Department of Paediatric Audiology, Chear, Shepreth, Royston, Herts, United Kingdom.
Ear Hear. 2018 Jan/Feb;39(1):20-31. doi: 10.1097/AUD.0000000000000460.
To assess whether there are significant differences between speech scores for different hearing aid prescription methods, specifically DSL i/o, DSL V, and NAL-NL1, using age-appropriate closed- and open-set speech tests with young children, designed to avoid floor and ceiling effects.
Participants were 44 children with moderate or severe bilateral hearing loss, 8 aged 2 to 3 years, 15 aged 4 to 5 years, and 21 aged 6 to 9 years. Children wore bilateral hearing aids fitted with each prescription method in turn in a balanced double-blind design. The speech tests used with each child (and for some tests the levels) were chosen so as to avoid floor and ceiling effects. For the closed-set tests, the level used was selected for each child based on their hearing loss. The tests used were: (1) The closed-set Consonant Confusion Test of word identification; (2) The closed-set Chear Auditory Perception Test (CAPT) of word identification. This has separate sections assessing discrimination of consonants and vowels and detection of consonants; (3) The open-set Cambridge Auditory Word Lists for testing word identification at levels of 50 and 65 dBA, utilizing 10 consonant-vowel-consonant real words that are likely to be familiar to children aged 3 years or older; (4) The open-set Common Phrases Test to measure the speech reception threshold in quiet; (5) Measurement of the levels required for identification of the Ling 5 sounds, using a recording of the sounds made at the University of Western Ontario.
Scores for the Consonant Confusion Test and CAPT consonant discrimination and consonant detection were lower for the NAL-NL1 prescription than for the DSL prescriptions. Scores for the CAPT vowel-in-noise discrimination test were higher for DSL V than for either of the other prescriptions. Scores for the Cambridge Auditory Word Lists did not differ across prescriptions for the level of 65 dBA, but were lower for the NAL-NL1 prescription than for either of the DSL prescriptions for the level of 50 dBA. The speech reception threshold measured using the Common Phrases Test and the levels required for identification of the Ling 5 sounds were higher (worse) for the NAL-NL1 prescription than for the DSL prescriptions.
The higher gains prescribed by the DSL i/o and DSL V prescription methods relative to NAL-NL1 led to significantly better detection and discrimination of low-level speech sounds.
使用适合年龄的闭合和开放式语音测试，评估不同助听器验配方法（特别是 DSL i/o、DSL V 和 NAL-NL1）之间的语音得分是否存在显著差异，这些测试专为避免地板效应和天花板效应而设计。
参与者为 44 名患有中度或重度双侧听力损失的儿童，其中 8 名年龄在 2 至 3 岁之间，15 名年龄在 4 至 5 岁之间，21 名年龄在 6 至 9 岁之间。儿童在双侧助听器中轮流佩戴每种处方方法，采用平衡双盲设计。为每个孩子选择（并且对于某些测试，还选择了级别）使用的语音测试，以避免地板效应和天花板效应。对于闭合测试，根据孩子的听力损失选择每个孩子的使用级别。使用的测试是：（1）闭合测试词识别的辅音混淆测试；（2）闭合测试的 Chear 听觉感知测试（CAPT）的词识别。该测试有单独的部分，用于评估辅音和元音的辨别以及辅音的检测；（3）开放式测试剑桥听觉词列表，用于在 50 和 65 dBA 的水平上测试词识别，使用 10 个可能为 3 岁或以上儿童所熟悉的辅音-元音-辅音的真实单词；（4）开放式测试安静环境下的常用短语测试，以测量语音接收阈值；（5）使用安大略西部大学录制的声音，测量识别 Ling 5 声音所需的水平。
与 DSL 处方相比，NAL-NL1 处方的辅音混淆测试和 CAPT 辅音辨别和辅音检测得分较低。与其他两种处方相比，DSL V 处方的 CAPT 元音噪声辨别测试得分较高。对于 65 dBA 的水平，剑桥听觉词列表的分数在处方之间没有差异，但对于 50 dBA 的水平，NAL-NL1 处方的分数低于任何一种 DSL 处方。使用常用短语测试测量的语音接收阈值和识别 Ling 5 声音所需的水平，NAL-NL1 处方的得分（更差）高于 DSL 处方。
与 NAL-NL1 处方相比，DSL i/o 和 DSL V 处方方法规定的增益更高，导致对低水平语音的检测和辨别能力显著提高。
