Development of a Speech Intelligibility Test for Children in Swiss German Dialects.

The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.

Evaluation of the long-term safety and performance of an active middle ear implant (AMEI) in the treatment of hearing loss in children and adolescents with a primary focus on improvement in speech discrimination. Prospective, multicentric, single-subject repeated-measures design in which each subject serves as his or her own control. Thirty-one pediatric subjects aged 5 to 17 years. Implantation of an active middle ear implant. Improvement in word recognition scores, speech reception thresholds (SRT) in quiet and noise, in addition to air conduction, bone conduction, and sound field thresholds were evaluated in two age groups. Residual hearing did not change over time and speech intelligibility significantly improved and remained stable after 36 months. Children aged 5 to 9 improved in WRS from 21.92 to 95.38% and in SRT in quiet and in noise respectively from 62.45 dB SPL (sound pressure level) and +1.14 dB SNR to 42.07 dB SPL and -4.45 dB SNR. Adolescents aged 10 to 17 improved in WRS from 12.78 to 84.71% and in SRT in quiet and in noise respectively from 63.96 dB SPL and +3.32 dB SNR to 35.31 dB SPL and -4.55 dB SNR. The AMEI, under investigation, is a safe treatment for children and adolescents, and significantly improved audiological performance that remains stable on the long-term scale (up to 36 mo postimplantation). In general, all adult-related issues and questions regarding safety and performance can also be applied to the pediatric population, as no apparent specific issues developed.

The Turkish Digit Triplet Test for hearing self-screening purposes and the Turkish Matrix Test (TURMatrix) for follow-up hearing diagnostics offer an automated closed-set response format where patients respond by choosing from response alternatives. Their applicability for testing Turkish-speaking patients in their native language by German audiologists with different Turkish language skills was investigated. Tests were composed of spoken numbers (Turkish Digit Triplet Test) or sentences (TURMatrix). For 49 participants differing in hearing ability, speech reception thresholds (SRTs) in noise and quiet were obtained, for the TURMatrix with either the open- or closed-set response format, by audiologists with and without Turkish language skills, respectively. SRTs of both tests correlate closely with each other as well as with hearing ability, but not as closely as individual SRTs in quiet with hearing ability. SRTs in noise of listeners with normal hearing were about 0.7 dB lower for the closed-set than for the open-set response format. The 2 tests yield comparable results and are applicable to professionals without suitable language skills. For the closed-set response format of the TURMatrix, literacy is crucial and supplemental (visual) cues improve performance. Speech audiometry in noise should assess suprathreshold processing deficits independently from language proficiency in the majority language.

Newborn hearing screening, early intervention programs, and advancements in cochlear implant and hearing aid technology have greatly increased opportunities for children with hearing loss to become intelligible talkers. Optimizing speech intelligibility requires that progress be monitored closely. Although direct assessment of intelligibility has been a cumbersome undertaking, advancements in digital recording technology and expanded strategies for recruiting listener-judges can make this tool much more practical in contemporary school and clinical settings. The main purposes of this tutorial are to present a rationale for assessing children's connected speech intelligibility, review important uses for intelligibility scores, and describe time-efficient ways to estimate how well children's connected speech can be understood. This information is offered to encourage routine assessment of connected speech intelligibility in preschool and school-age children with hearing loss.

This investigation sought to determine whether scores from a commonly used word-based articulation test are closely associated with speech intelligibility in children with hearing loss. If the scores are closely related, articulation testing results might be used to estimate intelligibility. If not, the importance of direct assessment of intelligibility is reinforced. Forty-four children with hearing losses produced words from the Goldman Fristoe Test of Articulation-Second Edition (Goldman & Fristoe, 2000) and sets of 10 short sentences. Correlation analyses were conducted between scores for 7 word-based predictor variables and percent-intelligible scores derived from listener judgments of stimulus sentences. Six of 7 predictor variables were significantly correlated with percent-intelligible scores. However, regression analysis revealed that no single predictor variable or multivariable model accounted for more than 25% of the variability in intelligibility scores. The findings confirm the importance of assessing connected speech intelligibility directly.

Relations between perception of suprathreshold speech and auditory functions were examined in 24 hearing-impaired listeners and 12 normal-hearing listeners. The speech intelligibility index (SII) was used to account for audibility. The auditory functions included detection efficiency, temporal and spectral resolution, temporal and spectral integration, and discrimination of intensity, frequency, rhythm, and spectro-temporal shape. All auditory functions were measured at 1 kHz. Speech intelligibility was assessed with the speech-reception threshold (SRT) in quiet and in noise, and with the speech-reception bandwidth threshold (SRBT), previously developed for investigating speech perception in a limited frequency region around 1 kHz. The results showed that the elevated SRT in quiet could be explained on the basis of audibility. Audibility could only partly account for the elevated SRT values in noise and the deviant SRBT values, suggesting that suprathreshold deficits affected intelligibility in these conditions. SII predictions for the SRBT improved significantly by including the individually measured upward spread of masking in the SII model. Reduced spectral resolution, reduced temporal resolution, and reduced frequency discrimination appeared to be related to speech perception deficits. Loss of peripheral compression appeared to have the smallest effect on the intelligibility of suprathreshold speech.

The random forest technique, a tree-based study model, predicts the results by using random decision trees based on the bootstrap technique. Therefore, it has a high prediction power and fewer errors, which are advantages of this method. This study aimed to provide baseline data regarding the language therapy after cochlear implantation by identifying the factors associated with the speech intelligibility of children with cochlear implantation. This study evaluating the factors associated with the articulation accuracy of children with cochlear implantation. This study targeted 82 hearing-impaired children, who lived in Seoul, Incheon, and Suwon areas, were between 4 and 8 years old, and had been worn cochlear implant at least one year and less than five years. Explanatory variables used in this study included gender, age, household income, the wear time of a cochlear implant, vocabulary index, and corrected hearing. Speech intelligibility was analyzed using the 'speech intelligibility test tool' composed of nine sentences. The predictive model for speech intelligibility of children with cochlear implants was developed using random forest. The major predictors of the articulation accuracy of children with cochlear implantation were the wear time of a cochlear implant, the time since cochlear implantation, vocabulary, household income, age, and gender, in the order of the magnitude. The final error rate of the random forest model developed by generating 500 bootstrap samples was 0.22, and the prediction rate was 78.8%. The results of this study on a prediction model suggested that it would be necessary to implement cochlear implantation and to develop a customized aural rehabilitation program considering the linguistic ability of a subject for enhancing the speech intelligibility of a child with cochlear implantation.

To evaluate speech intelligibility in children using cochlear implantation systems. The study included 75 children from 4 to 14 years old, with an average age of 7.43±2.85 years, implanted with Med-el, Advanced Bionics, Cochlear and Neurelec systems. The group included children, who had been using CI for more than 1 year, without any other pathology, who could perform speech tests. The method of speech audiometry in free field was used before setting the CI processor, within 1 month after setting the CI processor. Russian speech material was used (M.Yu. Boboshko, E.I. Riehakainen, 2019). According to speech audiometry in the free sound field before fitting the speech processor the intelligibility of monosyllabic words was 73.06±12.92%; multi-syllabic words - 75.86±14.24%; monosyllabic words in noise - 73.15±10.70%; multi-syllabic words in noise - 79.01±12.28%. The results of speech intelligibility after setting the CI processor: monosyllabic - 79.28±12.26%; multi-syllabic-85.50±12.34%; monosyllabic in noise - 77.48±8.79%; multi-syllabic in noise - 85.05±14.26%. Speech audiometry in a free sound field in silence and noise is a simple and effective additional method for correcting the parameters of CI processor.

Background and Aim: Cochlear implants (CIs) can lead to the development of verbal communication in areas such as sound repertoire, speech intelligibility (SI), and conversational skills. The SI refers to the ability to make recognizable speech sounds. Children with CIs may experience poorer SI than normal- hearing (NH) children. This study aims to compare the SI between children with CIs and NH peers matched for chronological age and hearing age. Methods: The speech samples of 40 monolingual Persian-speaking children, including 20 children with CIs and 20 NH children were used in this study. The children’s SI was analyzed using three measures of the percentage of correct consonants, percentage of correct vowels, and percentage of intelligible words. One speech-language pathologist and two non-professional listeners transcribed each speech sample. Results: The results showed no significant difference in any measures of SI between CI children and NH hearing age-matched peers, but there was a significant difference between CI children and NH chronological age-matched peers (p<0.05). Conclusion: The SI in Persian-speaking children with CIs is the same as in NH hearing age-matched peers, but it was poorer compared to NH chronological age-matched peers. If the children with hearing impairments receive CIs sooner, their SI can be greater. Cochlear implantation improves SI by increasing the hearing experience. Keywords: Speech intelligibility; percentage of correct consonants; percentage of correct vowels; percentage of intelligible words; cochlear implant; hearing age

AimThis European multicentric study aimed to prove safety and performance of the Bonebridge BCI 602 in children and adults suffering from either conductive hearing loss (CHL), mixed hearing loss (MHL), or single-sided sensorineural deafness (SSD).Methods33 patients (13 adults and 10 children with either CHL or MHL and 10 patients with SSD) in three study groups were included. Patients were their own controls (single-subject repeated measures), comparing the unaided or pre-operative to the 3-month post-operative outcomes. Performance was evaluated by sound field thresholds (SF), word recognition scores (WRS) and/or speech reception thresholds in quiet (SRT) and in noise (SNR). Safety was demonstrated with a device-specific surgical questionnaire, adverse event reporting and stable pure-tone measurements.ResultsThe Bonebridge BCI 602 significantly improved SF thresholds (+ 25.5 dB CHL/MHL/SSD), speech intelligibility in WRS (+ 68.0% CHL/MHL) and SRT in quiet (− 16.5 dB C/MHL) and in noise (− 3.51 dB SNR SSD). Air conduction (AC) and bone conduction (BC) thresholds remained stable over time. All adverse events were resolved, with none unanticipated. Mean audio processor wearing times in hours [h] per day for the CHL/MHL group were ~ 13 h for adults, ~ 11 h for paediatrics and ~ 6 h for the SSD group. The average surgical length was 57 min for the CHL/MHL group and 42 min for the SSD group. The versatility of the BCI 602 (reduced drilling depth and ability to bend the transition for optimal placement) allows for treatment of normal, pre-operated and malformed anatomies. All audiological endpoints were reached.ConclusionsThe Bonebridge BCI 602 significantly improved hearing thresholds and speech understanding. Since implant placement follows the patient’s anatomy instead of the shape of the device and the duration of surgery is shorter than with its predecessor, implantation is easier with the BCI 602. Performance and safety were proven for adults and children as well as for the CHL/MHL and SSD indications 3 months post-operatively.

Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the muscles used for speech. Resulting speech difficulties can range from mild, with slightly slurred articulation and breathy voice, to profound, with an inability to produce any recognisable words. Children with dysarthria are often prescribed communication aids to supplement their natural forms of communication. However, there is variation in practice regarding the provision of therapy focusing on voice and speech production. Descriptive studies have suggested that therapy may improve speech, but its effectiveness has not been evaluated. To assess whether any speech and language therapy intervention aimed at improving the speech of children with dysarthria is more effective in increasing children's speech intelligibility or communicative participation than no intervention at all , and to compare the efficacy of individual types of speech language therapy in improving the speech intelligibility or communicative participation of children with dysarthria. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015 , Issue 7 ), MEDLINE, EMBASE, CINAHL , LLBA, ERIC, PsychInfo, Web of Science, Scopus, UK National Research Register and Dissertation Abstracts up to July 2015, handsearched relevant journals published between 1980 and July 2015, and searched proceedings of relevant conferences between 1996 to 2015. We placed no restrictions on the language or setting of the studies. A previous version of this review considered studies published up to April 2009. In this update we searched for studies published from April 2009 to July 2015. We considered randomised controlled trials and studies using quasi-experimental designs in which children were allocated to groups using non-random methods. One author (LP) conducted searches of all databases, journals and conference reports. All searches included a reliability check in which a second review author independently checked a random sample comprising 15% of all identified reports. We planned that two review authors would independently assess the quality and extract data from eligible studies. No randomised controlled trials or group studies were identified. This review found no evidence from randomised trials of the effectiveness of speech and language therapy interventions to improve the speech of children with early acquired dysarthria. Rigorous, fully powered randomised controlled trials are needed to investigate if the positive changes in children's speech observed in phase I and phase II studies are generalisable to the population of children with early acquired dysarthria served by speech and language therapy services. Research should examine change in children's speech production and intelligibility. It must also investigate children's participation in social and educational activities, and their quality of life, as well as the cost and acceptability of interventions.

A Dutch sentence test (LIST) and a Dutch number test (LINT) have been developed and validated for the accurate measurement of speech reception thresholds (SRT) in quiet and in noise with severely hearing-impaired individuals and cochlear implant recipients in Flanders and the Netherlands. The LIST consists of 35 lists of 10 sentences of equal known difficulty uttered by a female speaker; while the LINT consists of 400 numbers (1–100) by two male and two female speakers. Normative values were determined at fixed S/N ratios and using the adaptive method (Plomp & Mimpen, ), yielding identical results for SRT and slope. For the LIST, average fitted SRTs were 27.1 (0.9) dB SPL in quiet and −7.8 dB (0.2) SNR in noise. In addition, the LIST in noise displayed a steep discrimination function (17%/dB) and good reliability (within-subject standard deviation=1.2 dB). For the LINT average fitted SRTs in quiet were 20.7 (0.9) dB SPL and about −9.0 dB SNR in noise. Again, the slopes of the performance intensity functions were relatively steep, i.e. 8.5%/dB in quiet and 15.2%/dB in noise, suggesting that the LINT is accurate and efficient and thus capable of reflecting subtle changes in performance. First data with cochlear implanted subjects show that both LIST and LINT are feasible and are capable of mapping a large range of hearing disabilities.

For pre-school children, the home literacy environment (HLE) plays an important role in the development of language and literacy skills. As there is little known about the HLE of children with intellectual disabilities (ID), the aim of the present study was to investigate the HLE of children with ID in comparison with children without disabilities. Parent questionnaires concerning aspects of the HLE were used to investigate differences between 48 children with ID, 107 children without disabilities of the same chronological age and 36 children without disabilities of the same mental age (MA). Furthermore, for the children with ID, correlations were computed between aspects of the HLE and children's non-verbal intelligence, speech intelligibility, language and early literacy skills. From the results of the multivariate analyses of variance it could be concluded that the HLE of children with ID differed from that of children in the chronological age group on almost all aspects. When compared with children in the MA group, differences in the HLE remained. However, differences mainly concerned child-initiated activities and not parent-initiated activities. Correlation analyses showed that children's activities with literacy materials were positively related with MA, productive syntax and vocabulary age, and book orientation skills. Also, children's involvement during storybook reading was related with their MA, receptive language age, productive syntax and vocabulary age, book orientation and rapid naming of pictures. The amount of literacy materials parents provided was related to a higher productive syntax age and level of book orientation of the children. Parent play activities were also positively related to children's speech intelligibility. The cognitive disabilities of the children were the main cause of the differences found in the HLE between children with ID and children without disabilities. Parents also adapt their level to the developmental level of their child, which may not always be the most stimulating for the children.

Previous studies have shown that levels for 50% speech intelligibility in quiet and in noise differ for different languages. Here, we aimed to find out whether these differences may relate to different auditory processing of temporal sound features in different languages, and to determine the influence of tinnitus on speech comprehension in different languages. We measured speech intelligibility under various conditions (words in quiet, sentences in babble noise, interrupted sentences) along with tone detection thresholds in quiet [PTA] and in noise [PTAnoise], gap detection thresholds [GDT], and detection thresholds for frequency modulation [FMT], and compared them between Czech and Swiss subjects matched in mean age and PTA. The Swiss subjects exhibited higher speech reception thresholds in quiet, higher threshold speech-to-noise ratio, and shallower slope of performance-intensity function for the words in quiet. Importantly, the intelligibility of temporally gated speech was similar in the Czech and Swiss subjects. The PTAnoise, GDT, and FMT were similar in the two groups. The Czech subjects exhibited correlations of the speech tests with GDT and FMT, which was not the case in the Swiss group. Qualitatively, the results of comparisons between the Swiss and Czech populations were not influenced by presence of subjective tinnitus. The results support the notion of language-specific differences in speech comprehension which persists also in tinnitus subjects, and indicates different associations with the elementary measures of auditory temporal processing.

An adaptive method for measuring speech reception threshold in noise (S/N-threshold) was evaluated with regard to reliability and learning effect. A corresponding method was also tested for speech reception threshold in quiet (SRT). The methods are designed for use with a speech and noise material developed by Hagerman (1982a). Ten normal-hearing subjects and 40 hearing-impaired subjects were tested, the results showing that the test-retest reliability of the S/N-threshold was much better with the new, adaptive, method than with the old one, which was not adaptive. With the new method, a S/N-threshold can be measured within two minutes for most patients (after the initial short training) with a reliability, i.e. standard deviation, of 0.78 dB and a learning effect that is negligible for most subjects if one training list is presented before the test session. It was also concluded that the adaptive method designed for the sentences in quiet gives at least as reliable an SRT result as the old spondée method (including learning effects), but in a shorter time.