Mandarin Hearing In Noise Test Research Articles

Validation of a Bluetooth Self-Fitting Device for People With Mild-to-Moderate Hearing Loss in Quiet or Noisy Environments.

The purpose of this study was to evaluate the benefits of a Bluetooth self-fitting device using an in situ hearing screening test and self-fitting processes. Thirty Mandarin-speaking individuals (16 men and 14 women) with mild-to-moderate hearing loss participated in this study. The hearing screening test was conducted using neckband earphones of a Bluetooth self-fitting device controlled by a smartphone app. The hearing screening tests were compared with the pure-tone audiometry in an audiometric booth. The amplification benefits of the self-fitting program-aided condition were evaluated and compared with those of unaided and preset program-aided conditions using the Mandarin Hearing in Noise Test (MHINT) and questionnaires. The pure-tone audiometry and hearing screening test results exhibited strong positive correlations at all test frequencies. In the environment with 90° noise, the sentence reception thresholds (SRTs) obtained for the self-fitting program-aided condition were significantly lower (p = .032) than those obtained for the unaided condition, whereas no significant difference was observed between the preset program-aided and the unaided conditions. Moreover, the participants' satisfaction ratings for the devices were consistent with their MHINT results, with a strong positive correlation observed between satisfaction with self-fitting and user satisfaction in smartphone app's control, functionality, and learning. Younger participants were significantly more satisfied in learning to use the app. Bluetooth self-fitting devices can be used for simplified in situ hearing screenings with a sensitivity of 90.4%. The satisfaction ratings and improvements in SRTs indicate significant clinical benefits of the self-fitting program compared with the preset program, particularly in the 90°-noise environments.

Performance of Sequentially Bilateral Cochlear Implanted Children Who Speak Mandarin

Introduction: Cochlear implantation is an effective treatment for children with deafness. Although the binaural effect of bilateral cochlear implantation on sound localization and speech perception in noisy environments has been demonstrated, the outcome and performance predictors of the second cochlear implant (CI2) remain uncertain for patients receiving sequential implantation. This study evaluated the hearing performance between the first cochlear implant (CI1), CI2, and bilateral cochlear implants (CI1+2) among children with sequential bilateral cochlear implantation. Methods: This single-center retrospective study enrolled 14 children and adolescents aged 8–18 years who underwent sequential bilateral cochlear implantation with a mean interimplant interval of 8.2 years. The Mandarin Lexical Neighborhood Test (M-LNT), the Mandarin Hearing in Noise Test (M-HINT), and the Comprehensive Cochlear Implant Questionnaire (CCIQ) scores of participants were evaluated. Mann-Whitney U tests and Spearman correlation analysis were performed to analyze factors associated with CI2 performance. Results: In the 1-year follow-up period after CI2 implantation, although the M-LNT mean score for CI2 was significantly lower than that for CI1, the M-LNT scores for CI2 and CI1+2 improved significantly over time. In a noisy environment, CI1+2 significantly outperformed CI1 in the M-HINT. The M-LNT score for CI2 was significantly associated with preoperative bimodal fitting, residual hearing of the second implanted ear, and CI2 daily-usage time. Specific to CI2, the CCIQ showed improvement 1 year after CI2 implantation. Conclusion: CI2 improved the hearing performance and quality of life of recipients with longer interimplant intervals, especially in noisy environments, and its efficacy was associated with preoperative bimodal fitting and regular daily use.

Effects of Wireless Remote Microphone on Speech Recognition in Noise for Hearing Aid Users in China.

Objective: This study was aimed at evaluating improvements in speech-in-noise recognition ability as measured by signal-to-noise ratio (SNR) with the use of wireless remote microphone technology. These microphones transmit digital signals via radio frequency directly to hearing aids and may be a valuable assistive listening device for the hearing-impaired population of Mandarin speakers in China.Methods: Twenty-three adults (aged 19–80 years old) and fourteen children (aged 8–17 years old) with bilateral sensorineural hearing loss were recruited. The Mandarin Hearing in Noise Test was used to test speech recognition ability in adult subjects, and the Mandarin Hearing in Noise Test for Children was used for children. The subjects’ perceived SNR was measured using sentence recognition ability at three different listening distances of 1.5, 3, and 6 m. At each distance, SNR was obtained under three device settings: hearing aid microphone alone, wireless remote microphone alone, and hearing aid microphone and wireless remote microphone simultaneously.Results: At each test distance, for both adult and pediatric groups, speech-in-noise recognition thresholds were significantly lower with the use of the wireless remote microphone in comparison with the hearing aid microphones alone (P < 0.05), indicating better SNR performance with the wireless remote microphone. Moreover, when the wireless remote microphone was used, test distance had no effect on speech-in-noise recognition for either adults or children.Conclusion: Wireless remote microphone technology can significantly improve speech recognition performance in challenging listening environments for Mandarin speaking hearing aid users in China.

Acute Recreational Noise-Induced Cochlear Synaptic Dysfunction in Humans With Normal Hearing: A Prospective Cohort Study

ObjectivesThe objective of the study was to identify the acute high-intensity recreational noise-induced effects on auditory function, especially the cochlear synaptopathy-related audiological metrics, in humans with normal hearing.MethodsThis prospective cohort study enrolled 32 young adults (14 males and 18 females); the mean age was 24.1 ± 2.4 years (ranging from 20 to 29). All participants with normal hearing (audiometric thresholds ≤25 dB HL at frequencies of 0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz for both ears) had already decided to participate in the outdoor music festival. Participants were asked to measure the noise exposure dose and complete auditory examinations, including the air-conduction pure-tone audiometry (PTA), distortion product otoacoustic emission (DPOAE), contralateral suppression (CS) on transient evoked otoacoustic emission (TEOAE), auditory brainstem response (ABR) test and Mandarin Hearing in Noise Test (MHINT), at baseline and 1 day and 14 days after music festival noise exposure.ResultsThe mean time of attending the music festival was 7.34 ± 0.63 h (ranging from 6.4 to 9.5), the mean time-weighted average (TWA) of noise exposure dose was 93.2 ± 2.39 dB(A) (ranging from 87.9 to 97.7). At neither 1 day nor 14 days post exposure, there were no statistically significant effects on PTA thresholds, DPOAE amplitudes, CS on TEOAEs, or MHINT signal-to-noise ratios (SNRs) of acute outdoor music festival noise exposure, regardless of sex. While the ABR wave I amplitudes significantly decreased at 1 day after exposure and recovered at 14 days after exposure, the exposed/unexposed ABR wave I amplitude ratio was significantly correlated with MHINT SNR change at 1 day after exposure, although it was not correlated with the noise exposure dose.ConclusionIn young adults with normal hearing, we found the self-compared decrement of ABR wave I amplitudes at 1 day post acute recreational noise exposure at high intensity, which also contributes to the change in speech perceptual ability in noisy backgrounds. This study indicated that auditory electrophysiological metric changes might be a more sensitive and efficient indicator of noise-induced cochlear synaptic dysfunction in humans. More attention should be paid to the recreational noise-induced cochlear synaptopathy and auditory perceptual disorder.

Increased Right Frontal Brain Activity During the Mandarin Hearing-in-Noise Test.

PurposePrevious studies have revealed increased frontal brain activation during speech comprehension in background noise. Few, however, used tonal languages. The normal pattern of brain activation during a challenging speech-in-nose task using a tonal language remains unclear. The Mandarin Hearing-in-Noise Test (HINT) is a well-established test for assessing the ability to interpret speech in background noise. The current study used Mandarin HINT (MHINT) sentences and functional magnetic resonance imaging (fMRI) to assess brain activation with MHINT sentences.MethodsThirty native Mandarin-speaking subjects with normal peripheral hearing were recruited. Functional MRI was performed while subjects were presented with either HINT “clear” sentences with low-level background noise [signal-to-noise ratio (SNR) = +3 dB] or “noisy” sentences with high-level background noise (SNR = −5 dB). Subjects were instructed to answer with a button press whether a visually presented target word was included in the sentence. Brain activation between noisy and clear sentences was compared. Activation in each condition was also compared to a resting, no sentence presentation, condition.ResultsNoisy sentence comprehension showed increased activity in areas associated with tone processing and working memory, including the right superior and middle frontal gyri [Brodmann Areas (BAs) 46, 10]. Reduced activity with noisy sentences was seen in auditory, language, memory and somatosensory areas, including the bilateral superior and middle temporal gyri, left Heschl’s gyrus (BAs 21, 22), right temporal pole (BA 38), bilateral amygdala-hippocampus junction, and parahippocampal gyrus (BAs 28, 35), left inferior parietal lobule extending to left postcentral gyrus (BAs 2, 40), and left putamen.ConclusionIncreased frontal activation in the right hemisphere occurred when comprehending noisy spoken sentences in Mandarin. Compared to studies using non-tonal languages, this activation was strongly right-sided and involved subregions not previously reported. These findings may reflect additional effort in lexical tone perception in this tonal language. Additionally, this continuous fMRI protocol may offer a time-efficient way to assess group differences in brain activation with a challenging speech-in-noise task.

Speech Perception and Sound-Quality Rating with an Adaptive Nonlinear Frequency Compression Algorithm in Mandarin-Speaking Hearing Aid Users.

Mandarin Chinese has a rich repertoire of high-frequency speech sounds. This may pose a remarkable challenge to hearing-impaired listeners who speak Mandarin Chinese because of their high-frequency sloping hearing loss. An adaptive nonlinear frequency compression (adaptive NLFC) algorithm has been implemented in contemporary hearing aids to alleviate the problem. The present study examined the performance of speech perception and sound-quality rating in Mandarin-speaking hearing-impaired listeners using hearing aids fitted with adaptive NLFC (i.e., SoundRecover2 or SR2) at different parameter settings. Hearing-impaired listeners' phoneme detection thresholds, speech reception thresholds, and sound-quality ratings were collected with various SR2 settings. The participants included 15 Mandarin-speaking adults aged 32 to 84 years old who had symmetric sloping severe-to-profound sensorineural hearing loss. The participants were fitted bilaterally with Phonak Naida V90-SP hearing aids. The outcome measures included phoneme detection threshold using the Mandarin Phonak Phoneme Perception test, speech reception threshold using the Mandarin hearing in noise test (M-HINT), and sound-quality ratings on human speech in quiet and noise, bird chirps, and music in quiet. For each test, five experimental settings were applied and compared: SR2-off, SR2-weak, SR2-default, SR2-strong 1, and SR2-strong 2. The results showed that listeners performed significantly better with SR2-strong 1 and SR2-strong 2 settings than with SR2-off or SR2-weak settings for speech reception threshold and phoneme detection threshold. However, no significant improvement was observed in sound-quality ratings among different settings. These preliminary findings suggested that the adaptive NLFC algorithm provides perceptual benefit to Mandarin-speaking people with severe-to-profound hearing loss.

Ensemble Hierarchical Extreme Learning Machine for Speech Dereverberation

Data-driven deep learning solutions with gradient-based neural architecture, have proven useful in overcoming some limitations of traditional signal processing techniques. However, a large number of reverberant–anechoic training utterance pairs covering as many environmental conditions as possible is required to achieve robust dereverberation performance in unseen testing conditions. In this article, we propose to address the data requirement issue while preserving the advantages of deep neural structures leveraging upon hierarchical extreme learning machines (HELMs), which are not gradient-based neural architectures. In particular, an ensemble HELM learning framework is established to effectively recover anechoic speech from a reverberant one based on spectral mapping. In addition to the ensemble learning framework, we further derive two novel HELM models, namely, highway HELM [HELM(Hwy)] and residual HELM [HELM(Res)], both incorporating low-level features to enrich the information for spectral mapping. We evaluated the proposed ensemble learning framework using simulated and measured impulse responses by employing Texas Instrument and Massachusetts Institute of Technology (TIMIT), Mandarin hearing in noise test (MHINT), and reverberant voice enhancement and recognition benchmark (REVERB) corpora. The experimental results show that the proposed framework outperforms both traditional methods and a recently proposed integrated deep and ensemble learning algorithm in terms of standardized objective and subjective evaluations under matched and mismatched testing conditions for simulated and measured impulse responses.

Time-compression thresholds for Mandarin sentences in normal-hearing and cochlear implant listeners

Faster speech may facilitate more efficient communication, but if speech is too fast it becomes unintelligible. The maximum speeds at which Mandarin words were intelligible in a sentence context were quantified for normal hearing (NH) and cochlear implant (CI) listeners by measuring time-compression thresholds (TCTs) in an adaptive staircase procedure. In Experiment 1, both original and CI-vocoded time-compressed speech from the MSP (Mandarin speech perception) and MHINT (Mandarin hearing in noise test) corpora was presented to 10 NH subjects over headphones. In Experiment 2, original time-compressed speech was presented to 10 CI subjects and another 10 NH subjects through a loudspeaker in a soundproof room. Sentences were time-compressed without changing their spectral profile, and were presented up to three times within a single trial. At the end of each trial, the number of correctly identified words in the sentence was scored. A 50%-word recognition threshold was tracked in the psychophysical procedure. The observed median TCTs were very similar for MSP and MHINT speech. For NH listeners, median TCTs were around 16.7 syllables/s for normal speech, and 11.8 and 8.6 syllables/s respectively for 8 and 4 channel tone-carrier vocoded speech. For CI listeners, TCTs were only around 6.8 syllables/s. The interquartile range of the TCTs within each cohort was smaller than 3.0 syllables/s. Speech reception thresholds in noise were also measured in Experiment 2, and were found to be strongly correlated with TCTs for CI listeners. In conclusion, the Mandarin sentence TCTs were around 16.7 syllables/s for most NH subjects, but rarely faster than 10.0 syllables/s for CI listeners, which quantitatively illustrated upper limits of fast speech information processing with CIs.

Hearing Loss in Children With Otitis Media With Effusion: Actual and Simulated Effects on Speech Perception.

Conductive hearing loss simulations have attempted to estimate the speech-understanding difficulties of children with otitis media with effusion (OME). However, the validity of this approach has not been evaluated. The research aim of the present study was to investigate whether a simple, frequency-specific, attenuation-based simulation of OME-related hearing loss was able to reflect the actual effects of conductive hearing loss on speech perception. Forty-one school-age children with OME-related hearing loss were recruited. Each child with OME was matched with a same sex and age counterpart with normal hearing to make a participant pair. Pure-tone threshold differences at octave frequencies from 125 to 8000 Hz for every participant pair were used as the simulation attenuation levels for the normal-hearing children. Another group of 41 school-age otologically normal children were recruited as a control group without actual or simulated hearing loss. The Mandarin Hearing in Noise Test was utilized, and sentence recall accuracy at four signal to noise ratios (SNR) considered representative of classroom-listening conditions were derived, as well as reception thresholds for sentences (RTS) in quiet and in noise using adaptive protocols. The speech perception in quiet and in noise of children with simulated OME-related hearing loss was significantly poorer than that of otologically normal children. Analysis showed that RTS in quiet of children with OME-related hearing loss and of children with simulated OME-related hearing loss was significantly correlated and comparable. A repeated-measures analysis suggested that sentence recall accuracy obtained at 5-dB SNR, 0-dB SNR, and -5-dB SNR was similar between children with actual and simulated OME-related hearing loss. However, RTS in noise in children with OME was significantly better than that for children with simulated OME-related hearing loss. The present frequency-specific, attenuation-based simulation method reflected the effects of OME-related hearing loss on speech perception impairment in quiet environments. In noisy environments, the simulation method could only approximately estimate the effects of OME-related hearing loss on speech perception in typical classroom noise levels. Children with OME-related hearing loss may develop compensatory strategies to reduce the effects of hearing loss in adverse listening environments.

Benefits of incorporating the adaptive dynamic range optimization amplification scheme into an assistive listening device for people with mild or moderate hearing loss

ABSTRACTThis study investigated whether a self-designed assistive listening device (ALD) that incorporates an adaptive dynamic range optimization (ADRO) amplification strategy can surpass a commercially available monaurally worn linear ALD, SM100. Both subjective and objective measurements were implemented. Mandarin Hearing-In-Noise Test (MHINT) scores were the objective measurement, whereas participant satisfaction was the subjective measurement. The comparison was performed in a mixed design (i.e., subjects’ hearing status being mild or moderate, quiet versus noisy, and linear versus ADRO scheme). The participants were two groups of hearing-impaired subjects, nine mild and eight moderate, respectively. The results of the ADRO system revealed a significant difference in the MHINT sentence reception threshold (SRT) in noisy environments between monaurally aided and unaided conditions, whereas the linear system did not. The benchmark results showed that the ADRO scheme is effectively beneficial to people who experience mild or moderate hearing loss in noisy environments. The satisfaction rating regarding overall speech quality indicated that the participants were satisfied with the speech quality of both ADRO and linear schemes in quiet environments, and they were more satisfied with ADRO than they with the linear scheme in noisy environments.

Extended bandwidth nonlinear frequency compression in Mandarin-speaking hearing-aid users.

The high frequency information of consonant messages is important for recognition of speech. Recently, the nonlinear frequency compression (NLFC) technique has been shown to improve the speech perception in patients with high frequency hearing loss. In Mandarin, seven consonants are located over 10-16kHz. Extended-bandwidth (EB) NLFC may provide an additional benefit for recognition of Mandarin words. The purpose of this study was to explore the effects of NLFC and EB-NLFC on Mandarin word recognition in patients with high frequency hearing loss. Fourteen native Mandarin-speaking adult patients, aged 20-65 years with bilateral, moderate to severe, sensorineural hearing loss, specifically high frequency hearing loss were included in single-blind randomized study. The assessment tools included the Mandarin Monosyllable Recognition Test (MMRT), Mandarin Hearing in Noise Test (MHINT), and International Outcome Inventory for Hearing Aids (IOI-HA) and sound quality scale of the hearing aids. The patients were tested under unaided condition, after which they were randomly assigned to wear NLFC and EB-NLFC hearing aids, alternatively, in a crossover fashion. After each 4-week block, the patients were tested again to obtain the test outcomes. Patients with hearing aids with EB-NLFC had a significantly better word and consonant recognition using the MMRT (p<0.05). The MHINT was better for the EB-NLFC group without significant differences. The EB-NLFC group had better scores in both the IOI-HA and sound quality scale but not statistically significant. Patients with high-frequency hearing loss may benefit more from using EB-NLFC for word and consonant recognition; however, the improvement was small under a noisy listening environment. The subjective questionnaires did not show significant benefit of EB-NLFC either.

Pure tone hearing profiles in children with otitis media with effusion

Introduction: Otitis media with effusion (OME) is a common middle ear disease in children. The associated conductive hearing loss is a major concern for hearing health professionals. The aim of the present study was to describe the configuration of pure tone audiograms of children with OME and to design a statistical stratification algorithm to facilitate hearing loss profiling in children with OME.Methods: School age children with OME were recruited. Bone and air conduction thresholds were obtained using standard procedures. Hierarchical cluster analysis was employed to determine audiometric profile groups. The Mandarin Hearing in Noise Test was used to measure sentence perception in children for cluster analysis validity assessment.Results: Ninety-seven children (164 ears) aged between 72 months and 153 months were examined. Air conduction thresholds averaged for 500 Hz, 1000 Hz and 2000 Hz were in the range of 8.3–53.3 dB HL with a mean of 26.8 dB HL. Bone conduction thresholds were found to be influenced by middle ear pathology with a maximal elevation at 2000 Hz of 25 dB HL. Four audiometric profiles were identified. Cluster 1 contained 54 ears (32.9%) with normal or near normal hearing, Clusters 2 contained 37 ears (22.6%) with mild hearing loss, Cluster 3 included 48 ears (29.3%) and Cluster 4 included 25 ears (15.2%) with moderate hearing loss. Stability and validity of the four-cluster profiling procedure was examined and established with satisfactory results.Conclusions: OME in children is associated with pure tone hearing thresholds ranging from normal to moderate hearing loss. The hierarchical clustering algorithm proved useful as a novel means of profiling hearing loss in children with OME and may assist in identifying affected children at greater risk of auditory disadvantage.Implications for rehabilitationA hierarchical cluster analysis method can be used to determine audiometric profiles in children with OME.This algorithm assists to identify children at greater risk of auditory disadvantage.Cluster groups with more elevated pure tone thresholds may be targeted for priority in clinical surveillance and medical/surgical intervention.

Speech recognition outcomes in Mandarin-speaking cochlear implant users with fine structure processing

Conclusion: Mandarin-speaking adults can use the Fine Structure Processing (FSP) coding strategy as well as the Continuous Interleaved Sampling (CIS+) coding strategy. No loss in performance was observed after switch-over. Tone identification improves over time with the FSP coding strategy, which is of benefit to tonal-language users. After some time, fine structure was preferred.Objective: This study aimed to determine speech perception, tone perception, and the subjective preferences of Mandarin-speaking adults who received the FSP coding strategy, at upgrade from the CIS + coding strategy.Methods: Thirteen Mandarin-speaking subjects were tested at switch-over from CIS + to the FSP coding strategy ∼1-month after switch-over, 2-months after switch-over, and 3-months after switch-over with the Mandarin Hearing in Noise Test (M-HINT), the Mandarin Tone Identification in Noise Test (M-TINT), and a visual analogue scale assessing Sound and Speech Assessment (SSA).Results: There were no significant differences in the M-HINT between presentation levels (62 dB SPL vs 65 dB SPL), over time, nor when compared to the CIS + coding strategy. Tone perception improved significantly over time with the FSP coding strategy. Subjects rated the FSP coding strategy with the OPUS 2 as significantly more ‘full’ and ‘rich’ than with the CIS + coding strategy after 3-months.

Effects of Within-Talker Variability on Speech Intelligibility in Mandarin-Speaking Adult and Pediatric Cochlear Implant Patients.

Cochlear implant (CI) speech performance is typically evaluated using well-enunciated speech produced at a normal rate by a single talker. CI users often have greater difficulty with variations in speech production encountered in everyday listening. Within a single talker, speaking rate, amplitude, duration, and voice pitch information may be quite variable, depending on the production context. The coarse spectral resolution afforded by the CI limits perception of voice pitch, which is an important cue for speech prosody and for tonal languages such as Mandarin Chinese. In this study, sentence recognition from the Mandarin speech perception database was measured in adult and pediatric Mandarin-speaking CI listeners for a variety of speaking styles: voiced speech produced at slow, normal, and fast speaking rates; whispered speech; voiced emotional speech; and voiced shouted speech. Recognition of Mandarin Hearing in Noise Test sentences was also measured. Results showed that performance was significantly poorer with whispered speech relative to the other speaking styles and that performance was significantly better with slow speech than with fast or emotional speech. Results also showed that adult and pediatric performance was significantly poorer with Mandarin Hearing in Noise Test than with Mandarin speech perception sentences at the normal rate. The results suggest that adult and pediatric Mandarin-speaking CI patients are highly susceptible to whispered speech, due to the lack of lexically important voice pitch cues and perhaps other qualities associated with whispered speech. The results also suggest that test materials may contribute to differences in performance observed between adult and pediatric CI users.

Development and Preliminary Verification of a Mandarin-Based Hearing-Aid Fitting Strategy

ObjectiveThe purpose of this study was to design and to verify a new hearing-aid fitting strategy (Aescu HRL-1) based on the acoustic features of Mandarin. The subjective and objective outcomes were compared to those fitted with NAL-NL1 (National Acoustic Laboratory Non-Linear, version1) in Mandarin-speaking hearing-aid users. DesignFifteen subjects with sensorineural hearing loss participated in this preliminary study. Each subject wore a pair of four-channel hearing aids fitted with the Aescu HRL-1 and NAL-NL1 prescriptions alternatively for 1 month. Objective and subjective tests including the Mandarin Monosyllable Recognition Test (MMRT), Mandarin Hearing in Noise Test (MHINT), International Outcome Inventory for Hearing Aids (IOI-HA), and a sound-quality questionnaire were used to evaluate the performance of the two prescriptions. ResultsThe mean MMRT scores were 79.9% and 81.1% for NAL-NL1 and Aescu HRL-1 respectively. They are not statistically different. The corresponding MHINT signal-to-noise ratios were 0.87 and 0.85 dB, also, no significant difference was found between these two strategies. However, in subjective questionnaires, overall, the sound-quality and IOI-HA scores were higher for Aescu HRL-1. ConclusionsThe speech recognition performance based on Aescu HRL-1 is as good as that of NAL-NL1 for Mandarin-speaking hearing-aid users. Moreover, the subjects generally responded that Aescu HRL-1 provides a more natural, richer, and better sound quality than does NAL-NL1.

Cochlear implants with fine structure processing improve speech and tone perception in Mandarin-speaking adults

Conclusion: This study indicates that Mandarin-speaking subjects acquire significant benefit from a cochlear implant (CI) and audio processor with the fine structure processing (FSP) coding strategy. It can take adult Mandarin CI users time to become accustomed to their CI and appreciate the benefits. Objectives: This study aimed to determine speech perception outcomes in Mandarin-speaking adults who received the FSP coding strategy. Methods: This was a prospective study. Ten adults who were implanted unilaterally with a PULSARCI100, and received an OPUS 1 or OPUS 2 speech processor, were included in this study. The mean age at implantation was 31.1 years. We determined the benefit to postlingually deafened Mandarin-speaking adults with a severe to profound hearing loss using the tests: monosyllables in quiet, sentences in quiet and the Mandarin Hearing in Noise Test (MHINT). Tone perception was evaluated using a tone perception test. A visual analog scale (VAS) was used to score sound quality and ease of listening. Results: The results showed a significant improvement between first fitting and 6 months in all speech tests and in tone perception. The VAS scores showed a significant improvement over 6 months in sound quality and an immediate benefit in ease of listening.

Reception Thresholds for Sentences in Quiet and Noise for Monolingual English and Bilingual Mandarin-English Listeners

Bilingual (BL) listeners' difficulties in adverse noise conditions are exacerbated when perceiving their second language (L2) relative to their first language (L1). Perception of L2 is also significantly poorer by BL listeners compared to native monolingual (ML) listeners. The purpose of the study was to examine the effect of stationary and nonstationary energetic noise maskers on L1 and L2 speech perception in native and nonnative listeners. A mixed multivariate quasi-experimental design was employed. Two groups of 12 ML English-speaking and BL Mandarin-English-speaking normal-hearing young adult female volunteers participated. An adaptive technique was employed to determine reception thresholds for sentences (RTSs) in quiet and in backgrounds of competing continuous and interrupted noise. The noises differed only in their temporal continuity. The sentence stimuli employed consisted of the Hearing in Noise Test (HINT) and the Mandarin Hearing in Noise Test (MHINT). ML participants received the HINT stimuli while the BL participants received both HINT and MHINT stimuli. Between-group differences in RTSs were examined for the same stimuli (i.e., HINT) and for L1 stimuli (i.e., HINT vs. MHINT). Within-group differences in RTSs were examined with the BL participants' perception of L1 and L2 stimuli (i.e., MHINT vs. HINT). The amount of "release from masking" (i.e., the difference of RTS signal-to-noise ratios [SNRs] in interrupted and continuous noise) was also examined between and within groups. In quiet there was no significant difference in mean RTSs between the BL and ML participants with their respective L1 stimuli; MLs had significantly lower mean RTSs in English compared to the BLs; and mean RTSs for the BLs were significantly lower for L1 versus L2 stimulus. In noise, a significantly higher RTS SNR was found for the MLs in continuous noise but not interrupted noise for L1 stimuli compared to the BLs; BLs had a significantly higher mean RTSs in English compared to the MLs; and BLs had significantly higher mean RTSs for L2 versus L1 stimuli. The release from masking was significantly greater for MLs compared to BLs with their respective L1 stimuli and with the same English stimuli. There was no significant difference for the BLs' release from masking with L1 versus L2 stimulus. BL listeners display significantly poorer performance when perceiving nonnative L2 sentences in quiet and in continuous and interrupted noise relative ML listeners. When listening to their respective native L1 sentences, only a difference in continuous noise was found. This difference was attributed to differential masking effect on the English stimuli. Similar performance in the interrupted noise between the ML and BL participants with L1 stimuli and the equivalent release from masking with the BL participants for both L1 and L2 stimuli suggest comparable basic auditory temporal resolving capacities between these ethnic groups.

Hearing in Noise Test in Subjects With Conductive Hearing Loss

It has been reported that patients with pure conductive hearing loss (CHL) have remarked that their hearing is better in the presence of background noise. This study investigated the ability for speech discrimination under background noise in adult subjects with CHL, using the Mandarin Hearing in Noise Test (M-HINT). Seventeen subjects with unilateral CHL and 15 with bilateral CHL participated in this study. Twenty normal-hearing subjects served as controls. During the M-HINT, the sentences and noise were presented in a soundproof chamber. Reception threshold for sentences (RTS) in quiet were obtained first, and then three more blocks, including noise from the front, right and left, were measured for each subject. The RTS in quiet was significantly elevated in unilateral and bilateral CHL groups. For the unilateral group, regardless of whether noise came from the front, affected side, or normal side, the signal-tonoise ratio (SNR) that was needed to reach 50% correction was significantly higher than in the control group. For the bilateral group, the SNR for noise from the front, left and right was significantly elevated compared with that in the unilateral and control groups. The noise composite score was also significantly different among these three groups (control < unilateral < bilateral). There was reduced speech discrimination ability under background noise in adult subjects with unilateral or bilateral CHL.

Development of the Mandarin Hearing in Noise Test (MHINT)

To develop two versions of the Mandarin Hearing In Noise Test (MHINT). These tests are adaptive tests that measure the reception threshold for sentences (RTSs) in quiet and in noise. The RTS is the presentation level at which half the sentences are correctly recognized. Four studies were undertaken to (1) develop sentence materials, (2) equalize sentence difficulty, (3) create phonemically balanced sentence lists; and (4) evaluate within-list response variability, inter-list reliability, and produce normative data. A total of 137 native Mandarin (Putonghua) speaking subjects in Mainland China and 89 native Mandarin speakers in Taiwan participated. They had normal hearing thresholds at 25 dB HL or better. RTSs were measured under four headphone test conditions: Quiet, and in noise with noise originating from the 0 degree (Noise Front), 90 degrees to the right (Noise Right), and 90 degrees to the left (Noise Left). The speech originated from the front (0 degree) in all conditions. The noise level was fixed at 65 dBA, and the speech was varied adaptively to find the RTS. Two versions of the test materials, consisting of 24, 20-sentence lists each in Mandarin spoken in the Mainland (the MHINT-M) and the dialect of Mandarin spoken in Taiwan (the MHINT-T), were created from two sets of 240 sentences containing 10 syllables per sentence. The mean Quiet RTS was 14.7 dBA, using the MHINT-M, and 19.4 dBA, using the MHINT-T. Using the MHINT-M, the mean RTS for Noise Front was -4.3 dB signal-to-noise ratio (SNR), -11.7 dB SNR for Noise Right, and -11.7 dB SNR for Noise Left. Using the MHINT-T, the Noise Front RTS was -4.0 dB SNR, -10.7 dB SNR for Noise Right, and -11.0 dB SNR for Noise Left. Results in noise are slightly better than those seen for the English HINT norms. Response variability within list was low, and inter-list reliability was high, indicating that consistent results can be obtained using any list. Confidence intervals are reported. The two versions of the MHINT are the first standardized Mandarin sentence speech intelligibility tests. Similar to other language versions of the HINT, the MHINT was developed using the same rationale as the English HINT, allowing norm-referenced results for the MHINT to be compared directly with results in other languages. The MHINT would benefit from further evaluation of its validity.