Department of Otolaryngology-Head and Neck Surgery, Section Ear and Hearing, VU University Medical Center, Amsterdam, The Netherlands.
NSDSK, Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, The Netherlands.
Ear Hear. 2018 Nov/Dec;39(6):1091-1103. doi: 10.1097/AUD.0000000000000569.
The main purpose of this study was to examine developmental effects for speech recognition in noise abilities for normal-hearing children in several listening conditions, relevant for daily life. Our aim was to study the auditory component in these listening abilities by using a test that was designed to minimize the dependency on nonauditory factors, the digits-in-noise (DIN) test. Secondary aims were to examine the feasibility of the DIN test for children, and to establish age-dependent normative data for diotic and dichotic listening conditions in both stationary and interrupted noise.
In experiment 1, a newly designed pediatric DIN (pDIN) test was compared with the standard DIN test. Major differences with the DIN test are that the pDIN test uses 79% correct instead of 50% correct as a target point, single digits (except 0) instead of triplets, and animations in the test procedure. In this experiment, 43 normal-hearing subjects between 4 and 12 years of age and 10 adult subjects participated. The authors measured the monaural speech reception threshold for both DIN test and pDIN test using headphones. Experiment 2 used the standard DIN test to measure speech reception thresholds in noise in 112 normal-hearing children between 4 and 12 years of age and 33 adults. The DIN test was applied using headphones in stationary and interrupted noise, and in diotic and dichotic conditions, to study also binaural unmasking and the benefit of listening in the gaps.
Most children could reliably do both pDIN test and DIN test, and measurement errors for the pDIN test were comparable between children and adults. There was no significant difference between the score for the pDIN test and that of the DIN test. Speech recognition scores increase with age for all conditions tested, and performance is adult-like by 10 to 12 years of age in stationary noise but not interrupted noise. The youngest, 4-year-old children have speech reception thresholds 3 to 7 dB less favorable than adults, depending on test conditions. The authors found significant age effects on binaural unmasking and fluctuating masker benefit, even after correction for the lower baseline speech reception threshold of adults in stationary noise.
Speech recognition in noise abilities develop well into adolescence, and young children need a more favorable signal-to-noise ratio than adults for all listening conditions. Speech recognition abilities in children in stationary and interrupted noise can accurately and reliably be tested using the DIN test. A pediatric version of the test was shown to be unnecessary. Normative data were established for the DIN test in stationary and fluctuating maskers, and in diotic and dichotic conditions. The DIN test can thus be used to test speech recognition abilities for normal-hearing children from the age of 4 years and older.
本研究的主要目的是在几种与日常生活相关的听力条件下,研究正常听力儿童的噪声言语识别能力的发育效应。我们的目的是通过使用旨在最小化非听觉因素依赖性的测试来研究这些听力能力中的听觉成分,即数字噪声测试(DIN 测试)。次要目的是研究 DIN 测试对儿童的可行性,并为在稳定和中断噪声中的单耳和双耳聆听条件建立年龄相关的正常数据。
在实验 1 中,将新设计的儿科 DIN(pDIN)测试与标准 DIN 测试进行了比较。与 DIN 测试的主要区别在于,pDIN 测试使用 79%正确而非 50%正确作为目标点,使用单个数字(0 除外)而非三胞胎,并且在测试过程中使用动画。在此实验中,43 名 4 至 12 岁的正常听力受试者和 10 名成年受试者参加了实验。作者使用耳机测量了 DIN 测试和 pDIN 测试的单耳言语接收阈值。实验 2 使用标准 DIN 测试测量了 112 名 4 至 12 岁的正常听力儿童和 33 名成年受试者在噪声中的言语接收阈值。DIN 测试使用耳机在稳定和中断噪声中,以及在单耳和双耳条件下进行,以研究双耳掩蔽和解掩蔽间隙的益处。
大多数儿童都可以可靠地完成 pDIN 测试和 DIN 测试,并且儿童和成人之间的 pDIN 测试测量误差相当。pDIN 测试的分数与 DIN 测试的分数没有显著差异。所有测试条件下的言语识别得分均随年龄增长而提高,10 至 12 岁时在稳定噪声中表现出与成人相似的水平,但在中断噪声中则不然。年龄最小的 4 岁儿童的言语接收阈值比成人低 3 至 7dB,具体取决于测试条件。即使在稳定噪声中校正了成人较低的基线言语接收阈值,作者仍发现双耳掩蔽和解掩蔽间隙的益处存在显著的年龄效应。
噪声言语识别能力在青春期后发育良好,儿童在所有听力条件下都需要比成人更有利的信噪比。DIN 测试可准确可靠地测试儿童在稳定和中断噪声中的言语识别能力。不需要儿科版本的测试。建立了 DIN 测试在稳定和波动掩蔽器以及单耳和双耳条件下的正常数据。因此,DIN 测试可用于测试 4 岁及以上正常听力儿童的言语识别能力。