Τρίτη 6 Νοεμβρίου 2018

Vocal Biomarkers of Mild-to-Moderate Hearing Loss in Children and Adults: Voiceless Sibilants

Purpose
The purpose of this study was to determine if an objective measure of speech production could serve as a vocal biomarker for the effects of high-frequency hearing loss on speech perception. It was hypothesized that production of voiceless sibilants is governed sufficiently by auditory feedback that high-frequency hearing loss results in subtle but significant shifts in the spectral characteristics of these sibilants.
Method
Sibilant production was examined in individuals with mild to moderately severe congenital (22 children; 8–17 years old) and acquired (23 adults; 55–80 years old) hearing losses. Measures of hearing level (pure-tone average thresholds at 4 and 8 kHz), speech perception (detection of nonsense words within sentences), and speech production (spectral center of gravity [COG] for /s/ and /ʃ/) were obtained in unaided and aided conditions.
Results
For both children and adults, detection of nonsense words increased significantly as hearing thresholds improved. Spectral COG for /ʃ/ was unaffected by hearing loss in both listening conditions, whereas the spectral COG for /s/ significantly decreased as high-frequency hearing loss increased. The distance in spectral COG between /s/ and /ʃ/ decreased significantly with increasing hearing level. COG distance significantly predicted nonsense-word detection in children but not in adults.
Conclusions
At least one aspect of speech production (voiceless sibilants) is measurably affected by high-frequency hearing loss and is related to speech perception in children. Speech production did not predict speech perception in adults, suggesting a more complex relationship between auditory feedback and feedforward mechanisms with age. Even so, these results suggest that this vocal biomarker may be useful for identifying the presence of high-frequency hearing loss in adults and children and for predicting the impact of hearing loss in children.

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Relations Between Teacher Talk Characteristics and Child Language in Spoken Language, Deaf, and Hard-of-Hearing Classrooms

Purpose
The aim of this study was to examine relations between teachers' conversational techniques and language gains made by their deaf and hard-of-hearing students. Specifically, we considered teachers' reformulations of child utterances, language elicitations, explicit vocabulary and syntax instruction, and wait time.
Method
This was an observational, longitudinal study that examined the characteristics of teacher talk in 25 kindergarten through second-grade classrooms of 68 deaf and hard-of-hearing children who used spoken English. Standardized assessments provided measures of child vocabulary and morphosyntax in the fall and spring of a school year. Characteristics of teacher talk were coded from classroom video recordings during the winter of that year.
Results
Hierarchical linear modeling indicated that reformulating child statements and explicitly teaching vocabulary were significant predictors of child vocabulary gains across a school year. Explicitly teaching vocabulary also significantly predicted gains in morphosyntax abilities. There were wide individual differences in the teachers' use of these conversational techniques.
Conclusion
Reformulation and explicit vocabulary instruction may be areas where training can help teachers improve, and improvements in the teachers' talk may benefit their students.

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The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey

Purpose
Stuttering is a disorder that has been associated with coexisting developmental disorders. To date, detailed descriptions of the coexistence of such conditions have not consistently emerged in the literature. Identifying and understanding these conditions can be important to the overall management of children who stutter (CWS). The objective of this study was to generate a profile of the existence of disabling developmental conditions among CWS using national data.
Method
Six years of data from the National Health Interview Survey (2010–2015) were analyzed for this project. The sample consisted of children whose respondents clearly indicated the presence or absence of stuttering. Chi-square tests of independence were used for comparing categorical variables; and independent-samples t tests, for comparing continuous variables. Multiple logistic regression analyses were used for determining the odds of having a coexisting disabling developmental condition.
Results
This study sample included 62,450 children, of which 1,231 were CWS. Overall, the presence of at least 1 disabling developmental condition was 5.5 times higher in CWS when compared with children who do not stutter. The presence of stuttering was also associated with higher odds of each of the following coexisting developmental conditions: intellectual disability (odds ratio [OR] = 6.67, p < .001), learning disability (OR = 5.45, p < .001), attention-deficit hyperactivity disorder/attention-deficit disorder (OR = 3.09, p < .001), seizures (OR = 7.52, p < .001), autism/Asperger's/pervasive developmental disorder (OR = 5.48, p < .001), and any other developmental delay (OR = 7.10, p < .001).
Conclusion
Evidence from the National Health Interview Survey suggests a higher prevalence of coexisting developmental disabilities in CWS. The existence of coexisting disabling developmental conditions should be considered as part of an overall management plan for CWS.

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Vocal Biomarkers of Mild-to-Moderate Hearing Loss in Children and Adults: Voiceless Sibilants

Purpose
The purpose of this study was to determine if an objective measure of speech production could serve as a vocal biomarker for the effects of high-frequency hearing loss on speech perception. It was hypothesized that production of voiceless sibilants is governed sufficiently by auditory feedback that high-frequency hearing loss results in subtle but significant shifts in the spectral characteristics of these sibilants.
Method
Sibilant production was examined in individuals with mild to moderately severe congenital (22 children; 8–17 years old) and acquired (23 adults; 55–80 years old) hearing losses. Measures of hearing level (pure-tone average thresholds at 4 and 8 kHz), speech perception (detection of nonsense words within sentences), and speech production (spectral center of gravity [COG] for /s/ and /ʃ/) were obtained in unaided and aided conditions.
Results
For both children and adults, detection of nonsense words increased significantly as hearing thresholds improved. Spectral COG for /ʃ/ was unaffected by hearing loss in both listening conditions, whereas the spectral COG for /s/ significantly decreased as high-frequency hearing loss increased. The distance in spectral COG between /s/ and /ʃ/ decreased significantly with increasing hearing level. COG distance significantly predicted nonsense-word detection in children but not in adults.
Conclusions
At least one aspect of speech production (voiceless sibilants) is measurably affected by high-frequency hearing loss and is related to speech perception in children. Speech production did not predict speech perception in adults, suggesting a more complex relationship between auditory feedback and feedforward mechanisms with age. Even so, these results suggest that this vocal biomarker may be useful for identifying the presence of high-frequency hearing loss in adults and children and for predicting the impact of hearing loss in children.

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Relations Between Teacher Talk Characteristics and Child Language in Spoken Language, Deaf, and Hard-of-Hearing Classrooms

Purpose
The aim of this study was to examine relations between teachers' conversational techniques and language gains made by their deaf and hard-of-hearing students. Specifically, we considered teachers' reformulations of child utterances, language elicitations, explicit vocabulary and syntax instruction, and wait time.
Method
This was an observational, longitudinal study that examined the characteristics of teacher talk in 25 kindergarten through second-grade classrooms of 68 deaf and hard-of-hearing children who used spoken English. Standardized assessments provided measures of child vocabulary and morphosyntax in the fall and spring of a school year. Characteristics of teacher talk were coded from classroom video recordings during the winter of that year.
Results
Hierarchical linear modeling indicated that reformulating child statements and explicitly teaching vocabulary were significant predictors of child vocabulary gains across a school year. Explicitly teaching vocabulary also significantly predicted gains in morphosyntax abilities. There were wide individual differences in the teachers' use of these conversational techniques.
Conclusion
Reformulation and explicit vocabulary instruction may be areas where training can help teachers improve, and improvements in the teachers' talk may benefit their students.

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The Coexistence of Disabling Conditions in Children Who Stutter: Evidence From the National Health Interview Survey

Purpose
Stuttering is a disorder that has been associated with coexisting developmental disorders. To date, detailed descriptions of the coexistence of such conditions have not consistently emerged in the literature. Identifying and understanding these conditions can be important to the overall management of children who stutter (CWS). The objective of this study was to generate a profile of the existence of disabling developmental conditions among CWS using national data.
Method
Six years of data from the National Health Interview Survey (2010–2015) were analyzed for this project. The sample consisted of children whose respondents clearly indicated the presence or absence of stuttering. Chi-square tests of independence were used for comparing categorical variables; and independent-samples t tests, for comparing continuous variables. Multiple logistic regression analyses were used for determining the odds of having a coexisting disabling developmental condition.
Results
This study sample included 62,450 children, of which 1,231 were CWS. Overall, the presence of at least 1 disabling developmental condition was 5.5 times higher in CWS when compared with children who do not stutter. The presence of stuttering was also associated with higher odds of each of the following coexisting developmental conditions: intellectual disability (odds ratio [OR] = 6.67, p < .001), learning disability (OR = 5.45, p < .001), attention-deficit hyperactivity disorder/attention-deficit disorder (OR = 3.09, p < .001), seizures (OR = 7.52, p < .001), autism/Asperger's/pervasive developmental disorder (OR = 5.48, p < .001), and any other developmental delay (OR = 7.10, p < .001).
Conclusion
Evidence from the National Health Interview Survey suggests a higher prevalence of coexisting developmental disabilities in CWS. The existence of coexisting disabling developmental conditions should be considered as part of an overall management plan for CWS.

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Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Related Articles

Feedback reduction system influence on additional gain before feedback and maximum stable gain in open-fitted hearing aids.

Int J Audiol. 2018 Oct;57(10):737-745

Authors: Marcrum SC, Picou EM, Bohr C, Steffens T

Abstract
OBJECTIVE: The primary purpose of this study was to update existing data on additional gain before feedback and maximum stable gain in commercially available, open-fit hearing instruments. A secondary purpose was to evaluate ratings of sound quality with feedback reduction systems active.
DESIGN: Additional gain before feedback, maximum stable gain and subjective sound quality ratings were obtained for six commercially available hearing instruments utilising modern feedback reduction systems.
STUDY SAMPLE: Twenty adults (22-46 years) with normal hearing participated in gain measurement testing. Thirty adults (22-39 years) with normal hearing provided ratings of sound quality.
RESULTS: Mean additional gain before feedback for 2000-4000 Hz ranged from 5 to 16 dB across manufacturers. Mean maximum stable gain in the same frequency region ranged from 25 to 35 dB across manufacturers. However, meaningful performance differences between participants within each given manufacturer were also identified. Sound quality ratings were not related to the type of feedback reduction algorithm.
CONCLUSIONS: AGBF and MSG continue to vary significantly both across manufacturers as well as individual ears within a given manufacturer. User satisfaction and performance with hearing aids might be improved by identifying the feedback reduction system optimal for the individual patient.

PMID: 30394158 [PubMed - in process]



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