Speech Perception Difficulties Research Articles

Development of Trisyllabic Word Recognition in Noise Test for Marathi-Speaking Children

Abstract Background Language and culture-specific speech perception tests help in the assessment of children's linguistic proficiency and comprehension. Recognizing difficulties in speech perception and implementing interventions in challenging auditory conditions are pivotal for their holistic development. Objective The aim of this study was to develop a speech perception in noise test in Marathi using trisyllabic words for children between the age ranges of 3 and 6 years. Method The study was conducted in two phases. The first phase comprised the development of trisyllabic word recognition in noise test in Marathi and the second phase comprised administration of the test on 90 typically developing normal hearing children aged 3 to 6 years. These children were divided into three groups (group A: >3–4 years; group B: >4–5 years; and group C: >5–6 years), with 30 participants in each group. Results As the signal-to-noise ratio (SNR) increases, children across different age range show an improvement in their speech perception scores. Also, young children require a more favorable SNR compared with older children to effectively comprehend speech in noisy conditions. Conclusion The Trisyllabic word recognition in noise test will help in optimizing classroom acoustics for typical developing and hearing-impaired children. An SNR-based evaluation can provide guidance regarding interventions, amplification decisions, and auditory training, ensuring effective education and communication for children with hearing impairment.

Single-Sided Deafness (SSD) - With the "Second" You Hear Better

Single-sided deafness (SSD) is characterised by deafness in one ear while the other ear has normal hearing. The most common cause in congenital SSD is aplasia of the auditory nerve, and in post-lingual SSD idiopathic hearing loss. Patients with SSD mainly suffer from impaired sound localisation and difficulties in speech perception in noise. There are various therapy options, but binaural hearing is only possible with a cochlear implant (CI).

Evaluating benefits of remote microphone technology for adults with hearing loss using behavioural and predictive metrics

Objective To investigate the benefit of remote-microphone (RM) systems for adults with sensory hearing loss. Design Speech recognition in quiet and in background noise was assessed. Participants with hearing loss underwent testing in two device conditions: hearing aids (HAs) alone and HAs with a RM. Normal hearing participants completed testing in the unaided condition. Predictive speech intelligibility modelling using the Hearing-Aid Speech Perception Index (HASPI) was also performed on recordings of HA processed test material. Study Sample Twenty adults with sensory hearing loss and 10 adults with normal hearing participated. Results Speech recognition for participants with hearing loss improved significantly when using the RM compared to HAs alone fit to Phonak’s proprietary prescription. Largest benefits were observed in the most challenging conditions. At the lowest signal-to-noise ratio, participants with hearing loss using a RM outperformed normal hearing listeners. Predicted intelligibility scores produced by HASPI were strongly correlated to behavioural results. Conclusions Adults using HAs who have significant difficulties understanding speech in noise will experience considerable benefits with the addition of a RM. Improvements in speech recognition were observed for all participants using RM systems, including those with relatively mild hearing loss. HASPI modelling reliably predicted the speech perception difficulties experienced.

Speech perception difficulty modulates theta-band encoding of articulatory synergies.

The human brain tracks available speech acoustics and extrapolates missing information such as the speaker's articulatory patterns. However, the extent to which articulatory reconstruction supports speech perception remains unclear. This study explores the relationship between articulatory reconstruction and task difficulty. Participants listened to sentences and performed a speech-rhyming task. Real kinematic data of the speaker's vocal tract were recorded via electromagnetic articulography (EMA) and aligned to corresponding acoustic outputs. We extracted articulatory synergies from the EMA data with principal component analysis (PCA) and employed partial information decomposition (PID) to separate the electroencephalographic (EEG) encoding of acoustic and articulatory features into unique, redundant, and synergistic atoms of information. We median-split sentences into easy (ES) and hard (HS) based on participants' performance and found that greater task difficulty involved greater encoding of unique articulatory information in the theta band. We conclude that fine-grained articulatory reconstruction plays a complementary role in the encoding of speech acoustics, lending further support to the claim that motor processes support speech perception.NEW & NOTEWORTHY Top-down processes originating from the motor system contribute to speech perception through the reconstruction of the speaker's articulatory movement. This study investigates the role of such articulatory simulation under variable task difficulty. We show that more challenging listening tasks lead to increased encoding of articulatory kinematics in the theta band and suggest that, in such situations, fine-grained articulatory reconstruction complements acoustic encoding.

Effects of Age on the Auditory Cortex During Speech Perception in Noise: Evidence From Functional Near-Infrared Spectroscopy.

Age-related speech perception difficulties may be related to a decline in central auditory processing abilities, particularly in noisy or challenging environments. However, how the activation patterns related to speech stimulation in different noise situations change with normal aging has yet to be elucidated. In this study, we aimed to investigate the effects of noisy environments and aging on patterns of auditory cortical activation. We analyzed the functional near-infrared spectroscopy signals of 20 young adults, 21 middle-aged adults, and 21 elderly adults, and evaluated their cortical response patterns to speech stimuli under five different signal to noise ratios (SNRs). In addition, we analyzed the behavior score, activation intensity, oxyhemoglobin variability, and dominant hemisphere, to investigate the effects of aging and noisy environments on auditory cortical activation. Activation intensity and oxyhemoglobin variability both showed a decreasing trend with aging at an SNR of 0 dB; we also identified a strong correlation between activation intensity and age under this condition. However, we observed an inconsistent activation pattern when the SNR was 5 dB. Furthermore, our analysis revealed that the left hemisphere may be more susceptible to aging than the right hemisphere. Activation in the right hemisphere was more evident in older adults than in the left hemisphere; in contrast, younger adults showed leftward lateralization. Our analysis showed that with aging, auditory cortical regions gradually become inflexible in noisy environments. Furthermore, changes in cortical activation patterns with aging may be related to SNR conditions, and that understandable speech with a low SNR ratio but still understandable may induce the highest level of activation. We also found that the left hemisphere was more affected by aging than the right hemisphere in speech perception tasks; the left-sided dominance observed in younger individuals gradually shifted to the right hemisphere with aging.

Variability in auditory processing performance is associated with reading difficulties rather than with history of otitis media.

The nature and cause of auditory processing deficits in dyslexic individuals have been debated for decades. Auditory processing deficits were argued to be the first step in a causal chain of difficulties, leading to difficulties in speech perception and thereby phonological processing and literacy difficulties. More recently, it has been argued that auditory processing difficulties may not be causally related to language and literacy difficulties. This study compares two groups who have phonological processing impairments for different reasons: dyslexia and a history of otitis media (OM). We compared their discrimination thresholds and response variability to chronological age- and reading age-matched controls, across three auditory processing tasks: frequency discrimination, rise-time discrimination and speech perception. Dyslexic children showed raised frequency discrimination thresholds in comparison with age-matched controls but did not differ from reading age-matched controls or individuals with a history of OM. There were no group differences on speech perception or rise-time tasks. For the dyslexic children, there was an association between phonological awareness and frequency discrimination response variability, but no association with thresholds. These findings are not consistent with a 'causal chain' explanation but could be accounted for within a multiple deficits view of literacy difficulties.

The diversity of speech-perception difficulties among autistic individuals.

Communicative and sensory differences are core autistic traits, yet speech-perception abilities and difficulties among autistic individuals remain poorly understood. Laboratory studies have produced mixed and inconclusive results, in part because of the lack of input from autistic individuals in defining the hypotheses and shaping the methods used in this field of research. Little in-depth qualitative research on autistic experiences of speech perception has been published, yet such research could form the basis for better laboratory research, for improved understanding of autistic experiences, and for the development of interventions. Existing qualitative research describes widespread autistic listening differences with significant impacts, but these results rely on data gathered via oral interviews in a small sample. The present study addresses these limitations and employs a mixed-methods approach to explore autistic listening experiences. We gathered survey data from 79 autistic individuals aged 18-55 without diagnosed hearing loss. The questionnaire included 20 closed-set questions on listening abilities and difficulties and three free-text questions on listening experiences. The free-text questions underwent deductive content analysis using a framework composed of themes from previous interview data on listening experiences (including auditory differences, contributing factors, impacts, and coping strategies). Concepts in the free-text data that were not part of the analysis framework were analyzed inductively. In the closed-set data, participants reported listening difficulties in most specified environments, but complex background sounds and particularly background voices caused the most difficulty. Those who reported listening difficulties expressed having substantially greater difficulties than other people the same age. Participants indicated multiple impacts from listening difficulties, most prominently in their social lives. Concepts in the free-text data strongly supported previous interview data on listening differences and factors that affect listening ability, especially the diversity of types of listening difficulties. Consistent with the closed-set data, background-sound complexity and concurrent voices were especially troubling. Some concepts in the free-text data were novel, particularly difficulties with remote, broadcast, and recorded audio, prompting the creation of new themes. Both forms of data indicate widespread listening differences-predominantly listening difficulties-affecting most autistic adults. Diverse types of listening difficulty are evident, potentially indicating heterogeneous underlying mechanisms, and complexity of background noise is consistently identified as an important factor. Listening difficulties are said to have substantial and varied impacts. Autistic adults are keen to share coping strategies, which are varied and usually self-devised. Based on both the quantitative and qualitative results, we provide recommendations to improve future research and support the autistic community. The data-revealing types of listening difficulties can guide better quantitative research into underlying mechanisms. Such research should take into account potential heterogeneity in listening difficulties. Suggestions for optimized collection of self-report data are also offered. Additionally, our results could be used to improve societal understanding of autistic listening differences and to create beneficial interventions for and with autistic individuals. Moreover, given the willingness of the autistic community to share coping strategies, systematic collation of these strategies could form the basis for self-help and clinical guidance.

Pearls & Oy-sters: Familial Verbal Auditory Agnosia Due to C9orf72 Repeat Expansion.

Chromosome 9 open reading frame 72 (C9orf72) gene pathogenic variants have been typically associated with frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), but recent studies suggest their involvement in other disorders. This report describes a family with an autosomal dominant pattern of inheritance of progressive verbal auditory agnosia due to GGGGCC repeat expansion in C9orf72. A 60-year-old right-handed male truck driver presented with slowly progressive poor speech perception for 8 years, which became most troublesome when receiving verbal orders over the phone. He had difficulty recognizing single-syllable spoken words beyond his hearing loss but had no problem understanding complex written language. He had a heterozygous pathogenic variant carrying 160 hexanucleotide repeats in the C9orf72 gene. His family history included his deceased mother with similar symptoms that had progressed over 30 years, as well as his older brother and youngest sister who experienced speech perception difficulty beginning in their early fifties. His asymptomatic younger brother had a heterozygous 2 repeat in the C9orf72 gene, while his symptomatic youngest sister had a heterozygous 159 repeat. The patient and his sister exhibited more pronounced cortical thinning in the frontotemporoparietal areas. The discrepancy observed between the distribution of atrophy and the presentation of symptoms in patients with C9orf72 pathogenic repeat expansion may be attributable to the slow progression of their clinical course over time. The variable symptom presentation of C9orf72 pathogenic repeat expansion highlights the importance of considering this pathogenic variant as a potential cause of autosomal dominant degenerative brain diseases beyond FTD and ALS.

Attentional modulation of neural sound tracking in children with and without dyslexia.

Auditory selective attention forms an important foundation of children's learning by enabling the prioritisation and encoding of relevant stimuli. It may also influence reading development, which relies on metalinguistic skills including the awareness of the sound structure of spoken language. Reports of attentional impairments and speech perception difficulties in noisy environments in dyslexic readers are also suggestive of the putative contribution of auditory attention to reading development. To date, it is unclear whether non-speech selective attention and its underlying neural mechanisms are impaired in children with dyslexia and to which extent these deficits relate to individual reading and speech perception abilities in suboptimal listening conditions. In this EEG study, we assessed non-speech sustained auditory selective attention in 106 7-to-12-year-old children with and without dyslexia. Children attended to one of two tone streams, detecting occasional sequence repeats in the attended stream, and performed a speech-in-speech perception task. Results show that when children directed their attention to one stream, inter-trial-phase-coherence at the attended rate increased in fronto-central sites; this, in turn, was associated with better target detection. Behavioural and neural indices of attention did not systematically differ as a function of dyslexia diagnosis. However, behavioural indices of attention did explain individual differences in reading fluency and speech-in-speech perception abilities: both these skills were impaired in dyslexic readers. Taken together, our results show that children with dyslexia do not show group-level auditory attention deficits but these deficits may represent a risk for developing reading impairments and problems with speech perception in complex acoustic environments. RESEARCH HIGHLIGHTS: Non-speech sustained auditory selective attention modulates EEG phase coherence in children with/without dyslexia Children with dyslexia show difficulties in speech-in-speech perception Attention relates to dyslexic readers' speech-in-speech perception and reading skills Dyslexia diagnosis is not linked to behavioural/EEG indices of auditory attention.

Compromised word-level neural tracking in the high-gamma band for children with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) exhibit pervasive difficulties in speech perception. Given that speech processing involves both acoustic and linguistic stages, it remains unclear which stage of speech processing is impaired in children with ADHD. To investigate this issue, we measured neural tracking of speech at syllable and word levels using electroencephalography (EEG), and evaluated the relationship between neural responses and ADHD symptoms in 6-8 years old children. Twenty-three children participated in the current study, and their ADHD symptoms were assessed with SNAP-IV questionnaires. In the experiment, the children listened to hierarchical speech sequences in which syllables and words were, respectively, repeated at 2.5 and 1.25 Hz. Using frequency domain analyses, reliable neural tracking of syllables and words was observed in both the low-frequency band (<4 Hz) and the high-gamma band (70-160 Hz). However, the neural tracking of words in the high-gamma band showed an anti-correlation with the ADHD symptom scores of the children. These results indicate that ADHD prominently impairs cortical encoding of linguistic information (e.g., words) in speech perception.

Age-related rollover for spectrally degraded temporal speech contrasts

Some speech sounds, or phonemes, are primarily distinguished acoustically from other phonemes by temporal cues. A decline in temporal-processing abilities is a common consequence of aging that might cause a listener to have difficulty differentiating between sounds, especially when the speech is degraded. One type of signal degradation occurs in a cochlear-implant vocoder simulation, which eliminates most of the spectral information in speech while maintaining the temporal envelope. In addition, temporal processing abilities may be challenged at higher presentation levels causing a decrease in performance (i.e., rollover), particularly in older listeners. This study measures the phoneme classification of younger and older listeners of four spectro-temporal contrasts when presented in quiet with and without vocoding at a range of presentation levels. We hypothesized that, due to declines in temporal processing abilities, older listeners would be more susceptible to rollover, measured by a decrease in phoneme classification performance for degraded temporal contrasts as presentation levels increase. We further hypothesized that performance rollover would occur more often for vocoded speech than for unprocessed speech, especially in older listeners. Preliminary data show interactions between speech contrasts, presentation levels, and vocoding. Our results will help facilitate understanding speech perception difficulties in older cochlear-implant users.

Speech Understanding in Complex Environments by School-Age Children with Mild Bilateral or Unilateral Hearing Loss.

Numerous studies have shown that children with mild bilateral (MBHL) or unilateral hearing loss (UHL) experience speech perception difficulties in poor acoustics. Much of the research in this area has been conducted via laboratory studies using speech-recognition tasks with a single talker and presentation via earphones and/or from a loudspeaker located directly in front of the listener. Real-world speech understanding is more complex, however, and these children may need to exert greater effort than their peers with normal hearing to understand speech, potentially impacting progress in a number of developmental areas. This article discusses issues and research relative to speech understanding in complex environments for children with MBHL or UHL and implications for real-world listening and understanding.

Responses in left inferior frontal gyrus are altered for speech-in-noise processing, but not for clear speech in autism.

Autistic individuals often have difficulties with recognizing what another person is saying in noisy conditions such as in a crowded classroom or a restaurant. The underlying neural mechanisms of this speech perception difficulty are unclear. In typically developed individuals, three cerebral cortex regions are particularly related to speech-in-noise perception: the left inferior frontal gyrus (IFG), the right insula, and the left inferior parietal lobule (IPL). Here, we tested whether responses in these cerebral cortex regions are altered in speech-in-noise perception in autism. Seventeen autistic adults and 17 typically developed controls (matched pairwise on age, sex, and IQ) performed an auditory-only speech recognition task during functional magnetic resonance imaging (fMRI). Speech was presented either with noise (noise condition) or without noise (no noise condition, i.e., clear speech). In the left IFG, blood-oxygenation-level-dependent (BOLD) responses were higher in the control compared to the autism group for recognizing speech-in-noise compared to clear speech. For this contrast, both groups had similar response magnitudes in the right insula and left IPL. Additionally, we replicated previous findings that BOLD responses in speech-related and auditory brain regions (including bilateral superior temporal sulcus and Heschl's gyrus) for clear speech were similar in both groups and that voice identity recognition was impaired for clear and noisy speech in autism. Our findings show that in autism, the processing of speech is particularly reduced under noisy conditions in the left IFG-a dysfunction that might be important in explaining restricted speech comprehension in noisy environments.

Auditory Spatial Training-Induced Changes in the Release of Informational Masking in Older Adults

Background and Aim: Generally, in noisy environments more informational masking occurs. Older adults benefit less than younger adults from spatial hearing and they have more problems of understanding speech in the presence of distracting speeches. This study was conducted to examine the effect of auditory spatial training on informational masking release in the elderly. Methods: Thirty-two 60-75-year-olds with normal hearing, who complain about difficulty in speech perception in noise, participated in control and intervention groups (16 people in each group). The intervention included fifteen sessions of auditory spatial training. The informational masking measurement test scores were compared before the intervention, one session after the intervention, and one month after between the two groups. Results: There was a significant improvement in informational masking measurement scores in the intervention group compared to the control (p&lt;0.02). The results showed no significant differences between the informational masking measurement scores before and after the intervention in the control group (p&gt;0.05) and a significant difference in most signal to noise ratio i.e. 0, -5 and -10, in the intervention group (p≤0.006). No significant difference was found between the results of the two assessments one session and one month after the intervention in any of the positions (p&gt;0.05), which suggests that both groups’ scores remained highly stable one month after the intervention Conclusion: This study introduced a spatial training program to improve speech perception in noise in normal-hearing elderly listeners. It was recommended that this kind of training be included in geriatric population auditory rehabilitation programs. Keywords: Informational masking; energetic masking; elderly; speech perception in noise

Speech Perception Variability in Childhood Apraxia of Speech: Implications for Assessment and Intervention.

Beyond hallmark production deficits characterizing childhood apraxia of speech (CAS), largely attributed to disruption(s) in speech motor planning, children with CAS often present with co-occurring speech perception and language difficulties. Thus, careful consideration of the potential for speech perception difficulties to have cascading downstream effects on intervention responsiveness and real-life functioning for some children with CAS is highly important. The purpose of this tutorial was to consider the impact of speech perception abilities in children with CAS, which carries implications for caring for the needs of the whole child. This tutorial summarizes the current literature on speech perception and how it relates to speech production, language, and reading abilities for children with CAS. We include case illustrations that are adapted from real clinical scenarios illustrating how speech perception difficulties may impact some children with CAS and provide recommendations for incorporating speech perception into assessment and intervention practices. Although speech perception difficulties do not seem to be a core deficit of CAS, they are strongly linked to language difficulties, which are highly prevalent among children with CAS. Speech perception and language difficulties are also associated with reading difficulties and risk for lower academic achievement. Children with CAS who have co-occurring language difficulties likely also demonstrate speech perception deficits, which puts them at heightened risk for reading difficulties and struggles with academic achievement. Comprehensive assessment of children with CAS should address speech perception and production, language, and reading abilities, which carries important implications for multifaceted approaches to intervention.

Frequency-Following Response to Steady-State Vowel in Quiet and Background Noise Among Marching Band Participants With Normal Hearing

Human studies enrolling individuals at high risk for cochlear synaptopathy (CS) have reported difficulties in speech perception in adverse listening conditions. The aim of this study is to determine if these individuals show a degradation in the neural encoding of speech in quiet and in the presence of background noise as reflected in neural phase-locking to both envelope periodicity and temporal fine structure (TFS). To our knowledge, there are no published reports that have specifically examined the neural encoding of both envelope periodicity and TFS of speech stimuli (in quiet and in adverse listening conditions) among a sample with loud-sound exposure history who are at risk for CS. Using scalp-recorded frequency-following response (FFR), the authors evaluated the neural encoding of envelope periodicity (FFRENV) and TFS (FFRTFS) for a steady-state vowel (English back vowel /u/) in quiet and in the presence of speech-shaped noise presented at +5- and 0 dB SNR. Participants were young individuals with normal hearing who participated in the marching band for at least 5 years (high-risk group) and non-marching band group with low-noise exposure history (low-risk group). The results showed no group differences in the neural encoding of either the FFRENV or the first formant (F1) in the FFRTFS in quiet and in noise. Paradoxically, the high-risk group demonstrated enhanced representation of F2 harmonics across all stimulus conditions. These results appear to be in line with a music experience-dependent enhancement of F2 harmonics. However, due to sound overexposure in the high-risk group, the role of homeostatic central compensation cannot be ruled out. A larger scale data set with different noise exposure background, longitudinal measurements with an array of behavioral and electrophysiological tests is needed to disentangle the nature of the complex interaction between the effects of central compensatory gain and experience-dependent enhancement.

High-frequency audiometry, speech perception in quiet and noise, and vestibular-evoked myogenic potential in women with polycystic ovary syndrome

PurposeThe study aimed to investigate the effect of PCOS on high-frequency thresholds, speech perception in quiet and in presence of noise, and vestibular functioning in women with and without PCOS and to correlate the speech perception scores with that of the pure-tone thresholds obtained at conventional and higher frequencies.MethodsWomen with and without PCOS in the age range of 18–40 years diagnosed between January 2019 and January 2020 were participants. Conventional and high-frequency audiometry (HFA), speech perception in quiet and in noise (SPIN), and cervical vestibular-evoked myogenic potentials (cVEMP) and ocular vestibular-evoked myogenic potentials (oVEMP) were assessed for both groups.ResultsConventional audiometry (250 Hz to 8000 Hz) showed no statistically significant difference between both groups. High-frequency audiometry (9000 Hz to 20,000 Hz) showed significantly poorer pure-tone thresholds for women with PCOS compared to women without PCOS. SPIN results showed significantly lower SPIN scores for women with PCOS for − 3dB SNR, − 6 dB SNR, and − 9dB SNR. No difference in scores was observed for quiet conditions and 0 dB SNR for women with and without PCOS. cVEMP and oVEMP responses showed reduced amplitude in women with PCOS.ConclusionAll the women diagnosed with having PCOS should be screened for hearing loss, speech perception difficulty in quiet and in presence of noise, and vestibular system functioning. If the hearing is affected, intervention should be started early in life.

One Size Does Not Fit All: Examining the Effects of Working Memory Capacity on Spoken Word Recognition in Older Adults Using Eye Tracking.

Difficulties understanding speech form one of the most prevalent complaints among older adults. Successful speech perception depends on top-down linguistic and cognitive processes that interact with the bottom-up sensory processing of the incoming acoustic information. The relative roles of these processes in age-related difficulties in speech perception, especially when listening conditions are not ideal, are still unclear. In the current study, we asked whether older adults with a larger working memory capacity process speech more efficiently than peers with lower capacity when speech is presented in noise, with another task performed in tandem. Using the Eye-tracking of Word Identification in Noise Under Memory Increased Load (E-WINDMIL) an adapted version of the “visual world” paradigm, 36 older listeners were asked to follow spoken instructions presented in background noise, while retaining digits for later recall under low (single-digit) or high (four-digits) memory load. In critical trials, instructions (e.g., “point at the candle”) directed listeners’ gaze to pictures of objects whose names shared onset or offset sounds with the name of a competitor that was displayed on the screen at the same time (e.g., candy or sandal). We compared listeners with different memory capacities on the time course for spoken word recognition under the two memory loads by testing eye-fixations on a named object, relative to fixations on an object whose name shared phonology with the named object. Results indicated two trends. (1) For older adults with lower working memory capacity, increased memory load did not affect online speech processing, however, it impaired offline word recognition accuracy. (2) The reverse pattern was observed for older adults with higher working memory capacity: increased task difficulty significantly decreases online speech processing efficiency but had no effect on offline word recognition accuracy. Results suggest that in older adults, adaptation to adverse listening conditions is at least partially supported by cognitive reserve. Therefore, additional cognitive capacity may lead to greater resilience of older listeners to adverse listening conditions. The differential effects documented by eye movements and accuracy highlight the importance of using both online and offline measures of speech processing to explore age-related changes in speech perception.

Pediatric speech understanding in noise and the role of working memory andcomprehension

Working memory is vital to a child’s cognitive processing and speech understanding in noise. More recent findings suggest that the relationship between speech recognition in noise and auditory comprehension may be capturing difficulties in understanding speech in noise which have been linked to cognitive and linguistic skills. Children’s auditory-cognitive performance is highly sensitive to processing load. The extent that children engage cognitive resources depends on demands of task difficulty and intensity level of four-talker babble. The combined costs of performing a difficult task in adverse acoustical conditions are greater than the sum of the individual costs. This suggest that the relationship between speech recognition in noise and auditory comprehension may be capturing difficulties in language which may have effects in academic success. Data will be presented (1) show that audibility alone does not account for difficulties in speech perception in noise (2) showing the complex relationship between working memory and auditory comprehension. (3) Implications for clinical speech in noise screener for children. While app-based interventions for speech and language exist, to our knowledge, none explicitly screen for perception of speech in the presence of noise.

Extended high-frequency audiometry in research and clinical practice.

Audiometric testing in research and in clinical settings rarely considers frequencies above 8 kHz. However, the sensitivity of young healthy ears extends to 20 kHz, and there is increasing evidence that testing in the extended high-frequency (EHF) region, above 8 kHz, might provide valuable additional information. Basal (EHF) cochlear regions are especially sensitive to the effects of aging, disease, ototoxic drugs, and possibly noise exposure. Hence, EHF loss may be an early warning of damage, useful for diagnosis and for monitoring hearing health. In certain environments, speech perception may rely on EHF information, and there is evidence for an association between EHF loss and speech perception difficulties, although this may not be causal: EHF loss may instead be a marker for sub-clinical damage at lower frequencies. If there is a causal relation, then amplification in the EHF range may be beneficial if the technical difficulties can be overcome. EHF audiometry in the clinic presents with no particular difficulty, the biggest obstacle being lack of specialist equipment. Currently, EHF audiometry has limited but increasing clinical application. With the development of international guidelines and standards, it is likely that EHF testing will become widespread in future.