Reverberation Impact on Spatial Hearing Development

Overseen By Z. Ellen Peng, PhD

Age: < 65

Sex: Any

Trial Phase: Phase < 1

Sponsor: Father Flanagan's Boys' Home

Disqualifiers: Hearing loss, Intellectual disability

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how children with normal hearing develop the ability to understand sounds in echo-filled spaces, like large rooms. It examines their perception of sound size, their ability to pinpoint sound origins, and their skill in distinguishing one sound from others. Participants will experience two sound environments: one with many echoes (High-Reverberation) and one with fewer echoes (Low-Reverberation). This study suits children aged 6 to 18 with normal hearing and no intellectual developmental disabilities. As an Early Phase 1 trial, the research focuses on understanding how children process sounds in different environments, offering a unique opportunity to contribute to foundational knowledge in auditory development.

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants must stop taking their current medications.

What prior data suggests that these reverberant environments are safe for children?

Research has shown that specific safety information about different sound environments, such as those in High-Reverberation and Low-Reverberation treatments, is lacking. In these settings, participants perform tasks in rooms with varying levels of sound reflection, similar to everyday indoor experiences. Although studies have not reported negative effects, they note that loud noise can sometimes be a general concern.

Since this trial is in an early stage, it often marks the first time this new treatment is tested on people, resulting in limited safety information. However, because the treatment involves listening tasks in simulated sound environments rather than a new drug or medical procedure, it is likely safe. Participants are exposed to different sound conditions, which are generally considered low-risk. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring how different acoustic environments, specifically high and low reverberation, might affect spatial hearing development. Unlike current approaches that focus on auditory training or assistive devices like hearing aids and cochlear implants, this study looks at the influence of the environment on hearing capabilities. By understanding how reverberation impacts spatial hearing, the trial could lead to new strategies for enhancing auditory perception, particularly in complex listening situations. This novel focus on environmental factors could open up new avenues for auditory rehabilitation and education.

What evidence suggests that this trial's reverberant environments could be effective for studying spatial hearing development?

Research has shown that in places with significant echo, people tend to move their heads more. This behavior appears to help them understand and locate sounds better, even when clarity is compromised. In this trial, participants will perform tasks in both high-reverberation and low-reverberation environments to study these effects. Studies have found that people effectively adjust to echoing sounds in various places and situations. In areas with less echo, this adjustment is less noticeable but still aids in better hearing. Overall, regardless of the echo level, people must adapt their listening, which is crucial for understanding how hearing is learned in different spaces. ^{6 7 8 9 10}

Who Is on the Research Team?

Z. Ellen Peng

Principal Investigator

Father Flanagan's Boys' Home

Are You a Good Fit for This Trial?

This trial is for typically developing children aged 6-18 with normal hearing, able to hear sounds at a soft level across a range of pitches. It excludes those who don't pass the hearing test or have intellectual developmental disabilities.

Inclusion Criteria

I am within the age limit and have normal hearing across all tested frequencies.

Exclusion Criteria

Individuals who fail hearing screen as described above.

Individuals who have a diagnosed intellectual developmental disability.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Psychoacoustic Task Performance

Participants perform psychoacoustic tasks in virtual acoustic environments with varying levels of reverberation

3 years

Regular visits for task performance

Follow-up

Participants are monitored for the development of spatial hearing abilities

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• High-Reverberation
• Low-Reverberation

Trial Overview The study examines how kids develop the ability to hear in places with echo (reverberation). They'll do listening tasks in virtual rooms designed to have no echo or different levels of it, similar to real indoor spaces.

How Is the Trial Designed?

Group I: Low-Reverberation Experimental Treatment 1 Intervention

Participants perform psychoacoustic tasks under a low-reverberant environment and a control environment without reverberation.

Group II: High-Reverberation Experimental Treatment 1 Intervention

Participants perform psychoacoustic tasks under a high-reverberant environment and a control environment without reverberation.

Who Is Running the Clinical Trial?

Father Flanagan's Boys' Home

Lead Sponsor

Trials

14

Recruited

1,600+

Published Research Related to This Trial

In a study assessing speech recognition across different acoustic environments, subjects with varying degrees of sensorineural hearing impairment showed significant differences in their ability to understand speech, particularly in more reverberant conditions.

The study found that as hearing impairment increased, the negative effects of background noise and room reverberation on speech recognition also intensified, indicating that individuals with greater hearing loss may struggle more in challenging listening environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of reverberation and noise on speech recognition by adults with various amounts of sensorineural hearing impairment. Harris, RW., Swenson, DW.[2019]

In a study of four different classroom types with 22-23 kindergarten children each, it was found that larger open plan classrooms had higher noise levels, which negatively impacted children's ability to perceive speech during tests.

As noise levels increased, children's accuracy and speed in speech perception tasks decreased, especially when seated further from the sound source, indicating that open plan classrooms may not be suitable for effective learning without proper acoustic design.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of different open plan and enclosed classroom acoustic conditions on speech perception in Kindergarten children. Mealings, KT., Demuth, K., Buchholz, JM., et al.[2015]

Bilateral cochlear implant users showed significant benefits from binaural hearing advantages, particularly the head-shadow effect, in highly reverberant environments, although other advantages like spatial release from masking were minimal.

The study, involving 10 adults with postlingual deafness, found that reverberation negatively impacts binaural performance, suggesting that CI recipients may struggle more in everyday listening situations with high reverberation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Binaural Speech Understanding With Bilateral Cochlear Implants in Reverberation. Kokkinakis, K.[2022]

In a study involving 12 cochlear implant recipients, speech intelligibility (SI) significantly decreased at longer distances from the speaker, particularly in small, highly reverberant rooms.

When background noise was present, the most disruptive type was anechoic noise due to its modulation, indicating that both room size and reverberation play crucial roles in how well CI users can understand speech.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of noise and reverberation on speech intelligibility for cochlear implant recipients in realistic sound environments. Badajoz-Davila, J., Buchholz, JM., Van-Hoesel, R.[2022]

Users of bilateral cochlear implants (BCIs) showed significantly poorer ability to localize speech compared to individuals with normal hearing (NH) across various noise and reverberation conditions, indicating challenges in spatial hearing for BCI users.

BCI users began to struggle with speech localization at higher signal-to-noise ratios and shorter reverberation times than NH listeners, suggesting that improvements in cochlear implant processing strategies and rehabilitation plans are needed to enhance their listening experiences in noisy environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Combined Effects of Noise and Reverberation on Sound Localization for Listeners With Normal Hearing and Bilateral Cochlear Implants. Zheng, Y., Koehnke, J., Besing, J.[2022]

Students with unilateral hearing loss (UHL) need to sit closer to the teacher in noisy classrooms, specifically between 4.35 m and 6.27 m, to achieve similar speech discrimination scores (SDS) as their normal-hearing peers.

In a study involving 75 participants (25 with UHL, 25 normal-hearing students, and 25 normal-hearing adults), the UHL group showed significantly lower SDS at various distances, highlighting the importance of optimal seating for effective communication in educational settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How close should a student with unilateral hearing loss stay to a teacher in a noisy classroom? Noh, H., Park, YG.[2012]

Subjects with single-sided deafness using cochlear implants (SSD-CI) showed no significant decline in sound localization accuracy when exposed to reverberation, maintaining similar performance in both free-field and reverberant conditions.

However, SSD-CI users experienced a greater deterioration in speech perception in noisy environments due to reverberation compared to normal-hearing individuals, indicating that while sound localization may be preserved, speech understanding remains more challenging for those with SSD-CI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Reverberation on Speech Perception and Sound Localization Accuracy in Cochlear Implant Users With Single-Sided Deafness. Körtje, M., Eichenauer, A., Stöver, T., et al.[2023]

Younger children have more difficulty recognizing speech in noisy and reverberant environments compared to older peers and adults, indicating they need better acoustic conditions for effective communication.

The study found that reverberation reduces the ability of children to release from masking noise, which is a crucial factor in understanding speech, highlighting the importance of minimizing noise and reverberation in classroom settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of reverberation on speech recognition in stationary and modulated noise by school-aged children and young adults. Wróblewski, M., Lewis, DE., Valente, DL., et al.[2021]

Prior exposure to reverberant environments can enhance speech understanding, but this effect can quickly diminish with changes in the acoustic environment, particularly in late reverberation characteristics.

The study found that changes in early reflections within the same room did not disrupt the speech understanding effect, supporting the idea that the phenomenon is closely tied to the temporal modulation characteristics of the sound environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech intelligibility in rooms: Disrupting the effect of prior listening exposure. Brandewie, EJ., Zahorik, P.[2019]

In a study involving 34 normal-hearing and 14 hearing-impaired listeners, reverberation times of 0.9 seconds improved speech recognition for hearing-impaired individuals compared to longer reverberation and no reverberation, highlighting the importance of realistic listening conditions in testing.

Normal-hearing listeners did not show significant differences in performance across different reverberation conditions, suggesting that reverberation may have a more pronounced effect on those with hearing impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An exploratory investigation of speech recognition thresholds in noise with auralisations of two reverberant rooms. Kuusinen, A., Saariniemi, E., Sivonen, V., et al.[2021]

The study found that a smartphone application can reliably measure classroom acoustics, making it a useful tool for assessing the sound environment in classrooms with children who are hard of hearing.

Many general education classrooms exceeded recommended noise levels set by the American National Standards Institute, highlighting the need for better noise management strategies to support speech perception for all students, especially those who are hard of hearing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of an Application to Verify Classroom Acoustic Recommendations for Children Who Are Hard of Hearing in a General Education Setting. Spratford, M., Walker, EA., McCreery, RW.[2020]

A study measuring background noise and reverberation in 32 elementary classrooms found that most did not meet the American National Standards Institute (ANSI) standards for acoustical characteristics, which can negatively impact children's learning, especially those with hearing difficulties.

The research indicated that a simple checklist was ineffective in predicting which classrooms had higher levels of noise and reverberation, suggesting a need for more reliable assessment methods to improve classroom acoustics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Background noise levels and reverberation times in unoccupied classrooms: predictions and measurements. Knecht, HA., Nelson, PB., Whitelaw, GM., et al.[2019]

Citations

1. nature.com nature.com/articles/s44384-025-00027-4

Effects of auditory distance cues and reverberation on ... Results show increased head movement in reverberant environments, suggesting an adaptive response to degraded binaural cues. While distance did ...

2. arxiv.org arxiv.org/html/2505.18020v1

Effects of auditory distance cues and reverberation on ... This study aims to address this gap by investigating the effects of listener movement, reverberation, and distance on localisation accuracy in a more ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11384524/

Adaptation to Reverberation for Speech Perception Our results showed that adaptation to reverberant speech is robust across diverse environments, experimental setups, speech units, and tasks, in noise-masked ...

4. pubs.aip.org pubs.aip.org/asa/jasa/article/158/4/3592/3370248/Effects-of-reverberation-and-binaural-sensitivity

Effects of reverberation and binaural sensitivity on spatial ... In reverberant environments, reflected acoustic waves interfere with the direct sound, reducing interaural coherence (Beranek, 2004) and causing ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0378595525002175

Influence of simulated spatial conditions and reverberation ... The current study focuses on evaluating the binaural extension of the Simulation Framework for Auditory Discrimination Experiments (FADE) ( ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT05815537

Development of Functional Spatial Hearing in Reverberation High-Reverberation. Participants perform psychoacoustic tasks under a high-reverberant environment and a control environment without reverberation.

7. withpower.com withpower.com/trial/early-phase-1-spatial-hearing-development-6-2022-fc0ab

Reverberation Impact on Spatial Hearing Development The research does not provide specific safety data on exposure to different reverberation environments, but it does highlight that excessive noise and ...

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1746809421003116

Improved spatialization performance for joint speech ... This work presented a technique for joint noise-reduction and speech-dereverberation in binaural hearing aids that provides perceptually relevant preservation ...

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2693331/

Accurate Sound Localization in Reverberant Environments is ... In reverberant environments, acoustic reflections interfere with the direct sound arriving at a listener's ears, distorting the spatial cues for sound ...

10. researchgate.net researchgate.net/publication/396464968_Effects_of_auditory_distance_cues_and_reverberation_on_spatial_perception_and_listening_strategies

(PDF) Effects of auditory distance cues and reverberation ... Effects of auditory distance cues and reverberation on spatial perception and listening strategies. October 2025; npj Acoustics. DOI:10.1038/ ...