van Wieringen Astrid, Magits Sara, Francart Tom, Wouters Jan
Experimental ORL, Department of Neurosciences, KU Leuven, Leuven, Belgium.
Front Neurosci. 2021 Nov 30;15:773427. doi: 10.3389/fnins.2021.773427. eCollection 2021.
Speech-perception testing is essential for monitoring outcomes with a hearing aid or cochlear implant (CI). However, clinical care is time-consuming and often challenging with an increasing number of clients. A potential approach to alleviating some clinical care and possibly making room for other outcome measures is to employ technologies that assess performance in the home environment. In this study, we investigate 3 different speech perception indices in the same 40 CI users: phoneme identification (vowels and consonants), digits in noise (DiN) and sentence recognition in noise (SiN). The first two tasks were implemented on a tablet and performed multiple times by each client in their home environment, while the sentence task was administered at the clinic. Speech perception outcomes in the same forty CI users showed that DiN assessed at home can serve as an alternative to SiN assessed at the clinic. DiN scores are in line with the SiN ones by 3-4 dB improvement and are useful to monitor performance at regular intervals and to detect changes in auditory performance. Phoneme identification in quiet also explains a significant part of speech perception in noise, and provides additional information on the detectability and discriminability of speech cues. The added benefit of the phoneme identification task, which also proved to be easy to administer at home, is the information transmission analysis in addition to the summary score. Performance changes for the different indices can be interpreted by comparing against measurement error and help to target personalized rehabilitation. Altogether, home-based speech testing is reliable and proves powerful to complement care in the clinic for CI users.
言语感知测试对于监测助听器或人工耳蜗（CI）的使用效果至关重要。然而，随着客户数量的增加，临床护理既耗时又往往具有挑战性。一种减轻部分临床护理负担并可能为其他效果评估留出空间的潜在方法是采用能够在家庭环境中评估表现的技术。在本研究中，我们对40名相同的CI使用者调查了3种不同的言语感知指标：音素识别（元音和辅音）、噪声中的数字（DiN）以及噪声中的句子识别（SiN）。前两项任务在平板电脑上完成，每位客户在其家庭环境中进行多次，而句子任务则在诊所进行。对这40名相同的CI使用者的言语感知结果表明，在家中评估的DiN可以作为在诊所评估的SiN的替代指标。DiN分数与SiN分数相符，改善了3 - 4 dB，有助于定期监测表现并检测听觉表现的变化。安静环境中的音素识别也在很大程度上解释了噪声中的言语感知情况，并提供了有关语音线索的可检测性和可辨别性的额外信息。音素识别任务的额外好处在于，除了总分之外，还能进行信息传输分析，而且该任务在家庭中也很容易实施。通过与测量误差进行比较，可以解释不同指标的表现变化，并有助于针对个性化康复。总体而言，基于家庭的言语测试是可靠的，并且被证明对补充CI使用者的临床护理很有帮助。
