Establishment of Age-Specific Normative Data for the Canadian French Version of the Hearing in Noise Test for Children

Abstract

A Canadian French version of the Hearing in Noise Test (HINT) has been developed to assess children's ability to recognize speech in noise. To avoid testing a large number of children in each clinical test site to establish soundfield norms, a protocol based on the use of correction factors has been proposed and validated in the current study. More specifically, the objective of this study was to provide a protocol for the establishment of age-specific normative data for the Canadian French HINT for children to facilitate its clinical use and allow comparing an individual child's performance with that of age-matched normal hearing children. Using the proposed protocol, a limited number of normal hearing adults are tested in each HINT condition to correct the adult headphone norms for the soundfield in question, and the correction factors established in the current study are then applied to generate age-specific soundfield norms. Mean adult performance values obtained in a given soundfield are entered into the HINT software, which automatically derives the soundfield adult norms, age-specific children norms, and percentile rankings. Speech reception thresholds (SRT) for sentences were measured in 70 native French-speaking subjects to establish mean performances across various age groups, and correction factors were calculated by comparing performance in each age group with adult performance. To validate the normalization protocol, 28 additional subjects were tested in a new soundfield. The correction factors were applied to adult performance (N = 15) and the resulting predicted scores were compared with measured performance in a group of 9-yr olds (N = 13). Statistical analyses indicate that SRTs decrease with age and reach adult values in older children (12-yr olds). Correction factors are therefore provided for children 6 to 12 yrs old. Spatial separation advantage, the improvement in SRT when speech and noise are spatially separated, also improves with age. The correction factors were effective in predicting mean SRTs for a previously untested age group in all HINT conditions apart from the quiet condition. The difference between predicted and measured performances was less than 0.5 dB for the noise conditions but exceeded 4 dB in the quiet condition. The reliability of SRT measures was determined, with an overall within-subjects SD of repeated measurements of 0.7 dB for the noise front condition. No learning effect was found in the current data. Correction factors can be used to predict performance on the HINT in a group of normal-hearing children in all HINT conditions, apart from quiet. Findings of the current study concur with the literature on age effects in auditory processing abilities, where performance on a variety of auditory tasks has been demonstrated to increase with age to reach adult-like values in adolescence or past 10 yrs.