Separating Contributions of Hearing, Lexical Knowledge, and Speech Production to Speech-Perception Scores in Children With Hearing Impairments

Abstract

Open-set word and sentence speech-perception test scores are commonly used as a measure of hearing abilities in children and adults using cochlear implants and/or hearing aids. These tests are usually presented auditorily with a verbal response. In the case of children, scores are typically lower and more variable than for adults with hearing impairments using similar devices. It is difficult to interpret children's speech-perception scores without considering the effects of lexical knowledge and speech-production abilities on their responses. This study postulated a simple mathematical model to describe the effects of hearing, lexical knowledge, and speech production on the perception test scores for monosyllabic words by children with impaired hearing. Thirty-three primary-school children with impaired hearing, fitted with hearing aids and/or cochlear implants, were evaluated using speech-perception, reading-aloud, speech-production, and language measures. These various measures were incorporated in the mathematical model, which revealed that performance in an open-set word-perception test in the auditory-alone mode is strongly dependent on residual hearing levels, lexical knowledge, and speech-production abilities. Further applications of the model provided an estimate of the effect of each component on the overall speech-perception score for each child.

Speech and language outcomes in children with auditory neuropathy/dys-synchrony managed with either cochlear implants or hearing aids

“…Rate of receptive vocabulary acquisition in this group was 69% of that expected for a normally hearing child, average phoneme production scores were around 90%, and production error rates were approximately 8% higher than expected for age. This level of performance is consistent with previously reported findings for implanted youngsters (Blamey et al, 2001;Paatsch et al, 2004).…”

“…To date there is no other published data describing speech and language outcomes in implanted AN/AD children. Results for the implanted subject groups in this study and previously reported findings for hearing-impaired children (Blamey et al, 2001;Paatsch et al, 2004) do, however, indicate a link between spoken language development and speech perception ability, and there is growing evidence that a small proportion of AN/AD children will not obtain significantly improved perception of speech with a cochlear implant (Gibson & Sanli, 2007;Rance & Barker, 2007;Zeng & Lui, 2006). The development of techniques that can pre-operatively determine an individual's potential for benefit from cochlear implantation (such as recording EABRs via a trans-tympanic needle electrode placed on the cochlear promontory or round window) is an area of ongoing research.…”

Evidence-Based Approach for Making Cochlear Implant Recommendations for Infants With Residual Hearing

“…A possible explanation for the different result for OSW and sentences could be related to the nature of each speech perception test against the backdrop of linguistic competence. Linguistic competence has been found to have a significant effect on speech perception scores for hearing-impaired children (Cowan et al 1997;Blamey and Sarant 2002;Paatsch et al 2004). A monosyllabic word test requires that a child repeat the word as they perceive it, without necessarily understanding the meaning of the word.…”

Hear here: Children with hearing loss learn words by listening

“…Although there are comparative studies examining the relationship between speech perception skills and speech development [70,71], this is one of the first studies to demonstrate on the impact of auditory intervention using a defined auditory hierarchy, on speech development. This prospective intervention study using speech perception tests scored independent of children's speech output is therefore an important contribution to the understanding of the impact of speech perception development on speech development.…”