Contribution of Temporal Fine Structure Cues to Concurrent Vowel Identification and Perception of Zebra Speech.

Introduction The limited access to temporal fine structure (TFS) cues is a reason for reduced speech-in-noise recognition in cochlear implant (CI) users. The CI signal processing schemes like electroacoustic stimulation (EAS) and fine structure processing (FSP) encode TFS in the low frequency whereas theoretical strategies such as frequency amplitude modulation encoder (FAME) encode TFS in all the bands. Objective The present study compared the effect of simulated CI signal processing schemes that either encode no TFS, TFS information in all bands, or TFS only in low-frequency bands on concurrent vowel identification (CVI) and Zebra speech perception (ZSP). Methods Temporal fine structure information was systematically manipulated using a 30-band sine-wave (SV) vocoder. The TFS was either absent (SV) or presented in all the bands as frequency modulations simulating the FAME algorithm or only in bands below 525 Hz to simulate EAS. Concurrent vowel identification and ZSP were measured under each condition in 15 adults with normal hearing. Results The CVI scores did not differ between the 3 schemes (F (2, 28) = 0.62, p = 0.55, η 2 p = 0.04). The effect of encoding TFS was observed for ZSP (F (2, 28) = 5.73, p = 0.008, η 2 p = 0.29). Perception of Zebra speech was significantly better with EAS and FAME than with SV. There was no significant difference in ZSP scores obtained with EAS and FAME ( p = 1.00) Conclusion For ZSP, the TFS cues from FAME and EAS resulted in equivalent improvements in performance compared to the SV scheme. The presence or absence of TFS did not affect the CVI scores.

Rhythms in Speech.

Speech can be defined as the human ability to communicate through a sequence of vocal sounds. Consequently, speech requires an emitter (the speaker) capable of generating the acoustic signal and a receiver (the listener) able to successfully decode the sounds produced by the emitter (i.e., the acoustic signal). Time plays a central role at both ends of this interaction. On the one hand, speech production requires precise and rapid coordination, typically within the order of milliseconds, of the upper vocal tract articulators (i.e., tongue, jaw, lips, and velum), their composite movements, and the activation of the vocal folds. On the other hand, the generated acoustic signal unfolds in time, carrying information at different timescales. This information must be parsed and integrated by the receiver for the correct transmission of meaning. This chapter describes the temporal patterns that characterize the speech signal and reviews research that explores the neural mechanisms underlying the generation of these patterns and the role they play in speech comprehension.

Influence of Speech Rate on Auditory Recognition in Cochlear Implant Users.

INTRODUCTION: This study aimed to verify the influence of speech stimulus presentation and speed on auditory recognition in cochlear implant (CI) users with poorer performance. METHODS: The cross-sectional observational study applied auditory speech perception tests to fifteen adults, using three different ways of presenting the stimulus, in the absence of competitive noise: monitored live voice (MLV); recorded speech at typical speed (RSTS); recorded speech at slow speed (RSSS). The scores were assessed using the Percent Sentence Recognition Index (PSRI). The data were inferentially analysed using the Friedman and Wilcoxon tests with a 95% confidence interval and 5% significance level (p < 0.05). RESULTS: The mean age was 41.1 years, the mean duration of CI use was 11.4 years, and the mean hearing threshold was 29.7 ± 5.9 dBHL. Test performance, as determined by the PSRI, was MLV = 42.4 ± 17.9%; RSTS = 20.3 ± 14.3%; RSSS = 40.6 ± 20.7%. There was a significant difference identified for RSTS compared to MLV and RSSS. CONCLUSION: The way the stimulus is presented and the speed at which it is presented enable greater auditory speech recognition in CI users, thus favouring comprehension when the tests are applied in the MLV and RSSS modalities.

Clinical experience of an adhesive bone conduction hearing system in children with congenital single-sided deafness.

OBJECTIVES: This study aimed to investigate the effects of an adhesive bone conduction device (aBCD) in children with congenital single-sided deafness (SSD). Specifically, we examined whether the aBCD elicits improvement in the speech perception ability of children with congenital SSD and whether using this device would adversely affect the horizontal localisation abilities of these children. METHODS: Thirteen school-aged children with SSD and seven children with Normal Hearing (NH) were included in this study. Speech perception in noise was measured using the Mandarin Speech Test Materials and sound localisation performance was evaluated using broadband noise stimuli (0.5-20 kHz), randomly played from seven loudspeakers at different stimulus levels (65-, 70-, and 75-dB SPL). RESULTS: All children with SSD showed inferior speech perception and sound localisation performance compared with children with NH. The aBCD use remarkably improved the speech perception abilities of these children under quiet and noise conditions; however, their sound localisation abilities neither improved nor deteriorated. CONCLUSION: This study reveals the effectiveness and safety of a non-surgical aBCD in paediatric patients with SSD. Our results provide a theoretical basis for early hearing intervention with an aBCD in children with congenital SSD who are temporarily unable to undergo ear surgery. LEVEL OF EVIDENCE: Level 3.

Cochlear Implants after Meningitis and Otosclerosis: A Comparison between Cochlear Ossification and Speech Perception Tests.

(1) Background: Performance after Cochlear Implantation (CI) can vary depending on numerous factors. This study aims to investigate how meningitis or otosclerosis can influence CI performance. (2) Methods: Retrospective analysis of CI performance in patients with etiological diagnosis of meningitis or otosclerosis, comparing the etiologies and analyzing the image findings, along with electrode array insertion status and technique. (3) Results: Speech recognition in CI patients with otosclerosis improves faster than in patients with meningitis. Other features such as radiological findings, degree of cochlear ossification, surgical technique used and total or partial insertion of electrodes do not seem to be directly related to speech recognition test performance. (4) Conclusions: Patients should be warned that their postoperative results have a strong correlation with the disease that caused their hearing loss and that, in cases of meningitis, a longer duration of speech-language training may be necessary to reach satisfactory results.

Speech perception: Auditory and visual cue integration in children with and without phonological disorder in voiceless fricatives.

The literature reports contradictory results regarding the influence of visual cues on speech perception tasks in children with phonological disorder (PD). This study aimed to compare the performance of children with (n = 15) and without PD (n = 15) in audiovisual perception task in voiceless fricatives. Assuming that PD could be associated with an inability to integrate phonological information from two sensory sources, we presumed that children with PD would present difficulties in integrating auditory and visual cues compared to typical children. A syllable identification task was conducted. The stimuli were presented according to four conditions: auditory-only (AO); visual-only (VO); audiovisual congruent (AV+); and audiovisual incongruent (AV-). The percentages of correct answers and the respective reaction times in the AO, VO, and AV+ conditions were considered for the analysis. The correct percentage of auditory stimuli was considered for the AV- condition, as well as the percentage of perceptual preference: auditory, visual, and/or illusion (McGurk effect), with the respective reaction time. In comparing the four conditions, children with PD presented a lower number of correct answers and longer reaction time than children with typical development, mainly for the VO. Both groups showed a preference for auditory stimuli for the AV- condition. However, children with PD showed higher percentages for visual perceptual preference and the McGurk effect than typical children. The superiority of typical children over PD children in auditory-visual speech perception depends on type of stimuli and condition of presentation.

Processamento auditivo central e questionário de autopercepção pós-treinamento auditivo acusticamente controlado em indivíduos com traumatismo cranioencefálico leve / Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury

RESUMO Objetivo Correlacionar os resultados da avaliação comportamental do processamento auditivo central e do questionário de autopercepção após o treinamento auditivo acusticamente controlado. Método Foram avaliados dez indivíduos com média de idade de 44,5 anos, que sofreram traumatismo cranioencefálico de grau leve. Os indivíduos foram submetidos a avaliação comportamental do processamento auditivo central e também responderam ao questionário de autopercepção "Treinamento Auditivo Formal" após a intervenção terapêutica. O questionário foi composto por questões referentes a percepção auditiva, compreensão de ordens, solicitação de repetição de enunciados, ocorrência mal-entendidos, tempo de atenção, desempenho auditivo em ambiente ruidoso, comunicação ao telefone e autoestima e os pacientes foram solicitados a assinalar a frequência de ocorrência dos comportamentos listados. Resultados As habilidades auditivas de figura-fundo e memória para sons em sequência e processamento temporal correlacionaram-se com melhora para seguir instruções, diminuição das solicitações de repetições e aumento do tempo de atenção e melhora da comunicação e da compreensão ao telefone e para assistir TV. Conclusão Observou-se adequação das habilidades auditivas de fechamento auditivo, figura fundo, e processamento temporal na avaliação pós-treinamento auditivo acusticamente controlado, além de redução das queixas quanto ao comportamento auditivo.

ABSTRACT Purpose To correlate behavioral assessment results of central auditory processing and the self-perception questionnaire after acoustically controlled auditory training. Methods The study assessed 10 individuals with a mean age of 44.5 years who had suffered mild traumatic brain injury. They underwent behavioral assessment of central auditory processing and answered the Formal Auditory Training self-perception questionnaire after the therapeutic intervention - whose questions address auditory perception, understanding orders, request to repeat statements, occurrence of misunderstandings, attention span, auditory performance in noisy environments, telephone communication, and self-esteem. Patients were asked to indicate the frequency with which the listed behaviors occurred. Results Figure-ground, sequential memory for sounds, and temporal processing correlated with improvement in following instructions, fewer requests to repeat statements, increased attention span, improved communication, and understanding on the phone and when watching TV. Conclusion Auditory closure, figure-ground, and temporal processing had improved in the assessment after the acoustically controlled auditory training, and there were fewer auditory behavior complaints.

Teste de palavras no ruído: confiabilidade no teste-reteste em adultos normo-ouvintes / The word-with-noise test: test-retest reliability in normal-hearing adults

RESUMO Objetivo Investigar a confiabilidade do Teste de Palavras no Ruído em um grupo de adultos normo-ouvintes. Método Participaram da pesquisa 45 sujeitos adultos normo-ouvintes. O intervalo entre a primeira e a segunda avaliação foi de 14 a 28 dias, realizadas no mesmo turno do dia e pelo mesmo avaliador. A análise de comparação entre teste e reteste foi realizada considerando o resultado geral das orelhas, totalizando 90 orelhas avaliadas. A análise inferencial incluiu a comparação das situações na primeira e segunda avaliação por meio do Teste de Wilcoxon, cálculo e interpretação do Índice de Correlação Intraclasse. Resultados Houve diferença estatisticamente significante entre os desempenhos no teste e reteste. Os coeficientes de correlação intraclasse obtidos foram indicativos de boa confiabilidade (r=0,759; p<0,001) para o estímulo monossilábico e de moderada confiabilidade (r=0,631; p<0,001) para o dissilábico. Conclusão O Teste de Palavras no Ruído demonstrou satisfatória confiabilidade tanto para o estímulo monossilábico, quanto para o dissilábico.

ABSTRACT Purpose To investigate the reliability of the Word-with-Noise Test in a group of normal-hearing adults. Methods Forty-five normal-hearing adult subjects participated in the research. The interval between the first and second assessment was 14 to 28 days, performed during the same time of the day and by the same evaluator. The comparison analysis between the test and the retest was performed considering the general result of the ears, totaling 90 ears evaluated. The inferential analysis included the comparison of the situations in the first and second assessment using the Wilcoxon Test, calculation, and interpretation of the Intraclass Correlation Index. Results There was a statistically significant difference between the test and retest performances. The intraclass correlation coefficients obtained were indicative of good reliability (r=0.759; p<0.001) for the monosyllabic stimulus and moderate reliability (r=0.631; p<0.001) for the disyllabic stimulus. Conclusion The Word-with-Noise Test demonstrated satisfactory reliability for both the monosyllabic and disyllabic stimuli.

Idosos com perda auditiva e declínio cognitivo: desempenho da percepção de fala no ruído / Elderly people with hearing loss and cognitive decline: speech perception performance in noise

RESUMO Objetivo Verificar a influência das habilidades intelectuais-cognitivas verbais na percepção de fala no ruído, em idosos com perda auditiva sensorioneural, considerando a escolaridade, a idade e o grau da perda auditiva. Método Participaram 36 idosos entre 60 e 89 anos com perda auditiva sensorioneural bilateral, que após avaliação psicológica por meio do Wechsler Intelligence Scale for Adults (WAIS III), foram divididos em (GI) 24 idosos sem alteração cognitiva e (GII) 12 idosos com risco de alteração cognitiva. Foram submetidos à avaliação otorrinolaringológica, entrevista audiológica, audiometria tonal liminar e a avaliação da percepção de fala no ruído por meio do Hearing in Noise Test (HINT-Brasil). O teste estatístico U de Mann-Whitney comparou os resultados entre os grupos, e a correlação de Spearman verificou as variáveis idade, grau da perda auditiva e nível de escolaridade. Resultados Não houve diferença entre os grupos na habilidade de percepção de fala no ruído, exceto na condição ruído à esquerda, no qual o GII apresentou melhor desempenho no HINT-Brasil. O grau da perda auditiva e o nível de escolaridade influenciaram na percepção de fala no ruído. O nível de escolaridade teve correlação com os resultados do WAIS III. Conclusão O declínio das habilidades intelectuais-cognitivas verbais não interferiu na percepção de fala no ruído nos idosos com perda auditiva. O grau da perda auditiva e o nível de escolaridade influenciaram no desempenho dos idosos no teste de percepção de fala no ruído. O desempenho nas habilidades cognitivas verbais variou com o nível de escolaridade.

ABSTRACT Purpose To verify the influence of verbal intellectual-cognitive skills on speech perception in noise, in elderly with sensorineural hearing loss, considering education, age, and degree of hearing loss. Methods 36 elderly between 60 and 89 years old with bilateral sensorineural hearing loss participated in the study. After psychological assessment using the Wechsler Intelligence Scale for Adults (WAIS-III), they were grouped into (GI) 24 elderly without cognitive alteration and (GII) 12 elderly with risk of cognitive alteration. They underwent otorhinolaryngological assessment, audiological interview, pure tone audiometry, and assessment of speech perception in noise using the Hearing in Noise Test (HINT-Brazil). The Mann-Whitney U statistical test compared the results between the groups, and the Spearman correlation verified the variable's age, degree of hearing loss, and level of education. Results There was no difference between the groups in the ability to perceive speech in noise, except in the noise on the left condition, in which GII showed better performance in HINT-Brazil. The degree of hearing loss and level of education influenced the perception of speech in noise. The level of education was correlated with the WAIS-III results. Conclusion The decline in verbal intellectual-cognitive skills did not affect speech perception of noise in the elderly with hearing loss. The degree of hearing loss and level of education influenced the performance of the elderly in the speech perception test in noise. Performance in verbal cognitive skills varied according to the level of education.

Teste de palavras no ruído: desenvolvimento, validação e valores de referência / The word-with-noise test: development, validation and reference values

RESUMO Objetivo Propor um instrumento para a avaliação do reconhecimento de fala na presença de ruído competitivo. Definir sua estratégia de aplicação, para ser aplicado na rotina clínica. Obter evidências de validade de critério e apresentar seus valores de referência. Método Estudo realizado em três etapas: Organização do material que compôs o Teste de Palavras no Ruído (Etapa 1); Definição da estratégia de aplicação do instrumento (Etapa 2); Investigação da validade de critério e definição dos valores de referência para o teste (Etapa 3), por meio da avaliação de 50 sujeitos adultos normo-ouvintes e 12 sujeitos com perda auditiva. Resultados O Teste de Palavras no Ruído é composto por listas de vocábulos mono e dissilábicos e um ruído com espectro de fala (Etapa 1). Foi definida como estratégia de aplicação do teste, a realização do Limiar de Reconhecimento de Fala com ruído fixo em 55 dBNA (Etapa 2). Quanto à validade de critério, o instrumento apresentou adequada capacidade de distinção entre os sujeitos normo-ouvintes e os sujeitos com perda auditiva (Etapa 3). Foram definidos como valores de referência para o teste, os pontos de corte expressos em relação sinal/ruído de 1,47 dB para o estímulo monossilábico e de -2,02 dB para o dissilábico. Conclusão O Teste de Palavras no Ruído demonstrou ser rápido e de fácil aplicação e interpretação dos resultados, podendo ser uma ferramenta útil a ser utilizada na rotina clínica audiológica. Além disso, apresentou evidências satisfatórias de validade de critério, com valores de referência estabelecidos.

ABSTRACT Purpose To propose an instrument for assessing speech recognition in the presence of competing noise. To define its application strategy for use in clinical practice. To obtain evidence of criterion validity and present reference values. Methods The study was conducted in three stages: Organization of the material comprising the Word-with-Noise Test (Stage 1); Definition of the instrument's application strategy (Stage 2); Investigation of criterion validity and definition of reference values for the test (Stage 3) through the evaluation of 50 normal-hearing adult subjects and 12 subjects with hearing loss. Results The Word-with-Noise Test consists of lists of monosyllabic and disyllabic words and speech spectrum noise (Stage 1). The application strategy for the test was defined as the determination of the Speech Recognition Threshold with a fixed noise level at 55 dBHL (Stage 2). Regarding criterion validity, the instrument demonstrated adequate ability to distinguish between normal-hearing subjects and subjects with hearing loss (Stage 3). Reference values for the test were established as cut-off points expressed in terms of signal-to-noise ratio: 1.47 dB for the monosyllabic stimulus and -2.02 dB for the disyllabic stimulus. Conclusion: The Word-with-Noise Test proved to be quick to administer and interpret, making it a useful tool in audiological clinical practice. Furthermore, it showed satisfactory evidence of criterion validity, with established reference values.

Impact of hearing aid electroacoustic verification on speech perception and user performance in daily activities / Impacto do uso da verificação eletroacústica dos aparelhos de amplificação sonora individual na percepção de fala e desempenho do usuário nas atividades diárias

ABSTRACT Purpose: to assess the impact of electroacoustic verification on the satisfaction level and speech recognition in quiet and noise of hearing aid users. Methods: 24 individuals who had been using the device for at least 1 year and had not previously performed electroacoustic verification were assessed. In the first session, participants responded to the International Outcome Inventory for Hearing Aids validation questionnaire and indicated their satisfaction level on a visual analog scale. They were, then, subjected to speech perception tests in quiet and noise and electroacoustic verification, returning after 3 months and repeating the first stage assessments. The Wilcoxon test and paired t-test were used for data analysis, with significance set at p-value ≤ 0.05. Results: the visual analog scale assessment, the International Outcome Inventory for Hearing Aids score, the speech perception threshold in quiet and noise, and the signal/noise ratio improved after 3 months. Conclusion: individuals who had been using the device for at least 1 year had a substantial improvement in their satisfaction level and speech perception in quiet and noise after the electroacoustic verification.

RESUMO Objetivo: avaliar o impacto da verificação eletroacústica no grau de satisfação e no reconhecimento de fala no silêncio e no ruído em usuários de aparelho de amplificação sonora individual. Métodos: foram avaliados 24 usuários que utilizavam o dispositivo há pelo menos um ano e sem realização anterior de verificação eletroacústica. Em um primeiro encontro, os participantes responderam ao questionário de validação International Outcome Inventory for Hearing Aids e atribuíram uma nota de satisfação por meio da escala visual analógica. Em seguida, foram submetidos a testes de percepção de fala no silêncio e no ruído, finalizando com a realização da verificação eletroacústica. Retornaram após três meses e repetiram as avaliações da primeira etapa. Para a análise dos dados, foram utilizados os testes de Wilcoxon e Teste t pareado, valor de p ≤ 0,05. Resultados: observou-se melhora na avaliação da escala visual analógica, na pontuação do International Outcome Inventory for Hearing Aids, no limiar de percepção de fala no silêncio e ruído e na relação sinal/ruído no seguimento de três meses. Conclusão: após a verificação eletroacústica, os usuários que utilizavam o dispositivo há pelo menos um ano apresentaram melhora substancial no grau de satisfação e na percepção de fala no silêncio e no ruído.

Assessment of speech perception: A survey of speech-language-hearing therapists on their most frequent practices / Evaluación de la percepción del habla: encuesta a profesionales de la Fonoaudiología sobre sus prácticas más frecuentes

ABSTRACT Purpose: to characterize the practices of speech-language-hearing pathologists in Chile, regarding speech perception assessment in children and adolescents. Methods: an exploratory cross-sectional study carried out using a self-administered online survey to investigate knowledge and quantify trends in the practice of speech perception assessment, based on six focus groups with speech-language-hearing pathologists. The instrument was disseminated through the researchers' social media and contact networks. Descriptive statistical analysis was performed. Results: a total of 121 people responded to the survey, all of them being speech-language-hearing pathologists. These professionals, in Chile, highly value speech perception in child development, however, a large percentage of them do not assess it. Those who carry it out, reported a wide range of assessment practices. Conclusion: the results highlight the need for standardizing certain speech-language-hearing methods and the importance of understanding the assessment strategies in use to point out opportunities to improve both the assessment and subsequent therapeutic processes.

RESUMEN Objetivo: caracterizar las prácticas de los profesionales de la Fonoaudiología en Chile en torno a la evaluación de la percepción del habla en niños, niñas y adolescentes. Métodos: se realizó un estudio exploratorio de diseño transversal mediante una encuesta online autoadministrada diseñada para indagar en los saberes y cuantificar tendencias en la práctica de la evaluación de la percepción del habla. La encuesta fue confeccionada en base a seis grupos focales realizados con profesionales fonoaudiólogos. La difusión del instrumento se realizó a través de redes sociales y redes de contacto de los investigadores. El análisis estadístico realizado fue de carácter descriptivo. Resultados: un total de 121 personas respondieron la encuesta, todos profesionales de la Fonoaudiología. Los profesionales de la Fonoaudiología en Chile otorgan un alto valor a la percepción del habla en el desarrollo infantil, no obstante, un gran porcentaje no la evalúa. Aquellos profesionales que lo realizan, revelan una amplia diversidad en las prácticas evaluativas. Conclusión: los resultados permiten visibilizar la necesidad de estandarizar ciertos métodos fonoaudiológicos y resaltar la importancia de comprender las estrategias evaluativas en uso para señalar oportunidades de mejora tanto en la evaluación como en los posteriores procesos terapéuticos.

Encoding of speech sounds with frequency-following response in infants with Congenital Zika Syndrome: A case-controlled study

ABSTRACT Purpose: to investigate the frequency-following response (FFR) for sustained neural activity. Methods: 39 individuals, aged between 20 to 47 months old were divided into 2 groups: (i) 20 individuals without prenatal exposure to the congenital Zika syndrome (CZS) or hydrocephaly, normal development, no risk factors for hearing loss or syndromic hearing impairment and (ii) 19 individuals diagnosed with CZS and microcephaly - based on imaging studies linked to the clinical presentation of the condition. All participants exhibited normal click-ABR tests. FFR waveforms were documented using the /da/ syllable employing the Navigator Pro. The statistical analysis used was ANOVA (p-value <0.05). Results: no distinctions were observed concerning the variables of group, age, or gender with respect to FFR latency values, except for an interaction between gender and group for latency values associated with waves V and F. Children with CZS and microcephaly showed a difference for latency values in wave V for both males and females, when compared to the control group. Conclusion: children presented with CZS and microcephaly showed higher average latencies for waves V, A, C, D and F (male) compared to the control group, whereas, in waves E, F (female) and O they showed higher values in the control group.

Multisensory effects of mask wearing on speech intelligibility and the benefit of multilingualism / Efeitos multissensoriais do uso de máscara na inteligibilidade da fala e o benefício do multilinguismo

ABSTRACT Purpose Due to the pandemic of the Covid-19 disease, it became common to wear masks on some public spaces. By covering mouth and nose, visual-related speech cues are greatly reduced, while the auditory signal is both distorted and attenuated. The present study aimed to analyze the multisensory effects of mask wearing on speech intelligibility and the differences in these effects between participants who spoke 1, 2 and 3 languages. Methods The study consisted of the presentation of sentences from the SPIN test to 40 participants. Participants were asked to report the perceived sentences. There were four conditions: auditory with mask; audiovisual with mask; auditory without mask; audiovisual without mask. Two sessions were conducted, one week apart, each with the same stimuli but with a different signal-to-noise ratio. Results Results demonstrated that the use of the mask decreased speech intelligibility, both due to a decrease in the quality of auditory stimuli and due to the loss of visual information. Signal-to-noise ratio largely affects speech intelligibility and higher ratios are needed in mask-wearing conditions to obtain any degree of intelligibility. Those who speak more than one language are less affected by mask wearing, as are younger listeners. Conclusion Wearing a facial mask reduces speech intelligibility, both due to visual and auditory factors. Older people and people who only speak one language are affected the most.

RESUMO Objetivo Devido à pandemia da doença Covid-19, o uso de máscaras em espaços públicos tornou-se comum. Ao cobrir a boca e o nariz, reduzem-se amplamente as pistas visuais associadas à fala, assim como se distorce e atenua o sinal auditivo. Este estudo teve como objetivo analisar os efeitos multissensoriais do uso da máscara na percepção da fala e a diferença entre participantes falantes de uma, duas ou três línguas. Método Este estudo consistiu na apresentação de frases do SPIN teste a 40 participantes. Os participantes tinham como tarefa reportar as frases percebidas em quatro condições: Auditiva com máscara, audiovisual com máscara, auditiva sem máscara, audiovisual sem máscara. Conduziram-se duas sessões, com uma semana de intervalo, cada uma com os mesmos estímulos mas com diferente relação sinal-ruído. Resultados Os resultados demonstraram que o uso de máscara reduz a inteligibilidade da fala, tanto devido à diminuição da qualidade do estímulo auditivo, como devido à perda de informação visual. A relação sinal-ruído afeta a inteligibilidade e com o uso de máscara são necessárias relações mais altas para obter qualquer identificação correta. Aqueles que falam mais do que uma língua, assim como os mais novos, são menos afetados na percepção de fala com uso de máscara. Conclusão O uso de máscara facial reduz a inteligibilidade da fala, tanto devido a fatores visuais como auditivos. Indivíduos monolíngues, assim como os mais velhos, são os mais afetados nesta tarefa.

Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído / Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Simulation of hypernasality levels using trained actors: A brief communication / Simulación de niveles de hipernasalidad con actores entrenados: Una comunicación breve

ABSTRACT Purpose: to report an experience of simulation applied to a research context and assess the feasibility of using trained actors' audio recordings to simulate nasality levels. Methods: two clinical simulation actors selected and subsequently trained to simulate three nasality levels (non-nasal, mild to moderate hypernasal and severe hypernasal), resulting in a total of 6 audios. These files were analysed through a Praat script to obtain the measures A1-P0 compensated and the first formant's bandwidth. Afterwards, they were rated by two expert SLPs, according to their nasality and intelligibility, using perceptual scales. Results: according to A1-P0 and F1 bandwidth values in most conditions and the expert SLP's nasality and intelligibility ratings, the actors were able to simulate the previously defined nasality levels. Final Considerations: based on the preliminary data, it can be concluded that the use of clinical simulation in experimental contexts, offering new opportunities and benefits for researchers, is feasible. In this experience, the actors were able to simulate different nasality levels corroborated by acoustic analysis and experts' ratings.

RESUMEN Objetivo: informar una experiencia de la simulación aplicada a un contexto de investigación y evaluar la factibilidad de utilizar audios de actores entrenados para simular niveles de nasalidad. Métodos: dos actores de simulación clínica fueron seleccionados y posteriormente entrenados para simular tres niveles de nasalidad (no nasal, leve a moderado hipernasal, y severo hipernasal) dando como resultado 6 audios. Estos audios fueron analizados mediante un script de Praat para obtener las medidas A1-P0 compensado y el ancho de banda del primer formante. Posteriormente fueron calificados por dos fonoaudiólogos expertos según su nasalidad e inteligibilidad mediante escalas perceptuales. Resultados: de acuerdo con los valores de A1-P0 y ancho de banda de F1 en la mayoría de las condiciones y la evaluación de la nasalidad e inteligibilidad por los fonoaudiólogos expertos, los actores lograron simular los niveles de nasalidad previamente propuestos. Consideraciones Finales: de acuerdo con los resultados preliminares, podemos concluir que es factible utilizar la simulación clínica en contextos experimentales ofreciendo una nueva oportunidad y beneficios para los investigadores. En esta experiencia los actores lograron simular distintos niveles de nasalidad corroborado mediante análisis acústico y evaluación de expertos.

Benefits of Bimodal Stimulation to Speech Perception in Noise and Silence.

Introduction Understanding all the benefits of bimodality with self-assessment questionnaires on the effect of hearing on quality of life is still necessary. Objective To present whether bimodality still offers hearing benefits to the population who uses acoustic stimulation associated with electrical stimulation. Methods The present study included 13 participants aged between 16 and 80 years old who were users of cochlear implants from Cochlear Corporation and hearing aids. All patients underwent the Hearing in Noise Test, and their visual analog scale score was obtained. Four-tone means were collected, and the participants answered the Speech, Spatial and Hearing Qualities questionnaire. Results Bimodal users had an average sentence recognition rate of 76.0% in silence and 67.6% in fixed noise, and the signal-to-noise ratio in adaptive noise was +2.89dB. In addition, a lower level of difficulty was observed in the test using the visual analog scale. The domain with the highest average was auditory qualities (6.50), followed by spatial hearing (6.26) and hearing for speech (5.81). Individuals with an average between 50 and 70 dB of hearing level showed better sentence recognition in silence and noise. Conclusion Bimodal stimulation showed benefits for users with different degrees of hearing loss; however, individuals who presented greater hearing residue had better performance in speech recognition with noise and in silence in addition to a good perception of hearing quality.

Neurocognitive function in children with cochlear implants and hearing aids: a systematic review.

Purpose: To systematically review the existing literature that examines the relationship between cognition, hearing, and language in children using cochlear implants and hearing aids. Method: The review has been registered in Prospero (Registration: CRD 42020203974). The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and examined the scientific literature in VHL, MEDLINE, CINAHL, Scopus, WOS, and Embase. It included original observational studies in children using hearing aids and/or cochlear implants who underwent cognitive and auditory and/or language tests. Data were extracted from the studies and their level of evidence was graded with the Oxford Center for Evidence-Based Medicine: Levels of Evidence. Meta-analysis could not be performed due to data heterogeneity. Outcomes are described in narrative and tables synthesis. Results: The systematic search and subsequent full-text evaluation identified 21 studies, conducted in 10 different countries. Altogether, their samples comprised 1,098 individuals, aged 0.16-12.6 years. The studies assessed the following cognitive domains: memory, nonverbal cognition, reasoning, attention, executive functions, language, perceptual-motor function, visuoconstructive ability, processing speed, and phonological processing/phonological memory. Children with hearing loss using cochlear implants and hearing aids scored significantly lower in many cognitive functions than normal hearing (NH) children. Neurocognitive functions were correlated with hearing and language outcomes. Conclusion: Many cognitive tools were used to assess cognitive function in children with hearing devices. Results suggest that children with cochlear implants and hearing aids have cognitive deficits; these outcomes are mainly correlated with vocabulary. This study highlights the need to understand children's cognitive function and increase the knowledge of the relationship between cognition, language, and hearing in children using cochlear implants and hearing aids.

Evolution of speech perception in patients with ossified cochlea and short array cochlear implant.

Background: Short array cochlear implant is indicated as rehabilitation in patients with severe to profound deafness, especially when there is cochlear ossification. In these cases, with reduced intracochlear patency, total insertion becomes more difficult, requiring the use of this type of electrode (15 mm). Few studies have been published to evaluate auditory performance, presenting controversial audiological results.Aims/Objectives: To report the speech perception of users of cochlear implants (CI) with short array. Material and Methods: A retrospective analysis of medical records of patients who underwent surgery for cochlear implantation with a short array, between 2009 and 2020, at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) was carried out. Results: There was performance evolution in the speech perception tests in the data analysis. Meningitis and congenital hearing loss were the main indications for CI in the sample. Conclusion. CI with a short array is an alternative in the management of patients with a history of cochlear ossification and severe or profound sensorineural hearing loss. Significance: To demonstrate the evolution of speech perception tests with short array cochlear implant in patients with or without ossified cochlea and its characteristics for application in clinical practice.

Subclinical hearing loss associated with aging.

Objective: Contribute to clarifying the existence of subclinical hearing deficits associated with aging. Design: In this work, we study and compare the auditory perceptual and electrophysiological performance of normal-hearing young and adult subjects (tonal audiometry, high-frequency tone threshold, a triplet of digits in noise, and click-evoked auditory brainstem response). Study sample: 45 normal hearing volunteers were evaluated and divided into two groups according to age. 27 subjects were included in the "young group" (mean 22.1 years), and 18 subjects (mean 42.22 years) were included in the "adult group." Results: In the perceptual tests, the adult group presented significantly worse tonal thresholds in the high frequencies (12 and 16 kHz) and worse performance in the digit triplet tests in noise. In the electrophysiological test using the auditory brainstem response technique, the adult group presented significantly lower I and V wave amplitudes and higher V wave latencies at the supra-threshold level. At the threshold level, we observed a significantly higher latency in wave V in the adult group. In addition, in the partial correlation analysis, controlling for the hearing level, we observed a relationship (negative) between age and speech in noise performance and high-frequency thresholds. No significant association was observed between age and the auditory brainstem response. Conclusion: The results are compatible with subclinical hearing loss associated with aging.