Phoneme Scores Research Articles

Comparison of the Audiologic Results Obtained With the Bone-Anchored Hearing Aid Attached to the Headband, the Testband, and to the "Snap" Abutment

1) To quantify the audiometric differences between the preoperative tests with the Bone-Anchored Hearing Aid (BAHA) attached to the headband or the testband and the final postoperative result with the BAHA positioned at the implanted abutment. 2) To compare the results obtained with the headband and the testband. 3) To quantify the magnitude of the damping through the skin for the BAHA placed at the testband (important for comparison with the implantable hearing aids). Prospective. Tertiary otological referral centre. Ten adult (> or = 14 yr old) BAHA patients (6 male and 4 female subjects) with bilateral air-bone gaps of minimum 40-dB hearing loss and with more than 6 months of BAHA experience with the BAHA "Compact." Audiometric free-field thresholds and speech audiometry scores (Consonant-Vowel-Consonant lists, phonemic score) have been evaluated for 3 conditions: BAHA attached to the implanted "Snap" abutment, to the headband, or to the testband. For frequencies 1 to 4 kHz, significant differences in the range of 5 to 20 dB were found between the BAHA coupled with the Snap abutment and the preoperative testing conditions with the BAHA positioned at the headband or the testband. These differences were also reflected in the speech audiometry with a difference in speech reception threshold of approximately 4 to 7 dB. 1) Significant differences in the audiometric thresholds and the speech understanding scores were found between the preoperative test conditions and the final postoperative result. 2) Audiometric results obtained with the headband and the testband are comparable; therefore, the more comfortable headband is also suitable for the preoperative audiologic evaluation. 3) The magnitude of the skin damping must be accounted for when referring to the audiometric results obtained with the BAHA attached to the testband or headband.

Executive deficits in generalized and extrafrontal partial epilepsy: Long versus short seizure-free periods

The goal of this study was to examine the influence of seizure freedom on executive function in outpatients with generalized epilepsy and extrafrontal partial epilepsy. Recent investigations of cognitive function in epilepsy have revealed executive deficits in persons with focal temporal as well as generalized epilepsies. Additional studies have suggested an influence of seizure freedom on cognitive function. Thirty-five consecutive outpatients were divided into seizure free <or= 3 months (n=18) and seizure free >3 months (n=17). The neuropsychological tests administered included: verbal fluency tasks, the Cognitive Estimation Test, the Hayling and Brixton Test, and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) battery. Both patient groups were compared with matched healthy controls (n=16). The extensive testing revealed significant differences between patients with shorter seizure-free periods and healthy controls with respect to overall errors and phonemic verbal fluency, response suppression, and BADS overall profile scores. Subjects seizure free >3 months exhibited a trend toward impairment in the phonemic fluency task only. The results suggest that deficits in executive function were present in patients with extrafrontal partial epilepsy and generalized epilepsy, indicating the potential influence of epileptic activity on the ability to focus on relevant information and switch attention to other relevant information, to plan tasks and subtasks, and to check on and encode working memory content. The results also suggest that those deficits may be more pronounced in patients with relatively short seizure-free periods.

Cumulative exposure to high-strain and active jobs as predictors of cognitive function: the Whitehall II study

Objectives: A high-strain job (a combination of high job demands and low job control) is expected to increase the risk of health problems, whereas an active job (high demands and...

The Performance/Intensity Function: An Underused Resource

The purpose of this tutorial is to demonstrate the potential value of the Performance versus Intensity (PI) function in both research and clinical settings. The PI function describes recognition probability as a function of average speech amplitude. In effect, it shows the cumulative distribution of useful speech information across the amplitude domain, as speech rises from inaudibility to full audibility. The basic PI function can be modeled by a cubed exponential function with three free parameters representing: (a) threshold of initial audibility, (b) amplitude range from initial to full audibility, and (c) recognition probability at full audibility. Phoneme scoring of responses to consonant-vowel-consonant words makes it possible to obtain complete PI functions in a reasonably short time with acceptable test-retest reliability. Two examples of research applications are shown here: (a) the preclinical behavioral evaluation of compression amplification schemes, and (b) assessment of the distribution of reverberation effects in the amplitude domain. Three examples of clinical application show data from adults with different degrees and configurations of sensorineural hearing loss. In all three cases, the PI function provides potentially useful information over and above that which would be obtained from measurement of Speech Reception Threshold and Maximum word recognition in Phonectically Balanced lists. Clinical application can be simplified by appropriate software and by a routine to convert phoneme recognition scores into estimates of the more familiar whole-word recognition scores. By making assumptions about context effects, phoneme recognition scores can also be used to estimate word recognition in sentences. It is hard to escape the conclusion that the PI function is an easily available, potentially valuable, but largely neglected resource for both hearing research and clinical audiology.

Audiologic and radiographic response of NF2-related vestibular schwannoma to erlotinib therapy

A 48-year-old man presented to a neurologist with complaints of bilateral hearing loss and tinnitus. The patient was a member of a large family affected by neurofibromatosis type 2 and first noted hearing loss 10 years before presentation. Medical and neurological examination, MRI scan of the brain and spinal cord, pure-tone audiometry, NU-6 monosyllabic word test with phoneme scoring, City University of New York topic-related sentences test, noise/voice test of minimal auditory capability battery. Progressive neurofibromatosis-type-2-related vestibular schwannomas. Annual cranial MRI and audiology, surgical resection of right vestibular schwannoma, high-power behind-the-ear hearing aid, erlotinib therapy for progressive left vestibular schwannoma.

Automatic testing of speech understanding

Speech reception tests are commonly administered by manually scoring the oral response of the test subject. This requires a test supervisor to be continuously present, which can be avoided by having the subject type the response on a computer keyboard and automatically scoring the response. However, spelling errors may then be counted as recognition errors, and hence influence the test results. We demonstrate an autocorrection approach based on two scoring algorithms to cope with spelling errors. The first algorithm deals with sentences and is based on word score. The second algorithm deals with single words and is based on phoneme score. Both algorithms are evaluated with a corpus of typed answers based on three different Dutch speech materials. The percentage of differences between the autocorrection algorithm and the manual correction was calculated, in addition to the mean difference in speech recognition threshold between automatic and manual scoring. The sentence correction algorithm performed at higher accuracy than commonly obtained with these speech materials. The word correction algorithm performed better than the human operator. Both algorithms can be used in practice and allow speech reception tests with open set speech materials over the internet.

Speech Perception in Children With Auditory Neuropathy/Dyssynchrony Managed With Either Hearing Aids or Cochlear Implants

To evaluate speech perception skills in children with auditory neuropathy (AN)/auditory dyssynchrony (AD)-type hearing loss managed with either hearing aids or cochlear implants. Prospective data collection in 3 subject groups: AN/AD children fitted with bilateral amplification, AN/AD children fitted with cochlear implant (in 1 or both ears), and a matched control group of implanted children with sensorineural hearing loss. Open-set monosyllabic words (consonant-nucleus-consonant). Of the 10 implanted AN/AD children, 9 demonstrated significant speech discrimination (consonant-nucleus-consonant phoneme score > or =55%). Similar results were obtained for the aided AN/AD group. Findings for both AN/AD subject groups were poorer than those of the implanted sensorineural cohort. Cochlear implantation can offer useful hearing in subjects with AN/AD-type hearing loss. However, expectations for this group may need to be lower than for patients with peripheral (cochlear) loss.

Cochlear Implant Outcomes and Quality of Life in Adults with Prelingual Deafness

To evaluate sound and speech perception and quality of life in prelingually deafened adults implanted with state of the art devices. To investigate which patient factors influence postoperative performance. Prospective intervention study. Eight prelingually deafened subjects (with onset of severe hearing impairment before the age of 4 years and functioning in an oral-aural setting) participated in this study. Subjects were implanted at a mean age of 36 (range, 21-55) years with a CII or 90 K cochlear implant (Advanced Bionics Corp.). All subjects completed standard speech perception tests as well as quality of life measures (Health Utility Index Mark-II, Nijmegen Cochlear Implant Questionnaire, visual analogue scale for subject's hearing and health) at different points in time. Postoperative scores were compared with each other and with the baseline preoperative scores. The relationship between nine patient variables and the postoperative consonant-vowel-consonant (CVC) phoneme score was also investigated. Significant improvement was measured for CVC word and phoneme scores and several quality of life measures. Postoperative speech perception correlated with a new and promising factor named quality of a patient's own speech production (QoSP). With state of the art implants, speech perception and quality of life do improve in prelingually deafened adults. More importantly, the prognostic value of QoSP should be investigated further.

Contribution of High Frequencies to Speech Recognition in Quiet and Noise in Listeners With Varying Degrees of High-Frequency Sensorineural Hearing Loss

The contribution of audible high-frequency information to speech-understanding performance in listeners with varying degrees of high-frequency sensorineural hearing loss was examined. Thirty-six elderly hearing-impaired (EHI) and 24 young normal-hearing (YNH) listeners were tested in quiet (+20 dB speech-to-noise ratio [SNR]) and noise (+5 dB SNR) and under different bandpass conditions (narrow, 200-1600 Hz; midband, 200-3200 Hz; broadband, 200-6400 Hz), both without and with spectral shaping of the stimuli. Monosyllabic word-recognition performance was examined through use of both whole-word scoring and phoneme scoring. The 36 EHI listeners were divided into 3 groups of 12 listeners each, with the groups differing in the amount of high-frequency hearing loss. The 24 YNH participants were separated into 2 groups, each serving as a reference group for either the unshaped or spectrally shaped speech listening conditions. Results for spectrally shaped speech, in both quiet and noise, revealed that the 3 EHI groups performed equivalently in the different bandwidth conditions and demonstrated no change (increase or decrease) in word-recognition performance between the midband and broadband conditions. The YNH groups, however, demonstrated improved speech understanding attributable to the higher frequencies for the broadband condition in both the unshaped and shaped conditions. Data from the EHI listeners revealed that performance for unshaped speech was correlated moderately and negatively with degree of high-frequency hearing loss. Alternatively, recognition performance for shaped speech was related to neither the performance for unshaped speech nor the amount of high-frequency hearing loss.

Speech Understanding in Background Noise with the Two-Microphone Adaptive Beamformer BEAM™ in the Nucleus Freedom™ Cochlear Implant System

This paper evaluates the benefit of the two-microphone adaptive beamformer BEAM in the Nucleus Freedom cochlear implant (CI) system for speech understanding in background noise by CI users. A double-blind evaluation of the two-microphone adaptive beamformer BEAM and a hardware directional microphone was carried out with five adult Nucleus CI users. The test procedure consisted of a pre- and post-test in the lab and a 2-wk trial period at home. In the pre- and post-test, the speech reception threshold (SRT) with sentences and the percentage correct phoneme scores for CVC words were measured in quiet and background noise at different signal-to-noise ratios. Performance was assessed for two different noise configurations (with a single noise source and with three noise sources) and two different noise materials (stationary speech-weighted noise and multitalker babble). During the 2-wk trial period at home, the CI users evaluated the noise reduction performance in different listening conditions by means of the SSQ questionnaire. In addition to the perceptual evaluation, the noise reduction performance of the beamformer was measured physically as a function of the direction of the noise source. Significant improvements of both the SRT in noise (average improvement of 5-16 dB) and the percentage correct phoneme scores (average improvement of 10-41%) were observed with BEAM compared to the standard hardware directional microphone. In addition, the SSQ questionnaire and subjective evaluation in controlled and real-life scenarios suggested a possible preference for the beamformer in noisy environments. The evaluation demonstrates that the adaptive noise reduction algorithm BEAM in the Nucleus Freedom CI-system may significantly increase the speech perception by cochlear implantees in noisy listening conditions. This is the first monolateral (adaptive) noise reduction strategy actually implemented in a mainstream commercial CI.

A dynamic approach to phonological assessment

Dynamic and static assessments in phonological disorders provide different information about a child's skills and development. Dynamic assessments evaluate a child's phonological system when given support, whereas static assessments evaluate skills without support. The Scaffolding Scale of Stimulability (SSS), described in this article, is one example of a dynamic assessment used to evaluate phonological disorders. The SSS comprises a 21-point hierarchy of cues and environmental manipulations that can be used to support a child in the production of phonemes. Use of the SSS is illustrated by a case study of a 4-year-old boy with moderate phonological disorder. The SSS is compared to a static assessment, a probe of 60 single words based on the child's error patterns. The two assessments are compared across treatment at three time intervals: prior to treatment, after 3 months of treatment, and after 6 months of treatment. Results indicated that scores on the SSS could differentiate the boy's phoneme productions based on the amount of support needed, while phoneme scores on the probe were at 0% accuracy. As a composite score, the SSS showed a greater percentage of change earlier in treatment and across time when compared to the probe.

A STEP TOWARD EARLY PHONEMIC AWARENESS: THE EFFECTS OF THE TURTLE TALK TRAINING

Phonemic awareness has been known as the most important variable for developing reading skills. Although various training curricula and programs were developed in order to cultivate the phonemic awareness, this study introduces a new phonemic awareness curriculum, called Tturtletalk training program. The principle of this program in learning is pronouncing each letter of a word as slowly as possible in reading, making a child focus on each phoneme of a word. The children trained by this program have shown better phonemic awareness test score than those trained by a current reading training curriculum. The implication of these results and the prospect of the Turtletalk program were discussed.

The use of subsegmental information in sentence comprehension with or without formant transitions by normal-hearing and hearing-impaired listeners

Using a noise replacement paradigm, Lee and Kewley-Port [J. Acoust. Soc. Am., 119, (2006)] examined sentence comprehension by young normal-hearing (YNH) and elderly hearing-impaired (EHI) listeners when sentences were processed to present only subsegmental information (i.e., either steady-state or formant transitions) in sentences processed in four different ways. Results showed that correct word responses by EHI listeners were more affected by the type of information in the four conditions compared to YNH listeners. To compare the use of subsegmental information between listener groups who were carefully matched for audibility and age, new analyses of correctly identified phonemes and different word-error patterns were made for both correct and incorrect word responses. Correlation analyses examined the relations among correct and incorrect word responses, phoneme scoring, hearing thresholds, and age. Despite a larger number of incorrect answers by EHI listeners, word-error patterns, as well as an ability to extract phonemes using subsegmental information, were similar between YNH and EHI listeners. Analyses for EHI listeners showed correct word responses were strongly correlated with correct phoneme identification and with hearing thresholds, but not with age. [Work supported by NIHDCD-02229.]

Phonemic Fluency, Semantic Fluency, and Difference Scores: Normative Data for Adult Hebrew Speakers

Norms for Hebrew semantic and phonemic fluency were collected in a sample of 369 participants, ranging in age from 18 to 85. Two hundred and sixty nine persons completed both tests and the rest completed only the semantic test. Phonemic fluency was assessed with the use of three letters (bet, gimel, and shin) and semantic fluency with the use of three categories (animals, fruits and vegetables, and vehicles). Scores of individual letters and categories, sum scores, as well as the difference between the semantic and phonemic sum scores are presented for four age groups (18–30, 31–50, 51–70, and 71–85). Results show that age had the greatest effect on fluency performance, level of education was positively correlated to sum scores but contributed little to its prediction beyond the contribution of age, and gender had no significant effect.

Entwicklung eines neuen Kindersprachtests und Erprobung an CI-Kindern

Speech audiometry plays an important role for hearing evaluation in children. Hearing impaired children, such as those with cochlear implant (CI) who frequently undergo testing, learn the test words by heart. Furthermore, the standard tests use words of former time. Using the most frequently words of modern children's literature a speech assessment test was developed for children between 1 to 8 years. The material was first evaluated on normal hearing children. In a second step the phoneme and word perception scores of 35 CI children were measured using 60 - 100 dB SPL according to the most comfortable level (MCL) in free sound field. The performance-intensity function for the single words were highly comparable with those of the Freiburger or Göttinger speech perception test. The average speech reception threshold in CI children was 44 % (test I), 36 % (test II), 63 % (test III) and 69 % (test IV), respectively. Compared to the Mainzer and Göttinger speech perception test the new words were more difficult to understand than those of the known tests. However, a statistically significant difference could be noted only for test II. The new developed "Würzburger speech perception test" appears to be a useful additional tool for the evaluation of hearing impaired children in addition to the standard test procedures.

Cochlear implantation in patients with osteogenesis imperfecta

Hearing loss has been shown to occur in 42% to 58% of patients with osteogenesis imperfecta (OI), with deafness arising in 25% to 60% of the patients. Implantation in patients with OI is relatively rare, with only 4 prior single case reports published in the English-language literature. The goal of this study was to evaluate the feasibility and functional outcome of cochlear implantation in 2 patients with OI tarda type I with profound sensorineural hearing loss. Case series. The implantations were performed in a tertiary academic referral center (Johns Hopkins University). Though promontory vascularity was encountered, full insertion of a normal cochlear implant array could be achieved in both cases. One-year postimplant scores demonstrated 20 to 40 dB hearing thresholds, Consonant-Nucleus-Consonant Test word scores of 54% and 70%, Consonant-Nucleus-Consonant Test phoneme scores of 75% and 83%, Hearing in Noise Test scores of 76% and 99%, and Central Institute of the Deaf Sentence Score sentence scores of 99% and 100%, for patients 1 and 2, respectively. Cochlear implantation in patients with OI is not only technically possible but the results are similar to implant outcomes for patients with sensorineural hearing loss from a variety of other causes. C.

A Comparison of Two Approaches to Assessment of Speech Recognition Ability in Single Cases

Single-case design with the randomization test (RT) has been proposed as an alternative to the binomial distribution (BD) tables of Thornton and Raffin (1978) to assess changes in speech recognition performance in individual subjects. The present study investigated whether data analyzed using both approaches would result in similar outcomes. Sixty-two adults with normal hearing were evaluated using phoneme scoring and a restricted alternating treatments design under two signal-to-noise conditions. Results revealed a significant correlation between the RT and a BD analysis using at least 50-word lists, although the BD analysis was a more sensitive measure. The absence of correlation between the RT with a BD analysis using 25-word lists challenges the common clinical practice of using reduced list size, and supports the use of phoneme scoring and other attempts to find clinically acceptable yet evidence-based solutions to overcome the conflict between time and accuracy.

Evaluation of phoneme compression schemes designed to compensate for temporal and spectral masking in background noise

The effect of phonemic compression has been studied on speech intelligibility in background noise in hearing-impaired listeners with moderate-to-severe high-frequency losses. One configuration, anti-upward-spread-of-masking (anti-USOM) focuses on a release from spectral masking of high-frequency speech cues by selective spectral tilting. Release from temporal masking is the main goal of a second configuration, high-pass filtered compression (HFC), which reduces the speech modulations within a high-pass filtered compression channel. Speech intelligibility was measured with consonant-vowel-consonant (CVC) words in a multi-talker babble and a single-talker background noise. Anti-USOM has a significant negative effect on the phoneme scores in background noise. HFC compression tends to improve vowel intelligibility in a single-talker background noise, especially for the listeners with a relatively poor speech score. In a multi-talker babble noise the effects of HFC compression tend to be negative. It can be concluded that no significant release from spectral or temporal masking is obtained by the applied processing.SumarioEl efecto de la compresión fonémica ha sido estudiado en la inteligibilidad del lenguaje con ruido de fondo, en hipoacúsicos con pérdidas entre moderadas y severas en frecuencias agudas. Una configuración (anti USOM) esta centrada en la liberación del espectro enmascarante de claves lingüísticas de alta frecuencia por medio de un espectro selectivamente inclinado. La liberación del enmascaramiento temporal es el objetivo principal de la segunda configuración (HFC) que reduce las modulaciones del lenguaje en un canal de compresión de filtros de altas frecuencias. La inteligibilidad del lenguaje fue medida con palabras Consonante-Vocal-Consonante (CVC) en un fondo de ruido de hablantes múltiples y de hablante aislado. El Anti-USOM tuvo un efecto significativamente negativo en las puntuaciones de los fonemas con ruido de fondo. La compresión HFC tiende a mejorar la inteligibilidad de las vocales con ruido de fondo de hablante aislado, especialmente para personas con puntuaciones de lenguaje relativamente pobre. Con ruido de hablantes múltiples los efectos de la compresión HFC tienden a ser negativos. Se puede concluir que no se obtiene una liberación significativa a partir del enmascaramiento espectral o temporal con el procesamiento que se aplicó.

Frequency-place compression and expansion in cochlear implant listeners

In multichannel cochlear implants, low frequency information is delivered to apical cochlear locations while high frequency information is delivered to more basal locations, mimicking the normal acoustic tonotopic organization of the auditory nerves. In clinical practice, little attention has been paid to the distribution of acoustic input across the electrodes of an individual patient that might vary in terms of spacing and absolute tonotopic location. In normal-hearing listeners, Başkent and Shannon (J. Acoust. Soc. Am. 113, 2003) simulated implant signal processing conditions in which the frequency range assigned to the array was systematically made wider or narrower than the simulated stimulation range in the cochlea, resulting in frequency-place compression or expansion, respectively. In general, the best speech recognition was obtained when the input acoustic information was delivered to the matching tonotopic place in the cochlea with least frequency-place distortion. The present study measured phoneme and sentence recognition scores with similar frequency-place manipulations in six Med-El Combi 40+ implant subjects. Stimulation locations were estimated using the Greenwood mapping function based on the estimated electrode insertion depth. Results from frequency-place compression and expansion with implants were similar to simulation results, especially for postlingually deafened subjects, despite the uncertainty in the actual stimulation sites of the auditory nerves. The present study shows that frequency-place mapping is an important factor in implant performance and an individual implant patient's map could be optimized with functional tests using frequency-place manipulations.

A Digital Processing Strategy to Optimize Hearing Aid Outputs Directly

A new amplification strategy (ADRO), based on 64 independently operating channels, was compared with a nine-channel wide dynamic range compression strategy (WDRC). Open-platform in-the-ear hearing instruments were configured either with ADRO or the manufacturer's WDRC strategy. Twenty-two subjects with mild to moderate hearing loss took home the ADRO or WDRC hearing aids. After three weeks' acclimatization, the aids were evaluated using monosyllables in quiet at 50 to 65 dB SPL and sentences in eight-talker babble. The acclimatization and evaluation were repeated in the second phase of the balanced reverse-block blind experimental design. The ADRO program showed a statistically significant mean advantage of 7.85% word score (95% confidence interval 3.19% to 12.51%; p = 0.002) and 6.41% phoneme score for the monosyllables in quiet (95% confidence interval 2.03% to 10.79%; p = 0.006). A statistically significant advantage of 7.25% was also found for the ADRO program in background noise (95% confidence interval 1.95% to 12.55%; p = 0.010). The results are consistent with earlier data for listeners with moderate to severe hearing loss.