Kuk Francis, Jackson Amy, Keenan Denise, Lau Chi-Chuen
Widex Hearing Aid Company, Office of Research in Clinical Amplification, Lisle, IL 60532, USA.
J Am Acad Audiol. 2008 Jun;19(6):465-80. doi: 10.3766/jaaa.19.6.3.
Children with auditory processing disorders (APD) are described to have a signal-to-noise ratio (SNR) difficulty. Frequency-modulated (FM) systems have been reported to improve this situation. Yet the use of personal amplification that may be more portable has not been attempted.
To determine whether personal amplification would result in improvement in speech-in-noise performances (attentiveness and speech recognition) and daily functioning in children with diagnosed APD. In addition, the desired hearing aid features (such as required gain, directional microphone and noise reduction, and open-ear fitting) are examined.
A single-blind, longitudinal descriptive study in which subjects served as their own control in various hearing aid conditions.
Fourteen normal hearing children who had a diagnosis of APD and who were between the ages of 7 and 11 participated.
All subjects wore bilateral, mild-gain, behind-the-ear, wide dynamic range compression hearing aids fitted in an open-ear mode. Gain on the hearing aids was adjusted to provide approximately 10 dB of insertion gain for conversational input. Directional microphone and noise reduction were used on the hearing aids. Subjects wore the hearing aids home and were encouraged to use them as much as possible in their daily environments (school, home, and social activities). Subjects were seen four times: an initial visit where hearing aids were fitted, then visits at 2 weeks, 3 months, and 6 months after the initial fitting. The majority of the testing was completed during these final three visits.
The children were evaluated on the Northwestern University word-list (NU-6) and the Auditory Continuous Performance Test (ACPT) in noise at most visits. The hearing aids were evaluated in the omnidirectional microphone mode only, omnidirectional microphone with noise reduction (NR) mode, and directional microphone with NR mode. The children's parents and teachers were asked to complete the Children's Auditory Processing Performance Scale (CHAPS) questionnaire both before and at the end of the study.
The results showed that the use of hearing aids in the omnidirectional microphone mode alone did not improve speech identification in noise over the unaided condition. However, the inclusion of the NR algorithm and directional microphones improved speech understanding in noise. Amplification reduced the number of errors on the ACPT and improved several areas on the CHAPS; however, the results were not statistically significant.
The use of mild-gain, open-ear fitting hearing aids with a directional microphone and noise reduction algorithm may be attempted on some children with APD on a trial basis.
有听觉处理障碍（APD）的儿童被认为存在信噪比（SNR）方面的困难。据报道，调频（FM）系统可改善这种情况。然而，尚未尝试使用可能更便于携带的个人扩音设备。
确定个人扩音设备是否能改善已确诊患有APD的儿童在噪声环境中的言语表现（注意力和言语识别）及日常功能。此外，还对所需的助听器特性（如所需增益、方向性麦克风和降噪功能以及开放式耳模）进行了研究。
一项单盲纵向描述性研究，在不同的助听器条件下，受试者以自身作为对照。
14名年龄在7至11岁之间、已确诊患有APD的听力正常儿童参与了研究。
所有受试者均佩戴双侧、轻度增益、耳背式、宽动态范围压缩的助听器，采用开放式耳模佩戴方式。对助听器的增益进行调整，以便为对话输入提供约10 dB的插入增益。助听器使用了方向性麦克风和降噪功能。受试者将助听器带回家，并被鼓励在日常环境（学校、家庭和社交活动）中尽可能多地使用。受试者共接受4次检查：初次就诊时佩戴助听器，然后在初次佩戴后的2周、3个月和6个月进行复诊。大部分测试在这最后三次复诊时完成。
大多数就诊时，使用西北大学单词表（NU - 6）和噪声环境下的听觉连续性能测试（ACPT）对儿童进行评估。仅在全向麦克风模式、带降噪（NR）功能的全向麦克风模式以及带NR功能的方向性麦克风模式下对助听器进行评估。在研究开始前和结束时，要求儿童的家长和教师完成儿童听觉处理性能量表（CHAPS）问卷。
结果表明，仅使用全向麦克风模式的助听器并不能比未佩戴助听器时改善噪声环境下的言语识别能力。然而，加入NR算法和方向性麦克风可改善噪声环境下的言语理解能力。放大功能减少了ACPT中的错误数量，并改善了CHAPS中的几个方面；然而，结果无统计学意义。
对于一些患有APD的儿童，可尝试在试验基础上使用带有方向性麦克风和降噪算法的轻度增益、开放式耳模助听器。
