The word-with-noise test: development, validation and reference values

PURPOSE

To propose an instrument for assessing speech recognition in the presence of competing noise. To define its application strategy for use in clinical practice. To obtain evidence of criterion validity and present reference values.

METHODS

The study was conducted in three stages: Organization of the material comprising the Word-with-Noise Test (Stage 1); Definition of the instrument's application strategy (Stage 2); Investigation of criterion validity and definition of reference values for the test (Stage 3) through the evaluation of 50 normal-hearing adult subjects and 12 subjects with hearing loss.

RESULTS

The Word-with-Noise Test consists of lists of monosyllabic and disyllabic words and speech spectrum noise (Stage 1). The application strategy for the test was defined as the determination of the Speech Recognition Threshold with a fixed noise level at 55 dBHL (Stage 2). Regarding criterion validity, the instrument demonstrated adequate ability to distinguish between normal-hearing subjects and subjects with hearing loss (Stage 3). Reference values for the test were established as cut-off points expressed in terms of signal-to-noise ratio: 1.47 dB for the monosyllabic stimulus and -2.02 dB for the disyllabic stimulus. Conclusion: The Word-with-Noise Test proved to be quick to administer and interpret, making it a useful tool in audiological clinical practice. Furthermore, it showed satisfactory evidence of criterion validity, with established reference values.

Pediatric normative data for a novel and fast speech perception test in noise

OBJECTIVES

Communicating in noisy settings can be difficult due to interference and environmental noise, which can impact intelligibility for those with hearing impairments and those with normal hearing threshold. Speech intelligibility is commonly assessed in audiology through speech audiometry in quiet environments. Nevertheless, this test may not effectively assess hearing challenges in noisy environments, as total silence is rare in daily activities. A recently patented method, known as the SRT50 FAST, has been developed for conducting speech audiometry in noise. This new method enables the acceleration and simplification of free field speech audiometry tests involving competition noise. This study aims to establish normative scores and standardize the SRT50 FAST method as a test for evaluating speech perception in noise in pediatric patients.

METHODS

The study included 30 participants with normal hearing, consisting of 11 females and 19 males, ranging in age from 6 to 11 years. A series of speech audiometry tests were conducted to determine the speech reception threshold 50% (SRT50) in competing conditions. This included testing both the fast mode (SRT50 FAST) currently being studied and the traditional method (SRT50 CLASSIC). The SRT50, or Signal to Noise Ratio (SNR) at which 50% of speech recognition occurred, was investigated for both methods.

RESULTS

The mean SRT50 FAST test score was -2.69 (SD = 3.15). The dataset exhibited a normal distribution with values ranging from 3.60 to -8.60. Since the scores are expressed in SRT, higher scores indicate poorer performance. We have established a threshold of 3.60 as the upper limit of the normal range, therefore, patients with scores above this threshold are considered to have abnormal results.

CONCLUSIONS

This study aimed to establish normative data for the evaluation of free field speech in noise recognition using the SRT50 FAST method in the pediatric population. This method accurately investigates the necessary signal-to-noise ratio for achieving 50% recognition scores with bisyllabic words in a quick manner. The ultimate objective is to employ this test to identify the optimal configuration of hearing rehabilitation devices, particularly for pediatric patients with hearing aids and/or cochlear implants. Additionally, it can be used to assess pediatric patients with unilateral hearing loss.

The word-with-noise test: test-retest reliability in normal-hearing adults

PURPOSE

To investigate the reliability of the Word-with-Noise Test in a group of normal-hearing adults.

METHODS

Forty-five normal-hearing adult subjects participated in the research. The interval between the first and second assessment was 14 to 28 days, performed during the same time of the day and by the same evaluator. The comparison analysis between the test and the retest was performed considering the general result of the ears, totaling 90 ears evaluated. The inferential analysis included the comparison of the situations in the first and second assessment using the Wilcoxon Test, calculation, and interpretation of the Intraclass Correlation Index.

RESULTS

There was a statistically significant difference between the test and retest performances. The intraclass correlation coefficients obtained were indicative of good reliability (r=0.759; p<0.001) for the monosyllabic stimulus and moderate reliability (r=0.631; p<0.001) for the disyllabic stimulus.

CONCLUSION

The Word-with-Noise Test demonstrated satisfactory reliability for both the monosyllabic and disyllabic stimuli.

Measure of Auditory Working Memory Span Using Monosyllabic Word Recognition Test in Young Adults With Normal Hearing: A Preliminary Study

PURPOSE

Measuring working memory at hearing clinics is important. This study attempted to develop a test protocol that measures auditory working memory using a standardized monosyllabic word list in Korean Speech Audiometry (KSA).

METHOD

We included 25 young adults with normal hearing in this study. Participants conducted word recognition and word span tests concurrently using the KSA monosyllabic word lists. We designed four test conditions according to the presence or absence of background noise and word recall order: quiet-forward (QF), quiet-backward (QB), noise-forward, (NF), and noise-backward (NB). We implemented digit span tests in the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) to determine the validity of the working memory outcomes.

RESULTS

Word recognition scores of QF and QB were significantly higher than those of NF and NB. The percentages of correctly recalled words and word recall span scores were highest in QF and lowest in NB. Overall, the Pearson correlation and multiple regression statistics showed that our word span test outcomes for QB and NF were highly associated with digit span scores on the K-WAIS-IV.

CONCLUSION

Our proposed test protocol showed the possibility of measuring auditory working memory and monosyllabic word recognition simultaneously by validating the results with K-WAIS-IV outcomes.

Speech-derived haptic stimulation enhances speech recognition in a multi-talker background

Speech understanding, while effortless in quiet conditions, is challenging in noisy environments. Previous studies have revealed that a feasible approach to supplement speech-in-noise (SiN) perception consists in presenting speech-derived signals as haptic input. In the current study, we investigated whether the presentation of a vibrotactile signal derived from the speech temporal envelope can improve SiN intelligibility in a multi-talker background for untrained, normal-hearing listeners. We also determined if vibrotactile sensitivity, evaluated using vibrotactile detection thresholds, modulates the extent of audio-tactile SiN improvement. In practice, we measured participants' speech recognition in a multi-talker noise without (audio-only) and with (audio-tactile) concurrent vibrotactile stimulation delivered in three schemes: to the left or right palm, or to both. Averaged across the three stimulation delivery schemes, the vibrotactile stimulation led to a significant improvement of 0.41 dB in SiN recognition when compared to the audio-only condition. Notably, there were no significant differences observed between the improvements in these delivery schemes. In addition, audio-tactile SiN benefit was significantly predicted by participants' vibrotactile threshold levels and unimodal (audio-only) SiN performance. The extent of the improvement afforded by speech-envelope-derived vibrotactile stimulation was in line with previously uncovered vibrotactile enhancements of SiN perception in untrained listeners with no known hearing impairment. Overall, these results highlight the potential of concurrent vibrotactile stimulation to improve SiN recognition, especially in individuals with poor SiN perception abilities, and tentatively more so with increasing tactile sensitivity. Moreover, they lend support to the multimodal accounts of speech perception and research on tactile speech aid devices.

Effect of Serious Gaming on Speech-in-Noise Intelligibility in Adult Cochlear Implantees: A Randomized Controlled Study

Listening in noise remains challenging for adults with cochlear implants (CI) even after prolonged experience. Personalized auditory training (AT) programs can be proposed to improve specific auditory skills in adults with CI. The objective of this study was to assess serious gaming as a rehabilitation tool to improve speech-in-noise intelligibility in adult CI users. Thirty subjects with bilateral profound hearing loss and at least 9 months of CI experience were randomized to participate in a 5-week serious game-based AT program (n = 15) or a control group (n = 15). All participants were tested at enrolment and at 5 weeks using the sentence recognition-in-noise matrix test to measure the signal-to-noise ratio (SNR) allowing 70% of speech-in-noise understanding (70% speech reception threshold, SRT70). Thirteen subjects completed the AT program and nine of them were re-tested 5 weeks later. The mean SRT70 improved from 15.5 dB to 11.5 dB SNR after 5 weeks of AT (p < 0.001). No significant change in SRT70 was observed in the control group. In the study group, the magnitude of SRT70 improvement was not correlated to the total number of AT hours. A large inter-patient variability was observed for speech-in-noise intelligibility measured once the AT program was completed and at re-test. The results suggest that serious game-based AT may improve speech-in-noise intelligibility in adult CI users. Potential sources of inter-patient variability are discussed. Serious gaming may be considered as a complementary training approach for improving CI outcomes in adults.