Effects of hearing protector devices on speech intelligibility: the importance of individualized assessment.

Objectives. This study aimed to compare speech intelligibility in noise with and without hearing protection devices (HPDs). Methods. Fifty-one workers were distributed into three groups: noise-induced hearing loss group (NIHLG), normally hearing noise-exposed group (NG) and normally hearing non-exposed to noise group (CG). A free field system was used to emit monosyllables (65, 70 and 75 dB) and pink noise in different signal-to-noise ratios (SNRs) (0, -5, -10 and -15). Results. In situations with HPDs, all groups showed a decrease in the percentage of correct responses with an increase in noise level. The HPD had little effect on speech intelligibility in the NIHLG and NG. Considering the effect caused by the HPD on speech intelligibility, it was observed that the group with the greatest loss was the CG for SNRs of -5, -10 and -15. Conclusion. Although speech intelligibility is influenced by the hearing threshold, the noise level and SNR are crucial for good speech intelligibility, either with or without an HPD. It is highlighted that the NG had worse results when compared with the CG, which may indicate changes in the auditory pathway resulting from continuous noise exposure, even in the absence of changes in the audiometric thresholds.

Testes de fala no ruído na clínica audiológica - Uma Revisão Integrativa / Noise speech tests in the audiological clinic - An Integrative Review

Introdução: A audiometria convencional não é suficientemente confiável para prever a compreensão de uma pessoa num ambiente ruidoso e, desta forma, inserir testes de fala no ruído na rotina clínica audiológica pode ser uma ferramenta útil para detectar possíveis problemas da função auditiva central. Objetivo: Realizar uma revisão integrativa da literatura sobre testes de fala no ruído disponíveis para uso na clínica audiológica. Método: Busca de publicações sem delimitação temporal nos bancos de dados Lilacs, PubMed, Medline, IBCS e SciELO, utilizando-se como descritores: teste de fala no ruído, percepção auditiva, testes de discriminação auditiva, distúrbios auditivos, padronização, desenvolvimento, validação, testes do limiar de recepção da fala, percepção auditiva e perda auditiva. Não houve exclusão por período de publicação. Os artigos foram pesquisados nos meses de junho e julho de 2017. Resultados: Foram localizados um total de 1200 artigos e 39 foram inseridos nesta revisão integrativa por satisfazerem os critérios de inclusão. Nos artigos selecionados, foram localizados 25 materiais diferentes que utilizaram para avaliação de fala no ruído: sílabas, palavras, sentenças, dígitos e associação de palavras e tonalidade e palavras e sentenças. Os tipos de ruídos empregados foram: espectro de fala, ruído tipo babble, ruído branco e ruído estacionário e tais materiais foram desenvolvidos para uso em adultos e/ou crianças e sujeitos com e/ou sem perda auditiva. Conclusão: Todos os autores relataram a importância de inserir testes de fala no ruído na rotina clínica, já que só a audiometria convencional não prevê a compreensão de fala em ambiente ruidoso.

Introduction: Conventional audiometry is not reliable enough to predict a person's understanding in a noisy environment, so inserting speech noise tests into the audiological clinical routine can be a useful tool for detecting possible central auditory function problems. Objective: To conduct an integrative literature review on noise speech tests available for use in the audiological clinic. Method: Search for publications without temporal delimitation in the Lilacs, PubMed, Medline, IBCS and SciELO databases, using the following keywords: Noise speech test, auditory perception, auditory discrimination tests, hearing disorders, standardization, development, validation, speech reception threshold tests, hearing perception and hearing loss. There was no exclusion by publication period. The articles were searched in June and July 2017. Results: A total of 1200 articles were found and 39 were included in this integrative review because they met the inclusion criteria. In the selected articles, 25 different materials were used to evaluate speech in noise: syllables, words, sentences, digits and association of words and tone and words and sentences. The types of noise used were: speech spectrum, babble noise, white noise and stationary noise and these materials were developed for use in adults and / or children and subjects with and / or without hearing loss. Conclusion: All authors reported the importance of inserting speech tests in noise into the clinical routine, since only conventional audiometry does not predict speech comprehension in noisy environment.

Introducción: La audiometría convencional no es confiable para predecir la comprensión de una persona en entorno ruidoso, por lo que insertar pruebas de ruido del habla en la rutina audiológica puede ser una herramienta útil para detectar posibles problemas de la función auditiva central. Objetivo: realizar una revisión integral de literatura sobre las pruebas de ruido en el habla disponibles para su uso en la clínica audiológica. Método: Búsqueda de publicaciones sin delimitación temporal en las bases de datos Lilacs, PubMed, Medline, IBCS y SciELO, utilizando las palabras clave: prueba de ruido, percepción auditiva, pruebas de discriminación auditiva, trastornos auditivos, estandarización, desarrollo, validación , pruebas de umbral de recepción del habla, percepción auditiva y pérdida auditiva. No hubo exclusión por período de publicación. Se buscaron los artículos en junio y julio de 2017. Resultados: se encontraron un total de 1200 artículos y se incluyeron 39 en esta revisión porque cumplían con los criterios de inclusión. En los artículos seleccionados, se utilizaron 25 materiales diferentes para evaluar el habla en ruido: sílabas, palabras, oraciones, dígitos y asociación de palabras y tonos y oraciones. Tipos de ruido utilizados: espectro del habla, ruido de balbuceo, ruido blanco y ruido estacionario, y estos materiales se desarrollaron para su uso en adultos y/o niños y sujetos con y/o sin pérdida auditiva. Conclusión: Todos los autores informaron la importancia de insertar pruebas de habla en ruido en la rutina clínica, ya que solo la audiometría convencional no predice la comprensión del habla en entornos ruidosos.

Auditory processing self-report: How do normal-hearing individuals perceive themselves? / Autorreporte del procesamiento auditivo: ¿Cómo se perciben los individuos normoacúsicos?

Background: Hearing results from processes of modulation of the acoustic signal performed by the auditory pathway and cortical activity. Sound detection, location, discrimination, intelligibility in noise and silence require integrity of the auditory system. Objective: To recognize the auditory variability in competent users and examine the relationship of auditory processing abilities with peripheral sensitivity. Methods: 97 normal-hearing participants with comprehensive listening in a second language and/or music were studied with the Spanish version of the Amsterdam Inventory for Auditory Disability and Handicap (S-AIADH), audiometry and impedanciometry. Correlations between S-AIADH scores and audiometric tonal and acoustic thresholds were calculated. Results: Scores in sound distinction, intelligibility in noise and location showed the greatest dispersion. Auditory processing abilities did not correlate significantly with acoustic thresholds and reflexes, except for the intelligibility in noise that was positively associated with the tonal threshold at frequencies 500 and 1000 Hz in both ears. Conclusion: These results indicate a paradox, which reinforces the differentiation between hearing and listening. For a comprehensive approach, the study of hearing requires addressing both peripheral and central auditory processing, where the use of self-report instruments is important.

Introducción: la audición resulta de procesos de modulación de la señal acústica que realiza la vía auditiva y la actividad cortical. La detección de los sonidos, localización, discriminación, inteligibilidad del habla en ruido y en silencio requieren de la integridad funcional del sistema auditivo. Objetivo: reconocer la variabilidad auditiva en usuarios competentes y examinar la relación de las habilidades del procesamiento auditivo con la sensibilidad periférica. Métodos: un total de 97 participantes normoacúsicos con antecedentes de escucha comprensiva en una segunda lengua y/o música fueron valorados con el Inventario de Ámsterdam para la Discapacidad y Rendimiento Auditivo versión español (S-AIADH), audiometría e impedanciometría. Se calcularon las correlaciones entre los puntajes del S-AIADH y los umbrales tonales audiométricos y del reflejo estapedial. Resultados: los subtotales intratest con mayor dispersión pertenecen a la distinción de sonidos, inteligibilidad en ruido y localización. Las habilidades del procesamiento auditivo no se correlacionaron significativamente con los umbrales de detección de sonido y los reflejos estapediales, a excepción de la inteligibilidad en ruido que se asoció positivamente con el umbral tonal en las frecuencias 500 y 1000 Hz en ambos oídos. Conclusión: Estos resultados indican una paradoja, lo cual refuerza la diferenciación entre oír y escuchar. Para un abordaje integral, el estudio de la audición requiere de abordar tanto el procesamiento auditivo periférico como el central, donde el uso de instrumentos de autorreporte es de gran importancia.

Performance of children with speech sound disorders in the dynamic evaluation of motor speech skills. / Desempenho de crianças com distúrbios dos sons da fala no instrumento "Avaliação dinâmica das habilidades motoras da fala".

Purpose To compare performance between children with typical speech acquisition, phonological disorders, and childhood apraxia of speech for the variables overall articulatory accuracy and consistency of the Dynamic Evaluation of Motor Speech Skill - Brazilian Portuguese version (DEMSS-BR). Methods Study participants were 18 children of both genders aged 4 years and 6 months to 5 years and 8 months. The sample was divided into three groups: six children with typical speech acquisition (TSA), six children with phonological disorder (PD), and six individuals with childhood apraxia of speech (CAS). All participants were submitted to the DEMSS-BR and had their subscores of speech accuracy and consistency measured. Performance comparison between the groups was statistically evaluated using the Mann-Whitney U Test. Results Participants in the group with CAS presented poorer performance for the variables overall articulatory accuracy and consistency compared with those of participants in the other two groups. Conclusion The group of children with childhood apraxia of speech presented poorer performance on the DEMSS-BR compared with those of the groups with typical speech acquisition and phonological disorders. The study demonstrated that the DEMSS-BR assists with differential diagnosis of children with speech sound disorders.

Desempenho de crianças com distúrbios dos sons da fala no instrumento "Avaliação dinâmica das habilidades motoras da fala" / Performance of children with speech sound disorders in the dynamic evaluation of motor speech skills

RESUMO Objetivo Comparar o desempenho das crianças com aquisição de fala típica, desvio fonológico e com apraxia de fala na infância nas variáveis precisão de produção e consistência do instrumento "Avaliação dinâmica das habilidades motoras da fala" (DEMSS-BR). Método A amostra foi constituída por 18 crianças com idades entre 4 anos e 6 meses a 5 anos e 8 meses, de ambos os gêneros, divididas em três grupos: seis com aquisição típica de fala, seis com desvio fonológico e seis com apraxia de fala na infância. Todas foram avaliadas por meio do instrumento DEMSS-BR, e o desempenho foi observado a partir da análise das variáveis de precisão da produção e consistência da fala. Para comparação do desempenho entre grupos utilizou-se o teste U de Mann-Whitney. Resultados O grupo com apraxia de fala na infância apresentou desempenho inferior nas variáveis de precisão da produção e consistência da fala quando comparado aos demais grupos. Conclusão O grupo com apraxia de fala na infância apresentou pior desempenho no DEMSS-BR quando comparado aos de crianças típicas e com desvio fonológico. Desta forma, foi possível constatar que o DEMSS-BR auxilia no diagnóstico diferencial de crianças com distúrbios dos sons da fala.

ABSTRACT Purpose To compare performance between children with typical speech acquisition, phonological disorders, and childhood apraxia of speech for the variables overall articulatory accuracy and consistency of the Dynamic Evaluation of Motor Speech Skill - Brazilian Portuguese version (DEMSS-BR). Methods Study participants were 18 children of both genders aged 4 years and 6 months to 5 years and 8 months. The sample was divided into three groups: six children with typical speech acquisition (TSA), six children with phonological disorder (PD), and six individuals with childhood apraxia of speech (CAS). All participants were submitted to the DEMSS-BR and had their subscores of speech accuracy and consistency measured. Performance comparison between the groups was statistically evaluated using the Mann-Whitney U Test. Results Participants in the group with CAS presented poorer performance for the variables overall articulatory accuracy and consistency compared with those of participants in the other two groups. Conclusion The group of children with childhood apraxia of speech presented poorer performance on the DEMSS-BR compared with those of the groups with typical speech acquisition and phonological disorders. The study demonstrated that the DEMSS-BR assists with differential diagnosis of children with speech sound disorders.

Study on the application of the time-compressed speech in children. / Estudo do teste de fala comprimida em crianças.

PURPOSE: To analyze the performance of children without alteration of central auditory processing in the Time-compressed Speech Test. METHODS: This is a descriptive, observational, cross-sectional study. Study participants were 22 children aged 7-11 years without central auditory processing disorders. The following instruments were used to assess whether these children presented central auditory processing disorders: Scale of Auditory Behaviors, simplified evaluation of central auditory processing, and Dichotic Test of Digits (binaural integration stage). The Time-compressed Speech Test was applied to the children without auditory changes. RESULTS: The participants presented better performance in the list of monosyllabic words than in the list of disyllabic words, but with no statistically significant difference. No influence on test performance was observed with respect to order of presentation of the lists and the variables gender and ear. Regarding age, difference in performance was observed only in the list of disyllabic words. CONCLUSION: The mean score of children in the Time-compressed Speech Test was lower than that of adults reported in the national literature. Difference in test performance was observed only with respect to the age variable for the list of disyllabic words. No difference was observed in the order of presentation of the lists or in the type of stimulus.

OBJETIVO: Analisar o desempenho das crianças sem alteração do processamento auditivo central no teste de fala comprimida. MÉTODO: Trata-se de um estudo do tipo descritivo, observacional, transversal. Participaram do estudo 22 crianças com idade entre 7 e 11 anos, normo-ouvintes, sem transtorno do processamento auditivo central. Para descartar esse transtorno, foram aplicados o questionário Scale of Auditory Behaviors, a avaliação simplificada do processamento auditivo e o teste dicótico de dígitos na etapa de integração binaural. Nas crianças sem alteração, foi aplicado o teste de fala comprimida. RESULTADOS: Os indivíduos apresentaram melhor desempenho na lista de monossílabos do que na de dissílabos, apesar de não haver diferença significativa. Não houve influência da ordem de apresentação das listas, das variáveis gênero e orelha no desempenho do teste. Em relação à idade, apenas na lista de dissílabos houve diferença no desempenho. CONCLUSÃO: Foi possível concluir que a média de acertos das crianças no Teste de Fala Comprimida foi inferior aos achados na literatura nacional em adultos. Houve diferença no desempenho do Teste de Fala Comprimida com a idade apenas na lista de dissílabos. Não houve diferença quanto à ordem de apresentação das listas de aplicação nem em relação ao tipo de estímulo.

La inteligibilidad vocal en las personas con laringectomía que se comunican con erigmofonía / The vocal intelligibilityin people withlaryngectomythat communicate with erygmophony

Las personas a las que se le ha realizado una laringectomía total y extirpado completamente su laringe ven alteradas en grado variable las funciones propias de ese órgano: esfinteriana, respiratoria y vocal. Respecto a esta última y su producto final: la voz, la pérdida es completa, por lo que es necesario rehabilitar dicha función para que la persona pueda comunicarse. El objetivo de este trabajo es valorar la inteligibilidad vocal de las personas laringectomizadas que hayan sido rehabilitadas con erigmofonía. Material y métodos: diseño prospectivo en 17 personas laringectomizadas que utilizan la voz erigmofónica para comunicarse. Se estudiaron con el VHI-30, espectrograma de banda estrecha, evaluación perceptual (GRABS y CAPE-V) y, de forma novedosa, valorando la inteligibilidad vocal a través de la lectura y reconocimiento de palabras bisílabas. Resultados: el VHI-30 muestra que las personas laringectomizadas perciben su voz como una limitación leve y moderada. El espectrograma presenta diferencias sustanciales entre la voz erigmofónica y la voz laríngea fisiológica. La evaluación perceptual indica una afectación moderada/severa en GRABS y media/grave en CAPE-V. En la inteligibilidad verbal predominan los valores medios-bajos (88 por ciento), pero hay pacientes con valores altos (12 por ciento). No se han encontrado relaciones estadísticamente significativas entre el VHI-30, la evaluación perceptual y la inteligibilidad verbal. Conclusiones: la valoración de la inteligibilidad de la voz erigmofónica proporciona al rehabilitador datos útiles y de fácil adquisición sobre la capacidad comunicativa de las personas con laringectomía total, que permiten complementar otros procedimientos de valoración objetiva (espectrograma) y subjetiva (VHI-30, GRABS y CAPE-V)

People who have had a total laryngectomy and have completely extirpated their larynx have, in a variable degree, altered the functions of this organ: sphincter, respiratory, and vocal. Regarding the latter and its final product: the voice, the loss is complete, so it is necessary to rehabilitate this function so that the person can communicate. The aim of this work is to evaluate the vocal intelligibility of laryngectomized individuals who have been rehabilitated with erygmophony. Material and method: prospective design in 17 laryngectomized individuals that use the erygmophonic voice to communicate. They were studied with VHI-30, narrow band spectrogram, perceptual evaluation (GRABS and CAPE-V) and, in a novel way, assessing the vocal intelligibility through the reading and recognition of bisyllabic words. Results: VHI-30 shows that laryngectomized individuals perceive their voice as a mild and moderate limitation. The spectrogram shows substantial differences between the erygmophonic voice and the laryngeal physiological voice. Perceptual evaluation indicates moderate/severe affectation in GRABS and medium/severe involvement in CAPE-V. In the verbal intelligibility, the medium-low values (88 percent) are predominant, but there are patients with high values (12 percent). No statistically significant relationships were found between VHI-30, perceptual evaluation, and verbal intelligibility. Conclusions: the evaluation of the intelligibility of the erygmophonic voice provides the rehabilitator with useful and easy-to-read data on the communicative capacity of persons with total laryngectomy, complementing other objective (spectrogram) and subjective assessment procedures (VHI-30, GRABS and CAPE-V)

Time-compressed speech test in the elderly. / Teste de fala comprimida em idosos.

PURPOSE: The present study aimed to evaluate the performance of elderly people in the time-compressed speech test according to the variables ears and order of display, and analyze the types of errors presented by the volunteers. METHODS: This is an observational, descriptive, quantitative, analytical and primary cross-sectional study involving 22 elderly with normal hearing or mild sensorineural hearing loss between the ages of 60 and 80. The elderly were submitted to the time-compressed speech test with compression ratio of 60%, through the electromechanical time compression method. A list of 50 disyllables was applied to each ear and the initial side was chosen at random. RESULTS: On what concerns to the performance in the test, the elderly fell short in relation to the adults and there was no statistical difference between the ears. It was found statistical evidence of better performance for the second ear in the test. The most mistaken words were the ones initiated with the phonemes /p/ and /d/. The presence of consonant combination in a word also increased the occurrence of mistakes. CONCLUSION: The elderly have worse performance in the auditory closure ability when assessed by the time-compressed speech test compared to adults. This result suggests that elderly people have difficulty in recognizing speech when this is pronounced in faster rates. Therefore, strategies must be used to facilitate the communicative process, regardless the presence of hearing loss.

OBJETIVO: Avaliar o desempenho de idosos no teste de fala comprimida segundo as variáveis orelha, ordem de apresentação e idade, além de analisar a ocorrência de erros. MÉTODO: O estudo é caracterizado como observacional, descritivo, quantitativo, analítico e do tipo transversal primário, o qual envolveu 22 idosos entre 60 e 80 anos de idade, portadores de audição normal ou com perda neurossensorial de grau leve. Os idosos foram submetidos à aplicação do teste de fala comprimida apenas com dissílabos e com taxa de compressão de 60%, por meio do método de compressão de tempo eletromecânico. Em cada orelha, foi aplicada uma lista de 50 dissílabos, sendo a ordem de início de teste aleatória. RESULTADOS: Quanto ao desempenho no teste, verificou-se que não houve diferença estatística entre as orelhas e os idosos apresentaram resultados aquém do encontrado na população adulta. Encontrou-se significância estatística de melhor desempenho para a segunda orelha de início de teste. A maior ocorrência de erros se deu para as palavras que iniciaram com os fonemas /p/ e /d/. A presença de encontro consonantal na palavra também aumentou a ocorrência de erros. CONCLUSÃO: Os idosos apresentam pior desempenho na habilidade de fechamento auditivo, quando avaliados por meio do teste de fala comprimida, em comparação aos indivíduos adultos. Este resultado sugere que os idosos têm dificuldades para reconhecer a fala quando esta lhe é apresentada numa velocidade aumentada. Sendo assim, estratégias devem ser utilizadas para facilitar o processo comunicativo, independentemente da presença de uma perda auditiva.

Estudo do teste de fala comprimida em crianças / Study on the application of the time-compressed speech in children

RESUMO Objetivo Analisar o desempenho das crianças sem alteração do processamento auditivo central no teste de fala comprimida. Método Trata-se de um estudo do tipo descritivo, observacional, transversal. Participaram do estudo 22 crianças com idade entre 7 e 11 anos, normo-ouvintes, sem transtorno do processamento auditivo central. Para descartar esse transtorno, foram aplicados o questionário Scale of Auditory Behaviors, a avaliação simplificada do processamento auditivo e o teste dicótico de dígitos na etapa de integração binaural. Nas crianças sem alteração, foi aplicado o teste de fala comprimida. Resultados Os indivíduos apresentaram melhor desempenho na lista de monossílabos do que na de dissílabos, apesar de não haver diferença significativa. Não houve influência da ordem de apresentação das listas, das variáveis gênero e orelha no desempenho do teste. Em relação à idade, apenas na lista de dissílabos houve diferença no desempenho. Conclusão Foi possível concluir que a média de acertos das crianças no Teste de Fala Comprimida foi inferior aos achados na literatura nacional em adultos. Houve diferença no desempenho do Teste de Fala Comprimida com a idade apenas na lista de dissílabos. Não houve diferença quanto à ordem de apresentação das listas de aplicação nem em relação ao tipo de estímulo.

ABSTRACT Purpose To analyze the performance of children without alteration of central auditory processing in the Time-compressed Speech Test. Methods This is a descriptive, observational, cross-sectional study. Study participants were 22 children aged 7-11 years without central auditory processing disorders. The following instruments were used to assess whether these children presented central auditory processing disorders: Scale of Auditory Behaviors, simplified evaluation of central auditory processing, and Dichotic Test of Digits (binaural integration stage). The Time-compressed Speech Test was applied to the children without auditory changes. Results The participants presented better performance in the list of monosyllabic words than in the list of disyllabic words, but with no statistically significant difference. No influence on test performance was observed with respect to order of presentation of the lists and the variables gender and ear. Regarding age, difference in performance was observed only in the list of disyllabic words. Conclusion The mean score of children in the Time-compressed Speech Test was lower than that of adults reported in the national literature. Difference in test performance was observed only with respect to the age variable for the list of disyllabic words. No difference was observed in the order of presentation of the lists or in the type of stimulus.

Teste de fala comprimida em idosos / Time-compressed speech test in the elderly

RESUMO Objetivo Avaliar o desempenho de idosos no teste de fala comprimida segundo as variáveis orelha, ordem de apresentação e idade, além de analisar a ocorrência de erros. Método O estudo é caracterizado como observacional, descritivo, quantitativo, analítico e do tipo transversal primário, o qual envolveu 22 idosos entre 60 e 80 anos de idade, portadores de audição normal ou com perda neurossensorial de grau leve. Os idosos foram submetidos à aplicação do teste de fala comprimida apenas com dissílabos e com taxa de compressão de 60%, por meio do método de compressão de tempo eletromecânico. Em cada orelha, foi aplicada uma lista de 50 dissílabos, sendo a ordem de início de teste aleatória. Resultados Quanto ao desempenho no teste, verificou-se que não houve diferença estatística entre as orelhas e os idosos apresentaram resultados aquém do encontrado na população adulta. Encontrou-se significância estatística de melhor desempenho para a segunda orelha de início de teste. A maior ocorrência de erros se deu para as palavras que iniciaram com os fonemas /p/ e /d/. A presença de encontro consonantal na palavra também aumentou a ocorrência de erros. Conclusão Os idosos apresentam pior desempenho na habilidade de fechamento auditivo, quando avaliados por meio do teste de fala comprimida, em comparação aos indivíduos adultos. Este resultado sugere que os idosos têm dificuldades para reconhecer a fala quando esta lhe é apresentada numa velocidade aumentada. Sendo assim, estratégias devem ser utilizadas para facilitar o processo comunicativo, independentemente da presença de uma perda auditiva.

ABSTRACT Purpose The present study aimed to evaluate the performance of elderly people in the time-compressed speech test according to the variables ears and order of display, and analyze the types of errors presented by the volunteers. Methods This is an observational, descriptive, quantitative, analytical and primary cross-sectional study involving 22 elderly with normal hearing or mild sensorineural hearing loss between the ages of 60 and 80. The elderly were submitted to the time-compressed speech test with compression ratio of 60%, through the electromechanical time compression method. A list of 50 disyllables was applied to each ear and the initial side was chosen at random. Results On what concerns to the performance in the test, the elderly fell short in relation to the adults and there was no statistical difference between the ears. It was found statistical evidence of better performance for the second ear in the test. The most mistaken words were the ones initiated with the phonemes /p/ and /d/. The presence of consonant combination in a word also increased the occurrence of mistakes. Conclusion The elderly have worse performance in the auditory closure ability when assessed by the time-compressed speech test compared to adults. This result suggests that elderly people have difficulty in recognizing speech when this is pronounced in faster rates. Therefore, strategies must be used to facilitate the communicative process, regardless the presence of hearing loss.

Hearing loss classification by degree, configuration and relationship with amplified Speech Intelligibility Index (SII). / Classificação de perdas auditivas por grau e configuração e relações com Índice de Inteligibilidade de Fala (SII) amplificado.

PURPOSE: To establish the relationship between speech intelligibility index (SII) values generated at the verification of hearing aids programmed according to DSLm [i/o] v5 prescription rule and a proposed individual classification that considers the combination of hearing loss degree and configuration. METHODS: Forty-one children aged between 4 and 80 months were selected, totaling 78 ears for analysis. We considered hearing thresholds at the frequencies of 250, 500, 1000, 2000 and 4000 Hz; and analyzed values of the Speech Intelligibility Index (SII) for the input signal of 65 dB SPL obtained during the verification of hearing aids using the equipment Verifit®Audioscan. RESULTS: Hearing losses were classified into five homogeneous groups regarding audiometric degree and configuration. The groups were heterogeneous when compared to each other. From the groups, three ranges of SII values were determined. Equations were developed for classification of hearing loss according to groups and for determination of the adjusted SII values. CONCLUSION: The SII value is a useful indicator of audibility for speech sounds in different characteristics of hearing losses, and can guide observations of auditory skills. The SII has stronger relationship with the association of the audiometric degree and configuration when compared with degree of hearing loss alone.

Classificação de perdas auditivas por grau e configuração e relações com Índice de Inteligibilidade de Fala (SII) amplificado / Hearing loss classification by degree, configuration and relationship with amplified Speech Intelligibility Index (SII)

RESUMO Objetivo estabelecer relações entre valores do índice de inteligibilidade de fala - SII gerados na verificação dos aparelhos de amplificação sonora programados conforme regra prescritiva DSLm[i/o]v5 e uma proposta de classificação de indivíduos que considere a associação de grau e configuração de perdas auditivas. Método foram selecionadas 41 crianças com idades entre 4 e 80 meses, totalizando 78 orelhas para análise. Foram considerados os limiares auditivos nas frequências 250, 500, 1000, 2000 e 4000 Hz e analisados valores de SII para os sinais de entrada 65 dB NPS, obtidos na verificação dos AASI no equipamento Verifit®Audioscan. Resultados as perdas auditivas foram classificadas em cinco grupos homogêneos quanto às características audiológicas (grau e configuração audiométrica) e heterogêneos entre si. A partir dos grupos, determinaram-se três intervalos de valores de SII. Foram determinadas equações para classificação da perda auditiva conforme grupos e equações para determinação de valores de SII ajustado. Conclusão o valor de SII pode ser considerado um indicador da audibilidade para sons de fala para diferentes características de perdas auditivas e nortear avalições de comportamento auditivo. O SII tem relação mais forte com a associação das variáveis grau e configuração audiométrica, quando comparado com sua relação com o grau da perda auditiva isoladamente.

ABSTRACT Purpose To establish the relationship between speech intelligibility index (SII) values generated at the verification of hearing aids programmed according to DSLm [i/o] v5 prescription rule and a proposed individual classification that considers the combination of hearing loss degree and configuration. Methods Forty-one children aged between 4 and 80 months were selected, totaling 78 ears for analysis. We considered hearing thresholds at the frequencies of 250, 500, 1000, 2000 and 4000 Hz; and analyzed values of the Speech Intelligibility Index (SII) for the input signal of 65 dB SPL obtained during the verification of hearing aids using the equipment Verifit®Audioscan. Results Hearing losses were classified into five homogeneous groups regarding audiometric degree and configuration. The groups were heterogeneous when compared to each other. From the groups, three ranges of SII values were determined. Equations were developed for classification of hearing loss according to groups and for determination of the adjusted SII values. Conclusion The SII value is a useful indicator of audibility for speech sounds in different characteristics of hearing losses, and can guide observations of auditory skills. The SII has stronger relationship with the association of the audiometric degree and configuration when compared with degree of hearing loss alone.

Behavioral and electrophysiological auditory processing measures in traumatic brain injury after acoustically controlled auditory training: a long-term study.

OBJECTIVE: To investigate the long-term efficacy of acoustically controlled auditory training in adults after tarumatic brain injury. METHODS: A total of six audioogically normal individuals aged between 20 and 37 years were studied. They suffered severe traumatic brain injury with diffuse axional lesion and underwent an acoustically controlled auditory training program approximately one year before. The results obtained in the behavioral and electrophysiological evaluation of auditory processing immediately after acoustically controlled auditory training were compared to reassessment findings, one year later. RESULTS: Quantitative analysis of auditory brainsteim response showed increased absolute latency of all waves and interpeak intervals, bilaterraly, when comparing both evaluations. Moreover, increased amplitude of all waves, and the wave V amplitude was statistically significant for the right ear, and wave III for the left ear. As to P3, decreased latency and increased amplitude were found for both ears in reassessment. The previous and current behavioral assessment showed similar results, except for the staggered spondaic words in the left ear and the amount of errors on the dichotic consonant-vowel test. CONCLUSION: The acoustically controlled auditory training was effective in the long run, since better latency and amplitude results were observed in the electrophysiological evaluation, in addition to stability of behavioral measures after one-year training.

Behavioral and electrophysiological auditory processing measures in traumatic brain injury after acoustically controlled auditory training: a long-term study / Medidas comportamentais e eletrofisiológicas do processamento auditivo em traumatismo craniencefálico após treinamento auditivo acusticamente controlado: estudo de longo prazo

ABSTRACT Objective To investigate the long-term efficacy of acoustically controlled auditory training in adults after tarumatic brain injury. Methods A total of six audioogically normal individuals aged between 20 and 37 years were studied. They suffered severe traumatic brain injury with diffuse axional lesion and underwent an acoustically controlled auditory training program approximately one year before. The results obtained in the behavioral and electrophysiological evaluation of auditory processing immediately after acoustically controlled auditory training were compared to reassessment findings, one year later. Results Quantitative analysis of auditory brainsteim response showed increased absolute latency of all waves and interpeak intervals, bilaterraly, when comparing both evaluations. Moreover, increased amplitude of all waves, and the wave V amplitude was statistically significant for the right ear, and wave III for the left ear. As to P3, decreased latency and increased amplitude were found for both ears in reassessment. The previous and current behavioral assessment showed similar results, except for the staggered spondaic words in the left ear and the amount of errors on the dichotic consonant-vowel test. Conclusion The acoustically controlled auditory training was effective in the long run, since better latency and amplitude results were observed in the electrophysiological evaluation, in addition to stability of behavioral measures after one-year training.

RESUMO Objetivo Investigar a eficácia de longo prazo do treinamento auditivo acusticamente controlado em indivíduos adultos após traumatismo craniencefálico. Métodos Foram estudados seis indivíduos audiologicamente normais com idades entre 20 e 37 anos, que sofreram traumatismo craniencefálico grave com lesão axional difusa, submetidos a um programa de treinamento auditivo acusticamente controlado aproximadamente um ano antes. Foram comparados os resultados obtidos nas avaliações comportamental e eletrofisiológica do processamento auditivo imediatamente após o treinamento auditivo acusticamente controlado e a reavaliação, um ano após. Resultados Quanto ao potencial de tronco encefálico, observou-se aumento da latência absoluta de todas as ondas e os intervalos interpicos, na comparação entre as avaliações, bilateralmente, bem como aumento da amplitude de todas as ondas, sendo a onda V estatisticamente significativa, para a orelha direita e a onda III para a orelha esquerda. Quanto ao P3, observaram-se diminuição da latência e aumento da amplitude do P3 na avaliação atual em ambas as orelhas. A avaliação comportamental atual evidenciou desempenho semelhante nas duas avaliações, exceto no teste dicótico de dissílabos alternados na orelha esquerda e a quantidade de erros no teste dicótico consoante-vogal. Conclusão O treinamento auditivo acusticamente controlado mostrou-se eficaz em longo prazo, uma vez que foram observados resultados melhores de latência e amplitude na avaliação eletrofisiológica, bem como estabilidade das medidas comportamentais após um ano de treinamento.

Modulation masking release using the Brazilian-Portuguese HINT: psychometric functions and the effect of speech time compression.

OBJECTIVE: The Brazilian-Portuguese hearing in noise test (HINT) was used to investigate the benefit to speech recognition of listening in a fluctuating background. The goal was to determine whether modulation masking release varied as a function of the speech-to-masker ratio at threshold. Speech-to-masker ratio at threshold was manipulated using the novel approach of adjusting the time-compression of the speech. DESIGN: Experiment 1 measured performance-intensity functions in both a steady speech-shaped noise masker and a 10-Hz square-wave modulated masker. Experiment 2 measured speech-to-masker ratios at threshold as a function of time-compression of the speech (0, 33, and 50%) in both maskers. STUDY SAMPLE: Participants were normal-hearing adults who were native speakers of Brazilian Portuguese (Experiment 1: N = 10; Experiment 2: N = 30). RESULTS: The slope of the performance-intensity function was shallower in the modulated masker than in the steady masker for both words and sentences. Thresholds increased with increasing time-compression in both maskers, but more markedly in the modulated masker, resulting in reduced modulation masking release with increasing time-compression. CONCLUSIONS: Speech-to-masker ratio at threshold varies with time-compression of speech. The results are relevant to the issue of whether degree of masker modulation benefit depends on speech-to-masker ratio at threshold.

Speech recognition in natural background noise.

In the real world, human speech recognition nearly always involves listening in background noise. The impact of such noise on speech signals and on intelligibility performance increases with the separation of the listener from the speaker. The present behavioral experiment provides an overview of the effects of such acoustic disturbances on speech perception in conditions approaching ecologically valid contexts. We analysed the intelligibility loss in spoken word lists with increasing listener-to-speaker distance in a typical low-level natural background noise. The noise was combined with the simple spherical amplitude attenuation due to distance, basically changing the signal-to-noise ratio (SNR). Therefore, our study draws attention to some of the most basic environmental constraints that have pervaded spoken communication throughout human history. We evaluated the ability of native French participants to recognize French monosyllabic words (spoken at 65.3 dB(A), reference at 1 meter) at distances between 11 to 33 meters, which corresponded to the SNRs most revealing of the progressive effect of the selected natural noise (-8.8 dB to -18.4 dB). Our results showed that in such conditions, identity of vowels is mostly preserved, with the striking peculiarity of the absence of confusion in vowels. The results also confirmed the functional role of consonants during lexical identification. The extensive analysis of recognition scores, confusion patterns and associated acoustic cues revealed that sonorant, sibilant and burst properties were the most important parameters influencing phoneme recognition. . Altogether these analyses allowed us to extract a resistance scale from consonant recognition scores. We also identified specific perceptual consonant confusion groups depending of the place in the words (onset vs. coda). Finally our data suggested that listeners may access some acoustic cues of the CV transition, opening interesting perspectives for future studies.

Lingual frenectomy and alveolar tap production: an acoustic and perceptual study.

In this phonetic study, productions of the consonant in the stressed syllable position of the word arara as produced by 13 subjects with short and/or anterior lingual frenulum were compared before and after lingual frenectomy. The results from the measurement of the stressed consonant duration and from the identification of the consonant manners of articulation based on the inspection of spectral characteristics are discussed and related to the answers to a perceptual identification test. After surgery, the number of tap productions did not increase, but alveolar productions did. These clinically relevant findings show frenectomy improved tongue mobility, but, as temporal controls were not totally re-established after surgery and 6-month speech therapy sessions, the production of the alveolar tap remained largely unchanged.

Auditory processing in children and adolescents in situations of risk and vulnerability.

CONTEXT AND OBJECTIVE: Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group. DESIGN AND SETTING: Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo. METHODS: The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway. RESULTS: For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test. CONCLUSIONS: The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.

The relation between auditory discrimination and phonological disorder.

PURPOSE: To determine the most frequent errors of children with phonological disorders in an auditory discrimination test, and to correlate their performance with age, gender and severity of phonological disorder. METHODS: The sample consisted of 82 children with phonological disorders, of both gender, with ages between 4 years and 7 years and 11 months. All subjects were submitted to the Phonological Assessment of Child (Avaliação Fonológica da Criança) in order to establish the severity of phonological disorder, and to the auditory discrimination test. Data were statistically analyzed. RESULTS: It was found that 38% of the subjects had poor results on the test, and the most frequent errors were: posteriorization, devoicing of stops, and semivocalization of liquid consonants. Moreover, it was observed that auditory discrimination difficulties were less frequent in older subjects, and more severe according to the severity of the phonological disorder. CONCLUSION: Great part of the children with phonological disorders has difficulties in auditory discrimination. However, these difficulties were less frequent in older subjects and more severe according to the severity of the disorder. Male subjects seem to have more difficulty in discriminating speech sounds.

Comparing vowel perception and production in Spanish and Portuguese: European versus Latin American dialects.

Recent acoustic descriptions have shown that Spanish and Portuguese vowels are produced differently in Europe and Latin America. The present study investigates whether comparable between-variety differences exist in vowel perception. Spanish, Peruvian, Portuguese, and Brazilian listeners were tested in a vowel identification task with stimuli sampled from the whole vowel space. The mean perceived first (F1) and second formant (F2) of every vowel category were compared across varieties. For both languages, perception exhibited the same between-variety differences as production for F1 but not F2, which suggests correspondence between produced F1 and perceived vowel height but not between F2 and frontness.