Developmental Effects in the "Vocale Rapide dans le Bruit" Speech-in-Noise Identification Test: Reference Performances of Normal-Hearing Children and Adolescents.

PURPOSE: The main objective of this study was to assess the existence of developmental effects on the performance of the Vocale Rapide dans le Bruit (VRB) speech-in-noise (SIN) identification test that was recently developed for the French language and to collect reference scores for children and adolescents. METHOD: Seventy-two native French speakers, aged 10-20 years, participated in the study. Each participant listened and repeated four lists of eight sentences, each containing three key words to be scored. The sentences were presented in free field at different signal-to-noise ratios (SNRs) using a four-talker babble noise. The SNR yielding 50% of correct repetitions of key words (SNR50) was recorded for each list. RESULTS: A strong relationship between age and SNR50 was found, better performance occurring with increasing age (average drop in SNR50 per year: 0.34 dB). Large differences (Cohen's d ≥ 1.2) were observed between the SNR50 achieved by 10- to 13-year-old participants and those of adults. For participants aged 14-15 years, the difference fell just above the 5% level of significance. No effects of hearing thresholds or level of education were observed. CONCLUSIONS: The study confirms the existence of developmental effects on SIN identification performance as measured using the VRB test and provides reference data for taking into account these effects during clinical practice. Explanations as to why age effects perdure during adolescence are discussed.

Evaluation of binomial distribution estimates of confidence intervals of speech-recognition test scores.

Speech-recognition tests are a routine component of the clinical hearing evaluation. The most common type of test uses recorded monosyllabic words presented in quiet. The interpretation of test scores relies on an understanding of the variance of repeated tests. Confidence intervals are useful for determining if two scores are significantly different or if the difference is due to the variability of test scores. Because the response to each test item is binary, either correct or incorrect, the binomial distribution has been used to estimate confidence intervals. This method requires that test scores be independent. If the scores are not independent, the binomial distribution will not accurately estimate the variance of repeated scores. A previously published dataset with repeated scores from normal-hearing and hearing-impaired listeners was used to derive confidence intervals from actual test scores in contrast to the predicted confidence intervals in earlier reports. This analysis indicates that confidence intervals predicted by the binomial distribution substantially overestimate the variance of repeated scores resulting in erroneously broad confidence intervals. High correlations were found for repeated scores, indicating that scores are not independent. The interdependence of repeated scores invalidates confidence intervals predicted by the binomial distribution. Confidence intervals and confidence levels for repeated measures were determined empirically from measured test scores to assist in interpreting differences between repeat scores.

AzBio Sentence test in Hebrew (HeBio): development, preliminary validation, and the effect of noise.

The AzBio sentence test is widely used to assess speech perception pre- and post-cochlear implantation. This study created and validated a Hebrew version of AzBio (HeBio) and tested its intelligibility amidst background noise.In Experiment 1, 1,000 recorded Hebrew sentences were presented via five-channel vocoder to 10 normal hearing (NH) listeners for intelligibility testing. In Experiment 2, HeBio lists were presented to 25 post-lingual cochlear implant (CI) users amidst four-talker babble noise (4TBN) or in quiet, along with one-syllable word test. In Experiment 3, 20 NH listeners were presented with eight HeBio lists in two noise conditions [4TBN, speech shaped noise (SSN)] and four SNRs (+3, 0 dB, -3 dB, -6 dB).HeBio lists (33) produced 82% average understanding, no inter-list intelligibility differences among NH, and equal intelligibility for CI users. One-syllable words predicted 67% of the variance in HeBio among CI users. Higher intelligibility was found for SSN than for 4TBN, and the mean speech receptive threshold (SRT) was more negative for SSN than for 4TBN.HeBio results were similar to AzBio. Results obtained with two noise types were as expected. HeBio is recommended for evaluation of different populations in quiet and noise.

Is It Okay to Use Compressed NU-6 Files for Clinical Word Recognition Testing?

PURPOSE: The purpose of this study was to evaluate the impact of file compression on clinically measured word recognition scores obtained using the Northwestern University Test Number Six (NU-6; Auditec recording) materials. METHOD: Participants were 86 adults (N = 170 ears; M age = 65.5). The 25 most difficult words from each of four NU-6 test lists were used to measure word recognition. Two lists were compressed using a freely available Advanced Audio Coding compression algorithm and two were not. Word recognition was measured in each ear using one compressed file and one uncompressed file. Percent correct scores were calculated in each test condition and log transformed for analyses. Clinically meaningful differences between uncompressed and compressed scores were examined using 95% critical difference ranges. The effects of file compression on word recognition scores were examined in the context of multiple potential confounding effects, including age and degree of hearing loss, using linear mixed-effects models (LMMs). RESULTS: Differences between compressed and uncompressed scores in a given ear exceeded the 95% critical difference range in about 7% of cases, approximating the 5% of expected cases occurring due to chance. Likewise, LMM results revealed no significant effect of file compression on clinically measured NU-6 word recognition scores and no significant interactions between compression effects and age or degree of hearing loss. CONCLUSIONS: While the original uncompressed audio files are clearly the most appropriate stimuli for clinical purposes, our study results suggest that file compression, even at an aggressive 64 kilobits per second, does not have a statistically significant, or clinically meaningful, effect on word recognition scores when measured using these Auditec materials.

Cochlear Implant Outcomes in Prelingually Deafened Adults with and without Sound Deprivation: Are There Differences in Quality of Life?

BACKGROUND Indications for cochlear implantation (CI) are constantly being updated, and with them, the audiometric results achieved by patients. Patient satisfaction should always be considered, even in patients with lower audiological results. The aim of the present study was to compare quality of life (QoL), self-perceived hearing benefit, and audiometric results between prelingually and postlingually deafened patients, with and without sound deprivation, after CI. MATERIAL AND METHODS The sample included 46 patients with bilateral sensorineural hearing loss: 22 postlingually deafened and 24 prelingually deafened, further subdivided into sound-deprived (n=10) and non-sound-deprived (n=14). Auditory performance was evaluated with pure tone audiometry, speech recognition scores (SRS), and self-perceived hearing benefit, whereas QoL was evaluated with 2 self-reported questionnaires (Comprehensive Cochlear Implant Questionnaire and World Health Organization Quality of Life-BREF). RESULTS Audiometric results were worse in the prelingually deafened than in the postlingually deafened group, and worse in the prelingually deafened patients with sound deprivation. There was no marked difference in perceived CI benefit or QoL between the 2 groups or within the 2 prelingually deafened subgroups. No correlation was found between SRS and duration of CI use or between QoL and SRS in the prelingually and postlingually deafened groups. CONCLUSIONS Our findings demonstrate better auditory performance for the postlingually deafened group and no differences in perceived QoL or benefit of CI between the groups. The sound-deprived patients had equal scores on the perceived QoL questionnaire. These analyses suggest that sound-deprived, prelingually deafened patients may benefit from CI.

Association of In-Ear Device Use With Communication Quality Among Individuals Wearing Personal Protective Equipment in a Simulated Operating Room.

Importance: The COVID-19 pandemic has brought forth new challenges for health care workers, such as the daily use of personal protective equipment, including reusable facial respirators. Poor communication while wearing respirators may have fatal complications for patients, and no solution has been proposed to date. Objective: To examine whether use of an in-ear communication device is associated with improved communication while wearing different personal protective equipment (N95 mask, half-face elastomeric respirator, and powered air-purifying respirator [PAPR]) in the operating room. Design, Setting, and Participants: This quality improvement study was conducted in June 2020. Surgical residents from the Department of Otolaryngology-Head and Neck Surgery at McGill University in Montreal, Quebec, Canada, were recruited. All participants had normal hearing, were fluent in English, and had access to the operating rooms at the Royal Victoria Hospital. Exposures: All participants performed the speech intelligibility tasks with and without an in-ear communication device. Main Outcomes and Measures: Speech intelligibility was measured using a word recognition task (Modified Rhyme Test) and a sentence recognition task (AzBio Sentence Test). A percentage correct score (0% to 100%) was obtained for each speech intelligibility test. Listening effort was assessed using the NASA Task Load Index. An overall workload score, ranging from 0 points (low workload) to 100 points (high workload), was obtained. Results: A total of 12 participants were included (mean [SD] age, 31.2 [1.9] years; 8 women [66.7%]). AzBio Sentence Test results revealed that, while wearing the N95 mask, the mean (SD) speech intelligibility was 98.8% (1.8%) without the in-ear device vs 94.3% (7.4%) with the device. While wearing the half-face elastomeric respirator, the mean speech intelligibility was 58.5% (12.4%) without the in-ear device vs 90.8% (8.9%) with the device. While wearing the PAPR, the mean speech intelligibility was 84.6% (9.8%) without the in-ear device vs 94.5% (5.5%) with the device. Use of the in-ear device was associated with a significant improvement in speech intelligibility while wearing the half-face elastomeric respirator (32.3%; 95% CI, 23.8%-40.7%; P < .001) and the PAPR (9.9%; 95% CI, 1.4%-18.3%; P = .01). Furthermore, use of the device was associated with decreased listening effort. The NASA Task Load Index results reveal that, while wearing the N95 mask, the mean (SD) overall workload score was 12.6 (10.6) points without the in-ear device vs 17.6 (9.2) points with the device. While wearing the half-face elastomeric respirator, the mean overall workload score was 67.7 (21.6) points without the in-ear device vs 29.3 (14.4) points with the in-ear device. While wearing the PAPR, the mean overall workload score was 42.2 (18.2) points without the in-ear device vs 23.8 (12.8) points with the in-ear device. Use of the in-ear device was associated with a significant decrease in overall workload score while wearing the half-face elastomeric respirator (38.4; 95% CI, 23.5-53.3; P < .001) and the PAPR (18.4; 95% CI, 0.4-36.4; P = .04). Conclusions and Relevance: This study found that among participants using facial respirators that impaired communication, a novel in-ear device was associated with improved communication and decreased listening effort. Such a device may be a feasible solution for protecting health care workers in the operating room while allowing them to communicate safely, especially during the COVID-19 pandemic.

Modulation rate and age effect on intermittent speech recognition / Efeito da idade e da taxa de modulação no reconhecimento da fala intermitente

ABSTRACT Purpose: to investigate the auditory recognition of intermittent speech in relation to different modulation rates and ages. Methods: 20 young people, 20 middle-aged adults, and 16 older adults, all of them with auditory thresholds equal to or lower than 25 dB HL up to the frequency of 4000 Hz. The participants were submitted to intermittent speech recognition tests presented in three modulation conditions: 4 Hz, 10 Hz, and 64 Hz. The percentages of correct answers were compared between age groups and modulation rates. ANOVA and post hoc tests were conducted to investigate the modulation rate effect, and the mixed linear regression model (p < 0.001). Results: regarding the age effect, the data showed a significant difference between young people and older adults, and between middle-aged and older adults. As for the modulation rate effect, the indexes of correct answers were significantly lower at the slower rate (4 Hz) in the three age groups. Conclusion: an age effect was verified on intermittent speech recognition: older adults have greater difficulty. A modulation rate effect was also noticed in the three age groups: the higher the rate, the better the performance.

RESUMO Objetivo: investigar o reconhecimento auditivo da fala intermitente em função de diferentes taxas de modulação e em função da idade. Métodos: participaram do estudo vinte jovens, vinte adultos de meia idade, e dezesseis idosos, todos com limiares auditivos iguais ou menores que 25 dB NA até a frequência de 4000 Hz. Os participantes foram submetidos a testes de reconhecimento da fala intermitente apresentada em três condições de modulação: 4 Hz, 10 Hz e 64 Hz. Percentuais de acerto foram comparados entre grupos etários e taxas de modulação. Para a investigação do efeito da taxa de modulação foi realizada ANOVA e testes Post Hoc, enquanto para a investigação do efeito da idade, utilizou-se o modelo de regressão linear misto (p<0,001). Resultados: sobre o efeito da idade, os dados mostram diferença significante entre jovens e idosos, e entre adultos de meia idade e idosos. Sobre o efeito da taxa de modulação, os índices de acerto da taxa mais lenta (4Hz) foram significantemente menores nos três grupos etários. Conclusão: foi verificado um efeito da idade no reconhecimento da fala intermitente: idosos apresentaram maior dificuldade. Percebeu-se também um efeito de taxa de modulação nos três grupos etários: quanto maior a taxa, melhor o desempenho.

Recognition of vocoded words and sentences in quiet and multi-talker babble with children and adults.

A vocoder is used to simulate cochlear-implant sound processing in normal-hearing listeners. Typically, there is rapid improvement in vocoded speech recognition, but it is unclear if the improvement rate differs across age groups and speech materials. Children (8-10 years) and young adults (18-26 years) were trained and tested over 2 days (4 hours) on recognition of eight-channel noise-vocoded words and sentences, in quiet and in the presence of multi-talker babble at signal-to-noise ratios of 0, +5, and +10 dB. Children achieved poorer performance than adults in all conditions, for both word and sentence recognition. With training, vocoded speech recognition improvement rates were not significantly different between children and adults, suggesting that improvement in learning how to process speech cues degraded via vocoding is absent of developmental differences across these age groups and types of speech materials. Furthermore, this result confirms that the acutely measured age difference in vocoded speech recognition persists after extended training.

Comparing audiometric parameters between crushed and intact cartilage tympanoplasty: a double-blinded, randomised, controlled trial study.

OBJECTIVE: To investigate hearing and the take rate of crushed cartilage grafts in tympanoplasty. METHODS: In this double-blinded, randomised, controlled trial, 46 patients with tympanic membrane perforation were enrolled. A conchal cartilage graft was used for reconstruction in both intervention and control groups. In the intervention group, crushed cartilage was used. The success rate and hearing results were ascertained every four months over a one-year follow-up period. RESULTS: A total of 36 patients - 20 in the intervention group and 16 in the control group - completed one year of follow up. There were no statistically significant differences between the two groups in mean air-bone gap, bone conduction threshold, speech discrimination score or speech reception threshold. CONCLUSION: The reduction in living cells after crushed cartilage tympanoplasty may decrease the rigidity and the volume of the graft, but may not necessarily improve the hearing results.

Development of the Continuous Number Identification Test (CNIT): feasibility of dynamic assessment of speech intelligibility.

Objective: The present study was motivated by a need for a speech intelligibility test capable of indexing dynamic changes in the environment and adaptive processing in hearing aids. The Continuous Number Identification Test (CNIT) was developed to meet these aims.Design: From one location in the free field, speech was presented in noise (∼2 words/s) with a 100-ms inter-word interval. On average, every fourth word was a target digit and all other words were monosyllabic words. Non-numeric words had a fixed presentation level such that the dominant signal-to-noise-ratio (SNR) was held at +6 dB SNR relative to background maskers. To prevent ceiling effects, however, targets were presented at a user-specific SNR, determined by an initial adaptive-tracking procedure that estimated the 79.4% speech reception threshold.Study sample: Ten normal-hearing listeners participated.Results: The CNIT showed comparable psychometric qualities of other established speech tests for long time scales (Exp. 1). Target-location changes did not affect performance on the CNIT (Exp. 2), but the test did show high temporal resolution in assessing sudden changes to SNR (Exp. 3).Conclusions: The CNIT is highly customisable, and the initial experiments tested feasibility of its primary features which set it apart from currently available speech-in-noise tests.

Children with HIV: A scoping review of auditory processing skills.

INTRODUCTION: Auditory processing disorders can negatively affect academic performance in children. They can result from a number of aetiologies, including the human immunodeficiency virus (HIV). Although studies in paediatrics are limited, research suggests that HIV-infected children display poorer auditory processing skills than uninfected children. METHODS: The aims of this study were to scan the peer-reviewed literature on auditory processing skills in HIV-infected children, to describe how auditory processing was tested, how auditory processing skills were reported, and to identify gaps in current evidence. This systematic scoping review was conducted using a modified version of Arksey and O'Malley's framework. Key words comprised 'HIV', 'auditory processing', 'hearing' and 'child'. Electronic databases were searched for relevant articles published from 1 January 2000 to 30 April 2018, and reference lists of included studies were pearled. Two researchers reviewed the articles and extracted data on sample descriptors, auditory processing testing procedures, and auditory processing skills. A third author collated the results and resolved discrepancies. The American Speech-Language-Hearing Association description of auditory processing skills framed the analysis. RESULTS: Five articles were included in this review (three from Brazil, one each from Mexico and Tanzania). Samples, and methods of testing were heterogeneous. Three studies reported on localization abilities, while gap detection thresholds, performance on dichotic tasks and speech discrimination scores were reported in one article each. No one study tested all areas of auditory processing skills and there was limited information about the auditory processing skills required for learning. CONCLUSION: This review highlighted the current sparse evidence-base for auditory processing in HIV-infected children. It identified the need to standardise testing procedures, measures of auditory processing skills, and sample selection.

Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties

Abstract Introduction Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective Analyzing results of the SRI test applied to live voiceand recorded speeches from Paraná State, in different Brazilian counties. Method The sample comprised 125 individuals, 25 fromeach county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.

Vowel Duration Discrimination of Children With Childhood Apraxia of Speech: A Preliminary Study.

Purpose The ability of 5- and 6-year-old male children (23 participants) between the chronological ages of 5;0 and 6;11 (years;months) with childhood apraxia of speech (CAS; n = 9) and with typical development (TD; n = 14) to detect differences in vowel duration of syllable pairs is explored. We asked whether the children with CAS show different patterns of performance on the vowel duration difference experimental task than those of their similarly aged peers with TD. Method A male adult audio-recorded the syllable /bɑ/. The /ɑ/ was digitally lengthened and shortened, while maintaining uniform fundamental frequency and amplitude of the vowel and duration of the consonant /b/ at 42 ms. Vowel lengths increased in 40-ms increments, ranging from 208 to 488 ms. Eight pairs of syllables, 1 with equal length and 7 with differing vowel lengths, were randomly presented to the children 10 times in blocks of 16 pairs via a computer application. Results Numerous complementary analyses indicated patterns of performance differed for children with CAS compared to the children with TD. The children with CAS were notably less accurate in their duration discrimination and evidenced greater variability in their performances across duration difference conditions than their peers with TD, signifying they were generally challenged to discriminate the vowel duration differences. Conclusion These results suggest that CAS, which is more generally considered a motor speech disorder, may have a perceptual component of CAS related to vowel duration discrimination. Further research directions and clinical implications are discussed. Supplemental Material https://doi.org/10.23641/asha.8411876.

Diagnostic Precision of Open-Set Versus Closed-Set Word Recognition Testing.

Purpose The aim of the study was to examine the precision of forced-choice (closed-set) and open-ended (open-set) word recognition (WR) tasks for identifying a change in hearing. Method WR performance for closed-set (4 and 6 choices) and open-set tasks was obtained from 70 listeners with normal hearing. Speech recognition was degraded by presenting monosyllabic words in noise (-8, -4, 0, and 4 signal-to-noise ratios) or processed by a sine wave vocoder (2, 4, 6, and 8 channels). Results The 2 degraded speech understanding conditions yielded similarly shaped, monotonically increasing psychometric functions with the closed-set tasks having shallower slopes and higher scores than the open-set task for the same listening condition. Fitted psychometric functions to the average data were the input to a computer simulation conducted to assess the ability of each task to identify a change in hearing. Individual data were also analyzed using 95% confidence intervals for significant changes in scores for words and phonemes. These analyses found the following for the most to least efficient condition: open-set (phoneme), open-set (word), closed-set (6 choices), and closed-set (4 choices). Conclusions Closed-set WR testing has distinct advantages for implementation, but its poorer precision for identifying a change than open-set WR testing must be considered.

A Comparison of Word-Recognition Performances on the Auditec and VA Recorded Versions of Northwestern University Auditory Test No. 6 by Young Listeners with Normal Hearing and by Older Listeners with Sensorineural Hearing Loss Using a Randomized Presentation-Level Paradigm.

BACKGROUND: The Auditec of St. Louis and the Department of Veterans Affairs (VA) recorded versions of the Northwestern University Auditory Test No. 6 (NU-6) are in common usage. Data on young adults with normal hearing for pure tones (YNH) demonstrate equal recognition performances on the two versions when the VA version is presented 5 dB higher but similar data on older listeners with sensorineural hearing loss (OHL) are lacking. PURPOSE: To compare word-recognition performances on the Auditec and VA versions of NU-6 presented at six presentation levels with YNH and OHL listeners. RESEARCH DESIGN: A quasi-experimental, repeated-measures design was used. STUDY SAMPLE: Twelve YNH (M = 24.0 years; PTA = 9.9-dB HL) and 36 OHL listeners (M = 71.6 years; PTA = 26.7-dB HL) participated in three, one-hour sessions. DATA COLLECTION AND ANALYSES: Each listener received 100 stimulus words that were randomized by 6 presentation levels for each of two speakers (YNH, -2 to 28-dB SL; OHL, -2 to 38-dB SL). The sessions were limited to 25 practice and 400 experimental words. Digital versions of the 16, 25-word tracks for each session were alternated between speakers. RESULTS: Each of the 48 listeners had higher recognition performances on the Auditec version of NU-6 than on the VA version. The respective overall recognition performances on the Auditec and VA versions were 71.4% and 64.1% (YNH) and 68.7% and 58.2% (OHL). At the highest presentation levels, recognition performances on the two versions differed by only 0.5% (YNH) and 3.3% (OHL). At the 50% correct point, performances on the Auditec version were 3.2 dB (YNH) and 6.1 dB (OHL) better than those on the VA version. The slopes at the 50% points on the mean functions for both speakers were about 4.9%/dB (YNH) and 3.0%/dB (OHL); however, the slopes evaluated from the individual listener data were steeper, 5.2 to 5.3%/dB (YNH) and 3.3 to 3.5%/dB (OHL). When the individual data were transformed from dB SL to dB HL, the differences between the two listener groups were emphasized. The four functions (2 speakers by 2 listener groups) were plotted for each of the 48 participants and each of the 200 words, which revealed the gamut of relations among the datasets. Examination of the data for each speaker across test sessions, in the traditional 50-word lists, and in the typically used 25-word lists of Randomization A revealed no differences of clinical concern. Finally, introspective reports from the listeners revealed that 91.7% and 83.3% of the YNH and OHL listeners, respectively, thought the Auditec speaker was easier to understand than the VA speaker. Recognition performances on each participant and on each word are presented.

Perception of speech and language pathologists towards augmentative and alternative communication in Pakistan.

OBJECTIVE: To determine the level of understanding and use of augmentative and alternative communication devices in Pakistani speech pathologists.. METHODS: The cross-sectional survey was conducted from January to June 2015 in six major cities of Pakistan: Islamabad, Rawalpindi, Lahore, Karachi, Quetta and Peshawar. It comprised speech and language pathologists who were asked to fill a questionnaire that consisted of10 questions. Data was analysed using SPSS17. Result: Overall calculated mean and standard error of mean from the respondents who agreed and strongly agreed regarding understanding, opinion-assessment and treatment about augmentative and alternative communication was153±36.373 and 12.124 respectively. RESULTS: Of the 132 subjects, 68(51.5%) were in the education group and 64(48.5%) in the control group. Postintervention, 11(16.2%) women in the education group and 37(57.8%)in the control group developed severe preeclampsia. Subsequently, 44(64.7%) in the education group had no preeclampsia. The corresponding number in the control group was 15(23.4%). CONCLUSIONS: Speech pathologists had understanding of assessing and working with individuals using augmentative and alternative communication.

The MAndarin spoken word-Picture IDentification test in noise-Adaptive (MAPID-A) measures subtle speech-recognition-in-noise changes and spatial release from masking in very young children.

BACKGROUND: Spatial release of masking (SRM) is a measure of an individual's ability to perform speech-noise segregation, which is usually quantified by the extent of improvement of the individual's speech recognition performance when the noise is switched from a spatially co-located position (e.g., speech and noise both presented from the front) to a spatially separated position (e.g., speech presented from the front and noise presented from the right side) with reference to the target speech. SRM is a combined measure of head shadow and binaural unmasking benefits. SRM has only been investigated in young children at group level but not at individual participant level in the international literature due to the lack of reliable speech recognition test materials able to detect subtle statistically significant within-participant changes in speech-recognition-in-noise thresholds. METHOD: The performance to signal-to-noise ratio (P-SNR) functions of twenty-four disyllabic words were obtained from 40 native Mandarin-speaking children aged 3.6-6.2 years with reported normal speech, language and hearing. The test items' difficulty levels were homogenized by adjusting the speech intensity level of each item so that the adjusted signal-to-noise ratio for 50% correct score (SNR-50%) point of each item would overlap at the mean SNR-50% point of all test items. In the MAPID-A, the homogenized test items were randomly presented in an adaptive testing procedure at a fixed noise intensity level, but the speech intensity level of the upcoming test item varied in 2-dB SNR steps depending on the recognition result of the previous test item. The SNR reversal point is marked by a change from a decrease to an increase in the SNR or vice versa. Two successive SNR reversal points marked the boundaries of an excursion. The mid-points from 12 excursions (in dB SNR) were averaged to produce the adaptive SNR-50% measure (aSNR-50%). RESULTS: The aSNR-50% results were obtained from another 12 children aged 4.8-5.3 years with reported normal speech, language and hearing. The average 99% confidence interval (CI) of all participants' mean aSNR-50% values was ±1.61 dB SNR; therefore, 3.22 dB SNR was the average critical difference required to confirm a significant difference in the scores obtained from the same participant between two test conditions. Statistically significant within-participant SRM was identified in 95% of the participants; in other words, aSNR-50% obtained from the spatially separated condition outperformed aSNR-50% obtained from the spatially co-located condition. The adaptive testing procedure was highly reliable, with an within-participant test-retest reliability of 90.6%. and significantly limited testing time to an average of 4.2 min. This research study has fulfilled its aim on detecting subtle within-participant SRM in very young children starting from 4 years of age with a reliable statistical procedure. MAPID-A offers a reliable and efficient clinical tool to investigate speech-recognition-in-noise and SRM performances in young Mandarin-speaking children. CONCLUSIONS: The narrow CIs, high test-retest reliability, and short testing time has proven that the MAPID-A is a promising sensitive, reliable and time-efficient clinical tool to detect subtle within-participant speech-recognition-in-noise changes in children as young as 4-5 years. The MAPID-A offers a clinical tool to behaviorally track young children's development in speech-recognition-in-noise and SRM, and to potentially review the development of the auditory neural pathway and the cerebral dominance for speech-recognition-in-noise in young children.

[The adaptive Freiburg monosyllabic test in noise : Development of a procedure and comparison of the results with the Oldenburg sentence test]. / Die adaptive Messung des Freiburger Einsilbertests im Störschall : Entwicklung einer Messmethode und Vergleich der Ergebnisse mit dem Oldenburger Satztest.

BACKGROUND: Whereas sentence tests are commonly performed using an adaptive procedure, this method has not yet been transferred to the Freiburg monosyllabic speech test, the most important word test. When using different procedures, a comparison of results between sentence and word tests is not possible. Therefore, an adaptive procedure which has proven itself in sentence tests was transferred to the Freiburg monosyllabic test in noise. The results of the new procedure were compared to the standard of sentence tests, i.e., the Oldenburg sentence test. METHODS: The adaptive Freiburg monosyllabic speech test and the Oldenburg sentence test were applied in 40 otologically normal subjects in a randomized order. Results were analyzed with respect to time requirements, possible gender differences, the influence of test order, and correlation of test results. RESULTS: The time required for the adaptive Freiburg monosyllabic speech test was significantly higher than for the Oldenburg sentence test. No significant impact of gender or test order could be shown. The mean signal-to-noise ratio for 50% speech discrimination of the Oldenburg sentence test was significantly smaller than for the adaptive Freiburg monosyllabic speech test. No correlation could be shown between the results of the two tests CONCLUSION: The Freiburg monosyllabic test can not only be used for quantifying discrimination loss in percentage terms, but also to measure the 50% speech recognition threshold with an adaptive algorithm. However, the procedure of the adaptive Freiburg monosyllabic test is more time consuming than that of the Oldenburg sentence test. Concerning a possible missing correlation between the results for 50% speech discrimination, further studies with hearing-impaired persons are needed.

The effect of presentation level on spectrotemporal modulation detection.

The understanding of speech in noise relies (at least partially) on spectrotemporal modulation sensitivity. This sensitivity can be measured by spectral ripple tests, which can be administered at different presentation levels. However, it is not known how presentation level affects spectrotemporal modulation thresholds. In this work, we present behavioral data for normal-hearing adults which show that at higher ripple densities (2 and 4 ripples/oct), increasing presentation level led to worse discrimination thresholds. Results of a computational model suggested that the higher thresholds could be explained by a worsening of the spectrotemporal representation in the auditory nerve due to broadening of cochlear filters and neural activity saturation. Our results demonstrate the importance of taking presentation level into account when administering spectrotemporal modulation detection tests.

Vocal emotion recognition performance predicts the quality of life in adult cochlear implant users.

Clinical tests of cochlear implant (CI) outcomes in sentence recognition cannot fully reflect CI users' self-reported quality of life (QoL). Here, vocal emotion recognition scores, speech reception thresholds (SRTs), and demographic factors were tested as predictors of QoL scores assessed with the Nijmegen Cochlear Implant Questionnaire in postlingually deafened adult CI users. After correction for multiple comparisons, vocal emotion recognition scores were significantly correlated with QoL scores in all subdomains (social interaction, self-esteem, etc.), while SRTs and duration of CI use were not. Vocal emotion recognition may thus be used in clinic to accurately and broadly predict QoL with CIs.