Objective We examined how cognitive and linguistic skills affect speech recognition in noise for children with normal hearing. Children with better working memory and language abilities were expected to have better speech recognition in noise than peers with poorer skills in these domains. Design As part of a prospective, cross-sectional study, children with normal hearing completed speech recognition in noise for three types of stimuli: (1) monosyllabic words, (2) syntactically correct but semantically anomalous sentences and (3) semantically and syntactically anomalous word sequences. Measures of vocabulary, syntax and working memory were used to predict individual differences in speech recognition in noise. Study sample Ninety-six children with normal hearing, who were between 5 and 12 years of age. Results Higher working memory was associated with better speech recognition in noise for all three stimulus types. Higher vocabulary abilities were associated with better recognition in noise for sentences and word sequences, but not for words. Conclusions Working memory and language both influence children’s speech recognition in noise, but the relationships vary across types of stimuli. These findings suggest that clinical assessment of speech recognition is likely to reflect underlying cognitive and linguistic abilities, in addition to a child’s auditory skills, consistent with the Ease of Language Understanding model.

Children with HAs show deficits in sensitivity to phonological structure but appear to take advantage of vocabulary skills to support speech perception in the same way as children with NH. Further investigation is needed to understand the causes of the gap that exists between the overall speech perception abilities of children with HAs and children with NH.

Children's performance on psychophysical tasks improves with age. The relationship of spectro-temporal modulation detection to age, particularly in children who are hard of hearing, is not well-established. In this study, children with normal hearing (N = 22) and with sensorineural hearing loss (N = 15) completed measures of spectro-temporal modulation detection. Measures of aided audibility were completed in the children who are hard of hearing. Pearson product-moment correlations were completed with listener age and aided audibility as parameters. Spectro-temporal modulation detection performance increased with listener age and with greater aided audibility.

Objectives To determine whether an “optimal” DPOAE protocol including (1) optimal stimulus levels and primary-frequency ratios for each f2, (2) simultaneously measuring 2f2-f1 and 2f1-f2 distortion products, (3) controlling source contribution, (4) implementing improved calibration techniques, (5) accounting for the influence of middle-ear reflectance, and (6) applying multivariate analyses to DPOAE data results in improved accuracy in differentiating between normal-hearing and hearing-impaired ears, compared to a standard clinical protocol. Design Data were collected for f2 frequencies ranging from 0.75 to 8 kHz in 28 normal-hearing and 78 hearing-impaired subjects. The protocol included a control condition incorporating standard stimulus levels and primary-frequency ratios calibrated with a standard sound pressure level (SPL) method and three experimental conditions using optimized stimuli calibrated with an alternative forward pressure level (FPL) method. The experimental conditions differed with respect to the level of the reflection-source suppressor tone, and included conditions referred to as the null-suppressor (i.e., no suppressor tone presented), low-level suppressor (i.e., suppressor tone presented at 58 dB SPL), and high-level suppressor (i.e., suppressor tone presented at 68 dB SPL) conditions. The area under receiver operating characteristic (AROC) curves and sensitivities for fixed specificities (and vice versa) were estimated to evaluate test performance in each condition. Results AROC analyses indicated (1) improved test performance in all conditions using multivariate analyses, (2) improved performance in the null-suppressor and low-suppressor experimental conditions compared to the control condition, and (3) poorer performance below 4 kHz with the high-level suppressor. As expected from AROC, sensitivities for fixed specificities and specificities for fixed sensitivities were highest for the null-suppressor and low-suppressor conditions and lowest for standard clinical procedures. The influence of 2f2-f1 and reflectance on test performance was negligible. Conclusions Predictions of auditory status based on DPOAE measurements in clinical protocols may be improved by the inclusion of (1) optimized stimuli, (2) alternative calibration techniques, (3) low-level suppressors, and (4) multivariate analyses.