Abstract
Objectives: The aims of the current study were: (1) to compare growth trajectories of speech recognition in noise for children with normal hearing (CNH) and children who are hard of hearing (CHH) and (2) to determine the effects of auditory access, vocabulary size, and working memory on growth trajectories of speech recognition in noise in CHH.Design: Participants included 290 children enrolled in a longitudinal study. Children received a comprehensive battery of measures annually, including speech recognition in noise, vocabulary, and working memory. We collected measures of unaided and aided hearing and daily hearing aid (HA) use to quantify aided auditory experience (i.e., HA dosage). We used a longitudinal regression framework to examine the trajectories of speech recognition in noise in CNH and CHH. To determine factors that were associated with growth trajectories for CHH, we used a longitudinal regression model in which the dependent variable was speech recognition in noise scores, and the independent variables were grade, maternal education level, age at confirmation of hearing loss, vocabulary scores, working memory scores, and HA dosage.Results: We found a significant effect of grade and hearing status. Older children and CNH showed stronger speech recognition in noise scores compared to younger children and CHH. The growth trajectories for both groups were parallel over time. For CHH, older age, stronger vocabulary skills, and greater average HA dosage supported speech recognition in noise.Conclusion: The current study is among the first to compare developmental growth rates in speech recognition for CHH and CNH. CHH demonstrated persistent deficits in speech recognition in noise out to age 11, with no evidence of convergence or divergence between groups. These trends highlight the need to provide support for children with all degrees of hearing loss in the academic setting as they transition into secondary grades. The results also elucidate factors that influence growth trajectories for speech recognition in noise for children; stronger vocabulary skills and higher HA dosage supported speech recognition in degraded situations. This knowledge helps us to develop a more comprehensive model of spoken word recognition in children.
Highlights
Every year, approximately three in 1,000 children are born with a significant hearing loss (Mehra et al, 2009)
Children who are hard of hearing (CHH) have sufficient residual hearing to benefit from amplification
To better understand the impact of auditory access on listening in noise, we propose to conceptualize the auditory experience of CHH as a combination of unaided hearing, aided Speech Intelligibility Index (SII), and amount of hearing aids (HAs) use (Walker et al, accepted)
Summary
Approximately three in 1,000 children are born with a significant hearing loss (Mehra et al, 2009). Even though CHH have documented weaknesses with listening in noise (Crandell, 1993; Uhler et al, 2011; Caldwell and Nittrouer, 2013; Leibold et al, 2013; McCreery et al, 2015; Klein et al, 2017; Ching et al, 2018), there is little research on how their ability to recognize speech in noise develops over time during the school-age years. Increased knowledge in this area impacts both clinical decision-making and theoretical understanding of the mechanisms that drive listening in noise. The goals of the current study are twofold: (1) to investigate growth rates in speech recognition in noise for school-age CHH and CNH, and (2) to investigate the impact of auditory access and cognitive-linguistic abilities on CHH’s ability to listen in adverse acoustic conditions over time
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