television programme, a sign language interpreter is shown in-vision.
This is partly due to the stigma attached to hearing aids a€” theya€™re associated with being old.
Consonant identification was measured for 5 conditions: (a) 1-channel temporal-envelope information (minimal spectral cues), (b) 2-channel, (c) 4-channel, (d) 8-channel, and (e) an unprocessed (maximal spectral cues) speech condition.

Performance of listeners with normal hearing and listeners with hearing loss was similar in the 1-channel condition.
About half of all people over age 75 have some amount of age-related hearing loss. Symptoms The loss of hearing occurs slowly over time.
Performance increased with the number of frequency channels in both groups; however, increasing the number of channels led to smaller improvements in consonant identification in listeners with hearing loss.
Older listeners performed more poorly than younger listeners but did not have more difficulty combining temporal cues across channels than in a simple, 1-channel temporal task.
Age was a significant predictor of nonsense syllable identification, whereas amount of hearing loss was not. Talk to you health care provider if you have any of these symptoms. Exams and Tests A complete physical exam is performed to rule out medical conditions that can cause hearing loss. The results support an age-related deficit in use of temporal-envelope information with age, regardless of the number of channels. Sometimes, wax can block the ear canals and cause hearing loss. You may be sent to an ear, nose, and throat doctor and a hearing specialist (audiologist). Hearing tests can help determine the extent of hearing loss. Treatment There is no known cure for age-related hearing loss.
Three audio metrically matched groups of adults with hearing loss were tested to determine at what age performance declined relative to that expected on the basis of audibility.
Scores for WDRC-amplified speech were slightly lower than for linearly amplified speech across all groups and noise conditions.
The implant makes sounds seem louder, but does not restore normal hearing. Outlook (Prognosis) Age-related hearing loss is progressive, which means it slowly gets worse. The small reduction in scores for amplitude-modulated compared to steady noise and lack of ageinteraction suggests that the substantial deficit seen with age in multitalker babble for previous studies was due to some effect not elicited here, such as informational masking.This hypothesis is consistent with recent data that audibility also over-predicted adults performance in interrupted speech spectrum noise (Dubno et al, 2002). For example, Souza and Turner (1994) found speech recognition of older listeners with hearing loss to be 20% poorer, on average, in a background of multitalker babble versus a speech-spectrum noise with the same temporal characteristics.
We do not know what the relationship between audibility and recognition will be when speech in noise is WDRC amplified. Use of measured instead of nominal compression ratios was based onprevious work (Souza and Turner, 1999) that demonstrated improved accuracy of AAI predictions with that method.ProcedureThe listener was seated in a double walled sound-treated booth. Passages were paired according to the instructions forthe CST, in which predetermined passage pairs of are equal difficulty. As dictated by the test instructions, the listener was told the passage topic prior to each passage. After the listener was informed of the passage topic, one sentence was played at a time.The experimenter was seated outside the sound booth and recorded the responses as the listener repeated the sentences through an intercom system. For each condition, a percent-correct score was calculated for each passage pair based on50 words.
Sixteen test conditions were presented in random order, each consisting of a different background noise (steady state, amplitude modulated), SNR (-2, +2, +6, and +10 dB), and amplification type (linear, WDRC).RESULTSMean scores for each group and testcondition, averaged across the four signal-to-noise ratios, are shown in Table 3.
Variability was higher for the groupswith hearing loss than for the group with normal hearing and increased slightly with increasing age. As expected, these listeners performed well evenat reduced signal audibility, reaching an asymptotic score of 100%. Sherbecoe and Studebakera€™s (2003) performance predictions for the Connected Speech Test are also shown, along with the 95% critical difference range for these materials (Cox et al, 1988).
Scores for the WDRC-amplified speech were also well predicted at moderate to high audibility, although our listeners with normal hearing performed better than predicted at low audibility. Performance for the three older groups with hearing loss is shown in Figure 4 (linear) and Figure 5 (WDRC). In each panel, predicted score according to Sherbecoe and Studebaker (2003) was plotted for comparison, along with the 95% critical difference values (Cox et al, 1988).
The range of audibility was the same in each of the three groups, as expected because the mean audiogram was the same in each group. In comparison to the listeners with normal hearing, the listeners withhearing loss showed greater performancevariability, and performance for each group was poorer than predicted on the basis of audibility.Figure 3. Results are shown for the linearly amplified speech in steady noise (filled circles) and amplitude modulated noise (opencircles) and for the WDRC amplified speech in steady noise (filled triangles) and amplitude-modulated noise (open triangles). The left panel shows results for speech in steady noise, and the right panel shows results for speech in amplitude-modulated noise.
Data shown are for Group 1 (filled circles), Group 2 (open circles), and Group 3 (filled triangles). To examine the effect of listener age, these data were submitted to a three-way, repeated-measures analysis of variance. Comparisons were made across the two noise types, two amplification types, and four participant groups. On average, performance for steady noise was about 1.5% below performance for amplitude modulated noise.
Across all conditions and age groups, the actual-predicted difference was larger for linear than for WDRC amplification (p = .021).
This was not because of higher WDRC scores; on average, linear scores were higher by 1a€“2%. Instead, this difference reflected higher AAIs (and therefore higher predicted scores) for the linear conditions.
The left panel shows results for speech in steady noise, and the right panel shows results for speech in amplitude-modulatednoise. Data shown are for Group 1 (filled circles), Group 2 (open circles), and Group 3 (filled triangles).Solid line shows predicted performance, according to Sherbecoe and Studebaker (2003). Mean Deviation from Predicted Score (in RAU) for Each GroupIn the present study, performance worsened significantly with increasing age, even among listeners younger than75 years. Because the threegroups were well matched for amount of hearing loss, this finding was unlikely to be due to increasing threshold elevation.
Indeed, the youngest of the threehearing-impaired groups had the poorest average thresholds within the 1a€“4 kHz range.
Such questions are of great interest to researchers as this portion of the population increases, but we have found that practical issues of health, transportation, and fatigue limit the willingness of those adults to volunteer for research studies. We treated age as a categorical variableto allow comparison of performance across audiometrically matched groups.
An alternative approach would have been to treat age as a continuousvariable, recruit listeners of various ages regardless of audiogram, and apply statistical controls for degree of hearing loss.
Also, in contrast to the idea that the oldest listeners might be less able to distinguish between the varyingtemporal patterns of the speechand the masker, we found no interaction between age and type of noise.
At present, this is the only index that incorporates nonlinear amplification characteristics. For linearly amplified speech, the AAI was nearly identical to the conventional Articulation Index or Speech Intelligibility Index, albeit with small differences in the assumed short- term speech range.
Therefore, Speech Intelligibility Index derived performance predictions such as those developed by Sherbecoe and Studebaker (2003)seemed appropriate for comparison.
This was further verified by the close agreement between predicted performance (using the Speech Intelligibility Index-derived transfer function) and our normal-hearing data (Figure 3).
Previous work showed that the performance increase for a given increase in AAI was the same forlinearly amplified as for WDRCamplified speech (Souza and Turner,1999), suggesting that the same prediction function could be used for the WDRC condition. Because the long- term average spectrum of the amplitude- modulated noise and the steady noise was the same, the same noise levels were input to the AAI calculation for both noise backgrounds.
For the continuous noise used here, even though it is not a constant amplitude noise, the standard audibility index calculation was more appropriate. Some researchershave proposed including a correction for hearing loss a€?desensitizationa€? that would reduce predicted performance to be more typical of listeners with hearing loss. To that end, we expected that performance by the listeners with hearing loss would fall below predicted performance. Indeed, when considered as a single group of listeners with hearing loss, our results were similar to those reported by Sherbecoe and Studebaker (2003) for a variety of studies with the samematerials.
We were more interested in whether the difference between predicted and actual performance varied across age groups, or with different background noises. Thus, the data presented here do not answer thequestion of whether lower-than- predicted performance for Group 1 is due to hearing loss, to age, or to a combination of those factors.Wide-Dynamic Range CompressionAmplificationFor each presented signal-to-noise ratio, audibility was higher for the linear speech. In recent work (Souza et al, 2006), we noted a poorer signal-to-noise ratio at the output of a single channel, fast-acting WDRC system, due to an increase in noise level during the pauses between words.
Although this increased the long-term average noise level and therefore lowered the AAI, it may not significantly alter performance. At least for listeners with normal hearing, we expected that increased noise during speech pauses should have little effect on speech recognition, because at those points in the signal there was no speech to recognize.
For listeners with normal hearing, the critical issue was any noise present simultaneously with target words. This may be why the listeners with normal hearing performed better than predicted at low AAIs (Figure 4). This study provided a limited view ofperformance relative to that predicted by audibility when speech is WDRC amplified.
Based on previous work, we would expect to see little advantage of WDRC amplification at this input level, and greater improvements over multiple input levels or for low-intensity inputs (Souza and Turner, 1998; Jenstad et al,1999).
Second, multichannel WDRC amplification may also offer greater benefit, especially when the noise is lower (or higher) in frequency than speech and when reduced gain in some channels might improve the signal-to- noise ratio.
Prediction of speech recognition from audibility and psychoacoustic abilities of hearing impaired listeners.

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