Construction and evaluation of the Mandarin Chinese matrix (CMNmatrix) sentence test for the assessment of speech recognition in noise

Development of the mandarin reading span test and confirmation of its relationship with speech perception in noise

OBJECTIVE

This study aimed to develop a dual-task Mandarin Reading Span Test (RST) to assess verbal working memory related to speech perception in noise.

DESIGN

The test material was developed taking into account psycholinguistic factors (i.e. sentence structure, number of syllables, word familiarity, and sentences plausibility), to achieve good test reliability and face validity. The relationship between the 28-sentence Mandarin RST and speech perception in noise was confirmed using three speech perception in noise measures containing varying levels of contextual and linguistic information.

STUDY SAMPLE

The study comprised 42 young adults with normal hearing and 56 older adult who were hearing aid users with moderate to severe hearing loss.

RESULTS

In older hearing aid users, the 28-sentence RST showed significant correlation with speech reception thresholds as measured by three Mandarin sentence in noise tests (rs or r = -.681 to -.419) but not with the 2-digit sequence Digit-in-Noise Test.

CONCLUSION

The newly developed dual-task Mandarin RST, constructed with careful psycholinguistic consideration, demonstrates a significant relationship with sentence perception in noise. This suggests that the Mandarin RST could serve as a measure of verbal working memory.

Chinese Emotional Speech Audiometry Project (CESAP): Establishment and Validation of a New Material Set With Emotionally Neutral Disyllabic Words

PURPOSE

The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody.

METHOD

In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (-1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes.

RESULTS

First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%-80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%-80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%-80% slope (12%).

CONCLUSION

Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25742814.

Development of the Mandarin Digit-in-Noise Test and Examination of the Effect of the Number of Digits Used in the Test

OBJECTIVES

The study aimed to develop and validate the Mandarin digit-in-noise (DIN) test using four digit (i.e., two-, three-, four-, and five-digit) sequences. Test-retest reliability and criterion validity were evaluated. How the number of digits affected the results was examined. The research might lead to more informed choice of DIN tests for populations with specific cognitive needs such as memory impairment.

DESIGN

The International Collegium of Rehabilitative Audiology guideline for developing the DIN was adapted to create test materials. The test-retest reliability and psychometric function of each digit sequence were determined among young normal-hearing adults. The criterion validity of each digit sequence was determined by comparing the measured performance of older adult hearing aid users with that obtained from two other well-established sentence-in-noise tests: the Mandarin hearing-in-noise test and the Mandarin Chinese matrix test. The relation between the speech reception thresholds (SRTs) of each digit sequence of the DIN test and working memory capacity measured using the digit span test and the reading span test were explored among older adult hearing aid users. Together, the study sample consisted of 54 young normal-hearing adults and 56 older adult hearing aid users.

RESULTS

The slopes associated with the two-, three-, four-, and five-digit DIN test were 16.58, 18.79, 20.42, and 21.09 %/dB, respectively, and the mean SRTs were -11.11, -10.99, -10.56, and -10.02 dB SNR, respectively. Test-retest SRTs did not differ by more than 0.74 dB across all digit sequences, suggesting good test-retest reliability. Spearman rank-order correlation coefficients between SRTs obtained using the DIN across the four digit (i.e., two-, three-, four-, and five-digit) sequences and the two sentence-in-noise tests were uniformly high ( rs = 0.9) across all participants, when data from all participants were considered. Results from the digit span test and reading span test correlated significantly with the results of the five-digit sequences ( rs = -0.37 and -0.42, respectively) but not with the results of the two-, three-, and four-digit sequences among older hearing aid users.

CONCLUSIONS

While the three-digit sequence was found to be appropriate for clinical use for assessment of auditory perception, the two-digit sequence could be used for hearing screening. The five-digit sequence could be difficult for older hearing aid users, and with its SRT related to working memory capacity, its use in the evaluation of speech perception should be investigated further. The Mandarin DIN test was found to be reliable, and the findings are in line with SRTs obtained using standardized sentence tests, suggesting good criterion validity.

Evaluation of the American English Matrix Test with Cochlear Implant Recipients

OBJECTIVE

Currently, the variety of speech recognition tests used to evaluate cochlear implant (CI) recipients makes it difficult to compare results, especially across languages. The Matrix Test limits contextual cues and is available in multiple languages, including American English. The current study investigated test format and noise type for the American English Matrix Test (AMT) and compared results to AzBio sentence scores in adult CI recipients.

DESIGN

Fifteen experienced CI recipients were administered the AMT in fixed- and adaptive-level formats and AzBio sentences in a fixed-level format. Testing in noise used the AMT-specific noise and 4-talker babble.

RESULTS

Ceiling effects were present for all AMT fixed-level conditions and AzBio sentences in quiet. Group mean AzBio scores were poorer than AMT scores. Noise type affected performance regardless of format; 4-talker babble was more challenging.

CONCLUSIONS

The limited number of word choices in each category likely aided listeners performance for the AMT compared to AzBio sentences. The use of the AMT in the designed adaptive-level format would allow effective evaluation and comparison of CI performance internationally. A test battery with the AMT may also benefit from including AzBio sentences in 4-talker babble to reflect performance during listening challenges.

The Chinese Zodiac-in-Noise Test: An Internet-Based Speech-in-Noise Test for Large-Scale Hearing Screening

OBJECTIVES

Motivated by the growing need for hearing screening in China, the present study has two objectives. First, to develop and validate a new test, called the Chinese Zodiac-in-noise (ZIN) test, for large-scale hearing screening in China. Second, to conduct a large-scale remote hearing screening in China, using the ZIN test developed.

DESIGN

The ZIN test was developed following a similar procedure as the digits-in-noise test but emphasizes the importance of consonant recognition by employing the 12 zodiac animals in traditional Chinese culture as speech materials. It measures the speech reception threshold (SRT) using triplets of Chinese zodiac animals in speech-shaped noise with an adaptive procedure.

RESULTS

Normative data of the test were obtained in a group of 140 normal-hearing listeners, and the performance of the test was validated by comparisons with pure-tone audiometry in 116 listeners with various hearing abilities. The ZIN test has a reference SRT of -11.0 ± 1.6 dB in normal-hearing listeners with a test-retest variability of 1.7 dB and can be completed in 3 minutes. The ZIN SRT is highly correlated with the better-ear pure-tone threshold ( r = 0.82). With a cutoff value of -7.7 dB, the ZIN test has a sensitivity of 0.85 and a specificity of 0.94 for detecting a hearing loss of 25 dB HL or more at the better ear.A large-scale remote hearing screening involving 30,552 participants was performed using the ZIN test. The large-scale study found a hearing loss proportion of 21.0% across the study sample, with a high proportion of 57.1% in the elderly study sample aged over 60 years. Age and gender were also observed to have associations with hearing loss, with older individuals and males being more likely to have hearing loss.

CONCLUSIONS

The Chinese ZIN test is a valid and efficient solution for large-scale hearing screening in China. Its remote applications may improve access to hearing screening and enhance public awareness of hearing health.

Development and evaluation of the Cantonese matrix sentence test

OBJECTIVE

To develop the Cantonese matrix (YUEmatrix) test according to the international standard procedure and examine possible different outcomes in another tonal language.

DESIGN

A 50-word Cantonese base-matrix was established. Word-specific speech recognition functions, speech recognition thresholds (SRT), and slopes were obtained. The speech material was homogenised in intelligibility by applying level corrections up to ± 3 dB. Subsequently, the YUEmatrix test was evaluated in five aspects: training effect, test-list equivalence, test-retest reliability, establishment of reference data for normal-hearing Cantonese-speakers, and comparison with the Cantonese-Hearing-In-Noise-Test.

STUDY SAMPLE

Overall, 64 normal-hearing native Cantonese-speaking listeners.

RESULTS

SRT measurements with adaptive procedures resulted in a reference SRT of -9.7 ± 0.7 dB SNR for open-set and -11.1 ± 1.2 dB SNR for the closed-set response format. Fixed SNR measurements suggested a test-specific speech intelligibility function slope of 15.5 ± 0.7%/dB. Seventeen 10-sentences base test lists were confirmed to be equivalent with respect to speech intelligibility. Training effect was not observed after two measurements of 20-sentences lists.

CONCLUSIONS

The YUEmatrix yields comparable results to matrix tests in other languages including Mandarin. Level adjustments to homogenise sentences appear to be less effective for tonal languages than for most other languages developed so far.

List Equivalency and Critical Differences of a Mandarin Bamford-Kowal-Bench Sentence in Babble Noise Test for Adults and Preschool Children With Normal Hearing

PURPOSE

The purpose of this study was to determine the speech recognition equivalence of Mandarin Bamford-Kowal-Bench (BKB) sentence lists with adults and children with normal hearing.

METHOD

A total of 32 lists, each of nine sentences, were compiled from a corpus of BKB-like sentences with paired babble in Mandarin. Interlist equivalence, critical differences, and sensitivity of performance to signal-to-noise ratio (SNR) were examined. Experiment 1 included 64 native Mandarin-speaking adults with normal hearing. Experiment 2 included 54 native Mandarin-speaking children with normal hearing aged 4-6 years.

RESULTS

Among the 32 sentence lists, 28 lists were confirmed to be equivalent in adults, with a mean SNR required for 50% correct (SNR50) of -5.9 ± 0.1 dB, a mean slope of 22.3%/dB ± 1.5%/dB, and a grand 95% critical difference subsequently calculated as 27.2% for score. From the 28 equivalent lists, 27 lists were selected and observed to be equivalent in children, with a mean SNR50 threshold of -2.0 ± 0.2 dB, a mean slope of 15.8%/dB ± 1.1%/dB, and a grand 95% critical difference of 24.6% for score.

CONCLUSIONS

The Mandarin BKB sentences in babble noise test offers an opportunity for clinicians and researchers to assess speech understanding in adults and preschool children in an efficient manner. For comparisons of performance in different test conditions, 28 equivalent lists are available for adults and 27 equivalent lists for preschool children. The 95% critical difference values can be used for total percentage correct or SNR for 50% performance. Future work will examine the clinical utility for school-age children and children who are deaf and hard of hearing.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24400066.

Prognostic Factors for Speech Outcome among Patients with Submucous Cleft Palate Managed by Furlow Palatoplasty or Posterior Pharyngeal Flap

BACKGROUND

Submucous cleft palate (SMCP) is a particular subtype of cleft deformity for which the optimal surgical timing and technique are still under debate. This study aimed to identify potential prognostic factors for the speech outcome of patients with SMCP and provide evidence for further management strategy optimization.

METHODS

The authors reviewed patients with nonsyndromic SMCP who received either Furlow palatoplasty (FP) or posterior pharyngeal flap (PPF) between 2008 and 2021 in a tertiary hospital-based cleft center. Both univariate and multivariate logistic regression models were used to screen preoperative variables, including cleft type (overt or occult), age at surgery, mobility of velum and pharyngeal wall, velopharyngeal closure ratio, and pattern. The receiver operating characteristic curve was used to determine the cutoff value of the significant predictors for subgroup comparison.

RESULTS

A total of 131 patients were enrolled, with 92 receiving FP and 39 receiving PPF. Age at operation and cleft type were identified as having significant effects on FP outcome. Patients operated on before 9.5 years of age had a significantly higher velopharyngeal competence (VPC) rate than those operated on after that age. The speech outcome among patients with occult SMCP was significantly worse than that of patients with overt SMCP after FP treatment. No preoperative variable was found to be correlated with PPF outcome. PPF yielded a higher VPC rate than did FP among patients operated on after 9.5 years of age.

CONCLUSIONS

The prognosis of patients with SMCP treated with FP is sensitive to age at surgery and cleft type. PPF may be considered for older patients in settings with limited access to multiple surgical procedures, especially when occult SMCP is diagnosed.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, III.

Development and Validation of a Mandarin Chinese Adaptation of AzBio Sentence Test (CMnBio)

A new sentence recognition test in Mandarin Chinese was developed and validated following the principles and procedures of development of the English AzBio sentence materials. The study was conducted in two stages. In the first stage, 1,020 sentences spoken by 4 talkers (2 males and 2 females) were processed through a 5-channel noise vocoder and presented to 17 normal-hearing Mandarin-speaking adults for recognition. A total of 600 sentences (150 from each talker) in the range of approximately 62 to 92% correct (mean = 78.0% correct) were subsequently selected to compile 30, 20-sentence lists. In the second stage, 30 adult CI users were recruited to verify the list equivalency. A repeated-measures analysis of variance followed by the post hoc Tukey's test revealed that 26 of the 30 lists were equivalent. Finally, a binomial distribution model was adopted to account for the inherent variability in the lists. It was found that the inter-list variability could be best accounted for with a 65-item binomial distribution model. The lower and upper limits of the 95% critical differences for one- and two-list recognition scores were then generated to provide guidance for detection of a significant difference in recognition scores in clinical settings. The final set of 26 equivalent lists contains sentence materials more difficult than those found in other speech audiometry materials in Mandarin Chinese. This test should help minimize the ceiling effects when testing sentence recognition in Mandarin-speaking CI users.

Optimization of the Speech Test Material in a Group of Hearing Impaired Subjects: A Feasibility Study for Multilingual Digit Triplet Test Development

Background: The development of the global digit-in-noise test requires optimization of each language version on a group of normal-hearing native-speakers. An alternative solution may be an adaptive optimization during ongoing tests in a group of subjects with unknown hearing impairments. The objective of the research was to compare the optimization results between these groups. Methods: Digit triplets consisting of three pseudo-randomly selected digits were presented in speech-shaped noise at various signal-to-noise ratios (SNRs), according to the protocol of the final speech test. Digit-specific and position-specific speech reception thresholds (SRTs) were determined and compared between groups. Results: The study sample consisted of 82 subjects, 26 normal-hearing subjects and 56 patients with diverse hearing disorders. Statistically significant differences in digit-specific SRTs between the control and the investigated group were obtained for three digits in continuous noise (digits 0, 4, 6; p-value of 0.04, 0.03, 0.05) and two in modulated noise (digits 1 and 6; p-value of 0.05 and 0.01). An analysis including only ears with SRTs within the range of the normal hearing control group showed no statistically significant differences between digits. Conclusion: Optimization of speech material can be carried out in a group of subjects with unknown hearing impairments, provided the ears with scores outside normal range are rejected.

Inference of the distortion component of hearing impairment from speech recognition by predicting the effect of the attenuation component

OBJECTIVE

A model-based determination of the average supra-threshold ("distortion") component of hearing impairment which limits the benefit of hearing aid amplification.

DESIGN

Published speech recognition thresholds (SRTs) were predicted with the framework for auditory discrimination experiments (FADE), which simulates recognition processes, the speech intelligibility index (SII), which exploits frequency-dependent signal-to-noise ratios (SNR), and a modified SII with a hearing-loss-dependent band importance function (PAV). Their attenuation-component-based prediction errors were interpreted as estimates of the distortion component.

STUDY SAMPLE

Unaided SRTs of 315 hearing-impaired ears measured with the German matrix sentence test in stationary noise.

RESULTS

Overall, the models showed root-mean-square errors (RMSEs) of 7 dB, but for steeply sloping hearing loss FADE and PAV were more accurate (RMSE = 9 dB) than the SII (RMSE = 23 dB). Prediction errors of FADE and PAV increased linearly with the average hearing loss. The consideration of the distortion component estimate significantly improved the accuracy of FADE's and PAV's predictions.

CONCLUSIONS

The supra-threshold distortion component-estimated by prediction errors of FADE and PAV-seems to increase with the average hearing loss. Accounting for a distortion component improves the model predictions and implies a need for effective compensation strategies for supra-threshold processing deficits with increasing audibility loss.

Does Sentence-Level Coarticulation Affect Speech Recognition in Noise or a Speech Masker?

Purpose Three experiments were conducted to better understand the role of between-word coarticulation in masked speech recognition. Specifically, we explored whether naturally coarticulated sentences supported better masked speech recognition as compared to sentences derived from individually spoken concatenated words. We hypothesized that sentence recognition thresholds (SRTs) would be similar for coarticulated and concatenated sentences in a noise masker but would be better for coarticulated sentences in a speech masker. Method Sixty young adults participated (n = 20 per experiment). An adaptive tracking procedure was used to estimate SRTs in the presence of noise or two-talker speech maskers. Targets in Experiments 1 and 2 were matrix-style sentences, while targets in Experiment 3 were semantically meaningful sentences. All experiments included coarticulated and concatenated targets; Experiments 2 and 3 included a third target type, concatenated keyword-intensity-matched (KIM) sentences, in which the words were concatenated but individually scaled to replicate the intensity contours of the coarticulated sentences. Results Regression analyses evaluated the main effects of target type, masker type, and their interaction. Across all three experiments, effects of target type were small (< 2 dB). In Experiment 1, SRTs were slightly poorer for coarticulated than concatenated sentences. In Experiment 2, coarticulation facilitated speech recognition compared to the concatenated KIM condition. When listeners had access to semantic context (Experiment 3), a coarticulation benefit was observed in noise but not in the speech masker. Conclusions Overall, differences between SRTs for sentences with and without between-word coarticulation were small. Beneficial effects of coarticulation were only observed relative to the concatenated KIM targets; for unscaled concatenated targets, it appeared that consistent audibility across the sentence offsets any benefit of coarticulation. Contrary to our hypothesis, effects of coarticulation generally were not more pronounced in speech maskers than in noise maskers.

DARF: A data-reduced FADE version for simulations of speech recognition thresholds with real hearing aids

Developing and selecting hearing aids is a time consuming process which is simplified by using objective models. Previously, the framework for auditory discrimination experiments (FADE) accurately simulated benefits of hearing aid algorithms with root mean squared prediction errors below 3 dB. One FADE simulation requires several hours of (un)processed signals, which is obstructive when the signals have to be recorded. We propose and evaluate a data-reduced FADE version (DARF) which facilitates simulations with signals that cannot be processed digitally, but that can only be recorded in real-time. DARF simulates one speech recognition threshold (SRT) with about 30 min of recorded and processed signals of the (German) matrix sentence test. Benchmark experiments were carried out to compare DARF and standard FADE exhibiting small differences for stationary maskers (1 dB), but larger differences with strongly fluctuating maskers (5 dB). Hearing impairment and hearing aid algorithms seemed to reduce the differences. Hearing aid benefits were simulated in terms of speech recognition with three pairs of real hearing aids in silence (≥8 dB), in stationary and fluctuating maskers in co-located (stat. 2 dB; fluct. 6 dB), and spatially separated speech and noise signals (stat. ≥8 dB; fluct. 8 dB). The simulations were plausible in comparison to data from literature, but a comparison with empirical data is still open. DARF facilitates objective SRT simulations with real devices with unknown signal processing in real environments. Yet, a validation of DARF for devices with unknown signal processing is still pending since it was only tested with three similar devices. Nonetheless, DARF could be used for improving as well as for developing or model-based fitting of hearing aids.

APP Medical Diagnostic Check-up Consultation System Based on Speech Recognition

Background:

Medical test orders can display the physiological functions of patients by using medical means. The medical staff determines the patient's condition through medical test orders and completes the treatment. However, for most patients and their families, there are so many terminologies in the medical test list and they are inconvenient to understand and query, which would affect the patients’ cognition and treatment effect. Therefore, it is especially necessary to develop a consulting system that can provide related analysis after getting medical test data.

Objective :

This paper starts with information acquisition and speech recognition. It proposes a natural scene information acquisition and analysis model based on deep learning, focusing on improving the recognition rate of routine test list and achieving targeted smart search to allow users to get more accurate personalized health advice.

Methods :

Based on medical characteristics, considering the needs of patients, this paper constructs an APP-based conventional medical test consultation system, using artificial intelligence and voice recognition technology to collect user input; analyzing user needs with the help of conventional medical information knowledge database.

Results:

This model combines speech recognition and data mining methods to obtain routine test list data and is suitable for accurate analysis of problems in routine check-up procedure. The app provides effective explanations and guidance for the treatment and rehabilitation of patients.

Conclusion:

It organically links the Internet with personalized medicine, which can effectively improve the popularity of medical knowledge and provide a reference for the application of medical services on the Internet. Meanwhile, this app can contribute to the improvement of medical standards and provide new models for modern medical management.

Time-compression thresholds for Mandarin sentences in normal-hearing and cochlear implant listeners

Faster speech may facilitate more efficient communication, but if speech is too fast it becomes unintelligible. The maximum speeds at which Mandarin words were intelligible in a sentence context were quantified for normal hearing (NH) and cochlear implant (CI) listeners by measuring time-compression thresholds (TCTs) in an adaptive staircase procedure. In Experiment 1, both original and CI-vocoded time-compressed speech from the MSP (Mandarin speech perception) and MHINT (Mandarin hearing in noise test) corpora was presented to 10 NH subjects over headphones. In Experiment 2, original time-compressed speech was presented to 10 CI subjects and another 10 NH subjects through a loudspeaker in a soundproof room. Sentences were time-compressed without changing their spectral profile, and were presented up to three times within a single trial. At the end of each trial, the number of correctly identified words in the sentence was scored. A 50%-word recognition threshold was tracked in the psychophysical procedure. The observed median TCTs were very similar for MSP and MHINT speech. For NH listeners, median TCTs were around 16.7 syllables/s for normal speech, and 11.8 and 8.6 syllables/s respectively for 8 and 4 channel tone-carrier vocoded speech. For CI listeners, TCTs were only around 6.8 syllables/s. The interquartile range of the TCTs within each cohort was smaller than 3.0 syllables/s. Speech reception thresholds in noise were also measured in Experiment 2, and were found to be strongly correlated with TCTs for CI listeners. In conclusion, the Mandarin sentence TCTs were around 16.7 syllables/s for most NH subjects, but rarely faster than 10.0 syllables/s for CI listeners, which quantitatively illustrated upper limits of fast speech information processing with CIs.