Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, the Netherlands.
Audiological Centre Rotterdam of the Royal Auris Group, the Netherlands.
Ear Hear. 2021 July/Aug;42(4):973-981. doi: 10.1097/AUD.0000000000000989.
Speech perception in noise is an important aspect of the rehabilitation of children with hearing loss. We aimed to evaluate the feasibility and reliability of the Dutch digits-in-noise (DIN) test in the clinical follow-up of children with hearing aids (HAs) and/or cochlear implants (CIs). A second aim of the study was to gain insight in the speech perception in noise performance of children with different degrees of hearing loss.
We retrospectively analyzed DIN test data of Dutch-speaking children with hearing loss (N = 188; 5 to 18 years old). A free-field version of the DIN-test was used. Children with open-set phoneme recognition in quiet of >70% at 65 dB SPL (best aided condition) were included. Ages ranged from 5 to 18 years old. All were experienced HA or CI users and had used their device(s) for at least 1 year before the measurement in the study. The DIN-test was performed in the framework of a clinical rehabilitation program. During testing, children wore their own devices with normal daily programs.
The average speech reception threshold (SRT) was -3.6 dB (SD 3.6) for the first list and significantly improved to -4.0 dB (SD 3.1) for the second list. HA users had a 4-dB better SRT compared with CI users. The larger the child's hearing loss, the worse the SRT is. However, 15% of the children who completed a first list of 24 trials were unable to complete a second list. Mean adaptive staircase trajectories across trials suggested that learning occurred throughout the first list, and that loss of sustained attention contributed to response variability during the second list.
The DIN test can be used to assess speech perception in noise abilities for children with different degrees of hearing loss and using HAs or CIs. The children with hearing loss required a higher signal-to-noise ratio (SNR) than did normal-hearing children and the required SNR is larger as the hearing loss increases. However, the current measurement procedure should be optimized for use in standard pediatric audiological care, as 15% of the children were unable to conduct a second list after the first list to reach a more stable SNR.
在噪声环境下的言语感知能力是听障儿童康复的一个重要方面。本研究旨在评估荷兰数字在噪声中测试（DIN）在助听器（HA）和/或人工耳蜗（CI）佩戴儿童临床随访中的可行性和可靠性。本研究的第二个目的是深入了解不同听力损失程度儿童的噪声下言语感知能力。
我们回顾性分析了荷兰语听障儿童（N=188；5 至 18 岁）的 DIN 测试数据。使用自由场版本的 DIN 测试。在 65dB SPL（最佳助听条件）下，具有>70%开放式语音识别能力的儿童被纳入研究。年龄范围为 5 至 18 岁。所有儿童均为经验丰富的 HA 或 CI 用户，且在研究中的测量前已使用其设备至少 1 年。DIN 测试是在临床康复计划的框架内进行的。在测试过程中，儿童戴着自己的设备，并按照日常程序进行。
第一个列表的平均言语接受阈（SRT）为-3.6dB（SD 3.6），第二个列表的 SRT 显著提高至-4.0dB（SD 3.1）。与 CI 用户相比，HA 用户的 SRT 要好 4dB。儿童的听力损失越大，SRT 越差。然而，在完成了 24 个测试的第一个列表的 15%的儿童无法完成第二个列表。整个第一个列表中都存在学习过程，第二个列表中，注意力持续度的丧失导致了反应的可变性。
DIN 测试可用于评估使用 HA 或 CI 的不同听力损失程度儿童的噪声下言语感知能力。与正常听力儿童相比，听力损失儿童需要更高的信噪比（SNR），且 SNR 随着听力损失的增加而增大。然而，目前的测量程序应针对标准儿科听力学护理进行优化，因为 15%的儿童在完成第一个列表后无法进行第二个列表，以达到更稳定的 SNR。
