Long-term and short-term characteristics of speech: implications for hearing aid selection for young children.

This study examined the effects of distance and postural position of both parents and children on the long-term and short-term spectral characteristics of speech produced by the parents. Thirty children (ages 2 months to 3 1/2 years) and their parents (30 mothers and 15 fathers) participated. Third-octave band and overall levels of the long-term average speech spectrum (LTASS) for each speech sample were analyzed in three postural positions and a 1-meter reference condition for each age category. Short-term spectral characteristics of three phonemes (/s/, /integral of/, /t integral of/) also were analyzed. Results show that typical levels at the input to a child's hearing aid microphone may be as much as 20 dB higher than those found in face-to-face adult conversation. Furthermore, the spectral shape may deviate substantially from an idealized version of the LTASS. Results of the short-term analysis reveal that the peak levels of the three selected phonemes often exceed the LTASS by more than the 12 dB that is often quoted to represent the 1% rms levels of speech in relation to the long-term average. Implications of these results for specific hearing losses are discussed.

Coupling of FM systems to individuals with unilateral hearing loss.

This study examined the attenuation characteristics of five FM system sound delivery options for a group of 10 adults and 15 children (5-13 years). Sound delivery options included a tube-fitting, lightweight headphones, a CROS earmold with tubing, a CROS earmold with a snap-ring, and a standard snap-ring earmold with a vent. Attenuation was defined as the difference between probe-tube microphone measures of the ear canal resonance and the SPL in the ear canal with each sound delivery option in place. A statistically significant but clinically inconsequential difference in attenuation for the CROS earmold with tubing was noted between adults and children. No significant differences in attenuation for any of the other sound delivery options were noted between adults and children. An investigation of the relationship between magnitude of attenuation and percentage of the ear canal occluded suggests that degree of occlusion is a major factor in determining degree of attenuation provided by a particular sound delivery option. Results also indicate that significant attenuation of high-frequency signals can occur with earmolds commonly considered nonoccluding. Caution should be used in fitting hearing aids or FM systems to individuals with normal high-frequency hearing sensitivity to prevent attenuation of unamplified high-frequency speech information.

Effects of stimulus level on forward-masked psychophysical tuning curves in quiet and in noise.

Forward-masked psychophysical tuning curves were obtained from normal-hearing listeners at different probe levels in quiet and in a broadband background noise. In quiet, tuning-curve shape changed with probe level. For six listeners, tuning curves became broader with increasing probe level, primarily due to a decrease in the low-frequency slopes. For one listener, tuning curves became narrower with increasing probe level. The addition of a background noise, which was presented continuously at a level 10 dB below the noise level required to mask the probe tone, reduced the masker levels required to mask the probe tone. The reduction was greater near the tip of the tuning curve than on the tail, so that tuning curves in background noise were narrower than those obtained in quiet. Tuning curves with comparable masker levels near the tip of the tuning curve (Lmtip) were similar in shape, regardless of probe level or whether tuning curves were obtained in quiet or noise. Comparisons of tuning-curve characteristics derived by fitting tuning curves with least-squares procedures, indicated that low-frequency slopes decreased with Lmtip. As a consequence, Q10 dB values decreased with Lmtip. These results are consistent with the interpretation that tuning-curve shapes are determined by the intensities of the maskers required to mask the probe tone. The addition of a background noise restricted (partially masked) the excitation pattern of the probe so that lower masker intensities were required to "forward mask" the probe tone, and narrower tuning curves resulted from less intense markers. The results are well described by a two-process model of auditory excitation patterns.

Probe-tube microphone measures of ear-canal sound pressure levels in infants and children.

Probe-tube microphone measures of ear-canal sound-pressure levels were obtained for 31 children under 5 years of age. These data were compared to similar measures from a group of 21 adults. The intrasubject variability was smallest for the frequency range from 750 to 3000 Hz and at no frequency did the mean standard deviation exceed 3 dB. Real ear to coupler differences for the children showed the same pattern as a function of frequency as for adults but were significantly larger. A systematic decrease in real ear to coupler differences was observed with increasing age between 1000 and 3000 Hz. An estimate of ear-canal volume did not appear to be a clinically useful predictor of real ear to coupler differences.

Loudness discomfort levels in children.

Loudness discomfort levels (LDLs) traditionally have been used to set the saturation sound pressure level (SSPL) or maximum output of a hearing aid. Many procedures have been used to obtain LDLs for adults; however, no systematic study has been conducted to determine if LDLs could be obtained reliably for children. In the present study, LDLs were measured on 20 hearing-impaired children aged 7 to 14 years using a modification of a procedure described by Hawkins, Walden, Montgomery, and Prosek (Ear Hear 1987; 8: 162-169). Test-retest reliability measures were obtained for 8 of the 20 children, and this modified procedure was found to provide reasonably reliable results. Data from the group of 20 children also were compared with similar data obtained from 20 hearing-impaired adults. These results revealed no systematic differences in LDLs between the two groups, suggesting no a priori reason to limit the maximum output of a hearing aid for a child in this age range below the levels that are appropriate for adults. Poor correlation between LDLs and hearing levels for both age groups indicate a need for determining LDLs on an individual basis whenever possible.