Chinese Emotional Speech Audiometry Project (CESAP): Establishment and Validation of a New Material Set With Emotionally Neutral Disyllabic Words.

PURPOSE: The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody. METHOD: In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (-1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes. RESULTS: First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%-80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%-80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%-80% slope (12%). CONCLUSION: Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25742814.

Pediatric normative data for a novel and fast speech perception test in noise.

OBJECTIVES: Communicating in noisy settings can be difficult due to interference and environmental noise, which can impact intelligibility for those with hearing impairments and those with normal hearing threshold. Speech intelligibility is commonly assessed in audiology through speech audiometry in quiet environments. Nevertheless, this test may not effectively assess hearing challenges in noisy environments, as total silence is rare in daily activities. A recently patented method, known as the SRT50 FAST, has been developed for conducting speech audiometry in noise. This new method enables the acceleration and simplification of free field speech audiometry tests involving competition noise. This study aims to establish normative scores and standardize the SRT50 FAST method as a test for evaluating speech perception in noise in pediatric patients. METHODS: The study included 30 participants with normal hearing, consisting of 11 females and 19 males, ranging in age from 6 to 11 years. A series of speech audiometry tests were conducted to determine the speech reception threshold 50% (SRT50) in competing conditions. This included testing both the fast mode (SRT50 FAST) currently being studied and the traditional method (SRT50 CLASSIC). The SRT50, or Signal to Noise Ratio (SNR) at which 50% of speech recognition occurred, was investigated for both methods. RESULTS: The mean SRT50 FAST test score was -2.69 (SD = 3.15). The dataset exhibited a normal distribution with values ranging from 3.60 to -8.60. Since the scores are expressed in SRT, higher scores indicate poorer performance. We have established a threshold of 3.60 as the upper limit of the normal range, therefore, patients with scores above this threshold are considered to have abnormal results. CONCLUSIONS: This study aimed to establish normative data for the evaluation of free field speech in noise recognition using the SRT50 FAST method in the pediatric population. This method accurately investigates the necessary signal-to-noise ratio for achieving 50% recognition scores with bisyllabic words in a quick manner. The ultimate objective is to employ this test to identify the optimal configuration of hearing rehabilitation devices, particularly for pediatric patients with hearing aids and/or cochlear implants. Additionally, it can be used to assess pediatric patients with unilateral hearing loss.

Functional outcomes for speech-in-noise intelligibility of NAL-NL2 and DSL v.5 prescriptive fitting rules in hearing aid users.

PURPOSE: The primary aim of this research study is to assess whether differences exist in the application of the NAL-NL2 and DSL v.5 prescription formulas in terms of speech-in-noise intelligibility. METHODS: Data from 43 patients, were retrospectively evaluated and analyzed. Inclusion criteria were patients with bilateral conductive, sensorineural, or mixed hearing loss, already using hearing aids for at least 1 year, and aged 18 years or older. Patients were categorized into two groups based on the prescriptive method employed by the hearing aid: NAL-NL2 or DSL v.5. Pure tone audiometry, speech audiometry, free field pure tone and speech audiometry with the hearing aid, and Matrix sentence test were performed. The Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire was used to assess the personal audiological benefit provided by the hearing aid. RESULTS: No statistically significant differences were found comparing the free-field pure tone average (FF PTA) and the free-field Word Recognition Score (FF WRS). Comparing the Speech Reception Threshold (SRT) parameter of patients with NAL-NL2 vs DSL v.5, no statistically significant difference was found, thus highlighting a condition of comparability between the two prescription methods in terms of speech-in-noise intelligibility. Comparing the results of the APHAB questionnaire, no statistically significant differences were evident for all subscales and overall benefit. When conducting a comparison between male and female patients using the NAL-NL2 method, no differences were observed in SRT values, however, the APHAB questionnaire revealed a difference in the AV subscale score for the same subjects. CONCLUSION: Our analysis revealed no statistically significant differences in speech-in-noise intelligibility, as measured by the SRT values from the Matrix Sentence Test, when comparing the two prescriptive methods. This compelling result reinforces the notion that, functionally, both methods are comparably effective in enhancing speech intelligibility in real-world, noisy environments. However, it is crucial to underscore that the absence of differences does not diminish the importance of considering individual patient needs and preferences in the selection of a prescriptive method.

Development and Validation of a Mandarin Chinese Adaptation of AzBio Sentence Test (CMnBio).

A new sentence recognition test in Mandarin Chinese was developed and validated following the principles and procedures of development of the English AzBio sentence materials. The study was conducted in two stages. In the first stage, 1,020 sentences spoken by 4 talkers (2 males and 2 females) were processed through a 5-channel noise vocoder and presented to 17 normal-hearing Mandarin-speaking adults for recognition. A total of 600 sentences (150 from each talker) in the range of approximately 62 to 92% correct (mean = 78.0% correct) were subsequently selected to compile 30, 20-sentence lists. In the second stage, 30 adult CI users were recruited to verify the list equivalency. A repeated-measures analysis of variance followed by the post hoc Tukey's test revealed that 26 of the 30 lists were equivalent. Finally, a binomial distribution model was adopted to account for the inherent variability in the lists. It was found that the inter-list variability could be best accounted for with a 65-item binomial distribution model. The lower and upper limits of the 95% critical differences for one- and two-list recognition scores were then generated to provide guidance for detection of a significant difference in recognition scores in clinical settings. The final set of 26 equivalent lists contains sentence materials more difficult than those found in other speech audiometry materials in Mandarin Chinese. This test should help minimize the ceiling effects when testing sentence recognition in Mandarin-speaking CI users.

Challenges and opportunities for telehealth assessment during COVID-19: iT-RES, adapting a remote version of the test for rating emotions in speech.

OBJECTIVE: COVID-19 social isolation restrictions have accelerated the need to adapt clinical assessment tools to telemedicine. Remote adaptations are of special importance for populations at risk, e.g. older adults and individuals with chronic medical comorbidities. In response to this urgent clinical and scientific need, we describe a remote adaptation of the T-RES (Oron et al. 2020; IJA), designed to assess the complex processing of spoken emotions, based on identification and integration of the semantics and prosody of spoken sentences. DESIGN: We present iT-RES, an online version of the speech-perception assessment tool, detailing the challenges considered and solution chosen when designing the telehealth tool. We show a preliminary validation of performance against the original lab-based T-RES. STUDY SAMPLE: A between-participants design, within two groups of 78 young adults (T-RES, n = 39; iT-RES, n = 39). RESULTS: i-TRES performance closely followed that of T-RES, with no group differences found in the main trends, identification of emotions, selective attention, and integration. CONCLUSIONS: The design of iT-RES mapped the main challenges for remote auditory assessments, and solutions taken to address them. We hope that this will encourage further efforts for telehealth adaptations of clinical services, to meet the needs of special populations and avoid halting scientific research.

Teste de dígitos no ruído baseado em software para português brasileiro em crianças com transtorno do processamento auditivo central / Software-based digits-in-noise test for Brazilian Portuguese in children0ith central auditory processing disorder / Prueba de dígitos en ruido basado en software para portugués brasileño en niños con trastorno del central procesamiento auditivo

Introdução: Nas situações da vida diária, frequentemente, é necessário reconhecer a fala em ambientes com ruído competitivo, sendo que dificuldades neste reconhecimento é uma queixa comum de pessoas com transtornos do processamento auditivo central (TPAC). O Teste de Dígitos no Ruído (TDR), desenvolvido para triagem de perdas auditivas em adultos e idosos, apresenta vantagens que o tornam promissor para triagem em crianças com TPAC. Objetivo: Verificar o desempenho de crianças com TPAC no TDR baseado em software para o Português brasileiro. Método: A amostra de conveniência foi constituída por 31 crianças (8-12 anos), sendo 23 com TPAC, alocadas no G1, e oito sem o transtorno, que compuseram o G2. Todas realizaram avaliação audiológica básica, timpanometria, reconhecimento numérico visual e aleatório, aplicação do TDR e avaliação comportamental do processamento auditivo central (PAC) para determinar presença ou não do TPAC. Na análise foi utilizado Teste de Mann-Whitney no comparativo entre G1 e G2 e correlação de Sperman entre os testes de PAC e a média da relação S/R (RSR) do TDR. Resultados: G1 e G2 apresentaram desempenhos significativamente diferentes nos testes fala filtrada (orelha direita), dicótico de dígitos (orelha esquerda), fusão binaural e gaps-in-noise de ambas as orelhas e no teste de padrões de frequência. A média da relação sinal/ruído (RSR) do TDR foi de -7,29 dB (dp ± 4,76) nos sujeitos do G1 e de -8,42 dB (dp ± 2,93) no G2. Não houve diferença estatisticamente significante entre G1 e G2 no comparativo das médias de RSR final (p = 0,227). Não foi evidenciada correlação na maior parte dos testes de PAC e o TDR, exceto correlação negativa no FBOE e DDIOD. Conclusão: O desempenho das crianças com TPAC é similar ao de crianças sem TPAC no teste de dígitos no ruído em Português Brasileiro.

Speech recognition on noise is an auditory processing skill, important for children in contexts with competitive noise and reverberation and can test their functional capacity. The Digits-in-Noise (DIN) Test, developed for hearing screening in adults and the elderly, has advantages that make it promising for screening children with central auditory processing disorders (CAPD). Objective: Verify the performance of children with central auditory processing disorder in a software-based DIN Test for Brazilian Portuguese. Methods: The convenience sample comprised 31 children (8 to 12 years), 23 with CAPD placed in G1, and eight without the disorder that composed G2. All children underwent basic audiological assessment and tympanometry, visual and random numerical recognition, use of DIN and auditory processing behavioral assessment to determine the presence or absence of APD. We used the Mann-Whitney test to compare G1 and G2. Results: G1 and G2 presented different performances in the filtered speech (right ear), dichotic digits (left ear), binaural fusion and gaps-in-noise tests of both ears and in the frequency pattern test. We observed that the average DIN signal-to-noise ratio (SNR) was -7.29 dB (SD ± 4.76) in G1 subjects, and -8.42 dB (SD ± 2.93) in G2 subjects. There was no statistically significant difference between G1 and G2 in comparison of average final SNR (p = 0.227). Conclusion: Considering the average values of the final SNR, we found that the children's performance in the DIN test was similar between both groups.

Introducción: Reconocimiento de habla en ruido es una habilidad del procesamiento auditivo, importante para chicos en contextos con ruido competitivo y reverberación, y puede ser evaluada para determinar su capacidad funcional. La Prueba de Dígitos en Ruido (PDR), desarrollada para detectar pérdida de audición en adultos y ancianos, presentado ventajas que lo hacen prometedor para detección en niños con trastorno del procesamiento auditivo central (TPAC). Objetivo: Verificar el rendimiento de niños conTPAC en PDR basado en software en portugués brasileño. Metodos: La muestra de conveniencia consistió en 31 niños entre 8-12 año, 23 chicos con TPAC, asignado en G1, y ocho sin trastorno, que componen G2. Todos realizaron evaluación audiológica básica, timpanometría, reconocimiento numérico visual y aleatorio, aplicación del PDR y evaluación comportamental del procesamiento auditivo, aplicación del PDR e del comportamiento del procesamiento auditivo para determinar la presencia o ausencia de TPAC. Se utilizó la prueba de Mann-Whitney para análisis entre G1 y G2. Resultados: G1 y G2 presentaron diferentes rendimientos en pruebas de habla filtrada (oído derecho), dígitos dicóticos (oído izquierdo), fusión binaural y gaps-in-noise en ambos oídos y en la prueba del patrón de frecuencia. La Relación Señal/Ruido (S/R) del PDR fue -7.29 dB (sd ± 4.76) en chicos del G1 y -8.42 dB (sd ± 2.93) en G2. No hubo diferencias estadísticamente significativas entre G1 y G2 al comparar las medias finales de RSR (p = 0.227). Conclusión: Teniendo en cuenta valores de la media S/R final, hubo similitud de rendimiento en PDR en ambos grupos.

Pre- and Post-operative Speech Audiometry Evaluation in Patients with Chronic Otitis Media.

OBJECTIVES: The primary function of the human auditory system is to ensure proper speech comprehension. Speech audiometry enables the assessment of the conductive and the sensory aspects of the ears, providing some insight into the central auditory processing function. MATERIALS AND METHODS: We conducted an analysis of 79 patients with chronic otitis media (COM) undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College, in Kraków between 2005 and 2014. Tonal audiometry and speech audiometry were used as part of the hearing assessment. The pre-operative and long-term post-operative findings were compared, focusing mainly on speech audiometry. RESULTS: At the end of the mean 10-year follow-up, a significant percentage worsening in speech comprehension from the baseline was demonstrated in group III (hearing loss > 70 dB(decibels)), as compared with the remaining groups. There was a significant (p = 0.017) difference in speech comprehension between the treated and contralateral ears, with the mean maximum speech comprehension rates of 80% in the treated ear versus 92% in the contralateral ear. CONCLUSION: We demonstrated a correlation between the findings of tonal audiometry and speech audiometry. The severe damage caused by chronic middle ear diseases not only leads to conductive hearing loss but also acts as a significant contributor to poor speech comprehension in a long-term follow-up. The speech comprehension in a healthy ear is significantly better than in a diseased ear. Middle ear reconstructive surgery offers the maximum improvement in speech comprehension at the hearing loss of 41 to 70 dB in speech audiometry.

The French Cochlear Implant Registry (EPIIC): Cochlear implant candidacy assessment of off-label indications.

OBJECTIVE: Evaluate in France the outcomes of cochlear implantation outside the selection criteria, off-label. MATERIAL AND METHODS: This is a prospective cohort study including adults and children having received a cochlear implant (CI) in an off-label indication, that is outside the criteria established by the "Haute Autorité de santé (HAS)" in 2012. The data was collected from the "EPIIC" registry on recipients who received CIs in France between 2011 and 2014. Speech audiometry was performed at 60dB preimplantation and after one year of CI use, as well as an evaluation of the scores of the quality of life with the APHAB questionnaire, the scores for CAP and the professional/academic status in pre- and post-implantation conditions. Major and minor complications at surgery have been recorded. RESULTS: In total, 590 patients (447 adults and 143 children) with an off-label indication for CIs were included in this study from the EPIIC registry (11.7% of the whole cohort of EPIIC). For adults, the median percentage of comprehension using monosyllabic word lists was 41% in preimplantation condition versus 53% after one year of CI use (P<0.001) and 60% versus 71% in dissyllabic word lists (P<0.001). The CAP scores were 5 versus 6 in pre- and post-implantation conditions respectively (P<0.001) and the APHAB scores were statistically lower after implantation (P<0.001). In the children cohort, the median percentage of comprehension using monosyllabic word lists was 51% in preimplantation condition and 65% after CI (P<0.001), and 48% versus 82% (P<0.001) for dissyllabic word lists. The CAP scores were 5 versus 7 respectively in pre- and post-CI conditions (P<0.001). Thirty-two minor complications (5.4%) and 17 major complications (2.8%) were reported in our panel of off-label indication patients. CONCLUSION: These results suggest that a revision of the cochlear implantation candidacy criteria is necessary to allow more patients with severe or asymmetric hearing loss to benefit from a CI when there is an impact on quality of life despite the use of an optimal hearing aid.

The French National Cochlear Implant Registry (EPIIC): Bilateral cochlear implantation.

OBJECTIVES: Assessment of the incidence and results of bilateral cochlear implantation in adults and children in France. MATERIALS AND METHODS: Multicenter retrospective study of data in the French national registry of cochlear implantations from January 1st 2012 to December 31st 2016. Functional results from CAP (Category of Auditory Performance) questionnaires and speech audiometry tests, with mono- and di-syllabic word-lists, were compared before and after implantation. Speech audiometry tests were carried out against a noisy background, except before simultaneous implantations. RESULTS: Nine hundred and forty two bilateral cochlear implantations were performed during this period, that is, 16.4% of all cochlear implantations. Five hundred and eighty eight bilateral implantations were performed sequentially. 59% of the bilateral implantations were performed in children. Bilateral implants significantly improved CAP scores in all cases (P<0.001). Auditory performance, with the two types of word-list, were significantly improved after simultaneous implantation (P<0.01). After sequential implantation, the speech discrimination score, already very good with the first implant, reached 63±26% [0-100] with monosyllabic word lists, and 72±28% [0-100] with dissyllabic words. There were more complications due to surgery in bilateral cases than in the entire population of cochlear recipients (9.1% vs 6.4%, P<0.02). CONCLUSION: Hearing is significantly improved by simultaneous cochlear implantation. For sequential implantation, at one year, when auditory results were already excellent from the first implant, in the bimodal condition CAP scores were significantly improved, although there was no further change in speech audiometry in noise.

Spanish Pediatric Picture Identification Test.

Purpose The purpose of this study was to construct and validate a recorded word recognition test for monolingual Spanish-speaking children utilizing a picture board and a picture-pointing task. Design The Spanish Pediatric Picture Identification Test was developed and validated in this study. Test construction steps included (a) producing new digital recordings of word lists created by Comstock and Martin (1984) using a bilingual Spanish-English female, (b) obtaining list equivalency, (c) creating digitally illustrated pictures representing the word lists, (d) validating the pictures using monolingual Spanish-speaking and bilingual Spanish-English children, and (e) re-establishing list equivalency and obtaining performance-intensity functions using a picture-pointing task with monolingual Spanish-speaking children and bilingual Spanish-English adults. Results Normative data for three Spanish word recognition lists were established. Performance-intensity functions at sensation levels from 0 to 40 dB SL in 8-dB steps were obtained, establishing list equivalency for Lists 1, 2, and 3. Conclusions The Spanish Pediatric Picture Identification Test was developed and validated as a picture-pointing task for word recognition with monolingual Spanish-speaking children. The two validated channel recordings include an English translation for ease of testing by clinicians lacking Spanish language skills. Future validation will be conducted with bilingual Spanish-English children with normal hearing and with hearing loss.

Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy.

OBJECTIVES: To identify predictive factors for falls in patients with bilateral vestibulopathy (BV). Specific variables contributing to the general work-up of a vestibular patient were compared between BV patients experiencing falls and those who did not. DESIGN: Prospective multi-centric cohort study. SETTING: Department of Otorhinolaryngology & Head and Neck Surgery at two tertiary referral centers: Antwerp University Hospital and Maastricht University Medical Center. PARTICIPANTS: In total, 119 BV patients were included. BV diagnosis was defined in accordance with the diagnostic BV criteria, established by the Bárány Society in 2017. MAIN OUTCOME MEASURES: Patients were divided into fallers and non-fallers, depending on the experience of one or more falls in the preceding 12 months. Residual vestibular function on caloric testing, rotatory chair testing, video head impulse test (vHIT) and cervical vestibular evoked myogenic potentials (cVEMP) was evaluated as a predictive factor for falls. Furthermore, hearing function (speech perception in noise (SPIN)), sound localization performance, etiology, disease duration, sport practice, scores on the Dizziness Handicap Inventory (DHI) and the Oscillopsia Severity Questionnaire (OSQ) were compared between fallers and non-fallers. RESULTS: Forty-five (39%) patients reported falls. In a sub-analysis in the patients recruited at UZA (n = 69), 20% experienced three or more falls and three patients (4%) suffered from severe fall-related injuries. The DHI score and the OSQ score were significantly higher in fallers. Residual vestibular function, SPIN, sound localization performance, etiology, disease duration, age and sport practice did not differ between fallers and non-fallers. CONCLUSIONS: Falls and (severe) fall-related injuries are frequent among BV patients. A DHI score > 47 and an OSQ score > 27.5 might be indicative for BV patients at risk for falls, with a sensitivity of 70% and specificity of 60%. Residual vestibular function captured by single vestibular tests (vHIT, calorics, rotatory chair, cVEMP) or by overall vestibular function defined as the number of impaired vestibular sensors are not suitable to distinguish fallers and non-fallers in a BV population.

Assessment of Hidden Hearing Loss in Normal Hearing Individuals with and Without Tinnitus.

OBJECTIVES: To evaluate the functions of cochlear structures and the distal part of auditory nerve as well as dead regions within the cochlea in individuals with normal hearing with or without tinnitus by using electrophysiological tests. MATERIALS AND METHODS: Nine individuals (ages: 21-59 years) with normal hearing with tinnitus were included in the study group. Thirteen individuals (ages: 25-60 years) with normal hearing without tinnitus were included in the control group. Immitancemetric examination, pure-tone audiometry (125Hz-16kHz), speech audiometry in quiet and noise environments, transient evoked otoacoustic emissions (TEOAEs), distortion product otoacoustic emissions (DPOAEs), threshold equalizing noise (TEN test (500Hz-4kHz), and ECochG tests, Beck Depression Questionnaire, Tinnitus Handicap Questionnaire, and Visual Analog Scale were performed. RESULTS: In the study group, three patients were found to have a minimal depression and six were found to have a mild depression. In pure-tone audiometry, the threshold (6-16 kHz) in the study group was significantly higher than that of the control group at all frequencies. In the study group, lower performance scores were obtained in speech discrimination in noise in both ears. In the control group, no dead region was detected in the TEN test whereas 75% of subjects in the study group had dead regions. DPOAE and TEOAE responses between study and control group subjects were not different. In the ECochG test, subjects in the study group showed an increase in the summating potential/action potential (SP/AP) ratio in both ears. CONCLUSION: Determination of the SP/AP ratio in patients with tinnitus may be useful in diagnosing hidden hearing loss. Detection of dead regions in 75% of patients in the TEN test may indicate that inner hair cells may be responsible for tinnitus.

Evaluation of a sentence test in noise in children with hearing impairment.

INTRODUCTION: School-aged children with hearing impairment (HI) listen and learn in noisy environments. On-going monitoring of speech understanding in noise is essential to adjust clinical interventions accordingly. METHODS: The aim of this study was to assess Dantale II in a paediatric population. The secondary aims were identification of differences and similarities between groups of children with HI and normal hearing and between different hearing technologies; investigation of possible associations between Dantale II and verbal working memory. This was a longitudinal, prospective study comparing groups of children (n = 70) using the Dantale II with five-word sentences and verbal working memory with the Clinical Evaluation of Language Functioning-4. RESULTS: Dantale II seems clinically feasible from the age of six years. Children with NH outperformed children with HI both on completion of the tests and dB signal-to-noise ratio (SNR) scores. Children with hearing aids outperformed children with cochlear implants on dB SNR scores. A significant and moderately strong association between speech understanding in noise and verbal working memory was identified. CONCLUSIONS: Our study produced knowledge about a new generation of children with HI, who showed potentials not previously described. Future research on cognitive development of paediatric populations with HI is essential, as knowledge from adult populations cannot be transferred directly to paediatric populations. FUNDING: The project received funding from the Innovation Foundation, the Oticon Foundation, Decibel and The Capital Region of Denmark. TRIAL REGISTRATION: not relevant.

Development of a Revised Performance-Perceptual Test Using Quick Speech in Noise Test Material and Its Norms.

BACKGROUND: Two audiometric speech measures have been recognized to have associations with hearing aid use success: the Quick Speech in Noise (QuickSIN) test and the Performance-Perceptual Test (PPT). The PPT involves using the same speech test material (Hearing in Noise Test [HINT]) twice, to evaluate patients' objective and subjective speech recognition performance in noise and the discrepancy between the two measures (Performance-Perceptual Discrepancy [PPDIS]). Using the QuickSIN to conduct the PPT (revised-PPT) may provide clinicians two pieces of important information from one test to help predict hearing aid use success and the need for counseling. Moreover, we could achieve the desired clinical efficiency without purchasing additional test materials. PURPOSE: This study aimed (1) to evaluate the validity and reliability of using the QuickSIN speech material to administer the PPT and (2) to establish normative data across listeners with normal hearing (NH) and hearing loss (HL). RESEARCH DESIGN: This study used a repeated measures design. STUDY SAMPLE: Of the total 65 participants between 18 and 88 years of age, 20 (31%) had NH and 45 (69%) had sensorineural HL, ranging from mild to profound in both ears. Thirty-two of the 45 participants with HL were hearing aid users. DATA COLLECTION AND ANALYSIS: All participants completed the original PPT using HINT and the revised-PPT using QuickSIN, via sound field. Generalized linear mixed models were used to compare the performance, perceptual, and PPDIS data between the two test materials across all participants. Normative data for the revised-PPT were established from all participants. RESULTS: Significant main effects for both the test material and hearing status were found for the performance and perceptual data. All interactions were nonsignificant. There were no significant PPDIS differences between the original PPT and the revised-PPT. Normative values for the revised-PPT were established and comparable to the norms for the original PPT in the present study. The test-retest results suggested that the revised-PPT has good reliability. In addition, it appeared that there was a negative association between underestimation of hearing ability and hearing aid use success. CONCLUSIONS: It is concluded that the QuickSIN speech material can replace HINT to measure PPT. The revised-PPT may serve as a useful and efficient clinical tool in any clinics for hearing aid fitting and counseling.

Diverse Linguistic Development in Prelingually Deaf Children with Cochlear Implants.

The advent of cochlear implants has enormously improved the quality of sensory perception in deaf children. Notwithstanding these advantages, the current literature shows a substantial variability in language proficiency among implanted children. This case series explores the variability of language acquisition in congenitally deaf children with cochlear implants. We report 4 prelingually deaf children (mean age = 10.5; SD = 1.08), affected by a genetically determined bilateral deafness, due to GJB2 gene mutation Cx26. Each implanted child underwent a systematic assessment of speech perception and production, as well as of lexical, morphologic, and syntactic skills in both comprehension and production. Notwithstanding similar clinical histories and similarly good postimplant pure-tone audiometry, two of the four children fared very poorly in speech audiometry, whereas the other two children gained very good results. We suggest that the language impairment detected in (some) implanted children may not be fully accounted for by pure auditory thresholds and that may be the outcome of concomitant damage to core components of the child's linguistic brain.

Measuring open-set, word recognition in school-aged children: Corpus of monosyllabic target words and speech maskers.

A corpus of stimuli has been collected to support the use of common materials across research laboratories to examine school-aged children's word recognition in speech maskers. The corpus includes (1) 773 monosyllabic words that are known to be in the lexicon of 5- and 6-year-olds and (2) seven masker passages that are based on a first-grade child's writing samples. Materials were recorded by a total of 13 talkers (8 women; 5 men). All talkers recorded two masker passages; 3 talkers (2 women; 1 man) also recorded the target words. The annotated corpus is freely available online for research purposes.

Systematic Audiological Assessment of Auditory Functioning in Patients With Parkinson's Disease.

Purpose Alterations in primary auditory functioning have been reported in patients with Parkinson's disease (PD). Despite the current findings, the pathophysiological mechanisms underlying these alterations remain unclear, and the effect of dopaminergic medication on auditory functioning in PD has been explored insufficiently. Therefore, this study aimed to systematically investigate primary auditory functioning in patients with PD by using both subjective and objective audiological measurements. Method In this case-control study, 25 patients with PD and 25 age-, gender-, and education-matched healthy controls underwent an audiological test battery consisting of tonal audiometry, short increment sensitivity index, otoacoustic emissions (OAEs), and speech audiometry. Patients with PD were tested in the on- and off-medication states. Results Increased OAE amplitudes were found when patients with PD were tested without dopaminergic medication. In addition, speech audiometry in silence and multitalker babble noise demonstrated higher phoneme scores for patients with PD in the off-medication condition. The results showed no differences in auditory functioning between patients with PD in the on-medication condition and healthy controls. No effect of disease stage or motor score was evident. Conclusions This study provides evidence for a top-down involvement in auditory processing in PD at both central and peripheral levels. Most important, the increase in OAE amplitude in the off-medication condition in PD is hypothesized to be linked to a dysfunction of the olivocochlear efferent system, which is known to have an inhibitory effect on outer hair cell functioning. Future studies may clarify whether OAEs may facilitate an early diagnosis of PD.

'Normal' hearing thresholds and fundamental auditory grouping processes predict difficulties with speech-in-noise perception.

Understanding speech when background noise is present is a critical everyday task that varies widely among people. A key challenge is to understand why some people struggle with speech-in-noise perception, despite having clinically normal hearing. Here, we developed new figure-ground tests that require participants to extract a coherent tone pattern from a stochastic background of tones. These tests dissociated variability in speech-in-noise perception related to mechanisms for detecting static (same-frequency) patterns and those for tracking patterns that change frequency over time. In addition, elevated hearing thresholds that are widely considered to be 'normal' explained significant variance in speech-in-noise perception, independent of figure-ground perception. Overall, our results demonstrate that successful speech-in-noise perception is related to audiometric thresholds, fundamental grouping of static acoustic patterns, and tracking of acoustic sources that change in frequency. Crucially, speech-in-noise deficits are better assessed by measuring central (grouping) processes alongside audiometric thresholds.

Individual differences in the attentional modulation of the human auditory brainstem response to speech inform on speech-in-noise deficits.

People with normal hearing thresholds can nonetheless have difficulty with understanding speech in noisy backgrounds. The origins of such supra-threshold hearing deficits remain largely unclear. Previously we showed that the auditory brainstem response to running speech is modulated by selective attention, evidencing a subcortical mechanism that contributes to speech-in-noise comprehension. We observed, however, significant variation in the magnitude of the brainstem's attentional modulation between the different volunteers. Here we show that this variability relates to the ability of the subjects to understand speech in background noise. In particular, we assessed 43 young human volunteers with normal hearing thresholds for their speech-in-noise comprehension. We also recorded their auditory brainstem responses to running speech when selectively attending to one of two competing voices. To control for potential peripheral hearing deficits, and in particular for cochlear synaptopathy, we further assessed noise exposure, the temporal sensitivity threshold, the middle-ear muscle reflex, and the auditory-brainstem response to clicks in various levels of background noise. These tests did not show evidence for cochlear synaptopathy amongst the volunteers. Furthermore, we found that only the attentional modulation of the brainstem response to speech was significantly related to speech-in-noise comprehension. Our results therefore evidence an impact of top-down modulation of brainstem activity on the variability in speech-in-noise comprehension amongst the subjects.