Ng Stella L, Meston Christine N, Scollie Susan D, Seewald Richard C
School of Communication Sciences and Disorders, and the National Centre for Audiology, University of Western Ontario, London, Ontario.
J Am Acad Audiol. 2011 Jun;22(6):375-86. doi: 10.3766/jaaa.22.6.6.
There is a need for objective pediatric hearing aid outcome measurement and thus a need for the evaluation of outcome measures. We explored a commercially available pediatric sentence-in-noise measure adapted for use as an aided outcome measure.
The purposes of the current study were (1) to administer an adapted BKB-SIN (Bamford-Kowal-Bench Speech-in-Noise test) to adults and children who have normal hearing and children who use hearing aids and (2) to evaluate the utility of this adapted BKB-SIN as an aided, within-subjects outcome measure for amplification strategies.
We used a mixed within and between groups design to evaluate speech recognition in noise for the three groups of participants. The children who use hearing aids were tested under the omnidirectional, directional, and digital noise reduction (DNR) conditions. Results from each group were compared to each other, and we compared results of each aided condition for the children who use hearing aids to evaluate the test utility as an aided outcome measure.
The study sample consisted of 14 adults with normal hearing (aged 22-28 yr) and 15 children with normal hearing (aged 6-18 yr), recruited through word of mouth, and 14 children who use hearing aids (aged 9-16 yr) recruited from local audiology clinics.
List pairs of the BKB-SIN test were presented at 50 dB HL as follows: four list pairs to each participant with normal hearing, four list pairs in the omnidirectional condition, and two list pairs in the directional and DNR conditions. Children who use hearing aids were fitted bilaterally with laboratory devices and completed the BKB-SIN test aided. Data were plotted as mean percent of key words correct at each signal-to-noise ratio (SNR). Further, we conducted an analysis of variance for group differences and within-groups for the three aided conditions.
Adult participants outperformed children with normal hearing, who outperformed the children who use hearing aids. SNR-50 (signal-to-noise ratio at which listener can obtain a speech recognition score of 50% correct) scores demonstrated reliability of the adapted test implementation. The BKB-SIN test measured significant differences in performance for omnidirectional versus directional microphone conditions but not between omnidirectional and DNR conditions.
We conclude that the adapted implementation of the BKB-SIN test can be administered reliably and feasibly. Further study is warranted to develop norms for the adapted implementation as well as to determine if an adapted implementation can be sensitive to age effects. Until such norms are developed, clinicians should refrain from comparing results from the adapted test to the test manual norms and should instead use the adapted implementation as a within-subject measure.
需要客观的小儿助听器效果测量方法，因此需要对测量方法进行评估。我们探索了一种适用于辅助效果测量的市售小儿噪声环境下语句测试方法。
本研究的目的是：（1）对听力正常的成人和儿童以及使用助听器的儿童进行适应性的BKB-SIN（班福德-科瓦尔-本奇噪声环境下言语测试）；（2）评估这种适应性的BKB-SIN作为放大策略的辅助、受试者内效果测量方法的效用。
我们采用组内和组间混合设计来评估三组参与者在噪声中的言语识别能力。使用助听器的儿童在全向、定向和数字降噪（DNR）条件下进行测试。将每组的结果相互比较，并将使用助听器的儿童在每种辅助条件下的结果进行比较，以评估该测试作为辅助效果测量方法的效用。
研究样本包括通过口碑招募的14名听力正常的成年人（年龄22 - 28岁）和15名听力正常的儿童（年龄6 - 18岁），以及从当地听力学诊所招募的14名使用助听器的儿童（年龄9 - 16岁）。
BKB-SIN测试的列表对以50 dB HL呈现如下：给每个听力正常的参与者呈现四对列表，在全向条件下呈现四对列表，在定向和DNR条件下呈现两对列表。使用助听器的儿童双侧佩戴实验室设备并在佩戴助听器的情况下完成BKB-SIN测试。数据绘制为每个信噪比（SNR）下正确关键词的平均百分比。此外，我们对三组之间的差异以及三种辅助条件下的组内差异进行了方差分析。
成年参与者的表现优于听力正常的儿童，听力正常的儿童表现优于使用助听器的儿童。SNR-50（听众能够获得50%正确言语识别分数时的信噪比）得分证明了适应性测试实施的可靠性。BKB-SIN测试测量出全向与定向麦克风条件下表现存在显著差异，但全向与DNR条件之间没有差异。
我们得出结论，BKB-SIN测试的适应性实施可以可靠且可行地进行。有必要进一步研究以制定适应性实施的规范，并确定适应性实施是否对年龄效应敏感。在制定此类规范之前，临床医生应避免将适应性测试的结果与测试手册规范进行比较，而应将适应性实施作为受试者内测量方法使用。
