Relationships Among Speech Perception, Production, Language, Hearing Loss, and Age in Children With Impaired Hearing Eighty-seven primary-school children with impaired hearing were evaluated using speech perception, production, and language measures over a 3-year period. Forty-seven children with a mean unaided pure-tone-average hearing loss of 106 dB HL used a 22-electrode cochlear implant, and 40 with a mean unaided puretone-average hearing loss of 78 dB HL ... Research Article
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Research Article  |   April 01, 2001
Relationships Among Speech Perception, Production, Language, Hearing Loss, and Age in Children With Impaired Hearing
 
Author Affiliations & Notes
  • Peter J. Blamey
    Department of Otolaryngology University of Melbourne Australia
  • Julia Z. Sarant
    Bionic Ear Institute Melbourne, Australia
  • Louise E. Paatsch
    Department of Otolaryngology University of Melbourne Australia
  • Johanna G. Barry
    Department of Otolaryngology University of Melbourne Australia
  • Catherine P. Bow
    Department of Otolaryngology University of Melbourne Australia
  • Roger J. Wales
    Humanities & Social Sciences Faculty La Trobe University Melbourne, Australia
  • Maree Wright
    Children's Cochlear Implant Centre Sydney, Australia
  • Colleen Psarros
    Children's Cochlear Implant Centre Sydney, Australia
  • Kylie Rattigan
    Children's Cochlear Implant Centre Sydney, Australia
  • Rebecca Tooher
    Children's Cochlear Implant Centre Sydney, Australia
Article Information
Hearing & Speech Perception / Hearing Disorders / Hearing Aids, Cochlear Implants & Assistive Technology / Speech, Voice & Prosody / Hearing / Research Articles
Research Article   |   April 01, 2001
Relationships Among Speech Perception, Production, Language, Hearing Loss, and Age in Children With Impaired Hearing
Journal of Speech, Language, and Hearing Research, April 2001, Vol. 44, 264-285. doi:10.1044/1092-4388(2001/022)
History: Received November 24, 1999 , Accepted January 5, 2001
 
Journal of Speech, Language, and Hearing Research, April 2001, Vol. 44, 264-285. doi:10.1044/1092-4388(2001/022)
History: Received November 24, 1999; Accepted January 5, 2001
Web of Science® Times Cited: 181

Eighty-seven primary-school children with impaired hearing were evaluated using speech perception, production, and language measures over a 3-year period. Forty-seven children with a mean unaided pure-tone-average hearing loss of 106 dB HL used a 22-electrode cochlear implant, and 40 with a mean unaided puretone-average hearing loss of 78 dB HL were fitted with hearing aids. All children were enrolled in oral/aural habilitation programs, and most attended integrated classes with normally hearing children for part of the time at school. Multiple linear regression was used to describe the relationships among the speech perception, production, and language measures, and the trends over time. Little difference in the level of performance and trends was found for the two groups of children, so the perceptual effect of the implant is equivalent, on average, to an improvement of about 28 dB in hearing thresholds. Scores on the Peabody Picture Vocabulary Test (PPVT) and the Clinical Evaluation of Language Fundamentals showed an upward trend at about 60% of the rate for normally hearing children. Rates of improvement for individual children were not correlated significantly with degree of hearing loss. The children showed a wide scatter about the average speech production score of 40% of words correctly produced in spontaneous conversations, with no significant upward trend with age. Scores on the open-set Consonant-Nucleus-Consonant (CNC) monosyllabic word test and the Bench-Kowal-Bamford (BKB) sentence test were strongly related to language level (as measured by an equivalent age on the PPVT) and speech production scores for both auditory-visual and auditory test conditions. After allowing for differences in language, speech perception scores in the auditory test condition showed a slight downward trend over time, which is consistent with the known biological effects of hearing loss on the auditory periphery and brainstem. Speech perception scores in the auditory condition also decreased significantly by about 5% for every 10 dB of hearing loss in the hearing aid group. The regression analysis model allows separation of the effects of language, speech production, and hearing levels on speech perception scores so that the effects of habilitation and training in these areas can be observed and/or predicted. The model suggests that most of the children in the study will reach a level of over 90% sentence recognition in the auditory-visual condition when their language becomes equivalent to that of a normally hearing 7-year-old, but they will enter secondary school at age 12 with an average language delay of about 4 or 5 years unless they receive concentrated and effective language training.

Acknowledgments
The authors wish to acknowledge the children, their families, and the schools for their cooperation and assistance in the collection of data.In particular, Marilyn Dann of Mountview Primary School, Noeleen Bieske of St. Mary's School for Children With Impaired Hearing, Val Hunt of Rosanna Golf Links Primary School, and Michael Metherall of Princess Elizabeth Junior School were generous with their time and in allowing us to use school facilities. Discussions with Lois Martin, Rob Shepherd, Mario Svirsky, and Ann Geers have contributed to the formulation and expression of ideas for this paper. Carol De Filippo, Arlene Carney, Marilyn Demorest, and an anonymous reviewer gave perceptive guidance in refining the complex discussions of this manuscript. Financial support for the study was provided by National Health and Medical Research Council project grant #970257 and by the Bionic Ear Institute. The study was approved by the Human Research Ethics Committee of the Royal Victorian Eye and Ear Hospital, Project 96/289H.
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