Speech Perception Tests Research Articles

Toward a method of achieving balanced stimulation of bilateral auditory nerves: Evidence from children receiving matched and unmatched bilateral cochlear implants simultaneously

ObjectivesTo identify whether mismatched bilateral cochlear implants compromise balanced stimulation of the two auditory nerves and establish asymmetric hearing in children. MethodsBehavioural and electrophysiological measures were completed in 47 children receiving bilateral CIs in the same surgery (simultaneously): 27 children received a peri‑modiolar N24RE array in one ear and a 422 anti-modiolar array in the other (experimental group) and 20 children received 2 peri‑modiolar arrays (control group). Differences in current levels between the two devices were measured by electrically evoked compound action potentials (ECAPs) at the time of surgery. These data were compared with minimum and maximum comfortably loud levels programmed in each speech processor (T-levels, C-levels, respectively) after 12 months of bilateral CI use. Asymmetries in functional hearing between arrays were measured in open set speech perception testing between 3 to 5 years of CI use. ResultsHigher current levels were required from the anti-modiolar than peri‑modiolar array to evoke balanced interaural ECAP amplitudes (mismatched group: mean ± SD difference: -9.9 ± 22.6; matched group: -0.8 ± 26.5). This difference was larger in the experimental group than control group (t = -2.51; p = 0.016) and remained constant with increases in current level from ECAP threshold to maximum amplitudes (dynamic range) in many but not all children in both groups. T and C-levels were poorly predictive of levels needed to evoke balanced ECAP amplitudes in children with mismatched devices (F(1, 312) = 1.3, p = 0.263). Speech perception scores were more asymmetric between ears in children using bilateral mismatched arrays (mean ± SD: 73.8 ± 16.4 at the peri‑modiolar array; 57.7 ± 26.4 at the anti-modiolar array), compared to children with bilateral matched arrays (right ear: 78.0 ± 10.4; left ear: 74.9 ± 13.5). ConclusionHigher current level requirements at the anti-modiolar array compared to the peri‑modiolar array in children with bilateral mismatched CIs are not fully accounted for in device programming. Mismatched electrodes in children receiving bilateral cochlear implants increases the risk of asymmetric hearing.

Experience of adult cochlear implantation at a tertiary hospital.

The prevalence of adult cochlear implant (CI) surgery is increasing. However, the relevant adult CI data in Taiwan are insufficient due to the relatively small number of adult implant patients. The two main factors hindering adult implantation are the high cost of the surgery itself and inadequate knowledge regarding the effectiveness of CI for hearing and suppression of tinnitus. Here, we present data regarding adult CI outcomes from a single tertiary hospital. A total of 116 consecutive adult CI recipients (≥18 years old) who completed at least 12 months of speech perception tests (words and sentences) between January 1999 and December 2020 were enrolled in this retrospective population-based cohort study. Thirty patients completed speech perception (words and sentences) testing as well as three questionnaires relating to quality of life, and 71 completed full tinnitus suppression studies. Subjects' pre- and post-CI questionnaires were evaluated to assess overall CI outcome. For auditory evaluation, the scores of easy sentences (ES), difficult sentences (DS), and phonetically balanced (PB) word recognition tests reached a plateau at 3 months post-CI (p = 0.005, 0.001, and 0.004, respectively) in most subjects. The post-CI scores of bodily pain, mental health, and social role functioning were significantly higher than corresponding pre-CI scores on the SF-36 Health Survey-Taiwan version (p = 0.036, 0.019, and 0.002, respectively). Furthermore, the post-CI scores of basic sound perception, speech production, and advanced sound perception were significantly higher than the corresponding pre-CI scores on the Nijmegen Cochlear Implant Questionnaire (p < 0.001, 0.013, and <0.001, respectively). Self-esteem was significantly correlated with the Categories of Auditory Performance scale and Speech Intelligibility Rating scale at 3, 6, and 9 months post-CI. CI improved tinnitus in approximately 65.1% of 71 adults. Based on the Tinnitus Handicap Inventory, 66.7% of patients were in grade 3-5 before surgery. However, after CI, only 34.4% of patients remained in THI grade 3-5. This study confirmed that CI can improve speech perception (words and sentences), physical health, mental health, social interaction, and self-esteem in adult patients with profound hearing loss. CI also significantly alleviated tinnitus. The outcomes of ES, DS, and PB tests at 3 months post-CI were non-inferior to other longer post-CI periods and could be utilized as references for recovery and evaluation of prognosis.

More Than Words: the Relative Roles of Prosody and Semantics in the Perception of Emotions in Spoken Language by Postlingual Cochlear Implant Users.

The processing of emotional speech calls for the perception and integration of semantic and prosodic cues. Although cochlear implants allow for significant auditory improvements, they are limited in the transmission of spectro-temporal fine-structure information that may not support the processing of voice pitch cues. The goal of the current study is to compare the performance of postlingual cochlear implant (CI) users and a matched control group on perception, selective attention, and integration of emotional semantics and prosody. Fifteen CI users and 15 normal hearing (NH) peers (age range, 18-65 years) 1istened to spoken sentences composed of different combinations of four discrete emotions (anger, happiness, sadness, and neutrality) presented in prosodic and semantic channels-T-RES: Test for Rating Emotions in Speech. In three separate tasks, listeners were asked to attend to the sentence as a whole, thus integrating both speech channels (integration), or to focus on one channel only (rating of target emotion) and ignore the other (selective attention). Their task was to rate how much they agreed that the sentence conveyed each of the predefined emotions. In addition, all participants performed standard tests of speech perception. When asked to focus on one channel, semantics or prosody, both groups rated emotions similarly with comparable levels of selective attention. When the task was called for channel integration, group differences were found. CI users appeared to use semantic emotional information more than did their NH peers. CI users assigned higher ratings than did their NH peers to sentences that did not present the target emotion, indicating some degree of confusion. In addition, for CI users, individual differences in speech comprehension over the phone and identification of intonation were significantly related to emotional semantic and prosodic ratings, respectively. CI users and NH controls did not differ in perception of prosodic and semantic emotions and in auditory selective attention. However, when the task called for integration of prosody and semantics, CI users overused the semantic information (as compared with NH). We suggest that as CI users adopt diverse cue weighting strategies with device experience, their weighting of prosody and semantics differs from those used by NH. Finally, CI users may benefit from rehabilitation strategies that strengthen perception of prosodic information to better understand emotional speech.

Cochlear implantation in patients with asymmetric hearing loss: reporting and discussing the benefits in speech perception, speech reception threshold, squelch abilities, and patients' reported outcomes.

This study presents the results obtained in a group of patients with asymmetric hearing loss undergoing cochlear implantation at our institution. Prognostic factors are discussed in relation to different rehabilitative approaches for asymmetric hearing loss remediation. The current literature is also discussed. Nineteen adult patients with post-verbal asymmetric hearing loss were enrolled. The results were assessed by means of a speech perception test, completed in silence and with background noise, and a speech reception threshold test (Oldenburg Sentence Test). The subjectively perceived benefits were assessed using the Speech, Spatial and Qualities of Hearing Scale. Statistically significant improvements were achieved by all patients in terms of speech perception and speech reception threshold, and in subjective benefits. The results confirm the literature findings which suggest that patients with asymmetric hearing loss generally gain substantial benefit from cochlear implantation because of the binaural input, with significant improvement in speech perception abilities in noise, speech reception threshold, and squelch abilities.

Comparative analysis between effective gain and functional gain in bone-anchored hearing aid users.

The cases of ear malformations, conductive, mixed, and single-sided deafness hearing loss are candidates for surgery and use of Bone-Anchored Hearing Aids (BAHA). Commonly, the literature highlights two procedures to assess the benefits and characteristics of amplification in users: functional gain (FG) and effective gain (EG). Estimate and compare the EG and the FG to evaluate the benefits obtained by users of BAHA and, later, to compare tests of speech perception in silence and in noise. The sample (n=79) was divided into four groups, implanted from February 2014 to February 2021. The following tests were analyzed: pure-tone audiometry by air and bone; research of audiometric thresholds in free field; speech perception tests in silence and in noise. EG presented lower values than FG in all frequencies. The positive results of the speech perception tests were correlated with worse FG values. EG is the best method for evaluation, as it allows a proper comparison between devices, as well as a comparison with the prescription of validated rules. A better evaluation of results was observed on the EG values, indicating that it is a relevant method to assess auditory performance. In addition, the FG results were incompatible with the benefits obtained in the speech perception tests, showing that it is not a reliable tool for monitoring the results with the use of BAHA.

Figure-based speech perception test: applicability in children with Down syndrome.

To verify the applicability of the picture-based speech perception test in children with Down syndrome. Observational, descriptive, prospective study, carried out at two speech therapy centers, approved by their Research Ethics Committees under numbers 82522217.5.0000.5440 and 79510317.8.0000.5257. A total of 41 children with Down syndrome, of both sexes, aged 2 years to 10 years and 11 months participated. They were divided into three groups: GI (2 years to 4 years and 11 months); GII (5 years to 7 years and 11 months); GIII (8 years to 10 years and 11 months). We verified their medical history and carried out meatoscopy, pure-tone threshold audiometry, speech recognition threshold test with pictures, and immittance tests. For statistical analysis, we used Fisher's Exact Test with the 5% significance level. Results: The analysis of hits and misses in relation to chronological age revealed significance in seven words: "ice", "knife", "cow", "key", "mouse", "dog", and "sun". We then analyzed this study participants' performance in the speech test with pictures and those in the study that developed and validated this test. Comparing the percentage of correct answers in the two groups, we found that the words with the most correct answers were "hand", "house", and "frog". Conclusion: The test applied in this study provides a clear and objective interpretation of the results, regardless of the child's verbal production.

Optimising hearing aid output to paediatric prescriptive targets improves outcomes in children

Objective This study examined the accuracy of hearing aid output to DSL v5.0 Child targets in a group of children who wear hearing aids, and the impact on their auditory outcomes. Design For each participant, the output of the initial hearing aid fitting was compared to DSL v5.0 Child prescriptive targets and again after the fitting was adjusted using coupler-based verification and RECD measures. Outcomes for initial and adjusted fittings were examined using the Speech Intelligibility Index (SII), Parent’s Evaluation of Aural/Oral Performance of Children (PEACH) rating scale, and speech perception tests in quiet and noise. Study sample Sixty-eight children aged 3 months to 17 years with moderate to profound hearing loss participated in the study. Results Fit-to-targets improved significantly after hearing aids were adjusted to match targets to within 5 dB RMSE. Adjusted hearing aids provided increased aided audibility compared to initial fittings and resulted in improved speech perception scores and parent-reported hearing performance. Fifty percent of the children aged 6 to 17 years preferred their adjusted fitting compared to 10% who preferred their initial fitting. Conclusions Improvement in fit-to-target to a validated paediatric prescriptive formula using best practice procedures can result in improved auditory outcomes and possible self-reported satisfaction.

Home-Based Speech Perception Monitoring for Clinical Use With Cochlear Implant Users.

Speech-perception testing is essential for monitoring outcomes with a hearing aid or cochlear implant (CI). However, clinical care is time-consuming and often challenging with an increasing number of clients. A potential approach to alleviating some clinical care and possibly making room for other outcome measures is to employ technologies that assess performance in the home environment. In this study, we investigate 3 different speech perception indices in the same 40 CI users: phoneme identification (vowels and consonants), digits in noise (DiN) and sentence recognition in noise (SiN). The first two tasks were implemented on a tablet and performed multiple times by each client in their home environment, while the sentence task was administered at the clinic. Speech perception outcomes in the same forty CI users showed that DiN assessed at home can serve as an alternative to SiN assessed at the clinic. DiN scores are in line with the SiN ones by 3–4 dB improvement and are useful to monitor performance at regular intervals and to detect changes in auditory performance. Phoneme identification in quiet also explains a significant part of speech perception in noise, and provides additional information on the detectability and discriminability of speech cues. The added benefit of the phoneme identification task, which also proved to be easy to administer at home, is the information transmission analysis in addition to the summary score. Performance changes for the different indices can be interpreted by comparing against measurement error and help to target personalized rehabilitation. Altogether, home-based speech testing is reliable and proves powerful to complement care in the clinic for CI users.

Cutting Through the Noise: Noise-Induced Cochlear Synaptopathy and Individual Differences in Speech Understanding Among Listeners With Normal Audiograms.

Following a conversation in a crowded restaurant or at a lively party poses immense perceptual challenges for some individuals with normal hearing thresholds. A number of studies have investigated whether noise-induced cochlear synaptopathy (CS; damage to the synapses between cochlear hair cells and the auditory nerve following noise exposure that does not permanently elevate hearing thresholds) contributes to this difficulty. A few studies have observed correlations between proxies of noise-induced CS and speech perception in difficult listening conditions, but many have found no evidence of a relationship. To understand these mixed results, we reviewed previous studies that have examined noise-induced CS and performance on speech perception tasks in adverse listening conditions in adults with normal or near-normal hearing thresholds. Our review suggests that superficially similar speech perception paradigms used in previous investigations actually placed very different demands on sensory, perceptual, and cognitive processing. Speech perception tests that use low signal-to-noise ratios and maximize the importance of fine sensory details- specifically by using test stimuli for which lexical, syntactic, and semantic cues do not contribute to performance-are more likely to show a relationship to estimated CS levels. Thus, the current controversy as to whether or not noise-induced CS contributes to individual differences in speech perception under challenging listening conditions may be due in part to the fact that many of the speech perception tasks used in past studies are relatively insensitive to CS-induced deficits.

Individual Hearing Outcomes in Cochlear Implant Users Influence Social Engagement and Listening Behavior in Everyday Life.

The goal of this study was to assess the listening behavior and social engagement of cochlear implant (CI) users and normal-hearing (NH) adults in daily life and relate these actions to objective hearing outcomes. Ecological momentary assessments (EMAs) collected using a smartphone app were used to probe patterns of listening behavior in CI users and age-matched NH adults to detect differences in social engagement and listening behavior in daily life. Participants completed very short surveys every 2 hr to provide snapshots of typical, everyday listening and socializing, as well as longer, reflective surveys at the end of the day to assess listening strategies and coping behavior. Speech perception testing, with accompanying ratings of task difficulty, was also performed in a lab setting to uncover possible correlations between objective and subjective listening behavior. Comparisons between speech intelligibility testing and EMA responses showed poorer performing CI users spending more time at home and less time conversing with others than higher performing CI users and their NH peers. Perception of listening difficulty was also very different for CI users and NH listeners, with CI users reporting little difficulty despite poor speech perception performance. However, both CI users and NH listeners spent most of their time in listening environments they considered "not difficult." CI users also reported using several compensatory listening strategies, such as visual cues, whereas NH listeners did not. Overall, the data indicate systematic differences between how individual CI users and NH adults navigate and manipulate listening and social environments in everyday life.

Comparison of speech perception lists used to evaluate Japanese single syllable hearing

Objective: In Japan, the 57S and 67S single syllable lists have been used to test speech perception in cochlear implant (CI) users. However, due to advances in implants and processors, these lists have become too simple for CI users. In 2019, the Japan Otological Society created a new list, referred to as the iCI2004. The objective of this study was to compare the performance of these lists.Methods: The Japanese single syllable speech perception tests, iCI2004, 57S, and 67S, were administered to 70 patients with CI users. The effects of single syllable characteristics on the test scores were examined. The type and number of single syllables used in each list were different. Therefore, we compared the scores for normal lists, shared single syllables, and non-shared single syllables.Results: The average test results were 52% for iCI2004, 64% for 57S, and 77% for 67S; 67S performed the best, followed by 57S and iCI2004. The test results were significantly different. In a comparison of shared single syllables, the average scores were 58% for iCI2004 and 63% for 57S (45 pieces). A comparison of iCI2004 and 67S (17 pieces) showed that the average scores were 63% for iCI2004 and 75% for 67S. A comparison of 57S and 67S (20 pieces) showed that the average score for 57S was 70% and the average scored for 67S was 77%. No significant differences were detected under all conditions. Based on these results, the type of single syllable adopted affected the result.Conclusion: The data gives no clear indication that the selection of the word table or presentation of sound pressure affects listening to sound for CI users in Japan. Based on the type and number of single syllables used, iCI2004 seems appropriate for evaluation of hearing in patients using CI.

Long-Term Outcome With an Active Middle Ear Implant in Patients to Bilateral Aural Atresia

Objective: To describe the audiological results and complications following active middle ear implant (AMEI) surgery in users with bilateral ear atresia. Study Design: Observational and retrospective longitudinal follow-up. Setting: A tertiary referral hospital for hearing rehabilitation and craniofacial malformations. Patients: Medical records of 27 patients with bilateral congenital aural atresia (34 ears) who underwent surgery for AMEI were reviewed. Data were analyzed using descriptive and inferential statistics. The alpha error was assumed to be 5%. Outcome Measures: Medical and technical complications and audiological results were observed during follow-up. Results: The median postoperative follow-up was 37.5 months (27.7–75.5 mo). Medical or technical complications occurred in 35.3% (n = 12) of patients during follow-up, 14.7% (n = 5) required surgical revision. The auditory thresholds in the free field improved from 53.75 dB (46.87–56.25) to 25 dB (21.25–32.5) after 6 months using the AMEI (p &lt; 0.001) and remained stable till the last audiological evaluation (22.5: 21.25 26.25). Compared with the preoperative results, all speech perception tests also showed the benefits of AMEI at 6 months postoperatively and in the last audiological evaluation. Conclusions: Monitoring the use of AMEI in this sample demonstrated the safety of these implants compared with data available in the literature. The rates of medical and technical complications were consistent with data published by other groups. Finally, the audiological results remained stable during follow-up.

Music perception and speech intelligibility in noise performance by Italian-speaking cochlear implant users

ObjectiveThe goal of this study was to investigate the performance correlations between music perception and speech intelligibility in noise by Italian-speaking cochlear implant (CI) users.Materials and methodsTwenty postlingually deafened adults with unilateral CIs (mean age 65 years, range 46–92 years) were tested with a music quality questionnaire using three passages of music from Classical Music, Jazz, and Soul. Speech recognition in noise was assessed using two newly developed adaptive tests in Italian: The Sentence Test with Adaptive Randomized Roving levels (STARR) and Matrix tests.ResultsMedian quality ratings for Classical, Jazz and Soul music were 63%, 58% and 58%, respectively. Median SRTs for the STARR and Matrix tests were 14.3 dB and 7.6 dB, respectively. STARR performance was significantly correlated with Classical music ratings (rs = − 0.49, p = 0.029), whereas Matrix performance was significantly correlated with both Classical (rs = − 0.48, p = 0.031) and Jazz music ratings (rs = − 0.56, p = 0.011).ConclusionSpeech with competitive noise and music are naturally present in everyday listening environments. Recent speech perception tests based on an adaptive paradigm and sentence materials in relation with music quality measures might be representative of everyday performance in CI users. The present data contribute to cross-language studies and suggest that improving music perception in CI users may yield everyday benefit in speech perception in noise and may hence enhance the quality of listening for CI users.

Development Of Speech Material For An Armenian Speech Recognition Threshold Test

Introduction — For the Armenian language, no standardized audiometric speech perception test is available. The purpose of this research was to develop, digitally record and evaluate an Armenian multisyllabic speech audiometry test, which can be used to measure speech recognition thresholds in Armenian native speakers. Material and Methods — To create a homogeneous multisyllabic speech corpus, Armenian numerals from 10-100 with 2-4 syllables were selected as general sample and digitally recorded by a female native Armenian speaker. For equalizing the speech recognition threshold between the test items, the speech discrimination function for each numeral was subsequently evaluated by five normal hearing native Armenian listeners in an experimental study. Results — Based on the phonemic structure of the Armenian language, 20 phonemically homogeneous test lists were created. The phoneme distributions of each test list correlated significantly and positively with that of the general sample (all Pearson moment correlation coefficients &gt;0.960; all ps &lt;0.001). Comparison of the phoneme distributions of test lists to that of the Armenian language showed that the test lists represent the language corpus quite well. After adjusting for actual threshold levels, speech discrimination functions are comparable between all numerals used. Conclusion — The developed test lists are a phonetically homogenous representation of the Armenian language and serve as an appropriated base for future clinical measurements of speech recognition threshold in Armenian speaking listeners.

Phantom Stimulation for Cochlear Implant Users With Residual Low-Frequency Hearing.

Objective:In cochlear implants (CIs), phantom stimulation can be used to extend the pitch range toward apical regions of the cochlea. Phantom stimulation consists of partial bipolar stimulation, in which current is distributed across two intracochlear electrodes and one extracochlear electrode as defined by the compensation coefficient σ. The aim of this study was, (1) to evaluate the benefit of conveying low-frequency information through phantom stimulation for cochlear implant (CI) subjects with low-frequency residual hearing using electric stimulation alone, (2) to compare the speech reception thresholds obtained from electric-acoustic stimulation (EAS) and electric stimulation in combination with phantom stimulation (EPS), and (3) to investigate the effect of spectrally overlapped bandwidth of speech conveyed via simultaneous acoustic and phantom stimulation on speech reception thresholds.Design:Fourteen CI users with ipsilateral residual hearing participated in a repeated-measures design. Phantom stimulation was used to extend the frequency bandwidth of electric stimulation of EAS users towards lower frequencies without changing their accustomed electrode-frequency allocation. Three phantom stimulation configurations with different σ’s were tested causing different degrees of electric field shaping towards apical regions of the cochlea that may affect the place of stimulation. A baseline configuration using a moderate value of σ () for all subjects, a configuration that was equivalent to monopolar stimulation by setting σ to 0 () and a configuration that used the largest value of σ for each individual subject (). Speech reception thresholds were measured for electric stimulation alone, EAS and EPS. Additionally, acoustic stimulation and phantom stimulation were presented simultaneously (EAS+PS) to investigate their mutual interaction. Besides the spectral overlap, the electrode insertion depth obtained from cone-beam computed-tomography scans was determined to assess the impact of spatial overlap between electric and acoustic stimulation on speech reception.Results:Speech perception significantly improved by providing additional acoustic or phantom stimulation to electric stimulation. There was no significant difference between EAS and EPS. However, two of the tested subjects were able to perform the speech perception test using EAS but not using EPS. In comparison to the subject’s familiar EAS listening mode, the speech perception deteriorated when acoustic stimulation and phantom stimulation conveyed spectrally overlapped information simultaneously and this deterioration increased with larger spectral overlapConclusions:(1) CI users with low-frequency acoustic residual hearing benefit from low-frequency information conveyed acoustically through combined EAS. (2) Improved speech reception thresholds through low-frequency information conveyed via phantom stimulation were observed for EAS subjects when acoustic stimulation was not used. (3) Speech perception was negatively affected by combining acoustic and phantom stimulation when both stimulation modalities overlapped spectrally in comparison to the familiar EAS.

Long-term Hearing Preservation and Speech Perception Performance Outcomes With the Slim Modiolar Electrode.

Describe audiologic outcomes in hearing preservation (HP) cochlear implant candidates using a slim modiolar electrode (SME). Retrospective. Tertiary referral center. Two hundred three adult cochlear implant patients with preoperative low-frequency pure-tone average (LFPTA) ≤ 80 dB HL that received the SME. Implantation with a SME electrode. Primary outcome was postoperative HP, defined as LFPTA ≤80 dB HL. HP status was analyzed at "early" (activation or 3 mo) and "long-term" (6 or 12 mo) time frames using the patient's worst audiogram. Speech perception tests were compared between HP and non-HP cohorts. Of the 203 HP candidates, the tip fold-over rate was 7.4%. The mean shifts in LFPTA at the "early" and "long-term" time points were 25.9 ± 16.2 dB HL and 29.6 ± 16.9 dB HL, respectively. Of 117 patients with preoperative LFPTA ≤60 dB HL, the early and long-term mean LFPTA shifts were 19.5 ± 12.3 dB HL and 32.6 ± 17.2 dB HL, respectively; early and long-term HP rates were 61.1% and 50.8%, respectively. For patients with preoperative LFPTA ≤80 dB HL, early and long-term HP rates were 45.5% and 43.7%, respectively. No significant difference was observed in postoperative speech perception performance (CNC, AzBio, HINT) at 3, 6, or 12 months between HP versus non-HP groups. HP is feasible using the SME. While electroacoustic stimulation was not studied in this cohort, HP provided no clear advantage in speech perception abilities in this group of patients. The current reporting standard of what constitutes HP candidacy (preoperative LFPTA ≤80 dB HL) should be reconsidered.

Effects of Adaptive Non-linear Frequency Compression in Hearing Aids on Mandarin Speech and Sound-Quality Perception

ObjectiveThis study was aimed at examining the effects of an adaptive non-linear frequency compression algorithm implemented in hearing aids (i.e., SoundRecover2, or SR2) at different parameter settings and auditory acclimatization on speech and sound-quality perception in native Mandarin-speaking adult listeners with sensorineural hearing loss.DesignData consisted of participants’ unaided and aided hearing thresholds, Mandarin consonant and vowel recognition in quiet, and sentence recognition in noise, as well as sound-quality ratings through five sessions in a 12-week period with three SR2 settings (i.e., SR2 off, SR2 default, and SR2 strong).Study SampleTwenty-nine native Mandarin-speaking adults aged 37–76 years old with symmetric sloping moderate-to-profound sensorineural hearing loss were recruited. They were all fitted bilaterally with Phonak Naida V90-SP BTE hearing aids with hard ear-molds.ResultsThe participants demonstrated a significant improvement of aided hearing in detecting high frequency sounds at 8 kHz. For consonant recognition and overall sound-quality rating, the participants performed significantly better with the SR2 default setting than the other two settings. No significant differences were found in vowel and sentence recognition among the three SR2 settings. Test session was a significant factor that contributed to the participants’ performance in all speech and sound-quality perception tests. Specifically, the participants benefited from a longer duration of hearing aid use.ConclusionFindings from this study suggested possible perceptual benefit from the adaptive non-linear frequency compression algorithm for native Mandarin-speaking adults with moderate-to-profound hearing loss. Periods of acclimatization should be taken for better performance in novel technologies in hearing aids.

Whole-Exome Sequencing Identifies a Recurrent Small In-Frame Deletion in MYO15A Causing Autosomal Recessive Nonsyndromic Hearing Loss in 3 Iranian Pedigrees.

Hearing loss (HL) is the most prevalent and genetically heterogeneous sensory disabilities in humans throughout the world. In this study, we used whole-exome sequencing (WES) to determine the variant causing autosomal recessive nonsyndromic hearing loss (ARNSHL) segregating in 3 separate Iranian consanguineous families (with 3 different ethnicities: Azeri, Persian, and Lur), followed by cosegregation analysis, computational analysis, and structural modeling using the I-TASSER (Iterative Threading ASSEmbly Refinement) server. Also, we used speech-perception tests to measure cochlear implant (CI) performance in patients. One small in-frame deletion variant (MYO15A c.8309_8311del (p.Glu2770del)), resulting in deletion of a single amino-acid residue was identified. We found it to be cosegregating with the disease in the studied families. We provide some evidence suggesting the pathogenesis of this variant in HL based on the American College of Medical Genetics (ACMG) and Genomics guidelines. Evaluation of auditory and speech performance indicated favorable outcome after cochlear implantation in our patients. The findings of this study demonstrate the utility of WES in genetic diagnostics of HL.

The development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing abilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlation at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.

Teaching Children With Hearing Loss to Recognize Speech: Gains Made With Computer-Based Auditory and/or Speechreading Training.

Transfer appropriate processing (TAP) refers to a general finding that training gains are maximized when training and testing are conducted under the same conditions. The present study tested the extent to which TAP applies to speech perception training in children with hearing loss. Specifically, we assessed the benefits of computer-based speech perception training games for enhancing children's speech recognition by comparing three training groups: auditory training (AT), audiovisual training (AVT), and a combination of these two (AT/AVT). We also determined whether talker-specific training, as might occur when children train with the speech of a next year's classroom teacher, leads to better recognition of that talker's speech and if so, the extent to which training benefits generalize to untrained talkers. Consistent with TAP theory, we predicted that children would improve their ability to recognize the speech of the trained talker more than that of three untrained talkers and, depending on their training group, would improve more on an auditory-only (listening) or audiovisual (speechreading) speech perception assessment, that matched the type of training they received. We also hypothesized that benefit would generalize to untrained talkers and to test modalities in which they did not train, albeit to a lesser extent. Ninety-nine elementary school aged children with hearing loss were enrolled into a randomized control trial with a repeated measures A-A-B experimental mixed design in which children served as their own control for the assessment of overall benefit of a particular training type and three different groups of children yielded data for comparing the three types of training. We also assessed talker-specific learning and transfer of learning by including speech perception tests with stimuli spoken by the talker with whom a child trained and stimuli spoken by three talkers with whom the child did not train and by including speech perception tests that presented both auditory (listening) and audiovisual (speechreading) stimuli. Children received 16 hr of gamified training. The games provided word identification and connected speech comprehension training activities. Overall, children showed significant improvement in both their listening and speechreading performance. Consistent with TAP theory, children improved more on their trained talker than on the untrained talkers. Also consistent with TAP theory, the children who received AT improved more on the listening than the speechreading. However, children who received AVT improved on both types of assessment equally, which is not consistent with our predictions derived from a TAP perspective. Age, language level, and phonological awareness were either not predictive of training benefits or only negligibly so. The findings provide support for the practice of providing children who have hearing loss with structured speech perception training and suggest that future aural rehabilitation programs might include teacher-specific speech perception training to prepare children for an upcoming school year, especially since training will generalize to other talkers. The results also suggest that benefits of speech perception training were not significantly related to age, language level, or degree of phonological awareness. The findings are largely consistent with TAP theory, suggesting that the more aligned a training task is with the desired outcome, the more likely benefit will accrue.