# Benefits of Auditory Training with an Open-Set Sentences-in-Babble-Noise
## 4 Discussion
Previous studies showed subjective change following AT only for new HA users [40]. Thus, it is possible that for long-term HA users, as tested in the present study, a larger AT effect needs to occur for them to feel and report it subjectively. The generalization of AT is affected by individual differences among the trained population. The analysis examining individual differences in baseline speech perception showed that lower initial speech perception predicted greater generalization. This can be explained by the wide range of hearing loss, from mild to profound, observed in the present study's participants. The significant improvement in speech perception tasks of sentences with SSN or 4 TBN was predicted by lower initial speech perception in the sentence tasks. Speech perception baseline in sentences predicted the improvement in sentence tasks but not in word tasks (CVC words and DIN). Speech perception baseline in the DIN task predicted the improvement in sentence tasks but not in word tasks. The speech perception baseline in the CVC words task did not predict any improvement. The main limitation of the current study is that the trained stimuli were from the same pool of sentences as the untrained sentences. This may weaken our conclusion of generalization if not for the fact that it was observed for different sentences, different noise conditions, and also for words. The main strength of the current AT is that it uses sentences spoken by different talkers and accompanied by multi-talk babble noise, which makes it very similar to the stimuli participants will encounter in their daily communication. Thus, if generalization is generally weak, as was reported in many studies [7; 26; 27; 28; 29; 30; 31], it is recommended to use trained stimuli that are very similar to the untrained ones. In summary, a home-based computerized AT for older HA users using sentence-level auditory training amidst 4 TBN resulted in improvement in speech perception of sentences and words amidst wider noise bands (4 TBN and SSN). The improvement observed in the current study resulted after one month of training, and the additional training time did not have a considerable effect. Therefore, more extensive training does not appear necessary. The findings suggest that there is a top-down generalization from sentences to words and from babble noise to SSN and quiet. Therefore, synthetic training tasks should be chosen at the sentence level. In addition, an individualized approach to auditory training may be justified based on the ability to predict improvement on generalization tasks (better performance among those with poorer baseline speech perception capacity). Conceptualization, A.B., Y.S. and L.F.; methodology, A.B. and L.F.; software, A.B. and L.F.; validation, A.B. and L.F.; formal analysis, A.B. and L.F.; investigation, A.B. ; resources, L.F.; data curation, A.B. ; writing--original draft preparation, A.B. ; writing--review and editing, Y.S. and L.F.; visualization, A.B. and L.F.; supervision, Y.S. and L.F.; project administration, A.B. ; funding acquisition, L.F. All authors have read and agreed to the published version of the manuscript. **Funding:** This research was funded by Ariel University's Center for Aging Studies #RA1900000488. **Institutional Review Board Statement:** The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Ariel University (protocol code AU-HEA-LF-20201215, date of approval 15 December 2020). **Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. **Data Availability Statement:** Data from the study can be shared with interested parties by personal communication with the corresponding author. **Conflicts of Interest:** The authors declare no conflict of interest.