Lotfi Yones, Ahmadi Tayebeh, Moossavi Abdollah, Bakhshi Enayatollah
Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Auris Nasus Larynx. 2019 Feb;46(1):64-69. doi: 10.1016/j.anl.2018.06.005. Epub 2018 Jun 25.
Previous studies have shown that a subgroup of children with suspected (central) auditory processing disorder (SusCAPD) have insufficient ability to use binaural cues to benefit from spatial processing. Thus, they experience considerable listening difficulties in challenging auditory environments, such as classrooms. Some researchers have also indicated the probable role of binaural temporal fine structure (TFS) in the perceptual segregation of target signal from noise and hence in speech perception in noise. Therefore, in the present study, in order to further investigate the underlying reason for listening problems against background noise in this group of children, their performance was measured using binaural TFS sensitivity test (TFS-LF) as well as behavioral auditory lateralization in noise test, both of which are based on binaural temporal cues processing.
Participants in this analytical study included 91 children with normal hearing and no listening problems and 41 children (9-12 years old) with SusCAPD who found it challenging to understand speech in noise. Initially, the ability to use binaural TFS was measured at three frequencies (250, 500 and 750Hz) in both the groups, and the results of preliminary evaluations were compared between normal children and those with SusCAPD who participated in the study. Thereafter, the binaural performance of the 16 children with SusCAPD who had higher thresholds than the normal group at all three frequencies tested in TFS-LF test was examined using the lateralization test in 7 spatial locations.
Total 16 of the 41 children with SusCAPD who participated in this study (39%) showed poor performance on the TFS-LF test at all three frequencies, compared to both normal children and other children in the APD group (p<0.05). Furthermore, children in the APD group with binaural TFS coding deficits at all three frequencies revealed significant differences in the lateralization test results compared to normal children (p<0.05).
Findings of the current study demonstrated that one of the underlying causes for the difficulty understanding speech in noisy environments experienced by a subgroup of children with SusCAPD can be the reduced ability to benefit from binaural TFS information. This study also showed that a reduced ability to use binaural TFS cues in the group of children with SusCAPD was accompanied by reduced binaural processing abilities in the lateralization test which also admit the presence of binaural temporal processing deficits in this group of children.
先前的研究表明，一部分疑似（中枢）听觉处理障碍（SusCAPD）的儿童利用双耳线索从空间处理中获益的能力不足。因此，他们在具有挑战性的听觉环境（如教室）中会遇到相当大的听力困难。一些研究人员还指出了双耳时间精细结构（TFS）在从噪声中感知分离目标信号进而在噪声中语音感知方面可能发挥的作用。因此，在本研究中，为了进一步探究这组儿童在背景噪声下听力问题的潜在原因，使用基于双耳时间线索处理的双耳TFS敏感性测试（TFS-LF）以及噪声中的行为听觉定位测试来测量他们的表现。
这项分析研究的参与者包括91名听力正常且无听力问题的儿童以及41名（9至12岁）SusCAPD儿童，这些SusCAPD儿童发现在噪声中理解语音具有挑战性。最初，在两个组中于三个频率（250、500和750Hz）测量使用双耳TFS的能力，并比较正常儿童与参与研究的SusCAPD儿童的初步评估结果。此后，对16名在TFS-LF测试中所有三个测试频率阈值均高于正常组的SusCAPD儿童，在7个空间位置使用定位测试检查其双耳表现。
参与本研究的41名SusCAPD儿童中，共有16名（39%）在所有三个频率的TFS-LF测试中表现不佳，与正常儿童以及APD组中的其他儿童相比（p<0.05）。此外，在所有三个频率均存在双耳TFS编码缺陷的APD组儿童，与正常儿童相比，在定位测试结果上存在显著差异（p<0.05）。
本研究结果表明，一部分SusCAPD儿童在嘈杂环境中理解语音困难的潜在原因之一可能是从双耳TFS信息中获益的能力下降。本研究还表明，SusCAPD儿童组中使用双耳TFS线索的能力下降伴随着定位测试中双耳处理能力的下降，这也证实了该组儿童存在双耳时间处理缺陷。
