Factors influencing speech perception in noise for 5-year-old children using hearing aids or cochlear implants

Ching, Teresa Y. C.; Zhang, Vicky W.; Flynn, Christopher; Burns, Lauren; Button, Laura; Hou, Sanna; McGhie, Karen; Buynder, Patricia Van

doi:10.1080/14992027.2017.1346307

Cited by 56 publications

(66 citation statements)

References 58 publications

(102 reference statements)

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“…Most academic and extracurricular settings are characterized by background noise, which negatively affects speech recognition and academic outcomes in children with normal hearing (CNH), and has even greater consequences for CHH. Even though CHH have documented weaknesses with listening in noise (Crandell, 1993; Uhler et al, 2011; Caldwell and Nittrouer, 2013; Leibold et al, 2013; McCreery et al, 2015; Klein et al, 2017; Ching et al, 2018), there is little research on how their ability to recognize speech in noise develops over time during the school-age years. Increased knowledge in this area impacts both clinical decision-making and theoretical understanding of the mechanisms that drive listening in noise.…”

Section: Introductionmentioning

confidence: 99%

“…Stronger language skills allow individuals to make better predictions about an incoming message, even in the presence of limited sensory input (Nittrouer et al, 2013). Vocabulary knowledge accounts for a significant proportion of variance in word and sentence recognition in quiet for children with CIs and/or HAs (Blamey et al, 2001; Caldwell and Nittrouer, 2013), and language skills are significant predictors of speech recognition in noise for school-age CHH (McCreery et al, 2015; Klein et al, 2017; Ching et al, 2018). None of these studies included longitudinal data, so it was not possible to determine how these underlying mechanisms influence developmental trajectories of speech recognition in noise.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal Speech Recognition in Noise in Children: Effects of Hearing Status and Vocabulary

et al. 2019

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Objectives: The aims of the current study were: (1) to compare growth trajectories of speech recognition in noise for children with normal hearing (CNH) and children who are hard of hearing (CHH) and (2) to determine the effects of auditory access, vocabulary size, and working memory on growth trajectories of speech recognition in noise in CHH.Design: Participants included 290 children enrolled in a longitudinal study. Children received a comprehensive battery of measures annually, including speech recognition in noise, vocabulary, and working memory. We collected measures of unaided and aided hearing and daily hearing aid (HA) use to quantify aided auditory experience (i.e., HA dosage). We used a longitudinal regression framework to examine the trajectories of speech recognition in noise in CNH and CHH. To determine factors that were associated with growth trajectories for CHH, we used a longitudinal regression model in which the dependent variable was speech recognition in noise scores, and the independent variables were grade, maternal education level, age at confirmation of hearing loss, vocabulary scores, working memory scores, and HA dosage.Results: We found a significant effect of grade and hearing status. Older children and CNH showed stronger speech recognition in noise scores compared to younger children and CHH. The growth trajectories for both groups were parallel over time. For CHH, older age, stronger vocabulary skills, and greater average HA dosage supported speech recognition in noise.Conclusion: The current study is among the first to compare developmental growth rates in speech recognition for CHH and CNH. CHH demonstrated persistent deficits in speech recognition in noise out to age 11, with no evidence of convergence or divergence between groups. These trends highlight the need to provide support for children with all degrees of hearing loss in the academic setting as they transition into secondary grades. The results also elucidate factors that influence growth trajectories for speech recognition in noise for children; stronger vocabulary skills and higher HA dosage supported speech recognition in degraded situations. This knowledge helps us to develop a more comprehensive model of spoken word recognition in children.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Longitudinal Speech Recognition in Noise in Children: Effects of Hearing Status and Vocabulary

et al. 2019

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“…Speech perception tests for children with CIs are traditionally performed with live or recorded real words or sentences in quiet or in noise (e.g., Harrison et al, 2005; Zeitler et al, 2012; Ching et al, 2018). Such tests indisputably measure the children’s language skills in addition to their auditory skills.…”

Section: Introductionmentioning

confidence: 99%

Consonant and Vowel Confusions in Well-Performing Children and Adolescents With Cochlear Implants, Measured by a Nonsense Syllable Repetition Test

et al. 2019

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Although the majority of early implanted, profoundly deaf children with cochlear implants (CIs), will develop correct pronunciation if they receive adequate oral language stimulation, many of them have difficulties with perceiving minute details of speech. The main aim of this study is to measure the confusion of consonants and vowels in well-performing children and adolescents with CIs. The study also aims to investigate how age at onset of severe to profound deafness influences perception. The participants are 36 children and adolescents with CIs (18 girls), with a mean ( SD ) age of 11.6 (3.0) years (range: 5.9–16.0 years). Twenty-nine of them are prelingually deaf and seven are postlingually deaf. Two reference groups of normal-hearing (NH) 6- and 13-year-olds are included. Consonant and vowel perception is measured by repetition of 16 bisyllabic vowel-consonant-vowel nonsense words and nine monosyllabic consonant-vowel-consonant nonsense words in an open-set design. For the participants with CIs, consonants were mostly confused with consonants with the same voicing and manner, and the mean ( SD ) voiced consonant repetition score, 63.9 (10.6)%, was considerably lower than the mean ( SD ) unvoiced consonant score, 76.9 (9.3)%. There was a devoicing bias for the stops; unvoiced stops were confused with other unvoiced stops and not with voiced stops, and voiced stops were confused with both unvoiced stops and other voiced stops. The mean ( SD ) vowel repetition score was 85.2 (10.6)% and there was a bias in the confusions of [i:] and [y:]; [y:] was perceived as [i:] twice as often as [y:] was repeated correctly. Subgroup analyses showed no statistically significant differences between the consonant scores for pre- and postlingually deaf participants. For the NH participants, the consonant repetition scores were substantially higher and the difference between voiced and unvoiced consonant repetition scores considerably lower than for the participants with CIs. The participants with CIs obtained scores close to ceiling on vowels and real-word monosyllables, but their perception was substantially lower for voiced consonants. This may partly be related to limitations in the CI technology for the transmission of low-frequency sounds, such as insertion depth of the electrode and ability to convey temporal information.

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“…Future investigations on predictors of language outcomes of children using hearing aids at 9 years will need to include a wider range of factors reported in the literature (e.g., Tomblin et al, 2015) than was used in this study. For example, we did not include hearing device use or aided audibility in this study partly because the current focus is on the role of early cognitive factors on later language development; and partly because our earlier reports on the LOCHI cohort at 3 and 5 years of age showed that these factors did not account for unique variance after allowing for the effects of a range of child- and family-related factors (Ching et al, 2013, 2018a,b). Even though the question of the link between cognitive abilities and language development is not new, the current study is the first to investigate this relationship in a prospective study of a population-based cohort of children with mild to severe hearing loss using hearing aids.…”

Section: Discussionmentioning

confidence: 99%

Early Cognitive Predictors of 9-Year-Old Spoken Language in Children With Mild to Severe Hearing Loss Using Hearing Aids

2019

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This study examined the extent to which cognitive ability at 5 years of age predicted language development from 5 to 9 years of age in a population-based sample of children with hearing loss who participated in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. The developmental outcomes of 81 children with hearing loss were evaluated at 5 and 9 years of age. Hearing loss ranged from mild to severe degrees, and all participants used hearing aids. They all used spoken language as the primary mode of communication and education. Nine-year-old language was assessed using the Clinical Evaluation of Language Fundamentals – 4th edition (CELF-4), the Peabody Picture Vocabulary Test – 4th edition (PPVT-4), and the Expressive Vocabulary Test – 2nd edition (EVT-2). Multiple regression analyses were conducted to examine the extent to which children’s scores on these standardized assessments were predicted by their cognitive ability (non-verbal IQ and verbal working memory) measured at 5 years of age. The influence of early language scores at 5 years and a range of demographic characteristics on language scores at 9 years of age was evaluated. We found that 5-year-old digit span score was a significant predictor of receptive and expressive language, but not receptive or expressive vocabulary, at 9 years of age. Also, 5-year-old non-word repetition test score was a significant predictor of only expressive language and vocabulary, but not receptive language or vocabulary at 9 years of age. After allowing for the effects of non-verbal IQ and 5-year-old receptive vocabulary, early digit span score (but not non-word repetition score) was a significant predictor of expressive and receptive language scores at 9 years of age. The findings shed light on the unique role of early verbal working memory in predicting the development of receptive and expressive language skills and vocabulary skills in children who use hearing aids.

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Factors influencing speech perception in noise for 5-year-old children using hearing aids or cochlear implants

Abstract: Speech perception in children with hearing loss can be enhanced by improving their language abilities. Early age at cochlear implantation was also associated with better outcomes.

Cited by 56 publications

References 58 publications

Longitudinal Speech Recognition in Noise in Children: Effects of Hearing Status and Vocabulary

Longitudinal Speech Recognition in Noise in Children: Effects of Hearing Status and Vocabulary

Consonant and Vowel Confusions in Well-Performing Children and Adolescents With Cochlear Implants, Measured by a Nonsense Syllable Repetition Test

Early Cognitive Predictors of 9-Year-Old Spoken Language in Children With Mild to Severe Hearing Loss Using Hearing Aids

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