Speech pattern audiometry in hearing impaired children.

The aim of this study was to investigate the use of speech pattern audiometry (SPA) in assessing speech perception abilities of a group of 25 children with sensorineural hearing loss, and to compare their aided performance on SPA tests of four different phoneme contrasts with scores achieved on recorded Manchester Junior Word Lists (MJWL) at their most comfortable listening level (MCLL). The listeners were 25 children, 19 with congenital and six with acquired hearing loss aged between eight and 14 years. They were classified into three groups according to the severity of the hearing loss in the better hearing ear (20-60 dB HL, 61-80 dB HL and >81 dB HL). The SPA tests evaluated listeners' ability to identify word-initial plosives differing in the phonetic features of voicing and place of articulation. The main outcome measures were the SPA gradient measures, the SPA labelling function configuration and MJWL scores. The group with the most severe hearing loss (>81 dB HL) showed significantly poorer performance on the SPA tests and MJWL tests than the groups with mild (20-60 dB HL) to moderate (61-80 dB HL) hearing losses. There was significantly better performance on the two plosive voicing contrast tests than the two plosive place contrasts. For the MJWL, the performance of the group with the more severe hearing loss was also significantly different from the mild and moderate hearing loss groups. A MJWL score of up to 75% was associated with the random labelling configuration on all four SPA tests, emphasizing the different aspects of speech perception that were being examined with each type of test. This study suggests that there is a place for SPA as part of the test battery for speech perception testing in hearing-impaired children.