Presentation is loading. Please wait.

Presentation is loading. Please wait.

Assessing Hearing Acuity & Speech Recognition

Similar presentations


Presentation on theme: "Assessing Hearing Acuity & Speech Recognition"— Presentation transcript:

1 Assessing Hearing Acuity & Speech Recognition
Chapter 3 Perry C. Hanavan, AuD

2 Speech Test Applications
obtain information for counseling illustrate benefits of visual cues determine hearing aid candidacy or determine candidacy for CI or ALDs predict hearing aid benefit determine when binaural aids might NOT be appropriate 80%, AD and 20% AS determine amplification characteristics and features whether high frequency beneficial demonstrate advantage of special hearing aid features demonstrate aided performance is better than undaided determine whether cognitive or APD exists older person may have cognitive problems, anyone may have APD demonstrate that understanding of speech is impaired

3 Audiologic Evaluation
Information helpful to providing AR Audibility Dynamic Range Frequency Resolution Temporal Resolution

4 Audiologic Evaluation
Critical consideration in developing AR plan: Time of Onset of loss Degree of Loss Etiology Type of Loss Other factors

5 Audiologic Evaluation
Observations Interviews Questionnaires Otoscopic/Video Otoscopy examination Pure tone results Speech recognition Speech in noise Immittance OAE Electrophysiologic (ECochG, ABR, MLR, LR, etc.)

6 Pure Tone Results Degree of loss Type of loss
normal, minimal, mild, moderate, moderately severe, severe, profound Type of loss conductive sensorineural mixed

7 Functional Assessments
Ling 6 ELF LIFE SIFTER COW CHAPS PEACH / TEACH

8 Stimulus Units Context SNR Distance/ Intensity Familiarity Audition Only Vision Tactile Plus Equivalent Lists Many Items Stimulus Units Clinical Significance Listener Variables Test-Restest Variability Format Response Mode Learning Effects Speech Test Factors Within- Subject Statistical Procedure Paired t-statistic Open Set Closed Auditory Skill Cognitive Ability Linguistic Hearing Loss Com- munication Mode Live Recorded Synthesized Speech Altered Test Reliability Conditions

9 Stimulus Mode auditory alone vision alone tactile alone
Audition Only Vision Tactile Plus auditory alone vision alone tactile alone auditory and vision auditory and tactile tactile and vision auditory, vision and tactile

10 Auditory Alone phoneme, syllable, word, phrase, sentence
open, closed set high, low context cues quiet, noise – signal to noise ratio (SNR) recorded, live

11 Auditory Plus Vision Speechreading enhancement
speechreading enhancement ratio vision only / auditory plus vision = SE Children –Craig Sentence and Craig Words and CHIVE Adults –Iowa Sentence Test and CUNY Sentences Erber (vision and hearing assessment)

12 Auditory Plus Visual Information
Sumby and Pollack (1954) demonstrated that the addition of visual speech information could significantly improve speech perception performance and that the importance of visual speech information increased as the listening situation became more difficult.

13 Auditory Plus Vision Tye-Murray Eber CHIVE (adult) CAVET (children)
Audition plus vision Vision only Audition alone Eber Sent-Ident

14 Speechreading Enhancement/ Auditory Enhancement
Benefit from adding a visual signal to an auditory signal Refers to the benefit obtained from seeing and hearing a speaker compared with auditory alone Difference or ratio between speech recognition performance in an vision-only condition and an audition plus-vision condition Difference Score (AV-V) Normalized Difference (AV-V/100-V) Sam J. (V=50% AV score = 75%) 75-50=25% enhancement (difference score AV-V) (75-50)/(100-50)=__% (normalized difference score) Max H. (V score = 10% AV score = 55%) 55-10=45% visual enhancement (55-10)/(100-10)=__% (normalized difference score)

15 Integration Enhancement
Measure of ability to integrate auditory and visual information AV-[100-(100-A)+(100-V)]/100-[100-(100-V)+(100-A)]

16

17 Always put it back into hearing!
THE AUDITORY SANDWICH First, listen. HEAR Visual cues: lip-reading printed word cued speech signs Then, if need be, watch or say it. SEE - SAY Then, listen again (no visual cues) HEAR-UNDERSTAND Always put it back into hearing!

18 Back to “choices” AUDITORY VISUAL Auditory-Verbal Auditory-Oral
Cued Speech Total Communication ASL Language Communication Cognition AUDITORY VISUAL

19 A Av AV VA V Choices reframed Fully Auditory Mostly Visual
Communicator Mostly Visual A Av AV VA V

20 Flexibility is essential
Fully Auditory Communicator Mostly Visual A Av AV VA V

21 Stimulus Unit Stimulus Units Context SNR Distance/ Intensity Familiarity Units: phoneme, syllable, word, phrase, sentence, non-sense stimuli Proximity: distant, near Intensity: soft, comfortable, loud Context: high, low context cues, SNR: quiet, background sounds--signal to noise ratio Familiarity: high, low familiarity with material, nonsense material

22 Case Study Test and Stimulus Type Patients’ Scores in % Al Tom Bob
Iowa Consonant Test (phoneme) 55 61 87 CAVET (word) 45 30 Iowa Sentence Test (sentences) 58 38 48

23 Question Familiarity with items, procedures…not change in ability is:
Equivalent list Learning effect Clinical significance Statistical significance

24 Question Contain items that are presumed to be equally difficult to recognize Equivalent list Learning effect Clinical significance Statistical significance

25 Learning Effects Learning effect: familiarity with items, procedures…not a change in ability Repeated Frame Test Cinderella-Brahman Speech Recognition Test Equivalent lists: lists that contain items that are presumed to be equally difficult to recognize PB, sentences Repeated Frame Sentences Test QuickSIN AzBio Sentence Test Numerous stimuli Full lists rather than half lists Equivalent Lists Many Items

26 Stimulus Items Live vs. Recorded Synthesized speech Altered speech
Voicing frequency Intonation Speech rate Clarity of articulation Physical characteristics Synthesized speech Altered speech Time-compressed Expanded Filtered

27 Question Paired t-statistic: Equivalent list Learning effect
Clinical significance Statistical significance

28 Significance Clinical significance
Within- Subject Statistical Procedure Paired t-statistic Clinical significance When a small change in performance is clinically significant When a real difference or change exists between two equivalent test results Statistical design Paired t-statistic Within subject statistical significance

29 Significant Difference for NU-6 recorded speech tests SRA=86% SRA=62%

30 Listener Variables Degree of hearing loss Cognitive abilities
Ability Linguistic Hearing Loss Com- munication Mode Degree of hearing loss Cognitive abilities Thinking, reasoning, remembering, imagining, or learning words Linguistic abilities Knowledge of language Communication mode used Multicultural

31 Effects Ceiling effect Floor effect Example study Score 100%
Perfect score Floor effect Score 0% Miss all items Example study

32 Test Reliability Test reliability: degree to which a single test score approximates the true score Test-retest variability: measure of consistency from one test presentation to the next Test conditions: Variables affecting test-retest variability: mode of presentation—live vs recorded location—test booth vs classroom talker—familiar vs unfamiliar, male vs female number times item repeated—once, twice, etc. leads to better performance Test Reliability Conditions

33 Question Same-different essentially means: Detection Discrimination
Identification Comprehension

34 Response Format Closed or limited set Open set Auditory skill
Detection Discrimination Identification Comprehension Open Set Closed Auditory Skill

35 Diversity Monolingual Bilingual Language appropriate tests
Nonsense syllable tests

36 Speech Recognition Tests

37 WIPI Word Intelligibility by Picture Identification (WIPI)
closed-set picture-pointing (six pictures per plate) appropriate for children whose language age is between 5 and 10-11 comprised of four 25-monosyllabic word lists contains 26 color plates (one for practice), six pictures per page. (A, V, A-V)

38

39 NU-CHIPS NORTHWESTERN UNIVERSITY--CHILDREN’S PERCEPTION OF SPEECH (NU-CHIPS) closed set picture pointing word recognition test children whose language age is as low as three 50 words familiar to three-year-old children in four randomizations includes two picture books with 50 monochrome plates, four pictures per plate. Book A is used for forms A & B, book B for C & D. There are two recordings, one male and one female talker.

40 MAC The Minimal Auditory Capabilities (MAC) (2nd Edition) battery specifically targeted to CI patient Consists of a series of tasks which are graded in difficulty Most of the MAC battery sub-tests assume patient’s hearing loss has occurred post-lingual, but can be employed as a means of evaluating the hearing abilities of persons for whom traditional speech materials are too difficult Second edition has been standardized. The recorded materials include gross sound identification, inflection detection, contrast detection, accent discrimination, and word identification 14 sub-tests, 13 audio and one video

41 SERT SOUND EFFECTS RECOGNITION TEST (SERT) developed for those instances where conventional word recognition measures are not appropriate, such as when language limitations due to hearing impairment Certain children who are unable to recognize even simple speech can perceive correctly environmental sounds to which they are exposed in their daily lives Under these circumstances, the SERT can provide valuable information about the integrity of the auditory system. Closed set, picture-pointing tasks 10 sounds plus a practice sound

42 CID Every Day Sentences
EVERYDAY SPEECH 10 sets of 10 sentences each with 50 "target" words in each set for word recognition assessment under contextual conditions Can be employed in auditory training Sentences vary in length and are spoken with minimal inflection Normative data on recording lacking

43 BKB Sentences Bench, Koval, & Bamford (BKB) Open set sentences
Appropriate for linguistic abilities of most 8-15 years of age with hearing loss Lists of 16 simple sentences, including 50 key words were devised to include vocabulary, grammar and sentence length for 8-15 year olds The sentences are presented in an open-set format and the child imitates as much of the sentence as possible. Responses are recorded word-for-word and scored by percent of key words correctly repeated.

44 NU-6 NORTHWESTERN UNIVERSITY AUDITORY TEST NUMBER SIX (NU-6)
Phonetically balanced CNC monosyllabic open set word recognition test Four lists of 50 words each recorded in four randomizations Talker has a General American dialect Standardized

45 Auditory Numbers Test ANT
Test helps identify tactile from auditory listeners Word closed set recognition auditory alone test Appropriate for 3-8 year old children with severe to profound hearing loss Simple auditory alone test to measure ability to perceive simple auditory cues (Erber, 1980)

46 Auditory Numbers Test (ANT)
1 2 3 4 5

47 Iowa Consonant Confusion Test
Closed set consonant (phoneme) recognition test test can also be analyzed in terms of the listener's ability to identify phonetic features: Chance performance for consonant voicing, manner, and place of articulation identification is 50%, 33%, and 20% respectively Example: Mr. S achieved a total score of 79% correct, 96% on voicing, 94% on manner, and 85% on place 10 consonants presented 12 times in VCV context p, t, k, b, d, g, v, z, n, m Presentation examples: aba, ada, aga, etc Each consonant presented 12 times in random order Presented with carrier phrase “The next word is” (Tyler et al, 1983)

48 Example of Iowa Consonant Confusion Test (example: auditory alone)
Response p t k b d g v z n m S im i l u s 2 6 1 3 4 5 7 8 Example of Iowa Consonant Confusion Test (example: auditory alone)

49 Children’s Auditory Test
CAT Auditory alone limited set test assessing ability to perceive stress patterns and word recognition Consists of 12 words Monosyllabic words Trochees Spondees Trisyllabic words

50 IMSPAC Imitative tests of Speech Pattern Contrast Perception
Vowel–consonant–vowel (VCV) utterances Developed by Arthur Boothroyd Syllable level, 4 lists randomized Choose odd one of 3 (forced choice) Pointing, button-press or verbal response Ages 7 years and up

51 AB Short Word List Isophonemic Word List
Developed in 1968 by Arthur Boothroyd Speech recognition open set test Each list consists of ten words, and each word is constructed as consonant - vowel – consonant 30 phonemes, 10 vowels and 20 consonants present in each list CNC words Score is based on the phonemes correct out of 30

52 Question Test developed for assessing high frequency sounds? NU-6
CID Everyday Sentences Quick SIN BKB SIN UWO Plurals Test

53 Hearing Tests for High Frequency
University of Western Ontario Plurals Test Phonak Logatome Test BKB-SIN Recorded /sh/ and /s/, University Western Ontario

54 UWO Plurals Test Scollie & et al at the University of Western Ontario (UWO) Recorded test Open set test, auditory only, with female speaker Tests perception of high frequency sounds (English only) Consists of five randomized lists of 30 words familiar to school-aged children that have simple plural forms with the addition of a final /s/ or /z/. Skunk/skunks Book/books Fly/flies Crayon/crayons Presented at 50 dB SPL from loudspeaker 1 meter directly in front

55 UWO /s/--/sh/ Video Game

56

57

58 Phonak Logatom Test Adaptive, computer controlled test
Developed by Phonak Female speaker: “My name is…” ASA ASA (filter to 6 kHz) ADA AKA AFA ASHA ATA Software track level in dB SPL that corresponds to 50% correct performance

59 Larsen Recorded Test Auditory word discrimination test
Pairs of phonemes in words few vs. chew bill vs. mill nice vs. vice Lists represent an attempt to present the phone in the initial, medial and final position of a word Limited choice—select one of two words by drawing line through printed word heard

60

61 CAVET Children’s Audiovisual Enhancement Test
Assesses speechreading enhancement in children within the vocabulary level of 7-9 year olds with profound prelingual hearing loss Designed to minimize ceiling and floor effects, eliminate syntactic factors, and minimize semantic factors 3 lists of 20 words each with half of words easy to recognize in a vision-only condition and half are less likely to be recognized in each list but presented in random order Each list is designated for auditory alone, visual alone, or auditory-visual only mode Test available in CD-ROM and VHS format (Tye-Murray & Geers, 2002)

62 CUNY Sentences Test The City University of New York (CUNY)
Topic Related Sentence Sets consist of 25 equivalent sets of 12 sentences of varying length Each sentence is related to one of 12 topics Open set sentence recognition test Listener is presented with sentences in three listening conditions: A, V and AV The test is scored with the total number of words correctly identified (Boothroyd, Hannin, & Hnath, 1985)

63 Lexical Neighborhood Test (LNT)
Lexical neighbors--words that sound similar to a target item. Often defined as words that differ by a single phoneme from target word Open-set test that requires child to imitate stimulus words immediately after they are presented Each list consists of 50 monosyllabic words, 25 of which are high-frequency words with few lexical neighbors (easy) and 25 of which are lower frequency words with many lexical neighbors (hard) Words were selected to be familiar to children with limited vocabularies. Easy Words: juice, good, drive, time, hard, gray, foot, orange, count Hard Words: thumb, pie, wet, fight, toe, cut, pink, hi, song, fun, use, mine, Alternate version of test, the Multisyllabic Lexical Neighborhood Test (MLNT) consists of 50 words with two to three syllables. (Kirk, Pisoni, & Osberger, 1995)

64 QuickSIN Provides a one-minute estimate of SNR loss for adults
A quick method to quantify patient’s ability to hear in noise Can determine if extended high frequency emphasis improves or degrades understanding of speech in noise Assist in choosing appropriate amplification and/or other hearing assistance technologies Demonstrates directional microphones may improve speech intelligibility in noise Open set test recognition test Consists of list of six sentences with five key words per sentence presented in four-talker babble noise.  Sentences are presented at pre-recorded signal-to-noise ratios which decrease in 5dB steps from 25 (very easy) to 0 (extremely difficult).  The SNR's used are 25, 20, 15, 10, 5, 0, encompassing normal to severely impaired performance in noise.

65

66

67 BKB-SIN BKB-SIN 10 sentences presented twice
Increasing noise with each sentence Indicates ability to understand speech in noise Helps audiologist select appropriate hearing aid and hearing assistance technologies

68 BKB - SIN Similar to Quick-SIN but can be utilize with children
Sentence recognition using BKB sentence material Open set sentence recognition test BKB SIN test Test score sheets

69

70

71

72

73 HINT The HINT is a prerecorded test that measures sentence speech recognition abilities in quiet or in noise accurately, reliably and efficiently The HINT demonstrated the substantial role that binaural, directional hearing plays in a normal hearing individual's ability to communicate in noise Any degree of hearing impairment, therefore, reduces the benefits of directional hearing in noise and increases communication inadequacy Used to evaluate functional hearing capabilities of HI users, CI users and those in listening-critical jobs Copyrighted by the House Institute and is available for purchase on a compact disc recording to hearing clinics and research laboratories nationwide. A children's version of the HINT is also available

74

75 Question Test that evaluates function of corpus callosum in adults?
Quick-SIN BKB-SIN DSI UWO Plurals Test NU-6

76 DICHOTIC SENTENCE IDENTIFICATION (DSI)
Dichotic listening task minimally affected by peripheral HL Synthetic Sentence Identification (SSI) test presented dichotically Onsets and offsets of sentences aligned with accuracy of 100 msec Less susceptible to hearing loss than SSW test Viable test of central auditory function with hearing loss Test applicable for auditory assessment of (PTAs) up to 50 dBHL Closed set identification test Normative data available

77 Ling-6 Phoneme level detection and recognition test m, s, sh, e, a, u
Procedure Detection and identification of phonemes

78 Further Auditory Evaluations
Mark C. Flynn—Evaluation of Individuals with hearing loss

79

80

81

82 Assignment Assign each test discussed in this section on the following grid, thus, Be able to correctly indicate on the following template, each of the auditory tests discussed earlier

83 Speech Paradigm Detection Discrimination Recognition/ Identification
Comprehension Non speech sounds Phonemes Syllables Words Phrases Sentences Connected speech


Download ppt "Assessing Hearing Acuity & Speech Recognition"

Similar presentations


Ads by Google