Speech-in-Noise Perception in Children With Cochlear Implants, Hearing Aids, Developmental Language Disorder and Typical Development: The Effects of Linguistic and Cognitive Abilities

Abstract

Children with hearing loss, and those with language disorders, can have excellent speech recognition in quiet, but still experience unique challenges when listening to speech in noisy environments. However, little is known about how speech-in-noise (SiN) perception relates to individual differences in cognitive and linguistic abilities in these children. The present study used the Norwegian version of the Hearing in Noise Test (HINT) to investigate SiN perception in 175 children aged 5.5–12.9 years, including children with cochlear implants (CI, n = 64), hearing aids (HA, n = 37), developmental language disorder (DLD, n = 16) and typical development (TD, n = 58). Further, the study examined whether general language ability, verbal memory span, non-verbal IQ and speech perception of monosyllables and sentences in quiet were predictors of performance on the HINT. To allow comparisons across ages, scores derived from age-based norms were used for the HINT and the tests of language and cognition. There were significant differences in SiN perception between all the groups except between the HA and DLD groups, with the CI group requiring the highest signal-to-noise ratios (i.e., poorest performance) and the TD group requiring the lowest signal-to-noise ratios. For the full sample, language ability explained significant variance in HINT performance beyond speech perception in quiet. Follow-up analyses for the separate groups revealed that language ability was a significant predictor of HINT performance for children with CI, HA, and DLD, but not for children with TD. Memory span and IQ did not predict variance in SiN perception when language ability and speech perception in quiet were taken into account. The finding of a robust relation between SiN perception and general language skills in all three clinical groups call for further investigation into the mechanisms that underlie this association.

Auditory processing in children: Role of working memory and lexical ability in auditory closure

“…Relative to typically developing children, children with weak language systems do exhibit significant difficulty in understanding speech in adverse listening situations. Accordingly, a stronger relationship between language ability and listening has been observed in clinical populations when compared to typically developing children [ 61 , 73 ]. Significant difficulty understanding speech in noise is commonly reported in children suspected to have APD [ 66 ].…”

İşitme cihazı kullanan çocuklarda gürültüde konuşmayı anlama becerisinin değerlendirilmesi: Preliminer sonuçlar

“…Gürültüde konuşmayı anlama becerisi; işitme kaybı derecesi azaldıkça, işitme cihazlı eşikler iyileştikçe ve yaş arttıkça iyileşmektedir. Literatürdeki çalışmalar, işitme cihazı/koklear implant kullanan çocukların normal işiten çocuklara kıyasla, gürültüde konuşmayı anlama performansının daha iyi SGO durumunda bile önemli ölçüde düşük olduğunu bildirmektedir (Brännström et al, 2020;von Lochow, Lyberg-Åhlander, Sahlén, Kastberg, & Brännström, 2018). Sonuçlarımız bahsedilen çalışmalarla tutarlıdır.…”

“…İşitme kaybı olan ve/ GİRİŞ veya işitme cihazı kullanan çocuklar, normal işitenlere kıyasla, gürültülü ortamlardan biri olan sınıflarda daha fazla problemle karşılaşırlar. İşitme cihazları ve koklear implantlar işitilebilirliği iyileştirse de, normal işiten kişilere göre arka plan gürültüsü varlığında konuşulanları anlamak zor olmaya devam etmektedir (Brännström, von Lochow, Lyberg Åhlander, & Sahlén, 2020;Iglehart, 2020;Torkildsen, Hitchins, Myhrum, & Wie, 2019). Koklear işitme kaybında, işitsel sinyal işlemleme değişir, pitch ve loudness algısı bozulur.…”

“…Sinyal-gürültü oranı (SGO), konuşma seviyesi ile gürültü seviyesi arasındaki fark olarak tanımlanır. Negatif bir SGO, gürültünün konuşmadan daha yüksek olduğu ve dinlemenin daha zor olabileceği anlamına gelir (Torkildsen et al, 2019). SGO açısından zorlu (SGO'nun negatif veya negatife yakın olduğu durumlar) akustik ortamlarda dinleme ve konuşmayı anlama yeteneğinin ölçülmesi, geleneksel olan ve sessiz koşullarda gerçekleştirilen saf ses odyometrisi ve konuşma odyometrisi değerlendirmelerinden çok daha fazlasını içermelidir (DL & Abrams, 2018).…”

Do Acoustic Environment Characteristics Affect the Lexical Development of Children With Cochlear Implants? A Longitudinal Study Before and After Cochlear Implant Activation

“…Speech understanding in noisy environments is more problematic for children with CIs (Guerzoni & Cuda, 2017) than it is for children with typical development (Cameron et al, 2006;Gifford & Revit, 2010). CIs do not seem to fully make up for the discrimination deficits linked to sensorineural hearing loss (Iglehart, 2009); moreover, the children's difficulty in dealing with noisy environments is often intensified by the possession of lower language abilities (Ching et al, 2018;Torkildsen et al, 2019), which makes input reconstruction more challenging (Rönnberg et al, 2010). It is reasonable to expect that less exposure to speech in quiet over time (and especially over the first few years of the child's life) may affect language acquisition in children with CIs.…”