Adult listeners are able to recognize speech even under conditions of severe spectral degradation. To assess the developmental time course of this robust pattern recognition, speech recognition was measured in two groups of children (5-7 and 10-12 years of age) as a function of the degree of spectral resolution. Results were compared to recognition performance of adults listening to the same materials and conditions. The spectral detail was systematically manipulated using a noise-band vocoder in which filtered noise bands were modulated by the amplitude envelope from the same spectral bands in speech. Performance scores between adults and older children did not differ statistically, whereas scores by younger children were significantly lower; they required more spectral resolution to perform at the same level as adults and older children. Part of the deficit in younger children was due to their inability to utilize fully the sensory information, and part was due to their incomplete linguistic/cognitive development. The fact that young children cannot recognize spectrally degraded speech as well as adults suggests that a long learning period is required for robust acoustic pattern recognition. These findings have implications for the application of auditory sensory devices for young children with early-onset hearing loss.

The development of language and communication may play an important role in the emergence of behavioral problems in young children, but they are rarely included in predictive models of behavioral development. In this study, cross-sectional relationships between language, attention, and behavior problems were examined using parent report, videotaped observations, and performance measures in a sample of 116 severely and profoundly deaf and 69 normally hearing children ages 1.5 to 5 years. Secondary analyses were performed on data collected as part of the Childhood Development After Cochlear Implantation Study, funded by the National Institutes of Health. Hearing-impaired children showed more language, attention, and behavioral difficulties, and spent less time communicating with their parents than normally hearing children. Structural equation modeling indicated there were significant relationships between language, attention, and child behavior problems. Language was associated with behavior problems both directly and indirectly through effects on attention. Amount of parent–child communication was not related to behavior problems.

Sensitivity to the combined lexical properties of word frequency and neighborhood density was evident both for words and sentences. Lexically easy stimuli were recognized with greater accuracy than lexically hard stimuli across groups, affirming the robustness of this effect and verifying that words were being organized in relation to the frequency and acoustic-phonetic properties of other words. Syntactic context facilitated word recognition for the children with normal hearing and the high-performing implant group. The three low-performing children with cochlear implants recognized words more accurately than sentences, reflecting limitations in linguistic and cognitive capacity.

The Childhood Development after Cochlear Implantation (CDaCI) study is a longitudinal multicenter investigation designed to identify factors influencing spoken language in young deaf children with cochlear implants. Normal-hearing peers serve as controls. As part of a comprehensive evaluation battery, a speech recognition hierarchy was designed to assess how well these children recognize speech stimuli across developmental stages. Data were analyzed for the earliest measures in 42 pairs of children reaching 1 year of follow-up. A number of children in the cochlear implant group who met criteria for testing approached levels of performance similar to the normal-hearing controls, and some could identify sentences in competition. These results demonstrate the responsiveness of the speech recognition hierarchy in tracking emergent skills from a sample of the CDaCI cohort.

The age at achievement of benchmarks such as diagnosis, fitting of amplification, and enrollment in early intervention in children who were screened for hearing loss is on target with stated goals provided by the Academy of Pediatrics and the Joint Committee on Infant Hearing. In addition, children who are not screened for hearing loss continue to show dramatic delays in achievement of benchmarks by as much as 24 months. Evaluating achievement of benchmarks during the start-up period of NHS programs allowed a direct evaluation of ability of these screening programs to meet stated goals. This demonstrates, unequivocally, that the NHS process itself is responsible for improvements in age at diagnosis, hearing aid fitting, and enrollment in intervention.

To compare the communication outcomes between children with aided residual hearing and children with cochlear implants.Design: Measures of speech recognition and language were administered to pediatric hearing aid users and cochlear implant users followed up longitudinally as part of an ongoing investigation on cochlear implant outcomes. The speech recognition measures included the Lexical Neighborhood Test, Phonetically Balanced-Kindergarten Word Lists, and the Hearing in Noise Test for Children presented in quiet and noise (+5 dB signal-to-noise ratio). Language measures included the Peabody Picture Vocabulary Test: Third Edition (PPVT-III), the Reynell Developmental Language Scales, and the Clinical Evaluation of Language Fundamentals-Revised. Subjects:The experimental group was composed of 39 pediatric hearing aid users with a mean unaided puretone average threshold of 78.2 dB HL (hearing level). The comparison group was composed of 117 pediatric coch-lear implant users with a mean unaided pure-tone average threshold of 110.2 dB HL. On average, both groups lost their hearing at younger than 1 year and were fitted with their respective sensory aids at 2 to 2.6 years of age. Not every child was administered every test for a variety of reasons.Results: Between-group performance was equivalent on most speech recognition and language measures. The primary difference found between groups was on the PPVT-III, in which the hearing aid group had a significantly higher receptive vocabulary language quotient than the cochlear implant group. Notably, the cochlear implant group was substantially younger than the hearing aid group and had less experience with their sensory devices on this measure. Conclusion:Data obtained from children with aided residual hearing can be useful in determining cochlear implant candidacy.

Objective-Early detection of hearing loss in infants and toddlers has created a need for ageappropriate tests of auditory perceptual capabilities. This article describes a progressive test battery we have developed to evaluate phonetic contrast perception, phoneme recognition, and word recognition in children 6 months to 5 years. This battery is part of a clinical research protocol designed to track auditory development in this population.Methods-The progressive test battery originated from a model of auditory perceptual development to assess phonetic discrimination and word recognition. Phonetic discrimination is evaluated using the Battery of Auditory Speech Perception Tests for Infants and Toddlers (BATIT). The BATIT is composed of four measures (VRASPAC, PLAYSPAC, OLIMSPAC, and VIDSPAC) intended to assess the child's ability to distinguish between phonologically significant contrasts using developmentally appropriate tasks. Designed for children aged 6 months and up, performance is represented either by percent correct or by the level of confidence that the child's responses are not random. Phoneme and word recognition are assessed in children 4 years and older using lists of consonant-vowel-consonant (CVC) phonemes in words and lexically controlled words both in and out of sentence context (LEXSEN).Results-Cross-sectional data show that children with normal hearing may be assessed by the age of 7 months on VRASPAC; by 3 years on PLAYSPAC and OLIMSPAC; and by 4 to 5 years on VIDSPAC, CVC phonemes in words, and LEXSEN words in isolation and in sentences. Data from infants with hearing loss showed that VRASPAC was sensitive to degree of hearing loss, but performance with normally hearing children on this test declined after 12 months of age.Conclusion-Assessment of phonetic discrimination and word recognition is, for the most part, attainable in young children using a progressive test battery, but none of the tests used here was effective between 1 and 3 years of age. Continued development will be required to fill this gap and to separate auditory from non-auditory influences in performance.

Objective of the study The primary goal of this study was to examine relationships between scores obtained from measures of speech perception, standardized language, and spontaneous language samples in a group of young children with hearing loss (HL). Subjects and Methods Eighteen children with hearing loss (mean age = 4.3 years; range 2.4 – 6.3 years) and their mothers participated in this study. Speech perception was measured using the On-Line Imitative Test of Speech Pattern Contrast Perception (OLIMSPAC). Standardized language scores were obtained using the Reynell Developmental Language Scales-III. Number of word tokens, word types, and mean length of utterance (MLU) were extracted from the children’s spontaneous language samples. Results Only one significant positive association emerged between OLIMSPAC and standardized language scores. In contrast, strong positive associations emerged between OLIMSPAC and all measures derived from children’s spontaneous language samples (ranging from .77 to .90). Conclusions Assessment of speech perception, in combination with formal and informal language measures provides a more complete profile of the communication skills of young children with HL than each of these tests administered in isolation. Guidelines are offered for professionals who evaluate the communication abilities of young children with HL.