Relationships between extended high frequency hearing, cognition, and speech-in-noise performance
Related Experiment Video
Updated: Nov 5, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Claire M Dorey1, David A Eddins2, Ann C Eddins2
1Department of Communication Sciences and Disorders, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States.
Introduction:
Impaired speech-in-noise performance is a primary patient complaint in audiology clinics, and in addition to standard frequency (SF; 0.25-8 kHz) sensitivity, age, and cognition, recent work as focused on the association of extended high frequency (EHF, > 8 kHz) sensitivity with this degraded performance. Despite this accepted relationship, clinical utility of EHFs is limited because there is not a universally accepted cutoff value for normal vs. impaired sensitivity. The objective of the current study was to analyze the relationship between EHF sensitivity, SF sensitivity, cognition, and age with speech in-noise performance, as measured by the Words-in-Noise (WIN) test.
Methods:
The SF audiometry, EHF audiometry, and speechin-noise assessments were measured in 605 listeners between the years 2015 and 2024. Pure tone average (PTA) for both the SF (PTASF: 0.5, 1, 2, & 4 kHz) and EHF (PTAEHF: 9, 10, 12.5, & 14 kHz) were calculated for each participant. A normal hearing (NH) group was defined by having a PTASF ≤ 20 dB HL (N = 700 ears) and a hearing loss group (HL) had a PTASF > 20 dB HL (N = 505 ears). Cognition was also measured via the Montreal Cognitive Assessment (MoCA) in 524 of the participants.
Results:
PTASF and PTAEHF were both found to be associated with WIN performance across all participants. However, when we analyzed solely participants with NH, PTAEHF explained more variance in WIN thresholds than PTASF. Data were further assessed to determine functional cutoffs. The NH participants were broken into 5-dB-HL bins to determine cutoff values for WIN performance, and significant cutoffs were found at a PTASF > 10 dB HL and a PTAEHF > 35 dB HL. The EHFPTA, MoCA scores, and age each had a significant effect on WIN threshold, but EHFPTA was found to be a stronger predictor, despite limited EHF spectral information in the WIN stimuli.
Discussion:
These findings are consistent with previous literature and support the clinical relevance of EHF sensitivity. EHF threshold measurements may provide valuable information, given their association with speech-in-noise deficits, a common patient complaint.
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