Department of Otolaryngology, National Cheng Kung University Hospital, National Cheng Kung University Medical College, Tainan, Taiwan.
Clin Exp Otorhinolaryngol. 2012 Apr;5 Suppl 1(Suppl 1):S73-5. doi: 10.3342/ceo.2012.5.S1.S73. Epub 2012 Apr 30.
In order to understand the communicative abilities of hearing impaired children in noisy situations and their communication problems, this study was undertaken to examine speech recognition at different background noise levels, and to compare how context cues in noisy situations affect speech recognition.
Thirty-four children with severe/profound hearing impairment were enrolled. Fifteen children had cochlear implants (CIs) and 19 used hearing aids (HAs). The Mandarin Speech Perception in Noise (SPIN) test was performed under two levels of background noise, signal-to-noise ratio (SNR) 10 dB and SNR 0 dB (high and low levels, respectively). High predictive (HP) and low predictive (LP) sentences SPIN test scores were recorded to test the effect of context cues on speech recognition.
Performance was significantly better in children with CIs (SNR 10: mean, 49.44, standard deviation [SD], 13.90; SNR 0: mean, 31.95, SD, 15.72) than in children with HAs (SNR 10: mean, 33.33, SD, 9.72; SNR 0: mean, 19.52, SD, 6.67; P<0.05) in both noise backgrounds, but no significant interaction was found between devices and background noise level. Hearing-impaired children performed better at SNR 10 dB (mean, 40.44; SD, 14.12) than at SNR 0 dB (mean, 25.0; SD, 12.98), significantly (P<0.001). Performance for HP sentences (mean, 38.6; SD, 12.66) was significantly (P<0.001) better than that for LP sentences (mean, 25.25; SD, 12.93). An interaction was found to between background noise level and contextual cues in sentences (F=8.47, P<0.01).
The study shows that SNR conditions significantly influence speech recognition performance in children with severe/profound hearing impairment. Under better SNR listening situations, children have better speech recognition when listening to sentences with contextual cues. Children with CIs perform better than children with HAs at both noise levels.
为了了解听障儿童在噪声环境中的交流能力和他们的交流问题，本研究旨在检查不同背景噪声水平下的言语识别能力，并比较在噪声环境中语境线索如何影响言语识别。
共纳入 34 名重度/极重度听力障碍儿童。15 名儿童使用人工耳蜗（CI），19 名儿童使用助听器（HA）。在两种背景噪声水平下（信噪比 SNR 10dB 和 SNR 0dB，分别为高和低水平）进行普通话语音感知在噪声中（SPIN）测试。记录高预测（HP）和低预测（LP）句子 SPIN 测试分数，以测试语境线索对言语识别的影响。
在两种噪声背景下，CI 组儿童（SNR 10：均值 49.44，标准差[SD] 13.90；SNR 0：均值 31.95，SD 15.72）的表现明显优于 HA 组儿童（SNR 10：均值 33.33，SD 9.72；SNR 0：均值 19.52，SD 6.67；P<0.05），但设备和背景噪声水平之间无显著交互作用。听力障碍儿童在 SNR 10dB（均值 40.44，SD 14.12）时的表现优于 SNR 0dB（均值 25.0，SD 12.98），差异有统计学意义（P<0.001）。HP 句子（均值 38.6，SD 12.66）的表现明显优于 LP 句子（均值 25.25，SD 12.93），差异有统计学意义（P<0.001）。背景噪声水平和句子语境线索之间存在交互作用（F=8.47，P<0.01）。
研究表明，信噪比条件显著影响重度/极重度听力障碍儿童的言语识别表现。在更好的 SNR 听力环境下，儿童在聆听带有语境线索的句子时，言语识别能力更好。在两种噪声水平下，CI 组儿童的表现均优于 HA 组儿童。
