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Speech Recognition and Parent Ratings From Auditory Development Questionnaires in Children Who Are Hard of Hearing.

ABSTRACT: Progress has been made in recent years in the provision of amplification and early intervention for children who are hard of hearing. However, children who use hearing aids (HAs) may have inconsistent access to their auditory environment due to limitations in speech audibility through their HAs or limited HA use. The effects of variability in children's auditory experience on parent-reported auditory skills questionnaires and on speech recognition in quiet and in noise were examined for a large group of children who were followed as part of the Outcomes of Children with Hearing Loss study.Parent ratings on auditory development questionnaires and children's speech recognition were assessed for 306 children who are hard of hearing. Children ranged in age from 12 months to 9 years. Three questionnaires involving parent ratings of auditory skill development and behavior were used, including the LittlEARS Auditory Questionnaire, Parents Evaluation of Oral/Aural Performance in Children rating scale, and an adaptation of the Speech, Spatial, and Qualities of Hearing scale. Speech recognition in quiet was assessed using the Open- and Closed-Set Test, Early Speech Perception test, Lexical Neighborhood Test, and Phonetically Balanced Kindergarten word lists. Speech recognition in noise was assessed using the Computer-Assisted Speech Perception Assessment. Children who are hard of hearing were compared with peers with normal hearing matched for age, maternal educational level, and nonverbal intelligence. The effects of aided audibility, HA use, and language ability on parent responses to auditory development questionnaires and on children's speech recognition were also examined.Children who are hard of hearing had poorer performance than peers with normal hearing on parent ratings of auditory skills and had poorer speech recognition. Significant individual variability among children who are hard of hearing was observed. Children with greater aided audibility through their HAs, more hours of HA use, and better language abilities generally had higher parent ratings of auditory skills and better speech-recognition abilities in quiet and in noise than peers with less audibility, more limited HA use, or poorer language abilities. In addition to the auditory and language factors that were predictive for speech recognition in quiet, phonological working memory was also a positive predictor for word recognition abilities in noise.Children who are hard of hearing continue to experience delays in auditory skill development and speech-recognition abilities compared with peers with normal hearing. However, significant improvements in these domains have occurred in comparison to similar data reported before the adoption of universal newborn hearing screening and early intervention programs for children who are hard of hearing. Increasing the audibility of speech has a direct positive effect on auditory skill development and speech-recognition abilities and also may enhance these skills by improving language abilities in children who are hard of hearing. Greater number of hours of HA use also had a significant positive impact on parent ratings of auditory skills and children's speech recognition.

SUBMITTER: McCreery RW

PROVIDER: S-EPMC4703361 | biostudies-literature | 2015 Nov-Dec

REPOSITORIES: biostudies-literature

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Speech Recognition and Parent Ratings From Auditory Development Questionnaires in Children Who Are Hard of Hearing.

McCreery Ryan W RW Walker Elizabeth A EA Spratford Meredith M Oleson Jacob J Bentler Ruth R Holte Lenore L Roush Patricia P

Ear and hearing 20151101

<h4>Objectives</h4>Progress has been made in recent years in the provision of amplification and early intervention for children who are hard of hearing. However, children who use hearing aids (HAs) may have inconsistent access to their auditory environment due to limitations in speech audibility through their HAs or limited HA use. The effects of variability in children's auditory experience on parent-reported auditory skills questionnaires and on speech recognition in quiet and in noise were ex ...[more]

PMID: 26731160

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Project description:PurposeIt is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children's access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI.MethodThe first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed.ConclusionsYoung DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across disciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment. Presentation Video: https://doi.org/10.23641/asha.21215900.

Project description:This research studied whether the mode of input (auditory versus audiovisual) influenced semantic access by speech in children with sensorineural hearing impairment (HI).Participants, 31 children with HI and 62 children with normal hearing (NH), were tested with the authors' new multimodal picture word task. Children were instructed to name pictures displayed on a monitor and ignore auditory or audiovisual speech distractors. The semantic content of the distractors was varied to be related versus unrelated to the pictures (e.g., picture distractor of dog-bear versus dog-cheese, respectively). In children with NH, picture-naming times were slower in the presence of semantically related distractors. This slowing, called semantic interference, is attributed to the meaning-related picture-distractor entries competing for selection and control of the response (the lexical selection by competition hypothesis). Recently, a modification of the lexical selection by competition hypothesis, called the competition threshold (CT) hypothesis, proposed that (1) the competition between the picture-distractor entries is determined by a threshold, and (2) distractors with experimentally reduced fidelity cannot reach the CT. Thus, semantically related distractors with reduced fidelity do not produce the normal interference effect, but instead no effect or semantic facilitation (faster picture naming times for semantically related versus unrelated distractors). Facilitation occurs because the activation level of the semantically related distractor with reduced fidelity (1) is not sufficient to exceed the CT and produce interference but (2) is sufficient to activate its concept, which then strengthens the activation of the picture and facilitates naming. This research investigated whether the proposals of the CT hypothesis generalize to the auditory domain, to the natural degradation of speech due to HI, and to participants who are children. Our multimodal picture word task allowed us to (1) quantify picture naming results in the presence of auditory speech distractors and (2) probe whether the addition of visual speech enriched the fidelity of the auditory input sufficiently to influence results.In the HI group, the auditory distractors produced no effect or a facilitative effect, in agreement with proposals of the CT hypothesis. In contrast, the audiovisual distractors produced the normal semantic interference effect. Results in the HI versus NH groups differed significantly for the auditory mode, but not for the audiovisual mode.This research indicates that the lower fidelity auditory speech associated with HI affects the normalcy of semantic access by children. Further, adding visual speech enriches the lower fidelity auditory input sufficiently to produce the semantic interference effect typical of children with NH.

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Speech Recognition and Parent Ratings From Auditory Development Questionnaires in Children Who Are Hard of Hearing.

Publications

Speech Recognition and Parent Ratings From Auditory Development Questionnaires in Children Who Are Hard of Hearing.

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