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Rachel A. McArdle Bay Pines VA Healthcare System, Bay Pines, FL, and University of South Florida, Tampa Sherri L. Smith James H. Quillen VA Medical Center and East Tennessee State University Contact author: Richard H. Wilson, James H. Quillen VA Medical Center, Audiology (126), Mountain Home, TN 37684. E-mail: richard.wilson2{at}va.gov . Purpose: The purpose of this study was to examine in listeners with normal hearing and listeners with sensorineural hearing loss the within- and between-group differences obtained with 4 commonly available speech-in-noise protocols. Method: Recognition performances by 24 listeners with normal hearing and 72 listeners with sensorineural hearing loss were compared for 4 speech-in-noise protocols that varied with respect to the amount of contextual cues conveyed in the target signal. The protocols studied included the Bamford-Kowal-Bench Speech-in-Noise Test (BKB-SIN; Etym tic Research, 2005; J. Bench, A. Kowal, & J. Bamford, 1979; P. Niquette et al., 2003), the Quick Speech-in-Noise Test (QuickSIN; M. C. Killion, P. A. Niquette, G. I. Gudmundsen, L. J. Revit, & S. Banerjee, 2004), and the Words-in-Noise test (WIN; R. H. Wilson, 2003; R. H. Wilson & C. A. Burks, 2005), each of which used multitalker babble and a modified method of constants, as well as the Hearing in Noise Test (HINT; M. Nilsson, S. Soli, & J. Sullivan, 1994), which used speech-spectrum noise and an adaptive psychophysical procedure. Results: The 50% points for the listeners with normal hearing were in the 1- to 4-dB signal-to-babble ratio (S/B) range and for the listeners with hearing loss in the 5- to 14-dB S/B range. Separation between groups was least with the BKB-SIN and HINT (4–6 dB) and most with the QuickSIN and WIN (8–10 dB). Conclusion: The QuickSIN and WIN materials are more sensitive measures of recognition performance in background noise than are the BKB-SIN and HINT materials. KEY WORDS: auditory perception, hearing loss, speech perception, word recognition in multitalker babble CiteULike     Connotea     Del.icio.us     Digg     Facebook     Reddit     Technorati     Twitter     What's this?

Data from earlier studies that presented 70 words at 24 to 0 dB signal-to-babble (S/B) ratios indicated that most young listeners with normal hearing required 0 to 6 dB S/B ratios to attain 50% correct word recognition. Older listeners with hearing loss often required a >12 dB S/B ratio to attain 50% correct word recognition. In our study, we converted the Words in Noise test from one 70-word list into two 35-word lists for quicker administration by clinicians. Using baseline data from previous studies, we used two strategies to randomize the 35-word lists: based on recognition performance at each S/B ratio and based on recognition performance only. With the first randomization strategy, the 50% correct word-recognition points on the two lists differed by 0.5 dB for 72 listeners with hearing loss. With the second randomization strategy, 48 listeners with hearing loss performed identically on the two lists.

Understanding speech when background noise is present is a critical everyday task that varies widely among people. A key challenge is to understand why some people struggle with speech-in-noise perception, despite having clinically normal hearing. Here, we developed new figure-ground tests that require participants to extract a coherent tone pattern from a stochastic background of tones. These tests dissociated variability in speech-in-noise perception related to mechanisms for detecting static (same-frequency) patterns and those for tracking patterns that change frequency over time. In addition, elevated hearing thresholds that are widely considered to be ‘normal’ explained significant variance in speech-in-noise perception, independent of figure-ground perception. Overall, our results demonstrate that successful speech-in-noise perception is related to audiometric thresholds, fundamental grouping of static acoustic patterns, and tracking of acoustic sources that change in frequency. Crucially, speech-in-noise deficits are better assessed by measuring central (grouping) processes alongside audiometric thresholds.

Background We designed and validated a speech recognition test for Persian-speaking children aged 36–71 months. Methods This project was a cross-sectional and methodological study. Different steps of test development, encompassing item generation, content validity, construct validity, and reliability, were used to develop the scale. Results The percentages of agreement among the experts’ answers concerning test characteristics were all greater than 88%. After this phase, 20 items were removed. In the second phase of content validity, 18 additional pictures were suggested to be removed by the experts. Finally, a test with 162 pictures was developed among which 120 corresponding words were presented orally (the remaining pictures were distractors). The Persian speech recognition test revealed an age difference in speech recognition for both ears ( p-value < 0.001 , df = 5 ). There was no significant association between sex and total score on the Persian speech recognition test for right ear (U = 3063, p- value = 0.092) and left ear (U = 3009, p-value = 0.063 ). Test-retest values were excellent for both ears (right ear: r  = 0.97, left ear: r  = 0.98), p-value < 0.001 ). Conclusions Given the findings in typically developing (TD) children, the Persian speech recognition test is valid and reliable. However, future studies are highly recommended to apply this test in hearing-impaired children.

IntroductionSpeech audiometry is widely used in routine clinical settings to assess auditory function in children. Appropriate test materials are available in languages such as English or German; however, formally validated translations do not exist in less widely spoken languages such as Hungarian. This protocol aims to describe an evidence-based process of translation, cultural adaptation and validation of a paediatric speech audiometry test from its original language into another.Methods and analysisThe Mainzer Audiometric Test for Children (MATCH) is a picture-pointing speech audiometry test for children aged 3–6 years. It will be translated from the original German into Hungarian in six phases: (1) identification of MATCH test items and validation of MATCH picture recognisability among children; (2) confirmation of linguistic conformity by comparing phoneme distribution of Hungarian test vocabulary to spontaneous Hungarian speech reference data; (3) recording of Hungarian speech material in a sound-treated environment complying with ISO 8253-3:2022 standards; (4) evaluation of the homogeneity of the intelligibility of the recorded Hungarian test items through speech recognition testing in adults; (5) standardisation of the Hungarian MATCH test on a cohort of normal-hearing children aged 3–6 years whose dominant language is Hungarian and (6) assessment of the diagnostic validity of the Hungarian version of the MATCH by comparing MATCH speech recognition thresholds to pure-tone audiometry results. To determine sensitivity, specificity and optimal cut-off points for the Hungarian test in detecting hearing loss among children aged 3–6 years, receiver operating characteristic analysis will be used.Ethics and disseminationThe protocol has been registered on ClinicalTrials.gov (NCT07156825), complies with the Declaration of Helsinki, and has been approved by the medical ethics committee at Semmelweis University Budapest (Ref. nr.: SE RKEB 312/2021). The study using the speech test is currently in progress. The results and conclusions will be shared with the scientific community through publication in a peer-reviewed journal.Trial registration numberNCT07156825.

Background Hearing impairment is the most common body system disability in veterans. In 2008, nearly 520,000 veterans had a disability for hearing loss through the Department of Veterans Affairs (VA). Changes in eligibility for hearing aid services, along with the aging population, contributed to a greater than 300% increase in the number of hearing aids dispensed from 1996 to 2006. In 2006, the VA committed to having no wait times for patient visits while providing quality clinically-appropriate care. One approach to achieving this goal is the use of group visits as an alternative to individual visits. We sought to determine: 1) if group hearing aid fitting and follow-up visits were at least as effective as individual visits, and 2) whether group visits lead to cost savings through the six month period after the hearing aid fitting. We describe the rationale, design, and characteristics of the baseline cohort of the first randomized clinical trial to study the impact of group versus individual hearing aid fitting and follow-up visits. Methods Participants were recruited from the VA Puget Sound Health Care System Audiology Clinic. Eligible patients had no previous hearing aid use and monaural or binaural air-conduction hearing aids were ordered at the evaluation visit. Participants were randomized to receive the hearing aid fitting and the hearing aid follow-up in an individual or group visit. The primary outcomes were hearing-related function, measured with the first module of the Effectiveness of Aural Rehabilitation (Inner EAR), and hearing aid adherence. We tracked the total cost of planned and unplanned audiology visits over the 6-month interval after the hearing aid fitting. Discussion A cohort of 659 participants was randomized to receive group or individual hearing aid fitting and follow-up visits. Baseline demographic and self-reported health status and hearing-related measures were evenly distributed across the treatment arms. Outcomes after the 6-month follow-up period are needed to determine if group visits were as least as good as those for individual visits and will be reported in subsequent publication. Trial Registration NCT00260663

Speech audiometry is an essential part of audiological diagnostics and clinical measurements. Development times of speech recognition tests are rather long, depending on the size of speech corpus and optimization necessity. The aim of this study was to examine whether this development effort could be reduced by using synthetic speech in speech audiometry, especially in a matrix test for speech recognition. For this purpose, the speech material of the German matrix test was replicated using a preselected commercial system to generate the synthetic speech files. In contrast to the conventional matrix test, no level adjustments or optimization tests were performed while producing the synthetic speech material. Evaluation measurements were conducted by presenting both versions of the German matrix test (with natural or synthetic speech), alternately and at three different signal-to-noise ratios, to 48 young, normal-hearing participants. Psychometric functions were fitted to the empirical data. Speech recognition thresholds were 0.5 dB signal-to-noise ratio higher (worse) for the synthetic speech, while slopes were equal for both speech types. Nevertheless, speech recognition scores were comparable with the literature and the threshold difference lay within the same range as recordings of two different natural speakers. Although no optimization was applied, the synthetic-speech signals led to equivalent recognition of the different test lists and word categories. The outcomes of this study indicate that the application of synthetic speech in speech recognition tests could considerably reduce the development costs and evaluation time. This offers the opportunity to increase the speech corpus for speech recognition tests with acceptable effort.

Objectives: To evaluate the simplified version of the Arabic matrix test in individuals with normal hearing to derive reference ranges for future measurements with the test material. Methods: The test was conducted in 80 native Arabic individuals (20 adults and 60 children across different age groups between 5-10 years) from November 2020 to Mar 2023. Evaluation measurements were conducted in adults and children to derive the reference psychometric functions and assess the training effect. The test list equivalence was verified only in the adults group. Results: The reference ranges for speech-intelligibility in noise for 80% thresholds or speech-recognition threshold (SRT80) were as follows: -0.8 [+ or -] 2.4 dB signal-to-noise ratio (SNR) (Group 1; 5-6 years), -2.4 [+ or -] 2.5 dB SNR (Group 2; 7-8 years) and -2.9 [+ or -] 2.3 dB SNR (Group 3; 9-10 years). Conclusion: The study demonstrated an influence of age on the measured word recognition performance in children, highlighting the test's suitability for this population. The reliability of the test was 1.1 dB for 80% threshold and 1.4 dB for 50% threshold. With promising results, this test can be used as a new tool in speech audiometry in audiological diagnostics and management with special focus on modern standard Arabic for children. Keywords: Speech audiometry, matrix sentence test, simplified Arabic matrix test, signal-to-noise ratio, speech recognition threshold

People with normal hearing thresholds can nonetheless have difficulty with understanding speech in noisy backgrounds. The origins of such supra-threshold hearing deficits remain largely unclear. Previously we showed that the auditory brainstem response to running speech is modulated by selective attention, evidencing a subcortical mechanism that contributes to speech-in-noise comprehension. We observed, however, significant variation in the magnitude of the brainstem’s attentional modulation between the different volunteers. Here we show that this variability relates to the ability of the subjects to understand speech in background noise. In particular, we assessed 43 young human volunteers with normal hearing thresholds for their speech-in-noise comprehension. We also recorded their auditory brainstem responses to running speech when selectively attending to one of two competing voices. To control for potential peripheral hearing deficits, and in particular for cochlear synaptopathy, we further assessed noise exposure, the temporal sensitivity threshold, the middle-ear muscle reflex, and the auditory-brainstem response to clicks in various levels of background noise. These tests did not show evidence for cochlear synaptopathy amongst the volunteers. Furthermore, we found that only the attentional modulation of the brainstem response to speech was significantly related to speech-in-noise comprehension. Our results therefore evidence an impact of top-down modulation of brainstem activity on the variability in speech-in-noise comprehension amongst the subjects.

Speech-in-noise testing is a valuable component of audiological examination that can provide estimates of a listener's ability to communicate in their everyday life. It has long been recognized, however, that the acoustics of real-world environments are complex and variable and not well represented by a typical clinical test setup. The first aim of this study was to quantify real-world environments in terms of several acoustic parameters that may be relevant for speech understanding (namely speech-likeness, interaural coherence, and interaural time and level differences). Earlier acoustic analyses of binaural recordings in natural environments were extended to binaural re-creations of natural environments that included conversational speech embedded in recorded backgrounds and allowed a systematic manipulation of signal-to-noise ratio. The second aim of the study was to examine these same parameters in typical clinical speech-in-noise tests and consider the “acoustic realism” of such tests. We confirmed that the parameter spaces of natural environments are poorly covered by those of the most commonly used clinical test with one frontal loudspeaker. We also demonstrated that a simple variation of the clinical test, which uses two spatially separated loudspeakers to present speech and noise, leads to better coverage of the parameter spaces of natural environments. Overall, the results provide a framework for characterizing different listening environments that may guide future efforts to increase the real-world relevance of clinical speech-in-noise testing.