Despite decades of research and technological development, speech understanding in noise remains the number one complaint among hearing aid wearers. Approaches that focus on improving the SNR, such as directional microphones, have provided incremental benefits. Additionally, outcome measures such as sentences in noise provide an incomplete understanding of how people will perform in complex listening environments. In order to develop and validate technology to improve speech understanding in noise, new tools are necessary to understand the complex nature of auditory perception in difficult listening situations. These tools will not only provide an understanding of why people with hearing loss struggle in complex environments, but also what the unique differences are among individuals who seem to cope differently in difficult listening situations.

This talk will review what we know about and current research into the complex nature of speech in noise performance. New technology that is being developed to help people with hearing loss understand speech in complex environments will also be reviewed.