Wolfe Jace, Duke Mila, Schafer Erin, Jones Christine, Rakita Lori
Hearts for Hearing Foundation, Oklahoma City, OK.
Department of Audiology & Speech-Language Pathology, University of North Texas, Denton, TX.
J Am Acad Audiol. 2017 May;28(5):415-435. doi: 10.3766/jaaa.16015.
Children with hearing loss experience significant difficulty understanding speech in noisy and reverberant situations. Adaptive noise management technologies, such as fully adaptive directional microphones and digital noise reduction, have the potential to improve communication in noise for children with hearing aids. However, there are no published studies evaluating the potential benefits children receive from the use of adaptive noise management technologies in simulated real-world environments as well as in daily situations.
The objective of this study was to compare speech recognition, speech intelligibility ratings (SIRs), and sound preferences of children using hearing aids equipped with and without adaptive noise management technologies.
A single-group, repeated measures design was used to evaluate performance differences obtained in four simulated environments. In each simulated environment, participants were tested in a basic listening program with minimal noise management features, a manual program designed for that scene, and the hearing instruments' adaptive operating system that steered hearing instrument parameterization based on the characteristics of the environment.
Twelve children with mild to moderately severe sensorineural hearing loss.
Speech recognition and SIRs were evaluated in three hearing aid programs with and without noise management technologies across two different test sessions and various listening environments. Also, the participants' perceptual hearing performance in daily real-world listening situations with two of the hearing aid programs was evaluated during a four- to six-week field trial that took place between the two laboratory sessions.
On average, the use of adaptive noise management technology improved sentence recognition in noise for speech presented in front of the participant but resulted in a decrement in performance for signals arriving from behind when the participant was facing forward. However, the improvement with adaptive noise management exceeded the decrement obtained when the signal arrived from behind. Most participants reported better subjective SIRs when using adaptive noise management technologies, particularly when the signal of interest arrived from in front of the listener. In addition, most participants reported a preference for the technology with an automatically switching, adaptive directional microphone and adaptive noise reduction in real-world listening situations when compared to conventional, omnidirectional microphone use with minimal noise reduction processing.
Use of the adaptive noise management technologies evaluated in this study improves school-age children's speech recognition in noise for signals arriving from the front. Although a small decrement in speech recognition in noise was observed for signals arriving from behind the listener, most participants reported a preference for use of noise management technology both when the signal arrived from in front and from behind the child. The results of this study suggest that adaptive noise management technologies should be considered for use with school-age children when listening in academic and social situations.
听力损失儿童在嘈杂和混响环境中理解言语存在显著困难。自适应噪声管理技术，如全自适应方向性麦克风和数字降噪技术，有可能改善佩戴助听器儿童在噪声环境中的交流。然而，尚无已发表的研究评估儿童在模拟真实世界环境以及日常情况下使用自适应噪声管理技术所获得的潜在益处。
本研究的目的是比较使用配备和未配备自适应噪声管理技术的助听器的儿童的言语识别、言语可懂度评分（SIR）和声音偏好。
采用单组重复测量设计来评估在四种模拟环境中获得的性能差异。在每个模拟环境中，参与者在具有最小噪声管理功能的基本听力程序、为该场景设计的手动程序以及基于环境特征引导助听器参数设置的助听器自适应操作系统中进行测试。
12名轻度至中度重度感音神经性听力损失儿童。
在两个不同的测试时段以及各种聆听环境中，对配备和未配备噪声管理技术的三种助听器程序进行言语识别和SIR评估。此外，在两次实验室测试之间进行的为期四至六周的现场试验中，评估了参与者在日常真实聆听情况下使用其中两种助听器程序时的感知听力表现。
平均而言，使用自适应噪声管理技术可提高参与者前方呈现言语在噪声中的句子识别能力，但当参与者面向前方时，来自后方的信号性能会下降。然而，自适应噪声管理带来的改善超过了信号从后方传来时的性能下降。大多数参与者报告称，使用自适应噪声管理技术时主观SIR更好，尤其是当感兴趣的信号从听众前方传来时。此外，与使用具有最小降噪处理的传统全向麦克风相比，大多数参与者报告在真实世界聆听情况下更喜欢具有自动切换的自适应方向性麦克风和自适应降噪功能的技术。
本研究中评估的自适应噪声管理技术的使用提高了学龄儿童对前方传来信号在噪声中的言语识别能力。尽管观察到听众后方传来的信号在噪声中的言语识别略有下降，但大多数参与者报告称，当信号从儿童前方和后方传来时，都更喜欢使用噪声管理技术。本研究结果表明，在学术和社交场合聆听时，应考虑为学龄儿童使用自适应噪声管理技术。
