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PubMed1991

Evaluating the benefits of cochlear implants in an education setting.

The material presented here summarizes the first year of a study to determine whether cochlear implants, tactile aids, acoustic hearing aids, or some combination of these are best for developing spoken language in prelingual profoundly deaf children. The effects of each device over and above the gains normally achieved as a result of oral instruction are examined. Each group contains three matched children, one fitted with each device, who are enrolled in the Central Institute for the Deaf (CID) school for 3 years of evaluation and training. This report describes results obtained from four groups of matched subjects during their first year in the study. These subjects improved in all areas evaluated, regardless of the device used. However, the implanted subjects exhibited a greater rate of progress in acquiring auditory speech perception skills. They exhibited no advantage in acquiring speech production skills and spoken language skills during their first year with the device. The subtle advantages provided by the implant may become apparent in spoken language development when 2- and 3-year post-test results are examined.

Child↗
PubMed1984

Clinical measurements of speech reception threshold in noise.

New lists of spoken sentences, edited in a computer, word by word, were tested clinically together with a noise, spectrally shaped as the speech. The purpose was to investigate the reliability and the learning effect of the speech reception threshold in noise, and also to assess the relations of this threshold to conventional audiometric measures. The threshold values ranged from -7 to +7 dB signal-to-noise ratio for the 97 ears investigated. Reliability, expressed as standard deviation for repeated measurements, deteriorated from 0.7 to 1.1 dB as the threshold deteriorated. Learning effect between the first and the second threshold increased from 0 to 1 dB as the threshold deteriorated. No conventional audiometric test showed a high correlation to this threshold measure. The discrimination of the sentences without noise as well as the self-rated speech recognition in noise were also investigated.

Audiometry, Pure-Tone↗
PubMed1988

Sentence reception in noise from one versus two sources: effects of aging and hearing loss.

Sentence reception thresholds (SRTs) and babble detection thresholds (BDTs) were measured for signals presented from loudspeakers located at 0 deg and 90 deg azimuth. In addition, the S/B ratios necessary to achieve SRT in the presence of a 12-talker babble were determined under three conditions in which the speech and babble were presented from the same or spatially separated loudspeakers. In the first experiment, normal-hearing subjects were tested on two occasions. The results were highly reliable, with standard errors of the test-retest differences of less than 1dB for all conditions. In the second experiment, SRTs, BDTs, and S/B ratios were measured for three normal-hearing groups (less than or equal to 39, 40-54, and greater than or equal to 55 years) and for a fourth group with presbycusis (greater than or equal to 55 years). Presbycusics had higher SRTs and BDTs than all other groups regardless of age, and the oldest normals had higher thresholds than younger subjects. Presbycusics required higher S/B ratios than any of the normal groups, and the oldest normal group needed a higher S/B ratio compared to the youngest group. All groups demonstrated a significant advantage in S/B ratio when the sentences and babble sources were spatially separated compared to when they were presented from the same loudspeaker. There was no significant difference in the magnitude of advantage due to spatial separation of speech and noise between the normal groups regardless of age, but the presbycusics had significantly smaller advantages than all normals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Efficiency of speech audiometry and other tests.

A formula for expressing the efficiency of audiological tests is proposed: E = (vb/vw - 1)/T where vb is the variance between subjects, vw is the variance within subjects and T is the testing time. This makes it possible to compare various tests even if they require different testing times. The formula has been used on various speech tests and on pure-tone thresholds for a specific group of hearing-impaired subjects, showing that pure-tone threshold tests are much more efficient than speech tests. Some suggestions are given on how to make speech tests in noise more efficient. It is concluded that the proposed formula of test efficiency should be considered when new tests are designed in order to get quick tests which add as much information as possible.

Analysis of Variance↗
PubMed1999

Auditory function in whiplash-associated disorders.

This was a consecutive, prospective clinical study on 153 ambulatory patients in a tertiary referral center (i.e., a county hospital). All patients had whiplash-associated disorders (WAD) of at least grade II, according to the Quebec classification. All patients underwent pure-tone audiometry, and their audiograms were compared with ISO standards. Fourteen percent of patients with WAD had a hearing impairment exceeding the 90th percentile of the ISO standards. However, in most cases the hearing was not associated with whiplash injury. A subgroup (33 patients)--with normal hearing or slight hearing impairment according to the audiogram--was selected from the total group of patients with WAD. The 33 selected patients and 33 matched controls were tested with the speech-in-noise test (SRN test). However, 40% of this subgroup of patients with WAD reported hearing problems. As many as 30% of the patients with WAD had an abnormal SRN test result, as against 5% of the controls. Significant relations were found between the SRN test and self-assessed hearing loss, but not between the SRN test and tinnitus.

Adolescent↗
PubMedDate not supplied

Speech recognition and just-follow-conversation tasks for normal-hearing and hearing-impaired listeners with different maskers.

Speech recognition (SRT) and just-follow-conversation (JFC) tasks were performed by normal-hearing and hearing-impaired listeners matched for age and sex using three masking backgrounds: speech spectrum random noise, continuous forward speech and reversed speech. In the SRT task, the signal-to-noise (S/N) ratio for 50% correctly repeated words of short, 5-word, low-redundancy sentences was determined. In the JFC task, the listener adjusted the speech level until he felt he could just understand what was being said. The listeners needed a higher S/N ratio for the JFC task than for the SRT task. The speech maskers gave less masking than the random noise. No difference between forward and reversed speech was observed. The hearing-impaired listeners needed a higher S/N ratio than the normal-hearing subjects. Correlations between results obtained with the SRT and the JFC techniques were significant with speech but not with random noise as masker. The highest correlations between pure-tone hearing thresholds at different frequencies and results in the SRT and JFC tests were seen at 0.5 and 1 kHz.

Adult↗
PubMed1994

A comparison of American Speech-Language Hearing Association guidelines for obtaining speech-recognition thresholds.

This study compared two approaches for measuring speech-recognition thresholds (SRTs): the ASHA (1979) and ASHA (1988) guidelines. The subjects were 30 veterans with impaired hearing. Contrary to prior reports, the ASHA (1979) approach was found to be slightly less time consuming than the ASHA (1988) approach. The ASHA (1979) approach also yielded slightly better pure tone average (PTA)-SRT agreement than the ASHA (1988) approach for two of three generally accepted measures for comparing these tests; the third measure yielded equivalent results. Although statistically significant, the differences between these guidelines in test time and PTA-SRT agreement were small and are considered to be clinically insignificant.

Adult↗
PubMedDate not supplied

A five-generation family with late-onset progressive hereditary hearing impairment due to cochleosaccular degeneration.

Cochleosaccular dysplasia or degeneration (Scheibe degeneration) is considered the most common cause of profound congenital hearing impairment, and accounts for approximately 70% of cases 2 with hereditary deafness. A five-generation family with hereditary hearing impairment associated with cochleosaccular degeneration has recently been identified. The diagnosis of classical Scheibe degeneration was based on histopathological findings in the temporal bones of the proband, a 61-year-old profoundly deaf male. Auditory structures in the brainstem of the proband were also studied. Twenty-two members of the family were contacted for surveys and blood samples. Of these, 6 males and 2 females have hearing impairment. Complete audiological evaluation was done on 12 family members, and prior audiologic records of the proband and affected family members were available for study. Affected family members suffer a mild bilateral high-frequency hearing loss during childhood and adolescence, and progress to moderate-to-profound deafness in the second and third decades of life. The family is suitable for linkage analysis and does not map to previously reported loci harboring autosomal dominant, nonsyndromic hereditary hearing impairment genes. The genetic study of this family will be helpful in identifying the genes which, when mutated, result in Scheibe degeneration.

Acoustic Impedance Tests↗
PubMed2003

Tri-word presentations with phonemic scoring for practical high-reliability speech recognition assessment.

Speech recognition test reliability is optimized with 450 test items, and the Computer Assisted Speech Recognition Assessment (CASRA) test is a practical approach for achieving this goal by combining 50 presentations of 3 consonant-vowel nucleus-consonant (CNC) words each with phonemic scoring (S. A. Gelfand, 1998). However, optimized reliability might not be essential if reliability is as high as possible in light of practical constraints and what the clinician is trying to do with the results. The CASRA paradigm addresses these compromise goals with a reduced number of 3-word sets: 25 sets yield 25 (groups) x 3 (words) x 3 (phonemes) = 225 test items, 20 sets give 20 x 3 x 3 = 180 items, and 10 sets provide 10 x 3 x 3 = 90 items. This study addressed the empirical reliability of such an approach, and the extent to which results on shortened versions predict full-test scores. Test and retest scores were obtained for 10-, 20-, and 25-set versions of the CASRA for 144 participants with a wide range of hearing ability. For group data, first and second scores were highly correlated and not significantly different from each other for all 3 test sizes. Performance based on 20 and 25 sets accounted for roughly 97% of the variance of full (50-set) test scores, and scores based on 10 sets accounted for about 88% of the full-test variance. Individual test-retest reliability agreed with theoretical expectations based on 95% binomial confidence intervals. Cases outside the 95% confidence limits were 7.6% for 10 sets, and 3.5% for 20 and 25 sets with phoneme scoring, and 4.9% for 10 and 20 sets and 3.5% for 25 sets with word scoring. The shortened CASRA is a practical way to achieve improvements in reliability over traditional word tests. The 20-set version may approximate the strongest compromise when trying to shorten test size without appreciably reducing reliability for clinical purposes. However, the 10-set version is probably a more practical approach for routine use because it accounts for 88% of full-test variance, is more reliable than a traditional 75-word test, and does not appear to be subject to significant short-term learning effects.

Adolescent↗
PubMed1996

Speech recognition in noise. Development of a computerized test and preparation of test material.

In adaptable, Finnish language, "speech in noise" test was developed using a personal computer equipped with a sound card. each of the 1000 test items stored as a separate digitized wave form file on the hard disk of a personal computer consisted of disyllabic words on one stereo track and synchronized speech noise on the other. Because only a few randomly selected words are presented in this test for SRTN (speech recognition threshold in noise or S/N ratio corresponding to 50% recognition) the selection and equalization of test material is considered to be crucial to the achievement of reproducible results in short time. Equalization of the test items (word + noise) in accordance with degree of difficulty, by adapting the noise signal to the properties of the corresponding word, and selection of 510 of the initial 1,000 recordings with the smallest SDs are described. The effect of this procedure on the test-retest reliability of testing SRTN is evaluated. Despite contrary expectations, the procedure appears to have no effect on the reliability of the speech recognition threshold in noise (SD from 1.5 to 1.7 dB).

Audiometry, Speech↗
PubMed2006

Relationship between Mandarin speech reception thresholds and pure-tone thresholds in the geriatric population.

BACKGROUND/PURPOSE: In the geriatric population, the reliability of pure-tone threshold (PTT) is sometimes poorer than that in young adults because of various reasons. This study assessed the relationship between Mandarin speech reception thresholds (SRTs) and PTTs in the aged and developed SRT as a measure for corroborating PTT. METHODS: This prospective study enrolled 46 consecutive subjects over 60 years of age. The results of SRT and PTT were collected from one ear randomly selected from each subject. Simple linear and multiple regressions were used to determine the correlation and linear regression coefficients between SRTs and PTTs at various frequencies. RESULTS: In the simple regression analysis, the correlation coefficient was highest at 1000 Hz (r = 0.949) and 500 Hz (r = 0.922), followed by 250 Hz (r = 0.850) and 2000 Hz (r = 0.792). In the multiple regression model with SRT as the dependent variable and PTTs as predictor variables, the resultant multiple correlation coefficient R was 0.967, while R2 was 0.936. In this model, PTTs at the frequencies of 500 Hz and 1000 Hz contributed significantly to the variance in SRTs with p values of 0.029 and < 0.001, respectively. These results demonstrated that the Mandarin SRT is strongly associated with PTTs at the frequencies of 500 Hz and 1000 Hz. CONCLUSION: This study established the agreement between Mandarin SRTs and PTTs in the low tone area of speech frequencies in the geriatric population. In clinical settings, SRT test can be rapidly and easily performed and is relatively inexpensive. It is a vital indicator of the accuracy of PTT measurement.

Aged↗
PubMed2002

[Digital vs. analog hearing aids for children. Is there a method for making an objective comparison possible?].

Until now, the assumed benefits of digital hearing aids are reflected only in subjective descriptions by patients with hearing aids, but cannot be documented adequately by routine diagnostic methods. Seventeen schoolchildren with moderate severe bilateral symmetrical sensorineural hearing loss were examined in a double-blinded crossover study. Differences in performance between a fully digital hearing aid (DigiFocus compact/Oticon) and an analogous digitally programmable two-channel hearing aid were evaluated. Of the 17 children, 13 choose the digital and 4 the analogous hearing aid. In contrast to the clear subjective preferences for the fully digital hearing aid, we could not obtain any significant results with routine diagnostic methods. Using the "virtual hearing aid," a subjective comparison and speech recognition performance task yielded significant differences. The virtual hearing aid proved to be suitable for a direct comparison of different hearing aids and can be used for double-blind testing in a pediatric population.

Child↗
PubMed1997

Acclimatization to hearing aids.

OBJECTIVE: To investigate acclimatization to hearing aids. DESIGN: Forty-eight subjects took part in a study in which hearing aid benefit was measured four times over the initial 3 mos of participation. At the start, 24 subjects were experienced hearing aid users and 24 had never worn a hearing aid before. Subjects wore one of three models of hearing aid with one of six different configurations (combination of frequency response and method of output limiting). Hearing aid benefit was measured with CID W-1 spondees and the Hearing in Noise Test (HINT) test. Testing took place on Days 0 (day of fitting), 30, 60, and 90. Analyses of variance were used to determine whether hearing aid benefit changed over time as a function of hearing aid user status, hearing aid configuration, and hearing aid volume setting. RESULTS: There were small, nonsignificant changes in hearing aid benefit over the test sessions with both sets of test materials. There were no interactions between hearing aid benefit over time and hearing aid user status or hearing aid volume setting. There was an interaction between benefit over time and hearing aid configuration on one test measure only. CONCLUSIONS: The data showed little evidence of acclimatization over the 3 mo of hearing aid use. The test materials used here were low- to mid-frequency sensitive, and, therefore, it is concluded that if acclimatization did occur, it did so primarily at high frequencies. Because the HINT test has good face validity to everyday listening situations, it is suggested that the clinical ramifications of acclimatization are probably small.

Aged↗
PubMed1996

Identification of pseudohypacusis using speech recognition thresholds.

OBJECTIVE: To determine the extent to which procedural variations affect pure-tone average-spondee threshold (PTA-SRT) agreement in pseudohypacusis, to propose a theoretical framework to account for threshold differences due to procedural variations, and to devise an effective screening test for identification of pseudohypacusis. DESIGN: The subjects were normally hearing listeners who feigned a hearing loss. One experimental group received an ascending pure-tone (PT) technique combined with an ascending SRT procedure. A second experimental group received an ascending PT technique paired with a descending SRT procedure. A third experimental group received an ascending SRT procedure paired with a descending PT procedure. RESULTS: The group mean difference between the three-frequency PTA and the SRT was 10.6, 2.3, and 41.6 dB for the first, second, and third experimental groups, respectively. Comparison SRTs and PTAs from cooperative patients with hearing loss showed that a two-frequency PTA yielded a more effective test for pseudohypacusis than did a three-frequency PTA. CONCLUSIONS: The procedural differences noted in this study are consistent with a loudness bias. It is recommended that clinicians employ an ascending procedure to measure SRTs and a descending procedure to measure PT thresholds to maximize the effectiveness of a screening test for pseudohypacusis based on PTA-SRT differences.

Adult↗
PubMed1975

Relative intelligibility of the CID spondees as presented via monitored live voice.

Using three speakers and 75 subjects, a 7.90dB range in the relative intelligibility of the Central Institute for the Deaf (CID) spondees was found when they were presented via monitored live voice. This range is consistent with previous research and is considered unnecessarily large and detrimental to the efficiency and precision of the speech reception threshold (SRT) test. The exclusive use of 18 words that have a mean range of 1.5 dB is suggested. The slope of the 3l-item spondee articulation function is 12 percent per decibel and is slightly steeper than previous research using the CID W-1 recorded spondees. The slope for the suggested 18-item test is also about 12 percent per decibel. For the 36-item test the mean speech detection threshold (SDT) was 6.6 dB sound pressure level (SPL) and the mean SRT was 14.2 db SPL. The 7.6-dB difference between the two speech measures is consistent with previous research but the SRT is about 6 dB better than the 20 dB SPL recommended by ANSI 1969. For the suggested 18-item test, the mean SRT was 14.5 dB SPL, which was 7.9 dB above SDT. When the 18-item test is used, average normal hearing can be expected to be about 5.5 dB better than specified by ANSI 1969.

Adult↗
PubMed1991

Speech recognition in noise for hearing-impaired subjects: effects of an adaptive filter hearing aid.

Speech-recognition thresholds (SRTs) were obtained in nine sensorineural hearing-impaired subjects wearing an adaptive-filter hearing aid under four separate listening conditions. The SRT was obtained with the filter in and out of the circuit in order to relate the effects of noise reduction to speech recognition performance. The noise level was held constant while the speech level varied (transformed up-down method). For the majority of the subjects tested, the activation of the noise-suppression circuit in the aid resulted in performance equivalent to or worse than that obtained without the circuit activated. For the group, a significant improvement (less than 0.05) in recognition was observed only in low-frequency noise competition.

Aged↗
PubMed1995

Clinical application of distorted speech audiometry.

The clinical validity of four different low-redundant speech tests was calculated using four groups of 83 patients with retrocochlear or central auditory lesions. The speech tests used were: interrupted speech (7 or 10 interruptions/s) time-compressed speech and filtered speech. A comparison between patients and age-matched normal-hearing controls showed that the patients had significantly lower speech recognition score. The best sensitivity ratings of the tests were between 47% and 80%, the highest in patients with cerebellopontine angle tumours and temporal lobe lesions, and the lowest in vascular brainstem lesions. The speech tests with the highest sensitivity were 7 interruptions/s and time-compressed speech.

Adult↗