Electrophysiological Measures of Listening-in-Noise With and Without Remote Microphone System Use in Autistic and Non-Autistic Youth.

OBJECTIVES: This study examined the neural mechanisms by which remote microphone (RM) systems might lead to improved behavioral performance on listening-in-noise tasks in autistic and non-autistic youth. DESIGN: Cortical auditory evoked potentials (CAEPs) were recorded in autistic (n = 25) and non-autistic (n = 22) youth who were matched at the group level on chronological age ( M = 14.21 ± 3.39 years) and biological sex. Potentials were recorded during an active syllable identification task completed in quiet and in multi-talker babble noise with and without the use of an RM system. The effects of noise and RM system use on speech-sound-evoked P1-N1-P2 responses and the associations between the cortical responses and behavioral performance on syllable identification were examined. RESULTS: No group differences were observed for behavioral or CAEP measures of speech processing in quiet or in noise. In the combined sample, syllable identification in noise was less accurate and slower than in the quiet condition. The addition of the RM system to the noise condition restored accuracy, but not the response speed, to the levels observed in quiet. The CAEP analyses noted amplitude reductions and latency delays in the noise compared with the quiet condition. The RM system use increased the N1 amplitude as well as reduced and delayed the P2 response relative to the quiet and noise conditions. Exploratory brain-behavior correlations revealed that larger N1 amplitudes in the RM condition were associated with greater behavioral accuracy of syllable identification. Reduced N1 amplitude and accelerated P2 response were associated with shorter syllable identification response times when listening with the RM system. CONCLUSIONS: Findings suggest that although listening-in-noise with an RM system might remain effortful, the improved signal to noise ratio facilitates attention to the sensory features of the stimuli and increases speech sound identification accuracy.

Rethinking household size and children's language environment.

The number of U.S. children living in households with extended families has greatly increased in the last 4 decades. This demographic shift calls for a reevaluation of the impact of household size on children's development. Household density (HHD), measured as the ratio of people to bedrooms in a home, has been shown to negatively relate to children's language. Here, we propose that while greater HHD may result in poorer language abilities, more adults in relation to the number of children in the home may have a positive impact on children's language. To test this hypothesis, we studied relations between HHD and adult-to-child ratio with children's vocabulary scores, as well as whether maternal education and household chaos accounted for these associations. Participants included families from a range of socioeconomic and ethnic backgrounds (N = 275; Mage = 10.85; 51% female; 51% Hispanic; annual income range less than $10,000-over $100,000). In general, higher HHD was related to lower child vocabulary scores. Conversely, higher adult-to-child ratio was related to higher child vocabulary and lower household chaos. These patterns were primarily driven by effects in Hispanic families. Our results suggest that a reevaluation of household size is needed, as more adults in the home can be protective for children's language development in larger families, an effect that may vary by culture. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cultural differences in auditory ecology.

Demographic differences in acoustic environments are usually studied using geographic area monitoring. This approach, however, may miss valuable information differentiating cultures. This motivated the current study, which used wearable sound recorders to measure noise levels and speech-to-noise ratios (SNRs) in the immediate acoustic environment of Latinx and European-American college students. Latinx experienced higher noise levels (64.8 dBC) and lower SNRs (3.7 dB) compared to European-Americans (noise levels, 63 dB; SNRs, 5.4 dB). This work provides a framework for a larger study on the impact of culture on auditory ecology.

Plasticity Changes in Central Auditory Systems of School-Age Children Following a Brief Training With a Remote Microphone System.

OBJECTIVES: The objective of this study was to investigate whether a brief speech-in-noise training with a remote microphone (RM) system (favorable listening condition) would contribute to enhanced post-training plasticity changes in the auditory system of school-age children. DESIGN: Before training, event-related potentials (ERPs) were recorded from 49 typically developing children, who actively identified two syllables in quiet and in noise (+5 dB signal-to-noise ratio [SNR]). During training, children completed the same syllable identification task as in the pre-training noise condition, but received feedback on their performance. Following random assignment, half of the sample used an RM system during training (experimental group), while the other half did not (control group). That is, during training' children in the experimental group listened to a more favorable speech signal (+15 dB SNR) than children from the control group (+5 dB SNR). ERPs were collected after training at +5 dB SNR to evaluate the effects of training with and without the RM system. Electrical neuroimaging analyses quantified the effects of training in each group on ERP global field power (GFP) and topography, indexing response strength and network changes, respectively. Behavioral speech-perception-in-noise skills of children were also evaluated and compared before and after training. We hypothesized that training with the RM system (experimental group) would lead to greater enhancement of GFP and greater topographical changes post-training than training without the RM system (control group). We also expected greater behavioral improvement on the speech-perception-in-noise task when training with than without the RM system. RESULTS: GFP was enhanced after training only in the experimental group. These effects were observed on early time-windows corresponding to traditional P1-N1 (100 to 200 msec) and P2-N2 (200 to 400 msec) ERP components. No training effects were observed on response topography. Finally, both groups increased their speech-perception-in-noise skills post-training. CONCLUSIONS: Enhanced GFP after training with the RM system indicates plasticity changes in the neural representation of sound resulting from listening to an enriched auditory signal. Further investigation of longer training or auditory experiences with favorable listening conditions is needed to determine if that results in long-term speech-perception-in-noise benefits.

Caregiver Experiences With Oral Bilingualism in Children Who Are Deaf and Hard of Hearing in the United States: Impact on Child Language Proficiency.

PURPOSE: Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency. METHOD: Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency. RESULTS: We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not. CONCLUSIONS: Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21644846.

Evidence for a Musician Speech-Perception-in-Noise Advantage in School-Age Children.

PURPOSE: The objective of this study was to evaluate whether child musicians are better at listening to speech in noise (SPIN) than nonmusicians of the same age. In addition, we aimed to explore whether the musician SPIN advantage in children was related to general intelligence (IQ). METHOD: Fifty-one children aged 8.2-11.8 years and with different levels of music training participated in the study. A between-group design and correlational analyses were used to determine differences in SPIN skills as they relate to music training. IQ was used as a covariate to explore the relationship between intelligence and SPIN ability. RESULTS: More years of music training were associated with better SPIN skills than fewer years of music training. Furthermore, this difference in SPIN skills remained even when accounting for IQ. These results were found at the group level and also when years of instrument training was treated as a continuous variable (i.e., correlational analyses). CONCLUSIONS: We confirmed results from previous studies in which child musicians outperformed nonmusicians in SPIN skills. We also showed that this effect was not related to differences in IQ between the musicians and nonmusicians for this cohort of children. However, confirmation of this finding with a cohort of children from more diverse socioeconomic statuses and cognitive profiles is warranted.

Central auditory system responses from children while listening to speech in noise.

Cortical auditory evoked potentials (CAEPs) have been successfully used to explore the effects of noise on speech processing at the cortical level in adults and children. The purpose of this study was to determine whether +15 dB signal-to-noise ratios (SNRs), often recommended for optimal speech perception in children, elicit higher amplitude CAEPs than more realistic SNRs encountered by children during their daily lives (+10 dB SNR). Moreover, we aimed to investigate whether cortical speech categorization is observable in children in quiet and in noise and whether CAEPs to speech in noise are related to behavioral speech perception in noise performance in children. CAEPs were measured during a passive speech-syllable task in 51 normal hearing children aged 8 to 11 years. The speech syllables /da/ and /ga/ were presented in quiet and in the presence of a 4-talker-babble noise at +15 dB and +10 dB SNR. N1 latencies and P2 amplitudes and latencies varied as a function of SNR, with poorer SNRs (+10 dB) eliciting significantly smaller P2 amplitudes and delayed N1 and P2 latencies relative to the higher SNR (+15 dB). Finally, speech categorization was present at the cortical level in this group of children in quiet and at both SNRs; however, N1 and P2 amplitudes and latencies were not related to behavioral speech-in-noise perception of children.

The Challenge of Listening at Home: Speech and Noise Levels in Homes of Young Children With Hearing Loss.

OBJECTIVES: The objective of this study was to characterize the acoustics of the home environment of young children with hearing loss. Specifically, we aimed to quantify the range of speech levels, noise levels, and signal-to-noise ratios (SNRs) encountered by children with hearing loss in their homes. DESIGN: Nine families participated in the study. The children with hearing loss in these families were between 2 and 5 years of age. Acoustic recordings were made in the children's homes over one weekend (Saturday and Sunday) using Language ENvironmental Analysis (LENA) recorders. These recordings were analyzed using LENA's proprietary software to determine the range of speech and noise levels in the child's home. A custom Matlab program analyzed the LENA output to estimate the SNRs in the children's homes. RESULTS: The average SNR encountered by children with hearing loss in our sample was approximately +7.9 dB SNR. It is important to note that our analyses revealed that approximately 84% of the SNRs experienced by these children with hearing loss were below the +15 dB SNR recommended by the American Speech-Language Hearing Association. Averaged across families, speech and noise levels were 70.1 and 62.2 C-weighted decibels, respectively. CONCLUSIONS: These data show that, for much of the time, young children with hearing loss are forced to listen under suboptimal conditions in their home environments. This has important implications as listening under these conditions could negatively affect learning opportunities for young children with hearing loss. To mitigate these potential negative effects, the use of assistive listening devices that improve the SNR (e.g., remote microphone systems) should be considered for use at home by young children with hearing loss.

Remote Microphone System Use in the Homes of Children With Hearing Loss: Impact on Caregiver Communication and Child Vocalizations.

Purpose This study examined the impact of home use of remote microphone systems (RMSs) on caregiver communication and child vocalizations in families of children with hearing loss. Method We drew on data from a prior study in which Language ENvironmental Analysis recorders were used with 9 families during 2 consecutive weekends-1 that involved using an RMS and 1 that did not. Audio samples from Language ENvironmental Analysis recorders were (a) manually coded to quantify the frequency of verbal repetitions and alert phrases caregivers utilized in communicating to children with hearing loss and (b) automatically analyzed to quantify children's vocalization rate, duration, complexity, and reciprocity when using and not using an RMS. Results When using an RMS at home, caregivers did not repeat or clarify their statements as often as when not using an RMS while communicating with their children with hearing loss. However, no between-condition differences were observed in children's vocal characteristics. Conclusions Results provide further support for home RMS use for children with hearing loss. Specifically, findings lend empirical support to prior parental reports suggesting that RMS use eases caregiver communication in the home setting. Studies exploring RMS use over a longer duration of time might provide further insight into potential long-term effects on children's vocal production.

Remote Microphone System Use at Home: Impact on Child-Directed Speech.

Purpose The impact of home use of a remote microphone system (RMS) on the caregiver production of, and child access to, child-directed speech (CDS) in families with a young child with hearing loss was investigated. Method We drew upon extant data that were collected via Language ENvironment Analysis (LENA) recorders used with 9 families during 2 consecutive weekends (RMS weekend and no-RMS weekend). Audio recordings of primary caregivers and their children with hearing loss obtained while wearing and not wearing an RMS were manually coded to estimate the amount of CDS produced. The proportion of CDS that was likely accessible to children with hearing loss under both conditions was determined. Results Caregivers produced the same amount of CDS when using and when not using the RMS. However, it was concluded that children with hearing loss, on average, could potentially access 12% more CDS if caregivers used an RMS because of their distance from their children when talking to them. Conclusion Given our understanding of typical child language development, findings from this investigation suggest that children with hearing loss could receive auditory, speech, and language benefits from the use of an RMS in the home environment.

Bilingual Versus Monolingual Vocabulary Instruction for Bilingual Children with Hearing Loss.

Effective vocabulary interventions for children with hearing loss, including children who are bilingual, are needed because of persistent vocabulary deficits in this population. Current instructional practices for children with hearing loss who are bilingual vary in the degree to which they incorporate the language the child uses at home. Unfortunately, there is little direct evidence as to whether bilingual or monolingual instructional practices yield greater benefits for these children. Three Spanish-English-speaking children participated in this single case adapted alternating treatments design study that evaluated the effectiveness and efficiency of bilingual and monolingual teaching procedures for an expressive vocabulary intervention. Contrary to predictions from a monolingual instruction perspective, no evidence of an inhibitory effect of bilingual instruction on English performance was identified. Participants exhibited gains in Spanish for words in the bilingual condition only. Findings suggest more efficient word learning in the bilingual condition as measured by conceptual vocabulary.

Remote Microphone System Use at Home: Impact on Caregiver Talk.

Purpose: The purpose of this study was to investigate the effects of home use of a remote microphone system (RMS) on the spoken language production of caregivers with young children who have hearing loss. Method: Language Environment Analysis recorders were used with 10 families during 2 consecutive weekends (RMS weekend and No-RMS weekend). The amount of talk from a single caregiver that could be made accessible to children with hearing loss when using an RMS was estimated using Language Environment Analysis software. The total amount of caregiver talk (close and far talk) was also compared across both weekends. In addition, caregivers' perceptions of RMS use were gathered. Results: Children, with the use of RMSs, could potentially have access to approximately 42% more words per day. In addition, although caregivers produced an equivalent number of words on both weekends, they tended to talk more from a distance when using the RMS than when not. Finally, caregivers reported positive perceived communication benefits of RMS use. Conclusions: Findings from this investigation suggest that children with hearing loss have increased access to caregiver talk when using an RMS in the home environment. Clinical implications and future directions for research are discussed.