Effects of Auditory Training and Remote Microphone Technology on the Behavioral Performance of Children and Young Adults Who Have Autism Spectrum Disorder.

BACKGROUND: Individuals who have a normal pure-tone audiogram but are diagnosed with autism spectrum disorder (ASD) often exhibit poorer speech recognition and auditory processing when compared with neurotypical peers with normal pure-tone audiograms. PURPOSE: The purpose of this study was to determine the efficacy and effectiveness of a 12-week auditory processing training (APT) program that was designed to address the deleterious effects of background noise and auditory processing deficits that are common among individuals diagnosed with ASD. RESEARCH DESIGN: A repeated measures design was used. STUDY SAMPLE: The sample consisted of 15 high-functioning children and young adults who had a formal diagnosis of ASD and who were recruited from local clinics and school districts. INTERVENTION: Participants completed the 12-week APT program consisting of computerized dichotic training, one-on-one therapist-directed auditory training, and the use of remote microphone (RM) technology at home and in the classroom. DATA COLLECTION AND ANALYSIS: Participants completed a comprehensive test battery to assess general auditory processing skills, speech recognition in noise, acceptance of background noise, spatial processing, binaural integration abilities, self-perceived difficulties, and observed behaviors. Testing was conducted before (n = 15), immediately after (n = 15), and 12 weeks after (n = 7) the completion of the APT program. Paired t-tests, repeated measures analysis of variance, or nonparametric tests were used to analyze the data. RESULTS: On average, the APT program significantly enhanced general auditory processing abilities, including binaural integration and subjective listening abilities in the classroom. When the RM was used, significantly improved speech recognition and improved acceptance of background noise was measured relative to a condition with no technology. CONCLUSIONS: Following the APT program, the participants exhibited the greatest improvements in testing that required binaural integration and auditory working memory. The use of the RM technology was able to address the deleterious effects of noise on speech recognition in noise and acceptance of noise levels.

Speech Recognition in Noise in Adults and Children Who Speak English or Chinese as Their First Language.

BACKGROUND: Speech recognition of individuals who are listening to a nonnative language is significantly degraded in the presence of background noise and may be influenced by proficiency, age of acquisition, language experience, and daily use of the nonnative language. PURPOSE: The purpose of this study is to examine and compare speech recognition in noise performance across test conditions with varying signal-to-noise ratios (SNRs) as well as the presence of vocal and spatial cues in listeners who speak American English as a native language or Mandarin Chinese as a native language. Self-rated English proficiency and experience were collected for native Mandarin Chinese speakers to determine its relationship to performance on the test measures. RESEARCH DESIGN: A cross-sectional repeated measures design was used for the study. STUDY SAMPLE: Four groups of participants were included in the study. The adult groups consisted of 25 adults who speak native English and 25 adults who speak native Mandarin Chinese with English as an additional language. The pediatric groups consisted of 16 children who speak native English and 16 children who speak native Mandarin Chinese with English as an additional language. DATA COLLECTION AND ANALYSES: Percent correct speech recognition in noise was assessed at three SNRs (-3, 0, +3 dB) using the adult or pediatric versions of the AzBio sentence test. The Listening in Spatialized Noise-Sentence (LiSN-S) test was used to determine the effect of providing spatial and vocal cues on the speech recognition in noise performance of the groups of participants. The data for each age group and test measure were analyzed with a repeated measures analysis of variance. Correlation analyses were performed to examine relationships between English proficiency and experience on performance across the speech recognition test conditions. RESULTS: Analysis of the data from the adult or pediatric AzBio sentence test identified a significant effect of native language for adults but no significant effect for children. The higher SNRs yielded better performance for all listeners. On the LiSN-S test, results for the adult and pediatric groups were similar and showed significantly better performance for the native English speakers in every test condition. The demographic and language characteristics that most affected speech recognition performance across the test measures included the length of time the person lived in the United States, the age of English acquisition, the number of minutes per day English was spoken by the participant, and the self-rated English proficiency. CONCLUSIONS: The findings in this study highlight the importance and benefit of higher SNRs as well as the provision of vocal and spatial cues for improving speech recognition performance in noise of adult and pediatric listeners who speak Mandarin Chinese as a native language.

Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder.

The goal of this study was to conduct assistive technology evaluations on 12 children diagnosed with Autism Spectrum Disorder (ASD) to evaluate the potential benefits of remote-microphone (RM) technology. A single group, within-subjects design was utilized to explore individual and group data from functional questionnaires and behavioral test measures administered, designed to assess school- and home-based listening abilities, once with and once without RM technology. Because some of the children were unable to complete the behavioral test measures, particular focus was given to the functional questionnaires completed by primary teachers, participants, and parents. Behavioral test measures with and without the RM technology included speech recognition in noise, auditory comprehension, and acceptable noise levels. The individual and group teacher (n=8-9), parent (n=8-9), and participant (n=9) questionnaire ratings revealed substantially less listening difficulty when RM technology was used compared to the no-device ratings. On the behavioral measures, individual data revealed varied findings, which will be discussed in detail in the results section. However, on average, the use of the RM technology resulted in improvements in speech recognition in noise (4.6dB improvement) in eight children, higher auditory working memory and comprehension scores (12-13 point improvement) in seven children, and acceptance of poorer signal-to-noise ratios (8.6dB improvement) in five children. The individual and group data from this study suggest that RM technology may improve auditory function in children with ASD in the classroom, at home, and in social situations. However, variability in the data and the inability of some children to complete the behavioral measures indicates that individualized assistive technology evaluations including functional questionnaires will be necessary to determine if the RM technology will be of benefit to a particular child who has ASD.