Including Speech Perception Research Articles

Improving Health-Related Quality of Life in Single-Sided Deafness: A Systematic Review and Meta-Analysis

Unilateral severe-to-profound hearing loss, or single-sided deafness (SSD), impairs listening abilities supported by the use of two ears, including speech perception in background noise and sound localisation. Hearing-assistive devices can aid listening by re-routing sounds from the impaired to the non-impaired ear or by restoring input to the impaired ear. A systematic review of the literature examined the impact of hearing-assistive devices on the health-related quality of life (HRQoL) of adults with SSD as measured using generic and disease-specific instruments. A majority of studies used observational designs, and the quality of the evidence was low to moderate. Only two studies used generic instruments. A mixed-effect meta-analysis of disease-specific measures suggested that hearing-assistive devices have a small-to-medium impact on HRQoL. The Speech, Spatial and Qualities of Hearing Scale and the Health Utilities Index Mark 3 (HUI3) were identified as instruments that are sensitive to device-related changes in disease-specific and generic HRQoL, respectively.

Greater BOLD variability in older compared with younger adults during audiovisual speech perception.

Older adults exhibit decreased performance and increased trial-to-trial variability on a range of cognitive tasks, including speech perception. We used blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI) to search for neural correlates of these behavioral phenomena. We compared brain responses to simple speech stimuli (audiovisual syllables) in 24 healthy older adults (53 to 70 years old) and 14 younger adults (23 to 39 years old) using two independent analysis strategies: region-of-interest (ROI) and voxel-wise whole-brain analysis. While mean response amplitudes were moderately greater in younger adults, older adults had much greater within-subject variability. The greatly increased variability in older adults was observed for both individual voxels in the whole-brain analysis and for ROIs in the left superior temporal sulcus, the left auditory cortex, and the left visual cortex. Increased variability in older adults could not be attributed to differences in head movements between the groups. Increased neural variability may be related to the performance declines and increased behavioral variability that occur with aging.

Fast transfer of crossmodal time interval training

Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an "element motion" or a "group motion" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock.

The impact of spectral resolution on listening effort revealed by pupil dilation

Poor spectral resolution is a consequence of cochlear hearing loss and remains arguably the primarily limiting factor in success with a cochlear implant. In addition to showing reduced success on word recognition compared to their normal-hearing peers, listeners with hearing impairment also are reported to exert greater effort in everyday listening, leading to difficulties at the workplace and in social settings. Pupil dilation is an index of cognitive effort in various tasks, including speech perception. In this study, spectral resolution was explicitly controlled for in listeners with normal hearing using a noise vocoder with variable number of processing channels. Pupil dilation during a sentence listening and repetition task revealed a systematic relationship between spectral resolution and listening effort; as resolution grew poorer, effort increased. Significant changes in listening effort belie the notion of “ceiling” performance in degraded conditions; listeners are able to achieve success in the face of signal degradation at least partly on behalf of extra effort required to listen. We provide a model by which interventions for clinical populations (e.g., processing strategies) can be evaluated on the basis of listening effort, beyond the conventional techniques of word and sentence recognition accuracy.

NONWORD REPETITION ABILITY IN THIRD-GRADE STUDENTS WITH DYSLEXIA

Introduction: Developmental dyslexia has been recognized as being one of the most common types of reading disorders. According to phonological deficit hypothesis, the main difficulties in affected children are phonological processing and making incorrect representations. Nonword repetition task taps the encoding, storage and retrieval of phonological representations, and therefore, is an appropriate tool for measuring these skills, particularly phonological working memory. This task involves a variety of underlying processes including speech perception, lexical and phonological knowledge, motor planning, and articulation. The aim of this study was to investigate the performance of dyslexic students in nonword repetition task and to analysis their errors. Materials and Methods: This was a nonexprimental analytical cross-sectional study in which a case control paradigm was adopted. Participants were 15 students with dyslexia and 35 normal students, all of whom were studying at the third grade of elementary school at the time of the study. These students did not have any gross neurological impairments, psychiatric problems or speech- language disorders and had normal intelligence and hearing acuity. 40 one-to-four-syllable nonwords were used for the assessment. Broad transcription was applied for recording responses. The results were statistically analyzed using descriptive and analytic methods. Results: The dyslexic group obtained lower scores than did the control group in nonword repetition task and the difference between these two groups was statistically significant. Conclusion: The errors of dyslexic students in nonword repetition showed that they suffer some deficits in accessing, maintaining and retrieving phonological codes. Moreover, they have difficulties in distinguishing phonemes that were poorly encoded. Keywords: Nonword, Dyslexic, Phonological processing, Phonological working memory

Long-Term Benefit and Sound Localization in Patients With Single-Sided Deafness Rehabilitated With an Osseointegrated Bone-Conduction Device

Investigation of long-term satisfaction and correlation with audiometric measurements after osseointegrated bone-conduction device (OBCD) surgery for patients with single-sided deafness (SSD). Thirty-six patients implanted with an OBCD for SSD. Retrospective review in a university medical center. Rehabilitative. The patients were implanted after a test with an OBCD worn on a headband during 15 days in a daily use. The patients were implanted if the test gave us satisfaction. A series of audiometric tests, including speech perception in noise, prosthetic gain, and sound localization measurements, with and without OBCD on headband before surgery and on the transcutaneous implant remote from the surgery. Assessment of benefit and satisfaction using the modified Entific Medical System Questionnaire (EMSQ), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Glasgow Benefit Index (GBI). The mean follow-up is 2.2 years. Approximately 64% of the patients use their OBCD more than 8 hours per day and 82% more than 4 hours per day. Mean satisfaction score is 7.3/10. The APHAB and GBI show a significant benefit (APHAB ease of communication before and after implantation, +21; GBI total score, +17). These results show an improvement in speech perception in noise with the OBCD, but no differences between the preoperative and postoperative tests. There is no improvement in sound localization. A high level of satisfaction is correlated with good results on the pre operative speech perception in noise. The OBCD is an effective way of rehabilitation for SSD. The BAHA improves the speech perception in noise but provided no significant improvement in sound localization as revealed in the postoperative test. With 3 questionnaires we noticed an improvement in the quality of life with the OBCD.

Tone Discrimination as a Window Into Acoustic Perceptual Deficits in Parkinson’s Disease

Deficits in auditory perception compromise a range of linguistic processes in persons with Parkinson's disease (PD), including speech perception and sensitivity to affective and linguistic prosody. An unanswered question is whether this deficit exists not only at the level of speech perception, but also at a more pervasive level of auditory perception. It is possible that PD produces a selective impairment in the perception of a salient acoustic feature such as frequency, amplitude, or duration. Auditory perception in persons with PD was investigated using a tone discrimination task where clients ( N = 12) and age-matched controls ( N = 15) made same/different judgments for pairs of pure tones that were factorially varied by acoustic feature (i.e., frequency, amplitude, or duration) crossed with perceptual distance (i.e., close vs. far). Relative to healthy age-matched controls, persons with PD showed marked impairment in tone discrimination. Persons with PD showed an acoustic feature by perceptual distance interaction that was characterized by deficits in detecting frequency and amplitude differences for perceptually near tones. These results suggest that persons with PD show a reduced ability to notice change in frequency and amplitude as compared to normal older adults. More generally, these findings implicate a frontal-striatal contribution to auditory perception.

Uses and interpretations of non‐word repetition tasks in children with and without specific language impairments (SLI)

The non-word repetition task (NRT) has gained wide acceptance in describing language acquisition in both children with normal language development (NL) and children with specific language impairments (SLI). This task has gained wide acceptance because it so closely matches the phonological component of word learning, and correlates with measures of phonological working memory, a deficit in which is hypothesized to underlie SLI. Recent uses of the NRT seem to accept it as a measure of phonological working memory capacity in spite of the fact that researchers have consistently acknowledged that the task taps many language processes, including speech perception, phonological encoding, phonological memory, phonological assembly and articulation. This paper reviews the literature on the use of the non-word repetition task (NRT) in children with NL and children with SLI, emphasizing the component skills necessary for successful repetition. For children with NL, discussion has focused on (1) the relationship between non-word repetition ability and vocabulary, and (2) lexical and sublexical influences on repetition accuracy. For children with SLI, discussion has focused on these factors as well, but has also considered other component skills that support non-word repetition. Researchers have examined speech perception and discrimination, phonological encoding, phonological memory, phonological assembly, motor planning, and articulation, and have found evidence that children with SLI exhibit impairments in each of these supporting skills. Because repetition accuracy depends on lexical and sublexical properties, the NRT can be used to examine the structural properties of the lexicon in both children with NL and with SLI. Further, because the task taps so many underlying skills, it is a powerful tool that can be used to identify children with language impairments.

Hearing Preservation in Patients With a Cochlear Implant

Hearing Preservation in Patients With a Cochlear Implant

Multimodal access to verbal name codes

Congruent information conveyed over different sensory modalities often facilitates a variety of cognitive processes, including speech perception (Sumby & Pollack, 1954). Since auditory processing is substantially faster than visual processing, auditory-visual integration can occur over a surprisingly wide temporal window (Stein, 1998). We investigated the processing architecture mediating the integration of acoustic digit names with corresponding symbolic visual forms. The digits "1" or "2" were presented in auditory, visual, or bimodal format at several stimulus onset asynchronies (SOAs; 0, 75, 150, and 225 msec). The reaction times (RTs) for echoing unimodal auditory stimuli were approximately 100 msec faster than the RTs for naming their visual forms. Correspondingly, bimodal facilitation violated race model predictions, but only at SOA values greater than 75 msec. These results indicate that the acoustic and visual information are pooled prior to verbal response programming. However, full expression of this bimodal summation is dependent on the central coincidence of the visual and auditory inputs. These results are considered in the context of studies demonstrating multimodal activation of regions involved in speech production.

Comparison of Continuous Interleaved Sampling and Simultaneous Analog Stimulation Speech Processing Strategies in Newly Implanted Adults with a Clarion 1.2 Cochlear Implant

This study consisted of a within-subjects comparison of speech recognition and patient preference when subjects used two different cochlear implant speech processing strategies with a Clarion 1.2 (enhanced bipolar) device: Simultaneous Analog Stimulation (SAS), and Continuous Interleaved Sampling (CIS). These two strategies used two different electrode configurations: the SAS strategy used bipolar stimulation, whereas the CIS strategy used monopolar stimulation. This was a multicenter study that used a within-subjects balanced crossover design. Experience with the two strategies was replicated in each subject using an ABAB design. Order of strategy use was balanced across all subjects. The study was carried out at several cochlear implant centers affiliated with tertiary medical centers. Subjects consisted of 25 postlingually deafened adults who received a Clarion cochlear implant. Total involvement by each subject was 14 weeks. Speech perception testing and sound quality assessments were performed after use with each strategy. Primary outcome measures include speech perception data and patient responses to questionnaires regarding speech and sound quality. Analyses revealed that performance did not differ significantly by the strategy encountered first as relative to the strategy encountered second and that the order in which a strategy was used did not appear to affect subjects' eventual preference for a particular strategy. Although speech recognition scores tended to be higher for CIS for most of the test measures at most of the test intervals, the analysis of variance to evaluate differences in strategy did not reveal a significant effect of strategy. Further analysis of scores obtained at the replication interval, however, revealed that scores obtained with CIS were significantly higher than scores obtained with SAS on the Hearing in Noise Test sentences in quiet and noise. In addition, significantly more patients indicated a final preference for the CIS strategy than for the SAS strategy. Importantly, both the analysis evaluating order and the analysis evaluating strategy revealed significant effects of evaluation period, indicating that time/experience with the implant had a significant effect on scores for each strategy, regardless of the order in which it was used (first or second). This study demonstrates that important learning occurs during the first several weeks of cochlear implant use, making it difficult to adequately compare performance with different speech processing strategies. However, the finding that patients often prefer the strategy they understand speech the best with supports the clinical practice of letting adult patients select their preferred strategy without formally evaluating speech perception with each available strategy.

The COCHLEA: A new functional outcome measure for pediatric cochlear implant patients

Problem: Pediatric cochlear implant recipients have been historically assessed postoperatively with audiometric testing in a soundproof booth by trained audiologists. Assessment of functional outcome after cochlear implantation must also consider a number of other factors including speech perception, speech intelligibility, mode of communication, educational placement, as well as the social and psychological factors that affect one’s ability to function in the mainstream environment. No uniform tool for assessing effective functional outcome in the daily life of pediatric cochlear implant recipients has been developed. Methods: Using a cross-sectional design, the COCHLEA (Children’s Outcome for Cochlear Implant Hearing, Language, and Environmental Assessment) questionnaire, designed to measure functional outcomes in the pediatric cochlear implant population, was administered. The questionnaire was tested for reliability and validity, while investigating for any possible respondent or administrative burden. The parents of children with cochlear implants completed the questionnaire. The subjects were individuals with nonsyndromic sensorineural hearing loss (SNHL) implanted at Children’s Hospital and Regional Medical Center before 12/31/2001, aged 3–12 years. Implantation must have occurred before age 7. Non-English-speaking children/families were excluded secondary to a lack of resources. Results: Thirty-one patients were enrolled in the study. Preliminary results indicate that absolute scores of this outcome measure correlate with higher global health measures, including the Child Health Questionnaire (CHQ), and predict better audiometric scores. Conclusion: The COCHLEA functional outcome measure appears to be a reliable and valid method for assessing effective cochlear implantation. More research is necessary to determine this questionnaire’s sensitivity to longitudinal change. Significance: The COCHLEA questionnaire represents the first disease-specific functional outcome measure for the pediatric cochlear implant patient population. Ultimately it may be used to compare the effectiveness of cochlear implants and rehabilitation strategies. Support: None reported.

Children’s need for favorable acoustics in schools

Children continue to improve their understanding of speech in noise and reverberation throughout childhood and adolescence. They do not typically achieve adult performance levels until their late teenage years. As a result, schools that are designed to be acoustically adequate for adult understanding may be insufficient for full understanding by young children. In addition, children with hearing loss, those with attention problems, and those learning in a non-native language require even more favorable signal-to-noise ratios. This tutorial will review the literature gathered by the ANSl/ASA working group on classroom acoustics that shaped the recommendations of the working group. Special topics will include speech perception data from typically developing infants and children, from children with hearing loss, and from adults and children listening in a non-native language. In addition, the tutorial will overview recommendations contained within ANSI standard 12.60-2002: Acoustical Performance Criteria, Design Requirements, and Guidelines for Schools. The discussion will also include issues related to designing quiet classrooms and working with local schools and professionals.

Second oral language capabilities in children with cochlear implants.

The development of oral language in children with a cochlear implant is dependent on numerous factors. Although baseline achievements have been established, ceiling attainment levels have yet to be explored. One indicator of a higher capability level is the ability of children with implants to learn to communicate orally using a second language. The purpose of this research was to explore 1) the feasibility of children with cochlear implants developing oral fluency in a second language and 2) the factors that affect the development. Retrospective study of children fulfilling the criteria. University medical center. Eighteen profoundly hearing-impaired children who were reported to be bilingual. Cochlear implantation at age 5 or younger. The subjects were evaluated using standard speech perception and receptive and expressive language measures. The data revealed the ability of some pediatric cochlear implant recipients to develop competency in a second spoken language in addition to their primary language. Equally as important is the fact that the majority showed age-appropriate receptive and/or expressive language abilities in their primary language commensurate with normal-hearing children. High levels of achievement including the learning of a second spoken language are possible after implantation in the pediatric population. Variables include speech perception postimplantation, the linguistic environment, type of intervention, and educational placement.

Amplification for Infants

Amplification for Infants

The cognitive neuropsychology of the cerebellum

We review evidence from neuropsychological studies of patients with damage to the cerebellum that suggests cerebellar involvement in four general categories of cognition: (1) speech and language; (2) temporal processing; (3) implicit learning and memory; (4) visuospatial processing and attention. A relatively strong case can be made for cerebellar contributions to language (including speech perception, lexical retrieval, and working memory) and to temporal processing. However, the evidence concerning cerebellar involvement in non-motor implicit learning and visuospatial processing is more equivocal. We argue that cerebellar contributions to cognition are computationally plausible, given its reciprocal connectivity with the cerebral cortex, and suggest that this function of the cerebellum may be an example of an evolutionary process by which mechanisms originally evolved for one function (in this case, motor control) are adapted to other functions (cognition).

Individual differences in auditory capabilities: A preliminary test battery

On occasion, listeners are encountered in psychoacoustic studies who have audiometrically normal hearing but seem unable to perform certain auditory tasks at the same level as other people. In addition, clinical research has related individual differences in auditory processing to some disorders of communication, cognition, and learning. However, it is difficult to label performance on many auditory tasks as “impaired,” in the absence of a normative data base. To this end, an auditory test battery is being developed. The first version includes masked and quiet thresholds; intensity, frequency, and temporal discrimination; and discrimination of tonal sequences. The components of the test battery were chosen to sample the auditory capabilities that underlie complex auditory processing, including speech perception. Each test is continued until asymptotic performance is observed in an adaptive psychophysical procedure. Although most audiometrically normal listeners perform very much like one another on all of the subtests, a few individuals show patterns of significantly deviant (<2σ) performance for specific clusters of subtests, such as those requiring frequency resolution or those requiring temporal discrimination. [Work supported by NIH.]