Speech Perception in Classroom Acoustics by Children With Hearing Loss and Wearing Hearing Aids.
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ABSTRACT:
SUBMITTER: Iglehart F
PROVIDER: S-EPMC7229780 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
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Project description:Purpose:We examined the effects of vocabulary, lexical characteristics (age of acquisition and phonotactic probability), and auditory access (aided audibility and daily hearing aid [HA] use) on speech perception skills in children with HAs. Method:Participants included 24 children with HAs and 25 children with normal hearing (NH), ages 5-12 years. Groups were matched on age, expressive and receptive vocabulary, articulation, and nonverbal working memory. Participants repeated monosyllabic words and nonwords in noise. Stimuli varied on age of acquisition, lexical frequency, and phonotactic probability. Performance in each condition was measured by the signal-to-noise ratio at which the child could accurately repeat 50% of the stimuli. Results:Children from both groups with larger vocabularies showed better performance than children with smaller vocabularies on nonwords and late-acquired words but not early-acquired words. Overall, children with HAs showed poorer performance than children with NH. Auditory access was not associated with speech perception for the children with HAs. Conclusions:Children with HAs show deficits in sensitivity to phonological structure but appear to take advantage of vocabulary skills to support speech perception in the same way as children with NH. Further investigation is needed to understand the causes of the gap that exists between the overall speech perception abilities of children with HAs and children with NH.
| S-EPMC5829804 | biostudies-literature
Project description:IMPORTANCE Hearing loss (HL) in children can be deleterious to their speech and language development. The standard of practice has been early provision of hearing aids (HAs) to moderate these effects; however, there have been few empirical studies evaluating the effectiveness of this practice on speech and language development among children with mild-to-severe HL. OBJECTIVE To investigate the contributions of aided hearing and duration of HA use to speech and language outcomes in children with mild-to-severe HL. DESIGN, SETTING, AND PARTICIPANTS An observational cross-sectional design was used to examine the association of aided hearing levels and length of HA use with levels of speech and language outcomes. One hundred eighty 3- and 5-year-old children with HL were recruited through records of Universal Newborn Hearing Screening and referrals from clinical service providers in the general community in 6 US states. INTERVENTIONS All but 4 children had been fitted with HAs, and measures of aided hearing and the duration of HA use were obtained. MAIN OUTCOMES AND MEASURES Standardized measures of speech and language ability were obtained. RESULTS Measures of the gain in hearing ability for speech provided by the HA were significantly correlated with levels of speech (?179?=?0.20; P?=?.008) and language: ?155?=?0.21; P?=?.01) ability. These correlations were indicative of modest levels of association between aided hearing and speech and language outcomes. These benefits were found for children with mild and moderate-to-severe HL. In addition, the amount of benefit from aided hearing interacted with the duration of HA experience (Speech: F4,161?=?4.98; P?<?.001; Language: F4,138?=?2.91; P?<?.02). Longer duration of HA experience was most beneficial for children who had the best aided hearing. CONCLUSIONS AND RELEVANCE The degree of improved hearing provided by HAs was associated with better speech and language development in children. In addition, the duration of HA experience interacted with the aided hearing to influence outcomes. These results provide support for the provision of well-fitted HAs to children with HL. In particular, the findings support early HA fitting and HA provision to children with mild HL.
| S-EPMC4066968 | biostudies-literature
Project description:Cubick and Dau [(2016). Acta Acust. Acust. 102, 547-557] showed that speech reception thresholds (SRTs) in noise, obtained with normal-hearing listeners, were significantly higher with hearing aids (HAs) than without. Some listeners reported a change in their spatial perception of the stimuli due to the HA processing, with auditory images often being broader and closer to the head or even internalized. The current study investigated whether worse speech intelligibility with HAs might be explained by distorted spatial perception and the resulting reduced ability to spatially segregate the target speech from the interferers. SRTs were measured in normal-hearing listeners with or without HAs in the presence of three interfering talkers or speech-shaped noises. Furthermore, listeners were asked to sketch their spatial perception of the acoustic scene. Consistent with the previous study, SRTs increased with HAs. Spatial release from masking was lower with HAs than without. The effects were similar for noise and speech maskers and appeared to be accounted for by changes to energetic masking. This interpretation was supported by results from a binaural speech intelligibility model. Even though the sketches indicated a change of spatial perception with HAs, no direct link between spatial perception and segregation of talkers could be shown.
| S-EPMC6246072 | biostudies-other
Project description:Purpose:There is a growing interest in speech intelligibility and auditory perception of deaf children. The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children with Hearing Aid (HA), Cochlear Implant (CI), and Typical Hearing (TH). Methods:The research design was descriptive-analytic and comparative. The participants comprised 75 male pre-school children aged 4-6 years in the 2017-2018 from Tehran, Iran. The participants were divided into three groups, and each group consisted of 25 children. The first and second groups were respectively selected from pre-school children with HA and CI using the convenience sampling method, while the third group was selected from pre-school children with TH by random sampling method. All children completed Speech Intelligibility Rating and Categories of Auditory Performance Questionnaires. Results:The findings indicated that the mean scores of speech intelligibility and auditory perception of the group with TH were significantly higher than those of the other groups (P < 0.0001). The mean scores of speech intelligibility in the group with CI did not significantly differ from those of the group with HA (P < 0.38). Also, the mean scores of auditory perception in the group with CI were significantly higher than those of the group with HA (P < 0.002). Conclusion:The results showed that auditory perception in children with CI was significantly higher than children with HA. This finding highlights the importance of cochlear implantation at a younger age and its significant impact on auditory perception in deaf children.
| S-EPMC7231984 | biostudies-literature
Project description:This article reports on the psychosocial development and factors influencing outcomes of 5-year-old children with cochlear implants (CIs) or hearing aids (HAs). It further examines differences between children with CIs and HAs with similar levels of hearing loss. Data were collected as part of the Longitudinal Outcomes of Children with Hearing Impairment study-a prospective, population-based study. Parents/caregivers of children completed the Strengths and Difficulties Questionnaire ( n = 333), the Social Skills subscale from the Child Development Inventory ( n = 317), and questionnaires on functional auditory behavior (Parents' Evaluation of Aural/oral performance of Children), and demographics. Children completed assessments of nonverbal cognitive ability (Wechsler Non-verbal Scale of Ability) and language (Preschool Language Scale - fourth edition). On average, parent-rated Strengths and Difficulties Questionnaire scores on emotional or behavioral difficulties were within 1 SD of the normative mean; however, Child Development Inventory scores on social skills were more than 1 SD below the norm. Children with severe-to-profound hearing losses using HAs had significantly more behavioral problems than children with CIs. Regression analyses showed that non-verbal cognitive ability, language, and functional auditory behavior were significantly associated with psychosocial outcomes for children with HAs, whereas outcomes for children with CIs were associated with functional auditory behavior and the presence of additional disabilities. Age at hearing intervention, severity of hearing loss, and communication mode were not associated with outcomes. The results suggest that even children who develop good language ability with the help of a HA or CI may have psychosocial problems if they exhibit difficulties with listening and communicating in everyday environments. The findings have implications for developing interventions for young children with hearing loss.
| S-EPMC5536374 | biostudies-other
Project description:The integration of virtual acoustic environments (VAEs) with functional near-infrared spectroscopy (fNIRS) offers novel avenues to investigate behavioral and neural processes of speech-in-noise (SIN) comprehension in complex auditory scenes. Particularly in children with hearing aids (HAs), the combined application might offer new insights into the neural mechanism of SIN perception in simulated real-life acoustic scenarios. Here, we present first pilot data from six children with normal hearing (NH) and three children with bilateral HAs to explore the potential applicability of this novel approach. Children with NH received a speech recognition benefit from low room reverberation and target-distractors' spatial separation, particularly when the pitch of the target and the distractors was similar. On the neural level, the left inferior frontal gyrus appeared to support SIN comprehension during effortful listening. Children with HAs showed decreased SIN perception across conditions. The VAE-fNIRS approach is critically compared to traditional SIN assessments. Although the current study shows that feasibility still needs to be improved, the combined application potentially offers a promising tool to investigate novel research questions in simulated real-life listening. Future modified VAE-fNIRS applications are warranted to replicate the current findings and to validate its application in research and clinical settings.
| S-EPMC7695031 | biostudies-literature
Project description:OBJECTIVES:Visual information from talkers facilitates speech intelligibility for listeners when audibility is challenged by environmental noise and hearing loss. Less is known about how listeners actively process and attend to visual information from different talkers in complex multi-talker environments. This study tracked looking behavior in children with normal hearing (NH), mild bilateral hearing loss (MBHL), and unilateral hearing loss (UHL) in a complex multi-talker environment to examine the extent to which children look at talkers and whether looking patterns relate to performance on a speech-understanding task. It was hypothesized that performance would decrease as perceptual complexity increased and that children with hearing loss would perform more poorly than their peers with NH. Children with MBHL or UHL were expected to demonstrate greater attention to individual talkers during multi-talker exchanges, indicating that they were more likely to attempt to use visual information from talkers to assist in speech understanding in adverse acoustics. It also was of interest to examine whether MBHL, versus UHL, would differentially affect performance and looking behavior. DESIGN:Eighteen children with NH, eight children with MBHL, and 10 children with UHL participated (8-12 years). They followed audiovisual instructions for placing objects on a mat under three conditions: a single talker providing instructions via a video monitor, four possible talkers alternately providing instructions on separate monitors in front of the listener, and the same four talkers providing both target and nontarget information. Multi-talker background noise was presented at a 5 dB signal-to-noise ratio during testing. An eye tracker monitored looking behavior while children performed the experimental task. RESULTS:Behavioral task performance was higher for children with NH than for either group of children with hearing loss. There were no differences in performance between children with UHL and children with MBHL. Eye-tracker analysis revealed that children with NH looked more at the screens overall than did children with MBHL or UHL, though individual differences were greater in the groups with hearing loss. Listeners in all groups spent a small proportion of time looking at relevant screens as talkers spoke. Although looking was distributed across all screens, there was a bias toward the right side of the display. There was no relationship between overall looking behavior and performance on the task. CONCLUSIONS:The present study examined the processing of audiovisual speech in the context of a naturalistic task. Results demonstrated that children distributed their looking to a variety of sources during the task, but that children with NH were more likely to look at screens than were those with MBHL/UHL. However, all groups looked at the relevant talkers as they were speaking only a small proportion of the time. Despite variability in looking behavior, listeners were able to follow the audiovisual instructions and children with NH demonstrated better performance than children with MBHL/UHL. These results suggest that performance on some challenging multi-talker audiovisual tasks is not dependent on visual fixation to relevant talkers for children with NH or with MBHL/UHL.
| S-EPMC6003828 | biostudies-literature
Project description:Young healthy adults can hear tones up to at least 20 kHz. However, clinical audiometry, by which hearing loss is diagnosed, is limited at high frequencies to 8 kHz. Evidence suggests there is salient information at extended high frequencies (EHFs; 8 to 20 kHz) that may influence speech intelligibility, but whether that information is used in challenging listening conditions remains unknown. Difficulty understanding speech in noisy environments is the most common concern people have about their hearing and usually the first sign of age-related hearing loss. Digits-in-noise (DIN), a widely used test of speech-in-noise perception, can be sensitized for detection of high-frequency hearing loss by low-pass filtering the broadband masking noise. Here, we used standard and EHF audiometry, self-report, and successively higher cutoff frequency filters (2 to 8 kHz) in a DIN test to investigate contributions of higher-frequency hearing to speech-in-noise perception. Three surprising results were found. First, 74 of 116 "normally hearing," mostly younger adults had some hearing loss at frequencies above 8 kHz. Early EHF hearing loss may thus be an easily measured, preventive warning to protect hearing. Second, EHF hearing loss correlated with self-reported difficulty hearing in noise. Finally, even with the broadest filtered noise (?8 kHz), DIN hearing thresholds were significantly better (P < 0.0001) than those using broadband noise. Sound energy above 8 kHz thus contributes to speech perception in noise. People with "normal hearing" frequently report difficulty hearing in challenging environments. Our results suggest that one contribution to this difficulty is EHF hearing loss.
| S-EPMC6876232 | biostudies-literature
Project description:BackgroundThe main clinical intervention for mild to moderate hearing loss is the provision of hearing aids. These are routinely offered and fitted to those who seek help for hearing difficulties. By amplifying and improving access to sounds, and speech sounds in particular, the aim of hearing aid use is to reduce the negative consequences of hearing loss and improve participation in everyday life.ObjectivesTo evaluate the effects of hearing aids for mild to moderate hearing loss in adults.Search methodsThe Cochrane ENT Information Specialist searched the ENT Trials Register; the Cochrane Register of Studies Online; MEDLINE; PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 23 March 2017.Selection criteriaRandomised controlled trials (RCTs) of hearing aids compared to a passive or active control in adults with mild to moderate hearing loss.Data collection and analysisWe used the standard methodological procedures expected by Cochrane. The primary outcomes in this review were hearing-specific health-related quality of life and the adverse effect pain. Secondary outcomes were health-related quality of life, listening ability and the adverse effect noise-induced hearing loss. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics.Main resultsWe included five RCTs involving 825 participants. The studies were carried out in the USA and Europe, and were published between 1987 and 2017. Risk of bias across the studies varied. Most had low risk for selection, reporting and attrition bias, and a high risk for performance and detection bias because blinding was inadequate or absent.All participants had mild to moderate hearing loss. The average age across all five studies was between 69 and 83 years. The duration of the studies ranged between six weeks and six months.There was a large beneficial effect of hearing aids on hearing-specific health-related quality of life associated with participation in daily life as measured using the Hearing Handicap Inventory for the Elderly (HHIE, scale range 1 to 100) compared to the unaided/placebo condition (mean difference (MD) -26.47, 95% confidence interval (CI) -42.16 to -10.77; 722 participants; three studies) (moderate-quality evidence).There was a small beneficial effect of hearing aids on general health-related quality of life (standardised mean difference (SMD) -0.38, 95% CI -0.55 to -0.21; 568 participants; two studies) (moderate-quality evidence). There was a large beneficial effect of hearing aids on listening ability (SMD -1.88, 95% CI -3.24 to -0.52; 534 participants; two studies) (moderate-quality evidence).Adverse effects were measured in only one study (48 participants) and none were reported (very low-quality evidence).Authors' conclusionsThe available evidence concurs that hearing aids are effective at improving hearing-specific health-related quality of life, general health-related quality of life and listening ability in adults with mild to moderate hearing loss. The evidence is compatible with the widespread provision of hearing aids as the first-line clinical management in those who seek help for hearing difficulties. Greater consistency is needed in the choice of outcome measures used to assess benefits from hearing aids. Further placebo-controlled studies would increase our confidence in the estimates of these effects and ascertain whether they vary according to age, gender, degree of hearing loss and type of hearing aid.
| S-EPMC6483809 | biostudies-literature
Project description:ObjectivesThe purpose of this study was to examine age- and hearing-related differences in school-age children's benefit from visual speech cues. The study addressed three questions: (1) Do age and hearing loss affect degree of audiovisual (AV) speech enhancement in school-age children? (2) Are there age- and hearing-related differences in the mechanisms underlying AV speech enhancement in school-age children? (3) What cognitive and linguistic variables predict individual differences in AV benefit among school-age children?DesignForty-eight children between 6 and 13 years of age (19 with mild to severe sensorineural hearing loss; 29 with normal hearing) and 14 adults with normal hearing completed measures of auditory and AV syllable detection and/or sentence recognition in a two-talker masker type and a spectrally matched noise. Children also completed standardized behavioral measures of receptive vocabulary, visuospatial working memory, and executive attention. Mixed linear modeling was used to examine effects of modality, listener group, and masker on sentence recognition accuracy and syllable detection thresholds. Pearson correlations were used to examine the relationship between individual differences in children's AV enhancement (AV-auditory-only) and age, vocabulary, working memory, executive attention, and degree of hearing loss.ResultsSignificant AV enhancement was observed across all tasks, masker types, and listener groups. AV enhancement of sentence recognition was similar across maskers, but children with normal hearing exhibited less AV enhancement of sentence recognition than adults with normal hearing and children with hearing loss. AV enhancement of syllable detection was greater in the two-talker masker than the noise masker, but did not vary significantly across listener groups. Degree of hearing loss positively correlated with individual differences in AV benefit on the sentence recognition task in noise, but not on the detection task. None of the cognitive and linguistic variables correlated with individual differences in AV enhancement of syllable detection or sentence recognition.ConclusionsAlthough AV benefit to syllable detection results from the use of visual speech to increase temporal expectancy, AV benefit to sentence recognition requires that an observer extracts phonetic information from the visual speech signal. The findings from this study suggest that all listener groups were equally good at using temporal cues in visual speech to detect auditory speech, but that adults with normal hearing and children with hearing loss were better than children with normal hearing at extracting phonetic information from the visual signal and/or using visual speech information to access phonetic/lexical representations in long-term memory. These results suggest that standard, auditory-only clinical speech recognition measures likely underestimate real-world speech recognition skills of children with mild to severe hearing loss.
| S-EPMC7822589 | biostudies-literature