Nakeva von Mentzer Cecilia
Dept Neuroscience, Unit for SLP, Uppsala University, 751 23, Uppsala, Sweden.
Int J Pediatr Otorhinolaryngol. 2020 Jun;133:109981. doi: 10.1016/j.ijporl.2020.109981. Epub 2020 Mar 4.
The long-term objective of this research is to highlight the importance of speech perception assessment in children with developmental language disorder (DLD), and to investigate how hearing contributes to speech and language skills. As a first step in fulfilling this aim, the present study explored relations between phonemic discrimination and reproduction, and sensitive measures of hearing in young healthy children.
The American Listen-Say test was developed and served as speech perception tool. This test reports speech discrimination of phonemic contrasts quantitatively for both quiet and in noise conditions, along with reproduction scores, all measured within one session. Speech tokens were perceptually homogenized in noise. Forty-one 4-5-year-old American children participated. Phonemic discrimination (quiet and speech shaped noise) and phonemic reproduction, audiometric thresholds in the conventional (1-8 kHz) and extended high frequency (EHF; 10-16 kHz) range, and distortion product otoacoustic emissions (DPOAEs) were examined.
All children had normal hearing thresholds within the conventional range (mean PTA bilaterally 8.6 dB HL). Ten (24.3%) of the children had elevated EHF thresholds (> 20 dB HL) for one or more frequencies or ears, and six (14.6%) had DPOAE signal to noise ratios (SNR) < 6 dB. EHF thresholds and DPOAE SNRs were significantly associated. Children's phonemic discrimination was impaired in noise, relative to quiet. There was a moderate, significant correlation between overall phonemic discrimination in noise and EHF audiometric thresholds.
Overall, the present study showed that sensitive hearing measures enabled the detection of subtle hearing difficulties in young healthy children. In particular, phonemic discrimination in noise showed associations with hearing. Implications of including sensitive hearing measures in children with DLD are discussed.
本研究的长期目标是强调言语感知评估在发育性语言障碍（DLD）儿童中的重要性，并研究听力如何影响言语和语言技能。作为实现这一目标的第一步，本研究探讨了健康幼儿的音素辨别与再现以及听力敏感指标之间的关系。
开发了美国听说法测试并将其用作言语感知工具。该测试在一次测试中对安静和噪声环境下的音素对比言语辨别进行定量报告，并给出再现分数。言语样本在噪声中进行了感知同质化处理。41名4至5岁的美国儿童参与了研究。检测了音素辨别（安静和言语塑造噪声环境下）、音素再现、常规（1 - 8kHz）和扩展高频（EHF；10 - 16kHz）范围内的听力阈值以及畸变产物耳声发射（DPOAE）。
所有儿童在常规范围内听力阈值均正常（双侧平均纯音听阈8.6dB HL）。10名（24.3%）儿童在一个或多个频率或耳朵的EHF阈值升高（>20dB HL），6名（14.6%）儿童的DPOAE信噪比（SNR）<6dB。EHF阈值和DPOAE SNR显著相关。与安静环境相比，儿童在噪声中的音素辨别受损。噪声中总体音素辨别与EHF听力阈值之间存在中度显著相关性。
总体而言，本研究表明敏感的听力检测方法能够检测出健康幼儿中细微的听力问题。特别是，噪声中的音素辨别与听力有关。讨论了在DLD儿童中纳入敏感听力检测方法的意义。
